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Relying on an independent study by the Institute of
Medicine, Secretary of Veterans Affairs Eric K.
Shinseki decided to establish a service-connection
for Vietnam Veterans with three specific illnesses based
on the latest evidence of an association with the herbicides
referred to Agent Orange. The illnesses affected by the
recent decision are B cell leukemias, such as hairy cell
leukemia; Parkinson’s disease; and ischemic heart disease.
Used in Vietnam to defoliate trees and remove concealment
for the enemy, Agent Orange left a legacy of suffering and
disability that continues to the present. Between January
1965 and April 1970, an estimated 2.6 million military
personnel who served in Vietnam were potentially exposed
to sprayed Agent Orange.
In practical terms, Veterans who served in Vietnam
during the war and who have a “presumed” illness don’t
have to prove an association between their illnesses and their
military service. This “presumption” simplifies and speeds
up the application process for benefits. The Secretary’s
decision brings to 15 the number of presumed illnesses
recognized by the Department of Veterans Affairs (VA).
“We must do better reviews of illnesses that may
be connected to service, and we will,” Shinseki added.
“Veterans who endure health problems deserve timely
decisions based on solid evidence.”
Other illnesses previously recognized under VA’s
“presumption” rule as being caused by exposure to herbicides
during the Vietnam War are:
• Acute and Subacute Transient Peripheral Neuropathy
- • AL Amyloidosis
- • Chloracne
- • Chronic Lymphocytic Leukemia
- • Diabetes Mellitus (Type 2)
- • Hodgkin’s Disease
- • Multiple Myeloma
- • Non-Hodgkin’s Lymphoma
- • Porphyria Cutanea Tarda
- • Prostate Cancer
- • Respiratory Cancers, and
- • Soft Tissue Sarcoma (other than Osteosarcoma,
Chondrosarcoma, Kaposi’s sarcoma, or Mesothelioma)
Additional information about Agent Orange and VA’s
services and programs for Veterans exposed to the chemical
are available at www.publichealth.va.gov/exposures/
agentorange.
National Defense Authorization Act for FY2010
The House and Senate Armed
Services Committees finished negotiating
differences in their versions of the
National Defense Authorization Bills
for FY2010, which began on October
1, 2009. The final version provided
good and bad news for military personnel,
retirees and their families. Some
of the major provisions of the Act are
covered below.
Military Pay and Compensation
• Authorizes a 3.4 percent pay raise
for active, Reserve and National
Guard personnel. The administration
had requested 2.9 percent.
The 0.5 % increase over the request
continues the process which has
been in place for several years to
bring military pay up to parity with
private sector pay, by providing
a one-half per cent increase over
the Employment Cost Index (ECI)
which is the statistic measured by
the Department of Labor to determine
the annual change in private
sector wage.
• Increases the maximum amount
of Supplemental Subsistence
Allowance from $500 to $1000 per
month. It also directed the Secretary
of Defense to submit to Congress a
plan to ensure that service members
and their families are not dependent
on food stamps. These steps
should end the disgraceful practice
of having some of the nation’s
warriors eligible for food stamps.
• Directs the Government Accountability
Office to conduct a study
comparing military pay and benefits,
including the value of health
care and retirement with comparable
private sector pay and benefits. AMS has long held that there is no comparison
of military life with civilian work even in peace time,
much less during a war. Design of this study can greatly
influence the outcome and must be carefully monitored.
It will be nearly impossible for the members of the study
panel to properly place a value on all of the requirements
facing a military service member that the normal civilian
employee does not face.
• Authorizes transportation allowances for eligible relatives
of a warrior who dies while on active duty for relatives’
travel to a memorial service that is separate from
the funeral.
• Reduces the maximum percentage of monthly pay that
may be involuntarily collected to pay overpayments erroneously
paid to service members through no fault of their
own from 20% to 15%.
