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RAO Bulletin Update
15 August 2007


THIS BULLETIN [CONTAINS THE FOLLOWING ARTICLES:

-- Tricare Hospice Care -------------------------------- (Coverage)
-- Military Spouse Monument ------------------------- (Proposed)
-- VA Claims Assistance [03] ------------ (Triple Compensation)
-- Fisher House Expansion [01] ------------------ (Tampa Opens)
-- Tricare Uniform Formulary [21] ------- (Changes Announced)
-- Publix Prescription Offer ----------------- (No Cost Antibiotics)
-- Filipino Vet Inequities [05] ------------- (Republicans Protest)
-- VDBC [20] --------------- (CRDP Recommendation Reversed)
-- Minnesota Veterans Homes --------- (Commission Appointed)
-- Acid Reflux Disease ---------------------------- (Cancer Impact)
-- Minnesota LinkVet ----------------------------- (First in Nation)
-- VA Clinic Openings [06] -------- (Non-hospital Dental Care)
-- Tricare Prime Travel Reimbursement ----------- (100 miles +)
-- Tricare Provider Tax Credit --------------------------- (Oregon)
-- Oregon Taxes --------------------------------- (Military Retirees)
-- Depleted Uranium [04] ------------------ (Report Due OCT 07)
-- VA North Texas SITREP ----------------- (Array of Problems)
-- VA Care Vet Backlash -------------------- (Claim Acceptance)
-- Puerto Rico Medical Fraud ------- (AZ-FL-NY-TX-VA Impact)
-- Saluting the Flag --------------------------------------- (Veterans)
-- VA Facility Expansion [05] -------------------------- (Ft. Bragg)
-- VA Local Access ---------------------------------- (Where to Go)
-- VA Clinic Openings [05] --------------- (Guam Summer 2009)
-- SBP Basics [01] ------------------------ (Program Explanation)
-- Retiree Annual COLAs [01] -------------- (Tracking Inflation)
-- VA Fraud [01] --------------------------- ($120,000 Embezzled)
-- Vet Home Tennessee ------------------------ (Fined $200,000)
-- HVAC [02] --------------------------------- (Support for 7 Bills)
-- Commissary Construction --------------- (Program Impacted)
-- SBP Paid Up Provision [03] ----------------- (30 Year Payers)
-- Agent Orange Diseases [01] ---------------------- (Associated)
-- Agent Orange Diseases [02] ---------------- (Non-Associated)
-- Agent Orange & Hypertension -------- (Possible Association)
-- Retirement Tax Considerations ------------- (Sales & Income)
-- Veteran Legislation Status 13 AUG 07 ---- (Where We Stand)


Editor Note 1:  Effective immediately I will cease using the email
 addee raoemo@mozcom.com because  Spam messages at this addee have reached
 150 daily.  My email addee raoemo@sbcglobal.net will be the only addee I
 will be monitoring after 15 SEP.   Also, I will be relocating to the
 Philippines 21 AUG and will not be able to respond to messages 20 to 24
 AUG.  [Source: RAO Director]

Editor’s Note 2:  Attached is a listing of veteran legislation with
 current cosponsor status that has been introduced in the 110th Congress.
  To see any of these bills passed into law representatives need input
 from their veteran constituents to instruct them on how to vote.


TRICARE HOSPICE CARE:   Tricare hospice care is available to
 beneficiaries who have received a terminal diagnosis.  Its function is to provide
 care for terminally ill patients with a life expectancy of six months
 or less if the illness runs its normal course. In particular, curative
 treatments are not covered, while personal care and home health aide
 services are covered.  It may include physician services, nursing care,
 counseling, medical equipment, supplies, medications, medical social
 services, physical and occupational services, speech and language
 pathology, and hospice short term inpatient care to manage acute or chronic
 symptoms or to control pain. Room and board are not covered under the
 Tricare hospice benefit; however, inpatient care is covered when needed.
 You cannot receive other Tricare services or benefits related to curative
 treatment of the terminal illness, unless the hospice election is
 formally revoked.

     The hospice, in conjunction with your regional contractor, is
 responsible for the arrangement of all care while you are under the hospice
 election. To formally revoke the hospice election, you must submit a
 signed and dated statement through the hospice provider. This does not
 alter your ability to elect and reenter hospice care at a later time.
 Hospice care can be provided in a Home, Hospice facility or Inpatient
 acute care facility.  Care can shift among these facilities without
 affecting the hospice benefit. For example, if you are receiving hospice care
 at home, but the family member caring for you is overwhelmed with
 caretaking responsibilities, you may choose to receive short term,
 inpatient respite care at a hospice facility in consultation with your hospice
 care team. This is an available option under the hospice benefit.

     Hospice care is managed by the hospice medical director, the
 hospice care team managing your case, and your primary care manager (PCM) or
 primary care provider, who are always in consultation with you and
 your family. Your case manager and PCM or primary care provider will
 assist in locating appropriate hospice care. A hospice evaluation does not
 require authorization. Only Medicare certified hospices are authorized
 to provide covered services to TRICARE beneficiaries. You can locate a
 Tricare authorized hospice provider through your regional contractor.
  There is no deductible for hospice care, and Tricare pays the cost of
 all covered services, except for small cost share amounts which may be
 collected by the individual hospice (at their option) for outpatient
 drugs and inpatient respite care.  Check with your regional contractor or
 hospice provider for specific cost information.

     Hospice care is provided in three benefit periods, each of which
 requires prior authorization from your regional contractor. The first
 two benefit periods are each 90 days long.  The first period begins on
 the day you sign a hospice election statement and both the attending
 physician and the hospice medical director sign a physician’s certificate
 of terminal illness. Each subsequent period requires recertification of
 the terminal illness by the hospice medical director or the physician
 on your hospice care team.  The final benefit period is made up of an
 unlimited number of 60 day periods, each of which requires physician
 recertification of the terminal illness.

     You, your PCM or primary care provider, or a family member acting
 on your behalf can initiate hospice care. However, it is important to
 understand that the hospice cannot provide services without a referral
 from your PCM or primary care provider, prior authorization from your
 regional contractor, and certification of the terminal illness.  When
 considering hospice care, you should discuss the options with family
 members and your PCM or primary care provider. The hospice benefit also
 covers a consultation with the medical director of a Medicare certified
 hospice so you may ask questions and learn more about a specific hospice
 program.  You must complete and sign an “election statement,” which the
 hospice provides, that indicates your full understanding of hospice
 care.  By signing this statement, you waive your right to any Tricare
 benefits associated with curative treatment of your illness. The election
 statement is then filed with your regional contractor.  [Source:
  Tricare Hospice Care Brochure 29 Nov 06 ++]


MILITARY SPOUSE MONUMENT:  Due to the efforts of two military spouses,
 the first steps toward a monument to honor the courage and sacrifice of
 military spouses have been taken. Representative Thelma Drake
 (R-VA-02) recently introduced The Military Spouses Memorial Act of 2007 (H.R.
 3026) to authorize a monument to be erected in the Washington DC area.
  The Military Spouses Legacy Association, Inc. was founded in 2007 by
 Nicole Alcorn, herself a military spouse and the daughter of a military
 widow, and Karie Darga, who lost her husband in Iraq. The association
 has received its 501(c)3 non-profit status and is collecting the private
 donations to fund the construction and maintenance of the monument. To
 learn more about the Military Spouses Legacy Association, refer to
 http://www.militaryspousemonument.org/home.html.  [Source:  NMFA
 Government & You e-News 14 Aug 07 ++]


VA CLAIMS ASSISTANCE UPDATE 03:   A recent study by the Institute for
 Defense Analysis shows that wounded veterans who approach the V.A.
 without professional assistance receive on average about one-third of the
 compensation that those who are represented by a lawyer or service
 organization like the Disabled American Veterans (DAV) get.  DAV
 representative Eric McGinnis said, "That's not surprising at all. If you know the
 proper vernacular, a few simple phrases, it makes things a lot easier.
 But you'd be hard-pressed to find a vet who knows exactly the right
 things to say and do."  McGinnis' experience in that arena is both
 professional and personal. The Army veteran came to work for the DAV after the
 organization helped him obtain compensation after the VA initially told
 him he'd get none. "It's a common story," he said.  Complicating
 matters further, is a compensation process that requires veterans to
 approach the VA, openly advertising their own physical and psychological
 wounds in order to receive benefits. "These aren't always people who are
 comfortable advocating for themselves," said McGinnis.  Utah State
 Department of Veterans Affairs Director Terry Schow said it would be nice if
 the system weren't so adversarial and complex that veterans needed help
 from outside groups to obtain just compensation for their wounds. "The
 process is so involved and complicated, that I think it's just wise to
 do that. And so we encourage everyone to get assistance from a service
 organization."

      DAV is an organization of disabled veterans who are focused on
 building better lives for disabled veterans and their families. They
 accomplish this by providing assistance to veterans, their families, their
 widowed spouses and their orphans in obtaining benefits and services
 earned through their military service. The organization is fully funded
 through its 1.2 million membership dues and public contributions. It is
 not a government agency and receives no government funds. However, it
 is the foremost representative of the interests of disabled veterans and
 before federal, state, and local governments. In 88 offices, 260
 National Service Officers (NSOs) and 26 Transition Service Officers (TSOs)
 directly represent veterans with claims for benefits from the Department
 of Veterans Affairs and the Department of Defense.  NSO/TSO personnel
 assist in filing claims for VA disability compensation, rehabilitation
 and education programs, pensions, death benefits, employment and
 training programs, and many other programs.  This service is available to all
 veterans at no charge.  DAV’s Voluntary Service Program consists of a
 transportation network which provides veterans with rides to and from
 VA medical facilities for treatment, and a program which facilitates
 volunteers at VA hospitals, clinics, and nursing homes.

       NSO representation covers development and prosecution veterans'
 claims through in-depth reviews of medical histories in conjunction
 with sound application of current law and regulations. In representing
 veterans and their families, NSOs assist in the thorough preparation of
 claims and written briefs, which includes helping to assemble evidence in
 support of those claims. They also review rating board decisions and
 inform veterans and their families of the appeals process and their
 appellate rights.  DAV National Appeal Officers represent the largest
 percentage of claimants in cases decided by the Board of Veterans Appeals
 (BVA). They also provide representation before the U.S. Court of Appeals
 for Veterans Claims through which veterans have the right to
 independent judicial review of appeals denied by the BVA. Veterans seeking
 assistance can refer to www.dav.org/veterans/service_office.html to locate an
 office accessible to them.  [Source:  The Salt Lake Tribune Mathew
 LaPlante article 13 Aug 07 ++]


FISHER HOUSE EXPANSION UPDATE 01:   The newest Fisher House was
 dedicated 6 AUG 07  at the James A. Haley Veterans’ Hospital in Tampa,
 Florida.  The new Fisher House will provide families free lodging, making it
 easier to participate in the care and recovery of loved ones. Veterans
 Affairs Secretary Jim Nicholson participated in a ceremony transferring
 ownership of the Fisher House to the VA.  It will operate and maintain
 the home at no cost to its residents.   This is the 38th Fisher House
 built by the Fisher House Foundation and the ninth operated by VA. At
 16,000 square feet, the Tampa Fisher House is among the largest of these
 comfort homes, which can accommodate up to 21 families.  Some families
 travel long distances to Tampa’s Polytrauma Center – one of four unique
 VA polytrauma facilities in the United States where the most severely
 injured and disabled veterans are treated.  In addition to polytrauma
 patients, those receiving care in the hospital’s other specialized
 programs, such as spinal cord injury, post-traumatic stress disorder and
 traumatic brain injury, will benefit from the Fisher House.  [Source: NAUS
 Weekly Update 10 Aug 07 ++]


TRICARE UNIFORM FORMULARY UPDATE 21:   The Tricare Management Activity
 announced the following changes to the Uniform Formulary:

- Nexium, which is used to treat heartburn and gastric disorders, has
 been reclassified as a first-tier medication. First-tier medications
 (formulary generics) are available at most military treatment facilities
 at no charge, or for a $3 co-pay through the Tricare Retail Pharmacy
 (30-day supply) or the Tricare Mail Order Pharmacy (90-day supply).
- Prevacid, Zegerid, Protonix and Aciphex, are also used to treat
 gastric disorders and will be reclassified as non-formulary medications
 effective 24 OCT 07. 
- Avodart, a medication used to treat prostrate-related problems will
 move to the third tier on 24 OCT.
- Hypertension drugs Avapro, Avilide, Benicar, Benicar HCT, Diovan,
 Diovan HCT, Teveten, and Teveten HCT along with cholesterol-lowering
 medications Anatara, Tricor, Omacor, and WelChol will be reclassified as
 non-formulary medications on 21 NOV.  The price of non-formulary
 medications is $22.

