Tuesday, November 3, 2009

VA Announces Creation of a 'Holistic', Internal Gulf War Veterans Task Force

Written by Anthony Hardie, 91outcomes

(Washington, DC - November 3, 2009) - The U.S. Department of Veterans Affairs has created a “holistic” internal task force related to meeting the needs of veterans of the 1991 Gulf War, according to VA Chief of Staff John Gingrich, who chairs the task force.

In a public briefing today before the Congressionally chartered Research Advisory Committee on Gulf War Veterans’ Illnesses, Gingrich noted the failings of the VA with regards to Gulf War and other veterans.  “Gulf War veterans’ perceptions of VA is that it is bureaucratic, slow to respond, has uncaring staff, is dysfunctional, has poor databases, and is failing veterans,” said Gingrich, but in announcing the creation of the task force said, “We are trying to get it right.”

According to Gingrich, the goal of the internal VA task force on 1991 Gulf War veterans, which is already up and running, is to, “conduct a comprehensive review of all VA programs and services that serve this cohort of veterans.”

He said the task force’s charge is to challenge all assumptions and identify gaps in services and opportunities to better serve this veteran cohort.   He expects results-oriented recommendations to decisively advance VA’s efforts to address 1991 Gulf War veterans’ needs, with the desired end state being a coherent, comprehensive and facts-based action plan which considers and integrates appropriate viewpoints from stakeholders, subject matter experts, and advisory committees on Gulf War veterans.

The announcement that the task force had been created seemed to echo the comments earlier this year by VA Secretary Eric “Ric” Shinseki , who told the nation’s veterans In a series of speeches before the nation’s veterans service organizations between July and September 2009, “We are asking why, 40 years after agent orange was last used in Vietnam, this secretary is still adjudicating claims for service-connected disabilities related to it.  And why, 20 years after Desert Storm, we are still debating the debilitating effects of whatever causes Gulf War Illness.  Left to our present processes, 20 or 40 years from now, some future secretary could be adjudicating service-connected disabilities from our ongoing conflicts.  We must do better, and we will.”

In a military career spanning 30 years, Gingrich served in a variety of command and staff positions including commander of a U.S. Army Field Artillery Battalion in Operation Desert Storm. 
Appointed in January 200 as Chief of Staff, he works closely with the Secretary and Deputy Secretary in managing day-to-day operations of the federal government’s second-largest Cabinet department, with some 286,000 employees in VA medical centers, clinics, benefits offices and national cemeteries throughout the country. 


According to the VA, the new 1991 Gulf War veteran task force’s efforts will include:

  • Defining all key areas of review
  • Consulting key experts and relevant stakeholders and reports.
  • Capturing the issues, data, as wells as program and performance info to inform decisions.
  • Looking holistically at issues and opportunities to advocate for the veteran.
  • Identifiying as a priority effect, initiatives that enhance identification and Treatment of this cohort’s undiagnosed and unexplained illnesses.


The VA's 1991 Gulf War veteran task force action plan has several components, all due January 31, 2010 according to Gingrich, including the following:

DATA SHARING:   The task force will prepare a white paper on data sharing between VA and DOD.

OUTREACH:  The task force will prepare a white paper with the goals of leveraging lessons learned to reconnect to this cohort.  The white paper will address the creation of a new VA campaign to conduct outreach to 1991 Gulf War veterans to learn more about the best ways of communicating with them, including what these veterans want to know.  VA will conduct a literature review and other background info about what makes this cohort unique demographically and what sources of information these veterans use to educate themselves on issues of importance to them, and is conducting national calls.

BENEFITS:    To date among the 696,842 veterans of the 1991 Gulf War, VA has processed 250,897 claims, with 220,541 awarded service-connected disability compensation, including  15,181 approved for one or more undiagnosed illnesses.  
  • Benefits Access Goal: expand outreach and education to Gulf War veterans.
  • Benefits Claims Adjudication Goal: Timely presumption of service-connected disability.  The task force will identify how VA will look for higher rates of illnesses among deployed versus non-deployed veterans of the 1991 Gulf War, establish population–based connections between specific military deployment and long-term health effects through prospective studies initiated prior to and immediately post-deployment.    The  current process requires a review of all existing science.  Meanwhile, veterans’ perceptions are that the current process detached from their concerns and experiences, so the goal is to shorten the claims adjudication timeline while still employing appropriate scientific evidence. 
CLINICAL CARE:  Provide holistic care for Gulf War veterans that addresses the whole veteran.  One possibility would be to apply the existing VA post-deployment integrated care model developed and used for veterans of the current wars in Iraq and Afghanistan.  The model is of a post-deployment health clinic that includes primary care, social work, and mental health.  Additional services include those of the suicide prevention coordinator, pain clinic, compensation and pension, polytrauma, orthopedics, dental, women’s health, and rehabilitative medicine and prosthetics.

CLINICAL TRAINING:  This is a Gulf War Veterans’ Illnesses action plan item, which the task force will provide recommendations to enhance.  The review process will include content review, a field clinician focus group survey, development of design and modularization, a restructuring and rewriting of the current clinician guide, testing the new guide, and making the new clinician guide available on VA Intranet in April or May 2010.    

COMMUNICATION & TIMELINESS:  Tracking the health of veteran over time is important for providing timely info about the relationship of past exposures and health.  There is an identified need to establish surveillance studies, which the task force will address in its recommendations.

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