• Failed to include a House provision to end the offset
of Chapter 61 disabled retirees by the amount of VA
compensation they receive. This item had been included
in the President’s budget submission. However, the
Senate objected and the provision was deleted. Even
though the provision had some shortcomings, it would
have been a big step in the right direction.
• Failed to repeal the SBP/DIC offset for surviving spouses
of warriors who died as a result of service connected
disabilities. This provision was in the Senate bill but was
killed in conference.
Enacting Concurrent Receipt and ending the SBP/DIC
offset are long overdue corrections to the compensation
system and once again our friends in Congress were defeated
in their efforts to correct these long-standing inequities. We
will continue our efforts to obtain passage. The opponents
in Congress are using the rules to defeat us, while making
exceptions to these rules to fund the items they want. We
will need all the help we can get to continue efforts to solve
these inequities. Abraham Lincoln’s admonishment to
“care for him who has borne the battle and his widow and
orphan” is being widely ignored.
Health Care
• Authorizes more than $28 billion for the Defense Health
Program. This is a bargain for the nation. The military is
fighting wars in Iraq and Afghanistan, supporting various
other contingencies around the world, providing health
care for over 2.9 million beneficiaries, and making sure
that its nurses, medical aid personnel, physicians and
other health care professionals, military and civilian and
contract, have the resources necessary to carry out their
various missions.
• Prohibits the military services from converting military
medical and dental positions to civilian medical
and dental positions. Continuing this effort is critical.
However, more needs to be done. Providing care in
Military Treatment Facilities is the most cost effective
care that the military services can provide. More health
care needs to be moved into MTFs.
The Secretary of Defense has said earlier this year that
military health care was “eating the Department alive.”
Nothing could be farther from the truth. Military health care
is a force multiplier. Unfortunately, by failing to maintain
the uniformed military medical professional strength levels,
costs are rising because of increased reliance on private
sector providers. However, Secretary Gates can turn this
around without increasing fees, co-pays and deductibles—
and should do so. DoD must not saddle military personnel,
retirees, their families and survivors with additional health
care costs. Such proposals might save millions, however,
increasing the uniformed military in-house capability will
save billions. Actions this year by DoD make it clear that
military health care is under attack. Defense health officials
announced a TRICARE Standard fee increase for the inpatient
cost share from $535 to $645. This $110 increase per
day is a 20.9 percent hike –huge by any measure especially
since TRICARE inpatient fees are already among the highest
of any insurance company in the country. Fortunately, AMS
and other associations objected and Congress blocked the
increase. However, the handwriting is on the wall. We can
expect more such attacks and must begin the fight to oppose
it now.
Military and Overseas Absentee Voting Rights
AMS members and staff have worked to improve
absentee voting for military personnel and their families
for many years and we have made some progress. However,
this year, we have joined and are working with the Alliance
for Military and Overseas Voters (AMOVR), to improve
the procedures for military and overseas civilians to receive
absentee ballots in time, and to allow time for them to be
returned and counted. With every state using different
rules, different procedures and with different primary election
dates, the problems are enormous. However, we have
made progress this year and will build on that progress in the
future. Fixing this problem is badly needed. Studies have
shown in recent elections, of over 400,000 ballots requested,
nearly 100,000 were lost, i.e., mailed out by absentee votersmostly
military – and never received by election officials.
Further, of those received many were rejected for things like
addresses, signature missing or invalid or no notary certification.
The current effort is designed to fix many of these
problems and the provisions incorporated in the defense bill
for 2010 are a major step forward.
One of the biggest challenges in publishing a
newsletter or magazine is to report news that is as
current as possible. After all the articles for the
Advocate are written they have to be sent to a designer to be
put in the format that you’ll receive. Then it must be sent to
the printer, and finally taken to the post office for delivery.
Although we attempt to maintain a regular publishing
schedule, sometimes we have to delay because we want to
bring you the most up-to-date information possible. That
has been true with this issue.
