How to get VA health care without all the paperwork - We Are The Mighty
MIGHTY CULTURE

How to get VA health care without all the paperwork

It will soon be easier for you to get VA health care in your community without paperwork.

As of January 2020, you won’t have to provide a signed, written authorization for VA to release your electronic VA health information to a participating community care provider.

VA will automatically begin sharing your health information with participating community care providers using the Veterans Health Information Exchange. The electronic system is secure and safe.

This change will make it easier for your health care team to make better decisions about your health care. It can also help you be safer, especially during emergencies.


No action needed

If you are OK with VA sharing your electronic patient information with your community care provider, you don’t have to do a thing. Your information will be shared automatically.

How to get VA health care without all the paperwork

Form needed to OPT OUT of electronic sharing

However, if you do not want to share your information electronically, you must submit VA Form 10-10164 (Opt Out of Sharing).

There is no September 30 deadline to submit your form 10-10164

You can submit your Form 10-10164 at any time. VA will share your information until you submit your form.

If you submitted Form 10-0484 before September 30, you do NOT need to submit Form 10-10164.

You can return VA Form 10-10164 at any VA Medical Center. Just visit the Release of Information (ROI) office. You can also send it by mail. After VA processes your form, your VA health information will not be shared electronically with community providers you see for treatment.

How to get VA health care without all the paperwork

(Photo by John Schnobrich)

Change your mind? No problem

You change your mind and share your health record with your participating community provider. Just complete and return VA Form 10-10163 (Opt In for Sharing) at any time.

You also can still ask VA to share your information with participating community care providers by fax or mail service.

If you don’t share your information, it will not affect your VA health care or your relationship with your VA health care provider.

Download and print forms here.

This article originally appeared on VAntage Point. Follow @DeptVetAffairs on Twitter.

MIGHTY TACTICAL

Veterans benefit from new portable ultrasound device

Clinicians who are, or becoming, experts in Point of Care Ultrasonography (POCUS) are in awe of a new ultra-portable ultrasound device, the Butterfly IQ.

The Butterfly’s first use in the United States was at VA NY Harbor Healthcare System and at NYU Langone. It is a very lightweight probe that looks like a sleek black electric razor. It plugs into an iPhone.

The user prompts the probe into action and gives it directions with a finger-flick of an app and a tap on individual links that are pre-programmed for screening of the heart, lungs, veins of the legs and other parts of the body.


Squeezing some gel onto the head of the probe, the physician then places the device on a patient’s body in the specific area of concern. For example, it might be placed on the side of the patient’s chest corresponding to the location of the lungs. The interior structure and movement of the lungs then is visualized in real time on the physician’s cell phone screen.

Introducing Butterfly iQ

www.youtube.com

“Most of the time, you can figure out why a patient is having trouble breathing immediately at the bedside without sending the patient for any additional test,” said Dr. Harald Sauthoff.

Dr. Sauthoff considers the Medical Intensive Care Unit (MICU) as his “home”, but he also sees patients on the general medicine wards, where he was using the Butterfly to examine LoRusso, a veteran with lung cancer. Fluid had been drawn and removed the previous day with a needle guided by ultrasound.

Dr. Sauthoff said, “I can still see a lot of fluid around the lung.” The patient was most concerned about not having another tissue biopsy that had been performed some weeks before. Dr. Sauthoff explained that use of the sonogram, unfortunately, might not eliminate the need for another biopsy.

He told the Korean War veteran that taking and testing more fluid might provide enough information to identify and then target the specific type of cancer cells that caused his disease.

Point-of-care ultrasonography (POCUS) is revolutionizing the way physicians examine their patients. Rather than just feeling and listening, physicians can now look into their patients’ bodies often supporting an immediate bedside diagnosis without delay and potentially harmful radiation.

Lightweight, portable, and simple to use, the Butterfly IQ is an enormously attractive clinical tool because it produces precise, high-quality results. The low cost will make it possible for more clinicians to examine their patients using ultrasound at the bedside, carrying an ultrasound probe in their coat next to the stethoscope.

The remaining hurdle for the widespread utilization of POCUS is lack of physician training in this powerful technology. Because most attending physicians are not trained in the use of POCUS, the traditional method of teaching students and residents is ineffective.

For this reason, Dr. Sauthoff has recently created a POCUS teaching course for hospitalist attending physicians across NYU, including VA NY Harbor Healthcare System’s Manhattan Campus. Carrying a Butterfly during their rounds, they are rapidly learning to use this powerful tool, and they will soon help to teach students and residents and change the culture of bedside diagnosis across VA and NYU.

Dr. Sauthoff using the Butterfly was recorded by BBC TV for an online program about innovation called The Disruptors.

This article originally appeared on the United States Department of Veterans Affairs. Follow @DeptVetAffairs on Twitter.

MIGHTY MILSPOUSE

American pirates? Us privateers could help win a war with China

After nearly two decades of counter-terror operations the world over, the United States military is now shifting its focus back toward great power competition with the likes of China and Russia. Unfortunately, as is so often the case, the past two decades have left the U.S. military particularly well suited for the war at hand, but not very well positioned for the wars that are feasibly to come.

During this era of counter-terror operations, China has had the opportunity to seek higher degrees of technological and tactical parity, while having the benefit of not being actively engaged in expensive combat operations on the same scale. That has allowed China’s sea-faring power to grow at an exponential rate in recent years, with an active fleet of more than 770 vessels sailing under the banners of the People’s Liberation Army-Navy, their militarized Coast Guard, and a maritime miitia that takes its orders from the Chinese military as well.


