I beat Dave to the punch, looks like a pretty good site.

quote:

Originally posted by Dave_M:
I am 100% SC and usually I can get an appointment easily for my doctor - I only see VA for SC issues. When I had seen my doctor in November they where not scheduling the clinic. When they reminded me, it took 3 more months to get in. Part of the issue was my doctor was out of town for several conferences. If I wanted to I could see another doctor or fellow in the service - several have also treated me, and if I wanted i would have. I needed an Rx, and I asked for that doc to write it in the absence of my regular since he had treated me before. He called me and we got it done.

I often choose care outside the VA for more control. I am lucky, I have choices. I also have a good care system that I have built. That is part of the reason we have not moved to the SE - trying to replace our care system would be hard.

You too are one of the lucky ones who have a choice of health care providers as I do...

Here is a little true story..There is a WW2 veteran goes the the PTSD clinic as I do. He is 100% P+T... He was a Ranger who had gotten captured after receiving many wounds. He just couldn't get away so he was captured + remained as a POW... The bullets and metal are still in him as they give him problems from time to time...He as some of us had many visits to the VA and had outside care. Some of us prefer the outside care from a private doctor...

Expensive? I think so.. $325/month to me is expensive...I often think that why should we veterans who have 100% P+T like the WW2 vet and me really need to go outside to get treatment? Well, it is the comforting feeling that we as combat vets should be able to choose what we need and want to do whenever the need arises.. So we pay extra for the option of giving us and our families a simple fact of giving us peace of mind.

Another veteran, a Marine, at the clinic went outside (private doctor) to get a problem corrected. It was noted as "PTSD" and he was indeed diagnosed as having this terrible disorder. His outcome was postive. Positive because after several years of documentation and his private doctors visits were that the VA approved of his private doctors results..His next step was another VA C+P which eventually gave him and his family the security they required .....100%

I trusted the VA for my proper treatment and I was diagnosed as having PTSD...I did have a great VSO and good VA doctors for this problem..I also had a very good private doctor who in 1984 originally documented this as a "Stress" disorder because no one knew of PTSD...

PTSD did not go away and I believe will never go away but having the security of my wife having medical through the VA and whereever she wants to go gives me one less thing to worry about...

I guess waiting in line does get me ticked off so nowadays I get medicated and have them (the VA) send the scripts to my home address. We vets should NOT be burdened to wait in any line at the VA. We also need to be fully income tax exempt..Contact your congressperson...

God Bless our troops...

Sua Sponte
Steve

Steve I am fortunate - when I went back into the VA system, I was already rated 70% and my doctor at University's wife was a VA doc. She told him what I need to get the care at the VA and he sent me to one of his partners who was on staff at the VA. At the time the care they thought I needed had a lifetime cost of about $1 million dollars and I was concerned out my 20%. Since it was for my SC, they did the testing, etc. Fortunately after about 18 months it was clear for now that was not an issue, and in that time my rating was increased enough that I was able to put my finances in order.

If I need the surgery, I will probably have it private (the closed the program I was using), but the VA has agreed to pay the ongoing medicine which is a huge part of the total cost.

quote:

Reply

VETERANS REJECTING CARE AT PRIVATIZED VA OUTPATIENT

CLINICS -- Valor Healthcare gets a flat, per-patient rate. Vets claim,

"...The more money they saved, the more money they made."

Now, VA says they are "not satisfied" with Valor's performance



Veterans complain about county clinics

By Marty Schladen
The Daily News
Published April 13, 2008

Some locals say that care and customer service at veterans’ medical clinics in Galveston County has been so bad it’s made some sick and left others worrying they might get sick if they keep using them.

They question whether an arrangement under which the U.S. Department of Veterans Affairs pays a contractor a flat, per-patient rate to operate the clinics gives the contractor a financial motive to deny care.


http://www.galvnews.com/story.lasso?ewcd=76cf47e23b2831...0a15c000F5yyW32920A3

Vietnam vet confronts his demons, finds his calling

For years, "Doc" Bernie Duff dreamed about Vietnam: the horror of war, the hell inflicted on him and his fellow man.


http://www.mlive.com/news/index.ssf/2008/04/heaven_and_hell.html

A SINGLE TREATMENT FOR PTSD? -- Larry Scott, founder of VA

Watchdog dot Org, contends that the IOM report furthers the VA's real intention: to curtail spiraling disability benefits by narrowing the diagnosis and treatment of PTSD.


http://vawatchdog.org/08/nf08/nfMAR08/nf032408-3.htm

RETURNING VETERANS FACE NEW STRUGGLE -- Increasing number of soldiers returning from Iraq and Afghanistan are falling into homelessness upon discharge.