As you know, after Congress came back into session
after their August recess they were pre-occupied with
trying to reform health care. As a result, they did not pass
new legislation necessary to fund the various departments
of the federal government before the end of September,
which meant they had to pass what they call a “continuing
resolution,” which funded the government through October.
If they hadn’t done that the government would have had to
shut down.
The main problem was in the Senate because the House
had passed funding legislation for both the Department
of Defense and the Department of Veterans Affairs in
mid-summer. During the first couple of weeks in October
the Senate finally managed to pass funding legislation for
both departments, but once they did that the bills had to go
to a House-Senate conference committee to work out the
differences between the bills.
They finally got the bills out of conference committee,
and elsewhere in this issue Chuck Partridge reports on the
National Defense Authorization Act as it came out of the
conference committee. As we go to press the President still
has not signed the bill, but most people believe he will do
it soon.
The same is true of the funding bill for the Department
of Veterans Affairs health programs, which will now be
funded two years in advance. We also report on that in this
issue.
Finally, the bill that funds the Department of Defense
for 2010 (defense appropriations) has been passed in each
house of Congress. However, as we go to press there is talk
that the leadership of the House of Representatives may try
to add a measure to the bill to give the residents of the District
of Columbia a member in the House of Representatives with
full voting rights – something that is very controversial and
about which there are strong differences between the two
political parties. It is not clear at this point if they will be
able to work it all out and send a final defense spending bill
to the President before the current funding expires. If they
can’t they’ll need to pass another continuing resolution for
DOD.
I realize this can get very complicated, but I wanted
you to have a little feel for how things actually work in
Washington. You can rest assured that AMS is keeping track
of all of this and we’re fighting to protect your hard-earned
retirement benefits.
Finally, this is the last issue of this year, so I want
to wish each of you a very Happy Thanksgiving, Merry
Christmas, Happy Hanukkah, and a Happy New Year.
Congress has passed historic
legislation to put the
Department of Veterans Affairs
health care programs on a two-year
budget cycle. This bill, which AMS
strongly supported, approves funding
for those programs a year in advance.
The change was urgently needed
because for the past 19 out of 22
years Congress did not enact final
appropriations for the VA health
programs before the start of the new
fiscal year. This caused veterans’
access to VA services to be slowed
and it thwarted needed construction
and facilities upgrades, among other
things.
We believe this new funding
structure should guarantee a smooth
transition from year to year and result
in better service to veterans using the
health care programs.
Ironically, what is happening
this year is a classic example of the
problem faced by the VA most of the
time. As this is written, the Senate still
has not passed a bill to fund the rest of
the Department of Veterans Affairs for
the new fiscal year, which we are more
than a month into. And once the Senate
finally does pass their bill it must then
go to a conference committee with the
House of Representatives, and then go
back to each house for a final vote of
approval before it can be sent to the
President for his signature.
Thankfully, the VA budget is
one of the least controversial in the
federal government, so the bill should
eventually be passed. But this delay
is what has consistently hurt the VA
health care programs in the past, and
which should now no longer be a
problem.
The announcement late in September by DOD that
they were going to raise inpatient TRICARE fees by
nearly 21 percent came as a huge shock to everyone
in the military retiree community. But then just a couple
of days later it was announced that the House-Senate
conference committee had blocked those fee increases in
the FY2010 National Defense Authorization Act.
As a result of Congress’ action, the following letter
was sent by AMS to Senate Armed Services Committee
Chairman Carl Levin.
October 5, 2009
The Honorable Carl Levin
Chairman, Committee on Armed Services
United States Senate
Washington, DC 20510
Dear Mr. Chairman:
Thank you for halting the steep increase in the TRICARE Standard fee which would have
raised the inpatient cost share from $535 to $645 per day, or 20.9 percent. Your prompt action is
greatly appreciated.
When defense health officials announced the increase to be effective October 1, 2009, the
military community reacted with understandable shock and outrage. It was particularly disturbing
because of previous statements by Secretary Gates that DOD would not seek additional fees from
beneficiaries of the military health system for 2010.
