DEAL REACHED ON 2017 NDAA

A halt to the drawdown of Soldiers was only one of the items AUSA cheered as the details of a negotiated annual defense policy bill were released. 

The topline for the National Defense Authorization Act (NDAA) for FY 2017 is $618.7 billion including $67.8 billion for the overseas contingency operations account and the president's supplemental $5.8 billion request.

Force Levels.  Earlier this year, AUSA waged an aggressive campaign to urge members of Congress to back legislation that would limit reductions in the Army and Marine Corps, a pause that would allow the next president to assess land force capabilities and needs before deciding troop levels.  Elements of the bill, offered by Rep. Chris Gibson, R-N.Y., and Rep. Mike Turner, R-Ohio, chairman of the House Armed Services Committee’s tactical air and land forces subcommittee, were included in the House version of the NDAA.  We are very pleased that it was included in the final bill. 

In a statement, AUSA President Gen. Carter Ham, USA, Ret., said, “We are pleased the bipartisan agreement stops and slightly reverses reductions in the number of soldiers.  For the Regular Army, this means 16,000 more soldiers.  For the Army National Guard, this adds 8,000. And for the Army Reserve, the agreement represents a 4,000 increase.  We are glad the Army is authorized additional resources to cover the added personnel costs.”

We would have preferred the additional personnel costs be part of the base budget, rather than overseas contingency operations funding.  A goal for next year will be to secure permanent funding.

Pay Raise.  Another reason to cheer is the 2.1 percent pay raise negotiated by lawmakers.  The White House and the Senate had pushed for a 1.6 percent pay raise.  The higher raise matches the projected increase in private sector wages and would be the first time in six years the pay raise tops 2 percent. 

Basic Allowance for Housing.  AUSA was strongly opposed to a provision included in the Senate’s bill that tied basic allowance for housing (BAH) to service members’ actual rent and utilities costs rather than a flat-rate stipend based on estimated housing costs within a zip code.  Additionally, for dual-military couples or housing sharers, the Senate wanted to divide BAH by the number of service members in domicile.

AUSA prevailed.  The provision was not included in the final bill. 

Military Health Care.  Good news for current military personnel and retirees, the conference report will not raise TRICARE fees or co-pays for you.  It will, however, increase enrollment fees, deductibles, catastrophic caps, and co-pays for beneficiaries who join the military on or after January 1, 2018. 

The agreement does remove responsibility for military treatment facilities from the individual services and consolidates it under the Defense Health Agency, beginning October 1, 2018. 

AUSA remains concerned that the overhaul of the management of military health care programs could reduce the Army's ability to allocate its own medical resources.  This is an issue we will monitor closely as it progresses.

Some of the other health care-related provisions include:

• The establishment of an open enrollment period with a grace period during the first year of open enrollment
• Renaming the TRICARE Preferred health plan option to TRICARE Select

• Improvement to access of urgent care services in both military medical treatment facilities (MTFs) and the private sector.  The provision would ensure that covered beneficiaries have access to urgent care services through the health care provider network under the TRICARE program, without the need for preauthorization, in areas where no MTFs exist for those services.  

• Expanded business hours on weekdays and weekends

• Implementation of a standardized appointment system in the military health system by January 1, 2018

The measure also mandated changes to the Defense Department’s organizational structure by eliminating the position of undersecretary of defense for acquisition, technology and logistics.  Instead it splits the position into two - an undersecretary of research and engineering and an undersecretary of acquisition and support. 

It also removes the U.S. Cyber Command from the U.S. Strategic Command and elevates it to a full combatant command. 

Overall, with some exceptions, AUSA is pleased with the bill.  The House is scheduled to vote on the measure Friday with the Senate vote coming next week. 

STOPGAP UNTIL MAY??

Not only is AUSA NOT cheering an extension of the stopgap spending measure into next year, we are actively booing the prospect that it could last until April or May.

Defense Secretary Ash Carter expressed his displeasure over the prospect in a letter to Hill leaders. 

His letter to House Speaker Paul D. Ryan, R-Wis., and Senate Majority Leader Mitch McConnell, R-Ky., said, “A short-term CR is bad enough, but a CR through May means DOD would have to operate under its constraints for two-thirds of the fiscal year.  This is unprecedented and unacceptable, especially when we have so many troops operating in harm's way.  I strongly urge Congress to reject this approach.”

Carter’s missive will probably fall on deaf ears.  House and Senate leaders said Wednesday that the new stopgap spending bill will almost certainly stretch into April and possibly longer due to the Senate's crowded 2017 schedule that will include confirmations of the incoming cabinet. 

We will know soon what direction Congress will take.  The current stopgap measure expires on Dec. 9.  The text of the new version should be released next week.

ARMY HELICOPTER PROCUREMENT PROGRAMS MERIT SPECIAL ATTENTION IN STOPGAP MEASURE

Congressional leaders released the details of a continuing resolution (CR) that replaces the one expiring on Dec. 9. The new CR will maintain government funding at its current levels until April 28, 2017.

In an effort to partially minimize the harmful effects a long-term stopgap spending measure would have on the Pentagon, House Appropriations Committee Chairman Hal Rogers, R-Ky., said that the CR includes “provisions needed to prevent catastrophic, irreversible, or detrimental changes to government programs, to support our national security, and to ensure good government.”

The Army’s Apache Attack Helicopter and Black Hawk Helicopter multiyear procurements were singled out as programs that garnered special attention.  A return to annual contracts would cost the two programs up to $880 million over five years. 

Funding for the Navy’s ballistic missile submarine and the Air Force’s aerial refueling tanker programs were also included in the CR.   

The measure incorporated provisions outlined in the fiscal 2017 Security Assistance Appropriations Act, which provides an additional $10.1 billion in Overseas Contingency Operations funding.  The Department of Defense would receive $5.8 billion while the Department of State portion would be $4.3 billion. 

Of the $5.8 billion provided for defense, $5.1 billion is to support counterterrorism operations, including salaries and mission support for additional troops in Afghanistan and efforts to defeat ISIL, and $652 million is to support the European Reassurance Initiative.

For the past several years, Congress has relied on stopgap spending bills to keep the government running because of their inability to pass routine spending bills.  Typically, the duration of the measure is relatively short.  This year, however, the stopgap will last more than half of the fiscal year. 

House and Senate leaders said that the longer stopgap was necessary because of the Senate's crowded 2017 schedule that will include confirmations of the incoming cabinet.

The House is scheduled to vote on the measure Thursday followed by a Senate vote on Friday. 

SENATE VOTE ON NDAA THIS WEEK

Last week’s Legislative Update touched on some of the provisions included in the fiscal 2017 National Defense Authorization Act (NDAA).  Here are some more to mull and ponder. 

The legislation:

• Authorizes up to 12 weeks of paid leave (including 6 weeks medical recuperation leave) for primary caregivers after childbirth and 21 days for a servicemember who is the secondary caregiver.
• Extends the Special Survivor Indemnity allowance for SBP-DIC widows through May 2018 at the current $310 monthly rate.
• Authorizes the Defense Department to provide hearing aids to family members of retirees at DoD cost.
• Authorizes retired members and families to participate in federal civilian dental and vision plan.
• Authorizes a pilot program that will offer commercial insurance coverage to Reserve component members and families.
• Authorizes operation and maintenance support for a larger force, including increased depot maintenance, facilities sustainment and modernization, and ship maintenance.
• Replenishes depleted munitions inventories.
• Allows variable pricing and the development of private label products for commissaries.

The Senate voted to invoke cloture on the motion to proceed Wednesday.  It is anticipated that a final vote on the measure will occur Thursday.  After that, it will head to the president’s desk for signature. 

AUSA’S HAM AND DUBIK TESTIFY BEFORE CONGRESS

Two senior members of the Association of the U.S. Army testified before a House committee about managing force levels in combat theaters, and about the risk of degrading unit readiness and driving up operating costs if this isn’t done right.

Retired Gen. Carter F. Ham, AUSA’s president and CEO, and retired Lt. Gen. James Dubik, a senior fellow at AUSA’s Institute of Land Warfare, were asked to testify before a House Armed Services Committee subcommittee on oversight and investigations, which is looking into how troop caps are set for contingency operations.

Ham, who retired from active duty in 2013, served in active-duty assignments that included deputy director for force structure requirements for U.S. Central Command from 2001 to 2003; commander of Multinational Brigade North in Iraq from 2004 to 2005; and Joint Staff director for operations from 2007 to 2008.

Dubik, who retired from active duty in 2008, served his final assignment as commander of Multinational Security Transition Command-Iraq and NATO Training Mission-Iraq, which had the lead on training and developing all Iraqi security forces.

Caps on the number of U.S. troops who can be deployed to combat theaters like Iraq and Afghanistan—formally known as “force management levels”—can degrade unit readiness and drive up operating costs, Ham and Dubik said.

“I think there is utility in force management levels,” Ham said. “I think it’s in the application where we have difficulty sometimes.”

Dubik said a force management level should be the product of an extensive and thorough dialogue between civil and military authorities “of the range of options and risks.”

“If that process is aborted or an arbitrary force management level is set in lieu of having that kind of discussion … the result is generally a level of force that is unlikely to succeed,” Dubik said. “And that is not a good position to be in.”

Troop caps have been a mainstay of military operation since the Vietnam War. The troop cap in Afghanistan, now about 9,800, is due to drop in January to 8,448. In Iraq, the troop cap increased in September to 5,262 from 4,647, the third increase in that theater this year.

Ham and Dubik used the example of an Army aviation unit to illustrate the potential impact of troop caps on readiness. If most of a unit’s airframes and crews deploy but most or all of its maintenance personnel stay at home station, “there's a very real concern about how the maintenance personnel retain their proficiency,” Ham said. “For the most part, I think those skills would atrophy.”

