RAO Bulletin Update
May 15, 2007

This bulletin contains the following articles:

• VA NSLI - (Paid Up Benefit)
• Navy Reserve Bonus - (Up to $20,000)
• Mobilized Reserve 9 MAY 07 - (Net Increase 1117)
• Awards Replacement - (Where to Write)
• SAMHSA (New Web Page)
• GI Bill [15] - (Cost Gap Increasing)
• Veteran Presence Diminishing - (Demographic Shifts)
• AFRH Gulfport [04] (Reopening March 2010)
• PTSD [14] - (VA Policies Problematic)
• Veteran Legislation 2007 [01] - ($80 Billion Price Tag)
• DFAS myPay System [04] - (New Security Measure)
• Vacation Travel Cost - (Car vs. Airline)
• DoD Millennium Cohort Study - (21 Year Study)
• VA OIF/OEF Advisory Committee - (Committee Formed)
• Vet Cemetery Florida [05] - (Sarasota Opening Fall 08)
• DoD to VA Transition [05] - (No Date Set)
• DoD to VA Transition [06] - (16th Hearing Comments)
• Rental Car Age Restriction - (Age 70 & Over)
• Indiana Vet Initiatives [01] - (Signed Into Law)
• SSA COLA 2008 - (Lowest in History)
• VA Claim Backlog [07] - (125 Day Goal)
• Vet Organization Bingo - (Instant Bingo)
• Homeless Vet Stand Down - (LA Statewide Event)
• Pneumonia Vaccinations - (Covered By Medicare)
• Army Retiree Council [01] - (Retiree Council Issues)
• NDAA 2008 [01] - (Progress Report)
• VA Vet Centers [01] - (Staffing Shortfalls)
• GI Bill [14] - (10-year Deadline)
• WRAMC [09] - (Gates Supports Closing)
• Tricare/CHAMPUS Fraud [06] - ($40 million Lawsuit)
• Gulf War Syndrome [02] - (Brain Size Findings)
• VA Bonuses - (Amount Questioned)
• VA Bonuses [01] - (Secretary Asked to Resign)
• SGLI [07] - (Beneficiary Options)
• Tricare Pharmacy Copay [01] - Increase Impact on Savings)
• VA Chiropractic Care [02] (H.R.1470)
• VA Data Breach [33] - (GAO Report)
• Emergency Contraception - (H.R. 2064)
• DoD to VA Transition [04] - (New Legislation)
• COLA 2008 [04] - (0.8% thru MAR 07)
• VA Rural Access [01] - (Legislation Review)
• USO - (New DC Airport Lounge)
• SDVI [01] - (New Legislation)
• AL Dependents' Scholarship Program (Started OCT 47)
• Insurrection Act - (S.513 to Repeal)
• National Veterans Wheelchair Games - (19 - 23 JUN)
• Eat More, Stay Thin - (What to Do)
• Email Addressing - (Bcc Use)
• Veteran Legislation Status 14 May 07 (Where we stand)

VA NSLI - (Paid Up Benefit)
The VA has offered numerous forms of life insurance going back to 1914. One of them is the National Service Life Insurance (NSLI) policy, which was available from 1940 to 1951. In 1984, Congress passed a law to cap the premiums of this policy at the age-70 rates. Once you turned 70, your premiums never increased. Since September 2000, a capped NSLI term policy will receive a termination dividend if the policy lapses, or if the policyholder voluntarily cancels their policy. The termination dividend will be used to purchase paid-up additional whole life insurance. Not covered in the handbook is the fact the policy is considered paid-up at age 101, per VA counselors. If you are paying premiums at the capped age 70 rates, the termination dividend with paid-up whole life option may offer you the opportunity to stop paying premiums and maintain some coverage. However, you must call the VA to determine the amount of paid-up whole life you qualify for, which may or may not cover your needs. Furthermore, the paid-up benefit will not equal $10,000. Call the VA at 1(800) 669-8477 to talk about your specific case. For more information on NSLI and all other VA life insurances, refer to VA Life Insurance handbook. [Source: MOAA http://moaa.org/Services May 07 ++]

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Navy Reserve Bonus - (Up to $20,000)
The Navy Reserve expects to begin paying bonuses within the next few months to encourage reservists to transition to deployment-intensive ratings as part of an effort to shift the reserve component to a more expeditionary footing — and that should mean significantly longer mobilizations for most reservists in coming years. The Navy Reserve announced in March that it will pay bonuses of up to $20,000 to people who sign up for six-year hitches and $10,000 for those who sign up for three-year commitments in 15 deployment-intensive ratings. Bonuses for civilians who go directly into the Navy Reserve are being paid for several Seabee ratings, hospital corpsmen, intelligence specialists and masters at arms. Bonuses for sailors leaving active duty are being paid for those ratings, plus for divers, linguists and SEALs. But bonuses are not available to current reservists who want to switch to these ratings. That should change soon. Lt. Adam Bashaw, spokesman for the Navy Reserve Forces Command, confirmed that a decision is pending on paying bonuses to entice reservists to switch to deployment-intensive ratings, but he declined to speculate on the amount of bonuses that will be paid, the ratings they will be paid for, or the date the bonuses will be approved. The bonuses are needed, advocates said, because lengthy mobilizations have put pressure on reservists’ professional and family lives. Of the 10 most mobilized ratings in the Navy Reserve in 2006, all but three (storekeeper, information systems technician and boatswain’s mate) net bonuses for people off the street and those coming from active duty. Vice Adm. John G. Cotton, chief of the Navy Reserve, said that within six years, he expects there to be 50,000 sailors assigned to Navy Expeditionary Combat Command, the group to which a large percentage of deployment-intensive ratings belongs. About half of those will be reservists, Cotton said. Navy active duty retention bonuses in critical rates are also becoming more lucrative. For example, effective 1 MAY active-duty SEAL officers who hold the unrestricted line designator 1130 or the limited-duty officer designator 6150 can apply for up to a $125,000 bonus provided they have:

• No remaining obligated service; and
• If a SEAL unrestricted line officer completed at least 15, but not more than 25, years of active commissioned service; and
• If a SEAL limited duty officer have served at least 10 years, but not more than 20 years of commissioned service; and
• Completed an executive officer tour and been assigned the additional qualification designator as being executive officer qualified. The bonus is designed to improve retention in special warfare officers

The bonus is designed to improve retention in special warfare officers in pay grades O-4 through O-6. [Source: NavyTimes Chris Amos article 11 May 07 ++]

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Mobilized Reserve 9 MAY 07 - (Net Increase 1117)
The Army, Navy, Air Force, Marine Corps and Coast Guard announced the current number of reservists on active duty as of 9 MAY 07 in support of the partial mobilization. The net collective result is 1117 more reservists mobilized than last reported for 25 APR 07. Total number currently on active duty in support of the partial mobilization for the Army National Guard and Army Reserve is 64,005; Navy Reserve, 5,859; Air National Guard and Air Force Reserve, 5,886; Marine Corps Reserve, 5,356; and the Coast Guard Reserve, 302. This brings the total National Guard and Reserve personnel, who have been mobilized, to 81,408, including both units and individual augmentees. At any given time, services may mobilize some units and individuals while demobilizing others, making it possible for these figures to either increase or decrease. A cumulative roster of all National Guard and Reserve personnel, who are currently mobilized, can be found at http://www.defenselink.mil/news/May2007/d20070509ngr.pdf . [Source: DoD News Release 9 May 07 ++]

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Awards Replacement - (Where to Write)
Retirees who have lost medals or decorations, or never received ones they earned, may request them at any time. The government will generally replace lost or destroyed decorations for service or valor at no cost. There may be a charge for campaign ribbons and badges. At www.thestrelz.com/mildec.htm you can view decorations and ribbons, Army right breast pocket ribbons for citations and commendations, specialty and staff badges for each service, U S Merchant Marine ribbons, plus State and Other Foreign Decorations. Former service members and the survivors of deceased veterans can obtain replacement medals or make appeals by writing to their respective service below. For Air Force (including Army Air Corps) and Army personnel, the National Personnel Records Center will verify the awards to which a veteran is entitled and forward the request with the verification to the appropriate service department for issuance of the medals. The Standard Form (SF 180), Request Pertaining to Military Records is recommended for requesting medals and awards. This form can be downloaded in PDF format at http://www.archives.gov/veterans/military-service-records/standard-form-180.html.

Air Force: National Personnel Records Center, Air force Reference Branch NRPMF, 9700 Page Blvd., St. Louis, MO 63132-5100. For appeals or problems write to Headquarters Air Force Personnel Ctr, AFPC/DPPPR, 550 C Street West, Suite 12, Randolph AFB, TX 78150-4714.

Army: National Personnel Records Center, Medals Section (NRPMA-M), 9700 Page Blvd., St. Louis, MO 63132-5100. Send appeals to: Commander PERSCOM, Attn: TAPC-PDO-PA, 200 Stovall Street, Alexandria, VA 22332-0471

Navy: Bureau of Naval Personnel, Liaison Office Room 5409, 9700 Page Blvd., St. Louis, MO 63132-5100. For appeals or problems write to Chief of Naval Operations, (OPNAV 09B33), Awards & Special Projects, Washington, DC 20350-2000.

Marine Corps: Bureau of Naval Personnel, Liaison Office Room 5409, 9700 Page Blvd., St. Louis, MO 63132-5100. For appeals or problems write to Commandant of the Marine Corps, Military Awards Branch (MMMA), 3280 Russell Road, Quantico VA 22134-5100.

Coast Guard: Bureau of Naval Personnel, Liaison Office Room 5409, 9700 Page Blvd., St. Louis, MO 63132-5100. For appeals or problems write to Commandant U.S. Coast Guard, Medals and Awards Branch (PMP-4), Washington, DC 20593-0001

Your letter should include as much of the following information as possible:

• Full name
• Social Security Account Number and Former Service Numbers if any
• Date and place of Birth
• Inclusive dates in the service
• Complete Mailing Address
• Telephone & Fax Number plus Email address (if you have one)

Make it easy for them to contact you, the easier the better. Be sure and include a copy of your DD214 and/or Separation Documents plus any other documents germane to your request. Indicate what you are looking for in the way of an award or correction regarding an award in your letter. If it is for corrections spell it out. Highlight the error on a copy of the related document and in your letter include what you think it should be. On medals and campaign ribbons if you are not sure indicate that you believe an award is indicated for a specific time frame and place of service and that you feel you qualify. Ask that your records be reviewed for additional unit or individual awards and decorations not reflected on the enclosed DD Form 214, or DD 215 correction of the DD Form 214, and issuance of a complete replacement set of awards and decorations. The more information you provide them the easier it is for them to verify and award you the ribbon. If your information is lengthy then put it on another sheet of paper and reference it in your letter. Be sure and put your full name, SSN and date on that sheet at the top and bottom. Upon receipt NPRC pulls the records, attaches the request and sends the case to AFPC to work. Veterans should be prepared to wait at least four-six months for a response. Any request for changes to a DD Form 214 should be accompanied by the necessary documents to substantiate the claim. [Source: TREA News Flash 10 May 07 ++]

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SAMHSA (New Web Page)
Substance Abuse and Mental Health Services Administration (SAMHSA) is a public health agency within the Department of Health and Human Services. The agency is responsible for improving the accountability, capacity and effectiveness of the nation's substance abuse prevention, addictions treatment, and mental health services delivery system. A new section of the SAMHSA website at http://www.samhsa.gov has been launched for veterans and their families. The site provides critical information on prevention, treatment and recovery support for mental and substance use disorders. Publications, fact sheets, and links to relevant agencies are provided along with information on SAMHSA-funded programs, agency activities, and training and technical assistance opportunities. Individuals seeking substance use and mental health services can easily find information about local programs by using SAMHSA’s treatment facility locator.

