DoD Civilian Work Force Update 01 - American Legion Post 58



November 02, 2016DoD Civilian Work Force Update 01 ? Reduction Cost Savings UnknownThe Defense Department is still not tracking the cost savings it is achieving from cutting civilian employees, according to a new report. The Pentagon has tracked how many total employees it has cut since fiscal 2012, according to the Government Accountability Office audit, but not how much money it has saved from those efforts. At the same time, the department has tracked its cost savings for its contractor workforce but not the number of full-time equivalents it has successfully trimmed. The 2013 National Defense Authorization Act required Defense to make the reductions and track both figures. The law dictated the contractor and civilian spending cuts should at least equal that of the military reductions, which the Pentagon said will equal 6.4 percent by fiscal 2017. Defense has estimated it will exceed that number on the civilian side—predicting a net cost savings of 7.1 percent from fiscal 2012 to fiscal 2017—but will not reach its target for the contract workforce. The department said it could not produce the exact number of full-time equivalent contractors it has cut because it is “unable to provide an accurate number” on the size of the workforce. It estimated it reduced contractor workforce costs between fiscal years 2012 and 2015 by 3.2 percent. The Pentagon shed 5.2 percent of its civilian workforce in the same time period, cutting about 40,000 employees. It reduced military personnel by 4.8 percent in that timeframe. The department excluded more than 70 percent of its civilians—538,000 employees—from the reductions, though GAO noted it has not offered adequate reasoning to explain the exceptions as required by law. The estimate that Defense would meet its required civilian workforce savings is based only on the 240,000 non-excepted portion of workers, GAO said. The department said it failed to produce year-by-year savings on its civilian cuts because it thought it only had to do so in 2017. GAO advised Defense to provide the cost savings in a report it released in December. The department said it has fully complied with the auditors’ recommendations, but GAO disagreed. Defense has yet to produce efficiency plans detailing how it would achieve and implement its reductions, according to GAO. “Without an efficiencies plan, including an explanation of its exclusions, DoD has not provided Congress with information on how the department will achieve required savings,” the auditors wrote. GAO said detailed savings data was consequential because it could otherwise trim workers without realizing any financial benefit. “While FTE’s may go down, costs may go up due to a variety of factors, including annual automatic pay increases,” GAO wrote. Defense would not be able to inform Congress whether it is achieving required savings without the cost estimates, the auditors added.? [Source: Defense One | Eric Katz | October 14, 2016 ++]*****************************DoD Fraud, Waste & Abuse ? Reported 16 thru 31 OCT 2016?Dallas, TX -- Federal prosecutors in Texas said 14 OCT that a dozen people have been charged in a $100 million health care scheme targeting military veterans and their families. The defendants, including doctors, pharmacists and marketers, were charged in a 35-count overruling indictment returned last week in Dallas, according to U.S. Attorney John Parker. Prosecutors contend the men sought to defraud Tricare, the health insurance program for veterans and their families. Authorities say the scheme involved the prescription of pain and scar creams. They say a Dallas-based company was formed to market compounds that had little medical benefit and that kickbacks were provided to physicians and others who promoted the compounds. Authorities said in a news release that nine people were arrested this week on charges that include conspiracy to commit health care fraud. A 10th person surrendered to the FBI and two others were arrested earlier this year. "The indictments and arrests in this investigation highlight another step forward by DCIS and its law enforcement partners to protect the integrity of the Department of Defense (DoD) health care program known as TRICARE," Special Agent in Charge Janice M. Flores said. "Fraud and abuse by pharmacies and medical providers that bill for compounded prescriptions and/or medications is a significant threat to the DoD health care system." Flores continued by saying that DCIS must keep investigating fraud in order to preserve taxpayer dollars. [Source: Associated Press | October 14, 2016 ++]*****************************Burn Pit Toxic Exposure Update 38 ? GAO SEP Report IssuesThe Pentagon needs to study the long-term health effects of exposure to the chemicals inhaled from burn pits at its overseas military bases, the Government Accountability Office says in a report. While the report, released in September, credited the Department of Defense with improving practices to mitigate the risks of exposure to the burn pits, the department still needs to ensure that “research specifically examines the relationship between direct burn pit exposure and long-term health issues.” The GAO found there hasn’t been enough progress on this issue over the past five years, when it first said more study was needed. “The current lack of data on emissions specific to burn pits and related individual exposures limits efforts to characterize potential long-term health impacts on service members and other base personnel,” the report warned. Open-air burning has always been a mainstay of waste disposal during times of war. But the technology of modern warfare means that such new items as plastic bottles and electronics are being burned, presenting new health risks. Burn pits were constructed at more than 230 U.S. military bases across Iraq and Afghanistan before their use was restricted in 2009. Although the military gave assurances that the air quality was within safe levels, troops returning home began complaining of problems as early as 2004. Massive open-air burn pits at the bases billowed the toxic smoke and ash of everything from Styrofoam, metals and plastics to electrical equipment and even human body parts. The flames were stoked with jet fuel. While it took nearly three decades for the U.S. government to eventually link Agent Orange, the defoliant used in Vietnam, to cancer, President Obama has pledged quick action to make determinations about the effect of the burn pits on perhaps as many as 60,000 U.S. troops. A 2011 report by the Institute of Medicine outlined the data needed for assessing exposures and potential related health risks. In response, the Department of Veterans Affairs established a registry to collect information. However, the Department of Defense has not undertaken data-gathering and research efforts to specifically examine this relationship to fully understand any associated health risks, the GAO report said. To date, the VA’s official position is that research has not established evidence of long-term health problems from exposure to burn pits. The magnitude of the issue, however, may not be clear for decades as delayed war ?casualties slowly emerge. In Minnesota alone, it is estimated that more than 14,000 Minnesota Army and Air Guard troops qualify to be part of a national registry for potential burn pit exposure, based on where they were stationed during deployments. The Star Tribune recently documented the plight of Minnesota Air National Guard veteran Amie Muller, who is battling pancreatic cancer and several other maladies after returning from deployments to Balad Air Base in Iraq, site of one of the most notorious military base burn pits. Despite the mounting public outcry from vets, their families and members of Congress, the VA continues to say research does not show evidence of long-term health problems, and that most irritation is likely temporary. U.S. Sen. Amy Klobuchar has proposed a national center to study the long-term affects of burn pits. While generally agreeing with the GAO report, the Pentagon said the report should have acknowledged research that the Department of Defense already has completed with other organizations. [Source: Minnesota Star Tribune | Mark Brunswick | October 24, 2016 ++]*****************************Gulf War Syndrome Update 40 ? Claim Time Limit ExtensionThe VA is seeking to expand the time limit that veterans can claim disability benefits for Gulf War Syndrome by five years. In a document to be published in the Federal Register on 17 OCT, the VA seeks to expand the time limit that veterans of the Gulf War may claim disability benefits for the chronic multi symptom illness known as Gulf War Syndrome from December 31, 2016 until December 31, 2021. The VA is inviting the public to comment on their plans by December 18, 2016. The document, with instructions for commenting can be found on the Federal Register website . Gulf War Syndrome is defined by the VA as a cluster of medically unexplained chronic symptoms that can include fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems. REfer to Gulf War Syndrome page benefits/veterans-health-care/gulf-war-syndrome.html for more details. There is no medical or scientific evidence about the nature and cause of the illnesses suffered by Gulf War veterans, however the VA says that studies by the National Academy of Sciences proved that these conditions occur in Gulf War Veterans three times more than they do in the civilian population. Based on that fact, the VA grants what it calls "presumptive disability" to veterans suffering from these conditions. Presumptive Disability means that Gulf War Veterans suffering from these conditions don't need to prove their military service caused the health problems in order to receive VA disability compensation. In their request to extend the time period that veterans may claim disability for Gulf War Syndrome, the VA cited a study done earlier this year by the National Academy of Sciences that stated "at present, there is insufficient basis to identify the point, if any, at which the increased risk of chronic multi symptom illness may abate". That means the symptoms may still show up in veterans more than 25 years after the war's end. In order to provide fairness to affected veterans the VA says they want to continue to provide disability benefits to veterans suffering from Gulf War Syndrome no matter when the illnesses begin. [Source: | Jim Absher | October 14, 2016 ++]*****************************Traumatic Brain Injury Update 57 ? Improperly Examined VetsThousands of veterans may have been improperly diagnosed by the VA. The federal department admits it was improperly testing for traumatic brain injuries from 2007 through 2015. The VA sent out letters to all veterans they believe may have had an improper screening. If you are a veteran who is concerned about your TBI exam you can call 1-800-749-8387.-o-o-O-o-o-Number of veterans who may have been impacted:StationRegional OfficeUnique Veterans318Winston-Salem2,992316Atlanta2,091346Seattle2,076362Houston1,800377San Diego1,394344Los Angeles1,288351Muskogee1,279349Waco994335St Paul742322Montgomery950314Roanoke818317St Petersburg652329Detroit485341Salt Lake City477325Cleveland428327Louisville409330Milwaukee383348Portland370340Albuquerque331320Nashville309321New Orleans309326Indianapolis309339Denver301331St Louis298345Phoenix277343Oakland250310Philadelphia234319Columbia212350Little Rock209301Boston171459Honolulu167328Chicago149307Buffalo133354Reno102311Pittsburgh102405White River Junction101306New York86313Baltimore80438Sioux Falls77308Hartford77452Wichita70323Jackson66315Huntington55347Boise55355San Juan54333Des Moines51334Lincoln47309Newark46373Manchester45436Fort Harrison45304Providence36442Cheyenne27402Togus25463Anchorage21372Washington10437Fargo10460Wilmington8358Manila5Total*24,588[Source: WNCN Raleigh NC | Jonathan Rodriguez | October 27, 2016 ++]VA Agent Orange Claims Update 07 ? Herbicide Use in ThailandFor years, the U.S. military and Department of Veterans Affairs have used the work of a Wyoming-based herbicide expert to flatly reject the claims of groups of veterans who believe Agent Orange made them sick. But occasionally, individual veterans have fought back — and even more rarely, they have won. One of them is Air Force veteran Phil Cacioppo. In 2007, Cacioppo was diagnosed with a rare form of non-Hodgkin lymphoma. He assumed he’d be approved for cash compensation and to receive treatment at VA hospitals. After all, he believed he’d been exposed to Agent Orange while he served as a ground radio equipment repairman at the U-Tapao Airfield in Thailand from 1969 to 1970. And his type of cancer had been associated with the herbicides used during the Vietnam War. But Cacioppo’s claim for benefits was denied, at least in part based on the research of Alvin Young, the government’s oft-chosen expert, records show. “U-Tapao Airfield is not on the Department of Defense listing of herbicide spray areas and test sites outside the Republic of Vietnam,” the VA’s St. Louis Regional Office wrote in its 2011 claim denial. While the denial letter didn’t cite Young, it relied on the conclusions of a 2006 report he wrote under contract for the Pentagon. In it, Young said many veterans confused commercial herbicides, used on many bases to kill weeds, with the stronger “tactical herbicides,” including Agent Orange, which were used in combat. In his appeal to the Board of Veterans’ Appeals, Cacioppo argued that there was no evidence that the military distinguished between tactical and commercial herbicides. In 2012, the board sent the claim back for further consideration, noting “the Veteran’s contention that a distinction between tactical and commercial herbicides did not exist in records published during the Vietnam era.” Cacioppo, 70, a semi-retired engineer in Kansas City, Missouri, ultimately won his claim in 2013. The VA didn’t mention Agent Orange, but said he’d been exposed to herbicides and deserved benefits. “We have conceded your … exposure to herbicide agents while stationed in Thailand,” the VA wrote in granting him 100 percent disability. “Our review of the multiple lay statements and military and VA documents contained within your claims folder provided us with enough credible evidence to determine you conducted military duties near the air base perimeter.” The VA had previously determined that extremely strong herbicides of some sort had been sprayed there. In a 2013 report for the VA, Young criticized the VA’s decision to grant such benefits, saying it ran counter to the evidence he found. Cacioppo ended up receiving compensation dating back to 2007, when he first filed a claim, but he blames Young for the delay, which kept him from having his cancer treatment and expensive medications covered at VA hospitals until 2013. “This report by Alvin Young has been used often to deny ill veterans benefits that were stationed in Thailand such as myself,” he wrote to the VA in May 2013. Cacioppo has contributed to a website () to help other Thailand veterans win benefits — and overcome Young’s contentions. “I don’t think it should have been that hard,” he said in a recent interview.-o-o-O-o-o- DEPARTMENT OF VETERANS AFFAIRSVeterans Benefits AdministrationWashington, D.C. 20420Memorandum for the RecordSubject: Herbicide use in Thailand during the Vietnam Era10The Compensation and Pension Service has reviewed a listing of herbicide use and test sites outside Vietnam provided to our office by the Department of Defense (DoD). This list contains 71 sites within the U.S. and in foreign countries where tactical herbicides, such as Agent Orange, were used, tested, or stored. Testing and evaluations of these tactical herbicides were conducted by or under the direction of the U.S. Army Chemical Corps, Fort Detrick, Maryland. The list does not contain names of individuals. Additionally, it does not contain any references to routine base maintenance activities such as range management, brush clearing, weed killing, etc., because these vegetation control activities were conducted by the Base Civil Engineer and involved the use of commercial herbicides approved by the Armed Forces Pest Control Board. The application of commercial herbicides on military installations was conducted by certified applicators. DoD has advised us that commercial herbicides were routinely purchased by the Base Civil Engineer under federal guidelines and that records of these procurements were generally kept no longer than two years. We have also reviewed a series of official DoD monographs describing in detail the use, testing, and storage of herbicides at various foreign and domestic locations. In addition, the Project CHECO Southeast Asia Report: Base Defense in Thailand, produced during the Vietnam era, has been reviewed. Regarding your veteran claimant with Thailand service, the DoD list indicates only that limited testing of tactical herbicides was conducted in Thailand from 2 April through 8 September 1964. Specifically, the location identified was the Pranburi Military Reservation associated with the Replacement Training Center of the Royal Thai Army, near Pranburi, Thailand. The Report of these tests noted that 5 civilian and 5 military personnel from Fort Detrick, Maryland conducted the spray operations and subsequent research. This location was not near any U.S. military installation or Royal Thai Air Force Base.Tactical herbicides, such as Agent Orange, were used and stored in Vietnam, not Thailand. We received a letter from the Department of the Air Force stating that, other than the 1964 tests on the Pranburi Military Reservation, there are no records of tactical herbicide storage or use in Thailand. There are records indicating that commercial herbicides were frequently used for vegetation control within the perimeters of air bases during the Vietnam era, but all such use required approval of both the Armed Forces Pest Control Board and the Base Civil Engineer. In Vietnam, tactical herbicides were aerially applied by UC-123 aircraft in Operation RANCH HAND or by helicopters under the control of the U.S. Army Chemical Corps. Base Civil Engineers were not permitted to purchase or apply tactical herbicides. There are no records of tactical herbicide spraying by RANCH HAND or Army Chemical Corps aircraft in Thailand after 1964, and RANCH HAND aircraft that sprayed herbicides in Vietnam were stationed in Vietnam, not in Thailand. However, there are records indicating that modified RANCH HAND aircraft flew 17 insecticide missions in Thailand from 30 August through 16 September 1963 and from 14 –17 October 1966. The 1966 missions involved the spraying of malathion insecticide for the “control of malaria carrying mosquitoes.” These facts are not sufficient to establish tactical herbicide exposure for any veteran based solely on service in Thailand.While the Thailand CHECO Report does not report the use of tactical herbicides on allied bases in Thailand, it does indicate sporadic use of non-tactical (commercial) herbicides within fenced perimeters. Therefore, if a veteran’s MOS (military occupational specialty) or unit is one that regularly had contact with the base perimeter, there was a greater likelihood of exposure to commercial pesticides, including herbicides. Security police units were known to have walked the perimeters, especially dog handlers. However, as noted above, there are no records to show that the same tactical herbicides used in Vietnam were used in Thailand. Please consider this information when you evaluate the veteran’s claim.If the veteran’s claim is based on servicing or working on aircraft that flew bombing missions over Vietnam, please be advised that there is no