Without VA Lease Authority, Veterans To Be Denied Care


Without VA Lease Authority, Veterans To Be Denied             Care              

Take Action!


Please Contact Your Elected Officials Today!

The Department of Veterans Affairs (VA) plans to open 38 new community outpatient clinics, in 22 states and territories, between now and 2017. These clinics will be in leased buildings,   with VA employees providing the services. This same arrangement has worked well in hundreds of existing VA clinics, nationwide. Last year, the Congressional Budget Office (CBO), an  independent arm of Congress, decided these lease contracts would  become long-term debts of the federal government. In considering  the first 15 leases, Congress, based on the new CBO     interpretation, forced VA to find funds for all 15 leases to cover an entire 20-year leasing period, rather than provide the money for only the first year. The authorizing law only requires the  first year to be funded, with future payments to be managed   through the annual VA budget. Because VA could not pay the entire           cost (between $1.2 and $1.5 billion) in the first year for 15 clinics, this new interpretation effectively stopped all VA proposed leases. This program, both new clinic leases and renewals  for existing leases, is now in jeopardy.

Without these clinics, VA will be denying care to veterans in  need, while making their health care more expensive overall. The cost to the government is far less than construction of major VA  hospitals. Without the ability to lease, from a practical point of  view the change in Congressional policy forces VA to buy land and  build government-owned clinics, or to do nothing. At a minimum this new requirement will add years to the existing planning  process, will delay or deny care for veterans, and is unacceptable to veterans who need VA health care.VA is managing almost 900 existing community-based outpatient  clinics, all established under the prior policy, and operating   under leases. Veterans who receive this care are highly satisfied. In our opinion this successful arrangement should not be abandoned at the expense of 340,000 or more veterans who would be denied               care.

Please use the prepared letter, or write your own letter, to   urge your two Senators and Member of the House of Representatives to solve this problem, to ensure veterans receive the care they earned and deserve. Recently, the Executive Directors of the major veterans service organizations sent a letter to Congressional               leaders expressing our concerns

VA, DoD and HHS Partner to Expand Access to Mental Health Services for Veterans, Service Members and Families


May 21, 2013

VA, DoD and HHS Partner to Expand Access to Mental Health Services for Veterans, Service Members and Families

Inter-Agency Effort to Increase Access to Mental Health Services Responds to Executive Order

WASHINGTON – Today, the Departments of Veterans Affairs (VA), Defense (DoD) and Health and Human Services (HHS) announced the progress made to date on initiatives called for in President Obama’s August 31, 2012, Executive Order to Improve Access to Mental Health Services for Veterans, Service Members, and their families.

“We have made strong progress to expand Veterans’ access to quality mental health services, and President Obama has challenged us to do even more,” said Secretary of Veterans Affairs Eric K. Shinseki. “Our ongoing, joint efforts reflect our commitment to the health and well-being of the men and women who have served the Nation.”

“One of the great challenges we face as a nation is how to provide quality, accessible, long term, mental health care for service members, veterans and their families.  Using the combined resources and expertise from across the government we are advancing services for those who have sacrificed so much for our nation,” said Secretary of Defense Chuck Hagel.

President Obama’s Executive Order directed VA, DoD, and HHS, in coordination with other federal agencies, to take a number of steps to ensure that Veterans, Service Members, and their families receive the mental health services and support they need.

“There’s no more important work than taking care of those who protect our nation,” said Health and Human Services Secretary Kathleen Sebelius.  “By working together, we can make sure our service men and women, our veterans, and their families have the behavioral health services they need to build healthy and fulfilling lives.”

Today, the Departments released an interim report, found here, outlining progress on this initiative, including:

•             Increasing the capacity of the Veterans Crisis Line by 50 percent to help ensure that Veterans in crisis can readily reach help.

•             Establishing 15 pilot projects in seven states where VA is working with community-based mental health providers to help Veterans access mental health services in a timely way.