How to get VA health care without all the paperwork

Chinese Navy on parade (Chinese state television)

The addition of China’s massive ballistic missile stockpile, including hypersonic anti-ship platforms the U.S. Navy currently has no means to defend against, has further established China’s advantage in the Pacific. Even if the U.S. Navy leveraged every vessel in its 293-ship fleet, American forces would still be outnumbered by Chinese ships by more than two to one. Importantly, however, the United States likely couldn’t devote its entire fleet to any single conflict due to its global commitments to security and stability, especially regarding essential shipping lanes.

Today, the U.S. Navy and Marine Corps are both actively seeking ways to mitigate China’s numbers advantage, as well as the area-denial bubble created by China’s anti-ship platforms. Multiple possible solutions are being explored, ranging from hot-loading Marine Corps F-35Bs on austere airstrips on captured islands in the case of the Marines, to the Navy’s ongoing development of the MQ-25 aerial refueling drone that aims to extend the reach of America’s carrier-based fighters. Still, thus far, there has been no magic bullet. In fact, concerns about a near-peer conflict with China has even prompted several high-ranking defense officials to question the practicality of America’s fleet of super-carriers, both because of their immense cost, and because of the likelihood that they could be sunk by China’s hypersonic missiles long before they could get close enough to Chinese shores to begin launching sorties of F-35Cs and F/A-18 Super Hornets.

How to get VA health care without all the paperwork

(U.S. Navy photo by Mass Communication Specialist Seaman Mohamed Labanieh/Released)

The fundamental challenges a war with China would present are clear: Finding a way to mitigate the risks posed by advanced anti-ship missiles and offsetting the significant numbers advantage Chinese forces would have within the region. In the past, we’ve discussed the possibility of arming commercial cargo ships with modular weapons systems in a “missile barge” fleet as a means to bolster American numbers and capabilities. Another feasible option that could even work in conjunction with this strategy would be issuing “letters of marque” to private operations, effectively allowing non-military forces to serve as privateers for the U.S. government.

How to get VA health care without all the paperwork

The Capture of a French Ship by Royal Family Privateers by Charles Brooking

American Privateers or Pirates?

The concept of issuing letters of marque to American privateers was recently discussed by retired Marine Colonel Mark Cancian and Brandon Schwartz in the U.S. Naval Institute’s publication, “Proceedings.” Although the idea seems almost ridiculous in the 21st Century, the legal framework outlined by Cancian and Schwartz is sound, and one could argue that their assertions about the viability and strategic value of privateer fleets are as well.

Cancian and Schwartz argue that privateering is not piracy, as there are laws governing it and precedent for the practice established in past U.S. conflicts, including the American Revolutionary War and the War of 1812.

“Privateering is not piracy—there are rules and commissions, called letters of marque, that governments issue to civilians, allowing them to capture or destroy enemy ships. The U.S. Constitution expressly grants Congress the power to issue them (Article I, section 8, clause 11).”
-“Unleash the Privateers!” In Proceedings

However, despite their argument being technically right, it’s difficult to dismiss how the piracy narrative would almost certainly affect public perception of the use of privateers, and potentially even the conflict at large.

While the United States could argue that privateers operate with specifically outlined rules and commissions, even the American public would likely see American privateers as pirates. And because America has found itself trailing behind nations like China and Russia in terms of manipulating public narratives, that narrative could indeed hurt not only public support for the conflict; it could even jeopardize some international relationships.

How to get VA health care without all the paperwork

The Pride of Baltimore, left, and the Lynx, two privateer vessels, reenact a battle of the War of 1812 in Boston Harbor during Boston Navy Week 2012. (U.S. Navy photo by Mass Communication Specialist 1st Class Elisandro T. Diaz/Released)

Privateers are not pirates in the literal sense only because a government is sanctioning their piracy. In the eyes of those who don’t recognize America’s authority to grant such permissions in far-flung waterways, the two terms would be interchangeable.

Regardless of vernacular, the United States has used this approach to great success in the past. Although the last time American privateers set sale was more than 200 years ago, their approach was modern enough to set precedent for a return to the concept.

“The privateering business was thoroughly modern and capitalistic, with ownership consortiums to split investment costs and profits or losses, and a group contract to incentivize the crew, who were paid only if their ship made profits. A sophisticated set of laws ensured that the capture was ‘good prize,’ and not fraud or robbery. After the courts determined that a merchant ship was a legitimate capture, auctioneers sold off her cargo of coffee, rum, wine, food, hardware, china, or similar consumer goods, which ultimately were bought and consumed by Americans.”
-Frederick C. Leiner in “Yes, Privateers Mattered

In the event of a large-scale conflict with a nation like China, that potential narrative blowback may be a necessary evil. However, the ramifications of that evil could be mitigated through a concerted narrative effort to frame privateer actions in the minds of the populous as an essential part of a broader war effort that has the American people’s best interests in mind.

In the War of 1812, privateering saw such public support (in large part thanks to the profits it drove) that some took to calling the conflict the “War of the People.” Managing the narrative surrounding American privateers could make the concept far more palatable to the American people.

As for the legal aspects of privateering, you can read a thorough legal justification for the practice in a separate piece written by Schwartz called “U.S. Privateering is legal.”

How to get VA health care without all the paperwork

(Italian Center for International Studies)

The role of American privateers at war

China’s massive fleet of vessels in the Pacific can be broken down into their three command groups, all of which ultimately answer to China’s People’s Liberation Army. China’s maritime militia accounts for approximately 300 vessels, the militarized Coast Guard has 135 more, and the PLA-Navy itself boasts an ever-growing roster expected to reach 450 surface vessels by the end of the decade.

In the event of a war with China, the American Navy would have more than its hands full engaging with such a massive force, limiting its ability to cut China off from one of its most significant revenue sources, overseas trade. China’s reliance on shipping products to other nations has helped its economy grow rapidly, but it also represents a strategic disadvantage, as Cancian and Schwartz point out, if America can find the means to disrupt this exchange.

