November 15, 2015
Exchange Online Shopping Update 04
► All Vet Proposal Status
The idea of expanding online exchange-shopping benefits to all honorably discharged veterans is moving closer to
reality, with all three military-exchange services supporting the idea. The Defense Department’s deputy chief
management officer is addressing the related issues, Army and Air Force Exchange Service CEO Thomas C. Shull
confirmed. Once the concept is approved, the online benefit could be rolled out to veterans within as little as six
months. At a session of the American Logistics Association’s annual convention 27 OCT, DoD Deputy Chief
Management Officer Peter Levine did not directly talk about online exchange privileges for veterans, but he did say
the department is looking at ways to expand the customer base in the military resale community.
The Navy and its Navy Exchange Service Command support the idea, said NEXCOM CEO and retired Rear Adm.
Robert J. Bianchi. There are details to be worked out, but “in general, we all believe we can get there,” Bianchi said
in an interview. “It’s a nice way to provide a version of a nonpay benefit to those who have served," Bianchi said. The
benefit would be for online shopping only; honorably discharged veterans would be able to shop at the Navy Exchange
website, Mynavyexchange.com, as well as the AAFES website, Shopmyexchange.com. While Shull has been the point
man on the idea, Bianchi said, “we’ve been working collaboratively." "Frankly, [veterans] would go back and forth
between [the sites] and have freedom of choice," Bianchi said, "And Veterans Canteen Service would continue to
have an online presence."
Cindy Whitman Lacy, director of the Marine Corps’ Nonappropriated Fund Business and Support Services
Division, said the Marine Corps Exchange is also supportive of the veterans online-shopping benefit. While all the
services, including the Marine Corps and Coast Guard, support the idea, “we still have work to do” with the Veterans
Canteen Service, Shull said. “We want to make it work for them, too," he said. VCS operates resale stores in Veterans
Affairs medical facilities. One reason the benefit hasn’t been rolled out already, Shull said, is concerns about whether
the AAFES website could handle the potential large wave of extra customers.
The website suffered myriad problems when it was relaunched a year ago, but those issues have been resolved, he
said. Shull noted that about 50 percent of online customers had complaints a year ago, compared to about 4 percent
now. Shull submitted a proposal to defense officials in May 2014, arguing that even if they don’t serve to retirement,
honorably discharged veterans should get this modest benefit to honor their service. He said it’s particularly
appropriate in light of the numerous wartime deployments over the past 15 years. “If I could leave with my team this
legacy, providing a benefit where all veterans could shop online — strictly online — I’d feel like I actually made a
real contribution,” Shull told the convention. [Source: MilitaryTimes | Karen Jowers | October 30, 2015 ++]
*********************************
ID Card Expiration Date Update 01
► Action Required if INDEF
In 2011, officials began replacing the Social Security Account Number, or SSAN, with a 10-digit number unique to
the Department of Defense on all ID cards. Retirees, their family members, and survivors with an “INDEF” expiration
date may not have replaced their ID card before and may therefore still have an SSAN printed on their card. DOD
officials are urging people who have an ID card with an “INDEF” expiration date to visit a DOD ID card facility for
a new ID card with the DOD ID number in place of the SSAN to reduce their risk of identity theft. Officials stress that
until an ID card with a printed SSAN expires, it remains valid and does not need to be confiscated or replaced.
In time, every ID card will have a printed DOD number instead of a printed SSAN. Family members and survivors
will have their own DOD ID number printed on their cards, not that of their sponsor. Because DoD ID cards will no
longer have the sponsor’s printed SSN, cardholders may be asked to provide it verbally. To find your nearest DoD ID
card facility, visit http://www.dmdc.osd.mil/rsl or call the Total Force Service Center at 1-800-525-0102. To confirm
required documentation, refer to the Pre-Arrival Checklist at www.cac.mil/docs/required_docs.pdf. Note that the
nearest facility does not have to be an Air Force installation in order to serve Air Force retirees and their family
members. People should check with the issuing facility to verify appointment requirements and hours of operation.
[Source: Afterburner | Spring-Summer 2015 ++]
*********************************
Commissary Elimination Update 04 ►
DoD Concludes Not Necessary
Defense officials have concluded that a merger or consolidation of the military's commissary and
exchange systems is not necessary, said the official leading the efforts to find taxpayer savings in
the department's resale operations. "We believe we can get efficiencies without consolidation,"
said Peter Levine, the Defense Department's deputy chief management officer, speaking to the
annual convention of the American Logistics Association. Defense officials, spurred by
lawmakers' rejection of DoD proposals over the last couple of years to drastically cut the level of
taxpayer dollars that operate military commissaries, have changed the way they are looking at
the stores, Levine said. Defense officials had proposed cutting $1 billion of the roughly $1.4
billion annual commissary operating budget, a proposal perceived as being driven by the need
for money, rather than the need for reform. Exchanges operate for the most part without taxpayer
funding.
The thinking among DoD officials also has been colored by recent recommendations from the
Military Retirement and Compensation Modernization Commission and the Boston Consulting
Group. Studies by both groups recommended consolidating the commissary and exchange
systems. However, both studies also concluded that DoD can attain significant savings without
reducing the benefit to the military community. Lawmakers were concerned that focusing on
cutting taxpayer dollars would directly result in a cut to the commissary benefit — the significant
savings customers enjoy in those stores compared to off-base grocery stores. Those taxpayer
dollars, which cover commissary operating costs, enable the stores to sell groceries at cost,
giving military patrons an average of about 30 percent savings over civilian stores outside the
gates. Now, Levine said officials will "look for efficiencies first and let efficiencies drive the
budget, rather than the other way around."
Over the next six months, a new Defense Retail Business Optimization Board will review a
number of recommendations for efficiencies, looking at areas of common business practices,
such as acquisition and warehouse systems, and develop a plan for these savings, Levine said.
The board includes the leaders of the exchange and commissary systems. But legislative change
also is needed, Levine said, including a more flexible pricing system — also known as variable
pricing — in which officials are allowed to raise prices on some items and lower them on others.
By law, items in commissaries now must be sold at cost, defined as what the Defense
Commissary Agency (DeCA) pays for the item from the manufacturer or distributor. Customers
also pay a five percent surcharge at cash registers, which is used to fund store construction and
renovation.
Defense officials also want legislative authority to allow DeCA to sell its own private-label
items. "It doesn't do DeCA any good to do [that] under the current pricing system," Levine said.
While a private label does require oversight and marketing within the organization, the idea is
that these items would give patrons another savings option, while also providing DeCA some
ability to make a profit that would cover some operations costs. Levine said officials also are
looking at ways to expand the customer base, but did not elaborate on that point. A proposal in
the pending 2016 defense authorization bill would require DoD to come up with a plan to operate
the commissaries without taxpayer dollars by fiscal 2018, while maintaining the customer
benefit. DoD has determined that the most that can be cut out of the commissary budget by that
time is $300 million, a little over 21 percent of the current annual operating budget. "The only
way to get $1.1 billion in additional savings is by reducing savings, closing stores or both,"
Levine said. "My message is that we can't take that drastic step and expect to maintain the
benefit." [Source: MilitaryTimes | Karen Jowers | October 27, 2015 ++]
*********************************
Commissary Funding Update 23 ► Catch 22
In budget cutting exercises, commissaries are often easy pickings for the chopping block. Critics
say the $1.4 billion Congress spends on groceries for military families could be better spent on
other purposes. The almost 12 million patrons authorized to use the commissary tell a different
story. Being able to buy groceries at cost, with a five percent surcharge, can save military
families big bucks. DeCA, the Defense Commissary Agency, estimates that a military family of
four can save almost $3,000 a year. This year’s defense bill calls for DoD to figure out how to
make the commissary system cost neutral. The report, due in March, will look at how DoD can
privatize commissaries while keeping the same level of customer savings and satisfaction. It will
also look at strategically closing commissaries in markets with competing shopping options, and
the willingness of commercial grocers to provide eligible commissary patrons discounts.
If cutting funding without increasing costs for consumers seem like conflicting ideas, it’s
because they are. It’s unlikely that commissaries will be able to take the budget cut without
passing the buck to shoppers. “The language of the report establishes standards that are
impossible to meet,” said Karen Golden, Deputy Director at MOAA. Commissary patrons are
particularly sensitive to price fluctuations. For many commissary shoppers, particularly junior
enlisted members without access to off base shopping, they are literally a captive audience.
According to RAND, a consultancy, “the elimination of the appropriation, while reducing the
DoD budget, comes at a cost borne primarily by those currently and formerly in the armed
forces.”
RAND’s findings go on to note that increasing commissary pricing may have negative effects
on retention and recruitment, cuts to Morale, Well-Being, and Recreation programs, and possible
changes in the calculated cost of living adjustment. Previously, some national chains expressed
willingness to provide discounts to military families to match commissary prices. But to date, no
major retailer has made good on the offer. After the report, DoD has the authority to launch a
two year study on privatization in five of the largest stateside commissary markets. [Source:
MOAA | Jamie Naughton | Oct 2015 ++]
DoD Fraud, Waste, and Abuse ►
Reported 01 thru 14 NOV
Kettering OH -- An Ohio National Guardsman from Kettering accused last week of claiming thousands of dollars in
mileage reimbursements for area honor guard duty he didn't attend told investigators he was at the funerals secretly
observing the soldiers performing the services. He could not explain, however, how he performed a funeral at 10 a.m.
in Kettering, then traveled roughly 94 miles to Lima to observe a funeral at 11 a.m., and then drove another 94 miles
to West Alexandria to perform a funeral at 12:30 p.m., according to a report released Friday by the Ohio Inspector
General. Sgt. 1st Class Jason Daniel Edwards, 38, was indicted last week in a Franklin County court after an OIG
investigation concluded he billed for $10,852 in mileage reimbursements for 130 funerals he didn't attend. Edwards
is charged with the third-degree felonies of theft in office and tampering with records. Each carries a maximum penalty
of up to three years in prison and a $10,000 fine.
Edwards was a part-time Guardsman after a 17-year military career that included coordinating military funerals in
the Dayton area. When he moved to part-time in 2014, his sister took over the task of coordinating the funerals but
Edwards kept doing it, according to the OIG report. From September 2013 to July 2014, investigators found Edwards
claimed mileage reimbursements for 89 funerals that paperwork did not list him as attending. On another 17 funerals,
he was listed as attending but claimed mileage to a funeral farther away. And 24 times he claimed reimbursement for
mileage to a location where there was no funeral. Edwards told investigators that he was receiving complaints about
some of the soldiers on funeral details, so he went to the funerals and observed them covertly. He said he didn't tell
his bosses he was doing this because "It would never be authorized." He said the days he claimed mileage when there
was no funeral were probably days when he got a late call and rushed out to do a funeral by himself.
The OIG recommends that the Ohio Guard require additional documentation to better track the reasons why people
are claiming travel reimbursements, a daily vehicle log and a policy on inspecting funeral details. "We do take
misconduct very seriously," said Ohio National Guard spokeswoman Maj. Nicole Ashcroft. "The Adjutant General
(head of the Ohio National Guard) is reviewing and considering the recommendations that the IG made in the report."
[Source: Dayton Daily News | Josh Sweigart | September 9, 2015 ++]
-o-o-O-o-o-
New York NY — A Texas man who prosecutors say was a secret agent who stole technology for the Russian military
has pleaded guilty to federal charges in New York. The U.S. Attorney's office says Alexander Fishenko pleaded guilty
8 SEP to a slew of charges, including acting as an agent of the Russian government in the United States. Prosecutors
say the 49-year-old led a conspiracy to obtain microelectronics and export the goods to Russia. The devices are
commonly used in missile guidance systems, detonation triggers and radar systems. Prosecutors say federal agents
intercepted transmissions from Russia's Federal Security Service that said it obtained the microchips from Fishenko's
company. Fishenko's attorney didn't immediately respond to a request for comment. Four others charged in the case
have been convicted. The other six have pleaded not guilty. [Source: The Associated Press | September 9, 2015 ++]
-o-o-O-o-oTravel Pay -- An Ohio National Guardsman from Kettering accused last week of claiming thousands of dollars in
mileage reimbursements for area honor guard duty he didn't attend told investigators he was at the funerals secretly
observing the soldiers performing the services. He could not explain, however, how he performed a funeral at 10 a.m.
in Kettering, then traveled roughly 94 miles to Lima to observe a funeral at 11 a.m., and then drove another 94 miles
to West Alexandria to perform a funeral at 12:30 p.m., according to a report released Friday by the Ohio Inspector
General. Sgt. 1st Class Jason Daniel Edwards, 38, was indicted last week in a Franklin County court after an OIG
investigation concluded he billed for $10,852 in mileage reimbursements for 130 funerals he didn't attend. Edwards
is charged with the third-degree felonies of theft in office and tampering with records. Each carries a maximum penalty
of up to three years in prison and a $10,000 fine.
Edwards was a part-time Guardsman after a 17-year military career that included coordinating military funerals in
the Dayton area. When he moved to part-time in 2014, his sister took over the task of coordinating the funerals but
Edwards kept doing it, according to the OIG report. From September 2013 to July 2014, investigators found Edwards
claimed mileage reimbursements for 89 funerals that paperwork did not list him as attending. On another 17 funerals,
he was listed as attending but claimed mileage to a funeral farther away. And 24 times he claimed reimbursement for
mileage to a location where there was no funeral. Edwards told investigators that he was receiving complaints about
some of the soldiers on funeral details, so he went to the funerals and observed them covertly. He said he didn't tell
his bosses he was doing this because "It would never be authorized." He said the days he claimed mileage when there
was no funeral were probably days when he got a late call and rushed out to do a funeral by himself.
The OIG recommends that the Ohio Guard require additional documentation to better track the reasons why people
are claiming travel reimbursements, a daily vehicle log and a policy on inspecting funeral details. "We do take
misconduct very seriously," said Ohio National Guard spokeswoman Maj. Nicole Ashcroft. "The Adjutant General
(head of the Ohio National Guard) is reviewing and considering the recommendations that the IG made in the report."
[Source: Dayton Daily News | Josh Sweigart | September 9, 2015 ++]
*********************************
DoD Lawsuit
►
Veterans Used In Secret Experiments Sue
American service members used in chemical and biological testing have some questions: What exactly where they
exposed to? And how is it affecting their health? Tens of thousands of troops were used in testing conducted by the
U.S. military between 1922 and 1975. As one Army scientist explained, the military wanted to learn how to induce
symptoms such as "fear, panic, hysteria, and hallucinations" in enemy soldiers. Recruitment was done on a volunteer
basis, but the details of the testing and associated risks were often withheld from those who signed up. Many of the
veterans who served as test subjects have since died. But today, those who are still alive are part of a class action
lawsuit against the Army. If they're successful, the Army will have to explain to anyone who was used in testing
exactly what substances they were given and any known risks. The Army would also have to provide those veterans
with health care for any illnesses that result, in whole or in part, from the testing.
The law firm representing the veterans estimates at least 70,000 troops were used in the testing, including World
War II veterans exposed to mustard gas, whom NPR reported on earlier this summer. Bill Blazinski has chronic
lymphocytic leukemia, which he thinks may have been caused by the military tests. He was 20 years old when he
volunteered in 1968. "There would be a guaranteed three-day pass every weekend unless you had a test," he says.
"There would be no kitchen police duties, no guard duties. And it sounded like a pretty good duty."
What sounded more like a vacation than military duty quickly changed, he says. In one test, doctors said they would
inject him with an agent and its antidote back to back. "We were placed in individual padded cells. And you know the
nurse left and I'm looking at this padded wall and I knew it was solid but all of a sudden started fluttering like a flag
does up on a flag pole," he recalls. To learn about what substances made him hallucinate, in 2006, Blazinski requested
the original test documents under the Freedom of Information Act. "It showed an experimental antidote for nerve
agent poisoning with known side effects, and another drug designed to reverse the effects of the firs," he says."
Researchers kept information about which agents they were administering from test subjects to avoid influencing
the test results. A lawyer representing the veterans, Ben Patterson of the law firm Morrison and Foerster, says that's a
problem. "They don't know what they were exposed to. You know, some of these substances were only referred to by
code names," Patterson says. Code names such as CAR 302668. That's one of the agents, records show that researchers
injected into Frank Rochelle in 1968. During one test, Rochelle remembers that the freckles on his arms and legs
appeared to be moving. Thinking bugs had crawled under his skin, he tried using a razor blade from his shaving kit to
cut them out. After that test, he says he hallucinated for 40 hours. "There were animals coming out of the walls," he
says. "I saw a huge rabbit and he was solid white with red eyes."
In 1975, the Army's chief of medical research admitted to Congress that he didn't have the funding to monitor test
subjects' health after they went through the experiments. Since then, the military says it has ended all chemical and
biological testing. Test subjects like Rochelle say that's not enough. "We were assured that everything that went on
inside the clinic, we were going to be under 100 percent observation; they were going to do nothing to harm us," he
says. "And also we were sure that we would be taken care of afterwards if anything happened. Instead we were left to
hang out to dry." The Department of Justice is representing the Army in the case and declined to comment for this
story. In June, an appeals court ruled in favor of the veterans. On 4 SEP, the Army filed for a rehearing. [Source:
NPR | Caitlin Dickerson | September 5, 2015 ++]
*********************************
Military Conduct
► GAO Releases Ethics & Professionalism Report
The Defense Department has failed to follow through on several key initiatives designed to reduce ethics problems
and poor professionalism in the military, according to a new report from the Government Accountability Office. The
GAO found numerous examples in which top military officials evaded orders from Congress or highly touted Pentagon
programs aimed at reducing misconduct, especially among senior officers. Congress last year ordered the GAO to
conduct a broad investigation of the military's ethics training programs amid a spate of revelations about senior officer
misconduct in 2012 and 2013. That included a massive Navy bribery scandal, Army generals accused of sexual assault
and Air Force generals fired for drinking on duty.
The report released 3 SEP said the military has no reliable way to even determine whether misconduct or
unprofessional behavior is on the rise. "Our review found that the department's ability to assess department-wide
trends in ethical behavior is limited because misconduct report data are not collected in a consistent manner across
DoD," the GAO said. The report noted that in 2014, DoD officials said about 146,000 people received annual ethics
training, or about 5 percent of the department's total workforce. The GAO pointed to a 2014 order from Congress that
the military services take several actions to reduce sexual assault and the command climates that foster it. Those
included a requirement that incoming commanders conduct a "command climate assessment" regarding sexual assault
issues. The Air Force adhered to all the laws passed by Congress, but the Army, Navy and Marine Corps failed to
execute key components designed give the new law some teeth by requiring sexual assault command climate
assessments — or the failure to conduct one — to be noted in commanding officers' performance evaluations.
Another example was the push to make the top brass submit to "360-degree" evaluations, which include input from
peers and underlings and are widely used in the private sector as a way to improve leader effectiveness. In 2013, Army
Gen. Martin Dempsey, chairman of the Joint Chiefs, issued a memo calling for all general and flag officers to undergo
360-degree evaluations. Dempsey also sent a memo to the White House and cited this effort as a way to address ethical
concerns. While the Army and Air Force have implemented the 360-degree reviews for all general officers, the Navy
and Marine Corps have in most cases failed to do the same, according to the report.
The GAO applauded a move by then-Defense Secretary Chuck Hagel to establish a two-year, potentially
renewable, position for a senior adviser for military professionalism to oversee forcewide ethics and professionalism
programs. The appointee, Rear Adm. Margaret Klein, has launched several key initiatives, the GAO report said. But
DoD does not have information to track that office's progress or assess whether the new position should be retained
after its initial two-year authorization ends in March. The 2010 survey found that an above-average number of defense
employees believe "DoD rewards unethical behavior" and say they "fear retribution for reporting managerial or
commander misconduct," according to the GAO. The new report ultimately recommends that DoD make additional
efforts to comply with the laws and policies addressing ethical issues. The GAO also said military officials should
develop better tools for identifying ethical misconduct across the force and tracking the impact of prevention efforts.
The Pentagon agreed with most of the recommendations. [Source: MilitaryTimes | Andrew Tilghman | September 3,
2015 ++]
*********************************
AAFES Mission Fulfillment
► Status Sep 2015
Contrary to what some in Congress say, the Army & Air Force Exchange Service provides a great benefit for all in
the military family and also paid a dividend of $224 million in 2014 to morale, welfare and recreation efforts for the
Army, Air Force, Marine Corps and Navy. In the past 10 years, the Exchange has provided more than $2.4 billion in
dividends to military programs such as youth services, family counseling and other activities that make life better for
military members and their families. “Roughly two-thirds of Exchange earnings are paid to the Services’ morale,
welfare and recreation programs, while the other third goes toward building new stores and renovating facilities,” said
Air Force Chief Master Sgt. Sean Applegate, the Exchange’s senior enlisted advisor.
In 2014, the Exchange opened a new shopping center and Express at Fort Meade, Md. In addition, Expresses were
opened at Homestead Air Reserve Base, Fla., Tyndall Air Force Base, Fla., and Wright-Patterson Air Force Base,
Ohio. The Exchange also opened one troop store in Moon Township, Pa., serving Soldiers, Airmen, Reservists and
Guardsmen in Western Pennsylvania, Ohio and West Virginia. Exchange support to the military goes beyond Soldiers
and Airmen. Because the Exchange operates at Marine and Navy locations, funds are also returned to Marines and
Sailors. The FY 2014 dividend of $224 million was distributed as follows:
 Army:
$125.3M
 Air Force:
74.1M
 Marines:
19.5M
 Navy:
5.1M
Total:
$224.0M
The Exchange’s mission of providing quality goods and services at competitively low prices while generating
earnings to support quality-of-life efforts means that the Exchange benefit is more than finding a good price on
merchandise. This structure ensures that shoppers who take advantage of their Exchange benefit at brick-and-mortar
stores or online are working to better their communities. “100 percent of Exchange earnings serve Soldiers, Airmen
and their families,” Applegate said. “When service members shop or dine at their Exchange, they’re investing in their
own community, making it a better place to live and work.” [Source: NAUS Weekly Update | Watchdog | September
4, 2015 ++]
*********************************
VA Undersecretary for Benefits
► Resigns Amid New Scandal
Allison Hickey, the Veterans Affairs Department’s top benefits official and arguably the most polarizing figure in the
VA leadership ranks in recent years, abruptly stepped down from her post 16 OCT amid praise from colleagues and
renewed attacks from critics. The move came as House lawmakers prepared to subpoena her to discuss the VA’s latest
management scandal, allegations that senior managers abused a employee relocation program to gain questionable
promotions and bonuses.
As VA benefits chief, Hickey oversaw more than 20,000 employees and the delivery of benefits to more than 12
million veterans and their families. She is one of the last holdovers from former VA Secretary Eric Shinseki’s tenure,
often praised by top officials for her efforts to modernize the department and her dedication to veterans. “She has been
an exceptional colleague and an even better friend to me,” VA Secretary Bob McDonald said in a statement. “Her
commitment to excellence and service to our country is unquestioned.” But her work also drew intense criticism from
conservatives in Congress and some veterans advocates, who blamed her for management failings within the Veterans
Benefits Administration. In March 2013, Rep. Jeff Miller (R-FL), chairman of the House Veterans’ Affairs
Committee, called for her resignation as the number of backlogged veterans’ disability claims ballooned to more than
600,000. American Legion officials later followed suit. The same critics have renewed those calls after reports
emerged about the relocation bonuses. A VA Inspector General report suggested Hickey should be investigated for
negligent oversight of the program, and Miller’s committee scheduled a hearing on the issue.
A senior VA official said those repeated requests have taken a toll on the 57-year-old Hickey, who worried she had
become a distraction to further reform efforts. But VA leaders stressed that her resignation was her own decision, one
that McDonald reluctantly accepted. They praised her steady leadership through an era of unprecedented VA
transformation that has seen the number of veterans seeking benefits rise dramatically as the wars in Iraq and
Afghanistan have wound down. Since peaking in March 2013, the disability benefits backlog has fallen steadily each
month, to just under 74,000 cases in October. Officials have credited that 88 percent drop in part to Hickey’s
modernization push, trading piles of paperwork for more automated electronic systems. “She has done a tremendous
job rebuilding the morale of the VBA workforce amid some big challenges,” the senior official said. “She has been
both a leader and a shield for them.”
In a farewell letter to employees, Hickey called her four-plus years both a challenge and a privilege. “There has
never been a job I have been blessed to do that was so rich with purpose; no customer so honored to serve; no team
so amazing to work alongside as this noble mission,” she wrote. “But we aren’t done yet. There is more to do, and
that will take new, fresh thinking and energy from your next leader in VBA.” Principal Deputy Undersecretary Danny
Pummill has taken over as acting under secretary. Former VA Undersecretary for Benefits Allison Hickey was part of
the first class of female cadets to graduate from the Air Force Academy in 1980, and rose to brigadier general during
her 27-year military career. [Source: NavyTimes | Leo Shane III | 2 Nov 2015 ++]
*********************************
VA Bonuses Update 28
► $142M Paid in 2014 Despite Scandals
The Department of Veterans Affairs doled out more than $142 million in bonuses to executives and employees for
performance in 2014 even as scandals over veterans' health care and other issues racked the agency. Among the
recipients were claims processors in a Philadelphia benefits office that investigators dubbed the worst in the country
last year. They received $300 to $900 each. Managers in Tomah, Wis., got $1,000 to $4,000, even though they oversaw
the over-prescription of opiates to veterans – one of whom died. The VA also rewarded executives who managed
construction of a facility in Denver, a disastrous project years overdue and more than $1 billion over budget. They
took home $4,000 to $8,000 each. And in St. Cloud, Minn., where an internal investigation report last year outlined
mismanagement that led to mass resignations of health care providers, the chief of staff cited by investigators received
a performance bonus of almost $4,000.