•             Increasing VA mental health services capacity through VA hiring of nearly 1,400 mental health providers and 248 new peer specialists.

•             Implementing a national suicide prevention campaign to connect Veterans and Service Members to mental health services.

The Departments are actively working on additional deliverables called for in the Executive Order, including the development of a National Research Action Plan.


Federal Department actions to date include:

Suicide Prevention:  VA and DoD jointly developed and are implementing a national suicide prevention campaign to connect Veterans and Service Members to mental health services.  This year-long effort began Sep. 1, 2012.  The program continues to save lives and link Veterans with effective ongoing mental health services on a daily basis.  As of March 2013, the Veterans Crisis Line (1-800-273-8255, press 1) has received over 814,000 calls, over 94,000 chats, as well as over 7,200 texts, and has helped more than 28,000 Veterans in imminent danger.  VA has also completed the hiring and training of additional staff to increase the capacity of the Veterans Crisis Line that were called for in the Executive Order. In addition, the DoD has initiated a thorough review of its mental health and substance abuse prevention, education and outreach programs informed by the expertise of the Department of Health and Human Services’ Substance Abuse and Mental

Health Services Administration.

Enhanced Partnerships Between the VA and Community Providers:  VA worked with HHS to help identify potential local community resources to improve Veterans access to mental health services.  VA has enhanced access to mental health care by establishing 15 VA pilot agreements with clinics in local communities to improve access to mental health service.

Expanded VA Mental Health Staffing:  As of May 7, 2013, VA has hired a total of 1,360 mental health clinical providers towards the goal of 1,600 new mental health professionals outlined in the Executive Order. Additionally, VA has hired 2,036 mental health clinical providers to fill existing vacancies.   VA has also hired nearly 250 new peer specialists in support of the specific goal of 800 peer specialists outlined in the Executive Order.  The interim report indicated that as of Jan. 29, 2013, VA had hired 1,058 mental health clinical providers in support of the specific goal of 1,600 mental health professionals, and over 100 peer specialists in support of the specific goal of 800 peer specialists.

Improved Research and Development: The development of a National Research Action Plan to better understand and develop treatments for post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), and co-occurring conditions; and identify strategies to support collaborative research efforts to address suicide prevention is underway. VA, DoD and HHS and the Department of Education have collaborated and submitted the plan on time. DoD and VA are investing more than $100 million in new research to improve diagnosis and treatment of Traumatic Brain Injury (mTBI) and Post-traumatic Stress Disorder (PTSD).  They have launched two initiatives to establish joint DoD/VA research consortia with academia and industry partnerships to study the chronic effects of mild TBI and PTSD.


Working together, the Departments will continue to expand the public health approach to providing optimal support for the mental health needs of Veterans, Service Members and their families.  They also will continue to provide updates on their work as it progresses.


Blue Button Reaches One Million Registered Patients Cutting Edge Technology Expands to Empower More Patients   WASHINGTON – The Department of Veterans Affairs announced today that, during the month of August, the one millionth patient has registered for Blue Button to access and download their Personal Health Record (PHR) information.   “Since President Obama announced the availability of Blue Button two years ago, VA has worked tirelessly with our sister agencies to make online access to personal health records convenient, reliable, and safe.  I am very pleased with our progress,” said Secretary of Veterans Affairs Eric K. Shinseki.    The Blue Button enables patients to assemble and download personal health information into a single, portable file that can be used inside a growing number of private health care electronic records–as well as those in the VA, Department of Defense, Centers for Medicare and Medicaid Services, and private sector partners.  The VA Blue Button PHR includes prescription history, the ability to review past appointments and medical history details, wellness reminders and emergency contact information. Because it is web-based, the information is available anywhere, any time.  Its security measures are identical to those employed by retail websites that accept credit cards.   “VA believes that patients are hungry for their health information,” said Peter Levin, VA’s Chief Technology Officer. “The simplicity of Blue Button makes it easy for other public agencies and Federal Employee Health Program carriers to participate.  Getting to one million registered users so quickly is a great validation for our team.”   The Blue Button will see even wider use as more non-profit organizations and health care industry partners, such as Kaiser Permanente and Aetna adopt it as an integral part of their customer health records.   One of the most recent Blue Button partners is UnitedHealth Group.   “We are just thrilled to see how Blue Button has expanded so quickly, both in the richness of its content as well as the number of institutions that have pledged to make their data available,” said U.S. Chief Technology Officer Todd Park.  He went on to say that Blue Button has become the model of data liberation throughout the Federal Government.  “Data is the rocket fuel of job creation in the high tech sector.  Blue Button is just a terrific example of what people can do once we liberate their data – safely and privately – from our vaults.”   For more information on the Blue Button initiative, please visit:  http://www.va.gov/bluebutton/   # # #