“Thirty-eight percent of its gross domestic product (GDP) comes from trade, against only 9 percent of U.S. GDP. Chinese social stability is built on a trade-off: The Chinese Communist Party has told the people they will not have democratic institutions, but they will receive economic prosperity.”
-“Unleash the Privateers!” In Proceedings

In 2018, China’s merchant fleet was already approaching 2,200 total vessels, thanks to massive external demand for inexpensive Chinese exports. America’s Navy would likely be stretched too thin to actually blockade such an expansive merchant fleet. Like with aircraft, America’s preference for large and expensive ships that are capable of fulfilling multiple roles has offered increased capability but significantly decreased numbers. At its peak during World War II, the U.S. Navy boasted more than 6,000 ships. Today, the Navy has 293 far more capable vessels, but none can be in more than one place at a time.

How to get VA health care without all the paperwork

(DoD Photo)

American Arleigh Burke-class guided-missile destroyers, for instance, are too big and expensive to task with waiting out Chinese ships hiding in foreign ports, and would likely largely be assigned to Aegis missile defense operations. This is where American privateers could offer an important service.

American privateers wouldn’t be tasked with engaging the Chinese Navy or even with sinking merchant ships. Instead, they would be tasked with capturing Chinese cargo vessels, offering them a multi-million dollar bounty on each, and quickly compromising China’s ability to sustain its export sales.

“Since the goal is to capture the hulls and cargo, privateers do not want to sink the vessel, just convince the crew to surrender. How many merchant crews would be inclined to fight rather than surrender and spend the war in comfortable internment?”
-“Unleash the Privateers!” In Proceedings

Of course, despite Cancian and Schwartz’ dismissive take on how apt Chinese crews would be to fight to maintain control of their ships, it’s important to remember that these privateers would likely be engaging in close quarters fighting with Chinese crews or security on board. As American privateers proved more costly to the Chinese government, an increased emphasis on protecting these cargo ships would almost certainly follow.

This begs an essential question: Where do you find privateer crews?

How to get VA health care without all the paperwork

Private security contractors in Iraq (DoD photo)

Private infrastructure already exists

While the concept of American privateers seems borderline fantastical, the truth is, the United States has already leveraged the premise of using non-military personnel for security and defensive operations the world over. American security firm Blackwater (now Academi) is perhaps the highest-profile example of America’s use of private military contractors. In fact, contractors in Iraq have reached numbers as high as 160,000 at some points, nearly equaling the total number of U.S. military personnel in the region. At least 20,000 of those private contractors filled armed security roles.

So while the term “privateer” or even pirate suggests an entirely unconventional approach to modern warfare, the premise is already in play. Terminology may dictate perception to a significant degree, but in practice, privateering wouldn’t be all that different from existing relationships the United States maintains with private security outfits. Further, private security firms, including Blackwater, have already operated at sea in a similar manner to privateers, from Blackwater’s armed patrol craft policing Somali pirates off the Horn of Africa to countless armed and privately owned boats patrolling the Indian Ocean today.

How to get VA health care without all the paperwork

In 2007, Blackwater acquired the McArther from the NOAAS. (WikiMedia Commons)

Many such organizations, with existing infrastructure and established relationships with the U.S. government, would likely seek and win contracts, or letters of marque, in the early days of a burgeoning Sino-American war, and stand up their own forces far more quickly than the United States could expand its naval force in the same volume. Rather than building ships and enlisting crews, the United States could simply authorize existing ships with existing crews to go on the offensive against China’s commercial fleets.

The American government’s experience with military contractors throughout the War on Terror means these relationships would not be as without precedent as they may seem, and the existing private military industry would make American privateers a quick and effective means to grow America’s offensive capabilities.

How to get VA health care without all the paperwork

China claims sovereignty over much of the South China Sea (shown in red). A conflict with China would undoubtedly play out here. (WikiMedia Commons)

A complicated solution to a complex problem

Of course, there are many variables at play when discussing a future conflict with China. Incorporating privateers into such a strategy admittedly seems rather extreme from our vantage point in 2020, but it’s important to note that there is no precedent for what something like a 21st Century Sino-American war might look like. The massive sea battles of World War II may offer some sense of scale, but the rapid advancement of technology in the intervening decades creates a hypothetical war that is simply incongruous with the World War II models.

America does boast the largest and most powerful military in the world, but China’s rapidly expanding and modernizing force has not been growing in a vacuum. From space operations to warship construction, China has been developing its war-fighting apparatus with America specifically in mind. China isn’t interested in competing with the United States on its terms and instead has been focused on identifying potential American vulnerabilities and tailoring new capabilities to leverage those flaws.

How to get VA health care without all the paperwork

China’s Type 002 Aircraft carrier (Tyg728 on WikiMedia Commons)

Large scale warfare between technological and economic giants would play out differently than any conflict we’ve ever seen. In order to emerge from such a conflict successfully, America has to do much more than win. Once the price of victory begins to compromise America’s ability to sustain its way of life thereafter, that victory becomes less pronounced.

In order to win in such a conflict, the United States will need to dig deep into its bag of tricks. On the home front, it would mean finding ways to rapidly expand America’s industrial base to replenish vehicles, supplies, and equipment as they’re expended or destroyed on the front lines. The U.S. Navy, Marine Corps, Army, Air Force, and Space Force will all be required to communicate and rely on one another in ways never before accomplished on a battlefield.

And China’s massive numbers advantage would have to be mitigated somehow. American privateers, or pirates as the press would surely call them, might just do the trick.

This article originally appeared on Sandboxx. Follow Sandboxx on Facebook.