Beneficiaries using the above medications may want to consult with
 their health care providers about other options including generic
 equivalents or establishing medical necessity for the third-tier medication if
 appropriate.  If medical necessity is established, the co-payment is
 reduced to $9.  Third-tier medications are not available at military
 treatment facility (MTF) pharmacies unless an MTF provider establishes
 medical necessity and writes the prescription.  Medical necessity forms and
 criteria are available at
www.tricare.mil/pharmacy/medical-nonformulary.cfm.  For a complete list
 of medications, their formulary status and where they are available,
 beneficiaries may refer to
www.tricareformularysearch.org/dod/medicationcenter/default.aspx.
  Additional information on the TRICARE Retail Pharmacy and locations, and
 the TRICARE Mail Order Pharmacy can be found at
 www.express-scripts.com/TRICARE  or by calling 1(866) 363-8779 for the retail pharmacy or
 1(866)363-8667 for the mail order pharmacy.  [Source: NAUS Weekly Update 10
 Aug 07 ++]


PUBLIX PRESCRIPTION OFFER:  On 6 AUG the Publix Super Market chain said
 it would make seven common prescription oral antibiotics at no charge
 to its customers via their 648 pharmacies.  With a valid prescription,
 new or current Publix customers can receive a 14-day supply that will
 be filled at no charge and can be refilled. The antibiotics include:
* Amoxicillin
* Cephalexin
* Sulfamethoxazole/Trimethoprim (SMZ-TMP)
* Ciprofloxacin (excluding ciprofloxacin XR)
* Penicillin VK
* Ampicillin
* Erythromycin (excluding Ery-Tab)
These antibiotics account for almost 50% of the generic, pediatric
 prescriptions filled at Publix. Publix is not limiting the number of
 prescriptions customers may fill.  The antibiotics will be provided to
 customers regardless of their prescription insurance provider. Publix
 operates stores in Florida, Georgia, South Carolina, Alabama and Tennessee.
  [Source: NAUS Weekly Update 10 Aug 07 ++]


FILIPINO VET INEQUITIES UPDATE 05:   The Filipino Veterans Equity Act
 of 2007 (H.R.760) passed the House Committee on Veterans Affairs.  This
 is a bill to amend title 38, United States Code, to deem certain
 service in the organized military forces of the Government of the
 Commonwealth of the Philippines and the Philippine Scouts to have been active
 service for purposes of benefits under programs administered by the
 Secretary of Veterans Affairs. As amended it will eliminate special monthly
 pensions currently being paid for severely disabled veterans over 65 who
 are also receiving pensions for wartime service. The legislation would
 use nearly all of the $965 million saved by this unprecedented cut in
 veterans' benefits to provide budgetary offsets to fund oversized
 pensions for non-citizen, non-resident World War II Filipino veterans.
  Similar legislation, S.1315, is being considered in the Senate. The American
 Legion among others does not support this legislation as amended.
  While the Legion supports improvements to Filipino Veterans Benefits they
 oppose overturning the Court decision in the Hartness case and
 eliminating an earned benefit for disabled veterans.  The American Legion is
 asking hat their membership contact their members of Congress and express
 support for securing the earned benefits of severely disabled veterans
 by protecting the Hartness decision. [Source: AL Weekly Update 10 Aug
 07 ++]


VDBC UPDATE 20:  Veterans won an important victory this week when the
 Veterans Disability Benefits Commission (VDBC) reversed itself on the
 issue of giving both VA disability payments and full military retirement
 pay to Chapter 61 and TERA retirees. At the JUL 07 meeting of the
 Commission they pointedly voted to not support both benefits for those
 groups. But discussion among a number of the commissioners after that vote
 in July made it apparent that many of them did not understand the
 implications of their votes. In the weeks since that meeting, veterans groups
 provided information to the commission that led to the change this
 week. The new language adopted by the Commission in a 12 to 1 vote was as
 follows: Congress should eliminate the ban on concurrent receipt for
 all retirees and disability retirees. Future priority should be given to
 Chapter 61 retirees with less than 20 years and greater than 50%
 service-connected disabled and all combat disabled Chapter 61’s.  At last
 month’s meeting the Commission already decided to recommend that both full
 Military Retired Pay and VA Disability Pay be given immediately to all
 longevity retirees with VA disabilities ratings (including those with
 10%-40% ratings.)

     The Commission next meets 22-24 AUG in Washington, D.C., at the
 Hotel Washington, which is located at 15th St. and Pennsylvania Avenue,
 NW.  Anyone in the area or visiting D.C. is encouraged to attend this
 very important meeting. The purpose of the Veterans' Disability Benefits
 Commission is to carry out a study of the benefits under the laws of
 the United States that are provided to compensate and assist veterans and
 their survivors for disabilities and deaths attributable to military
 service, and to produce a report on the study.  The VDBC is meeting
 several times a month in order to complete the work of the Commission by
 its 1 OCT deadline to make their report to Congress and the President.
  Their conclusions are only recommendations but they will certainly help
 in veteran groups lobbying efforts. is due sometime around the 1 OCT
 this year.  [Source: TREA News flash 10 Aug 07 ++]


MINNESOTA VETERANS HOMES:  The Minnesota Veterans Home – Minneapolis,
 once called the Old Soldiers Home, was built in the late 1800’s for
 indigent veterans of the Civil War.  The Home is located on a 51 acre
 wooded campus overlooking the Mississippi River near Minnehaha Falls.  At
 the end of the 19th century the intent was to create a beautiful,
 comfortable, community for veterans in need of care in their later years.
  Unfortunately, the home has experienced numerous inspection problems in
 recent months.  Gov. Tim Pawlenty appointed a seven-member Veterans
 Long-Term Care Advisory Commission tasked with recommending ways to end the
 Minneapolis home's frequent problems and consider whether the five
 Minnesota homes should serve more people than the 863 people housed in its
 nursing homes and assisted-living facilities.  Since 2005, the
 Minneapolis Home has been cited by the state for 67 rule violations, the most
 recent last month, and fined $42,300 when the problems were not
 corrected.  Separately, the U.S. Department of Veterans Affairs, which pays
 about 20% of the care costs, found 48 violations since 2005. 

     The Minneapolis facility has asked the federal government to
 approve a $44 million "Cadillac plan" to renovate the nursing home. The
 proposed renovation project, still in the design phase, would reduce the
 number of beds in the home's main building from 250 to 198. The remodeled
 home would be divided into 14 to 16 room "neighborhoods," each with
 its own kitchen. All the beds in the renovated facility would be in
 single rooms with private baths. The home also has a 91-bed nursing-home
 dementia unit and a 61-bed assisted-living facility in separate buildings.
  It had to stop taking new nursing-home residents in December while it
 fixes the care problems and now has about 350 people on its waiting
 list.  The home’s governing board  has submitted the plan to federal
 officials as a project list "place holder." If approved, the VA would pay
 65% of the $44 million cost. The Legislature would have to approve the
 remaining $15 million. As the Minneapolis Home plans a major overhaul, a
 commission is considering an expanded role for the five state-owned
 residences. The plan would have the board provide an array of services
 for the state's 140,000 aging veterans.

     Admissions criteria for acceptance in a Minnesota home include:
 Honorably Discharge, 181 Consecutive Days on Active Duty, Minnesota
 Resident (or had service credited to Minnesota), Spouses of eligible
 Veterans over 55 years of age and reside in the state, and applicants ability
 to demonstrate medical need.  The states five homes are located at:
- 1821 North Park ST., Fergus Falls MN  56537 Tel: (218) 736-0400 or
 1(877) 838-4633.
- 1200 East 18th ST., Hastings, MN 55033 Tel; (651) 438-8504 or 1(877)
 838-3803)
- 1300 North Kniss Ave., P.O. Box 539, Luverne MN 56156 Tel: (507)
 283-1100 or 1(877) 588-8387.
- 5101 Minnehaha Ave. South, Minneapolis MN 55417 Tel: (612) 721-0600
 or 1(877) 838-6757.
- 45 Banks Boulevard, Silver Bay MN 55614 Tel: (218) 226-6300 or
 877-729-8387
[Source: Minneapolis Star Tribune Warren Wolfe article 9 Aug 07 ++]


ACID REFLUX DISEASE:    Acid Reflux (i.e. heartburn) is caused when
 acid from the stomach flows upwards into the long feeding tube that
 connects the stomach and throat (esophagus) causing a burning sensation.
 Unlike the stomach, which has a lining that protects it from the acid, the
 esophagus is delicate and easily irritated by acid. Nighttime heartburn
 is heartburn that occurs at night. Anyone can have occasional
 heartburn as might occur after a spicy meal. Frequent and recurring heartburn,
 however, may be a symptom of a more serious condition.
  Gastroesophageal reflux disease is caused when the opening between the esophagus and
 the stomach becomes looser or relaxes at the wrong times. Normally, this
 opening allows food to travel only from your esophagus into your
 stomach. A muscular valve, called a sphincter, normally keeps stomach
 contents, including stomach acid, in the stomach. When the sphincter between
 the stomach and the esophagus becomes loose or relaxes at the wrong
 time, the stomach contents can flow up from the stomach into the
 esophagus. This irritates the esophagus, which doesn't have a special lining to
 protect it from acid like the stomach does. Studies have also shown
 that if you lie in bed, the protective effect of gravity can become
 lessened.

     New research from scientists at UT Southwestern Medical Center and
 the Dallas Veterans Affairs Medical Center underscores the importance
 of preventing recurring acid reflux while also uncovering tantalizing
 clues on how typical acid reflux can turn potentially cancerous. In
 research published in July and August, scientists discovered that people
 with acid reflux disease, particularly those with a complication of acid
 reflux called Barrett’s esophagus, have altered cells in their
 esophagus containing shortened telomeres, the ending sequences in DNA strands.
 Combined with related research to be published in AUG, the findings
 indicate that the shortened sequences might allow other cells more prone
 to cancer to take over. “The research supports why it is important to
 prevent reflux, because the more reflux you have and the longer you have
 it, the more it might predispose you to getting Barrett’s esophagus. So
 you want to suppress that reflux,” said Dr. Rhonda Souza, associate
 professor of internal medicine at UT Southwestern and lead author of the
 paper which appears in the July issue of the American Journal of
 Physiology – Gastrointestinal and Liver Physiology.