On 10 MAY SAMHSA convened a meeting with the Department of Veterans Affairs, the Department of Defense and veterans’ service organizations to better understand the needs and to identify ways local community-based substance abuse and mental health service organizations can best be prepared to assist veterans and their families. The discussion will help inform the development of guidance materials for states, local communities, and providers to ensure a coordinated approach to providing mental health and substance use services. For more information refer to Resources for Returning Veterans and Their Families at http://www.samhsa.gov/vets/ . [Source: SAMHSA Press Office 10 May 07 ++]

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GI Bill [15] - (Cost Gap Increasing)
The GI Bill which once covered nearly the entire cost of a veteran's college expenses continues to fall further behind the soaring price of higher education. Despite several attempts by Congress to boost benefits in past decades, the gap has grown so large that many veterans are forced to take out sizable student loans. The maximum GI Bill amount a currently enrolled veteran who served on active duty can qualify for during a college career is roughly $38,700. But for many students, that is not nearly enough to pay for tuition, room, board and books. And the GI Bill covers only four years of school, leaving veterans on their own if they take longer to graduate The average cost of one year's tuition, room and board at four-year public institutions in 2006-07 was $12,796, according to the College Board. For private schools, the one-year cost was $30,367. Tuition and fees at all schools have risen 35% in the past five years, while the highest GI Bill monthly payout has increased only 20% since 2002. Big student loans are not uncommon among college students in general; the average graduate now leaves school with $19,000 in loans.

Congress has boosted the GI benefit several times since its inception - the last a $9 billion, 10-year increase passed in 2001 that even then was criticized as too small to keep up with soaring costs. Some lawmakers want to try again. Legislation in the House and Senate would make National Guard and Reserve troops, who are relied on heavily in Iraq and Afghanistan, eligible for the same GI Bill payments as active-duty personnel. Currently, Guard members and reservists receive a much lower educational benefit. A bill sponsored by Sen. Jim Webb (D-VA), a former Marine and Navy secretary, would pay the entire tuition, room and board of veterans and provide them with a monthly stipend of $1,000. Webb touted the bill 9 MAY in the Senate Committee on Veterans' Affairs, saying it would help boost recruiting, ease the transition of returning soldiers and raise the quality of life for veterans. The legislation is backed by several veterans groups..

To enroll, troops must buy in to the program. Their pay is reduced by $1,200 during the first year of service, and then they must serve their full enlistment period. Those who serve three years or more are eligible for the full benefit of $1,075 per month. Some may qualify for additional money provided by each military branch, known as a GI Bill ``kicker.'' The Department of Veterans Affairs, which administers the program, distributed $2.76 billion in education aid to 498,123 people last year. While that amount is substantial, it falls short of original program's scope. President Franklin D. Roosevelt signed the GI Bill, officially called the Servicemen's Readjustment Act, in 1944, largely to keep millions of demobilized World War II soldiers from flooding the job market. By 1956, 7.8 million servicemen had used the benefit for either college or vocational training. Veterans initially received about $500 per year, which was then enough to pay for tuition, room and books at most colleges. [Source: Associated Press Stephen Manning article 10 May 07 ++]

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Veteran Presence Diminishing - (Demographic Shifts)
Veterans make up a shrinking part of American society. As the generations that fought World War II, Korea, and Vietnam fade away, there is no cohort of twenty and thirty something draftees to take their place. About 2.5 million Americans serve today in uniform which is 0.84% of the total population and 2.83% of people of draft age. As their numbers shrink, these military folk are concentrating themselves in geographically insular parts of the country, going to live near the largest military bases in the South and Midwest. These demographic shifts have a profound effect and result in Americans having little or no personal contact with the military. [Source: Slate Magazine Phillip Carter article 9 May 07 ++]

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AFRH Gulfport [04] (Reopening March 2010)
The rebuilding project of the Armed Forces Retirement Home (AFRH), Gulfport, is underway. General Services Administration (GSA) officials met with the AFRH management team in February to officially kick off the AFRH Gulfport Rebuild Project. GSA was appointed by Congress to take the lead in the demolition, design and construction of a new facility to replace the existing structure that suffered extensive damage from Hurricane Katrina. Demolition of the damaged facility is slated to begin in late July. $240 million has been designated and transferred to GSA for this project. Nearly half of the 560 residents living at the Gulfport AFRH at the time of the hurricane relocated to the sister campus in Washington, DC. Some have permanently settled into their new surroundings but most of the South Mississippi veterans are looking forward to returning to Gulfport when the home reopens in March 2010 and are already on a list for returning residents.

For those considering applying to AFRH, veterans are eligible to become residents if their active duty service was at least 50% enlisted, warrant officer or limited duty officer and they meet at least one of the following criteria:

• Retired military with 20 or more years of active duty service who are at least 60 years old, or
• Veterans unable to earn a livelihood due to a service-connected disability, or
• Veterans unable to earn a livelihood due to injuries, disease, or disability, and who served in a war theater or received hostile pay or
• Female veterans who served prior to 1948. For more information about the AFRH, refer to http://www.afrh.gov or call 1(800) 422-9988. Renditions of the design of the new Gulfport facility as well as time lines for the project will be made available on the Web site as the project progresses.

[Source: MRGRG Rex Roark pass along 9 May 07 ++]

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PTSD [14] - (VA Policies Problematic)
An influential scientific advisory group said 8 MAY the government's methods for deciding compensation for emotionally disturbed veterans have little basis in science, are applied unevenly and may even create disincentives for veterans to get better. The critique by the Institute of Medicine, which provides advice to the federal government on medical science issues, comes at a time of sharp increases in cases of post-traumatic stress disorder (PTSD) among veterans and skyrocketing costs for disability compensation. The study was undertaken at the request of the Department of Veterans Affairs amid fears that troops returning from the wars in Iraq and Afghanistan will produce a tidal wave of new PTSD cases. Between 1999 and 2004, benefit payments for PTSD increased nearly 150%, from $1.72 billion to $4.28 billion, the report noted. Compensation payments for disorders related to psychological trauma account for an outsize portion of VA's budget at 8.7% of all claims, but 20.5% of compensation payments. VA officials said they welcomed the report. "VA is studying the findings, conclusions and recommendations of the report to determine actions that can be taken to further enhance the services we provide," spokesman Matt Burns said in a statement.

The report suggested changes to VA policies, but the panel could not say whether those changes would result in more or fewer PTSD diagnoses, or in greater or lesser expense for taxpayers Psychiatrist Nancy Andreasen of the University of Iowa, who chaired the panel. said, "PTSD has become a very serious public health problem for the veterans of current conflicts and past conflicts… A comprehensive revision of the disability determination criteria are needed .. the current VA system, in which PTSD compensation is limited to those who are unable to hold a job, places many veterans in a Catch-22. You can't get a disability payment if you get a job -- that's not a logical way to proceed in terms of providing an incentive to become healthier and a more productive member of society. The practice is especially wrong, she added, because it is at odds with VA policies for other kinds of injuries. To determine the compensation a wounded veteran should get, the government assigns one a disability score. Veterans who are quadriplegic, for example, can be assigned a disability level of 100 percent even if they hold a job, whereas veterans with PTSD must show they are unable to work to get compensation. The policies are problematic, in the sense that they require the person given compensation to be unemployed. This is a disincentive for full or even partial recovery." One solution suggested by the panel was to set a minimum compensation level for veterans disabled by PTSD, which would allow those who can seek work to do so.

Larry Scott, founder of the group VAWatchdog.org, who applauded the conclusions said, "This is the report the VA didn't want. If the IOM's recommendations are implemented, they will cost VA billions of dollars -- more staff, more staff training, more data collection, more clinical evaluations and higher awards." The report identified problems with both arms of VA's evaluation and compensation procedures: A veteran currently undergoes an evaluation to determine if he or she has PTSD, and the results are used by other raters to determine the level of disability and the amount of compensation. The Institute of Medicine panel said the scale used to evaluate veterans is outdated and largely designed for people who suffer from other mental disorders. Andreasen and other members also said they had heard from veterans who had received wildly different kinds of evaluations -- some lasting 20 minutes while others took hours. The scientists said VA should standardize the evaluations using state-of-the-art diagnostic techniques.

While VA requires its experts to determine what proportion of a veteran's disabilities were caused by particular traumatic experiences, and to what extent overlapping symptoms are related to particular disorders, the IOM said there is no scientific way to classify symptoms in this manner. "The VA's disability policies for veterans with PTSD were developed over 60 years ago and now require major, fundamental reform," said Chris Frueh, a former VA clinician who is now a psychologist at the University of Hawaii at Hilo and was not involved with producing the new report. But even though better care is needed for veterans, Frueh said, it is important not to assume that trauma always results in a mental disorder. "Scientific evidence indicates that resilience is the most common human response to trauma," he said. "Even for the most severe forms of trauma, such as rape or combat, most people do not develop PTSD." [Source: Washington Post Shankar Vedantam article 9 May 07 ++]

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Veteran Legislation 2007 [01] - ($80 Billion Price Tag)
The Senate Veteran’ Affairs Committee (SVAC) held a hearing on 9 MAY to review veterans’ benefits legislation (26 bills) now pending before the Committee Legislation under consideration included bills specific to veterans returning from the current conflicts in Iraq and Afghanistan, as well as broad legislation to benefit veterans of previous wars. Chairman Akaka noted that much of the legislation on the agenda addressed the needs of veterans with service-connected disabilities. During hearing Sen. Larry Craig, the ranking member of the minority party, received positive reactions to six veteran bills he is sponsoring. One, (S.225) would amend the Wounded Warrior legislation he sponsored and Congress passed in 2005. The new bill would expand the number of individuals qualifying for retroactive benefits from traumatic injury protection coverage under Servicemembers' Group Life Insurance by extending coverage to all servicemembers, no matter where they were, from the start of the war on terror. Craig’s original Wounded Warrior bill has since provided nearly $200 million to over 3,000 veterans seriously wounded and injured since 911. The payments range from $25,000 to $100,000, depending on the severity of the injury. The average payout is approximately $64,000. Payments are generally made within eight weeks after the servicemember is hurt. But as the Idaho Republican talked about changes that are needed to improve the lives of veterans, he cautioned that if Congress passed all 26 bills now before the Senate Committee on Veterans’ Affairs, the total would come to nearly $100 billion dollars. Spending on VA programs has already grown from $48 billion in 2001 to over $80 billion this year. [Source: SVAC Press Release 9 May 07 ++]

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DFAS myPay System [04] - (New Security Measure)
myPay officials announced 9 MAY that another new security feature has been added to protect customers’ data on the pay account system. As part of their on-going commitment to strengthen password and account security to protect customers' data, Defense Finance and Accounting Service has implemented the “virtual keyboard” to assist in protecting against malicious software such as Spyware, Trojans and Keylogging. The virtual keyboard is available beginning mid-May. Each time a user arrives at myPay to log on, the virtual keyboard will appear on the screen. The user will type in their Login ID and then the user will "press" the keys on the screen by clicking on them with their mouse to enter their Personal Identification Number (PIN) instead of typing the actual keys. The virtual keyboard is to be used only for the user’s PIN. To enhance security, the keyboard layout changes or keys are displayed randomly every time the page is refreshed.