Army Standardizes PTSD Diagnosis

Army Standardizes PTSD Diagnosis

Week of August 20, 2012

The U.S. Army, along with the other military services and the Department of Veterans Affairs, is standardizing the diagnosis and treatment of post-traumatic stress disorder (PTSD). The Army medical community is now being trained on guidelines spelled out in Army Medical Command Policy Memo 12-035 (Apr. 10, 2012), Policy Guidance on the Assessment and Treatment of Post-Traumatic Stress Disorder. The memo emphasizes the urgency of the issue. PTSD occurs in three to six percent of servicemembers with no deployment experience and in five to 25 percent of servicemembers who have been deployed to combat zones. For PTSD resources, visit the Army Behavioral Health PTSD Information webpage <http://www.behavioralhealth.army.mil/ptsd/index.html> . For an immediate crisis, visit the National Suicide Prevention Hotline website <http://www.suicidepreventionlifeline.org/>  and call 1-800-273-TALK (8255) <http://www.suicidepreventionlifeline.org/> .



Bill to Extend Health Care Benefits to Camp Lejeune Veterans and Families

Congressional negotiators have taken a big leap in expanding veterans’ health care by proposing Veterans Affairs Department treatment for veterans and dependents exposed to contaminated well water at Camp Lejeune, N.C.   Up to 750,000 people — Navy and Marine Corps members and their families — may have been exposed to water found to be contaminated by carcinogens from the 1950s into the 1980s.   North Carolina lawmakers have been pushing for years for the federal government to cover health costs for people who were exposed, but there have been sharp disagreements about who should be responsible: the Defense Department, which owned the base, or VA, which covers service-connected illness, injury and disability.   This is a big step because VA provides very little health care for dependents, concentrating on veterans rather than their families. But it is not unprecedented.   Those covered must have lived or worked on Camp Lejeune for at least 30 days from Jan. 1, 1957 through Dec. 31, 1987.   VA ends up with responsibility under terms of a compromise reached June 21 between members of the House and Senate veterans’ affairs committees on a comprehensive veterans bill made up of provisions that have passed at least one of the committees over the past two years.   The compromise bill is expected to pass the Senate as early as next week and could be on its way to the White House by the Fourth of July, according to congressional staffers.   The agreement is a victory for Sen. Richard Burr, R-N.C., who has been pushing the veterans affairs committee and the Senate Armed Services Committee to get help for the former Lejeune residents.   “I am pleased this legislation has moved further than ever before, and I am hopeful it will receive the attention of the full Senate very soon,” Burr said. “The Marines, sailors, and their families who were affected by exposures to toxic water at Camp Lejeune deserve this care, and I hope this bill will finally pass so we can provide it for them.”   It’s also a victory Sen. Patty Murray, D-Wash., the Senate Veterans’ Affairs Committee chairwoman, and for Rep. Jeff Miller, R-Fla., her House counterpart, for reaching a compromise that sweeps up a large pack of abandoned legislation.   In a statement, Miller said the comprehensive bill, HR 1627, is the result of months of compromise.   “This bill includes nearly 50 provisions, which combines House-passed legislation and Senate Committee-reported bills,” he said, adding that veterans organizations also provided input.   He called it a “fiscally responsible” bill that “will not cost the taxpayer an extra dime.” Costs are covered by extensions of fees on veterans home loans and other adjustments. Full details were not yet available on offsets, but congressional aides who worked on the compromise said no benefits are cut and no services are canceled to pay for any of the provisions in the bill.   Among them:   • Allow waiver of copays for veterans receiving telehealth and telemedicine visits, a change aimed at encouraging veterans who live far from a VA clinic or hospital to use the service.   • Require comprehensive reporting and tracking of sexual assaults and safety problems, an idea taken from a bill sponsored in 2011 by Rep. Ann Marie Buerkle, R-N.Y., after unreported or underreported sexual assaults were discovered on VA property, including in hospitals.   • Allow service dogs, when trained by an accredited agency or organization, onto any VA-owned or -controlled property.   • Permanently authorize adjustable-rate mortgages and hybrid adjustable-rate mortgages under the VA home loan program, options that might be especially attractive to home buyers because of low mortgage interest rates.   • Make VA-backed loans available to some surviving spouses. This would apply to survivors of a totally disabled veteran who had been receiving disability compensation for at least 10 years or who died within five years of leaving active duty. It also would apply to survivors of former prisoners of war who had been totally disabled for at least one year prior to their deaths.   • Codify in law the prohibition against reserving gravesites at Arlington National Cemetery and prohibit more than one gravesite from being provided to a veteran or service member.   http://www.navytimes.com/news/2012/06/military-lawmakers-propose-va-care-for-those-exposed-to-lejeune-water-062212w/   IMPORTANT NOTICE! This email message, including any attachments, is for the sole use of the intended recipient and may contain privileged and/or confidential information. If you are not the intended recipient, you are hereby notified that any unauthorized review, use, disclosure, or distribution of this electronic information and/or any attachment is prohibited. If you have received this email message in error, please notify the sender immediately and then delete the electronic message and any attachments.


VA encourages HIV Testing for All Veterans


VA Encourages HIV Tests for All Veterans

National HIV Testing Day Is June 27

WASHINGTON – The Department of Veterans Affairs is encouraging all Veterans to be tested for HIV at least once in their lives.

“VA offers HIV testing as part of its comprehensive, world-class care for the men and women who have served this Nation in uniform,” said Secretary of Veterans Affairs Eric K. Shinseki.  “Testing, regardless of age or risk factors, is an important step to healthier, longer lives.”

Some VA facilities offer HIV testing on a walk-in basis or through routine primary care appointments.  Others offer testing as part of special health fairs.  More information about the benefits of being tested is available at www.hiv.va.gov.

June 27 is National HIV Testing Day, designed to raise awareness of the importance of early detection, which can help prevent the spread of the virus, extend life expectancy and reduce overall medical expenses.

It is estimated that 1.2 million people in the United States are living with HIV, and one out of five are unaware they are infected.

VA operates one of the nation’s largest integrated health care systems in the country.  With a health care budget of about $50 billion, VA expects to provide care to 6.3 million patients during 920,000 hospitalizations and nearly 90 million outpatient visits this year.  VA’s health care network includes 152 major medical centers and more than 800 community-based outpatient clinics.

VA Supports Family and Friends Seeking to Encourage Vets to Get Mental Health Services

VA Supports Family and Friends Seeking to Encourage Vets to Get Mental Health Services

Media Campaign Promotes “Coaching Into Care” Program

WASHINGTON – The Department of Veterans Affairs recently completed a media campaign for its call center “Coaching Into Care,” a telephone service which provides assistance to family members and friends trying to encourage their Veteran to seek health care for possible readjustment and mental health issues.

Coaching Into Care is a valuable service for family members and friends of Veterans who might be reluctant to seek mental health care,” said VA Secretary Eric K. Shinseki.  “In the last three years, VA has devoted more people, programs, and resources toward mental health services to serve the growing number of Veterans seeking mental health care and this marketing effort is designed to expand our reach to those who need our services the most.”