     Over time, the persistent acid bath from acid reflux can cause
 normal skin-like cells in the esophagus to change into tougher, more
 acid-resistant cells of the type found in the stomach and intestine, a
 condition called Barrett’s esophagus, explained Dr. Stuart Spechler,
 professor of internal medicine and senior author of the paper. “Unfortunately,
 those acid-resistant cells are also more prone to cancer,” Dr.
 Spechler said.  According to the National Cancer Institute Adenocarcinoma of
 the esophagus, the cancer that is especially associated with Barrett’s
 esophagus, is currently the most rapidly rising cancer in the U.S., with
 a six fold increase in cases during the past 30 years. Understanding
 how and why the cells change in some cases and not others has been a
 major challenge for investigators. The research was funded by the
 Department of Veteran’s Affairs, National Institutes of Health, the Harris
 Methodist Health Foundation, the Dr. Clark R. Gregg Fund and AstraZeneca.
  [Source: UT Southwestern Medical Center article 10 Aug 07 ++]


MINNESOTA LinkVet:   To make it easier to find services and to ensure
 immediate crisis intervention, Minnesota Gov. Tim Pawlenty announced the
 launch of LinkVet — the Veterans Linkage Line for Minnesota veterans
 and their family members. The toll-free customer service line is the
 first of its kind in the nation and will provide information referrals,
 immediate crisis intervention and psychological counseling 24 hours a
 day, seven days a week at (888) LINKVET (546-5838). The new line is up and
 running.  LinkVet will be answered by trained staff at the Minnesota
 Department of Veterans Affairs (MDVA) and Crisis Connection, a Twin
 Cities based non-profit mental health telephone counseling service. MDVA
 staff, who are veterans themselves, will manage the lines M-F from
 08-1600. Crisis Connection social workers will field all crisis calls during
 business hours, and all calls after hours, on weekends and holidays.
 Veterans who call LinkVet and need to be transferred to someone other
 than a MDVA staff member will be connected in a three-way call to the
 necessary resources. MDVA staff will remain on the line with the caller
 until the veteran’s issue has been successfully resolved.

     LinkVet was developed by the Governor’s Yellow Ribbon Task Force
 Crisis Line Workgroup. This group met during the spring and included
 representatives from several state agencies, the National Guard and
 non-profit veteran services providers.  After discovering there were several
 toll-free lines for crisis intervention and suicide prevention for
 returning soldiers and veterans, and that United Way’s 211 referral line is
 not cell phone accessible, the workgroup proposed a statewide one-stop
 call line for veterans similar to the Senior Linkage and Disability
 Linkage lines.  Revation, the company that has supplied the software for
 Senior Linkage and Disability Linkage lines, has agreed to provide a
 one-year free trial of the Veterans Linkage Line software. After the
 first year, there will be no additional hardware required and approximately
 $0.04 per minute operating costs. Last year, MDVA launched
 www.minnesotaveteran.org, a one-stop Web site for information about education,
 medical, employment, retirement and other benefits.  [Source:  Independent
 Review Kristin Holtz article 13 Aug 07 ++]


VA CLINIC OPENINGS UPDATE 06:   A joint effort of two Department of
 Veterans’ Affairs medical centers has put dental health care closer to the
 homes of many eastern North Carolina veterans.  An open house was held
 9 AUG at the VA Outpatient Clinic in Morehead City to celebrate the
 opening of the first community-based VA dental clinic in the state.
  Eligible veterans, who would normally travel to either the VA medical
 centers in Durham or Fayetteville, can now be referred to the Morehead City
 clinic for general dentistry and dental cleanings. While the Morehead
 City clinic is affiliated with the medical center in Durham, many area
 veterans who are patients at the Fayetteville medical center also live
 close to the Carteret County site. By working together, the two medical
 centers are making the new dental clinic accessible to all those
 eligible veterans who live nearby.  While VA dental services have
 traditionally been associated with its hospitals, VA Mid-Atlantic Health Care
 Network Director Daniel Hoffmann believes the Morehead City clinic will be
 an example for others to follow.

     For many of the area's veterans, trips to a VA hospital require
 several hours. While specialty dental care may still require visits to
 Durham or Fayetteville, the Morehead City clinic is now equipped with
 four dental exam rooms and will be staffed by two general dentists, a
 dental hygienist and dental assistants. The Morehead City outpatient clinic
 currently provides primary care and mental health care services to
 about 2,400 veterans. The planned enrollment for the dental clinic is
 expected to be about 700 patients in the first year.  The clinic was
 originally designed under the premise that it would serve as a joint clinic
 with the U.S. Navy. When that plan did not work out, the VA decided to
 proceed with building the larger facility to accommodate future growth.
  At a community meeting last October, it was announced that VA staff
 would be taking over operations of the clinic from the private
 corporation that had provided care since the clinic's opening. VA officials said
 at that time that the move would allow for better health care for
 veterans in the area.  An eye clinic is expected to be added to the
 Morehead City site in October and the possibility of other services is being
 evaluated. All the unused space will be filled with the additions, but
 other services such as dermatology or podiatry might be possible through
 visiting specialists.

    The dental care at the Morehead City clinic is for dental-eligible
 veterans only.  Congress has established special eligibility rules for
 dental care for veterans. The majority of patients who are eligible are
 either 100% disabled due to a service-connected condition, have a
 service-connected disability for a dental condition or are within 90 days
 of discharge from active duty.  Patients must be referred to the clinic
 by the VA Medical Center in Durham. Priority will be given to eligible
 dental patients who are currently treated in Durham or Fayetteville,
 who live closer to Morehead City and whose providers feel they may
 transfer their care. Patients in these categories will be called or will
 receive a letter telling them of their options to transfer their routine
 dental care to the Morehead City clinic. Current users of VA care who
 would like to request dental care at the Morehead City clinic may call the
 Durham VA Medical Center at1 (888) 878-6890, ext. 6247. New patients
 to the VA system should complete VA Form 10-10EZ in full, listing
 "Morehead City CBOC" in section 1B. Packets can be picked up at the clinic,
 requested from the Durham VA Medical Center or obtained electronically
 at www.1010ez.med.va.gov. Include a copy of DD214 if available and mail
 to: Eligibility Office (136); VA Medical Center; 508 Fulton St.;
 Durham, N.C. 27705. Patients will be contacted by phone once registration is
 complete. [Source: Jacksonville NC Daily News Staff Jannette Pippin
 article 9 Aug 07 ++]


TRICARE PRIME TRAVEL REIMBURSEMENT:  Tricare Prime beneficiaries
 referred by their primary care manager for specialty services at a location
 more than 100 miles from their provider’s location may be eligible to
 have their reasonable travel expenses reimbursed by Tricare.
 Beneficiaries must have a valid referral and travel orders prior to traveling, and
 file a travel claim upon their return.  This can be requested at the
 military treatment facility (MTF) or from the Tricare Regional Offices
 (TRO) if the doctor is a Tricare network provider. Beneficiaries will
 receive a briefing on the entitlement process, coverage, and their
 responsibilities at the MTF or from the TRO point of contact. Reasonable
 travel expenses are the actual costs incurred by the beneficiary when
 traveling to their specialty provider.  Costs include meals, gas, tolls,
 parking, and tickets for public transportation (i.e., airplane, train, bus,
 etc.).  Beneficiaries must submit receipts for expenses above $75. The
 MTF or TRO will provide the beneficiary with specific instructions on
 how and where to submit his or her travel entitlement claim. Government
 rates are used to estimate the reasonable cost.  Beneficiaries are
 expected to use the least costly mode of transportation.  Costs of lodging
 and meals may be reimbursed up to the government per diem rate. This
 benefit does not apply to travel expense for specialty care experienced
 by active duty uniformed service members, or active duty family members
 residing with their sponsors overseas, which are reimbursed by other
 travel entitlements.  For more information on the Tricare Prime Travel
 Reimbursement, refer to www.tricare.mil/factsheets.  [Source: Tricare
 News Release 8 Aug 07++]


TRICARE PROVIDER TAX CREDIT:   The leadership of the state of Oregon
 took a giant step forward in their unprecedented efforts to help Tricare
 beneficiaries receive the health care they deserve.  A bill-signing
 ceremony was part of the fanfare surrounding the legislation, which
 features a tax incentive package that encourages health care providers to
 support military families by participating in Tricare, the health care
 plan for the uniformed services, retirees, and their families. The
 incentives include a one-time tax credit of $2,500 for new providers in the
 Tricare system, plus an additional annual credit for treating patients
 enrolled in Tricare.  It also creates a deduction from federal taxable
 income in the first two years of a provider's participation in the
 Tricare system. TriWest Healthcare Alliance, the managed care support
 contractor for the Tricare benefit in Oregon and 20 other western states,
 applauded the efforts of Oregon Governor Ted Kulongoski and the Oregon
 legislature.

     TriWest has been conducting a proactive campaign to enlist state
 governors in their service area to support active duty, retiree and
 Guard and Reserve families by encouraging physicians to accept patients
 with Tricare. With the encouragement and support of state leadership, the
 Oregon War Veterans Association and the Oregon Medical Association,
 TriWest Healthcare Alliance has increased the Tricare provider network in
 Oregon by 35% since the fall of 2004.  There are currently more than
 9,000 providers serving the 65,000 Tricare beneficiaries in Oregon. Maj.
 Gen. Elder Granger, Deputy Director, TMA said, “Increased availability
 of health care providers will become even more important as an improved
 Tricare Reserve Select (TRS) health care program launches this fall.”
 TRS offers a premium-based health care plan to National Guard and
 Reserve members.  Starting 1 OCT 07, all eligible members of the Selected
 Reserve will be able to purchase health care coverage under the new TRS
 and all will pay the same low monthly premium.  The current TRS plan,
 which remains in effect through 30 SEP, has a complex three-tier system
 requiring activation in support of a contingency operation, among
 others, to qualify for the lowest monthly premiums. Members of the Selected
 Reserve can refer to www.tricare.mil for more information on the
 improved TRS program.  [Source:  Tricare News Release 8 Aug 07 ++]


OREGON TAXES:   The following taxes are applicable to military
 retirees:
Sales Taxes - State Sales Tax: None; Gasoline Tax: 24.9 cents/gallon &
 Diesel Fuel Tax: 24.3 cents/gallon (Local fuel taxes may add 1 to 3
 cents/gallon); Cigarette Tax: $1.18/pack of 20. 

Personal Income Taxes - Tax Rate Range: Low - 5%; High - 9%. For joint
 returns, the taxes are twice the tax imposed on half the income.
- Income Brackets: Lowest - $2,750; Highest - $6,851 w/3 brackets.
- Personal Tax Credits: Single - $154; Married - $308; Dependents -
 $154; and a credit equal to 40% of federal credit
- Standard Deduction: Single - $1,840; Married filing jointly -
 $3,685; Single over 65 - $1,200; Married over 65 filing jointly $2,000.
- Medical/Dental Deduction: Full only for age 59 or older, if itemized.
- Federal Income Tax Deduction: $5,000 ($2,500 if married filing
 separately)
- Oregon has a statutory provision for automatic adjustment of tax
 brackets, personal exemption or standard deductions to the rate of
 inflation.