DFAS uses a variety of security features to protect customer’s data on the myPay system and asks that customers do everything they can to protect data from being compromised or captured on home computers. Under frequently asked question on the myPay homepage (https://mypay.dfas.mil) customers can find more information on steps to secure their home computers. To Login to myPay using the Virtual Keyboard:

1. Type LoginID under Account Access on the homepage.
2. Next, click on the numbers and letters (if using a restricted access PIN) of your PIN using the mouse and virtual keyboard on the screen. (Each number and/or letter will appear as an asterisk in the textbox above the virtual keyboard.)
3. When finished, click the “GO” button. Once in myPay users will continue to navigate as usual. For more about DFAS refer to http://www.dfas.mil.

[Source: DFAS Press Release 9 May 07 ++]

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Vacation Travel Cost - (Car vs. Airline)
The present price of gas makes travel by car more expensive. The major factors are how many passengers are involved and how much time you have. It might be cheaper to fly than drive. AAA has a fuel cost calculator at www.fuelcostcalculator.com that will help you decide. Sure, you could estimate the cost of driving. But AAA will give you precise results based on the make and model of your car. You can also see the daily average gas price in different regions of the country. For example a roundtrip from San Diego CA to Washington DC by car with a new Honda Accord would take an average 92 gal of gas at a cost of $597.14 at today’s price to make the 5310 mile roundtrip. Once you arrive you are looking at $17 to $25 daily parking fees for your vehicle. Taking into consideration driving an average of 500 miles a day for 10 days and staying at moderate priced motels in route which average $50 to $55 a day you are looking at about $1100 total cost for the trip by car for two people. On the internet e-ticket for roundtrip fare from San Diego to Washington D.C. can be purchased for $320 to $400 each for a 7 to 9 hour flight. The $300 to $400 savings for two people would more than pay for a rental while there and save wear and tear on your car. The travel time saved would allow a longer stay in the capital with side trips to other points of interest in the area. Airlines offer even lower fares as specials during low season periods and or non-weekend travel days. A little shopping on the internet could result in a more enjoyable vacation at a lower price. [Source: NCPOA Don Harribine article 9 May 07 ++]

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DoD Millennium Cohort Study - (21 Year Study)
Starting in May, the Department of Defense will launch the third and final recruitment phase of the largest prospective health project in military history – the Millennium Cohort Study. Designed to evaluate the long-term health effects of military service, including deployments, the cohort is tracking the health status of more than 140,000 service members from active, Reserve, and Guard duty status until well into their civilian careers or retirement. The survey participants are chosen at random from personnel rosters of all the service branches. While cooperation is not mandatory, the program has been endorsed by Chairman of the Joint Chiefs of Staff Peter Pace as well as several veterans’ service organizations. While the study is entering its sixth year out of a twenty-one year study period, initial data has already sparked much interest in the medical community. Navy CDR Margaret Ryan, a medical doctor who is the principal investigator for the study said, “This project will usher in a new era of insight and understanding in the areas of deployment-related exposures, long-term mental health challenges, and service-related health issues to name just a few of the topics these findings will address,” Funded by the Department of Defense and supported by military, Department of Veterans Affairs, and civilian researchers, nearly 110,000 people are already participating in this groundbreaking study. [Source: Tricare News Release 9 May 07 ++]

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VA OIF/OEF Advisory Committee - (Committee Formed)
Secretary of Veterans Affairs Jim Nicholson announced 8 MAY the formation of a formal, 17-person committee that will advise him on ways to improve VA programs serving veterans of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) and their families. The panel will report directly to the Secretary who is asking for their ideas and input on how VA can consistently ensure world-class service to America’s newest generation of heroes, particularly severely disabled veterans and their families. The Secretary’s announcement about the Affairs VA panel, called the Advisory Committee on OIF/OEF Veterans and Families, comes on the heels of his presentation 24 APR of recommendations from a presidential task force to improve services to the nation’s newest generation of combat veterans. The committee, to be chaired by retired Lt. Gen. David Barno, consists of OIF and OEF wounded veterans, family members, survivors, leaders of the major veterans organizations and long-time veterans advocates.

The new OIF/OEF advisory committee’s inaugural meeting started 14 MAY in Alexandria, VA to discuss its general work program, future meeting dates, and plans for site visits to VA facilities around the country. The schedule includes briefings by senior officials of VA’s key programs, comments by members of the public who register in advance with the committee, discussions about “seamless transition” goals and procedures affecting combat veterans moving from the military to civilian life. Members of the Committee are: Lt. Gen. Barno of Washington DC; Dawn Halfaker of Washington DC; Lonnie Moore of San Diego CA; Jack L. Tilley of Riverview FL; Gary Wilson of Carlsbad CA; Liza Biggers of New York City; Pam Estes of Dayton MD; Caroline Maney of Shalimar FL; Kimberly Hazelgrove of Lorton VA; Michael Ayoub of Ashburn VA; Rocky McPherson of Tallahassee FL; John Sommer of Annandale VA; Dennis Donovan of Atlanta GA; Frances Hackett of South Plainfield NJ.; Paul F. Livengood of Manassas VA; Tim McClain of Alexandria VA; and Chris Yoder of Baltimore MD. Those seeking more information about the committee or who wish to register to make a statement of up to five minutes should contact VA’s Tiffany Glover by e-mail at tiffany.glover@va.gov. [Source: VA News Release 8 May 07 ++]

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Vet Cemetery Florida [05] - (Sarasota Opening Fall 08)
After almost a year of negotiations, the federal government has reached a deal to buy 295 acres in Sarasota County to build a new veterans cemetery. Rep. Vern Buchanan (R-FL-13) confirmed 8 MAY that the Department of Veterans Affairs has agreed to pay about $14 million to buy the land at the Hawkins Ranch in eastern Sarasota County. Construction is expected to begin this year, with the first burial likely to be in fall 2008. Sarasota veterans groups have been pushing for a national cemetery for years, citing the almost 400,000 veterans living within 75 miles of Sarasota. The closest VA cemetery to Sarasota now is the Bay Pines Cemetery in St. Petersburg. The VA began negotiating with ranch owner J. Arlin Hawkins to buy the land in late May 2006. His family has run the ranch, which is about four miles east of Interstate 75 on Clark Road, since the 1870s. The federal government is in the largest cemetery expansion mode since the Civil War, according to the VA. Last month, a new national cemetery was opened in Palm Beach County Florida. Besides the site in Sarasota, five others around the nation will become cemeteries. There are now five national cemeteries in Florida, not including the ones planned for Sarasota and Jacksonville. [Source: Sarasota Herald Tribune 9 May 07 ++]

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DoD to VA Transition [05] - (No Date Set)
A Government Accountability Office (GAO) official said 8 MAY that neither the Defense nor the Veterans Affairs departments have set a date for deploying modernized electronic health record systems that would ensure seamless data interchange between the two agencies, Valerie Melvin, GAO's director of human capital management, told a House Veterans Affairs subcommittee that the Pentagon had originally projected that it would finish deployment of its Armed Forces Health Longitudinal Technology Application, which is designed to contain outpatient records, and its Clinical Data Repository - holding information on more than 9 million active duty and retired military personnel -- by 2011. The VA, she said, had estimated it would deploy its Health eVet records system, which is intended to replace its existing Veterans Health Information Systems and Technology Architecture system, by 2012. But, she said, officials at both departments told GAO there is currently no completion date for either system.

The two departments have made some progress in short-term projects to share health information, but Melvin said, "These exchanges are as yet limited, and significant work needs to be done to expand the data shared and integrate the various initiatives. Exchange of information between Defense and the VA on troops severely wounded in combat in Afghanistan and Iraq is frustrated by the Pentagon's paper-based records system. Soldiers wounded in combat are first evacuated to the Landstuhl Regional Medical Center in Germany, where inpatient records (except discharge summaries) are paper-based. Defense hospitals that later receive wounded patients, such as Walter Reed Army Medical Center and the National Naval Medical Center in Bethesda, have an inpatient electronic records system called the Clinical Information System. But only a limited number of clinicians at three VA polytrauma centers (Tampa FL; Richmond VA; and Palo Alto CA) have electronic access to that system. Such centers serve soldiers with severe injuries to more than one organ system.”

When patients are transferred from Walter Reed to those polytrauma centers, staff at Walter Reed has to print records from the Clinical Information System, scan the paper and transmit the scanned data to the VA. Defense staff told GAO that this labor-intensive process is feasible only because of the small number of records of polytrauma patients involved in the process -- about 350 to date. Access to radiological images is a high priority for polytrauma doctors, but Melvin said transmitting these images from Walter Reed or the Bethesda Naval Medical Center requires manual intervention when each image is received by the VA. The Pentagon and the VA have made some progress in sharing electronic patient information, she said, through a project known as the Bidirectional Health Information Exchange, which allows text-only viewing of certain data.

Dr. Gerald M. Cross, acting principal deputy undersecretary for health at the VA, told the subcommittee that the department has installed BHIE at every one of the VA's 154 hospitals and more than 800 clinics. He said Defense has installed the system at 18 hospitals and more than 190 outpatient clinics, and by JUN 07 expects it to be up and running at all of its facilities. Melvin said that the VA and Defense also have successfully fielded the Laboratory Data Sharing Interface, allowing the two departments to share lab test data. Stephen Jones, assistant Defense secretary for health affairs, told the subcommittee that to date, his department has electronically transferred medical records on 3.8 million patients to the VA. Both departments, he said, have started work to develop a joint inpatient electronic health records system. They expect to identify the requirements for the project by the spring of 2008. [Source: GOVEXEC.com Bob Brewin article 8 May 07 ++]

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DoD to VA Transition [06] - (16th Hearing Comments)
Since 2000, the Committee on Veterans’ Affairs has held at least sixteen hearings in order to push DoD and VA to share critical medical information on patients being seen or transferred to VA. The House Committee on Veterans Affairs (HVAC) Subcommittee on Oversight and Investigations met yet again 8 MAY to assess the progress made by VA and DoD and its current status on the long term project of electronic medical information sharing. The need for both departments to share medical data is imperative in order to help ensure high quality health care for active-duty military personnel and veterans. Billions have been spent throughout the past twenty years by VA and DoD working on independently stove-piped electronic medical records systems that would provide better care to those serving on the front line of our nation’s efforts for freedom. Yet, neither to date seems to work together in a coordinated effort of care.