Articles

This is the competition for special operations experts

Who are the best commandos in the Western Hemisphere? Throw Navy SEALs, Green Berets, Rangers, Marine Force Recon, the Marine Special Operations Command, or even Air Force Special Tactics airmen into a ring and find out. Sort of.


Which is kind of what happens during an annual competition called Fuerzas Commandos. It’s been held 13 times. In 2017, Honduras took the trophy from Colombia, an eight-time winner of the 11-day event.

So, what, exactly goes down at these commando Olympics?

How to get VA health care without all the paperwork
Team Colombia, winners of Fuerzas Comando 2016, return the trophy to Paraguayan Brig. Gen. Hector Limenza at the opening ceremony for Fuerzas Comando 2017 in Mariano Roque Alonso, Paraguay, on July 17, 2017. (U.S. Army photo by Sgt. Christine Lorenz)

First, there is an opening ceremony during which the trophy is returned to an officer of the host nation.

This year, 20 countries (Argentina, Belize, Brazil, Chile, Colombia, Costa Rica, Dominican Republic, El Salvador, Guatemala, Guyana, Haiti, Honduras, Jamaica, Mexico, Panama, Paraguay, Peru, Trinidad and Tobago, United States, and Uruguay) competed, sending over 700 commandos.

Participants take part in both an Assault Team Competition and a Sniper Team Competition.

How to get VA health care without all the paperwork
A member from Team Uruguay during the physical fitness test, which includes push-ups, sit-ups, pull-ups, and a 4-mile run. (U.S. Army photo by Spc. Elizabeth Williams)

The Assault Team Competition features a number of challenges. One is a physical fitness test.

How to get VA health care without all the paperwork
Colombian competitors sprint through the finish line of the obstacle course event, taking a step closer to securing the Fuerzas Comando 2017 championship, July 24, 2017 in Paraguay. (U.S. Army photo by Staff Sgt. Chad Menegay)

There is a “confidence course” and an obstacle course is run as well.

How to get VA health care without all the paperwork
Peruvian competitors run the 14-kilometer ruck march while picking up and moving various objects, ending with team marksmanship at a firing range. (U.S. Army photo by Sgt. 1st Class James Brown)

Close-quarters combat skills are tested and there is a rucksack march.

How to get VA health care without all the paperwork
Costa Rican competitors clear a room in a live-fire shoot house where they must clear a building and rescue a simulated hostage as efficiently as possible. (U.S. Army photo by Sgt. 1st Class James Brown)

Don’t forget the aquatic events or the hostage rescue events.

How to get VA health care without all the paperwork
A Guyanese sniper loads a round into his rifle while his teammate scans the range for targets. (U.S. Army photo by Spc. Elizabeth Williams)

The Sniper Team Competition features marksmanship.

How to get VA health care without all the paperwork
A Mexican soldier looks over his ghillie suit before the beginning of a stalk-and-shoot event July 20, 2017 during Fuerzas Comando in Ñu Guazú, Paraguay. (U.S. Army photo by Spc. Tonya Deardorf)

Then there is concealment.

How to get VA health care without all the paperwork
Competitors drag litters 100 meters then work together to haul them onto a platform. (U.S. Army photo by Sgt. 1st Class James Brown)

They also have a physical fitness test and there’s a mobility event.

How to get VA health care without all the paperwork
Honduran, Colombian, and U.S. Soldiers commemorate a successful Fuerzas Comando on July 27, 2017, in Mariano Roque Alonso, Paraguay. (U.S. Army photo by Sgt. Joanna Bradshaw)

This year, Honduras won the title, Colombia finished second, and the USA took third place. Next year, Panama will host Fuerzes Commandos. Will Honduras defend their title, will the Colombians make it nine out of fourteen, or will there be a surprise winner?

Articles

The 5 biggest stories around the military right now (Aug. 6 edition)

Here are the headlines you need to make it through the rest of the day mission-ready:


Now: We’re freaked about Iran, but what other countries already have nukes?

Articles

The VA might actually be getting its act together

Trying to emerge from scandals that shook the agency to its core, the U.S. Department of Veterans Affairs is attempting to overhaul what officials admit was sometimes pretty bad customer service.


Quietly, since 2015, the U.S Department of Veterans Affairs has built a national Veterans Experience Office.

The office’s first steps have been rolling out over 100 community veterans committees nationwide and retraining employees to be less rigid and more customer-focused.

The VA even hired professional writers to redraft the language of 1,200 official letter templates to make them more reader friendly.

“(We) had somehow gotten away from the primary mission of organizing the enterprise through the eyes of the customer,” said Joy White, who leads the office’s Pacific district, which includes California and the West Coast.

“(We did) things that made sense to us, made it easy for us as the VA,” White said. “But, in all of that, we lost the voice of the customer.”

The task at hand: How to change the culture of a massive federal agency that provides everything from medical care to monthly disability checks to funerals.

How to get VA health care without all the paperwork
Or her widow, Mr. President. Or her widow. (Photo: Veterans Affairs)

Some might wonder if — with what’s a famously dense bureaucracy — it can be done. Even new VA Secretary David Shulkin has said it’s a struggle to fire bad apples, including employees who watch porn on the job.

The new Veterans Experience Office’s budget this fiscal year is $55.4 million, up from $49 million last year, “to lead the My VA transformation,” according to a budget document. About 150 jobs now fall under this office’s umbrella.

Two years in, the nation’s veterans organizations are still taking a wait-and-see position.

“We’re not sure how much the VEO has improved the VA to date, but we are encouraged by this initiative and hope to see it succeed,” said Joe Plenzler, American Legion spokesman. “Any effort to improve dialogue between veterans and VA employees and administrators is time and money well spent.”