presumption of “secondary exposure” based on being near or working on aircraft that flew over Vietnam or handling equipment once used in Vietnam. Aerial spraying of tactical herbicides in Vietnam did not occur everywhere, and it is inaccurate to think that herbicides covered every aircraft and piece of equipment associated with Vietnam. Additionally, the high altitude jet aircraft stationed in Thailand generally flew far above the low and slow flying UC-123 aircraft that sprayed tactical herbicides over Vietnam during Operation RANCH HAND. Also, there are no studies that we are aware of showing harmful health effects for any such secondary or remote herbicide contact that may have occurred.If the veteran’s claim is based on general herbicide use within the base, such as small-scale brush or weed clearing activity along the flight line or around living quarters, there are no records of such activity involving tactical herbicides, only the commercial herbicides that would have been approved by the Armed Forces Pest Control Board and sprayed under the control of the Base Civil Engineer. Since 1957, the Armed Forces Pest Control Board (now the Armed Forces Pest Management Board) has routinely provided listings of all approved herbicides and other pesticides used on U.S. Military Installations worldwide. The Compensation and Pension Service cannot provide any additional evidence beyond that described above to support the veteran’s claim. Therefore, unless the claim is inherently incredible, clearly lacks merit, or there is no reasonable possibility that further VA assistance would substantiate the claim [see 38 CFR 3.159(d)], regional offices should send a request to JSRRC for any information that this organization can provide to corroborate the veteran’s claimed exposure. ReferencesBuckingham WA (1982): The Air Force and Herbicides in Southeast Asia, 1961-1971. Office of Air Force History, United States Air Force, Washington DCBarnette BH, Jr., Barrow JR (1973): Base Defense in Thailand - 1968-1972. Project CHECO Report. Air Force Historical Research Center, Maxwell AFB, ALCecil PF (1986): Herbicide Warfare – The RANCH HAND Project in Vietnam. Praeger Special Studies, Praeger Scientific, New York NYCecil PF, Young AL (2008): Operation FLYSWATTER: A War Within A War. Env Sci Pollut Res 15(1): 3-7-o-o-O-o-o-[Source: ProPublica | Charles Ornstein | October 26, 2016 ++]VA Leadership ? Alleged 'New' Are Transferees From Within VAAlthough Veterans Affairs Secretary Bob McDonald has asserted that more than “90%” of the VA’s medical centers have “new leadership” or “leadership teams” since he took over the troubled agency in 2014, a USA TODAY investigation found the VA has hired just eight medical center directors from outside the agency during that time.The rest of the “new leadership” McDonald cites is the result of moving existing managers between jobs and medical centers. Some managers were transferred to new jobs despite concerns about the care provided to veterans at the facilities they were previously managing. USA TODAY determined that of 140 medical center directors, 92 are new since McDonald took office in July 2014. That's 66%. Of those, only 69 are permanent placements; the rest are interim appointees. And all but eight of these directors already worked at the VA. VA officials said McDonald cited an erroneous statistic and the actual percentage of new medical center leaders is 84%. That figure includes new chiefs of staff, associate directors and other top executives, even where center directors remained the same. The agency considers a center as having new leadership if one member of its top management team has transferred from another center or job. “I said very carefully, and I’ve always said ‘leadership or leadership teams’ — both are important,” McDonald said in an interview. “In some cases, you’ve got directors who are doing a great job, but they’ve got a chief of staff who’s not and you’ve got to change that person.” McDonald said the number itself is “almost irrelevant” and what’s important is that he and other VA leaders are “trying to attract top talent, to get them in the right seats on the bus, in order to make outcome changes for veterans.” VA Undersecretary for Health David Shulkin said salary constraints, a lengthy hiring process and other factors have limited the agency’s ability to attract non-VA applicants. “We tend to use lots of numbers and that can be confusing, and what I’m trying to do is simplify the message, so here’s my message: I need help,” Shulkin said. “I need the right leaders to come in and to take these positions of responsibility on behalf of the country, and I don’t care if it’s 90%, 80%, or 60%. I know I have openings and I don’t have the applicants.” USA TODAY scoured hundreds of documents, news accounts and web archives to build a database tracking VA personnel moves since the wait-time scandal broke in 2014, starting with a Phoenix VA facility where 40 veterans had died awaiting care. That case revealed widespread mismanagement of VA facilities and led to McDonald’s appointment with a mandate to fix veterans' care. President Obama has echoed McDonald's pride in the VA's transformation, saying on a recent CNN forum that “we have, in fact, fired a whole bunch of people who are in charge of these facilities.” In fact, the VA only moved to fire seven medical center directors. One of them quit and another retired first.? Of the 69 permanent directors installed since McDonald took over, 49 transferred from a different VA medical center, while 12 came from different jobs within the same hospital. The moves included promotions, for instance from associate director to director of a medical center. In 22 cases, the VA moved directors from one center to another, sometimes to more complex hospitals, but at other times, to less complex facilities. In Ohio, directors in Chillicothe and Columbus simply switched places. Some of the directors came from facilities where they faced issues ranging from low-ranking quality of care to wait-time falsification to mismanagement identified by outside investigators. Among them:Kathleen Fogarty cut veterans’ access to outside care to help overcome a multimillion-dollar deficit as director of the Tampa, Fla., VA, in 2011 and repeatedly denied publicly that she was doing it, according to the Tampa Bay Times. In March 2015, the VA transferred her to the director’s post at the Kansas City, Mo., VA.Joe Battle, who had been the director of the Jackson, Miss, VA, replaced Fogarty in Tampa. The Office of Special Counsel, which investigates whistle-blower claims, concluded in 2013 that Battle had downplayed serious problems with veteran care in Jackson, “calling into question the facility’s commitment to implementing serious reforms.” During his tenure in Jackson, doctors prescribed narcotics to patients they hadn’t seen, schedulers slotted veterans into “ghost clinics” that didn’t exist, and the American Legion, two years after he took over, said it was “appalled” by conditions at the facility.Robert Walton went from director of the Harlingen, Texas, VA, to director of the San Antonio VA in November last year. During his tenure in Harlingen, the facility ranked among the lowest in the country in quality and efficiency by the VA’s own metrics and investigators found schedulers had routinely falsified veteran wait times under pressure from supervisors.Deborah Amdur went from director in White River Junction, Vt., to director of the troubled Phoenix VA last December. In Vermont, the VA's Office of Inspector General found routine scheduling manipulation directed by supervisors and a doctor told investigators that management pressure to increase productivity led to missed cancer diagnoses. Amdur retired in August citing “personal health reasons.” Several weeks later, the inspector general released the results of another investigation at the Phoenix VA that found more scheduling improprieties.RimaAnn Nelson, who was director of a VA benefits and outpatient clinic in the Philippines, took over for Amdur in Phoenix. She previously had been director of the St. Louis VA when 1,800 veterans were potentially exposed to HIV and hepatitis because of poor sterilization. A follow-up investigation during her tenure found some of the problems hadn’t been adequately addressed. VA officials declined to comment on many of the transfers, citing privacy laws, but said that in general, they were consistent with federal guidelines. They said the vast majority of the moves were promotions. In at least one case, a director requested a transfer for personal reasons and the VA approved it. "You can't have a robust human resource system unless you are providing opportunities for progression," McDonald said. "I'm sure the process we follow for promotion or for transfer to a larger facility is the government-regulated process, which is a fair process dictated by Congress and I'm sure the people who moved to new facilities were, you know, deserved that movement." Shulkin said the Phoenix crisis and ensuing media scrutiny triggered an exodus of leaders at the VA, and the agency hasn’t been able to attract enough applicants to fill those slots. He said VA officials have filled as many as they could with a mix of inside and outside candidates. Shulkin said there are still more than two dozen directors’ jobs open. They are being filled right now by acting or interim directors, who have cycled through posts frequently at times, destabilizing leadership at some facilities. St. Louis had eight temporary directors between 2013 and this month, when the VA promoted an associate director to fill the role. Los Angeles had four; Oklahoma City and Phoenix had five. Shulkin said one of the issues is salary: Pay for VA medical center directors without specialized medical degrees is capped at $185,100, but in the private sector, the average pay for overseeing a medical center was $349,000, according to 2015 statistics cited by the VA. The agency has asked Congress to increase the pay cap, but that effort has stalled on Capitol Hill. Shulkin said another problem is the federal hiring process, which can take seven months on average for a medical center director and is “heavily weighted” toward applicants with federal government experience. He said he has been working to change that and said three non-VA candidates are currently in the pipeline to take jobs as medical center directors. “Is it fast enough? No,” he said. “Are there enough people responding to my call for assistance? No. But you know I hope somebody reading this might have a reaction that says ‘You know what? Maybe I will, maybe I’ll consider sending in my CV, this would be a way to give back.'”Regarding the Phoenix VA, Shulkin approved Nelson's transfer there because he said she took immediate action to fix problems at her prior posting in St. Louis and he feels comfortable with her leadership skills. “In my assessment she was an effective leader and the type of leader I need in my toughest place in the country right now, which is Phoenix,” he said.In Tampa, Battle said in a statement that investigators thoroughly reviewed problems at his previous facility in Mississippi. “We addressed any recommendations for improvement and took actions as appropriate,” he said, adding that under his leadership, Jackson passed all accreditation reviews on quality of care.In San Antonio, VA spokeswoman Nenette Madla said the Inspector General and the VA Office of Accountability Review cleared Walton of wrongdoing at his previous post in Harlingen. She did not address quality of care.\At the Kansas City VA officials did not respond to multiple messages seeking comment on Fogarty’s record. Fogarty told The Arizona Republic in 2014 that she balanced the budget at her previous post in Tampa by reducing the amount of time veterans spent in non-VA hospitals. She also said she has a record of fixing troubled VA facilities during her more than 30 years with the agency. Amdur could not be reached. She has retired from the VA, and a home number listed for in public records is disconnected. Amdur told The Arizona Republic earlier this year that she was the one who asked the inspector general to investigate wait time manipulation during her tenure in Vermont. “As information from the investigation was revealed, we made changes immediately," she said. Whatever the case, Phoenix VA whistle-blower Brandon Coleman told USA TODAY that it looks like “bad apples, instead of being fired, are put into other facilities. “And then the VA acts like the problem’s solved," he said. "‘Nothing else to see here, please move on.’”[Source: USA TODAY | Donovan Slack | October 18, 2016 ++]*****************************VA Health Care Access Update 45 ? 522K+ Vets Waiting Over 30 DaysThe number of veterans waiting more than a month for care at Department of Veterans Affairs hospitals increased by thousands in two weeks, climbing to well over half a million at the start of October. Over 522,000 veterans are waiting for appointments scheduled more than 30 days after their “preferred date” for care, according to the most recent patient access data released biweekly by the agency. The data, which reflects appointments scheduled as of October 1, indicates that the number of veterans waiting over 30 days at the VA has climbed by more than 14,000 in two weeks. This also represents a 10-week high for the number of veterans waiting over a month for care. The data sheds light on the agency’s efforts to take care of veterans as scrutiny intensifies over systemic cultural and leadership problems at its network of federally run hospitals. While the VA has kept the percentage of appointments scheduled over 30 days roughly steady—it has hovered between 7 and 7.5 percent for several months and even decreased in the most recent reporting period—the number of veterans seeking appointments at VA hospitals has increased, meaning more veterans are waiting longer for care. More than 7.3 million veterans had pending appointments at the VA as of October 1, roughly 400,000 more than just two weeks ago. The VA has been criticized over patient wait times and mismanagement since 2014, when it was discovered that schedulers at some agency hospitals were keeping secret lists to hide how long veterans were waiting for care. The practice resulting in veterans dying while waiting for appointments. An investigation by the VA inspector general released this month confirmed that delays in care persist at the Phoenix VA Health Care System, the center of the wait list scandal, and that at least one veteran died while waiting for care. Hospital staffers also were found to be inappropriately canceling appointments and other consultations, resulting in delays. The Washington Free Beacon reported last month that veterans with colorectal cancer died after delays in care at the New Mexico VA. The inspector general said these deaths resulted from a lack of oversight of the hospital system’s cancer screening program. According to the new data, just over 8,000 veterans in Phoenix are scheduled to wait more than 30 days for appointments. The situation at other hospitals is worse. More than 13,000 veterans in the greater Los Angeles area and more than 13,700 veterans in Denver are expected to wait that long for care. The VA measures wait times as the amount of time that lapses between a veteran’s “preferred date”—the date he wishes to be seen or the date his doctor determines he needs to be seen—and the actual date of his appointment. The agency does not begin counting when the veteran requests the appointment, meaning that that the VA patient access data likely underestimates actual wait times. A recent audit by the Government Accountability Office found that schedulers at multiple VA hospitals made errors when recording veterans’ “preferred dates,” which resulted in wait times that appeared shorter than they actually were. At one hospital, wait times were understated by an average of 20 days. Some veterans wait much longer than a month for VA appointments. According to the new data, more than 304,000 veterans will wait between one and two months for appointments, 126,000 will wait between two and three months, and over 50,000 will wait between three and four months. Nearly 42,000 veterans are expected to go more than four months without being seen by a VA professional. The VA did not return a request for comment. VA Secretary Robert McDonald has minimized the importance of wait times in measuring the agency’s success, comparing appointment waits to lines at Disney theme parks in May. McDonald later expressed regret over the analogy, which sparked outrage. Congressional lawmakers considered legislation to further reform the VA after reports exposed continued shortfalls at the agency’s hospitals despite a reform bill enacted in response to the 2014 wait list controversy. Legislative efforts have centered around expanding VA’s firing powers and allowing veterans more flexibility in choosing where they receive care, among other changes. An independent commission convened by Congress to review the VA hospital network recommended this year that it undergo a “far-reaching” transformation that would involve changes in governance structure and more private options for veterans. [Source: The Washington Free Beacon | Morgan Chalfant | October 18, 2016 ++]*****************************VA Treatment Delays ? Why It MattersTHE ISSUE: There are an estimated 21.6 million veterans in the United States. Among them, nearly 9 million are enrolled in health care provided by the Department of Veterans Affairs. About 4.3 million veterans get disability compensation from the VA and nearly 900,000 have been diagnosed with post-traumatic stress disorder. A 2014 law signed by President Barack Obama aimed to alleviate delays many veterans faced in getting treatment at VA hospitals and clinics and end the widespread practice of fake wait lists that covered up long waits for veterans seeking health care. Two years later, many of the problems remain.WHERE THEY STANDHillary Clinton has pledged to ensure veterans have access to timely and high-quality health care and vows to block efforts to privatize the Veterans Health Administration, the VA's health-care arm. Clinton also wants to bolster veterans' benefits, including education and housing aid included in the GI bill. She would ensure that military sexual trauma is acknowledged as a disability under VA rules.Donald Trump says he will expand programs that allow veterans to choose their doctor — regardless of whether they're affiliated with the VA — and still receive government-paid medical care. Trump says that's not privatized care but, he told The Associated Press, "a way of not allowing people to die waiting for doctors." Trump also pledged to fire or discipline VA employees who fail veterans or breach the public trust. He also would increase mental health professionals and create a "White House hotline" dedicated to veterans. If a valid complaint is not addressed, "I will pick up the phone and fix it myself if I have to," Trump said.WHY IT MATTERSLifetime health care is part of the bargain for many of those who put their lives on the line in the armed forces, and it's become clear the government isn't holding up its end. Veterans care has gained prominence since a 2014 scandal in which as many as 40 veterans died while waiting for care at a Phoenix VA hospital. Similar problems were soon discovered nationwide. Veterans waited months for care even as VA employees created secret waiting lists and other falsehoods to cover up the delays. A law approved after the scandal broke created a program that allows veterans to seek private care at government expense, but the program is limited to veterans who have waited 30 days for