As one of his final acts last year before resigning, then-VA secretary Eric Shinseki announced he was suspending
bonuses in the wake of revelations that VA employees falsified wait lists to meet wait-time targets — ostensibly as
part of efforts to secure the extra pay. But he only curtailed them for a sliver of VA executives -- those in senior levels
of the Veterans Health Administration, which oversees health care. The agency has continued to pay performancebased bonuses to nearly half of agency employees, including in health administration, according to data provided to
USA TODAY by the House Veterans’ Affairs Committee. In all, some 156,000 executives, managers and employees
received them for 2014 performance. VA spokesman James Hutton said the vast majority of agency employees are
committed to serving veterans. “VA will continue to review tools and options in order to ensure the department is able
to attract and retain the best talent to serve our nation's veterans, while operating as a good steward of taxpayer funds,”
Hutton said.
That’s not good enough for Florida Republican Rep. Jeff Miller, chairman of the House VA committee, which has
been investigating questionable VA bonuses for years. Miller says the most recent awards reflect a “disturbing trend
of rewarding employees who preside over corruption and incompetence.” He noted the agency paid more than
$380,000 in 2013 performance bonuses to top officials at hospitals where veterans faced long delays in receiving
treatment, including those under investigation for wait-time manipulation. “Rewarding failure only breeds more
failure,” he said Tuesday. “Until VA leaders learn this important lesson and make a commitment to supporting real
accountability at the department, efforts to reform VA are doomed to fail.” Miller spearheaded – and the House passed
– a measure last year that would have eliminated bonuses for VA senior executives for five years. But ultimately the
House and Senate compromised on legislation that still allows the VA to hand out up to $360 million annually to
executives, managers and employees.
Overall, the agency awarded $276 million in incentives in 2014, including retention and relocation payments,
rewards for saving money on travel and coming up with inventive ideas, according to committee data. The cash
bonuses of $142.5 million were tied to performance reviews. Employees were eligible to receive the lump-sum
payments for ratings of “fully successful” or higher. The payments ranged from $8 to as much as $12,705. Most were
more than $500. The average payout was $909. Here are some of the recipients:


Tomah WI: The former chief of staff of the VA medical center there, Dr. David Houlihan — whom veterans
nicknamed the “Candy Man” because of his prolific prescribing of narcotics — received a $4,000 bonus in
December. That was nine months after an inspector general investigation report concluded he was prescribing
alarmingly high amounts of opiates. And it was four months after Marine Corps veteran Jason Simcakoski,
35, died of "mixed-drug toxicity" as an inpatient at Tomah after he was prescribed a fatal cocktail of
medications, including opiates. The inpatient pharmacist supervisor also received a $1,050 bonus in
December. A spokesman for the Tomah VA declined to comment. The VA moved last month to fire
Houlihan. A lawyer who represented him did not respond to a message Tuesday seeking comment.
Colorado. The flawed facility construction project in Denver was overseen in part by several VA officials
headquartered in Washington. Among them were Stella Fiotes, executive director of the VA’s Office of
Construction and Facilities Management, who received a $8,985 bonus; Dennis Milsten, an associate director
in the same office, who got $8,069; and Chris Kyrgos, former national acquisitions director, who took home




$3,800. VA spokesman Hutton did not address those awards beyond his general statement about the VA
continually reviewing incentive options.
St. Cloud MN: Chief of staff Dr. Susan Markstrom got a $3,900 bonus in 2014. She was cited in an internal
investigation report in January 2014 that concluded mismanagement led to mass resignations of health care
providers at the facility. The report also said she and other leaders oversaw a work environment where
employees were scared to report problems. St. Cloud VA spokesman Barry Venable said issues cited in the
report were in 2013 and that Markstrom is “an excellent chief of staff" whose "ongoing contributions to
patient care and safety are significant.”
Augusta GA: VA financial manager Jed Fillingim was awarded a $900 performance bonus. He drew
scrutiny from Congress last year after news reports revealed he admitted drinking and driving a government
truck to a VA meeting in 2010 and a co-worker fell from the truck and was killed. Fillingim resigned from
the VA after the incident but was rehired in March 2011, WRC-TV reported. A spokesman for the VA
Medical Center in Augusta, Brian Rothwell, said Fillingim is not employed there.
Phoenix AZ: Sandra Flint, now-former director of the Phoenix regional VA benefits office, received a bonus
of $8,348. Irate veterans confronted Flint at a public forum in August 2014 over a backlog of about 8,200
pending benefit claims. Included were 3,667 pending longer than 125 days. A spokeswoman at the office
could not be reached for comment.
St. Paul MN: VA benefits office director Kimberly Graves received a bonus of $8,697 for 2014
performance. A VA inspector general report issued in September this year concluded Graves improperly used
her authority to engineer a switch into her current post in October 2014. IG investigators concluded she also
improperly received an additional $129,000 related to the move. Graves pleaded the Fifth Amendment and
declined to answer questions at a House VA Committee hearing last week.
Hutton, the national VA spokesman, underscored that no top senior executives in the Veterans Health
Administration received bonuses. “The issues raised in your questions focus on challenges VA has faced in the past,”
he said. “(T)he department is working diligently to plan a foundation for the future that will modernize VA’s culture,
processes, and capabilities to put the needs, expectations and interests of veterans and their families first.” Miller said
the agency, if it hands out bonuses at all, should do more to ensure they don’t reward the wrong behavior. He also
wants the agency to take back bonuses deemed inappropriate after they are awarded. “VA loves to tout its bonus
program as a way to attract and retain the best and brightest employees,” he said. “Unfortunately, often times the
employees VA rewards with thousands in taxpayer-funded bonuses are not the type of people the department should
be interested in attracting or retaining.” [Source: USA TODAY | Donovan Slack & Bill Theobald | November 11,
2015 ++]
*********************************
Planning for Getting Older
► It is Never to Early
Why Plan for Getting Older? It’s so easy to get comfortable with the “I’m going to live forever” mentality. But the
reality is that we all get older. We can’t predict the future. But we may be able to influence future decisions. The VA
can help – with Shared Decision Making and Advance Care Planning. Many of us work hard to protect our money –
how we spend it, where we keep it and who will get anything that’s left over after we die. But a lot more Americans,
including Veterans, leave many other issues related to getting older and elder care to chance. They don’t realize that
70 percent of us will need long-term care at some point. Most say they want to stay in their own home, but fail to plan
for changes that will make “aging in place” much easier. They stop focusing on wellness habits, even though research
shows that staying active, eating healthy, and sleeping well makes a difference.
A Veteran’s Story – It Was Time So, what can you do?
Consider Vietnam Veteran Larry Smith’s story. Larry lives in Salem, OR. and often travels to the Portland VA
Medical Center to receive care for his diabetes, vascular degeneration, neuropathy and a few other ailments. He
chooses to focus on living and not on his illnesses. “I know the day could come when I cannot make decisions for
myself.” Nonetheless, he knew it was time to make plans for the future. “I went to the VA’s website,
http://www.va.gov/geriatrics , to check out my options.” Larry feels better knowing what his options are for long-term
services and supports. “Nobody is ever ready to deal with this stuff, but the doctors have told me what I’ll likely have
to deal with. I know the VA can provide palliative care, which is what I want to help deal with my symptoms and
whatever it can do for my quality of life.” He’s not particularly close to his family. “I know the day could come when
I cannot make decisions for myself. I chose a close friend, Paige, who is about 15 years younger than I am to be my
health care agent. I talked over my wishes with her and filled out paperwork I downloaded from the Internet that took
about 20 minutes to complete. I’m confident that she’ll advocate for me, if needed.”
Know Your Options
More than half our nation’s Veterans are over age 65. Many Veterans do not know about all of their options if or
when the time comes. VA’s website for elder Veterans and their family caregivers details home and community based
services, residential settings, and nursing homes. It provides valuable Worksheets for Veterans and family members
to guide them in the process of making shared decisions with their VA health care providers and social workers. The
webaitte also has helpful sections on paying for long term care and well-being. Refer to:
 www.va.gov/GERIATRICS/Guide/LongTermCare/Shared_Decision_Making_Worksheet.pdf
 www.va.gov/geriatrics/Guide/LongTermCare/advance_Care_Planning.asp
 www.va.gov/GERIATRICS/Guide/LongTermCare/Shared_Decision_Making_Worksheet.pdf
Shared Decision Making and Advance Care Planning Can Help
The goal of shared decision making is for you to get the services and supports that best meet your long term care
needs and preferences. You can use more than one service at a time. And you can change the mix of services and
supports you receive as your needs and preferences change. Advance care planning is the process where you identify
your values and wishes for your health care at a future time if you are no longer capable of making choices for yourself.
Part of the process is filling out a VA advance directive http://www.va.gov/vaforms/medical/pdf/vha-10-0137-fill.pdf.
This is a legal form that helps your loved ones and doctors understand your wishes about medical and mental health
care. At www.va.gov/geriatrics/images/Advance_Care_Planning_Values_Worksheet.pdf can be found VA’s one-stop
website for aging Veterans provides a Values Worksheet to help you get started as well as resources
(www.va.gov/geriatrics/Guide/LongTermCare/advance_Care_Planning.asp) for talking with family members and
your health care provider. We all get older – it’s never too early to plan. [Source: Veterans Health | Sheri Reder & and
Taryn Oestreich |November 3, 2015 ++]
*********************************
Agent Orange Act Extension Update 01
► Provision Expires
The Agent Orange Act of 1991 (AOA) established a presumption of service connection for diseases associated with
Agent Orange exposure, relieving Vietnam veterans from the burden of providing evidence that their illness was a
result of military service. This law directs the National Academy of Sciences (NAS) to periodically research and
review diseases that might be associated with Agent Orange exposure. Under the Act the VA was required to add
diseases the NAS found to have a positive association to Agent Orange exposure to the VA’s list of presumptive
service connected diseases. In early October, the House and Senate veterans affairs committees quietly allowed a
provision of the Agent Orange Act of 1991 to expire. How significant that will be for Vietnam veterans and their
benefits is disputed.
Committee staff and the Department of Veterans Affairs agree the change has not impacted the VA secretary’s
authority to decide to expand the list of diseases presumed connected to wartime herbicide exposure. But veteran
advocates and at least one lawmaker suggest the change is intended to dampen VA cost risks and perhaps ease political
pressure on the secretary and Congress facing a potential tsunami of disability claims. That scenario assumes that a
final review of medical science will establish a stronger link between Agent Orange and hypertension (high blood
pressure), a condition that the Center for Disease Control says is so common it afflicts a third of the U.S. adult
population. VA had asked Congress to keep the Agent Orange law intact five more years. Rep. Timothy J. Walz (DMN), a VA committee member, offered a compromise, a bill to leave the law unchanged for two years, long enough
so its secretarial review requirements held during VA consideration of a final report of the Institute of Medicine (IOM)
of the National Academy of Sciences on health conditions associated with Agent Orange.
The VA committees declined to back these delays because, said a House committee staff member, under separate
law “the secretary already has authority to make such [presumption] decisions, and we felt he did not need to be
compelled by [the Agent Orange] law to do so.” The provision that “sunset” 1 OCT required the secretary to adhere
to certain standards and procedures in determining if additional diseases associated with herbicide exposure should be
presumed service connected. Vietnam War veterans diagnosed with ailments on the presumptive list qualify for VA
disability pay and medical care. The expired provision also set a timetable for the secretary to accept or reject IOM
findings and required him to explain in writing if he declined to add IOM identified conditions to the presumptive list.
Walz told colleagues at a hearing last week they effectively “allowed the Agent Orange Act to expire” and “it’s
altogether possible” the next IOM report, due in March, will support adding hypertension and stroke to the presumptive
list. Consequently, Walz said, “literally hundreds of thousands of people” will be able to point to scientific data
showing they experienced health consequences from exposure to Agent Orange. “And the pressure is going to be on,”
he warned.
Turning to VA Secretary Bob McDonald, Walz advised that if Congress doesn’t “have the courage” to respond to
the IOM findings, presumably with bigger VA budgets to cover the influx of claims, “they’re going to ask you. And
much like the Nehmer claims, it’s going to add to your work.” Walz was referring to a federal court ruling, Nehmer
v. Department of Veterans Affairs, which forced VA the last time it added conditions to its presumptive list, including
heart disease and Parkinson’s, to review all previously filed claims for these conditions and make payments retroactive
to original claim dates, or the date of the 1985 Nehmer decision, whichever is later. The scope and cost of this
requirement surprised then-VA Secretary Eric Shinseki, as he later conceded. It also exploded the VA claims backlog.
So McDonald told Walz he had made “a very good point.” Earlier in the hearing McDonald noted that disability
claims backlog still stood at 611,000 in May of 2013, but that VA finally had reduced it below 75,000. “If we add
another pre-condition and we don’t get the people to do it, the 80-plus-percent progress we’ve made on the backlog
will go away,” McDonald testified.
Walz sympathized, saying he might face a tough decision resulting in many new claims. McDonald said how
Congress responds would be key. “We prefer to do what’s right for the veteran, and then have you help us get the
people we need for the job,” McDonald said. No one interviewed was certain what the next IOM report will
recommend. Regardless of those findings, or the Agent Orange law change, the secretary still will have authority to
expand the list of presumptive conditions, said David R. McLenachen, VA deputy undersecretary for disability
assistance, in a phone interview 14 OCT. “It’s always good to have it straight in the law, set up clearly, what our
authority is regarding the Agent Orange Act,” McLenachen said. That’s why VA didn’t want the provision to expire
on 1 OCT. But the secretary still has general rulemaking authority that “allows us, even while these provisions are
expired, to add presumptions,” he said.
Barton Stichman, joint executive director of the National Veterans Services Legal Program, a nonprofit group that
fights for veterans’ benefits, said there is reason to be concerned that the secretary no longer is required by law to
consider IOM findings on presumptive diseases, that whatever he decides doesn’t have to be explained, and he will
have no deadline to decide. From a practical standpoint, Stichman added, any secretary will feel pressured from
veterans and support groups to act on IOM findings. But IOM did find “limited or suggested evidence of association”
between hypertension and Agent Orange in 2006, and while other conditions with the same degree of association
became presumptive, hypertension did not. About 2.6 million veterans served in Vietnam. Most are still alive. Current
law presumes that all of them have been exposed to Agent Orange. VA grants disability ratings of 10 to 60 percent
for hypertension, depending on severity, and the Center for Disease Control says high blood pressure grows more
common as any population ages. So will this secretary, or future VA secretaries, feel at least as much pressure from
Congress to hold down disability costs as VA budgets tighten as he does from advocates for Vietnam veterans?
The Congressional Budget Office apparently heard the same rumors as Walz about the next IOM report and
hypertension. Walz wasn’t available to be interviewed but a member of his staff said costs were a committee
consideration for not embracing his bill. In informal discussions, she said, CBO analysts had raised the specter of
added costs “in the billions” if the secretarial review provision of the Agent Orange law didn’t expire. Asked to
comment, a House committee staff member said, “CBO has not released an official cost estimate, and we can't
speculate regarding potential costs associated with a report [IOM] has not produced. [Source: Stars & Stripes | Tom
Philpott | 15 Oct 2015 ++]
*********************************
GI Bill Update 195
► VA Overpayments | $416 Uncollected in 2014
A newly released GAO report says The Department of Veterans Affairs is overpaying hundreds of millions of
dollars to schools and veterans under the post-9/11 GI Bill when students drop a class or leave school, letting $416
million go uncollected in fiscal 2014 alone. The program works like this: When a veteran enrolls, the
government sends money for tuition and fees to the school and begins sending housing and living stipends to the
veteran. If a student drops or fails to complete a class, the VA is supposed to scale back the benefits accordingly. The
student becomes responsible for any overpayments. These debts often come as a surprise to students because the VA,
which administers the massive education program for service members and veterans who served after the terror attacks
of Sept. 11, 2001, has not been clear about the rules, the Government Accountability Office found. “Because VA is
not effectively communicating its program policies to veterans, some veterans may be incurring debts that they could
have otherwise avoided,” auditors wrote. One in every four students getting GI Bill benefits — about 225,000 veterans
— incurred a debt to the government that averaged about $570, the GAO said. And more than 7,000 veterans owed
more than $5,000 to the government after they withdrew from school or continued to get housing benefits when they
shouldn’t have.
In most cases, veterans are responsible for repaying the debt resulting from government overpayments,
with schools responsible in a small number of cases. VA officials have recouped more than half of the overpayments
from fiscal 2014, but another $110 million from previous years is still uncollected, most of it from veterans. “Unless
VA expands its monitoring of overpayment debts and collections, it will not be able to ensure that it is taking
appropriate steps to safeguard taxpayer funds,” said the report, requested by Sen. Tom Carper (D-DE), the top
Democrat on the Senate’s government oversight panel. The wasted money is one piece of what the government calls
accidental “improper payments,” 90 percent of which are overpayments by federal agencies, from Social Security
checks to Medicare reimbursements to doctors. In a related report early this month, the GAO found that these
payments expanded in fiscal 2014 after declining for several years, reaching $124.8 billion or just over 3 cents of
every dollar spent by the government. The money has totaled $1 trillion since fiscal 2003.
Three-quarters of the improper payments come from three programs — Medicare, Medicaid and the Earned Income
Tax Credit — all of which are meant to help the elderly and the poor. Close to 10 percent of Medicare’s $603 billion
in outlays were improperly paid, and the error rate for the $65 billion earned income credit was 27 percent. The same
year, the VA provided $10.8 billion in GI Bill education benefits to almost 800,000 veterans and others.
Auditors found that these debts are magnified by a paper-based system of notifying students they owe money and
by porous oversight of the program. Addresses in the agency’s files often are out of date, so some students don’t even
receive notifications that they owe money and miss deadlines for disputing them. VA does not require veterans to
verify their enrollment each month, causing a “significant time lapse” between when veterans drop courses and when
the government learns about the enrollment change and can reassess payments.
The VA has taken steps to address processing errors through technology improvements, quality assurance reviews,
and training, the report noted. But it recommended that VA find better ways to communicate its policies to individual
veterans, notify them more promptly when an overpayment occurs and improve its system for verifying enrollment.
VA officials said they will pursue those changes, including expanding their monitoring of overpayments and
collections, providing more information to veterans upfront and developing a system for verifying veterans’ monthly
enrollment. The agency noted in a response to auditors that school officials have spotty attendance at training VA
offers in administering the GI Bill; the VA said it can’t force schools to participate. [Source: The Washington Post |
Lisa Rein | 2 Oct 2015 ++]
*********************************
Gulf War Syndrome Update 35
► Mitochondria Cell Damage Link
A new study could provide new clues for doctors struggling to treat a mysterious illness that has affected tens of
thousands of Gulf War veterans for decades. The study, done with Department of Veterans Affairs funding in
conjunction with Rutgers University, found that veterans suffering from Gulf War illness have damaged mitochondria,
which can lead to chronic fatigue, one of the main symptoms reported by Gulf War veterans. “The more we know
about the type of (damage) and the more we can characterize the mitochondrial damage in these veterans, the better
we can treat them,” said Michael Falvo, the study’s senior researcher and a faculty member of the VA War Related
Illness and Injury Study Center in Orange, N.J. “The symptoms are so diverse and vary so much person to person that
that’s been a challenging piece.”
Gulf War illness (also known as Gulf War syndrome) is a multi-symptom disorder characterized by chronic fatigue,
muscle pain and cognitive problems. While many believe that toxin exposure is to blame, and one study found a
possible link to anti-nerve agent pills -- toxic chemicals can damage mitochondria -- the exact cause of the illness is
still unknown. Falvo warned that while the study could help find better treatment, it was unlikely to uncover the root
cause. “If I was a veteran experiencing Gulf War illness, I would want to know, too,” he said. “This many years after,
that’s going to be a really difficult, if not impossible, thing to figure out.”
The study, undertaken by Falvo and Rutgers Biomedical and Health Sciences doctoral researcher Yang Chen, was
based on blood samples from more than 30 Gulf War Veterans including about two dozen who suffer from Gulf War
illness. White blood cells were separated from the samples and researchers were able to study the mitochondrial DNA
for evidence of damage. These are preliminary findings and the study will continue through the summer, with
researchers hoping to present a final paper by the end of the year, Falvo said. A larger study will be needed to confirm
the study’s findings, he said. Twenty-five years after the U.S. sent forces into Iraq after Saddam Hussein’s invasion
of his oil rich neighbor, Kuwait, many veterans are frustrated with the pace of research on Gulf War illness.
According to a 2008 government report, at least one quarter of all Gulf War veterans have experienced symptoms
of the illness, and the Pentagon and VA were slow to publicly acknowledge it. Many vets are still fighting to get their
illnesses recognized as related to their service in the Gulf War. Ronald Brown, president of the National Gulf War
Resource Center, said he welcomes new research but similar small studies into the causes of the illness have rarely
received funding for wider research, leaving the findings to languish unproven. “We have piles of studies that show
promise that are sitting on shelves, collecting dust,” he said. [Source: Stars & Stripes | Heath Druzin | September 10,
2015 ++]
*********************************
VAMC Minneapolis Update 04
►
TBI Exam Doctors Names Withheld
In the wake of disclosures that unqualified doctors performed hundreds of brain injury exams at the Minneapolis
Veterans Affairs Medical Center, the Department of Veterans Affairs is now refusing to release the names of doctors
who performed initial traumatic brain injury (TBI) exams at other VA facilities across the country. Without those
names, it's virtually impossible to independently verify whether the doctors were properly qualified. VA policy states
that only four types of specialists, including neurologists and neurosurgeons, are qualified to make the initial diagnosis
of whether a veteran has suffered a TBI. KARE 11 News reported last month that, contrary to the policy, hundreds of
initial TBI exams conducted from 2010 through 2014 in Minneapolis had been done by unqualified medical personnel.
Vietnam veteran Butch Hamersma's medical records show his TBI exam was performed by a VA nurse practitioner,
not a neurologist. As a result of the improper exam, Hamersma was denied TBI benefits. That decision was made even
though records show Hamersma's skull was shattered in an explosion near Chu Lai in November 1968.
"Run over a land mine," he recalled. "Three days later I woke up in Japan." "First time I looked in the mirror I
thought I done got killed," he said. After KARE 11's initial report, a Minneapolis VA spokesperson acknowledged
that some veterans had been evaluated by doctors, "who were not specialists." In a written statement, Ralph Heussner
said those veterans were being given new examinations, adding "we greatly regret the inconvenience to Veterans who
returned for a repeat evaluation." In a form letter sent to veterans, the VA said only a "small number" of cases were
involved. But new records obtained by KARE 11 indicate the problem is more serious. In at least one case, medical
records show a veteran was denied benefits not once, but twice, after being examined by two different unqualified
doctors. "There's no excuse," says Twin Cities attorney Ben Krause, who handled the veteran's appeals. "The VA has
absolutely no excuse."
Records detail the veteran involved suffered a concussion in 1958 on the USS Yorktown when a heavy metal hatch
smashed into his head and knocked him out. Years later, when the veteran developed a brain tumor, VA Neurologist
Khalaf Bushara concluded the old head injury "likely caused inflammation in the brain and the meningioma." He
wrote the tumor "at least as likely as not" was "caused by the inflammation caused by the traumatic brain injury" he
suffered on the Yorktown. But when the veteran applied for TBI benefits, he was given a TBI exam by Dr. Danny
Smith. Records show Smith is an osteopath – not an approved specialist. Dr. Smith concluded the veteran didn't have
a TBI. "Concluded he did not have traumatic brain injury when in fact he did," said Krause. "And it was clearly in the
record." When Krause filed an appeal, records show the VA agreed that Dr. Smith was "not qualified" to have done
the TBI examination. So they agreed to order another one. This time by Dr. Ephraim Gabriel who the VA claimed
was a "qualified TBI examiner." He also found, "no current clinical diagnosis of TBI."
But attorney Krause discovered that Dr. Gabriel was not qualified to diagnosis TBI's either. He is not one of the
four specialists required by VA policy. "And they had him conduct the exam anyway and drag my client through the
dirt," Krause told KARE 11. In effect, a veteran was denied benefits after exams by two different doctors who were
not qualified TBI specialists, overriding the findings of the VA's own highly trained neurologist. When he learned of
the situation, Dr. Bushara wrote a scathing memo about the "errors" in the diagnosis, saying that doctors Smith and
Gabriel had "failed to consult with an expert in the field that could have provided a competent medical opinion." "Dr.
Smith and Dr. Gabriel should never have conducted the initial TBI exam for my client," says Krause. After another
appeal, records show the Minneapolis VA finally had a qualified doctor examine the veteran. That doctor agreed there
was a TBI. Now the veteran gets more than $1,400 a month in VA benefits. "Had he just gone away he would have
been shy a $1,000 a month for the rest of his life," says Krause. "And that's the end incentive there, to save a little bit
of money."
KARE 11 News wanted to know how many initial TBI exams were done by the same two unqualified doctors. In
response to our Freedom of Information Act requests, the Minneapolis VA admitted that since 2010 they've done a
total of 127 exams. But that may be the tip of the iceberg. Congressman Tim Walz (D-MN) says more than 300
veterans were impacted at the Minneapolis VA alone. To help determine whether the problem was widespread, KARE
11 and other TEGNA-owned television stations across the county filed Freedom of Information Act (FOIA) requests
asking for the names of doctors who had performed initial TBI exams and their specialties. Although the VA originally
released information about Dr. Smith and Dr. Gabriel, the Department of Veterans Affairs is now claiming that the
names of doctors who performed TBI exams is confidential. In a series of FOIA denial letters, the agency wrote the
names are private information that won't "contribute significantly to the public's understanding of the activities of the
federal government."
