Veterans Affairs Report - November
2007
MEDICARE PART “D” UPDATE
Three lawmakers have introduced legislation in the House and Senate
to establish a Medicare-administered drug benefit that would compete
with private plans currently offered under Part D. The law’s
introduction was announced by Representatives Marion Berry (D-AR)
and Jan Schakowsky (D-IL) at an 23 OCT press call scheduled to
publicize both the legislation and a report by the Medicare Rights
Center (MRC) and Consumers Union assessing the shortcomings of
private Part D plans and the advantages of providing a public
option. The Medicare Prescription Drug Savings and Choice Act of
2007, sponsored by Senator Richard Durbin (D-IL) in the Senate and
co-sponsored by Representatives Schakowsky and Berry in the House,
would offer a public drug plan administered by Medicare with a
nationally uniform premium, formulary (list of drugs covered) and
cost-sharing requirements. The legislation would require the
Secretary of the Department of Health and Human Services to use the
breadth of the nationwide formulary to negotiate lower drug prices
from pharmaceutical companies.
According to the MRC & Consumers Union
report, The Best Medicine: A Drug Coverage Option Under Original
Medicare, the privatized delivery of Medicare drug coverage has
resulted in coverage gaps created by inconsistent formularies and an
ineffective appeals process. Changing formularies and premiums has
meant instability in coverage for people with Medicare, particularly
those with low incomes, according to the report. In a related
development, the House of Representatives Committee on Oversight and
Government Reform released a report showing the high administrative
costs associated with using insurance companies to deliver Part D
coverage. Total administrative costs for Part D amounted to 9.8% of
the total cost of the program. In comparison, overhead and
administrative costs amount to only 1.7% of the cost of original
Medicare.
In testimony given at an 16 OCT hearing
held by the House of Representatives Committee on Ways and Means
Subcommittees on Health and Oversight it was revealed that private
Medicare plan benefit packages are not adequately regulated by the
federal government, resulting in inadequate financial protections
for plan enrollees and unpredictable cost-sharing requirements for
expensive health services. The subcommittees were convened in
response to a JUL 07 report by the GAO, Required Audits of Limited
Value, which found that the Centers for Medicare & Medicaid Services
had not met the legal requirement to audit at least one-third of
private Medicare plans. Instead, the proportion of companies audited
decreased from 23.6% in 2001 to 13.9% in 2006. Paul Precht, deputy
policy director at the Medicare Rights Center, provided testimony on
the lack of federal regulation of plan benefit packages, which
allows plans to charge higher prices than Original Medicare for
high-cost services and carve-out specific services, such as
chemotherapy and other doctor-administered drugs, from yearly
out-of-pocket spending limits.
[Source: Medicare Watch newsletter 30 Oct 07 ++]
VA BUDGET 2008 UPDATE
In a risky change of strategy, Democrats are pursuing a plan that
would dare President Bush to veto a massive bill that combines
spending for veterans care, education and the Pentagon. The package,
which combines three bills into one, would total almost $675 billion
in discretionary spending for the fiscal year that began 1 OCT. Of
this, more than 70% is defense-related. The rest is expected to
incorporate about $14 billion more for domestic priorities than Mr.
Bush has requested. The plan is a significant tactical change.
Democrats had been expected to treat the three bills individually
and send them to the White House in a sequence that allowed the
party to spell out its priorities. Supporters of the new,
more-unified approach say it better serves the party's political
message by melding national security and domestic issues. But they
also concede it could prove a confrontational, gamble that risks
alienating Republican moderates whose support is vital if Congress
is to convince the White House to negotiate over domestic spending.
Education, veterans' health care and
medical-research programs would most benefit from the added $14
billion. That is about a third of the growth in defense spending
over 2007 -- a contrast Democrats will try to draw in the unified
bill.
At the same time, the leadership wants
to showcase a commitment to fiscal discipline by cutting special
spending projects for lawmakers known as "earmarks" by 40% from 2006
levels, when Republicans controlled Congress. House-Senate
negotiators hope to agree on the individual pieces by 31 OCT, after
which a final decision must be made on assembling the package. House
Appropriations Committee Chairman David Obey (D-WI) appears to be
leaning toward the new option in hope of combining enough popular
interests to override any veto. White House officials say the
inclusion of defense spending in the bill won't alter Mr. Bush's
willingness to use his veto power, however. The recent fight over
child health insurance suggests that if Democrats are seen as being
too political, they won't win over the moderate Republicans they
need to prevail. Just last week, for example, House Democrats failed
for the third time to get a veto-proof majority for their health
bill. Moderates complained Speaker Nancy Pelosi (D-CA) failed to
include them adequately in shaping the newest version.
The same could happen in the budget
fight now. In an interview last week Sen. Thad Cochran (R-MS),
senior Republican on the Senate Appropriations Committee, signaled a
willingness to intercede with the White House to try to reach some
compromise on spending. But when told yesterday of the new proposal
to bundle bills together, he was much cooler. "The Democrats are not
going to win my support by packaging the bills together," Mr.
Cochran said. The fact that Democrats are still debating their
legislative strategy this far into the fiscal year reflects the
extraordinary confusion surrounding the budget debate this fall. No
one predicts a government shutdown, but the Democratic majority
faces a lame-duck president who has interpreted the 2006 elections
as a call to vigorously exercise his veto power against spending. As
a result, none of the 12 annual spending bills has been approved and
most of the government has been left to operate under a stopgap
spending resolution due to expire 16 NOV.
The heart of the dispute lies in about
$22 to $23 billion that would be added to Mr. Bush's requests for
domestic programs such as veterans' care, education, medical
research and law enforcement. The $14 billion in the proposed
package constitutes about two-thirds of this money, and Democrats
hope to draw a contrast between the increases they want and the much
larger increases Mr. Bush will get for his defense priorities. The
big exception is funding for the Iraq and Afghanistan military
operations, which Mr. Bush designated "emergency" expenditures
outside the budget caps. The president wants almost $190 billion, of
which defense negotiators were prepared to provide a down payment of
up $50 billion added to the core Pentagon budget bill. But if the
Pentagon budget is to be combined with education and veterans funds,
Democrats won't want any Iraq-related money in the bill since it
would make it harder for their liberal members to back the package.
[Source: Wall Street Journal David Rogers article 30 Oct 07 ++]
VA DIVERTING PATIENTS:
James A. Haley VA Medical Center in Tampa and Bay Pines VA Medical
Center in St. Petersburg are the nation’s busiest and fourth-busiest
Veterans Affairs hospitals, respectively. Haley has been on “divert”
status for critical patients 27% of the time since 1 JAN 06, or the
equivalent of about 170 days, VA figures reviewed by the St.
Petersburg Times show. The hospital diverts all patients regardless
of condition 16% of the time. Since 2000, Bay Pines has diverted
patients far more frequently than any other hospital in Pinellas
County. Last year, it diverted veterans during 1,150 hours about 48
days, or 13% of the time, Pinellas paramedic records show. “There’s
no intent to deny veterans care,” said Dr. George Van Buskirk, chief
of staff at Bay Pines. “I like to think we’re as compassionate as
possible. We’d rather send them out to a place that can take care of
them than have them languish on a gurney in the hallway.” But some
question the VA’s resources. “The VA has never dealt with its
capacity issues seriously,” said Bill Geden, district director in
west-central Florida for the Blinded Veterans Association. “They’re
under-funded, undermanned and overloaded.” In one instance, Bay
Pines said it “made a rare mistake” last June when it turned away a
non-veteran who suffered a fatal heart attack 200 feet from its
emergency room.
