Four spouses and two fiancées of veterans eligible for the Department of Veterans Affairs‘ family caregiver program have filed a lawsuit against the VA for denying or improperly revoking their benefits.
In a suit filed Jan. 22, 2018, in the U.S. Court of Federal Claims, the plaintiffs, led by Florida resident Zamantha Tapia, fiancée of Army veteran Cesar Silva, allege that the VA did not follow the laws and regulations governing the department’s Comprehensive Assistance for Family Caregivers program, which provides compensation and health benefits to those who provide care for seriously injured post-9/11 veterans.
According to the suit, Silva and Tapia’s application was denied, and the benefits of the other plaintiffs were inappropriately downgraded or terminated without proper investigation or determination.
In 2017, veterans and their caregivers enrolled in the program began seeing their benefits curtailed or terminated — often with no reason given, other than that their VA providers determined they no longer needed help with their daily activities.
In August 2018, the VA Office of Inspector General found that across the VA, facilities didn’t adequately manage the program, failing to provide consistent access to it, improperly accepting ineligible veterans and declining to monitor the health statuses of nearly half the veterans it discharged from the program.
The IG also learned that the department paid out .8 million to caregivers of veterans who weren’t eligible for the program, and the VA “failed to manage the program effectively because it did not establish governance that promoted accountability for program management,” staff members wrote in the report.
In 2015, plaintiff Jennifer Wilmot and her husband George Wilmot, an Army National Guard veteran who served from October 2007 to May 2013, were booted from the program.
The Wilmots were accepted into the caregiver program in 2013 but should have received the highest level of compensation rather than the level they were awarded, according to attorneys Jason Perry and Luke Miller.
Then came the dismissal.
“After completing a comprehensive review of your medical records, it appears that you have met the intention of the program and your participation will be discontinued,” VA officials wrote to the Wilmots.
The lawsuit calls the termination “arbitrary and capricious.”
Silva was deployed to Iraq from November 2003 to August 2004, sustaining shrapnel injuries in an attack. According to the lawsuit, he received a VA disability rating of 70 percent in 2009 for rotator cuff strain and impingement and suffers from chronic headaches, degenerative joint disease, back pain and neuropathy. He also has PTSD, TBI, memory loss, depression and irritable bowel syndrome.
Tapia and Silva applied for the family caregiver program in 2014 but were denied. According to the suit, the VA found that Silva did not need assistance for physical injuries and said his mental health conditions were not service-connected. They reapplied in 2017, but following a phone assessment, VA officials said that Silva was not “receiving medical treatment” — an error, the lawsuit alleges — and that Tapia was “an enabler.”
According to Perry, an attorney in Wellington, Florida, and Miller, of Military Disability Lawyer LLC in Salem, Oregon, the plaintiffs have asked the court to certify the suit as a class action, meaning that other affected caregivers could sign on if it is approved.
They estimate that the VA received more than 100,000 applications for the family caregiver program between May 2011 and September 2018 and, therefore, thousands may be able to sign on to the possible class action.
The plaintiffs also are requesting that the VA stop what they perceive as arbitrary dismissals from the program and are seeking monetary compensation in an amount “to be determined at trial,” according to the suit.
The federal government has until March 25, 2019, to file a response in the case, and a status conference is scheduled for March 29, 2019, according to court documents.
This article originally appeared on Military.com. Follow @militarydotcom on Twitter.
Syria’s coastal city of Latakia, which hosts a large Russian naval base and military presence, has come under attack from an unclaimed missile strike that Syria attributes to Israel.
“Air defenses have confronted enemy missiles coming from the sea in the direction of the Latakia city, and intercepted a number of them,” Syrian state-run media said, according to Reuters.
Syrian officials blamed Israel for the strike, but Israel rarely takes credit for its air raids in Syria and has frequently fired missiles from outside of Syrian airspace before.
The strikes followed Israel releasing satellite images of Damascus International Airport and the palace where Syrian President Bashar Assad lives in a possible threat. Syria also blames Israel for a Sept. 16, 2018 strike on the airport.
Syria and Israel have fought wars against each other in the past and Israel has taken military measures to resist Iran’s influence and ability to transfer arms in southern Syria near Israel’s borders.
The Syrian Observatory for Human Rights said missiles targeted ammunition depots of the technical industry institution in the eastern outskirts of Latakia, according to Reuters.
Unlike the semi-regular strikes that hit Iranians-aligned forces in southern Syria, this strike hit an area rich with Russian forces and missile defenses. In past US-led strikes, Syria has shown little proof that its air defense can actually fend off large-scale naval cruise missile strikes.
Russia recently concluded naval exercises in the Mediterranean near Latakia and maintains a consistent naval presence in the region.
So far nothing indicates Russian military bases have been targeted, but Syria-based correspondents have reported Russian air defenses operating.
Russia has, since 2015, stationed warships at Latakia and operated some of the world’s top missile defenses near Latakia. Video and photos claiming to show the air battle over Latakia show what look like massive surface to air fires with missiles streaking overhead, indicating a state military rather than a rebel or terror group.
Featured image: A video claims to show a massive missile strike in Latakia.
This article originally appeared on Business Insider. Follow @BusinessInsider on Twitter.
In the realm of medicine, what you don’t know can indeed kill you.
Six months have passed since China reported the first coronavirus cases to the World Health Organization. But even now, what experts are still trying to understand sometimes seems to outweigh what they can say for certain.
That is little surprise to any infectious-disease researcher: Highly contagious diseases can move through communities much more quickly than the methodical pace of science can produce vital answers.
What we do know is that the coronavirus seems to have emerged in China as early as mid-November and has now reached 188 countries, infected more than 10.4 million people, and killed around 510,000. Population-level studies using new testing could boost case numbers about 10-fold in the US and perhaps elsewhere as well.
Here are 11 of the biggest questions surrounding the coronavirus and COVID-19, and why answering each one is critically important.
How did the new coronavirus get into people?
The first coronavirus infections was thought to have emerged in a wet market in Wuhan, in China’s Hubei province. But newer research suggests the market may simply have been a major spreading site.
Researchers are fairly certain that the virus — a spiky ball roughly the size of a smoke particle — developed in bats. Lab tests show that it shares roughly 80% of its 30,000-letter genome with SARS (severe acute respiratory syndrome), a virus that also came from bats and triggered an epidemic in 2002 and 2003. It also shares about 96% of its genome with other coronaviruses in bats.
Still, researchers still aren’t sure how the coronavirus made the jump from bats to humans. In the case of SARS, the weasel-like civet became an intermediate animal host. Researchers have suggested that civets, pigs, snakes, or possibly pangolins — scaly nocturnal mammals often poached for the keratin in their scales — were an intermediary host for the new coronavirus. But it could also be that the virus jumped straight from bats to humans.
A May study suggested that SARS-CoV-2 (the virus’ clinical name) may be a hybrid of bat and pangolin viruses.