"But, hopefully, in the last 25 years, we've learned some things so we can give people the help they need," Gilbert said.



http://www.vawatchdog.org/08/nf08/nfAPR08/nf041408-6.htm



Is there something new about this declaration? This has been happening for decades. This is no "new Struggle", give me a break.

What is it, that they've learned about the "last 25 years'?

quote:

Is there something new about this declaration? This has been happening for decades. This is no "new Struggle", give me a break.

What is it, that they've learned about the "last 25 years'?

Nothing new at all, it is the same problem our generation faced, upon return from our duty. It is high time we correct the problem. Time to draw the line. Those who didn't go need to give support to those who did go, to PRESERVE their our way of life.

From the Ohio State Association of County Veterans Service officers:

BROWN URGES FEDS TO RELEASE MILITARY PERSONNEL FILES AT NO COST

Senator: Our Nation’s Veterans Should Not Have To Pay For Their Own Records

Washington, DC – U.S. Senator Sherrod Brown (D-OH) today urged the administration to release military personnel files for veterans for free. Under current rules, the National Archives and Records Administration (NARA) charges veterans and their families fees of up to $50 to access their individual Official Military Personnel Files (OMPF). In a letter to Allen Weinstein, Archivist of the United States, Brown asked that the fees be waived for any veteran or family member seeking to obtain their personnel file.

“Charging veterans for a copy of their personnel records is an outrage,” Brown said. “Particularly when you consider that our nation has yet to fully fund the benefits these veterans earned with their service to our country. These records are a symbol of the sacrifice veterans and their families have made. They are meaningful to veterans, they are meaningful to their families, and they should be free.”

While the NARA waives fees for veterans or immediate family members seeking to validate a benefit or entitlement, Brown believes this exemption is too narrow and charging any fee to any veteran or family member is unjustifiable. He is concerned that many veterans who served in World War II will be unable to afford the fees to acquire their records.

“We must honor the service and sacrifice of our nation’s veterans. Providing veterans and their family members unfettered access to desired military records is the very least we can do,” Brown wrote today.
# # #

I have received many an invoice over the years however they were always waived. Recently a move by the VA Central Office is to prevent those veterans service officers working in VA Medical Centers or Regional Offices from accessing NPRC records. This is just another move to limit the ability of a VSO, to prove stressors and/or other pertinent facts as Agent Orange exposure locations in claim development. Multiple hundreds of times, I have found information previously undiscovered information.
Oh well, we will find a way, after all we learned how to improvise on active duty, serving our nation.

Charging veterans for a copy of their personnel records is an outrage,” Brown said. “Particularly when you consider that our nation has yet to fully fund the benefits these veterans earned with their service to our country. These records are a symbol of the sacrifice veterans and their families have made. They are meaningful to veterans, they are meaningful to their families, and they should be free.”

I read this above,, and just shooked my head in sadness, and fruststratation... These files belong to us.. we should be able to see them or get a copy.

SSgt65

My worst nightmares, is getting civilian med records for the VA. Something in the HIPA, privacy act, etc, precludes a hospital or doctor from giving you YOUR records for the VA without huge charges. I just get very loud and say "you mean you discriminate against combat veterans? You will furnish them for a dozen reasons free, but charge a veteran trying to get his disability compensation from defending your country?" I always seem to "win", they decide to make an exception for me.
I guess PTSD DOES have its good points!

Schwanke. a person should be able to get any medical records from their outside providers free but often (and you are right) they want you to pay.

I recently went to an orientation for people considering a surgery that is not provided by the VA and we were told that this (the above) is very common but if you use the legal words that you need your records for 'continuity of care' they are required to furnish copies free and cannot refuse to do so.

I didn't need to do this as 99% of my care is thru the VA and all I need to go to records to get free copies.

Hope this helps

They got an excuse for that too. "Just give me the name and address of your doctor and we will send them right over". Also, they WILL furnish them to the VA, but although I was born in the dark, it was last night! Can you imagine the VA getting copies of your records and actually getting them to your file?
Then is usually when the shouting starts. If there is a small crowd, it takes less hollering.

I get copies of my records of tests when they are created so that the VA, my disability insurance and my other doctors have the information.