The VA says it cannot assess how the
Florida hospitals’ diversion rates compare to others nationally. But
officials at both Haley and Bay Pines say they are making it a
priority to achieve better performance. In 2003, for example, Bay
Pines diverted paramedics 2,464 hours or 28% of the time. Similar
statistics were posted in 2004. This year, Bay Pines is diverting
about 7% of the time, roughly 500 hours so far. Haley’s diversion
numbers have not improved in recent years, though it also has
expanded its emergency care and hired three “bed czars.” Meanwhile,
the number of patients treated at both hospitals is on the rise.
“It’s like putting your finger in a dike, actually,” said Dr. Edward
Cutolo, Haley’s chief of staff. Bay Pines treated 49,800 patients in
2000 and tallied 516,000 outpatient visits. In 2006, the numbers
increased to 95,000 and 1.1 million. The problem is not specific to
VA hospitals. About 36% of all hospitals reported going on
diversion, a survey by the American Hospital Association shows.
“It’s a crisis across America, not just the VA,” said Michael
O’Rourke, assistant director of veterans health policy at the
Veterans of Foreign Wars. “There’s a shortage of emergency room
physicians, and there’s a shortage of beds, and there’s a shortage
of nursing staff.”
[Source: Associated Press article 29 Oct 07 ++]
VA GUARDIAN:
Payment of benefits to a duly recognized fiduciary may be made on
behalf of a person who is mentally incompetent or who is a minor;
or, payment may be made directly to the beneficiary or to a relative
or other person for the use of the beneficiary, regardless of legal
disability, when it is determined to be in the best interest of the
beneficiary by the VA’s Veterans Service Center Manager. Unless
otherwise contraindicated by evidence of record, payment will be
made direct to the following classes of minors without any referral
to the Veterans Service Center Manager:
• Those who are serving in or have been discharged from the military
forces of the United States; and
• Those who qualify for survivors benefits as a surviving spouse.
Unless otherwise contraindicated by evidence of record, immediate
payment of benefits may be made to the spouse of an incompetent
veteran having no guardian for the use of the veteran and his or her
dependents prior to referral to the Veterans Service Center Manager
under the following circumstances:
• When payments have been discontinued or withheld from a fiduciary,
benefits may be temporarily paid to the person having custody of the
minor or incompetent.
• Where a child is in the custody of a natural, adoptive or
stepparent, benefits payable on behalf of such child may be paid to
the parent as custodian of the child.
• Benefits due a minor or incompetent adult Indian who is a
recognized ward of the Government, for whom no fiduciary has been
appointed, may be paid to the proper officer of the Indian Service
designated by the Secretary of the Interior to receive funds for
said person.
Guardians are allowed to keep a percentage of the VA payments if the
state in which they reside allows it. In Florida this is 5%.
[Source:
www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_850 Oct 07
++]
VA TIDBITS:
• The law provides a grant not to exceed $5,500 for certain disabled
veterans toward the purchase of an automobile. If a veteran received
this grant when the amount was lower, he cannot use the difference
toward the purchase of another automobile. A veteran with a
qualifying service-connected disability or disabilities may receive
only one VA automobile grant.
• There is no limit to the number of
times VA can furnish specially adapted equipment for a veteran's
automobile. For qualifying veterans, VA will pay for the purchase,
repair, replacement, or reinstallation of adaptive equipment needed
for the safe operation of a vehicle.
• A veteran does not have to be rated
100% in order to be eligible for an automobile grant. If he or she
has lost the use of a limb and that injury is service-connected, he
or she meets the eligibility requirements.
• Divorce terminates all eligible for a
spouse to receive any part of a veterans disability compensation
when it becomes final.
• Under the improved pension plan all
other VA compensation and/or pensions are counted as income. The VA
will not accept an election of improved pension unless it is to your
advantage.
• The VA audits the periodic
guardianship accountings that are required by the Probate Court. If
discrepancies are discovered, the Probate Court is notified and
asked to take corrective action. The welfare and needs of disabled
veterans under guardianship are monitored by VA Field Examiners who
make periodic visits with these veterans. Unattended needs or
adverse conditions are reported to the guardian or, if necessary to
the Probate Court for required action.
• If a veteran dies in a VA hospital,
for confidentiality reasons the VA does not put a death notice or
obituary in the local newspaper or newspaper from where the veteran
lived. Such notices are at the discretion of the veteran's family or
guardian and are handled either by the funeral home with the
family's guidance, or by the family itself.
[Source: www.va.gov Oct 07 ++]
VA FLAG-FOLDING RECITATION BAN:
Complaints about religious content have led to a ban on flag-folding
recitations by Veterans Administration employees and volunteers at
all 125 national cemeteries. It all started because of one complaint
about the ceremony at Riverside National Cemetery in California.
During thousands of military burials, the volunteers have folded the
American flag 13 times and recited the significance of every fold to
survivors. For example, the 12th fold glorifies "God the Father, the
Son and Holy Ghost." The complaint revolved around the narration in
the 11th fold, which celebrates Jewish war veterans and "glorifies
the God of Abraham, the God of Isaac and the God of Jacob." The
National Cemetery Administration decided to ban the entire recital
at all national cemeteries. Details of the complaint weren't
disclosed.
VA spokesman Mike Nacincik said the new
policy outlined in a 27 SEP memorandum is aimed at creating uniform
services throughout the military graveyard system. He said the
13-fold recital is not part of the U.S. Flag Code and is not
government-approved.
Veterans and honor detail volunteers,
including Bobby Castillo, 85, and Rees Lloyd, 59, are furious. "That
the actions of one disgruntled, whining, narcissistic and intolerant
individual is preventing veterans from getting the honors they
deserve is truly an outrage. These are decisions that should be made
by the families of our deceased veteran comrades and not by
Washington bureaucrats" Lloyd said. "This is another attempt by
secularist fanatics to cleanse any reference to God." Lloyd, who is
a California civil rights attorney, says he and his allies at the
Alliance Defense Fund are considering their legal options. World War
II Navy veteran Castillo said it's "a slap in the face to every
veteran. When we got back from the war, we didn't ask for a whole
lot," Castillo said. "We just want to give our veterans the respect
they deserve. No one has ever complained to us about it. I just
don't understand." Lloyd and Castillo are part of a 16-member detail
that has performed military honors at more than 1,400 services. They
were preparing to read the flag-folding remarks at the Riverside
cemetery when graveyard staff members stopped them.
Charlie Waters, parliamentarian for the
American Legion of California, said he's advising memorial honor
details to ignore the edict. "This is nuts," Waters told the
Riverside Press-Enterprise by telephone from Fresno. "There are 26
million veterans in this country, and they're not going to take us
all to prison." An American Legion commander in California says he
and other veterans will defy the new ban. VA spokesman Nacincik said
that though the flag-folding narrative includes references to God
that the government does not endorse, the main reason for the new
rules is uniformity. "We are looking at consistency," Nacincik said.
"We think that's important." Rabbi Yitzhak Miller of Temple Beth El
said he understands the ban. "It is a perfect example of government
choosing to ignore religion in order to avoid offending some
religions," Miller said. "To me, ignoring religion in general is
just as problematic as endorsing any one religion." [Source: AP
OneNewsNow.com article 26 Oct 07 ++]
VA FLAG-FOLDING RECITATION BAN UPDATE 01:
To ensure burial services at the 125 national cemeteries operated by
the Department of Veterans Affairs (VA) reflect the wishes of
veterans and their families, VA officials have clarified the
Department’s policy about recitations made while the U.S. flag is
folded at the gravesite of a veteran. “Honoring the burial wishes of
veterans is one of the highest commitments for the men and women of
VA,” said William F. Tuerk, VA’s Under Secretary for Memorial
Affairs. “A family may request the recitation of words to accompany
the meaningful presentation of the American flag as we honor the
dedication and sacrifice of their loved ones.” Traditional gravesite
military funeral honors include the silent folding and presentation
of an American flag, a 21-gun rifle salute, and the playing of
“Taps.” The clarification includes the following:
• Volunteer honor guards are authorized
to read the so-called “13-fold” flag recitation or any comparable
script;
• Survivors of the deceased need to
provide material and request it be read by the volunteer honor
guards; and
• Volunteer honor guards will accept
requests for recitations that reflect any or no religious
traditions, on an equal basis.
