Friday, April 30, 2010
Human beings are hardwired to fear things — the lion in the grass, the assailant in the alley — and if one of those fears gets realized, we may never settle down again. The pain associated with that condition is known as posttraumatic stress disorder (PTSD), a mix of depression, anxiety, anger and isolation. No one is doing more to end that suffering than psychologist Edna Foa, 72, of the University of Pennsylvania.
The severity of PTSD is matched by the horror of the things that set it off — rape, childhood sexual abuse, natural disasters. And then there's war. Half a million veterans from the Vietnam era alone may suffer from PTSD — and up to 300,000 from the wars in Afghanistan and Iraq. Too many cope with the disorder by working to exhaustion, drinking to unconsciousness and never, ever talking about it.
Foa, who studied first at Bar-Ilan University in Israel and later in the U.S., always found that unsatisfactory. Thirty years ago, she began studying post-rape trauma, cobbling together therapeutic bits from other anxiety disorders. But it wasn't until 2000 that it all began to come together. That year, she and her husband visited Israel on sabbatical. Just five days after they arrived, the second intifadeh began. It was a crucible for trauma, and that got Foa focused specifically on combat-related PTSD.
The therapy she developed is known as prolonged exposure, or PE, and involves identifying thoughts and situations that trigger the most fear and then gently exposing sufferers to them. Patients first summon up memories of the trauma. Next comes physical exposure to places or circumstances that call it up more vividly. Facing the memories strips them of power. The approach not only works; it works fast — usually within 12 sessions.
The U.S. military — which isn't easily wowed — is embracing PE. The Department of Veterans Affairs is putting the protocol into wide use and implementing programs to teach it across the various services. "The national rollouts are historic," says psychologist Joan Cook, of Yale University, who is studying PTSD in veterans of the Korean War and World War II. "They are unparalleled in the mental-health field."
To Foa, spreading the word is what matters most now. "If you develop a wonderful protocol, it's useless if nobody uses it," she says. There's little danger of that — as hundreds of thousands of service members may one day be able to attest.
KINGS BAY NAVAL SUBMARINE BASE, Ga. -- The first U.S. women allowed to serve aboard submarines will be reporting for duty by 2012, the Navy said Thursday as the military ordered an end to one of its few remaining gender barriers.
The cramped quarters and scant privacy aboard submarines, combined with long tours of up to 90 days at sea, kept them off-limits to female sailors for 16 years after the Navy began allowing women to serve on all its surface ships in 1994.
There were some protests, particularly from wives of sub sailors, after the military began formulating a plan last fall. But it received no objections from Congress after Defense Secretary Robert Gates notified lawmakers in mid-February that the Navy intended to lift the ban. The deadline for Congress to intervene passed at midnight Wednesday.
Rear Adm. Barry Bruner, who led the Navy's task force on integrating women onto submarines, brushed aside questions from reporters about the potential for sexual misconduct or unexpected pregnancies among a coed crew.
"We're going to look back on this four or five years from now, shrug our shoulders and say, 'What was everybody worrying about?' " said Bruner, the top sub commander at Kings Bay Naval Submarine Base in coastal Georgia, where the announcement was made.
The first group of women will consist entirely of officers assigned to guided-missile attack submarines and ballistic-missile submarines, which have the most living space in the Navy's fleet. They'll be assigned to two subs based at Kings Bay on the East Coast, and two at the West Coast naval hub of Bangor, Wash.
Limiting women to officer slots lets the Navy, for a time at least, sidestep the more vexing and cost-prohibitive problem of modifying subs to have separate bunks and bathrooms for enlisted men and women. Enlisted sailors make up about 90 percent of a sub's 160-sailor crew. No timeline was given for integrating enlisted women onto subs.
Bruner said 24 women will be able to begin training for submarine officers, which takes at least 15 months, this summer. They'll be divided up so that three women are assigned to each sub's two rotating crews.
That grouping will let all three women aboard a sub share a single stateroom for sleeping. The single bathroom shared by a sub's 15 officers will be equipped with a sign to show if it's occupied by men or women.
Otherwise, most changes will likely be behavioral shifts by male sailors who aren't used to having women aboard, said Lt. Cmdr. Daniel Lombardo, executive officer of the submarine USS Alaska.
"The guys are probably used to walking to the restroom in their boxer shorts and stuff," Lombardo said. "But all in all, I think the adjustments for the crew are going to be minor."
