- On Nov. 13, 2007, President Bush signed into law H.R.
3222, Department of Defense Appropriations Act, 2008. This legislation provides
$459.6 billion in appropriations for the FY 2008 Department of Defense (DOD) military
programs, and it provides FY 2008 appropriations for continuing projects and activities
of the federal government through Friday, Dec. 14, 2007.
- President Bush vetoed H.R. 3043, the Departments of
Labor, Health and Human Services, and Education, and Related Agencies appropriations
Act of 2008, on Nov. 13, 2007.
- On Nov. 14, 2007, the House passed H.R. 4156, providing
emergency supplemental appropriations for the Department of Defense for the fiscal
year ending September 30, 2008, and for other purposes.
- The Senate Veterans Affairs Committee held a hearing
on Nov. 14, 2007, to pass:
- S. 2004, the Epilepsy Centers of Excellence, which would
designate at least six VA facilities as centers of excellence for epilepsy treatment;
- S. 2142, the Veterans Emergency Care Fairness Act of
2007, which would require the Department of Veterans Affairs to reimburse some veterans
for emergency care they receive at non-VA facilities. Veterans covered under the
bill would include those receiving treatment for injuries related to their military
service, all veterans with total service-related disability and those receiving
vocational rehabilitation and participating in training programs;
- S. 2160, the Veterans Pain Care Act of 2007; and S.
2162, the Mental Health Improvements Act of 2007, which would establish six "centers
of excellence" for post-traumatic stress disorder and substance abuse treatment
and would establish protocols for the treatment of mental illnesses.
- S 2162, the Veterans Pain Care Act of 2007, which would establish six
"centers of excellence" for post-traumatic stress disorder and substance abuse treatment
and would establish protocols for the treatment of mental illnesses.
In addition, the Committee heard testimony regarding the
nomination of Michael W. Hager, of Virginia, to be Assistant Secretary of Veterans
Affairs for Human Resources and Management.
- On Nov. 14, 2007, the Senate Health, Education, Labor
and Pensions Committee approved three bills that would authorize funds for community
health centers and pediatric cancer and tuberculosis research. The committee
approved an unnumbered bill that would reauthorize the Community Health Center program
at more than $14 billion annually from FY 2008 to FY 2012. The legislation would
authorize $2.2 billion for the program in FY 2008, with funds for the program scheduled
to increase each fiscal year to $3.5 billion in FY 2012. In addition, the
Committee passed S. 911, the Conquer Childhood Cancer Act, which expands, enhances,
and intensifies pediatric cancer research programs; and S. 1551, the Comprehensive
Tuberculosis Elimination Act, which provides additional authorities to NIH and the
Centers for Disease Control (CDC) to control domestic tuberculosis more effectively.
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Military Health Care News
- The Association of Military Surgeons of the United States
(AMSUS) awarded its 2007 AMSUS Outstanding Medical Information Management Executive
Award to Col. Claude Hines, Jr., program manager for theater medical information
systems.
The AMSUS award recognizes a senior healthcare executive
in military or public health who has made "outstanding contributions to federal
healthcare through demonstrated superior leadership and visionary management ability.”
Col. Hines revitalized the theater medical care program
by successfully reorganizing it into four strategic areas that are integrated among
all branches of the armed services as follows: electronic health records (EHRs),
medical command and control, medical logistics, and patient movement and tracking.
- TRICARE Management Activity announced that it will now
cover Zostavax, which is the recommended vaccine by the Centers for Disease Control
and Prevention (CDC), to prevent shingles in beneficiaries 60 and older.
Shingles is a painful viral disease that affects more than
one million Americans every year. More than half of those cases happen in
people age 60 or older. The CDC recommends a single dose of shingles vaccine for
everyone age 60 and older.
In a shingles prevention study done by the Veterans Affairs
Cooperative Trial program, run by Dr. Michael Oxman out of the University of California,
San Diego, Zostavax was more than 50 percent effective in reducing the incidence
of shingles and more than 60 percent effective in reducing some of its associated
symptoms. Even in people who suffer from the disease, most of those who were
vaccinated experienced less pain.
Beneficiaries who receive the shingles vaccine after Oct.