The Department denied our request in spite of the fact you can find the name and certification of every VA doctor,
at every VA hospital, anywhere in America on its own website. What's more, as federal employees, every dollar they
are paid, including bonuses, is already public information. What's not known is which doctors performed the TBI
exams. The VA's ruling surprised some experts. "The presumption is for access," said Leita Walker, a Twin Cities
attorney specializing in freedom of information issues. She describes public access to government records as a
cornerstone of democracy. "There's an expression that sunshine is the best disinfectant, right? That if you can't see
what your government is doing, that there's an opportunity for corruption to arise," she said. KARE 11 and our parent
company TEGNA are appealing the VA's FOIA denial, arguing that releasing the names of the doctors who have
performed initial TBI exams will allow thousands of veterans and the public to determine how often exams by
unqualified doctors may have denied Veterans benefits and access to medical care. [Source: KARE 11 Minneapolis
| A.J. Lagoe & Steve Eckert | September 8, 2015 ++]
*********************************
VA Whistleblowers Update 36
► Terminated Vet Employee Reinstated
A Veterans Affairs Department employee who was fired for contacting his senator to report problems at the department
is back on the job this week after a two-year legal fight that ended with the U.S. Office of Special Counsel chastising
VA officials. The news comes amid continued criticism from lawmakers about VA’s treatment of whistleblowers and
commitment to fixing internal problems instead of covering them up. OSC officials said they hope the case will serve
as a warning to VA leaders and staffers to take such reports more seriously, and to follow the law. “The constitutional
right to petition Congress must be guaranteed for all Americans,” Special Counsel Carolyn Lerner said in a statement.
“Federal agencies cannot deny their employees this right even if it leads to scrutiny of their operations.”
In February 2013, disabled Army veteran Bradie Frink was hired as a clerk at the VA’s Baltimore Regional Office.
Since he had a pending benefits claim at that facility, officials opted to transfer the file to a different office for
processing to avoid any potential conflict of interest. But OSC officials said his benefits folder got lost in transit,
delaying his already year-old claim. After a few months of waiting, he asked co-workers and outside advocates to help
find the missing documents, without success. In June 2013, Frink reached out to Sen. Barbara Mikulski (D-MD) about
his missing files. Days later, her staffers contacted VA officials about his case. Before the end of the month, Frink
was fired for “failing to follow supervisory instructions, including using inappropriate methods to search for his claims
folder.”
OSC investigators called the reasons for the firing flimsy and found cases of more serious workplace violations
that yielded much less severe punishment. They recommended punishment against two Baltimore VA supervisors for
the move. Shortly after VA Secretary Bob McDonald took over that leadership post in August 2014, he promised new
protections for whistleblowers and punishment for individuals who retaliated against them. OSC officials said that in
recent months, VA supervisors have worked with their office to resolve Frink’s case, including back pay for the
months of unemployment, compensatory damages for emotional distress, and reinstatement in his job.
In a statement, VA officials said they are building a stronger relationship with the Office of Special Counsel to
meet those goals. “Intimidation or retaliation, not just against whistleblowers but against any employee who raises a
hand to identify a problem … is absolutely unacceptable,” officials said in a statement. Frink’s file was found a few
weeks after Mikulski’s office intervened. His claim was processed later that year. VA officials did not say whether
they have taken any disciplinary action against the supervisors. [Source: Military.com | Leo Shane | September 8,
2015 ++]
*********************************
VA Data Mismanagement
► VA OIG Audit Report
Bad data and poor system controls are compounding the backlog problems at the Department of Veterans Affairs,
according to a new VA Office of Inspector General audit. The audit substantiates allegations by whistleblowers that
867,000 records were marked as pending and that 47,000 veterans died while awaiting care. The backlog of pending
healthcare applications, veterans who died while their applications were pending, as well as purged or deleted veteran
health records and unprocessed applications, have all contributed to VA’s data mismanagement. Auditors specifically
looked into allegations of mismanagement at the Veterans Health Administration’s Health Eligibility Center (HEC),
the VA’s central authority for eligibility and enrollment processing activities. The HEC and four VA medical centers
process healthcare applications using the Enrollment System (ES), which receives data from an older component of
the Veterans Health Information System and Technology Architecture. “Enrollment program data were generally
unreliable for monitoring, reporting on the status of healthcare enrollments, and making decisions regarding overall
processing timeliness,” reports OIG, which substantiated that ES had about 867,000 pending records as of September
30, 2014. “These ES records were coded as pending because they had not reached a final determination status.”
Auditors also confirmed that pending ES records included entries for individuals reported to be deceased. As of
September 2014, more than 307,000 pending ES records, or about 35 percent of all pending records, were for
individuals reported as deceased by the Social Security Administration. “These conditions occurred because the
enrollment program did not effectively define, collect, and manage enrollment data,” states the report. “In addition,
VHA lacked adequate procedures to identify date of death information and implement necessary updates to the
individual’s status. Unless VHA officials establish effective procedures to identify deceased individuals and accurately
update their status, ES will continue to provide unreliable information on the status of applications for veterans seeking
enrollment in the VA healthcare system.” OIG also confirmed that VA employees incorrectly marked unprocessed
applications as completed and possibly deleted 10,000 or more transactions from the Workload Reporting and
Productivity (WRAP) tool over the past five years. “WRAP was vulnerable because the Health Eligibility Center did
not ensure that adequate business processes and security controls were in place, did not manage WRAP user
permissions, and did not maintain audit trails to identify reviews and approvals of deleted transactions,” concluded
auditors.
OIG provided recommendations to the Under Secretary for Health (USH) to address enrollment system data
integrity issues, enrollment program policy limitations, and the access and security of the WRAP tool. The report also
provided recommendations to the Assistant Secretary for Information and Technology (OI&T) to implement adequate
security controls for the WRAP tool, and ensure the collection and retention of WRAP audit logs and system backups.
Further, OIG recommended that the USH and Assistant Secretary OI&T confer with the Office of Human Resources
and the Office of General Counsel to fully evaluate the implications of the findings of the report, determine if
administrative action should be taken against any VHA or OI&T senior officials involved, and ensure that appropriate
action is taken. The USH and Assistant Secretary OI&T concurred with OIG’s findings and recommendations.
[Source: Health Data Management | Greg Slabodkin | September 8, 2015 ++]
*********************************
VA Health Care Access Update 26
► Vietnam-Era Veterans Impact
The latest challenges facing the Veterans Affairs Department stem in part from a surge in health care needs and claims
from Vietnam-era veterans, the agency's top official said. "The problems of the VA in 2014 were not because of
Afghanistan and Iraq," VA Secretary Robert McDonald said on Wednesday during a speech in Washington, D.C. "We
have Vietnam-era veterans qualifying for issues that we didn't even know how to define during the Vietnam War."
The department last year was plagued by reports of falsified documents and wait times at facilities so long that veterans
died before receiving care. A recent IG report indicated some 300,000 veterans with pending enrollment applications
were reported as deceased, but VA officials said that figure doesn't indicate they went without medical care or died
while actively seeking enrollment into the VA system.
.
Regardless, the wait list scandal and other issues forced the resignation of former VA Eric Shinseki and provided
fodder for lawmakers such as Sen. John McCain, R-Arizona, who want to change the law so more veterans can seek
treatment outside the VA system. Disability claims filed with the agency are anticipated to hit 1.44 million in 2017 –
an almost 50 percent increase from 2009, when they were at 1 million, McDonald said in remarks at the annual Military
Officers Association of America (MOAA) Warrior Family Symposium in Washington, D.C. About 10 million
veterans will be over age 65 in 2017, he said. "People are 10 times more likely to survive the battlefield today, but
because you survive with much more catastrophic injuries," he said. "If we don't build the capability today, where are
we going to be 20 years from now, 30 years from now, 40 years from now as the veterans who fought in Iraq and
Afghanistan age?" The VA announced last month that it has reduced its claim backlog to less than 100,000 from its
peak at more than 600,000 in 2013.
McDonald warned if lawmakers don't fund the VA in fiscal 2016 at the requested amount of about $168 billion,
the agency will be underprepared the needs of Iraq and Afghanistan veterans. The U.S. House of Representatives and
Senate passed spending bills funding the department at well under that amount. House lawmakers passed a bill funding
the VA at $163.2 billion, while the Senate agreed on $163.7 billion. The final 2016 funding level, which will be
decided in conference, is anticipated to be announced by lawmakers this month before heading to the President's desk
for his signature. [Source: Military.com | Amy Bushatz | September 9, 2015 ++]
*********************************
VA Facility Maintenance Update 02
► Let VA Shed Real Estate
The Veterans Affairs Department could save $25 million a year if it closed outdated and unused facilities, the VA's
leader said 9 SEP. As part of an ongoing lobbying effort to gain more budget flexibility, VA Secretary
Robert McDonald has been pressing Congress for permission to dispose of 10 million square feet of space that the
department doesn’t use or thinks it does not need. At a military and family forum in Washington, D.C., McDonald
asked veterans and military advocates to support the effort, which he said faces an uphill battle from lawmakers. “We
need Congress to get the courage to allow us to close these spaces so we can make better use of the money we have,”
McDonald said. The VA’s inventory includes hundreds of historic, aging or blighted buildings. Among those popular
with veterans is the historic Battle Mountain Sanitarium in Hot Springs, South Dakota, a facility that once served Civil
War veterans of the battles of Gettysburg and Antietam and is part of the VA Black Hills Health Care System. But
other buildings, like a former quartermaster’s office in Minneapolis, have been vacant for years and fallen into
disrepair.
According to VA, it has 336 buildings that are vacant or less than half-occupied. The money it takes to manage
these properties — $25 million — could hire 200 registered nurses or pay for nearly 150,000 primary care visits and
more. But proposing to close buildings is a tough sell. "Members of Congress and others don’t like us to close things
in their geographic regions,” McDonald said. In a hearing earlier this year, Florida Rep. Corrine Brown, the senior
Democrat on the House Veterans' Affairs Committee, voiced the reticence felt by many lawmakers about shuttering
VA facilities. But she also expressed support for a concept similar to a base realignment and closure plan. “We support
closing some of the VA facilities ... just as long as you don't close any in Florida,” she joked. “That's kind of the
mentality of the members of Congress. So as we work through it, we've got to keep in mind, it is a team effort.”
McDonald has pressed for more flexibility, not only to control VA real estate but also to shift money between
programs, to cover a budget crunch related to increases in medical costs and disability claims as well to support
new construction and hire more personnel. In the past year, the VA has added 1,100 physicians, 3,500 nurses and
increased office hours at some facilities by 12 percent, to include nights and weekends, according to the VA. But the
department needs resources to build additional capacity and ensure it will be prepared to care for Afghanistan and Iraq
veterans in the future, McDonald said. "VA is the canary in the coal mine," he said. "We see the problems with
American medicine before the rest of the country because we are the largest integrated health care system in the
country. We see the effects of the aging population before everyone else and need to get ahead of this now.” [Source:
MilitaryTimes | Patricia Kime | September 9, 2015 ++]
*********************************
VA Choice Act Update 12
► GI Bill School Acceptance Provision
The Department of Veterans' Affairs announced that 45 states and several territories are now compliant with the
provision of the Veterans Access, Choice, and Accountability Act of 2014 (“the Choice Act”) that affects students
using the Post-9/11 GI Bill®and Montgomery GI Bill. Section 702 of the Choice Act requires VA to disapprove
programs at public colleges for Post-9/11 GI Bill and MGIB benefits that don’t provide the resident-rate tuition and
fee charges to covered individuals. The disapproval applies to any terms beginning after July 1, 2015. This change
affects thousands of Post-9/11 GI Bill and MGIB – AD students. To remain approved for VA’s GI Bill programs,
schools must charge in-state tuition and fee amounts to those covered by this law.
Last May Secretary of the Department of Veterans' Affairs Bob McDonald decided to exercise his waiver authority
and grant more time for states and territories to comply. Now nearly 5,000 public schools, covering nearly 93% of the
GI Bill student population, are participating. Now, that doesn’t mean that all of their students will qualify; the school
still has to verify that someone is a covered individual. But it does demonstrate the breadth and depth of the progress
that has been made. The remaining few non-compliant states and territories have until December 31, 2015, to comply,
thanks to the Secretary’s waiver. All of them have indicated they intend to comply. You can read more about the
resident-rate requirements of the Choice Act by visiting our website at http://www.benefits.va.gov/gibill/702.asp .
There you can also track the latest compliance status by state, territory, and school on the site’s compliance map.
[Source: TREA News for the Enlisted | September 1, 2015 ++]
*********************************
VA Vet Choice Program Update 24
► Program Is A Game Changer
The Veterans Choice program is a game changer in providing health services for veterans, with more seeking treatment
— and getting it — rather than languishing on waitlists, the chairman of the Senate Veterans' Affairs Committee said
9 SEP. Addressing a military and family symposium hosted by the Military Officers Association of America in
Washington, D.C., Sen. Johnny Isakson (R-GA) said 7.5 million more medical appointments have been made under
the VA Choice program this year than last. But he warned that VA Choice needs time to work and chastised veterans
groups who oppose it because they see it as a step toward privatizing VA health services. “A lot of people have said
VA Choice is a cop-out," Isakson said. "But you just don’t provide health care to 6.5 million veterans by snapping
your fingers. We don’t have the money in the federal government to provide all the health care to veterans if we
wanted to. We have to empower the private sector through programs that work."
VA Choice was launched earlier this year to provide health care to veterans by letting them see a private doctor if
they live more than 40 miles from a VA health facility or cannot get an appointment at a VA clinic or hospital within
30 days. But its rollout has faced challenges: Veterans who live within a 40-mile radius of a clinic often must still
travel long distances to reach a VA facility that provides specialty care. Veterans in rural, sparsely populated areas
also face challenges finding a doctor who knows the program; in Alaska, for example, many vets are going without
care, according to Sen. Dan Sullivan (R-AK) "It's been nothing less than an unmitigated failure," Sullivan said during
a Senate Veterans' Affairs Committee field hearing 25 AG. Veterans groups have said that privatization of VA health
care will be a major talking point in the upcoming fiscal year and in the runup to the 2016 election.
Republican presidential candidate Dr. Ben Carson proposed last month that VA health care be eliminated in favor
of providing vouchers to veterans for private care, and combining VA services with Tricare, the Defense Department’s
health program. Isakson said VA Choice needs “time to work,” but added that the program, which last year received
$10 billion in funding intended to last through 2017, along with health care provided at VA facilities, has “a long way
to go” to reach the goal of providing seamless, quality care to veterans. He also said the VA faces several challenges
in preparing for the long-term care of post-9/11 veterans, to include improving health services for female veterans,
mental health treatment, substance abuse, and pain management. He pledged that Congress, VA, veterans groups and
the private sector would work together to ensure that VA has the funding and oversight it needs to get the job done.
"We are making progress. We are a long ways from where we want to go, but we are getting there," he said. [Source:
Military.com | Patricia Kime | September 9, 2015 ++]
*********************************
VA Claims Backlog Update 150
► VA Disputes 300,000 Died Awaiting Care
The Veterans Affairs Department is rejecting reports that 300,000 veterans likely died while awaiting care, even
though the figure came from its own inspector general. The number reflects the number of veterans with pending
enrollment applications that the Social Security Administration reports as deceased -- but nothing indicates they went
without medical care or died while actively seeking enrollment into the VA system, according to a senior official with
the department’s Veterans Health Administration. “[The IG] could not determine specifically how many pending
records represent veterans who applied for health care benefits or when they may have applied,” Acting Deputy Under
Secretary for Health for Operations and Management Janet Murphy said in an official VA blog post on 27 AUG.
Lawmakers cited the figure as further evidence of mismanagement at the VA, which has been rocked by a series
of scandals over the past few years, notably reports that many hospitals kept secret wait lists to conceal the fact that
so many veterans were stuck in the system and unable to receive treatment. Sen. John McCain (R-AZ) said the IG
report is evidence that veterans should be able to get their health care needs met anywhere and not be tied to the VA
system. “It is absolutely clear that the way ahead for reform of the VA must be to empower all veterans to immediately
get the care they need where and when they need it -- regardless of the location -- and never allow bureaucrats to deny
our nation’s heroes the benefits they deserve,” he said. Rep. Dan Benishek (R-MI) called the IG findings “outrageous
and ... tragic.” “The endless amount of probing and investigations that it takes before the VA finally reveals the truth
about the mismanagement that is occurring has got to stop now,” said Benishek, who spent 20 years as a doctor with
the VA Medical Center in Iron Mountain, Michigan.
But according to Murphy, the department official, the lawmakers and the media reports based on the IG findings
aren’t accurate. Some of the veterans could have applied for health care years ago and gone on to get care outside the
VA. Murphy said the department does not have the authority to remove a claim from pending status even if they
attempt, but fail, to contact the veteran. For that reason, any number of applications for care could remain in the
system, regardless of when it went in and whether the individual is alive or deceased. Murphy did concede that its
own system is the reason the IG was not able to say exactly how many pending records represented veterans who
applied for health care benefits or when they applied, calling it “data weaknesses within our system which we are
working hard to improve.”
Applications stay in pending status if they’re not complete, if a veteran’s record is transferred into the system even
though he or she may not have initiated enrollment, or if a veteran accessed VA care prior to 1998, according to
Murphy. She also said that the veterans with pending applications are not already enrolled in VA health care, so that
it’s a mistake to think that of the deceased had been department patients or enrollees. She criticized media reports
suggesting otherwise, saying “VA has repeatedly pointed this out to inquiring media.” Author Kelly Kennedy, a Gulf
War veteran and former reporter who now writes on veterans’ issues for the law firm Bergmann & Moore, which
specializes in veterans’ cases, responded to Murphy’s blog posting on her own site. The VA posting, she wrote,
“started out nicely: a contrite acknowledgement that things need to be fixed. And then it went downhill, into a
convoluted statement that things aren’t as bad as the media are making them out to be (it’s always the media’s fault
because blame-shifting), but we can’t tell you exactly how bad they are because we don’t know.” [Source:
Military.com | Bryant Jordan | September 4, 2015 ++]
*********************************
VA Suicide Prevention Update 27
► Research is Vital
More than 40,000 Americans die by suicide each year, with Veterans accounting for an estimated one in five of those
deaths. Suicide is also a leading cause of death among active U.S. military members. That’s why VA has made suicide
prevention a top priority. Research is vital in shaping VA’s overall suicide prevention strategy, which covers medical
treatment, provider training, community programs, crisis intervention procedures, and policy. As director of the VA
VISN 2 Center of Excellence for Suicide Prevention, based in upstate New York at the Canandaigua VA Medical
Center, Kenneth R. Conner has an excellent perspective on what it takes to ensure that VA is consistently providing
the best evidence-based life-saving interventions. Research has identified numerous risk factors for suicidal behavior.
These include behavioral health conditions, such as depression; major stressful events, such as the loss of a loved one;
and physical health problems, such as chronic pain.
While each of these factors increases risk, none is necessary or sufficient on its own to lead to suicidal behavior.
Rather, multiple factors are usually involved. Moreover, research shows that most of those who die by suicide were
not in treatment for depression or other mental health conditions at the time of death. Therefore, tackling the complex
and far-reaching problem of suicide requires a broad approach. At our Center of Excellence, where Conner leads a
team of researchers, educators and administrators, that means:
 Identifying risk factors and protective factors for suicidal behavior in Veterans broadly and in key subgroups
(for example, those with chronic pain).
 Developing, implementing and evaluating suicide-prevention interventions.
 Preparing junior researchers to contribute to the field of suicide research in a variety of ways.
 Providing education on suicide prevention.
Whether we are researchers, medical professionals, friends, families or Veterans, we are all on the front line of
suicide prevention. People may not believe that they can make a difference in the lives of others, but they can. One
person can help save a life. While suicide is complex, and unfortunately cannot be prevented entirely, we can make
great progress by using a well-informed and comprehensive approach. [Source: VAntage Point | Kenneth R. Conner
| September 4, 2015 ++]
*********************************
VA Construction Management Authority Update 01
► Cost Overruns
Huge cost overruns and long delays at new VA hospitals in Colorado, Florida and Louisiana were caused by multiple
design changes, mismanaged contracts or poor budget controls, according to Army Corps of Engineers reports released
3 SEP. High costs at a fourth veterans facility in Las Vegas were the result of a decision to change the plan from an
outpatient clinic to a full hospital, the reports said. Under fire for ballooning expenses and long delays, the Veterans
Affairs Department asked the Corps of Engineers to review its overall construction practices as well as the four new
hospitals. The Corps warned that the VA needs to make fundamental changes in the way it handles construction or it
will suffer similar overruns and delays on future projects.
The Corps said the VA has conflicting lines of authority and its priorities, expectations and accountability standards
don't mesh. It also said the VA needs more disciplined leadership. The half-finished Colorado medical center, under
construction outside Denver, is the VA's most embarrassing problem. It's now expected to cost up to $1.73 billion,
nearly triple the earlier estimates. Congress wants the VA to fire the executives responsible for the Denver failures.
The VA says it's investigating what went wrong. Congress also wants the VA to turn over large construction projects
to the Corps of Engineers in the future.
A look at the Corps' findings:
COLORADO - The VA repeatedly changed the design and square footage of a new medical center in the Denver
suburb of Aurora, the Corps said. The VA also used a complicated contract process that department officials didn't
understand, and they adopted it too late in the process, leading to disputes and conflicting cost estimates, the report
said. A panel of judges ruled last year the VA had breached its contract with the builder by not delivering a plan that
could be built within the budget. Construction stopped for a time, but it has continued at a slower pace under a series
of stop-gap funding measures. VA Deputy Secretary Sloan Gibson, who visited the construction site Thursday, said
his department accepts the findings and is making changes. The VA is asking Congress for an additional $625 million
to finish a scaled-back version, on top of the $1 billion authorized to date. Gibson said he was optimistic a funding
deal will be reached before the project hits its current spending cap at the end of the month. The Corps of Engineers
also said the VA didn't have enough construction management staffers in Denver to handle a project of this scale, and
they were overwhelmed trying to meet deadlines.
LOUISIANA - The VA is building a medical center in New Orleans to replace one heavily damaged by Hurricane
Katrina in 2005. Cost estimates rose from $625 million in 2009 to $995 million today. The VA first planned to build
and operate the new hospital jointly with Louisiana State University, but it switched to a stand-alone veterans facility.
The VA also ran into environmental problems on the construction site that were costly to resolve.The Corps of
Engineers said the VA used an ill-informed process that designed the hospital to meet the perceived need, not to fit a
budget. Budget controls weren't always followed because of complex and conflicting lines of authority in the VA, the
report said. Planners also used some design standards dating to the 1970s, the Corps said.
FLORIDA - The cost of a new medical center in Orlando rose in part because the VA issued multiple contracts for
the foundation, structure, fittings and finish and because the electrical design was flawed, the Corps said. Elaborate
finishes and architectural features drove up construction costs and will increase operating and maintenance costs in
the future, the report said. The report didn't include cost figures, but officials have said the price more than doubled
from $254 million to around $600 million.
NEVADA - The VA originally planned to partner with the Defense Department to build a huge outpatient clinic at
Nellis Air Force Base outside Las Vegas, but security restrictions made that impractical. After the VA decided to build
a stand-alone clinic in North Las Vegas, it changed the plan to a full medical center. But the VA didn't have specific
targets on the square footage, the Corps said. The report generally praised the VA's management of the Nevada project.
[Source: Associated Press | Dan Elliott | September 3, 2015 ++]
*********************************
SGLI/VGLI Update 14
►
Beneficiary Updating
Life Insurance should give you and your loved ones peace of mind that they will have funds available if anything
happens to you. But that may not happen if your insurance beneficiary designation isn’t up to date. Consider the
following:
What Could Happen if I Don’t Update My Beneficiaries?
Not keeping insurance beneficiaries up to date may result in your benefits going to a former spouse, a deceased parent’s
estate, and your estate! It could also result in payment delays at a time when your loved one needs the money. For
example, if the listed beneficiaries are children from a first marriage, then children from a current marriage might
contest the claim if they believe they have more recent documents showing they should be the beneficiaries. No one
could be paid until it is determined who legally is entitled to the money.
What If I Name a Minor Child as Beneficiary?
If you name a minor child as your insurance beneficiary, then the proceeds will be paid to the court-appointed guardian
of the child’s estate. Or, the funds will be paid to the child when he or she reaches the “age of majority,” which varies
from state to state.
Can I Name a Trust as Beneficiary?
Yes, but designating a Trust as your beneficiary does not create a Trust. You must work with a financial or legal
professional to set up a Trust before naming one as your insurance beneficiary.
Update Your Beneficiaries Today.
If you’ve had a recent life event such as a change in marital status, the addition of a child, or the death of a loved one,
then now is a good time to review your insurance beneficiary designation for Servicemembers’ Group Life Insurance
(SGLI), Veterans’ Group Life Insurance (VGLI) and VA Insurance policies starting with V, RH, RS, J, K or W. It’s
the best way to ensure your life insurance benefit is paid to the people you want. Even if you haven’t had a recent life
event, it’s a good idea to review your beneficiaries at least once a year. So, mark it on your calendar as an annual
event. And remember, you have the legal right to name any beneficiary you want and change your beneficiary at any
time.
How do I Update My Beneficiaries?
Refer to the chart below for information on how to review and update your beneficiaries.
