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NMFA Government and You E-News - December 19, 2006

Topics in this Week's News Include:

1. New DoD Policy Focuses on Mental Health and Deployment

2. 2007 Housing Rates Posted

3. AMVETS Report Highlights Needs of Returning Service Members

4. Adaptive Sports Programs Aid Injured Service Members

5. AKO Offers Video E-mails to Deployed Soldiers and Families

6. Close Call on Physician Reimbursement Rates

7. NMFA Attends America Supports You Conference

8. What's Important to You?

9. Merry Christmas, Happy Holidays, and Happy New Year!

Here's the News!!!

1. New DoD Policy Focuses on Mental Health and Deployment: The Department of Defense has issued improved policy guidance formilitary personnel with deployment-limiting psychiatric conditions, andfor those who are prescribed psychiatric medications. The new policysatisfies many requirements established in the 2007 National DefenseAuthorization Act (NDAA). Section 738 of the law, P.L. 109-364,requires DoD to specify conditions and treatments that preclude aservice member from deploying to a combat or contingency operation. Thenew policy is intended to improve mental health screening by guidingphysicians' decisions regarding the deployment of service members whoexperience mental conditions. NMFA has often raised the issue of thedeployment and treatment in theater of service members with identifiedmental health conditions, seeking information on such questions aboutwhether and how many service members on psychiatric medications aredeployed, how service members on medications are monitored in theater,and whether consistent guidelines are followed in determining whichservice members with identified mental health conditions should not bedeployed.

Early identification and treatment of mental health problems arekeys to continuation of active service and return to duty. DoDofficials maintain service personnel with psychiatric conditions inremission and without duty performance impairment are generally fit todeploy. However, under the new guidelines, these individuals mustdemonstrate a pattern of stability without significant symptoms for atleast three months prior to deployment. Some psychiatric disordersrequire extensive and long-term care and treatment. These conditionswill cause service members to be unfit for duty and therefore routinelyprocessed out the military. Additionally, those deployed servicemembers with conditions determined to be at significant risk forperforming poorly or decompensating in an operational environment whodo not respond to treatment within two weeks will be returned to homestation. 

While not altering or replacing existing accession, retention, andgeneral fitness for duty standards, the new guidance standardizesdeployment-related mental health policy across the Service branches.The guidelines stipulate that few medications are inherentlydisqualifying for deployment. Lithium and anticonvulsants to controlmanic-depressive bipolar illness are considered disqualifyingmedications, as are antipsychotic drugs for psychotic, bipolar andchronic insomnia symptoms. Psychotic and bipolar spectrum disorders arealso disqualifying. To view the entire policy guidance, go to: http://www.ha.osd.mil/policies/2006/061107_deployment-limiting_psych_conditions_meds.pdf. (Source: http://www.tricare.mil/pressroom/news.aspx?fid=250)

2. 2007 Housing Rates Posted:Service members will receive an average 3.5 percent boost in theirBasic Allowance for Housing in 2007. The planned BAH increase startingJanuary 1 works out to approximately $300 million more than what waspaid in 2006, Department of Defense officials say. BAH is paid toservice members living off military installations or in privatizedhousing on installations. Military housing allowances are computedaccording to three key criteria: median current market rent; averageutilities, to include electricity, heat and water/sewer costs; andaverage renter's insurance. BAH rates also are based on dwelling typeand number of bedrooms in a given area and then calculated for each paygrade, both with and without family members.

Some areas' housing costs have remained relatively stable, whileothers continue to rise. Most of the costliest housing in the UnitedStates with the highest BAH rates are clustered on or near the East andWest coasts, and the state of Hawaii. For service members with familymembers, average increases in the BAH are approximately $44 per month.For example, a typical specialist/corporal (E-4) will receive about $34per month more in BAH than in 2006, while a master sergeant/firstsergeant (E-8) will receive about $42 per month more than this year.These increases do vary according to location and rank. An E-4 assignedto the Pentagon, with dependents, will receive $1,657 per month, upfrom $1,614. An E-8 with dependents in the Washington, DC Metro areawill see a monthly increase of only $10 per month, from $2,191 to$2,201. In the fast-growing community surrounding Fort Riley, Kansas,an E-4 with dependents will receive only a $17 per month increase (from$816 to $833), while an E-8 will receive a $74 per month increase,going from $1,122 to $1,196. Increases in the high cost San Diego areaare similar to those for the Metro DC area, with larger increases goingto junior service members with families.