an appointment or live 40 miles from a VA health center. Trump says he would vastly expand the program, calling problems at the VA under President Barack Obama "widespread and totally inexcusable." Clinton says the VA must retain "the ultimate responsibility" for veterans care. She cites the Veterans Health Administration's leadership in areas such as prosthetics and traumatic brain injury. She promises to create an oversight board to monitor quality of care. Veterans groups are encouraged by the increased focus on the VA, as evidenced by a recent forum that featured both Clinton and Trump. But they say the VA must do more to improve access to health care, address veterans' suicide and change VA's culture to ensure real accountability. With nearly 370,000 employees and an annual budget of nearly $167 billion, the VA is the largest civilian agency in the government, and second overall to the Defense Department. Veterans are also a politically consequential group. Nearly 70 percent voted in the 2012 presidential election, a higher rate than the general population. [Source: Associated Press | Matthew Daly | October 18, 2016 ++]*****************************VA Endovascular Care ? Cardiac & Vascular Surgery Referrals Thousands of United States veterans wait daily to receive standard of care in vascular and cardiac surgery. The face of these medical specialties today is a stark contrast to their existence 25 years ago: What was once a long incision over the belly for repair an aortic aneurysm is now two small punctures in the groin. What once required cracking the chest open to replace a heart valve, leaves only a tiny scar. These amazing advances in cardiovascular disease are due to one word, endovascular, meaning from within the vessel, and those who’ve put their lives on the line don’t have access to what is now the best care available. Most U.S. hospitals have what’s called a hybrid operating room or have plans to build one in the next five years. This is a specially designed surgery suite with the ability to perform CT scans and moving X-rays during a procedure. Unfortunately, if a veteran were to call their local Veterans Administration hospital, they would find a far different answer: Less than 10 percent of Veterans Affairs (VA) hospitals in this country have a hybrid room. Endovascular repair requires moving X-rays and even CT scans intraoperatively, and in the 1990s, mobile X-ray machines, were brought into the operating room for this purpose. However, as this technique quickly expanded to virtually all avenues of vascular disease, higher-level imaging was required. Thus the hybrid suite was born, a modern solution that combines the high definition of X-ray imaging, while performing a sterile invasive vascular operation. And while university medical centers and the vast majority of large community hospitals adjust their real estate and budget to accommodate hybrid rooms for their insured and out-of-pocket paying patients, the VA system Dr. Kristine Orion is sad to say is, at best, slow to respond even 20 years later. Frankly, these rooms cost about $1 million dollars to build, but Orion asserts there are veterans who need complex cardiac or vascular procedures that absolutely require hybrid rooms. How then are these veterans getting those surgeries? Currently, they are sent to a local university. This is option provided by the VA administration allows payment to a non-VA facility, which can provide a necessary service the local VA does not offer. Dr. Orion challenges a single VA hospital to calculate current fee-based costs for the past five years. He suspects this sum would far outreach the actual budget to build their own hybrid operating room, as many VA neurosurgeons, interventional cardiologists, interventional radiologists, and neuro-interventional radiologists are all fee-basing out complex patients to the nearest hybrid room. Orion, as a practicing academic vascular surgeon, says the issue is not money; it is the dedication to provide medical care to America’s veterans, and the complexity of the case doesn’t matter. When Dr. Jason Lee of Stanford University evaluated outcomes of straight-forward aneurysm repair in a hybrid room compared to the traditional X-ray he found a trend toward decreased radiation exposure and complications. Do not get Dr. Orion wrong. He feels VA hospitals are institutions of excellence, and countless veterans love their VA. VA hospitals are a warm and welcoming family where “welcome to Walmart” is replaced by “Thank you for your service.” Some veterans feel a sense of belonging among their fellow brothers and sisters and enjoy the familiarity of one facility from primary care to podiatry. The thought of driving to a cold, white titanic of a university hospital where they will pay a fortune for parking does not sit well. They have come to expect quality care and are absolutely entitled to just that. There have been many movements since the calamity of the Vietnam War to embrace our veterans and acknowledge their dedication and sacrifice for their country: the Greenlight campaign, Mission 22, and public awareness for post-traumatic stress disorder. This is the call to provide the same standard of cardiovascular care to the veterans most Americans already enjoy. Dr. Kristine Orion, a Public Voices Fellow, is an assistant professor of surgery at Yale School of Medicine. [Source: The Hill | Kristine Orion | October 14, 2016 ++]*****************************VA Nursing Update 05 ? 230K Responses Assigned to One Reviewer We’ve all seen the recent headlines or heard the horror stories about American military veterans in dire need of medical treatment, their conditions worsening while they wait for weeks or months to receive care. Amid accusations and blame from all sides, the U.S. Department of Veterans Affairs issued a notice in May 2016 for public comments about a plan to allow nurse practitioners to provide a broader range of care for veterans. Naturally, if finalized into regulation, permitting NPs to deliver anesthesia, prescribe medications, and other clinical services could alleviate bottlenecks in the system, shortening unacceptably long queues. The VA’s request for public comments on this high-profile and sensitive issue stimulated a massive response. For an agency that received an average total of just 1,500 public comments in each of the previous two years, the 230,000 comments received by the VA during the 60-day comment period between May and July this year has utterly swamped its capacity to review and categorize them all, as required by law. John Davis was excited a couple of weeks ago when his company, Notice & Comment (N&C), received a call from the VA requesting their assistance to process the massive influx of public comments on the proposed nurse practitioner regulation. Built on IBM’s trailblazing Watson Explorer platform, their solution can review tens of thousands of comments in mere minutes and — with advanced cognitive computing and natural language processing — assess the sentiment and substantiveness of each one. As it turns out, the VA employs just one person responsible for reviewing each and every one of the 230,000 comments the agency received on the proposed nurse practitioner regulation. For such a vital issue, with so many opposing positions expressed by a myriad healthcare industry representatives and patient rights groups, this lone VA employee faced a practically insurmountable task. N&C's innovative solution was conceived, designed, and built to quickly conquer exactly this type of critical resource challenge. In 2013, N&C was invited as the only small business to join IBM, SAP, and other major IT services firms to participate in the White House Big Data Commission. The blue-ribbon group was formed at the Obama administration’s request to assess how advanced analytics technology could enable public agencies to become more transparent and responsive in a new era of open-source government. Eventually, N&C and IBM partnered to develop a solution capable of ingesting and analyzing massive volumes of public comments. It has been successfully demonstrated and tested at 23 separate federal agencies and departments since then. Unfortunately for the lone individual VA employee reaching out to N&C for assistance in reviewing the massive influx of public comments on the proposed nurse practitioner regulation, the agency has ZERO budget for engaging any support. Charged with completing the massive assignment before the current administration’s term ends, it’s hard to imagine this overburdened civil servant will have time to eat, sleep, or enjoy any upcoming holidays. Meanwhile, the possibility that veterans might access additional care providers in the VA system remains in limbo. For too long the court of public comments has been skewed toward special interests, in part because many if not most individual Americans are simply unaware of their power to affect the regulatory process, and do not exercise their rights in this capacity. Low participation rates aside, to the extent that comments are made -- by individuals, businesses, associations, corporations, etc. – tools already exist to ensure a level playing field and provide a rapid, unprecedented level of intelligence and transparency. I would argue these tools should be deployed by every regulatory agency required to consider public comments, sooner rather than later. [Source: The Hill | John W. Davis | October 14, 2016 ++]*****************************VA Clinical Pharmacists ? Expanding Role Cuts Wait TimesSomething astonishing has happened in the past year to outpatient treatment at the Veterans Affairs hospital in Madison. Vets regularly get next-day and even same-day appointments for primary care now, no longer waiting a month or more to see a doctor as many once did. The reason is they don’t all see doctors. Clinical pharmacists — whose special training permits them to prescribe drugs, order lab tests, make referrals to specialists and do physical examinations — are handling more patients’ chronic care needs. That frees physicians to concentrate on new patients and others with complex needs. A quarter of primary care appointments at the Madison hospital are now handled by clinical pharmacists since they were integrated in patient care teams in 2015. Several VA hospitals — in El Paso, Texas, and Kansas City, Mo., among them — have followed Madison’s approach and more than 36 others are considering it, according to hospital officials. “It’s made a tremendous positive impact in improving access,” said Dr. Jean Montgomery, chief of primary care services at the Madison hospital. That’s critical for the VA, the focus of a national scandal in 2014 after news reports revealed the Phoenix VA hospital had booked primary care appointments months in advance, schedulers falsified wait times to make them look shorter and dozens had died awaiting care. Further investigations uncovered similar problems at other VA facilities. More than two years later, tens of thousands of vets are still waiting a month or two for an appointment, according to the latest data from the VA. The Obama administration has allowed some veterans to seek care in the private sector if they choose, but VA wait times remain long and more action is needed, the General Accountability Office reported in April. Expanding clinical pharmacists’ role is a solution. They receive two more years of education than regular pharmacists and they can handle many primary care needs for patients, particularly after physicians have diagnosed their conditions. The VA has had them for more than 20 years, but their growing involvement in patient care is more recent. This year it employs 3,185 clinical pharmacists with authority to prescribe medications, order lab tests and perform physical assessments — nearly a 50 percent increase since 2011. “It’s having a significant impact on reducing wait times and our office is trying to expand more of them nationally to increase access,” said Heather Ourth, national clinical program manager for VA Pharmacy Benefits Management Services. In 2015, VA clinical pharmacists wrote 1.9 million prescriptions for chronic diseases, according to a report co-authored by Ourth and published in September in the American Journal of Health-System Pharmacy. A goal is to increase the use of clinical pharmacists to help patients with mental health needs and pain management. “This helps open up appointment slots for physicians to meet patients with acute care needs,” Ourth said. Clinical pharmacists’ authority is determined at each VA hospital based on their training and knowledge. The Madison VA allowed clinical pharmacists to take over management of patients with chronic diseases such as diabetes and high blood pressure, participate in weekly meetings with doctors and other members of patients’ care teams and handle patients’ calls about medications. They typically see five patients in their office each day, usually for 30 minutes each, and they talk to another 10 by telephone, said Ellina Seckel, the clinical pharmacist who led the changes at the hospital. Many issues involve adjusting medication dosages such as insulin, which do not require a face-to-face visit. When Seckel sees patients, she often helps them lower the number of drugs they take because they may cause unnecessary complications. Expanding clinical pharmacists’ role in primary care has cut readmission rates and helped more patients keep their diabetes under control, Seckel said. VA hospital officials in both Madison and El Paso said they faced challenges initially in persuading doctors to delegate some duties to qualified pharmacists. “Some physicians feel like it’s a turf war and don’t want to refer their patients because they feel the clinical pharmacist is trying to practice medicine,” said Lanre’ Obisesan, a clinical pharmacist and assistant chief of pharmacy at the El Paso VA. Even so, the El Paso VA’s average wait time fell from two months to two weeks, he said, after it added several clinical pharmacists and gave them independence to help patients. About 30 percent of the VA patients in El Paso have used clinical pharmacists, Obisesan said. That share will rise. The hospital now has one clinical pharmacist for every six physicians, but it aims to add more pharmacists to reduce the ratio to 1 to 3. The Madison VA is close to that ratio now after adding four clinical pharmacist positions in the past year. Patients there can choose whether to see a doctor or a pharmacist. With approval from primary care physicians, pharmacists took over 27 percent of the follow-up appointments for patients with chronic illnesses, Seckel said. That shift yields benefits for both doctors and patients, said Montgomery, the head of primary care services at the Madison VA. Many VA doctors only have time to deal with patients’ acute care issues, such as knee or back pain, with little time to focus on a patient’s multiple chronic illnesses and often a dozen or more medications they may be taking for them. “The more we can have members of the team to do routine things that do not require a physician’s time the better the quality of the visit and the better patient outcomes,” he said. Patients seem to like what the hospital is doing. Stephen Howard Foster saw a clinical pharmacist recently who told him he could stop taking one heartburn medication and switched him to another medicine to reduce side effects. He said he was comfortable with the pharmacist advising him without first consulting his physician and he saved time. “This is a good idea rather than put up with normal delays,” said Foster, 51. Another Madison VA patient, Mike Fonger, 71, saw clinical pharmacist Anita Kashyap recently to get a blood pressure check, lab test results, a review of his medications and to change an ointment he was taking for back and shoulder pain. Kashyap also helped him ease the side effects from the cholesterol-lowering drug he takes by cutting his dosage in half. “I like the extra attention I get here,” Fonger said. [Source: Kaiser Health News | Phil Galewitz?| October 25, 2016 ++]*****************************VA Hospital Quality of Care Update 03 ? Performance Data AvailabilityCMS has announced the availability of Department of Veterans Affairs (VA) hospital performance data on its Hospital Compare website . It said further VA hospital data would be added to the site in December and that plans are in progress for "future seamless integration" to make it possible for consumers to compare VA and civilian hospital data. The announcement follows controversial news reports indicating CMS had previously included VA hospital data, but that the VA had stopped submitting its data for several months over the summer because it was told the two agencies needed to arrange a new data sharing agreement. The matter of the VA's data sharing renewed concerns around the agency's transparency, which have dogged it ever since its wait time scandal erupted in 2014, resulting in discussion of increased agency oversight and other changes to improve veterans' timely and reasonable access to healthcare. The VA had begun sharing patient satisfaction and quality data in 2008 and specifically announced it was sharing with Hospital Compare in 2011, according to Law Firm Newswire. The agency was required by law in 2014 to share even more data following the wait time scandal. Joe Francis, VA's director of clinical analytics and reporting, had said they stopped sending data on the request of HHS lawyers and called the situation "deeply frustrating." The available VA data will now include satisfaction survey results, outcomes measures, behavioral health measures, and patient safety measures, CMS announced. [Source: CBS News | Jennifer Earl | October 11, 2016 ++]*****************************VA Advance Directive ? Advance Care PlanningYou know the kinds of foods you like, so when you go to a restaurant, you can usually make your choices without much difficulty. However, when it comes to making choices related to future health care, it can be more challenging. You may not be sick now or even want to think or talk about what you’d want if you do get sick and are unable to make decisions. But, just like it’s helpful to know what’s on the menu, there are benefits to becoming informed and thinking in advance about your future health care. Advance Care Planning is the process of clarifying your values and your preferences for future health care, and identifying who you would like to speak for you – your “Health Care Agent” – if you are no longer able to make decisions for yourself. An Advance Directive is the legal document that you should use to tell others what your preferences are and who you have chosen to be your Health Care Agent. In the future, if something happens to you and you can’t make decisions for yourself – maybe you’re unconscious or too ill – your health care team will use your Advance Directive to contact your Health Care Agent and together, look to your preferences on the Advance Directive as a guide to decisions about your care. Have you thought about what is important to you and what kind of medical care or mental health care you might want in the future? Have you thought about who you would want to be your Health Care Agent? Are you ready to make your choices? If so, it’s time for you to complete VA’s Advance Directive form. If you are facing a serious illness right now, you may want to choose from a different menu – one that addresses your current health care goals. Talk with your health care team about what is important to you now. Your doctors can help you decide which treatments and services would best help you reach your current health care goals. Based on this conversation, they can write medical orders to ensure that the treatment