December 3, 2014

Agenda

9:00 a.m. - 10:00 a.m. - Networking, Coffee & Donuts10:00 a.m. - 10:10 a.m.

– Pledge of Allegiance– Announcements– Recognition

10:10 a.m. - 10:50 a.m.– Toxicity of the Battlefield: Chapter 1 Agent Orange Exposure - Mark

Kane, Ph.D. – Access to Benefits - Carrie Roy, Manager, Kent County Veterans Affairs

10:50 a.m. - 11:05 a.m.– Michigan Works! - Veterans Services Program

11:05 a.m. - Noon– Podio Demonstration - Natalie Harris– WMVC Website

MissionTo improve the lives of veterans, their families, and anyone that served in the Armed Forces by connecting them to all available services and resources throughout West Michigan.

• Kevin Stotts – Talent 2025• Brandi McBride – Goodwill Industries, Talent 2025• Patrick Owen – SDI Consulting• Erik Olgeirsson – SDI Consulting• Thomas Koziol – Web Design

Thank you!

Toxicity on the Battlefield Chapter 1: Vietnam War

Chapter 2: Gulf War

Chapter 3: OEF/OIF/OND

* DISCLAIMER

Information during this presentation is for educational purposes only—it is not a substitute for informed medical advice or training. You should not use this information to diagnose or treat a mental health problem without consulting a qualified professional/ provider.

5

Chapter 1: Agent Orange West Michigan Veterans Coalition

December 3, 2014

Overview

The Dark Shadow of Agent Orange

What is/are dioxin(s)

VHA response to Vietnam War

Presumptive conditions

Exposures of special groups

The future

Resources

Questions

The Dark Shadow of Agent Orange

Operation Ranch Hand

“Ranch Handers” motto was “only you can prevent a forest”

Operation Ranch Hand was a U.S. Military operation during the Vietnam War lasting 1962 – until 1971

Inspired by the British use of Agent Orange during the Malayan Emergency in the 1950s. “Operation Trail Dust”

Spraying an estimated 20 million U.S. gallons to deprive the Viet Cong of food and vegetation cover

95% of the herbicides and defoliants used in the war were sprayed by U.S. Air Force as part of Operation Ranch Hand

5% sprayed by the U.S. Chemical Corps, other military branches, and the Republic of Vietnam using hand sprayers, spray trucks, helicopters and boats, primarily around U.S. military installations.

Herbicide (Agent) Orange (1)

1:1 mixture of 2,4-dichlorophenoxy acetic acid (2,4-D, 50%) and 2,4,5-trichlorphenoxyacetic acid (2,4,5-T, 50%)

2,4,5-T was used extensively as an herbicide in forestry and agriculture domestically and abroad starting in the 1940s.

Shipped to Vietnam in 55-gallon steel drums with an orange stripe around the middle

~12/19x106 gallons used in Vietnam = A.O.

2,4-Dichlorophenoxyacetic acid 2,4,5-Trichlorophenoxyacetic acid

Other Herbicides Used in Vietnam

“Agent Blue”Cacodilic Acid

“Agent White”Picloram

Dibenzofuran

Heavily Sprayed Areas - Map

Inland forests near the demarcation zone

Inland forests at the junction of the borders of Cambodia, Laos, and South Vietnam

Inland forests north and northwest of Saigon

Mangrove forests on the southernmost peninsula of Vietnam

Mangrove forests along major shipping channels southeast of Saigon

Politics

In 1970 - Concerns about the health effects of exposure to Agent Orange A study reported the incidence of birth defects in laboratory mice

given high doses of the herbicide 2,4,5-T. TCDD, a dioxin contaminant of 2,4,5-T, was isolated as the actual cause of the birth defects

In 1971 - Congress ordered the end of Herbicide Agent spraying when two studies showed birth defects and other endocrine-related pathology in rats

The herbicide was banned completely in 1985 by the Environmental Protection Agency

In 1991 – Congress enacted the Agent Orange Act, giving the Department of Veterans Affairs the authority to declare certain conditions ‘presumptive’ to exposure to Agent Orange/dioxin. Veterans who served in Vietnam eligible to receive treatment and compensation

Federal Response to Vietnam

1970s - Agent Orange examination and Agent Orange Review

1980s – Epidemiology/Case law/Legislation

VHA EES; CDC

1991 – Agent Orange Act

1960s – 2011 – Scientific Study

1980s – Air Force Ranch Hand

1990s et. seq. – NAS/IOM biennial AO Report

Presumptive Conditions

Acute and Subacute Peripheral Neuropathy A nervous system condition that causes numbness, tingling, and motor weakness. Under VA's rating regulations, it must be at least 10% disabling within 1 year of exposure to herbicides and resolve within 2 years after the date it began.

