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

For the week of December 18, 2007

1. HEART Act Passes Senate with New Provisions: As previously reported in the Government and You E-News, NMFA has been closely following H.R. 3997, The Heroes Earnings Assistance and Relief Tax (HEART) Act of 2007. The bill unanimously passed the House in November. On December 12th the Senate passed H.R. 3997 with amendments and returned it to the House. The bill is now titled “Defenders of Freedom Tax Relief Act of 2007”. Some provisions from S. 1593 have been added and an important provision for military families has been stripped out of the current bill.

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

We remain concerned about the provision requiring civilian employers to fully vest Reservists killed during military service for purposes of employer life insurance, pension and survivor benefits. This provision creates a disproportionate survivor benefit package for survivors of Reserve personnel while disregarding the survivor benefits provided by the Department of Defense to any service member killed on active duty. As NMFA has argued in the past, survivor benefits must be consistent for all families. Congress recognized that fact when the increased death gratuity was provided to all active duty deaths rather than only those that occurred in a combat theater. Creating additional benefits for certain survivors creates dissention within the community and places a higher value on certain service.

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

2. Visual Disturbances Related to TBI a Rising Concern: The Department of Veterans Affairs (VA), Department of Defense (DoD), and the Rehabilitation Strategic Healthcare Group recently hosted the Visual Consequences of Acquired Brain Injury Conference on December 4-6th in San Antonio, TX. More than 500 DoD/VA neurologists, ophthalmologists, optometrists, vision and rehabilitation specialists were in attendance to obtain and discuss pertinent information on Operation Iraqi Freedom and Operation Enduring Freedom service members and veterans who are demonstrating signs of visual disturbances following a Traumatic Brain Injury. The goals of the conference were to:

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

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

The recently released National Defense Authorization Act for Fiscal Year 2008 conference report established a Center of Excellence for military eye injuries creating DoD/VA collaboration, a Military Eye Injury Registry, the coordination of care and benefits, documentation of OIF/OEF eye injuries, and vision screening, diagnosis, rehabilitation, and research on visual disturbances related to TBI. NMFA was pleased with Congress’ recognition of this silent epidemic visual disturbances following a TBI, but was surprised Congress has chosen not to provide any funding for this Center.

3. Defense Health Board Hears Task Force’s Recommendations: On December 11th, the Department of Defense’s (DoD) Task Force on the Future of the Military Health Care discussed their 12 draft recommendations on methods to improve the Military Healthcare System with the Defense Health Board. The Task Force’s guiding principles are to improve DoD’s ability to meet readiness and improve effectiveness, and preserve a generous health care benefit without any additional cost to the active duty service member or their family.

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

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

Members of the Task Force reiterated the need for DoD to adopt and build on existing public and private sectors’ best practice, but at the same time be mindful not to erode the beneficiary’s trust or lower their quality of care and benefit.

The draft report will be given to the Secretary of Defense on December 19th for his approval. Public release of the report at a Pentagon press conference is scheduled for December 20th. The National Military Family Association has been following the Task Force recommendation’s closely for its impact on TRICARE beneficiaries’ quality of care and benefit. We are awaiting the release of the final report.

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

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

The National Military Family Association is pleased Congress is acting on this very important piece of legislation. The last thing military families’ need, as we head into our seventh year on the Global War on Terror, is for TRICARE health care providers, especially mental health care providers, to decide to no longer see TRICARE beneficiaries.

5. New Secretary of Veterans Affairs Confirmed: On December 14th, the United State’s Senate confirmed by unanimous consent Lieutenant General James B. Peake (USA, retired) as the new Secretary of the Department of Veterans Affairs (VA). He will relieve Gordon Mansfield, Acting Secretary of the VA.

LTG Peake’s last assignment was as the Army’s 40th Surgeon General and Commander, U.S. Army Medical Command from 2000 to 2004. His background includes a Bachelor of Science from the United States Military Academy in 1966 and commissioning as a second lieutenant in the Infantry. He served as a combat soldier in Vietnam with the 101st Airborne Division were he was awarded a Silver Star, a Bronze Star, and two Purple Hearts. Gen. Peake received a medical doctorate from Cornell University Medical School in 1972. He is board certified in general and thoracic surgery. His most recent role was as the Chief Operating Officer for a non-profit organization, Project HOPE.

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

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

6. NMFA Hosts Roundtable on Support for Wounded Warriors: At the request of Colleen Tuddenham, Soldier and Family Assistance Center (SFAC) Program Manager, the National Military Family Association (NMFA) and the Military Officers Association of America (MOAA) hosted a roundtable on Tuesday, December 11th entitled “America’s Wounded Warriors: A Look at Non-Governmental Agency Support and Collaborative Efforts.” Representatives from charitable organizations, military and veteran service organizations, corporations and the military community joined forces to identify what was now being done and describe how their groups were helping Wounded Warriors and their families.

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

The organizations in attendance were eager to discuss how they could support the SFACs as many of them already do at Walter Reed and Brooke Army Medical Center. They discussed the role of the national and local organizations and the importance of each. Attendees learned of each other’s missions and functions and networked throughout the day.

The group came to consensus on the need for guidelines to make sure that organizations meet certain criteria to protect the Wounded Warriors and their families. They also agreed a loose coalition of groups helping the wounded would be beneficial and to work with the SFACs at the national and local level to maximize the aid they can provide to wounded soldiers, their families and the SFAC staff.

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

NMFA’s Joanne Holbrook Patton Military Spouse Scholarships are awarded to military spouses to obtain professional certification or to attend post secondary or graduate school. Scholarships normally range from $500 to $1,000 and may be used for tuition, fees, and school room and board. Spouses of uniformed service members (active duty, National Guard and Reserve, retirees, and survivors) of any branch or rank are eligible to apply. Applications are accepted online January 15 through March 15, 2008.

“Through our partnership with the Defense Commissary Agency, in seven years, we have been able to provide more than $5.5 million in scholarship grants to more than 3,500 military children. We are partnering with the NMFA to be able to expand our grants to military spouses,” said David A. Coker, President, Fisher House Foundation. “We are impressed with the scope of the NMFA program and are confident they will award the scholarship grants to the most deserving spouses.

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

8. NMFA Earns an “A”! A December 13 article in the Washington Post listed NMFA as one of the top-rated military charities. A chart accompanying the article, “Study Faults Charities for Veterans,” showed the ratings given by a charity watchdog organization, the American Institute of Philanthropy, for 20 military and veterans-related charities, including NMFA. While 12 of the rated charities earned an “F” grade, generally for managing their resources poorly and paying high overhead costs and direct-mail fundraising fees, NMFA received an “A.” The importance of ensuring military and veterans’ charities are directing their donated resources to the people they claim to serve was emphasized at a Congressional hearing the same day conducted by the House Committee on Oversight and Government Reform.

All of us who are associated with NMFA are proud of our Association’s stewardship of the funds entrusted to us to support military families. In addition to our “A” rating from the American Institute of Philanthropy, NMFA has also received a 4-star rating (highest) from Charity Navigator for three consecutive years, a distinction only attained by approximately 9% of the charities it rates, for fiscal responsibility in applying donations towards our mission. NMFA also meets all 20 standards for Charity Accountability by the Better Business Bureau’s Wise Giving Alliance. The achievement of these benchmarks reflects our staff’s hard work and attention to detail and the oversight by our Board of Governors.

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

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

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