Veterans with a discharge other than
dishonorable, their spouses and eligible dependent children can be
buried in a national cemetery. Other burial benefits available for
all eligible veterans, regardless of whether they are buried in a
national cemetery or a private cemetery, include a burial flag, a
Presidential Memorial Certificate and a government headstone or
marker.
[Source: VA News Release 30 Oct 07 ++]
AGENT ORANGE LAWSUITS UPDATE:
The Haas vs. Department of Veterans Affairs case is going to be
argued on 7 NOV at the US Court of Appeals for the Federal Circuit.
This case has implications far beyond the payment or continuing
non-payment of Agent Orange related benefits to Blue Water Navy
sailors who never set foot on the ground. If the lower court (the US
Court of Appeals for Veterans Claims) is upheld in tissue 06
decision, the DVA will be forced to begin processing claims for, and
paying benefits to US Navy, Coast Guard, and Marine Corps, [and
possibly Merchant Marine] veterans who served off the coast of
Vietnam during the war, but never set foot on the ground. In
essence, the decision reverts to the policy of granting presumptive
eligibility to anyone who was rewarded the Vietnam Service Medal, or
the Armed Forces Expeditionary Medal for service in Vietnam, a
policy which was in effect from the enactment of the Agent Orange
Act of 1991 until the DVA erroneously and unilaterally stop paying
benefits to Blue Water Navy Veterans in 2002. But, the case, once it
is upheld, will also, by dint of the presumptive service connection,
create a new class of potential litigants in lawsuits against the
chemical companies that manufactured the dioxin based defoliants,
but also the United States Government, which specifically demanded
the chemical composition to be delivered by the chemical
manufacturers.
It is the reason cited in the paragraph
above on which the decision in Haas rests. The government escaped
the Agent Orange Class Action Lawsuit of the 1990s as part of a
structured deal going into litigation -- otherwise it would never
have been settled. That may now be a moot point, however. The folks
at BlueWaterNavy.org, the former Blue Water Navy Forum at Yahoo
Groups, and the VNVets Blog have organized the Blue Water Navy
Vietnam Veterans Association, and in doing so, have achieved class
action size and status. Regardless of how the court rules in Haas,
the option now exists to litigate a new class action settlement from
both the Agent Orange chemical companies and the government. The new
association is a unified focal point for blue water navy veterans
and all of their issues, including the addition to the list of
diseases, and subsidiary diseases and conditions currently
authorized for payment under the Agent Orange Act. Keep in mind, a
law suit is not a guaranteed outcome, nor is inclusion in it
guaranteed. Often, those variables are negotiated prior to
litigation, and sometimes during the suit.
One of the things being looked at is the
cross reference of spray maps and the locations of ships off shore
vs. AO conditions in veterans who were on those ships at that time.
The association has already begun collecting data. Instructions for
enrollment in the association are available via the BlueWaterNavy
Forum at
http://bluewaternavy.org/phpBB2/index.php. Interested veterans
and their wives, widows, and/or children are invited to register and
log in to the forum. Membership in the forum is not the same as
membership in the Association, nor is membership in either one
automatic. Membership is open to Blue Water Navy Veterans, USMC
Veterans and USCG and USMM Veterans who served off the coast of
Vietnam during the war and did not set foot on the ground. Veterans
Advocates can also enroll regardless of their service background.
[Source: Blue Water Navy Vietnam Veterans Association notice 26 Oct
07 ++]
VA FLU SHOTS UPDATE:
To safeguard the health of America’s veterans, the Department of
Veterans Affairs (VA) is urging all veterans, especially those
enrolled in VA’s health care system, to receive flu vaccinations
this season.
Walk-in clinics, even drive-in clinics
for the vaccinations— which are free for veterans enrolled in VA’s
health care system—are being offered at many of VA’s 153 hospitals
and more than 900 outpatient clinics. Veterans should check with
their nearest VA health care facility to learn about local
vaccination programs.
“Vaccination is a simple way of
preventing serious health care problems, especially among the
elderly, those with compromised immune systems and veterans with
spinal cord injuries,” said Acting Secretary of Veterans Affairs
Gordon H. Mansfield. “Part of VA’s health care service is ensuring
veterans get their flu shots.” Veterans should discuss flu
vaccinations with their primary health care provider. Physicians
recommend flu vaccinations for pregnant women, people with chronic
medical conditions, those at least 50 years of age, patients in
long-term care facilities, and people who live with those at high
risk for complications from flu. A recent study by Dr. Kristin
Nichol, a nationally recognized expert on the flu and chief of
medicine at the Minneapolis VA Medical Center, found dramatic
reductions in deaths and sickness after getting a flu shot.
Vaccination reduced hospitalizations for pneumonia or influenza by
27%, and there was a 48% reduction in deaths. In addition to
information about flu vaccines available in VA’s medical centers and
clinics, VA maintains information for consumers on its Web site at:
http://www.publichealth.va.gov/flu/.
[Source: VA Media Relations 25 Oct 07 ++]
TRICARE FLU IMMUNIZATION:
Fall is the best time to get the flu vaccination in the United
States, according to health officials. This gives the body a chance
to build up immunity before the winter flu season. “Tricare
beneficiaries should check with their local military treatment
facility or primary care manager to find out when and where they are
offering the flu vaccine,” said Army Major General Elder Granger,
Deputy Director, Tricare Management Activity (TMA). “All
beneficiaries are encouraged to protect themselves against this
potentially deadly virus.” Influenza kills about 36,000 Americans
each year, and leads to about 200,000 hospitalizations, according to
the Centers for Disease Control and Prevention. It is strongly
recommended that the following people get vaccinated each year: all
children aged six months to their fifth birthday; adults aged 50
years and older; persons with underlying chronic medical conditions;
pregnant women; health care workers involved in direct patient care;
child care and elderly care workers; and persons at high risk for
severe complications from influenza. Tricare will cover the Flu
shots administered in a civilian pharmacy or drugstore are not
covered by Tricare. For Tricare for Life beneficiaries, Medicare
covers flu vaccinations and Tricare would pay as second payer, if
needed. Tricare covers two types of vaccinations; the inactivated
vaccine containing a killed virus and given with a needle, and the
nasal-spray flu vaccine made with live, weakened flu viruses that do
not cause the flu. For more information about influenza refer to
www.cdc.gov/flu/. For more
information about your Tricare benefits refer to
www.Tricare.mil.
[Source: TMA Press Release 25 Oct 07 ++]
VA SECRETARY UPDATE:
The Secretary of Veterans Affairs presides over the U.S.
government's second largest Cabinet department, after Defense. It is
a politically sensitive job, especially of late, with new studies
showing that the Bush administration has vastly underestimated the
cost of providing health care to the more than 750,000 soldiers who
have returned home from the wars in Iraq and Afghanistan. But three
months ago, former secretary James Nicholson resigned abruptly after
a difficult tenure and tension among vets is rising because the
White House still hasn't nominated a replacement. Some veterans
advocates say the VA is in such disarray that the White House has
been unable to find a top-notch candidate willing to take the job,
much less go through a confirmation hearing. "Who wants to come in
for 15 months and take over a department that has been left in
shambles?" asks Paul Sullivan, a former VA official who now heads
Veterans for Common Sense. White House spokeswoman Emily Lawrimore
declined to comment on particular candidates, but says, "We are
working hard to nominate a highly qualified individual." She adds
that the White House hopes to announce a nominee "soon."