Retirement Income Taxes: Federal income tax rules generally determine
 the amount of your pension that is taxed by Oregon.  However, you may
 subtract some pensions on your Oregon return that were taxed on your
 federal return.  Pensions not taxed are Social Security benefits, Veterans
 Administration benefits and Railroad Board benefits.  Oregon allows a
 subtraction for part or all of the payments you receive from the federal
 pension system.  Generally, retirement income is subject to Oregon
 tax.  A tax credit of up to 9% of taxable pension income is available to
 recipients of pension income, including most private pension income,
 whose household income was less than $22,5000 (single) and $45,000
 (joint), and who received less than $7,500/$15,000 in Social Security or
 Railroad Retirement benefits.  The credit is the lesser of tax liability or
 9% of taxable pension income.
a. Retired Military Pay: Federal retirees, including military
 personnel, may be able to subtract some or all of their federal pension income.
  This includes benefits paid to the retiree or to the surviving
 spouse.  The subtraction amount is based on the number of months of federal
 service before and after October 1, 1991.  Retirees can subtract their
 entire federal pension if all the months of federal service occurred
 before October 1, 1991.  If there are no months of service before October
 1, 1991, retirees cannot subtract any federal pension.  If service
 included months before and after October 1, 1991, retirees can subtract a
 percentage of their pension income.
b. Military Disability Retired Pay: Disability Portion - Length of
 Service Pay; Member on September 24, 1975 - No tax; Not Member on September
 24, 1975 - Taxed, unless combat incurred.  Retired Pay - Based solely
 on disability: Member on September 24, 1975 - No tax; Not Member on
 September 24, 1975 - Taxed, unless all pay based on disability and
 disability resulted from armed conflict, extra-hazardous service, simulated
 war, or an instrumentality of war.
c. VA Disability Dependency and Indemnity Compensation: Not subject to
 federal or state taxes.
d. Military SBP/SSBP/RCSBP/RSFPP: Generally subject to state taxes for
 those states with income tax.  Check with state department of revenue
 office.

Property Taxes:  Oregon does not grant homeowners a homestead
 exemption.  Tax rates are set by the counties and any special considerations are
 levied by county officials. Homeowners 62 or older may delay paying
 property taxes based on certain income criteria.  The state offers a
 Disabled Citizen Property Tax Deferral Program and a Senior Citizen
 Property Tax Deferral Program.  Both deferral programs allow qualified
 taxpayers to defer payment of their property taxes on their homes.  The state
 pays the taxes to the county, maintains the account, and charges 6%
 simple interest, which also is deferred.  Taxes are owed when the taxpayer
 receiving the deferral dies, sells the property, ceases to live
 permanently on the property, or the property changes ownership. To qualify
 for either program, the taxpayer must live on the property and have a
 total household income of less than $36,500 for the year before
 application.  Participants may remain on either program as long as their federal
 adjusted gross income does not exceed that amount.  If a participant's
 income exceeds the $36,500 limit, part of the taxes still may be
 deferred.  Participants can come in and out of the programs if their income
 changes.  In addition to meeting the income limitation and property
 ownership requirement, disabled persons must be receiving or be eligible to
 receive federal Social Security Disability benefits to qualify.
  Residents must be 62 years old or older to qualify for the Senior Citizen
 Property Tax Deferral Program.  Call 800-356-4222 or 503-376-4988 for
 details or refer to
 http://www.oregon.gov/DOR/SCD/faq.shtml#Anchor-What-49575.

Inheritance and Estate Taxes:  An Oregon inheritance tax return is
 required to be filed whenever a federal estate tax return (Form 706) is
 required to be filed.  For a resident decedent, Oregon taxes real property
 and tangible personal property located in Oregon and intangible
 personal property wherever it is located.  For a nonresident decedent, Oregon
 taxes real property, tangible personal property, and intangible
 personal property located in Oregon.  An exemption is allowed for intangible
 personal property located in Oregon if a like exemption is allowed by
 the state of residence.

For latest information, visit the Oregon Department of Revenue site
 http://www.oregon.gov/DOR/ or call (503) 378-4988. [Source:
 http://www.retirementliving.com/RLstate3.html Aug 07 ++]


DEPLETED URANIUM UPDATE 04:   In the wake of an Iraqi official in
 blaming America’s use of depleted uranium (DU) munitions in its 2003 "Shock
 and Awe" campaign for a surge in cancer there, the Defense Department
 is facing an OCT 07 deadline for providing a comprehensive report to
 Congress on the health effects of such weapons. The report is required by
 the National Defense Authorization Act for Fiscal Year 2007, which
 President Bush signed into law last year. The request for the study is an
 outgrowth of claims by Iraq war veterans that exposure to depleted
 uranium and other toxic substances there has negatively affected their
 health and that, therefore, their illnesses should be recognized as
 war-related and the treatment covered by the Veterans Administration.
 Currently, the State Department's Web site says fears about adverse health
 effects of  DU, are "unwarranted," and it lists worries about DU under a
 section called "identifying misinformation." The site says the American
 military uses the material in ammunition to take advantage of its
 unsurpassed ability to penetrate armored vehicles, and it cites four separate
 studies -- by NATO, the Rand Corporation, the European Commission, and
 the World Health Organization -- that found no evidence of adverse
 health effects from depleted uranium.

     Even so, worries persist. According to Rep. Jim McDermott [D-WA
 07] who pushed for the report from the Pentagon, "There are countless
 stories of mysterious illnesses, higher rates of serious illnesses, and
 even birth defects. We do not know what role, if any, DU plays in the
 medical tragedies in Iraq, but we must find out." In contrast to soldiers
 who have lost limbs to explosive devices in Iraq, who qualify for
 Traumatic Servicemembers Group Life Insurance injury benefits of up to
 $100,000, veterans with unexplained cancers  don't get benefits because
 cancer is a disease and not a war wound. On 23 JUL 07, Iraq's environment
 minister blamed at least 350 sites in Iraq being contaminated during
 bombing with depleted uranium weapons for about 140,000 cases of cancer
 there and for between 7,000 and 8,000 new cases each year. A U.N.
 Environment Program report states that depleted uranium poses little threat if
 spent munitions are cleared from the ground. However, no major
 clean-up or public awareness campaigns have been reported in Iraq, the report
 added.  [Source:  New York Sun R.B. Stuart article 6 Aug 07 ++]


VA NORTH TEXAS SITREP:   The Veterans Affairs medical system in North
 Texas has a new director, Joe Dalpiaz, the third director in less than
 three years.  He faces many challenges one of which is restoring local
 veteran’s faith in the ability of VA to care for their needs. The
 veterans of Tarrant, Johnson, Parker and Wise counties can hardly be faulted
 for their concerns. The VA's clinic on West Rosedale Street has been
 acutely overcrowded for close to a decade, and officials have talked
 about needing a larger one for at least six years. The VA system in North
 Texas is confronting a daunting array of problems -- overwhelming demand
 for services, long waits for appointments, complaints about rude
 employees and scathing reports from its own inspector general. Dalpiaz, 49,
 who took over in May as part of a management overhaul, vows to work on
 getting it right. The North Texas system  (the Dallas hospital, Fort
 Worth clinic and a hospital and nursing home in Bonham) is the
 fifth-largest VA system in the nation, drawing from a pool of 481,000 veterans in
 40 counties. This year's budget is $511 million. Even as it has
 struggled, and sometimes failed, to handle the World War II, Korean War and
 Vietnam-era veterans, hundreds of veterans from the Iraq and Afghanistan
 wars have further burdened the system. Thirty percent of the new
 enrollees are young men and women, many with complex mental health or brain
 injuries that require considerable time and care.

     Dalpiaz seemed surprised when he took over to discover there was
 no strategic plan, no blueprint for where to go or how to get there. He
 insists that veterans must be treated better by employees. The Fort
 Worth hospital terminated 150 employees in the last year as a result of
 stricter performance and customer-service expectations, and the hospital
 is actively seeking more and better nurses, Dalpiaz said. He would like
 to improve the morale of nurses and physicians, and he said he is
 working to improve pay in a brutally competitive medical market in North
 Texas. He also expects to hire more people to answer the phones and
 reduce the wait time for a doctor appointment, all of which he believes
 would improve people's perceptions of their care. Eight months ago, the
 Fort Worth clinic closed its enrollment to veterans, an extraordinary
 step. The 45,000-square-foot building, opened in DEC 91, was designed for
 45,000 outpatient visits a year. But just a few years after the facility
 opened, the squeeze started, in part because the Air Force closed the
 hospital at Carswell AFB. Patient numbers rose after a congressional
 decision to open VA healthcare to any veteran, the managed-care crunch
 and ballooning cost of prescription drugs. Last year, the facility
 recorded 149,429 outpatient visits -- three times more than it was designed
 to handle. In December, officials at the Fort Worth clinic decided to
 close enrollment to new veterans when the patient workload per doctor
 exceeded standards for care. There are only 13 doctors and physician
 assistants working in the building.

     Anyone new who joins the system must drive to the Dallas hospital
 in Oak Cliff. "That's not good," Dalpiaz conceded. That's because the
 Dallas facility is no less crowded than the Fort Worth clinic. The
 Dallas facility sees close to 91,000 veterans annually and recorded more
 than 700,000 outpatient visits last year. Just trying to park at the
 Dallas facility can take half an hour or more and involve a 10-minute walk.
The VA's requirement that a veteran get an appointment within 30 days
 is being met only half the time. Mike George, the newly named clinic
 administrator, said there's a ripple effect on the entire facility if a
 doctor falls behind, a suicidal patient shows up, a doctor calls in sick
 or a crush of veterans drop in without appointments.  Eldon Armstrong
 of Grand Prairie, adjutant of the state Disabled American Veterans
 chapter, said more funding is the answer to the VA's problems. Other than an
 overburdened system, he characterized VA care in North Texas as
 outstanding. "If the Congress would fund the VA to build additional
 facilities and fund the cost of staffing those, then that would help a patient
 like me get a timely appointment," Armstrong said.

     The VA has closed a real estate deal in south Fort Worth and drawn
 up conceptual plans, and money has been set aside in the budget.
 Officials expect to break ground by the summer or fall of 2008. The new
 clinic will dwarf the existing building -- 193,000 square feet larger,
 hundreds more parking spaces, a lunch cafe and expansion room just off
 Interstate 20. The two-story building will have room for 32 doctors, more
 than a twofold increase. The VA also hopes to start offering cardiology,
 endoscopy, pulmonary and dermatology services in Fort Worth and would
 like to open a women's clinic. Plans include moving mental health
 services back into the facility. "It will be the largest leased clinic in
 the entire VA system," said Bob Bearden, a facility planner for the
 system. Like the facility on Rosedale, the VA will lease it from a private
 developer for 20 years. Officials believed that they could no longer
 wait for VA construction money to build it. But that means that the
 estimated $4.2 million lease will come out of the North Texas system's
 operating budget -- the same money used to buy drugs and pay nurses. The VA
 will increase doctors, nurses and support staff in Fort Worth, but
 whether it can afford to fully staff the clinic remains to be seen.
  [Source: Fort Worth Star-Telegram Chris Vaughn article 5 Aug 07 ++]


VA CARE VET BACKLASH:   Angry veterans shouted down U.S. Rep. Ciro
 Rodriguez [D-TX-23] as he tried to bring order to a forum for veterans held
 in downtown San Antonio 5 AUG.  "We know, we understand, how crucial
 this issue is," the San Antonio congressman tried to tell an overflow
 crowd of veterans who had been invited to ask questions and share
 experiences with U.S. Rep. Bob Filner [D-CA] , chairman of the House Committee
 on Veterans' Affairs, along with Rodriguez and two other Democratic
 congressmen from Texas. But Rodriguez was drowned out and ultimately gave
 the floor to Jack E. Long, one of several vets who heckled the
 moderator as she tried to read e-mail questions that had been sent to the
 congressmen in advance.  "Don't try to talk over me!" Long yelled to
 Rodriguez as he clutched his wife's hand. "I've had PTSD for years, and I've
 been turned away from the VA five times! I served my country for 44
 years!" Veterans and their families around him cheered and clapped. Then
 they set about telling the congressmen that a nation that claims to
 support its troops hasn't done well by them since they served; many of them
 said they've had to deal with PTSD, or post-traumatic stress disorder.
 Hancock Darrell refused to sit until he, too, could tell his story.
  "I've had PTSD for 24 years," Darrell shouted. "I've been diagnosed five
 times. But what does the VA say? 'We need more information.' And they
 turn me down again."

