Secretary of the Department of Veterans Affairs - Moves On

Department of Veterans Affairs Names
Acting Director to Embattled Canandaigua VA

Robert Wilson Ratliff, Ph.D., FACHE
Deputy Director
SES III
Central Texas Veterans Health Care System

Robert W. Ratliff, Ph.D., FACHE, was appointed Deputy Director for the
Central Texas Veterans Health Care System, and a member of the Senior
Executive Service effective April 22, 2001. As Deputy Director, Dr.
Ratliff is responsible for all the day-to-day operations of this
multi-million dollar VA health care system, which is one of the
largest in the country with an annual budget of over $325 million and
nearly 2,700 employees. It is comprised of two VA hospitals in Temple
and Waco, a large stand-alone outpatient clinic in Austin, and several
community based outpatient clinics throughout Central Texas.
Additionally, from January 3, 2004, until September 19, 2004, Dr.
Ratliff served as Acting Director.

Dr. Ratliff started his career in the Department of Veterans Affairs
in 1979 as a Pharmacist (GS-11) at the VA Medical Center (VAMC) in San
Diego, CA., after graduating from the University of Mississippi with a
Bachelor of Science degree in Pharmacy. He served as a clinical
pharmacist at several VAs prior to being selected as Chief of Pharmacy
at Waco, Texas, in 1986. He served in this capacity until 1990 and
during this time he also served six months as Acting Associate
Director for VAMC Waco. In 1990 he was selected for the Associate
Director Trainee program and trained in San Antonio, TX. In April of
1991, after completion of the program, he was selected as Associate
Director (GM-14/15) for the VAMC in Nashville, TN. While in this
capacity he was detailed by Southern Region to Murfreesboro VAMC as
Acting Associate Director from September 1994 until April 1995. Dr.
Ratliff was Associate Director for VAMC Nashville until August 2000
when he was selected as Associate Director (GM-15) for the newly
merged VA Tennessee Valley Healthcare System. Dr, Ratliff was
designated by the CNOs office as the lead management negotiator for the merger of the Nashville and Murfreesboro VAs.

In addition to his Bachelor's Degree in Pharmacy, Dr. Ratliff holds a
Diploma in Health Care Administration from the Academy of Health
Sciences, U.S. Army, Fort Sam Houston, TX; a Master of Science Degree
in Health Care Administration from Texas State University; and a Ph.D.
in Health Education from Texas A&M University. Dr. Ratliff was the Regents Graduate
Fellow for his Department at Texas A&M University. He attended
Leadership VA in 1988 and has served on the Leadership VA selection
panel. Dr. Ratliff served on the Consensus Congress Planning Committee
from 1999-2000 and has served on the Graduate Healthcare
Administrative Training Program (GHATP) Board since 2000.

Dr. Ratliff is a Fellow in the American College of Healthcare
Executives, a member of the Association of Military Surgeons of the
U.S. and served on the ACHE Regent's Advisory Board since 1995.

Dr. Ratliff has received numerous awards and recognitions throughout
his career. This year he was named Outstanding Alumni for 2004 from
Texas State University and receiving the Allen G Herkimer Award from
Texas State University. In 2000 and 2001 his station received the
Vice President's Hammer and Scissor Award for improvements and innovations in healthcare
and received a VA National Patient Safety Award. Dr. Ratliff has served
as an active member on countless National VA and local community
committees, been published in several journals, and has continually
mentored and taught students in Healthcare Management and serves as
graduate faculty.
 

5 Local Names on V.A. Panel

New committee to decide fate of Canandaigua medical facility.

Jack Jones
Staff writer

(October 31, 2004) — CANANDAIGUA — True to his word, U.S. Secretary of Veterans Affairs Anthony Principi has named five local residents to a nine-member panel that will shape the future of the Canandaigua veterans hospital.

