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NEVADA NEWS AND VIEWS

Attorney General Laxalt Releases Office of Military Legal Assistance @EASE Program

November 11, 2016

Business Case in Honor of Veterans Day November 11, 2016 (NV) Today, Nevada Attorney General Adam Paul Laxalt is pleased to announce the completion of the business case for the Office of Military Legal Assistance @EASE Program. The program was officially launched one year ago in November, 2015, and is the nation’s first attorney general-led, public-private partnership offering our military communities access to pro bono civil legal services. In practice, the program pairs military Service members in need of legal assistance with pro bono private legal counsel for civil matters including consumer fraud, military rights, immigration, landlord/tenant, predatory lending and creditor/debtor issues. The program also provides monthly workshops dedicated to drafting free wills and powers of attorney for Nevada veterans across the state.

The @EASE program strives to bolster military readiness by providing Service members with the knowledge that the program has the capacity to manage legal affairs in their absence—putting our Service members @EASE. Earlier this year, the Department of Defense named the Office a “Best Practice Program,” and recommended that the program be duplicated in states throughout the country. The program has partnered with the Nevada State Bar, County Bars and numerous statewide legal organizations to recruit more than 150 local attorneys willing to represent our Service members and their families free of charge.

“Today, on behalf of all Nevadans, I salute the millions of veterans who have dedicated their lives to protecting the life and liberty of all Americans, and hope you will join me in extending our deepest gratitude for their service,” said Attorney General Adam Laxalt. “Nevada is home to an estimated 11,400 active duty military members, 7,620 reserve members and over 228,000 veterans, and the Office of Military Legal Assistance @EASE program, through its pro bono partnerships, is proud to have helped Nevada’s Service members and veterans handle over 900 pro bono matters in its first year. With the completion of this business case, there is now empirical data justifying the need for this program and a roadmap to support efforts to form legal assistance offices in other states. It is my hope that this program will demonstrate a commitment to our military communities for years to come, and that eligible Nevadans will continue to take advantage of these services.

” For more information about the program, visit nvagomla.nv.gov . Nevada attorneys hoping to volunteer pro bono hours to the program should email Heather Cooney at HCooney@ag.nv.gov

flapjack fundraiser

Attached is the flyer for the flapjack fundraiser.

please pass this to all your friends in las vegas

Fwd: FlapJack Fundraiser Flyer

 

 

 

 

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Save to OneDrive - Personal

Robert, can you put this in Chap 711 May & June newsletters?  Other newsletters too?

Thanks, Len

  

Please see attached flyer (In .png format for web posting). Request Widest dissemination.

We still need volunteers to serve.

So far I have two Volunteers, Cathy Breedlove (NVEnergy) and Peggy Randal (WVON). Volunteers should arrive between 730-745 on June 10th.

We have 100 tickets (pre-event) we can get more printed.

Julie-10 tickets

Karen-10 tickets

Sheila-12 tickets

The Agenda

a\way.

By ARTHUR ALLEN

03/19/17 07:56 AM EDT

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Four decades ago, in 1977, a conspiracy began bubbling up from the basements of the vast network of hospitals belonging to the Veterans Administration. Across the country, software geeks and doctors were puzzling out how they could make medical care better with these new devices called personal computers. Working sometimes at night or in their spare time, they started to cobble together a system that helped doctors organize their prescriptions, their CAT scans and patient notes, and to share their experiences electronically to help improve care for veterans.

Within a few years, this band of altruistic docs and nerds—they called themselves “The Hardhats,” and sometimes “the conspiracy”—had built something totally new, a system that would transform medicine. Today, the medical-data revolution is taken for granted, and electronic health records are a multibillion-dollar industry. Back then, the whole idea was a novelty, even a threat. The VA pioneers were years ahead of their time. Their project was innovative, entrepreneurial and public-spirited—all those things the government wasn’t supposed to be.

Of course, the government tried to kill it.

Though the system has survived for decades, even topping the lists of the most effective and popular medical records systems, it’s now on the verge of being eliminated: The secretary of what is now the Department of Veterans Affairs has already said he wants the agency to switch over to a commercial system. An official decision is scheduled for July 1. Throwing it out and starting over will cost $16 billion, according to one estimate.

What happened? The story of the VA’s unique computer system—how the government actually managed to build a pioneering and effective medical data network, and then managed to neglect it to the point of irreparability—is emblematic of how politics can lead to the bungling of a vital, complex technology. As recently as last August, a Medscape survey of 15,000 physicians found that the VA system, called VistA, ranked as the most usable and useful medical records system, above hundreds of other commercial versions marketed by hotshot tech companies with powerful Washington lobbyists. Back in 2009, some of the architects of the Affordable Care Act saw VistA as a model for the transformation of American medical records and even floated giving it away to every doctor in America.

Today, VistA is a whipping boy for Congress; the VA’s senior IT leadership and its overseers in the House and Senate are all sharpening their knives for the system, which they caricature as a scruffy old nag that fails the veterans riding on it. Big commercial companies are circling, each one putting forward its own proprietary technology as the answer to the VA’s woes. The VA leadership seems to agree with them. “We need to move towards commercially tested products,” VA Secretary David Shulkin told a congressional committee on March 7. “If somebody could explain to me why veterans benefit from VA being a good software developer, then maybe I’d change my mind.”

You’d have to be a very brave VA administrator, and perhaps a foolhardy one, to keep VistA in 2017: The system’s homegrown structure creates security and maintenance challenges; a huge amount of talent has fled the agency, and many Congress members are leery of it. Because it serves nearly 9 million veterans at 167 hospitals and 1,700 sites of care, however, the wrangling over VistA concerns much more than just another computer software system. The men and women who created and shaped VistA over the decades were pathfinders in efforts to use data to reshape the multi-trillion-dollar U.S. health care system. Much of what they’ve done continues to serve veterans well; it’s an open question whether the Beltway solution to replacing VistA, and the billions that will be spent pursuing it, will result in a system that serves the VA—and the nation—as well in the long run.

What’s clear, though, is that the whole story of how VistA was born, grew and slid into disrepair illustrates just how difficult it can be for the government to handle innovation in its midst.

YOU COULD SAY that VistA—which stands for the Veterans Information Systems and Technology Architecture—began as a giant hack.

Its birth occurred in 1977, far back in the era of paper medical records, with a pair of computer nerds from the National Bureau of Standards. Ted O’Neill and Marty Johnson had helped standardize a computer language, originally developed at Massachusetts General Hospital, called MUMPS, and the two men were hired by the VA to see whether MUMPS could be the basis of a new computer system connecting the VA’s hospitals. Computerizing the one-on-one art of medical care seemed like a sacrilege at the time, but the VA, struggling with casualties of the Vietnam War, was underfunded, disorganized and needed all the help it could get.

O’Neill and Johnson began recruiting other techies to the effort, some of whom were already working in VA hospitals in places such as St. Petersburg, Florida; Lexington, Kentucky; and San Francisco. Though they were on an official mission, their approach—highly decentralized, with different teams trying things in various hospitals—ran against the grain of a big bureaucracy and aroused the suspicions of the central office. The project soon had the feeling of a conspiracy, something that nonconformists did in secret. They gave themselves an internal nickname—the Hardhats. People who followed the project recall being struck by just how idealistic it was. “This will sound a bit hokey, but they saw a way to improve health care at less cost than was being proposed in the central office,” says Nancy Tomich, a writer who was covering VA health care at the time. As bureaucratic battles mounted, she says, “I remember how impressed I was by these dedicated people who put their personal welfare on the line.”