Global tallies of cases, deaths, recoveries, and active infections reflect only the confirmed numbers — researchers suspect the actual number of cases is far, far larger.
For every person who tests positive for the novel coronavirus, there may be about 10 undetected cases. This is because testing capacity lags behind the pace of the disease, and many governments, including in the US, failed to implement widespread testing early on.
New estimates from MIT suggest the world had already seen 249 million coronavirus cases and 1.75 million deaths by June 18. That would make the global case total 12 times higher than official reports, and the global death toll 1.5 times higher.
Other similar research estimated that the US alone may have seen 8.7 million coronavirus cases from March 8 to 28. US researchers also suggested in May that the nation’s official death count may “substantially understate” the actual number of coronavirus fatalities.
Why it matters: An accurate assessment is critical in helping researchers better understand the coronavirus’ spread, COVID-19’s mortality rate, the prevalence of asymptomatic carriers, and other factors. It would also give scientists a more accurate picture of the effects of social distancing, lockdowns, contact tracing, and quarantining.
What makes the coronavirus so good at spreading?
Viruses are small, streamlined particles that have evolved to make many, many copies of themselves by hijacking living cells of a host.
The measurement of a virus’ ability to spread from one person to another is called R0, or R-naught. The higher the value, the greater the contagiousness — though it varies by region and setting. The novel coronavirus’ average R0 is roughly 2.2, meaning one infected person, on average, spreads it to 2.2 people. But it had a whopping R0 of 5.7 in some densely populated regions early in the pandemic.
A person’s ability to transmit the virus depends partly on their viral load: the amount of virus particles they release into the environment. Coronavirus patients tend to have high viral loads in the throat, nasal cavity, and upper respiratory tract, which makes the virus highly contagious. Research indicates that there’s little difference in the viral loads between coronavirus patients who show symptoms and those who don’t.
Coughing — a signature symptom of COVID-19 — helps spread viruses in tiny droplets, especially in confined spaces. But the virus can also spread through singing, normal breathing, or even loud conversation.
Why it matters: Knowing how a virus gets around can help everyone better prevent its spread. Getting a handle on its behavior may also spur governments to act sooner to contain future outbreaks of this or other similar diseases.
What drives mortality in people infected by the coronavirus?
First, the virus’ spiky proteins latch onto cell receptors in the lungs called ACE2. Our immune system then senses a threat and responds by activating white blood cells. Among patients who develop severe outcomes, immune systems can overreact by producing a “cytokine storm” — a release of chemical signals that instruct the body to attack its own cells.
The reaction may cause milder coronavirus symptoms like fever, fatigue, muscle aches, or swollen toes. But it can also lead to severe symptoms including blood clots, excessive leaking in the blood vessels, fluid in the lungs, depleted oxygen in the blood, and low blood pressure.
Doctors have linked blood clots to the increased prevalence of strokes among coronavirus patients. An aggressive immune response can also damage the heart, kidneys, intestines, and liver. But most coronavirus deaths are due to respiratory failure, meaning the lungs aren’t supplying enough oxygen to the blood.
Why it matters: Understanding how the coronavirus does so much harm could lead to more effective treatments in hospitals and make for promising drug targets.
What percent of people infected by the coronavirus die?
Death rates for COVID-19 are not one-size-fits-all. Many factors are at work.
Age is a big one. Older people are more likely to die as a result of lung failure, strokes, heart attacks, and other problems triggered by coronavirus infections, while younger individuals are much less likely to do so. However, people of all ages, including children, have experienced severe symptoms and sometimes death.
One hypothesis is that the answer lies in an individual’s genetic code. People whose genes tell their bodies to make more ACE2 receptors — which the coronavirus uses to invade our cells — could get hit harder.
Why it matters: Variations in death rates help researchers expose flaws in government responses, supply chains, patient care, and more, ideally leading to fixes. Being able to identify the people at higher risk of severe symptoms and treati them accordingly could also lower death rates. However, the early data is clear enough: The coronavirus has the capacity to kill millions of people in a relatively short time.
Why do young people face the least risk of dying?
On a per-capita basis, young people are the most resilient to the coronavirus. But they do get infected and suffer from it. Even blood clots and strokes have emerged among some younger patients.
Typically, young kids and older people are in the same risk category for diseases like the flu. But it’s not so with COVID-19: About 70% of US deaths have been people 70 and older. Children, meanwhile, represent less than 2% of confirmed coronavirus infections in China, Spain, Korea, Italy, and the US.
It’s not clear yet whether kids are less likely to contract the virus in the first place, or whether many of their cases are simply being missed because they are often mild or asymptomatic.
Out of more than 2,500 pediatric cases in the CDC study, only three patients died. The study concluded that “most COVID-19 cases in children are not severe.”
One reason for this could be that children have less mature ACE2 receptors — the enzymes that serve as ports of entry for the coronavirus — which could make it more difficult for the virus to infect a child’s cells.
Why it matters: Understanding why kids don’t often show signs of the disease — either because they’re not as prone to infection or because they more often experience very mild, cold-like symptoms — could have huge ramifications for vaccine development and understanding how the disease spreads.
Can you get reinfected?
The body almost certainly develops short-term immunity in the form of antibodies, and immune-system researchers are reasonably confident that the body will recognize and fight the coronavirus in the future.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told the “Daily Show” host Trevor Noah in March that he’d be “willing to bet anything that people who recover are really protected against reinfection.”
There have been a small number of cases in which people tested positive for the coronavirus, were later found to be free of the virus, then tested positive again after that. But these cases are mostly the result of false positives and misinterpretations of test results, since some diagnostic tests can detect leftover pieces of dead virus in the body.
Still, no one is certain about the prospects for long-term immunity. For other coronaviruses like SARS and MERS, antibodies seemed to peak within months of an infection and last for a year or more. But a June study found that SARS-CoV-2 antibodies may only last two to three months after infection. Asymptomatic individuals also demonstrated a weaker immune response to the virus, meaning they could be less likely to test positive for antibodies.
Researchers also don’t know the specific levels of antibodies required for a person to be fully immune.
A May study from Mount Sinai Hospital in New York showed that most people with confirmed coronavirus cases tested positive for antibodies — but longer or more severe cases didn’t necessarily produce more antibodies than mild ones. Instead, the amount of antibodies a person produces may be related to innate differences in people’s immune responses.
Why it matters: Understanding whether long-term immunity is the norm would have major ramifications for controlling the pandemic and could enable officials to lift social-distancing restrictions for people who have already gotten sick.
How seasonal is the coronavirus?
Warmer temperatures and lower humidity may hinder the virus’ spread, according to research published in June. That could explain why New York City had a higher growth rate of new infections compared to Singapore in March, though other factors like testing and contact tracing likely played a role as well.