For twenty plus years, VA and DOD have been less than enthusiastically addressing this problem, yet there is no solution in sight. In fact, the witnesses at the Subcommittee hearing could not give HVAC any sort of a firm deadline when they expect an interoperable electronic medical records system to be up and running. Subcommittee Ranking Member Ginny Brown-Waite (R-FL) said, “This foot-dragging and bureaucratic passing of the buck is unacceptable. In the past twenty years, entire cities have been built on the sands of the Dubai peninsula; all while these two agencies spend billions of taxpayer dollars with little results to show for their efforts. This Subcommittee will not accept the same tired excuses – we expect action and results … The DoD has seven separate medical legacy systems, and none of them can communicate with the VA systems … Even though the President directed, with Executive Order 13410 in August 2006, the VA and DoD to develop a computer-based system for sharing medical records by January of 2007, the representatives of the VA and DoD at today's hearing could not provide a date for achieving this directive … DoD is studying the feasibility of a shared inpatient record and hopes to have that study done by 2008. After two decades, the goal still remains the same, that finally, there will be a system that will permit the exchange of critical medical information that is interoperable, bi-directional, and occurs in real-time.” For news from House Committee on Veterans’ Affairs Republicans, refer to: http://www.veterans.house.gov/republicans/. [Source: HVAC Press Release 8 My 07 ++]

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Rental Car Age Restriction - (Age 70 & Over)
More seniors are traveling than ever before, and the travel industry has responded by offering a wide range of senior travel discounts and incentives, but there are still a few places in the travel world where age works against you. One example is the car rental counter in some European, African and South Pacific countries, where a little known regulation has stranded more than one unsuspecting senior traveler, leaving them without transportation because they are “too old” to drive the rental car they have reserved. Rental agency’s Insurance companies mandate the maximum age for car rental, and they usually set the cutoff age at 70 or 75. If an older customer has an accident, the company's insurance carrier will increase rates across the board, unless the company agrees to refuse service to any customer above a certain age. Different rental car companies have different insurance carriers, however, so the only way to know whether you will be allowed to drive away in the car you have reserved before leaving on your trip is to ask specifically about age restrictions for rental cars, and how they apply in the area where you will be traveling.

The rules about renting cars after a certain age haven’t become more rigid, but with more seniors traveling the frequency of problems has increased. Most people know there is a minimum age for rental cars, but few people realize that there is also an upper age limit. Dealing exclusively with major rental car companies like Hertz or Avis won’t necessarily help you avoid the problem. While some of the major companies don’t impose age maximums for rental cars at their corporate sites, many have franchise operations in various locations that restrict rental cars by age to meet insurance requirements. Companies don’t always post rental car age restrictions on their Web sites in a place that is easy to find. If you’re 70 or older, call the rental car company directly and ask about their policy in the area where you want to travel. If you get a clerk who doesn’t know or seems uncertain about the policy, ask to speak to a supervisor and keep going up the ladder until you find someone who can verify that you can rent a car at your destination. [Source: About Senior Living Sharon OBrien article 8 May 07 ++]

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Indiana Vet Initiatives [01] - (Signed Into Law)
On 3 MAY Indiana Governor Mitch Daniels signed two bills that will assist military service members and their families. Senate Bill 480 contains several provisions that affect the quality of life of Indiana military families, including:

• Exempting active duty military pay earned by mobilized reserve component members from individual income tax.
• Increasing the military pay income tax deduction from $2,000 to $5,000.
• Establishing a veterans affairs trust fund and a military and veterans’ benefits board.
• Establishing eligibility for active duty military personnel and their family members to receive resident tuition rates at state educational institutions.
• Authorizing education boards and other licensing boards to adopt rules to expedite the licensure of individuals whose spouses are stationed on active duty in Indiana. House Bill 1092 improves employment and legal benefits including:
• Establishing an unpaid leave of absence of up to 10 working days for certain family members when a reserve component service member is ordered to active duty.
• Providing grants from the military family relief fund for child care assistance.
• Creating penalties for landlords who refuse to rent to military members.
• Exempting an individual on active duty from serving on a jury. Complete information on the provisions of both bills may be found at http://www.in.gov/law.htm and looking under legislative information.

[Source: NMFA Government & You E-News 7 May 07 ++]

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SSA COLA 2008 - (Lowest in History)
In its annual report released to Congress earlier this week, Social Security's Trustees announced that the Social Security Cost of Living Adjustment (COLA) for 2008 is forecast to be just 1.4%, and could be as low as 1.2%. Since the COLA went into effect in 1975, it has never been lower than 1.3%, and has failed to exceed two percent only three times in its 32 year history. That increase means that a senior with an average benefit of $1,044 would see a bump of just $14.60 per month beginning in JAN 08. In contrast, Medicare Part B premiums alone have increased by an average of more than 11% per year over the past five years. Due to hitting a spending warning this year, some analysts expect Part B premiums to climb by double digits again in 2008. As a result, the COLA would be wiped out for most seniors by increases in Part B premiums alone. A majority of the 48 million Americans aged 65 and over who receive a Social Security check depend on it for at least 50% of their total income, and one in three beneficiaries rely on it for 90% or more of their total income. But because the Social Security COLA trails rising costs in everything from Medicare to energy costs, seniors will see their spending power diminish again next year, as it has for several straight years.

The Senior Citizens League is lobbying for a change in the Consumer Price Index (CPI) used to determine the COLA to help seniors offset the increasing cost of Medicare Part B. The government currently calculates the COLA based on the CPI for Urban Wage Earners and Clerical Workers (CPI-W), a slower-rising index that tracks the spending habits of younger workers who don't spend a high percentage of their income on health expenditures. However, the government does track the spending patterns of older Americans, and has done so since 1983 with the CPI for Elderly Consumers, or CPI-E. By tying the annual SSA increase in the COLA to the CPI-E, seniors would see much needed relief in their monthly checks. For example, a senior who retired with a benefit of $460 in 1984 would have received almost $10,300 more over the past 23 years with the CPI-E. Rep. Charles Gonzalez (D-TX-20) has introduced “The Consumer Price Index for Elderly Consumers Act (H.R. 1953)” in the 110th Congress which would require this. Rep. Peter DeFazio (OR-4) has introduced a second CPI-E bill H.R. 2032. The difference in the two bills is that H.R. 2032 requires the CPI-E for Medicare benefits as well. [Source: TREA msg. 8 May 07 ++]

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VA Claim Backlog [07] - (125 Day Goal)
Veterans filing disability claims with the Veterans Affairs Department wait for an average of almost six months for a response -- about six times longer than is typical in the private sector. Pending disability claims with the VA take an average of 177 days to process, according to VA records. For some, the wait time is almost a year. And for veterans appealing a decision on a claim, the average wait time is 657 days. For people filing disability claims with insurance companies, about 75% to 80% of claims are handled within 30 days, said America's Health Insurance Plans. Federal law requires disability claims with private insurers to be settled within 45 days, although extensions of 30 days or longer are possible. "The backlog issue is not going to go away until the federal government rolls up its sleeves and takes a serious look at expediting the resolution of claims," said Luz Rebollar, a national service officer with AMVETS who guides veterans through the VA claims process. The biggest factor in the growing backlog is the increased number of veterans using the system. The VA processed almost 775,000 claims last year, pushing the backlog total to about 600,000. With the VA expecting 800,000 claims this year, in part because of the thousands of troops returning from service in Iraq and Afghanistan, the problem is poised to get worse before it gets better, said Dan Bertoni, the Government Accountability Office's(GAO) acting director of education, work force and income security issues. "We had a claims system that didn't work well in peacetime, and it's certainly showing strain now." Bertoni said.

The VA says it's unfair to compare processing times with that of the private sector because the department must prove that the injury or ailment was service-related -- a complex process that includes many hurdles beyond its control. The types of injuries suffered by troops, particularly in Iraq and Afghanistan, also are difficult to evaluate. These claims can involve post-traumatic stress disorder and environmental and infectious disease risks. And claims are becoming increasingly complex, as veterans include more potential disabilities per request than in the past, with each requiring a separate evaluation and rating, the VA says. Some claims involve injuries or ailments that are decades old, further complicating the evaluation process. "There is a large block of time involved in all of this evidence-gathering," said Ronald Aument, the VA's deputy undersecretary for benefits. Still another problem is the VA's difficulty in obtaining medical records and other evidence from the Defense Department, which uses a different computer system, requiring medical records to be physically delivered. The agency says it's working to reduce the appeals processing times by paying greater deference to decisions made at the appeals level. The VA also plans to hire 400 additional claims specialists by summer to help chip away at the backlog.

Aument says his goal is to reduce the average wait time for claims to 160 days by 30 SEP 07 with the agency's long-term target for processing a claim in 125 days. Speeding up the process anymore would require changes in laws that would cut corners and "infringe on veterans rights." That's not fast enough for some on Capitol Hill. "No veteran should have to wait six months or a year for their claim to be decided and then endure an appeal that adds another year or two," said Rep. Doug Lamborn, Colorado Republican, at a House Veterans Affairs subcommittee hearing in March about the claims backlog. "For some veterans, this is not mere inconvenience, it is financial and potentially emotional disaster." In a report submitted at the same hearing and to other congressional panels about the VA's claims backlog, the GAO said the backlog problems may lie in more fundamental reform of the VA's disability compensation program. The GAO suggests that the VA update its 62-year-old criteria for awarding disability claims, which the agency says often results in claimants being classified as disabled when they wouldn't be in the private sector. It also said the VA also could streamline the process by overhauling the structure and division of labor among field offices, which had caused wait times to vary greatly for veterans in different cities and regions. [Source: The Washington Times Sean Lengell article 8 May 07 ++]

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Vet Organization Bingo - (Instant Bingo)
With a new governor in office, veterans groups and other charitable organizations in Florida that rely on bingo to raise money hope a long-sought new income source will be made available: instant bingo. Bingo crowds have dwindled over the years, and so has the money groups like Disabled American Veterans (DAV) has to provide services such as van transportation for medical appointments and food for homeless veterans. The old way of setting the calling of numbers and putting a card down is not as exciting as it once was. The group’s new hope is that they will be able to sell instant bingo tickets during bingo games, which will help boost that revenue. It’s been a top priority for veterans groups for years, and one that was squashed by Gov. Jeb Bush’s veto in 2004. Now, they’re hoping for a change in heart with Gov. Charlie Crist in office. The tickets are similar to Florida Lottery instant tickets, except instead of scratching away at the surface to see if a player has won or lost, cardboard tabs are pulled to reveal a prize. They would cost no more than $1 and only be sold at bingo games.

At present 38 other states have allowed instant bingo and that ticket sales have been able to boost income for the nonprofit groups by 30 to 40%. For a group like the DAV, that could be a big help as chapters try to stay afloat, said Al Linden, executive director of the organization’s Florida branch. Last year the DAV organization lost two chapters in Florida because they couldn’t sustain bingo anymore. In the last 20 years the number of DAV chapters has decreased from 103 to 73. Of the remaining chapters, about one-third rely heavily on bingo. There was opposition to the idea in the Florida Legislature, where the House voted 78-38 and the Senate 29-6 for the bill (SB 500) which would allow the ticket sales. Like Bush three years ago, some lawmakers said they oppose any expansion of gambling. Veterans groups argue that it’s not a significant expansion of gambling because ticket sales are limited to bingo halls. Plus, they say, the money goes to charitable causes. [Source: Associated Press article 7 May 07 ++]

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Homeless Vet Stand Down - (LA Statewide Event)
Homeless veterans from across Louisiana are being invited to participate in “Stand Down 2007,” Louisiana’s first statewide event to provide them with medical and social services. The event will assist homeless veterans from 23 & 24 MAY from 09-1530 at the VFW Hall Post 3652 at 15800 DeMarco Lane, Hammond LA. The event is co-sponsored by the Louisiana Department of Labor, VFW Post 3652, Louisiana Army National Guard 205th Battalion, Quad Vets, AM Vets and the American Legion. In times of war, a “stand down” occurs when a combat unit is temporarily moved out of the field and back to base camp for rest and rehabilitation. Homeless veterans are in some ways comparable to soldiers in a war zone — living exposed in the field, enduring extreme conditions and surviving with limited rations.