In 1978, with personal computers just starting to appear in the homes of nerdy hobbyists, the Hardhats bought thousands of personal data processors and distributed them throughout the VA. Software geeks and physicians were soon exploring how patient care could be improved with these new devices. A scheduling system was built in Oklahoma City, while technicians in Columbia, Missouri, built a radiology program, and the Washington, D.C., VA’s Hardhats worked on a cardiology program. In Silicon Valley, Steve Wozniak was building a computer in his garage that would overturn an industry; at the VA, these unsung rebels were doing something that was equally disruptive in its own way—and threatening to the VA’s central computer office, which had a staff and budget hundreds of times greater and planned to service the data-processing needs of the VA hospitals and clinics by means of leased lines to regional mainframe centers. While the bureaucrats in the central office had their own empire, Tomich recalled, the Hardhats—some of them straight-looking guys with burr haircuts and pocket pen protectors, some scruffy, bearded dudes in T-shirts—were “in the field planting seeds, raising crops and things were blossoming,’’ she says.

The Hardhats’ key insight—and the reason VistA still has such dedicated fans today—was that the system would work well only if they brought doctors into the loop as they built their new tools. In fact, it would be best if doctors actually helped build them. Pre-specified computer design might work for an airplane or a ship, but a hospital had hundreds of thousands of variable processes. You needed a “co-evolutionary loop between those using the system and the system you provide them,” says one of the early converts, mathematician Tom Munnecke, a polymathic entrepreneur and philanthropist who joined the VA hospital in Loma Linda, California, in 1978.

So rather than sitting in an office writing code and having the bureaucracy implement it, the computer scientists fanned out to doctors’ offices to figure out what they needed. Doctors with a feel for technology jumped into the fray. “I got involved because it solved my problems,” says Ross Fletcher, a cardiologist at the Washington, D.C., VA—where he is now chief of staff—since 1972. Working in close consultation with their clinical partners, sometimes coding at home at night or in their spare time, the computer experts built software that enabled doctors to legibly organize their prescriptions, CAT scans and patient notes, and to share their experiences electronically. Fletcher, who had studied a little computer science in college, worked with a software developer to help create an electronic EKG record. “The technical staff was embedded with clinical staff. I had lunch with the doctors, and in the parking lot in the morning we’d report what we’d done the night before,” says Munnecke.

Munnecke, a leading Hardhat, remembers it as an exhilarating time. He used a PDP11/34 computer with 32 kilobytes of memory, and stored his programs, development work and his hospital’s database on a 5-megabyte dish the size of a personal pizza. One day, Munnecke and a colleague, George Timson, sat in a restaurant and sketched out a circular diagram on a paper place mat, a design for what initially would be called the Decentralized Hospital Computer Program, and later VistA. MUMPs computer language was at the center of the diagram, surrounded by a kernel of programs used by everyone at the VA, with applications floating around the fringes like electrons in an atom. MUMPS was a ludicrously simple coding language that could run with limited memory and great speed on a low-powered computer. The architecture of VistA was open, modular and decentralized. All around the edges, the apps flourished through the cooperation of computer scientists and doctors.

“We didn’t call it ‘agile development,’ but it was agile,” says Howard Hayes, another VA IT veteran who served as CIO for the Indian Health Service, which adopted VistA. “Tight relationships between user and programmer, and sometimes they were one and the same.” Instead of top-down goals and project sign-offs, teams of techies and doctors kept working to improve the system. “The developer did something, the user tried it, called him up or walked down the hall and says ‘It really needs to do this.’ The next day they had another build,” says Hayes.

The VA’s centralized computer department, which relied on contractors, was not amused. Its leadership wanted control, and they believed, with a position remarkably similar to current-day criticisms of the VA’s IT work, that it made more sense to let the outside experts move the ball than have “garages” full of unconventional nerds and upstart doctors. The Hardhats were sharing records among doctors and hospitals. They were digitizing X-ray images. They were doing everything much less expensively and more successfully than the central office. They had to be stopped. In 1979, Ted O’Neill was fired (he drove a cab for a while, and later became a real estate agent). The main Hardhats office was shut down, and “pretty much everybody in the Washington part of the organization headed for the hills,” says Munnecke.

But, remarkably, the project didn’t die. There were still Hardhats dispersed throughout the VA system who had been hired locally and couldn’t be sacked, and they carried on. A regular Monday morning telephone tree, which Munnecke created by patching together six people at a time from different parts of the country, each of whom would patch in others, kept them moving together.

The project took on the feeling of an insurgency, and the establishment began to retaliate. In Columbia, Missouri, Hardhat Bob Wickizer got back to his computer room from lunch one day to discover that his new desktop had been unplugged and put in a crate. In Washington, D.C., paper medical records were used to start a fire in the computer room that housed the code developed by Hardhats. “There were fires in the computer rooms. Sand in gas tanks. Not a pleasant fight,” says Fletcher. “Fascinatingly enough, it occurred within a government institution.”

Munnecke and his colleagues fretted about being fired for developing something that was far superior to anything that existed at the time. The participants called themselves “the conspiracy,” and they developed kernels of essential software, which they shared via 300-baud modems (which transmit 300 words a minute) at 3 a.m. on Sunday mornings, or via disk packs the size of laundry baskets. “They went through a period of persecution," says Phillip Longman, who wrote about it in his book on the VA health system, The Best Care Anywhere. "And that was good, because it created bonding experiences.”

Then one day in 1981, VA Chief Medical Director Donald Custis visited the Washington VA medical center and found administrators and practitioners using the unauthorized software. Astonished, he blurted out, “It looks like we have an underground railroad here,” according to Munnecke, who was so tickled by the phrase that he had membership cards printed up with a microchip glued onto a train engine, and a title, “VA MUMPS Underground Railroad.” Munnecke handed the cards to friends, colleagues and higher-ups he was trying to woo. And eventually, the rebels won over some leaders, including VA Administrator Robert Nimmo, who gave them a budget. The money allowed the applications developed piecemeal at hospitals across the country to be shared, recalls George Timson. By 1985, most hospitals were being updated regularly through a database management system Timson developed called FileMan. They all used the same structure of application building, which meant they were integrated; the mainframers had advocated a more traditional approach of buying commercial modules and lashing them together through interfaces.

The VA's medical operating system in use in a hospital in Nigeria in 1993. | Flickr/Tom Munnecke

“The combination of cheap computers and an efficient language allowed the VA to leapfrog over the existing technology,” says Stephan Fihn, the VA’s current director of analytics and business intelligence. “We competed to make it better,” recalls Fletcher. “They’d holler at us because we were late on some project. … Late for what? There were no other options.” And after beating back the mainframe people, Munnecke could crow with his foot planted on the chest of the enemy. “Every one of their systems is totally dependent on a specific vendor, incompatible with every other system they have developed,” he said in a 1982 speech that sounds strangely familiar to students of current, commercial EHR systems, notorious for being “walled gardens” that have trouble sharing data with one another. “Every one of our systems is vendor-independent and compatible with every other of our systems.”

New features could be added as quickly as they were developed in far-flung basements. Responding to doctors’ requests, developers created tools that were good at organizing care for the millions of veterans with chronic illnesses. Doctors could find a patient’s records easily and compare outcomes in patients who’d undergone different treatments, finding the best treatments in different settings and leading to improved guidelines for populationwide care. As it grew, VistA genuinely changed medicine: The Hardhats created databases that allowed researchers to aggregate clinical cases, which led to discoveries linking blood pressure to stroke and the arthritis medicine Vioxx to heart attacks, among others. They helped make VA clinics the best in the world to avoid amputation if you were a diabetic. They also gave the world the patient wristband, whose bar codes assured that the right patients got the right dose at the right time. VA patients in New Orleans were the only ones in the city who emerged from Hurricane Katrina in 2006 with their records—including medication lists—intact.

All that customization was a great joy to the doctors who helped create it, and who used it. But it also held the seeds of a monstrous problem—all those thousands of pieces of code, like all code, would need to be updated and integrated with new computer technology. Sometimes the original coder had moved on, and trying to update his or her work was like editing a book written decades before, in another language, by a dead author.