An April study found a similar link between the virus’ lifespan and the surrounding temperature. At 4 degrees Celsius (39 degrees Fahrenheit), the coronavirus lasted up to two weeks in a test tube. When the temperature was turned up to 37 degrees Celsius (99 degrees Fahrenheit), that lifespan dropped to one day.
But warmer temperatures haven’t done much to quell the US outbreak. The nation’s surge in new daily cases has surpassed its prior peak in April.
Why it matters: Knowing how much — if at all — the coronavirus is affected by changing seasons would help governments around the world better deploy resources to stop its spread.
Are there any safe and effective drugs to treat COVID-19?
There is, as of yet, no slam-dunk treatment for the coronavirus or its symptoms. However, 17 leading treatments are being tested.
Clinical trials have also shown that dexamethasone, a common, cheap, steroid, can reduce deaths in severely ill COVID-19 patients.
Why it matters: Having tools to slow infections or perhaps even stop the coronavirus from harming people could curtail its spread, reduce suffering, ease the burdens on healthcare systems, and save lives.
Will there be a vaccine for the coronavirus, and when?
Arguably the most promising vaccine is a messenger RNA (mRNA) vaccine developed by biotech company Moderna. The company was the first to publish early results in humans after starting its first trial on March 16. It aims to start a late-stage efficacy trial with 30,000 people in July.
Other promising candidates include “vector vaccines” — which use live viruses to teach the immune system how to fight off pathogens — developed by the University of Oxford and Johnson Johnson. The Oxford vaccine is spearheaded by British pharma company AstraZeneca, which will start its own efficacy trial in August. Johnson Johnson aims to enroll more than 1,000 healthy volunteers in a clinical trial in July.
The US government hopes to have hundreds of millions doses of a vaccine ready by January 2021 — a record timeline. But some vaccinologists and industry analysts doubt a vaccine will be ready before 2022 or 2023.
Why it matters: Developing a vaccine would help the world put an end to the pandemic.
What are the long-term consequences for those who survive COVID-19?
It’s not yet clear what the long-term consequences of weathering a severe bout of COVID-19 might be. In severe cases, the virus may cause permanent damage to the lungs and other organs, resulting in chronic, lifelong issues.
Patients who experience blood clots also face a risk of longer-term damage, pain, and loss of function, especially in organs.
While some people’s symptoms seem to clear up after two weeks, even those with milder cases have reported symptoms lasting for several months — including fatigue, chest pain, difficulty breathing, and loss of taste and smell. These symptoms may be the result of lingering inflammation rather than an active infection.
“The symptoms are probably coming from an immune reaction,” Dr. Ramzi Asfour, an infectious-disease doctor in the San Francisco Bay Area, told Business Insider.
“You have to separate the damage from the disease,” he added. “It’s going to be difficult to tell for now what subset is active, ongoing infection and what subset is really just pure immune dysfunction.”
Why it matters: Knowing the extent of lasting damage due to the coronavirus can help governments prepare for long-term strain on healthcare systems, impacts to the workforce, and slower economic recoveries. Governments can also push for more research into the underlying causes of lingering symptoms and effective treatments for them.
It is hard to build the kind of muscle that gets noticed on the street, in the office, or, hell, by your partner. It takes intention, planning, and hard work. The best functional strength training programs, after all, tend to not have an effect for weeks. If you’re looking for something more specific — and difficult — like getting big arms — you’re going to have to plan that much further in advance.
But what if you just need to build muscle fast? Whether it’s to look good for your college roommate’s BBQ pool party in a few weeks or just trying to jumpstart your strength training, there are a few tips and tricks to expedite the process. We’re not saying you’ll be looking super fit come next Saturday’s party or that you’ll be moving weights like your gym rats friend, but, hey, it’s a start.
1. Eat more, not less
It seems counterintuitive, but if you’re looking to build muscle, you need to slightly overfeed your body. Not only does your body need extra calories to build new muscle, but muscle burns more calories than fat so you have to reload on energy in order to support new muscle growth. Restricting calories to lose weight will backfire big time, since your body senses “starvation mode” and respond but shutting down the production of new muscle cells.
You’ve probably heard that the amount of weight you use is the critical component to whether or not your build muscle. But actually, increasing your number of reps is equally essential for muscle growth. Switch up your lifting routine so that you spend at least one day a week lifting 50 to 75 percent of your one rep max, for 15-20 reps per set, aiming for about 6 sets.
3. Eat more protein
Protein is the more important building block for new muscles, so make sure you’re getting enough in your diet. According to the American College for Sports Medicine, if you’re looking to build muscle mass, aim for .5 to .8 grams of protein per pound of body weight, or about 95 to 148 grams of protein daily for a 185-pound guy.
Known as the progressive overload principle, the fastest way to build more muscle is to force it to adapt to a stimulus above and beyond anything you’ve yet done. That means if you had been using 25-pound dumbbells for curls, you should try doing one set with 30 pounds, then progress to 35-pound weights.
5. Get your 7 to 9
The National Sleep Foundation recommends 7 to 9 hours of sleep every night for optimal health. Achieving the prescribed dose of nightly sleep plays a key role in expediting muscle development. During sleep, muscle fibers that have been mildly damaged from a tough workout (not a bad thing, that’s how growth occurs) have a chance to repair themselves, knitting back together in a tighter formation that translates to muscle strength. If you cut your zzz’s short, you’re also shortening the amount of time your muscles have to grow.
6. Slow it down
The process of building new muscle, also known as hypertrophy, benefits from placing muscles under duress for an extended period of time. For this reason, rather than pumping iron as fiercely and frantically as you can, you should do at least one set of every strength-training exercise at slo-mo speed. And, yes, it burns.
While isolation moves like biceps curls are great for honing in on one specific muscle, you’ll get the biggest bang for your strength-training buck with moves that recruit multiple muscle groups at once. That’s because the more mass you can put behind a move like squats, pullups or deadlifts, the greater the load your body can bear, and the stronger you can make your muscles.
8. Mix it up
Just like you need to test your muscles using progressive overload, you also need to surprise them by serving up new types of exercises every week. Your muscles, it turns out, are pretty smart. They very quickly adapt to whatever exercise you’re doing, so the next time you do it, it feels easier — because it is. Rather than fall into the same sequence of moves week after week, seek out new ones that are different enough that they stress slightly different parts of your body.
This article originally appeared on Fatherly. Follow @FatherlyHQ on Twitter.
Growing up, learning about World War I usually involved learning about three things: trench foot, poison gas, and bloody stalemate. Right before the history teacher moves on to World War II, we learn the old mnemonic device — on the 11th hour of the 11th day of the 11th month of 1918, ‘The War to End All Wars’ ended with an armistice.
Then, there was one kickass, worldwide party.
Obviously, glossing over one of the deadliest, most expensive, and most avoidable wars in American history does the Doughboys of the American Expeditionary Force an injustice. We need to remember that World War I was more than just a prelude to World War II. The horrors of WWI led to the annual recognition of those the who had to fight it. The day The Great War ended came to be remembered thereafter as Armistice Day.
