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NEWS: AO in Okinawa
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1) Officer: "Perfect Storm" brewing in Mil med mental care
2) Bush eliminates Traumatic Brain Injury care for Veterans
3) Veterans WIN at BVA !!!
4) AO: BVA rules presumptive exposure on OKINAWA !!

1) OFFICER: "Perfect Storm" brewing RE Mil Mental Health Care

From:"Democratic Leader Pelosi"

To:"Democratic Leader Pelosi"
Subject:Officer:'perfect storm' brewing in military's mental health care system-Stars and Stripes
Date:Fri, 22 Sep 2006 12:04:12 -0400
Officer sees 'perfect storm' brewing in military's mental health care system

By Allison Batdorff, Stars and Stripes
Pacific edition, Friday, September 22, 2006

YOKOSUKA NAVAL BASE, Japan - Gaps in care - combined with the stress of combat in Iraq and Afghanistan - are creating a "perfect storm" within the U.S. military mental health system, according to a Navy commander who spoke at Yokosuka Naval Base on Wednesday.

Quick to say that his opinions are unofficial - the product of his 24-year military career and not the U.S. Navy or Department of Defense - Cmdr. Mark Russell gave a well-attended lecture called "Broken Promises: The Unspoken Truth of Mental Health Care in the DOD" during the final day of the Multinational Medical Conference.

Russell, a child psychologist and director of Educational and Development Intervention Services for bases across Japan, painted a picture of unmet needs and unrecognized opportunity stemming from the global war on terrorism.

"We are in a crisis situation," Russell said. "And it's going to get worse.

"We're making progress but are far from making good on our promise to provide the best mental health care possible for the men and women we send to war," Russell told the gathering.

More than 56,000 troops, or 10 percent, have returned from Iraq and Afghanistan with a mental health diagnosis, making up a third of those in Veterans Affairs care. The cost of mental health care is high, he said - the VA spent $4.3 billion on post-traumatic stress disorder alone in 2004.

Also, of the 9,145 (out of a possible 178,644) veterans who showed signs of PTSD between 2001 and 2004, only 22 percent were referred on to mental health care. That creates a chasm between a need for care and actually getting it, Russell said.

Another gap falls between DOD guidelines for mental health treatment and the training given to mental health workers, he said.

"Out of 133 mental health providers I surveyed, 90 percent of them had no training in the top four treatments the DOD recommends for PTSD," Russell said.

There also are problems with leadership, high burnout rates among caregivers and the tendency to treat those suffering from hyper-arousal compared to those who disassociate, he said.

"The bottom line is that we have increased demand and fewer resources to meet that demand," Russell said.

But the DOD has made significant strides, especially in terms of front-line combat mental health care, he added. The military's PIES system - basing combat mental health care on proximity, immediacy, expectancy and simplicity - is working, he said.

"The numbers of mental health workers on the front lines is unprecedented," Russell said. "This is an all-out effort."

More troops are using front-line mental health services, with 40 percent getting help in 2005 compared to 29 percent in 2004. And, most importantly, 90 percent of those who get front-line help return to duty, he said.

The DOD also has improved screening programs, has established deployment centers with quality information, is conducting more surveys and is getting more information out to veterans after they come home, Russell said.

But the DOD could be doing more for the troops, caregivers and for combat mental health in terms of treating the "invisible wounds of warfare," he said.

"Right now, the DOD is in an historically unique position to lead the world in understanding, assessment, prevention and treatment," Russell said. "Have we advanced science?"

The military has a "love/hate relationship" with mental health care, he added.

"We like it in war and know that increased mental health is a force multiplier," Russell said. "But in peacetime, mental health falls to the low end of the totem pole."

It's up to the military health professionals today to "take up the sword," he said.

"I've already turned in my retirement paperwork," he said.     
(c) 2006 Stars and Stripes. All Rights Reserved.

Friday, September 22, 2006

Expect more cuts in family support programs, Army warns

By Leo Shane III, Stars and Stripes
European edition, Friday, September 22, 2006

WASHINGTON - Army officials have told base commanders to prepare for even deeper cuts in family support programs and other non-war-related expenses next fiscal year.

In June, the Army announced cuts in base discretionary spending and other non-war expenses to offset unexpected costs associated with military operations in Iraq and Afghanistan. Even after Congress approved supplemental military funding in response, service officials said they would continue to curb spending.

And although the fiscal 2007 defense budget is still being debated in Congress, Army officials already have warned base commanders that they'll likely face more belt tightening under next year's budget because of the ongoing combat operations.

"The time of having as much money as bases want for everything they want to do is gone," said Stephen Oertwig, spokesman for the Army Installation Management Agency. "We don't know what the exact budget will be, but we know it will be a very austere budget."

On Thursday, military family advocates warned that further cuts in vital family support programs could jeopardize military readiness by distracting soldiers.

"When families need these programs the most, they shouldn't be asked to do without," said Joyce Raezer, director of government relations for the National Military Family Association. "Those soldiers need to know that their families are being taken care of."

The House Armed Service Committee's ranking Democrat, Missouri's Rep. Ike Skelton, said the Army received about $500 million less for base maintenance and programs this year because of the unexpected extra war costs.

Raezer said she's already heard concerns from military spouses worldwide about the cuts. At Fort Bragg in North Carolina, families have seen cuts in staff at the base child-care facilities. At Fort Campbell in Kentucky, the hours and staff at the Family Readiness Assistance Center have been scaled back.

In Germany, several teen internship programs at Friedberg and Giessen Army facilities were canceled, leaving more than 40 dependents without planned summer jobs.

Raezer said other problems, such as shorter dining hall hours and part-time military spouses losing their on-base jobs, are widespread.