If you have:
Get current beneficiary info
by calling:
Update your beneficiaries by
completing:
A VA policy starting with Department of Veterans Affairs: Form 29-336*
800-827-1000
V, RH, RS, J, K or W
SGLI Coverage
Your branch of service
Form SGLV 8286*
Form SGLV 8721* or log
onto
The Office of Servicemembers’
your VGLI Online Account at
VGLI Coverage
Group Life Insurance (OSGLI):
800-419-1473
www.benefits.va.gov/insuranc
e
*You can access all Change of Beneficiary forms at www.benefits.va.gov/INSURANCE/updatebene.asp.
[Source: VAntage Point | VA Official Blog | September 3, 2015 ++]
*********************************
VA Medical Error Investigations ►
Down 18% | Errors Up 14%
Hospitals across the country are under growing pressure to reduce preventable medical mistakes, the errors that can
cause real harm and even death to patients. But the Department of Veterans Affairs, which runs a massive system of
hospitals and clinics that cared for 5.8 million veterans last year, is doing less, not more, to identify what went wrong
to make sure it doesn’t happen again. A 28 AUG report from the Government Accountability Office found that the
number of investigations of adverse events — the formal term for medical errors —plunged 18 percent from fiscal
2010 to fiscal 2014. The examinations shrank just as medical errors grew 7 percent over these years, a jump that
roughly coincided with 14 percent growth in the number of veterans getting medical care through VA’s system.
Auditors said it was hard for them to know whether the decline in investigations (called root cause analyses) means
that fewer errors are being reported, or that these mistakes, while on the rise, are not serious enough to warrant scrutiny.
But the reason for the caution is itself disconcerting: VA officials apparently have no idea why they are doing fewer
investigations of medical errors. They told auditors that they haven’t looked into the decline or even whether hospitals
are turning to another system. This VHA chart shows root cause analyses (RCA) of preventable medical errors done
by hospitals and clinics
The National Center for Patient Safety, the office in the Veterans Health Administration responsible for
monitoring investigations of medical errors, “has limited awareness of what hospitals are doing to address the root
causes of adverse events,” the report concluded. Patient safety officials are “not aware of the extent to which these
processes are used, the types of events being reviewed, or the changes resulting from them,” GAO wrote. It added
that “the lack of complete information may result in missed opportunities to identify needed system-wide patient
safety improvements.” Auditors said the lack of analysis is “inconsistent” with federal standards on internal controls,
which require agencies to look at significant changes in data.
An adverse event is an incident that causes injury to a patient as the result of an intervention that shouldn’t have
been made, or one that failed to happen, rather than the patient’s underlying medical condition. These kinds of errors
are considered preventable, which is why hospitals and physicians are under pressure to put new systems in place or
update their standards and procedures. They often result from a combination of system and medical errors. Some
examples: Medical equipment was improperly sterilized, leading a patient or multiple patients to be exposed to
infectious diseases. Surgery was done on the wrong patient, with the wrong procedure on the wrong side. A patient
falls or is burned. A patient gets the wrong medication or the wrong dose.
VA officials, in response to a draft of the report, generally agreed with its conclusions and with GAO’s
recommendation that they get a better handle on why fewer root-cause investigations are done. The patient safety
office has started a review that’s scheduled to be done in November. Officials acknowledged that while hospitals use
other systems (such as the Six Sigma management method) to review medical errors, “these processes are not a
replacement” for root-cause analyses. The report was requested by three leading Senate Democrats and two House
members who are ranking members or serve on committees that oversee VA, including presidential hopeful Bernie
Sanders (I-VT); Sen. Richard Blumenthal (CT); Rep. Corrine Brown (FL); Sen. Patty Murray (WA) and Rep. Eddie
Bernice Johnson (TX) Although they collected data from the entire system of 150 VA hospitals and clinics, auditors
did a deeper dive at four: the Salt Lake City Health Care System; Robley Rex Medical Center in Louisville, Ky.;
Southeast Louisiana Veterans Healthcare System in New Orleans and James E. Van Zandt Medical Center in Altoona,
Pa.
Patient safety officials told auditors that while they haven’t done an analysis of why there are fewer investigations
of medical errors, they observed a “change in the culture of safety” at many hospitals. This is a revealing observation:
“[Patient safety] officials stated that they have observed a change in the culture of safety in recent years in which
staff feel less comfortable reporting adverse events than they did previously. Officials added that this change is
reflected in [their] periodic survey on staff perceptions of safety; specifically, 2014 scores showed decreases from
2011 on questions measuring staff’s overall perception of patient safety, as well as decreases in perceptions of the
extent to which staff work in an environment with a nonpunitive response to error.”
Still, the number of reports of medical errors has been increasing. Root-cause analyses are launched depending on
the severity of the error. High-risk mistakes that seem destined to recur require investigations. Lower-risk errors are
up to the discretion of hospital staff. [Source: Washington Post | Lisa Rein August 31 | August 31, 2015 ++]
*********************************
VA Whistleblowers Update 35
► OIG Report on VHA HEC Allegations
The Department of Veterans Affairs Office of Inspector General (OIG) received a request from the Chairman of the
U.S House Committee on Veterans’ Affairs to determine the merits of allegations made by a whistleblower about the
Veterans Health Administration’s (VHA) Health Eligibility Center (HEC). The OIG found the Chief Business Office
has not effectively managed its business processes to ensure the consistent creation and maintenance of essential data
and recommended a multiyear project management plan to address the accuracy of pending Enrollment System records
to improve the usefulness of such data. The OIG published a report http://www.va.gov/oig/pubs/VAOIG-14-01792510.pdf on September 2, 2015, addressing the following four questions:
 Did the HEC have a backlog of 889,000 health care applications in a pending status?
 Did 47,000 veterans die while their health care applications were in a pending status?
 Were over 10,000 veteran health records purged or deleted at the HEC?
 Were 40,000 unprocessed applications, spanning a 3-year time period, discovered in January 2013?
We substantiated the first allegation that VHA’s enrollment system had about 867,000 pending records as of
September 30, 2014. However, due to serious enrollment data limitations, such as an estimated 477,000 pending
records not having application dates, we could not reliably determine how many records were associated with actual
applications for enrollment. OIG also substantiated that pending records included entries for over 307,000 individuals
reported as deceased by the Social Security Administration. Again because of data limitations, we could not determine
how many pending records represent veterans who applied for health care benefits. We also substantiated that
employees incorrectly marked unprocessed applications as completed and possibly deleted 10,000 or more
transactions over the past 5 years. Information security deficiencies, such as the lack of audit trails and system backups,
limited our ability to review some issues fully and rule out data manipulation. Finally, we substantiated that the HEC
identified over 11,000 unprocessed health care applications and about 28,000 other transactions in January 2013. This
backlog developed because the HEC did not adequately manage its workload and lacked controls to ensure entry of
its workload into the enrollment system.
OIG recommended VHA assign and hold accountable a senior executive to develop and implement a project
management plan to correct data integrity issues, to identify veterans whose applications have not been processed,
enrollment program policy limitations, and access and security controls. We also provided recommendations to OI&T
to implement adequate security controls and ensure the collection and retention of audit logs and system backups. OIG
further recommended that VHA and OI&T officials confer with the Office of Human Resources and the Office of
General Counsel to determine if administrative action should be taken against any VHA or OI&T senior officials
involved, and ensure that appropriate action is taken. As this issue demonstrates, whistleblowers have proven to be a
valuable information source to pursue accountability and corrective actions in VA programs.
LINDA A. HALLIDAY
Deputy Inspector General
[Source: VA OIG | September 2, 2015 ++]
*********************************
VA eBenefits Portal Update 03
► 5 Million User Milestone Reached
Participation in the joint VA and Department of Defense (DoD) eBenefits website topped five million users in AUG
2015, two months ahead of schedule. VA established an agency priority goal of reaching five million eBenefits users
by the end of fiscal year 2015. VA achieved this early milestone through aggressive outreach efforts and with the
support of DoD and its Veterans Service Organization partners. “Veterans are encouraged to enroll in eBenefits and
file their claims online through this one-stop shop for benefits-related tools and information,” said Under Secretary
for Benefits Allison Hickey. “We have already implemented nearly 60 self-service features and we continue to expand
eBenefits capabilities to give Veterans and Servicemembers greater flexibility in securing their information.”
The number of eBenefits users is a key measure of VA’s success in improving Veterans’ access to VA benefits and
services and is reported on www.performance.gov . To enroll in eBenefits, Veterans and Servicemembers must obtain
a DoD Self-Service Logon (DS Logon), which provides access to several Veterans and military benefits resources
using a single username and password. The service is free and may be obtained online at www.ebenefits.va.gov or in
person at a VA Regional Office. “The successful collaboration of eBenefits and DS Logon is just one more example
of how the DoD and VA are working together to continue bringing current and former Servicemembers secure online
access to the benefits they’ve earned,” said Mary Dixon, Director of Defense Manpower Data Center.
The rapid and continued growth in the utilization of the eBenefits website demonstrates the importance of giving
Veterans greater access to information about their own benefits. In addition to filing claims online and checking the
status of those claims, Veterans can also message their VA doctor, order prescription drug refills and obtain official
military documents through eBenefits. More than 7.5 million VA letters have been generated and downloaded by
Veterans that show proof of disability, income or Veterans preference used in federal or state government hiring. Go
to http://www.benefits.va.gov for more information about VA benefits. [Source: VAntage Point | September 2015
++]
*********************************
VAMC Cincinnati Update 01 ►
New Technology | 5 State ICU Monitoring
In a modest room on the ninth floor of the Cincinnati VA Medical Center, a team of doctors and nurses are providing
care to critically-injured veterans across five states. The hospital is working to improve and expedite care for the
nation’s veterans through more than 60 computer monitors, high-resolution cameras and the real-time sharing of
hundreds of electronic medical records every day. Cincinnati’s Tele-Intensive Care Unit opened in early 2012 to
monitor 72 ICU beds in Ohio’s four VA medical centers, including Dayton and Cleveland. The operation continues
to expand, now overseeing 213 ICU beds in states as far south as Georgia and Alabama, said Michael Torok, RN,
Tele-ICU operations director. “We are watching over our veterans,” Torok said. “The VA is a high-tech, government
hospital system. This shows the investment the VA puts into its patients.”
The original investment was $4 million by the VA and an annual operating budget of $7 million, according to
Torok. The Tele-ICU is staffed with critical care nurses 24 hours a day, and with physicians board certified in critical
care from 4 p.m. to 8 a.m. Monday to Friday and 24 hours a day on weekends. There are 27 full-time equivalent nurses
and eight critical care physicians, also called intensivists. “The ICU is our sickest patients,” Torok said, recovering
from a complex surgery or cardiac event, for example. In Ohio alone, there were over 52,000 uses of the Tele-ICU in
2014, according to Torok. In the first two quarters of this year, the cameras have been used 21,760 times for Ohio
veterans. The operation continues to grow as more hospitals request to join, Torok said. They are currently in
negotiations to add another seven hospitals — 100 more ICU beds — in 2016. To keep up with demand, a Tele-ICU
satellite location opened in 2013 in Cleveland and a second satellite will open in October in Greater Los Angeles,
according to Torok. The Tele-ICU itself is also in contract negotiations to relocate its growing operations into a 6,000square-foot space in the John Weld Peck Federal Building downtown. That move would increase capacity from 10
work stations to 25 work stations.
All the 213 ICU rooms have a red eICU button that when pushed will request a Tele-ICU nurse or physician. After
ringing a virtual doorbell, the Tele-ICU worker appears on a flat screen TV and uses their mouse to move the room’s
camera around to communicate with the patient and on-site medical workers. Torok said, for example, if an injured
veteran is admitted to an ICU at 2 a.m. on a Sunday, the Tele-ICU is an immediate way to have qualified critical care
staff on hand to troubleshoot the patient’s problems during those off and late hours. Inside the Tele-ICU in Cincinnati,
each work station consists of six computer screens to monitor the patient’s vitals, receive calls, read lab results and
submit work orders, among other things, said Alex Geimeier, a critical care registered nurse in the unit. “We don’t
take the place of any nurse or doctor by the bedside,” Geimeier said. “We monitor and oversee and call the nurse into
the room if (the patient) gets worse.” Geimeier said while an ICU nurse might manage two patients, a Tele-ICU nurse
can manage up to 40 patients — and the physicians about 150 patients.
To help effectively manage all those patients, an electronic medical program “scores” patients as either low,
medium or high. That determines how often the Tele-ICU nurse checks on the patient beyond routine checks, Geimeier
said. If a patient scores high they are checked every two hours, while those scored as low risk are checked every eight
hours. Patients are also color coordinated on whether their status is improving or declining. Geimeier said the
electronic system constantly updates to reflect a patient’s changing vital signs, new lab results or X-rays, and six body
systems — respiratory, hematology (blood count), cardiovascular, infectious disease, renal (kidneys) and central
nervous system. “Nurses are tasked with more and more; we can help check medications, read lab reports, make phone
calls to keep them at the bedside,” Geimeier said. Torok said the Tele-ICU staff is credentialed to be able to
immediately start treating a patient that is quickly deteriorating while the on-site staff is responding.
On weekends at the Chillicothe VA Medical Center, the medical staff is reduced to just two physicians for the
entire hospital, said Angie Thomas, nurse manager in the Chillicothe ICU. She said their ICU calls on the Tele-ICU
for help at least once a day. “It’s an extra set of eyes for patients,” Thomas said, in an interview through the Tele-ICU
monitors. “Having the Tele-ICU here, we hit the button and have a doctor here in the evenings.” Torok said a TeleICU is one solution to “spread out the expertise over a large area,” in the midst of physician and nurse shortages in
critical care. “VA hospitals are seeking us out,” Torok said. “We started out small but VAs are looking for ways to
supplement coverage.” [Source: Dayton Daily News | Hannah Poturalski | September 1, 2015 ++]
********************************
VA Fraud, Waste & Abuse
► Reported 01 Sep thru 15 Nov 2015
Columbus OH – A Gahanna woman has been charged with illegally receiving benefits through the Department of
Veterans Affairs Dependency and Indemnity Compensation after an indictment by a federal grand jury 3 SEP. Rita
Green, 54, was indicted in Columbus for allegedly keeping $89,646.22, which, prosecutors say, she was "not entitled
to." Carter Stewart, U.S. attorney for the Southern District of Ohio, Gavin McClaren, resident agent in charge with
the Department of Veterans Affairs Office of Inspector General, and Angela Byers, special agent in charge with the
Federal Bureau of Investigation's Cincinnati Field Division, announced the indictment 3 SEP. The indictment alleges
that Green's mother died in 2009 and that for the next four years, Green continued to withdraw the benefits from a
bank account under her mother's name.
\
Theft of public money is a crime punishable by up to 10 years in prison and a $250,000 fine. Green is a former
Columbus police officer. In 1991, Green's 2-year-old son fatally shot himself with her .38-caliber revolver at their
home, according to The Columbus Dispatch. She was a DARE officer at the time. The boy, Rico Green, found the
loaded pistol under a bed and fired a single shot into his face, according to Dispatch stories at the time. Police classified
the death as accidental. In 2002, Green was stripped of her badge and gun during an investigation of dereliction of
duty after she was accused of standing by while her son beat up a woman, according to The Dispatch. That case
eventually was dismissed, according to court records, and Green returned to duty. [Source: Rocky fork Enterprise |
Andrew King | September 9, 2015 ++]
-o-o-O-o-oAlexandria LA — A Ferriday woman has pleaded guilty to stealing more than $100,000 of her deceased aunt's
Veterans Affairs benefits. U.S. Attorney Stephanie A. Finley said 8 SEP that 45-year-old Linda Sue Bourgeois pleaded
guilty before U.S. District Judge Dee D. Drell to one count of theft of government property or funds. Court documents
show that even though Bourgeois' aunt died in July 2007, Bourgeois did not inform Veterans Affairs and took the
benefits from a shared bank account until March when the payments terminated. Bourgeois stole $107,452. Bourgeois
faces up to 10 years in prison, three years supervised release, a $250,000 fine and restitution. A sentencing date of
Dec. 17 was set. [Source: Associated Press | September 9, 2015++]
*********************************
VA Managers
► AFGE Report | Disruptive and Ineffective Tales
Tales of harassment, discrimination, bullying, and incompetence color the 40-page report compiled by a federal
employee union on some managers at the Veterans Affairs Department. The American Federation of Government
Employees Local 17 reportedly gathered information about the “disruptive and ineffective” managers at the request
of VA Secretary Bob McDonald, submitting the litany of allegations and names to the department in July. Government
Executive filed a Freedom of Information Act request with the VA for the report and received it last week. However,
not all of the managers’ names were redacted from the report; VA is correcting the error and issuing another fully
redacted version soon, which Government Executive will publish. Some allegations against the managers, all of whom
work in VA’s Central Office, are specific examples of abuse or intolerance, while others are more general criticisms
of managers’ leadership abilities and communication skills.
 One senior executive allegedly directed subordinates to sign documents indicating that mid-year performance
reviews had taken place even though they had not;
 Another manager played favorites with employees who share his religious beliefs, according to the report.
 Another supervisor, who is described as a “disgrace” with a “disordered personality,” harasses female
employees, the report claimed.
 Others have allegedly made disparaging remarks about a subordinate’s sexual orientation, forced employees
to ask for permission to use the bathroom, yelled and cursed at subordinates, and ignored requests for
reasonable accommodations and advance sick leave – some from disabled veterans.
 One manager’s abuses are “legendary,” the report said. “He is grandiose, distrustful, jealous, vengeful,
manipulative, resentful, and vicious. He spreads rumors, reveals employee confidences, harasses
subordinates, is intolerant, orchestrates conflict, engages in questionable employment practices, and ruins
careers.”
 A description of another manager – “a very large man” – said he “uses his heft to intimidate his staff” and
has a monitor at his desk “to surveil his employees.”
 Other complaints discuss certain managers’ over-reliance on contractors, unwillingness to deal with problem
employees, lack of technical expertise, and unprofessional behavior. “[Redacted name]’s poor judgment
creates an uncomfortable environment for her subordinates,” the report said, claiming she “openly discusses
her romantic partners and their physical attributes in an explicit and inappropriate manner.” She also talks
about sex at the lunch table and “at times appears to be nursing a hangover,” according to the report.
Local 17 included employees’ views in the report, but there are no rebuttals from the managers named. AFGE
would not comment on the report. VA did not return a request for comment. It’s not clear what, if anything, VA has
done with the information and the allegations contained in the report. Carol Bonosaro, president of the Senior
Executives Association, said if the abuses are true, “they are to be condemned and should immediately be dealt with
through the proper channels.” But Bonosaro said that the “uncorroborated” report uses “salacious” language and often
“offers little detail on general accusations beyond hearsay.” SEA and the Federal Managers Association in August
sent a letter to several congressional committees asking them to look into what they called “a hit list” and determine
whether the union put together the report on official time. “As you know, official time provides for federal labor
organizations to conduct representational activities,” the letter said. “However, to our knowledge, official time does
not cover a union investigating agency managers and executives for the purposes of creating a hit list of those it seeks
to have removed from the agency.” [Source: GovExec.com | Kellie Lunney | October 19, 2015 ++]
Vet Jobs Update 181
► Vet Unemployment Rate Drops to 7-yr Low
The unemployment rate for veterans dropped to a seven-year low in August, and the rate for Iraq and Afghanistan
war-era veterans fell to the lowest level since federal officials started tracking that population. The news came the
same day that Bureau of Labor Statistics officials announced the national unemployment rate in August had dropped
to its lowest level since 2008, before President Obama took office. Analysts have cautioned against making long-term
assumptions based on the monthly figures, but the veterans and national rates for August continue a steady downward
trend in the unemployment estimates over the past two years. BLS officials said the unemployment rate for all veterans
fell to 4.2 percent in August, a drop from 4.7 percent a month earlier and from 5.6 percent a year ago. The monthly
mark hasn’t been that low since May 2008. The figure translates into about 450,000 veterans nationwide looking for
work. That estimate was over 1 million about four years ago and near 700,000 in early 2014.
Labor Department researchers didn’t begin tracking veterans from the “Gulf War II” era until September 2008, and
had never recorded an unemployment rate for that group below 5.0 percent until last month. BLS estimated the August
rate to be 4.7 percent, or roughly 134,000 young veterans unable to find work last month. August was also the third
time in the last year that the unemployment rate for younger veterans outpaced the national rate (5.1 percent in August.)
The overall veterans rate have been below the national averages for almost four years straight. The positive
unemployment news 4 SEP, released just before the start of Labor Day weekend, came despite job creation numbers
falling short of economists’ estimates for the month. The U.S. economy added about 173,000 jobs in August, almost
50,000 fewer than what had been predicted. White House and congressional officials have made veteran employment
a major legislative focus in recent years, enacting a number of transition programs and conducting national campaigns
to encourage employers to see veterans as a reliable, adaptable workforce. [Source: MilitaryTimes | Leo Shane |
September 4, 2015 ++]
*********************************
Vet Toxic Exposure~Lejeune Update 55
► Presumptive-Disability Status
The VA is beginning the process of amending its regulations to establish presumptive-disability status for veterans
who have certain diseases linked to contaminated drinking water at Camp Lejeune. By establishing presumptive status,
it is presumed that the disease was caused by service, making it easier for veterans to obtain disability benefits. In a
recent announcement, the VA said it is reviewing potential presumptive service connection for kidney cancer,
angiosarcoma of the liver and acute myelogenous leukemia, which it said are known to be related to long-term
exposure to the chemicals that were in the water at Lejeune from the 1950s through 1987. “The chemicals are benzene,
vinyl chloride, trichloroethylene and perchloroethylene, which are known as volatile organic compounds, used in
industrial solvents and components of fuels,” the agency explained. (For more on Camp Lejeune and cancer, see the
Oncology Focus on page xx.)
Working with the Agency for Toxic Substances and Disease Registry (ATSDR) and potentially the National
Academy of Sciences “to evaluate the body of scientific knowledge and research related to exposure to these chemicals
and the subsequent development of other diseases,” adding, “VA will carefully consider all public comments received
when determining the final scope of any presumptions,” the VA explained. A study from ATSDR researchers,
published last month, linked the contaminated water to higher rates of early onset male breast cancer. Previous studies
from the same group had found associations between the chemicals at the North Carolina base and a range of cancers.
“The evidence has been accumulating for years now — many of those who lived or worked at Camp Lejeune in
years past developed certain diseases after exposure to contaminated drinking water. Compensating these victims, our
nation’s heroes and their families, is simply the right thing to do,” said Sen. Thom Tillis (R-NC). Sen. Richard Burr
(R-NC), a key advocate for those impacted by the contaminated water at Camp Lejeune, said he was disappointed that
we had to pressure the VA to do the right thing for our veterans in the first place. “The scientific research is strong,
and the widespread denials of benefits will soon end,” Burr said. “Now, these veterans and their families members
will not have to fight for benefits they are due.”
The announcement follows the approval by Congress in 2012 of the Janey Ensminger Act, which provides no-cost
health benefits to veterans who served at Camp Lejeune for 30 days or more between 1953 and 1987 for 15 qualifying
conditions. The passage of that legislation came after advocates tirelessly made the case that their health conditions
stemmed from exposure to contaminated water from wells at the base. The wells eventually were shut down the mid1980s. The law was unusual in that it also mandated reimbursement of expenses related to the 15 qualifying conditions
for eligible family members who resided at Camp Lejeune during the period of contamination, although those benefits
don’t begin until all other health insurance is applied. “This bill ends a decade-long struggle for those who serve at
Camp Lejeune,” President Barack Obama said during the signing of the bill. Still, while that law provides healthcare
at no cost for specific conditions, it did not necessarily qualify a veteran for any related disability compensation. The
VA now is working toward that.
Gavin Smith, founder of Civilian Exposure, a Camp Lejuene advocacy group, told U.S. Medicine that the recent
announcement is a “great step in the right direction” for veterans. Camp Lejeune veterans had faced a claims process
that was “loaded with red tape” when it came to filing a claim related to exposure to the water, he said, suggesting
presumptive status should ease the process. Still, he said he hopes that the “civilian folks that worked there aren’t left
behind.” While the Janey Ensminger Act applies to veterans and affected family members, he explained, it does not
cover other workers who were employed on the base and were exposed to the contaminated water. “That law does
nothing for them,” Smith said, adding that he would like to see legislation passed to help that group. “I don’t think
amending the 2012 law would be the answer. I think it is probably not the best way to go,” he noted, “I think there
may be another set of legislation needed for the rest of the community affected at the base.” [Source: "Veteran Issues
| Sandra Basu/Colonel Dan Cedusky | 13 Oct 2015 ++]
*********************************
Don’t Ask, Don't Tell Update 13
► Less than Honorable Discharge Appeals
An 80-year-old Buffalo veteran is now trying to clear his name, more than 50 years after being given a less-thanhonorable discharge from the military. Jim Estep served his country for 10 years. His only "transgression"? He was
found out to be gay. Estep of Buffalo loved his time flying as a Navy pilot. "There's that sense of exhilaration and
you're totally free," says Estep. Estep grew up in a coal mining town in West Virginia and graduated from the Naval
Academy in 1958. He became an attack pilot in the Navy. Scott Brown: "So you were one of those guys taking off
and landing on carriers right?" Jim Estep: "Yes. Under all kinds of circumstances, day night, hurricanes, big storms,
big waves didn't make any difference, we had a mission to accomplish.