One vocal critic of the VA said the office has potential but not if it tries to just “paper over” structural issues facing the veterans agency.

“Doing things that are more feel-good measures, but actually don’t address some of the core problems of the VA, could distract from what’s needed to be done,” said Dan Caldwell, policy director at Concerned Veterans for America.

“That’s the danger I see, potentially, with this office. But I want to say there’s a lot of opportunity here. If this office is managed well and insists that they are here to improve the outcomes for veterans — and not just ‘the experience’ — they could be successful.”

Also read: The VA is set to lower copays for prescriptions

The “veterans experience” campaign started under former VA Secretary Bob McDonald, the retired Proctor Gamble chief executive brought in by President Barack Obama in mid-2014 following a national scandal over wait times for VA medical care.

McDonald installed a “chief veterans experience officer” in early 2015.

The office reports directly to the VA secretary — now Shulkin, a doctor and health-care executive who is the first non-veteran to lead the agency.

Whether he will continue the “experience” campaign is an open question.

However, in April he named Lynda Davis, a former Army officer and Pentagon civilian executive with experience in personnel and suicide prevention, to head the office. She replaces a former McDonald’s executive, Tom Allin, who held the job for about two years.

How to get VA health care without all the paperwork
Talihina Veterans Center (Oklahona Department of Veterans Affairs)

Some of the hiring was for “human-centered design” teams. These teams, which include people from Stanford’s prestigious D School, are supposed to re-engineer VA routines that aren’t working.

They produced a “journey map” showing what VA patients experience.

It identifies “pain points” along the way, such as cancelled appointments. It also calls out “moments that matter,” such as the check-in process and whether it’s hard or easy to park.

Two early goals were to establish one consumer-oriented website and one toll-free telephone number for all VA divisions. The result was vets.gov and 1 (844) My-VA311.

The VA is now looking for inspiration from national brands famous for good service. Starbucks, Marriott, and Walgreens are on the list.

“We get the experience that we design. Historically, we haven’t put an emphasis as an organization on customer service. There was no program of record that said ‘this how we do customer service,'” White told the San Diego Union-Tribune.

“You walk into a Starbucks anywhere in the country, there is something that looks and feels very familiar wherever you go.”

Also read: Starbucks donated free coffee to every US service member in Afghanistan

One change the Veterans Experience Office has led: hiring for customer-service skills, instead of just looking for people qualified for a position.

“We weren’t hiring for attitude,” said White, who said her office identified questions to insert in the VA’s interview process to draw out whether an applicant had customer service aptitude.

In a changing health-care industry, this is a bandwagon that the VA is belatedly jumping on.

Other hospital organizations have rebooted their customer experience in the past decade in response to a shift in Medicare reimbursement policy that now rewards for patient satisfaction, experts said. The power of social media is also a factor.

The Cleveland Clinic was the first major academic medical center to appoint a chief experience officer in 2007. Across the country, hospitals have built grand entrances, opened restaurants intended to draw non-patients and put flowers by bedsides.

“My sense of it is that we live in the age of the empowered consumer,” said John Romley, an economist at the University of Southern California’s Schaeffer center for health policy.

“VA customers maybe have less choice in the matter, but at the same time, there’s a great deal of sensitivity in the broader population about how we treat these people in the VA system.”

The VA’s new customer service motto — Own the Moment — sounds a bit like a commercial TV jingle.

Training is rolling out across the country, including at the La Jolla VA hospital.

The premise: Each VA employee should “own” their time with a customer, the veteran, and do their best to ensure the person gets the help he or she needs.

That contrasts to the like-it-or-lump-it experience that veterans have sometimes complained about in the past.

“We’re moving away from a rules-based organization to a more of what we call a values, principle-based organization,” said Allan Castellanos, the VA employee teaching the La Jolla seminar.

“I call it more like integrated ethics, like doing the right thing for the right reason,” he said.

The employees were shown a video of VA workers going the extra mile to welcome an uncertain new veteran into a clinic.

In another, VA workers allowed the family of a dying veteran to bring his horse onto hospital grounds.

The VA is trying to emerge from bunker mentality after back-to-back national embarrassments.

First, in 2013, the backlog of disability claims rose to mountainous proportions, bringing down the wrath of Congress and the public.

How to get VA health care without all the paperwork
We just wanna see more vets smiling. (Photo: U.S. Department of Veterans Affairs)

Then, in 2014, news reports revealed that VA medical workers were keeping secret lists of patients waiting for appointments to make wait-time data appear satisfactory.

All of this occurred as the VA struggled to handle a flood of new veterans coming home from the Iraq and Afghanistan wars.

A few of the ideas being pursued by the Veterans Experience Office have origins in San Diego.

Officials acknowledge that what they are calling Community Veterans Experience Boards — the 152 community boards they eventually want to create nationally — came from San Diego’s longstanding example.

San Diego veterans leaders meet monthly with VA officials here in both closed-door and public sessions.

Additionally, the tragic suicide of 35-year-old Marine Corps veteran Jeremy Sears appears to have helped spur a campaign to redraft VA correspondence to make it more user friendly.

Sears shot himself at an Oceanside gun range in 2014 after being rejected for VA disability benefits despite the cumulative effects of several combat tours.

Veterans advocates suggested that the VA rejection letter could have offered advice on where to go for counseling and other assistance, instead of just a “no.”

“That was one of the ‘pain points’ that was identified,” White said, referring to the veteran’s “journey mapping” that her office did. “There was a lot of legalese, when in fact we just want it to be simple and clean.”

They started with the Veterans Benefit Administration’s correspondence and are working their way toward the Veterans Health Administration’s appointment cards.

Veterans Experience Office officials first told the Union-Tribune that they could provide examples of the rewritten letter formats, but later said they weren’t ready yet.