But, when the 11th day of the 11 month rolls around, we all celebrate Veterans Day. What happened?
This is what Armistice Day 1938 looked like in Omaha, Nebraska.
The first public celebration of Armistice Day came in November, 1920. Much like how we celebrate Veterans Day today, the occasion was marked by speeches, parades, and exchange of drinks and stories between veterans of the war. The exception came when that 11th hour rolled around. For a moment, there was a pause in all activities across the country.
In that moment, mere years ago, millions of armed men stopped butchering each other over control of several yards of No Man’s Land.
In 1926, Congress made Armistice Day official, resolving that the “recurring anniversary of November 11, 1918, should be commemorated with thanksgiving and prayer and exercises designed to perpetuate peace between nations.” In 1938, Armistice Day became a Federal Holiday.
As we all know, the “War to End All Wars” didn’t actually end all wars — or any wars. It actually led very directly to the next war, World War II. Which led to the next war, the Korean War, which was part of a greater war, the Cold War. You get the point. By the time the Korean War ended, there was a whole new generation of war veterans who felt deserving of recognition for a job well done.
Veterans of those war lobbied Congress to change Armistice Day to Veterans Day in 1954, in order to honor veterans of every war. Congress agreed and President Eisenhower signed on to it, too.
Gerald Ford, the voice of reason.
In 1968, Congress acted again. This time, they wanted to give federal employees a couple of three-day weekends throughout the year, so they changed the dates of some major holidays to fall on certain Mondays. Columbus Day, Memorial Day, and Washington’s Birthday were all given Mondays. And Veterans Day was moved from the historic date of November 11 to “the fourth Monday in October.”
The states rightly thought that was a stupid idea and refused to recognize the movement of Veterans Day until President Ford changed it back in 1975.
Veterans Day is currently celebrated nationally on November 11, as it has been for decades. When the day was originally changed to Veterans Day in 1954, it was just in time for then-104-year old Albert Woolson, the last surviving veteran of the Civil War, to celebrate it. With him were two veterans of the Plains Wars, veterans of the Spanish-American War, and vets from the Philippines War.
States, local municipalities, and other governments have declared their own Veterans Days, some dating as far back as the end of World War II, recognizing the courage and sacrifices of every U.S. citizen who answered the country’s call to arms.
At least one US special forces soldier was killed and four US service members were wounded after an enemy attack in Jubaland, Somalia, according to a statement from US Africa Command (AFRICOM).
One US service member reportedly received sufficient medical care at the scene and three others were transported out of the area to receive treatment.
A coalition comprised of around 800 US, Somalian, and Kenyan forces came under attack by mortar and small-arms fire at around 2:45 p.m. local time, AFRICOM said. One coalition service member was wounded.
The coalition forces were conducting a “multi-day operation” to clear al-Shabaab — an Islamist militant group — from villages and establish a “permanent combat outpost” around 217 miles southwest of Mogadishu.
The role of US troops during the operation was to provide aerial surveillance and to provide other assistance to the coalition group. The US’s role in AFRICOM’s area of responsibility has come under heavy scrutiny following an October 2017 ambush in Niger that left four soldiers dead.
According to a military source, the slain Green Beret provided intelligence during a mission to build a joint base for Somali forces, The Daily Beast reported.
President Donald Trump offered his condolences following the announcement: “My thoughts and prayers are with the families of our serviceman who was killed and his fellow servicemen who were wounded in [Somalia],” Trump said in a tweet. “They are truly all HEROES.”
On June 11, 2018, the US military said it killed 49 members of al-Shabaab in three separate airstrike over a period of 12 days. The US said no civilians were killed during the strikes.
This article originally appeared on Business Insider. Follow @BusinessInsider on Twitter.
The maintenance team from the Army’s 2nd Battalion, 501st Aviation Regiment has been working nonstop in Puerto Rico since they flew in from Fort Bliss, Texas, Oct. 9. The crew maintains six CH-47 Chinook helicopters that deliver humanitarian supplies daily to some of the hardest-hit and most remote areas of Puerto Rico following Hurricanes Irma and Maria.
Soldiers need to do 90 percent of the maintenance work at night to allow full usage of the helicopters during the day for essential humanitarian missions, said Army Lt. Col Chris Chung, the battalion commander.
“At first, night shift was running from 3 p.m. to 1 a.m., sometimes 2 or 3 a.m.,” said Army Sgt. Jason Gonsalves, a CH-47 helicopter repairer. “We were working long days, only stopping to take a break for thirty minutes.”
When the unit arrived, the maintenance team had to reassemble the Chinooks, which they had only recently disassembled to fit on C-5 Galaxy transport aircraft for the trip from Texas, Gonsalves said.
In order for two Chinook helicopters to fit aboard a C-5, their rotor systems and housings must be detached and disassembled.
The maintainers had the helicopters back together and ready to fly within 48 hours, said Army Pfc. Zachariah Ingram, a CH-47 helicopter repairer.
In addition to regularly scheduled maintenance, the crew has to be vigilant for other problems that come with the operating environment. For example, the salt air and humidity inherent with operating in tropical environments can lead to corrosion, Gonsalves said.
When not working on the helicopters, the maintainers volunteer to help with the humanitarian airlift.
“I’ve gone on a flight to help pass out supplies and talk to the populace,” said Army Spc. Juan Betancourt, a CH-47 maintainer.
Betancourt, a native Spanish speaker, uses his skills to help other soldiers communicate with the island’s residents.
“There was a younger girl, maybe 12 or 13, who came up and gave me a hug and said ‘Thank you,'” Betancourt said. “It was heartwarming.”
The work of the maintenance crews has not gone unnoticed.
“Our maintainers have done a phenomenal job keeping the Chinooks … up and running at the mission-capable status that we need to continue to achieve missions that are requested of us and to be on standby for those that are not,” Chung said. “It’s not a small task and it’s not a small feat.”
The hero has been the most popular archetype of human-storytelling for as long as stories have been told. From the Epic of Gilgamesh to the Odyssey to comic books to the epic film franchises that bring in billions of dollars in revenue, superhero stories are here to stay.
Superheroes all have origin stories, which tell how they gained their powers and chose to fight against evil.
But some heroes felt the call to serve before being recruited by special agencies — some even before having heightened abilities.
Get ready because this is your SPOILER WARNING: we’ll be discussing plots from comics and films — both released and upcoming — from the DC and Marvel universes.
“You might remember that ‘annoyed’ is my natural state.”
10. Logan aka James Howlett (Wolverine)
Wolverine’s mutations — accelerated healing powers and longevity; heightened senses, speed, and stamina; and retractable bone claws which were later plated with nearly indestructible adamantium — render him a powerful fighting machine.