The BAH rate system has built-in protections to ensure that anindividual service member in a given location won't see his or her BAHrate decrease. This provision assures that members who have madelong-term lease or contract commitments are not penalized if the area'shousing costs decrease. If rates are lowered in 2007 for that locationor certain ranks, incoming service members will receive the lower BAHwhile service members remaining at the location will continue toreceive the higher figure from a previous year.

To view BAH rates by year, rank, and zip code, go to: https://secureapp2.hqda.pentagon.mil/perdiem/bah.html. (Source: http://www.defenselink.mil/News/NewsArticle.aspx?ID=2458

3. AMVETS Report Highlights Needs of Returning Service Members:On November 9, 2006, AMVETS released the report, Voices For Action: Afocus on the changing needs of America's Veterans. The report resultedfrom their first ever National Symposium for the Needs of YoungVeterans held in October. The four-day event involved leaders frombusiness, government, and educational institutions, along with activeduty service members, veterans, and their families, in discussing waysto improve transition and benefit services for uniformed servicemembers and veterans. The report is broken into four major categories:benefits, employment, health care, and homelessness. It also outlinesan extensive list of concerns, recommendations, and rationales.

  • Benefits concerns included: insufficient manpower to handle appealsprocesses; training and knowledge issues involving Review Officers,Veteran Service Officers, health care, and service providers; lack ofadequate funding and collaboration between DoD and the Department ofVeterans' Affairs (DVA); and the poor quality and timeliness ofinformation given to families regarding available benefits. AMVETS'recommendation for centralized information dissemination and theestablishment of inter-government partnerships between DoD and DVA forseamless transition is similar to NMFA's position.
  • Employmentissues involved the lack of a uniform hiring policy for veteransbetween state and local governments. The current utilization of Reserveand the National Guard has exacerbated hiring issues. The reportrecommends the federal government establish a standard definition forveteran to offset the disparities in how de-mobilized Guard, Reserve,and former active duty members are treated in terms of employmentservices. NMFA supports this recommendation.
  • Homelessness is anissue for several agencies charged with supporting veterans. A largepercentage of the U.S. homeless population consists of veterans.Approximately 194,000 veterans, including those from the current war,were found living in shelters or on the street. Contributing factorshave been unemployment, housing inadequacies, untreated mental healthillness, misinformation about or disqualification for pensions, and theinability for some veterans to obtain timely access to care. The reportstates that, not only should the DVA be involved, but the Department ofHousing and Urban Development (HUD) should be held accountable forlocal homeless housing and include veterans in their continuum of care.Federal and state governments must be involved in outreach programs forreemployment. Homeless veterans' compensation and pension claims shouldbe expedited. Transportation to DVA health care facilities and serviceproviders must be provided. Participants also stated the VA should havemandatory versus discretionary funding. NMFA acknowledges homelessnessas a major concern and agrees that these recommendations would helpcorrect this growing problem.
  • Health Care issues highlightedthe problems some of the new veterans found in accessing quality healthcare. The report noted that high operational tempo has causedadditional family needs, such as legal, health care, and deploymenteducation and support. Traditionally, the VA health care system hasfocused on the health needs of the service member and veteran, but noton the family member. Even though current trends have been to includethe family for more services, more is needed. Post-traumatic stressdisorder (PTSD) was a topic of concern in regards to education toservice members, veterans, and families about presenting symptoms, lackof prompt treatment, and the potential for the service member'sdisqualification from further military service. Also, the growingpresence of women veterans may place a strain on a health care systemnot accustomed to dealing with women's health issues. Estimates showwomen will represent 14 percent of the veteran population and amajority will be under the age of 45.