Estep says he didn't hide his sexuality, and that no one is his squadron made an issue of it. "It didn't make any
difference in that we were all together to perform a mission. And that was what was important. So it really truly was
an unofficial policy of don't ask, don't tell," says Estep. But after six years as a pilot, a letter he had written to a gay
friend who was also in the military was discovered and turned over to Naval Intelligence. "They said they had a lot of
information and (asked me) what did I do and who did I meet and I told them nothing about men whose inclination I
was aware of. And they were not happy with that. And that's when I told them I was not happy in staying in the Navy
under these circumstances," says Estep.
Estep said he was forced to sign a false confession which stated that he had had a number of one night stands with
men, some of them in the military. And with that, his career and his service to his country was over. Despite a string
of exemplary fitness reports, Estep was given a less than honorable discharge, something surprisingly, he has accepted
without bitterness. "I broke a rule, I got caught and I paid the price for that, that was something I learned at the Naval
Academy," says Estep. Out of the military, Estep went back to school eventually receiving a doctorate in physiology.
He came to Buffalo in the late 1980s to teach at D'Youvile College.
Years ago, Estep applied to get to get his discharge changed to honorable, but it was denied based on that false
confession he had signed. The military's "don't ask, don't tell" policy was repealed five years ago, permitting openly
gay people to serve in the military. And now, Jim Estep retired and content with his life, wants to try once again to
clear his name. When asked, “What has prompted you at this point in your life to try and get this changed?" He
replied, "Well I'm starting my 80th year, so I want to get some loose ends wrapped up. Having a less than honorable
discharge on my record, is not satisfactory right now and I want to correct that and get it changed."
Local veterans interested in appealing their discharges can contact: Paul Romesser, Veterans Benefits Advisor,
NYS Division of Veterans' Affairs, 5583 Main Street, Williamsville, N.Y. 14221 Trl: (716) 632-4190 – Email:
paul.romesser@veterans.ny.gov. [Source: 2WGRZ.com | September 10, 2015 ++]
*********************************
Vet Federal Employment Update 09
► Vets Don't Stay Long
Almost half of the government employees hired last year were former service members, evidence that President Barack
Obama's push for the federal government to hire veterans is working. But those veterans don't stay long. The
Washington Post reported that one in three government workers is now a veteran, which shows federal agencies have
adhered to the president's wishes that veterans be given preference in hiring. Veterans who’ve joined the government
find it’s just too bureaucratic. They bristle at the resentment they feel from colleagues who know they went to the
head of the hiring queue. They acknowledge that they don’t always fit in: Just below the surface, deep culture clashes
in their offices simmer.
These are some of the issues at the root of why veterans don’t stay long in federal jobs, say former troops still
working in government and those who’ve quit. With new data out showing that veterans leave within two years on
average despite the Obama administration’s sustained efforts to hire them — a shorter average tenure than nonveterans at most agencies — we asked some of them why. Like non-veterans, former service members move on for a
variety of reasons, from better opportunities to relocation for family reasons. But veterans say a federal office cubicle
can be a bad fit after military service, with limited opportunities to advance.
“Some veterans will say, ‘I go to staff meetings with a pen and paper and I’m all about the mission,'” said Walter
Elmore, a drill instructor during the Vietnam War who set up an affinity group for veterans at the Department of
Housing and Urban Development. “Things don’t move that quickly in government. There’s a culture here that’s very
different from the culture our veterans are used to dealing with. Elmore said veterans suffer from a widespread
perception that they aren’t qualified for the jobs they got, since they benefit from preferential hiring for civil service
jobs. “People look at us in a very hostile way,” he said. “It’s a little bit of ‘Who do they think they are?’ When you
come into a place and you feel like you don’t fit, you say, it’s a good job, but I want a certain peace of mind.'”
As of fiscal 2014, 85 percent of veterans hired at HUD had left within two years, compared to 78 percent of nonveterans, according to new statistics compiled by the Office of Personnel Management on the biggest push to reward
military service since the draft ended in the 1970s. Only the Defense and State departments had kept more veterans
than non-veterans on board longer. Army Maj. Sean Gilfillan, 37, led soldiers during the U.S. invasion of Iraq and
was awarded a Bronze Star in 2004. Afterwards, he joined the State Department, serving a tour as a diplomat in
Warsaw handling public affairs and outreach. But he left in 2013 to devote his time to his company, which provides
entertainment for the armed forces. Many of his friends are leaving federal service too, he said — to start businesses,
work for nonprofits or find jobs where they are in control and there is high risk, because they’re drawn to that.
Gilfillan said he grew impatient with the sluggish pace of decision making in government and a lack of innovative
thinking. “You leave the military, where you spend a lot of time outside, traveling, doing important missions, etc.
Then you go work in a federal building. Boooooring. While he said he didn’t leave because it was boring, he said, “I
left because advancement is 95 percent based on tenure vs. merit and there is very little individual responsibility verses
the military.” He also said most veterans also are confident they can make more money in private industry.
As The Post reported last fall, non-veterans have their own frustrations and grievances with former troops. While
they’re welcomed in some federal offices as go-getters bringing new energy, their colleagues in the civil service say
that while veterans work hard, they rarely display independent thinking and often show blind deference to authority.
While OPM says it’s too early to draw conclusions from the numbers, advocates for veterans in government now are
very focused now on helping them stay put. Almost two dozen agencies with affinity groups have banded together to
help veterans think about developing their careers and find more leadership opportunities. “Veterans entering federal
service struggle to gain ready and consistent access to career development education and technical training beyond
their initial on-boarding and orientation training,” said John Angevine, a retired Army colonel now specializing in
veterans affairs for the Brookings Institution. Veterans are “often being told they have to ‘wait their turn’ for more
senior employees,” he said. He’s proposed that agencies authorize official time for veterans to use their GI Bill
education benefits for career-related education and training.
Sometimes the departures are not the government’s fault, veterans say. “It’s a two-way street and veterans don’t
always know how to describe their experience and skills from the military,” said Lloyd Calderon, who was in the Air
Force for 23 years and was hired in 2013 by the Small Business Administration, where he started an affinity group.
“They speak veteran,” Calderon said. “And we need to help them translate.” The SBA had the most trouble keeping
veterans in fiscal 2014, with just 62 percent staying two years or more, compared to 88 percent of non-veterans.
Calderon said many veterans at his agency feel they’re overqualified for their jobs. They’re frustrated by the slow pace
of advancement. Veterans with disabilities also complain that agencies are slow to accommodate their needs, Calderon
said.
Brandon Friedman, 37, worked in government twice, the first to start an office of digital media at the Department
of Veterans Affairs after commanding a platoon during the invasion of Iraq and receiving two Bronze Stars for his
service in that country and Afghanistan. After three years at VA, he was lured by a global corporate public relations
firm. Then he went to HUD for just 18 months as deputy assistant secretary for public affairs. In July, he left
government again to start his own PR firm with friends, The McPherson Square Group. Friedman said he was much
more comfortable in government because there were so many veterans. But he had higher-paying opportunities
outside, and being a veteran helped him land them. He said veterans “are used to bouncing around every three years
or so” when they’re reassigned, which may explain why many stay in government for relatively short periods:
“They’re used to that lifestyle.” [Source: Washington Post | Lisa Rein and Emily Wax-Thibodeaux | September 1,
2015 ++]
*********************************
Burn Pit Lawsuit Update 02
► Taxpayer’s to Pay KBR’s Legal Expenses
U.S. taxpayers will have to pay at least $30 million to cover attorney fees incurred by defense contractor KBR Inc.,
accused of wrongly exposing U.S. and British soldiers to dangerously toxic chemicals during a 2003 deployment to
Iraq duty in the Iraq War. A federal magistrate in Portland ruled 2 SEP that Oregon Army National Guard soldiers
will not have to pay the defense contractor's legal expenses. KBR filed a motion in June to recoup $850,000 from a
dozen of the more than 30 soldiers who accuse the company of causing them to become sick as they guarded a water
treatment plant in the oilfields of Iraq. The dust contained hexavalent chromium, which they say caused respiratory
illnesses and other health problems.
A jury in Portland's U.S. District Court found in favor of the vets in 2012, finding KBR negligent, and the panel
awarded a dozen of them $85 million. But last May, the 9th U.S. Circuit Court of Appeals threw out that verdict on
jurisdictional grounds. The following month, as lawyers for the soldiers prepared to transfer the case to Houston
(KBR's headquarters), the defense contractor's attorneys filed a motion seeking to recover their litigation costs. The
move sparked an immediate outcry from Democratic members of the Oregon congressional delegation; they were still
raising a stink about it on Wednesday when U.S. Magistrate Judge Paul Papak denied KBR's motion. KBR
immediately filed a motion to appeal Papak's opinion. "It's consistent with KBR's attitude toward the veterans that not
only would they pursue these fees, but also appealed their denial within hours of the judge's opinion," said Mike Doyle,
who represents the soldiers. [Source: The Oregonian | Bryan Denson | September 2, 2015 ++]
*********************************
Wounded Warrior Leave
► H.R.313 Signed Into Law
President Obama has signed into law the Wounded Warriors Federal Leave Act of 2015 sponsored by U.S. Rep.
Stephen Lynch aimed at giving federal workers who are also veterans extra time off to seek medical care. The new
law provides the employees with 104 hours of what Lynch calls "Wounded Warrior leave" during their first year in
the federal workforce so that they can seek medical treatment for service-connected disabilities without being forced
to take unpaid leave or forego their appointments. The Massachusetts Democrat said getting the proposal to Obama's
desk was a bipartisan effort. The measure passed the House unanimously on 28 SEP and then passed the Senate, also
unanimously, on 26 OCT. Lynch said the new law reflects Congress' gratitude and appreciation for the hardship and
sacrifices made by veterans. [Source: The Associated Press | November 8, 2015 ++]
*********************************
VA Medical Marijuana Update 15
► Veterans Equal Access Amendment
Legislation passed 10 NOV by the Senate includes a provision (formerly H.R.667) that would allow VA doctors to
recommend medical marijuana to patients in states where it is legal. Some veterans groups have pressed Congress for
years to allow the drug for patients suffering from post-traumatic stress disorder. The so-called Veterans Equal Access
Amendment would do so and was sponsored by Sens. Steve Daines (R-MT) and Jeff Merkley (D-OR). In a statement,
Daines noted that the provision "does not change current laws preventing the possession or dispensing of marijuana
on VA property, but simply allows veterans to discuss all options that are legally available in their state with their VA
doctor." Michael Collins, deputy director of national affairs for the Drug Policy Alliance, welcomed the move.
"Veterans in medical marijuana states should be treated the same as any other resident, and should be able to discuss
marijuana with their doctor," he said. "It makes no sense that a veteran can’t use medical marijuana if it helps them
and it is legal in their state."
The provision was inserted into the Military and Veterans Construction bill, which the upper chamber unanimously
passed. Similar language was included in legislation introduced in the House of Representatives in February by Rep.
Earl Blumenauer, D-Oregon, but it has stalled in committee. The VA concedes that some veterans use medical
marijuana to relieve PTSD symptoms but questions its effectiveness and suggests the practice might actually be
harmful. "Controlled studies have not been conducted to evaluate the safety or effectiveness of medical marijuana for
PTSD," states a report by Marcel O. Bonn-Miller, Ph.D. and Glenna S. Rousseau, Ph.D. "Thus, there is no evidence
at this time that marijuana is an effective treatment for PTSD. In fact, research suggests that marijuana can be harmful
to individuals with PTSD." The federal government last year approved a study on medical marijuana to be conducted
by the Multidisciplinary Association for Psychedelic Studies, a California-based nonprofit research center. But the
testing has been delayed over the supply of approved marijuana and a change in testing sites, MAPS spokesman Brad
Burg told Military.com in April. [Source: Military.com | Bryant Jordan | November 11, 2015 ++\
*********************************
Agent Orange Extension Act
► Time is Running Out | H.R.4323
Congressman Tim Walz (MN) recently introduced the FRA-supported “Agent Orange Extension Act,” (H.R. 3423)
which would extend by two years the original sunset deadline of the Agent Orange Act of 1991 to ensure that Vietnam
veterans exposed to Agent Orange receive just compensation and care. The Act expires on September 30, 2015 and
the legislation would extend the sunset to September 30, 2017. FRA warned the House and Senate Veterans Affairs
Committees regarding the sunset of the Act during its March 18, 2015 testimony.
The Agent Orange Act of 1991 (AOA) established a presumption of service connection for diseases associated
with Agent Orange exposure, relieving Vietnam veterans from the burden of providing evidence that their illness was
a result of military service. This law directs the National Academy of Sciences (NAS) to periodically research and
review diseases that might be associated with Agent Orange exposure. The VA is required to add diseases the NAS
finds to have a positive association to Agent Orange exposure to the VA’s list of presumptive service connected
diseases.
Since the enactment of the AOA, the NAS has issued reports that have led to the presumption of service connection
for diseases such as Parkinson’s, B-cell leukemia and early onset peripheral neuropathy. Without these studies,
thousands of Vietnam era veterans would have gone without the benefits they greatly deserve.
If the AOA expires before the final report is issued, the VA would no longer be obligated to review the NAS report
or add any new diseases to the presumption of service list, in the process denying thousands of veterans their right to
compensation. Veterans are urged to use the FRA Action Center’s preformatted editable message at
http://capwiz.com/fra/issues/alert/?alertid=67677626&queueid=10976908306 to ask their Representative to support
this important legislation. [Source: FRA Making Waves | September 1, 2015 ++]
*********************************
Vet Bills Submitted to 114th Congress
► 150901 thru 151114
Refer to this Bulletin’s “House & Senate Veteran Legislation” attachment for a listing of Congressional bills of
interest to the veteran community introduced in the 114 th Congress. The list contains the bill’s number and name,
what it is intended to do, it’s sponsor, any related bills, and the committees it has been assigned to. Support of these
bills through cosponsorship by other legislators is critical if they are ever going to move through the legislative process
for a floor vote to become law. A good indication of that likelihood is the number of cosponsors who have signed
onto the bill. Any number of members may cosponsor a bill in the House or Senate. At https://beta.congress.gov you
can review a copy of each bill’s content, determine its current status, the committee it has been assigned to, and if
your legislator is a sponsor or cosponsor of it by entering the bill number in the site’s search engine. To determine
what bills, amendments your representative/senator has sponsored, cosponsored, or dropped sponsorship on go to:
https://beta.congress.gov/search?q=%7B%22source%22%3A%5B%22legislation%22%5D%7D,
Select
the
‘Sponsor’ tab, and click on your congress person’s name. You can also go to http://thomas.loc.gov/home/thomas.php.
Grassroots lobbying is the most effective way to let your Congressional representatives know your wants and
dislikes. If you are not sure who is your Congressman go to https://beta.congress.gov/members. Members of Congress
are receptive and open to suggestions from their constituents. The key to increasing cosponsorship support on veteran
related bills and subsequent passage into law is letting legislators know of veteran’s feelings on issues. You can reach
their Washington office via the Capital Operator direct at (866) 272-6622, (800) 828-0498, or (866) 340-9281 to
express your views. Otherwise, you can locate their phone number, mailing address, or email/website to communicate
with a message or letter of your own making at either:
http://www.senate.gov/general/contact_information/senators_cfm.cfm
http://www.house.gov/representatives
FOLLOWING IS A SUMMARY OF VETERAN RELATED LEGISLATION INTRODUCED IN THE
HOUSE SINCE THE LAST BULLETIN WAS PUBLISHED
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H.R.3471 : Veterans Mobility Safety Act of 2015. A bill to amend title 38, United States Code, to make
certain improvements in the provision of automobiles and adaptive equipment by the Department of Veterans
Affairs.
H.R.3484 : Los Angeles Homeless Veterans Leasing Act of 2015. A bill to authorize the Secretary of
Veterans Affairs to enter into certain leases at the Department of Veterans Affairs West Los Angeles Campus
in Los Angeles, California, and for other purposes.
H.R.3499 : Veteran Disability Rating Parity Act. A bill to amend titles II and XVI of the Social Security
Act to provide for treatment of disability rated and certified as total by the Secretary of Veterans Affairs as
disability for purposes of such titles.
H.R.3547 : Lawrence J. Hackett Jr. Vietnam Veterans Agent Orange Fairness Act. A bill to direct the
Secretary of Veterans Affairs to establish a task force on Agent Orange exposure.
H.R.3549 : VA Billing Accountability Act. A bill to amend title 38, United States Code, to authorize the
Secretary of Veterans Affairs to waive the requirement of certain veterans to make copayments for hospital
care and medical services in the case of an error by the Department of Veterans Affairs, and for other
purposes.
H.R.3588 : Guaranteed 3 Percent COLA for Seniors Act of 2015. A bill to require the establishment of
a Consumer Price Index for Elderly Consumers to compute cost-of-living increases for Social Security
benefits under title II of the Social Security Act and to provide, in the case of elderly beneficiaries under such
title, for an annual cost-of-living increase which is not less than 3 percent.
H.R.3590 : Halt Tax Increases on the Middle Class and Seniors Act. A bill to amend the Internal Revenue
Code of 1986 to repeal the increase in the income threshold used in determining the deduction for medical
care.
H.R.3596 : Department of Veterans Affairs Expiring Authorities Act of 2015. A bill to amend title 38,
United States Code, to extend certain expiring provisions of law administered by the Secretary of Veterans
Affairs, and for other purposes.
H.R.3639 : Veterans Access to Care Act. A bill to amend the Public Health Service Act to designate certain
medical facilities of the Department of Veterans Affairs as health professional shortage areas, and for other
purposes.
H.R.3686 : Veterans Care and Reporting Enforcement Act. A bill to direct the Inspector General of the
Department of Veterans Affairs to make certain reports publicly available and for other purposes.
H.R.3709 : Helping our Rural Veterans Receive Health Care Act. A bill to make permanent the pilot
program administered by the Secretary of Veterans Affairs regarding enhanced contract care authority for
the health care needs of veterans located in highly rural areas, and for other purposes.
H.R.3739 : Veterans' Expanded Trucking Opportunities Act. A bill to provide for qualified physicians
to perform a medical certification for an operator of a commercial motor vehicle who is a veteran, and for
other purposes.
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H.R.3789 : Honor Our Fallen Heroes Act of 2015. A bill to amend title 38, United States Code, to direct
the Secretary of Veterans Affairs to furnish a memorial headstone or marker to commemorate an eligible
individual whose remains are identified and available but the location of the gravesite is unknown.
H.R.3849 : Acupuncture for Heroes and Seniors Act of 2015. A bill to amend title 10, United States
Code, to ensure access to qualified acupuncturist services for military members and military dependents, to
amend title 38, United States Code, to ensure access to acupuncturist services through the Department of
Veterans Affairs, to amend title XVIII of the Social Security Act to provide for coverage of qualified
acupuncturist services under the Medicare program; to amend the Public Health Service Act to authorize the
appointment of qualified acupuncturists as officers in the commissioned Regular Corp and the Ready Reserve
Corps of the Public Health Service, and for other purposes.
H.R.3870 : Atomic Veterans Healthcare Parity Act. A bill to amend title 38, United States Code, to
provide for the treatment of veterans who participated in the cleanup of Enewetak Atoll as radiation
exposed veterans for purposes of the presumption of service-connection of certain disabilities by the
Secretary of Veterans Affairs.
H.R.3879 : Enhanced Veteran Healthcare Act of 2015. A bill to amend title 38, United States Code, to
provide for covered agreements and contracts between the Secretary of Veterans Affairs and eligible
academic affiliates for the mutually beneficial coordination, use, or exchange of health-care resources, and
for other purposes.
H.R.3883 : Veteran's Choice Accountability Act. A bill to improve the provision of health care by the
Department of Veterans Affairs, and for other purposes.
H.R.3884 : Veterans Collaboration Act. A bill to direct the Secretary of Veterans Affairs to carry out a
pilot program to promote and encourage collaboration between the Department of Veterans Affairs and
nonprofit organizations and institutions of higher learning that provide administrative assistance to
veterans.
H.R.3885 : Veterans Affairs Transfer of Information and sharing of Disability Examination
Procedures with DOD Doctors Act. A bill to amend title 10, United States Code, to include a single
comprehensive disability examination as part of the required Department of Defense physical examination
for separating members of the Armed Forces, and for other purposes.
H.R.3909 : Veterans Health and Accountability Act. A bill to amend the Veterans Access, Choice, and
Accountability Act of 2014 to expand the Veterans Choice Program, to amend title 38, United States Code,
to provide for the removal or demotion of employees of the Department of Veterans Affairs based on
performance or misconduct, and for other purposes.
H.R.3936 : Veteran Engagement Team Event Pilot Program. A bill to direct the Secretary of Veterans
Affairs to carry out a pilot program under which the Secretary carries out Veteran Engagement Team
events where veterans can complete claims for disability compensation and pension under the laws
administered by the Secretary, and for other purposes.
H.R.3951 : VA Office of Health Care Quality. A bill to establish in the Veterans Health Administration
of the Department of Veterans Affairs the Office of Health Care Quality.
H.R.3954 : Camp Lejeune Reserve Component VA Medical Services. To amend title 38, United States
Code, to provide for access to hospital care and medical services furnished by the Department of Veterans
Affairs for certain members of the reserve components who received training at Camp Lejeune, North
Carolina, and for other purposes.
H.R.3958 : Veterans Health Care Stamp. A bill to provide for the issuance of a Veterans Health Care
Stamp.
H.R.3960 : Homeless Female Vet Survey. To provide for a survey regarding homeless female veterans,
and for other purposes.
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H.R.3963 : Purple Heart Vet’s Commissary/Exchange Privilege. To amend title 10, United States
Code, to extend military commissary and exchange store privileges to certain veterans who have been
awarded the Purple Heart and to their dependents.
H.R.3970 : Abandoned Homes Renovation for Homeless Vets. A bill to direct the Secretary of Veterans
Affairs to establish a pilot grant program to acquire and renovate abandoned homes for homeless veterans.
H.R.3972 : Suicidal Vet Mental Health Services Enhancement. A bill to direct the Secretary of
Defense and the Secretary of Veterans Affairs to more effectively provide mental health resources for
members of the Armed Forces and veterans at high risk of suicide, and for other purposes.
H.R.3974 : VA Physician Assistant Vet Training Educational Assistance. A bill to require the
Secretary of Veterans Affairs to carry out a pilot program to provide educational assistance to certain
former members of the Armed Forces for education and training as physician assistants of the Department
of Veterans Affairs, to establish pay grades and require competitive pay for physician assistants of the
Department, and for other purposes.
H.R.3975 : First-Time Vet Homebuyers Tax Credit. A bill to amend the Internal Revenue Code of 1986
to allow a credit for veteran first-time homebuyers and for adaptive housing and mobility improvements for
disabled veterans, and for other purposes.
H.R.3980 : Eliminate Veterans Choice Program Sunset Date. A bill to eliminate the sunset date for the
Veterans Choice Program of the Department of Veterans Affairs, to expand eligibility for such program,
and for other purposes.
H.R.3989 : Vet Caregiver Benefits Eligibility. A bill to amend title 38, United States Code, to improve
the process for determining the eligibility of caregivers of veterans to certain benefits administered by the
Secretary of Veterans Affairs.
FOLLOWING IS A SUMMARY OF VETERAN RELATED LEGISLATION INTRODUCED IN THE
SENATE SINCE THE LAST BULLETIN WAS PUBLISHED
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S.1955 : Alaska Native Veterans Land Allotment Equity Act. A bill to amend the Alaska Native Claims
Settlement Act to provide for equitable allotment of land to Alaska Native veterans.
S.1982 : Korean War Veterans Memorial Wall of Remembrance Act of 2015. A bill to authorize a Wall
of Remembrance as part of the Korean War Veterans Memorial and to allow certain private contributions to
fund the Wall of Remembrance.
S.1991 : Permanent Department of Veterans Affairs Choice Card Act of 2015. A bill to eliminate the
sunset date for the Choice Program of the Department of Veterans Affairs, to expand eligibility for such
program, and for other purposes.
S.2000 : Veterans Access to Long Term Care and Health Services Act. A bill to amend title 38, United
States Code, to allow the Secretary of Veterans Affairs to enter into certain agreements with non-Department
of Veterans Affairs health care providers if the Secretary is not feasibly able to provide health care in facilities
of the Department or through contracts or sharing agreements, and for other purposes.
S.2013 : VA West Los Angeles Campus Leasing Authority. A bill to authorize the Secretary of Veterans
Affairs to enter into certain leases at the Department of Veterans Affairs West Los Angeles Campus in Los
Angeles, California, and for other purposes.
S.2052 : Department of Veterans Affairs Billing Accountability Act of 2015. A bill to amend title 38,
United States Code, to authorize the Secretary of Veterans Affairs to waive the requirement of certain
veterans to make copayments for hospital care and medical services in the case of an error by the Department
of Veterans Affairs, and for other purposes.
S.2062 : VARO Manila Operation Extension. A bill to amend title 38, United States Code, to extend
authority for operation of the Department of Veterans Affairs Regional Office in Manila, the Republic of the
Philippines.
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S.2081 : VA Presumption Of Service Connection for Exposure to Herbicide Agents Extension. A bill
to amend title 38, United States Code, to extend authorities for the Secretary of Veterans Affairs to expand
presumption of service connection for compensation for diseases the Secretary determines are associated
with exposure to herbicide agents, and for other purposes.
S.2082 : Department of Veterans Affairs Expiring Authorities Act of 2015. A bill to amend title 38,
United States Code, to extend certain expiring provisions of law administered by the Secretary of Veterans
Affairs, and for other purposes.
S.2106 : VA VOCHAB Action Plan Development. A bill to require the Secretary of Veterans Affairs to
develop and publish an action plan for improving the vocational rehabilitation services and assistance
provided by the Department of Veterans Affairs, and for other purposes.