According to the film, X-Men Origins: Wolverine, Logan was born in the 1800s. He fled his childhood home and fought as a soldier in the American Civil War, both World Wars, and the Vietnam War. That’s a century of combat, by the way.
When he was discovered by Maj. William Stryker — a military scientist biased against mutants and intent on destroying them — Wolverine’s military career came to an end, leading him on a path towards the X-Men.
In the comics, Wolverine has many storylines, including a journey to hell, but we’ll stick with the cinematic telling of his life. He can never fully escape his painful past, and even when he’s fighting for the good guys, he’s got a bad attitude. He’s like the Senior NCO who doesn’t have any more f*cks to give but is so great at his job that everyone just lets him do his thing.
Nonetheless, his moral compass remains true until the end.
“I’m more of a soldier than a spy.”
9. Sam Wilson (Falcon)
Sam Wilson is a former Air Force Pararescue Jumper, which made him a great candidate for the superhero with a tendency to jump into the middle of a combat situation to ice evildoers and save lives.
Wilson is important for many reasons. Created in 1969 by Stan Lee and artist Gene Colan, he was the first African-American superhero in mainstream comics, making his mark on the civil rights movement of the 60s.
In the comics, Wilson has a telepathic link to his bird, Redwing, which allows him to see through the bird’s eyes. He’s also skilled in hand-to-hand combat and operating the Falcon Flight Harness.
In the Marvel Cinematic Universe, the powers are gone, but the harness remains. It was actually a secret military asset, which Wilson somehow stole… and, somehow, there were never consequences levied by the U.S. government for that, but okay…
Most importantly, Wilson counsels veterans with post-traumatic stress issues, embodying the ideal of service after service and the value of supporting our fellow brothers- and sisters-in-arms.
“But being the best you can be…that’s doable. That’s possible for anybody if they put their mind to it.”
8. Carol Danvers (Captain Marvel)
Major Carol Danvers is a trained military intelligence officer and erstwhile spy. She’s one of the most distinguished officers in the superhero universe and a graduate of the Air Force Academy, where Nick Fury recruited her for the CIA.
In the comics, she retired from the Air Force as a Colonel to be Chief of Security at NASA before becoming half-Kree (a militaristic, alien race in the Marvel Universe). She became Captain Marvel after meeting a Kree alien named Mar-Vell, but she acquired superpowers after an explosion merged her DNA with the first Captain Marvel… well, it’s complicated.
Danvers is an author and feminist and her powers include flight, enhanced strength and durability, shooting energy bursts from her hands, and being able to verbally judo one Tony Stark.
“The future of air combat… is it manned or unmanned? I’ll tell you, in my experience, no unmanned aerial vehicle will ever trump a pilot’s instinct.”
7. James Rhodes (War Machine)
There’s a bit of a discrepancy here. In the Marvel Cinematic Universe, James Rhodes is an airman. In the comic books, he’s always been a Marine. If I told you that a hero was named “War Machine” and had little understanding of ammo consumption, would you think he was an airman or a Marine?
Screw it — let’s dive into both!
First, the comics: A former pilot in the Marine Corps, Rhodes met Tony Stark aka Iron Man while he was still deployed in Vietnam. Rhodes was shot down behind enemy lines when he encountered Stark in the prototype Iron Man suit. The two teamed up and became best friends. Rhodes conducts himself according to military honor codes, which often contrasts with Tony Stark’s relativistic heroism, and even assumes the mantle of Iron Man when Stark struggles with alcohol addiction.
In the MCU, Rhodes becomes War Machine and struggles to balance his loyalty to the Avengers with the legal obligations of the military and the Sokovia Accords. This tension eventually earns him a court-martial, when he’s forced to disobey the Accords to help Captain America travel to Wakanda.
But hey, is a military infraction even that big a deal when half of the universe is being wiped out?
“Three minutes and twenty seconds, really? If you were my agents, it wouldn’t be for long.”
6. Maria Hill
Maria Hill commissioned in the Marine Corps before joining S.H.I.E.L.D. She quickly rose through its ranks and was appointed Deputy Director under Nick Fury. She possesses normal human strength, which makes her participation in supernatural phenomenon even more impressive.
As a S.H.I.E.L.D. agent, she is experienced in espionage, hand-to-hand combat, weapons expertise, and tactical vehicle operation.
In the comics, Hill served under Fury until after Marvel’s Civil War, when she assassinated Captain America. But that’s okay because she was only evil because she was controlled by Red Skull — and no one stays dead in comics anyway (except Uncle Ben).
In the MCU, Hill provides intel and support for the Avengers and remains the one person Nick Fury can trust.
“Daddy needs to express some rage.”
5. Wade Wilson (Deadpool)
Deadpool is the guy in your unit that just won’t take anything seriously. That’s true for his character, both in the comics and on-screen, but it’s also true for the actual creators of Deadpool, who break convention in more ways than one. For example, he knows that he is a fictional character and he commonly breaks the fourth wall. Most antiheroes are dark and tortured, and Deadpool certainly is that… but he’s also… just… uncouth and rather undignified, which is what makes him so unique.
His origins are rather vague and are subject to change. Stories have been retconned, conveniently forgotten, or just ignored (like what we’re going to do with Deadpool’s appearance in X-Men Origins: Wolverine…). Nonetheless, there seems to be a consensus that Wade Wilson (if that’s even his name) served in the U.S. Army Special Forces before he was dishonorably discharged.
In the film, he is diagnosed with terminal cancer and undergoes an experiment where he is injected with a serum meant to activate his mutant genes. After prolonged stress and torture, the experiment works. Cancer continues to consume his body, but his superhuman healing allows him to cure it simultaneously, leaving him disfigured, but unkillable.
He becomes a mercenary who continues to fight the chaotic-good fight.
“I’m all out of wiseass answers.”
4. Jonah Hex
Though he initially joined the United States Army as a cavalry scout, Jonah Hex‘s story really began during the Civil War. As a southerner, he fought for the Confederacy, but he found himself increasingly uncomfortable with slavery. Unwilling to betray his fellow soldiers, but loathe to fight for the South, Hex surrendered himself to the Union.
Tried for treason and exiled to the wild west, Hex would later be branded with the mark of the demon and be forced to walk the land as a supernatural bounty hunter. At some point, he’d also travel time (because comic logic) and fight alongside other superheroes.
He also fought alongside Yosemite Sam. Yeah, the Looney Toons’ Yosemite Sam.
Hex didn’t have supernatural abilities, but he was an outstanding marksman, a quick draw, and an expert fighter in the wild west.
“I still believe in heroes.”
3. Nick Fury
As with many comic book heroes, whose stories continue for decades, Nick Fury has a sliding history that keeps him current in conflicts. His first appearance was in Sgt. Fury and his Howling Commandos #1, which took place during World War II.