plan designed for you is based on your goals. There are many Advance Care Planning resources for Veterans and their loved ones. VA’s website for older Veterans (Geriatrics) has an entire section on Advance Care Planning with --Links to the VA Advance Directive form.Podcasts for you to listen to on advance care planning, choosing a Health Care Agent, how to be a Health Care Agent, and setting health care goals. This information about Advance Directives, choosing a Health Care Agent, and how to have a conversation about Advance Care Planning with your loved ones is of value to EVERYONE, Veterans and civilians, regardless of age or health status. If you want help considering what matters to you, take a look at this Values Worksheet and for more information talk with your VA social worker. If you are facing a serious illness, and want more information, you can review ethics.docs/GoCC/lst_booklet_for_patients_setting_health_care_goals_final.pdf (i.e. Setting Health Care Goals: A Guide for People with Health Problems.) So, you can make your choices now. If your preferences and priorities change over time or as your health status changes, it’s okay to change your mind and make different decisions. You can complete a new Advance Directive whenever you want, just let VA know. They are here to serve you! [Source: VAntage Point | October 25, 2016 ++]| *****************************VA Fraud, Waste & Abuse ? Reported 16 thru 31 OCT 2016Murfreesboro, TN — Edmond Deslatte, 46, pleaded guilty 25 OCT to making a false statement to a federal agent in connection with an investigation into his disability benefits payments. During a plea hearing before U.S. District Court Judge Aleta A. Trauger, Deslatte admitted making a false statement during an April 2011 interview with a special agent with the U.S. Department of Veterans Affairs (“VA”) Office of Inspector General (“OIG”). At the time of the April 2011 interview, Deslatte was receiving 100% disability benefit payments from the VA, although he had been working full-time. At his plea hearing, Deslatte admitted that, during his April 2011 interview, he falsely represented to the VA-OIG agent that medication prescribed for his medical condition had rendered him disabled and unable to work. Deslatte further admitted that he had not been taking the medication as he had represented to the VA-OIG agent. According to Deslatte, he made the misrepresentations in an effort to continue receiving disability benefit payments from the VA. In May 2014 a VA physician determined that Deslatte did not suffer from the medical condition that had supposedly rendered him disabled, and the VA subsequently terminated Deslatte’s disability payments. The intended loss associated with Deslatte’s misrepresentations to the VA was approximately $148,000. Deslatte faces up to 5 years in prison and a fine of up to $250,000. Deslatte will be sentenced by Judge Trauger on January 19, 2017. Deslatte’s sentence will be imposed by the Court after consideration of the U.S. Sentencing Guidelines and applicable federal statutes. [Source: DoJ Middle Dist of TN | U.S. Attorney’s Office | October 17, 2016 ++]-o-o-O-o-o-Huntington, KY — A veteran was sentenced today to two years in federal prison and ordered to pay $789,472 in restitution for defrauding the Veterans Health Administration. Phillip M. Henderson, 51, of Olive Hill, was previously found guilty by a federal jury sitting in Huntington following a five-day jury trial. The jury required only an hour of deliberations before finding Henderson guilty. Henderson served in the United States Army from 1983 to 1986. After he was discharged, Henderson filed multiple claims for benefits with the United States Department of Veterans Affairs (VA). In 1995, Henderson received a diagnosis from the VA of Retinitis Pigmentosa, an inherited and degenerative eye disease which can lead to total blindness. After this diagnosis, Henderson continued to undergo VA eye examinations through 2013, during which time VA medical staff continued to conduct tests to determine the extent of his vision loss. The results of these tests relied significantly, if not completely, on Henderson’s cooperation and accurate reporting of his vision levels. Witnesses for the United States, including four medical doctors, testified that Henderson falsely responded to the vision testing and significantly misrepresented his vision loss. Witnesses further testified that Henderson pretended he could barely read the letters on the eye charts and pretended that his peripheral vision was severely reduced. As part of his scheme to defraud the VA, Henderson did not reveal that he had a Kentucky driver’s license and that he could and did drive. Henderson received the maximum disability and healthcare benefits he could get for his claimed disability and vision loss. VA benefits representatives testified that from 1996 to 2015, Henderson received approximately $697,000 in disability compensation. In addition to this monthly monetary compensation, Henderson also received an $11,000 grant to purchase an automobile in 2006, which was intended for another person to drive Henderson, and another $10,000 grant towards the installation of an in-ground swimming pool, which was intended for his exercise and to maintain his well-being as a blind veteran. Furthermore, Henderson received the maximum healthcare benefits possible for him and his family based upon his claimed diagnosis and vision loss. During the same time period, Henderson received the highest priority in getting medical treatment from the VA, free medical and dental services, free prescriptions, reimbursement for travel from his home in Kentucky to the VA Medical Center in Huntington for medical appointments, free training for the blind in Connecticut and Alabama for extended periods of time, and free equipment designed to assist the blind, such as canes, computers, talking telephones, and night vision goggles. [Source: DoJ Southern Dist of WV | U.S. Attorney’s Office | October 17, 2016 ++]-o-o-O-o-o-Augusta, GA — In what the judge called a "tragic case," a former Charlie Norwood VA Medical Center supervisor was sentenced 20 OCT to 27 months in federal prison for making false statements in medical files, making it look like requests for care had been fulfilled when they had not. In sentencing Cathedral Henderson, U.S. District Court Judge J. Randal Hall noted that the incident occurred during an ongoing and much larger VA scandal about long waits for care and other problems with getting proper care to veterans. "This is a national tragedy that unfortunately seems like it will never go away," Hall said. In 2013, the VA found that it had a massive backlog of consults pending, which are requests for tests or exams or specialized medical care. There were 2.1 million open nationwide and about 30,000 in Augusta, according to trial testimony. The national office issued a mandate to close out all of them within a year, and officials were under pressure to get it done. About two weeks before he was to take another job at the VA, Henderson was given 2,700 files to close. After initially objecting that he and his staff were not medically qualified to do that, Henderson ultimately ordered the consults closed with the phrase "services rendered or patient refused services," for which he was convicted of 50 counts of making a false statement in relation to health care. Hall noted that Henderson's prosecution is one of the few that have emerged from the larger VA scandal nationally. The Augusta trial revealed "an agency whose bureaucracy seems to be in disarray," he said. "It's a case that is troubling to me." In objecting to a recommendation in the pre-sentencing report, Assistant U.S. Attorney Lamont Belk said the sentence should be enhanced because Henderson's illegal closure of the files put patients at risk of harm. He noted in particular a man who should had been referred for a sonogram to check for an abdominal aortic aneurysm, a weakening in the blood vessel wall that can have tragic consequences if it bursts, that the patient had not received when Henderson ordered the file be closed. "It's like a weak spot in a tire," Belk said. "It could blow." Henderson "knew the impact of his actions on the veterans," he said. Defense attorney Keith Johnson argued that Henderson initially objected to closing out the files and asked for medical personnel to help but was told by his boss that he didn't need it to close the files. "She is assuring him he is equipped to handle this," Johnson said. But Hall said it was clear Henderson "knew the risks" and ultimately chose to disregard them. Johnson noted that Henderson is a veteran who served nearly a decade before joining the VA, where he started out as a janitor before working his way up to be a mid-level supervisor. "But for this situation, we would look at it as an American success story," he said. Johnson had been prepared to ask the court for home confinement, noting that Henderson is "not a threat to the community." Henderson had never been in trouble before and "he will never be in a courtroom again," he said. In addressing the court, Henderson said he volunteered to go to the Persian Gulf War and stayed behind after the conflict ended to help tend to the injured. Friends and co-workers had asked to come and testify on his behalf, he said. "They know I would never intentionally do anything to harm a veteran," Henderson said. But even with noting his service and good record, Hall imposed a prison sentence because veterans had been put at risk and also as deterrent to any VA workers who might be considering a similar action. "Putting hundreds of veterans at risk is one of the more serious offenses you could bring to this court," he said. "It's a tragic case." [Source: Augusta Chronicle | Tom Corwin | October 21, 2016 ++]-o-o-O-o-o-St. Louis, MO — Tamara Jones was charged with theft of government funds and misappropriation in connection with her service as a fiduciary representative of an area disabled veteran. According to the indictment, Jones was enrolled as a financial fiduciary through the United States Department of Veterans Affairs. As such, she was eligible to handle the financial affairs of disabled veterans pursuant to an agreement with the VA. In September 2014, having been appointed fiduciary for a disabled veteran living in St. Louis County area, whose initials are A.W., Jones drained most of a $38,000 back pay award she found in his financial account. Jones is also accused of failing to maintain records and file required reports and accountings of A.W.’s affairs. When confronted by VA auditors and investigators, Jones could not explain the situation and repeatedly failed to provide records, reports or A.W.’s funds despite repeated promises to do so. The indictment was returned October 26. Jones is expected to appear in federal court later this week. If convicted of theft of government funds, Jones faces up to 10 years in prison. If convicted of misappropriation by a fiduciary, she faces up to 5 years in prison. Both counts also carry the possibility of a fine of up to $250,000. Restitution to the victim is also mandatory. In determining the actual sentences, a Judge is required to consider the U.S. Sentencing Guidelines, which provide recommended sentencing ranges. As is always the case, charges set forth in an indictment are merely accusations and do not constitute proof of guilt. Every defendant is presumed to be innocent unless and until proven guilty. [Source: DoJ Eastern Dist of MO | U.S. Attorney’s Office | October 27, 2016 ++]*****************************VAMC Denver CO Update 05 ? Unofficial Vet Wait Lists Alleged Government investigators said they are examining allegations that Department of Veterans Affairs employees in Colorado kept unofficial lists of veterans waiting for health care that could conceal how long it takes to get an appointment, possibly broadening a nationwide scandal. The VA's internal watchdog announced an audit in a letter 19 OCT to Republican Sens. Ron Johnson of Wisconsin and Cory Gardner of Colorado. The Associated Press obtained a copy of the letter. Johnson and Gardner asked for the inquiry after a whistleblower told them the lists were allegedly used at the Denver VA Medical Center and VA health clinics in Colorado Springs and the Denver suburb of Golden. The inquiry by the VA's inspector general also will look into the whistleblower's allegations that records at the Colorado Springs clinic were falsified after a veteran committed suicide while awaiting treatment for post-traumatic stress disorder. Unofficial or secret lists have been used at VA facilities across the country to hide lengthy delays in care for veterans. Forty veterans died while waiting for appointments at a Phoenix VA hospital. The scandal led Congress to fund the Veterans Choice program, which allows veterans to seek private care at government expense if they have waited 30 days or longer. It also led to the ouster of VA Secretary Eric Shinseki. Johnson and Gardner asked for the inquiry four weeks ago. Wednesday's letter from VA Inspector General Michael Missal was the first confirmation that the audit would be done. It also confirmed that the alleged wait lists were unofficial records that could hide true wait times. In a statement, Gardner said he welcomed the inspector general's announcement. He called the allegations serious and said they should be reviewed thoroughly. Inspector general's spokesman Mike Nacincik described it as an audit rather than an investigation. He said auditors could refer the results to investigators, depending on what they find.VA wait times in Colorado have been an issue before. In February, the inspector general said workers at the Colorado Springs clinic incorrectly reported that some veterans got appointments sooner than they actually did, while at least 288 people had to wait longer than the 30-day target. Investigators didn't say whether the records were deliberately falsified. The inspector general's office said in May that it found no indication of improper scheduling lists at an endoscopy clinic in Grand Junction and clinics for prosthetics and audiology in Denver. [Source: The Virginian-Pilot | Courtney Mabeus | October 7, 2016 ++]*****************************VA HCS Phoenix Update 28 ? Funding/Training Response to FailuresThe Department of Veterans Affairs announced 14 OCT that more money, training and employees would be part of an effort to correct the Phoenix VA Health Care System after an inspection found veterans continue to suffer with long waits for appointments with specialists. The Phoenix VA was at the center of a scandal in 2014, when it was discovered veterans died while waiting for care. Staff had manipulated wait-time data there and at other VA hospitals across the United States. After the U.S. government poured billions of dollars into reform efforts in following years, 215 patients died while waiting for treatment at the Phoenix VA, according to a report released Oct. 4 by the VA’s Office of Inspector General. One patient was unable to see a VA cardiologist, which “may have contributed” to his death, the report stated. “The sustained and continued improvement of the Phoenix VA Health Care System is a department priority,” VA Deputy Secretary Sloan Gibson said in a news release. “There are best practices and expertise from across the nation that we are bringing to bear in order to deliver more consistent, high-quality care to veterans.” The VA announced it would allocate $28 million to the Phoenix VA in addition to its annual budget. Most of the funds will be used to hire more employees, said VA Press Secretary Victoria Dillon. Leadership at the Phoenix VA is attempting to open two new facilities in early 2017, expanding its number of community-based clinics from seven to nine. “One of the big challenges in Phoenix was not enough medical center staff, doctors and nurses, and not enough clinical space,” Dillon said. They’re also providing more training on scheduling medical appointments. All new employees will be required to take a two-week course, while current employees will go through a three-day course, according to the release. The inspector general’s office has issued a half-dozen reports in the past two years citing ongoing problems in Phoenix, despite new VA policies and increased training in scheduling appointments, the new report stated. Inspectors found the number of active patient cases in Phoenix had grown from 32,500 in March to 38,000 by July. The additional cases were caused partly by staff not scheduling patient’s appointments in a timely manner, according to inspectors. “As a result, patients attempting to get care at [the Phoenix VA] continued to encounter delays in obtaining such care,” the report read. “We substantiated that one patient waited in excess of 300 days for vascular care.” Several lawmakers reacted to the findings, including Rep. Jeff Miller (R-FL), chairman of the House Committee on Veterans’ Affairs; Sen. John McCain (R-AZ), Sen. Jeff Flake (R-AZ), and Rep. Ann Kirkpatrick (D-AZ)., who is running against McCain in the November election. “More than two years after the Phoenix VA Health Care System became ground zero for VA’s wait-time scandal, many of its original problems remain, and this report is proof of that sad fact,” Miller said in a written statement. “…it’s clear veterans are still dying while waiting for care, that delays may have contributed to the recent death of at least one veteran and the work environment in Phoenix is marred by confusion and dysfunction.” Concerned Veterans for America, a conservative-leaning veterans group, said 14 OCT that the VA was only throwing money at the problems in Phoenix. “This is a structural and cultural problem within the VA that starts at the top with the leadership,” Matt Dobson, the organization’s Arizona director, wrote in an emailed statement. “Wasting even more taxpayer dollars is not the answer.” The inspector general’s report was released only about a week after the announcement of a new director for the beleaguered Phoenix VA. The appointment of RimaAnn Nelson, the seventh Phoenix director in three years, was criticized by lawmakers and veterans service organizations, including Concerned Veterans for America. Nelson once led the VA health care system in St. Louis, where inspectors in 2011 found unsanitary conditions in a dental facility. The VA responded to the concerns by issuing a statement that Nelson appropriately closed the dental clinic and initiated a cleanup, the Arizona Republic reported. Now that Nelson has filled the position, the VA is looking to fill two other leadership positions in Phoenix: the deputy medical center director and associate director. In the VA release 14 OCT, Nelson said she has started “frank conversations” in Phoenix about the path forward. Her statement came after Gibson’s second visit to Phoenix in two months. Gibson is planning monthly visits through the end of the year, Dillon said. “I’m appreciative of the support we’re receiving,” Nelson said. “Some of the best and brightest from across VA are coming to Phoenix and that can only mean good things for the veterans we serve.” [Source: Stars And Stripes | Nikki Wentling | October 4, 2016 ++]Veterans Day Freebies ? Restaurants | 2016The list below is not all inclusive. For additional freebies in your geographic area check with your local; veterans organization. Recommend before heading out on Veterans Day contact the restaurant beforehand. That way you can not only be confident that they are participating in a free Veterans Day offer, but also so you can verify that the time mentioned is correct for your favorite restaurant. Remember to thank the business for their support.Applebee's Veterans Day