     Filner then told the audience that the House had committed "tens
 of billions" into the 2008 budget for PTSD. He said he was working to
 change the adversarial relationship the Department of Veterans Affairs
 has with so many veterans, especially those of the Vietnam era. "I want
 to run a claim system like the IRS," he said.  Such a system would
 accept a veteran's claim on its face rather than force the veteran "to prove
 Agent Orange caused this. You shouldn't have to prove anything. You
 served us; now we should be serving you."  U.S. Rep. Charlie Gonzalez
 [D-TX-20] of San Antonio, who joined Filner, Rep. Henry Cuellar [D-TX-28]
 of Laredo and Rodriguez on the stage, took the microphone to plead for
 unity.  "We're not fighting smart," he said. "We're fighting ourselves
 here today. We have to show people that veterans are not part of our
 past." The key to a healthy volunteer military, he said, is showing young
 people who might be interested in serving that they will be taken care
 of after they leave the military. Rodriguez, who sits on the Veterans'
 Affairs Committee, noted that 80% of veterans get no care from the VA,
 many because they've become disillusioned with an agency that has a
 backlog of claims close to 800,000 claims that can take years to resolve.
 

     In his opening remarks, Filner said he had come to listen and
 learn, and he asked the capacity crowd how many had served in Vietnam. The
 majority in the room raised their hands. "Thank you for your service,"
 he said, "And I am sorry. We did not do the job for you." More than
 200,000 homeless Vietnam veterans will sleep on the streets tonight, he
 told the crowd, and as many Vietnam veterans have now committed suicide
 as died in the war.  "And that is a moral disgrace. We must correct it
 as best we can and make sure it never happens again." The ratio of
 injured to killed in today's wars is a staggering 17-to-1, he said. In
 Vietnam, it was 3-to-1. "We spend $1 billion every two and a half days" in
 Iraq and Afghanistan, he said. "Supporting our troops at home needs to
 be part of that cost." Congress has added $13 billion to the 2008 budget
 for veterans’ affairs, Filner said, calling it the largest increase
 ever. "The resources will be there. It's our job to make sure they serve
 you." Long before the audience was ready, the hour long session came to
 a close and the congressmen headed to Del Rio for another veterans
 forum that evening.  [Source: San Antonio Express-News Tracy Hamilton
 article 5 Aug 07 ++]
 

PUERTO RICO MEDICAL FRAUD:   Over 80 doctors and licensing board
 administrators from Puerto Rico have been indicted by a US federal grand jury
 for taking part in a large scale fraud that helped unqualified doctors
 in the self governing US territory obtain medical licenses through
 alleged bribery and deception. Most of the defendants are Puerto Rican and
 have been practicing as doctors in Puerto Rico, including in emergency
 departments, but so far, according to the authorities, none has
 practiced on mainland USA. A medical license from Puerto Rico is recognized
 in five US states: Arizona, Florida, New York, Texas, and Virginia. The
 defendants are said to have obtained false licenses by various means,
 including bribing officials with up to $10,000 and substituting exam
 papers submitted by successful candidates for their own. According to ABC
 News, a secretary at the licensing board allegedly cut and paste
 extracts of papers from successful candidates into the papers submitted by
 some of the defendants so they could be passed off as authentic. Some of
 the cases are thought to have involved “intermediaries”. These are
 people who approached doctors who failed their exams and suggested to them
 they could get licenses by other means. The intermediaries liaised
 between the doctors and the licensing board officials.

     Some of the defendants had failed their medical exams a dozen
 times. Most of them did their medical training overseas, for instance in
 the Dominican Republic, Mexico and Cuba. One of the people arrested is
 the former executive director of the licensing board in Puerto Rico,
 Pablo Valentin. Television news showed him being led away by local police
 and agents from the US Food and Drug Administration (FDA). The current
 list of charges could be the tip of the iceberg as federal agencies
 unravel the threads of a fraud that could stretch farther back than 2001,
 the year the current charges reaches back to. The pattern of the scores
 on the test papers suggests this could have been going on much earlier,
 said one attorney. Also, there could be implications in other areas of
 the law. For instance, if the defendants have prescribed medication
 while unlicensed, then they could face charges under the Controlled
 Substances Act. And if they have submitted claims to Medicare or Medicaid
 while unlicensed, these actions may attract charges of false statements
 and mail fraud. The defendants, if convicted, could face prison terms of
 5 to 20 years. Federal authorities are searching for nine other
 suspects, 3 believed to be in Puerto Rico and 5 in Philadelphia, Florida and
 the Dominican Republic.  [Source: AP Michael Melia article 3 Aug 07 ++]
 


SALUTING THE FLAG:   The Senate has passed legislation to ensure that
 veterans and service members can salute the flag when not in uniform.
  The bill S.1877, sponsored by Sen. James Inhofe [R-OK] would address the
 ambiguity of current law, which states that veterans and service
 members not in uniform should place their hand over their hearts, without
 specifying whether they can or should salute the flag. Inhofe said, “The
 salute is a form of honor and respect, representing pride in one’s
 military service. Unfortunately, current U.S. law leaves confusion as to
 whether veterans and service members out of uniform can or should salute
 the flag.” Inhofe said he believes this is “an appropriate way to honor
 and recognize the 25 million veterans who have served in the military
 and remain as role models to others citizens. Those who are currently
 serving or have served in the military have earned this right, and their
 recognition will be an inspiration to others.” The House would have to
 agree to the legislation before it could become law.  The bill does
 not address the ambiguity of veterans saluting during The Pledge of
 Allegiance and playing of the National Anthem.  Present policy for saluting
 is:

- When the flag passes in a procession, or when it is hoisted or
 lowered, all should face the flag and salute.
- To salute, all persons come to attention.
- Those in uniform give the appropriate formal salute.
- Citizens not in uniform salute by placing their right hand over the
 heart and men with head cover should remove it and hold it to left
 shoulder, hand over the heart.
- Members of organizations in formation salute upon command of the
 person in charge.
- The pledge of allegiance should be rendered by standing at attention,
 facing the flag, and saluting. When the national anthem is played or
 sung, citizens should stand at attention and salute at the first note
 and hold the salute through the last note. The salute is directed to the
 flag, if displayed, otherwise to the music.
[Source:  ArmyTimes Daily News Roundup 3 Aug 07 ++]


VA FACILITY EXPANSION UPDATE 05:  VA and Ft. Bragg have opened a newly
 expanded facility to explain benefits to transitioning service members
 at the post’s Soldier Support Center. Dedication of the facility,
 called a Benefits Delivery Office, was held 1 AUG at Building 4-2843 on
 Normandy Drive.  In North Carolina, in addition to Fort Bragg, VA operates
 benefits offices on Camp Lejeune Marine Corps Base and New River Marine
 Corps Air Station, with services provided at Cherry Point Marine Corps
 Air Station and Seymour Johnson Air Force Base. The Benefits Delivery
 Office is open from 08-1600 weekdays. Information on VA benefits can
 also be obtained by calling 1(800) 827-1000, or by visiting the VA
 website at www.va.gov. [Source: NAUS Weekly Update 3Aug 07 ++]


VA LOCAL ACCESS:  The Department of Veterans Affairs is represented by
 numerous Regional offices (VARO), state Benefit Offices, Vet Centers,
 and medical facilities throughout the U.S. and its territories.
 Locations of these facilities can be found at:
- VARO: http://www.vba.va.gov/benefits/ROcontacts.htm
- State Benefit Offices: http://www.va.gov/statedva.htm
- Vet Centers: http://www1.va.gov/directory/guide/vetcenter.asp
- Medical, cemetery, and all the above:
  http://www1.va.gov/directory/guide/home.asp.
- The yellow pages of your local telephone directory under “Government
 Offices”

For questions or information you get an email response by asking your
 question at
 https://iris.va.gov/scripts/iris.cfg/php.exe/enduser/home.php.  To talk
 to someone you can go to your local VA office or call the following
- VA Benefits: 1(800) 827-1000 for Burial; Civilian Health & Medical
 Program of the Department of Veterans Affairs (CHAMPVA); Death Pension;
 Dependency Indemnity Compensation; Direct Deposit; Directions to VA
 Benefits Regional Offices; Disability Compensation; Disability Pension;
 Education; Home Loan Guaranty; Life Insurance; Medical Care; Vocational
 Rehabilitation & Employment.
- Education (GI Bill): 1(888) 442-4551
- Health Care Benefits: 1(877) 222-8387
- Income Verification and Means Testing: 1(800) 929-8387
- Life Insurance: 1(800) 669-8477
- Mammography Helpline: 1(888) 492-7844
- Special Issues - Gulf War/Agent Orange/Project Shad/Mustard Agents
 and Lewisite/Ionizing Radiation: 1(800) 749-8387
- Status of Headstones and Markers: 1(800) 697-6947
- Telecommunications Device for the Deaf (TDD): 1(800) 829-4833
- Suicide Call Center: 1(800) 273-TALK (8255).
[Source:  VA website www.vba.gov Aug 07 ++]


VA CLINIC OPENINGS UPDATE 05: The Department of Veterans Affairs (VA)
 announced week to construct in Guam a new $5.4 million outpatient clinic
 (OPC) on the periphery of the island’s naval hospital.  The plan
 approved by VA Secretary Jim Nicholson calls for a 6,000 square-foot
 outpatient clinic next to the grounds of the naval hospital, with its own
 parking area.  Patients will not have to pass through Navy security to get
 to the facility.  The new OPC is scheduled to open in the summer of
 2009.  It will replace the existing 2,700 square-foot VA OPC at the naval
 hospital.  VA will still partner with the naval facility for emergency
 and after-hours health care, acute inpatient care and some specialty
 services.  About 9,000 veterans live on the island.  The existing clinic
 employs a staff of 11, including an internal medicine physician,
 psychiatrist and nurse practitioner.  It provides primary care, mental health
 care, limited specialty services and physical examinations for VA’s
 compensation and pension benefits.  [Source: NAUS Weekly Update 3 Aug 07
 ++]


SBP BASICS UPDATE 01:  When a military retiree dies their retirement
 pay stops. This means that the surviving spouse will be left without a
 substantial income source. If you are considering retirement you need to
 give serious thought to how you can protect your spouse from the
 hardships caused by the loss your retirement pay.  One option available to
 you is the Survivor Benefit Plan (SBP). This is an insurance plan that
 will pay your surviving spouse a monthly payment (taxable annuity) to
 help make up for the loss of your retirement income. The plan is designed
 to protect your survivors against the risks of your early death; your
 survivor outliving the benefits; and inflation. At retirement, full
 basic SBP for spouse and children will take effect automatically if you
 make no other valid election. You may not reduce or decline spouse
 coverage without your spouse's written consent. This means you will have to
 have your spouses input in the decision and his or her signature is
 required.  If you are divorced or not married than any future spouse can be
 signed up within one year of the marriage. 
 