19, 2007, must have vaccinations administered in a provider’s office. Zostavax
is covered under the TRICARE medical benefit and is not reimbursable under the pharmacy
benefit. Beneficiaries with coverage or claims questions should contact the
TRICARE regional claims processor found on their beneficiary explanation of benefits
(EOB) notice. http://www.tricare.mil/pressroom/news.aspx?fid=345
- The Department of Defense (DoD) published a notice in
the Federal Register announcing its intent to establish the Traumatic Brain Injury
Family Caregiver Panel as a subcommittee of the Defense Health Board, as mandated
by the John Warner National Defense Authorization Act for Fiscal Year 2007.
The Traumatic Brain Injury Family Caregiver Panel will be
responsible for developing the required curricula, and the Secretary of Defense
shall disseminate the curricula to:
- Health care professionals who or otherwise work with
members and former members of the Armed Forces with traumatic brain injury;
- Family members affected by the traumatic brain injury
of such members and former members; and
- Other care or support personnel who may provide service
to members or former members affected by traumatic brain injury.
No later than one year after the development of the curricula,
the Secretary of Defense and the Secretary of Veterans Affairs shall submit to the
Committees on Armed Services and Veterans Affairs of the Senate and the House of
Representatives a report describing the actions undertaken and the recommendations
to improve or update the training curriculum developed.
This non-discretionary advisory committee, which will operate
as a subcommittee of the Defense Health Board, shall provide the DoD and VA independent
advice and recommendations on the development of training curricula to be used by
family members of members and former members of the Armed Forces on techniques,
strategies, and skills for care and assistance for such members and former members
with traumatic brain injury.
The Traumatic Brain Injury Family Caregiver Panel shall
consist of 15 members appointed by the Secretary of Defense in consultation with
the Secretary of Veterans Affairs.
- The Army published “Longitudinal Assessment of Mental
Health Problems Among Active and Reserve Component Soldiers Returning From the Iraq
War,” on Nov. 14, 2007, in the Journal of the American
Medical Association.
In the report, Army medical officials
examined increased soldier-reported mental-health concerns in mandatory post-deployment
health screenings.
Cols. Charles Milliken, MD, and Charles W. Hoge, MD, two
of the study's authors, found that between the initial Post-Deployment Health Assessment
(PDHA) and the Post-Deployment Health Re-assessment (PDHRA) three to six months
later, soldiers are more likely to report signs of post-combat stress and Post Traumatic
Stress Disorder.
The study examined the assessments of 88,235 Iraq veterans
completed between June 1, 2005, and December 31, 2006, and found that while only
4 to 5 percent of soldiers were referred for mental healthcare on the PDHA, three
to six months later that number jumped to 20.3 percent for active-duty soldiers
and 42.4 percent for reserve-component soldiers.
The second set of numbers encompasses the PDHA, PDHRA and
soldiers who were under mental-health care because of self-referral or employee-assistance
referrals. According to Col. Milliken, these soldiers were not necessarily diagnosed
with PTSD, but they were exhibiting symptoms that were serious enough that a medical
provider wanted to have them evaluated.
Similarly, symptoms of depression reported on the PDHA rose
from 5 percent to 10 percent on the PDHRA.
The highest jump the study found between the PDHA and PDHRA
occurred in reports of conflict with family and friends. This rose from 3.5
to 14 percent for active-duty soldiers and 4.2 to 21.1 percent for reserve-component
soldiers.
The disparity between active and Army Reserve and National
Guard soldiers was a bit more challenging for the study's authors, especially because
they determined that combat exposure for Reserve and National Guard soldiers was
virtually identical to that of active-duty soldiers, and they reported more physical
health concerns as well.
Col. Milliken believes this may be due to the differences
in health coverage for reserve-component and active-duty soldiers.Those on active
duty can go to sick call any time, he said, and may not feel as pressed to report
every little concern, whereas Reserve and National Guard soldiers only have six
months of TRICARE coverage when they return and two years of Department of Veterans
Affairs benefits. After that, the VA will pay for service-related injuries or illnesses,
if they are documented on forms like the PDHRA.