RAO Report Page 1
I BILL UPDATE 19: In APR representatives Harry Mitchell (D-AZ) and Bobby Scott (D-VA) introduced a sweeping GI Bill reform package with the “Post 9/11 Veterans Education Assistance Act” (H.R.5740). This is the new companion bill to the "Veterans Educational Assistance Act of 2007" ( S22) introduced by Sen. Jim Webb (D-VA) 4 JAN 07. The house bill would:
• Reimburse the cost of a veteran's education up to the highest in-state cost at public colleges or universities and establish a housing allowance based on DoD's geographic housing allowance. Each veteran would get an individualized benefit based on school cost and location.
• Create a partnership with private colleges or universities. Private schools would be invited to pay half the difference between what the new GI Bill pays and the cost of the private college. The government would pick up the other half.
• Reservists called to active duty on "contingency operation" orders would accrue entitlement to the new GI Bill in proportion to the number of 90-day tours served, up to a maximum of 36 months.
• Officers commissioned from a service academy or ROTC scholarship program (who currently are denied GI Bill coverage) would be entitled to the benefits if they agreed to extend their service commitments.

Earlier, House Veterans Affairs Subcommittee Chairwoman Stephanie Herseth-Sandlin (D-SD) and Ranking Member John Boozman (R-AR) sponsored their own plan to upgrade GI Bill benefits, H.R.5684. This bill would raise GI Bill payment rates to $1,450 from the current rate $1,101 monthly rate -- a total of $52,200 for 36 months of full-time study. The bill would offer a $500 per month housing stipend for full-time study and $250 for half-time study. Under this proposal, a veteran who applies for other federal financial aid would not be required to report as income the value of MGIB benefits and could even use the benefit to repay prior federal student loans. However, H.R.5684 would not address the "accrual" issue for reservists called up for multiple tours of active duty.

H.R. 5740 already has garnered 182 bipartisan cosponsors in just a few days. Both bills would extend the post-service usage period from 10 to 15 years. The major difference between the two proposals is that H.R. 5684 would pay a single monthly rate ($1450) under current MGIB rules to all veterans and pay a set stipend for living expenses. H.R.5740, on the other hand, would tailor benefits to each veteran's program, including housing costs. Both bills face the daunting challenge of overcoming congressional budgeting requirements to pay for the increased benefits with offsetting budget cuts or higher taxes. According to Hill sources, lawmakers are considering bypassing those rules by using the Iraq War Emergency Supplemental funding mechanism to jumpstart the cost of a new GI Bill. [Source: MOAA Leg Up 11 Apr 08 ++]


TRICARE SUPPLEMENTAL INSURANCE UPDATE 03: On 28 MAR DoD published a proposed regulation establishing rules on what employers can and can't do for employees who choose to use Tricare rather than employer-sponsored health plan(s). This regulation will clarify a law change that took effect in January which bars employers from offering Tricare-specific incentives for employees to drop employer health coverage and use Tricare instead. Congress' intent in passing the law was to stop employers from consciously seeking to shift their health care costs to the Defense Department. It was in reaction to the discovery that some airlines, defense contractors, and state governments had sent letters to Tricare-eligible employees offering them special incentives to do that, including offering to pay for their Tricare supplement policies. The new law bars such practices. However, the law's specific language did not explicitly address other common situations, such as employers who offer only cafeteria plans with cash payments that employees can use to purchase coverage tailored to their needs. It also did not address employers who offer a flat cash payment to any employee who uses some other coverage, such as federal employee health coverage, a spouse's coverage, or Tricare. In the absence of a regulation clarifying the law, some employers simply stopped offering Tricare supplemental policies, arbitrarily excluded military retirees from cafeteria plans, or refused to extend the same cash payments to Tricare beneficiaries that they offer to other employees who use some alternative coverage. The new draft regulation clarifies that cafeteria plans are not excluded under the law and that cash payments offered by employers to those who use other coverage are permissible for Tricare-eligibles as long as equal payments are made to all who use alternative coverage (not just Tricare). The regulation is expected to take effect by mid-summer after a brief public comment period. [Source: MOAA Leg Up 11 Apr 08 ++]


FVE SCHOLARSHIPS: Currently the maximum educational benefit available to veterans of Iraq and Afghanistan under the GI Bill is just $1,101 per month, or $39,636 over four years. Those veterans who served combat tours with the National Guard or Reserves are eligible for even less - typically just $440 per month. In contrast, the College Board reports that the average four-year public college costs more than $65,000 for an in-state student, while a private university costs upward of $133,000. To help bridge that gap additional assistance can be applied for through the Fund for Veterans' Education (FVE). This fund provides higher education scholarships to veterans of all branches of the United States Armed Forces who have served in Iraq or Afghanistan. Founded in 2007, the FVE will provide scholarships for undergraduate study during the 2008 and 2009 academic years. Scholarships will be awarded, based on need, to veterans from all fifty states and the District of Columbia who are pursuing undergraduate degrees at four-year colleges and universities, two-year community colleges, and a range of technical and vocational schools. The FVE is a program of The Kisco Foundation, Inc. an independent, not-for-profit 501(c)3 organization. The Fund's revenue is derived entirely from grants and gifts from foundations, corporations, and individuals. All gifts are tax deductible. The Fund for Veterans Education will award up to $3.5 million in 2008-09 in undergraduate scholarships for veterans returning From Iraq and Afghanistan . Applications are available beginning 1 APR for the fall 2008 term. The next application deadline is 15 JUN 08. The awards, which may be renewed for the following academic year, are intended to cover financial need not met with need-based grants and military education benefits. For more information and to apply refer to http://www.veteransfund.org/apply.php. [Source: NAUS Weekly Update 11 Apr 08 ++]