But such problems would take years to become acute. In the meantime, the system’s popularity began to spread beyond the VA. In the 1980s, the Finnish health system and some German hospitals adopted VistA, and, later, hospitals in Jordan, India, Australia and Japan. In the U.S., the Indian Health Service essentially cloned and then adapted the system. Over the years there would be many suggestions that the Pentagon also use VistA—the DOD runs its own massive health care system, unconnected to the VA, for active-duty service members—but it always resisted. Munnecke says he tried to wire the Pentagon with VistA at least three times. “Each time, I was technically correct and politically incorrect,” he says. The problem, in his view, was that the Pentagon didn’t want to run on the same system as the VA. If it did, Congress would start asking why it had to pay for redundancies. “Why do you need two hospitals? Someone’s going to get riffed. The person who cooperates most gets the least turf. It’s all turf. If I sound bitter, it’s because I’ve been beating my head against the wall so long.” The conflict between VA and DOD, it turned out, would end up becoming VistA’s fatal flaw.

WHEN KEN KIZER, who had run California’s Medicaid program, took over the VA health care system in 1994, it was under widespread attack for poor access and quality of care, to the extent that some GOP leaders were calling for its privatization. The IT system also had problems—most of the programming had been focused on developing applications but not modernizing the core, Munnecke would say later. Kizer, who knew nothing about electronic health records, funded a feasibility study to install a commercial system but discovered that the VA’s system was clearly superior to anything available. So he went in a different direction: He hired one of the original Hardhats, the brilliant Rob Kolodner, as his chief health informatics officer, and, armed with a $400 million annual budget, Kolodner oversaw the implementation of a bright new user interface and record-tracking software. Kizer also implemented quality performance measures and started coordinated care projects well ahead of the rest of health care, and his staff built a web service, which for the first time allowed providers to see a veteran’s electronic records from anywhere in the country. By 1999, Kizer testified in Congress that the new system he’d built—it was rechristened VistA from Decentralized Hospital Computer Program—wasn't just working out for the VA, it could be the basis of a national commercial health IT system.

But the 2001 administration change was not kind to VistA. Kizer’s creation cost a lot to support, and several members of Congress, concerned by IT spending at the VA, sought to enforce a law requiring that the IT system in each federal agency be run by a single CIO. In other words, they wanted VistA’s work to be handled from a central office, a recurring theme in VistA’s development. VistA’s innovative approach, indeed its value to doctors, resulted from being brewed in small, decentralized units throughout the sprawling VA system. But whenever projects missed their deadlines, critics of the system would say it lacked accountability. “In the federal government, and in VA in particular, there are these cycles of decentralization and centralization, and you have to figure out where you are dropped into the cycle,” says Gary Christopherson, who held various IT positions at the Veterans Health Administration, including CIO from 2000 to 2002. “It’s not because there is necessarily a rationale for one or the other. You’d hear, ‘They’re out of control, we need to centralize.’ Or, ‘Centralization isn’t working—we need to put power out to the field.’ When I got there, we were in decentralization phase. There are always people in both neighborhoods.”

Then too, there were few people in positions of power, particularly in Congress, who could really grasp the complex issues at play. “You have a subject that’s vital to the fate of health care, the fate of the nation, but few people have the skill set to navigate it intelligently,” says Longman. In 2000, Christopherson convened a White House discussion bringing together federal IT officials, doctors groups and private industry to standardize data so that different health systems would be able to communicate with one another. Everyone agreed it was a good idea. It was scrapped when the new administration took office and, in the way of new administrations, was determined to leave its own mark. “The discussion you hear today about standards, interoperability, information exchange, all those things, was agreed to back in 2000-2002 but still hasn’t occurred,” says Christopherson, who is now a sculptor in Wisconsin. “It’s very sad, very tragic, very stupid.”

In 2004, the Pentagon hired outside contractors to revise its medical-records system, implementing a clunky version of VistA known as AHLTA. The Pentagon’s approach was strictly a top-down IT job, unlike the collaborative approach used with such success in building VistA, and it lacked finesse. Many military doctors considered AHLTA a disaster—unreliable, with frequent crashes and inaccessible data. Its initials, some said, stood for, “Aw hell, let’s try again.” The system ranked at the bottom of physician preference lists. At the top of the list? VistA. (The Pentagon system was like “running on sand,” residents told Ross Fletcher, while VistA was “running on asphalt.”)

Meanwhile, the enemies of VistA in the bureaucracy and industry were moving in. A 2005 Gartner study said the agency could save $345 million a year by consolidating the agency’s health IT efforts within the central office. The agency was reluctant to fully centralize, but when a burglar stole a computer containing 26.5 million patient records from the home of a VistA engineer, the knives came out at a series of House Veterans Affairs Committee hearings. The security of veterans’ records became an issue. Steve Buyer, the Indiana Republican who chaired the committee, was determined to recentralize. At one hearing, he called decentralization proponents “the gargoyles that defend bureaucracy and the old way of doing business.”

In 2006, two important things happened to VistA: It won the Harvard Business School’s coveted Innovations in American Government Award—given each year to promote creativity in the public sector—and its budget disappeared. Congress ordered that all IT work at VA report to the agency’s chief information officer, creating new bureaucratic barriers to getting things done and putting power in the hands of an office whose priorities were different from those of IT workers in the field. “We became the only health care system in the world where the health care CIO didn’t report to the CEO of health care,” recalled a senior official. As funding for health IT development dried up, hundreds of VistA experts left to join the private sector, taking their coding memory, their Fingerspitzengefuhl, with them. The collaborative relationships between doctors and developers were over. Several blue-ribbon panels since have said that the reorganization, aimed at efficiency, smothered VistA innovation. “Modern management techniques killed it,” says the former official. “We always wondered whether it was a plot to help the private vendors. But whether it was or not, it had that effect.”

Top VA officials attend a House Committee hearing in 2006 on the breach of data security at the department. | Getty Images

When Buyer left Congress in 2011, he took an assignment for the giant contractor McKesson—lobbying Congress for the company, a major producer of commercial EHR systems—on health IT and Veterans Affairs issues.

VISTA CONTINUED TO serve the VA, and well enough to continue to receive high user ratings in surveys. Of course, the world around it had changed a lot by 2009. Health IT had blossomed into an industry—big companies like Epic, Cerner, GE and Siemens were selling to big hospital systems, which appreciated their strengths at handling billing—an area where VistA lacked good applications, since the VA was both the provider of care and the agency that paid for it. But VistA was still well ahead of the industry standard for clinical care. It had things like computerized physician order entry, in which the physician electronically requests things like drug prescriptions and radiological scans. Its population health programs had produced a wealth of recommendations for the best treatment of chronic conditions. (MUMPS, VistA’s language, was old but is also still the basis for major commercial EHRs, such as those produced by Epic, Allscripts and McKesson.) VistA was so far ahead of the pack, in fact, that in the year President Barack Obama was elected, Rep. Pete Stark (D-Calif.), the chairman of the Ways and Means Committee, had introduced a bill that would provide VistA for free to every hospital and doctor in the United States. Geoff Gerhardt, a member of Stark’s staff, felt the idea needed tweaking and got the congressman to support an alternative that would give the Centers for Medicare and Medicaid Services money to incentivize doctors who “meaningfully used” EHRs—thereby giving birth to the term that defined Obama’s EHR subsidy program, the HITECH Act.

The Obama administration included the HITECH subsidies in its $831 billion stimulus program. But Stark was the only big proponent of open-source software at the table, and his proposal to give away VistA to doctors en masse ran into trouble. Republicans and Democrats like Anna Eshoo, who represents Silicon Valley, were not particular fans. “There weren’t a lot of members who felt strongly [in favor],” Gerhardt recalls, “and when you have Microsoft opposing it …” Instead of directing the administration to distribute VistA to doctors, the final language included a sort of “public option,” whereby HHS would make available a version of the open-source software to doctors. It never did. Senior administration officials felt the government lacked the expertise to provide software directly.

And so, when $35 billion was teed up for doctors, VistA was not available to them. A few startups, like MedSphere, had adapted the software and used it to wire some hospitals and other medical practices, at a price that was pennies on the dollar compared with the bills for the big EHR systems, which had started out as administrative billing software. So nearly all of that money was funneled into purchases of commercial EHRs.