AL Amyloidosis A rare disease caused when an abnormal protein, amyloid, enters tissues or organs.

Chloracne (or Similar Acneform Disease) A skin condition that occurs soon after exposure to chemicals and looks like common forms of acne seen in teenagers. Under VA's rating regulations, chloracne (or other acneform disease similar to chloracne) must be at least 10% disabling within 1 year of exposure to herbicides.

Presumptive Conditions (2)

Chronic B-cell Leukemias A type of cancer which affects white blood cells.

Diabetes Mellitus (Type 2) A disease characterized by high blood sugar levels resulting from the body’s inability to respond properly to the hormone insulin.

Hodgkin’s Disease A malignant lymphoma (cancer) characterized by progressive enlargement of the lymph nodes, liver, and spleen, and by progressive anemia.

Presumptive Conditions (3)

Ischemic Heart Disease A disease characterized by a reduced supply of blood to the heart, that leads to chest pain.

Multiple Myeloma A cancer of plasma cells, a type of white blood cell in bone marrow.

Non-Hodgkin’s Lymphoma A group of cancers that affect the lymph glands and other lymphatic tissue.

Presumptive Conditions (4)

Porphyria Cutanea Tarda A disorder characterized by liver dysfunction and by thinning and blistering of the skin in sun-exposed areas. Under VA's rating regulations, it must be at least 10% disabling within 1 year of exposure to herbicides.

Prostate Cancer Cancer of the prostate; one of the most common cancers among men.

Presumptive Conditions (5)

Respiratory Cancers Cancers of the lung, larynx, trachea, and bronchus.

Soft Tissue Sarcoma (other than Osteosarcoma, Chondrosarcoma, Kaposi’s sarcoma, or Mesothelioma) A group of different types of cancers in body tissues such as muscle, fat, blood and lymph vessels, and connective tissues.

Other Military Exposures

Korea - In or near the Korean demilitarized zone anytime between April 1, 1968 and August 31, 1971

Thailand - Vietnam-era Veterans whose service involved duty on or near the perimeters of military bases in Thailand anytime between February 28, 1961 and May 7, 1975 may have been exposed to herbicides and may qualify for VA benefits.

Waterways

Inland

Costal

On-shore

Blue water*

*Veterans who served on open sea ships off the shore of Vietnam during Vietnam War are sometimes called “Blue Water Veterans”

Women Veterans and Offspring

Am J Ind Med. 2000 Oct;38(4):447-54.

Pregnancy outcomes among U.S. women Vietnam veterans.

Kang HK, Mahan CM, Lee KY, Magee CA, Mather SH, Matanoski G.

A comparison of self-reported pregnancy outcomes for 4,140 women Vietnam veterans with those of 4,140 contemporary women veterans who were not deployed to Vietnam.

There was no statistically significant association between military service in Vietnam and index pregnancies resulting in miscarriage or stillbirth, low birth weight, pre-term delivery, or infant death. The risk of having children with "moderate-to-severe" birth defects was significantly elevated among Vietnam veterans (adjusted OR = 1.46, 95% CI = 1.06-2.02).

The risk of birth defects among index children was signficantly associated with mother‘s military service in Vietnam.

Covered Birth Defects (1)

Achondroplasia

Cleft lip and cleft palate

Congenital heart disease

Congenital talipes equinovarus (clubfoot)

Esophageal and intestinal atresia

Hallerman-Streiff syndrome

Hallerman-Streiff

syndrome

Cleft lip and cleft palate

Achondroplasia

Congenital talipes equinovarus (clubfoot)

Covered Birth Defects (2)

Hip dysplasia

Hirschprung's disease (congenital megacolon)

Hydrocephalus due to aqueductal stenosis

Hypospadias

Imperforate anus

Neural tube defects

Neural tube defects

Image of Spina Bifida

Covered Birth Defects (3)

Poland syndrome

Pyloric stenosis

Syndactyly (fused digits)

Tracheoesophageal fistula

Undescended testicle

Williams syndrome

Death from Agent Orange

Surviving spouses, dependent children and dependent parents of Veterans who were exposed to Agent Orange and died as the result of diseases related to Agent Orange exposure may be eligible for survivors' benefits.

