VA program to provide private care stumbling out of the gate

A year after explosive accusations that patients had died waiting for appointments at the VA Medical Center in Phoenix, Arizona, the administration’s path to making health care more accessible for America’s veterans remains on shaky ground.
Critics say a program rolled out to give certain veterans the option of government-funded private care is experiencing serious bumps: according to reports, only 27,000 vets have taken advantage of the Choice Card program since it was launched in November.
Technically, to be eligible to see a non-VA doctor, a veteran must be at least 40 miles away from the nearest VA hospital, or have waited at least 30 days for an appointment.
But veterans groups say confusion about eligibility remains the big problem – not everyone qualifies, but some vets who thought they would reported they were turned away. Some say the process isn’t clear, and bureaucratic red tape has led to conflicting messages to veterans about whether or not they can access the system. Others have just gotten responses that weren't very helpful.
Air Force veteran Pat Baughman, for example, told Fox News he lives about 50 miles away from the nearest VA hospital in Bay Springs, Miss. -- approximately a one-hour drive. But when Baughman called the Choice Card phone number last November, he was told to drive more than three hours away to a hospital in Natchez, Miss.
“It didn’t make sense at all. I told them that’s longer than what I’m driving now. So they said they’d get back with me,” Baughman said, adding he received a call the next day and was told to drive to another location instead -- two hours away.
Baughman told FoxNews.com he finally gave up on the program and is using Medicare to pay his medical bills at a local doctor.
He's not alone in his frustration. According to a survey conducted by the Veterans of Foreign Wars (VFW) in February, 80 percent of the 1,068 respondents who believed they were eligible to see a private doctor in lieu of VA care found out they were not. It's unclear whether this is due mostly to misperceptions about the program by veterans, or missteps by VA officials.
“Here we are in March and there is a lot of confusion,” said Garry Augustine, executive director of the Disabled American Veterans (DAV), which is advocating with other major veterans organizations for some clarity in the legislation. “I think when you rush into a new program you are going to have growing pains.”
President Obama made his first visit on Friday to the scandal-scarred Phoenix center and referenced Choice Card -- praising the program, while acknowledging there was more to do in restoring trust in VA programs overall. Congress passed that Choice Card legislation last July, after an inspector general report on mismanagement and manipulation of wait-time data fueled calls for VA reform. The scandal also resulted in the resignation of VA Secretary Eric Shinseki in May.
Cards went out to eligible vets first, and then to all 9 million vets who currently receive VA care as of Aug. 1 -- in case they, too, meet the eligibility standards. It is up to the card holder to call the VA to see if they qualify and if so, they are then sent to a third-party administrator for a list of participating doctors.
One area of confusion is that according to the rules, a veteran must be 40 miles away from the nearest VA -- “as the crow flies.” But this can lead to unequal treatment, since residents in areas with winding roads, or simply crowded roads, could face a longer drive than others.
Augustine said about 500,000 should be eligible under the distance requirements, but the "as the crow flies" standard is throwing everything off. He and others are behind legislation that would clarify the rule to accommodate a 40-mile driving distance.
"The VA is construing the eligibility criteria as it relates to the 40-mile rule so narrowly that it is excluding too many who are far away from the care that they need,” wrote a group of senators to VA Secretary Robert McDonald on Feb. 25, urging him to not only consider tweaking the distance requirement, but to look at reports that veterans who need specialty care should be able to access that, even if there is a VA clinic that does not provide specialists within the 40-mile spectrum.
This was a problem for Minnesota veteran Paul Walker, who has cancer. He told local KARE-11 that he was turned down for private care for cancer treatment because there was a VA clinic within 20 miles of his home -- but the closest VA hospital which offers the treatment he needs reportedly is more than 50 miles away.
"I tried using it and I got flatly turned down," said Walker, who told the network that at the clinic, "all they do is dental work there and eye work and some basic kinds of different minor things... but I have cancer stage 4."
So, he said, "I don't get a choice. I get to die. So, to me that's not a choice."
Rep. Tim Huelskamp, R-Kan., has 63 counties and no VA hospital in his district. He also is joining members in moving legislation that could help people like Walker. He told McDonald in a recent hearing that he has been fielding complaints from veterans on this issue, too.
“I got an email by a veteran who drives 340 miles one way for cardiology,” he said. “If the VA choice program can’t provide something closer for him then we have to re-look how we are implementing” the program.
The Choice Card program was allocated $10 billion and is supposed to be temporary until the system gets up to speed with taking care of veterans in house, which would mean getting through the backlogs plaguing the nation’s VA hospitals. Aside from the Choice Card, there are other separate options for veterans to access private care, but veterans have to be referred by the VA directly, said Augustine.
Sen. Jerry Moran, R-Kan., who was one of the senators on the recent letter to McDonald, says he doesn’t feel the VA’s heart is into providing private care.
“The concern I have is that the VA has a mentality against outside care, even in the circumstances of (when veterans) can’t get care within 30 days or within 40 miles,” Moran said in a statement.
For his part, McDonald has said he, too, is not satisfied with the low number of veterans accessing the new program and has agreed the complaints are valid.
“We’re talking about how we can do a better way of marketing it,” he said in the February hearing at the House Veterans Affairs Committee. Further addressing the distance issue in relation to specialty care, he said, “distance from the place where you can’t get the service seems like a relatively weak measure." As for the “crow flies” issue, “we can look at the 40 miles, change the interpretation ... so we can make the program more robust. I am for whatever it takes to satisfy veterans.”
A representative with the VA did not return a request for comment on Friday.
Augustine says that consistency and communication and anything they can do to end the confusion –