BACK AT THE VA, VistA was running into different kinds of problems. Roger Baker, who became the VA’s CIO in 2009, was an Obama transition team member with a background in corporate IT. To deal with the perception of disorganization and cost overruns at VistA, Baker set up the Project Management Accountability System, which required each IT project, such as modifications of VistA’s lab and prescription software, to be up and running within six months and capped each project at two years. The federal government loved the accountability system, declaring it a model government program. It used lots of record-keeping, monitoring and strictly enforced business rules to keep projects from spinning out of control and burning up truckloads of money. And it succeeded at that, but at the same time became so burdensome that it strangled initiative. “It’s like having a building, refusing to properly maintain it, and then when it inevitably starts to fall apart you say, ‘See, there is no reason to maintain this building. It’s falling apart,’” says Fred Trotter, CEO of DocGraph and one of the country’s leading health IT hackers.

Baker, to his credit, was committed to making VistA flourish again. “When people are passionate about a product, they want to keep working it,” he told me. “They do outrageous amounts of work to make the product as good as possible. In the 1980s and 1990s, that happened with VistA. By the time I got there, the passion wasn’t at the VA anymore.” To reignite the original spirit of the VistA team, he created a sort of “X Prize,” an initiative for a relatively inexpensive project that would bring in open-source hackers, including some former VistA programmers, to wrap VistA in more contemporary code. The Veterans Health Administration put out bids for that work in 2011.

For the VistA lovers, the idealists who still thought open-source technology was the logical system for medical records, this was perhaps the last best chance to restore a treasured common property. Munnecke was one of them. So were Longman and a techie colleague at the New America Foundation, Sascha Meinrath. They created a consortium and enrolled Red Hat, a federal contractor and leading open source developer, as well as several former Hardhats to help them shape the bid. They were sure they would get the job, although midway through the process, the entire Wisconsin congressional delegation—Epic, the big EHR maker, was based outside Madison—wrote Baker, urging him not to focus exclusively on open source developers. In the end, the bid went to another consortium led by well-known contractors. It created a nonprofit organization that serves as a forum for open-source EHR developers, but, while full of idealists, the organization is underfunded and relatively toothless.

The loss of that contract stings Meinrath, now a technology professor at Penn State University, because he’s convinced that VistA’s open-source technology could have been used across the health care system. “If we’d been able to do this, [the] Healthcare.gov [disaster] wouldn’t have happened,” he maintains. “We could have built a backbone record-keeping system that was standardized and extensible to all the systems that all the different states were using.”

Baker tried to strengthen VistA by attempting, once again, to convince the Pentagon to incorporate the VA’s software in a shared health-records project. Even entering the project, many VA officials were convinced it would fail because they sensed the DOD was not really interested. The climax, after $564 million in spending, came at a November 2012 meeting at which the VA and Pentagon leaders of the project presented slides to VA Secretary Eric Shinseki and Defense Secretary Leon Panetta. “If you’ve ever been on the receiving side of a full fusillade from Leon Panetta. … It was not a lot of fun,” says a former VA official who attended the meeting. “If we could have gotten DOD in, we could have gotten the critical mass we needed to rebuild VistA.” With the failure of the shared records project, VistA’s future also seemed to slip away.

 

Veterans Affairs Secretary Eric Shinseki testifies at a Senate Veterans' Affairs Committee hearing on wait times veterans face to get medical care in 2014. | Getty Images

THE VA STILL runs on VistA, and IT teams are still working to improve the interface for clinicians and to improve connections between the Veterans Health Administration, the Pentagon and other VA programs, such as the one that enrolls vets in benefits. But there’s a bull’s-eye on the program’s back. Since the failure of the integration effort, and the subsequent 2014 scheduling fiasco, in which VA officials in Phoenix falsified records to make the agency look better at timely treatment of veterans, congressional committees have repeatedly called VA and Defense officials to testify. The solons blast the bureaucrats over the scheduling system and shake their fists about the supposed lack of interoperability between Defense and the VA—though in fact, experts say, there is far better transfer of information between the VA and DOD than between any two other U.S. health care entities. And minds are made up about VistA. “It’s like an old Buick that gets you from Point A to Point B. But wouldn’t we rather be riding inside an air-conditioned new Cadillac?” the new Veterans Affairs Committee chairman, physician Phil Roe of Tennessee, said at a hearing last year.

An updated user interface for VistA, called the Enterprise Health Management Program, seems to be progressing, although when it was implemented at the VA in Hampton Roads, Virginia, in a March 2015 pilot, it caused a system crash that affected clinical services at the hospital for a month. Not enough good computer expertise was left at VistA to manage the task, according to one former senior official. With the dramatic growth of commercial EHRs, the skills and training and innovation had moved out of VistA and out of open source EHRs, says David Waltman, special assistant to the chief information officer at VA. A blue-ribbon panel on the VA’s future urged the agency to dump VistA. The membership of the panel included conservative-funded veterans groups and was led by leaders of hospital systems that have spent hundreds of millions to install Epic software. Not a single VistA expert was on the panel or consulted by it.

At a summer meeting of the open source EHR forum, the VA’s then-chief information officer, Laverne Council, indicated it was time to move on.

“Technologists accept change and hate old stuff,” she said. VistA had become a victim of the factors that led to its strength. Its distributed development resulted in a thousand flowers blooming, each one a different species, and in the foggy ruins of time no one could identify the people who wrote the code or how it could be amended. Managing all of those applications across a 167-hospital national system, some said, was a nightmare—more than half of the VA’s $4 billion annual IT budget goes to maintaining existing software. Under its current tentative plans, the VA will continue to update VistA’s interface through 2018. After that, the VA is likely to swap out VistA for a commercial EHR. The speculation is that bid would go to Leidos and Cerner—if their current partnership with the DOD continues to move along on schedule. Some believe the fix is in already, because a number of Leidos IT specialists already work inside the VA. At least two other big EHR vendors, Epic and Allscripts, say they’ll also bid to take over the VA’s EHR duties.

This is bitter fruit for many VistA fans. Some still say the system could be fixed for $200 million a year—the cost of a medium-sized hospital system’s EHR installation. “I don't know if there even is an EHR out there with data comparable to the longitudinal data that VistA has about veterans, and we certainly do not want to throw that data out if a new EHR were to be used,” says Nancy Anthracite, a Hardhat and an infectious-disease physician.

Replacing VistA could be a colossal task—the military is spending $4.3 billion to switch to a Cerner EHR by the end of 2022, and Baker has estimated it could cost the VA $16 billion to rip and replace VistA. To maintain the functions that doctors like about it would require intricately lacing together new and existing software. Pitching all the good old stuff because it’s too old and complex to integrate with a new EHR would be tremendously wasteful and frustrating to doctors. A decision on whether to switch to a commercial system has been set for July 1. Some, including former CIO Baker, think the VA should wait until at least September, at which point the IT world will have a clearer picture of how the military’s implementation of a Cerner EHR is progressing.

“If they change the system and it becomes user unfriendly, that would be a major disaster,” says Ross Fletcher. “I would hope that the creativity and leadership are not supplanted. Creativity is important.”

OUTSIDE THE VA, the story of digitization of American medicine isn’t any smoother than the story of VistA. It’s true that an industry that used to run on paper records and folders is now mostly digital—a transformation accelerated by the $35 billion in subsidies offered as part of the stimulus package. But the promises of electronic records—improving care, improving health and making the industry more efficient—have only been partly borne out. Today the verdict is that electronic health records may have made medicine safer, but they’ve actually reduced, not improved, its efficiency.

Doctors now spend an average of $32,000 a year each on health IT installation and maintenance, and roughly 40 percent of their time working on the computer. Ask doctors what really bugs them and it doesn't take long to get to the software: clunky, vulnerable to hackers, and built by competing players without agreed-upon standards, so patient information often ends up locked in the records of competing software companies and hospital systems. The highly educated doctor delivering you cutting-edge medicine is stuck on a computer system you’d have been annoyed to find on your desktop back in 2005.