The “Coaching Into Care” service offers free coaching to callers, with no limit to the number of calls they can make.  The goal of these sessions is to connect a Veteran with VA care in his or her community with the help and encouragement of family members or friends.  Callers will be coached on solving specific logistical problems and ways to encourage the Veteran to seek care while respecting his or her right to make personal decisions.

The service is available toll-free at 1-888-823-7458, 8 a.m. – 8 p.m. Eastern time, Monday through Friday, and online at http://www.mirecc.va.gov/coaching/.  If a Veteran is experiencing an acute crisis, callers should contact the Veterans Crisis Line at 1-800-273-8255 for immediate help.  “Coaching Into Care” works directly with the Veterans Crisis Line and the Caregiver Support Line to provide guidance and referrals.

The department is a pioneer in mental health research, high-quality, evidence-based treatment and access to high-quality care.  VA has many entry points to care through the use of 300 Vet Centers, the Veterans Crisis Line, and integration of mental health services in the primary care setting.

This campaign is part of VA’s overall mental health program.  Last year, VA provided quality, specialty mental health services to 1.3 million Veterans. Since 2009, VA has increased the mental health care budget by 39 percent.  Since 2007, VA has seen a 35 percent increase in the number of Veterans receiving mental health services, and a 41 percent increase in mental health staff.

In April, as part of an ongoing review of mental health operations, Secretary Shinseki announced VA would add approximately 1,600 mental health clinicians as well as nearly 300 support staff to its existing workforce of 20,590 mental health staff to help meet the increased demand for mental health services.

The “Coaching Into Care” advertisements ran on cable TV and radio stations in media markets throughout the U.S.  The ads featured three scenarios that many Veterans and their family members commonly experience following the Veteran’s return from combat experiences.  Veterans were directly involved in the media campaign.  VA launched the media campaign as part of its observation of June as “PTSD Awareness Month.”


VA Launches New PTSD Outreach Tool

VA Continues PTSD Outreach with AboutFace Campaign

Veterans Provide Video Testimonials on Experiences with PTSD

WASHINGTON (June 20, 2012) – In observance of June as PTSD Awareness Month, the Department of Veterans Affairs National Center for Post-Traumatic Stress Disorder (PTSD) has begun a new online initiative, AboutFace, focused on helping Veterans recognize PTSD symptoms and motivating them to seek treatment.

“We must do all we can to help Veterans identify possible indicators that they may be suffering from PTSD,” said Secretary of Veterans Affairs Eric K. Shinseki.  “It requires a comprehensive, multi-faceted approach to be effective.  We hope that this initiative, while just one aspect of our program, will play an important role in that effort.”

The AboutFace campaign introduces viewers to Veterans from all eras who have experienced PTSD and turned their lives around with treatment.  Through personal videos, viewers will meet Veterans and hear how PTSD has affected them and their loved ones.  Visitors will also learn the steps to take to gain control of their lives.

AboutFace, which is PTSD specific, was designed as a complementary campaign to VA’s current Make the Connection (www.MakeTheConnection.net) campaign.  Make the Connection uses personal testimonials to illustrate true stories of Veterans who faced life events, experiences, physical ailments, or psychological symptoms; reached out for support; and found ways to overcome their challenges.

“VA is committed to ensuring the men and women who bravely served our Nation can access the resources and services tailored for them that can lead to a more fulfilling life,” said Dr. Robert Petzel, VA’s under secretary for health.  “We want Veterans to recognize themselves in these stories and to feel optimistic that they can overcome their challenges with proper treatment.  We set aside this month of June to urge everyone to increase awareness of PTSD so those in need can get effective treatment that will enable them to lead productive, fulfilling and enjoyable lives.”