U.S. Sen. Charles Schumer, D-N.Y., on Saturday confirmed that a list of the appointees obtained by the Democrat and Chronicle from V.A. sources will include:
Korean War veteran Ralph Calabrese of Canandaigua, who last year spearheaded a grass-roots community effort to save the facility from closure.
Sam Casella, town of Canandaigua supervisor.
Helen Sherman, director of the Ontario County Office for the Aging.
Daniel Hayes, president of Finger Lakes Community College. Earl Gleason, director of the Yates County Veterans Service Office in Penn Yan.

Schumer's office also confirmed that retiring Rep. Amo Houghton of Corning, a World War II veteran, has been named chair of the committee. It also will include state Veterans Services Director George Basher; Dr. Lawrence Flesh, chief medical officer for the upstate Veterans Integrated Services Network II; and James Cody, director of the Syracuse V.A. hospital.
Area officials and veterans on Saturday praised the selections as balanced and reflective of veterans' and community interests.

"It's an excellent list of very good people," said Assemblyman Brian Kolb, R-Canandaigua, who joined a bipartisan effort last year to resist a proposal by senior V.A. administrators to close the 71-year-old Canandaigua hospital.

"It's a good balance of veterans, community people and health care experts," Kolb said. "I know that Amo will do a great job as chair ... and I think it's very important that they included at least one elected local official. Sam Casella will do a good job representing the community."

Casella said he looks forward to serving on the committee that will decide, among other issues, whether a proposed new V.A. Outpatient Clinic and Nursing Home will be built on the 172-acre V.A. campus or at another location in the Canandaigua area.

"We've sure got our work cut out for us," said Casella, whose father, World War II combat veteran Samuel T. Casella, died at the Canandaigua hospital in 1996.

Casella and another committee member, Gleason, said they hope to persuade V.A. leaders to preserve as much as possible of the existing historic campus and to place the proposed outpatient clinic and nursing home there.

"Some people say it would be more costly to rehab the buildings there now than to build new ones, but I want to see the numbers," said Gleason, a Vietnam combat veteran. "They've already spent a lot of money bringing that hospital up to date, and it's a beautiful place. It's also my hospital, the place I go for my medical care."

In recent months, some veterans and community leaders who worked together to save the facility have been at odds over whether to preserve it for use only by veterans or to defray costs by renting empty space in some of the rambling brick buildings to other agencies.

"In my heart of hearts, I'd like to see them keep as much as possible like it is today to serve as many veterans as we can in the future," Casella said. "But it's going to be a real challenge. No matter what we do, we aren't going to please everybody."

Canandaigua City Manager Stephen Cole said it's important for the committee to make the right decisions about the hospital, which serves more than 25,000 regional veterans and contributes more than $30 million annually to the local economy.

"I'm happy to hear the committee has been appointed and now they can begin work," Cole said. "I'd like to see someone from the city on there, but this is an excellent group of people."

Schumer, who along with Houghton and U.S. Sen. Hillary Clinton, D-N.Y., joined the battle to keep the hospital open, also praised Principi's choices. Schumer said, however, that he might ask Principi to consider adding another person to the list.

"We'd like to see someone representing the hospital workers on there," he said.

JJONES@DemocratandChronicle.com

Skeptical vets rally for V.A. hospital

The V.A. proposed in 2003 that the Canandaigua campus be closed as part of a nationwide streamlining of the V.A. hospital network. The proposal led to a sustained protest by Rochester-area veterans and local, state and federal officials.

Their efforts appeared to pay off when Principi made his announcement three months ago. Questions have arisen since about whether a vacant portion of the facility would be leased to Finger Lakes Community College, whether jobs would be cut and whether the hospital would stay open for years to come.

Principi said only that Canandaigua would have a new outpatient clinic and a 120-bed long-term care facility, and that details would come from a V.A. Master Plan Committee. He didn't promise that the existing V.A. center would be the site of those facilities.

At Saturday's rally on the medical center campus, veterans said the need for medical facilities remains great.