The Veterans Experience Office, headquartered in Washington, now has split the country into five districts and dispatched “relationship managers” to each.

The Veterans Experience Office is now trying to finesse those moments that matter to veterans. In 2017, officials expect to roll out a veterans real-time feedback tool in 10 locations. They also plan to release a patient experience “program of record.”

“Our goal is to build trust with veterans, their family members, and survivors,” White said. “How do we do that? By bringing their voices to everything we do.”

MIGHTY TRENDING

The Army’s new sensors can track small arms fire to its source

The Army is engineering new Hostile Fire Detection sensors for its fleet of armored combat vehicles to identify, track, and target enemy small arms fire.


Even if the enemy rounds being fired are from small arms fire and not necessarily an urgent or immediate threat to heavily armored combat vehicles such as an Abrams, Stryker, or Bradley, there is naturally great value in quickly finding the location of incoming enemy attacks, Army weapons developers explain.

There is a range of sensors now being explored by Army developers; infrared sensors, for example, are designed to identify the “heat” signature emerging from enemy fire and, over the years, the Army has also used focal plane array detection technology as well as acoustic sensors.

“We are collecting threat signature data and assessing sensors and algorithm performance,” Gene Klager, Deputy Director, Ground Combat Systems Division, Night Vision, and Electronic Sensors Directorate, told Warrior Maven in an interview.

How to get VA health care without all the paperwork
An M2 Bradley Infantry Fighting Vehicle. (Photo from DoD)

Klager’s unit, which works closely with Army acquisition to identify and, at times, fast-track technology to war, is part of the Army’s Communications, Electronics, Research, Development, and Engineering Center (CERDEC).

Army senior leaders also told Warrior Maven the service will be further integrating HFD sensors this year in preparation for more formals testing to follow in 2019.

Enabling counterattack is a fundamental element of this because being able to ID enemy fire would enable vehicle crews to attack targets from beneath the protection of an armored hatch.

The Army currently deploys a targeting and attack system called Common Remotely Operated Weapons System, or CROWS; using a display screen, targeting sensors and controls operating externally mounted weapons, CROWS enables soldiers to attack from beneath the protection of armor.

“If we get a hostile fire detection, the CROWS could be slued to that location to engage what we call slue to cue,” Klager said.

Much of the emerging technology tied to these sensors can be understood in the context of artificial intelligence, or AI. Computer automation, using advanced algorithms and various forms of analytics, can quickly process incoming sensor data to ID a hostile fire signature.

“AI also takes other information into account and helps reduce false alarms,” Klager explained.

Also Read: US Navy exploring artificial intelligence for warfare network

AI developers often explain that computers are able to much more efficiently organize information and perform key procedural functions, such as performing checklists or identifying points of relevance; however, many of those same experts also add that human cognition, as something uniquely suited to solving dynamic problems and weighing multiple variables in real time, is nonetheless something still indispensable to most combat operations.

Over the years, there have been a handful of small arms detection technologies tested and incorporated into helicopters; one of them, which first emerged as something the Army was evaluating in 2010 is called Ground Fire Acquisition System, or GFAS.

This system, integrated onto Apache Attack helicopters, uses infrared sensors to ID a “muzzle flash” or heat signature from an enemy weapon. The location of enemy fire could then be determined by a gateway processor on board the helicopter able to quickly geolocate the attack.

While Klager said there are, without question, similarities between air-combat HFD technologies and those emerging for ground combat vehicles, he did point to some distinct differences.

“From ground to ground, you have a lot more moving objects,” he said.

Potential integration between HFD and Active Protection Systems is also part of the calculus, Klager explained. APS technology, now being assessed on Army Abrams tanks, Bradleys and Strykers, uses sensors, fire control technology and interceptors to ID and knock out incoming RPGs and ATGMs, among other things. While APS, in concept and application, involves threats larger or more substantial than things like small arms fire, there is great combat utility in synching APS to HFD.

“HFD involves the same function that would serve as a cueing sensor as part of an APS system,” Klager said

The advantages of this kind of interoperability are multi-faceted. Given that RPGs and ATGMs are often fired from the same location as enemy small arms fire, an ability to track one, the other, or both in real time greatly improves situational awareness and targeting possibilities.

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Two ISIS recruits operate their weapons, a RPG (right) and a PKM (left). (ISIS photo)

Furthermore, such an initiative is entirely consistent with ongoing Army modernization efforts which increasingly look toward more capable, multi-function sensors. The idea is to have a merged or integrated smaller hardware footprint, coupled with advanced sensing technology, able to perform a wide range of tasks historically performed by multiple separate, onboard systems.

Consolidating vehicle technologies and “boxes” is the primary thrust of an emerging Army combat vehicle C4ISR/EW effort called “Victory” architecture. Using Ethernet networking tech, Victory synthesizes sensors and vehicle systems onto a common, interoperable system. This technology is already showing a massively increased ability to conduct electronic warfare attacks from combat vehicles, among other things.

HFD for ground combat vehicles, when viewed in light of rapidly advancing combat networking technologies, could bring substantial advantages in the realm of unmanned systems. The Army and industry are currently developing algorithms to better enable manned-unmanned teaming among combat vehicles. The idea is to have a “robotic wingman,” operating in tandem with armored combat vehicles, able to test enemy defenses, find targets, conduct ISR, carry weapons and ammunition or even attack enemies.

“All that we are looking at could easily be applicable to an unmanned system,” Klager said.

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5 things to know about Air Force Secretary nominee Heather Wilson

According to a report by the Washington Examiner, President Donald Trump today announced that former New Mexico Republican Rep. Heather Wilson is his pick to serve as Secretary of the Air Force.