RESERVE RETIREMENT AGE UPDATE 13: A bipartisan group of 10 senators moved 9 APR to greatly expand a new reserve retirement pay formula to provide credit toward earlier retirement checks for any time spent mobilized since 911. A new law took effect in January that allows reservists, who now must wait until age 60 to draw military retirement pay, to get payments 90 days earlier for every 90 days of continuous mobilization. But credit is given only for days spent on active duty as of the date the bill became law. The lack of retroactive credit in the new law, included in the 2008 Defense Authorization Act that was signed on 28 JAN, prompted complaints from a host of military and veterans groups, including the major National Guard and reserve associations. Sens. John Kerry (D-MA) and Saxby Chambliss (R-GA) are the chief sponsors of the new bill. Cosponsors include Sens. Lamar Alexander (R-TN); Hillary Rodham Clinton (D-NY); Norm Coleman (R-MN); Susan (R-ME);; Johnny Isakson (R-GA); Blanche Lincoln (D-AR); Mark Pryor (D-AR); and Pat Roberts (R-KS). Chambliss was the chief sponsor of last year’s reserve retirement proposal, passed by the Senate, that would have been retroactive to 2001. The effective date was changed in negotiations with the House as a money-saving move. Chambliss said the 2001 effective date makes more sense because that is when the role of the National Guard and reserve components “fundamentally changed.” The bill is called the National Guard and Reserve Retired Pay Equity Act. It was referred to the Senate Armed Services Committee, which will hold a hearing next week on pay and benefits issues. Congressional aides, speaking on the condition of anonymity, said there is little doubt the Senate will pass the bill. The big obstacle remains the House of Representatives, which operates under tougher budgetary rules that would require lawmakers to pinpoint a source of funding for the retroactive benefits. Such a funding source has not yet been identified, Chambliss aides said. [Source: NavyTimes Rick Maze article 9 Apr 08 ++]


DEPLETED URANIUM UPDATE 05: It's been 16 months since New York lawmakers approved a plan to help veterans get tested for war-related toxins, including radioactive particles from tank-killing depleted uranium shells used in the Persian Gulf. But with just two members of the 11-person panel that's supposed to oversee the effort actually appointed, testing has yet to start. Joe Franklin, vice chairman of the National Disabled Veteran Business Council and other advocates on 8 APR called for a number of measures to help veterans, including the stalled effort to test for toxins. According to the legislation, the Assembly speaker and Senate majority leader each appoint two members to the panel, while the minority leaders each appoint one and the governor names five. So far, Speaker Sheldon Silver and Majority Leader Joseph L. Bruno have made one appointment each, with Bruno naming SUNY researcher David Carpenter and Silver putting Phillip Landrigan of Mount Sinai medical center on the board. But without the other nine members, little if anything has been done. And there seems to be little communication among lawmakers, the governor's office and government agencies that would be working with the new task force. One advocate said she thought the lack of action by the governor's office may be the result of former Gov. Eliot Spitzer's battles with Bruno last summer over a travel records scandal, followed by Spitzer's sudden resignation last month in a prostitution scandal. Depleted uranium, used in the first Gulf War, has a high density that allows it to penetrate tank armor. But when it explodes or catches fire, the uranium is released as microscopic particles, which can be inhaled or ingested. Since the particles are radioactive, some fear anyone exposed to them could contract cancer years later. Activists draw parallels to the problems that arose from Agent Orange, a defoliant which used during the Vietnam War and linked to illnesses among some veterans exposed to it. "This whole scenario is playing out much like Agent Orange," said Assemblyman Dan Burling, R-Warsaw, and a Vietnam veteran. [Source: Capitol Bureau Rick Karlin article 9 Apr 08 ++]