    If you do not decline SBP you will be required to pay a monthly
 premium. If a marriage ends, the SBP premium payments are stopped when the
 retiree notifies DFAS. Premiums and benefits are based on the base
 amount or benefit level that you elect. Your base amount can be any amount
 from full coverage down to as little as $300 a month. Full coverage is
 based on your full retired pay meaning your spouse will receive 55% of
 your retirement pay. If you select lesser coverage then your spouse
 will receive 55% of your elected base amount.  A surviving spouse's SBP
 annuity is reduced when they reach age 62 and become eligible for Social
 Security. This is called the Social Security offset. In the past the
 offset reduced the SBP annuity to 35% of the base amount.  Fortunately
 the NDAA of 2005 established a phase out of the offset.  This will
 increase the SBP offset percentage from the present 50 to 55% effective 1
 APR 08. Categories of coverage are:
- Spouse Only: Eligibility for this requires that a surviving spouse be
 a widow or widower who was married to a retiree at the time of his or
 her enrollment; or, if not married at the time of enrollment, was
 married to the deceased retiree for at least one year prior to the retiree’s
 death; or, if not married at time of enrollment and was not married to
 the deceased retiree for at least one year prior to death, was the
 parent of issue by that marriage. Spouse coverage applies not only to the
 spouse a member has at time of enrollment, but also automatically to
 any subsequent spouse the member might acquire, unless the member elects
 to decline coverage for a subsequent spouse within one year of the date
 of marriage (concurrence of the subsequent spouse is not required, but
 that spouse will be notified of the member’s declination).
- Spouse (or Former Spouse) and Child: SBP protection is expanded to
 cover an eligible child or children if there is no surviving spouse, or
 if a surviving spouse subsequently dies or becomes ineligible to receive
 benefits due to remarriage before the age of 55. Thus, if there is a
 divorce or if the spouse dies before the retiree, the full annuity will
 be paid to the eligible surviving child or children in the same manner
 as if the member had elected Child Only coverage.
- Child Only: This option provides an annuity only for dependent
 children regardless of whether a member is married or not at time of
 enrollment (although a married member’s spouse must concur with a child only
 election). Children remain beneficiaries until age 18 or age 22 if a
 full-time, unmarried student. Children mentally or physically incapable of
 self-support remain eligible, while unmarried, for as long as the
 incapacitation exists. A member with no dependent children at time of
 eligibility to elect coverage may elect coverage for a child subsequently
 acquired, but the child must be added within one year of being acquired
 (born, adopted, etc.).
- Former Spouse: A member who has a former spouse upon becoming
 eligible to elect a survivor annuity may elect coverage for a former spouse.
 If the member has more than one former spouse, the member must specify
 which former spouse is being covered. An election for a former spouse
 prevents payment of an annuity to a current spouse. A former spouse who
 was not a member’s former spouse on the date a member became eligible to
 participate in SBP must have been married to the member for at least
 one year in order to be named as a former spouse beneficiary.
- Insurable Interest:  A member who does not have a spouse or dependent
 child when eligible to make a program election may elect to provide
 coverage for a person with an insurable interest in the member (such as,
 a business partner or parent). DoD defines an insurable interest as a
 natural person who has a reasonable and lawful expectation of financial
 benefit from the continued life of the participating member, or any
 individual having a reasonable and lawful basis, founded upon the relation
 of parties to each other, either financial or of blood or affinity, to
 expect some benefit or advantage from the continuance of the life of
 the retired member. If the election is for a person who is more nearly
 related than a cousin, no proof of financial expectation is required. An
 election for insurable interest coverage, for other than a dependent
 made by a member retiring on or after 24 NOV 03 under a military
 disability provision, who dies within one year after being retired due to a
 cause related to the disability for which retired, shall be voided and
 any premiums paid for that coverage will be paid to the person to whom
 the annuity would have been paid.

Like your retirement pay the SBP annuity is protected from inflation.
 Each year when retired pay gets a COLA, so does the base amount, and as
 a result, so do premiums and annuity payments.  Meaning that your
 premiums and annuity payments will increase with the COLA. These increases
 are determined by the previous year's Consumer Price Index and averages
 approximately 2.5%. For specific costs on your election refer to
 http://www.military.com/benefits/survivor-benefits/coverage-cost-and-benefits.
 NOTE: Survivors should report retiree deaths to the DFAS casualty
 office at 1(800) 269-5170. Faxes can be sent to the office at 1(800)
 469-6559.  [Source: NCPOA Don Harribine 2 Aug 07 ++]


RETIREE ANNUAL COLAS UPDATE 01: Military retired pay rises each year to
 ensure that inflation does not erode the purchasing power of retirees.
 These cost-of-living adjustments, known as COLAs, match the annual
 increase in Social Security benefits. They become effective each 1 DEC and
 first show up in January paychecks. The foundation for the COLA
 adjustment is the Labor Department’s Consumer Price Index, a measure of the
 cost of certain categories of goods and services that is updated
 monthly. There is one overall CPI, as well as a variety of more specific
 indexes. The index upon which the retired pay COLA is based is called the
 CPI for Urban Wage Earners and Clerical Workers, or CPI-W. The rate of
 inflation may rise and fall throughout the year, but the exact increase
 in retired pay is based only on the average inflation rate over the last
 quarter of the fiscal year that runs from Oct. 1 to Sept 30. The size
 of the increase is equal to the difference between the average
 inflation rate in that quarter and the average inflation rate in the same
 quarter of the previous fiscal year. For the purposes of military retired
 pay, this means the only months in which inflation matters are July,
 August and September.  So far this fiscal year inflation rates have been
 OCT 06 (-1.1), NOV 06 (-1.2), DEC 06 (-1.0), JAN 07 (-0.8), FEB 07
 (-0.3), MAR 07 (0.8), APR 07 (1.5), MAY 07 (2.3), & JUN 07 (2.4).  Thus, if
 the last the month’s CPI-W rates were to be used to compute the 2008
 COLA we would be looking at an increase of  1.5 + 2.3 + 2.4 divided by 3
 which equates to  2.1%. Service members who retire in a given fiscal
 year receive a partial COLA for that year only, based on the date of their
 retirement. They receive the full COLA in subsequent years. The
 retired pay COLA technically is not automatic; Congress must formally approve
 it each year. To track CPI-W yourself go to www.armytimes.com and
 click on "Retirement Tracking your COLA”.  [Source:  Army Times Aug 07 ++]


VA FRAUD UPDATE 01:  The U.S. attorney's office announced 1 AUG that a
 grand jury has indicted a 63-year-old San Diego woman on charges
 alleging that she embezzled more than $120,000 in military veteran's survivor
 benefits over a 10-year period. Linda Bent Lampert is scheduled to be
 arraigned on the 36-count indictment 6 AUG, federal prosecutors said in
 a news release. Lampert is alleged to have received benefits through
 the Dependency Indemnity Compensation (DIC) program, which provides
 money to the unmarried, surviving spouses of military veterans who have
 died. Lampert's mother was eligible to receive the benefits from DEC 75
 until her death in AUG 96, but Lampert continued to receive the payments
 after her mother died, according to federal prosecutors. Lampert is
 alleged to have forged her mother's signature in AUG 03 on a document
 submitted to the Department of Veterans Affairs, which administers the
 program, according to federal prosecutors. [Source: San Diego North County
 Times Scott Marshal article 1 Aug 07 ++]


VET HOME TENNESSEE:   On 1 AUG state officials said the state veterans'
 home in Murfreesboro TN has been fined nearly $200,000 for violations
 thus far this year.  The home was being fined $6,000 a day by the
 Centers for Medicare and Medicaid Services, but that fine has since been
 knocked down to $800 a day because of improvements in care.  State Finance
 Commissioner Dave Goetz told a joint legislative committee that the
 state can't simply pay the $198,900 fine because the veterans' homes were
 set up by the Legislature to be managed by an independent board.
  Goetz recommended that lawmakers consider changing the management structure
 for the veterans' homes in Murfreesboro, Humboldt and Knoxville. Gov.
 Phil Bredesen in JUN 07 put a freeze on new admissions to the homes
 after an investigation into the Murfreesboro facility found the staff
 failed to manage residents who showed aggressive behavior, protect
 residents from harm, report unusual incidents and investigate injuries.  The
 nursing home was also fined by state and federal officials last year
 after a report by the state Health Department found workers failed to treat
 bedsores and follow doctors' orders, putting residents' lives in
 danger.  Bredesen lifted the admissions ban for the Knoxville and Humboldt
 homes last month.

     When the state's first veterans home opened in Murfreesboro, the
 plan was for it and any other homes to finance themselves through
 federal Veterans Affairs money, from Medicare and Medicaid payments and from
 private pay. But the homes have not become self-sufficient.  They have
 also become riddled with accounting problems that have led to
 incomplete financial records, according to a state audit. Goetz said the state
 has put on hold a plan to open a new veterans home in Clarksville.
 "Given all the things we've had going on, I didn't think we'd get a very
 positive reception if we pressed at this moment," he said. "I think we're
 going to have to kind of get things straightened out before we consider
 proceeding ahead with Clarksville."
 
    The first Tennessee veterans’ home located on a seven acre lot,
 deeded to the Board by the U.S. Department of Veterans Affairs, adjacent
 to the Alvin C. York VA. Medical Center opened in Murfreesboro 10 JUN
 91. It is a 140 bed facility offering intermediate and skilled levels of
 nursing care in a one-story building encompassing 69,278 square feet.
 Legislation passed by the state’s General Assembly in 1993 provided for
 construction of a second facility in Humboldt Tennessee. Also, a 140
 bed facility offering intermediate and skilled levels of nursing care.
 This one-story building encompassing some 74,870 square feet opened 7 FEB
 96. The third home in Knox County opened in DEC 06. This 140 bed
 facility, offered intermediate and skilled levels of nursing care in a
 spacious 73,065 square foot, one-story building and is  currently accepting
 residents. In each of the three facilities, 20 of the beds are located
 in a secure, special needs unit.  Eligible applicants for admission are
 veterans who are entitled to medical treatment and/or other benefits
 from the USDVA, and who also meet at least one of the below additional
 requirements:
- Resident of Tennessee at time of admission.
- Born in Tennessee.
- Entered the U.S. Armed Forces in Tennessee.
- Tennessee address is official Home of Record on Veteran's Military
 Record.
- Has an immediate family member (Parent, Spouse, Sibling, or Child) or
 Legal Guardian who would serve as primary caregiver, who is a resident
 of Tennessee.

Spouse, Widow/Widower or Gold Star Parent may also be eligible for
 admission on a space available basis. Upon meeting the eligibility
 requirements, an applicant's name will be placed on a Potential Admissions Wait
 List.  Applications are available for download at http://www.tsvh.org
 as well pricing and availability information.  Also, a video/DVD on
 Tennessee’s homes can be ordered at no charge. Assistance on completing
 the application can be obtained by calling  call the Admissions office in
 Murfreesboro at (615) 225-1852, in Humboldt at (731) 824-5776, or in
 Knoxville at (865) 862-8152.  [Source: AP Erik Schelzig article Aug 07
 ++]


HVAC UPDATE 02:   In a Subcommittee on Disability Assistance and
 Memorial Affairs legislative hearing 1 AUG on H.R. 674, H.R. 1273, H.R. 1900,
 H.R. 1901, H.R. 2346, H.R. 2696, and H.R. 2697, members expressed
 general bipartisan support for these bills.  One area of concern among
 subcommittee Republicans is the lack of cost information now available,
 especially as much of the legislation considered involves the need for
 PAYGO mandatory funding offsets. H.R. 2696, H.R. 2697, and H.R. 2346 each
 directly address how Congress determines the location of national
 cemeteries in a timely manner.  Following are the bills that are under
 consideration:

- H.R. 2696, the Veterans Dignified Burial Assistance Act of 2007
 introduced by subcommittee ranking member Doug Lamborn (R-CO) contains
 provisions which would improve the VA burial benefit and state veteran’s
 cemeteries.  This bill would increase the burial and plot allowance for a
 veteran’s burial in a private cemetery from $300 to $400.  The bill
 would also repeal the current time limitation for state reimbursement of
 interment costs by VA.  Occasionally, a state locates the remains of
 veterans who were not buried.  When states bury these veterans, VA may not
 be able to reimburse them because of a time limit on reimbursement.
 Additionally, the bill would authorize the VA secretary to make
 additional grants to states for improving and expanding state veteran
 cemeteries.  States would have to submit an application to the secretary, and
 could receive up to $5 million.