Free Meal (Friday, November 11, 2016)Stop in to a participating Applebee's to get your Veterans day free meal. You'll be able to choose a meal from a limited Veterans Day menu that includes items like steak, cheeseburgers, chicken tenders, and lots more: This deal is for dine-in only, and requires that you bring in ID that Applebee's considers proof of military service.Bob Evans Free Hotcakes on Veterans DayVeterans and active military personnel can stop into a Bob Evans location and receive free all you can eat hotcakes .You'll need to bring proof of military service to get your Veterans Day free meal.Carrabba's Free Appetizer for Veterans Day (November 9 - 16, 2016)If you are a veteran or active military member, you can stop by a Carrabba's near you and get a free appetizer of your choice. There's no purchase necessary or coupon required; you just need to bring military ID or come in your uniformChili's Veterans Day Free Meal (Friday, November 11, 2016)Visit a participating Chili's on Wednesday, November 11, 2015, to get your Veterans Day free meal if you are a veteran or on active military duty. Options for this free meal include: Oldtimer with Cheese, any lunch combo, Soup & Salad, Grilled Chicken Salad, Chipotle or Margarita Chicken Fresh Mex Bowl, Grilled Chicken Burrito, Southwest Pairings Pick-2, and Any Full Size Flatbread. You'll need to show proof of military service to get your Veterans Day free meal.Denny's Veterans Day Free Grand Slam (Friday, November 11, 2016)Stop by Denny's and all active, non-active, and retired military personnel can get a free Build Your Own Grand Slam Breakfast from 5:00 AM to Noon. All Denny's locations are participating in this promotion and you'll just need to bring a valid military ID along with you. This is for dine-in only.Famous Dave's Veterans Day Free MealsFamous Dave's will be giving out free meals for Veterans Day The Veterans Day free meal includes a One-Meat BBQ Salute, a corn muffin, and a side. This offer is valid between 11:00 AM and 4:30 PM for participating locations only.Golden Corral Veterans Day Free Meal (Friday, November 11, 2016)On November 11, 2016 from 5:00 PM to 9:00 PM, Golden Corral will be giving out Veterans Day free meals and a beverage to any person who has ever served in the U.S. military or is on current active duty.Hooters. Hooters invites all veterans and current servicemen and women to a free meal, up to $10.99 in value with any drink purchase, by presenting a military ID or proof of service at any Hooters location across the country.IHOP Free Veterans Day Pancakes at IHOPIHOP will be honoring veterans and active military men and women with a free stack of Red, White, and Blue pancakes. Not all locations are participating, so be sure to call ahead to make sure your local IHOP is offering this Veterans Day free meal. Some locations may include the pancakes with free eggs, bacon, and hash browns. Individuals must show proof of their service before receiving this offer, such as coming in their uniform, showing a photo of them in their uniform, or showing a military ID cardIkea. Many Ikea locations are offering a free meal for veterans. Search for your local Ikea store , go to the store home page and select the Special Offers tab for details.Little Caesars Pizza Free Veterans Day Pizza (Friday, November 11, 2016)Little Caesars Pizza is giving free pizza to all US Armed Forces veterans and active military members this Veterans Day between 11:00 AM and 2:00 PM. This Veterans Day free meal includes both a $5 HOT-N-READY Lunch Combo and a 20 oz Pepsi product. A coupon is not required to redeem this offer, but you will need to bring along proof of service. Not all locations are participating, so be sure to call ahead to your local Little Caesars Pizza location. Little Caesars Pizza is also running their 9th Little Caesars Veterans Program this year, which helps veterans get thousands of dollars in discounts when they start up their own Little Caesars Pizza location.Long Horn Steak House. Receive a complimentary Texas Tonion appetizer and a non-alcoholic beverage on Nov. 11. Includes veterans and current service membersMax & Erma's Veterans Day Free Meal (Friday, November 11, 2016)Max & Erma's will be honoring veterans and active military personnel by giving out a free Best Cheeseburger in America 3-Course Combo which includes choice of Tortilla Soup or side House Salad, a cheeseburger, endless seasoned french fries, and a fresh baked chocolate chip cookie for dessert. A beverage is not included. This offer is valid only for participating Max & Erma's so be sure to contact your local restaurant before heading out. This is for dine-in only and you'll need to show proof of military service.Olive Garden Veterans Day Free Meal (Friday, November 11, 2016)Olive Garden is having a Veterans Day free meal for all active-duty military and military veterans who provide proof of service. Veterans can choose a free entree from a special menu of Olive Garden's seven most popular items. All of these entrees come with freshly baked garlic breadsticks and a choice of unlimited soup or salad. In addition to this, Olive Garden is letting friends and family dining with veterans to have 10% taken off their mealsPonderosa Steak House. From 4pm-close, all former and current military service men and women enjoy a free buffet (beverage not included) from participating Ponderosa locations. Contact your local Ponderosa for more details.Red Lobster Veterans Day Free Appetizer or Dessert (November 10 - 11, 2016)Active duty military, reserve, and military veterans can stop by Red Lobster and get a free appetizer or dessert on Monday, November 10 and 11. They get to choose from any of these appetizers: Sweet Chili Shrimp, Parrot Isle Jumbo Coconut Shrimp, Lobster-Artichoke-and-Seafood Dip, Lobster-Crab-and-Seafood-Stuffed Mushrooms, Lobster Pizza, Signature Shrimp Cocktail, Crispy Calamari and Vegetables, Mozzarella Cheesesticks, Crispy Shrimp Lettuce Wraps, White-Wine-and-Roasted-Garlic-Mussels, and Shrimp Nachos. Dessert options include the following: Warm Chocolate Chip Lava cookie, NY Style Cheesecake with Strawberries, Carrot Cake, Warm Apple Crostada, and Chocolate Wave.Red Robin FREE Veterans Day MealRed Robin is serving up a FREE Red’s Tavern Double Burger and Bottomless Steak Fries for all veterans and active military personnel. Offer valid all day on Wednesday, November 11, 2016. Valid military ID or proof of service is required to get this deal. Not all locations are participating, so be sure to call and confirm before heading to Red Robin on Veterans Day.Ruby Tuesday Free Veterans Day Appetizer (November 11, 2016)Veterans, active duty, and reserve service men and women can visit Ruby Tuesday on Veterans Day to get a free appetizer. Be sure to call ahead to make sure your local Ruby Tuesday is participating. Proof of service is required.Starbucks Free Coffee on Veterans DayStarbucks will be giving out free tall brewed coffees to veterans, active-duty military, and their spouses on Veterans Day. Call ahead to make sure your local Starbucks is participating.Steak n Shake. Get Veterans Day Special, free breakfast skillet and coffee.Texas Roadhouse Veterans Day Free Meal (Friday, November 11, 2016)Texas Roadhouse will be giving away Veterans Day free meals for lunch to active, former, or retired military. Free entrees include your choice of steak, country fried chicken, country fried sirloin, pulled pork, grilled pork chop, cheeseburger, BBQ chicken sandwich, pulled pork sandwich, grilled chicken salad, or chicken critter salad. Plus, your choice of sides and a coca-cola product, tea, or coffee. This is for dine-in only. You'll need to bring in a military ID, Veterans Affairs card, or Discharge papers for proof of service.Tim Hortons Veterans Day Free DonutAll U.S. locations of Tim Hortons is giving away a free donut to all active and inactive U.S. military veterans.Veterans will need to be in uniform or show military ID. No purchase necessaryTGI Fridays Free Lunch. Veterans and active duty military service members are invited to have lunch from a special menu on T.G.I Friday’s this Veterans DayTubby's Free Sub on Veterans Day (Friday, November 11, 2016)Veterans and active duty military members can get a free small Grilled Steak N' Cheese or Tubby's Famous Sub at participating Tubby's locations. Be sure to bring along your military ID or DD214. This offer is for carry-out only.[Source: Various | October 1, 2016 ++]*****************************Congressional Military Vets ? Too Few (18%) in Congress?A retired Marine general says in his new book that adding more to Congress likely would break the gridlock that prevents anything from getting done. "I really do believe that," retired Maj. Gen. Arnold L. Punaro told DoD Buzz, an online journal that covers defense issues. Punaro, the chairman of the Reserve Forces Policy Board and a frequent speaker at the annual NGAUS conference, made the claim in his book "On War And Politics: The Battlefield Inside Washington's Beltway." In an interview he said, "Today's so-called 'leaders' are fully aware of the problems that need solving. They just don't seem to have the courage to make the hard choices, not if it means they may lose votes or campaign contributions. I believe it's because most of todays' bureaucrats and elected officials have never faced a real battle or had to risk their very lives in a shared effort." He points out that 64 percent of the Congress had military backgrounds in 1981. That had fallen to 18 percent in 2015. He said veterans would understand "when mutual sacrifice was necessary to achieve a common goal," something most members of Congress now do not recognize or are unwilling to do. [Source: NGAUS Washington Report | October 18, 2016 ++]*****************************VA Burial Benefits Update 39 ? Benefit Expansion Bill H.R.4757The Congressional Budget Office (CBO) has submitted their report on H.R. 4757. The bill would modify burial programs administered by the Department of Veterans Affairs (VA) and would make certain deceased veterans eligible for Presidential Memorial Certificates. CBO estimates that enacting H.R. 4757 would increase direct spending by $36 million over the 2017-2026 period. Pay-as-you-go procedures apply because enacting the legislation would affect direct spending. Enacting the bill would not affect revenues. In addition, CBO estimates that implementing the bill would have discretionary costs totaling less than $500,000 over the 2017-2021 period; that spending would be subject to the availability of appropriated funds. CBO estimates that enacting the legislation would not increase net direct spending or on-budget deficits by more than $5 billion in any of the four consecutive 10-year periods beginning in 2027. H.R. 4757 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act (UMRA) and would not affect the budgets of state, local, or tribal governments. To review the entire report refer to . [Source: CBO Publications | H. Samuel Papenfuss | October 13, 2016 ++]*****************************VA Unethical Health Care Practices ? Reporting Responsibility BillThe Congressional Budget Office (CBO) has submitted their report on H.R. 5399: Ethical Patient Care for Veterans Act of 2016. The bill would require physicians employed by the Department of Veterans Affairs (VA) to report unethical health care practices that take place at VA medical facilities to the appropriate state licensing authority within five days of occurrence. The bill also would require VA to inform physicians of that responsibility. Under current law, VA monitors and evaluates the quality of health care through its quality-assurance program. Under that program, physicians may confidentially submit reports of unethical practices that they witness. CBO expects that VA would distribute information about the new reporting requirement through electronic correspondence. As a result, CBO estimates that implementing H.R. 5399 would have insignificant costs for administrative activities over the 2017-2021 period; that spending would be subject to the availability of appropriated funds. Enacting the legislation would not affect direct spending or revenues; therefore, pay-as-you-go procedures do not apply. CBO estimates that enacting H.R. 5399 would not increase net direct spending or on-budget deficits in any of the four consecutive 10-year periods beginning in 2027. H.R. 5399 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act and would impose no costs on state, local, or tribal governments. [Source: CBO Publications | Ann E. Futrell | October 13, 2016 ++]*****************************PTSD Update 221 ? H.R. 5600: No Hero Left Untreated ActThe Congressional Budget Office (CBO) has submitted their report on H.R. 5600: No Hero Left Untreated Act. The bill would require the Department of Veterans Affairs (VA) to establish a one-year pilot program to treat a limited number of veterans with post-traumatic stress disorder, traumatic brain injury, military sexual trauma, chronic pain, or opiate addiction by using Magnetic eResonance Therapy technology (MeRT technology). The bill also would require VA to report to the Congress on the results of that pilot program. MeRT technology is a customized neurological treatment that uses magnetic pulses to stimulate brain tissue. The Brain Treatment Center (BTC) in Southern California developed the MeRT technology and has proprietary rights to the treatment. Over the 2012-2015 period, the center has treated more than 400 veterans at four locations in the state of California and the state of Washington. Under this proposal, VA would be required to carry out the one-year pilot program with no more than 50 veterans in one or two medical facilities. Because the technologuy is proprietary, we expect that VA would contract with BTC to provide MeRT technology to those veterans. On the basis of information from BTC, CBO expects the average patient at VA would undergo an initial assessment at a cost of $1,000 and at least 20 MeRT sessions over a 30-day period at a cost of $22,000. On that basis, CBO estimates that implementing this bill would cost $1 million over the 2017-2021 period; that spending would be subject to the availability of appropriated funds. Enacting the legislation would not affect direct spending or revenues; therefore, pay-as-you-go procedures do not apply. CBO estimates that enacting H.R. 5600 would not increase net direct spending or on-budget deficits in any of the four consecutive 10-year periods beginning in 2027. H.R. 5600 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act and would not affect the budgets of state, local, or tribal governments. [Source: CBO Publications | Ann E. Futrell | October 13, 2016 ++]****************************House Vet Bill Progress ? 31 OCT 2016Veteran Related Bills Recently Introduced in the House:None. House is currently adjourned. All outstanding bills will be archived at the end of this session leaving no business for the new Congress. For continued consideration their sponsors will have to introduce them as new legislation in the next Congress. A new Congress (115th) consisting of two sessions will meet at noon on January 3, 2017. It will last for two years, each of which will constitute one session. When Congress reconvenes the process will start all over again. Bills will be introduced and given a chronological number. Expect a flurry of activity in the first few weeksVeteran Related Bills Recently Reported on by the Congressional Budget Office (CBO)H.R. 5428, Military Residency Choice Act. Military personnel can retain their residences or domiciles for purposes of state and local taxation and voter registration when they leave a state if that move, and any subsequent moves, are made in compliance with military orders. Under the Military Spouses Residency Relief Act, spouses of service members can retain their states of residency if they move and reside with the service member; they cannot use the service members’ states of residency for taxation or voting purposes unless they can independently establish entitlement according to state laws. H.R. 5428 would allow spouses of service members to claim the same state of residence as the service member for those purposes, regardless of whether the spouse had ever resided in that state. To read the complete report refer to H.R. 5099, Communities Helping Invest through Property Improvements Needed for Veterans Act of 2016 This legislation would authorize the Department of Veterans Affairs (VA) to accept up to five donations of real property such as land or facilities from nonfederal entities for a pilot program to construct VA facilities. Any such donated property would need to meet a requirement for capital improvements that VA had previously identified as necessary to provide services or benefits to veterans. The department could help finance such a project using any amounts that had been appropriated for that project before it entered into an agreement with the nonfederal entity. The bill would prohibit VA from spending any funds from a subsequent appropriation to complete construction of a donated facility or to pay for the use of such a facility once it is complete. The authority to accept such donations would expire five years after enactment of the bill. To read the complete report refer to . [Source: | October 31, 2016 ++]*****************************Senate Vet Bill Progress ? 