TRICARE PROVIDER AVAILABILITY UPDATE 01: According to the DoD Survey of Civilian Physician Acceptance of Tricare Standard, findings show that in fiscal 2007, almost 93% of responding physicians in 53 hospital service areas were aware of the Tricare program, with 84% of physicians in those 53 HSAs accepting new Tricare Standard patients. Overall this indicates the number of providers in the program is increasing. The 2007 survey was the final installment of a three-year national effort to measure awareness of Tricare and to determine the number of physicians who accept new Tricare Standard patients. DOD officials randomly surveyed physicians in 20 states in both FYs 2005 and 2006. The 10 remaining states and Washington, D.C., were surveyed in FY 2007. Physicians in local HSAs also were surveyed each year. Approximately 40,000 physicians from a variety of medical specialties were randomly picked. The aggregate results show that civilian provider awareness and acceptance is generally high, but may vary depending on location. In addition, the survey revealed a need for increasing both Tricare awareness and acceptance among psychiatrists, a specialty critical in meeting the behavioral health needs of veterans of the war on terrorism. Specifically, the three-year findings across all states and HSAs show:
• Approximately 87% of all physicians surveyed are aware of the Tricare program.
• About 81% of physicians that accept new patients also accept new Tricare Standard patients.
• Of those accepting new Tricare Standard patients, almost 91% do so for all patients, rather than on a case-by-case basis.
• Reimbursement rates were among the most commonly cited reasons for not accepting Tricare Standard.

Army Maj. Gen. Elder Granger, deputy director of the Tricare Management Activity (TMA) said, "In some locations, access to Tricare Standard providers remains a major concern for family members and retirees. Some doctors limit the number of Tricare patients they see or refuse to see them altogether. This leads to fewer choices for beneficiaries. While active duty service members receive the bulk of their medical care at one of the more than 500 military treatment facilities, family members, National Guard and Reserve members, and retirees often rely on civilian physicians for their health care needs. The survey findings exceeded TMA’s expectations. The surveys provide TMA with a reliable measurement as to our effectiveness in expanding access to Tricare providers and the challenges of getting more doctors on board. Congress has given additional guidance to continue the survey process through 2011. States showing a need to increase acceptance and awareness of Tricare include Alaska, Maryland, Colorado, Hawaii, Oklahoma, New York, New Jersey and Texas. Hospital service areas with lower than average Tricare acceptance include Washington DC; Raleigh NC; Seattle & Olympia WA; Lihue/Kealakekua/Wailuku HI; Dallas TX; and Falls Church VA. Tricare officials, with support from their managed care support contractors, are working to overcome these challenges.

TMA has an outreach program that reaches out to state officials, medical associations and
individual physicians to educate them and appeal to their sense of patriotism in accepting Tricare. One positive result of the program is that the Oregon legislature approved incentives including a one-time tax credit for new providers in the Tricare network, plus an additional annual credit for treating patients enrolled in Tricare. Since 2004, Oregon's Tricare provider network has increased by 35%. In addition, the governors of 20 western states have supported TMA’s efforts to encourage more health care providers to accept new Tricare patients. Their combined efforts led to an overall increase in western region Tricare network doctors from approximately 80,000 in 2004 to more than 125,000 today. Overall, there are presently more than 220,000 men and women Tricare providers. [Source: Air Force Link article 9 Apr 08 ++]


VA HIRING UPDATE 02: Pay systems pose significant challenges to the Veterans Affairs Department's efforts to hire enough doctors and nurses to meet the growing health care needs of veterans, said lawmakers and witnesses at a Senate Veterans' Affairs Committee hearing on 9 APR. Committee chairman Daniel Akaka (D-HI) daid, "A simple truth of VA health care is that its providers are the real backbone of the system. If the providers are not present, or are there but unhappy in their jobs, it is unlikely that veterans will receive the quality care they need and deserve." A number of witnesses pointed to the growing vacancy rate of certified registered nurse anesthetists as an indication of the challenge's magnitude. The Government Accountability Office reported in DEC07 that in fiscal 2005, the vacancy rate for CRNAs in VA was 13%, and 74% of chief anesthesiologists said they had trouble recruiting CRNAs in 2005 and 2006. Of those chief anesthesiologists surveyed, 79% said salaries for department CRNAs were lower than salaries at other hospitals. Half of CRNAs were older than 51, and the average certified registered nurse anesthetist working at VA was seven years closer to retirement eligibility than those working outside the system, the agency found. Of the 43 medical facilities GAO examined, 15 reported CRNA vacancy rates of 40% or higher. GAO found that those vacancies were affecting the department's ability to deliver health care services. Of the anesthesiologists surveyed, 54% said they temporarily closed operating rooms due to CRNA shortages, and 72% said those vacancies caused them to delay elective surgeries.