- H.R. 2697, also introduced by Lamborn, would extend eligibility for
 Veterans Mortgage Life Insurance (VMLI) to members of the armed forces.
  VMLI is a special type of life insurance that is only available to
 veterans who qualify for specially adapted housing grants. Many of our
 nation’s injured active duty servicemembers may eventually qualify for
 VMLI, and would benefit by having this eligibility.

- H.R. 2346, introduced by Vito Fossella (R-NY), would direct VA to
 establish a process to determine whether a geographic area is sufficiently
 served by existing veterans’ cemeteries.  The process will take into
 account the following variables for each geographic area: (1) total
 number of veterans;  (2) average distance a resident must travel to reach
 the nearest national cemetery; (3) population density; (4) average
 amount of time it takes a resident to travel to the nearest national
 cemetery; (5) availability of public transportation for purposes of traveling
 to national cemeteries; and (6) average amount of fees charged to an
 individual traveling on the major roads leading to the national
 cemeteries.  This process will be a departure from the current 175,000
 population and 75-mile thresholds that the VA uses for determining the need of a
 national cemetery.

- H.R. 674, introduced by Luis Gutierrez (D-IL) would repeal the 2008
 sunset provision on VA’s Advisory Committee on Minority Veterans.  The
 committee comprises representatives from minority groups, veterans’
 service organizations, and representatives from many federal, state, and
 local government agencies.  The major functions include: (1) advising the
 VA secretary and Congress on VA’s administration of benefits and
 provisions of health care, benefits, and services to minority veterans; (2)
 providing an annual report to Congress outlining recommendations,
 concerns and observations on VA’s delivery of services to minority veterans;
 (3) meeting with VA officials, veteran service organizations, and
 other stakeholders to assess the department’s efforts in providing benefits
 and outreach to minority veterans; and (4) making periodic site visits
 and holding town hall meetings with veterans to address their
 concerns.

- H.R. 1273, introduced by Shelley Berkley (D-NV) extends eligibility
 for a $300 plot allowance for burial in a private cemetery who is
 eligible for burial in a national cemetery and who: (1) was discharged from
 active service for a disability incurred or aggravated in the line of
 duty; or (2) is a veteran of any war.  Currently, a veteran is only
 eligible for this plot allowance if they were receiving VA compensation,
 pension benefits, or died of service-connected injuries.  The bill also
 authorizes the VA secretary to reimburse a veteran’s family for the cost
 of buying a non-governmental headstone.  While this authorization would
 be of great help to families of deceased veterans, significant
 mandatory funding offsets would be required needed for its passage.

- H.R. 1900, introduced by Nick Rahall (D-WV), would extend eligibility
 for pension benefits under laws administered by the VA secretary to
 veterans who received an Armed Forces Expeditionary Medal. The VA has
 designated “periods of war” to identify veterans who qualify for certain
 veterans’ pension benefits.  However, these periods of war may differ
 from dates given in declarations of war, termination of hostility dates,
 proclamations, laws, or treaties; thus many veterans who served in
 hostile areas are not eligible for veterans’ pension benefits.

- H.R. 1901, also introduced by Rahall, is similar to H.R. 1900, but
 would only extend the pension benefit to veterans who served during the
 following time periods: (1) the period beginning on 1 FEB 55, and ending
 on 4 AUG 64, in the case of active military, naval, or air service
 performed in the Republic of Korea; (2) the period beginning on 8 MAY 75,
 and ending on 1 AUG 90, in the case of active military, naval, or air
 service performed in the Republic of Korea; (3) the period beginning on
 24 AUG 82, and ending on 31 JUL 84, in the case of active military,
 naval, or air service performed in Lebanon or Granada; and (4) the period
 beginning on 20 DEC 89, and ending on 31 JAN 90, in the case of active
 military, naval, or air service performed in Panama.
[Source:  HVAC Republican Press Release 1 Aug 07 ++]


COMMISSARY CONSTRUCTION FUNDING:  The chairman of the Senate defense
 appropriations subcommittee Sen. Daniel Inouye (D-HI) has asked Defense
 Secretary Robert Gates to help the Defense Commissary Agency (DeCA) with
 a looming cash squeeze for store construction. Movement of force
 structure due to base closings and realignment, the planned restationing of
 forces from forward areas in Europe, and the ongoing expansion of the
 Army and Marine Corps is forcing the DeCA to divert resources from its
 ongoing modernization program, “indefinitely delaying many needed
 projects,” Inouye wrote in a 23 JUL letter to Gates. “I have learned that
 nearly the entire fiscal year 2008 and 2009 construction program has been
 revamped to accommodate the restationing program … I strongly urge you
 to allow commissaries to receive military construction or base closure
 and realignment funding to meet the restationing requirement and will
 work with you in this regard.  It is the right thing to do.” wrote
 Inouye. Michael Dominguez, principal deputy undersecretary of defense for
 personnel and readiness, told lawmakers at a 13 MAR House hearing that
 his office unsuccessfully sought $3.1 billion for construction costs for
 commissaries and exchanges as part of the Pentagon’s fiscal 2008 budget
 plan.     Patrick Nixon, DeCA director, testified in the earlier
 hearing that the strain on the surcharge account, derived from the standard
 5% markup on commissary items that traditionally supports store
 construction and renovation, represents the commissary system’s biggest
 challenge. At the 16 military communities that will see significant personnel
 increases in the next few years, “our existing facilities will not be
 able to accommodate the increased patron demand,” he said. BRAC actions
 will close six installations with commissaries, while overseas
 rebasing will affect 28 other stores in various ways. But the concern is those
 16 installations (10 stateside and six overseas) which are expected to
 gain a significant number of people as a result of the ongoing moves,
 will require increased near-term store construction and expansion. To
 address that, defense officials have two choices: raise the current 5%
 surcharge that customers pay on all commissary items, or supplement the
 surcharge fund by pumping in additional taxpayer dollars. “Besides
 penalizing servicemen and women at the bases that will have their projects
 delayed, it is unfair to ask our military people to pay again for
 construction of stores after they have already paid once for stores at
 existing bases that are now being closed or down sized,” Inouye said in his
 letter.  [Source: Army News Karen Jowers article 2 Aug 07 ++]


SBP PAID UP PROVISION UPDATE 03:  Effective 1 OCT 08 Uniformed Services
 Survivor Benefit Plan (SBP) participants who reach 70 years of age and
 have made 360 payments (30 years), will no longer have to pay premiums
 for continued SBP coverage and will be placed in “Paid-up SBP” status.
 Paid-up SBP provisions were mandated by the National Defense
 Authorization Act for fiscal 1999.  The law also established a paid-up status,
 also beginning on 1 OCT 08 for participants in the Retired Serviceman’s
 Family Protection Plan once they reach 70 years of age. No action is
 required of SBP participants to be placed in Paid-up SBP status.  Once
 the eligibility criteria has been met, the Defense Finance and Accounting
 Service (DFAS) will automatically stop deducting premiums from
 qualifying military retired pay accounts. The law establishing Paid-up SBP
 does not allow for refunds of premiums paid before October 1, 2008, even
 though a retiree may have reached age 70 and made 360 or more premium
 payments.

      DFAS is currently developing changes to the military retiree pay
 systems that will monitor the number of SBP premiums paid and the age
 of the participant.  The system updates are targeted for a May 2008
 completion date.  At that time, SBP participants who will be eligible for
 Paid-up SBP status on October 1, 2008, or will meet eligibility within a
 short time of the implementation date, will be notified by mail of
 their impending paid-up status.  Those military retirees who become
 eligible for Paid-up SBP status after the initial group will be notified of
 their SBP status on their DEC 08 annual Retiree Account Statements (RAS)
 that will note the number of premiums paid to date.  Each RAS issued
 after DEC 08, whether annually or as a result of a pay change, will
 include the Paid-up SBP premium “counter,” based on DFAS records, to help
 retirees monitor their eligibility status. More information on Paid-up
 SBP, including frequently asked questions and news updates, should be
 available at the DFAS Web site at www.dfas.mil/ retiredpay. html within
 the next several months. [Source: DFAS Notice Aug 07 ++]


AGENT ORANGE DISEASES UPDATE 01:   The VA has determined that a
 presumption of service connection will apply to certain claims based on
 exposure to herbicides that were used during the Vietnam war era.  This
 determination is based primarily but not solely on the Institute of
 Medicine’s [IOM] ability to determine association exists.  The following
 categories of Association are applicable to presumptive conditions:
- Sufficient - Evidence is sufficient to conclude that there is a
 positive association. That is, a positive association has been observed
 between exposure to herbicides and the outcome in studies in which chance,
 bias, and confounding could be ruled out with reasonable confidence.
 For example, if several small studies that are free from bias and
 confounding show an association that is consistent in magnitude and direction,
 there could be sufficient evidence of an association.
- Limited or Suggestive - Evidence suggests an association between
 exposure to herbicides and the outcome, but a firm conclusion is limited
 because chance, bias, and confounding could not be ruled out with
 confidence.  For example, a well-conducted study with strong findings in
 accord with less compelling results from studies of populations with similar
 exposures could constitute such evidence.

The National Academy of Sciences “The Veterans and Agent Orange: Update
 2006” IOM report has assigned association categories on the following
 medical conditions: 
1.  Sufficient Evidence of Association:
     -  Chloracne
     -  Cancers:
        a.  Chronic lymphocytic leukemia (CLL).
        b.  Non-Hodgkin’s lymphoma.
        c.  Hodgkin’s disease
        d.  Soft-tissue sarcoma

2.  Limited or Suggestive Evidence of Association:
     -  Early-onset transient peripheral neuropathy.
     -  AL amyloidosis.
     -  Hypertension.
     -  Porphyria cutanea tarda.
     -  Type 2 diabetes (mellitus)
     -  Cancers:
         a.  Larynx
         b.  Lung, bronchus, or trachea
         c.  Multiple myeloma
         d.  Prostate
      -  In offspring of exposed individuals - Spina bifida
[Source:  Various Aug 07 ++]


AGENT ORANGE DISEASES UPDATE 02:   The VA has determined that a
 non-presumption of service connection will apply to certain claims based on
 exposure to herbicides that were used during the Vietnam war era. This
 determination is based primarily but not solely on the Institute of
 Medicine’s [IOM] ability to determine if association exists.  The following
 categories of association are applicable to non-presumptive conditions:
- Inadequate or Insufficient - The available studies are of
 insufficient quality, consistency, or statistical power to permit a conclusion
 regarding the presence or absence of an association. For example, studies
 fail to control for confounding, have inadequate exposure assessment,
 or fail to address latency.
- Limited or Suggestive Evidence of No Association - Several adequate
 studies, which cover the full range of human exposure, are consistent in
 not showing a positive association between any magnitude of exposure
 to the herbicides of interest and the outcome. A conclusion of “no
 association” is inevitably limited to the conditions, exposure, and length
 of observation covered by the available studies. In addition, the
 possibility of a very small increase in risk at the exposure studied can
 never be excluded.