31 OCT 2016Veteran Related Bills Recently Introduced in the Senate:None. Senate is currently adjourned. All outstanding bills will be archived at the end of this session leaving no business for the new Congress. For continued consideration their sponsors will have to introduce them as new legislation in the next Congress. A new Congress (115th) consisting of two sessions will meet at noon on January 3, 2017. It will last for two years, each of which will constitute one session. When Congress reconvenes the process will start all over again. Bills will be introduced and given a chronological number. Expect a flurry of activity in the first few weeks[Source: | October 31, 2016 ++]USERRA Update 19 ? Federal Court Ruling Impacts ReservistsA high-level federal court on Friday delivered a blow to the rights of military reservists. The case involved a Navy reservist who claimed that his civilian employer fired him because he was mobilized and deployed to Afghanistan, a violation of federal laws designed to protect reservists from discrimination based on their military service. But Kevin Ziober lost his case before the Ninth Circuit U.S. Court of Appeals, one step below the U.S. Supreme Court, which ruled that his pre-employment arbitration agreement prohibited him from suing his former employer. And although the court ruled against Ziober, the judge appeared to urge Congress to consider changing or strengthening the 1994 law, the Uniformed Services Employment and Reemployment Rights Act, or USERRA. “If we have erred by construing [USERRA] too narrowly, Congress will surely let us know,” Circuit Judge Paul J. Watford wrote in a concurring opinion released Friday. The USERRA law requires employers to allow reservists to return to their civilian jobs after periods of active-duty service. Ziober testified before Congress in June, describing his experience and the need to strengthen the law. Ziober was a Navy lieutenant in 2012 when he was working for a California real estate management company, BLB Resources. He was fired on his last day of work before deploying to Afghanistan. The company said he was fired for reasons unrelated to his military service. However, when Ziober started working for BLB Resources, he signed an contract agreeing to resolve outside of court any future legal disputes with his employer. Such arbitration agreements typically bar employees from filing lawsuits. Ziober tried to file a lawsuit in federal court after he was fired. It alleged discrimination in violation of USERRA. But that lawsuit failed when a district-level federal court said the arbitration agreement stripped Ziober of his right to sue under USERRA. Ziober’s attorney suggested the ruling could harm military recruiting and retention, and ultimately impact military readiness. “USERRA is there to protect the rights of service members and veterans, and without USERRA rights, and enforcement of those rights, [National] Guard and reserve members can’t do their duty with the confidence they need that they can get back to their jobs and put food on the table for their families,” said Peter Romer-Friedman, a Washington attorney who has represented numerous reservists with USERRA claims. “When court decisions take away USEERRA rights, they weaken our armed forces, they make us less safe and less secure.” The appellate judge acknowledged that Ziober made a strong case. But the USERRA law does not specifically include language stating a power to legally supersede arbitration agreements. “With reasonable arguments to be made on both sides, I don’t think it’s prudent for us to [reverse] the district court’s ruling, particularly given the ease with which Congress can fix this problem,” Wagner wrote. “If we and other circuits have misinterpreted the scope of [USERRA] Congress can amend the statute to make clear that it does render pre-dispute agreements to arbitrate USERRA claims – unenforceable.” Connecticut Sen. Richard Blumenthal, a Democrat, has proposed a law that would eliminate any ambiguity in the USERRA law and state explicitly that service members cannot be blocked from the court system by arbitration agreements. Ziober remains in the Navy reserve and now has a federal civilian job in California. [Source: Military Times | Andrew Tilghman | October 15, 2016 ++]*****************************Reservist Health Care ? Line-of- Duty Not Always CoveredCapt. Shane Morgan was getting over bronchitis, but he felt pretty good the morning of his PT test last November. By 15 push-ups, he was starting to feel beyond terrible. Morgan was suffering from a heart attack, and, following a line-of-duty investigation, the Army has determined that the Army Physical Fitness Test didn't trigger it, leaving the Army Reserve officer with upwards of $30,000 in medical bills. "It's literally a miracle he survived," his wife, Jaime, told Army Times. Now, both Morgan's Army and civilian careers are in jeopardy because, nearly a year later, the bills are damaging his credit -- which could affect his top secret security clearance. "I’ve already been sent to collections for a $889 bill, and there are more to come," he said in a phone interview, including a $2,000 ambulance bill that he said he has submitted to Tricare three times. Morgan is telling his story, he said, because he wants the Army to overturn his LOD investigation, and he wants any other soldiers who've been through the same thing to know that they have options. Line-of-duty investigations are used when service members become ill or injured, to determine whether they are at fault due to their own negligence or misconduct. Depending on the severity of the illness or accident, soldiers can be formally disciplined, or it can affect their discharges and benefits if they are determined no longer fit for duty. Morgan said he was surprised that his chain of command initiated an LOD at all, and though the Army didn't rule in his favor, they did not accuse him of misconduct or negligence. His case is getting attention up his chain of command, he added. He got a call on 12 OCT from his outgoing commanding officer at the 335th Signal Command informing him that Maj. Gen. David Conboy, the deputy commander of the Reserve, was aware of his case and looking into it. A Reserve spokesman declined to comment on the case, but confirmed that Morgan is an information systems management officer assigned to Army Reserve Cyber Operations Group Northeast at Fort Devens, Massachusetts. During the week, he works on classified projects at BAE Systems in New Hampshire, Morgan said, adding that he's had to report his collections status to his employer. "This could affect my security clearance, which could affect my ability to do my job," he said. They don't have my back' Morgan's ambulance ride, two-day hospital stay and follow-up care racked up $115,000 in bills in the past year, he said. During that time, his command was also carrying out an investigation to determine whether the Army would foot all of those bills. On Oct. 5, his wife said, they were notified that his heart attack would be treated as outside the line of duty. Morgan received the official paperwork a week later, he said, and from what he understands, it means that Tricare is done paying for his care. According to the determination, which Morgan's wife provided to Army Times, the heart attack was ruled out of the line of duty because it falls into a grey area. "Based on what is provided for supporting medical documents, it is clear you had a heart attack, but this type of blockage of the artery does not occur solely during or while performing of the Army Physical Fitness Test," it said. "The mere fact that the soldier was in an 'authorized status' does not support a determination of 'in Line of Duty' in and of itself." The Army reviewed Morgan's most recent health assessment, from Sept. 2015, and found that some of his blood work was abnormal. But on the day of the event, Morgan said, his blood work was normal when he was admitted to the hospital. "No, I’m not in good shape, and I wasn’t in good shape," he said. "But I was in good enough shape to pass the Army PT test." He's never failed a PT test in three years as a reservist, three years of active duty and another six in the Coast Guard before that, he said. Still, the heart attack is probably going to cost him his career, Morgan said, and he wants to make sure that he's taken care of once he's out. "I love the Army and I'm probably not going to get to continue it," he said, once he goes through a physical evaluation or medical board. The difference is, a heart attack in the line of duty would assure that his bills are paid, he's able to complete cardiac rehabilitation therapy, and he has access to VA benefits. "It’s time to walk the talk. Take care of your soldiers," he said. "The Army is telling me they don’t have my back. That’s what it feels like." [Source: Army Times | Meghann Myers | October 14, 2016 ++]*****************************Military History Quiz 2 ? Do You Know?1. Which war is commonly referred to as "The Forgotten War?"2. Whose army conquered more territory than any single ruler in world history -- Genghis Khan, Adolf Hitler, or Alexander the Great?3. What city was the first atomic bomb dropped on -- Tokyo, Osaka, Kyoto, or Hiroshima?4. What TV show was set during the Korean War?5. Which American general famously defected to the British during the American Revolution?6. At its height, which modern-day areas did the Roman Empire NOT control -- Russia, Egypt, England or Spain?7. Where were the first shots of the US Civil War fired -- Fort Sumter, Fort McHenry, Fort Dietrich, or Fort Key?8. What arbitrary geographical line was the Korean War fought over?9. Which war featured the rallying cry "Remember the Alamo"?10. WWI German pilot Manfred von Richtofen was better known by what nickname?11. Which war preceded and ultimately helped lead to the American Revolution -- Mexican War, French and Indian War, or the Spanish-American War?12. Which treaty concluded World War I and was referred to as the document of German humiliation -Treaty of Ghent or the Treaty of Versailles? [Source: | September 2016 ++]*****************************Military History Quiz 2 ? Did you Answer Correctly?1. The Korean War (1950-53) is considered the Forgotten War for the simple reason that people always seem to forget it happened.2. "Genghis Khan". At its apex, the Mongolian Empire spanned an absolutely massive amount of territory across Asia and into Europe, encompassing Russia, Central Asia, China, Korea, Northern India, and the Middle East.3. The US dropped the atomic bomb on Hiroshima on August 6, 1945.4. M.A.S.H., which ran for 11 seasons (so 7 years longer than the actual war itself), was about a surgical trauma camp in the Korean War, is one of the most popular American TV shows ever.5. Benedict Arnold'. His name became synonymous for "traitor" after he attempted to surrender West Point to the British in 1780.6. The Roman Empire, though massive, never stretched as far as Russia.7. The first shots of the war were fired on Fort Sumter in the harbor of Charleston, South Carolina -- though the "battle" was ultimately bloodless.8. The 38th latitudinal parallel which was the official border between North and South Korea after World War II.9. "The Texas Revolution". The revenge cry was in reference to the Battle in when General Santa Anna of Mexico had killed the Texan defenders of the Alamo mission to the last man.10. The Red Baron. Considered the greatest ace of the war, he was called such because his plane was painted bright red. Hewas finally shot down over Amiens, France in 1918. Now they use his name to sell frozen pizzas.11. The French and Indian War, Part of the larger worldwide Seven Years War, saw the British and their colonial American subjects fight against the French and many Native American tribes.12. The Treaty of Versailles is often referred to as "the document of German humiliation" because of the harsh sanctions it imposed on Germany in the aftermath of World War I, and is sometimes blamed for allowing Hitler to come to power.[Source: | September 2016*****************************TRICARE Urgent Care Update 02 ? Understanding the Pilot ProgramThe Urgent Care Pilot lets most TRICARE Prime beneficiaries get up to two urgent primary care visits in the U.S. each fiscal year (Oct. 1–Sept. 30) without a referral or prior authorization. However, you can save your two visits for when you need them most by getting a referral for urgent care from your primary care manager (PCM) whenever possible. To be eligible for the Urgent Care Pilot, you must be an active duty service member (ADSM) in TRICARE Prime Remote (TPR); a non-ADSM in TRICARE Prime, TPR or TRICARE Young Adult; or a TRICARE Overseas Program beneficiary traveling in the U.S. Urgent Care and the Nurse Advice Line: If you aren’t sure what level of care you need, or if you want to try to keep your two visits, call the Nurse Advice Line (NAL) at 1-800-TRICARE (1-800-874-2273) and choose option 1. If you’re enrolled with a military hospital or clinic, the NAL will try to schedule an appointment at your military hospital or clinic within 24 hours. If nothing is available, the NAL will help you find the closest network urgent care center and tell you to ask your PCM for a referral. If you’re enrolled with a TRICARE network provider, the NAL will help you find the closest network urgent care center and tell you to ask your PCM for a referral. Getting Urgent Care After Your Two Referral-Free Visits. If you use your two urgent care visits without a referral and need urgent care again, you have three options: See if your PCM has an available appointment within 24 hours or ask for a referral from your PCM. Call the NAL. Depending on if you are enrolled with a military hospital or clinic or with a civilian provider, the NAL will help you decide where to get care. You will need a referral from your PCM for civilian care. Seek urgent care without a referral or prior authorization and pay higher pointof-service (POS) charges. The POS option lets you see any TRICARE network or non-network provider and pay POS fees instead of your regular copayment. The POS option is not available to ADSMs. Go to tricare.mil/pointofservice for more information. Notify your PCM within 24 hours if you see another provider for urgent care. For more information go to tricare.mil/urgentcarepilot. [Source: TRICARE Health Matters | Issue 4, 2016 ++]*****************************Depression Update 04 ? Tools to Fight ItFor a quick look at depression in the United States, check out these statistics:Depression is one of the most common mental disorders in our country, according to the National Institute of Mental Health.Our country ranks third as the most depressed country in the world, according to the World Health Organization.Approximately one in five adult Americans experiences some form of mental illness each year, according to the National Alliance on Mental Illness. With reports like these, we should keep tools to fight depression handy. The National Center for Telehealth and Technology (T2), with the Department of Veterans Affairs, designs tools like apps for your smartphone. And these days, there are few things handier than a mobile app. However, before you explore the T2 suite of apps at here’s an overview of depression:Depression. This condition isn’t a simple feeling (sad, down, blue, etc.); it is a serious condition that requires patience, understanding and treatment. Clinical depression is a medical condition and like other medical conditions, it can interfere with a person’s daily life and can make normal functioning a challenge. Depression can vary in type and symptoms. Signs and Symptoms are:Intense sadness, feelings of hopelessnessMemory lapse, trouble with attentionSocial isolationLoss of interest in hobbiesThoughts of death, suicideExhaustion, fatigueSleep problems (too much or too little)Impatient, fidgetyLoss of appetite, changes in weightBody aches (headaches, cramps or digestive problems) without a clear physical connection and no relief even with treatmentCauses. According to the “VA/DoD Clinical Practice Guideline for the Management of Major Depressive Disorder (PDF)”:“Depression is considered a biological illness but can result from a combination of genetic, biological, environmental, and psychological factors. Trauma, loss of a loved one, a difficult relationship, or any stressful situation may trigger depression, but depression can also occur without an obvious trigger.”It can present at any age and may co-occur with other medical conditions such as a traumatic brain injury, diabetes or cancer.Treatment. Health care providers can treat depression. The earlier a person starts treatment, the better the outcome. Treatment involves psychotherapy, medication, or a combination of the two. Without treatment, depression can recur frequently and may become chronic. “If you experience several depression symptoms that last longer than two weeks and interfere with normal daily activities, it’s time to see a health care provider,” said Cmdr. Angela Williams, chief of evidence-based practice at the Deployment Health Clinical Center. “Most people who engage in treatment for depression get better.”Fight Depression with Mobile Apps. This list of mobile apps from T2 can help users understand and manage depression symptoms:ACT Coach at uses mindfulness and acceptance strategies to help users cope with emotions and symptoms of psychological health conditions.LifeArmor at offers information, support tools (such as depression assessments), videos and a symptom tracker. It is the mobile compliment to AfterDeployment. . Mindfulness Coach at teaches focused attention using guided mindfulness meditation practices. It includes session logs to track progress and educational materials.Moving Forward at features problem-solving tools designed to teach life skills.Positive Activity Jackpot at helps users overcome depression and build resilience. It uses augmented reality technology to locate positive activities nearby.T2 Mood Tracker at helps users monitor and track their emotional health. Results are displayed in an easy-to-understand graph.Virtual Hope Box at strengthens coping, relaxation and distraction skills. Users can add personal photos, inspirational quotes, etc., to support positive thinking. If you, or someone close to you, are experiencing depression, talk to your health care provider. For more information about depression and available resources in your area, contact the 24/7 DCoE Outreach Center at Professional health resource consultants stand ready to help you access information specific to your needs. Call or email today: 866-966-1020 or resources@. [Source: Off The Base | Bobbie O'Brien | October 21, 2016 ++]*****************************Congestive Heart Failure ? TRICARE CoverageCongestive Heart Failure is now a covered diagnosis under the TRICARE cardiac rehabilitation benefit. Heart failure occurs when the heart is unable to pump enough blood to meet the body’s needs. This may happen when the heart muscle itself is weaker than normal or when there is a defect in the heart that prevents blood from getting out into the circulation. The American Heart Association lists several signs of heart failure:Shortness of breathChronic coughing or wheezingBuild-up of fluidFatigue or feeling light headedNausea or lack of appetiteConfusion High heart rate If you are experiencing these symptoms, talk to your health care provider. If you have been diagnosed with heart failure, it's important for you to manage and keep track of symptoms and report any sudden changes to your healthcare team. Providers of cardiac rehabilitation services must be TRICARE-authorized hospitals or freestanding cardiac rehabilitation facilities. All cardiac rehabilitation services must be ordered by a physician. For more details visit: on what’s covered. on heart attack warning signs.