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| ADVOCATE NEWSLETTER | |||||||||||||||||||||||||
Volume 23• Number 6 » VA Extends “Agent Orange” Benefits to More Veterans » Inspector General Completes Study of VA Endoscopic Programs » Secretary Shinseki Announces New Efforts to Explore Health Consequences of Service in Vietnam |
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VA Extends “Agent Orange” Benefits to More Veterans 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
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.President's Column
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 Passes Law to Fund VA Health Care Programs for Two Years–But Still Hasn’t Passed Overall VA Funding Bill 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
Dear Mr. Chairman:
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,
Inspector General Completes Study of VA Endoscopic Programs 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 Shinseki Announces New Efforts to Explore Health Consequences of Service in Vietnam 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. Shinseki: “Voice of Survivors” Will Strengthen Existing Programs 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. Fire Action Plan
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! This information brought to you by Liberty Mutual and the American Military Society. Our partnership with Liberty Mutual offers competitive rates on Auto and Home insurance and superior service to AMS members. For more information, or to request a quote, call toll-free 1-800-524- 9400 and mention client #3825 or visit www.libertymutual.com/ams. VA Warns Veterans of Telephone Prescription Scam 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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