The first “Stand Down” for homeless veterans was organized in 1988 by a group of Vietnam veterans in San Diego CA. Since then, “Stand Downs” have been used in reaching out to homeless veterans throughout the United States. Participants in “Stand Down 2007” will have access to dental, vision, hearing and medical screening, information about job services and job training programs, Veterans Affairs benefits, Social Security benefits, grooming services, gift packs, a hot meal and more. Efforts are under way to provide transportation for homeless veterans from all areas of the state to attend the event. For more information or to offer transportation or any other assistance, call Quad Vets at (800) 639-7823 [Source: Advocate Staff Report 7 May 07 ++]

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Pneumonia Vaccinations - (Covered By Medicare)
The Army Medical Department is working to reduce the suffering and death caused by the widespread failure of older beneficiaries to get pneumonia vaccinations. Also known as the pneumococcal shot, the pneumonia vaccine is safe, highly effective and has no side effects. For maximum safety, medical officials also suggest getting a flu vaccine annually. To encourage older patients to get the shot, 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).
• Pneumonia can make you miserably ill (100,000 -130,000 hospitalizations annually in the U.S.). It usually causes fever, cough and shortness of breath.
• Pneumococcal disease can affect people of all ages, but those age 65 and older are at higher risk for complications. 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, and Medicare Part B will pay for it.

For more information, contact your local military treatment facility or your health care provider. [Source: Army Echoes May-Aug 07 ++]

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Army Retiree Council [01] - (Retiree Council Issues)
The Army Chief of Staff’s (CSA) Retiree Council reported after their annual meeting 23-27APR at the Pentagon that health care remains the greatest issue for more than 900,000 Retired Soldiers, Wounded Warriors and surviving spouses worldwide. The Council also took on one of the CSA's seven initiatives (strategic communication) as a key issue for Retired Soldiers. The Council is made up of 14 retired officers and NCOs and is co-chaired by LTG (Ret.) Frederick E. Vollrath and SMA (Ret.) Jack L. Tilley. Members are nominated by their installation retiree councils and approved by the CSA. At its annual meeting, the Council reviews retiree issues forwarded by installation councils worldwide and determines which should be reported to the CSA and which can be addressed at the installation level. For example, at last year’s meeting, the Council asked the CSA for a new Army Retired pin. At this meeting, Council members were among the first to receive the new pin which is being mailed to all Retired Soldiers.

This year, the Council reviewed 42 issues, about a third of them dealing with health care. The Council cited successes such as Tricare for Life, but recommended that DoD:

• Sustain the military health care system by continuing to support full-resourcing of high-quality health.
• Limit any increase in Tricare fees (if DoD must increase them) to the annual growth in retired pay.
• Raise the Tricare provider reimbursement levels, as necessary, to attract physicians to provide accessible health care services to all beneficiaries.
• Improve the non-subsidized Retiree Dental Program by providing the ability to buy higher levels of service and by expanding the program to countries with sufficient population to make it commercially viable, such as Germany and Korea.
• Continue to support collaboration between the DoD and the VA health care systems to preserve and improve benefits for all beneficiaries and to ensure a seamless transition, especially for Wounded Warriors.

In the strategic communication arena, the Council stated that Retired Soldiers are an operational reserve of potential force-multipliers whose effectiveness in telling the Army story can be enhanced if they’re armed with talking points and support material such as DVDs and handouts. To support these efforts, the Council recommended that the Army:

• Tailor a section of the Army 2007 Strategic Communication Guide to Retired Soldiers to provide topics to use in interactions in their communities.
• That the CSA communicate personally with all Retired Soldiers at least annually to share his priorities and the messages he wants them to pass on.
• Include talking points for telling the Army story in every issue of Army Echoes.
• Continue to fund three issues a year of Army Echoes, with the e-mail version remaining an option, not a requirement.
• Continue to resource the educational efforts in retirement programs such as Retiree Appreciation Days, Retirement Services Officer (RSO) Training; and full, un-sponsored access to Army Knowledge Online (AKO) (https://www.us.army.mil) by Retired Soldiers, their family members and surviving spouses.
• Include the Army Retirement Services Office in distribution of Army press releases, for publication in Echoes and distribution to Council members.

In addition, the Council asked the CSA to:

Implement the new standardized job description and grade for installation RSOs and fund them expeditiously to increase levels of support across the Army.
• Support efforts to eliminate the Dependency and Indemnity Compensation (DIC) offset to the Survivor Benefit Plan (SBP) annuity.
• Continue to support ongoing programs leading to full concurrent receipt of military retired pay and VA disability compensation for all eligible military retirees.
• Further equity for retired Army Reserve and National Guard Soldiers by supporting the transformation of the Reserve Component retirement system to recognize the risks of multiple deployments and to retain those who wish to complete their Reserve Component careers.
• Urge DoD to support legislation to authorize pretax payment of TRICARE Prime enrollment fees and premiums for TRICARE supplemental, long-term care and Retiree Dental Program fees.
• Support changing military postal system rules to authorize mail privileges for retirees for parcels up to five pounds, unless restricted by host governments.

The Co-Chairmen will meet with the CSA in October to be updated on progress with these issues and to offer their further support. [Source: Army Echoes May-Aug 07 ++]

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NDAA 2008 [01] - (Progress Report)
The House Armed Services Subcommittee on Military Personnel met the first week of MAY to mark up their portion of the 2008 National Defense Authorization Act (H.R. 1585). The subcommittee’s actions were very encouraging and if approved by Congress as a whole, would greatly benefit all members of the military community. First and foremost, the subcommittee voted to block the Administrations plans for drastic increases in Tricare enrollment fees, deductibles and pharmacy co-pays. Additionally, they added $200 million to the services projected health budgets to make up for “efficiency wedges” imposed on the services health chiefs by the DoD. Other items blessed by the subcommittee include:

• A 3.5% pay raise for active duty members--0.5% higher than requested.
• Expansion of Combat Related Special Compensation (CRSC) to include medically retired (Chapter 61) members who served at least 15 years, were forced from service due to combat-related injuries, and have disability ratings of at least 60%. Those who meet the criteria would be able to draw their VA disability compensation plus a monthly CRSC equal in value to a military retirement annuity calculated on their years actually served. For example, an eligible retiree forced out after 16 years would receive a monthly CRSC payment equal to 2.5 percent of monthly basic pay multiplied by 16 years. (This assumes they were not serving under Redux, a discounted retirement plan.)
• A new survivor indemnity allowance to start incrementally removing the Survivor Benefit Plan/Dependency Indemnity Compensation (SBP/DIC) offset. The allowance would begin on 1 OCT 08 and initially would be valued up to $40 a month. The subcommittee promised this issue would be re-addressed in the future when better cost estimates would be available.
• An increase of force levels by 46,500. The Army would gain an additional 36,000 troops; Marine Corps 9,000; and addressing a concern that the Navy and Air Force were converting too many of their active duty medical personnel to civilian contractors, the subcommittee added 963 personnel to the Air Force and 698 to the Navy to block further conversions.
• A transfer of responsibility for the Selected Reserve Montgomery GI Bill from DoD to the VA where reserve benefits could be raised annually in conjunction with active duty GI bill benefits.

Additionally, “The Wounded Warriors Relief Act” ( H.R.1538), which would improve the management of medical care, personnel actions, and quality of life for members of the Armed Forces receiving medical care in an outpatient status was adopted in it’s entirety by the subcommittee and forwarded as part of their recommendations. The Senate will mark up its version of the 2008 defense bill later this month, no doubt approving a somewhat different set of personnel initiatives. A House-Senate conference later will smooth out the differences. [Source: NAUS Weekly Update May 07 ++]

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VA Vet Centers [01] - (Staffing Shortfalls)
Congressman Phil Hare (D-IL), a member of the House Veterans' Affairs Committee and 43 of his colleagues from both parties sent a letter to VA Secretary Jim Nicholson this week. The letter urged him to immediately address the staffing crisis at our nation's VA walk-in clinics (commonly referred to as Vet Centers) and requested information about his proposed plans for action. It specifically asked Secretary Nicholson (1) what actions are planned to meet the staffing crisis at Vet Centers; and (2) how much funding or other federal resources would be required to fully staff Vet Centers over the next five years.

While the number of returning Iraq and Afghanistan combat veterans visiting Vet Centers has more than doubled since 2004, staffing has only increased by 10%. The bipartisan letter addressing this issue read, "…These staffing shortages unacceptably jeopardize the mental and physical health of both returning troops and aging veterans at a time when more than one in four troops have acknowledged mental health issues. We cannot continue to care for our veterans on the cheap. When we fail to provide a standard of care worthy of the sacrifices of our military veterans, what kind of message does that send to the brave men and women currently fighting around the world? Not only do these shortages place the mental health and well-being of veterans at risk, but they place a significant strain on an already overworked staff. This has resulted in the institution of waiting lists, further increasing the backlog at the VA." [Source: Daily Review Atlas Stacey Creasy article 2 May 09 ++]

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GI Bill [14] - (10-year Deadline)
The 10-year window for using GI Bill education benefits after leaving active-duty service would be eliminated under a bill introduced 2 MAY in the Senate. The chief sponsor, Sen. Maria Cantwell (D-WA) said the 10-year limit is outdated and could be part of the reason why up to 60% of veterans who have earned GI Bill benefits do not use them. Veterans who did not attend college or vocational school immediately after leaving the military might need the help when they get older and need new skills to compete for jobs, she said. “In the 21st-century global labor market, enhancing skills through education and job training is now more important than ever,” she said. The bill, S.1261, is called the Montgomery GI bill for Life Act, and is cosponsored by Senators Tom Harkin (D-IA) and Sherrod Brown (D-OH).

The so-called 10-year “delimiting” period of the modern-day Montgomery GI Bill is not new. The same 10-year window to use benefits was imposed during the Vietnam era, based on the idea that benefits with an expiration date would encourage people to make use of them as soon as possible after leaving the service. During the Vietnam era, however, there were fewer married service members, making it easier to attend college after discharge. Setting a termination date on the benefits also makes it easier to budget for the costs of the GI Bill. With the potential for veterans to use GI Bill benefits to attend college throughout their lives, even after retiring from the military or from a second career, the Veterans Affairs Department’s expenses for the GI Bill could be as much as 50% higher, said congressional aides who have looked at the issue of extending the 10-year window. [Source: NavyTimes Rick Maze article 2 May 07 ++]

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WRAMC [09] - (Gates Supports Closing)
Defense Secretary Robert Gates said 2 MAY that Walter Reed Army Medical Center should be closed as planned. Gates' conclusion, following a review of Walter Reed by an independent advisory group, runs counter to the recommendation of some in Congress who have called recently for the Pentagon to reverse its 2005 decision to close the facility. The review group, which presented a summary of its conclusions at a Pentagon news conference with Gates, recommended that Walter Reed remain on a list of military facilities to be closed. It also urged that a plan to move the hospital's capabilities to an expanded National Naval Medical Center at Bethesda, Md., be accelerated. The review group's central finding, released last month, was that money woes and Pentagon neglect were mainly to blame for shoddy outpatient conditions and bureaucratic delays at Walter Reed, the Army's premier medical center. Citing lapses in leadership and oversight as main reasons for the problems, the nine-member independent group concluded that the Defense Department was, or should have been, aware of the widespread problems but neglected them because they knew Walter Reed was scheduled for eventual closure.