Sheila Cullen, medical director of the San Francisco VA Medical Center, said the problem wasn't simply that salaries in the VA system were lower, but that the pay system itself limited the center's ability to provide nurses with opportunities to advance up the salary ladder. "Current law only allows the General Schedule salary chart to be extended out an additional 18 steps," Cullen said. "Since most of these employees are hired in difficult-to-recruit clinical specialties, their salary is often set at the higher end of the pay range. This limits their opportunity for future step increases." Marjorie Kanof, GAO's managing director for health care, said VA didn't always have strong private sector salary data to use for comparison and to set pay levels. She cited one facility where planners resorted to using salary data from the Web site Hotjobs.com to make pay decisions. Even the qualities that made VA an attractive employer, such as its mission to care for wounded veterans and the ability to do groundbreaking research in its labs, were undermined by structural limitations that undercut nurses' pay or work hours, said one witness. "Unlike clinicians at most academic medical centers, VA clinicians may not fund a portion of their salaries through research grant support," said Jennifer Strauss, a health scientist at the Center for Health Services Research at the Durham VA Medical Center in North Carolina. "[VA clinicians] typically must donate their time, often performing research duties early in the morning or very late into the night after a long day of seeing patients."

Lawmakers said the pressures VA faced reflected larger challenges in the U.S. health care system. Sen. Larry Craig (R-ID), said his experiences visiting VA health care facilities had convinced him that health care payment and service delivery systems were not effectively integrated, preventing patients from seeking care at the facilities of their choice and forcing health care systems to subcontract services from each other. North Carolina Republican Sen. Richard Burr said focusing only on the VA system ignored the pressure that other hospitals and health care centers encountered as they competed for the same specialists. "VA has hired nearly 3,800 mental health workers since 2005, and may add an additional 500 in the near future," said Burr. "What impact does this have on the supply of mental health workers in the community both now and long-term? We need to be prepared to take a comprehensive view of addressing the problems." Problems with VA services in rural communities reflect and amplify a larger crisis in rural healthcare. "Some of what bothers me about what's going on right now in veterans' health care is that veterans who live in rural areas don't live as long," said Sen. Jon Tester (D-MT). "It's not a VA-exclusive problem. Every hospital in the state of Montana has a hard time recruiting and keeping people." [Source: GOVExec.com Alyssa Rosenberg article 9 Apr 08++]


VA HIRING UPDATE 03: Secretary of Veterans Affairs Dr. James B. Peake announced creation of a Veterans Employment Coordination Service (VECS) to oversee the Department’s program to recruit new veterans into the VA workforce, especially recently disabled combat veterans. The new office will work with military transition programs, veterans service organizations and other VA programs to promote careers in the VA workforce. The program will also work with VA managers and human resource offices to ensure supervisors are aware of programs for hiring veterans. Efforts to assist severely injured veterans have already begun with the Department’s participation in local career fairs targeting veterans of the Global War on Terror. In NOV 07 VA announced plans to hire 10 full-time regional veterans employment coordinators who provide hands-on assistance to veterans interested in careers at the Department. The new office will oversee the regional coordinators. About 31% of VA’s 260,000 employees are veterans, and nearly 8% are service-connected disabled veterans. VA ranks first among non-Defense agencies in the hiring of disabled veterans and is second only to the Department of Defense in the overall number of veterans on the workforce. Last fiscal year, VA hired more than 9,000 veterans. [Source: Alexander VA News Channel 5 Chris Blalock article 10 Apr 08 ++]


SENIOR MOMENTS: All of us have “senior moments” at one time or another. Perhaps you forgot where you placed your car keys, or you returned from the grocery store only to realize you forgot to purchase milk. These small “brain glitches” are normal at any age and become more frequent with age. But how can you tell if your loved one is crossing the line from normal forgetfulness to true dementia? The key to recognizing early warning signs of dementia is to be aware of the pattern, consistency, and type of forgetfulness displayed by those you re concerned about. If these senior moments are increasing in frequency and affecting their ability to carry out day-to-day functions, you have cause to be concerned. Ask a health care provider to evaluate your parent if you spot any of the following telltale signs:
• Repeating the same conversation each time you talk
• Forgetting to take medications or taking extra pills because of forgetfulness
• Paying bills late or missing payments
• Getting lost while driving familiar routes
• Difficulty balancing thee checkbook
• Unexplained purchases (including large quantities or unusual items)
• Unexplained weight loss (perhaps because of forgetting to eat)
• Change in appearance (wearing the same outfit everyday, an unkempt appearance)