http://www.publichealth.va.gov/exposures/agentorange/benefits/survivors.asp

NAS/IOM Veterans and Agent Orange – 2012

Veterans and Agent Orange: Update 2012 -http://www.iom.edu/Reports/2013/Veterans-and-Agent-Orange-Update-2012.aspx

Released: December 3, 2013

Veterans Review of the Health Effects in Vietnam Veterans of Exposure to Herbicides (Ninth) Biennial Update

Resources Agent Orange Registry Health Exam for Veterans

http://www.publichealth.va.gov/exposures/agentorange/benefits/registry-exam.asp

VHA Agent Orange Home Pagehttp://www.publichealth.va.gov/exposures/agentorange

Vietnam Veterans of America Home Pagehttp://VVA.org

The VVA Self-Help Guide to Service-Connected Disability Compensation for Exposure to Agent Orange –http://www.vva.org/Guides/AgentOrangeGuide.pdf

Thank you!Mark S. Kane, Ph.D. Licensed Psychologist

Fellow Michigan Psychological Association

Riverview Psychological Services, P.C.

drmskane@gmail.com 616-464-0811 28

Fully Developed Claims for

Dioxide Exposure

Presented by Carrie Roy

Different Methods of Filing

• Ebenefits

• Self

• Law Firms

• Accredited Veterans Service Officer

Forms Needed to File

• DD214

• VA Form 21-526EZ

• DBQ (specific to claimed condition)

Where to find Accredited VSOs

• http://macvc.net/

• http://www.michiganveterans.com/

• Kent County Department of Veterans Affairs 82 Ionia NW STE 380, Grand Rapids, MI 49503

616-632-5722

Area Community Services

Employment and Training Council (ACSET)

Mission

Create opportunities for economic self-sufficiency for low-

income, economically disadvantaged, elderly, disabled,

unemployed and underemployed individuals, and

dislocated workers.

• Services offered at each location are designated to prepare job seekers

for employment and connect potential applicants to employers

• Assistance filing for unemployment benefits

• Individual Job search assistance and training opportunities to qualified

job seekers

• Kent County: Two full service centers and one satellite center

• Allegan County: One full service center, one satellite center

• Barry County: One full service center

MI Works! SystemMichigan Works! AgencyACSET, as the Michigan Works! Agency (MWA) for Kent, Allegan & Barry Counties……

• Pure Michigan Talent Connect – a collaborative effort of the State

of Michigan’s Workforce Development Agency (WDA) and the

Michigan Economic Development Corporation (MEDC). Pure

Michigan Talent Connect serves as the state’s labor exchange

system.

– Internet-based website, available 24 hours a day

– Allows job seekers to list their qualifications & interests

– Allows job seekers to see available jobs throughout Michigan

– Allows registered employers to search for qualified talent

MI Works! SystemMichigan Talent Connect

MI Works! SystemServices

• assessments of skill levels, aptitudes, abilities, and support service needs

• information on local service providers

• help filing claims and evaluating eligibility programs or aid

• job search and placement assistance, career counseling

• up-to-date labor market information

• workshops

For job seekers

• Business Services Representatives work with employers within industry

sectors such as manufacturing, information technology, agriculture / food

preparation and health care

• Maintain partnerships with regional economic development agencies and

educational institutions to provide the most comprehensive solution to

current and future employment demands

• Talent Development Specialists who are able to connect job seekers

directly to community employers

MI Works! SystemBusiness ServicesMichigan Works! is a Demand-driven Workforce System

MI Works! SystemServices

• labor exchange services

• recruitment assistance

• applicant screening

• job postings

• testing services

• job fairs / employer of the

day events

For employers

• Program available to former employees who have lost their jobs

as a result of foreign competition

• Available for companies specifically approved by the U.S.

Department of Labor

• Aim is to offer adversely affected workers with opportunities to

obtain skills, credentials, resources, and support needed to

become reemployed

• Services offered include: training, job search assistance,

relocation assistance, alternative Trade benefits for mature

workers, & Health Care Tax Credit

• More information is available at: http://doleta.gov/tradeact/

MI Works! SystemPrograms – Trade Act

MI Works! SystemPrograms – Workforce Investment Act (WIA)

Three separate funding streams to serve

• Adults

• Dislocated Workers

• Youth

• One-on-one job search assistance with a certified

Career Coach

• Free workshops and resume assistance

• Individual Training Accounts for in-demand training up to 12 months and

$6,500 for all eligible customers

• On-the-Job Training reimbursement available to employers

• Work Keys assessments and other Career Guidance tools

• Mentoring, goal-setting and work experience for youth

MI Works! SystemPrograms – Workforce Investment Act (WIA)