Fury served as a colonel during the Cold War before becoming the director for S.H.I.E.L.D. (then known as “Supreme Headquarters International Espionage Law-enforcement Division”). His skills and experience with espionage were put to use against the Soviet Union and primed him for his position at S.H.I.E.L.D. and the Avengers Initiative.
From leading his Howling Commandos to becoming the Director of S.H.I.E.L.D. to transforming into the silent observer of Earth, Nick Fury has done it all without any actual abilities — and with only one eye. He obtained the Infinity Formula, which kept him from aging, but it was his mind and skill on the battlefield that allowed him to take down nearly every superhero in the Marvel universe.
“I can do this all day.”
2. Steve Rogers (Captain America)
Steve Rogers is the ultimate example of patriotism, bravery, and sense of duty. In fact, that’s why he was chosen for the Super Soldier Serum project in the first place.
During World War II, Rogers made multiple attempts to enlist, but failed to meet the physical requirements. But his tenacity caught the eye of a scientist who recognized that Rogers’ attitude made him the perfect Project Rebirth candidate.
Rogers began his career doing propaganda to support the war effort, but he would eventually be unleashed in Europe in the fight against the Nazi faction, HYDRA.
His military service ended when he sacrificed himself to save the United States from a HYDRA-coordinated WMD attack. He was suspended in ice until he was revived by S.H.I.E.L.D. in the modern day.
Rogers later joined the Avengers, but his sense of duty and his compulsion to act in the face of injustice — no matter what the laws are — pitted him against other Avengers after creation of the Sokovia Accords, which established U.N. oversight of the team.
“If you want peace, prepare for war.”
1. Frank Castle (Punisher)
The Punisher is a psychologically troubled antihero, which makes his story both unsettling and, in many ways, very familiar for combat-veterans. He is a vigilante who fights crime by any means necessary, no matter how brutal those means might be.
Frank Castle joined the Marines after dropping out of Priest school when he was asked if he could ever forgive a murderer. Because of Marvel’s sliding timeline, through which they avoid putting firm dates on characters, Castle’s story changes every now and then to reflect modern, real-world events.
Hands down, the most “Marine” story in The Punisher canon goes to Punisher: Born. Set in Vietnam, it is essentially the origin story of how Castle goes from being the gun-slinging badass that Marines think they are to actually being the gun-slinging badass Marines know they are.
Fan theories speculate the narrator of the story is actually Ares, the Greek God of War, who makes an unsuspecting Castle his avatar.
Editor’s Note: Parts of this article have appeared previously on We Are The Mighty.
Jeff “Skunk” Baxter has earned eight platinum records in a music career that started in the 1960s, and he has received numerous security clearances and contracting jobs since the 1980s as a self-taught expert on missile-defense and counterterrorism.
Baxter was one of many luminaries at the White House on Oct. 11, 2018, to watch President Donald Trump sign the Music Modernization Act, which reforms copyright laws.
Baxter dropped out of college in Boston in 1969 to join a short-lived psychedelic-rock band. After that, he moved to California and become one of the original six members of Steely Dan, which he left in 1974 to join the Doobie Brothers, which he left in 1979.
Baxter has said he “fell into his second profession almost by accident.”
While living in California in the 1970s, Baxter helped a neighbor dig out their house after a mudslide.
“Afterward, he invited me into his study and I saw all these pictures of airplanes and missiles on the wall — it turned out he was one of the guys who had invented the Sidewinder missile,” Baxter said in a 2013 interview. “As a gift for helping him clean out his house he gave me a subscription to Aviation Week and to Jane’s Defense. It was amazing.”
Baxter found the technical aspects of music and of defense, particularly missile defense, coincided.
“Technology is really neutral. It’s just a question of application,” he told MTV in 2001. “For instance, if TRW came up with a new data compression algorithms for their spy satellites, I could use that same information and apply it for a musical instrument or a hard disc recording unit. So it was just a natural progression.”
He immersed himself in technical journals and defense publications during the 1980s.
“The good news is that I live in America and am something of a, I guess the term is an “autodidact,” he said in 2013, when asked about his formal education. “There’s so much information available. The opportunity for self-education in this country is enormous.”
The big shift came in 1994.
Inspired by a friend’s work on an op-ed about NATO, Baxter sat down and punched out a five-page paper on the Aegis ship-based antiaircraft missile system, arguing it could be converted to a missile-defense system.
“One day, I don’t know what happened. I sat down at my Tandy 200 and wrote this paper about how to convert the Aegis weapon system,” he said in a 2016 speech. “I have no idea. I just did it.”
Baxter, who had recently retired as a reserve police officer in Los Angeles, was already in touch with California Republican Rep. Dana Rohrabacher as an adviser. Baxter gave his paper to Rohrabacher.
“Skunk really blew my mind with that report,” Rohrabacher told The Wall Street Journal in 2005. “He was talking over my head half the time, and the fact that he was a rock star who had basically learned it all on his own was mind-boggling.”
Rohrabacher gave the paper to Pennsylvania Rep. Curt Weldon, a Republican and member of the House Armed Services Committee, who asked, “Is this guy from Raytheon or Boeing?” according to Baxter.
Rohrabacher replied, “No, he’s a guitar player for the Doobie Brothers.”
Like Rohrabacher, Weldon was struck by Baxter’s prowess. In 1995, he nominated Baxter to chair the Civilian Advisory Board for Ballistic Missile Defense, a congressional panel.
Arleigh Burke-class guided-missile destroyer USS Hopper, equipped with the Aegis integrated weapons system, launches a missile during an exercise in the Pacific Ocean, July 30, 2009.
(Department of Defense Photo)
“The next thing I knew, I was up to my teeth in national security, mostly in missile defense, but because the pointy end of the missile sometimes is not just nuclear, but chemical, biological or volumetric, I got involved in the terrorism side of things,” Baxter told MTV in 2001.
The appointment to the panel “sort of opened up a door for me to end up working in the Strategic Defense Initiative Organization (SDIO), which then morphed into the Ballistic Missile Defense Organization (BMDO), which then morphed into the Missile Defense Agency (MDA),” Baxter said in 2013.
He’s also worked with the National Geospatial Intelligence Agency and contractors like Northrup Grumman.
“We did some pretty cool stuff,” Baxter said in 2016 of his work on SDI, which President Ronald Reagan first proposed in 1983. “Reagan’s plan was a bit much. It was a plan to drive the Russians nuts, and it worked. They believed what we were doing was real and spent lots of money trying to counter it.”
He was also a hit at the Pentagon.
“Some of these people who are generals now were listening to my music when they were lieutenant colonels or lieutenant commanders, so there was a bond there,” Baxter said in 2001. “But what they realized is that they’re looking for people who think out of the box, who approach a problem with a very different point of view because we’re talking about asymmetrical warfare here.”
Military leaders brought him in to consult, regularly asking him to play the role of the enemy during war games.