“Heather Wilson is going to make an outstanding Secretary of the Air Force,” Trump said in a release. “Her distinguished military service, high level of knowledge and success in so many different fields gives me great confidence that she will lead our nation’s Air Force with the greatest competence and integrity.”

Here are a few things to know about her:

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Official portrait of Congresswoman Heather Wilson. (US House of Representatives)

1. She is the President of the South Dakota School of Mines and Technology

Wilson took the post in June 2013 after two failed senate races. According to a release from the school, it was listed among the most veteran-friendly schools throughout her tenure as president of that institution.

2. She was a Rhodes Scholar

According to her official biography at the South Dakota School of Mines and Technology, Heather Wilson’s graduate studies were at Oxford University as a Rhodes Scholar. She earned both a master’s degree and a Ph.D from the institution in 1985.

3. She would be the first Air Force Academy Graduate to serve as SECAF

According to the Air Force Times, Wilson is the first graduate of the United States Air Force Academy to be nominated for this position. Wilson was among the first women to attend the Air Force Academy and received her commission in 1982. She served for seven years mostly as a defense planner to NATO and the U.K. She separated as a captain and became an advisor to the National Security Council under President George H. W. Bush.

4. She is an instrument-rated private pilot

Congresswoman Wilson’s official bio at the home page of the South Dakota School of Mines and Technology reveals she is an instrument-rated private pilot. We don’t know if that means she gets to fly any of the Air Force’s planes, though. We hope it does.

5. She served just over 10 years in Congress

Wilson first won a special election in 1998 to replace a congressman who lost a battle with cancer. According to the Biographical Directory of the United States Congress, she served until 2009, when she stepped down after losing a senate primary the previous year. She served on the Energy and Commerce and Select Intelligence Committees, according to the 2008 Congressional Directory, and also served on the House Armed Services Committee.

“America and our vital national interests continue to be threatened,” Wilson said in a statement after her nomination. “I will do my best, working with our men and women in the military, to strengthen American air and space power to keep the country safe.”

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7 mind hacks Navy SEALs use to take on everything

From day one, Navy SEAL training requires complete dedication from your body and your mind. You can prepare your body for the physical toll BUD/S will exact on you, but mental preparation is something else altogether. Navy SEALs gave out some of their mental preparation hacks that not only got them through training, but also through the high operations tempo SEALs face these days.


But even if you can’t be a SEAL (for whatever reason) or you don’t want to be (for whatever reason), you can still use Navy SEAL mind tricks to advance yourself along the path to your personal or professional goals using the tips in the infographic below, courtesy of Mike’s Gear Reviews.

We’ve all heard SEAL quotes before. “Get comfortable with being uncomfortable,” “the only easy day was yesterday,” and, of course, the ever-accurate “40 percent rule.” Get ready for some new axioms, because these might help you conquer the world — or at least the world as you see it.

Chances are good that you have a big event coming up in your life (and if you don’t, what are you doing? Go find one!) and you’ll need some focus, mental clarity, and calmness before you go out and change the world. Remember to visualize your objectives. Observe, orient, decide, and act. Trigger your consciousness. Control your arousal. Convert your fears to confidence.

And above all, save room for the Hooyah.

MIGHTY CULTURE

What Snowden has to say about theory that the government is hiding aliens

Edward Snowden shut down the conspiracy theory that the US government is secretly harboring aliens at its top secret facilities during an episode of “The Joe Rogan Experience” podcast, which aired on Oct. 23, 2019.

Snowden, an American whistleblower who revealed details of classified US government surveillance programs in 2013, addressed rumors about secret extraterrestrial lifeforms in his recently released memoir “Permanent Record.”

“I know, Joe, I know you want there to be aliens,” he said. “I know Neil deGrasse Tyson badly wants there to be aliens. And there probably are, right?”

“I do,” Rogan responded.


Speaking to Rogan from Russia, where he has been granted asylum, Snowden said as far as he knew the US government has not made contact with aliens and is not housing them at their facilities, like that of Area 51 in Nevada.

“But the idea that we’re hiding them — if we are hiding them — I had ridiculous access to the networks of the NSA, the CIA, the military, all these groups. I couldn’t find anything,” he asserted.

He said, he found no evidence of extraterrestrial life during his time spent snooping through government databases when he worked as a contractor for the National Security Agency (NSA) and the Central Intelligence Agency (CIA).

Joe Rogan Experience #1368 – Edward Snowden

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He admitted that it was entirely possible that knowledge of alien contact were “hidden really damn well” from people with direct access to classified information.

“Everybody wants to believe in conspiracy theories because it helps life make sense,” he told Rogan. “It helps us believe that somebody is in control, that somebody is calling the shots.”

In his book, which came out September 2019, Snowden shut down other popular conspiracy theories, like the idea that the US faked the moon landing, or that climate science is a hoax.

“For the record, as far as I could tell, aliens have never contacted Earth, or at least they haven’t contacted US intelligence,” he wrote.

“Yes, man really did land on the moon. Climate change is real. Chemtrails are not a thing,” he added.

This article originally appeared on Business Insider. Follow @BusinessInsider on Twitter.

MIGHTY CULTURE

Vets answer EVEN MOAR dumb military questions

We’re baaaaaaack.

There are so many dumb questions, but don’t worry, we’re here for you with the answers. We Are The Mighty regulars are joined by special guests U.S. Navy SEAL Remi Adeleke and Green Beret Terry Schappert in the third installment of this riveting series.

RIVETING.


Do soldiers fall in love while in war zones? | Dumb Military Questions 103

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Do soldiers fall in love while in war zones?

“Have you ever seen someone cry at the U.S. Army basic training?”

The video opens strong with the cold human truth: oh yes — everyone cries at the U.S. Army basic training (phrasing kept intact here because it’s hilarious; can we make adding ‘the’ to basic training a universal thing?).