Gates indicated to reporters that he saw little wisdom in pouring money into Walter Reed to keep it open indefinitely. "Far better to make an investment in brand-new, 21st-century facilities," he said, referring to the plan announced in 2005 to expand the Bethesda medical center and to build a new medical center at Fort Belvoir VA. He said that based on currently available information it would make sense to go ahead with the plan to close Walter Reed in 2011. "But we ought to have the flexibility to make sure that it stays open until Bethesda and Fort Belvoir are completely ready to take on the responsibilities of the patients and the staff that are at Walter Reed now. Walter Reed should not be closed unless those other facilities are ready to go, in my opinion," he added. Gates also announced the formation of a committee of senior military and civilian officials to make sure that recommendations of the review group and those of a presidential commission are promptly implemented and coordinated. [Source: Associated Press article May 07 ++]

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Tricare/CHAMPUS Fraud [06] - ($40 million Lawsuit)
The federal government has filed a civil lawsuit against a hand surgeon, accusing him of making more than $2.6 million in false claims to Medicaid, Medicare and the military’s TRICARE program. The lawsuit seeks more than $40 million in damages from the surgeon, Houshang Seradge, his associates and family members. Seradge and his Orthopedic & Reconstructive Center business released a joint statement 30 APR, stating “reimbursement rules are complicated and subject to varying and sometimes inconsistent interpretations. Dr. Seradge ... and the others named in this matter deny any intentional breach of any such rules.” The lawsuit accuses Seradge and his associates of filing more than 6,400 false claims. The lawsuit also alleges that Seradge’s daughter, Espanta Seradge Steppe, and his mother, Hadjieh Hassani, both were employees of Seradge and received compensation from money obtained by fraud.

No criminal charges have been filed. Under federal law, government attorneys are seeking recovery of the $2.6 million, triple that amount in damages, plus $5,000 to $11,000 for each false claim that allegedly was filed. The false billings allegedly were submitted and paid between 1994 and the present, according to documents filed in federal court in Oklahoma City. Fraud allegations against Seradge initially were made in a civil lawsuit filed under seal seven years ago by three former employees. Seradge, in his statement, described the three former employees as disgruntled and said one of them previously brought an unsuccessful suit against him. Seradge said he plans to continue providing medical care in Oklahoma City.

Anyone can identify potential fraud and abuse. Call 1(888) 584-9378 or fax 1(602) 564-2458 to anonymously report suspected fraud and/or abuse and give as much information as possible. Those who call will be asked to make a recording giving specific information on the alleged fraud. If they provide their name and contact number they will be called back within 72 hours. Types of activities that should be reported include:

• A provider billing for services when services were not rendered.
• Services billed do not match the services rendered .
• A provider waiving copayments or deductibles.
• Someone you know is not TRICARE eligible but is receiving benefits

[Source: ArmyTimes AP article 2 May 07 ++]

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Gulf War Syndrome [02] - (Brain Size Findings)
Roberta White, chairman of environmental health at the Boston University School of Public Health believes something is happening to the brain structure of the 1991 Gulf War veterans. Especially among those soldiers who complain of multiple symptoms arising from duty performed in routing Iraqi troops that had occupied Kuwait. She said at the 59th annual meeting of the American Academy of Neurology in Boston, "We found that two regions of the brain had significant shrinking compared with other soldiers who have lower levels of symptoms.” The two regions of the brain -- the rostral anterior cingulate gyrus and the overall cortex -- are involved in thinking and memory. The rostral anterior cingulate gyrus was 6% smaller and the overall cortex was 5% smaller in the brains of veterans who complained of at least five symptoms, when compared with veterans who returned from the Gulf with fewer than five complaints. The measurements were derived using magnetic resonance imaging scans of the 18 patients with more than five medical issues and scans of 18 soldiers with fewer complaints. Overall, White said her study will eventually include 62 veterans, with 31 in each category.

The soldiers complained of fatigue, memory loss, joint pain, headaches, respiratory infections and skin rashes that were severe enough to cause disruption in their activities of daily living, White said 1 MAY in her presentation at the meeting of 12,000 specialists in ailments of the brain and central nervous system. White told United Press International that the changes she recorded on the imaging scans correlated with delayed recall and learning on standard memory tests. "The question of whether there is anything to these complaints continues to be controversial," Robert Haley, professor of internal medicine at the University of Texas Southwestern Medical School at Dallas, told UPI. "These results are part of the mosaic that appears to show that there is something to these complaints. It doesn't nail it down, but adds to the evidence that something happened to these men that has caused physical changes in their brain structure." Haley did not participate in the study presented at the AAN meeting but has also studied effects of Gulf War syndrome in his patients. "These findings suggest there is a loss of brain cells due to a toxic effect of pesticides and nerve gas, which then causes brain volume shrinkage," he said.

Last year the Institute of Medicine convened a panel of experts to review Gulf War syndrome. That panel determined that even though soldiers who served in Iraq and Kuwait suffer increased rates of many ailments, it could find no evidence that the syndrome existed. Haley said that the changes in the brain could have occurred from exposure to some sort of chemical and would not have been caused by the mental stress of fighting a war as suggested by those who doubt the syndrome. White said that many of the men in her study served across Iraq and in the area of Khamisiyah when U.S. forces destroyed a munitions dump that contained chemical weapons including nerve agents sarin and cyclosarin. "These are really important findings given that the Institute of Medicine has stated that the Gulf War syndrome is imaginary and has no physical basis," White said. "When you combine these findings with greater rates of amyotrophic lateral sclerosis in the vets, it is pretty clear something happened to the Gulf War veterans' brains, and we're just beginning to see what these effects are," she said. Studies suggest that serving in the first Gulf War doubles veterans' risk of amyotrophic lateral sclerosis, a rare, progressive and fatal illness also known as Lou Gehrig's disease. White said in a news briefing, "It took us 20 years to find out about Agent Orange and the Vietnam War. Now, 16 years later, we are beginning to find out about central nervous system ailments in Gulf War veterans." [Source: UPI Ed Susman article 1 May 07 ++]

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VA Bonuses - (Amount Questioned)
On 30 APR Senator Daniel K. Akaka (D-HI), Chairman of the Senate Committee on Veterans’ Affairs, sent a letter to R. James Nicholson, Secretary of Veterans Affairs, expressing concerns about bonus awards paid to some of VA’s highest-ranking civil servants. The letter indicates that personnel based in Washington, D.C. received higher bonuses than their colleagues outside of DC, and that some employees received large bonuses in spite of their role in the budget shortfall in 2005. Akaka said, “Just one year after VA’s notorious budget shortfall, when VA management was forced to request emergency funds based on a determination that the budget was short billions of dollars, several senior budget staff each received VA’s highest bonus award of $33,000. I am concerned by this generous pat on the back for those who failed to ensure that their budget requests accurately reflected VA’s needs.” A copy of the letter follows:

April 30, 2007
The Honorable R. James Nicholson
Secretary of Veterans Affairs
810 Vermont Avenue, NW Washington, DC 20420

Dear Secretary Nicholson,
I am writing to share with you my thoughts and concerns about bonus awards paid to some of VA’s highest ranking civil servants. The staff of the Committee on Veterans’ Affairs has reviewed the summary of bonus awards paid in FY 2006 to VA Senior Executive Service (SES) personnel that you forwarded to me earlier this year. The staff found that bonuses to SES personnel were not distributed evenly across the organization, and that some employees received large bonuses in spite of questionable performance outcomes. For example, SES personnel based in Washington, DC received, on average, significantly higher bonuses than their counterparts in other geographic areas. In the VBA, SES bonus recipients based in Washington received an average of $6,800 or 41 percent more than their counterparts elsewhere. In the VHA, bonus awards were an average of $4,600 or 30 percent higher for SES personnel based in Washington. While I understand that these higher bonuses may to some extent constitute an informal cost of living adjustment, there are many U.S. cities where the cost of living is equally high if not higher than here.

VISN directors were the only non-Washington based cohort to receive high bonuses as a whole, and were among the most generously rewarded in FY 2006. 18 VISN directors across the country received bonuses, to an average of $24,000. Their subordinate system and facility directors received, on average, over 40 percent less, and accounted for virtually all recipients of bonuses of under $10,000, the bottom end of the SES bonus range. It is evident to me that, on average, managers based outside of Washington received significantly lower bonuses in FY 2006. It is also clear that award size rose in relation to proximity to the center of the organization. On the whole, medical center directors received the lowest bonuses, while VISN directors nationwide and top managers in Washington received the largest. This is despite the fact that all personnel earned roughly the same base pay, and held the same rank in the sense that they were all at the top of the Federal salary pyramid and mostly ineligible for substantial increases in pay.

Another concern is that just one year after requesting emergency funds based on a determination that the FY 2005 budget and FY 2006 budget request included insufficient funding, several senior VA budget staff each received the VA’s highest award of $33,000. I am not concerned that VA’s SES bonuses are among the highest of any agency, because I believe that VA has some of the most dedicated and hard-working employees of any agency. But I also believe that in the Federal government, awards should be determined according to performance and retention considerations, and should not give the appearance of an entitlement for the most centrally placed or well-connected staff. I would appreciate your thoughts on the FY 2006 bonus awards as well as on what steps you will take to ensure that future bonus awards are more fairly distributed throughout the Department. Thank you for your attention to this matter. Sincerely, DANIEL K. AKAKA Chairman [Source: Sen. Akaka Press Release 2 May 07 ++]

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VA Bonuses [01] - (Secretary Asked to Resign)
Congressman Phil G. Hare (D-IL-17) is calling on Secretary of Veterans Affairs R. James Nicholson to resign for having paid bonuses to senior federal workers who were responsible for a $1 billion shortfall in the VA budget. Hare, a member of the House Veterans’ Affairs Committee, isn’t the first lawmaker to call on Nicholson, a decorated Vietnam veteran and former Republican National Committee chairman, to resign. But Nicholson has survived worse blows that this — such as the loss of personal information on 26 million people last year and claims that the VA is not fully prepared to handle Iraq and Afghanistan combat casualties — and his payment of bonuses is not universally despised, even among Democrats. The chairman of the Senate Veterans’ Affairs Committee Daniel Akaka (D-HI) said that he had no problem with paying big bonuses to VA workers, who he thinks are very dedicated, but he did question their distribution. Like Hare, Akaka said he was not certain that senior members of the budget staff at the VA deserved bonuses averaging $33,000 (about 20% of their annual salaries) when the VA had a major budget crisis because costs were underestimated. Also receiving a top bonus was the deputy undersecretary for benefits, who helps manage a disability claims system that has a backlog of cases and delays averaging 177 days in getting benefits to injured veterans.

Akaka also noted that employees in Washington, D.C., received bigger average payments than VA workers outside of D.C., implying an “entitlement for the most centrally placed or well-connected staff. VA officials told the AP that the department’s Washington-based jobs are more difficult, often involving the management of several layers of divisions. VA spokesman Matt Burns said the VA did nothing wrong and on 3 MAY issued a statement on performance awards to senior career civil servants. It noted that VA and its leaders are committed to providing the best possible care and services to our nation's veterans. To best fulfill that commitment, VA needs to be able to retain knowledgeable and professional career civil servants. VA often must compete with significantly higher private sector salaries to keep its career executive leaders. One of the tools the Congress has given government agencies to help keep experienced career executives in public service is performance-based awards, which make their compensation more competitive with the private sector. Without such tools, VA would be much less likely to retain its most experienced career civil servants - which could reduce the quality of services provided to veterans and increase costs to taxpayers in the long run. The VA’s bonus payments also were supported by Jeffrey Phillips, a spokesman for the Republican members of the House Veterans’ Affairs Committee.