In such instances, a common workaround for the military is to hire civilian contractors to fill the capability gaps in theater—which means the military essentially pays twice for the same services.

“We have those uniformed maintainers, we've paid for them, we've trained them, we've developed them, we've bought their equipment, but yet we then pay again to provide a contract maintenance capability in theater,” Ham said.

Dubik called that “a complex and very costly approach to conducting what could be, should be, a military task.”

He also noted that in addition to increased personnel costs, contractors are limited to performing the specific tasks of their contracts. In contrast, “a soldier who is a cook, a mechanic, a clerk, if you need additional convoy security people, there they are. A soldier deployed is much more flexible than a contractor.”

“From a purely military standpoint,” force management levels are “one way to manage the global force,” Ham said. “It does constrain unanticipated growth, so-called mission creep, from occurring without approval. But when activities are driven by a number, rather than by the mission, then I think we’ve got things out of whack and out of priority.”

Dubik said that during his active-duty service, he had been under troop caps three times, in Haiti, Bosnia and Iraq. “And each of those times, in my opinion, the force management levels were set correctly by the strategic objective. Not as high as the military commanders wanted but not as low as they are now. So, there is a role for these things. But … the strategic aim is really the key question. If the troop cap is not based on a strategic mission that the country can buy into, it’s going to be wrong regardless of whether it’s high or low.”

Veterans Boost Ranks in Congress

The U.S. Army will be well-represented in Congress in January when the new legislative session convenes. More than half of the veterans serving in the House of Representatives and one-third of the veterans in the Senate served in the Army, a new analysis shows.

Twenty-six percent of incoming freshmen in the House are military veterans, “a much higher share than in recent freshman classes,” said Seth Lynn, executive director of the nonprofit Veterans Campaign, which did the analysis. Veterans made up only 17 percent of House freshmen in the 113th Congress and 20 percent in the 114th Congress.

A total of 82 veterans of all branches will serve in the House. Forty-four are Army veterans, including seven incoming freshmen. 

Thirty House veterans have combat experience in Iraq and Afghanistan. Nine of those are former soldiers, including two incoming freshmen: Reps. Brian Mast, R-Fla., and Anthony Brown, D-Md.

Incumbents who served post-9/11 combat deployments in the Army are Republican Reps. Lee Zeldin of New York, Brad Wenstrup and Steve Stivers of Ohio, Steve Russell of Oklahoma and Scott Perry of Pennsylvania; and Democrats Tulsi Gabbard of Hawaii and Tim Walz of Minnesota.

The Senate will be home to 10 Army veterans, including three with Operation Iraqi Freedom/Operation Enduring Freedom service: Republicans Tom Cotton of Arkansas and Joni Ernest of Iowa, and Tammy Duckworth, D-Ill.

The overall number of veterans in the Senate will remain constant at 21. This is the second consecutive election in which that number did not drop, following a steady 32-year decline.

At the end of the Vietnam War, fully three-quarters of legislators in the House and Senate had military experience.

The full Veterans Campaign analysis is online at www.veteranscampaign.org/research.

Secretary Carter Opens Vietnam War Commemoration Pentagon Corridor Honoring Vietnam Veterans and Their Families

Secretary of Defense Ash Carter, along with former Defense Secretary and Vietnam veteran Chuck Hagel, provided remarks before cutting the ribbon and officially opening a corridor in the Pentagon honoring Vietnam veterans and their families.

The secretaries joined 15 Vietnam veterans Tuesday afternoon to mark the official opening of the museum-quality exhibit.  The permanent exhibit, located on the 3rd floor of the Pentagon between corridors 2 and 3, uniquely documents and illustrates the history of U.S. involvement in the Vietnam War through a variety of media outlets of the time.  It exhibits historically accurate material and interactive experiences that will help today’s American public better understand and appreciate the service of our Vietnam veterans and their families, and the history of U.S. involvement in the Vietnam War.

The commemoration took place at the center of the exhibit, an alcove that features two Huey helicopters.  Other highlights in the corridor include a binnacle from the SS Mayaguez, iconic memorabilia left at the Vietnam Veterans Memorial Wall, statues and paintings, and chronological and thematic timelines of the Vietnam War.

“Today's unveiling and the government-wide commemoration that accompany it are an important part of commitment to honor veterans from Vietnam and their families, for service, for valor, for sacrifice,” said Secretary of Defense Ash Carter.

"This exhibit really and truly represents the service of a generation of citizens who were asked to do something for their country at a difficult time, as difficult a time as probably we've seen in our lifetimes,” said former Secretary of Defense Chuck Hagel.  “This exhibit very much reflects all that and pays tribute to men and women who never asked for anything in return; they never came back to any expectations. They wanted to get on with their lives and put that war experience behind them.”  

The United States of America Vietnam War Commemoration leads the nation’s effort to thank and honor the more than seven million living Vietnam veterans and the families of the nine million who served.  The commemoration was authorized by Congress, established under the secretary of defense, and launched in 2012 by President Barack Obama. The commemoration has partnered with more than 10,000 organizations to thank veterans and their families in their hometowns across the country.

Further information regarding The United States of America Vietnam War Commemoration, including how organizations can become commemorative partners and how individual veterans can find events in their hometowns,  can be found at http://www.vietnamwar50th.com/

For information regarding arranging a tour of the Pentagon, please visit https://pentagontours.osd.mil/Tours/

AUSA ANNUAL MEETING NAMED A TOP DC EVENT

The Association of the U.S. Army’s Annual Meeting and Exposition made a top 100 list of Washington, D.C.’s, most impactful events of 2016.

BizBash, which bills itself as North America’s top source of “ideas, news, and resources for event and meeting professionals,” slotted AUSA’s annual meeting in the No. 3 position in its trade shows and conventions category, behind only the NBC4 Health and Fitness Expo and the Washington Auto Show.

BizBash noted that about 26,000 people attended this year’s AUSA signature event, held Oct. 3-5 in downtown Washington at the Walter E. Washington Convention Center.

“Widely considered to be the largest land power exposition and professional development forum in North America, the expo had 600 displays in more than 250,000 square feet of exhibit space,” BizBash noted.

To compile its top 100 list, BizBash says it considers a variety of factors, including “economic impact, buzz, innovation and an event’s prominence within the communities it intends to serve.”

The full list of Washington events that had the most impact in 2016 can be viewed here

Nearly 100,000 Vets Enrolled in Burn Pit Registry

By Stephanie Green Eber, Health Science Specialist Post Deployment Health Services

Tuesday, December 20, 2016

Join VA’s Airborne Hazards and Open Burn Pit Registry

VA launched the Airborne Hazards and Open Burn Pit Registry in June 2014 to better understand the long-term health effects of exposure to burn pits and other airborne hazards during deployment. The number of new participants in this registry is climbing steadily, and will soon reach the milestone of 100,000 participants. As of December 9, 2016, the Airborne Hazards and Open Burn Pit Registry includes 95,593 Veterans and Service members.  An estimated 3 million Veterans and Service members are eligible to join the registry.

“The benefit of the Airborne Hazards and Open Burn Pit Registry for participants is that they can document their exposure to burn pits and other airborne hazards in an online questionnaire and print a copy of their questionnaire to discuss with their health care provider. Also, Veterans can get a free medical evaluation from VA.” said Michael Montopoli, MD, MPH, Director of the Post-9/11 Era Environmental Health Program in VA’s Office of Patient Care Services. 

“The registry will help VA provide the right health care services for Veterans in the future.”

Veterans and Servicemembers who served in the Southwest Asia theater of operations after August 2, 1990, or in Afghanistan or Djibouti, Africa, after September 11, 2001 are eligible to participate in the registry.  Participants complete a survey which asks where the Veteran or Servicemember lives, what type of work they do, and their exposures, health care use, and hobbies. The survey takes about 40 minutes to complete.

Many Veterans have reported concerns about their respiratory, cardiovascular, gastrointestinal, and dermatologic health, along with concerns about cancer. VA would like to learn more about the experiences of those who served.

“The registry informs VA and DoD about the health concerns, exposures, and health outcomes of Veterans and Servicemembers,” said Montopoli.  “The registry will help VA provide the right health care services for Veterans in the future.”

Are you a Veteran or Servicemember who would like to join the growing number of participants in the burn pit registry?  Go to  
https://veteran.mobilehealth.va.gov/AHBurnPitRegistry/.  Additional information about the registry is available at  http://www.publichealth.va.gov/exposures/burnpits/registry.asp.