Priority Services to Veterans and Eligible Spouses:

• Have the option to work with a Career Coach who is also a veteran

• Income qualify for WIA services or receiving or exhausted UIA benefits

• Active Military Service / discharged under “other than dishonorable”

conditions

• Provides a copy of DD214

• Eligible Spouse

• Service member is missing in action, captured or forcibly detained

• Veteran has total service-connected disability, per VA evaluation

• Veteran died of a service-connected disability

• Veteran died while a total service-connected disability, per VA evaluation, was in existence

MI Works! System

State of Michigan

Veterans’ Services Division

To deliver intensive employment services to a targeted veteran population as an

integrated partner with the Michigan Works! Agency, in accordance with the intent of

the Jobs for Veterans State Grant program.

The Jobs for Veterans State Grant (JVSG) assists eligible Veterans and

Spouses reduce/remove barriers to employment by providing intensive

employment services at Michigan Works! Service Centers through funding

for Disabled Veterans’ Outreach Program (DVOP) Specialists and Local

Veterans’ Employment Representative (LVER) staff.

MI Works! SystemVeterans’ Services Division

DVOP Specialists and LVERs are state employees whose salaries and

benefits are funded through U.S. Department of Labor formula grants to

the states, District of Columbia, Puerto Rico, Virgin Islands, and Guam.

Jobs for Veterans State Grant

VSD RegionsRegion 1 Prosperity Regions: 1, 2, 3, 5, 6Number of DVOP Specialists: 11

Region 2Prosperity Regions: 4, 7, 8, 9Number of DVOP Specialists: 16

Region 3Prosperity Region: 10Number of DVOP Specialists: 18

The State of Michigan employs 45 DVOP Specialist who are located within

MI Works! Service Centers throughout the state.

MI Works! SystemVeterans’ Services Division

As an integrated partner within the MI Works! Service Center the DVOP

Specialist provides intensive individualized employment services, within a

case management framework, to an eligible veteran population who are

unlikely to obtain employment without receiving such services. Services

include, but not limited to:

• Development of an action plan to meet employment goals

• Vocational guidance

• Job search assistance

• Direct referral to other services needed to reduce/eliminate barriers to

employment

Priority of Service

MI Works! SystemVeterans’ Services Division

All Veterans and eligible spouses are entitled to Priority of Service in any

program funded, in whole or part, by the U.S. Department of Labor.

Meaning Veterans receive services at the MI Works! Service Center before

or instead of a non-covered person.

When a Veteran or eligible spouse identifies themselves as such the MI

Works! staff informs them of their entitlement to Priority of Service and

describes the full array of services.

• At the point of entry the Veteran’s (or eligible spouse’s) eligibility for

DVOP services is determined. If eligible the Veteran is referred to

the respective DVOP Specialist. If NOT eligible the Veteran will be

referred to an appropriate program/service.

Questions?

MI Works! System

An Overview of Podio

How Coalition Members Can Navigate and Use Podio to Better Serve

Veterans, their Families and Caregivers

The Need

Implementing the “No Wrong Door” philosophy

• Service providers need to be identified

• Their information has to be collected

• Service providers have to come together to educate one another

Collective Efforts

• Effective Coordination of Services

• Integration of Services

Collaborative Tool Requirements

Gather Information Share Information

Foster Communication within the VCAT

Produce Informative

Products that Aid the VCAT’s Mission

The Focus of Today’s Demonstration

• Coalition Based Service Provider Directory

• Assistance and Support Requests

• Collaboration Space for Working Groups

• Veterans’ Resources and Events

Podio’s Functionality

Coalition Based Service Provider Directory

• Allows member service providers to collect each others information.

• The ability to search and filter the directory to locate services for helping veterans.

• Organization and Coalition Member Directory

Assistance and Support Request

• Allows member service providers to request support or assistance with helping a Veteran.

• Ability to document case management (randomized ID number) with multiple providers assisting in the resolution process.

• Can store completed requests for others to reference navigation routes to obtain services.

Collaboration for Working Groups

• A space for VCAT working groups to collaborate remotely, store resources, document projects and capture action steps to achieve the groups objectives.

Veterans Resources and Events

• A central location for member service providers to locate events, documents, and helpful websites to better serve our Veterans, dependents and caregivers.

Workspace Example

Any Questions?

Natalie HarrisonNatalie.Harrison@altarum.org