"I hope to God we don't need these hospitals anymore, but if our sons and daughters are coming back from Iraq and Afghanistan, then we will," said Ralph Calabrese, a Korean War veteran.

Webster resident Edward Laughlin attended in support of his father, a World War II veteran who served in the Army and used the Canandaigua hospital's services.

"The need is real and the people that are coming home need to know what they did was with honor," said Laughlin, who also served in the Army in 1971 and 1972.

Simes said he plans to hold a community awareness meeting on Oct. 27, with details to be announced later.

Psychiatric Symptoms Abound in Soldiers Returning from Mid East

COLORADO SPRINGS, Colo., May 13 (UPI) -- Soldiers at Fort Carson report a wave of serious mental problems among troops back from the "war on terrorism," according to interviews with soldiers, their families and a therapist working with them.

 The torment seems linked to troubling behavior -- including a suicide, violence and heavy drinking among a number of the 12,000 troops arriving back in Colorado Springs, nestled in the eastern foothills of the Rocky Mountains, 60 miles south of Denver.

 They say the Army frequently fails to diagnose or properly help suffering soldiers. In some cases -- particularly in elite fighting units -- soldiers hide problems fearing damage to their careers, turning instead to alcohol and sometimes resulting in domestic violence.

 "The pattern I'm seeing is that they are not being evaluated very thoroughly," said Kaye Baron, a clinical psychologist in Colorado Springs. Baron treats soldiers in her private practice and helps the Department of Veterans Affairs evaluate the mental health of soldiers leaving the Army.

 Baron said the Army is not properly diagnosing or treating soldiers who have mental problems. Instead, some are pushed out of the Army, making them feel worse.

 "Why is the military discounting the problems? Why are they disposing of people? Do they not have the resources? Are they in denial? Is it corruption? I'd like to know," Baron said. "My belief is that we should honor these soldiers and acknowledge that these people are going to be affected."

 Among the incidents:

 Two soldiers deployed from Fort Carson apparently committed suicide in Iraq, according to soldiers and data compiled by United Press International. Another two Fort Carson died in Iraq in incidents reported as "non-combat-related" weapons discharges -- a term employed by the Pentagon to refer to accidents or suicides.

 In March, Special Forces Chief Warrant Officer William Howell shot himself in the head in front of his Monument, Colo., home just three weeks after returning to Fort Carson from Iraq. Before taking his own life, Howell beat his wife and threatened her with his .357-caliber revolver before putting the gun to his own temple and firing.

 Interviews showed other frightening behavior:

 "I wake up sometimes with a fat lip," said the husband of one soldier during an interview with the couple at a restaurant north of town. Since returning from Iraq last summer, his wife not only punches and hits him in her sleep, she recently "freaked out" during the day, punching and biting him in the belief that he intended to kill her.

 Soldiers interviewed at Fort Carson insisted on anonymity for fear of retribution. They said they knew that the Army charged one Fort Carson soldier, Staff Sgt. George-Andreas Pogany, with cowardice last year after he apparently asked his chain of command for help with what he said was a panic attic in Iraq. That charge was dropped, but his legal status, career and medical care remain in limbo.

 Like Pogany, some soldiers at Fort Carson are worried that some of the emotional turbulence may be long-term side effects from Lariam, an anti-malaria drug heavily used among troops deployed from the base. The Food and Drug Administration warns that Lariam may cause long-term depression, psychosis, aggression, anxiety, panic attacks and sleeping problems, and it warns about reports of suicide among users. Combat stress -- post-traumatic stress disorder -- also can produce those symptoms. Howell, the Special Forces soldier who committed suicide, took Lariam in Iraq.

 One Special Forces soldier at Fort Carson said mental problems are occurring even in elite units returning from war, but soldiers will not admit it. "Everybody has it," this soldier said. "If somebody says they don't have it, they are lying."