- See more at: http://www.va.gov/HEALTH/NewsFeatures/2016/December/Nearly-100000-Vets-Enrolled-in-Burn-Pit-Registry.asp#sthash.F6QSHFNQ.dpuf

FOR IMMEDIATE RELEASE December 20, 2016 -Veterans Crisis Line Improves Service with New Call Center Opening in Atlanta

WASHINGTON- The Department of Veteran Affairs cut the ribbon today for its new Veteran Crisis Line (VCL) satellite office in Atlanta allowing the life-saving hotline to expand capacity by nearly 600 Veterans each day essentially doubling VA’s ability to help Veterans in need. As a part of the MyVA initiative, the largest restructuring in the Department’s history, improvements of the VCL are a key priority, with the goal of providing 24/7, world-class suicide prevention and crisis intervention services to Veterans, servicemembers and their family members across the globe. “The addition of the second Veterans Crisis Line facility enhances VA’s ability to provide 24/7 suicide prevention and crisis intervention services by trained, dedicated VA employees to Veterans, Service members and their families,” said VA Deputy Secretary Sloan Gibson who joined Veterans Crisis Line responders and partners in today’s ribbon cutting. “The work at the Veterans Crisis Line is some of the most important work we do in VA. Today we follow through on our commitment to give those who save lives every day at the Crisis Line the training, additional staff and modern call center technology they need to make the Veterans Crisis Line a Gold Standard operation. The Veterans of this nation, especially those in most need of our help, deserve no less.” The VCL is critical to connecting Veterans with facility-based Suicide Prevention Coordinators (SPCs). SPC teams within each Veterans Affairs Medical Center (VAMC) work to engage Veterans and communities to raise awareness about VA’s suicide prevention and behavioral health resources. The VCL interfaces with various stakeholders, including the Veterans Health Administration (VHA) Suicide Prevention Program Office and the Substance Abuse and Mental Health Services Administration (SAMHSA), to provide critical services that ultimately provide a safe haven for Veterans and servicemembers. Since VCL was launched in 2007, the crisis line counselors have: Answered nearly 2.6 million calls Dispatched emergency services to callers in imminent crisis more than 67,000 times Engaged nearly 314,000 Veterans or concerned family members through the chat option launched in 2009 Responded to nearly 62,000 requests since the launch of text services in November 2011 Forwarded more than 416,000 referrals to local VA suicide prevention coordinators on behalf of Forwarded more than 416,000 referrals to local VA suicide prevention coordinators on behalf of Veterans to ensure continuity of care with Veterans’ local VA providers The VCL staff has grown over the years. Initially housed at Canandaigua VAMC in N.Y., it began with 14 responders and two health care technicians answering four phone lines. Today, the combined facilities employ more than 500 professionals, and VA is hiring more to handle the growing volume of calls. Atlanta offers 200 call responders and 25 social service assistants and support staff, while Canandaigua houses 310 and 43, respectively. Callers dial the National Suicide Prevention Hotline number 1-800-273-TALK (8255) and Veterans choose option 1 to reach a VHA VCL Responder. The text number is 838255 or Veterans may chat with our trained professionals online at Vets.gov. Calls, texts, and chats are immediately directed to a VA professional who is specially trained to handle emotional and mental health crises for Veterans and servicemembers. VA is also streamlining and standardizing how crisis calls from other locations, such as VAMCs, reach the VCL, including full implementation of the automatic transfer function that directly connects Veterans who call their local VAMC to the VCL by pressing a single digit during the initial automated phone greeting. For more information about the Veteran Crisis Line service expansion, see the VCL expansion fact sheet on VA’s website.

FOR IMMEDIATE RELEASE December 20, 2016 VA Study Finds EEG Can Help Tell Apart PTSD & Mild Traumatic Brain Injury

WASHINGTON – A recent VA study points to a possible breakthrough in differentiating between post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI), otherwise known as a concussion. The two disorders often carry similar symptoms, such as irritability, restlessness, hypersensitivity to stimulation, memory loss, fatigue and dizziness. Scientists have tried to distinguish between mTBI and PTSD in hopes of improving treatment options for Veterans, but many symptom-based studies have been inconclusive because the chronic effects of the two conditions are so similar. If someone is rating high on an mTBI scale, for example, that person may also rate high for PTSD symptoms. The researchers used electroencephalogram, or EEG, a test that measures electrical activity in the brain. The size and direction of the brain waves can signal abnormalities. Analyzing a large set of EEGs given to military personnel from the wars in Iraq and Afghanistan, the researchers saw patterns of activity at different locations on the scalp for mTBI and PTSD. They saw brain waves moving slowly in opposite directions, likely coming from separate places in the brain. The researchers emphasize that these effects don't pinpoint a region in the brain where the disorders differ. Rather, they show a pattern that distinguishes the disorders when the EEG results are averaged among a large group. “When you're looking at an EEG, you can't easily tell where in the brain signals associated with TBI and PTSD are coming from,” said Laura Manning Franke, Ph.D., the study's lead researcher and research psychologist at the Hunter Holmes McGuire VA Medical Center in Richmond, Virginia. “You get kind of a coarse measure – left, right, anterior, posterior. We had a different distribution, which suggests that different parts of the brain are involved. In order to determine what patterns are tracking their TBI and PTSD, you need an average to do that,” Franke added. The study linked mTBI with increases in low-frequency waves, especially in the prefrontal and right temporal regions of the brain, and PTSD with decreases in low-frequency waves, notably in the right temporoparietal region. The differences in the levels of the waves may explain some of the symptoms of the two disorders, suggesting a decline in responsiveness for someone with mTBI, for example, and more anxiety for someone with PTSD. Franke also noted that more low-frequency power has also been linked to cognitive disorders such as Alzheimer's disease and less low-frequency power to problems such as drug addiction. Additionally, spotting distinct patterns of mTBI and PTSD in separate parts of the brain is key for two reasons: the possibility these conditions can be confused with each other is reduced. That can help improve diagnosis and treatment and the patterns show that electrical activity appears to be affected long after combat-related mTBI, suggesting long-term changes in neural communication, the signaling between cells in the nervous system. “That could help, in part, explain the reason for persistent problems.” The study included 147 active-duty service members or Veterans who had been exposed to blasts in Iraq and Afghanistan. Of those, 115 had mTBI, which accounts for nearly 80 percent of all traumatic brain injuries. Forty of the participants had PTSD, and 35 had both conditions. Despite the new findings, Franke and her team believe more work is needed to better explain the differences in the patterns of both conditions in the brain's electrical activity. Researchers need to analyze the differences in scans from larger numbers of patients. Meanwhile, though, she said she hopes the research will play a role in helping medical professionals better diagnose someone's condition through an individual EEG—whether that person has PTSD, a brain injury, or a combination of the two. "That's the holy grail," said Franke. "We want to use the EEG to differentiate the problems, but also to predict recovery and be able to measure how people are doing in a more biological way than just measuring symptoms, although those are still relevant. But symptoms are also problematic because they're influenced by so many things that aren't the disease that we're interested in." For more information about VA research on PTSD and TBI, visit Posttraumatic Stress Disorder and Traumatic Brain Injury. Information about Franke’s study may be found at the International Journal of Psychophysiology

Consumer Financial Protection Bureau Takes Second Action Against Military Credit Services for Improper Contract Disclosures

Bureau Orders Lender to Pay $200,000 Civil Penalty

DEC 20, 2016

WASHINGTON, D.C. – The Consumer Financial Protection Bureau (CFPB) today sued Military Credit Services, LLC (MCS) for making loans with improper disclosures. This is the CFPB’s second enforcement action against MCS. In 2014, the CFPB, along with the states of North Carolina and Virginia, sued the company for similar violations, and the company was ordered to revise its contract disclosures in 2015. In today’s action, the CFPB ordered the company to ensure that its contracts comply with the law. It also required the company to hire an independent consultant to review its practices and to pay a $200,000 civil penalty.

“Today’s action sends a clear message that lenders cannot ignore their responsibilities under the law,” said CFPB Director Richard Cordray. “This is the Consumer Bureau’s second action against Military Credit Services for improper disclosures. We are imposing further penalties, and we will continue to closely monitor their compliance in the future.”

Military Credit Services is a Virginia-based company that extends credit to consumers through retailers nationwide and, through a commonly owned company, collects debts owed under the credit contracts. The CFPB found the company violated federal law by failing to properly disclose the terms of preauthorized transfers and interest rates on the loans it offered. Without those legally required disclosures, consumers cannot make informed decisions about important financial decisions they face.

Under the Dodd-Frank Act, the CFPB is authorized to take action against institutions engaged in unfair, deceptive, or abusive acts or practices or that otherwise violate federal consumer financial laws.

Under the terms of the CFPB order released today, Military Credit Services is required to:

• Cease its unlawful conduct: The company is ordered to ensure that its contracts comply with applicable laws.
• Pay for an independent review: The company must hire an independent consultant with specialized experience in consumer-finance compliance to conduct an independent review of the company’s issuance and servicing of credit. The independent report will be provided to the company and to the CFPB.
• Pay a $200,000 civil penalty: The company must pay $200,000 to the CFPB’s Civil Penalty Fund.

The full text of the CFPB’s consent order is available here: http://files.consumerfinance.gov/f/documents/201612_cfpb_MilitaryCreditServices-consentorder.pdf 

More information about the original lawsuit and resulting stipulated final judgment in 2015 is available here: http://www.consumerfinance.gov/about-us/newsroom/cfpb-and-states-take-action-against-freedom-stores-for-illegal-debt-collection-practices-against-servicemembers/ 

DFAS Releases 2016 Tax Statement Schedule

2016 tax statements for military, retiree, annuitant and federal civilian employee customers serviced by the Defense Finance and Accounting Service will be distributed mid-December through January 2017.

The IRS tax forms will be available via myPay, the Department of Defense online pay account management system (https://mypay.dfas.mil/mypay.aspx) for most of the 6.3 million DFAS customers. The electronic online forms are available one to two weeks earlier than those sent to customers electing hardcopy delivery by mail.

For the second year, DFAS will also be providing IRS Forms 1095-B or 1095-C for military, retiree and federal civilian employees who receive healthcare insurance coverage through the Tricare or Federal Employee Health Benefit programs.

DFAS officials encourage everyone paid by the agency and will be receiving tax documents over the next month and a half to select electronic-only delivery of their documents to help reduce costs for the military services and federal government departments or agencies. While the deadline for opting in to electronic deliver- only for W-2s has passed for 2016, selection can still be made for 1095 forms until Dec. 31.

2016 tax statement myPay and USPS mail schedule: 

* Voluntary Separation Incentive/Special Separation Benefit
** Military non-appropriate fund civilian employees receive tax statements from their respective military service.  Army NAF employee tax statements are made available via myPay.

DFAS Issues Warning About Fraudulent Emails

BEWARE! Several myPay customers have informed us that fraudulent SmartDocs email messages are being sent that could put your information and finances at risk.