“I’m told I make a very good bad guy,” Baxter said in 2005. People who worked with him also told The Journal he could be a self-promoter.
Baxter has kept up his musical work. He became a sought-after session guitarist, working with acts like Dolly Parton, Rod Stewart, and Eric Clapton.
In 2004 he flew 230,000 miles to reach all his gigs. That year he also made more money from his defense work than from music.
For his part, Baxter has pointed to his creativity as his biggest asset.
“We thought turntables were for playing records until rappers began to use them as instruments, and we thought airplanes were for carrying passengers until terrorists realized they could be used as missiles,” he said in 2005.
“My big thing is to look at existing technologies and try to see other ways they can be used, which happens in music all the time and happens to be what terrorists are incredibly good at.”
This article originally appeared on Business Insider. Follow @BusinessInsider on Twitter.
The cheerleaders looked less than thrilled to see a likeness of Kim before them. The squad is hand-picked for meeting stringent physical requirements, they are unpaid and train for months at a time, and have been imprisoned in the past for talking about the world they see outside of North Korea.
To get a feel for the pictures, check out Star.OhMyNews.com, which first reported the incident. Anna Fifield, Tokyo bureau chief for The Washington Post, also tweeted an image of the incident:
It’s not very often we Americans want to cheer for the Internal Revenue Service. This is the organization that takes a significant chunk of our paychecks every week, after all. But trust me, by the end of this, you’re going to give this particular law enforcement agency its due. So while they irk us for the money it takes, the IRS also busts tax cheats and will reach out to taxpayers to inform them bout how to pay and pay the right way.
Oh, and they helped bring down one of the largest child pornography websites ever, netting hundreds of pedophiles worldwide, people who thought they’d never get caught. It became an international, inter-agency success story.
It’s a well-known fact that almost anything, no matter how illicit, is available on the dark web, a section of the Internet that isn’t indexed by search engines and is protected by layers and layers of encryption that can only be accessed using Tor, a special browser. An estimated 57 percent of dark web activities are illegal in nature, including the sale of stolen bank accounts, drugs, and child pornography. Because of the anonymity of the dark web, blockchain technology, and the bitcoin used to purchase much of these items, predators, hackers, and drug dealers think it’s a reasonably safe marketplace. Now the IRS can tick off its first score against these illicit practices.
An informant revealed the existence of a child pornography website to federal agents, one that appeared because other sites were shut down by authorities. This site, called “Welcome to Video,” accepted bitcoin as payment, a further way to guarantee the users’ anonymity. But the IRS doesn’t normally cover this ground. So they turned to Homeland Security for help in following the money.
The investigators weren’t able to trace the source of the server hosting the imagery, but through a defect in the website, they were able to trace individual elements of the site. Meanwhile, IRS agents sent bitcoin to addresses associated with the Welcome to Video site. The addresses, they found, were going to addresses given to them by a criminal informant. The feds were able to trace the blockchain ledgers of bitcoin transactions within Tor, a supposedly anonymous browser. Then they divided their resources, one would find the users of the site, and another would find its host.
Federal agents copied one of the confirmed users’ mobile phones and laptops when it was confiscated at an international airport. From there, they traced its bitcoin transactions to South Korea and the United States. They confirmed payments to the Welcome to Video site but also found the website operator’s bitcoin transactions. That’s when they hit the jackpot – the operator of the website opened his U.S. exchange account with a selfie – holding his South Korean passport.
Authorities in Seoul raided the home of a 22-year-old living with his parents, who hosted a “mammoth” child porn site. They took down the site but didn’t alert its users. They were next. Instead, they uploaded a page in broken English about updates being made to the site.
Now that they had the server, authorities in the U.S., South Korea, and London had access to all of “Welcome to Video’s” users. This information led to the arrest of some 300 people in 12 countries – including DHS Agents and other Americans in Georgia, Texas, and Kansas. The Wall Street Journal reports that as a result of the server’s seizure, 23 minors were rescued, all being held and abused by users of the website.
Most of the arrested individuals have since pled guilty or are already serving time. One of the alleged users jumped from his balcony, killing himself.
For the whole story and more details about the amazing work of the IRS, check out the full story in the Wall Street Journal… and try to remember this on April 15th.
Erwin Rommel entered France in 1940 in command of a panzer division, moving around the Maginot Line with the bulk of German attackers and slamming into the French defenses from behind. He would go on to lead troops in North Africa as Hitler’s favored general.
But the bloom was off the rose in 1944 when Hitler made Rommel kill himself.
Field Marshal Erwin Rommel and senior officers in France.
(German Bundesarchiv Bild)
The Desert Fox made his legend in France, and then fought in the African desert in 1941. His troops there loved him, and he fought tooth and nail to hold the oil fields and ports in that part of the world. With limited numbers and supplies, he bloodied the nose of British forces and their French and American allies over and over again.
The British tried to kidnap him. They tried to kill him. But mostly, they tried to beat him. And, eventually, with the crushing weight of American armor at their back, they did.
Rommel evacuated north with his surviving forces, and he was put in command of the Atlantic Wall, the bulwark of Fortress Europe. He was brilliant in the role, predicting that the Allies would try to land somewhere other than a deepwater port, and suspecting portions of Normandy beaches in particular. He pushed his men to build defenses, and he pushed the government to send him more supplies.
Field Marshal Erwin Rommel and his staff in North Africa.
(German Bundesarchiv Bild)
But all the while, from North Africa to the Atlantic Coast, he was lamenting the clear resource advantage that America had given the Allies. He worried that the war was lost and that further fighting would just cost German blood and weaken its place at the bargaining table.
In 1943, while preparing those defenses in Normandy, he began to see signs that the anti-war movement was right, that Germany was conducting heinous acts besides just prosecuting the war. He could stomach battles, but he was unsettled when he ran into evidence of the rumored death camps, especially when was given an apartment that had, until that very morning, been the property of a Jewish family.
And so he whispered more and more about how Hitler wasn’t to be trusted, about how the war was bad for Germany, and about how the Third Reich couldn’t possibly survive what was coming. When the Allies hit the beaches in June 1944, Rommel’s pessimism became too much to bear.
Field Marshal Erwin Rommel’s command tank in World War II.
(German Bundesarchiv Bild)
And so, when an attempt to assassinate Hitler in July 1944 failed, it didn’t matter that there was no strong evidence linking him to the plot. The perpetrators had all been senior military officers, so it was easy to pin a little blame on Rommel, especially since both his chief of staff and his commanding officer were implicated and executed.
Rommel was popular, though. So, he couldn’t just be dragged out back and shot like many of the Valkyrie plotters. Instead, Third Reich officers were sent to Rommel’s home on October 14, 1944. He was there, healing from wounds sustained in a July 17 attack by a British aircraft.
‘At twelve o’clock to-day two Generals are coming to discuss my future employment,’ my father started the conversation. ‘So today will decide what is planned for me; whether a People’s Court or a new command in the East.’