The National Academy of Sciences “The Veterans and Agent Orange: Update
 2006” IOM report has assigned association categories on the following
 medical conditions: 
1.  Inadequate or Insufficient Evidence to Determine Association
     -  Neurobehavioral disorders (cognitive and neuropsychiatric)
     -  Movement disorders, including Parkinson’s disease and
 amyotrophic lateral sclerosis
     -  Chronic peripheral nervous system disorders
     -  Respiratory disorders
     - Gastrointestinal, metabolic, and digestive disorders (changes in
 liver enzymes, lipid abnormalities, ulcers)
     -  Immune system disorders (immune suppression, autoimmunity)
     -  Ischemic heart disease *
     -  Circulatory disorders (other than hypertension)
     -  Endometriosis
     -  Effects on thyroid homeostasis
     -  Cancers:
a. Oral cavity (including tongue), pharynx (including tonsils), or
 nasal cavity (including ears and sinuses).
b. Pleura, mediastinum, and other unspecified sites within the
 respiratory system and intrathoracic organs.
c. Esophagus.
d. Stomach.
e. Colorectal cancer (including small intestine and anus).
f. Hepatobiliary cancers (liver, gallbladder, and bile ducts).
g. Pancreas.
h. Bone and joint.
i. Melanoma *
j. Non-melanoma skin cancer (basal cell and squamous cell).
k. Breast *
l. Reproductive organs (cervix, uterus, ovary, testes, and penis;
 excluding prostate).
m. Urinary bladder.
n. Kidney.
o. Brain and nervous system (including eye) .
p. Endocrine cancers (thyroid, thymus, and other endocrine).
q. Leukemia (other than CLL).
r. Other and unspecified sites.
     -  Abnormal sperm characteristics and infertility.
     -  Spontaneous abortion (other than for paternal exposure to
 TCDD).
     -  In offspring of exposed individuals:
a. Neonatal or infant death and stillbirth.
b. Low birth weight.
c. Birth defects (other than spina bifida).
d. Childhood cancer (including acute myelogenous leukemia)
* Indicates  the committee could not reach consensus as to whether the
 evidence for these health outcomes related to exposure to the chemicals
 of concern was “limited, suggestive” or “inadequate,” so they were
 retained in the inadequate category.

2.  Limited or Suggestive Evidence of No Association - Spontaneous
 abortion following paternal exposure to TCDD
[Source: Various Aug 07 ++]


AGENT ORANGE & HYPERTENSION:  A new report from the Institute of
 Medicine (IOM) finds suggestive but limited evidence that exposure to Agent
 Orange and other herbicides used during the Vietnam War is associated
 with an increased chance of developing high blood pressure in some
 veterans.  The report is the latest update in a congressionally mandated
 series by the IOM that reviews every two years the evidence about the
 health effects of these herbicides and the type of dioxin — TCDD — that
 contaminated some of them.  The committee that wrote the report also
 concluded that there is suggestive but limited evidence that AL amyloidosis
 is associated with herbicide exposure.  Characterized by the
 accumulation of protein deposits in and around organs, this rare condition affects
 one in 100,000 people annually in the United States.  The committee
 based its conclusion on the fact that AL amyloidosis shares many
 biological and pathological similarities with multiple myeloma and certain
 B-cell lymphomas, which have been found to be associated with exposure to
 herbicides.

      A finding of "limited or suggestive evidence of an association"
 means that scientific studies of adequate quality have yielded
 information pointing to a possible statistical link or plausible biological
 means by which exposure to the chemicals of concern could result in a
 particular health effect, but that contradictory results from other studies,
 biases, or other confounding factors limit the certainty of the
 evidence.  Two recently published studies of Vietnam veterans who handled
 Agent Orange and other defoliants provide evidence that these veterans
 have higher rates of hypertension.  Defined as blood pressure exceeding
 140/90, hypertension affects more than 70 million American adults and is
 a major risk factor for heart attack, stroke, and other cardiovascular
 ailments.  It is often associated with age, race, being overweight, or
 having diabetes.  The two new studies were able to adjust for the
 impact of common risk factors for hypertension on the results.  The results
 also were consistent with findings from several other studies that
 looked at the health effects of herbicides and their contaminants on
 Vietnam veterans but were not adjusted for known risk factors and had poorer
 measures of exposure.  At the same time, a new environmental study and
 an earlier study of workers in an herbicide manufacturing plant did not
 find evidence of an association between herbicide or dioxin exposure
 and increased incidence of high blood pressure.  Given the studies'
 limitations and inconsistent results, the committee found the cumulative
 body of evidence suggestive of, but insufficient to conclude with
 certainty, an association between high blood pressure and herbicide exposure.

     The committee also reviewed studies that provide intriguing
 findings on rates of ischemic heart disease and exposure to defoliants or
 dioxin.  However, many of the studies did not have information necessary
 to adjust for the impact of weight, smoking, and other known risk
 factors on the results, and their measures of heart disease were somewhat
 imprecise.  The committee members could not agree on whether these factors
 distort the studies' results. The report presents scientific data only
 and does not imply or suggest policy decisions that the U.S.
 Department of Veterans Affairs might make.  Also, the findings relate to
 exposures and outcomes in populations.  Researchers' abilities to pinpoint the
 health risks faced by individual veterans are hampered by inadequate
 information about veterans' exposure levels during their service in
 Vietnam.  The report series is sponsored by the U.S. Department of Veterans
 Affairs and can be read at http://national-academies.org.  Established
 in 1970 under the charter of the National Academy of Sciences, the IOM
 provides independent, objective, evidence-based advice to
 policymakers, health professionals, the private sector, and the public.
  Pre-publication copy of Veterans and Agent Orange: Update 2006 can be read on the
 Internet at http://books.nap.edu/openbook.php?isbn=0309107083.
  [Source: NAS New/Report 27 Jul 07 ++]


RETIREMENT TAX CONSIDERATIONS:   If you plan to move to another state
 when you retire, examine the tax burden you’ll face when you arrive.
 State taxes are increasingly important to everyone, but retirees have
 extra cause for concern since their income may be fixed. Many people
 planning to retire use the presence or absence of a state income tax as a
 litmus test for a retirement destination.  This is a serious
 miscalculation since higher sales and property taxes can more than offset the lack
 of a state income tax. The lack of a state income tax doesn’t
 necessarily ensure a low total tax burden.  States raise revenue in many ways
 including sales taxes, excise taxes, license taxes, income taxes,
 intangible taxes, property taxes, estate taxes and inheritance taxes.
  Depending on where you live, you may end up paying all of them or just a few.
  At http://www.retirementliving.com/RLtaxes.html you can obtain
 information by state on state income taxes, sales and fuel taxes, taxes on
 retirement income, property taxes and inheritance and estate taxes. It is
 intended to give you some insight into which states may offer a lower
 cost of living.  Since everything is subject to changes recommend you
 check with the state tax office you decide to retire in to obtain the
 latest tax information.

    All states except Alaska, Delaware, Montana, New Hampshire and
 Oregon, collect sales taxes.   Some have a single rate throughout the state
 though most permit local additions to the base tax rate. Those states
 with a single rate include Connecticut, Hawaii, Indiana, Kentucky,
 Maine, Maryland, Massachusetts, Michigan, Mississippi, New Jersey, Rhode
 Island, Vermont, Virginia, and West Virginia. States with the highest
 sales tax are: California (7.25%), Mississippi (7.0%), New Jersey (7.0%),
 Tennessee (7.0%), Rhode Island (7.0%), Minnesota (6.5%), Nevada (6.5%),
 and Washington (6.5%).  Many cities and counties have the option of
 imposing an additional local option sales tax.  For instance, in
 Tennessee some cities add as much as 2.75%.  Nevada's sales tax varies by
 county and can be as high as 7.75%. Most states exempt prescription drugs
 from sales taxes. Some also exempt food and clothing purchases and a few
 also exempt non-prescription drugs.

     A total of 41 states impose income taxes. New Hampshire and
 Tennessee apply it only to income from interest and dividends. Seven states
 (Alaska, Florida, Nevada, South Dakota, Texas, Washington, and Wyoming)
 do not tax personal income. Of the 41 with a broad-based income tax, 35
 base the taxes on federal returns, typically taking a portion of what
 you pay the IRS or using your federal adjusted gross income or taxable
 income as the starting point. Most states specify amounts for taxpayers
 and each of their dependents that can be used as an offset in
 determining taxable income. Most also specify the amounts that persons 65 or
 older can deduct. Most states treat health care expenses as having
 already been deducted from federal returns. Two states (North Dakota and
 Oregon) allow full deductions while Indiana does not permit itemized
 deductions on state taxes. Only 12 of the 41 states with broad-based income
 taxes permit taxpayers to deduct federal income taxes.  This is an
 advantage if you are deciding between two states with similar rate
 structures but only one allows you to deduct. The latter would give you a lower
 effective tax rate.  [Source: www.retirementliving.com/RLtaxes.html Jul
 07 ++]


VETERAN LEGISLATION STATUS 13 AUG 07:   The House and Senate have both
 adjourned for the August recess.  Congress will return on 4 SEP. For a
 listing of Congressional bills of interest to the veteran community
 that have been introduced in the 110th Congress refer to the Bulletin
 attachment.  By clicking on the bill number indicated you can access the
 actual legislative language of the bill and see if your representative
 has signed on as a cosponsor. Support of these bills through
 cosponsorship by other legislators is critical if they are ever going to move
 through the legislative process for a floor vote to become law.  A good
 indication on that likelihood is the number of cosponsors who have signed
 onto the bill. A cosponsor is a member of Congress who has joined one or
 more other members in his/her chamber (i.e. House or Senate) to
 sponsor a bill or amendment. The member who introduces the bill is considered
 the sponsor.  Members subsequently signing on are called cosponsors.
 Any number of members may cosponsor a bill in the House or Senate. At
 http://thomas.loc.gov you can also review a copy of each bill,
 determine its current status, the committee it has been assigned to, and if
 your legislator is a sponsor or cosponsor of it.  To determine what bills,
 amendments your representative has sponsored, cosponsored, or dropped
 sponsorship on refer to http://thomas.loc.gov/bss/d110/sponlst.html.
  The key to increasing cosponsorship on veteran related bills is letting
 our representatives know of veteran’s feelings on issues.  At the end
 of some listed bills is a web link that can be used to do that.
 Otherwise, you can locate on http://thomas.loc.gov who your representative is
 and his/her phone number, mailing address, or email/website to
 communicate with a message or letter of your own making.  [Source: RAO Bulletin
 Attachment 30 Jun 07 ++] 


Lt. James "EMO" Tichacek, USN (Ret)
Director, Retiree Assistance Office, U.S. Embassy Warden & IRS VITA
 Baguio City RP
PSC 517 Box RCB, FPO AP 96517
Tel: (760) 839-9003 when in U.S. & Cell: 0915-361-3503 when in
 Philippines.
Email: raoemo@sbcglobal.net Web:
 http://post_119_gulfport_ms.tripod.com/rao1.html
AL/AMVETS/DAV/FRA/NAUS/NCOA/MOAA/USDR/VFW/VVA/CG33/DD890/AD37 member

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