One of the most difficult groups to win over on the concept of coed subs has been women themselves -- at least those who are married to submarine sailors.
On blogs and online networking sites, wives of submariners have warned that close contact between the sexes at sea could lead to temptation and allegations of sexual harassment.
"There's a lot of Navy wives worried about their husbands cheating," said Petty Officer 1st Class Glenn Gray, a missile technician on the Alaska, who said his wife isn't crazy about the idea. "I've told her not to worry, because I'm married to her."
Bruner said that when his task force talked with the wives of submariners, the wives' primary concern wasn't that their husbands might cheat. Instead, most were concerned that unqualified women would be allowed onboard the subs to the detriment of the crew and potentially take jobs from their husbands.
Bruner said he found the opposite was true: If women are held to the same performance standards as men, as the Navy plans, allowing women aboard subs will ensure that each sub is staffed with the most capable staff possible.
The Navy declined several requests by The Associated Press to interview female sailors and cadets at U.S. bases about the policy change.
Women are currently allowed to serve on subs in a few countries, including Australia, Canada, Norway, Spain and Sweden.
About 52,446 women serve on active duty in the U.S. Navy, or about 15 percent of total personnel. Navy officials said women also make up about half the pool of potential recruits with educational degrees that qualify them for training as submarine officers.
"We literally could not run the Navy without women today," Navy Secretary Ray Mabus said in a statement.
Sailors interviewed aboard the Alaska at Kings Bay on Thursday said they're not opposed to the change.
But Petty Officer 2nd Class Chris Merceri predicted there will be "a little more anxiety" when female officers come aboard for the first time.
"Everybody's going to be really up on their P's and Q's, very formal and careful of what they do," Merceri said. "After that, everyone will be relaxed and comfortable. It'll be another day at work."
On the Net: • Navy Submarine Force www.subforce.navy.mil
• Associated Press writer Pauline Jelinek contributed to this story from Washington. Russ Bynum has covered the military based in Georgia since 2001.
Conducted by the federal Institute of Medicine, the study says costs for the nearly 2 million veterans of the two wars will expand over the next 30 years before tapering off.
The VA's budget is almost $113 billion and has almost doubled since 2003.
"VA does not have the personnel, the funding or the mandate from Congress to produce broad forecasts," the study says, adding that "the human burdens of war extend far beyond the period of active conflict."
These projections are crucial for anticipating how much money and how many services the government must set aside for helping Iraq and Afghanistan veterans, the report says. Gauging those needs is difficult because the wars in Iraq and Afghanistan are "fundamentally different" than previous wars. For example:
• Troops serve multiple combat deployments for cumulatively longer periods.
• Body armor and improved battlefield care save lives, but many wounded servicemembers are left with complex psychological and physical problems.
• The heavy use of National Guard and reservists means older troops serve more than in previous wars.
• Troops are more likely to be married with children than in the past, complicating the impact of deployments. Research has shown that spouses and children can suffer emotional problems linked to deployments.
• More women than ever serve in combat zones, and they tend to have more health issues than male troops. That will lead to higher costs.
History shows that health care costs keep rising after wars end, the study says. Disability compensation or pension payouts for veterans of World War I, World War II and the Korean conflict increased for 25 to 47 years after the end of hostilities.
The VA agreed with many of report's recommendations, says Victoria Cassano, who is managing the department's response to the study. She said some 30-year projections on benefits and veteran populations are possible.
By Gregg Zoroya
WASHINGTON � The Pentagon effort to consolidate two premier hospitals for treating wounded troops has more than doubled in price and is so rudderless that an independent review and a bipartisan group of legislators say the care could suffer.
The cost of closing Walter Reed Army Medical Center, replacing it with a larger complex at the National Naval Medical Center in Bethesda, Md., and building a hospital at Fort Belvoir, Va., has risen from $1 billion to $2.6 billion, Pentagon records show.
Correcting the problems raised by Congress will cost $781 million more, according to a Pentagon report released Monday. And improvements must wait until after the new Bethesda facility � named the Walter Reed National Military Medical Center � is finished in September 2011, the report says.
The independent review last year found that, without improvements, the center would lack an adequate number of operating rooms and some would be too small to accommodate the latest surgical technology. There would not be enough single-patient rooms, critical for controlling infections.
The center will not be "world-class" as Congress envisioned, legislators say. "Wounded warrior care will suffer," they wrote to the Pentagon in a January letter made public last week.