 "In Special Forces, you are supposed to be in an elite crowd. When you are in that type of field, you don't show any weakness, even when you are being torn up." He said he can't sleep and drinks too much. "We all came back with drinking problems," he said of his unit. He said his temper is frightening and that he sometimes has the urge to tackle problems "the way that I did over there" -- by killing.

 Fort Carson spokesman Richard Bridges said Fort Carson would not respond to any questions on this article and would not allow a reporter on the base. The Department of the Army referred questions to Army Forces Command in Atlanta. Jack Coffey, a spokesman for Army Forces Command, did not respond to requests for comment made by phone and in writing.

 Bridges has told reporters that soldiers must receive seven hours of counseling for a deployment. None of the soldiers interviewed by UPI said they had received seven hours of counseling. The Special Forces soldier said he had received his first mental health debriefing months after returning from war.

 Steve Robinson, executive director of the National Gulf War Resource Center and a retired Army Ranger, has visited returning troops in the United States and Europe. Post-traumatic stress disorder rates among troops from the first Gulf War ran around 6 percent, he said, but he estimates PTSD among veterans from Iraq at 14 percent and climbing. With well over 100,000 troops returning from Iraq this year, Robinson predicted a "wave" of serious issues among troops back home.

 "We have not seen but the froth of the wave of people who will come back with mental problems," he said.

 A soldier at Fort Carson with the 52nd Engineer Combat Battalion said he is suffering from anxiety attacks, sleeplessness and intense anger he said he did not have before serving in Iraq. He said the Army has diagnosed him with a major depression disorder. "I don't feel depressed," he said about the Army diagnosis. "But I guess I don't have to feel depressed to be depressed."

 He claims that in Iraq a physician's assistant -- not a psychiatrist -- handed him anti-depressant drugs and sleeping pills. He also claims he was threatened because of his anger problems. "When I went to Combat Stress they told me that if I had one more outburst they would (put) me out (of the Army) with a personality disorder," the soldier said.

 The wife of another soldier in that unit complained that her husband had become increasingly violent since returning from Iraq and recently tore off the top of the stove. "He threw the stovetop at me. He's always had a temper, but not like this," she said.

 The mental issues at Fort Carson appear similar to problems across the country apparent in interviews at other bases, media reports and Pentagon data.

 At least seven soldiers, including Howell, returned from Operation Iraqi Freedom and committed suicide, according to the Army. At least 23 soldiers committed suicide in Iraq and Kuwait during 2003. Another two soldiers have committed suicide there this year.

 Two of the suicides in the United States occurred at Walter Reed Army Medical Center in Washington, the Army's flagship hospital. Soldiers there recently report at least two other suicide attempts among soldiers back from Iraq. Walter Reed spokesman Jim Stueve referred questions to the Army Surgeon General. The Surgeon General's office did not comment.

 Army Reservist Lt. Brandon Ratliff, a veteran of Afghanistan, shot himself in the head last month after he lost a promotion promised to him by a city agency in Columbus, Ohio. At least six others who served in Operation Enduring Freedom, the broader "war on terrorism" including Afghanistan, have committed suicide after returning.

 Other returning soldiers have turned their anger outward, with frightening and sometimes bizarre consequences.

 Police say Master Sgt. Kenneth Lee Schweitzer walked into a bank in Keokuk, Iowa, in April, fired a large-caliber handgun into the air, demanded cash, and then drove to the local police department and surrendered. Schweitzer, an Iraq war veteran from the 101st Airborne Division, reportedly told police he wanted to be put in jail because he "just couldn't take it anymore." He reportedly chose a one-story bank so he could safely fire his weapon toward the ceiling.

 Also in April, a soldier in the 82nd Airborne Division based at Fort Bragg, N.C., was charged with felony child abuse in the severe beating of his 2-year-old daughter. Authorities said alcohol did not appear to be a factor, the Fayetteville Observer reported. He had been in Iraq for a month earlier this year. It was not clear why his tour was so short.