The report's health care concerns and recommendations were numerousand mirror many issues raised by NMFA. Navigating the military healthcare system can be challenging, but it is even harder for young familymembers or those of Guard and Reserve members, who may be unaccustomedto military life. Recognizing the service members' extended family andeducating them about the military healthcare system was seen as a keyobjective. Offering special identification for families of the deployedwould allow easier access to military installations and health carefacilities. Frequent and lengthy deployments make it imperative familymembers are educated and incorporated into the military culture.Conference participants stated that supporting government agenciesshould build care around a philosophically embracing a lifetimecontinuum of care to service members and veterans. This new philosophywould include a commitment to quality care that encompasses everyaspect of service members' lives from enlistment to death. Thiscontinuum of care must involve all support agencies and health andservice providers, at federal, state, and local levels. DoD and DVAmust work together to streamline care and address gaps within thesystems. They must also increase resources for women's health care.

NMFA appreciates the work AMVETS did holding the symposium andputting this detailed report together. Their findings will benefitwounded service members, veterans and their families.  The full reportcan be found at: http://www.amvets.org/Assets/pdfs/Amvets_Symposium_Report_FINAL.pdf.

4. Adaptive Sports Programs Aid Injured Service Members:Active duty service member's lives change after they become wounded.Many had very active lives and participated in many different sportingventures. Thanks to modern technology, they don't have to give up thoseactivities. 

In November, the Sun Valley Adaptive Sports held a snow camp forseverely wounded service members. Outfitted with adaptive equipment,they were able to snowboard, ski, hunt, and participate in otheroutdoor activities. The camp is part of a growing trend towards helpingwounded service members with their rehabilitation. During his visits tomilitary hospitals' casualty wards, Senator Larry Craig (R-ID),Chairman of the Senate Veterans' Affairs Committee, was struck withinjured service members' desire to become physically active again. Thiscreated a partnership between the Committee and several organizations,such as the Wounded Warrior Project, Disabled Sports Program, and SunValley, to promote rehabilitation through sports and recreation. Theidea is to get the injured active again, which increases theirself-esteem and renews a sense of accomplishment. Sun Valley isprepared to assist 50 wounded service members each year through theirsummer and winter programs. Their next camp will be held in January2007.

5. AKO Offers Video E-mails to Deployed Soldiers and Families:Soldiers and families can now communicate by video e-mail through theArmy Knowledge Online (AKO) intranet portal. On the first day, morethan 3,500 video emails were transmitted. AKO video messaging allowsall deployed active-duty, National Guard, and Army Reserve Soldiers tocreate video messages on a computer with a webcam. The message is thenstored on a server and sent to the recipient via a URL link. Uponopening an e-mail, the user clicks on the link to get streaming videoand sound. The video-streaming software allows a Soldier to hear andview video email even in limited bandwidth environments, but the linkcan be accessed anytime, from anywhere.

Instructions are on a link on the AKO home page (https://www.us.army.mil/suite/login/welcome.html).Soldiers must follow the same Department of Defense security measuresused for standard e-mail. Webcams will not be used in secure areas.

Families with an AKO account can send video e-mails from home with apersonal computer and a webcam. They can also use webcams in many ofthe yellow ribbon rooms or family centers on military installations.In-theater military bases typically have webcams available at cybercafes. Service members can authorize an AKO guest account for familymembers by following the registration instructions on the site.(Source: http://www.army.mil/-news/2006/12/11/919-video-email-launches-for-deployed-soldiers-families/)

6. Close Call on Physician Reimbursement Rates:On December 7, Congress passed H.R. 6111, the "Tax Relief and HealthCare Act of 2006". Of particular interest to military families is theprovision to allow physician payments to continue at previousreimbursement rates. This is important because TRICARE reimbursementrates are directly tied to Medicare physician rates. If the 109thCongress had not acted, payments would have been cut by 5 percent inJanuary.

NMFA and other member organizations of The Military Coalitionadvocated on behalf of military families to stop any decrease inreimbursement rates. A Coalition letter was sent to Chairman BillThomas (R-CA, 22nd) supporting legislative language to maintain thecurrent physician reimbursement rate. If this language had not beenincluded, eligible TRICARE providers would have been reimbursed atlower rates. Military associations feared the lower rate might promptphysicians to drop out of the TRICARE provider networks or to refuse tosee TRICARE Standard patients. Providers might also cut back on theirMedicare patient load, possibly affecting access for Medicare-eligiblemilitary beneficiaries in TRICARE for Life.