AboutFace launched in June in time to help bring attention to PTSD Awareness Month.  It is located on the National Center for PTSD website, www.ptsd.va.gov.  There viewers will watch as Veterans candidly describe how they knew they had PTSD; how PTSD affected the people they love; why they didn’t get help right away; what finally caused them to seek treatment; what treatment is like and how treatment helps.

VA provides effective PTSD treatment and conducts extensive research on PTSD, including prevention.  Those interested in further information can go to www.ptsd.va.gov to find educational materials including courses for providers on the best practices in PTSD treatment and the award-winning VA/DoD PTSD Coach Mobile App for electronic devices, which provides symptom management strategies.

These campaigns are part of VA’s overall mental health program.  Last year, VA provided quality, specialty mental health services to 1.3 million Veterans.  Since 2009, VA has increased the mental health care budget by 39 percent.  Since 2007, VA has seen a 35 percent increase in the number of Veterans receiving mental health services, and a 41 percent increase in mental health staff.

In April, as part of an ongoing review of mental health operations, Secretary Shinseki announced VA would add approximately 1,600 mental health clinicians as well as nearly 300 support staff to its existing workforce of 20,590 to help meet the increased demand for mental health services.  The additional staff would include nurses, psychiatrists, psychologists and social workers.

For more information on AboutFace, visit www.ptsd.va.gov/aboutface/ or contact the National Center for PTSD at (802) 296-5132.

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VA to Increase Mental Health Care Access through 200,000 Telemental Health Consultations in 2012


VA  to Increase Mental Health Care Access through 200,000 Telemental Health Consultations in 2012


WASHINGTON (June 20, 2012)– In a continuing effort to increase Veterans’ access to mental health care, the Department of Veterans Affairs has set a goal to conduct more than 200,000 clinic-based, telemental health consultations for all mental health specialties in fiscal year 2012.  This follows VA’s announcement last month that it would no longer charge Veterans a copayment when they receive care in their homes from VA health professionals using video conferencing.


“Telemental health provides Veterans quicker and more efficient access to the types of care they seek,” said Secretary of Veterans Affairs Eric K. Shinseki. “We are leveraging technology to reduce the distance they have to travel, increase the flexibility of the system they use, and improve their overall quality of life.  We are expanding the reach of our mental health services beyond our major medical centers and treating Veterans closer to their homes.”


The clinic-based telehealth program involves the more than 800 VA community-based outpatient clinics (CBOCs) where many Veterans receive primary care.  If the CBOCs do not have a mental health care provider available, secure video teleconferencing technology is used to connect the Veteran to a provider within VA’s nationwide system of care.


As a result, Veterans can arrange appointments at times more in synch with their schedules.  The program improves access to general and specialty services in geographically remote areas where it can be difficult to recruit mental health professionals.


“As technology is improving people’s lives in many areas, telemental health is making access to health care and support easier for Veterans with mental health conditions,” said Dr. Robert A. Petzel, Under Secretary for Health.  “For example, one combat Veteran from Iraq cites telemental health as a critical factor in rebuilding her life and coping with the aftermath of Post-Traumatic Stress Disorder and military sexual trauma.  Telemental health offered her a safe and convenient setting to receive gender sensitive services that helped her fit back into civilian life after three months of therapy.”


Since the start of the Telemental Health Program, VA has completed over 550,000 patient encounters.  In Fiscal Year 2011 alone, more than 140,000 encounters were conducted with 55,000 Veterans via CBOCs, where providers at 150 hospitals delivered care to veterans at more than 500 clinics.


The Telehealth Expansion Initiative launched in May 2011 called for an additional 21 regional leads, 144 facility coordinators and 1,150 clinical technicians to VA’s workforce.  When fully implemented, the expansion will provide a potential capacity of 1.2 million consultations annually.


Video to the home is currently projected to grow to 2,000 patients by the end of fiscal year 2012, with 1,500 using innovative new Internet Protocol (IP) video connected to Veterans’ personal computers.