Rep. Bob Filner (D-C) the House Veterans’ Affairs Committee chairman, who has called on Nicholson to resign in the past, did not endorse Hare’s new call for Nicholson to step down, but said he also questions the bonuses. Annual bonuses to senior VA officials now average more than $16,000 -- the most lucrative in government. Filner said, “Over the last two years, the VA has faced an almost $2 billion shortfall, largely because it had not fully taken into account the cost of helping returning war veterans. It concerns me that the same officials that miscalculated the needs of our veterans were awarded with significant bonuses. Filner said his committee’s oversight and investigations panel will review the bonuses. Rep. John Hall (D-NY) said he was introducing legislation to place a hold on this year's bonuses. The White House came to Nicholson’s support, with White House spokesman Tony Snow saying that the veterans’ secretary wasn’t going to quit. [Source: NavyTimes Rick Maze article 3 May 07 ++]

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SGLI [07] - (Beneficiary Options)
While appropriations bills generally include only funding provisions, occasionally Congress will include some “authorizing” language in these bills. In the case of H.R.1591, the FY 2007 Supplemental Appropriations bill, Congress included a change to the death gratuity in the supplemental spending bill. The change would have permitted a service member to designate up to 50% of the death gratuity amount to a person other than a spouse or surviving child. The balance of the amount would then be paid to or for the living survivors in the following order:

1. Service member’s lawful surviving spouse.
2. If there is no spouse, to the child or children of the member and descendants of deceased children on their behalf.
3. In the absence of a spouse or children, the parents of the member in equal shares or to the surviving parent.
4. In the absence of surviving parents, to the duly appointed legal representative of the service member’s estate

The nature of the death gratuity changed significantly when it was increased to $100,000. Under the proposed change in H.R. 1591, a portion of the death gratuity could be allocated like a life insurance settlement, providing flexibility for unique family situations. It is unfortunate that this spending bill was doomed from the start by a presentational veto over troop withdrawal dates. Some type of change is needed to accommodate the variety of family situations present in today’s force and to ensure that surviving family members, especially those guardians of a service member’s minor children, have immediate use of the death gratuity for expenses until other benefit payments begin. If you would like to see similar legislation reintroduced you need to bring the issue to your congressional representative. [Source: NMFA Government & You e-News ++]

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Tricare Pharmacy Copay [01] - Increase Impact on Savings)
Pharmacy benefit managers and DoD officials have theorized there is a relationship between medication co-payments and the use of generics by beneficiaries: as the difference in co-payment widens between two groups (generics and preferred-band named medication to non-preferred brand named drugs), beneficiaries will chose the lower costing medications. Recent studies have examined this theory and found its implementation may be a bit more complicated than expected. One study found there must be a considerable difference between the two co-payment levels before beneficiaries will choose to purchase lower priced medications. The study showed beneficiaries were more likely to switch to a generic or preferred-brand name medication when the difference exceeded $21 or more per prescription.

Another study showed a high co-payment does not necessarily drive beneficiaries to choose to purchase lower priced medications. It examined the impact of a company’s decision to increase beneficiaries’ co-payments significantly without educating them about the change in price. The sharp increase was expected to cause beneficiaries to increase their purchase of generics and over the counter medications, decrease the purchase of unnecessary drugs, and increase beneficiaries involvement in the decision making process due to the change in their out of pocket expense. Instead, the study found patients did not switch to the lower cost generics and there was a decrease in overall medication purchases by consumers. This decrease in drug utilization meant consumers were no longer adhering to or complying with their medication regime, which could lead to increased Emergency Room visits and in-patient hospital stays. Results may have been different if beneficiaries had been told the reason behind the large increases and provided information on ways to lower their drug costs through the purchase of generics and preferred-brand named drugs.

However, there may have been other contributing factors that influenced results: drug price changes may not affect consumer buying patterns or behaviors in the same manner as other market driven goods; and adherence/compliance by consumers is not driven just by co-payment structures, but by a complexity of issues, such as the overall cost of drug treatment and disease management, and the treatment regimes being too difficult to follow. To review these studies refer to www.express-scripts.com/ ourcompany/news/outcomesresearch/ onlinepublications/study/afterCDHCEnrollment.pdf & www.express-scripts.com/ourcompany/ news/outcomesresearch/onlinepublications/ study/optimizingcopaydiff.pdf) [Source: NMFA Government & You e-News ++]

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VA Chiropractic Care [02] (H.R.1470)
Due to a measure introduced in March by Rep. Bob Filner [D-CA-51] it is looking more promising for veterans to get proper chiropractic care for common ailments such as neck pain, low back pain and degenerative conditions. H.R.1470 known as the “Chiropractic Care Available to All Veterans Act” would require the Veterans Administration to have a chiropractor on staff at no fewer than 75 major VA medical centers before the end of 2009, and for all major VA medical centers to have a chiropractor on staff before the end of 2011. Currently, Doctors of Chiropractic serve at only 30 VA sites. [Source: US Newswire Press Release 1 May 07 ++]

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VA Data Breach [33] - (GAO Report)
A U.S. Government Accountability Office (GAO) report issued 30 APR in response to the May 2006 data breach at the Department of Veterans Affairs says federal agencies should have uniform guidelines governing when to offer credit monitoring to individuals whose personal information is exposed. Veterans were denied the opportunity to take prompt steps to protect themselves against identity theft last year because internal delays kept key VA officials, including the agency's secretary, in the dark for up to two weeks. The delay in notifying Secretary Nicholson led to the GAO assessment that "federal agencies must have rapid internal notification of key officials." The report, however, said that while agencies should have a reaction team in place to decide the response to any data breach, said response is not always warranted. Affected individuals need not always be notified, adding that "notification when there is little or no risk of harm might create unnecessary concern and confusion, desensitize consumers to the dangers of identity theft, and be costly for both government agencies and individuals." [Source: NetworkWorld.com/news Jon Brodkin article 30 Apr 07 ++]

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Emergency Contraception - (H.R. 2064)
Emergency contraceptives may not be available on every base, but one so-called “morning after” drug, Plan B, is available from some military pharmacies and by prescription under the military’s health care plan, a defense spokesman said. The Pentagon’s comments, provided in a 30 APR statement, come as a group of lawmakers, led by Rep. Martin Meehan (D-MA) are pushing to have Plan B made available at every military hospital and clinic. The bill (H.R.6024) was referred to the House Armed Services Committee, which could take up the issue over the next two weeks as an amendment to the 2008 defense authorization bill. James Tyll, a spokesman for the assistant defense secretary for health affairs, said in a statement that two-thirds of military treatment facilities once carried Plan B, which was approved by the FDA in 1999. But after the drug was removed from the military’s drug formulary amid controversy in 2002, hospitals and clinics are no longer required to have the drug on hand. The formulary is a list of drugs that every pharmacy should have available.

Each pharmacy decides what drugs to carry, and can add items not on the basic list. At locations where the drug is in not in stock, there are alternatives. A mega-dose of oral contraceptive taken in a specific sequence would have the same effect as Plan B and could be prescribed, Tyll said. Plan B was added to the basic core formulary in MAR 02 but it did not remain on the list for long. Within hours, the Tricare Management Agency started receiving inquires from lawmakers that centered on whether Plan B caused an abortion. Tyll said it was the Defense Department’s view that the drug does not cause an abortion but rather prevents a pregnancy. But after more criticism, Plan B was removed from the formulary 8 MAY 02. Tyll said, “The Defense Department is studying whether to place it back on the formulary. Since 2002, Plan B remains available to military beneficiaries. There is no policy prohibiting beneficiary access to emergency contraception, nor is there a policy prohibiting military treatment facilities from adding Plan B” to their respective formularies. Tricare covers Plan B either through retail pharmacies or by mail order. Additionally, all military treatment facilities care “at least eight different types of regular oral contraceptive pills.” [Source: NavyTimes Rick Maze article 30 Apr 07 ++]

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DoD to VA Transition [04] - (New Legislation)
U.S. Rep. Peter Welch will introduce three new bills aimed at improving health care for veterans in his attempt to fix the bureaucratic mistakes exposed by the recent Walter Reed scandal. Welch said the three proposals are aimed at fixing administrative problems that face soldiers as they transition from the military to civilian life, a problem that he believes affects veterans from Washington to Vermont.

The first is aimed at streamlining the transition for soldiers between the U.S. Department of Defense, which oversees the military, and the U.S. Department of Veteran's Affairs, which manages the health care system for returning soldiers. The legislation would require the military to give soldiers medical exams before they are discharged. With the soldier's permission, the military would then send that information to the VA to determine benefits eligibility. The second bill would boost the number of claims representatives at VA centers across the country, including the facility in White River Junction. The bill would require that at least two new positions are opened up at each facility to handle the load. Welch said, “Pending claims have jumped from 69,000 in 2001 to 400,000 in 2006 and that the Bush administration did not properly prepare for the surge in claims. A claim delayed often becomes a claim denied. The administration simply did not plan for the care of these soldiers when they launched the wars in Iraq and Afghanistan."

The third would allow members of the National Guard and Reservists to join an army program that would allow them to begin receiving medical benefits as soon as they leave the military. The program called Benefits Delivery at Discharge is open only to traditional branches of the national military, although guard and reservists comprise up to 40% of the U.S. forces serving in the Middle East and have a benefits denial rate of twice as much as other branches of the military.

Earlier this year, Welch proposed creating an ombudsman position within the military's health care system to act as advocates for veterans. That amendment was added to a veterans care funding bill that passed the U.S. House in MAR 07. [Source: Rutland Herald Daniel Barlow article 1 May 07 ++]

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COLA 2008 [04] - (0.8% thru MAR 07)
The Consumer Price Index continued its recent trend and rose a full 1% above February's value, edging inflation into positive territory for the first time in FY2007. The March CPI-W was 200.612 which is above the February CPI-W of 198.544. The CPI-W change from the COLA base of 199.1 at the beginning of the year is now 0.8%. The primary reason for the increase in the CPI-W was a 6.0% increase in energy prices which we are all observing at the gas pumps. Inflation was this low in only four out of the previous 30 years through March. Still, those four previous years ultimately provided COLAs that ranged from 1.4% to 3.6%. [Source: MOAA Leg Up 27 Apr 07]

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VA Rural Access [01] - (Legislation Review)
On 26 APR the House Committee on Veterans' Affairs Subcommittee on Health held a legislative hearing on 12 bills addressing veterans' health care, five of which had a focus on improving rural access to care and three more focused on general access issues such as reducing waiting times for care. Jeff Miller (R-FL-01), subcommittee ranking member said, "Since 2003, the number of patients VA is treating has grown from 4.8 million to an expected 5.8 million in fiscal year 2008. In 2008, VA anticipates treating 263,000 Operation Iraqi Freedom and Operation Enduring Freedom veterans, 25.8% more than the 2007 level. This surge in demand for health care is expected to continue and creates new challenges for VA's capacity to deliver both primary and specialty care. The discussion today on legislation that will help us provide us the best care for our veterans, whether it is through contract care, or requiring more VA medical centers to provide chiropractic services, was productive. I look forward to working on a bipartisan basis with my colleagues to move forward legislation from among today's offerings that will truly help our veterans and their families.” Following is a list of the bills the committee addressed. More complete info on these bills and how they can improve veteran health care is available at http://thomas.loc.gov:

• H.R. 0000 Draft Rural Health Care Bill; (Michaud, D-ME)
• H.R. 0092 Veterans Timely Access to Health Care Act; (Brown-Waite, R-FL)
• H.R. 0315 HEALTHY Vets Act of 2007; (Pearce, R-NM)
• H.R. 0339 Veterans Outpatient Care Access Act of 2007 (Duncan. R-TN)
• H.R. 0463 Honor Our Commitment to Veterans Act; (Rothman, D-NJ)
• H.R. 0538 South Texas Veterans Access to Care Act of 2007; (Ortiz, D-TX)
• H.R. 1426 Veterans' Access to Local Health Care Options & Resources Act; (Latham, R-IA)
• H.R. 1470 the Chiropractic Care Available to All Veterans Act; (Filner, D-CA.)
• H.R. 1471 Better Access to Chiropractors to Keep our Veterans Healthy Act (Filner, D-CA)
• H.R. 1527 the Rural Veterans Access to Care Act; (Moran, R-KS)
• H.R. 1944 Veterans Traumatic Brain Injury Treatment Act of 2007; (Altmire, D-PA)
• H.R. 0542 to require the DVA to provide mental health services in languages other than English, as needed, for veterans with limited English proficiency, and for other purpose; (Solis, D-CA)

[Source: TREA Washington Update 27 Apr 07 ++]

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USO - (New DC Airport Lounge)
Recently the United Services Organization (USO) of Metropolitan Washington opened its much-anticipated lounge at Dulles International Airport. The new 770-square-foot facility at Dulles is located on the arrivals level across from Baggage Claim 12. There, servicemembers can get information and assistance, have a snack, watch a movie, and make unlimited domestic and international phone calls. Business services, including wireless Internet, photocopying and faxing are also available. Servicemembers now have USOs in each of the three Washington D.C. metropolitan area airports, Baltimore-Washington International, Ronald Reagan Washington National and Dulles International.

The USO is a private, nonprofit organization whose mission is to provide morale, welfare and recreation-type services to our men and women in uniform and the military community. It was founded in response to a request from President Franklin Delano Roosevelt to provide morale and recreation services to military personnel and was incorporated Feb. 4, 1941. The original intent of Congress and the enduring style of USO delivery is to represent the American people by extending a touch of home to the military. The USO currently operates more than 130 centers worldwide, including ten mobile canteens located in the continental United States and overseas. Overseas centers are located in Germany, Italy, the United Arab Emirates, Japan, Qatar, Korea, Afghanistan, Guam, and Kuwait with a paid staff and a volunteer corps numbering 25,000. . Service members and their families visit USO centers more than 5.6 million times each year. USO celebrity entertainment tours bring volunteer celebrities to entertain, lift morale, and express the gratitude and support of the American people. For more information on USO facilities and programs, refer to http://www.uso.org/. [Source: NAUS Weekly Update 27 Apr 07 ++]

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SDVI [01] - (New Legislation)
Congressman Walter Jones (R-NC-03) has introduced H. R. 2026, the Disabled Veterans Insurance Improvement Act of 2007, a bill that would increase the amount of supplemental life insurance available for totally disabled veterans. H.R. 2026 would increase the coverage available by $20,000, making a total of $50,000 of life insurance available to totally disabled veterans. Senator Daniel Akaka (D-HI), Chairman of the Senate Committee on Veterans’ Affairs, has also introduced companion legislation S.1315 in the U.S. Senate. Jones said “The $30,000 maximum life insurance coverage currently available for totally disabled veterans falls well short of the death benefits available to servicemembers and veterans enrolled in the Service members' Group Life Insurance and Veterans' Group Life Insurance programs. Because many totally disabled veterans have difficulty getting life insurance on the commercial market, this legislation would help these heroes by providing them, and their families, with a sense of security for the future.”

Service-Disabled Veterans' Insurance (S-DVI) was established during the Korean War to provide life insurance to veterans with service-connected disabilities through a $10,000 benefit (totally disabled veterans are eligible for waiver of premiums on this benefit). This amount has never been increased. In 1992, supplemental coverage worth $20,000 was offered to the veterans who qualify for S-DVI (premiums must be paid for this coverage), making the maximum possible coverage for totally disabled veterans $30,000. The Disabled Veterans Insurance Improvement Act of 2007 would allow totally disabled veterans to purchase an additional $20,000 in coverage, bringing their total possible coverage to $50,000: $10,000 (original) + $20,000 (1992 supplemental) + $20,000 (2007 supplemental) = $50,000 available to totally disabled veterans. [Source: TREA Washington Update 27 Apr 07 ++]

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AL Dependents' Scholarship Program (Started OCT 47)
This nationally-renowned program was created by Act 633 and approved OCT 47 by the Alabama Legislature. It is administered by the Alabama Department of Veterans Affairs and is governed by the Code of Alabama 1975, Section 31-6-1. The veteran must meet the following qualifications to establish eligibility of his/her dependents. A dependent is defined as a child, stepchild, spouse or the un-remarried widow(er) of the veteran.

The veteran must have honorably served at least 90 or more days of continuous active federal military service or honorably discharged by reason of service-connected disability after serving less than 90 days. The veteran must be rated 20% or more due to service-connected disabilities or have held the qualifying rating at the time of death, a former prisoner of war (POW), declared missing in action (MIA), died as the result of a service-connected disability, or died while on active military service in the line of duty. The veteran must have been a permanent civilian resident of the State of Alabama for at least one year immediately prior to (a) the initial entry into active military service or (b) any subsequent period of military service in which a break (1 year or more) in service occurred and the Alabama civilian residency was established. Permanently service-connected veterans rated at 100% who did not enter service from Alabama, may qualify after establishing at least five years of permanent residency in Alabama prior to filing of an application or immediately prior to death, if deceased.

The program will provide four standard academic years or part-time equivalent at any Alabama state-supported institution of higher learning or a prescribed course of study at any Alabama state-supported technical school without payment of any tuition, required textbooks or instructional fees. However, for a spouse or un-remarried widow(er) of a veteran who is rated 20 - 90% due to service-connected disabilities ise only entitled to two standard academic years without payment of tuition, required textbooks and instructional fees or a prescribed technical course not to exceed 18 months of training. Spouses forfeit benefits upon divorce from veteran in which the spouse derived their eligibility. A widow(er) forfeits benefits upon remarriage. The child or stepchild must initiate training prior to their 26th birthday. Age 30 deadline may apply in certain situations. There is no age deadline for submission of the application by the spouse or un-remarried widow(er). The Alabama department of Veteran Affairs maintains an office in each county of the State which can furnish information and assist in filing your application. [Source: NTWS Newsletter 26 Apr 07 ++]

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Insurrection Act - (S.513 to Repeal)
The Senate Judiciary Committee heard testimony 24 APR relating to Presidential authority to deploy the National Guard in emergencies. A provision that was quietly inserted into the 2007 Defense Authorization Act amended the Insurrection Act of 1807, expanding the President’s authority to federalize the National Guard. The move has drawn criticism from members of Congress, the Guard, Governors, and law enforcement officials, who believe it will undermine the states’ abilities to respond to emergencies. Senator Christopher Bond (R-MO) called the measure “ill-conceived, unnecessary, and dumb” and Senator Patrick Leahy (D-VT) said it “stripped control of the National Guard from the Governors.” Senators Bond and Leahy have sponsored S.513, a bill designed to repeal the language inserted into last year’s defense authorization act. The bill is supported by all 50 Governors, including North Carolina Governor Michael Easley, who said in testimony Tuesday that the provision “undermines our ability to protect the people we serve.” Lt. Gen. Steven Blum, Chief of the National Guard Bureau, testified that the employment of the Insurrection Act takes authority from the Governors and places it with the federal government and Maj. Gen. Timothy Lowenberg, Adjutant General of Washington, told the Judiciary Committee that, in times of emergencies, states need federal assistance, not a federal takeover. While the Insurrection Act granted the President the authority to respond to acts of insurrection or domestic violence, the new language expands that right to “restore public order,” a term that is not so simply defined. Leahy took further issue with the way that the language was slipped into the bill. “It’s not just bad process,” he said. “It’s bad policy.” [Source: NGAUS Leg Up 27 Apr 07 ++]

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National Veterans Wheelchair Games - (19 - 23 JUN)
Five hundred disabled American heroes will converge on Milwaukee 19 - 23 JUN to test their agility, athleticism and strength of spirit in the 27th National Veterans Wheelchair Games, the largest annual wheelchair sports event in the world. Veterans from the recent conflicts in Afghanistan and Iraq will again join veterans from the Gulf War, Vietnam and other conflicts in 17 competitive events. The vent provides a chance for disabled veterans to share in the camaraderie of friendly competition. The Wheelchair Games, presented by the Department of Veterans Affairs (VA) and Paralyzed Veterans of America (PVA), are open to all U.S. military veterans who use wheelchairs for sports competition due to spinal cord injuries, certain neurological conditions, amputations or other mobility impairments. For the first time at the Games, a demonstration track event will be held for athletes who are able to stand using prosthetic devices.

The Clement J. Zablocki VA Medical Center in Milwaukee and the Wisconsin chapter of the Paralyzed Veterans of America (PVA) are hosting the 2007 Games. Veterans competing in the National Veterans Wheelchair Games come from nearly all 50-states, plus the District of Columbia, Puerto Rico and Great Britain. At the Games, veterans will compete in track and field, swimming, basketball, weightlifting, softball, air guns, quad rugby, 9-ball, bowling, table tennis, archery, handcycling, a motorized rally, wheelchair slalom, a power wheelchair relay and power soccer. Trap shooting and wheelchair curling will be exhibition events this year. Sports are important in the therapy used to treat many disabilities. VA is a recognized leader in rehabilitation, with therapy programs available at VA health care facilities across the nation. For many injured veterans, the Wheelchair Games provide their first exposure to wheelchair athletics.

The 27th National Veterans Wheelchair Games begin 19 JUN with a wheelchair basketball demonstration at Red Arrow Park, as well as the 2007 Disabled Sports, Recreation and Fitness Expo. Kids Day at the Games is slated to take place on 22 JUN at the Milwaukee County Zoo, where local children, many with disabilities, will meet the athletes and learn about wheelchair sports. Opening and closing ceremonies will be held at the Midwest Airlines Convention Center, along with many of the week’s competitive events. Admission is free to the public and the community is encouraged to attend. To volunteer during the week, or to obtain more information about the competitive events, visit the Games Web site at http://www1.va.gov/vetevent/nvwg/2007/default.cfm. [Source: VA News Release 26 Apr 07 ++]

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Eat More, Stay Thin - (What to Do)
Obesity is only 50% genetics. The other 50% is just personal habits. Differences in genetics and metabolism are not conclusive factors in making someone overweight. When you look closely, it turns out that lifelong-lean people just have better control over what they put in their mouths. Most lean people learned the habits that keep their weight under control in childhood. What that means is that the rest of us can adopt these slenderizing habits, too. Here's what that trim person isn't telling you.

1. Never say diet: The weight you lose during a two-week crash diet rarely stays off for long; you've probably experienced that. As soon as you stop restricting what you eat, the pounds come right back—and they generally bring friends. Why? Dieters unintentionally train their bodies to store more body fat at a faster rate. "Under normal conditions, humans absorb only about 80 to 90% of the nutrients from the food they eat. The rest—calories and all—passes through. But when the body is deprived of nourishment it becomes a super efficient machine, absorbing a much higher percentage of nutrients from food. So when a dieting person begins eating normally again, the body continues absorbing food at the higher rate—and stores more of it as fat. Rather than d