Field Marshal Erwin Rommel
(German Bundesarchiv Bild)
Despite Rommel’s worries about Germany’s aggression, he believed that a Soviet conquest of Europe would be devastating for all the rest of Europe, worse than any outcome under Germany. And so he told his son that he would take a command in the Eastern Front, if it was offered.
But that was not what the officers were coming to offer him. And they were not going to put him in front of the People’s Courts either. Instead, after Rommel met with the men for a short time, he went upstairs, and Manfred Rommel, his 15-year-old son, followed him upstairs.
‘I have just had to tell your mother,’ he began slowly, ‘that I shall be dead in a quarter of an hour.’ He was calm as he continued: ‘To die by the hand of one’s own people is hard. But the house is surrounded and Hitler is charging me with high treason. ‘ “In view of my services in Africa,” ‘ he quoted sarcastically, ‘I am to have the chance of dying by poison. The two generals have brought it with them. It’s fatal in three seconds. If I accept, none of the usual steps will be taken against my family, that is against you. They will also leave my staff alone.’
And so that was the deal that Rommel accepted. His family would be made safe. His staff would be made safe. But he would have to drink a fast-acting poison. Manfred briefly pitched the idea of fighting free, but his father was certain they lacked the numbers or ammunition to be successful.
So Rommel left. He carried his field marshal’s baton to the car, shook the hands of his son and his aide, and got in the car of the two generals. They drove a few hundred yards into an open space in the woods and Rommel drank.
He was given a state funeral just four days later. Hitler would follow him into death the following May. But where Rommel committed suicide to save his family, Hitler did it to escape judgment for that and thousand of other actions.
Claims piled up at the VA Regional Office in Winston-Salem, N.C.
A $16 billion effort to give veterans lifetime electronic health records that meshed with the Pentagon’s has been marked by repeated delays and oversight failures that could have put patients at risk, according to reports from the VA Inspector General.
The IG reports released Monday detailed confusion in the overall implementation of the plan and failures to train staff and put in place adequate equipment for the pilot program, such as new laptops.
The first IG report, titled “Deficiencies in Infrastructure Readiness for Deploying VA’s New Electronic Health Record [EHR] System,” looked at how the Department of Veterans Affairs went about implementing the initial billion, 10-year contract with Cerner Corp. of Kansas.
The VA now estimates that the contract, awarded in May 2018 by then-Acting VA Secretary Robert Wilkie without competitive bidding, will now cost at least another billion for management and equipment.
The second report focused on delays and failures in the pilot program, even after it was scaled back from three test sites to one at the Mann-Grandstaff VA Medical Center (VAMC) in Spokane, Washington.
One of the main findings of the second report was that patient safety at the Spokane facility could have been put at risk due to poor preparation for the planned switchover to the Cerner system in the pilot program.
The IG’s report found that the VA and the Spokane leadership failed to hire and train adequate staff to handle the transition, and overlooked the impact on how the hospital would continue to function while the inevitable kinks in the system were worked out.
“For example, online prescription refills, the most popular form for refilling prescriptions at the facility, was identified as a capability that would be absent when going live,” the IG’s report said of the pilot program at the Mann-Grandstaff VAMC. “The OIG determined that the multiple work-arounds needed to address the removal of an online prescription refill process presents a patient safety risk.”
In addition, the IG found that the VA’s expanded program to allow veterans to choose community care — made policy by the Mission Act of 2018 — had suffered as the Spokane facility focused on the switchover to EHR.
“The OIG identified that facility leaders addressed recent in-house access to care challenges within primary care, but a significant backlog of 21,155 care in the community consults remained as of January 9, 2020,” the report said.
Outrage on the Hill
In May 2019, VA Secretary Robert Wilkie identified the transition to EHR as one of his top priorities, noting its potential “to change the way our veterans are treated, but also change the way we do business, to make the delivery of our services more efficient, make it more timely.”
In that same month, then-acting Defense Secretary Patrick Shanahan took a beating during a hearing of the House Defense Appropriations Subcommittee when he projected a possible four-year delay in implementing the transition.
“I don’t ever recall being as outraged about an issue than I am about the electronic health record program,” Rep. Kay Granger, R-Texas, told Shanahan.
“For 10 years we’ve heard the same assurances” that the electronic health records problem will be solved, Rep. Hal Rogers, R-Kentucky, said. “It’s incredible that we can’t get this fixed.”
Veterans were suffering “because of bureaucratic crap,” he added.
Over the years, previous attempts to mesh the EHR systems of the VA and DoD have either failed or been abandoned, most recently in 2013 when then-Defense Secretary Leon Panetta and then-VA Secretary Eric Shinseki dropped an integration plan after a four-year effort and about id=”listicle-2645875913″ billion spent.
The goal of the new effort to integrate the records was to overcome the track record of failure by the VA and the DoD to meet a congressional mandate to bring their separate medical records systems in line with one another, ensuring a seamless transition for service members to civilian life.
In its overview of the VA’s latest attempt, the IG report noted that “there are tremendous costs and challenges associated with this effort.”
Under the current plan the VA’s legacy information system — Veterans Information Systems and Technology Architecture (VistA) — would be replaced by Cerner’s commercial off-the-shelf solution called “Millennium.”
The plan was to have VA’s Millenium mesh with DoD’s electronic health record system — Military Health System (MHS) GENESIS — which at its core also consists of Cerner’s Millennium, the IG report said.
The ultimate connection of VA and DoD’s electronic health records “will result in a comprehensive, lifetime health record for service members,” the report said, improving health outcomes by giving providers more complete information.
However, the indefinite hold put on the pilot program in Spokane underlines the huge challenges ahead in implementing the transition as the nation seeks to recover from the coronavirus pandemic, the IG said.
The report found widespread failure in VA’s preparations to start up the new system in Spokane.
“The lack of important upgrades jeopardizes VA’s ability to properly deploy the new electronic health record system and increases risks of delays to the overall schedule,” the report said. “Until modifications are complete, many aspects of the physical infrastructure existing in the telecommunications rooms [such as cabling] and data center do not meet national industry standards or VA’s internal requirements.”
The VA’s response essentially concurred with the findings and recommendations of the IG’s overview and the separate report on the pilot program in Spokane.
In his response, Dr. Richard Stone, executive in charge of the Veterans Health Administration, said that the VA was working to correct the problems with infrastructure and staffing noted by the IG.
“I appreciate the concerns regarding mitigation strategies and capabilities of the new electronic health records [EHR] system,” Stone said.
He said that as the target date was approaching for the launch of the pilot program in Spokane, “Secretary Wilkie received feedback from clinical and technical staff.”
“He decided to postpone the Go-Live so that the system can provide the greatest functionality at Go-Live and VHA staff are confident in providing care with the new system with the least mitigation strategies,” Stone said.