Another provision of interest in the bill is a new quality incentivefor Medicare providers. A 1.5 percent bonus will be paid directly tophysician providers for reporting on quality measures. NMFA willexplore whether this reimbursement bonus will apply to physician claimsfor care provided to TRICARE patients since TRICARE reimbursements aretied to Medicare. Also, the bill requires a report by the InspectorGeneral on Medicare payments made for services that resulted in seriousand preventable medical errors. The National Quality Forum, whichdeveloped the national health care quality measurement standards,created this list of errors. The report will review whether payment wasdenied or the costs recovered from these services by the Centers forMedicare and Medicaid Services. NMFA will be monitoring this study todetermine how the information can be applied in the TRICARE program.

Text of the bill and additional information can be found at: http://waysandmeans.house.gov/ResourceKits.asp?section=2544.

7. NMFA Attends America Supports You Conference:Across America, ordinary people have found significant ways to showtheir unwavering support of our service members and their families. TheDepartment of Defense America Supports You (ASY) program is theumbrella organization that pulls 238 non-profit organizations and 30corporate sponsors together through integrated marketing andcommunications initiatives in support of service members and theirfamilies. ASY provides an avenue for these member organizations tohighlight the services they provide and in some cases link up withcorporate sponsors to provide funding for their endeavors. The new ASYlogo "We're At War; Are You Doing All You Can?" encourages these andother organizations to assist in letting service members and theirfamilies know that Americans are here for them.

ASY hosted its second Washington, DC, summit on December 13. NMFAwas among the 86 membership organizations in attendance. Some of themost noteworthy ASY organizations' achievements during 2006 include:

  • Sending more than 3,002,00 care packages to deployed service members;
  • Providing more than $3,417,000 in financial support to military members and their families;
  • Greeting more than 75,000 redeploying troops;
  • Sending more than 500,000 books to deployed service members; and
  • Building and/or adapting more than 2 dozen homes for wounded service members

During this Summit, member organizations received briefings fromSecretary of Defense, Donald Rumsfeld, and Deputy Assistant Secretaryof Defense for Public Affairs, Allison Barber. Additionally, GeneralMark O. Schissler, USAF, provided a very concise briefing on the GlobalWar on Terror. Stephen Epstein, DoD General Counsel's Standards ofConduct Office ended the formal session by discussing the legality ofgift giving to service members (including the wounded) and theirfamilies.

As a part of the Summit, the membership organizations were affordedan opportunity to provide input to ASY during break out sessions.Recommendations included:

  • Provide member organizations with an opportunity to meet with keyCongressional leaders--this will be a part of the 2007 Summit;
  • Develop a process to link member organizations with corporate partners;
  • Highlight best practices of member organizations;
  • Develop a screening process for membership organizations wishing to participate with ASY;
  • Conduct quarterly conference calls for member organizations

ASY also sponsors the national Freedom Walks. In 2006, more than 160locations across the United States and in the Middle East conductedFreedom Walks as a tribute to those who lost their lives on September11, 2001. These events allow all Americans the opportunity to remember,reflect, recommit, and show respect for the men and women in uniform,past and present, who protect the freedoms we enjoy.  For moreinformation on America Supports You, go to: http://www.americasupportsyou.mil/.            

8. What's Important to You? ShouldDoD do more to support families of deployed service members? Is helpingmilitary spouses in their careers a priority? How about making iteasier for you to get an appointment at your local military medicalfacility? Should Congress provide bigger military pay raises or housingallowances? As the year comes to a close, NMFA is preparing its list oflegislative and policy goals for 2007. We know we will be asked byMembers of Congress and others about the critical challenges facingmilitary families, about what's working for them, and about what isimportant to them. Now's your chance to help us tell them what reallyis important to military families. Complete our "What's Important?"survey today! Go to: www.nmfa.org/whatsimportant

9. Merry Christmas, Happy Holidays, and Happy New Year!This is the last NMFA Government and You E-News for 2006. Look for itsreturn on Tuesday, January 9. The NMFA Government Relations staffwishes you and your loved ones a happy and joyous holiday season. Ourthoughts will be with all military families during the holidays: thosewhose service members are deployed, those who are deploying, those whohave recently returned, those who work hard to support the mission athome and abroad, those who are wounded or ill. We also send our specialwishes to the families of the fallen as they face the holidays withouttheir loved ones. We thank you all for your service to our Nation.

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