The reported invalid emails contain what appears to be from a valid SmartDocs email address. The originators of these emails have “spoofed” their messages to hide their true origin and placed the SmartDocs address in the “From” line to make the email appear legitimate.

Valid SmartDocs messages from DFAS are always sent in plain text, do not include attachments and do not ask you to send any information in response. Your email program may automatically convert a valid SmartDocs message into HTML and convert some text into clickable links. We recommend that you do NOT click on any links within any email message.  To access a site referenced in an email, open your browser and type the link (URL) directly into the browser.

Don’t get fooled. If you receive a SmartDocs message that contains a link, don’t click on it.  If a URL is listed in the message type it in manually within your browser.  Delete  unexpected or unsolicited  messages that contain  attachments or that request you to send information back.

Becoming a victim is easy.  Utilizing a few basic precautions with email handling are critical to protecting your information, finances and identity.

DoD Unveils Redesigned National Resource Directory

The National Resource Directory (www.nrd.gov), a website that provides access to services and resources at the national, state and local levels, unveiled an updated design and layout last week. The updates were implemented to make the site more user- friendly for the thousands of service members, veterans and family members who use the Directory each month.

“The National Resource Directory has been an invaluable collection of resources for our service members, veterans and their families,” said James Rodriguez, deputy assistant secretary of defense, Office of Warrior Care Policy. “Improving the site and expanding its capabilities was an easy decision.”

Enhancements to the Directory include a refreshed appearance, updated search engine, and behind the scenes software updates that will improve the speed and accuracy of managing the programs and services listed. Also included in the redesign is the addition of widgets­, a stand-alone application that organizations can use to enable access to Directory functions through their own websites.

“The National Resource Directory is a great place for everyone to find vetted and organized resources, but it can be particularly helpful for those professionals and other organizations helping to coordinate care for our wounded, ill and injured service members,” said Rodriguez. “For our Recovery Care Coordinators, those men and women who are working each day to support wounded, ill and injured service members, the updates to the National Resource Directory will allow them to find and connect service members with appropriate resources more efficiently.”

The Directory continues to be one of the largest online collections of government and nongovernment resources specifically designed for service members, their families, military caregivers and veterans. With a unique collection of more than 18,000 organized and vetted resources, the Directory provides information covering a variety of topics, including benefits and compensation, education and training, family and military caregiver support, health, homeless assistance, housing, and other services and programs.

The Directory’s participation policy uses crowd-sourced data points from watchdog organizations in addition to government data sources to ensure the quality of resources on the site.

House, Senate Pass Bill to Stop Improper Taxation of Disability Severance Payments

Last week Congress passed the Combat-Injured Veterans Tax Fairness Act of 2016, which ends the taxation of severance payments from the Department of Defense to combat-injured veterans. The bill now heads to President Obama’s desk, where it is expected to be signed.

The legislation directs DOD to identify veterans who have been separated from service for combat-related injuries and received a severance payment that was improperly taxed by the federal government. It instructs DOD to determine how much the combat-wounded veterans are owed and allow veterans who have been improperly taxed to recover the withheld amounts.

Under federal law, veterans who suffer combat-related injuries and who are separated from the military are not supposed to be taxed on the one-time lump sum disability severance payment they receive from DOD. Unfortunately, taxes on combat-related disability severance payments have nonetheless been withheld from qualifying veterans due to the limitations of DOD’s automated payment system. Veterans are typically unaware that their benefits were improperly reduced as a result of DOD’s actions.

U.S. Senators John Boozman (R-AR) and Mark Warner (D-VA) introduced the identical legislation in the Senate in March.

It is estimated that over 13,800 veterans may have been denied full severance pay as a result of wrongful taxation as far back as 1991.

VA Grants Full Practice Authority to Advance Practice Registered Nurses

The Department of Veterans Affairs Has Issued the Following Press Release:

The Department of Veterans Affairs (VA) has announced that it is amending provider regulations to permit full practice authority to three roles of VA advanced practice registered nurses (APRN) to practice to the full extent of their education, training, and certification, regardless of State restrictions that limit such full practice authority, except for applicable State restrictions on the authority to prescribe and administer controlled substances, when such APRNs are acting within the scope of their VA employment.

“Advanced practice registered nurses are valuable members of VA’s health care system,” said VA Under Secretary for Health Dr. David J. Shulkin. “Amending this regulation increases our capacity to provide timely, efficient, effective and safe primary care, aids VA in making the most efficient use of APRN staff capabilities, and provides a degree of much needed experience to alleviate the current access challenges that are affecting VA.”   

APRNs are clinicians with advanced degrees and training who provide primary, acute and specialty health care services; they complete masters, post-masters or doctoral degrees. There are four APRN roles: Certified Nurse Practitioner, Clinical Nurse Specialist, Certified Registered Nurse Anesthetist, and Certified Nurse Midwife.

“CRNAs provide an invaluable service to our Veterans,” Under Secretary for Health Shulkin continued. “Though CRNAs will not be included in VA’s full practice authority under this final rule, we are requesting comments on whether there are access issues or other unconsidered circumstances that might warrant their inclusion in a future rulemaking.  In the meantime, we owe it to Veterans to increase access to care in areas where we know we have immediate and broad access challenges.”

All VA APRNs are required to obtain and maintain current national certification.

The final rulemaking establishes professional qualifications an individual must possess to be appointed as an APRN within VA, establishes the criteria under which VA may grant full practice authority to an APRN and defines the scope of full practice authority for each of the three roles of APRN. Certified Registered Nurse Anesthetists will not be included in VA’s full practice authority under this final rule.   

VA is the nation’s largest employer of nurses; as of July 2016 its workforce of approximately 93,500 nurses (RNs, LPNs, NAs) includes approximately 5,769 APRNs

Congress Passes Major Veterans Bill:

This week Congress sent major veterans legislation to the president for his signature. H.R. 6416, the Jeff Miller and Richard Blumenthal Veterans Health Care and Benefits Improvement Act of 2016, The bill expands eligibility for grave marker medallions to be issued by VA to include those veterans who died before November 1990. Another section of the bill provides for researching how the health of children of veterans exposed to toxic substances is impacted. Changes that make uniform the definition of homelessness were also included in the bill.

Additional legislation to require VA to pilot a self-scheduling program, to authorize VA to partner with non-governmental agencies to finance VA facilities, and to pay back money withheld from veterans discharged after January 17, 1991 who received severance pay also cleared Congress and awaits the president’s signature. This concludes the 114th Congress..

National Defense Authorization Act Clears Congress:

Legislation providing $618.7 billion and a 2.1 percent pay raise for the military cleared Congress and was sent to the White House this week. The bill also includes requiring DOD to formulate a process by which veterans who received Less-Than-Honorable discharges due to misconduct resulting from the effects of Post-traumatic stress disorder, Military sexual trauma (MST) and
Traumatic brain injury are given a fair shake when appealing for discharge upgrade; calculating the military retirement owed to a former spouse based on the rank at time of divorce instead of at time of retirement; and improved reporting and treatment of service members who are victims of MST.

Army VSO/MSO Roundtable:

We participated in a veteran and military service organization roundtable on Wednesday with Under Secretary of the Army Patrick Murphy, who was joined by senior officials from Manpower, Force Development, Army Review Board, Army Wounded Warrior Program and Soldier for Life. Discussions focused on the “Meet Your Army” campaign, discharge review boards, “Soldier 2020” gender integration, the future of the force and transition topics.

SECAF Holds Facebook Town Hall:

Air Force Secretary Deborah Lee James held a Facebook town hall on Dec. 12 to discuss concerns expressed during the October Air Force Spouse and Family Forum. Topics included the hiring of additional family support coordinators; an increase in respite care hours allowed under the Exceptional Family Member Program (EFMP); quarterly EFMP-related webcasts starting Jan 12; an increase in months of leave without pay available to spouses during moves; the expansion of parental leave per the 2017 National Defense Authorization Act; and additional steps being taken to address other childcare and spouse employment challenges. Read more at: http://www.af.mil/News/ArticleDisplay/tabid/223/Article/1027513/secaf-shares-developments-with-spouse-and-family-programs-at-townhall.aspx

WWI Centennial Commission:

The World War I Centennial Commission was created by Congress to commemorate America’s significant role during the “war to end all wars,” as well as the subsequent rebuilding of war-torn Europe afterwards. Approximately 4.7 million American men and women served during World War I, with 2 million deploying “over there.” Sadly, 116,516 paid the ultimate price. The commission is engaging with communities across the nation, partnering with the History Channel and the Smithsonian museums, and designing a new National World War I Memorial

in Washington, D.C. The VFW is fully supportive of commission initiatives, which include naming Quartermaster General Debra Anderson as a commissioner, identifying those Posts that are named after fallen WWI soldiers, sailors, airmen and Marines, publicizing America’s contributions in the VFW magazine, and supporting the 100 Cities/100 Memorials matching grant challenge. Learn more at: http://www.worldwar1centennial.org/index.php.

MIA Update:

The Defense POW/MIA Accounting Agency announced the identification of remains of 12 Americans who had been missing in action from World War II and Korea. Returning home for burial with full military honors are:

-- Navy Seaman 2nd Class Floyd F. Clifford was assigned to the USS Oklahoma, which was moored off Ford Island in Pearl Harbor, Hawaii, when Japanese aircraft attacked his ship on Dec. 7, 1941. Clifford was one of 429 crewmen killed in the attack. Interment services are pending. Read more at: http://www.dpaa.mil/News-Stories/Recent-News-Stories/Article/1030547/sailor-missing-from-world-war-ii-identified-clifford/.

-- Navy Fireman 3rd Class Kenneth L. Holm was assigned to the USS Oklahoma, which was moored off Ford Island in Pearl Harbor, Hawaii, when Japanese aircraft attacked his ship on Dec. 7, 1941. Holm was one of 429 crewmen killed in the attack. Interment services are pending. Read more at: http://www.dpaa.mil/News-Stories/Recent-News-Stories/Article/1030832/sailor-missing-from-world-war-ii-identified-holm/.