Oertwig said commanders have been open and honest with military families about the potential program cuts, to help them prepare for the changes.

"Our local commanders know what their audience needs, and it's their job to balance the issues on a tight budget," he said. "It's not something that's being ignored. All of our commanders are doing the best they can to take care of these families."

House and Senate negotiators are currently finalizing the 2007 Defense budget and are expected to complete their work in the next few days.    
(c) 2006 Stars and Stripes. All Rights Reserved.


2) Bush eliminates TBI care for Veterans !!

From:"Democratic Leader Pelosi"

To: "Democratic Leader Pelosi"
Subject: Op-ed NY Daily News on TBI
Date: Thu, 21 Sep 2006 14:43:33 -0400
Please see an op-ed below by the head of Iraq and Afghan Veterans of America on cuts to programs that treat Traumatic Brain Injury (TBI).  The Republican-Controlled Congress has cut the funding for the treatment of TBI that affects more than 100,000 Iraq war veterans. 

In March of this year House Democratic Leader Nancy Pelosi and other Democrats warned Americans and the Congress that the GOP budget would eliminate TBI programs.

See the warning by Democrats below:

Eliminates Traumatic Brain Injury programs.  The Bush budget eliminates funding for the $9 million Traumatic Brain Injury (TBI) state grant program and the $3.1 million TBI Protection and Advocacy Grants program.  There are 5.3 million Americans who live with disabilities resulting from brain injury.  

New York Daily News -

Congress adds insult to vets' brain injuries
Tuesday, September 19th, 2006

As a veteran of the current conflict in Iraq , I am sickened - but unfortunately not surprised - by a new development out of Washington , D.C.

Politicians in Congress are on the verge of cutting funding for the treatment of a health problem that affects more than 100,000 Iraq war vets. Yes, you read that correctly.

The condition is called traumatic brain injury (TBI). Here's the typical way U.S. soldiers in Iraq - including friends of mine - come to suffer from TBI: by barely escaping a rocket-propelled grenade attack or being a little too close when an improvised explosive device goes off near a Humvee.

In milder cases, this results in vision, hearing or speech problems, dizziness and memory loss. In more severe cases, TBI causes serious brain damage. It's becoming known as the signature wound of this war.

Why? Because one in 10 Iraq vets has sustained a concussion at some point during his or her tour of duty. This severe blow to the head jars the brain against the inside of the skull, and often leads to TBI.

The injury doesn't just affect the service member. Families bear the burden. One mother of a 23-year old Iraq vet diagnosed with TBI told me, "My son's not the same person anymore. He's got judgment problems, memory problems. I can't leave him alone in the house."

So, how does Congress respond to this growing need? It's preparing to slash funding for research and treatment of brain injuries caused by bomb blasts. The current House version of the 2007 defense appropriations bill contains just $7 million for the Defense and Veterans Brain Injury Center - half of what was allocated to the center last year.

How on Earth do they try to explain this unpardonable cut? A congressional spokeswoman, Jenny Manley, told USA Today, "There were just so many priorities." Defending the elected officials, she added, "They didn't have any flexibility in such a tight fiscal year."

Let's get this straight. In a bill appropriating more than $400 billion in defense spending, primarily to support a war in Iraq that has already cost hundreds of billions ofdollars, Congress can't find a fewmillion to adequately treat troops wounded with brain injuries for the rest of their lives?

Thankfully, because of a public outcry, the issue is still on the table. Any day now, a congressional committee will meet to make the final decision. It had better do the right thing and fully fund the brain injury center's original budget request of $19 million.

Americans remember how, last year, Congress and the President dropped everything to address the issues of just one brain-damaged woman: Terri Schiavo. Now, our leaders will either lift up or let down thousands of brain-damaged troops. Which will they choose?

Rieckhoff is the executive director of Iraq and Afghanistan Veterans of America and author of "Chasing Ghosts: A Soldier's Fight from Baghdad to Washington ."


3) Veterans WIN at Board of Veterans Appeals!
Citation Nr: 0519111
Docket No.: 04-20 235A
Appeal of Gary O. Kendall
At Issue: Entitlement to payment or reimbursement for medical services provided by (private medical provider) pusuant to the "Millenium Bill Act."
After the VAMC Boise, Chief of Medical Administration erroneously refused payment of emergency private medical care given to the Veteran, the issue was taken before the Board of Veterans Appeals with a formal notice of Disagreement and demand for BVA hearing.
The Veteran formed his own legal complaint based upon his research into 38USC, 38CFR, and the Veterans Millenium Bill Act.
The BVA ruled nearly word-for-word, on every point of law, in favor of the Veteran.
This ruling sets a precendent beneficial to all Veterans who receive private provision of emergency or diagnostic medical care that the VA cannot provide.
Please familiarize yourselves with these issues and the ruling.

4) Agent Orange: BVA rules
presumptive exposure on Okinawa
during Vietnam!
The ruling cited here was rendered in 1998, and was so well buried in a government attempt to hide it, that an eight month long web crawler search was required to ferret it out.
For those who have been searching for evidence and VA disability claims support for AO exposure elsewhere than Vietnam, check this out:
  BVA presumptive AO exposure on Okinawa, 1970’s
  Citation NR: 9800877
Decision Date: 01/13/98 Archive Date: 01/21/98
DOCKET NO.  97-05 078 )

Now, thanks to the diligent Veteran in this case, AO exposure in areas other than Vietnam is ruled presumptive and service connected via proof of assignment, proof of AO in the area, and symptoms arising anytime in the claiming Veterans life!
For those who served on Okinawa, show symptoms, and have been denied - try again bros and sisters - and this time cite this ruling in support of your claim.

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Dr. Sam and the Managed Care Blues Band

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