S.2120 : Veterans Justice Outreach Act of 2015. A bill to amend title 38, United States Code, to require
the Secretary of Veterans Affairs to carry out a program to support veterans in contact with the criminal
justice system by discouraging unnecessary criminalization of mental illness and other nonviolent crimes,
and for other purposes.
S.2170 : Veterans E-Health and Telemedicine Support Act of 2015. A bill to amend title 38, United
States Code, to improve the ability of health care professionals to treat veterans through the use of
telemedicine, and for other purposes.
S.2175 : Department of Veterans Affairs Provider Equity Act. A bill to amend title 38, United States
Code, to clarify the role of podiatrists in the Department of Veterans Affairs, and for other purposes.
S.2179 : Veteran CARE Act. A bill to amend title 38, United States Code, to allow the Secretary of
Veterans Affairs to enter into certain agreements with non-Department of Veterans Affairs health care
providers if the Secretary is not feasibly able to provide health care in facilities of the Department or through
contracts or sharing agreements, and for other purposes.
S.2210 : Veteran Partners' Efforts to Enhance Reintegration Act. A bill to require the Secretary of
Veterans Affairs to carry out a program to establish peer specialists in patient aligned care teams at medical
centers of the Department of Veterans Affairs, and for other purposes.
S.2229 : Veterans Scheduling Accountability Act. A bill to require the Comptroller General of the United
States to conduct audits relating to the timely access of veterans to hospital care, medical services, and other
health care from the Department of Veterans Affairs.
S.2265 : Improve Rural Area VA Health Care. A bill to improve the provision of health care by the
Department of Veterans Affairs to veterans in rural and highly rural areas, and for other purposes.
S.2279 : VA Health Care Worker (Vet) Recruitment. A bill to require the Secretary of Veterans
Affairs to carry out a program to increase efficiency in the recruitment and hiring by the Department of
Veterans Affairs of health care workers that are undergoing separation from the Armed Forces, to create
uniform credentialing standards for certain health care professionals of the Department, and for other
purposes.
[Source: https://beta.congress.gov & http: //www.govtrack.us/congress/bills November 14, 2015 ++]
Military Separation Pay
► Pay Back Provision
Stephen, a Marine Corps staff sergeant, agreed to leave service a few years ago when the Corps offered him
voluntary separation pay in an effort to trim its personnel ranks. They gave him about $80,000 to leave, and at the
time it seemed like a good deal. The money helped him buy a house in Texas and get started with a job as a financial
planner. But now the government wants that money back. That's because Stephen, who asked to be identified by his
first name only, recently went to the Veterans Affairs Department and secured an 80 percent disability rating for a
combination of post-traumatic stress, tinnitus and a jaw problem. The VA said he's due an $1,800 monthly stipend.
But the VA won't send him any checks until 2018 because federal law requires veterans to pay back any separation
pay received before becoming eligible for disability benefits.
"I wasn't aware of that, and that could have changed my decision altogether" about whether to accept the
voluntary separation pay in the first place, Stephen said. The 30-year-old former platoon sergeant, who deployed
twice to Iraq, is now battling bureaucracy at the Pentagon and the VA in an effort to keep the money, which he has
already spent. About 17,000 troops each year have been granted involuntary separation pay in 2014 and 2015,
mostly soldiers and Marines, according to Pentagon data. Thousands of such vets likely face recoupment of
separation pay, although the VA was unable to say precisely how many veterans currently have benefits blocked for
this reason. And getting any relief from the Pentagon or the VA will be an uphill battle because the payback
requirement is written into federal law. Specifically, the law affects both voluntary and involuntary separation pay.
VA payments are withheld, or offset, until the full amount of separation pay is repaid. In the case of voluntary
separation pay, the law allows the military service secretaries to waive the debt, but such waivers are rare.
It's a common subject for complaints, said Claire Lawless, a veterans transition manager with the Washingtonbased advocacy group Iraq and Afghanistan Veterans of America. "I've definitely seen a slew of veterans come in in
need of financial assistance, usually related to housing or school or something, and they are reaching out because
they got the disability rating they were expecting, but then were told that you have to basically wait until you've
quote-unquote 'paid off your severance,' " Lawless said. "Being told that you won't get the money that you thought
you were relying on is incredibly disheartening," she went on. "And really debilitating because if you lose your
housing, everything starts to fall apart. "Most of them tell me they had no idea this was going to happen. I don't
think it's properly communicated by DoD that when you separate, this will impact your ability to receive benefits
down the line." Some veterans have successfully appealed the debt and had it reduced after proving an urgent
financial hardship. But the bureaucratic process for that is complex and cumbersome and veterans usually need to
contact their congressional representative to serve as their advocate, Lawless said. "The VA , the DoD, these are
bureaucracies ... and going in and battling a bureaucracy on your own without a lot of understanding is challenging
and its helps to have somebody in your corner," Lawless said. IAVA supports veterans in that process through its
Rapid Response Referral Program. The law potentially affects thousands of troops who were forced to separate
recently by their service's "up-or-out" rules.
For example, Shane Collins, a 13-year Marine who was passed over for promotion to staff sergeant last year, was
involuntarily separated in March. Collins received about $46,000 in involuntary separation pay, more specifically a
check for about $33,000 after taxes. He moved back to Twin Falls, Idaho, and used the money to pay off some bills,
buy his wife Amanda a car and set up a home purchased with a VA-backed loan. In May, the VA awarded him a 70percent disability rating due to post-traumatic stress and some hearing loss. That should warrant a $1,300 monthly
benefit. But the VA told him his payments won't start until mid-2017 because he received the military separation
pay. Collins, now 32, has struggled to find work and worries he might fall behind on his $895 monthly mortgage
payment. He has complained to the VA but was told that receiving separation pay and disability benefits is akin to
"double dipping."
Collins strongly disagrees. "It's completely two different areas," he said. "Your involuntary separated, you're
given that amount of money because you were denied reenlistment, and it helps you to transition back to civilian
live." Collins said he does not recall anyone from the Marine Corps telling him that the separation pay might need to
be paid back. Lawless said she has heard that refrain before. "I think the term 'paying back' is very confusing for
people because it doesn't seem like something they should have to pay back," she said. "They seem like two very
separate things — your disability pay and your separation pay. I think that is what's frustrating because it doesn't
seem like it should be coming from the same pot." [Source: MilitaryTimes | Andrew Tilghman, Staff | October 18,
2015 ++]
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Military Compensation Update 05
► History Repeating
President Obama sent a disappointing letter to Congressional leaders last week stating that he plans to use his executive
authority to cap military pay for the third consecutive year. In 2014 and 2015, pay raises were capped at 1 percent.
The president intends to cap 2016 pay raises at 1.3 percent, instead of the 2.3 percent raise called for by law. The
troops’ last four raises averaged less than 1.4 percent, with the FY14 and FY15 pay raises being the lowest in 50 years.
In his letter, Obama said that he is, “strongly committed to supporting our uniformed service members, who have
made such great contributions to our Nation over the past decade of war.” However, he insisted that this move is
necessary to, “maintain efforts to keep our Nation on a sustainable fiscal course.”
DoD leadership came out in support of the president’s announcement, insisting that the pay cap is needed to support
modernization and training. Several years of capping pay below private sector wage growth took place during the
1980’s and 90’s, until servicemembers faced a 13.5 percent pay gap. Because recruitment and retention ultimately
suffered, Congress spent a decade trying to fix the issue by providing pay raises above the Employment Cost Index
(ECI). After coming within 2.5 percent of pay parity in 2013, DoD and Congress considered the issue resolved. Now
it looks like all of the hard work Congress did is unwinding. A third year of pay caps expands the difference between
pay in the military and private sector to 5 percent. And with four more years of DoD-proposed caps, it will get much
worse.
Three years of pay caps really add up. An E-5 with ten years of service will receive about $976 less annually. For
an O-3 with 10 years, it will be about $1,870. “Although Congress and the administration are under pressure from
budget restrictions, this is incredibly disappointing,” said MOAA Director of Government Relations, Col Mike
Hayden, USAF (Ret). “Past experience with capping military raises below private sector pay growth has shown that
once pay raise caps begin, they continue until they undermine retention and readiness of the all-volunteer force.”
Military pay comparability only works when it’s sustained through both good and bad budget times. [Source: MOAA
Leg Up | September 4, 2015 ++]
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Women in Combat Update 01
► Most Combat Jobs Likely to Open
Adm. Jonathan Greenert, the Navy's top officer, says the service plans to open its elite SEAL teams to women who
can pass the training regimen. In an interview with the publication Defense News, Greenert said he and Rear Adm.
Brian Losey, head of Naval Special Warfare Command, believe that women should be allowed to serve as SEALs if
they can pass the six-month Basic Underwater Demolition/SEAL training. "Why shouldn't anybody who can meet
these (standards) be accepted? And the answer is, there is no reason," Greenert told Defense News on 18 AUG. "So
we're on a track to say, 'Hey, look, anybody who can meet the gender-nonspecific standards, then you can become a
SEAL.' " Greenert didn't specify a timeline for allowing women into SEAL training.
The move to integrate the SEALs comes after a comprehensive review led by Losey that recommended women be
allowed under the same standards required of male candidates. Earlier that week, two women passed the Army's
grueling Ranger test, and other military services are poised to let women serve in most front-line combat jobs,
including special operations forces, senior officials told The Associated Press on Tuesday. Based on early talks,
officials say the Army and Air Force are unlikely to seek exceptions that close jobs to women. Marine Corps leaders,
they say, have expressed concerns about allowing women to serve in infantry jobs and yet may seek an exception. The
services are wrapping up reviews and must make their recommendations to Defense Secretary Ash Carter this fall.
The officials spoke with the AP on condition of anonymity because they were not authorized to discuss the internal
debate.
Even if Marine leaders object, they are likely to meet resistance from senior Navy and Defense Department officials
who want the military to be united on this issue. Undercutting the Marines' reservations is that Special Operations
Command is likely to allow women to compete for the most demanding military commando jobs - including the
SEALs and the Army's Delta Force - though with the knowledge that it may be years before women even try to enter
those fields. Women have been steadily moving into previously all-male jobs across the military, including as
members of the Army's 160th Special Operations Aviation Regiment, best known as the helicopter crews that flew
Virginia Beach-based Navy SEALs into Osama bin Laden's compound. Women are also now serving on Navy
submarines and in Army artillery units.
Friday will mark another milestone as two women graduate at Fort Benning, Ga., from the Army Ranger School,
a physically and mentally demanding two-month combat leadership course. Completing the course lets the two women
wear the coveted Ranger black-and-gold tab, but it does not let them become members of the Ranger regiment. Neither
woman has been publicly identified by the military. Longer term, the uncertainty of the Marine decision underscores
the wrenching debates going on within the military over the changing role of women, and it reflects the individual
identities of the services and how they view their warrior ethos. Only a handful of jobs in the Navy and Air Force are
closed to women. Last year, the Navy considered seeking an exception that would have prohibited women from
serving on older guided missile frigates, mine-countermeasure ships and patrol coast craft. Some argued that those
ships, which are due to be phased out in coming years, would need millions of dollars in construction to add facilities
for women, and it wasn't worth the expense. Navy Secretary Ray Mabus withdrew that plan in a memo late last month
that was obtained by the AP. Officials said Navy leaders concluded that since women can serve in all the same jobs
on other ships, no real exclusion existed.
The Army and Marine Corps, however, have thousands of infantry, artillery and armor jobs that are closed to
women. There has been a lot of study and debate over whether to open those positions because they often involve
fighting in small units on the front lines, doing physically punishing tasks. The Marine Corps set up a task force this
year to set gender-neutral job standards and determine whether incorporating women into small squads affected unit
cohesion or combat readiness. Army leaders did similar scientific analysis, reviewing all tasks needed to do the combat
jobs and have been creating gender-neutral standards that troops will have to meet to qualify. In recent days, officials
familiar with the discussions said they believe the Army will allow women to seek infantry and armor jobs as well.
[Source: AP & The Virginian-Pilot | TREA News for the Enlisted | September 1, 2015 ++]
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Women in Combat Update 02
► Time To Do Something About It
In the coming weeks, the service chiefs will likely cite reams of data to support their positions on whether to lift
restrictions on women serving in combat jobs. A couple things will be hard to miss:
 More than 9,000 female troops have earned Combat Action Badges during modern combat operations,
including those in Iraq and Afghanistan, and hundreds more have earned valor awards, including the Silver
Star, the Army's third-highest valor award.
 Advocates of lifting the restrictions argue that existing data show women are already serving in combat and
lifting the restrictions would only be recognizing that reality to allow them to prove they can meet the
standards for currently closed billets and receive the training they need.
 Opponents argue that imposing major social and cultural changes on the military would be fraught with risk
in an era of increasing global threats and cite statistics showing that women suffer injuries at twice the rate
of men in training.
At his Aug. 20 Pentagon news conference, Defense Secretary Ashton Carter restated the policy that has been in
effect since then-Defense Secretary Leon Panetta announced in January 2013 that all military occupational specialties
would be open to women unless the services argued for an exception. "Approximately 110,000 ground combat
positions have been opened to women since then, and the Department's policy is that all ground combat positions will
be open to women, unless rigorous analysis of factual data shows that the positions must remain closed," Carter said.
Some 200,000 combat positions remain closed to female troops. "On October 1st, the services will provide a report
to the Chairman requesting any exception to this policy, and I'll review the services recommendation and make a final
determination on that issue by the end of this year."
Carter spoke after placing a congratulatory phone call to the first women to pass the demanding 62-day Army
Ranger School – Army Capt. Kristen Griest and Army 1st Lt. Shaye Haver. "I take special satisfaction in the strides
like this," Carter said of the two women Ranger School graduates. He stressed that the service chiefs will now have
to make the case for a "justification for any -- if there are any -- exceptions" to the general rule to open billets. At
present:
 More than 214,000 women now serve in the military, account for about 14.5 percent of the force. The Marine
Corps has the lowest percentage – slightly less than 7 percent.
 More than 280,000 women have served in Iraq and Afghanistan.
 As of April 2015, 161 women have lost their lives and 1,015 had been wounded in action as part of Global
War on Terror (GWOT) operations" since the 9/11 terror attacks, according to the Congressional Research
Service (CRS). The Army alone reported 89 women killed in the line of duty in Iraq and 36 in Afghanistan.
 In modern combat operations, over 9,000 women have received Army Combat Action Badges for ‘actively
engaging or being engaged by the enemy,'" the CRS said.
 Through 2012, the Army reported that 437 women earned awards for valor to include two Silver Stars, three
Distinguished Flying Crosses, 31 Air Medals, and 16 Bronze Stars.
In releasing the report, then-Army Chief of Staff Gen. Ray Odierno said "It should be clear to all that women are
a major force in operations today. We're not starting from the ground up in the assessment period" on whether women
should serve in combat. "Women are integral in all theaters of combat as we speak." In some instances, the women
earning awards for valor led men in firefights. Then-Army Capt. Kellie McCoy, a West Point graduate, earned the
Bronze Star with "V" device for her actions on Sept. 18, 2003, for leading 11 male paratroopers from the 82nd
Airborne Division in breaking up an enemy ambush between Fallujah and Ramadi in Iraq's Anbar province. Her
citation said that "Capt. McCoy willingly and repeatedly took action to gather up her soldiers under enemy fire and
direct fire at the enemy. Her actions inspired her men to accomplish the mission and saved the lives of her fellow
soldiers."
In other instances, women have performed valiantly in combat under commanders well aware of the restrictions
who had no recourse under fire. In April 2007 in Afghanistan's Paktika province, then-Pfc. Monica Brown, an 18year-old Army medic from Lake Jackson, Texas, grabbed her kit and raced through enemy fire to save soldiers trapped
in a burning Humvee. She later received the Silver Star, the nation's third-highest award for valor, in a ceremony
presided over by then-Vice President Dick Cheney. "We weren't supposed to take her out" on missions "but we had
to because there was no other medic," Lt. Martin Robbins, a platoon leader with Charlie Troop, 4th Squadron, 73rd
Cavalry Regiment, later told the Washington Post "By regulations you're not supposed to," Robbins said, but Brown
"was one of the guys, mixing it up, clearing rooms, doing everything that anybody else was doing."
Those who oppose lifting the 1994 restrictions on women in the infantry, armor, artillery and Special Operations
cited statistics showing alarmingly higher injury rates for women, and artillery participating in the tests and
assessments currently being conducted by the services. The Army's Institute of Public Health reported that in basic
combat training, approximate average injury rates for women were 114 percent higher than those for men. In training
for engineers and military police, they were 108 percent higher, according to documents obtained by the Center for
Military Readiness headed by Elaine Donnelly, a frequent critic of social and cultural changes in the military.
Critics also cite the recent remarks at the Aspen Security Forum in Colorado of retired Navy Adm. Eric Olson,
head of the Special Operations Command from 2007-11 and the former top SEAL. "I think that we are only having
part of the discussion on women in combat," Olson said. "I think that we need to ask ourselves as a society if we are
willing to put women in front-line combat units to take the first bullet on target." Olson continued: "Are we willing to
cause every 18-year-old girl to sign up for selective service? Are we willing to cause women to serve in infantry units
against their will as we do men?" The Congressional Research Service summed up the arguments:
 "Those in favor of keeping restrictions cite physiological differences between men and women that could
potentially affect military readiness and unit effectiveness. Some also argue that social and cultural barriers
exist to the successful integration of women into combat occupations and all-male units."
 "Those who advocate for opening all military occupations to women emphasize equal rights and arguing it
is more difficult for service members to advance to top-ranking positions in the armed services without
combat experience. In their view, modern weapons have equalized the potential for women in combat since
wars are less likely to be fought on a hand-to-hand basis."
When the service chiefs send their findings to Carter late next month, Marine Gen. Joseph Dunford will be the first
to report and the most closely watched. The Marines are considered by some the most tradition-bound and resistant to
change of the services. According to Marine officials, Dunford, now the Marine Commandant, has committed to
sending the Marines' report to Carter before he is succeeded on Sept. 24 by Marine Gen. Robert Neller. Dunford will
take over in October as the new Joint Chiefs Chairman from retiring Army Gen. Martin Dempsey.
As JCS Chairman, Dempsey stood next to then-Defense Secretary Panetta when Panetta announced in January
2013 that the restrictions were being lifted unless the services asked for exceptions. At the Pentagon news conference,
Dempsey cited an anecdote from his own experience in taking over command of the 1st Armored Division in Iraq in
2003 as the insurgency gathered strength. On a trip outside his headquarters, Dempsey introduced himself to the crew
of his Humvee. "I slapped the turret gunner on the leg and I said, 'Who are you?' And she leaned down and said, I'm
Amanda.' And I said, 'Ah, OK,'" Dempsey said. "So, female turret-gunner protecting division commander. It's from
that point on that I realized something had changed, and it was time to do something about it," Dempsey said. [Source:
Military.com | Richard Sisk | August 31, 2015 ++]
*********************************
Space "A" Travel Update 19
► Dependent CONUS Travel Approved
Without any fanfare, on 9 June 2015, the eligibility requirements to use Space A travel within the Continental United
States (CONUS) were extended to include the dependents of service members who are deployed for 30 days or longer.
This is going to be a great benefit for families who might want to travel during deployment and can use Space A to
cut costs. Many years ago, spouses and children were not able to use Space A travel benefits within CONUS except
under very limited circumstances such as emergency leave and TDY for house hunting. In recent years, the rules have
been revised a few times to include dependents whose service member was deployed for a specified period of time.
This recent change, to 30 days deployment for eligibility, represents the most generous CONUS Space A benefits to
date. Dependents gaining their Space-A eligibility due to service member deployment will be Category IV in priority.
Those requesting travel will require a memo detailing their eligibility, and a sample memo can be found at the AMC
website http://www.amc.af.mil/shared/media/document/AFD-150625-025.pdf . This definitely requires a little preplanning to have the eligibility memo before you start the travel process. Unfortunately this change only applies to
dependents of active duty members. [Source: NAUS Weekly Update | Watchdog | September 4, 2015 ++]
*********************************
Medicare Premiums Update 01 | 2016
► Official Part B Rates Released
Medicare released the official 2016 Part B premium rates. They’re very close to, but slightly lower than, what MOAA
projected in an earlier legislative update. Because of the Bipartisan Budget Agreement, beneficiaries not protected by
the “hold-harmless” provision will see some relief in premium costs. Seventy percent of Part B enrollees won’t see
any change from the $105 monthly premium they’re now paying. The only people with incomes less than $85,000
($170,000 for a married couple) who will pay the higher $122 monthly rate are those who first become eligible for
Medicare in 2016, or who are not receiving a Social Security Check, or certain lower-income beneficiaries who are
dually eligible for Medicare and Medicaid. The budget agreement protected these groups and the higher-income
groups from a much larger 52 percent premium increase. Under the new calculations, these groups will only pay what
they would have paid anyway if there had been a normal retiree COLA.
[Source: MOAA Leg Up November 13, 2016 ++]
*********************************
Weight Control
► Walking Most Effective Exercise
Forget expensive gym memberships and intense workouts: A pair of walking shoes is all it takes to keep your weight
and waist in check, new research shows. People who regularly walk briskly for more than 30 minutes had lower body
mass index (BMI) scores and smaller waist circumferences than people who regularly do other types of exercise or
sports, according to a study to be published in the international peer-reviewed journal Risk Analysis. BMI scores are
a measure of weight that also incorporates height. The results were particularly pronounced in:
 Women.
 People over age 50.
 People on low incomes.
The research was led by assistant professor Grace Lordan, who specializes in health economics at the London
School of Economics and Political Science, a school of the University of London. She analyzed data on physical
activity levels from annual national English surveys from 1999 to 2012, focusing on activities that increase heart rate
and cause perspiration, and analyzed data on BMI scores and waist circumference. Survey participants had reported
information on how frequently they engaged in at least 30 minutes of:
 Walking at a fast or brisk pace.
 Moderate-intensity sports or exercise, such as swimming, cycling, working out at the gym, dancing, running,
football/rugby, badminton/tennis, squash, and exercises including press-ups and sit-ups.
 Heavy housework, such as moving heavy furniture, walking with heavy shopping and scrubbing floors.
 Heavy manual activities, such as digging, felling trees, chopping wood and moving heavy loads.
The study argues that public policies promoting more walking, rather than more healthy diets, could be a less
controversial yet effective way to combat obesity: “Recommending that people walk briskly more often is a cheap
and easy policy option. Additionally, there is no monetary cost to walking, so it is very likely that the benefits will
outweigh the costs.” [Source: MoneyTalksNews | Karla Bowsher | November 10, 2015 ++]
*********************************
TMOP Update 19
► Express Script’s Drug Shortage
Every few weeks, Tricare For Life beneficiary Patricia Petteruti receives a letter from Tricare pharmacy benefits
manager Express Scripts. She's supposed to get her prescription drugs in the mail, too. But instead, these letters inform
her that her medications — common prescriptions for a heart condition and hypotension — are out of stock. Like all
TFL beneficiaries — and, as of 1 OCT. any Tricare beneficiary taking a brand-name medication to manage a chronic
illness — Petteruti is required to fill long-term prescriptions through Tricare’s home delivery program or an on-base
military pharmacy. Since she lives 50 miles from the nearest base, she has opted for mail order. But since February,
the system has been anything but user-friendly. “Recently, I got two letters dated Sept. 11, 2015," she said. "One said:
‘We are unable to dispense your prescription ... temporarily unavailable.’ The other one: 'This letter is to inform you
that your medication is now in stock.’ What am I supposed to make of this?”
Retired Air Force Lt. Col. Howard Durant also tries to use the home delivery program. But earlier this year, his
generic medications stopped coming. He can fill the prescriptions at a Tricare network pharmacy, but unlike mail
order, which provides 90-day generic prescriptions for no co-payment, the drug store dispenses 30-day prescriptions
for a co-payment of $8. For his three medications, that's $24 a month and $288 per year for a benefit that the Defense
Department says Durant must use. “I’m doing everything I’m supposed to be doing to keep costs down, for myself
and the government," Durant said. "I’m using generics and I’m using mail order. But it's just not working. Sure seems
like Express Scripts has found a way to get out of filling prescriptions."
Tricare officials say the problem stems from drug shortages that are an "increasing problem across the industry."
And the shortages are exacerbated within the military system because by law, DoD is allowed to buy pharmaceuticals
only from certain manufacturers, according to Tricare pharmacy director Dr. George Jones. "The Drug Information
Service at the University of Utah found a dramatic increase in drug shortages over the last five years, peaking in 2014,"
Jones said. Shortages have begun to decline amid concerted efforts by government, manufacturers and the pharmacy
industry, he said, but remain "high compared to historic levels." The shortages peaked at about the time DoD began
requiring Medicare-eligible retirees and military family members to fill their long-term prescriptions by mail or at a
military pharmacy. On 1 OCT, all Tricare beneficiaries using brand-name medications for chronic conditions were
also required to start filling their prescriptions the same way. The program is designed to save money; DoD pays 17
percent less for maintenance medications filled by mail than at retail stores.
Savings over the first year of the Tricare For Life pilot program totaled $123 million, according to a recent
Government Accountability Office report. Tricare beneficiaries filled 25 million prescriptions by mail from February
2014 to February 2015, including 785,000 for TFL beneficiaries newly required by law to use the home delivery
program. During the first year of that TFL requirement, 5,069 patients — three percent of participants — received a
total of 5,611 letters notifying them of shortages and authorizing them to fill their prescriptions at retail pharmacies,
the GAO said. That meant shortages "affected less than one percent of home delivery prescriptions ... comparable to
the home delivery program at large," Jones said. And according to a 2013 DoD Inspector General report, 96 percent
of Tricare beneficiaries "are satisfied with home delivery and it has a 99.997 percent dispensing accuracy rate." But
DoD also noted that only 1,448 of the 5,611 exceptions granted due to shortages were actually filled at a retail store.