An evaluation will rule out any physical cause for behavioral and mental changes. Physical causes can include infection, low vitamin B or iron levels, depression, strokes, and seizures. A doctor also can give a presumptive diagnosis of dementia based on a physical exam, laboratory tests, a CT scan or MRI of the brain, and a mini mental exam (a set of questions and simple tests for cognitive function). A definitive diagnosis is more difficult, because brain structures affected by dementia are not always indicated on a scan. In addition, there are many forms of dementia:

• Alzheimer’s disease. This is the most widely recognized form of dementia and is characterized by the formation of plaques and tangling of nerve fibers in the brain. The decline that occurs as the condition progresses follows a distinct pattern, referred to as stages. Each stage marks a specific decline in memory and brain function.
• Vascular or multi-infarct. This form is caused by “mini-strokes,” which disrupt the blood flow to specific parts of the brain, rendering them useless. This condition might present itself more subtly than Alzheimer’s and doesn’t always follow prescribed stages.
• Lewy-body. Signs of dementia and Parkinson’s disease characterize this disease. In addition to the cognitive and memory problems, Lewy-body patients often have trouble maintaining balance and experience a shuffling gait, tremors, and stiffness of the arms and legs.
• Mixed dementia. This is a combination of Alzheimer’s and vascular dementia.
• Alcohol or drug-induced dementia. This form of brain damage often is seen in younger people, generally as a direct result of alcoholism or drug use.

Unfortunately, there is no cure for dementia. Treatment focuses on slowing the progressive nature of this disease. Your health care provider can tell you if one of the currently available drugs (such as Aricept, Exelon, Namenda, and Razadyne) is right for your loved one. Medications to treat dementia-associated depression, anxiety, and behavioral issues (agitation, paranoia, and delusions) also might be prescribed if appropriate. Dementia is not a diagnosis to wish on anyone, but erroneously attributing its warning signs to normal aging or senility can rob loved ones of years of improved function and quality of life. Early diagnosis and treatment are essential. For additional info on the subject refer to the Alzheimer’s Association www.alz.org and/or the Alzheimer’s Education and Referral Center www.alzheimers.org websites. [Source: MOAA News Exchange Nanette Lavoie-Vaughan article 21 Mar 08 ++]


VETERANS COMPENSATION EQUITY BILL: U.S. Senator Daniel K. Akaka (D-HI), Chairman of the Veterans' Affairs Committee, introduced the Veterans' Compensation Equity Act of 2008 bill S. 2825 on 7 APR to provide a minimum compensation level for veterans whose service-connected injuries require continuous medication or adaptive devices, such as hearing aids. Akaka said, "Today, veterans who suffer a service-connected injury that requires continual medication or adaptive devices, like hearing aids, may not receive any disability compensation payments. It is important that all of these veterans be compensated in a fair and equitable manner. Veterans with similar disabilities should receive similar benefits." The Veterans' Compensation Equity Act of 2008 would ensure a minimum 10% disability rating for all veterans whose service-connected disability requires continuous treatment. The provision is in line with a recommendation made by leading veterans service organizations in the Independent Budget. [Source: Federal Report 8 Apr 08 ++]


GOVERNMENT CREDIT CARD ABUSE: A report by the Government Accountability Office (GAO) examined spending controls across the federal government following reports of credit-card abuse at departments including Defense, Homeland Security and Veterans Affairs. The review of card spending at more than a dozen departments from 2005 to 2006 found that nearly 41% of roughly $14 billion in credit-card purchases, whether legitimate or questionable, did not follow procedure - either because they were not properly authorized or they had not been signed for by an independent third party as called for in federal rules to deter fraud. For purchases over $2,500, nearly half (i.e. 48%) were unauthorized or improperly received. Out of a sample of purchases totaling $2.7 million, the government could not account for hundreds of laptop computers, iPods and digital cameras worth more than $1.8 million. In one case, the U.S. Army could not say what happened to computer items making up 16 server configurations, each of which cost nearly $100,000. Agencies often could not provide the required paperwork to justify questionable purchases. Investigators also found that federal employees sometimes double-billed or improperly expensed lavish meals and Internet dating for many months without question from supervisors; the charges were often noticed only after auditors or whistle-blowers raised questions.

"Breakdowns in internal controls over the use of purchase cards leave the government highly vulnerable to fraud, waste and abuse," investigators wrote, calling the government wide failure rate in enforcing controls "unacceptably high." "This audit demonstrates that continued vigilance over purchase card use is necessary," the 57-page report stated. The report calls for the General Services Administration (GSA) and Office of Management and Budget (OMB, both of which help administer the government's credit-card program, to set guidance to improve accounting for purchased items, particularly Palm Pilots, iPods and other electronic equipment that could be easily stolen. OMB and GSA were also urged to tighten controls over convenience checks, which are a part of the credit-card program, and to remind federal employees that they will be held responsible for any items if the purchases are later deemed improper. In response, both OMB and GSA agreed with portions of the report. But GSA administrator Lurita Doan noted the vast majority of federal employees use their cards properly and that many oversight measures already are in place. She acknowledged there is room for improvement but added that by using purchase cards the federal government saves about $1.8 billion in administrative costs each year.

