Health Care Happenings

“Shocking!”

          “A National Disgrace!”

“Veterans and Their Families Suffer Repeated Indignities!”

          “VA has yet to explain why a 90-year-old veteran needs to “save” 20% or 30% of his monthly payments for ‘future needs’ when he cannot afford prescribed medicines and already has over $1000,000.00 in his name!”

The above quotes come from a pretty intensive House Veterans’ Affairs Subcommittee hearing I attended yesterday where witnesses described to lawmakers case-after-case and detailed examples of flaws and failures in the Department of Veterans Affairs Fiduciary System.

To put things in perspective, VA’s Fiduciary System has been under scruitiny on a number of fronts in recent years and there has been much concern about the efficiency, effectiveness, and efficacy of a system that is suppose to be looking out for the best interests of veterans and their beneficiaries. 

To many veterans and caregiver-family fiduciaries, the VA Health Administration (VHA) care and case management is far superior than the support they receive from the VA Benefits Administration (VBA) who manages and oversees the Fiduciary System.

Here’s some facts from the hearing:

• The system was establish in 1926 and has been operating off regulations dating back to 1975.
• VA oversees approximately 95,000 fiduciaries, managing the financial affairs of more than 121,000 beneficiaries, paying about $53.5 billion in compensation and pension benefits in 2011–fiduciaries managed approximately $171 million in VA benefits.
• Several hearings, Government Accounting Office, and VA Inspector General reports and investigations as far back as 1998 pointed to a number of deficiencies in managment controls and oversight, insufficient  staffing, training, and workload management. 
• Not until April 2011 did veterans and their beneficiaries get much needed relief and control of their finances and futures, “the day the U.S. Court of Appeals for Veterans Claims (Veterans Court”) held that the appointment of a VA fiduciary is appealable to the Board of Veterans’ Appeals and to the Veterans Court thereafter (Freeman v.Shinseki).  No longer are veterans’ fiduciary-related questions and disagreements discarded with a terse VA letter asserting that such issues are ‘within the sole descretion’ of the Secretary.”

While VA management has reorganized and consolidated their Fiduciary System, added more funding, personnel and accountability and oversight, witnesses cited a number of cases in the field, where the program still operates as before, and veterans continue to have their money taken away from them by VA-appointed fiduciaries who will not talk to them or their beneficiaries–veterans are suffering because they can’t get additional funds on an emergent or timely basis, and are unable to obtain basic account information regarding ‘their VA funds.” 

One caregiver, the mother of a severely injured servicemember who sustained multiple injuries in 2005 as a result of an IED blast in Iraq, was appointed as her son’s fiduciary in 2007. 

She told lawmakers she was stunned to receive three letters from the VBA citing her failure to submit timely accounting information as a breach of her fiduciary duty, threating to remove her as a fiduciary, even after her repeated efforts to communicate with VA and be proactive in her duties.

“From the perspective of a mother of a very severely wounded warrior, VBA communications like this–suggesting that with the stroke of a pen I could be deemed ‘unqualified’ and lose the right to manage my son’s finances–are very stressful.  Despite my being a loving caregiver, this program operates in a manner that leaves me feeling as though something threatening is always hanging over my head…I understand the need for methodical recordkeeping and reporting [as someone with a college degree in business/accounting] in the interest of documenting appropriate financial management of my son’s compensation.  But I do not understand an agency that is so quick to threaten, so unresponsive to questions, so much of a ‘black hole,” said the mother.

 Needless to say the stories were heart-breaking, including a number of cases two attorney witnesses shared with the Committee:

“After 10 years of ‘excellent’ account reports, a VA Field Examiner in Texas made a personal home visit and summarily removed the spouse-payee of one of my clients because of supposed accounting discrepancies.  That very same day the Examiner appointed a paid fiduciary and stopped the veteran’s direct deposit of monthly VA funds.  It was another 10 days before the veteran received a letter informing him of these actions.”

“Today, the VA will determine that a wife of more than 60 years with her full mental faculties is not qualified to make financial decisions for her veteran husband.”