It's reasonable to see this, of course, as the growing pains of a new industry, much like computers themselves, which were originally a mishmash of competing systems until they standardized around just a couple. The alternative seems unrealistic: a centrally designed system that has gone through years of testing and improvement. But in one of Washington's strange ironies, the government really did develop such a system. And the government is about to spend billions of dollars to scrap and replace it.

The four-decade struggle over the VA’s health IT system reveal some philosophical and logistical quandaries that arise in big health-care management systems, in government IT—and in the economy in general. Should the evolving pieces of a complex technological program run independently, or as an integrated, centralized whole? Should they be customized to user needs, or standardized for simplicity’s sake? Does the answer lie in open-source or proprietary technology? Does passion or accountability promise the most success? Problem solving or planning? Creativity or control? And who should be trusted to come up with the correct decisions—experienced careerists or outside analysts? Or politicians? And finally, who best serves the veteran: the private sector or the government?

There are still VistA die-hards who think it could be revived were it not for politics and money. “It’s hard to argue that VistA is an old racehorse when it still comes in first in the races,” says DocGraph’s Trotter, himself a Hardhat. For the most part, however, even the men and women who built and patched and rejuvenated VistA over the years have given up on it. It has been kicked around and neglected too long, like a former Kentucky Derby candidate chewing up pasture while awaiting a trip to the glue factory. Even so, a few dream that in a parallel universe, a place with less grandstanding about brave veterans and incompetent bureaucrats, a place with fewer lobbying dollars and more humility, the racehorse could keep on running.

“Perhaps this was a golden era of the kind of, ‘Let's all make the world a better place by working together’ attitude,” Munnecke says. “It seems terribly naive today, but it was a driving force back then.”

Authors:

Arthur Allen

aallen@politico.com

@@ArthurAllen202

NDVS Newsletter for February 2016

 

   

 

 

 

   Nevada Department of Veterans Services Newsletter February 2017 

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Governor Sandoval honors two women for outstanding commitment in helping fellow veterans

By Terri Hendry

(Carson City, NV) – Governor Brian Sandoval presented special recognition to two women, one of them a veteran herself, for their work and commitment to helping fellow veterans.
U.S. Army veteran, Peggy Bohn received the "Veteran of the Month" honor in a ceremony in Carson City on January 11, 2017. Bohn hosts LadyVets meetings where the program is designed to promote social time, information exchange, networking and VA benefits information. She also participates in veterans' events known as "Stand Downs," as well as helps veterans get the care they've earned through their service. She has also assisted with surveys, focus groups and collecting data that helps design programs to improve the quality of life for veterans.
The Governor also presented Linda Haigh with the "Veteran Supporter of the Month" honor for her extensive work in bettering the lives of veterans. Haigh and her husband Wayne founded the Adopt a Vet Dental program in 2010. It partners veterans in need to dentists who are willing to care for veterans free of charge. The program started with six dentists and today the number has grown to 110 dentists in 10 northern Nevada counties. In 2007, she started a Veterans Outreach Program at her church after discovering 60 low income veterans living and surviving with difficulty at an apartment complex in Reno. The church program provides items including clothing, bedding, food, bus passes and gift cards to veterans in need. 
The "Veteran of the Month" and "Veteran Supporter of the Month" awards are provided through the Nevada Department of Veterans Services. The awards are part of the Governor's commitment to make Nevada the "friendliest State in the nation" to its military community and veterans.

2017 Legislative Summit provides veterans with information about upcoming Session

(Carson City, NV) – The Nevada Department of Veterans Services (NDVS), in partnership with the United Veterans Legislative Council (UVLC), hosted two Legislative Summits in January. One was held in Las Vegas, the other in Carson City, Nevada.  

The Summit is designed to provide information to veterans, their families and veteran supporters with information about proposed legislation that could impact those serving in the military or veterans. UVLC President Kevin Burns and UVLC Vice-President Tony Yarborough walked attendees through key issues identified through 2016 Veterans Symposia. Some of those "big ideas" that surfaced in the series of symposiums included actions to prevent veteran suicide, take care of family survivors especially children and caregivers of veterans was well as improve the State's ability to connect veterans to benefits, particularly in the rural areas.  

In Las Vegas, State Senator Joe Hardy and Assemblyman Chris Edwards,  were on hand. In northern Nevada, Edwards joined Assemblyman Mike Sprinkle to address the audience.  

A number of key bills were discussed including the Governor's Legislative Bills. AB 24 would revise provisions governing the tuition charges assessed against certain students within the Nevada System of Higher Education. This bill would help veteran students. SB 33 would prohibit the foreclosure of real property owned by certain military personnel or their dependents in certain circumstances. SB 70 would revise provisions governing management of certain abandoned or unclaimed property deemed to have military value. It would allow the NDVS Director to transfer this kind of property to the Nevada State Museum or the Nevada Historical Society or any suitable state, federal or non-profit entity. This bill would also protect against the disposal or destruction of unclaimed property or artifacts with military value.  

There are also other key bills proposed such as AB 2 which would revise provisions regarding the Patriot Relief Act. This would remove the requirement that only those who have been called to active services are eligible for monetary relief. SB 7 would revise provisions of the Nevada Code of Military Justice updating it so certain offenses are subject to court-martial proceedings.  

Other bills of administrative importance, being brought forward by NDVS, were discussed but some of the agency's budget priorities include funding for the new Northern Nevada State Veterans Home, additional Veterans Service Officers to serve rural areas as well as capital improvement projects at Nevada's State Veterans Cemeteries. The Summit allowed participants to also learn how policies are developed as well as how to track legislation. You may learn more about the 79th Session of the Legislature as well as how to keep track of proposed legislation by visiting our website at http://www.veterans.nv.gov/page/nevada-79th-legislature

Veterans and Military Day at the Legislature in March

Mark your calendar and make sure you participate and attend the upcoming Veterans and Military Day at the Legislature on March 15, 2017.  

The day in Carson City starts at 8:00 AM with coffee and networking near the Veterans Memorial behind the Capitol Building. At 9:00 AM, the Governor will be signing critical veterans legislation and will host a ceremony honoring distinguished veterans. The Nevada National Guard will host the Color Guard as well as provide military static displays. Between around 11:30 AM and Noon, the Assembly and State Senate will pass resolutions in honor of Nevada’s Fallen. At noon, lunch will be served outside using the National Guard’s mobile kitchen.

If you would like to set up a display or exhibit booth at the event, just click here to register. We hope to see you there!  

Northern Nevada Mourns the Loss of a Great Warrior and Citizen

By Tyrus W. Cobb

Reno and the nation have suffered a great loss with the passing of Lt. General Martin Brandtner (USMC-Ret), who died unexpectedly on January 3. “Marty” was a heavily decorated and twice-wounded Marine, having been awarded the Navy Cross not once, but twice (The Navy Cross is just one level below the Medal of Honor)! He and his wife Sandra moved to northern Nevada in 2003, and he was deeply engaged with the National Security Forum, the Catholic Diocese, Manogue High School, and several service clubs.

As a Captain commanding a rifle company in Viet Nam in 1968, Brandtner led a reconnaissance patrol near the village of Lan Phuoc, where his lead platoon triggered an ambush by North Vietnamese (NVA) troops. As Brandtner moved forward to join the fight, he was hit badly when an enemy grenade showered him with shrapnel. Brandtner ignored his own injuries and moved forward to attack the North Vietnamese ambush position, tossing his own grenades, and destroyed the enemy stronghold. The fight continued as a short range grenade duel as other NVA troops moved forward. Ignoring his own wounds, Brandtner scooped up the enemy grenades and hurled them back at the NVA troops.

When a grenade landed near his own fire team, Brandtner picked the grenade up and threw it back at the enemy. Knowing the grenade’s force would also hit his own team, Brandtner flung himself atop his own men, absorbing the shrapnel himself. Despite his wounds, then Captain Brandtner consolidated his unit’s position, coordinating artillery strikes against the NVA positions. That forced the enemy to abandon its positions and flee, and only then did Brandtner allow the corpsmen to attend to his wounds.