Gitmo detainees 'splash' guards daily with human waste, Marine general tells lawmakers

Hard-core detainees at Guantanamo Bay routinely hurl their waste and vomit at their guards in daily, stomach-turning acts of defiance, a top Pentagon official told lawmakers.
"Splashing," as Marine Gen. John Kelly, the commander of U.S. Southern Command, called the practice in testimony before the Senate Armed Services Committee, is just one of the occupational hazards faced by the men and women guarding some 122 prisoners who remain at the compound. Kelly later elaborated that the term referred to throwing "a little cocktail" of "feces, urine, sperm, vomit" at the guards.
Guards have also been assaulted by prisoners and kneed in the groin, according to Kelly.

"If they can assault the guards physically, they'll do it."- Marine Gen. John Kelly

"If they can assault the guards physically, they'll do it," he said, vowing "I will not back off" from protecting the guards.
Abusive prisoners are restrained and sometimes moved to single cells, he said.
Kelly also said he was troubled by recent rulings from two military judges restricting female guards from dealing with several prisoners - including 9/11 mastermind Khalid Sheikh Mohammed, who complained that it was against Islam.
"Call me crazy -- that sounds like gender discrimination," Kelly said. "I'm also ashamed that I'm doing it," he said of limiting the duties of female guards."

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Lt. Gen John Kelly told lawmakers he will protect the men and women who serve under him. (Fox News Photo)

Word of the disgusting practice of terrorists throwing their bodily fluids at guards first surfaced last year, when Army Col. David Heath, the Guantanamo camp commander, said "splashing" by the prisoners was a near daily occurrence.
"In my experience, in the last four months it happens probably once a day," Heath told Agence France-Presse. "They don't discriminate in splashing. If you are at the right place at the wrong time, they'll splash whoever they can splash."
President Obama has vowed to close Guantanamo Bay, freeing dozens of detainees, including five who were traded for accused deserter Sgt. Bowe Bergdahl. Of those still at the facility, 55 have been cleared for repatriation or release to another country that will accept them, a Pentagon spokesman told Military.com.
Kelly said that the recidivism rate for those released from Guantanamo ranged as high as 30 percent, though the White House and State Department have maintained that the rate was closer to six percent.

Lawyers say Canadian-born Cruz eligible to run for president

While questions about Canadian-born Sen. Ted Cruz’s eligibility to be president haven’t drawn much attention, two former Justice Department lawyers have weighed in with a bipartisan verdict: Cruz, they say, is eligible to run for the White House.

Neal Katyal, acting solicitor general in the Obama administration, and Paul Clemente, solicitor general in President George W. Bush’s administration, got out in front of the issue in a Harvard Law Review article.

“There is no question that Senator Cruz has been a citizen from birth and is thus a ‘natural born Citizen’ within the meaning of the Constitution,” they wrote.  

Anti-Cruz “birthers” had questioned the Texas Republican senator’s eligibility to be president, challenging his citizenship status because he was born in Canada.  Two years ago, Cruz released his birth certificate showing his mother was a U.S. citizen born in Delaware, presumably satisfying the requirements for presidential eligibility as a “natural born citizen.”