In response to criticism over the issue, President Bush has unveiled
new proposals to revamp the health-care and disability system for
vets, partly by streamlining the bureaucracy. Days later, USA Today
reported the results of a new internal VA study showing that the
number of Iraq and Afghanistan vets diagnosed with
post-traumatic-stress disorder is rising rapidly, from 29,041 a year
ago to 48,559 this year. Few of these soldiers are even counted in
the Pentagon's official tally of 27,753 wounded in Iraq. Yet a
Pentagon task force recently concluded that the number of
mental-health professionals available to vets is woefully
inadequate, and the average wait time for disability claims is six
months. Linda Bilmes, a policy analyst at Harvard who will testify
before Congress this week, calculates that over the next decade, the
disability costs for vets will be at least $60 billion—more than six
times the administration's official projections. The numbers coming
out of government budget offices, she says, are significantly
underestimating the reality. All this has angered some vets and
their families. "I would love to have the president live my life for
one week to see how difficult it is," says Annette McLeod, wife of
Army specialist Wendell McLeod, who is suffering from PTSD after
serving in Iraq. "How do you fund a war but not fund the
casualties?"
[Source: Newsweek magazine Michael Isikoff and Jamie Reno article 29
Oct Issue ++]
VA SECRETARY UPDATE:
President Bush on 30 OCT nominated retired Army Lt. Gen. James Peake
to direct the embattled Department of Veterans Affairs, which is
strained by the influx of wounded troops returning from Iraq and
Afghanistan. "He will work tirelessly to eliminate backlogs and
ensure that our veterans receive the benefits they need to lead
lives of dignity and purpose," Bush said. Peake, 63, is a physician
who spent 40 years in military medicine and was decorated for his
service in Vietnam. He retired from the Army in 2004 after being
lead commander in several medical posts, including four years as the
U.S. Army surgeon general. The nomination comes as the
administration and Congress struggle to find clear answers to some
of the worst problems afflicting wounded warriors, such as adequate
mental health treatment and timely payment of disability benefits.
Peake currently is chief medical
director and chief operating officer of QTC Management Inc., which
provides government-outsourced occupational health, injury and
disability examination services. If confirmed by the Senate, Peake
would lead the government's second-largest agency with 235,000
employees in the waning months of the Bush administration. In his
new post, Peake, the son of a medical services officer and Army
nurse, would manage the VA, criticized for poor coordination in
providing medical treatment and disability benefits to millions of
veterans. Earlier this year, a presidential commission chaired by
former Sen. Bob Dole, R-Kan., and Donna Shalala, former Health and
Human Services Secretary during the Clinton administration, proposed
sweeping change that could add to the VA's backlogged system by
shifting most of the responsibility in awarding disability benefits
from the Pentagon to the VA. The VA's backlog is between 400,000 and
600,000 claims, with delays of 177 days. Former Secretary Nicholson
in May pledged to cut that time to 145 days, but little headway has
been made with thousands of veterans from Iraq and Afghanistan
returning home. "There is a lot of work to be done as we move
forward on implementing the Dole-Shalala commission
recommendations," Peake said. "The disability system is largely a
1945 product, 1945 processes around a 1945 family unit. About
everybody that has studied it recently said it is time to do some
revisions." Sen. Patty Murray, D-Wash., a member of the Senate
Veterans Affairs Committee, said Peake will have to prove he is up
to the task of improving the beleaguered veterans care system.
Peake, a graduate of the U.S. Military
Academy at West Point, was awarded the silver star and purple heart
for his service in Vietnam as a platoon leader with the 101st
Airborne Division. He was wounded twice in battle and received his
acceptance letter to Cornell University Medical College while in the
hospital recovering from injury. As surgeon general of the U.S.
Army, he commanded 50,000 medical personnel and 187 army medical
facilities across the world. He also was commanding general of the
U.S. Army Medical Department Center and School. From 2004 to 2006,
Peake was executive vice president and chief operating officer of
Project HOPE, a nonprofit international health foundation. While at
HOPE, he helped organize civilian volunteers aboard the Navy
hospital ship Mercy as it responded to the tsunami in Indonesia and
aboard the hospital ship Comfort which responded to Hurricane
Katrina. Joe Davis, a spokesman for Veterans of Foreign Wars, said
Peake appeared to be a strong nominee who will nevertheless face
many difficult challenges at the VA. "He will inherit a department
that continues to face significant challenges, ranging from the
influx of a new generation of disabled veterans and an
uncontrollable claims backlog, to not having an on-time budget for
eight consecutive years," Davis said. "He will walk into tremendous
challenges on day one."
[Source: Associated Press Deb Riechmann article 30 Oct 07 ++]
DOD DISABILITY EVALUATION SYSTEM UPDATE :
The Defense Department will soon unveil a new, streamlined
disability evaluation system that, in tandem with the Department of
Veterans Affairs, will replace the current cumbersome process with a
single exam and single disability rating. According to a copy of the
plan obtained by Military Times and confirmed by Pentagon officials,
veterans medically retired from service will be able to apply for,
and get, VA benefits immediately. Overall, the time spent in the
system, from the point a service member is found unfit for duty
until he begins receiving VA disability payments, will be cut “by
about half,” said to Bill Carr, undersecretary of defense for
military personnel policy. The plan is the Pentagon’s best effort to
make some fixes to the system immediately, without having to seek
congressional approval. A broader, longer-range plan unveiled by the
White House on 16 OCT, based on recent recommendations from a
blue-ribbon commission, will require congressional approval and will
take longer to implement. The Pentagon’s interim plan will be phased
in with a pilot program to be launched in late November at three
military hospitals: Walter Reed Army Medical Center in Washington
D.C.; National Naval Medical Center in Bethesda , MD ; and Malcolm
Grove Medical Center at Andrews Air Force Base, MD. The plan will
expand to other facilities as officials evaluate its effectiveness,
with the emphasis on facilities that treat greater numbers of troops
wounded in the wars. Carr said expansion will take place as fast as
it can.
The plan, a top priority of Defense
Secretary Robert Gates, is the Pentagon’s answer to the Walter Reed
scandal earlier this year in which media reports described wounded
troops caught in tangle of red tape during their treatment and
subsequent medical evaluations. The problems were complicated by the
slow-moving VA benefits process and poor coordination between VA and
the Pentagon — and exacerbated by the wars in Iraq and Afghanistan,
in which more than 28,000 troops have been wounded, more than 13,600
of them seriously. The new program will evaluate all service members
equally, regardless of how their condition developed. Each service
now does its own physical exam during the process leading to
possible separation, and each service member is rated for his
condition. A member medically separated or retired who then seeks VA
care faces another physical exam and yet another rating. The single
exam will be administered to troops as part of the standard Medical
Evaluation Board (MEB), which determines a member’s fitness for
duty. But instead of a military doctor, a VA-qualified provider with
access to the member’s medical records will perform the exam. In
addition to evaluating conditions that could make the member unfit
for service, the doctor will also consider problems the member may
say have been incurred in or aggravated by military service.
If the MEB, which also considers a
commanding officer’s input, decides the member does not meet
retention standards, the case is referred to a Physical Evaluation
Board (PEB). This board decides whether to retain, separate or
return the member to duty and, under the current system, can
determine the nature and amount of military disability benefits.
Troops will retain the right to appeal this decision to a formal PEB.