In addition to supporting these current programs, the VHA National Telemental Health Center in West Haven, Conn., has pioneered additional new programs that delivered 1,000 specialized patient encounters from mental health experts at multiple VA sites to Veterans throughout the nation.  These include over 100 compensation and pension exams, 700 clinical encounters to over 165 Veterans enrolled in behavioral pain treatment programs, and 200 clinical-video and telephone encounters to over 70 Veterans enrolled in a bipolar disorder treatment program.


This campaign is part of VA’s overall mental health program.  Last year, VA provided quality, specialty mental health services to 1.3 million Veterans.  Since 2009, VA has increased the mental health care budget by 39 percent.  Since 2007, VA has seen a 35 percent increase in the number of Veterans receiving mental health services, and a 41 percent increase in mental health staff.


In April, as part of an ongoing review of mental health operations, Secretary Shinseki announced VA would add approximately 1,600 mental health clinicians as well as nearly 300 support staff to its existing workforce of 20,590 to help meet the increased demand for mental health services.  The additional staff would include nurses, psychiatrists, psychologists, and social workers.


For more information, on VA’s telemental health, visit the Office of Telehealth Services at http://www.telehealth.va.gov/.




Brain Stimulation for Parkinson’s Offers Improvements in Symptoms Over Three Years

Brain Stimulation for Parkinson’s Offers Improvements in Symptoms Over Three Years

WASHINGTON – Patients with Parkinson’s disease who undergo deep brain stimulation (DBS)—a treatment in which a pacemaker-like device sends pulses to electrodes implanted in the brain—can expect stable improvement in muscle symptoms for at least three years, according to a Department of Veterans Affairs study appearing in the most recent issue of the journal Neurology.

“VA was proud to partner with the National Institutes of Health in this research,” said Secretary of Veterans Affairs Eric K. Shinseki.  “Our research on Parkinson’s helps ensure we continue to provide the best care possible for Veterans with this debilitating disease.”

VA cares for some 40,000 Veterans with the condition.

In DBS, surgeons implant electrodes in the brain and run thin wires under the skin to a pacemaker-like device placed at one of two locations in the brain. Electrical pulses from the battery-operated device jam the brain signals that cause muscle-related symptoms. Thousands of Americans have seen successful results from the procedure since it was first introduced in the late 1990s. But questions have remained about which stimulation site in the brain yields better outcomes, and over how many years the gains persist.

Initial results from the study appeared in 2009 in the Journal of the American Medical Association. Based on the six-month outcomes of 255 patients, the researchers concluded that DBS is riskier than carefully managed drug therapy—because of the possibility of surgery complications—but may hold significant benefits for those with Parkinson’s who no longer respond well to medication alone.

A follow-up report in the New England Journal of Medicine in 2010, using data from 24 months of follow-up, showed that similar results could be obtained from either of the two brain sites targeted in DBS.

The new report is based on 36 months of follow-up on 159 patients from the original group. It extends the previous findings: DBS produced marked improvements in motor (movement-related) function. The gains lasted over three years and did not differ by brain site.

Patients, on average, gained four to five hours a day free of troubling motor symptoms such as shaking, slowed movement, or stiffness. The effects were greatest at six months and leveled off slightly by three years.

According to VA Chief Research and Development Officer Joel Kupersmith, MD, “This rigorously conducted clinical trial offers valuable guidance for doctors and patients in VA and throughout the world. As our Veteran population and the general U.S. population grow older, this research and future studies on Parkinson’s will play an important role in helping us optimize care.”

The research took place at several VA and university medical centers and was supported by VA’s Cooperative Studies Program and the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health. The maker of the devices used in DBS, Medtronic Neurological, helped fund the research but did not play a role in designing the study or analyzing the results.

VA, which has the largest integrated health care system in the country, also has one of the largest medical research programs. This year, approximately 3,400 researchers will work on more than 2,300 projects with nearly $1.9 billion in funding.

For more information on VA research, visit www.research.va.gov.



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