-- Navy Seaman 1st Class Harold W. Roesch was assigned to the USS Oklahoma, which was moored off Ford Island in Pearl Harbor, Hawaii, when Japanese aircraft attacked his ship on Dec. 7, 1941. Roesch was one of 429 crewmen killed in the attack. Interment services are pending. Read more at: http://www.dpaa.mil/News-Stories/Recent-News-Stories/Article/1030550/sailor-missing-from-world-war-ii-identified-roesch/.

-- Navy Yeoman 3rd Class Edmund T. Ryan was assigned to the USS Oklahoma, which was moored off Ford Island in Pearl Harbor, Hawaii, when Japanese aircraft attacked his ship on Dec. 7, 1941. Ryan was one of 429 crewmen killed in the attack. Interment services are pending. Read more at: http://www.dpaa.mil/News-Stories/Recent-News-Stories/Article/1026982/sailor-missing-from-world-war-ii-identified-ryan/.

-- Army Air Forces Staff Sgt. Byron H. Nelson was a nose gunner aboard an American B-24G Liberator bomber with the 721st Bomb Squadron, 450th Bomb Group, 15th Air Force. During a bombing run near Varese, Italy, on April 25, 1944, Nelson’s aircraft and two others were separated from the formation due to dense clouds and later attacked by German fighters. Of the 10 crewmen, six parachuted from the aircraft and escaped capture, two parachuted and were captured by German forces, and two perished in the crash. Nelson was reported to be one of the two who perished. Interment services are pending. Read more at: http://www.dpaa.mil/News-Stories/Recent-News-Stories/Article/1027977/airman-missing-from-world-war-ii-identified-nelson/.

-- Army Air Forces Capt. Albert L. Schlegel, of Cleveland, Ohio, disappeared Aug. 28, 1944, while piloting his P-51D Mustang on a ground strafing mission near Strasbourg, France. In his final communication, the fighter “ace” radioed he’d been hit by heavy anti-aircraft fire and would need to bail out. Interment services are pending. Read more at: http://www.dpaa.mil/News-Stories/Recent-News-Stories/Article/1027011/airman-missing-from-world-war-ii-identified-schlegel/.

-- Army Cpl. Gerald I. Shepler was the lead scout on a reconnaissance patrol for Company K, 3rd Battalion, 187th Airborne Infantry Regiment, 7th Infantry Division, near Hajoyang-ni, North Korea, when his patrol was ambushed by enemy forces. Shepler was unaccounted for after the mission, and the U.S. Army declared him deceased on Nov. 29, 1950. Interment services are pending. Read more at: http://www.dpaa.mil/News-Stories/Recent-News-Stories/Article/1027031/soldier-missing-from-korean-war-identified-shepler/.

-- Army Sgt. Homer R. Abney was a member of Company A, 1st Battalion, 9th Infantry Regiment, 2nd Infantry Division, when his unit was engaged in heavy fighting with Chinese forces on the road from Kunu-ri to Sunch’on, North Korea — later named “The Gauntlet.” After several days of fighting, his regiment declared Abney missing on Nov. 30, 1950. Interment services are pending. Read more at: http://www.dpaa.mil/News-Stories/Recent-News-Stories/Article/1027019/soldier-missing-from-korean-war-identified-abney/.

-- Army Cpl. James T. Mainhart served with Company I, 31st Infantry Regiment, 7th Infantry Division, part of the 31st Regimental Combat Team deployed east of the Chosin Reservoir in North Korea. The RCT was attacked by an overwhelming number of Chinese forces in late November, 1950. Mainhart was among 1,300 members of the RCT killed or captured in enemy territory. He was reported missing as of Nov. 30, 1950. Interment services are pending. Read more at: http://www.dpaa.mil/News-Stories/Recent-News-Stories/Article/1027973/soldier-missing-from-korean-war-identified-mainhart/.

-- Army Cpl. Edward Pool was reported missing in action on Nov. 30, 1950, while serving with 31st Heavy Mortar Company, 31st Infantry Regiment, 7th Infantry Division. His unit was part of the 31st Regimental Combat Team deployed east of the Chosin Reservoir in North Korea. Pool could not be accounted for after several days of intense fighting. Interment services are pending. Read more at: http://www.dpaa.mil/News-Stories/Recent-News-Stories/Article/1027047/soldier-missing-from-korean-war-identified-pool/.

-- Army Cpl. Jules Hauterman was a medic with the Medical Platoon, 1st Battalion, 32nd Infantry Regiment, 7th Infantry Division, attached to the 31st Regimental Combat Team deployed east of the Chosin Reservoir in North Korea. The RCT was attacked by an overwhelming number of Chinese forces in late November, 1950. Mainhart was among 1,300 members of the RCT killed or captured in enemy territory. He was reported missing as of Dec 2, 1950. Interment services are pending. Read more at: http://www.dpaa.mil/News-Stories/Recent-News-Stories/Article/1030834/soldier-missing-from-korean-war-identified-hauterman/.

-- Army Cpl. George A. Perreault was part of Support Force 21, assigned to Headquarters Battery, 15th Field Artillery Battalion, 2nd Infantry Division, near the Central Corridor in South Korea. While supporting Korean-led attacks on Chinese forces, they were caught in a massive Chinese counterattack on Feb. 11, 1951. Perreault was declared missing on Feb. 13, 1951. Interment services are pending. Read more at: http://www.dpaa.mil/News-Stories/Recent-News-Stories/Article/1029293/soldier-missing-from-korean-war-identified-perreault/.

VA Lowers Co-Pays

Veterans now will pay less out of pocket for outpatient medications they get for non-service connected conditions. The amount of the price drop will vary, depending upon the type of medicine and the reason why it is being prescribed. They will apply to veterans without service-connected conditions, or with higher incomes and disability ratings lower than 50 percent who are getting outpatient treatment for a non-service connected condition. The usual exemptions from copayments – for former prisoners of war and catastrophically disabled veterans – remain in effect. The change will take place next Feb. 27. Here are the fees:

* $5 for a 30-day or less supply, for Tier 1 outpatient medication
* $8 for a 30-day or less supply, for Tier 2 outpatient medication
* $11 for a 30-day or less supply, for Tier 3 outpatient medication

Defense Bill Would Draw Line on Medical Costs  

The version of the 2017 defense-spending bill that the House and Senate agreed to would hold out-of-pocket expenses for health-care coverage under TRICARE where they are. S. 2943 also would: 

 * Offer managed-care and no-referral options for TRICARE coverage.

* Extend operating hours at military treatment facilities.

* Expand private-public partnerships in health care, to broaden the reach of services to beneficiaries.

* Allow retirees to buy durable medical equipment at the same price the Defense Department pays.

* Standardize appointment scheduling and first-call resolution at military clinics.

* Increase the number of available appointments at military treatment facilities. 

Trump Promises VA Reform

President-Elect Trump is promising to eliminate the claims backlogs and inefficient services that continue to beset the Department of Veterans Affairs. "Too many of our nation's veterans are not receiving the timely and effective care they need, wherever and whenever they need it," the president-elect's web site states. Trump promises that VA will deliver state-of-the-art treatment and resolve veterans' claims in a timely manner. "Dishonest" VA employees will lose their jobs as well, while those in the department who work hard to serve veterans will be rewarded with promotions, according to the web site. 

Former Army Doc Plans Health Care Focus For House Veteran Affairs Committee

Rep. Phil Roe has been a licensed physician for the last 46 years, so it comes as little surprise that health care issues will be among his top priorities when he takes over the House Veterans’ Affairs Committee next year. 

“You have got to put patients and doctors, veterans and doctors back in charge of the [department’s] health care system,” the 71-year-old Tennessee Republican said in an interview with Military Times. 

“Not bureaucrats deciding everywhere you go and everything you do. You’ve got to let patients decide what is best for them. That may be staying inside the VA system. Or it may be having your private doctor outside the system. But the veteran can decide that.”

Roe, an Army medical corps veteran entering his fifth term in Congress, will become House Republicans’ top voice on VA reform efforts next month, replacing retiring committee chairman Rep. Jeff Miller, R-Fla.

In that role, he’ll be at the forefront of efforts to expand veterans' medical choices in the wake of VA’s 2014 medical wait times scandal, a problem that administrators and lawmakers have fought over for the last two years. 

The debate has invoked criticism that conservatives are looking to tear apart the existing veterans health care system and slowly hand over those responsibilities (and funding) to private sector practices. 

But Roe insists his goal is finding the proper balance between choice for patients and a robust medical safety net for veterans. 

He trained at VA facilities early in his career, and said he sees partnerships with outside medical centers as a logical step in providing more care to veterans without dismantling VA infrastructure. 
 

Roe tapped to lead House Veterans' Affairs Committee next year

“If you read through the Commission on Care report, one of their primary recommendations was setting up a primary care network for veterans,” he said, referring to a congressional advisory board's recent findings. “So if that veteran lives 10 miles or 50 miles or 100 miles from a VA [hospital], you could see a … certified primary care doctor instead.” 

Like other Republicans in the House, he’s leery of major new VA builds after multiple construction projects have come in over budget and behind schedule. He has been pleased with smaller VA clinic builds and leases in under-served areas. 

Almost immediately, he’ll be charged with evaluating the future of the contentious VA Choice Card program, which allows some veterans to seek outside care at the department’s expense. It’s scheduled to run out of funding in 2017. 

VA's top congressional critic could become the department's next secretary

Senators including John McCain, R-Ariz., have pushed to refund the program and make it permanent, even as they complain that VA leaders have stalled and mismanaged the program. 