But if the original finding is confirmed, the new system will allow
troops to have any single condition or rating reconsidered by a VA
decision review officer while still on active duty. As it now
stands, if a member is rated by the military as at least 30%
disabled, he is medically retired. Unless the member served more
than 20 years, a rating below 30% calls for medical separation and,
under some conditions, a lump-sum, one-time payment. In the new
plan, the military no longer will issue ratings; that will be solely
the VA’s job. But until the law is changed, the military will
continue to base its disability ratings decisions only on those
conditions that make a member unfit for continued service. For
example, if a member is rated as 20% disabled for a knee injury and
10% disabled for hypertension, the military’s rating for the purpose
of deciding whether to keep or release the member would be 20%,
since hypertension is treatable, Carr said. In contrast, VA would
use the total rating of 30% to calculate disability compensation for
that member, using its own formula.
That disparity would vanish if Congress
adopts the plan announced 16 OCT by President Bush, Carr said. But
while that plan faces competition from separate wounded warrior
legislation introduced in the House and Senate, Carr said the
essence of the new Pentagon plan likely will stand no matter what
happens with follow-on efforts. Carr agreed that the shock of the
Walter Reed scandal and Gates’ subsequent push to fix the problems
sped the process along. But he said three congressionally mandated
Pentagon executive groups had been looking at such changes for the
past two years. In summary following is a summary of the current,
pilot, and future plans:
• Current plan – DoD & VA run separate
disability evaluation and ratings systems, each with its own
standards for medical exams and separate processes for setting the
level of disability, which in turn determines the military
disability retirement pay or severance pay from the Defense
Department and the amount of VA disability compensation.
• Pilot plan -- An interim program would
eliminate the separate military and veterans health exams and
separate systems of awarding a disability rating. Injured troops
would undergo a single exam and get a single rating based on VA’s
ratings schedule. DoD would continue paying disability retired pay
and severance pay, while the VA would continue paying disability
compensation.
• Future plan -- If Congress approves a
White House plan, DoD’s role in disability decisions would be
reduced to ruling on whether a person is fit to continue military
service. Those found unfit would get a pension based on their rank
and years of service. VA would then determine the level of
disability. Based on that rating, an individual would receive
enhanced disability compensation featuring several components — the
basic disability payment, plus a transition payment equal to a
minimum of three months of basic pay, plus a payment based on an
assessment of how the disability has diminished the veteran’s
quality of life and the potential loss of future income. The exact
levels of pay would be determined by a proposed seven-month study.
[Source: ArmyTimes William McMichael article 29 Oct 07 ++]
PENNSYLVANIA VET AGENCY:
A comprehensive study issued in OCT 07 supports state Sen. Richard
A. Kasunic’s bill calling for separate state government departments
to serve the needs of Pennsylvania’s military personnel and its
veterans. Kasunic, who has served as Democratic chairman of the
Senate Committee on Veterans Affairs & Emergency Preparedness,
estimated the Keystone State is home to 1.3 million veterans. The
154-page Legislative Budget and Finance Committee study’s first
recommendation calls for a new cabinet-level Department of Veterans
Affairs. Kasunic has introduced this measure in every legislative
session dating to 1983. According to the study, the federal
government annually spends an average of $545 less on Pennsylvania
veterans than on vets who reside in other states. Kasunic said that
amounts to $610 million fewer federal dollars, and $1.4 billion in
lost economic activity. Study recommendations include:
• Establishing a separate state
Department of Veterans Affairs.
• Funding the new department with its share of assets from the
current DoD & VA, and supplementing the new agency with about $14
million annually. The study claims that simply separating the
department without providing supplemental dollars would do little
more than drain already existing program resources.
• Establishing a state or county Veterans’ Service Officer, as well
as overseeing the management and funding of the Governor’s Veterans
Outreach and Assistance Centers.
• Providing at least $10 million in the next five years to refurbish
the Scotland School for Veterans’ Children in Franklin County. The
new department would be located at the facility.
• Increasing monthly benefits in the Educational Gratuity, Blind
Veterans’ Pension and Paralyzed Veterans’ Pension Programs.
• Changing the law, which excludes veterans younger than 60, to
allow any honorably discharged veteran to serve on the State
Veterans’ Commission.
• Transferring the Governor’s Outreach Assistance Center to the new
department.
[Source: The Tribune-Democrat article 21 Oct 07 ++]
VA MRSA TESTING UPDATE :
Lately the news has been saturated with stories on the increasing
rates of methicillin-resistant staphylococcus aureus (MRSA)
infections in the United States. The VA wants veterans to know they
have taken proactive steps to combat the infection at each of its
153 hospitals and are placing greater emphasis on hygiene and
screening procedures to help control spread of the disease. The new
disease control plan is based on a pilot program that reduced the
worrisome staph infection rate by 70% at a VA facility earlier this
year. “VA demonstrated that dramatic reductions in MRSA-related
infections are possible,” said Acting Secretary of Veterans Affairs
Gordon H. Mansfield. “VA’s completion of our national deployment of
these serious prevention measures reinforces VA’s stature as one of
the safest health care environments nationally.”
[Source: NAUS Weekly Update 19 Oct 07 ++]
MRSA resists many antibiotics and is
presently killing more people annually than AIDS, emphysema or
homicide, taking an estimated 19,000 lives in 2005, according to a
study published in the Journal of the American Medical Association.
The best defense against the potentially deadly infection is common
sense and cleanliness. Community-acquired staph infections, or CA-MRSA
is primarily a skin infection. It often resembles a pimple, boil or
spider bite, but it quickly worsens into an abscess or puss-filled
blister or sore. Patients who have sores that won’t heal or are
filled with pus should see a doctor and ask to be tested for staph
infection. They should not squeeze the sore or try to drain it —
that can spread the infection to other parts of the skin or deeper
into the body. The vast majority of MRSA cases happen in hospital
settings, but 10 to 15% occur in the community at large among
otherwise healthy people. Infections often occur among people who
are prone to cuts and scrapes, such as children and athletes. MRSA
typically spreads by skin-to-skin contact, crowded conditions and
the sharing of contaminated personal items. Others who should be
watchful: people who have regular contact with health care workers,
those who have recently taken such antibiotics as fluoroquinolones
or cephalosporin, homosexual men, military recruits and prisoners.
Clusters of infections have appeared in certain ethnic groups,
including Pacific Islanders, Alaskan Natives and Native Americans.
The risk of contracting MRSA can be
lowered by bathing regularly and washing hands before meals as a
start. Wash your hands often or use an antibacterial sanitizer after
you’ve been in public places or have touched handrails and other
highly trafficked surfaces. Make sure cuts and scrapes are bandaged
until they heal. Wash towels and sheets regularly, preferably in hot
water, and leave clothes in the dryer until they are completely dry.
Remind kids and teenagers that personal items shouldn’t be shared
with their friends. This includes brushes, combs, razors, towels,
makeup and cell phones. The bacteria may be found on the skin and in
the noses of nearly 30% of the population without causing harm.
Experts believe it survives on surfaces in 2 to 3% of homes, cars
and public places. But the bacteria are evolving, and the statistics
may already underestimate the prevalence of MRSA. Be especially
vigilant in health clubs and gyms — staph grows rapidly in warm,
moist environments. The risks of infection and necessary precautions
should be explained to student athletes, particularly those in
contact sports who often suffer cuts and spend time in locker rooms.
When working out at the gym, make sure you wipe down equipment
before you use it. And if you have a scrape or sore, keep it clean
and bandaged until it heals. Minor cuts and scrapes are the way MRSA
takes hold. For more info on MRSA refer to
www.Mayoclinic.com.