A key problem is that no one person is in charge of the project, according to the review done by a panel of the advisory Defense Health Board.
"(It's) a very simple issue. Someone has to be in charge," Kenneth Kizer, a former Department of Veterans Affairs official who led the review, told Congress last year.
A bill introduced last month by a bipartisan group of House Armed Services Committee members would place the deputy Defense secretary, William Lynn, in charge of the project. It would also budget another $400 million to make the new complex in Bethesda a "world-class medical facility."
In 2007, Walter Reed was rocked by scandal over poor care of wounded troops, and lawmakers said they don't want that to happen again.
"Our concerns need to be addressed," said Rep. Joe Wilson, R-S.C., a co-author of the bill that would reorganize the project's management.
"We would prefer that the Department of Defense come up with its own solution to ensure that we see a world-class center," Rep. Susan Davis, D-Calif, said. "But until we have the confidence that's going to happen, Congress will need to take action."
The Pentagon's top medical officer said last week that care of wounded troops will not suffer when the new Walter Reed center opens.
"We are going to achieve a facility for which the nation can be justifiably proud," said Charles Rice, the acting assistant secretary of Defense for health affairs.
Rice said the Pentagon is giving broader operational control over the project to its current commander, Navy Vice Adm. John Mateczun.
Stars and Stripes online edition
WASHINGTON — The Pentagon official in charge of the wounded warrior program said Sunday he has been forced to resign, as the military continues to struggle with how best to care for troops injured in combat.
Noel Koch said in an e-mail that he was asked to step down by Clifford Stanley, the undersecretary of defense for personnel. Koch had been serving as the deputy undersecretary of defense for wounded warrior care and transition policy.
The announcement came on the same day The New York Times published a scathing story that described the Army’s Warrior Transition Units as a place where physically or psychologically scarred troops are kept isolated and medicated.
Pentagon press secretary Geoff Morrell said Defense Secretary Robert Gates had asked Stanley to do a full review of the Pentagon’s personnel and readiness office. He said this is not the first nor the last change to take place.
“He was given wide latitude to make needed changes so that our men and women in uniform are better served,” said Morrell. “What you’re seeing is that the overhaul of that vitally important office is under way.”
Koch said he believes the decision was unjust and that he resigned “under duress” after Stanley told him he had no confidence in him. The Pentagon had no comment.
“No explanation was given, although I pressed for one,” he said. “No prior indication of dissatisfaction with the work of this office was cited.”
The New York Times interviewed more than a dozen soldiers and health care workers at the WTU in Fort Carson, Colo., for its story. Many of the soldiers told the paper that the treatment they’ve received there has made their suffering worse.
“It is just a dark place,” said Spc. Michael Crawford, who suffered two concussions from roadside bombs in Iraq and is waiting to be medically discharged from the Army. “Being in the WTU is worse than being in Iraq.”
Crawford, an Army sniper, said he was given a variety of medications to deal with anxiety, nightmares, depression and headaches, but told the Times that his once-a-week therapy sessions with a nurse case manager was not enough. Last summer, he attempted suicide with a combination of whiskey and painkillers.
Since 2007, at least four soldiers in Fort Carson’s WTU have committed suicide, the Times reported, citing Army figures. There are currently 465 soldiers in the Fort Carson unit and 7,200 soldiers at 32 transition units service-wide.
Senior officers in the Army’s Warrior Transition Command cited Army surveys showed positive responses to the treatment by a majority of the more than 50,000 soldiers treated in WTUs since 2007.
Lt. Col. Andrew L. Grantham, commander of the Warrior Transition Battalion at Fort Carson, suggested to the Times that many soldiers are unhappy largely because they feel guilty that they aren’t with their regular units or are ashamed of receiving treatment.“Some come to us with an identity crisis,” he said. “They don’t want to be seen
Former Army helicopter pilot Tammy Duckworth, who was injured in Iraq, shakes hands with Army Sgt. Derick Hurt after being sworn in as assistant secretary for Department of Veterans Affairs at a ceremony at Walter Reed Army Medical Center on May 20, 2009.
By Gregg Zoroya, USA TODAY
The surging costs are prompting the Pentagon and Congress to consider the first hike in out-of-pocket fees for military retirees and some active-duty families in 15 years, said Rear Adm. Christine Hunter, deputy director of TRICARE, the military health care program.