Roe said he supports the Choice initiative but wants his first steps as chairman to compile a guide plan for the future of VA, drawing input from fellow lawmakers and outside groups. He expects to conduct that work in the first three months of the new Congress, and use the findings as a framework for appropriate legislation. 

He’s also recruiting newly elected veterans and physicians to join the committee next session, hoping they can bring additional perspective to the work.   

“We need to be looking at what health care is going to be looking at in five, 10, 15 years,” he said. “We’ve been where we’ve been, and we can’t keep doing things the same. There’s not a bottomless pit of money. We have to spend resources more wisely.” 

FOR IMMEDIATE RELEASE December 14, 2016

VA Grants Full Practice Authority to Advance Practice Registered Nurses Decision Follows Federal Register Notice That Netted More Than 200,000 Comments

WASHINGTON - The Department of Veterans Affairs (VA) today announced that it is amending provider regulations to permit full practice authority to three roles of VA advanced practice registered nurses (APRN) to practice to the full extent of their education, training, and certification, regardless of State restrictions that limit such full practice authority, except for applicable State restrictions on the authority to prescribe and administer controlled substances, when such APRNs are acting within the scope of their VA employment. “Advanced practice registered nurses are valuable members of VA’s health care system,” said VA Under Secretary for Health Dr. David J. Shulkin. “Amending this regulation increases our capacity to provide timely, efficient, effective and safe primary care, aids VA in making the most efficient use of APRN staff capabilities, and provides a degree of much needed experience to alleviate the current access challenges that are affecting VA.” In May 2016, VA announced its intentions, through a proposed rule, to grant full practice authority to four APRN roles. Though VA does have some localized issues, we do not have immediate and broad access challenges in the area of anesthesia care across the full VA health care system that require full practice authority for all Certified Registered Nurse Anesthetists (CRNAs). Therefore, VA will not finalize the provision including CRNAs in the final rule as one of the APRN roles that may be granted full practice authority at this time. VA will request comment on the question of whether there are current anesthesia care access issues for particular states or VA facilities and whether permitting CRNAs to practice to the full extent of their advanced authority would resolve these issues. APRNs are clinicians with advanced degrees and training who provide primary, acute and specialty health care services; they complete masters, post-masters or doctoral degrees. There are four APRN roles: Certified Nurse Practitioner, Clinical Nurse Specialist, Certified Registered Nurse Anesthetist, and Certified Nurse Midwife. “CRNAs provide an invaluable service to our Veterans,” Under Secretary for Health Shulkin continued. “Though CRNAs will not be included in VA’s full practice authority under this final rule, we are requesting comments on whether there are access issues or other unconsidered circumstances that might warrant their inclusion in a future rulemaking. In the meantime, we owe it to Veterans to increase access to care in areas where we know we have immediate and broad access challenges.” All VA APRNs are required to obtain and maintain current national certification. The final rulemaking establishes professional qualifications an individual must possess to be appointed as an APRN within VA, establishes the criteria under which VA may grant full practice authority to an APRN and defines the scope of full practice authority for each of the three roles of APRN. Certified Registered Nurse Anesthetists will not be included in VA’s full practice authority under this final rule. VA is the nation’s largest employer of nurses; as of July 2016 its workforce of approximately 93,500 nurses (RNs, LPNs, NAs) includes approximately 5,769 APRNs For more information about openings for nurses or other health care positions at VA, visit Vacareers@va.gov.

Bill to Honor Certain Guard-Reserve Retirees as Veterans Passes Congress

Members of the Guard and Reserve have had the opportunity to serve for twenty years or more and earn a military retirement for many decades.  This service could be a combination of active duty and reserve component duty or totally reserve component duty.  When members retired from the reserve components they were recognized as military retirees and had the same benefits as other military retirees, including most VA benefits.  However, this did not include the right or opportunity to use VA health care facilities.  

In spite of that, they were not recognized by the government as a “veteran” unless they had served on active duty (Title 10) orders other than for training for 180 consecutive days or more. Upon retirement from the reserve components they did not receive a DD-214. 

That is about to change.  Congress has now passed legislation that will honor all members of the Guard and Reserve who are eligible for retirement pay as military veterans, although it does not confer any new or additional benefits.

Some actually serve in an operational capacity for more than 180 consecutive days, but the Reserve Components (RC) have over 20 categories of orders which they can use to mobilize Guardsmen and Reservists.  In fact, in many instances RC members were deliberately kept off of Title 10 orders in order to reduce the benefits they would be entitled to, including veterans benefits.

Especially now, when the RC have become an integral part of our Armed Forces, it makes sense to recognized Guard-Reserve retirees as veterans.  We want to extend special thanks to Congressman Tim Walz of Minnesota, the highest ranking enlisted person ever to serve in Congress, for his dogged determination, year after year, to champion this legislation.  Without his tireless support this probably would never have happened.  We have also had champions in the Senate including Senator John Boozman of Arkansas and Richard Blumenthal of Connecticut.  We are grateful to all of them for their hard work on this issue.

Career Ready Student Veterans Act Becomes Law

The short-term government funding bill that President Obama signed last week contained a provision that is intended to prevent student veterans from using their Post-9/11 G.I. Bill benefits on career programs that won't help them land a job.

The Career Ready Student Veterans Act, which TREA: The Enlisted Association supported, would prohibit institutions from receiving GI Bill benefits if their programs don't meet the requirements needed for required licensing exams or certification in order to enter the chosen career field.

A group called Veterans for Education Success conducted a study last year that found that 20 percent of about 300 approved programs to train veterans were improperly accredited and that, as a result, their graduates were not eligible to sit for licensing exams or certification in their fields of study. The report identified eight programs offered by 15 different institutions at 60 campuses that failed to meet employer or state requirements.

The legislation was originally sponsored by Senator Thom Tillis (R-NC).

“Privatization” Comes to Washington, D.C.

Will it Affect you?

One of the buzzwords being heard more frequently in the nation’s capital is “privatization.”  In a nutshell, the term means contracting with civilians and civilian companies to do the jobs that federal employees used to do.

In recent days there has been talk of privatizing Medicare and the Department of Veterans Affairs.  While it hasn’t been described as such, parts of the military have been privatized since the beginning of the wars in Iraq and Afghanistan by hiring contractors who do many of the jobs uniformed personnel used to do.  It’s true that contactors were used during World War II, but it was not nearly to the extent that they are being used today. 

There has been talk of privatizing commissaries for a few years now, and while actual privatization appears to be on hold, officials in the Pentagon who are in charge of the commissaries are moving ahead with a plan to reduce the commissaries’ dependence on tax dollars.  This is being done as a result of threats by Congress, led by Arizona Senator John McCain, to fully privatize commissaries.

The Pentagon officials have told Congress that the commissary benefit cannot be maintained if they are fully privatized.   But they are implementing programs they say are designed to reduce the taxpayer subsidy while keeping the benefit.

Next year commissary shoppers will see fewer overall name-brand products on the commissary shelves, while also seeing for the first time generic products – products with the commissary’s brand on them.  For instance, today if you go to Walmart to buy groceries, you see a brand called “Great Value,” which is the Walmart brand.  These products generally cost less than the name-brand products, but some people would argue the quality is also less. 

In any case, that is where the commissaries are headed.

With all of these issues, whether it’s commissaries or Veterans Affairs or Medicare or any others, you can be sure TREA is carefully monitoring these issues and will alert you anytime we believe your promised and earned military benefits are in danger.

 “Fairness for Vets Act” Included In NDAA

An important amendment to the Fiscal Year 2017 National Defense Authorization Act (NDAA) made it through both the House and Senate and is expected to be signed by President Obama:  it requires military record review boards to give liberal consideration to medical conditions like Post-Traumatic Stress Disorder (PTSD), Traumatic Brain Injury (TBI), and Military Sexual Trauma (MST) in the discharge review process.

This is essentially the codification of the “Hagel Memo,” which was penned by former Secretary of Defense Chuck Hagel in early 2014 but that has been haltingly applied by the various military Departments. For instance, the Army only recently hired two mental health specialists to work full-time on military record reviews; previously doctors with specialties like orthopedics or obstetrics were given the ability to weigh in on things like PTSD, when they had no formal training on the subject.

It should be pointed out that servicemembers who are discharged with “bad paper” discharges (which are General or Other-Than-Honorable discharges, NOT Dishonorables) have not been court-martialed, and are at vastly higher risk of developing substance abuse problems, unemployment and homelessness without access to the VA’s mental healthcare services.

Allowing these veterans to be treated at the VA can head off much more serious, life-threatening issues with simple, cost-effective treatment once the servicemember leaves the service. Currently these “bad paper discharge” servicemembers suffer for years and eventually become a much bigger burden to society than they would have been if we had just stepped to the plate and gotten them the help they needed at the outset, so they can get their lives back on track and become productive members of society.

 VA Study Confirms High Cure Rates With New Hepatitis C Drugs

Virus undetectable in high percentage of patients after treatment.

WASHINGTON – A Department of Veterans Affairs (VA) database study shows that new drug regimens for hepatitis C have resulted in “remarkably high” cure rates among patients in VA's national health care system.

Of the more than 17,000 Veterans in the study, all chronically infected with the hepatitis C virus at baseline, 75 percent to 93 percent had no detectable levels of the disease in their blood for 12 or more weeks after the end of treatment. The therapy regimens lasted 8 to 24 weeks, depending on patient characteristics.

“This promising news comes as VA is dedicating significant funds to help greater numbers of patients with hepatitis C,” said David Shulkin VA Under Secretary for Health. “In March, we announced our ability to fund care for all Veterans with hepatitis C for fiscal year 2016 regardless of the stage of the patient’s liver disease. VA has long led the country in screening for and treating hepatitis C. As of mid-September 2016 alone, the Department treated more than 100,000 Veterans infected with the virus. More than 68,000 of these patients had been treated with these new highly effective antivirals.”