[Source: NAUS Weekly Update 19 Oct & NY Times article 23 Oct 07 ++]
MEDICARE REIMBURSEMENT RULE (NEW):
To defuse physicians' and hospitals' opposition to the creation of
Medicare back in 1965, the program's congressional architects
selected payment mechanisms designed to preserve the status quo. But
as Medicare has expanded and problems of affordability and quality
of care have grown, such an approach has become untenable. Recently,
the Centers for Medicare and Medicaid Services (CMS) announced its
decision to cease paying hospitals for some of the care made
necessary by "preventable complications" — conditions that result
from medical errors or improper care and that can reasonably be
expected to be averted. This rule, which implements a
congressionally mandated change in hospital reimbursement, is the
latest in a series of steps that have rendered Medicare's payment
policy far less passive than it once was. The starting point for
current Medicare payments for inpatient care is the system based on
diagnosis-related groups (DRGs) that was adopted in 1983 by CMS's
predecessor, the Health Care Financing Administration. That system
is considered prospective, in that the amount paid to a hospital for
a patient is fixed in advance and depends only on the diagnoses and
major procedures reported at discharge (which, in turn, map to a
specific DRG).
In reality, payments under this system have never been completely
prospective, being influenced to some degree by what happens to an
individual patient during a hospitalization.
For example, higher payments are made on
behalf of patients in whom clinically significant complications
develop after admission than for those with the same diagnosis who
have no such complications. There are also so-called outlier
payments that partially compensate hospitals for the additional
expenses incurred for very-high-cost cases. With regard to
preventable complications, these retrospective features of the DRG
payment system have harbored a perverse incentive: hospitals that
improved patient safety and ameliorated problems such as nosocomial
infections saw their Medicare revenues — and sometimes their profits
— reduced. Believing that this counterproductive incentive should be
eliminated, Congress instructed the Secretary of Health and Human
Services in 2005 to select at least 2 conditions that are;
(a) High cost or high volume or both,
(b) Result in the assignment of a case to a DRG that has a higher
payment when present as a secondary diagnosis, and
(c) Could reasonably have been prevented through the application of
evidence-based guidelines.
After issuing a proposed set of measures
and considering comments from stakeholders and experts, CMS decided
to disallow incremental payments associated with eight secondary
conditions that it sees as reventable complications of medical care.
These conditions, if not present at the time of admission, will no
longer be taken into account in calculating payments to hospitals
after October 1, 2008. The new rule will result in hospitals seeing
substantial reductions in payment for the care of individual
patients with preventable complications. For example, if a patient
were admitted to a Boston-area hospital with pneumonia and developed
a urinary tract infection or bed sores during the hospitalization,
the hospital would currently be paid $6,253.58, under DRG 89
("pneumonia with complications"); under the new rule, if there were
no other complications, the hospital would be paid only $3,705.38,
under DRG 90 ("simple pneumonia") — a difference of $2,548.20 (a
reduction of approximately 40%). The policy, however, is unlikely to
change the total Medicare payments to hospitals substantially,
because the payment will be "reduced" only for instances in which
preventable complications were the only factors causing a case to be
reclassified under a more expensive DRG.
Medicare will continue to make outlier
payments for cases with costs substantially exceeding the average
for the appropriate DRG, even when these costs are the consequence
of preventable complications — and the likelihood of incurring such
outlier payments will actually be increased by the new policy,
because cases in which there are complications will more easily
exceed the threshold associated with the lower-paying DRG. Moreover,
preventable complications including the eight that CMS identified
for exclusion may continue to result in higher Medicare payments to
hospitals, because their downstream consequences may place cases in
entirely different and very-high-cost DRGs, such as DRG 483 (tracheostomy
with mechanical ventilation for 96 hours or more). The new approach
does not attempt to unravel these more complex clinical scenarios.
Conditions for which Medicare will no
longer pay more if acquired during an inpatient stay, number of
incidents in FY 2006, and average Medicare payment for admissions in
which condition was present are:
• Object left in patient during surgery
– 764 - $61,962
• Air embolism – 45 - $66,007
• Blood incompatability – 33 - $46,492
• Catheter-associated urinary tract infection – 11,780 - $40,347
• Pressure ulcer - 322,926 - $40,81
• Vasculat-catheter associated infection – Unknown
• Mediastinitus after coronary-artery bypass grafting – 108 -
$304,747
• Fall from bed -2,591 - $24,962
[Source: The New England Journal of Medicine Meredith B. Rosenthal
article 18 Oct 07 ++]
VA MRSA TESTING UPDATE 01:
Lately the news has been saturated with stories on the increasing
rates of methicillin-resistant staphylococcus aureus (MRSA)
infections in the United States. The VA wants veterans to know they
have taken proactive steps to combat the infection at each of its
153 hospitals and are placing greater emphasis on hygiene and
screening procedures to help control spread of the disease. The new
disease control plan is based on a pilot program that reduced the
worrisome staph infection rate by 70% at a VA facility earlier this
year. “VA demonstrated that dramatic reductions in MRSA-related
infections are possible,” said Acting Secretary of Veterans Affairs
Gordon H. Mansfield. “VA’s completion of our national deployment of
these serious prevention measures reinforces VA’s stature as one of
the safest health care environments nationally.”
[Source: NAUS Weekly Update 19 Oct 07 ++]
VA COMP PAYMENT DISPARITY UPDATE:
On 17 OCT, the House Veterans’ Affairs Subcommittee on Oversight and
Investigations held a hearing to review the disability claims rating
process and assess the causes of disparities in disability ratings
that are administered by the Department of Veterans Affairs.
Variances in VA disability compensation rates range from an average
of $12,000 per veteran in New Mexico to less than $8,000 per veteran
in Ohio. Among the actions under review are six recommendations from
the Institute for Defense Analyses (IDA) on providing improved
consistency in VA disability ratings and claims payments:
1.) Standardize training for rating
specialists;
2.) Standardize the medical evaluation reporting process;
3.) Increase oversight and review of rating decisions;
4.) Consolidate rating activities to a central locations;
5.) Develop metrics to monitor consistency in adjudication results;
and,
6.) Improve and expand data collection and retention.
The hearing marks what will hopefully be
the continuation of a more rigorous effort to modernize and improve
the way we evaluate disabilities and award compensation for injured
service members, exactly as the Veterans’ Disability Benefits
Commission and a number of other blue-ribbon panels have also
recommended.
[Source: NAUS Weekly Update 19 Oct 07 ++]
GRAYHOUND DISCOUNTS:
Military Discount: Active duty and retired military personnel and
their dependent family members may receive a 10% discount off the
Greyhound walk-up (unrestricted) fare. Another option for military
personnel is to travel on Greyhound for a maximum fare of $198 round
trip anywhere in the continental United States. The following
restrictions apply:
1. Fares are valid on Greyhound schedules and those of participating
interline carriers. Not available on Greyhound Canada routes.
2. This fare applies only to active and retired members of the
United States Armed Forces, which includes the U.S. Air Force, Army,
Coast Guard, Marines, and Navy; members of the National Guard,
reservists and bonafide identifiable spouses and dependents of the
above. A valid military picture identification card must be
presented upon request.
3. A 40% discount for children of military personnel referenced
above is available. Discount not available with $198 maximum
military fare. No other discounts apply.
4. Only totally unused tickets may be refunded to the location of
the original purchase. A 15% penalty fee applies upon refund. No
refund will be allowed if any portion of the ticket has been used.
5. Departure date and time may be changed for a charge of $10 per
ticket provided that the advance purchase requirement is not
violated.
6. Advance purchase tickets purchased over the phone require a
minimum of ten days for delivery by mail and for online orders.
7. Casino, commuter, Discovery Pass, student or other special
military fares do not qualify for the military discount.
8. Fares are subject to change until purchase and may be higher
during peak holiday travel periods.
9. Ten-percent discount may not be used in conjunction with the $198
maximum fare.