The report findings are considered encouraging because it
shows the Army's efforts to reduce the stigma around PTSD and seeking mental-health
assistance, including the chain-teaching and battlemind programs, are working since
soldiers are reporting when they have a problem.
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Veterans Health Care News
- The White House recently named two researchers from
the Department of Veterans Affairs (VA) -- Sterling C. Johnson, PhD, and William
S. Yancy Jr., MD, with the Presidential Early Career Awards for Scientists and Engineers.
They were among 60 scientists from 11 federal agencies honored for their “innovative
research at the frontiers of science and technology” and for their scientific leadership
and community outreach. The awards program was established in 1996.
Johnson is a clinical psychologist and neuroscience researcher
at the William S. Middleton Memorial Veterans Hospital in Madison, Wisc., and an
assistant professor at the University of Wisconsin School of Medicine and Public
Health.
He uses brain imaging and neuropsychological measurement
to study disorders that affect memory and self-awareness. One of his current
VA-funded studies involves combat veterans with traumatic brain injury.
Yancy is a physician at the Durham VA Medical Center in
North Carolina, an investigator at that site’s Center for Health Services Research
in Primary Care, and an assistant professor at Duke University Medical Center.
He studies the effects of diet and exercise on obesity and
its complications. A study by his group made headlines in 2004 when it showed
that people on a low-carbohydrate, high-protein diet lost more weight over six months
than people on a low-fat, low-cholesterol, low-calorie diet. The study was the first
randomized, controlled trial of an Atkins-style approach to eating.
As part of their awards, Johnson and Yancy will each receive
$125,000 over five years from VA’s Office of Research and Development in support
of their research.
- Connecticut Attorney General Richard Blumenthal marked
Veterans Day by announcing his office is launching a Veterans Advocacy Unit to assist
veterans and active duty military personnel with benefit, legal and other issues.
Starting Nov. 13, 2007, Connecticut veterans and active
duty men and women with legal, benefit, consumer protection, employment or other
questions or problems can call the Attorney General's Office at (860) 808-5318 and
speak with a lawyer who will seek to assist them.
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Health Care News
- The U.S. Food and Drug Administration announced that
the manufacturer of Avandia (rosiglitazone), a drug used to treat type 2 diabetes,
has agreed to add new information to the existing boxed warning in the drug's labeling
about potential increased risk for heart attacks.
People with type 2 diabetes who have underlying heart disease
or who are at high risk of heart attack should talk with their health care provider
about the revised warning as they evaluate treatment options. FDA advises health
care providers to closely monitor patients who take Avandia for cardiovascular risks.
Avandia, manufactured by GlaxoSmithKline (GSK), Philadelphia,
Pa., was approved in 1999 as an adjunct to diet and exercise to improve control
of blood sugar levels. Avandia is approved to be used as a single therapy or used
in combination with metformin and sulfonylureas, other oral anti-diabetes treatments.
During the past year, FDA has weighed several complex sources
of data, some which show conflicting results, related to the risk of chest pain,
heart attacks and heart-related deaths, and deaths from any cause in patients treated
with Avandia.
FDA has concluded that there isn't enough evidence to indicate
that the risks of heart attacks or death are different between Avandia and some
other oral type 2 diabetes treatments. Therefore, FDA has requested that GSK conduct
a new long-term study to evaluate the potential cardiovascular risk of Avandia,
compared to an active control agent. GSK has agreed to conduct the study and FDA
will ensure it is initiated promptly.
The revision of Avandia's existing boxed warning – FDA's
strongest form of warning –follows recommendations made at the July 2007 joint meeting
of FDA's Endocrine and Metabolic Drugs and Drug Safety and Risk Management Advisory
Committees. http://www.fda.gov/bbs/topics/NEWS/2007/NEW01743.html
- The Substance Abuse and Mental Health Services Administration
(SAMHSA) has developed a new Web page to assist the public in identifying evidence-based
programs and practices that can prevent and/or treat mental and substance use disorders.
A Guide to Evidence-Based Practices on the Web features 37 Web sites that contain information about specific
evidence-based interventions or provide comprehensive reviews of research findings.
The Web Guide – a component of SAMHSA’s Science and
Service Initiative - can be used by stakeholders throughout the behavioral health
field to promote awareness of current intervention research and to increase the
availability and implementation of evidence-based practices.