“Today, VA will decide a veteran’s financial needs for the next 3-years based on a single hour-long interrogation by a VA ‘field examiner’ who possesses no discernbable expertise in finance, social work, mental health, or any other discipline reasonably viewed as pertaining to such a task…”

…and these kind of stories are being lived out every day by our most vulnerable veterans and their families.

MOAA appreciates the Congress’ attention on this very important matter and applauds the action the Committee took at the close of the hearing to get answers from VA officials to address these grievous and unconscionable actions against our nation’s heroes.

MOAA intends to do all we can to help veterans, their families, the VA, and Congress put veteran’s first and right these system failures. 

I had to stop in my tracks when I saw a Military Times article that read:

“DoD:  Tricare beneficiaries should go to MTFs.”

The article states that the Defense Department [according to a Pentagon task force report] could save about $16.4 billion by eliminating all ‘purchased care contracts’ from the military health care system–or, more simply put, directing beneficiaries to get their care at military hospitals and clinics, or technically refered to as, ‘direct care,’ where patients are cared for by military and civilian providers that are directly hired by the military rather than civilian contractors.

Reading the article made me a little dizzy–from the outside looking in, it seems as though we’ve traveled back to earlier times, earlier proposals–is the Department a ship adrift with no compass–grabbing at any possible solution to address pending budget cuts?

Accordining to the assistant secretary of defense for health affairs, Dr. Jonathan Woodson, “about 4.5 million of the 7.7 million Tricare Prime-eligible beneficiaries use military treatment facilities”  — by optimizing the use of purchased and direct care systems the DoD would better managed costs.

So as a TRICARE benefiicary–purchased care or direct care user–

what are your thoughts?

My thoughts, we raise TRICARE Fees with the expectation that care and access will be better, only to learn that perhaps, what we have to say or what we think our needs are, aren’t nearly as important as what the “System” tells us is best for us.  I can’t say I’ve seen any indication these last several years that the DoD knows the true cost of delivering health care, much less how to manage these costs.

HOW’S YOUR HEART?

Did you know heart disease should be one of our most important concerns in midlife?

Though we may want the sports car or change to a career that is more fun and exciting, we also want to be healthy.  Health includes a Healthy Heart.

Accordinging to a study at the Northwestern University Feinberg School of Medicine, blood pressure plays a significant role in the long-term outlook of your heart health.

Eat Right!

Exercise!

Healthy Weight Level!…………………………….we know these are important factors to heart health, and our overall physical and mental health.

Often when we think of heart disease, we associate men with the condition.

However, heart disease is the leading cause of death for women in our country.

…And, women don’t always know or recognize the threat of heart disease or understand the risk factors associated with the disease.

In addition to high blood pressure,  other risk factors for both men and women include:

• high cholesterol
• diabetes
• overweight and obesity
• smoking
• lack of physical activity
• unhealthy diet
• stress

Want to learn more?  Visit the U.S. Department of Health and Human Services and make YOUR HEART and YOUR LIFE, A HAPPY ONE

First Lady Michelle Obama announced new regulations to the Family and Medical Leave Act (FMLA) this week at the Department of Labor, which will support military families and caregivers of the wounded, ill and injured.

“We want to recognize the extraordinary dedication, sacrifice and service of our nation’s caregivers, not simply with words, but with deeds,” said Mrs. Obama.  “These are men and women and children who will do anything for their loved ones, no matter the cost, no matter the sacrifice, no matter the consequences.” 

Secretary of Labor Hilda Solis joined the First Lady to recognize the contributions of caregivers, and highlight the many challenges facing servicemembers and their families when they come home–”many come home stressed, ill and injured…they need attention, care and support.” 

Generally, FMLA allows eligible employees to take up to 12 weeks of unpaid or job protected leave within a 12-month period for specified family and medical reasons such as birth, adoption or placement of a child, care of a family member with a health condition, or the employee’s own health condition.

The Act was further expanded in 2008 to provide certain family members of the National Guard, Reserves or regular armed forces up to 26-workweeks in a single 12-month period to care for a servicemember with a serious injury or illness incurred in the line of duty.