Next up:

“Why are the U.S. Navy’s and the U.S. Army’s special forces considered elite even though their training period before joining is only a few months long compared to civilian skills like guitar that take years to learn?”

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Schappert ain’t got time for that.

Dear twenty-something rich kid sitting in your mom’s basement playing ‘Wonderwall’ again on your six-string: we don’t know how to convey to you that pushing yourself beyond your physical limitations consistently for months on end while sleep deprived in order to learn tactics and skills that will keep you and your friends alive in the face of lethal force is harder than finally nailing your first F chord on the guitar. But please trust us: it is.

“Could a Green Beret break out of a supermax prison?”

Lucky for us, we had not one but two Green Berets on hand to answer this question.

“Why don’t we make our soldiers look scary or creepy? Wouldn’t that be good psychological warfare?”

How to get VA health care without all the paperwork

Trust me. Our soldiers are creepy. Just look through the We Are The Mighty comments sometime.

Watch the video above to see the full line-up of questions and their answers!

Then make sure you check out more videos right here:

Vets answer dumb military questions – part one

Vets answer dumb military questions – part two

How to get posted at Area 51 other dumb military questions answered

What happens if you refuse to shower other dumb questions

What do snipers think when they miss other dumb military questions

MIGHTY TRENDING

DARPA’s next big project is an airplane-deployed drone swarm

The Defense Advanced Research Project Agency plans to demonstrate an ability to launch and recover small drones from an Air Force C-130 aircraft as part of its continued development of the Gremlins program — a technical effort designed to deploy groups of small drones carrying 60-pound sensor payloads up to ranges of 300 nautical miles.


The program is expected to culminate in an air launch and recovery demonstration in 2019.

The drones are intended to perform a range of missions, such as testing enemy air defenses and conducting ISR missions for an hour on station before returning to an Air Force C-130, developers said. A key concept of the program is extending the mission range of aircraft, while allowing manned crews to operate at safer distances.

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The AC-130J Ghostrider will provide close air support, special operations armed airborne reconnaissance, and ordnance delivery to precise targets in support of ground forces. (Courtesy photo)

Gremlins moves beyond existing state-of-the-art programs able, which are able to launch, but not recover, swarms of mini-drones. The Pentagon’s Strategic Capabilities Office, an initiative aimed at harnessing near-term emerging technologies for operational use, demonstrated an ability to launch small drones from the flare dispenser of an F-16. While able to blanket areas with ISR and perform significant mission-enhancing functions, they are expendable and not available for re-use.

“For decades, U.S. military air operations have relied on increasingly capable multi-function manned aircraft to execute critical combat and non-combat missions. Adversaries’ abilities to detect and engage those aircraft from longer ranges have improved over time as well,” said DARPA in a statement.

Read More: Here’s how DARPA’s Gremlins are going to change strike warfare forever

Gremlins could well be described as a technological leap in manned-unmanned teaming beyond state-of-the-art technology, as it enables drones to launch, perform missions and then return to a host aircraft. As algorithms for increased levels of autonomy advance, aircraft will be able to control drones from the cockpit with a pilot in a command and control role, service experts have explained.

At the moment, Army helicopters can used “manned-unmanned” teaming to control the flight path and sensor payload of nearby drones, and the Air Force Chief Scientist Dr. Gregory Zacharias has told Warrior that F-35 and F-22 fighter jets may soon have the technical ability to navigate multiple drones from the air. The idea is to use unmanned aircraft to perform ISR missions, delivery weapons or test high-risk air defenses or enemy formations without putting pilots in harm’s way. This day is fast approaching, given the pace of current progress developing algorithms enabling higher levels of autonomy, Zacharias has explained.

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(GIF created from DARPAtv YouTube)

As of earlier this year, DARPA has continued its contract with General Atomics Aeronautical Systems and Dynetics to move Gremlins into the next phase of development, an effort which involves testing and a Preliminary Design Review.

The Gremlins’ expected lifetime of about 20 uses provides significant cost advantages over expendable systems by reducing payload and airframe costs and by having lower mission and maintenance costs than conventional platforms, a General Atomics statement said.

“We see the potential for using this technology on our own Predator B/MQ-9 Reaper® to offer our customers new mission capabilities,” David R. Alexander, president, Aircraft Systems, GA-ASI, said in a written statement.

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This Iraq war veteran has been running with the bulls since 2007

A former Army officer has been running with the bulls in Pamplona, Spain since 2007 — all while filming a documentary on the event which was released last month.


Each year in July, Pamplona hosts a fiesta that brings together approximately one million people for a massive party, but most people know the city for just one reason: the crazy event that sees people running as bulls chase them from behind.

Dennis Clancey, a West Point-educated Army officer who served in the Iraq War, wanted to document the run, while trying to understand why some people risk their lives in this way each year.

“This is beyond me just asking them what it is like to run,” Clancey told The Chicago Sun-Times. “The film is an accurate stamp of what it means to be a runner. The experienced runners are running out of a sense of obligation. They run in part to protect other runners. If someone falls, you do what you can to distract the bulls and protect your fellow runners.”

Clancey self-funded his documentary — called “Chasing Red” — from 2007 to 2011, until he met a fellow filmmaker who helped him put together a trailer for the project. The trailer helped generate interest in the project, and led to a successful backing on Kickstarter that helped raise nearly $23,000.

“It’s a character-driven documentary following eight runners,” Clancey told Outside Magazine. “They each have their own goals and aspirations and we follow them in their pursuits of those dreams.”

The film is now available to rent or download. Here’s the trailer:

NOW: This powerful film tells how Marines fought ‘one day in hell’ in Fallujah