Pentagon spending on health care has increased from $19 billion in 2001 to a projected $50.7 billion in 2011, a 167% increase.
The rapid rise has been driven by a surge in mental health and physical problems for troops who have deployed to war multiple times and by a flood of career military retirees fleeing less-generous civilian health programs, Hunter said.
Total U.S. spending on health care has climbed from nearly $1.5 trillion in 2001 to an estimated $2.7 trillion next year, an 84% increase.
As a share of overall defense spending, health care costs have risen from 6% to 9% and will keep growing, said Navy Lt. Cmdr. Kathleen Kesler, a Pentagon spokeswoman.
That upward trend is "beginning to eat us alive," Defense Secretary Robert Gates told Congress in February.
In addition to mental issues, multiple combat tours have created more strains on joints, backs and legs, Pentagon statistics show. Medical visits for such problems rose from 2.8 million in 2005 to 3.7 million in 2009.
Behavioral-health counseling sessions for troops and family members rose 65% since 2004. The Pentagon paid for 7.3 million visits last year — treatment of 140,000 patients each week, according to TRICARE numbers.
Other factors driving up costs:
• Many new patients are children suffering anxiety or depression because of a parent away at war. Children had 42% more counseling sessions last year than in 2005, TRICARE numbers show.
• The number of TRICARE beneficiaries has grown by 370,000 in the past two years to 9.6 million troops, family members and military retirees.
• Nearly 200,000 prescriptions were filled each day at civilian pharmacies last year.
Active-duty troops and their families receive free health care except for out-of-pocket co-payments of $3 or $9 per prescription at civilian pharmacies.
Retirees receive the same benefits by paying $230 a person or $460 a family each year, along with small co-payments for various types of care. The fees have not gone up since 1995. By contrast, private insurance plans try to limit expenses with frequent increases in premiums and copayments
"I want to be generous and fair to all those who serve, but there's a cost-containment problem," Sen. Lindsey Graham, R-S.C., said at a recent hearing. "I don't see how we can sustain this forever, where TRICARE is never subject to adjustment in terms of the premiums to be paid."
Hunter said higher out-of-pocket expenses are being explored by the Pentagon, too.
"The difference this year is that we see members of Congress saying we need to have a thoughtful discussion," Hunter said. "Where's the balance here? We want to be grateful for people's service, absolutely. But the costs are up. What's fair?"
By Tom Vanden Brook, USA TODAY
While riding in cars, he jumped when other vehicles pulled next to his. He drank too much. One night at his parents' home, his father, retired lieutenant general Stephen Speakes, found his son sitting awake at 2 a.m., rocking back and forth alone in a chair.
One night he finally crumbled.
"My dad had been calling, leaving messages asking why I didn't return his phone calls," Grant Speakes said. "I just broke down and told him all the stuff I was dealing with. I was crying outside Hooters on the phone in Killeen, Texas. That was a low point for me."
Soldiers such as Grant Speakes, who say they killed enemy troops in combat, are at greater risk of suffering combat stress and having emotional problems, a new study shows.
Those soldiers often pay a profound psychological and emotional toll, according to Shira Maguen, lead author of the study on soldiers and post-traumatic stress disorder. Of nearly 2,800 soldiers surveyed, 40% reported killing or being responsible for somebody's death in Iraq.
"Those who acknowledged killing somebody in combat were more likely to have PTSD symptoms, anger, relationship problems," said Maguen, a staff psychologist at the San Francisco Veterans Affairs Medical Center.
Grant Speakes is among tens of thousands of U.S. troops who say they have had some type of combat stress from their service in Iraq or Afghanistan. Of the nearly 2 million veterans, 5% to 20% have some symptoms of post-traumatic stress, according to the Joint Chiefs of Staff.
Speakes, now 27, feared the stigma that he and others say exists in the military concerning those who seek help. His father says the thought of career damage to him or his sons never concerned him. "I didn't know he was worried about it," Stephen Speakes says. "It never crossed my mind. I was very worried about how best to help him."
Today, he says, he's happy to have "90% of my son back." Both talked to USA TODAY about the young officer's ordeal, the stigma of mental health problems and the need for soldiers to address them.
Grant Speakes and his twin brother, Brennan, were born into the Army and moved from post to post as their father ascended the ranks. Later, Grant Speakes entered Texas A&M, a training ground for officers. There he met Christy Fischer. The two would marry, but not before Grant spent a harrowing year in Iraq.