The law review article, “On the Meaning of ‘Natural Born Citizen”, asserts that the interpretation of the term was settled in Cruz’s favor as early as the 1700’s. The lawyers wrote that the Supreme Court has long used British common law and enactments of the First Congress for guidance on defining a “natural born citizen.”
 
“Both confirm that the original meaning of the phrase ‘natural born Citizen’ includes persons born abroad who are citizens from birth based on the citizenship of a parent,” they wrote. They concluded someone like Cruz had “no need to go through naturalization proceedings,” making him eligible. Cruz is still weighing a presidential run.

Last month, Cruz addressed the citizenship issue during a question-and-answer session with moderator Sean Hannity, of Fox News, at the Conservative Political Action Conference.  “I was born in Calgary. My mother was an American citizen by birth,” Cruz said.  “Under federal law, that made me an American citizen by birth. The Constitution requires that you be a natural-born citizen.”

Hillary Cartoon

Professors: US flag symbolizes racism, should not be displayed on campus

A group of university professors has signed a letter showing their solidarity with students who tried to ban the American flag at the University of California, Irvine – because they said Old Glory contributes to racism.
“U.S. nationalism often contributes to racism and xenophobia, and that the paraphernalia of nationalism is in fact often used to intimidate,” read a letter obtained by the website Campus Reform.

A group of Californian lawmakers is working on a bill that that would prohibit publicly funded universities from banning the American flag.

Hundreds across the nation have signed the letter – including some U.C. Irvine professors, Campus Reform reported.
"We admire the courage of the resolution's supporters amid this environment of political immaturity and threat, and support them unequivocally" the letter stated.
How those professors can sleep at night knowing their salaries are paid for by a bunch of xenophobic racists is beyond me.
On March 3 the U.C. Irvine student government association voted 6-4-2 to remove Old Glory from a campus lobby for the sake of cultural inclusivity.
The un-American knuckleheads blathered on about how "the American flag has been flown in instances of colonialism and imperialism."
Breitbart quoted an unnamed student who said the student government association feared the flag might hurt the feelings of illegal aliens.
“There were people who were like, ‘the flag triggers me’ – that was their exact wording, too,” the student said.
Over the weekend, the executive leadership of student government met and vetoed the legislation and by Monday the flag was once again posted in the campus lobby.
“Our campus is patriotic and proud,” student government President Reza Zomorrodian told me. “We did something right for our campus.”
A March 10^th legislative meeting to discuss the controversy was canceled after the university received a “viable threat of violence.”
While the threat was not specific, university officials said they were taking the threat seriously and urged students to be diligent.
“Regardless of your opinion on the display of the American flag, we must be united in protecting the people who make this university a premier institution of higher learning,” Chancellor Howard Gillman wrote in a statement posted on the university’s website.
Meanwhile, a group of Californian lawmakers is working on a bill that that would prohibit publicly funded universities from banning the American flag.
Here's how it should work: you ban the flag -- we ban your student loans.
I'm old school. Where I come from, you salute Old Glory, you don't toss it in a closet. You don't ban it.

