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National Military Family Assn. - Government and You E-News

For the week of December 18, 2007

1. HEART Act Passes Senate with New Provisions

2. Visual Disturbances Related to TBI a Rising Concern

3. Defense Health Board Hears Task Force's Recommendations

4. Bill to Delay Medicare Physician Pay Cuts Crafted

5. New Secretary of Veterans Affairs Confirmed

6. NMFA Hosts Roundtable on Support for Wounded Warriors

7. Fisher House Foundation Joins NMFA to Give Military Spouses the Gift of Education

8. NMFA Earns An A!

9. Happy Holidays from the National Military Family Association

1. HEART Act Passes Senate with New Provisions: As previously reported in the Government and You E-News,NMFA has been closely following H.R. 3997, The Heroes EarningsAssistance and Relief Tax (HEART) Act of 2007. The bill unanimouslypassed the House in November. On December 12th the Senate passed H.R.3997 with amendments and returned it to the House. The bill is nowtitled "Defenders of Freedom Tax Relief Act of 2007". Some provisionsfrom S. 1593 have been added and an important provision for militaryfamilies has been stripped out of the current bill.

NMFA is pleased the provision to make permanent the treatment ofnontaxable combat pay as earned income for purposes of Earned IncomeTax Credit (EITC) qualification remains in the bill. In addition, theprovision permitting survivors to contribute all or part of the$100,000 death gratuity to a Roth IRA or Coverdell account would allowfamilies to provide for future education needs without tax penalties.We are disappointed that the provision to protect Supplemental SecurityIncome eligibility for families with disabled members has been removedfrom the Senate version of the bill.

We remain concerned about the provision requiring civilian employersto fully vest Reservists killed during military service for purposes ofemployer life insurance, pension and survivor benefits. This provisioncreates a disproportionate survivor benefit package for survivors ofReserve personnel while disregarding the survivor benefits provided bythe Department of Defense to any service member killed on active duty.As NMFA has argued in the past, survivor benefits must be consistentfor all families. Congress recognized that fact when the increaseddeath gratuity was provided to all active duty deaths rather than onlythose that occurred in a combat theater. Creating additional benefitsfor certain survivors creates dissention within the community andplaces a higher value on certain service.

NMFA will continue to monitor the progress of this important legislation. Watch for updates in future editions.

2. Visual Disturbances Related to TBI a Rising Concern: TheDepartment of Veterans Affairs (VA), Department of Defense (DoD), andthe Rehabilitation Strategic Healthcare Group recently hosted theVisual Consequences of Acquired Brain Injury Conference on December4-6th in San Antonio, TX. More than 500 DoD/VA neurologists,ophthalmologists, optometrists, vision and rehabilitation specialistswere in attendance to obtain and discuss pertinent information onOperation Iraqi Freedom and Operation Enduring Freedom service membersand veterans who are demonstrating signs of visual disturbancesfollowing a Traumatic Brain Injury. The goals of the conference were to:

  • Begin a dialogue between DoD and VA for an interdisciplinary approach to eye care,
  • Create a seamless transition from DoD /VA heath care facilities and vision/blind rehabilitation services,
  • Collaborate in the screening, evaluation, and treatment of visual disturbances in this population, and
  • Develop acute and long-term management of visual effects from TBI.

The VA Palo Alto Polytrauma Eye and Vision Research Team presentedtheir preliminary studies at the conference. They have found 75 percentof all polytrauma service members/veterans have self-reported some formof visual disturbance. Out of this group, 20 percent will be diagnosedwith a significant visual dysfunction, such as legal or totalblindness; 40 percent will be unable to pursue a vocational oreducational goal because of visual perception deficits; and, over halfwill be unable to comprehend any written material based at a 5th gradereading level. According to their research, 78 percent of thosediagnosed with mild TBI have mentioned some form of reading difficulty.

The recently released National Defense Authorization Act for FiscalYear 2008 conference report established a Center of Excellence formilitary eye injuries creating DoD/VA collaboration, a Military EyeInjury Registry, the coordination of care and benefits, documentationof OIF/OEF eye injuries, and vision screening, diagnosis,rehabilitation, and research on visual disturbances related to TBI.NMFA was pleased with Congress' recognition of this silent epidemicvisual disturbances following a TBI, but was surprised Congress haschosen not to provide any funding for this Center.

3. Defense Health Board Hears Task Force's Recommendations:On December 11th, the Department of Defense's (DoD) Task Force on theFuture of the Military Health Care discussed their 12 draftrecommendations on methods to improve the Military Healthcare Systemwith the Defense Health Board. The Task Force's guiding principles areto improve DoD's ability to meet readiness and improve effectiveness,and preserve a generous health care benefit without any additional costto the active duty service member or their family.