Veterans Discount:
With the Veterans Advantage Discount Card, members can save 15% on
walk-up fares at the terminal or online. Veterans Advantage is
available for U.S. Military Veterans, active duty, National Guard &
Reservists, and their family members. Membership is good for
discounts on travel, dining, entertainment, clothing, and many more
services and products. To become a member and get this discount,
apply online at the Veterans Advantage Web site, or call 1(866)
838-7392. A Veterans Advantage 30-day free trial offer is currently
available for Greyhound riders to thank you for your service. Full
memberships are available for as low as $59.95 for one year, plus
$4.95 to process enrollment.
VA Patient Discount:
A 25% discount on applicable one-way fares also is available to
patients of U.S. Veterans Administration Hospitals, patients
assigned by the U.S. Veterans Administration to Army, Navy, Air
Force, or military hospitals, or patients assigned by the U.S.
Veterans Administration to civil and state institutions when
traveling at their own expense. To qualify, the patient must present
a completed original Veterans Administration Request for Reduced
Rate Transportation Form (VA-Form 3068) to the ticket agent at time
of purchase. No copies, facsimiles, or other forms will be accepted
for this discount.
[Source: Military.com 18 Oct 07 ++]
PNEUMONIA VACCINATION:
The Army Medical Department is launching a concerted effort to
reduce the needless suffering, death, and waste of medical resources
that stem from widespread failure by older beneficiaries to get
their pneumonia vaccinations. Military medical facilities are being
pressed to stay on their toes about offering the shots to all their
older patients. Also known as the pneumococcal shot or Pneumococcal
Polysaccharide Vaccine or PPV, the pneumonia vaccine is safe and
highly effective, according to medical authorities—provided it gets
out of the bottle and inside somebody’s body. To encourage that to
happen more often, military medical leaders are stressing these
facts:
• Pneumococcal disease can kill you. It
is the sixth leading cause of death in the U.S. (40,000 deaths
annually).
• It can make you miserably and expensively ill. There are 100,000
-130,000 hospitalizations annually in the U.S.
• It can affect your lungs, blood, and brain. It usually causes
fever, cough, and shortness of breath.
• Pneumococcal disease can affect people of all ages, but older
adults ages 65 and over are at higher risk for complications from
both the flu and pneumococcal disease. The shot can help protect you
from getting a serious infection in your lungs, blood and brain.
• Getting the shot when you’re age 65 or older should protect you
for the rest of your life. You can get it any time of the year. The
shot is safe and most people have no side effects. For maximum
safety, medical officials also encourage beneficiaries to take the
flu vaccine annually.
Anyone can get pneumococcal disease, but
some people are at greater risk from the disease. These include
people 65 and older, the very young, and people with special health
problems. The pneumonia vaccine protects you from getting serious
infection in your blood or brain that can cause dangerous health
problems, hospitalization, and death. Pneumococcal disease can lead
to serious infections of the lungs (pneumonia), the blood (bacteremia),
and the covering of the brain (meningitis). About 1 out of every 20
people who get pneumococcal pneumonia dies from it, as do about two
people out of 10 who get bacteremia and three people out of 10 who
get meningitis. People with the special health problems are even
more likely to die from the disease. Drugs such as penicillin were
once effective in treating these infections; but the disease has
become more resistant to these drugs, making treatment of
pneumococcal infections more difficult. This makes prevention of the
disease through vaccination even more important. Those who should
get the pneumococcal shot are:
• All adults 65 years of age or older.
• Anyone over 2 years of age who has a long term health problem such
as: heart disease, lung, disease, sickle cell disease, diabetes,
alcoholism, cirrhosis, or leaks of cerebrospinal fluid.
• Anyone over 2 years of age who has a disease or condition that
lowers the body’s resistance to infection, such as: Hodgkin’s
disease, lymphoma, leukemia, kidney failure, multiple myeloma,
nephrotic syndrome, HIV infection or AIDS, damaged spleen, or no
spleen, organ transplant.
• Anyone over 2 years of age who is taking any drug or treatment
that lowers the body’s resistance to infection, such as: long-term
steroids, certain cancer drugs, radiation therapy.
• Alaskan Natives and certain Native American populations.
[Source: Army News Service Harry Noyes
article 18 Oct 07 ++]
VETERANS DAY FREE MEALS UPDATE:
In their annual salute to all veterans McCormick & Schmick's Seafood
Restaurants will again provide free meals in honor of Veterans Day.
All veterans can receive a free lunch or dinner entrée at McCormick
& Schmick's Seafood Restaurants nationwide on Sunday, 5 NOV 06. Vets
should show proper identification (VA card, VFW card, veterans ID,
discharge papers, etc.) Reservations are strongly encouraged! In a
show of thanks to our nation's veterans, Bill McCormick and Doug
Schmick offer to serve those who've served at their McCormick &
Schmick's Seafood Restaurants. Last year the company served nearly
15,000 vets nationwide. This year's event is taking place on the
Sunday before Veterans Day so that families can participate.
McCormick & Schmick's annual veterans program began as a small
effort in just one restaurant in 1999. Due to its overwhelming
popularity and positive response received from veterans the program
has expanded nationwide. A complete list of participating
restaurants may be found at
www.McCormickandSchmicks.com.
Also thanking active duty and veterans,
the Golden Corral restaurants will be having their annual salute to
the military on Monday 13 NOV from 17-2100. Military Appreciation
Monday (First Monday after Veteran's Day) is set aside for Golden
Corral to honor all active duty and retired military personnel with
a free "thank you" dinner and beverage at any Golden Corral
restaurant. No identification is required. Since 2001, Golden Corral
has served 1,230,960 free meals to active duty and retired military
personnel. For more info go to their website
http://www.goldencorral.net/.
[Source: The Veterans Voice
http://www.theveteransvoice.com/Hero.html Oct 07 ++]
SALUTING THE FLAG UPDATE:
S1877, introduced by Senator Inhofe of Oklahoma, to amend Title 4,
United States Code, to prescribe those members of the Armed Forces
and veterans out of uniform may render the military salute during
hoisting, lowering, or passing of the flag. The bill was sent to the
House Judiciary Committee for consideration. The Committee, to date,
has not set the bill for review. They have a huge backlog of issues
currently under consideration. The staff reports that the concern
with this bill is that there is no way to determine when people are
in civilian clothes who is and who is not a veteran. The staff also
said that there currently is in the law an appropriate method for
rendering honors and that is to place one's hand over one's heart.
It is not known at this point whether or not this bill will become
law, but it is expected to be mired in legal wrangling and
constitutional law review for quite some time. The Air Force
Association (AFA) in the interim is suggesting that veterans render
honors in a way they deem appropriate. If the situation warrants,
place your hand over your heart - if you'd rather salute, do that.
No law is going to change the way you feel about rendering honors.
You earned the privilege to do as you choose.
[Source: AFA Update 17 Oct 07 ++]
VETERANS MENTAL HEALTH BILL:
U.S. Senator Daniel K. Akaka (D-HI), Chairman of The Committee on
Veterans’ Affairs, has introduced comprehensive mental health
legislation. The bill, inspired by an 25 APR Committee hearing on
mental health care, would address the immediate needs of veterans by
ensuring high quality mental health services at VA facilities and in
their communities. In testimony at the hearing, veterans and their
family members told heart-wrenching stories of substance abuse, PTSD,
and suicide, which exposed flaws in the current mental health care
system for veterans. “Servicemen and women return from war suffering
from invisible wounds that are complicated and wide-ranging,” Akaka
said. “The solutions put forth in this legislation will help lead to
proper mental health care for our veterans.” In his floor statement
Akaka noted:
• A MAR 07 study published in the
Archives of Internal Medicine reported that more than one-third of
war veterans who have served in either Iraq or Afghanistan are
suffering from various mental ailments including post-traumatic
stress disorder, anxiety, depression, substance use disorder and
other problems. According to the study, a disproportionate number of
young soldiers suffer mental health problems.