The VA researchers analyzed data from four subgroups of patients infected with hepatitis C—genotypes 1, 2, 3, and 4—and found that genotype 1 patients showed the highest cure rates and genotype 3 the lowest. Genotype 1 was by far the most common type of infection among the four subgroups.

The study group of more than 17,000 Veterans included more than 11,000 patients with confirmed or likely cirrhosis, a liver disease that can result from hepatitis C, among other causes. The study team found "surprisingly high" response rates of around 87 percent in this group.

The overall results were consistent with those from earlier clinical trials that led to FDA approval of the three new drug regimens in the study: sofosbuvir (SOF), ledipasvir/sofosbuvir (LDV/SOF) and paritaprevir/ ritonavir/ ombitasvir and dasabuvir (PrOD).

The drugs, introduced in 2013 and 2014, have been credited with revolutionizing hepatitis C treatment, which means a cure is now in reach for the vast majority of patients infected with the virus. Previously, using earlier drug regimens, most patients could expect, at best, only a 50 percent chance of a cure.

"Our results demonstrate that LDV/SOF, PrOD and SOF regimens can achieve remarkably high SVR [sustained virologic response] rates in real-world clinical practice," VA researchers wrote.

The new drug regimens examined in the study do not contain interferon, which has troublesome side effects such as fever, fatigue, and low blood counts. The newer drugs are considered far more tolerable than the older interferon-based antiviral regimens, although they are far more expensive.

The researchers extracted anonymous data on all patients in VA care who received HCV antiviral treatments between January 2014 and June 2015 using the VA Corporate Data Warehouse, a national, continually updated repository of data from VA's computerized patient records.

The study's optimistic finding is a source of optimism for Veterans and others infected with the hepatitis C virus, according to coauthors Dr. Lauren Beste and Dr. George Ioannou, specialists in internal medicine and hepatology, respectively, with the VA Puget Sound Health Care System in Seattle.

According to the researchers, modern, direct-acting antiviral drugs for hepatitis C far outperform our older options in terms of efficacy and tolerability. With older drugs, most patients could not undergo antiviral treatment because they had contraindications or medication side effects. With newer options, almost anyone can safely undergo treatment for hepatitis C.

VA research continues to expand knowledge of the disease through scientific studies focused on effective care, screening, and health care delivery. Some studies look at particular groups of hepatitis C patients—for example, female Veterans, or those with complicated medical conditions in addition to hepatitis C.

For more information on VA care for hepatitis C, visit www.hepatitis.va.gov and www.hepatitis.va.gov/patient/hcv/index.asp. Information about the database study may be found in the September 2016 issue of the journal Gastroenterology.

- See more at: http://www.va.gov/opa/pressrel/pressrelease.cfm?id=2846#sthash.LaSgU6nY.dpuf

New Regulation Decreases Cost of Outpatient Medication Copay for Most Veterans Washington –

The Department of Veterans Affairs (VA) is amending its regulation on copayments for Veterans’ outpatient medications for non-service connected conditions. VA currently charges non-exempt Veterans either $8 or $9 for each 30-day or less supply of outpatient medication, and under current regulations, a calculation based on the medication of the Medical Consumer Price Index (CPI-P) would be used to determine the copayment amount in future years. “Switching to a tiered system continues to keep outpatient medication costs low for Veterans,” said VA Under Secretary for Health Dr. David J. Shulkin. “Reducing their out-of-pocket costs encourages greater adherence to prescribed outpatient medications and reduces the risk of fragmented care that results when multiple pharmacies are used; another way that VA is providing better service to Veterans.” This new regulation eliminates the formula used to calculate future rate increases and establishes three classes of outpatient medications identified as Tier 1, Preferred Generics; Tier 2, Non-Preferred Generics including over-the-counter medications; and Tier 3, Brand Name. Copayment amounts for each tier would be fixed and vary depending upon the class of outpatient medication in the tier. These copayment amounts will be effective February 27, 2017: $5 for a 30-day or less supply - Tier 1 outpatient medication $8 for a 30-day or less supply - Tier 2 outpatient medication $11 for a 30-day or less supply - Tier 3 outpatient medication These changes apply to Veterans without a service-connected condition, or Veterans with a disability rated less than 50 percent who are receiving outpatient treatment for a non-service connected condition, and whose annual income exceeds the limit set by law. Medication copayments do not apply to former Prisoners of War, catastrophically disabled Veterans, or those covered by other exceptions as set by law. Copayments stop each calendar year for Veterans in Priority Groups 2-8 once a $700 cap is reached. More information on the new tiered medication copayment can be found at: https://www.gpo.gov/fdsys/pkg/FR-2016-12-12/pdf/2016-29515.pdf

VA Recommends 14 Future Sites for Fisher House Construction Fisher Houses are Homes Away from Home for Families of Veterans Receiving Treatment

WASHINGTON – The Fisher House offers unique accommodations when a family member is receiving treatment at a VA medical center or military hospital. Located near the medical center or hospital, Fisher Houses offer the comforts of home at no cost to families while treatment is underway. To enable Fisher Houses to expand their good work, Department of Veterans Affairs’ Secretary Robert A. McDonald recommended 14 VA medical centers become priority sites for future Fisher Houses. “Fisher House is simply one of those best-in-class organizations and we want to do everything that we can to support their important and noble mission,” said Secretary McDonald. “Their goal is selfless: to serve the families of Veterans who served our nation.” The 14 recommended sites are: James J. Peters VA Medical Center, Bronx, N.Y. VA Hudson Valley Health Care System, Montrose, N.Y. Southeast Louisiana Veterans Health Care System, New Orleans Kansas City VA Medical Center, Kansas City, Mo. VA Ann Arbor Healthcare System, Ann Arbor, Mich. White River Junction VA Medical Center, White River Junction, Vt. Huntington VA Medical Center, Huntington, W.Va. William Jennings Bryan Dorn VA Medical Center, Columbia, S.C. Bay Pines VA Healthcare System (second house), Bay Pines, Fla. Hunter Holmes Maguire VA Medical Center (second house), Richmond, Va. Harry S. Truman Memorial Veterans' Hospital, Columbia, Mo. Perry Point VA Medical Center- VA Maryland Health Care System, Perry Point, Md. South Texas Veterans Healthcare System (second house) San Antonio Overton Brooks VA Medical Center, Shreveport, La. Following the Secretary’s recommendations, a timeline for construction will be completed by the Fisher House Foundation based on VA and Department of Defense construction priorities. In 2016, Fisher Houses accommodated over 23,000 families, saving guests over $3 million in lodging expenses. The addition of 14 VA Fisher House sites will support access to care for thousands of additional Veterans traveling to VA facilities for treatment. The Fisher House Foundation has built and donated 31 Fisher Houses to VA and 40 Fisher Houses to the Department of Defense. VA has 16 Fisher House sites in various stages of construction planning, with the newest being built in Charleston, S.C., Houston and Orlando, Fla. With the additional locations, VA will expand to at least 61 houses over the next several years. For more information on Fisher Houses, visit VA Fisher House Program.

Pearl Harbor Day:

On Wednesday, VFW Posts across the country commemorated the 75th anniversary of the surprise attack that brought the United States into World War II. In Hawaii, dozens of attack survivors were present, to include four of the five remaining USS Arizona survivors. Also present were VFW National Commander Brian Duffy and VFW Auxiliary National President Colette Bishop, who attended commemoration ceremonies and presented a VFW wreath aboard the Arizona Memorial. The Chief would also meet with the senior leadership of U.S. Pacific Command, Pacific Air Forces, and U.S.

Army-Pacific, and the Defense POW/MIA Accounting Agency to express our support of their missions, as well as to discuss the many troop and family support programs the VFW provides to military communities everywhere.

Veterans Legislation Passes:

This week the House of Representatives passed nine bills, two of which have previously passed the Senate. The two that have passed both chambers of Congress and await the president’s signature are S. 3076, a bill to ensure that veterans with no next-of-kin or who lack the financial resources are provided with a casket or urn; and S. 3492, which will name a VA outpatient clinic in Michigan after Colonel Demas T. Craw.

The remaining bills await Senate action. They are: H.R. 6435 will allow independent investigations at VA medical centers; H.R. 5099 allows VA to enter into five public-private partnerships to offset the cost of building VA medical centers; H.R. 4298 directs the Secretary of the Army to place a memorial at Arlington National Cemetery honoring Vietnam era helicopter pilots and crews;

H.R. 5399 will improve accountability of VA doctors; H.R. 4150 will allow VA to better schedule VA doctors’ work hours; H.R. 4352 calls for a pilot program to allow veterans to self-schedule their appointments; and H.R. 6416, a veterans omnibus package that will, among other provisions, allow for toxic exposure research, restore certain educational benefits for National Guard and Reservists and expand homeless veterans’ benefits.

Action Corps will provide you an update on the status of these and other bills that may pass in next week’s Action Corps Weekly.

VA Cemeteries Offering Pre-Enrollment for Eligible Veterans: 

The Department of Veterans Affairs (VA) this week announced it now provides eligibility determinations for interment in a VA national cemetery prior to the time of need. Through the Pre-Need Determination of Eligibility Program, upon request, individuals can learn if they are eligible for burial or memorialization in a VA national cemetery. Secretary of Veterans Affairs Robert A. McDonald said, “This new program reaffirms our commitment to providing a lifetime of benefits and services for veterans and their

families.” Now veterans and their families can plan for their burial needs which will alleviate some of the burden later.