Just eight days later, Brandtner and his company were establishing ambush positions when they were attacked by a battalion-sized NVA force. Ignoring enemy rifle, machine-gun and rocket fire, Captain Brandtner moved from position to position, directing his Marines’ fire, reorganizing the defense and inspiring his men. Over the next two hours, the NVA launched three more attacks and were thrown back with severe losses each time. The NVA attacked repeatedly, but the Marines held their positions and the enemy forces finally withdrew. During the two battles, while the North Vietnamese suffered considerable casualties, Brandtner’s company lost only one man! These two actions resulted in Brandtner receiving two Navy Crosses and the distinction of being one of only two Marines in Vietnam to earn the medal twice.

During his career as a Marine infantry officer, General Brandtner led at every level, commanding three platoons, two rifle companies, a battalion, the storied 5th Marine Regiment, and as the Chief of Staff of the 1st Marine Division. As a general officer, he served as Assistant Division Commander, 2nd Marine Division, Fleet Marine Forces (FMF), Commanding General, 10th Marine Expeditionary Brigade, and Commanding General, 2nd Force Service Support Group, FMF. 

General Brandtner’s staff assignments included serving as the Senior Military Assistant to the Under Secretary of Defense for Policy during the Reagan Administration.  In 1990, General Brandtner was nominated for his third star and assignment as Director for Operations, J-3, on the Joint Chiefs of Staff, serving under General Colin Powell.  As the J-3, General Brandtner was responsible for operational planning for Operations DESERT SHIELD and DESERT STORM, and subsequent major U. S. global operations in Turkey, Iraq, Bangladesh, Somalia, and Bosnia. 

General Brandtner is survived by his wife, Sandra, and four children and seven grandchildren.

Governor Brian Sandoval helps honor veterans in a special tribute and ceremony

By Terri Hendry 

(Reno, NV) - U.S. Navy, World War II veteran, Margaret Allen has seen a lot in her lifetime. At 107-years young, she has either served in or seen every US conflict beginning with World War I. Allen was among some 44 veterans who received a special honor and recognition during a Veterans in Care (VIC) ceremony, a program developed by the Nevada Department of Veterans Services. 

The VIC program is designed to identify and recognize veterans who are now living in eldercare communities. The January event featured three veterans who have celebrated 100 birthdays! Yes, you are correct, they are 100-years-old! Governor Brian Sandoval handed out specially minted coins to each veteran being honored. The approximately 100 people crowded in to the recreational room at Five Star Premiere Residences of Reno to watch the veterans receive their special recognition and to be honored. Some were brought to tears while they additionally received certificates and were also pinned with a commemorative VIC pin as part of the ceremony. Governor Sandoval said, "It is humbling and an honor to be among so many Nevada heroes." NDVS Director Katherine Miller said, "It is heart warming to see these men and women remembered and honored in this way." She added, "Some of them have told us they felt their service had been forgotten." As of December 2016, more than 500 veterans have been recognized through the VIC program. 

To watch media coverage of this event click here.

To learn more about the VIC program click here.

" Bravo Zulu" training puts focus on veteran elder care

By Julie Boyster

(Las Vegas & Reno, NV) -  The Nevada Department of Veterans Services held its inaugural launch of a Veterans In Care " Bravo Zulu" training initiative in Las Vegas in January. This program is designed to enhance awareness on how the military experience of aging veterans affects and impacts the role of those who provide care to them.

"Bravo Zulu: Achieving Excellence in Relationship-Centered Care", is a series of eight workshops with four being held in southern Nevada  and an additional four workshops being held in northern Nevada. The "Bravo Zulu" training is offered throughout the year for health care facilities and care partners. As you may already know, Nevada is home to nearly 300,000 veterans. Forty-three percent are over the age of 65. This statistic prompted the NDVS to partner with the Perry Foundation and its nationally known expert and author, Jennifer Carson, Ph.D.  Carson is a Professor at the University of Nevada-Reno. She developed the training and was the key presenter at the workshops. 

This first workshop had 54 attendees, from a variety of health care settings.  A closing panel of veterans, gave additional insights to the participants. Pictured left to right: Greg Flemming, an AmeriCorps State volunteer; Ben Jefferson, NDVS Veteran Services Officer; Shirley Pfannebecker, Nurse Manager at the Nevada State Veterans Home; Poppy Helgren, Chief Nursing Officer at the Nevada State Veterans Home; Bobbie Oats (USAF retired), Nevada Women's Veterans Advisory Council.

The second workshop was held at the Alzheimer's Association building on Cordone Street. 

Veterans Services featured on America Matters Radio KCKQ AM 1180

By Terri Hendry

(Reno, NV) - The Nevada Department of Veterans Services is reaching out so you can learn important information by sitting back and listening to the radio. Thanks to long-time Nevada veterans supporter, Connie McMullen, Publisher of the Senior Spectrum and Boomer Magazines, she is lending her hour long radio program to the NDVS! Just click the link to listen to the most recent program featuring the latest information from NDVS.

The most recent program was hosted by former television anchor-reporter, Terri Hendry and it featured NDVS Director Kat Miller. In program you heard about the recruitment to fill outreach positions with both the AmeriCorps State and the AmeriCorps Vista programs from AmeriCorps State Program Director, Tamalyn Gee and AmeriCorps Vista Outreach Coordinator, Blake Boles. 

ftp://shows.americamatters.us/Show/Senior%20Spectrum%20Editors%20Desk

NDVS will also host the upcoming programs on the following dates on KCKQ 1180 AM. Just tune in from 12:00 PM- 1:00 PM to listen or check back to our upcoming newsletters as we will provide links so  you can listen! 

2/1/17: New VA presumptive conditions associated with water contamination (1953-1987) at Camp Lejeune  

2/22/17: Native American Veterans, Generations of Veterans 

3/15/17: Incarcerated Veterans and Student Veterans 

4/5/17: Veteran Benefits—State and Federal 

NDVS wants to thank Connie McMullen for her generosity and support of Nevada's veterans! Also, thank you for listening! 

Veteran ‘Graduates’ 75 Years Later

By  Hail Bernstein Saylor/Boulder City Review

(Boulder City, NV) - George Markle receives kisses from Poppy Helgren, left, director of nursing, and Linda Gelinger, administrator, of the Nevada State Veterans Home in Boulder City after he was presented with his high school diploma Tuesday. Markle, 91, a World War II veteran, left high school in Bigelow, Arkansas, to join the Army after the Japanese bombed Pearl Harbor in 1941. He was honored through the Operation Recognition program, which helps veterans who left high school and served between World War II and the Vietnam War obtain their diplomas.

American Legion presentation at the Nevada State Veterans Home

A special recognition was held at the Nevada State Veterans Home, January 30th, 2017.  The American Legion "Spirit of Freedom" Post 76, presented each resident a "Veteran" ball cap with the seal of the branch of service they had served in.  Spouses in residence also received hats honoring their husband's service area.

Pictured are the members of the American Legion in front of a quilted Flag at the Home.  In addition, Commander Joel Forman presented the Director of Nurses Poppy Helgren, who is also an Army Veteran, with one of the hats.  A third picture shows Ron Michalski  of the Home's Independent Review Panel in the red cap with several of the American Legion members and Veterans in the home that were  honored . 

Congratulations Ross Bryant “Chapter Advisor of the Year!”

Contribution from George Ann Rice. Written by Terri Hendry

(Las Vegas, NV) - On Saturday night in Anaheim, at the Student Veterans of America 2017 National Conference, Ross Bryant was honored as the SVA “Chapter Advisor of the Year.” He was chosen out of 1400 SVA Chapters. After receiving the honor and award Bryant said, “I was shocked, humbled and honored. I appreciate our SVA chapter for nominating me, and I can’t emphasize enough that this has always been a team effort!”

UNLV was recognized as a campus that truly cares for and provides excellent service for our more than 1700 veterans. Since June of 2012, UNLV has made a great commitment in supporting the veterans returning from what is now more than 16 years of war. During the last 5 years, the Military & Veteran Services Center has enjoyed great support, community collaborations and greatly improved services. 