[Source: TRICARE News Release tricare.mil/CoveredServices/BenefitUpdates/Archives/10_19_16_CHF ++]*****************************Tricare Preventive Health Program Update 05 ? Making It BetterTRICARE has always had excellent coverage of important preventive services and they continue to make it better. TRICARE is adding new services and screenings to ensure their preventive services are aligned with recommendations of the United States Preventive Services Task Force (USPSTF), and the Health Resources and Services Administration’s (HRSA) guidelines. Effective Jan.1, 2017, TRICARE will cover annual preventive office visits for all Prime beneficiaries 6 years of age and older. Children under 6 are already covered by existing well-child coverage. This will ensure children in developing stages receive observation, physical examination, screening, immunizations, and various counseling services. TRICARE Standard beneficiaries can receive preventive services with no cost-share or copayment through Health Promotion and Disease Prevention (HP&DP) examinations (i.e. in connection with a covered immunization or cancer screening). Additionally, the annual well-woman exam will continue to be covered for all Prime and Standard beneficiaries under age 65 with no cost-share or copayment. The new covered services include free genetic counseling by a TRICARE-authorized provider. An authorized provider is any individual, institution/organization, or supplier that is licensed by a state, accredited by national organization, or meets other standards of the medical community, and is certified to provide benefits under TRICARE. There are two types of TRICARE-authorized providers: Network and Non-Network. before BRCA1 or BRCA2 gene testing for women who are identified as high risk for breast cancer by their primary care providers as well as the BRCA1 or BRCA2 gene testing for women who meet the coverage guidelines under the existing laboratory developed test (LDT) demonstration project. TRICARE will also cover stool DNA testing (e.g., Cologuard?) once every 3 years starting at age 50 for those who have an average risk of colon cancer. The effective date of Cologuard coverage is June 21, 2016. If you have recently received any of these services, be sure to save your receipts and file a claim. The regional contractors will be ready to process claims for the new preventive benefits on Nov. 14, 2016, the implementation date of this change. The implementation date is the date the contractor must be ready to communicate and process claims for this benefit. You can find information on both Medical Claims and Covered Services on the TRICARE websites & . [Source: TRICARE Communications | October 18, 2016 ++]*****************************Nursing Homes Update 11 ? How to Select TipsNo matter your reason for looking into long-term care, here are some tips to keep in mind when choosing a nursing home or care facility:Consider. What is important to you—nursing care, meals, physical therapy, a faith community, hospice care, or Special Care Units for dementia patients? Do you want a place close to family and friends so they can easily visit?Ask. Talk with friends, relatives, social workers, and your faith community to find out what places they suggest. Check with healthcare providers about which care facility they recommend. Use their suggestions to make a list of places that offer the services you want.Call. Get in touch with each place on your list. Ask questions about how many people live there and what it costs. Find out about waiting lists.Visit. Make plans to meet with the director and the nursing director. The Medicare Nursing Home Checklist has some good ideas to consider when visiting.Talk. Don’t be afraid to ask questions. You might want to find out how long the director and heads of nursing, food, and social services departments have worked at the care facility. If key members of the staff change often, that may mean there’s something wrong.Visit again. Make a second visit without calling ahead. Try another day of the week or time of day so you will meet other staff members and see different activities. Stop by at mealtime. Is the dining room attractive and clean? Does the food look tasty?Understand. Once you select a nursing home, carefully read the contract. Ask the director or assistant director about anything you don’t understand. Ask a trusted friend or family member to read over the contract before you sign it. Go to HYPERLINK "" to get more information about choosing a nursing home and paying for care. [Source: National Institute on Aging e-Update | October 18, 2016 ++]*****************************Breast Cancer Update 07 ? Prevention & DetectionHundreds of thousands of women are diagnosed with breast cancer each year. In fact, nearly 41,000 women—and about 400 men—die of the disease some years, according to the most recent data from the Centers for Disease Control and Prevention (CDC). That makes October—Breast Cancer Awareness Month—a good time to learn about risk factors and what you can do to detect the disease early when it’s most treatable.Preventive Screenings. TRICARE covers many preventive services to help detect cancer early, including a number of breast cancer screenings at little or no cost to you. Covered breast cancer screenings include:Clinical breast exams: during preventive health visits for women under age 40, or yearly starting at age 40.Mammograms: yearly for all women beginning at age 40, or at age 30 for those with certain risk factors.Breast screening MRI: yearly for women age 30 and older with certain risk factors.Signs and Symptoms. Signs of breast cancer can be different in different people. Symptoms among many others may include:New lumps in the breast or underarm.Pain in the breast.Irritation or dimpling of breast skin.Thickening or swelling of part of the breast, Risk Factors and Prevention. Factors that increase your chances of getting breast cancer include:Drinking.A family history of breast cancer.Aging.Getting menstrual cycles before age 12 or starting menopause after age 55. Physical inactivity.Certain hormone therapies or contraceptives, and more.Reducing Risk. Things you can do to reduce your risk, according to the CDC, include Regular exercise.Breast-feeding children.Getting enough sleep, and Avoiding alcohol and dangerous chemicals. [Source: TRICARE Health Matters | Issue 4, 2016 ++]*****************************Fall Prevention Update 01 ? Take Steps to Avoid InjuryFalling injures millions of people each year. Although common, falls can cause serious injuries, such as broken bones, internal bleeding or head wounds. Your chances of falling increase when recovering from an injury, illness or medical procedure. The good news is that falls can be prevented. Here are some tips to help prevent falls and create a safer environment: Take Care of Your Health ? Exercise to become stronger and improve your balance. ? Eat healthy and stay hydrated. Dehydration can make you feel weak and light-headed. ? Get your vision checked at least once a year. Update your lenses as needed. ? Talk to your doctor if your medicine makes you sleepy, dizzy or confused. Wear the Right Shoes and Clothing ? Wear shoes that have firm, flat and non-slip soles. Avoid shoes that don’t have backs. Make sure laces are tied. ? Avoid wearing long, loose-fitting clothing that can easily be caught or stepped on. Make Your Home Safe ? Use handrails and non-slip treads on staircases.? Add grab bars near the toilet and the bathtub/shower. ? Clear the floor and stairs of things you could trip over, such as shoes, small rugs or books. ? Make sure your home is well-lit. Replace dim bulbs and use night lights, timers or motion sensors. ? Place frequently used items in easy-to-reach places that don’t require using a step stool. ? Make sure your bed is easy to get into and out of. ? Immediately wipe up any spills on the floor. Be Extra Careful in the Hospital or a Medical Setting? Lower the height of the bed and make sure the call button is in reach. ? Ask for help when getting out of bed, using the bathroom or walking around. ? Wear non-slip socks or footwear. For more information on preventing falls, visit the Joint Commission website at . [Source: TRICARE Health Matters | Issue 4, 2016 ++]*****************************Saving Money ? Household Hacks | 7Our day-to-day routines are full of opportunities to employ life hacks that make things just a little bit smoother. Sure, a?new way of unspooling foil?or a pledge to use less laundry soap won’t bring about world peace. But it’ll make your life a little more pleasant, and may save you cash —?and that’s worth something. Following are seven simple hacks that can save you money on the stuff you do every day.1. Tame your aluminum foil. Here is a great hack you can use with aluminum foil: Apparently each end of the Reynolds Wrap box has a tab you can push in. Together the twin tabs keep the roll of foil in place while you pull out the amount you need.2. Squeeze your toothpaste gently. All you really need is a pea-sized dab. So why do commercials show a toothbrush completely covered with dentifrice? Because the faster you use it up, the sooner you have to buy more.3. Get stingy with the laundry soap. Don’t fill it to the line on the cap. Generally about one-fourth of the recommended amount is sufficient. Even if you’re a mechanic or you dig wells, you might still be able to get away with using one-third to one-half the amount. Again, the manufacturer wants you to buy this product — a lot of it. But you don’t have to oblige.4. Cut back on dishwasher soap. You don’t need to fill both cups. According to The New York Times that today’s dishwasher models are made to use less water and thus need less detergent, and the dishwasher soaps on the market are increasingly concentrated.5. Stretch your shampoo. Cut the last step out of the “lather, rinse, repeat” suggestion. One wash is almost always enough to do the trick. In addition, next time you have a half-empty bottle, fill it the rest of the way with water and shake well. Shake again before using, and you’ll be able to squirt out just enough of a soapy liquid that lathers easily.6. Use vinegar for … well, everything. Vinegar does more than just clean. It can act as a weed killer, conditioner, fungus fighter and even room deodorizer. Do you use an expensive, commercial fabric softener? Instead, just throw a cup of plain white vinegar into the last rinse. Vinegar! Is there anything it can’t do? For more tips, check out 83 Amazing and Environmentally Friendly Uses: 7. Reuse your brine. Used up the last pickle in the jar? Don’t toss that brine! Slice an English cucumber (or any other vegetable you like) into the jar of pickle juice you already have. Within a few days you’ll have more pickles, and you’ll probably have enough cuke left to add to your dinner salad, too. You can also use the brine as a marinade ingredient, keeping in mind that you probably won’t need to add salt. (Hint: It’s “brine,” not juice.) You can also add it to an almost-empty mustard bottle, making a mustard vinegar that’s very tasty on cooked lentils. For more tips along those lines, see “What to Do With Ketchup Dregs: Getting the Most From Your Condiments.” at [Source: MoneyTalksNews | Donna Freedman | September 23, 2016 ++]*****************************COLA 2017 Update 44 ? Military Retirees & VA BeneficiariesMilitary retirees and individuals receiving veterans benefits will see only a 0.3 percent cost-of-living increase in their federal benefits next year, a nominal increase matching 2016’s hike. On 18 OCT, officials from the Social Security Administration announced the small raise, the third consecutive year the benefits adjustment will be under 0.5 percent. Since 2009, the cost-of-living hike has been more than 2 percent only once, when it reached 3.6 percent in 2011. Veterans benefits are not automatically tied to the Social Security increase, but in July lawmakers passed legislation linking the two benefits for 2017. In the last few decades, veterans have seen their annual adjustment differ from the Social Security COLA only one time, and then only due to minor rounding differences. The Social Security COLA is calculated by the Bureau of Labor Statistics’ periodic Consumer Price Index, a statistical estimate of the anticipated price of a variety household goods and services. This year, officials are estimating only small increases in those costs, identical to the rise seen in expenses heading into 2016. The Social Security, military retiree and veterans benefits changes affect more than 70 million Americans, about 22 percent of the country’s population. According to the Associated Press, the 0.3 percent adjustment will mean less than $4 more a month for a Social Security recipient who sees the average payout of $1,238. The adjustment will go into effect for beneficiaries starting Dec. 30. Veterans using Medicare for health coverage may not see anything at all once those medical costs come into play. The Associated Press reports that Medicare Part B premiums, which are usually deducted from Social Security payments, are expected to increase next year, effectively wiping out the COLA hike. [Source: Military Times | Leo Shane | October 18, 2016 ++]*****************************SSA COLA 2017 ? 0.03% IncreaseAfter receiving no cost-of-living adjustment (COLA) in 2016, Social Security beneficiaries will finally receive a raise effective 1 HSN 2017. But the increase in benefits is so small, it will be the lowest payable COLA ever in the history of the program — raising a $1,000 benefit by just $3.00. The new low comes as COLAs have flat-lined over the past seven years, averaging just 1.2% — less than half the 3% average over the two decades prior to 2010. The long-term financial impact on anticipated retirement benefits is significant and growing, says TSCL’s Executive Director, Shannon Benton. “People lose the effect of compounding when benefit raises are at these extreme lows,” she explains. “That reduces the Social Security income that retirees may have been counting on over their retirement.” According to TSCL estimates, benefits are today 13% lower than if inflation had remained the more typical 3% for retirees who have been receiving Social Security since 2009 when the low COLAs started. A Social Security benefit of $1,000 in 2009 is about $142 per month lower today than if COLA had been the more typical 3%, with a total loss of about $6,697 in Social Security benefit growth over the past seven years. Over the same period, however, actual senior costs have continued to climb. Some 72% of retirees who participated in TSCL’s 2016 Senior Survey reported that their monthly expenses had gone up by more than $79 in 2015, despite the lack of growth in inflation. “The need for an Emergency COLA has never been greater,” says Benton. TSCL is meeting with Congress to urge lawmakers to enact emergency legislation to provide a COLA large enough to boost benefits in 2016 and 2017. In addition, TSCL is asking Members of Congress to pass legislation that would use a senior consumer price index, the Consumer Price Index for the Elderly (CPI-E), to more fairly calculate the annual boost. [Source: The Senior Citizens League | October 18, 2016 ++]*****************************SSA COLA 2017 Update 01 ? S.2251 | One-time $581 PaymentU.S. Senator Charles E. Schumer (D-NY) announced 23 OCT a new push to pass the Seniors and Veteran Emergency (SAVE) Benefits Act that would provide a one-time payment of $581 to Social Security recipients to offset the zero cost of living adjustment (COLA) in 2016, and low 0.3% COLA for 2017. Schumer urged his colleagues in the Senate to support the legislations and said that both sides of the aisle need to work to improve the too low Social Security COLA “There is nothing worse than delivering a flat Social Security COLA to our seniors,” said Schumer. "After a year with no cost-of-living increase, Social Security recipients will only receive an additional $5 each month next year, a paltry amount with which one can only do so much. New Yorkers and all the millions around the country who depend on Social Security need more than a mere $5 increase in order to keep up with living expenses. Congress needs to explore options to make Social Security benefits reflect current spending patterns. In the meantime, too many are in a vulnerable position and that's why I am pressing my colleagues to support the SAVE Benefits Act, which would provide a one-time $581 payment to Social Security recipients to help make up for their lost dollars.” According to the federal Social Security Administration (SSA), the purpose of the COLA is to ensure that the purchasing power of Social Security benefits is not eroded by inflation. COLAs are based on increases in the Consumer Price Index for Urban Wage Earners (CPI-E) and Clerical Workers (CPI-W). The annual change in the CPI is used as a measure of inflation. Both CPI formulas tracks the price of the “typical basket” of consumer goods. However, Schumer explained that the federal government's CPI formula heavily weights the price of gas and energy, which many seniors spend less on Schumer blamed a flawed funding formula used by the federal government to determine COLA increases. While the cost of rent and other expenses have increased, Schumer explained that lower gas prices, which do relatively little to help the disabled and elderly, who don't drive as much as the general population, are largely to blame for the low increase in Social Security benefits. Schumer said this is unfair, because several other cost of living indicators, like groceries, medicine and rent, are increasing, and these items impact seniors on fixed incomes in particular. A press release from Schumer's office stated the SAVE Benefits Act would provide a one-time check of approximately $581 for seniors and other Social Security recipients, and this would be fully paid for by "closing a loophole that benefits corporate compensation packages of over $1 million." The?SAVE Benefits Act was originally introduced last year?by Senator Elizabeth Warren. [Source: My Federal Retirement | October 27, 2016 ++]*****************************Deceased's Debt Update 01 ? Can Survivors Inherit Them?If you’re wondering whether you’re liable for your loved one’s debt, the short answer is no. Debt does not get passed down to heirs. Of course, creditors typically won’t tell you that, and they are often depending on your sense of duty to pay off those debts. They will be kind and sympathetic, but ultimately their job is to cajole you into paying. That said, there are exceptions to every rule, and the Federal Trade Commission cites four instances in which you might still be on the hook for a debt after your loved one dies:You co-signed on the debt.You live in a community property state (more on that in a minute).You are the spouse, and state law requires you to pay certain debts such as health care bills.You were responsible for resolving the estate and didn’t follow state laws. For everyone else, you can rest assured you won’t be responsible for paying Great-Aunt Helga’s credit card balance once she leaves this earthly plane. But estates may be liable While you’re not on the hook for the debt, your loved one’s estate may be. The estate — their remaining assets — may be required to cover the costs of outstanding debts left by your loved one. Creditors may file a claim in probate court, and money from the estate is used to pay those claims. What’s left then gets distributed to heirs. If an estate doesn’t have enough money to pay off creditors, it’s considered insolvent. In that case, the unpaid debt should disappear. However, that won’t stop some companies from calling you for payment, particularly if you’re the surviving spouse. A final note about estates: It’s important to note that not all assets are considered part of an estate. Non-probate assets are excluded, and creditors may not file claims against them. Typically, anything with a beneficiary or joint ownership is excluded from an estate and probate. Examples include:Life insuranceRetirement funds such as 401(k)’s and IRAsReal estate or joint checking or savings accounts with a right of survivorshipAccounts with payable-on-death or transfer-on-death provisionsIn other words, you don’t have to worry about your spouse’s life insurance policy being wiped out to pay off their credit cards. Community property states have different rules. Now, generally speaking, spouses aren’t responsible for any individual debt held by a husband or wife. In most states, if John Doe opens a credit card in his name alone, Jane Doe isn’t responsible for paying it off. However, it’s a different story if you live in a community property state. In these states, if John Doe opens a credit card in his name, the debt becomes both John and Jane Doe’s responsibility even if Jane doesn’t charge a penny. In a community law state, when your spouse dies, the spouse’s debt becomes your debt even if your name isn’t on the account. There are nine community property states where this scenario applies: Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Texas, Washington, and Wisconsin. Some marriages in Alaska may also be community property unions, but couples must specifically opt in to that arrangement. Community property provisions apply only to debts incurred during the marriage. So at least you don’t have to worry about paying off accounts opened prior to your wedding day. When a loved one dies, you’ll have enough to worry about without stressing over his or her debts. Fortunately, most of the time you won’t need to open your wallet to pay off outstanding balances. For advice pertaining to your specific situation, seek out the help of a competent estate attorney or finance professional. [Source: MoneyTalksNews | Maryalene Laponsie | October 24, 2016 ++]*****************************Home Inventory ? Tips On How To Develop OneHurricanes, earthquakes, tornadoes, floods and fires: Disaster strikes all the time. But until one hits close to home — literally — most people assume it could never happen to them. Sure, most of us have insurance to make us whole if the worst does occur. But do you have a full home inventory? If disaster strikes, it’s highly unlikely you’ll be able to remember everything you own. Not having a full inventory to jog your memory might mean you won’t get what you could from the insurance company. Here’s how to create an inventory of your home:1. Pick your software and storage methods - Scribbling on a napkin or taking a few snapshots is OK, but many better free options exist:Customizable spreadsheet: offers a home inventory spreadsheet that you can use with Microsoft Excel, OpenOffice or Google Docs. Go to Store photos and receipts separately, online or in a paper folder. suggests recording quick video clips of each room and storing them — along with your inventory and digital photos — on a flash drive.Know Your Stuff: The Insurance Information Institute, an insurance industry trade group, offers a guided online home inventory at . Users can store information and up to 1GB in photos in it.What You Own: The standalone program at has a clean interface and is easy to use. As with Know Your Stuff, you can link photos and receipts to your record of items.The Liberty Mutual Home Gallery app: At the home insurance company offers an app for Android and iOS devices (a separate app is offered for iPad) at iTunes and Google Play. 2. List your possessions - Tackle this project by concentrating on one room at a time. Write down the name of every object you own in the room, although you can group items of the same kind — such as kitchen utensils or books. Make notes on condition, model and estimated value. Keep receipts if you have them.3. Take photos and video - Use a digital camera or mobile phone camera to photograph your property. Make a brief video of each room while narrating what is in it and what it’s worth. Remember to open closets and drawers to show everything, and don’t forget to record storage and utility areas like the basement, laundry room and tool shed.4. Don’t forget important paperwork - Replacing records, financial and legal documents, and identification can be a major hassle. You might want to checkout HYPERLINK "" for advice on preserving or recovering these documents.5. List valuables separately - Big-ticket items like jewelry, collectibles and high-end electronics may require separate insurance, and you might want a separate section on the list for them. If you’re especially thorough anywhere, it should be here. A great rule of thumb is that the more you paid, the more you document. Try to include:MakeModelSerial numberPurchase date and locationMultiple photographs6. Keep copies away from home. Whatever your solution, remember you can’t store your inventory only on your computer’s hard drive. After all, your computer could be destroyed in a disaster. Print copies or copy your inventory to a digital storage device and stow it in a fireproof safe or in a safe-deposit box. Or swap lists with family and friends. Another option is to save your inventory to the cloud so you can access it anywhere. Do this by emailing it to yourself as an attachment or storing it at Google Docs []. You can also use free cloud storage services. [Source: MoneyTalksNews | Brandon Ballenger | October 24, 2016 ++]*****************************Notes of Interest ? 16 thru 31 OCT 2016New Zealand Ban. ?A U.S. Navy warship will visit New Zealand in NOV for the first time since the 1980s, ending a 30-year-old military stalemate between the countries that was triggered when New Zealand banned nuclear warships.?North Korea. North Korea has conducted an unsuccessful launch of an intermediate-range missile, according to the South Korean military. It was the second failed test in less than a week their recent launch of a Musudan missile, which has an estimated range of 4,000km (2,500 miles). It is said to be capable of hitting US bases as far away as Guam. The missile has been tested eight times this year, with only one success.B61 Nuclear Bomb. The life-extension program for the B61-12 atomic bomb will cost just over $8.25 billion, according to a new estimate from the National Nuclear Security Agency.Presidential Debate #3. The American Legion National commander is disappointed that the candidates, moderators did not allocate a single minute of debate time to address veterans health care.Deployment. More than 450 soldiers of the Virginia and Maryland National Guard are slated for a deployment to the Middle East, Guard officials said 19 OCT.MIA Families Sought. The Defense POW/MIA Accounting Agency is seeking families of missing American service members to attend informational update meetings and to collect DNA samples if one is not already on file. Learn more at: .Ratings Elimination Petition. A petition to the White House demanding the restoration of Navy rating titles has reached the 100,000 mark, the threshold required to get a response, nearly two days before the deadline.Petitions. 'We the People' is a means to call on the White House to take action on an issue that matters to you. Petitions are posted for 30 days only and require at least 100,000 signers to obtain a White House response within 60 days. You can view all petitions with updates at HYPERLINK "" . Fertility Treatments/Adoption. Recently President Obama signed legislation that will allow the VA to pay the costs for fertility treatments and adoptions for the next two years for veterans whose combat wounds have made them infertile.? The VA will seek legislation to make such payments permanent.Homeless Vets. The California nonprofit group Paso Cares and it program RVs for Veterans is seeking donations of RVs, motor homes, travel trailers, fifth wheels, trucks or vans for homeless veterans to live in. For more information, visit the Paso Cares website or call Cherie Michaelson at (805) 712-7067.Veterans Day Moment of Silence. President Obama has signed a new law that calls on all Americans to pause voluntarily for two minutes to honor the sacrifice of veterans. The silence will occur simultaneously across the nation on Veterans Day — at 2:11 p.m. eastern standard time on Veterans Day.The Illusionist. Go to and see if you can figure out how this entertaining skit was done.Smartphone. In a 2015 study commissioned by Microsoft, researchers found that the average human attention span has dropped from 12 seconds in the year 2000 to 8 seconds in 2015. A goldfish, on the other hand, has an attention span of 9 seconds. Coincidently, the first mobile email device, the Blackberry (remember those?) was introduced in 1999. The first modern Smartphone, the iPhone, was launched in missary. Starting 28 OCT, customers of Defense Department commissaries will receive a free reusable shopping bag courtesy of Military missary. The amount of money spent by commissary customers declined in fiscal 2016 – marking the fourth year of falling sales?–?but it's not clear whether that drop signals problems with customer satisfaction.?Dollar sales decreased by $258 million, to $5.25 billion in fiscal 2016.Lost Cause. America’s top intelligence official expressed deep skepticism on 25 OCT about the prospect of persuading North Korea to renounce nuclear weapons, saying it was “probably a lost cause.”Russian SSBN. Earlier this month, a Russian ballistic missile submarine (SSBN) slipped out of its pier at Severodvinsk for the first time in 16 years. But BS-64 Podmoskovie is no ordinary boomer. Over the course of nearly two decades, the massive submarine was modified to conduct special missions. But exactly what those missions might be remains somewhat of a mystery.Retiree Day. Joint Base Pearl Harbor Hickam Officers Club will host an annual Retiree day on Saturday Nov 5 from 0730 - 1230. For more info contact Lou Crompton at crompton@ .Male Breast Cancer. Each year, about 2,000 men are diagnosed with invasive breast cancer and about 450 die from it. The majority of breast cancer cases are diagnosed in men between the ages of 60 and 70. Signs and treatment of breast cancer in men are similar to those in women. Read more about male breast cancer at . College Tuition. According to the College Board’s annual report, the “sticker price” for in-state students to go to a public university this year is an average $20,090, which includes tuition and fees ($9,650), room and board. That reflects a 2.4 percent increase from the price tag in 2015.OPM Retirement Services. Every Day, 24K Federal Retirees Reach a Busy Signal on OPM's Toll-Free Line. More than one in four phone calls to the Office of Personnel Management in fiscal 2015 from annuitants seeking assistance were ignored entirely, the agency’ inspector general?found -- more calls than the previous year.?Separation Pay. A federal law (10 USC 1174) precludes duplication of military benefits. The law requires that the VA recoup military separation benefits paid by the Department of Defense in cases where a veteran is subsequently awarded VA compensation.TRICARE Mammogram Coverage. ?Medicare patients are covered for a 3-D mammogram, Tricare patients, even those on active duty, are not.??An AMA Study found a 41 percent increase in detection of invasive breast cancers, a 29 percent increase in detection of all breast cancers and a 15 percent decrease in patient recall for additional testing if 3-D equipment is used..Flying. If you value speed and security when you travel then perhaps Speedo Airlines is the airline for you. Check them out at .Battle of Chosin. A new documentary on a legendary Korean War battle will feature the personal perspectives of more than 20 veterans of the deadly, frigid, two-week ordeal.??It debuts 1 NOV on PBS and will be available for online viewing at? ?the next day. The two-hour film chronicles the men of 1st Marine Division, and attached soldiers, who for two weeks fought their way to the Korean coast through a larger Chinese force.??VA Bonuses. Despite the controversies still swirling around the Department of Veterans Affairs, nearly 189,000 employees received more than $177 million in bonuses for fiscal 2015, according to data obtained by USA TODAY. More than 300 senior executives of the troubled agency received $3.3 million in bonuses, for an average payment of about $10,000 each. VAMC Oklahoma City. The embattled chief of staff for the Oklahoma City VA Medical Center has left the medical center to “pursue other opportunities,” Director Kristopher "Wade" Vlosich confirmed 27 OCT. "He no longer works for the facility," Vlosich said. Vlosich said Dr. Mark Huycke's departure was "part of an ongoing investigation," so he could not comment further about the reasons behind it.DVA Overpayment. A 95-year-old Las Vegas World War II veteran is facing eviction. The Department of Veterans Affairs has stopped issuing Irene Miller her pension checks because they say they overpaid her for years. Now she needs to pay them back. "I started investigating and they told me they overpaid me," said Miller. For more refer to .*****************************Electoral College ? The Compromise to Elect Presidents The Electoral College is a process, not a place. The founding fathers established it in the Constitution as a compromise between election of the President by a vote in Congress and election of the President by a popular vote of qualified citizens. The Electoral College process consists of the selection of the electors, the meeting of the electors where they vote for President and Vice President, and the counting of the electoral votes by Congress. The Electoral College consists of 538 electors. A majority of 270 electoral votes is required to elect the President. Your state’s entitled allotment of electors equals the number of members in its Congressional delegation: one for each member in the House of Representatives plus two for your Senators. Read more about the allocation of electoral votes. Under the 23rd Amendment of the Constitution, the District of Columbia is allocated 3 electors and treated like a state for purposes of the Electoral College. For this reason, in the following discussion, the word “state” also refers to the District of Columbia. Each candidate running for President in your state has his or her own group of electors. The electors are generally chosen by the candidate’s political party, but state laws vary on how the electors are selected and what their responsibilities are. Read more about the qualifications of the Electors and restrictions on who the Electors may vote for. You help choose your state’s electors when you vote for President because when you vote for your candidate you are actually voting for your candidate’s electors. Most states have a “winner-take-all” system that awards all electors to the winning presidential candidate. However, Maine and Nebraska each have a variation of “proportional representation.” After the presidential election, your governor prepares a “Certificate of Ascertainment” listing all of the candidates who ran for President in your state along with the names of their respective electors. The Certificate of Ascertainment also declares the winning presidential candidate in your state and shows which electors will represent your state at the meeting of the electors in December of the election year. Your state’s Certificates of Ascertainments are sent to the Congress and the National Archives as part of the official records of the presidential election. The meeting of the electors takes place on the first Monday after the second Wednesday in December after the presidential election. The electors meet in their respective states, where they cast their votes for President and Vice President on separate ballots. Your state’s electors’ votes are recorded on a “Certificate of Vote,” which is prepared at the meeting by the electors. Your state’s Certificates of Votes are sent to the Congress and the National Archives as part of the official records of the presidential election. Each state’s electoral votes are counted in a joint session of Congress on the 6th of January in the year following the meeting of the electors. Members of the House and Senate meet in the House chamber to conduct the official tally of electoral votes. See the key dates for the 2016 election and information about the role and responsibilities of Congress in the Electoral College process. The Vice President, as President of the Senate, presides over the count and announces the results of the vote. The President of the Senate then declares which persons, if any, have been elected President and Vice President of the United States. The President-Elect takes the oath of office and is sworn in as President of the United States on January 20th in the year following the Presidential election.Roles and Responsibilities in the Electoral College ProcessThe Office of the Federal Register coordinates the functions of the Electoral College on behalf of the Archivist of the United States, the States, the Congress, and the American People. The Office of the Federal Register operates as an intermediary between the governors and secretaries of state of the States and the Congress. It also acts as a trusted agent of the Congress in the sense that it is responsible for reviewing the legal sufficiency of the certificates before the House and Senate accept them as evidence of official State action. For more on the Electors, their qualifications, their numbers, and their restrictions click on the following:How many electoral votes do States get?Who selects the Electors?What are the qualifications to be an Elector?Are there restrictions on who the Electors can vote for?[Source: National Archives and Records Administration | October 2016 ++]*****************************Military Wisdom ? The Lighter Side 'If the enemy is in range, so are you.' (Infantry Journal) 'It is generally inadvisable to eject directly over the area you just bombed.' (U.S. Air Force Manual) 'Whoever said the pen is mightier than the sword, obviously never encountered automatic weapons.' (General MacArthur) 'Tracers work both ways.' (Army Ordnance Manual) 'Five second fuses last about three seconds.' (Infantry Journal) 'Any ship can be a minesweeper. Once.' (Naval Ops Manual) 'Never tell the Platoon Sergeant you have nothing to do.' (Unknown Infantry Recruit) 'If you see a bomb technician running, try to keep up to him.' (Infantry Journal) 'Yea, Though I Fly Through the Valley of the Shadow of Death, I Shall Fear No Evil. For I am at 50,000 Feet and Climbing.' (Sign over SR71 Wing Ops) 'You've never been lost until you've been lost at Mach 3.' (SR71 test pilot Paul F. Crickmore)'The only time you have too much fuel is when you're on fire.' (Unknown Author) 'If the wings are traveling faster than the fuselage it has to be a helicopter - and therefore, unsafe.' (Fixed Wing Pilot) 'When one engine fails on a twin)engine airplane, you always have enough power left to get you to the scene of the crash.' (Multi-Engine Training Manual) 'Without ammunition, the Air Force is just an expensive flying club.' (Unknown Author) 'If you hear me yell;"Eject, Eject, Eject!", the last two will be echoes.' If you stop to ask "Why?", you'll be talking to yourself, because by then you'll be the pilot.' (Pre-flight Briefing from a Canadian F104 Pilot) 'What is the similarity between air traffic controllers and pilots? If a pilot screws up, the pilot dies; but if ATC screws up, .... the pilot dies.' (Sign over Control Tower Door) 'Never trade luck for skill.' (Author Unknown) The three most common expressions (or famous last words) in military aviation are: 'Did you feel that?' 'What's that noise?' and'Oh S....!' (Authors Unknown)'Airspeed, altitude and brains. Two are always needed to successfully complete the flight.' (Basic Flight Training Manual) 'Flying the airplane is more important than radioing your plight to a person on the ground incapable of understanding or doing anything about it.' (Emergency Checklist) 'The Piper Cub is the safest airplane in the world; it can just barely kill you.' (Attributed to Northrop test pilot Max Stanley) 'There is no reason to fly through a thunderstorm in peacetime.' (Sign over Squadron Ops Desk at Davis-Montham AFB, AZ) 'You know that your landing gear is up and locked when it takes full power to taxi to the terminal.' (Lead-in Fighter Training Manual)As the test pilot climbs out of the experimental aircraft, having torn off the wings and tail in the crash landing, the crash truck arrives.The rescuer sees the bloodied pilot and asks, 'What happened?'The pilot's reply: 'I don't know, I just got here myself!'[Source: Dave Hrynda via Michael Isam | October 20, 2016 ++]*****************************FAIR USE NOTICE: This newsletter may contain copyrighted material the use of which has not always been specifically authorized by the copyright owner. The Editor/Publisher of the Bulletin at times includes such material in an effort to advance reader’s understanding of veterans' issues. We believe this constitutes a 'fair use' of any such copyrighted material as provided for in section 107 of the US Copyright Law. In accordance with Title 17 U.S.C. Section 107, the material in this newsletter is distributed without profit to those who have expressed an interest in receiving the included information for educating themselves on veteran issues so they can better communicate with their legislators on issues affecting them. To obtain more information on Fair Use refer to: http: //law.cornell.edu/uscode/17/107.shtml. If you wish to use copyrighted material from this newsletter for purposes of your own that go beyond 'fair use', you must obtain permission from the copyright owner. ................
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