A TRICARE Management Activity spokesperson indicated that they were required to impose
the increase unless Congress acted to stop them. This should be changed. Only Congress should
have the authority to increase TRICARE fees. Currently, any change in military compensation and
retired pay requires action by Congress. Any TRICARE fee change directly affects military
compensation and retired pay and therefore only Congress should have that power.
This most recent action by the Department of Defense clearly shows their hand. The
longstanding consensus on the military health benefit has been breeched and DOD has decided that
the solution to savings is increasing the burden on military warriors and their families. This is
unacceptable.
We urge you to direct a study to review methods for controlling health care costs without
imposing additional fees on the beneficiaries. Further, we ask that you seek repeal of the authority of
the Secretary of Defense to increase health care fees and withhold that authority solely to Congress’
discretion.
Raising fees, cutting military compensation and retired pay is a questionable source of funds
at any time. It is particularly outrageous during wartime. We appreciate your stopping this egregious
action and hope that you can champion the changes that will make any such future action
unnecessary.
Sincerely,
Charles C. Partridge
Director, Government Relations
The Department of Veterans Affairs (VA) Office of
Inspector General inspected every VA medical site
with endoscopic equipment, independently verifying
the success of a national program VA instituted to ensure
safe and sterile procedures for reprocessing endoscopic
equipment across the country.
“VA’s top priority is to provide the highest quality care
to the Veterans of this Nation,” said Acting Under Secretary
for Health Dr. Gerald M. Cross. “This report shows VA’s
unparalleled quality assurance programs identified a risk
and successfully corrected that risk on a national scale.”
The VA Office of Inspector General report, dated
September 17, 2009, shares findings from 129 medical sites
inspected across the country. Only one discrepancy was
found, a typographical error in certification paperwork.
In late 2008 and early 2009, VA found that inconsistencies
in the sterilization of endoscopes at three medical
centers led to possible infection risks among 10,000 patients.
VA facilities rapidly notified patients of the risk and offered
testing. Since that time, VA has been able to contact over 99
percent of these patients. Although fifty-six patients potentially
screened positive for infections, though it is uncertain
whether the endoscopes are the source. The national information
line at 1-877-345-8555 is available for patients and
their families.
VA instituted a national review of facilities in February,
2009, to ensure all VA medical sites are trained on proper
endoscope use and cleaning procedures. VA then established
a new policy for the reprocessing of reusable medical
equipment, including certification of staff, to prevent future
incidents. VA has also currently taken over forty disciplinary
actions related to this event.
Following the completion of this national effort, the
Office of the Inspector General inspected every VA medical
site with endoscopic equipment for compliance with manufacturers’
instructions and VA’s national policy on endoscopic
equipment and procedures.
This report is found at:
http://www.va.gov/oig/54/reports/VAOIG-09-02848-218.pdf.
Secretary of Veterans Affairs Eric K. Shinseki
recently announced plans to begin additional
research by the Department of Veterans Affairs
(VA) to better understand the health consequences of
service in Vietnam.
“The National Vietnam Veterans Longitudinal Study
(NVVLS) will allow VA to pursue another valuable
research tool,” Secretary Shinseki said. “The insight we
gain from this study will help give us an understanding
of how to better serve America’s Veterans.”
NVVLS will study the Vietnam generation’s physical
and psychological health. The new study will
supplement research already underway at VA, including
studies on PTSD and on the health of women Vietnam
Veterans. This is a follow-up study to a previous one
that concluded in 1988.
VA has begun work to solicit bids to conduct the
study, which is expected to run from 2011 through 2013.
VA is responsible for providing federal benefits to
Veterans and their families. VA is the second largest
of the 15 cabinet departments and operates nationwide
programs for health care, financial assistance and burial
benefits. The VA health care system operates more than
1,400 sites of care. Nearly 5.5 million people received
care in VA health care facilities in 2008.
