Veterans employment: Identifying lessons learned from Rapid Retraining Program could benefit future efforts
Abstract: The Department of Veterans Affairs provided help for veterans who lost their jobs during the COVID-19 pandemic. The program offered a housing stipend and 12 months of tuition and fees for veterans to retrain for high-demand occupations. More than 13,000 veterans used the program to enroll in training. VA collected a lot of data from schools and veterans on program benefits and challenges, but doesn't have any plans to use the data to formally evaluate the program. We recommended identifying lessons learned to help VA improve any veteran retraining efforts or other benefits programs where quick implementation is necessary.
Abstract: Context: In response to the opioid crisis, federal guidelines were implemented, including the Veterans Health Administration's (VA) Opioid Safety Initiative in 2013. The impact of policies on patients near the end of life is unknown. Objective: Examine temporal trends in opioid prescribing, pain, and opioid overdoses among Veterans near the end of life. Methods: Retrospective, time series analysis of VA decedents between October 2009 and September 2018 whose next-of-kin participated in VA's Bereaved Family Survey (BFS). Using multivariate regression to adjust for sociodemographic and clinical covariates, we examined temporal trends in outpatient opioid prescribing, uncontrolled pain based on BFS report, and opioid overdose-related hospitalizations, in the last month of life, overall and by clinical diagnosis (cancer versus non-cancer). Results: Among 79,409 decedents, mean daily outpatient opioid dose in morphine milligram equivalents in the last month of life decreased from 4.6 mg in 2010 to 2.1 mg in 2018 (adjusted change -0.20 mg/year; P