Bryant said, “It begins with the exceptional UNLV support led by Dr. Juanita Fain and our AVP, Mike Sauer." He added, "They have ensured that we have a robust staff to help all the UNLV student veterans get their VA payments and benefits on time.” He also said, “The Military and Veteran Services Center certifying staff, led by Melissa Barber, includes Julie Kaeding, Sharon Savage and recently Tricia Rucinski (in the position formerly held by Erika Busbee) all do a tremendous job.” Bryant emphasized, “Nothing at UNLV happens without this team processing files, getting each veteran certified and meticulously posting payments. I appreciate and honor all of you. Thank you for working so harmoniously and cohesively as a team!”

Bryant credits the success to great partnerships with the VA's Vet Success program, the Nevada Department of Veteran Services (NDVS), the Student Veteran and Military Family Services Committee, the National PAVE program, the various community veteran support nonprofits/programs, the newly formed Veteran Community Engagement Council and the leadership of the two Student Veterans of America Chapters (Rebel Vets & Rebel Women Vets).

Bryant said, “All of these relationships have improved our services and positively impacted our student veteran population. I thank all of you who are involved with these programs and organizations.” He also gave a special thanks to his wife Amy Bryant said, “She has always been with me in the Army and later at UNLV. She is my ROCK!” 

One of Nevada’s oldest WWII veterans is special guest to Gov. Brian Sandoval

NEVADA APPEAL

(Carson City, NV) - Phyllis Anker Bendure, 97, was more than just a sergeant during World War II. One of Nevada’s oldest living WWII veterans, Phyllis also was a teacher in the military and in northern Nevada schools. She was a trusted aide and delivered top-secret information, and had tea with presidents’ wives. She’s a veteran many could look up to, as she was a part of the Women Army Corps in the 1940s. Her journey has led her to be Governor Brian Sandoval’s special guest at his "State of the State" Speech in January. “I think it’s wonderful,” she said. “I’ve never been so honored before.”
Click here to read more.

Applications to be accepted for 2017 National Veterans Golden Age Games

Event Takes Place in Biloxi, May 7-11

By Michael Molina

(Washington, D.C.) - The Department of Veterans Affairs (VA) will accept applications from Veterans interested in competing in the 2017 National Veterans Golden Age Games beginning Feb. 1, 2017. Veterans ages 55 and older and enrolled in VA health care may complete applications online at www.veteransgoldenagegames.va.gov. Applications will be accepted through March 1, 2017.

The National Veterans Gold Age Games Director, Carla Carmichael said, “The VA is committed to offer sports and fitness as an integral part of a successful healthcare program, and I encourage every eligible Veteran to take advantage of this opportunity.” Carmichael added, “There are significant health benefits to leading an active lifestyle, and in keeping with the Games motto, we want every Veteran to achieve 'Fitness For Life.’”

The 2017 National Veterans Golden Age Games will take place in Biloxi, Mississippi, May 7-11, 2017. Nearly 800 athletes are expected to compete in the national multi-sport competition for senior Veterans, embracing the “Fitness for Life” motto. The event encourages participants to make physical activity a central part of their lives, and supports the VA’s comprehensive recreation and rehabilitation therapy programs. Competitive events include air rifle, badminton, boccia, bowling, cycling, golf, horseshoes, nine ball, power walk, shuffleboard, swimming, table tennis, and track and field. Exhibition events include: air pistol, archery, basketball, blind disc golf and pickleball.

VA research and clinical experience verify that movement and exercise are important to maintaining good health, speeding recovery and improving overall quality of life. The games encourage participants to continue in local senior events in their home communities and every other year serve as a qualifying event for competition in the National Senior Games. VA Gulf Coast Veterans Health Care System will host this year’s games. The Gulf Coast Veterans Health Care System provides care for more than 50,000 Veterans throughout Mississippi, Alabama, and Florida.

For more information visit www.veteransgoldenagegames.va.gov and follow VA Adaptive Sports on Twitter at @VAAdaptiveSport or on Facebook at www.facebook.com/vaadaptivesports.

NDVS and AmeriCorps Want YOU! Opportunities Exist for Volunteer Service

Do you want to serve the heroes that have faithfully served us? Then join us as an AmeriCorps Member with the Nevada Department of Veterans Services!

Nevada has an estimated 300,000 veterans living within its borders, and their number is growing every day. Our goal is to make sure they know about all the benefits that they have earned, and are able to take advantage of them. Many have severe life barriers, and don't even know they're eligible for assistance.

In short, your work with us can potentially save lives!
AmeriCorps VISTA: As an Outreach Coordinator, you will be working on building capacity for many of our programs to assist student veterans, women veterans, the aged, destitute, and other special populations. This can be challenging, and we are looking for some bright, squared-away individuals to make a difference in their lives. You might also be assisting with social media, special events, newsletters, and marketing.

Positions are currently available in Elko, Las Vegas and Reno. 
AmeriCorps State: Primarily, you will reach out to various communities across Nevada to build Veteran Community Collaboratives (VCC's), which are integral to educating and disseminating valuable information to all of Nevada's veterans, wherever they may reside.

Positions are potentially available across the state. 
For more information about training, benefits and service, click on https://www.nationalservice.gov/programs/americorps/join-americorps

or contact Tamalyn Gee at 755-688-1653.

Thank you for your interest in serving Nevada's Heroes. We look forward to hearing from you!

Your Plate Benefits NV Veterans Programs

Any veteran or his or her spouse, parent or child can purchase a veteran license plate. The applicant certifies that he or she qualifies by signing the Veteran License Plate Application (SP 33). The initial cost for veterans plates with a standard number is $61 plus a Prison Industry fee of .50 cents per plate. The annual renewal fee is $30. The initial cost for personalized versions is $97 plus a Prison Industry fee of .50 cents per plate. The annual renewal is $50. Twenty five dollars of the initial fee and $20 of the annual renewal are used to support outreach programs and services for veterans and their families administered by Nevada Department of Veterans Services. Plates with standard numbers are in stock at DMV Full Service Offices. You can order personalized versions by mail, fax, or in person at a DMV Full Service Office. 

Veteran Unit Decal Plates: The DMV is authorized to offer veterans plates with extra space for unit logos. Army Airborne and Navy Seabees are available as well as Air Force and Army logos on National Guard Plates.

Motorcycle plates for Army Airborne and Navy Seabees are not in stock and must be custom-ordered. Visit the Nevada DMV website to learn more.

NDVS Veterans Service Officers Outreach

NDVS Veterans Service Officers (VSOs) are available to assist any veteran, family member of a veteran, or Nevada resident on active duty.

NDVS offers free assistance with filing claims for service-connected disabilities, non-service-connected pension, and other benefits afforded by the Department of Veterans Affairs (DVA).

There are three locations; 

Reno, 775-321-4880; Las Vegas,  702-224-6025; and Elko, 775-777-1000.

Assistance includes aid in the filing of claims, support during the appeals process, representation at local hearings, and guidance with requests for discharge upgrades. To schedule a claims appointment at one of our offices, call the number of the office closest to you.

In addition to in-office appointments, NDVS offers Rural Outreach events in the following areas:

NORTH -- Austin, Gardnerville, Hawthorne, Silver Springs, Battle Mountain, Ely, West Wendover and Winnemucca

SOUTH -- Beatty, Laughlin, Mesquite, Pahrump and Tonopah

For more information on our Rural Outreach, or to schedule an appointment during one of our Rural Outreach events, please call one of the numbers listed above to contact a VSO in your region.

FEBRUARY ROVER DATES

7th - Mesquite

Mesquite Veterans Center -

VVA 840 Hafen Lane

Mesquite NV USA

9:30 a - 2:30 p

9th and 23rd - Nevada Senior Services

901 N. Jones Blvd.

Las Vegas NV 89108 USA

9 a - 3 p

24th - Aging and Disabilities Resource Center

Reno Town Mall

4001 South Virginia Street, Suite F (Second Floor, Above the library)

Reno NV 89502 USA

9 a - 1 p

24th - Gardnerville

Douglas County Senior Center 

10 a - 3 p

Pahrump every Monday, Wednesday and Friday

Nevada's Office of Military Legal Assistance 2016 Dates

By NV AG Office

(Carson City, NV)--The Nevada Attorney General’s Office of Military Legal Assistance (OMLA) provides pro bono (free) legal assistance and representation to active duty, reserve and National Guard service members in a wide area of civil law matters. 