Dr. Gail R. Wilensky, the Task Force's co-chair, provided the recommendations:

  • Improve integration of direct and purchased care, especially where care is delivered at the local level
  • Collaborate with industry on best business practices
  • Audit to ensure only eligible beneficiaries are receiving care and ensure TRICARE is a second payer when appropriate
  • Standardize disease and case management
  • Restructure acquisition at TRICARE Management Activity (TMA)
  • Establish best practices in purchasing health care
  • Reassess incentives in current TMA contracts to be inline with their intended outcomes
  • Improve Reserve Component medical readiness
  • Adoptindustry's best pharmacy practices to encourage beneficiaries to usethe lowest point of service, such as establishing a tier and/or co-paystructure
  • Revise Retirees' enrollment fees and deductibles:
    • Restore cost sharing back to levels when TRICARE first started andindex future increases to maintain cost share levels at this same level
    • Tier fees according to retiree pay
    • Revise catastrophic cap
    • Institute a "modest" TRICARE for Life (TFL) enrollment fee
  • Establish pilot programs to improve TRICARE and Other Health Insurance (OHI) coordination
  • Establish metrics to assess strategic changes and the adoption of private health care sector's best practices

Members of the Task Force reiterated the need for DoD to adopt andbuild on existing public and private sectors' best practice, but at thesame time be mindful not to erode the beneficiary's trust or lowertheir quality of care and benefit.

The draft report will be given to the Secretary of Defense onDecember 19th for his approval. Public release of the report at aPentagon press conference is scheduled for December 20th. The NationalMilitary Family Association has been following the Task Forcerecommendation's closely for its impact on TRICARE beneficiaries'quality of care and benefit. We are awaiting the release of the finalreport.

4. Bill to Delay Medicare Physician Pay Cuts Crafted: SenateFinance Committee leaders reached a deal to delay for six months a 10percent cut to Medicare physician pay rates. The Finance Committee'sChairman Max Baucus (D-MT) and the Ranking Member Charles Grassley(R-IA) are formulating legislation to stop the Medicare cuts set totake effect January 1st. It will be a stand-alone bill. Once the billis passed by the Senate, it will be sent to the House ofRepresentatives for a vote.

TRICARE physician pay rates are directly linked to Medicarephysician payment rates. Congress has wrapped an increase to Medicarephysician fees into the State Children's Health Insurance Program(SCHIP) bills. However, both were vetoed by the President. The bill'sMedicare provisions would have implemented a 0.5% increase in Medicarephysician fees for 2008 and 2009 while creating six categories ofphysician services for which annual updates would be consideredseparately.

The National Military Family Association is pleased Congress isacting on this very important piece of legislation. The last thingmilitary families' need, as we head into our seventh year on the GlobalWar on Terror, is for TRICARE health care providers, especially mentalhealth care providers, to decide to no longer see TRICARE beneficiaries.

5. New Secretary of Veterans Affairs Confirmed:On December 14th, the United State's Senate confirmed by unanimousconsent Lieutenant General James B. Peake (USA, retired) as the newSecretary of the Department of Veterans Affairs (VA). He will relieveGordon Mansfield, Acting Secretary of the VA.

LTG Peake's last assignment was as the Army's 40th Surgeon Generaland Commander, U.S. Army Medical Command from 2000 to 2004. Hisbackground includes a Bachelor of Science from the United StatesMilitary Academy in 1966 and commissioning as a second lieutenant inthe Infantry. He served as a combat soldier in Vietnam with the 101stAirborne Division were he was awarded a Silver Star, a Bronze Star, andtwo Purple Hearts. Gen. Peake received a medical doctorate from CornellUniversity Medical School in 1972. He is board certified in general andthoracic surgery. His most recent role was as the Chief OperatingOfficer for a non-profit organization, Project HOPE.

The National Military Family Association worked with LTG Peakeduring his tenure as Surgeon General. We congratulate him on hisconfirmation and we look forward to working with him in his new role asthe Secretary of the VA.

(Source: http://www.whitehouse.gov/news/releases/2007/12/20071214-18.html)

6. NMFA Hosts Roundtable on Support for Wounded Warriors: Atthe request of Colleen Tuddenham, Soldier and Family Assistance Center(SFAC) Program Manager, the National Military Family Association (NMFA)and the Military Officers Association of America (MOAA) hosted aroundtable on Tuesday, December 11th entitled "America's Wounded Warriors: A Look at Non-Governmental Agency Support and Collaborative Efforts." Representativesfrom charitable organizations, military and veteran serviceorganizations, corporations and the military community joined forces toidentify what was now being done and describe how their groups werehelping Wounded Warriors and their families.