The White House and Department of Labor’s rule changes would extend FMLA leave protections to not only include military caregivers but also military families as a whole. Key aspects of the new rules would allow for:

• 26-weeks of military caregiver leave entitlement to cover family members caring for recent veterans with serious line of duty injuries or illness, including conditions that may surface up to five years after the member leaves military service.
• The spouse, child, or parent of an active duty servicemember to take leave to deal with deployment-related issues and events such as financial or legal issues, child care arrangement, or to attend military events before, during or after deployment to a foreign country.
• Up to 15-days of leave to spend time with a servicemember during rest and recuperation leave.

I was heartened to see such support continue to be a priority in our government, as well as very senior officials at the highest levels of the Departments of Defense, Veterans Affairs and Labor in attendance to celebrate these families-caregivers and endorse the new changes to the FMLA.

But nothing compared to the humble and extremely appreciative response of those military, veterans, families, and caregivers in the audience that day.

One caregiver, RyAnne Noss, spouse of Sgt. 1st Class Scott Noss who was injured in a helicopter crash in Afghanistan in early 2007, reflected this appreciation, but more importantly, the incredible strength, determination and unfailing love she has for her husband–to care for him no matter what.

“I’m proud to have been by Scott’s side through his rehabilitation and proud to have him home with me now where he continues to require around-the-clock-care…I’m proud to be my husband’s caregiver,” RyAnne told attendees. 

Like RyAnne, many caregivers and military families appreciate any and all the help they can get.

MOAA wants ReAnne and other caregivers-families to know they can count on us to to support them and be their voice.

Well, the dreaded time has finally come…what has been chatter and mounting talk about budget cuts and increases in health care fees is here.

No more what if’s.

No more maybe’s.

No more speculation.

The Defense Department put some information about proposed cuts on the table yesterday when the Secretary of Defense, Leon Panetta announced details of his FY2013 budget. 

Though the full details will not be released until February 13 when the President releases his buget to Congress, the targets for significant cuts are clearly in eye sight…

        Uncle Sam wants you to give back money you, and your family have earned through a full career of service and sacrifice

“…Given the significant fiscal constraints that have been imposed on this Department, our approach was to use this as an opportunity to maintain the strongest military in the world, to not hollow out the force, to take a balanced approach by putting everything on the table, and to not break faith with the troops or their families…,” said Panetta.

Retirees, under age 65, will be hit hardest by major increases in health care fees. 

Here’s what the Pentagon wants from YOU (see more details in this week’s MOAA Legislative Update):

• New enrollment fees and additional fee increases for those enrolled in TRICARE by creating a ‘tiered’ approach based on retired rank.  This means-testing will require senior grade retirees to pay more for their health care than junior retirees;
• An enrollment fee for TRICARE for Life beneficiaries 65 and older; and,
• Additional increases in pharmacy co-pays with the goal of increasing the use of generics and the mail order pharmacy.

Should Congress approve the ‘tiered’ approach to health care fees, then that would make military retirees the only group of government retirees to be subject to means-testing  

In other words, the longer and more successfully you serve, the less benefit you earn

So what do you think–Does this break faith with the troops or their families” (SecDef’s words)?

Tell us what you think…And, even more important, tell your legislators what you think about these and other drastic cuts. 

Please send your legislators a MOAA-suggested message and ask them to oppose these dramatic cuts…let MOAA help you communicate with lawmakers to stop these cuts.

VA WANTS YOU!

That’s right, they are looking for 1 MILLION Veterans to serve again.

This time though, the government, that is, the Department of Veterans Affairs (VA) is recruiting veterans to join the “Million Veteran Program” (MVP).

This medical research project is seeking veterans in an effort to learn more about how genes affect the health and illnesses of those who have served in the armed forces.  Results will help the VA to customize treatments for conditions that affect veterans.

MOAA members are servant leaders so helping others, particularly those in the military and those who have served is always near and dear to our hearts.

The Programs seems simple enough–go to one of the designated VA Medical Centers, provide blood samples, complete health surveys, and stay in contact with the researchers.

In fact, I think my next visit to my VA I’ll do just that and sign up!

Are you interested in helping other veterans for generations to come?

Then check out the program by clicking on ‘MVP‘

or

call toll free, 1-866-441-6075.