To strengthen the programs of the Department of
Veterans Affairs (VA) for the survivors of the nation’s
Veterans and military personnel, the Department has
staffed an office to serve as their advocate, with a charter
that includes creating or modifying programs, benefits and
services.
“Taking care of survivors is as essential as taking care of
our Veterans and military personnel,” Secretary of Veterans
Affairs Eric K. Shinseki said. “By taking care of survivors,
we are honoring a commitment made to our Veterans and
military members.”
The office serves as the primary advisor to the secretary
on all issues affecting the survivors and dependents of
deceased Veterans and service members. It will monitor
VA’s delivery of benefits to survivors, make appropriate
referrals to VA offices for survivors seeking benefits and
explore innovative ways of reaching survivors who are not
receiving the VA benefits for which they are eligible.
VA benefits for eligible survivors include educational
assistance, home loan guaranties, health care insurance
and Dependency and Indemnity Compensation, a monthly
payment to the survivors of some people who die on active
duty and some seriously disabled Veterans.
More than 554,000 spouses, dependents and other
survivors of Veterans are receiving VA benefits. That figure
includes nearly 5,000 spouses of World War I Veterans, 90
spouses and 94 children of Spanish-American War Veterans,
and two children of Civil War Veterans.
The establishment of this office was authorized in the
Veterans Benefits Improvement Act of 2008.
Take a few minutes to review these fire safety tips.
More Americans die in fires than in all natural disasters
combined and greater awareness of hazards in
the home can help prevent most fires.
To safeguard your family and home, take these precautions.
Place smoke alarms on every level of your home.
Test them monthly, change batteries twice a year and
replace alarms every 10 years. A working smoke
alarm cuts chances of dying in a fire by nearly half.
Keep fire extinguishers in your kitchen, by
the furnace and in the garage, and make
sure you know how to use them.
Keep matches and lighters away from
children in a high, locked cabinet.
Tell them to notify an adult if they
find these things or see a child
playing with fire.
Have your chimney and fireplace
professionally inspected each year.
Creosote coats the inside of chimneys
and can start a fire.
Never leave food cooking on a
stove top unattended. Cooking
fires are the number one cause
of home fires and home fire
injuries.
Don’t overload electrical sockets. Throw away frayed or worn extension cords.
Keep space heaters at least three feet from rugs,
curtains and other combustibles. Always turn them
off when you leave the house or go to sleep.
Never leave a burning candle unattended or near
flammable material. Home fires caused by candles
have doubled in the last decade.
Create a family fire escape plan with at least two
ways out of each room. Draw the plan on paper and
walk through it as a family. Pick a place outside,
such as a light post, where you can meet if you’re
separated. Then, hold family fire drills at least twice
a year.
Teach young children never to hide in a fire.
Familiarize them with firefighters and their gear
through books, pictures and visits to the fire
station.
Teach kids to crawl in heavy smoke, keeping
their heads one to two feet off the ground so
they can breathe the best air.
Be sure to visit BeFireSmart.com today!
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The Department of Veterans Affairs (VA) is warning
Veterans not to give credit card numbers over the
phone to callers claiming to update VA prescription
information.
“America’s Veterans have become targets in
an inexcusable scam that dishonors their service and
misrepresents the Department built for them,” said Dr.
Gerald Cross, VA’s Under Secretary for Health. “VA simply
does not call Veterans and ask them to disclose personal
financial information over the phone.”
Veteran Service Organizations have brought to VA’s
attention that callers are misrepresenting the VA to gain
personal information over the phone. They say VA recently
changed procedures for dispensing prescriptions and ask for
the Veteran’s credit card number.
“VA has not changed its processes for dispensing
prescription medicines,” Cross said. “Nor has VA changed
its long-standing commitment to protect the personal
information of this nation’s Veterans.”
Veterans with questions about VA services should
contact the nearest VA medical center or call, toll-free,
1-877-222-8387.
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