Ms. Tuddenham started the meeting by educating the group on thefunction of the SFAC and how the SFAC would be a one stop shop tosupport the wounded, ill and injured warrior and family members withinformation and support on travel, housing, employment, and otherbenefits, as the service member is cared for at the local militarytreatment facility. While most of the attendees were familiar with theSFAC at Walter Reed or Brooke Army Medical Center, Ms. Tuddenham toldhow these 32 new SFACs, scheduled to stand up early in 2008, would be afunction of Army Community Service with dedicated support of theWounded Warrior Battalion, Company, or Platoon at their installationthrough the Army Medical Action Plan. To view the slide presentation onthe new SFACs, click on www.nmfa.org/sfac.

The organizations in attendance were eager to discuss how they couldsupport the SFACs as many of them already do at Walter Reed and BrookeArmy Medical Center. They discussed the role of the national and localorganizations and the importance of each. Attendees learned of eachother's missions and functions and networked throughout the day.

The group came to consensus on the need for guidelines to make surethat organizations meet certain criteria to protect the WoundedWarriors and their families. They also agreed a loose coalition ofgroups helping the wounded would be beneficial and to work with theSFACs at the national and local level to maximize the aid they canprovide to wounded soldiers, their families and the SFAC staff.

7. Fisher House Foundation Joins NMFA to Give Military Spouses the Gift of Education:Military spouses now have a larger scholarship pool to draw from thanksto a new partnership between the National Military Family Association(NMFA) and Fisher House Foundation. This collaboration will enable theAssociation to expand the NMFA Joanne Holbrook Patton Military SpouseScholarship Program to many more deserving spouses.

NMFA's Joanne Holbrook Patton Military Spouse Scholarships areawarded to military spouses to obtain professional certification or toattend post secondary or graduate school. Scholarships normally rangefrom $500 to $1,000 and may be used for tuition, fees, and school roomand board. Spouses of uniformed service members (active duty, NationalGuard and Reserve, retirees, and survivors) of any branch or rank areeligible to apply. Applications are accepted online January 15 through March 15, 2008.

"Through our partnership with the Defense Commissary Agency, inseven years, we have been able to provide more than $5.5 million inscholarship grants to more than 3,500 military children. We arepartnering with the NMFA to be able to expand our grants to militaryspouses," said David A. Coker, President, Fisher House Foundation. "Weare impressed with the scope of the NMFA program and are confident theywill award the scholarship grants to the most deserving spouses.

For more information about the NMFA Joanne Holbrook Patton MilitarySpouse Scholarship Program or to sign-up to receive education updates,visit www.nmfa.org/scholarship.

8. NMFA Earns an "A"! A December 13 article in the Washington Post listed NMFA as one of the top-rated military charities. A chart accompanying the article, "Study Faults Charities for Veterans," showedthe ratings given by a charity watchdog organization, the AmericanInstitute of Philanthropy, for 20 military and veterans-relatedcharities, including NMFA. While 12 of the rated charities earned an"F" grade, generally for managing their resources poorly and payinghigh overhead costs and direct-mail fundraising fees, NMFA received an"A." The importance of ensuring military and veterans' charities aredirecting their donated resources to the people they claim to serve wasemphasized at a Congressional hearing the same day conducted by theHouse Committee on Oversight and Government Reform.

All of us who are associated with NMFA are proud of ourAssociation's stewardship of the funds entrusted to us to supportmilitary families. In addition to our "A" rating from the AmericanInstitute of Philanthropy, NMFA has also received a 4-star rating(highest) from Charity Navigator for three consecutive years, adistinction only attained by approximately 9% of the charities itrates, for fiscal responsibility in applying donations towards ourmission. NMFA also meets all 20 standards for CharityAccountability by the Better Business Bureau's Wise Giving Alliance.The achievement of these benchmarks reflects our staff's hard work andattention to detail and the oversight by our Board of Governors.

9. Happy Holidays from the National Military Family Association:NMFA wishes you and yours the merriest of Christmases, the happiest ofNew Years and the most relaxing of holidays. We hope that you will takethe next few weeks to enjoy your family, reflect on your blessings, andrelax and rejuvenate in preparation for the new year. Thank you for allyou do to improve the quality of life for those called upon to makegreat sacrifices, especially those whose loved one may be far from homethis holiday season. A special thank you to our technical staff, KimEdger and Hannah Pike, who translate our GR staff writings intoelectrons each week. We can never say thank you enough!

The Government Relations staff, Kathleen Moakler, Barbara Cohoon,Jessica Perdew, Candace Wheeler and Kelly Hruska will be spending timewith our families over the next two weeks and will suspend publicationof the Government and You E-News. See you again on January 8, 2008!

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