The OMLA is a comprehensive, statewide program combining the joint efforts of legal aid organizations, private sponsors and the State Bar of Nevada to address the need for affordable legal representation in our military communities.

The OMLA also currently provides assistance to veterans with wills and powers of attorney.

In order to receive legal assistance from this program, active military and reserve service members should seek referral from their respective Judge Advocate General.

Veterans should seek referral from their respective Veterans Services Office. Click here for the statewide listing.

February OMLA Dates

2/24, 10-2 AMERICAN LEGION POST 60, 1510 BRUCE WOODBURY DRIVE, LAUGHLIN

POC, CMD FRED DOTEN, 702-445-1694 

2/25, 10-2 NDVS VETERANS HOME, 100 VETERANS MEMORIAL DRIVE, BOULDER CITY

POC, JULIE BOYSTER, 702-332-6717

Calendar

We are constantly adding new events to our calendar, in our on-going mission to support the veteran community in Nevada. Click here to check out our VetNet calendar

Visit our website www.veterans.nv.gov

STAY CONNECTED

FYI FOR YOUR INFO

Department of Defense Announces Successful Micro-Drone Demonstration

 

Press Operations

Release No: NR-008-17
Jan. 9, 2017

In one of the most significant tests of autonomous systems under development by the Department of Defense, the Strategic Capabilities Office, partnering with Naval Air Systems Command, successfully demonstrated one of the world’s largest micro-drone swarms at China Lake, California. The test, conducted in October 2016 and documented on Sunday’s CBS News program “60 Minutes”, consisted of 103 Perdix drones launched from three F/A-18 Super Hornets. The micro-drones demonstrated advanced swarm behaviors such as collective decision-making, adaptive formation flying, and self-healing.  

“I congratulate the Strategic Capabilities Office for this successful demonstration,” said Secretary of Defense Ash Carter, who created SCO in 2012. “This is the kind of cutting-edge innovation that will keep us a step ahead of our adversaries. This demonstration will advance our development of autonomous systems.”

“Due to the complex nature of combat, Perdix are not pre-programmed synchronized individuals, they are a collective organism, sharing one distributed brain for decision-making and adapting to each other like swarms in nature,” said SCO Director William Roper. “Because every Perdix communicates and collaborates with every other Perdix, the swarm has no leader and can gracefully adapt to drones entering or exiting the team.”

The demonstration is one of the first examples of the Pentagon using teams of small, inexpensive, autonomous systems to perform missions once achieved only by large, expensive ones. Roper stressed the department’s conception of the future battle network is one where humans will always be in the loop. Machines and the autonomous systems being developed by the DoD, such as the micro-drones, will empower humans to make better decisions faster.

Originally designed by Massachusetts Institute of Technology engineering students, the Perdix drone was modified for military use by the scientists and engineers of MIT Lincoln Laboratory starting in 2013. Drawing inspiration from the commercial smartphone industry, Perdix software and hardware has been continually updated in successive design generations. Now in its sixth generation, October's test confirmed the reliability of the current all-commercial-component design under potential deployment conditions—speeds of Mach 0.6, temperatures of minus 10 degrees Celsius, and large shocks—encountered during ejection from fighter flare dispensers.

The “60 Minutes” segment also featured other new technology from across the Department of Defense such as the Navy’s unmanned ocean-going vessel, the Sea Hunter, and the Marine Corps’ Unmanned Tactical Control and Collaboration program.

As SCO works with the military Services to transition Perdix into existing programs of record, it is also partnering with the Defense Industrial Unit-Experimental, or DIUx, to find companies capable of accurately replicating Perdix using the MIT Lincoln Laboratory design. Its goal is to produce Perdix at scale in batches of up to 1,000.

Editor’s Note:

A fact sheet about Perdix can be found here.  

Perdix video footage:

Emailing: Announcement in RJ 6 Dec 2017.jpg

 

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Bob,

Please get the word out any way you can. This may  be our best chance to let the Veteran community know what is going on with the  Memorial Monument at the SNVMC.

Thanks.

Joel

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Subject: Emailing: Announcement in RJ 6 Dec 2017.jpg

In today's RJ. It does state "Doors open at 8:30 AM for networking"! THEY WANT US TO NETWORK!

Joel

Veterans Town Hall Southern NV, VA. N. LAS VEGAS

Nevada Attorney General Office of Military Legal Assistance

 

2017 Vegas Flyer.pdf388 KB

State Flyer 2.pdf3 MB

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Subject: Nevada Attorney General Office of Military Legal Assistance

Please find the attached flyers and text below, which is being forwarded to you from one of the members of the State Commander’s Group; for the good of the whole.

Thank you,

                D.C. Martinez

To all Veteran Organization Commanders:

Please disseminate to your veteran membership,

WHO:             The Nevada Attorney General’s Office of Military Legal Assistance @EASE Program and Nevada Legal Services.

WHAT:           Free civil legal assistance to Veterans and their families.

                        Free wills, medical/financial powers of attorney and legal advice pertaining to family law, bankruptcy, consumer issues, landlord/tenant and access/denial to public benefits. Veteran Service Officers will be on hand to assist with VA benefit questions.

WHERE:        The January workshops will take place on 1/27 at the VA Hospital Auditorium located at 6900 N. Pecos Road, North Las Vegas, Nevada, and on Jan 28th at American Legion Post 40 located at 425 E. Van Wegenen Street, Henderson, Nevada.  

WHEN:           Attorneys will be available to assist veterans and family members from 10am to 2pm both days.

NOTES:          Workshops will take place at least once per month throughout the State of Nevada. Please refer to our attached flyers. For more information or to receive email alerts on upcoming workshops, please email Hcooney@ag.nv.gov and we will add you to our email list.  Also, please visit our site at: nvagomla.nv.gov.

Ryan McDonald | Outreach Director
State of Nevada | Office of the Attorney General | Office of Military Legal Assistance  

T: (775) 684.1216 | F: (775) 684.1162 | E: rmcdonald@ag.nv.gov

From: Martinez, David C. (LV) [mailto:David.Martinez2@va.gov]
Sent: Wednesday, January 4, 2017 3:45 PM
To: Ryan J. McDonald <RMcDonald@ag.nv.gov>
Subject: OMLA Flyers - Corrected

If this rendition is final, you can send over the message for the commanders and I’ll send it out.  It will give them time to get the word out.

                D.C. Martinez

From: Ryan J. McDonald [mailto:RMcDonald@ag.nv.gov]
Sent: Wednesday, January 04, 2017 3:23 PM
To: Martinez, David C. (LV)
Subject: [EXTERNAL] RE: OMLA Flyers - Corrected

Yeah, couple of needed corrections. Thanks David. Ryan

Ryan McDonald | Outreach Director
State of Nevada | Office of the Attorney General | Office of Military Legal Assistance  

T: (775) 684.1216 | F: (775) 684.1162 | E: rmcdonald@ag.nv.gov

 

Hi Ryan,

Here is the newest rendition.

                D.C. Martinez

 

Attached.

Heather T. Cooney

Assistant to Nic Danna

Special Assistant Attorney General

Director Office of Military Legal Assistance

Nevada Office of the Attorney General

775-684-1202

Notice: This e-mail message and any attachments thereto may contain confidential, privileged or non-public information.  Use, dissemination, distribution or reproduction of this information by unintended recipients is strictly prohibited.  If you have received this message in error, please notify the sender immediately and destroy all copies.

Len Yelinek

Commander, Las Vegas Chapter 711

Military Order of the Purple Heart

(702) 362-7673-H    (702) 460-0769-C

5116 Longridge Ave, Las Vegas NV 89146