Users can browse the listings in the Web Guide by
content area, age group, or treatment setting. Each listing includes the name
of the organization sponsoring the Web site, a hyperlink to the actual Web site,
a statement of the site’s purpose and intended audience(s), and key features, such
as sources of evidence and review processes and information on resources needed
to implement the evidence-based practices properly. http://www.samhsa.gov/newsroom/advisories/0711095739.aspx
- On Nov. 14, 2007, the New York Times reported
that four transplant recipients at the University of Chicago Medical Center, the
Rush University Medical Center and Northwestern Memorial Hospital in Chicago have
contracted HIV from an organ donor, the first known cases in more than a decade
of the virus being spread by organ transplants.
The organs also gave all four patients hepatitis C, in what
health officials said was the first reported instance of the two viruses being spread
simultaneously by a transplant.
Though exceedingly rare, this type of transmission highlights
a known weakness in the system for checking organ donors for infection: the most
commonly used tests can fail to detect viral diseases if they are performed too
early in the course of the infection. Officials say the events in Chicago may lead
to widespread changes in testing methods.
Initially, the donor had tested negative for both HIV and
hepatitis C, apparently because the infection was too recent to be detected by commonly
used blood tests. Those tests do not find the virus itself, but instead look for
the body’s reaction to the infection — antibodies, produced by the immune system.
But the body takes time to react, and if the test is done too soon, within 22 days
of HIV infection or 82 days for hepatitis C, antibodies may not yet be detectable.
Doctors say that is what probably occurred in Chicago.
The transplants were coordinated by an organization called
the Gift of Hope, in Elmhurst, Ill. The Centers for Disease Control and Prevention
is investigating the cases.
It has been known that this kind of transmission was theoretically
possible, but it was considered highly unlikely. Since 1994 nearly 300,000
transplants have occurred without any reported cases of HIV transmission.
- The Food and Drug Administration (FDA) approved Zyrtec-D
(cetirizine HCl 5 mg and pseudoephedrine HCl 120 mg), an allergy drug, for nonprescription
use in adults and children 12 years of age and older. This drug combines an antihistamine
with a nasal decongestant.
Available as a prescription drug since 2001, Zyrtec-D is
now approved as a nonprescription drug for the relief of symptoms due to
hay fever or other upper respiratory allergies such as runny nose, sneezing, itchy,
watery eyes, itching of the nose or throat, and nasal congestion. Zyrtec-D is also
for reducing swelling of nasal passages, for relief of sinus congestion and pressure,
and for restoring freer breathing through the nose.
Hay fever and other allergies are the sixth leading cause
of chronic disease, with about 50 million sufferers each year in the United States,
according to the National Institute of Allergy and Infectious Diseases.
http://www.fda.gov/bbs/topics/NEWS/2007/NEW01742.html
- Griffin P. Rodgers, M.D., director of the National Institute
of Diabetes and Digestive and Kidney Diseases (NIDDK), has appointed Lucy Greene
associate director for management, NIDDK. In her new position, Dr. Greene will act
as the executive officer for the Institute and advise the NIDDK director and other
senior officials on all phases of administrative management involved in operating
the Institute in support of biomedical research.
Dr. Greene has served as the deputy executive officer at
the NIDDK since April 2006 and as the acting executive officer since April 2007.
Prior to coming to NIDDK, Dr. Greene was deputy executive officer and associate
director for administrative operations at the National Cancer Institute. She has
31 years of experience as an administrator in the federal government.
Dr. Greene earned a doctorate in planning and development
studies from the University of Southern California, an MA degree in museum studies
from George Washington University in Washington, D.C., and a BA cum laude in Latin
from Gettysburg College in Gettysburg, Pa.
- On Nov. 13, 2007, the National Diabetes Education Program
(NDEP) introduced a series of tip sheets and an online quiz specially created for
teens to help them manage their disease and reduce their risk for complications.
NDEP is jointly sponsored by the National Institutes of Health and the Centers for
Disease Control and Prevention (CDC).