 Soldiers who served in Operation Iraqi Freedom have allegedly committed a total of four homicides since returning:

 - In Columbus, Ga., four Fort Benning soldiers are charged in connection with the killing of a fifth a few days after returning from Iraq in July; police said one soldier stabbed the victim dozens of times, even piercing his skull.

 - In Tampa, Fla., a soldier who returned from to MacDill Air Force Base last spring was charged with killing his girlfriend six weeks later. A police detective described the scene as gruesome, with "blood from one end of that apartment to the other" and the victim stabbed in the thigh, right arm and left eye and shot in the left arm, left cheek and left ear, according to the Denver Post.

 - A third homicide is cited in an Army advisory team report on mental health problems among U.S. troops in Iraq. It occurred four months after the soldier's return, the report says: "The soldier allegedly shot and killed a man who was vandalizing his vehicle and committed suicide soon thereafter. Both soldiers had a history of psychiatric treatment." The report notes "the possibility that (Iraq)-related factors" played a role.

- Most recently, an Army sergeant back from a year in Iraq is charged with drowning his wife in April near Fort Lewis, Wash. His family told reporters that he had changed in Iraq, where he drove heavy equipment.

 The Special Forces soldier interviewed near Fort Carson predicted more problems as returning soldiers have trouble readjusting to civilian life. "Give it two months, when all these people are back," he said.

Baron, the clinical psychologist in Colorado Springs, worries that some soldiers' problems may last a long time. She estimates she has evaluated more than 700 veterans over the past 18 months, including around 50 back from Iraq in the past few months.

"This war is going to cause a detriment to our society," she said.

National Commission and the Future of Nursing in the VA

National Commission Chartered to Determine the Future of Nursing in the VA

The commission will provide advice to Congress and the Secretary, the Commission shall:
1. Assess the future of the nursing profession within the Department;
2. Consider legislative and organizational policy changes to enhance the recruitment and retention of nurses and other nursing personnel by the Department of Veterans Affairs.

3. The Commission, or at its direction any panel or member of the Commission, may hold hearings and take testimony to the extent considered advisable;
4. Secure directly from any Federal department or agency information necessary to carry out its responsibilities.

The nation has identified a shortage of healthcare personnel that will only intensify over the next ten years, the VA expects that that shortage will impact it's healthcare system adversely as well.

The commission acknowledged that the Veterans Health Administration is the largest employer of health care workers in the United States. It is also the employer of over 55,000 registered nurses, licensed practical nurses and nursing assistants. VHA provides inpatient, outpatient and home care across various settings. According to VA records, for the calendar year ending December 31, 2002, there were 162 VA hospitals, 137 nursing homes, 681 community clinics, 11 mobile clinics, and 43 domiciliaries. VHA reported over 550,000 admissions. During the same period, more than 49,000,000 outpatient visits were reported (Department of Veterans Affairs, 2002). VHA patient workload continues to rise in the midst of a growing nursing shortage.

The commission was established to;

1. Consider legislative and organizational policy changes to enhance the retention of nurses and other nursing personnel by the Department of Veterans Affairs.
2. Assess the future of the nursing profession within the Department.
3. Recommend legislative and organizational policy changes to enhance the recruitment and retention of nurses and other nursing personnel in the Department.


So far their studies on nursing satisfactions have revealed some common threads with staff here in Canandaigua they were; Work Environment; Fair Compensation; Leadership; Professional Development and Respect/Recognition.

From internal data including the "All Employees Satisfaction Survey" additional concerns surfaced surrounding the Professional Standards Board, Nurse Qualification Standards and Staffing Issues.


Over the next few months, the Commission will continue to synthesize data, consider expert opinion and formulate recommendations to prepare a final draft report. The Commission will submit its final report to the Secretary of the Department of Veterans Affairs, May 2004 with specific legislative and organizational recommendations to assure the availability of a qualified nursing workforce to meet the health care needs of America’s veterans.

To read the Commission preliminary report

Click here

 Thank You