• One in five Iraq War veterans are likely to develop PTSD, as
studies have estimated, and this is but one aspect of the mental
health challenges faced by veterans.
• We also know that veterans suffering from physical and mental
wounds use drugs and alcohol to assuage their pain. Experts believe
that stress is the number one cause of drug abuse, and of relapse to
drug abuse. Sixty to eighty percent of Vietnam veterans who have
sought PTSD treatment have alcohol use disorders. VA has been
dealing with substance abuse issues for decades, but much remains to
be done.
• This bill addresses the immediate needs of veterans by ensuring
high quality mental health services at VA facilities and in their
communities.
The bill also looks to the future through a number core provisions.
The legislation would:
• Require VA medical centers to offer a minimum range of services
for veterans in need of help to overcome their substance use
disorders.
• Require programs to prevent relapse and to provide medical
treatments to reduce cravings for alcohol and drugs, among others.
• Require that the confluence of substance use disorders and other
mental health disorders be treated by a well-qualified team of
health professionals who would treat the disorders concurrently.
• Create grants to enhance programs and fill holes. VA facilities
would compete for grants for various purposes, from increasing
weekend and evening hours to creating programs which encourage
urgent care physicians - who are often gateways for new patients -
to quickly refer those whom they believe may have a mental health
disorder.
• Require the VA Secretary to designate six inpatient facilities to
provide recovery services for veterans with comorbid PTSD and
substance use disorders.
• Require a comprehensive review of VA's residential mental health
facilities.
• Restate an existing law which allows families to have access to
care which will aid in the effective treatment and rehabilitation of
a veteran by clarifying the type of services to which family members
should have access.
• Set up a mental health research program based on the successful
pediatric oncology model. It proposes a network of sites with
adequate patient flow and clinical and research expertise with a
goal of promoting rapid progress from research to therapeutic
advancement and effective treatments for PTSD and PTSD in the
presence of a substance use disorder.
• Authorize the creation of new programs and expansion of existing
ones.
The Veterans Affairs Department on 24 OCT announced its opposition
to the mental health care legislation, contending that it duplicates
efforts already under way. Dr. Michael J. Kussman, the VA's
undersecretary for health, "said the substance abuse segment of the
bill was 'overly prescriptive and attempts to mandate the type of
treatments to be provided to covered veterans, the treatment
settings and the composition of treatment teams.' Kussman also said
the contracted care sections of the bill are duplicative of
currently existing authorities.
[Source: SCVA News Release 15 Oct 07 ++ ]
VA PAIN CARE:
On 15 OCT Senator Daniel K. Akaka (D-HI), Chairman of the Veterans’
Affairs Committee, and fellow Committee member Senator Sherrod Brown
(D-OH), introduced legislation that would enhance the Department of
Veterans Affairs’ pain management program. The Veterans Pain Care
Act of 2007 would assist in focusing attention on pain management as
a new generation of veterans suffering from pain enter VA’s health
care system. This legislation seeks to significantly bolster VA’s
existing pain management efforts and bring them up to par at a
national, system-wide level. This bill, among others, is scheduled
to be reviewed at the Committee’s 24 OCT 07 hearing on pending
legislation. It has been endorsed by the Pain Care Forum, a
consortium representing over 75 health care and health advocacy
organizations from across the country. Sen. Akaka noted in
introducing the legislation that:
• It is estimated that nearly 30% of
Americans – that’s some 86 million people – suffer from chronic or
acute pain every year. A recent study conducted by VA researchers in
Connecticut found that nearly 50% of veteran patients that are seen
at VA facilities reported that they experience pain regularly.
• While pain increases in severity with age, it is also a growing
problem among younger veterans who have been injured in the wars in
Iraq and Afghanistan. Many of these veterans are coming home with
severe injuries – often traumatic brain injuries – that require
intensive rehabilitation. In some cases, these younger veterans will
have to live with the long-term effects of their injuries, of which
pain is a large and debilitating part.
• Pain management is an area of health care that by many accounts is
not yet to up to par, in both the private and public sectors. The
legislation being introduced would enhance VA’s pain management
program on a national, system-wide level, by requiring VA to
establish a pain care initiative at every VA health care facility.
Every hospital and clinic would be required to employ a
professionally recognized pain assessment tool or process, and
ensure that every patient who is determined to be in chronic or
acute pain is treated appropriately.
• The profile of a veteran in pain is often times different than
that of his or her counterpart in the private sector. For example,
veterans suffering from chronic pain are more likely to be receiving
treatment for other problems including depression, substance abuse,
alcoholism, or post traumatic stress disorder. Understanding and
treating their pain must be a priority, and this bill will help VA
enhance the department’s existing pain management program.
• VA’s current pain management efforts are worthwhile, but are
unfortunately not adequate to meet all of the needs of veterans.
Pain management in VA continues to be relatively decentralized and
unstandardized. Some VA medical centers have adopted successful
approaches and procedures to deal with pain, while others have been
less active. Fortunately, VA has begun the work of identifying
professional talent and developing ideas that provide the groundwork
of an effective pain management program. This bill would build upon
that foundation and help ensure that these ideas become practice.
[Source: SCVA News Release 15 Oct 07 ++]
VA CLAIM BACKLOG UPDATE:
On 9 OCT at a field hearing of the House Veterans Affairs
Subcommittee on Disability Assistance and Memorial Affairs, Chairman
John Hall (D-NY-19) called on the VA to reduce the waiting time for
veterans stuck in its overwhelming claims backlog by two-thirds. He
pointed out that these veterans have mortgages, medical bills, and
tuition bills for their children’s education and that bill
collectors don’t wait 6 months, 2 years, or 5 years to collect—you
have to pay them every month. The VA must meet the same standard. He
is asking that the VA cut the waiting time from six months to two
months, and someday even be able to turn around a claim in 30 days.
The VA currently maintains a backlog of over 600,000 cases. Due to
funding shortfalls over the past five years, the backlog and waiting
times became exacerbated to the point of unmanageability. The
current average waiting periods at all levels in the VA disability
benefits system are staggering:
• 177 days at the Regional Office
• 751 days at the Board of Veterans Appeals
• 240 days at the Court of Appeals for Veterans Claims
Hal said, “This backlog is simply
unacceptable and the VA has shown little ability or interest in
reducing the number of claims pending a decision. These veterans
stood up for our country when asked, and now it’s our turn to stand
up for them.” The backlog New York veterans face is even worse than
that suffered by the average veteran in the U.S. The New York City
VA Regional Office’s performance on processing claims is far behind
the national average. Currently, it averages 255 days to complete a
claim and has a pending backlog of 9,638 claims (20% higher than its
goal of 7,952). Hall pointed out that the New York VA is working
with one arm tied behind its back due to a hiring freeze that began
in 2001 through JAN 06 to comply with federal cuts to VA funding.
The New York office’s accuracy rating is 83%, meaning 17% of
veterans are getting thrown into the hamster wheel of the appeals
process which can take years to complete.
The New York Regional Office has said it
needs at least a third more employees (40-50) to deal with the
number of claims it currently has and the number of claims
anticipated. Hall was joined by other Members of the Subcommittee
and by U.S. Rep. Maurice Hinchey at the rare field hearing held at
New Windsor Town Hall in Orange County. Testimony was heard from
local veterans who suffered financial and other problems as a result
of delays in receiving their veterans claim decision, from a
representative of the Veterans Administration, and representatives
from a number of Veterans Service Organizations.
[Source: Congressman Hall Press Release
9 Oct 07 ++]
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