Convicted illegal immigrants arrested in ICE sweep kept in US under Obama action

WASHINGTON –  Federal agents in a sweep targeting the most dangerous criminal immigrants arrested 15 people who have been allowed to remain in the U.S. under President Barack Obama's executive action intended to protect children who came to the U.S. years ago with their parents, The Associated Press has learned.
Fourteen of the 15 had been convicted of a crime, the Homeland Security Department confirmed late Thursday. In at least one case, the Obama administration renewed the protective status for a young immigrant after that person's conviction in a drug case, a U.S. official briefed on the arrests said.
One of the eligibility requirements for the program is that immigrants not have a criminal history. The official spoke on condition of anonymity because this person was not authorized to discuss the matter by name.
It was not immediately clear when 13 of the immigrants were convicted or what their crimes were. They were arrested by U.S. Immigrations and Customs Enforcement. The answers to those questions could undermine the integrity of the government's program, since eligibility is reserved for ambitious, young immigrants enrolled in school or who graduated and who would benefit American society.
None of the names of the immigrants was disclosed. One of the young immigrants arrested hadn't been convicted of a crime, but was arrested after being found armed with a gun, the official said.
Homeland Security spokeswoman Marsha Catron said eight other people arrested during the sweep had received the protective status at one point, including three who had it revoked. Catron did not provide additional details.
Under the program, known as Deferred Action for Childhood Arrivals, or DACA, more than 675,000 young immigrants since August 2012 have been granted a work permit and reprieve from deportation.
"With few fraud detection measures and effective background checks in place, it's no surprise that ICE arrested over a dozen DACA recipients last week, most of whom had already been convicted of a crime," said House Judiciary Committee Chairman Bob Goodlatte. "I and other members of the House Judiciary Committee have expressed concern about this for years."
Goodlatte, R-Va., and other Republicans have long decried Obama's executive immigration as a form of backdoor amnesty that circumvents Congress.
Senate Judiciary Committee Chairman Charles Grassley, R-Iowa, said the case "sheds light on what appears to be a haphazard and risky vetting process by an administration that is very interested in finding creative and possibly unconstitutional ways for people to stay in the country."
Catron said U.S. Citizenship and Immigration Services "is examining these cases to determine the appropriate course of action, which may include a denial or termination of deferred action."
The sweep also captured five immigrants with protective applications pending and 19 others who had already been denied protection from deportation under the program.
Earlier this week ICE Director Sarah Saldana said the operation focused on "the worst of the worst criminals."
"This was a targeted enforcement operation, aimed specifically at enhancing public safety," Saldana said. "It exemplifies our core mission, by taking dangerous criminals off the streets and removing them from the country we are addressing a very significant security and public safety vulnerability."
ICE agents arrested 2,059 convicted immigrants, including more than 1,000 people who had multiple convictions. More than 98 percent of those arrested in the weeklong operation were a top priority, Saldana said.
In November, Homeland Security Secretary Jeh Johnson announced new deportation priorities as part of Obama's planned expansion of programs to shield millions of immigrants from deportation.
The top priority includes immigrants suspected of being terrorists, gang members, convicted felons and those caught crossing the border illegally. The second priority includes immigrants convicted of three or more misdemeanors or a single serious misdemeanor, such as drunken driving or domestic violence.
Homeland Security Department documents say participation in the program can be revoked at any time. U.S. Citizenship and Immigration Services, which approves applications, reported to the House Judiciary Committee last year the government stripped that protection from 113 people as of August. The revocations included one case of gang membership, one aggravated assault, 11 driving-under-the-influence cases and 11 errors by USCIS, according to the committee.
Obama's planned expansion of the protection programs has been put on hold by a federal judge in Texas presiding over a lawsuit filed by 26 states to stop the effort. In February Judge Andrew Hanen temporarily blocked the expansion plans, which included granting protections and work permits to parents of U.S. citizens and legal permanent residents. On Thursday the U.S. government asked an appeals court to lift the temporary hold on the expansion.

Clinton has received $16 million in post-presidency benefits

Former President Bill Clinton has received nearly $16 million in taxpayer funds since leaving the White House, covering everything from his pension to personnel to benefits -- and renewing questions over how much taxpayers really should spend on ex-presidents who make millions after leaving office.
A new Politico report and analysis examined the payments since he left office in 2001, and claimed it amounts to more than any other ex-president has received. Meanwhile, Politico points out, Clinton has a personal annual income that beats all the other living former presidents. His $15 million advance -- then a record -- for his 2008 memoir was just a sliver of his earnings. According to reports he's made more than $106 million in speaking fees alone since 2001.
Clinton’s wife, former Secretary of State Hillary Clinton, also has earned millions in speaking fees -- and released a memoir, for which she reportedly got a $14 million advance, last year. In the first 16 months after leaving Foggy Bottom in 2012, she made at total of $12 million in personal income, according to Bloomberg.
This is a far cry from the picture of destitution that lawmakers feared might face ex-presidents if they did not pass the Former Presidents Act in 1958. Many former commanders-in-chief were in fact personally wealthy, but some were not. Harry S. Truman, according to a report by the Congressional Research Service, had numerous financial problems after he left office in 1953, which became the impetus for the act. The FSA affords a pension and money for numerous expenses, including for personnel, travel costs, health benefits and office space, for as long as the former presidents live.
From 2001 to 2014 Clinton has received a roughly $200,000 annual pension (all presidents received the same level of pension in 2014). Politico reported that the federal money, though, has also gone toward boosting the salaries of some employees of the Bill, Hillary and Chelsea Clinton Foundation. And nearly $1 million went toward equipment and communications-related costs, according to Politico.
While Clinton has gotten the most since 2001, ex-President George H.W. Bush is catching up, according to CRS. He received the second-highest amount of benefits -- $14 million since 2001. Meanwhile, George W. Bush, who has received $7 million from the government since 2009, spent marginally more than Clinton on office space in 2014 -- $420,000 for an office in Dallas, Texas, compared with Clinton’s $415,000 digs in Manhattan.
Criticism of the FSA might someday lead to reform of the law. Rep. Jason Chaffetz, R-Utah, has already introduced a bill that would cap the full package of annual benefits at $400,000.