Interested individuals may submit VA Form 40-10007, Application for Pre-Need Determination of Eligibility for Burial in a VA National Cemetery, and supporting documentation, such as a DD Form 214, if readily available, to the

VA National Cemetery Scheduling Office by toll-free fax at 1-855-840-8299; email to Eligibility.PreNeed@va.gov; or mail to the National Cemetery Scheduling Office, P.O. Box 510543, St. Louis, MO 63151.

MIA Update:

The Defense POW/MIA Accounting Agency announced the identification of remains of two Americans who had been missing in action from Korea. Returning home for burial with full military honors are:

-- Army Cpl. David T. Nordin, Jr., 23, of Los Angeles, will be buried in Kent, Washington, on Dec. 16. Nordin was a member of Company K, 3rd Battalion, 35th Infantry Regiment, 25th Infantry Division. He was declared missing Nov. 28, 1950, after his unit was attacked by Chinese forces while establishing a position near Unsan, North Korea, as part of a United Nations Command offensive.

Read more at: http://www.dpaa.mil/News-Stories/News-Releases/Article/1024527/soldier-killed-in-korean-war-accounted-for-nordin/.

-- Army Sgt. Stafford L. Morris was a member of Battery A, 503rd Field Artillery Battalion, 2nd Infantry Division. His unit was operating just north of Kujang-dong, North Korea, when it was attacked by overwhelming Chinese forces and was forced to withdraw through an area referred to as “The Gauntlet.” Morris was declared missing on Dec. 1, 1950. Interment services are pending. Read more at: http://www.dpaa.mil/News-Stories/Recent-News-Stories/Article/1024636/soldier-missing-from-korean-war-identified-morris/.

VA National Cemeteries Now Offering Pre-Need Eligibility Determinations WASHINGTON –

The Department of Veterans Affairs (VA) today announced it now provides eligibility determinations for interment in a VA national cemetery prior to the time of need. Through the Pre-Need Determination of Eligibility Program, upon request, individuals can learn if they are eligible for burial or memorialization in a VA national cemetery. “MyVA is about looking at VA from the Veterans’ perspective, and then doing everything we can to make the Veteran Experience effective and seamless,” said Secretary of Veterans Affairs Robert A. McDonald. “This new program reaffirms our commitment to providing a lifetime of benefits and services for Veterans and their families.” Interested individuals may submit VA Form 40-10007, Application for Pre-Need Determination of Eligibility for Burial in a VA National Cemetery, and supporting documentation, such as a DD Form 214, if readily available, to the VA National Cemetery Scheduling Office by: toll-free fax at 1-855-840-8299; email to Eligibility.PreNeed@va.gov; or mail to the National Cemetery Scheduling Office, P.O. Box 510543, St. Louis, MO 63151. VA will review applications and provide written notice of its determination of eligibility. VA will save determinations and supporting documentation in an electronic information system to expedite burial arrangements at the time of need. Because laws and personal circumstances change, upon receipt of a burial request, VA will validate all pre-need determinations in accordance with the laws in effect at that time. VA operates 135 national cemeteries and 33 soldiers’ lots in 40 states and Puerto Rico. More than 4 million Americans, including Veterans of every war and conflict, are buried in VA’s national cemeteries. VA also provides funding to establish, expand and maintain 105 Veterans cemeteries in 47 states and territories including tribal trust lands, Guam, and Saipan. For Veterans buried in private or other cemeteries, VA provides headstones, markers or medallions to commemorate their service. In 2016, VA honored more than 345,000 Veterans and their loved ones with memorial benefits in national, state, tribal and private cemeteries. Eligible individuals are entitled to burial in any open VA national cemetery, opening/closing of the grave, a grave liner, perpetual care of the gravesite, and a government-furnished headstone or marker or niche cover, all at no cost to the family. Veterans are also eligible for a burial flag and may be eligible for a Presidential Memorial Certificate. Information on VA burial benefits is available from local VA national cemetery offices, from the Internet at www.cem.va.gov, or by calling VA regional offices toll-free at 800-827-1000. To make burial arrangements at any open VA national cemetery at the time of need, call the National Cemetery Scheduling Office at 800-535-1117.

DOD Tried to Hide a Shocking Study About Its Wasteful Spending

According to a report in the Washington Post that was just released, the Pentagon wastes about $125 billion – nearly a quarter of its annual budget – on back-office administrative functions. But because DoD officials feared this would cause Congress to cut its budget instead of giving it more money they buried the study and hoped it would never be revealed.

Many have long advocated that the Department of Defense needs to be audited because of the huge amount of waste we believe takes place. The DoD, which has been under orders from Congress for years to get its books in order so it can be audited, kept making excuses and putting it off time after time. It is the only department of the federal government which has never been audited.

Amazingly, this study, done by outside businessmen, took less than a year to complete. According to the report in the Post, high ranking DoD officials had to intervene at times to get some information out of the bowels of the Pentagon because some people were trying to hide the information in the hope that the request would be forgotten and blow over.

The study identified ways DoD could save $125 billion over five years. According to the Post, “The plan would not have required layoffs of civil servants or reductions in military personnel. Instead, it would have streamlined the bureaucracy through attrition and early retirements, curtailed high-priced contractors and made better use of information technology.”

And yet, instead of trying to save money DoD officials tried to bury the report.

The Pentagon has complained that retirees and uniformed personnel cost too much, and year after year it has proposed dramatic cuts in retirement pay and health care for retirees and active duty personnel. Fortunately, Congress has blocked many of those proposals, but last year a new retirement system was put into law that will force active duty personnel to fund part of their own retirement.

In addition, Congress is on the verge of overhauling the military health care system and forcing active duty personnel and some retirees to pay more for their health care. This is because health care costs are supposedly “eating the Defense Department alive” in the words of former Defense Secretary Robert Gates.

The Coalition is not happy with the increased costs of health care that have been forced upon active duty personnel and some retirees but we hope that this new report will at least take the steam out of the constant calls for more cuts in health care and other benefits that have become so constant in recent years.

Finally, we have proof that what’s actually eating DoD alive is the incredible waste in its administrative and other functions. This is a story that should receive nation-wide attention by the media. The Pentagon needs to be held accountable and they bureaucrats need to stop blaming military personnel for the high costs of its operations.

You can read the entire Washington Post story here: https://www.washingtonpost.com/investigations/pentagon-buries-evidence-of-125-billion-in-bureaucratic-waste/2016/12/05/e0668c76-9af6-11e6-a0ed-ab0774c1eaa5_story.html?utm_term=.87aa269e31e0&wpisrc=nl_headlines&wpmm=1

Blood Pressure Study: Vietnam Era Veterans

Study of nearly 4,000 Veterans in the Army Chemical Corps between 1965 and 1973

By Stephanie Green Eber, MPH Health Science Specialist - Epidemiology Program VA Office of Patient Care

Tuesday, November 29, 2016

VA researchers found a link between service-related occupational exposure to herbicides and high blood pressure (hypertension) risk among U.S. Army Chemical Corps (ACC) Veterans, a group of Veterans assigned to do chemical operations during the Vietnam War. Researchers also found an association between military service in Vietnam and hypertension risk among these Veterans.

Researchers at VA’s Post Deployment Health Services Epidemiology Program, Office of Patient Care Services, conducted the Army Chemical Corps Vietnam-Era Veterans Health Study, a three-phase study of nearly 4,000 Veterans who served in the U.S. Army Chemical Corps between 1965 and 1973. The study included a survey that requested information on these Veterans’ exposure to herbicides, whether they were ever diagnosed with hypertension by a physician, and their health behaviors such as cigarette smoking and alcohol use. To confirm self-reported hypertension, researchers conducted in-home blood pressure measurements and a medical records review for a portion of study participants.  

Hypertension highest among Veterans who distributed or maintained herbicides (sprayers) in Vietnam.

ACC Veterans were studied because of their documented occupational involvement with chemical distribution, storage, and maintenance while in military service.This study follows a request by former Secretary of Veterans Affairs Eric K. Shinseki for VA to conduct research on the association between herbicide exposure and hypertension to learn more about if hypertension is related to military service in Vietnam. The research was originally designed and led by Han Kang, Dr.P.H., former director of VA’s Epidemiology Program (now retired). Yasmin Cypel, Ph.D., M.S., another researcher with VA’s Epidemiology Program, is currently the principal investigator on this study, which extends prior research on these Veterans.

“This study expands our knowledge of the relationship between hypertension risk and both herbicide exposure and service in Vietnam among Veterans who served during the War by focusing on a specific group of Vietnam era Veterans who were occupationally involved in chemical operations,” said Dr. Cypel.     

Self-reported hypertension was the highest among Veterans who distributed or maintained herbicides (sprayers) in Vietnam (81.6%), followed by Veterans who sprayed herbicides and served during the Vietnam War but never in Southeast Asia (non-Vietnam Veterans) (77.4%), Veterans who served in Vietnam but did not spray herbicides (72.2%), and Veterans who did not spray herbicides and were non-Vietnam Veterans (64.6%).

The odds of hypertension among herbicide sprayers were estimated to be 1.74 times the odds among non-sprayers, whereas the odds of hypertension among those who served in Vietnam was 1.26 times the odds among non-Vietnam Veterans.

The researchers would like to extend their thanks to all those Army Chemical Corps Vietnam Era Veterans who participated in this study for their contribution to the research.  Without their input there would be no findings to report and no additions to existing findings on the health consequences of military service during the Vietnam War. 

VA will review the results from this research, along with findings from other similar studies and recommendations from the recent National Academies of Science report on Veterans and Agent Orange, when considering whether to add hypertension as a presumptive service condition for Vietnam Veterans.

To read more about the Army Chemical Corps Vietnam-Era Veterans Health Study, go to http://www.publichealth.va.gov/epidemiology/studies/vietnam-army-chemical-corps.asp.  To read the published article containing findings from this study, go to https://www.ncbi.nlm.nih.gov/pubmed/27820763.