That year started Dec. 31, 2005, when Speakes, then a lieutenant with the 4th Brigade of the 4th Infantry Division, arrived at Forward Operating Base Falcon on the southern edge of Baghdad.
Early patrols were mostly routine. They became treacherous as insurgents began using larger roadside bombs and the first of a more powerful type, explosively formed penetrators (EFPs) that can pierce even heavily armored vehicles.
Speakes' unit saw heavy combat, including a battle in which he ordered the driver of his Humvee to crash it through a cinder block wall. The soldiers needed room to maneuver and shoot. "I got out of the truck and fired. I called in air support," Speakes says.
The soldiers captured 10 men suspected of financing insurgent attacks.
Back at the base, Speakes was spent. He would be awarded an Army Commendation medal for valor.
"That night, I realized I hadn't slept in 50 hours," he says. "You've got gunpowder ... on you. So I called home. 'Hey, Dad. I think I killed a dude. At least one.'
"Then I threw up. I was drinking a milkshake at the time. I'd like to pretend it was from the milkshake. But I don't think so."
The cost of killing
Soldiers who have killed in combat need treatment, Maguen's study says, and "may experience significant shame and/or guilt and need to know they will be allowed to explore the impact of killing in a safe and supportive environment."
Acknowledging killing experiences and analyzing them may stop soldiers from the "shame, stigma and secrecy associated with taking a life in combat," Maguen's study says. "Including killing in our evaluation and treatment planning will ensure that we are providing comprehensive health care to our newly returning veterans as they face the challenges of reintegration."
The toll became evident to Grant Speakes during a mid-tour leave.
He visited Christy and his brother in Oklahoma. The flight home was a highlight: He had been upgraded to first class and treated as a hero. But he couldn't relax, couldn't shake the need to be ever vigilant.
"I had to sit in the right passenger seat," he says. "I had to look for IEDs, something out of place. I'd look out the window. Like a dog's stare."
The Speakes family knew Grant needed treatment, but he feared the stigma that often surrounds those who seek mental health counseling.
At home in Washington, Grant Speakes couldn't relax and he startled easily, his father says. "The mood change was obvious," Stephen Speakes says. "In the case of Grant, he was the life of every party. ... He came back somber, dark, morose, depressed and occasionally angry."
Grant Speakes knew he needed counseling but says he was reluctant to seek it from the Army because another soldier might need it more.
"I also worried about the cloud it would put on my dad's career, my brother's and my own," he says. "It was something I wanted to talk about, but I couldn't. Because of that, it was hurting my relationship with Christy."
The family found a private psychiatrist, and Speakes began counseling and treatment.
'More at peace'
Treatment and time helped heal Speakes and allowed him to stay in the Army. He deployed to Iraq again in 2008 and returned home June 1, 2009, "more at peace," he says.
Stephen Speakes, who retired in the fall from a top Army budget position, says Army leaders recognize the toll combat takes on soldiers. He says what happened to his son in Iraq has left permanent scars.
Grant Speakes acknowledges that he's changed, in some ways for the better.
He's at Fort Benning, Ga., honing his skills as an officer. He's not certain when he will deploy again.
"There is life after PTSD," Speakes says. "I'm a survivor. I'm not holed up in a room with an M-4. Yes, you can acknowledge the issue and get through it."
Sunday, April 11, 2010
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Under the program, the Department of Health and Human Services database is searched to identify veterans who receive Medicaid. Then state veterans officials work with those veterans to determine whether they're eligible for health coverage, long-term care benefits or pensions through the U.S. Department of Veterans Affairs or Department of Defense.
If they are, the veterans are removed from Medicaid rolls, saving cash-strapped states money.
In Washington state, where innovative use of the Public Assistance Reporting Information System began in 2003, 5,655 veterans and their families have qualified for VA or Department of Defense health coverage, and 1,760 have received first-time or increased financial assistance. Savings so far to the state: $18 million that would have been paid by Medicaid, the low-income health program.
Rolla Riley, 88, a Marine wounded on Iwo Jima in World War II, was on Medicaid but now has the full cost of his Yakima, Wash., nursing home paid by the VA, says his stepson, Alan Abel. "It's just terrific," Abel says.
Veterans are shocked when they learn they have benefits often better than Medicaid, says Bill Allman of Washington state's Department of Social and Health Services. He's a Vietnam veteran who devised the system. "This isn't a handout," Allman says. "This is a benefit we earned."