About 154,000 children under age 20 have diabetes in the
United States. According to data reported by the CDC in 2006, one in 523 people
younger than age 20 has diabetes. Among this group, 79 percent are aged 10
to 19 years.
NDEP's new Tips for Teens with Diabetes series encourages
youth to take steps to manage their disease for a long, healthy life. NDEP
also has a tip sheet addressing teens at risk for type 2 diabetes, called Lower Your
Risk for Type 2 Diabetes. In addition, NDEP has developed an interactive
online quiz for teens with diabetes based on information found in the tip sheets,
using a question-and-answer format, with direct links to the new series of tip sheets.
All of the tip sheets are available at no charge from the NDEP.
The release of NDEP's new educational materials for teens and their parents coincides with National Diabetes
Awareness Month in November. The new tools also support the 2007 World Diabetes
Day campaign theme "Diabetes in Children and Adolescents," which raises awareness
of the rising prevalence of type 1 and type 2 diabetes among youth around the world.
World Diabetes Day, November 14, was sponsored by the International Diabetes Federation.
http://www.nih.gov/news/pr/nov2007/niddk-13.htm
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- The total number of Guard and Reserve currently on active
duty has increased by 102 from the last report to 93,364. The totals for
each service are Army National Guard and Army Reserve, 72,547; Navy Reserve, 5,886;
Air National Guard and Air Force Reserve, 7,308; Marine Corps Reserve, 7,265; and
the Coast Guard Reserve, 358.
www.defenselink.mil
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Reports/Policies
- The Congressional Budget Office (CBO) published “The
Long-Term Outlook for Health Care Spending,” in November 2007. This report
examines the implications of a continuation of current federal law as it pertains
to federal health care spending. The report predicts that unless changes in federal
law occur the total spending on health care would rise from 16 percent of gross
domestic product (GDP) in 2007 to 25 percent in 2025, 37 percent in 2050, and 49
percent in 2082. http://www.cbo.gov/ftpdoc.cfm?index=8758&type=1
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Legislation
- H.R.4133 (introduced Nov. 9, 2007): To amend
title X of the Public Health Service Act to prohibit family planning grants from
being awarded to any entity that performs abortions, and for other purposes was
referred to the House Committee on Energy and Commerce.
Sponsor: Representative Mike Pence [IN-6]
- H.R.4142 (introduced Nov. 9, 2007): To amend
title 38, United States Code, to permit Medicare-eligible veterans to receive an
out-patient medication benefit, to provide that certain veterans who receive such
benefit are not otherwise eligible for medical care and services from the Department
of Veterans Affairs, and for other purposes was referred to the House Committee
on Veterans' Affairs.
Sponsor: Representative Scott Garrett [NJ-5]
- H.R.4143 (introduced Nov. 9, 2007): To authorize
the Secretary of Veterans Affairs to carry out a major medical facility project
in Atlanta, Georgia was referred to the House Committee on Veterans' Affairs.
Sponsor: Representative Phil Gingrey [GA-11]
- H.R.4146 (introduced Nov. 9, 2007): To amend
title 38, United States Code, to clarify the availability of emergency medical care
for veterans in non-Department of Veterans Affairs medical facilities was referred
to the House Committee on Veterans' Affairs.
Sponsor: Representative Michael M. Honda [CA-15]
- H.R.4156 (introduced Nov. 13, 2007): Making emergency
supplemental appropriations for the Department of Defense for the fiscal year ending
September 30, 2008, and for other purposes was passed.
Sponsor: Representative David R. Obey [WI-7]
- S.2341 (introduced Nov. 13, 2007): A bill to
provide Individual Development Accounts to support foster youths who are transitioning
from the foster care system was referred to the Committee on Health, Education,
Labor, and Pensions.
Sponsor: Senator Hillary Rodham Clinton [NY]
- S.2352 (introduced Nov. 13, 2007): A bill to
amend title XVIII of the Social Security Act to provide Medicare beneficiaries greater
choice with regard to accessing hearing health services and benefits was referred
to the Committee on Finance.
Sponsor: Senator Tim Johnson [SD]
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Hill Hearings
- The House Veterans Subcommittee on Oversight and Investigations
will hold a hearing on Dec. 12, 2007, to examine outpatient waiting times.
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