ISIS accepts Boko Haram's allegiance pledge

A spokesman for the ISIS terror group said Thursday that it had accepted a pledge of loyalty from Nigeria-based Boko Haram that was made last weekend.
ISIS' media arm, al-Furqan, released an audio statement by spokesman Abu Mohammed al-Adnani that claimed the group's self-proclaimed caliphate had expanded to West Africa. al Adnani had previously urged fighters from around the world to migrate and join Boko Haram.
The announcement came as both groups struggled against increased military pressure in recent days. ISIS is battling against Iraqi forces seeking to recapture Saddam Hussein's hometown of Tikrit, while coming under fire from U.S.-led coalition air strikes in other parts of the country and in Syria.
Boko Haram, meanwhile, has been weakened by a multinational force that has dislodged it from a score of northeastern Nigerian towns. But its new Twitter account, increasingly slick and more frequent video messages and a new media arm all were considered signs that the group is now being helped by ISIS propagandists.
Then on Saturday, Boko Haram leader Abubakar Sheka posted an audio recording online that pledged allegiance to ISIS.
"We announce our allegiance to the Caliph of the Muslims ... and will hear and obey in times of difficulty and prosperity, in hardship and ease, and to endure being discriminated against, and not to dispute about rule with those in power, except in case of evident infidelity regarding that which there is a proof from Allah," said the message.
J. Peter Pham, director of the Africa Center at the Atlantic Council, a think tank in Washington, noted ISIS' quick acceptance of Boko Haram's allegiance and said that the bond highlights a new risk.
"Militants finding it increasingly harder to get to Syria and Iraq may choose instead to go to northeastern Nigeria and internationalize that conflict," he said.
The Boko Haram pledge of allegiance to ISIS comes as the militants reportedly were massing in the northeastern Nigerian town of Gwoza, considered their headquarters, for a showdown with the Chadian-led multinational force.
Boko Haram killed an estimated 10,000 people last year, and it is blamed for last April's abduction of more than 275 schoolgirls. Thousands of Nigerians have fled to neighboring Chad.
The group is waging a nearly 6-year insurgency to impose Muslim Sharia law in Nigeria. It began launching attacks across the border into Cameroon last year, and this year its fighters struck in Niger and Chad in retaliation to their agreement to form a multinational force to fight the militants.
Boko Haram followed the lead of ISIS in August by declaring an Islamic caliphate in northeast Nigeria that grew to cover an area the size of Belgium. ISIS had declared a caliphate in vast swaths of territory that it controls in Iraq and Syria.
The Nigerian group has also followed IS in publishing videos of beheadings. The latest one, published March 2, borrowed certain elements from IS productions, such as the sound of a beating heart and heavy breathing immediately before the execution, according to SITE Intelligence Group.
In video messages last year, Boko Haram's leader sent greetings and praise to both ISIS leader Abu Bakr al-Baghdadi and leaders of Al Qaeda. But Boko Haram has never been an affiliate of Al Qaeda, some analysts surmise because Al Qaeda considers the Nigerians' indiscriminate slaughter of Muslim civilians as un-Islamic.
Recent offensives have marked a sharp escalation by African nations against Boko Haram. An African Union summit agreed on sending a force of 8,750 troops to fight Boko Haram.
Military operations in Niger's east have killed at least 500 Boko Haram fighters since Feb. 8, Nigerien officials have said.
Members of the U.N. Security Council proposed Thursday that the international community supply money, equipment, troops and intelligence to a five-nation African force fighting Boko Haram.