Allman, who will discuss his state's efforts at a national conference next week, has been contacted by about 20 interested states. Among them:
•Montana. The system was implemented in 2007, says Russ Hill of the Department of Public Health and Human Services. It has saved the state almost $900,000 in Medicaid costs.
•Colorado. It began using the system in November and has identified about 1,600 individuals or families who might qualify, says Robert Douglas of the Department of Health Care Policy and Financing. Potential savings: about $8 million a year, he says.
•California. A test of the system that began last year in three counties has identified 32 veterans eligible for VA coverage, says Toby Douglas of the Department of Health Care Services.
The California Legislative Analyst's Office says the state could save $25 million if 10% of its veterans switched to VA health care. "We're doing the right thing both from a cost-avoidance perspective and ensuring that our veterans get the highest-quality services," Douglas says.
WASHINGTON — The Navy is banning smoking inside its submarines and will stock nicotine patches and gum on all boats to help sailors quit.
The new policy goes into effect no later than December 31 this year and was announced Thursday by Vice Adm. John J. Donnelly, Commander of the Navy's Submarine Forces.
He says the decision follows a yearlong study last year on nine submarines that showed unacceptable levels of second-hand smoke are present when the subs are submerged.
The new policy leaves allows individual sub commanders to decide whether they crews are permitted to smoke on deck while their sub is above water.
More than 250,000 of these veterans were unemployed last month. An additional 400,000 have left the workforce to attend college or raise children, or because they have stopped trying to find a job, Labor Department economist Jim Walker says. The overall national unemployment rate is 9.7%.
"It makes you almost want to go out and rip off all the 'Support Your Troops' bumper stickers," says Joe Davis, a spokesman for the 1.5-million-member Veterans of Foreign Wars. "If you want to support your troops, give them a job."
Reasons behind the joblessness:
•Veterans are having a difficult time translating military skills — initiative, leadership and coolness under pressure — into job-application language that civilian employers can grasp, says Sen. Patty Murray, D-Wash. She has been meeting with unemployed veterans while on recess from Congress.
"These guys are disciplined. They're great workers, and we should be getting them jobs," says Murray, who is sponsoring legislation to improve résumé training, expand the G.I. Bill to include apprenticeship programs and assist veterans starting small businesses.
•Employers are skittish about hiring National Guard and Reserve troops because these forces are so frequently deployed for up to a year or more, which requires employers to hold their jobs open, says Paul Rieckhoff, founder and executive director of Iraq and Afghanistan Veterans of America.
•Some employers don't understand combat-related illnesses, such as post-traumatic stress disorder, how frequently they occur and how they are treatable, Murray says.
The majority of Iraq and Afghanistan veterans show no signs of these illnesses, according to Pentagon data. Veterans "are telling me that they know they should get this job, but it's like the person hiring them is worried that they'll have post-traumatic stress syndrome and blow up on the job," she says.
The high unemployment is forcing servicemembers to make difficult choices, Davis says. "People are making decisions: 'Do I get out now and go into the unemployment line or do I stay and be subject to another deployment?' That's a tough decision, especially for the families," he says.
Recruitment and re-enlistment numbers for the Army, lagging during years before the recession, are now topping 100%, according to Army figures.
About 20% of Iraq- and Afghanistan-era veterans report having a service-connected disability compared with 13% of all veterans, according to the Labor Department. Among those Iraq and Afghanistan veterans with jobs, a third work in the public sector, the department reports.
President Obama announced in November an effort to expand federal recruitment, training and hiring of veterans.
"They are trainable. They are intelligent. They know what the words 'responsibility' and '(do it) now' mean," Davis says. "Who wouldn't want to have them as an employee? All they want is a chance."
The Air Force's nearly 50,000 BlackBerrys are not quite so handy anymore. Starting this month, airmen can no longer use the mobile devices to send text messages with photos or videos attached, or download new applications. Bluetooth capability is also being disabled on most BlackBerrys, the Air Force said. The service is making the changes to protect against cyberattacks, according to 24th Air Force, which is responsible for cybersecurity.
"Malicious activity can be carried through attachments, and that's what we are trying to avoid," said Capt. Christine Millette, 24th Air Force spokeswoman. � Tom Spoth, Air Force Times
Thursday, April 1, 2010
The Yellow Ribbon GI Education Enhancement Program (Yellow Ribbon Program) is a provision of the Post-9/11 Veterans Educational Assistance Act of 2008.