The GAO study comes amid increasing scrutiny of purchase cards, which are used by 300,000 federal employees and are directly payable by the U.S. government. The AP reported Sunday that VA employees last year racked up hundreds of thousands of dollars in government credit-card bills at casino and luxury hotels, movie theaters and high-end retailers such as Sharper Image. Government auditors have been investigating these and similar charges, citing past spending abuses. In the report released 8 APR, investigators did not seek to determine the extent of fraud or waste at each agency. They cited numerous cases of questionable spending, which they said represented what could be found government-wide, including the VA. Among the expenditures cited in the report:

• An Agriculture Department employee fraudulently wrote 180 convenience checks for more than $642,000 to a live-in boyfriend over a six-year period. The money was used for gambling, car and mortgage payments, dinners and retail purchases that went unnoticed until USDA's inspector general received a tip from a whistle-blower. The employee, who pleaded guilty to embezzlement and tax fraud charges, was sentenced last year to 21 months in prison and ordered to repay the money.
• U.S. Postal Service workers separately billed more than $14,000 to government credit cards for Internet dating services and a dinner at a Ruth's Chris Steakhouse in Orlando FL 81 people at a cost of $160 each for steaks and crab. The dinner bill also included more than 200 appetizers and more than $3,000 worth of wine and brand-name liquor such as Courvoisier, Belvedere and Johnny Walker Gold. In the Internet dating case, a postmaster charged $1,100 over 15 months for two online services, including the Ashley Madison Agency. The expenses went unnoticed for more than a year even though he was under internal investigation for viewing pornography on a government computer. The postmaster was eventually told to repay the Internet charges but faced no disciplinary action.
• At the Pentagon, four employees purchased $77,700 in clothing and accessories at high-end clothing and sporting goods stores. The spending included more than $45,000 at Brooks Brothers and similar stores for tailor-made suits - $7,000 of which were purchased a week before Christmas. The credit-card holders said the items were for service members working at U.S. embassies with civilian attire. Pentagon rules allow purchases of civilian clothing when performing official duty, but generally only up to $860 per person.
• Justice Department and FBI employees charged $11,000 at a Ritz Carlton hotel for coffee and "light" refreshments for 50 to 70 attendees for four days, averaging about $50 per person. Seventy percent of the total conference cost of $15,000 was for the food and beverages, while audiovisual and other support services totaled only about $4,000, or 30% of the charges. It was not clear what action, if any, that Justice took in light of the conference expenses, which GAO deemed excessive.
• At the State Department, one credit-card holder bought $360 worth of women's lingerie at Seduccion Boutique for use during jungle training by trainees of a drug enforcement program in Ecuador. One State Department official later agreed that the charge was questionable and stated that he would not have approved the purchase had he known about it.
[Source: Associated Press Writer Hope Yen article 9 Apr 08 ++]


ID CARD NUMBERS UPDATE 02: On 2 APR a senior DoD official said as a means of combating identity theft, the Defense Department will issue identification cards without full Social Security numbers printed onto them. Mary Dixon, director of the Defense Manpower Data Center based in Arlington VA told Pentagon Channel and American Forces Press Service reporters, “The Defense Department cares about protecting personal information as well as increasing database security, identity theft is a very real problem today. Criminals who pilfer SSN-bearing identity cards can virtually assume someone’s identity through a few computer keystrokes and clicks of a mouse.” Tricare, the military services’ health maintenance organization, already has removed Social Security numbers from its members’ identification cards, Dixon said. Plans are to remove the Social Security numbers from identification cards issued to military family members by the end of this year, Dixon said, noting that those cards still would display the sponsors’ SSN, for now. Between 2009 and 2010, all department-issued identification cards will feature only the last four digits of a holder’s Social Security number. About 3.4 million people now have department-issued common access cards. Around two-thirds of those card holders are military members, and some civilians who deploy overseas, who have full Social Security numbers printed onto the back of their CACs. Dixon pointed out that modern information technology precludes the need to have full social security numbers printed onto employee and family member ID cards. Today, all of our (computer) systems can ‘talk’ to each other, so we don’t necessarily need to know all of that information printed on your card,. New identification cards will be issued as they reach their expiration dates, Dixon said. [Source: AFPS Gerry J. Gilmore article 3 Apr 08 ++]