Possible explanations for that low usage rate, defense officials said, could include doctors changing their patients'
medications to an available drug, beneficiaries filling their prescriptions at a military pharmacy or beneficiaries simply
choosing not to fill them because of the higher co-payment. But GAO Health Care Director Debra Draper pointed out
that, since Tricare did not specifically track the satisfaction of beneficiaries now required to use the mail-order system
and did not monitor the availability of covered medications for these beneficiaries, DoD is unable to assess availability.
"DoD does not know what, if any problems, beneficiaries may have experienced filling their prescriptions," Draper
concluded in her report.
With the new requirement for all Tricare beneficiaries to get their non-generic maintenance medications by mail
— an estimated 416,000 beneficiaries new to the system — current users fear their problems will worsen. “These are
very common drugs, and I suspect a substantial portion of retirees take them," Durant said of his medications, taken
for angina and high blood pressure. He said he would like to see Tricare be allowed to expand its list of approved
vendors or reimburse beneficiaries for pharmacy co-payments. DoD officials say they are restricted to purchasing
through designated sources by the Trade Agreements Act of 1979 and simply can't reimburse for pharmacy co-pays.
"If a beneficiary chooses to use a retail pharmacy, DoD regulations do not allow [Express Scripts or the Defense
Health Agency] to waive co-pays," Jones said.
Express Scripts declined to answer questions on the problem and "deferred to the Defense Health Agency" for
response. Petteruti, a retired nurse, said she wants the problem resolved quickly, before retirees without easy access
to a pharmacy go without their medications or, worse, skip or double-up doses out of confusion related to erratic
deliveries or store purchases. Durant said the issue is not about having to pay more money for his medications, but
rather about ensuring that a program now mandatory for many Tricare beneficiaries actually works as intended. "It's
a privilege to have these pharmacy benefits," he said. "I'm just irritated with the bureaucracy." [Source: MilitaryTimes
| Patrcia Kime | October 21, 2015 ++]
*********************************
Drug Cost Increases Update 01
►
Soaring Costs | Why?
Over the past year I’ve been horrified to learn about the pricing tactics of what can only be described as the
Pharmaceutical Jihad. Anyone with a chronic health condition knows the feeling when your doctor gives you a new
prescription. You stare at the pharmacy receipt in sheer disbelief. You watch in terror as every prescription refill
torches and burns your Part D initial drug coverage limit. You slide ever more rapidly into Medicare’s drug coverage
gap known as the doughnut hole. Once there, beneficiaries are stretched for a much higher share of the cost — 65%
of the cost of generic drugs, or 45% of the cost of brand name drugs. Prices of both new and generic drugs are taking
terrifying climbs. According to a CBS “60 Minutes” program with Lesley Stahl, “The Cost of Cancer Drugs” new
cancer drugs are often priced at “well over $100,000” a year. And earlier this year the U.S. Food and Drug
Administration approved two new cholesterol drugs that reduce cholesterol by approximately 55%-60% in patients
who are already on or who cannot take cholesterol-reducing statin drugs. While the drugs may help up to 15 million
Americans a year, they come with a $14,000 a year price tag.
As complaints grow, the soaring cost of prescription drugs is becoming a top issue with both Medicare and younger
patients alike. A recent poll by the non-profit Kaiser Family Foundation found that making sure high – cost drugs for
chronic conditions are affordable is a number – one priority with the public. Drug companies are increasingly coming
under pressure to justify their prices. Drug makers claim the high costs of research and development are driving the
outrageous price tags. But that’s not the only reason. The Boston Globe recently reported that Vertex Pharmaceuticals
Inc. won approval for a medicine that could treat adult onset cystic fibrosis, a life – threatening lung disease. The twodrug therapy called Orkambi costs about $259,000 per patient annually. This is no typo. The Boston Globe went on
to report that the new drug regimen “is expected to help provide more than $53 million in one-time bonuses for 12
senior Vertex executives” if the company is profitable. The problem is that there are roughly only 15,000 Americans
who suffer from cystic fibrosis — one reason given for the astronomical six-figure cost per patient.
These are just a few of hundreds of examples —including mega cost increases in generic drugs as well. For example,
200 puff albuterol inhalers to treat asthma that used to cost about $10 now cost patients about $50. The public is
entitled to an explanation. Outrageous price tags for drugs are putting Medicare patients and the program at risk, while
Congress looks the other way. TSCL supports legislation that would give Medicare the authority to negotiate
pharmaceutical prices for covered drugs, and would require greater pricing transparency from manufacturers. [Source:
The Senior Citizens League | Mary Johnson, Editor | October 30th, 2015 ++]
*********************************
Hearing Loss
►
Pharmaceutical Hearing Protection
The crack of an M16 shot rings out at 156 decibels. A jet engine at takeoff blasts about 140 decibels. Submarine engine
rooms drone along at 120 decibels. Given that 85 decibels is the threshold for preventing permanent hearing loss,
military service is unquestionably hard on hearing. But what if troops could take a daily pill to protect themselves
from noise-related hearing loss? A researcher from Southern Illinois University School of Medicine is looking into
the prospect, testing a common antioxidant found in fermented dairy products on the firing range at the Army’s Drill
Sergeant Instructor Course at Fort Jackson, South Carolina. Kathleen Campbell, an audiologist and SIU professor, has
studied the protective properties of D-methionine — an antioxidant found in cheeses and yogurt — for well over a
decade, testing its effectiveness in preventing damage caused by excessive noise and other sources.
Noise-related hearing loss occurs when inner ear cells, which vibrate when exposed to sound, are overstimulated.
The ear’s response causes cochlear cells to release free radicals, damaging electrons that can kill off the cells. When
those cells die, a person loses the ability to hear sounds of certain frequencies. Campbell says D-methionine works
by neutralizing the free radicals and stimulating the body to produce glutathione, a natural antioxidant that may prevent
the cells from releasing free radicals in the first place or neutralize them shortly after noise exposure. “You can give
it after the noise exposure ceases and reverse the hearing back, preventing permanent damage,” Campbell said. For
the study, soldiers drink a beverage containing D-methionine before, during and after they are on the shooting range,
having fired 500 rounds over 11 days. Campbell takes a baseline hearing test from the subjects and then tests them
again two weeks later. While results from the Fort Jackson study are not available yet, Campbell has tested the
compound for safety and effectiveness in humans — on cancer patients taking chemotherapy drugs known to cause
hearing loss.
Campbell is not alone in examining the potential of using medications to reduce or prevent hearing loss. Since at
least 2004, researchers at Navy Medical Center San Diego and a private company, Seattle- based Sound
Pharmaceuticals, have tested two substances — N-acetlycysteine and ebselen, that also boost the body’s own natural
antioxidants. In tests involving Marine Corps recruits taking NAC during training in 2004 and 2009, the formulation
yielded less-than-promising results, reducing the number of people who experienced hearing loss by about 25 percent.
But officials with Sound Pharmaceuticals, which is testing the man-made compound ebselen, say their medication
reduced temporary hearing loss following exposure in 60 percent among those who took it, compared with a 20 percent
reduction in the control group, and did so quite quickly.
The Sound Pharmaceuticals research involved 83 University of Florida students listening to iPods for four hours
at levels loud enough to temporarily inhibit hearing. “A lot of people pooh-poohed the study, saying it was artificial,”
Sound Pharmaceuticals Chief Medical Officer Dr. Jonathan Kil said. But on 27 FEB, he noted, the World Health
Organization announced that 1.1 billion teens and young adults are at risk for noise induced hearing loss, “primarily
through personal audio players.” For the Fort Jackson study, participants wear standard hearing protection in addition
to taking the medication.
Researchers said they don’t see their medication replacing these safeguards, but rather augmenting them. “One of
the big advantages of pharmaceutical hearing protection is it does not cut down on situational awareness,” Campbell
said. “It gives you another level of protection without sacrificing your ability to hear your surroundings.” The Centers
For Disease Control and Prevention says about 10 million Americans have noise-related hearing loss, and 22 million
workers are exposed to potentially damaging noise annually. More than 800,000 veterans are compensated by the
Veterans Affairs Department for hearing-related conditions, at a cost of more than $1 billion a year.
These medications are still in the development phase, with Campbell expecting to analyze preliminary results of
the Fort Jackson study this fall. She declined to provide a timeline for when D-methionine would hit the market if
proved effective. Kill said he expects his company to file a new drug application with the Food and Drug
Administration sometime in the next three to four years. Campbell said she must follow strict guidelines to ensure that
Dmethionine passes muster by the FDA if it works. “My priority is finding something to take care of the troops. But
certainly, if we could develop this for the population in general — we live in a noisy world — that would be good,”
she said. [Source: NavyTimes | Patricia Kime | September 14, 2015 ++]
*********************************
Agent Orange & Bone Marrow Cancer Link
►
MGUS Precursor
Servicemembers exposed to Agent Orange during the Vietnam War are at higher risk of developing the precursor
stage of a bone marrow cancer, according to a study published 3 SEP in the Journal of the American Medical
Association Oncology. The study provides the first scientific evidence for a link between the precursor stage of
multiple myeloma — a cancer of white blood plasma cells that accumulate in bone marrow — and veterans exposed
to the herbicide Agent Orange, according to the study’s 12 authors, who are associated with medical centers across
the U.S. The precursor, called monoclonal gammopathy of undetermined significance, or MGUS, is not in and of itself
a problem.
“MGUS is not a cancer,” said Dr. Nikhil Munshi, who specializes in multiple myeloma at the Dana-Farber Cancer
Institute at Harvard Medical School in Boston. “A very large majority of patients with MGUS remain MGUS all
through their lives with no real consequence.” MGUS virtually always precedes multiple myeloma, but the
mechanisms that trigger its onset are not fully understood, said Munshi, who was not involved in the study but wrote
an editorial published in the same issue of JAMA Oncology. Previous studies have linked other insecticides, herbicides
and fungicides to higher risks of MGUS and multiple myeloma.
Agent Orange was used during Operation Ranch Hand in Southeast Asia to clear jungle foliage from 1962 to 1971.
It was usually sprayed via aircraft. Since then, Agent Orange has been linked to a host of health problems and diseases
in many servicemembers. The Veterans Administration maintains a list of “presumptive diseases” assumed to be
related to military service that automatically qualify them for VA benefits. The Institute of Medicine has identified
seven cancers with a positive association to Agent Orange, including chronic lymphocytic leukemia, Hodgkin
lymphoma and non-Hodgkin lymphoma — all of which have been accepted by the VA as presumptive diseases.
Multiple myeloma is a VA presumptive disease, but it has been classified as having “limited or suggestive evidence”
of a link to Vietnam War veterans’ exposure to herbicides, the authors of the JAMA study wrote.
The study looked at specimens from two groups of Air Force veterans that had been collected and stored in 2002
by the Air Force Health Study. A group of 479 veterans who had been exposed to Agent Orange during Operation
Ranch Hand were compared with a second group of the same size that had similar duties in Southeast Asia from 1962
to 1971 but were not involved with the herbicide. The Air Force Health Study had sampled servicemembers in the
two groups in 1987, 1992, 1997 and 2002 for exposure to Agent Orange and to 2,3,7,8-Tetrachlorodibenzo-p-dioxin,
or TCDD, which is an unintended contaminant of the herbicide considered the culprit for so many of its adverse
effects.
The researchers found that the prevalence of MGUS in Ranch Hand veterans was twice as high as in the comparison
group, with 34 of the 479 Ranch Hand veterans having MGUS compared with 15 out of 479 in the control group. That
translated to a 2.4-fold increased risk of MGUS for Ranch Hand veterans over their counterparts when adjusting for
factors such as age, race and other physical traits. “That’s an important number,” Munshi said. Researchers also found
significantly higher levels of TCDD in the Ranch Hand veterans who had developed MGUS, he said. Because all
cases of multiple myeloma originate from MGUS, the study has provided the first scientific evidence for a direct link
between Agent Orange and multiple myeloma, he said. [Source: Stars and Stripes | Wyatt Olson | September 3, 2015
++]
*********************************
Sleep Update 01
►
Crucial for Good Health
We’ve been told that the modern, connected life is taking a toll on our sleep. Compared to previous generations,
studies report, we’ve been sleeping less and less every year. And that is making us “more likely to suffer from chronic
diseases such as hypertension, diabetes, depression, and obesity, as well as from cancer, increased mortality, and
reduced quality of life and productivity.” It sounds terrifying, but it’s probably not true. For a long time doctors and
scientists had ignored sleep’s importance to health. We’ve only begun to see how much it matters in the last few
decades. And thus, we have never systematically gathered data on how much people really sleep. Now, researchers
have started to put together what scant data we have to look at the bigger picture. And what they have found is that
we aren’t sleeping any less today than before. Knowing precisely how much we sleep matters, because sleep plays a
pivotal role in many aspects of our health—from staying mentally fit to fending infections.
Disappearing sleep
In the 1980s, researchers began to probe how sleep affects health. A 1989 study set off alarms when researchers
showed that rats deprived of sleep start dying in as little as two or three weeks. By looking at the effects of sleep
deprivation on humans, it’s been determined that the average adult needs seven to nine hours of sleep. When we sleep
less than seven hours we have difficulty with memory and simple cognitive functions. (Though a tiny fraction of
people can get away with much less.) According to a survey conducted by the US Centers for Disease Control (CDC)
between 2005 and 2007, more than 30% of adults slept less than six hours a night. The National Sleep Foundation’s
own surveys reveal something similar: more than 20% of people in 2009 were sleeping less than six hours compared
to only 12% in 1998. The CDC declared that insufficient sleep was becoming a public health epidemic.
The CDC announcement came at a time when doctors across the US were increasingly prescribing sleeping aids
and sleeping pills. The number of adults on sleeping pills has tripled in the last decade alone. However, a 2010 analysis,
published in the journal Sleep, which used data from a different set of surveys conducted between 1975 and 2006,
found very different results. It showed that the proportion of short-sleepers (those sleeping less than six hours) hadn’t
changed much in the last 30 years. And, more surprising still, that proportion was only 9.3% in 2006. Why such a
large difference when compared to the CDC data? “Probably because those studies asked a different question,” Kristen
Knutson, a sleep researcher at the University of Chicago who conducted the 2010 analysis, told Quartz. For instance,
in the case of the CDC survey the participants were asked, “On average, how many hours of sleep do you get in a
day?”
Knutson believes that answers to such a question are likely to suffer from both conscious and unconscious biases,
which may make people give a different answer than reality. Sleeping less, for instance, is associated with being more
productive and some may consider it fashionable to say they sleep less. Some studies have also shown that people
underestimate how much they actually sleep—especially those who suffer from insomnia. A more effective approach
is to ask how people spend their average day then tease out data about total time spent sleeping, which is what
Knutson’s study does. It uses data from the American Time Use Survey (ATUS), which is conducted with input from
more than 150,000 people. Both the CDC and ATUS data only involve people in the US. If there were a cultural shift
in sleep patterns, it likely would’ve occurred across the Western world and would be reflected in other countries too.
A 2012 systematic review of 12 studies from 15 countries, published inSleep Medicine Reviews, showed that,
between 1960 and 2000, total sleep times across these countries hasn’t changed much at all. They increased by less
than an hour per night in seven countries (Bulgaria, Poland, Canada, France, Britain, Korea and the Netherlands),
decreased by less than 30 minutes per night in (Japan, Russia, Finland, Germany, Belgium and Austria), and showed
no change in Sweden and the US.
Conflicting data
When Shawn Youngstedt, a sleep researcher at Arizona State University, examined these studies, he realized that
there might be a way to resolve these conflicting results. Instead of using self-reported data, he wanted objective
data—that which is recorded using sleep-monitoring instruments or by observers as participants slept in a lab.
Youngstedt’s and his colleagues’ systematic review, published in Sleep Medicine Reviews, took into consideration
168 studies with objective data conducted between 1960 and 2013—involving more than 6,000 participants
(understandably a much smaller set than the self-reported surveys) across 15 countries. It too reveals that the total
sleep time hasn’t changed much in that period. Most of us sleep between seven and nine hours, and the proportion of
those sleeping less than six hours hasn’t increased in the last 50 years. Despite this, the CDC tells Quartz that poor
sleep remains a public health epidemic. The differences in the studies, it says, “may have arisen from the different
surveys used, different definitions of short sleep, as well as different statistical analyses conducted.” “To call
something an epidemic, you need an extraordinary amount of data supporting the claim,” Youngstedt told Quartz.
“But the data just doesn’t seem to show that.”
So why then are there widespread worries of a poor sleep “epidemic”? It’s probably a combination of social trends
that fuel the myth. Sleeping is commonly considered a leisure activity, and the modern fast-paced life creates an
illusion that we have less free time for rest. Cases of famous people succeeding on little sleep—from Margaret
Thatcher to Marissa Mayer—make matters worse. Some also believe that we must be sleeping less than our ancestors
who never had access to electricity. The invention of the light-bulb did change our sleep habits, but not the total
amount of time we slept. Before the 18th century, a segmented sleep pattern was common. People slept for four hours,
then woke up for a little bit of time and slept for four more hours later. Sleep wasn’t considered a crucial part of human
health for a long time, and as a result not many well-designed studies have been conducted in the past. “So we may
never definitively know how much people really slept then,” Youngstedt told Quartz.
His results are unlikely to represent all classes of sleepers. For instance, studies have shown that Black Americans
probably sleep much worse than White Americans. It has also been proposed as a possible explanation for the wide
health gap between the races. Also, his study only looked at healthy sleepers, and cannot say whether poor sleep
increases risk of diseases such as diabetes and obesity or whether those at risk of disease suffer from poor sleep.
Though we seemingly sleep enough, scientists are finally starting to understand just how crucial how sleep is for good
health. With the field of sleep research gathering pace and more of us strapping on wearable devices that can monitor
our sleep, we are bound to learn more. While that happens, there is little reason to lose sleep worrying about not
sleeping enough.
[Source: GovExec.com | Akshat Rathi Quartz | September 3, 2015 ++]
*********************************
Computer Eyes
►
How to Avoid Negative Effects
Sitting in front of a computer for hours can make your eyes tired, and your visual performance can suffer. To help
with potential negative effects, create an environment that has equal brightness everywhere around your computer
screen. Here are some helpful hints:
 Reduce intense fluorescent lights.
 Turn on some lights if you usually look at computer screens in the dark.
 Dim excess light coming through windows with blinds, tinting, or window covers.
 Avoid glare on your computer screen and
 Take microbreaks to look at distant objects.
If you’re in an office environment, if possible, turn off overhead lights and have a table lamp for softer light. If
you can’t control the lighting in your environment, there are screens you can place on top of your computer screen to
reduce glare. Experts suggest looking at a distant object at least twice every hour to help prevent visual fatigue. So if
you take a break every 20 minutes for brief stretching, make sure it also includes looking at a distant object to help
both your eyes and body! [Source: TRICARE Beneficiary Bulletin #321 | Lorraine Cwieka | September 4, 2015 ++]
*********************************
TRICARE Coverage Update 05
►
Covered Services Fact Sheet JUL 2015
TRICARE covers most care that is medically necessary and considered proven. There are special rules and limitations
for certain types of care, and some types of care are not covered at all. TRICARE policies are very specific about
which services are covered and which are not. It is in your best interest to take an active role in verifying your coverage.
To verify coverage, visit www.tricare.mil/coveredservices or call your regional contractor.
Note: Overseas, all host nation care must meet TRICARE’s policies for coverage. You are financially responsible for
100 percent of the cost for care that TRICARE does not cover. Beneficiary category and location determine which
overseas program options are available to you. Each program option has specific guidelines about how to access care.
Check with your TRICARE Overseas Program (TOP) Regional Call Center before visiting host nation providers.
To review what TRICARE Benefits you are entitled to refer to the attachment to this bulletin titled, “TRICARE
Covered Services Fact Sheet 2015”. [Source: TRICARE Communications | September 4, 2015 ++]
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TRICARE Prime Networks Update 01
► Metropolitan Area Users Sought
The Defense Health Agency has launched a marketing effort to draw military health beneficiaries living in major
metropolitan areas back to Tricare Prime, starting with the Washington, D.C., region. More than 57,000 military
households in the "National Capital Region" that encompasses the District, Northern Virginia and Southern Maryland
received packets from NCR Medical Director Rear Adm. Raquel Bono in August hyping the services available at 11
military hospitals or clinics across the area. The mailings lists the locations and addresses of the facilities, features and
available services, from routine care and extended pharmacy access to secure messaging with providers, wellness
benefits and treatment specialties such as orthopedics, pediatrics subspecialists and an advanced cancer treatment
facility.
Bono said the goal is to attract Tricare beneficiaries to Prime, a health program that operates at a lower cost to the
government than private health care services, but also bring patients into the system to ensure that military doctors
and researchers have the opportunity to seeing a range of patients. “In addition to receiving extraordinary health care,
enrollment at an MTF supports military medicine,” Bono wrote in the letter to beneficiaries. “Your Tricare Prime
coverage supports research and training of military health care professionals needed for our troops and their families.”
In fiscal 2012, the Defense Department spent $15.4 billion for beneficiary health care outside the military system,
more than double the cost in 2000 when adjusted for inflation. In contrast, care provided “in house” at military
treatment facilities cost $15 billion in fiscal 2012, but 45 percent of that amount was for salaries of military doctors,
nurses, staff and administrators, which the government pays regardless of how many patients are seen.
According to data provided by Tricare, the Washington, D.C., area is home to 455,000 Tricare-eligible
beneficiaries, about 250,000 of whom are enrolled in Prime. According to Defense Health Agency data, some facilities
in the Washington region, such as Naval Health Clinic Quantico, Virginia, have more enrollees than space, while
others are functioning below expectations. The Andrew Rader Army Health Clinic at Joint Base Myer-Henderson
Hall, Arlington, Virginia, for example, is running at 77 percent capacity, while the Joint Base Anacostia-Bolling Clinic
in the District of Columbia is at just 74 percent capacity. Other facilities in the area are in high demand but still have
room for more patients. According to the data, Walter Reed National Military Medical Center in Bethesda, Maryland,
is at 89 percent enrollment capacity and the Dumfries and Fairfax health centers, both in Virginia, are at 89 percent.
Fort Belvoir, Virginia, tops the list for the facility with the most Tricare Prime enrollees, 43,794; its capacity is 45,029.
Bono said nearly all active-duty service members and their families in the region are enrolled in Tricare Prime, but
the mailing, sent to Tricare-eligible beneficiaries in certain ZIP codes, was meant for eligible retirees and their family
members who use Standard or other health insurance. “We were very measured in looking at what our market could
do before we went out and extended this opportunity to our retirees,” Bono said. The Pentagon has sought for years
to curb its health care costs, including asking Congress twice in the past two years for permission to consolidate Tricare
into a single system designed to encourage beneficiaries to seek care from military facilities or network providers, or
pay more of their share of health care costs.
According to Pentagon estimates, the average active-duty family of three averages $13,615 in annual medical costs,
with the military bearing $13,448 of the expense while the family picks up $166, or about 1.2 percent. A working-age
retiree's family of three accrues $16,715 in medical costs annually, according to DoD, and pays $1,337, or 8.2 percent
of the cost. Many of DoD's recent health care proposals are designed to raise beneficiaries’ share of the cost closer to
the levels they were when Tricare was enacted — about 25 percent of total cost. Under Prime, retirees below age 65
and their family members pay enrollment fees of $289 for an individual and $555.84 for a family. Retirees and their
family members as well as family members of active-duty personnel pay no enrollment fees to use Standard, but they
pay a portion of their visits to primary care or specialty providers.
Bono said beneficiaries in other cities with significant military populations may see similar marketing campaigns
tailored to the needs of the beneficiaries and the military health care market in those regions. The Washington region
mailing campaign cost $65,800 and reached nearly 100,000 beneficiaries. “We have a health care system that is at
least on par, if not exceeds, some of the standards we see when compared with the civilian markets," Bono said. "We
really believe our military health system provides one of the best types of health care for our beneficiaries." [Source:
MilitaryTimes | Patricia Kime | September 3, 2015 ++]
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TRICARE Help
► Q&A 151115
Have a question on how TRICARE applies to your personal situation? Write to Tricare Help, Times News Service,
6883 Commercial Drive, Springfield, VA 22159; or tricarehelp@militarytimes.com. In e-mail, include the word
“Tricare” in the subject line and do not attach files. Information on all Tricare options, to include links to Handbooks
for the various options, can be found on the official Tricare website, at this web address:
http://www.tricare.mil/Plans/HealthPlans.aspx or you can your regional contractor. Following are some of the issues
addressed in recent weeks by these sources:
Military versus Federal Health Coverage
(Q) I’m a reservist enrolled in Tricare Reserve Select. I am pursuing a career as a federal employee. If that happens,
I’ve been told I would not be able to keep my Tricare coverage and would have to switch to the Federal Employees
Health Benefits Program. Is there a grace period for such a switch? And which FEHBP option most closely resembles
Tricare Reserve Select?