This program allows degree granting institutions in the United States to voluntarily enter into an agreement with the Veteran’s Administration (VA). Under this agreement, the school may contribute up to 50% of tuition expenses, and the VA will match that amount.
Detailed information about the Yellow Ribbon Program can be found on the website.
Since 2004, the Computer/Electronic Accommodations Program (CAP) has filled more than 15,200 requests by wounded service members for assistive technologies. CAP provides wounded veterans with the tools necessary to access computer and telecommunications environments.
Working closely with rehabilitation personnel at military treatment facilities, CAP makes sure service members get information about and exposure to assistive technologies early in their rehabilitation process. Knowing what types of tools exist can have a profound impact on the recovery process, with service members seeing themselves able to work or learn in an electronic environment despite their injuries.
CAP assesses a service member’s needs by considering the individual, the functional limitations they experience, and the job or task to be performed. For some service members their ‘job’ may be keeping medical and therapy appointments, working in a temporary duty assignment or preparing to continue on active duty. They can also be getting ready to separate from active duty where they’ll continue their education or work in the private sector or as a federal civilian employee.
A recent enhancement to CAP now allows service members to keep their assistive technologies when they leave active duty. Service members who get out and return to work for the federal government can receive the CAP tools they need in their new workplace.
For more information about the Computer/Electronic Accommodations Program, including how to submit a needs request assessment, go to www.tricare.mil/cap/WSM. To sign up for the CAP newsletter, visit www.tricare.mil/cap/news/Subscribe.cfm.
That's one of several changes in the military's law governing the service of gay troops that Gates and Adm. Michael Mullen, chairman of the Joint Chiefs of Staff, announced Thursday.
Although Gates said last month that he was ordering a study of the law, his decision Thursday pushed changes in the policy that go into effect immediately.
Supporters of scrapping the law applauded Gates' move, saying it would limit abuse under the policy and lead to its repeal. "These changes are by no means a substitute for full legislative repeal of the law this year, but they are certainly a good start," said Alexander Nicholson, a former U.S. Army interrogator who was discharged under the law and heads Servicemembers United, an interest group favoring repeal.
Co-sponsors of a Senate bill that would repeal the law commended the changes. "(It) is an important step on the path to a complete repeal," says Sen. Joe Lieberman, I-Conn., the bill's lead author. "This shows that our military can implement policies to end discrimination on the basis of sexual orientation while preserving our highest military standards."
Critics of changing the law, such as Sen. Saxby Chambliss, R-Ga., said Gates should wait for the results of the study and then decide what to do. "I'm a little bit surprised that he would take this kind of action," Chambliss said.
The changes are likely to create confusion and delay in discharge proceedings initiated under the law, says Elaine Donnelly, president of the Center for Military Readiness, which has advocated for keeping the policy in place.
"These changes will allow us to execute the law in a fair and more appropriate manner," Gates said. They "provide a greater measure of common sense and common decency to a process for handling what are difficult and complex issues for all involved."
Known as "don't ask, don't tell," the law allows openly gay men and lesbians to serve in the military but limits attempts to reveal their sexuality if they do not engage in improper behavior.
The changes in policy announced by Gates toughen the requirement for what constitutes credible evidence and demand special scrutiny of third parties who may be motivated to cause harm to a servicemember.
The guidelines ban certain categories of evidence such as information provided to lawyers, clergy and psychotherapists and to doctors providing medical treatment. The rules prohibit evidence about sexual orientation or conduct obtained during a security clearance investigation.
No bill to change the law has moved out of House or Senate committees. Lieberman's bill has 25 co-sponsors, all Democrats. A House bill introduced last year has 191 co-sponsors, including two Republicans, Ileana Ros-Lehtinen of Florida and Anh "Joseph" Cao of Louisiana.
The World War II era's so-called "Greatest Generation" will have to make room for the current generation of American servicemen and women. The burden members of this all-volunteer military have shouldered over the past eight-plus years is as great as any in the nation's history.
The Pentagon soon will take steps to ease that burden on both armed forces personnel and their families. McClatchy Newspapers writer Nancy A. Youssef reported this week that, beginning in the fall, the Marine Corps will make sure nearly all Marines spend at least 14 months at home for every seven months they spend in combat. Also, beginning in 2011, the Army will guarantee soldiers at least two years at home between every combat tour. Soldiers currently are spending from 15 to 18 months at home for every tour in Iraq or Afghanistan.
These guarantees of longer periods between deployments are long overdue. As early as 2004, roughly a third of our all-volunteer military had served two or more combat tours. Today, almost 40 percent of U.S. military personnel have served two or more extended tours in Iraq and Afghanistan. Almost 13,000 soldiers have spent three to four cumulative years in combat, according to a January article by USA Today writer Gregg Zoroya.
"It speaks pretty well to the fortitude of these folks that they just keep coming back for more," James Wilbanks of the U.S. Army Command and General Staff College in Fort Leavenworth, Kan., told Zoroya. "But it's difficult to watch, because it's really hard on them, and very, very difficult on the families."
Indeed, Youssef reports that the short periods of time at home between combat tours has been blamed for higher rates of suicide and divorce among returning servicemen and women. Mental health problems and prescription drug abuse also have risen — the latter likely due to the high number of wounded military personnel.
These problems can impact military readiness. Frequent long deployments away from home, for example, have made it more difficult to retain experienced veterans, both enlisted and officers. Pentagon brass also worry about the impact these long missions in Iraq and Afghanistan are having on training. Commanders told Youssef that having to prepare troops constantly for those two war zones leaves little time for training in skills unrelated to the conflicts.
The Pentagon has long sought to deploy troops abroad just once every several years, but the missions in Iraq and Afghanistan have made that impossible with a smaller, all-volunteer military. Apparently, the recent drawdown in Iraq will allow the Pentagon to make some improvement in the rotation of troops in and out combat. A little more than a year between combat tours for Marines and two years for soldiers is well short of what the Pentagon says is needed. But, given the small number of individuals shouldering the burden of these two wars, it's probably the best that can be done at this time.
Senate eyes leap to 3.8M prescriptionsBy Gregg Zoroya, USA Today
WASHINGTON — The military is trying to curb the volume of narcotics given to troops as the number of prescriptions for painkillers and instances of drug abuse continue to soar, according to Pentagon data and recent congressional testimony.
Military doctors wrote almost 3.8 million prescriptions for pain relief for servicemembers last year — more than four times the 866,773 doses handed out in 2001, according to data from the Pentagon health office.
"These are stunning statistics," says Sen. Jim Webb, D-Va., who intends to look into the issue next week during a Senate subcommittee hearing that he will chair. Surgeons general of the Army, Navy and Air Force will testify. "I would really like to dig down in the data here and get their thoughts about what is driving this."
Military officials and analysts say the increase in the use of narcotic pain medication reflects the continuing toll on ground troops fighting in Iraq and Afghanistan, often through more than one combat deployment. In addition to those who are wounded, larger numbers of soldiers and Marines develop aches and strains carrying heavy packs, body armor and weapons over rugged and mountainous terrain.
"Clearly the stress on the force, because of these continuous deployments, is a component (in the increasing of prescriptions)," says Webb, a member of the Senate Armed Services Committee and decorated Marine veteran of Vietnam.
The Army, which has done most of the fighting in Iraq and Afghanistan, is examining how it gives pain relief pills to its soldiers, says Assistant Army Secretary Thomas Lamont. A multiservice task force will outline how to limit prescription medication use and ensure that Army hospitals all use the same procedure for dispending medicine, he said.
"Our soldiers are coming back (from combat) wounded, sore, injured, in need of rehab," Lamont told a Senate subcommittee last week.
"We found every Army medical center was dealing with pain in altogether different ways, all individual ... but not an Army-wide program at all," Lamont says. "There was no consistency."
One in four soldiers admitted abusing prescribed drugs, mostly pain relievers, in the 12 months prior to a Pentagon survey in 2008, according to the results released this year. Fifteen percent said they had abused drugs in the 30 days before the survey.
"I think what we don't understand ... is what the motivation is," says Jack Smith, head of the clinical and program policy for the Pentagon's Health Affairs office.
More study is needed to understand why and how troops are abusing prescription medications, he says.
Pentagon records show the abuse of prescription drugs is higher in the military than among civilians. Five percent of civilians reported abusing prescription drugs in a 30-day period in 2007, compared to 11% of military personnel surveyed in 2008.
"The No. 1 thing we have to be focusing on here is the long-term well-being of the (troops)," Webb says. "They have no options in terms of deciding when, and how long, and how repeatedly they're deployed. And so it's up to the top (military) leadership and us over here (in Congress) to make sure we're taking care of their well-being."