A. You would indeed have to drop your TRS coverage if you take a job that offers FEHBP coverage. It would not
even matter whether you choose to enroll in FEHBP; if your employer offers it, you are ineligible for TRS. You can
end your TRS coverage at any time, effective at the end of any month you specify. To do that, go online to
www.dmdc.osd.mil/appj/reservetricare and log on to the Defense Manpower Data Center DMDC Reserve Component
Purchased TRICARE Application, then follow the instructions to “Disenroll.” Print, sign and mail or fax your
completed DD Form 2896-1 to the managed-care contractor for your Tricare region. Contacts for all Tricare regional
contractors are www.tricare.mil/ContactUs/CallUs.aspx . Again, the effective end date is either the last day of the
month in which the request is postmarked or received, or the last day of a future month specified by you. This lets you
coordinate the timing of your TRS disenrollment so you have little or no break in coverage when you pick up FEHBP
coverage.
TRS is modeled on Tricare Standard, a “fee-for-service plan” that lets you see any network provider that accepts
Tricare. The FEHBP has similar plans; get more details about comparable options here: www.opm.gov/healthcareinsurance/healthcare/plan-information/plan-types .
-o-o-O-o-oCorrection on Tricare Young Adult eligibility
The Aug. 31 Tricare Help column inaccurately characterized Tricare Young Adult eligibility for college students over
age 21. The correct information follows.
(Q) I have Tricare coverage through my parents. I’m a full-time college student who will turn 21 very soon. I may
need to drop a class because I’ve been sick and falling behind. That would put me under 12 semester hours. Would
this bar me from Tricare Young Adult eligibility after I hit 21?
A. Tricare does not determine full-time student status; individual schools do that, so check with your school. If
dropping that class indeed would make you a part-timer, then you’d lose eligibility for ordinary Tricare Prime or
Standard upon turning 21. But children of Tricare sponsors remain eligible for Tricare Young Adult until age 26
regardless of student status, as long as they stay single and have no access to other health coverage, such as through
an employer.
-o-o-O-o-o-
(Q) I am retired from the Air Force Reserve, and working as an Air Force civilian. My wife is retired and will turn
65 before I do. Will she be able to participate in Tricare for Life when she turns 65 even though I will only be 60 at
that time?
A. As you’re likely aware, as a retired reservist you become eligible for regular retired benefits, including military
health care coverage, at age 60. Once you pass that threshold, your wife will be eligible for whatever Tricare plan is
age appropriate for her — Tricare Prime or Standard while she is under 65, and Tricare for Life once she hits 65 and
qualifies for Medicare. Even though you would not make that transition yourself for several more years, the age of
your spouse in this situation doesn’t matter; all that matters is that she remains your spouse and you remain her sponsor
for Tricare purposes.
Some basic background on Tricare for Life can be found here:
www.tricare.mil/Plans/HealthPlans/TFL.aspx .
-o-o-O-o-o(Q) I would like to have my daughter covered under Tricare. She is 23, single and has no other health insurance
options. Can you advise me on how to get her health coverage?
A. Assuming that she is the child of a Tricare sponsor, your daughter’s Tricare options are limited. As long as she
remains 23, she is eligible for “regular” Tricare coverage — Tricare Prime or Tricare Standard — only if she is enrolled
in college as a full-time student. That eligibility would end on her 24th birthday. Her only other Tricare option would
be Tricare Young Adult, under which your daughter could be covered until her 26th birthday. TYA requires payment
of monthly premiums, and they are fairly hefty. For 2015, the monthly premium for TYA Standard is $181, and the
monthly premium for TYA Prime is $208. More information on TYA is here: www.tricare.mil/TYA.
-o-o-O-o-o(Q) If I am granted power of attorney with temporary guardianship of a child not related to me (to provide assistance
during a family crisis), can I enroll that child in DEERS to obtain Tricare coverage for him during the time that he
stays with me?
A. Your question implies that you, or your spouse, is a Tricare sponsor. If so, guardianship by itself normally is not
sufficient to gain Tricare eligibility for a minor child. Usually, the guardianship must be an intermediary step on the
way to legal adoption in order for the child to become eligible for Tricare in a scenario like the one you outline.
-o-o-O-o-o(Q) Is my dependent parent or parent-in-law eligible for TRICARE Overseas Program (TOP) Standard?
A. No, but dependent parents and parents-in-law may receive care in military hospitals and clinics and may enroll in
TRICARE Plus, if available at a military hospital or clinic. Note: TRICARE Plus does not meet the minimum essential
coverage requirement under the Affordable Care Act (ACA).
-o-o-O-o-o(Q) Are routine eye exams covered for retirees living overseas?
A. No, routine eye exams are not covered for TRICARE Standard beneficiaries overseas or in the United States,
except for those covered under the well-child benefit.
-o-o-O-o-o(Q) Can I use the Continued Health Care Benefit Program (CHCBP) overseas?
A. Yes, if you lose TRICARE coverage, including Transitional Assistance Management Program, TRICARE Young
Adult (TYA), TRICARE Reserve Select (TRS) and TRICARE Retired Reserve (TRR), you may qualify to purchase
CHCBP coverage. Coverage is available worldwide.
-o-o-O-o-o(Q) If I qualify for TRS, but have not enrolled and/or kept up with payments, do I still meet the minimum essential
coverage requirement under the ACA?
A. No. Premium-based TRICARE program options (e.g., TRS, TRR, TYA) and CHCBP are considered minimum
essential coverage under the ACA only when your premiums are paid and coverage is effective. These requirements
must be met on a monthly basis and reported each year. If there are any months that you are not enrolled or have not
paid your premium, and if you do not have another form of coverage, you do not meet the minimum essential coverage
requirement for those months. If you do not qualify for or choose not to purchase a TRICARE or CHCBP premiumbased program, you may find other coverage options that meet the minimum essential coverage requirement at
www.healthcare.gov or through another plan that qualifies as minimum essential coverage (e.g., coverage through a
civilian employer or Medicare).
[Source: MilitaryTimes | Sep 01 thru 14 Nov, 2015 ++]
Saving Money
► LED Lighting
There’s nothing but good news these days about LED (light-emitting diode) bulbs. The prices have come down (they
still cost more to buy than incandescent bulbs, but they’ll save you wads of money in the long run.) You can choose
warmer colors of light instead of the harsh, too-white light from older LEDs. And you’ll find more bulbs that work
with your home’s dimmer switches. The benefits of LED lights are clear. MIT Technology Review sums them up:
For the consumer, the main benefits of LED fixtures are they’re energy efficient, can last for more than 20 years and,
in many cases, give off good light. The prices have gone down steadily as well as the LED components have dropped
in price and lighting companies introduce better designs. Consumers have suffered from confusion when selecting
bulbs, however. It’s not surprising. LEDs come in different shapes and colors of light, and it’s hard to know at a glance
how they compare in brightness to our favorite incandescent bulbs. To simplify the experience of buying and using
LED bulbs, here’s what you need to know, boiled down into five rules:
By replacing your home's five most frequently used light fixtures or bulbs with models that have earned the ENERGY
STAR, you can save $75 each year.
1. Install LEDs where you’ll use them most. LED bulbs are still expensive and so, unless you have the budget to
replace all the bulbs in your home at once, you’ll have to replace bulbs as they burn out. In the long run, your
investment will pay you back in energy savings. It matters where you use your LED bulbs if you hope your investment
will repay you soon. Put an LED in your closet, for example, or another place where the bulb is seldom used, and it
may be years and years before the bulb’s cost is repaid in energy savings. It’s best to use your LEDs where the payoff
will be fastest, in the light fixtures that get most use in the high-traffic parts of your home.
2. Shop for lumens, not watts. Watts are a measure of how much energy the bulb draws, not its brightness.
Nevertheless, we are accustomed to shopping for incandescent light bulbs by their watts, and we know how much
light to expect from a 60-, 100- or 150-watt bulb. LED bulbs also are rated by watts. But that’s no help because there’s
no easy way to compare LED watts with incandescent watts. “[T]here isn’t a uniform way to covert incandescent
watts to LED watts,” says CNET. Now, instead of watts, use lumens as the yardstick for brightness. Packaging on
LED bulbs rates brightness in lumens (and in watts). To replace a 150-watt incandescent bulb, look for an LED rated
at 2600 lumens (25 to 28 LED watts), CNET says. Here’s CNET’s handy comparison chart:
Incandescent
LED
Watts
Watts
25
3-4
40
4-5
60
6-8
75
9-13
100
16-20
125
21-23
150
25-28
Lumens
250
450
800
1,100
1,600
2,000
2,600
3. Get the light color you want. If you were turned off by the harsh white quality of light from older LEDs you’ll
be glad to know there are more options now. LED bulbs offer a range of colors, from a warmer yellow-white, akin to
the color of incandescent bulbs, to a whiter white or blueish white. Check a bulb’s package for its light color, shown
by its temperature on the Kelvin Scale (learn more from Khan Academy). Lower Kelvin numbers mean warmercolored light. The higher the Kelvin number, the bluer the light. EarthEnergy, a retailer, offers this guide to shopping
for LED bulbs:
 Yellow light: 2700-3000K.
 White: 3500-4100K.
 Blue: 5000-6500K.
4. Match the bulb shape to your fixture. LED bulbs come in a number of unfamiliar shapes. You’ll find spiral
bulbs, different types of globes, spotlights, floodlights and some shaped like candle flames. One useful shape is the
MR16, a smallish, cone-shaped bulb. Which bulb will work in your can lights? Which is best for the ceiling-fan light?
For a table lamp? At www.energystar.gov/ia/products/fap/purchasing_checklist_revised.pdf?c9a7-beca you will find
a brief, illustrated Energy Star guide and EarthEnergy’s bulb guide show which shapes work best in various types of
fixtures.
5. Choose the right bulb for dimmers. Another problem with LEDs used to be finding bulbs that were compatible
with the dimmer switches in your home. Some buzz, flicker or just fail to respond to a dimmer switch. Those still can
be problems, but CNET tested 6 bulbs and has a recommendation. The Philips 60-watt LED performed best. It’s easily
found in stores, but don’t confuse it with the less-expensive Philips SlimStyle LED, which buzzed badly in a dimmer
(although it may be good for other uses). The Philips bulb isn’t the only solution. Read bulbs’ packaging to find the
ones recommended for use with dimmer switches. Or take another route: Replace your dimmer switches. Popular
Mechanics says: The solution is to buy a dimmer switch rated for both CFL and LED bulbs. Two reputable
manufacturers of CFL/LED dimmers are Leviton and Lutron; both provide lists of bulbs they’ve verified will work
with their dimmers.
Count the savings. Still wondering if LED bulbs are worth the trouble? A look at the cost savings may persuade
you. At http://energy.gov/energysaver/articles/how-energy-efficient-light-bulbs-compare-traditional-incandescents is
a chart comparing the cost of operating a 60-watt incandescent bulb and an equivalent 12-watt LED Based on 2 hrs/day
of usage with an electricity rate of 11 cents per kilowatt-hour. Overall the LED:
 Costs $1 a year to run vs. $4.80 for the incandescent bulb.
 Cuts your spending on electricity by 75 percent to 80 percent.
 Burns for about 25,000 hours vs. 1,000 hours for the incandescent bulb.
An online search shows the cost of a 12-watt LEDs is roughly $10 to $30 each vs. about $1 for a plain 60-watt
incandescent bulb. [Source: MoneyTalksNews | Marilyn Lewis | May 15, 2015 ++]
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Notes of Interest
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► 01 thru 14 Nov 2015
VA Home Quincy IL. Seven people died and 32 were sickened in a Legionnaires' disease outbreak at a
veterans home in Quincy, Illinois, state veterans and health officials said in a statement on 1 SEP.
China’s military. President Xi Jinping announced 3 SEP that China will cut its military by 300,000 troops,
a significant reduction in one of the largest militaries in the world and a move that the Chinese leader called
a gesture of peace.
Longevity. According to the CIA, the average American should expect to live about 79.56 years, or
41,844,484 minutes.
Online Purchases. Does the Web address have an “https” at the beginning indicating it is a secure link? If
not, that’s your cue to take your online shopping elsewhere to avoid having your credit card info disclosed
to whoever is on the other end.
Active duty Pay Raise. President Obama informed Congress 28 AUG that he’ll follow through with plans
to cap military pay raises at 1.3 percent next year, as part of an effort to keep down mounting defense
spending.
Military ID Cards RP. JUSMAG Philippines is now doing renewal ID cards for Retirees and Widows. You
must get appointment online. Spouse and dependent ID’s still require mail in renewals. Initial issues can still
be done through JUSMAG, but again appointment is required.
U.S. Citizenship. According to new government data, a record 1,426 Americans relinquished their U.S.
passports during the third quarter of this year. The new quarterly record for renunciations topped the previous
record of 1,335, which was set in the first quarter of 2015. So far this year, 3,221 Americans have renounced
their U.S. citizenship.
Country & Western. Go to https://www.facebook.com/OldFartsAndJackasses.Official for some oldies but
goodies.
Cable TV/Internet. Verizon has started offering veterans a discount on the use of their services. Proof of
service is required. Cellphones. Check out how one church is coping with attendee’s cellphone use during
services at http://www.youtube.com/embed/D2_c81Nnsc0 .
VAMC Aurora. The federal government awarded a final construction contract 27 NOV to complete an
over-budget veterans medical center in Aurora by January 2018. The contract authorizes builder KiewitTurner to spend about $571 million more to finish the VA Hospital, on top of nearly $1.1 billion already
spent.
The Fifties. Go to http://biggeekdad.com/2013/01/the-best-of-times/ for a little nostalgia if you are old
enough to remember the era.
God Bless America. Check out http://biggeekdad.com/2014/09/john-wayne-1970/#at_pco=smlrebh1.0&at_si=56401ed86613c598&at_ab=per-12&at_pos=5&at_tot=7 to see a little more nostalgia hosted by
John Wayne.
VA Employment. The Veterans Affairs Department has fired 400 more employees this year so far than in
2014, according to Secretary Bob McDonald.
Death Row. One in 10 death row inmates are veterans, according to a new DPIC report, which estimates
that roughly 300 former military personnel are awaiting execution in the U.S.
Football. The National Football League will pay back taxpayers for the money its teams received for public
salutes to the military at their stadiums. If signed into law, a provision in S.1356, the FY 2016 NDAA will
prevent future such expenditures by the Department of Defense.
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Rubber Bands. Check out https://www.youtube.com/embed/zHN_fQr8XYA?rel=0 for additional usage
tips that will save you time and money.
Women. According to the Census Bureau a higher percentage (36.4%) of young women (18-34) were living
with family in 2014 than in any other year on record. Today’s young women are more likely to marry later
in life. In 1940, the typical woman entered her first marriage at age 21.5, whereas last year, it was age 27.
And, as of 2014, 27 percent of young women were college students.
VA Transgender vet Clinic. For the first time, a U.S. Department of Veterans Affairs hospital is opening a
clinic for transgender patients. The Louis Stokes Cleveland VA Medical Center, starting this month. will be
able to provide them primary care, hormonal therapy, mental health care and other services.
USPS. The U.S. Postal Service turned an operational profit of $1.2 billion in fiscal 2015, marking the third
consecutive year its revenue exceeded its controllable costs, though it continued to bleed into the red with a
net loss of $5.1 billion due to external requirements from Congress.
A Salute to You. Go to https://www.youtube.com/v/AgYLr_LfhLo?version=3&hl=en_US&rel=0 for
something to show your grandchildren.
[Source: Various | Nov 14, 2015 ++]
Westgate Resorts Vacation Offer
► Free to 2500 Military
Westgate Resorts and CEO David Siegel are continuing the company tradition of honoring former and current U.S.
military personnel by giving away free vacations – and for the first time, the number of vacations is being increased
to 2,500. Beginning November 11 at 9 a.m., the first 2,500 eligible service members who complete the online military
appreciation form at www.westgatedestinations.com/thankyoumilitary will receive a complimentary three-day, twonight vacation at an eligible Westgate Resorts property in Orlando, Fla., River Ranch, Fla., Branson, Mo., Gatlinburg,
Tenn. or Las Vegas*. Westgate has now honored our military with more than 7,500 free vacations. “As a veteran, I
understand the dedication and sacrifice required of our troops,” said Siegel. “I am incredibly proud of these national
heroes, and it is our pleasure to thank them with an unforgettable vacation experience.” Other past U.S. military
members are eligible for Westgate’s special Veterans Day military discount, which offers a savings of 25 percent on
room rates for stays booked 11 NOV.
* Offer valid as of November 11, 2015, at 9 a.m. EST. Offer available by going online and filling out an availability
form at www.westgatedestinations.com/thankyoumilitary . Based upon availability. A credit card is required to book
the reservation. Credit card will not be charged. Only ONE reservation per family. Offer valid for the first 2,500
reservations. Must travel before November 26, 2016. Free Room Type for Westgate River Ranch Resort & Rodeo
(River Ranch, Fla.), Westgate Lakes Resort & Spa (Orlando, Fla.), Westgate Vacation Villas Resort & Spa
(Kissimmee, Fla.), Westgate Town Center Resort & Spa (Kissimmee, Fla.), Westgate Towers Resort, (Kissimmee,
Fla.) Westgate Branson Woods Resort (Branson, Mo.) and Westgate Smoky Mountain Resort & Spa (Gatlinburg,
Tenn.): Studio Only. Free Room Type for Westgate River Ranch Resort & Rodeo: Lodge Suite or Lodge Guest Room
Only. Free Room Type for Westgate Las Vegas Resort & Casino: Premium Room Only. No resort fee will be charged.
No Resort Preview Required. Not valid for Westgate employees. Upgrades are available for a minimal fee. Additional
night(s) will receive 10% off of “Best Available Rate”. Cancellation forfeits free reservation. There is no cancellation
fee. Blackout dates apply.
Founded in 1980 by David A. Siegel, Westgate Resorts is one of the largest resort developers in the United States.
Westgate features 28 themed destination resorts with over 13,000 luxury villas in premier locations throughout the
United States such as Orlando, Florida; Park City, Utah; Las Vegas, Nevada; Gatlinburg, Tennessee; Myrtle Beach,
South Carolina; Williamsburg, Virginia; Miami, Florida; Branson, Missouri; Mesa, Arizona; and Tunica, Mississippi.
For more information about Westgate Resorts, visit www.westgateresorts.com. [Source: Veteran Resources | Donnie
La Curan | October 30, 2015 ++]
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People Search
► Public Information Search Engine
People Search at www.zabasearch.com helps you find someone's contact information, reconnect with family and
friends, do an address search or a phone number lookup. You can also get social network profiles and an email search
with a People Search Plus Report. Type in your name and see what comes up. At no charge information on people
can be obtained by entering the following:
Name: Sample Search: Michelle Obama. Last name required. To narrow the search you can enter first name, city
and/or state Search any name in the U.S. with or without a middle initial. People search results will include address
and telephone numbers found in U.S. public records.
Telephone Number - Identifies, when available: phone type and carrier, owner's name, location, address history, age,
relatives, and more.
Criminal Record – First and last name required.
Reverse Phone Lookup: Sample Search: 3154480470. Search any 10-digit U.S. phone number. Reverse phone
search results will include the names and addresses found in U.S. public records that match the phone number being
searched. Geographical information related to the phone number search is also included.
Area Code Search: Sample Search: 312. Search any 3-digit area code in the U.S. Area code search results will
include geographical data about the area code, phone number exchanges in that area code, and a map of the area code
region.
Zip Code Search: Sample Search: 90210. Search any 5-digit zip code in the U.S. Zip code search results will include
geographical data about the zip code and a map of the zip code region.
IP Address Search: Sample Search: 64.233.187.99. Search an IP address. IP addess search results will include
geographical data associated with the IP, the owner of the ISP, and a map of the ISP region.
Message Search: Sample Search: George W Bush. Millions of messages have been left for people on the web. There
could be one waiting for you or someone you know. Search your name or the name of someone you know to find
messages to you. This search can take up to 60 seconds.
Top 25 Searches: Find the names searched most often in ZabaSearch within the previous hour. Click on the name to
see the search results for that name. Click on the number of times that name has been searched to see the estimated
location of people searching for that name.
ZabaSphere: Sample: Erin Spahn. Know who's searching for you online.
For a fee you can also search for:
 Social Security Number Search: Go to SS# Search. Search any 9-digit social security number to find the
person associated with that number, addresses, phone numbers, and additional information. This premium
social security number search is provided by Intelius.
 Background Check: Go to Background Check. Conduct a background check with as little information as a
name. Get a report with up to 20 years of history on the individual. This premium background check service
is provided by Intelius.
 Reverse Cell Search: Go to Reverse Cell Search. Search for any 10-digit U.S. cell number or land line to find
the name and location of the owner. This premium reverse phone search is provided by Intelius.
 People Search: Go to Premium People Search. Search people by name, previous address, and age to locate
current address and phone records for people you can't find in ZabaSearch. This premium service provided
by Intelius.
[Source: www.zabasearch.com | Oct 2015 ++]
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Superfluous Information
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►
Stuff You Probably Do Not Know
Men can read smaller print than women can; women can hear better.
Coca-Cola was originally green.
It is impossible to lick your little toe.
The State with the highest percentage of people who walk to work: Alaska
The percentage of Africa that is wilderness: 28%
The percentage of North America that is wilderness: 38%
The cost of raising a medium-size dog to the age of eleven: $ 16,400
The average number of people airborne over the U.S. in any given hour: 61,000
Intelligent people have more zinc and copper in their hair.
The first novel ever written on a typewriter was Tom Sawyer.
The San Francisco Cable cars are the only mobile National Monuments.
Each king in a deck of playing cards represents a great king from history: Spades - King David Hearts Charlemagne, Clubs -Alexander, the Great, Diamonds - Julius Caesar
111,111,111 x 111,111,111 = 12,345,678,987, 654,321
If a statue in the park of a person on a horse has both front legs in the air, the person died in battle. If the
horse has one front leg in the air, the person died because of wounds received in battle. If the horse has all
four legs on the ground, the person died of natural causes
Only two people signed the Declaration of Independence on July 4, John Hancock and Charles Thomson.
Most of the rest signed on August 2, but the last signature wasn't added until 5 years later.
In Shakespeare's time, mattresses were secured on bed frames by ropes. When you pulled on the ropes, the
mattress tightened, making the bed firmer to sleep on. Hence the phrase...'Goodnight, sleep tight'.
It was the accepted practice in Babylon 4,000 years ago that for a month after the wedding, the bride's
father would supply his new son-in-law with all the mead he could drink. Mead is a honey beer and
because their calendar was lunar based, this period was called the honey month, which we know today as
the honeymoon.
In English pubs, ale is ordered by pints and quarts... So in old England, when customers got unruly, the
bartender would yell at them 'Mind your pints and quarts, and settle down.' It's where we get the phrase
'mind your P's and Q's'.
Many years ago in England, pub frequenters had a whistle baked into the rim, or handle, of their ceramic
cups. When they needed a refill, they used the whistle to get some service. 'Wet your whistle' is the phrase
inspired by this practice.
YOU KNOW YOU ARE LIVING IN 2015 when...
1. You accidentally enter your PIN on the microwave.
2. You haven't played solitaire with real cards in years.
3. You have a list of 15 phone numbers to reach your family of three.
4. You e-mail the person who works at the desk next to you.
5. Your reason for not staying in touch with friends and family is that they don't have e-mail addresses.
6. You pull up in your own driveway and use your cell phone to see if anyone is home to help you carry in the
groceries.
7. Every commercial on television has a Web site at the bottom of the screen.
8. Leaving the house without your cell phone, which you didn't even have the first 20 or 30 (or 60) years of your
life, is now a cause for panic and you turn around to go and get it !
10. You get up in the morning and go on-line before getting your coffee.
11. You start tilting your head sideways to smile. :)
12 You're reading this and nodding and laughing.
13. Even worse, you know exactly to whom you are going to forward this message.
14. You are too busy to notice there was no #9 on this list.
15. You actually scrolled back up to check that there wasn't a #9 on this list.
Q. Half of all Americans live within 50 miles of what? (A) Their birthplace
Q. Most boat owners name their boats. What is the most popular boat name requested? (A) Obsession
Q. If you were to spell out numbers, how far would you have to go until you would find the letter 'A'? (A) One
thousand
Q. What do bulletproof vests, fire escapes, windshield wipers and laser printers have in common?
(A) All were invented by women.
Q. What is the only food that doesn't spoil? (A) Honey
Q. Which day of the year, are more collect calls made than any other day of the year? (A) Father's Day
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Have You Heard?
► Testicle Therapy!
Two women were playing golf. One teed off and watched in horror as her ball headed directly toward a foursome of
men playing the next hole.
The ball hit one of the men. He immediately clasped his hands together at his groin, fell to the ground and proceeded
to roll around in agony.
The woman rushed down to the man, and immediately began to apologize. 'Please allow me to help. I'm a Physical
Therapist and I know I could Relieve your pain if you'd allow me.' she told him.
'Oh, no, I'll be all right. I'll be fine in a few minutes,' the man replied. He was in obvious agony, lying in the fetal
position, still clasping his hands there at his groin.
At her persistence, however, he finally allowed her to help. She gently took his hands away and laid them to the
side, loosened his pants and put her hands inside.
She administered tender and artful massage for several long moments and asked, 'How does that feel?'
He replied: 'It feels great, but I still think my thumb's broken!'
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Have You Heard?
► Ba-da-ba-da BOOM
The Israelis are developing an airport security device that eliminates the privacy concerns that come with fullbody scanners.
It's an armored booth you step into that will not X-ray you,... but it will detonate any explosive device you may
have on your person.
Israel sees this as a win-win situation for everyone. There's none of the crap about racial profiling, and it eliminates
the costs of long, expensive trials. You're in the airport terminal... and you hear a muffled explosion. Shortly
thereafter, an announcement:
"Cleanup in booth #8", and "Attention to all standby passengers: El Al is pleased to announce a seat is available
on flight 670 to London. Shalom!"
BRILLIANT!
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