FEDERAL HEALTH UPDATE
September 19, 2008

Produced by Kate Connelly Theroux in collaboration with the Institute of Federal Health Care (IFHC)

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Congressional Schedule
  • On Sept. 17, 2008, the Senate passed S. 3001, the National Defense Authorization Act for Fiscal Year 2009, as amended.
  • On Sept. 17, 2008, the House passed H.R. 1594, the Michael A. Marzano Department of Veterans Affairs Outpatient Clinic Act.  This legislation designates the Department of Veterans Affairs Outpatient Clinic in Hermitage, Pennsylvania, as the Michael A. Marzano Department of Veterans Affairs Outpatient Clinic.
  • The House passed S. 2339, which designates the Department of Veterans Affairs clinic in Alpena, Michigan, as the Lt. Col. Clement C. Van Wagoner Department of Veterans Affairs Clinic.
  • The House Veterans Affairs Health subcommittee held a hearing on Sept. 18, 2008, to examine the suicide prevention hotline the VA operates in conjunction with SAMHSA, which is part of the Department of Health and Human Services (HHS).

Military Health Care News

  • Secretary of Defense Robert M. Gates has appointed Dr. Ronald Blanck, Dr. Haile Debas, Dr. Michael Johns, Dr. Kenneth Moritsugu and Dr. Gail Wilensky to serve as members of the Uniformed Services University of the Health Sciences (USU) Board of Regents. 

    USU is the nation’s federal school of medicine and graduate school of nursing. The university educates health care professionals dedicated to career service in DoD and the U.S. Public Health Service. Students are active-duty uniformed officers in the Army, Navy, Air Force and Public Health Service, who are being educated to deal with wartime casualties, national disasters, emerging infectious diseases and other public health emergencies.

    Departing from the board are, Everett Alvarez Jr. and Linda Stierle, who were key in shaping the university and in establishing a Graduate School of Nursing.

  • The Department of Defense’s (DoD’s) Force Health Protection and Readiness Directorate (FHP&R) has launched the Chemical-Biological Warfare Exposures Web site to provide service members, veterans, their families and the public with information on the testing of chemical and biological warfare agents from 1942 to 1975. The Web site presents sections on World War II, Project 112/SHAD (Shipboard Hazard and Defense) and the Cold War.

    To evaluate the ability of U.S. forces to fight on a chemical and biological battlefield, DoD conducted testing programs. In some programs, service members were present but not test subjects and in other programs they were volunteer human subjects.  This testing ended in 1975. DoD has been actively engaged in an extensive search of official records to find the names of veterans who may have been exposed to the chemical or biological agents. DoD plans to complete the search in 2011 but will pursue any leads from veterans or others who may have information.

    The service member names identified by DoD, along with specific exposure information, are provided to the Department of Veterans Affairs (VA). The VA then notifies the individuals of their potential exposure; provides treatment if necessary; and adjudicates any claim for compensation. For privacy reasons, the Web site does not contain the names of the veterans exposed.

Veterans Health Care News  

  • A newly formed advisory committee for the Department of Veterans Affairs (VA) will help improve VA's compensation system, especially recommending ways to update and improve the medical evaluations used for disability compensation.

    The Advisory Committee on VA Disability Compensation and Related Benefits consists of knowledgeable and experienced veterans, as well as advocates and experts in areas such as disability claims adjudication, vocational rehabilitation, disability programs management, workers compensation, rehabilitative medicine and mental health research, who will provide advice and counsel to the Secretary.

    Retired Army Lt. Gen. James Terry Scott will chair the Advisory Committee on VA Disability Compensation and Related Benefits.  A partner at Watson & Associates of Coleman, Texas, he served as chairman of the independent Veterans' Disability Benefits Commission, one of several recent commissions to examine the needs of combat veterans.

    The new 11-member VA panel will advise VA Secretary James B. Peake through periodic reviews of VA's disability evaluation regulations, as well as make recommendations on legislative changes to VA benefits that address the impact of veterans’ disabilities on quality of life, the need for transition assistance and the potential for successful rehabilitation.

    The committee is expected to hold a series of public meetings and invite testimony.  It will also submit periodic progress reports, the first of which is expected within six months of its first meeting.  Meetings will be announced in the Federal Register.

    The committee members are:

    • Lt. Gen. James Terry Scott (ret.) of Coleman, Texas.  Partner at Watson & Associates, a financial services firm.  He also teaches political science at Howard Payne University in Brownwood, Texas.  
    • Charles Battaglia of Alexandria, Va.  Member of the board of directors for the Wounded Warrior Project.  A retired naval officer, he previously served as executive director of the 2005 Defense Base Closure and Realignment Commission and also as a senior staff member of the U.S. Senate, serving in several positions. 
    • Robert J. Epley of Waxhaw, N.C.  Independent consultant working in the areas of strategic planning, training, performance management and the operations of federal entitlement programs.  Mr. Epley served with VA for 31 years, most recently as director of the Compensation and Pension Program. 
    • Lt. Gen. Thomas Carney (ret.) of Alexandria, Va.  Member of board of directors of CALIBRE Corp.  He has been an independent consultant to numerous companies, including CALIBRE, since his retirement in June 1994.  Previously, Carney was chief executive officer for the Library of Congress.  He spent 31 years on active duty in the Army. 
    • Maj. Daniel Gade of Athens, Ga.  Former associate director for domestic policy for the White House's Domestic Policy Council, where he was responsible for disability and health care issues, as well as matters relating to active military personnel and veterans.  As an Army officer, he was the first person in this position to be on active duty since the post was created in 2001. 
    • Robert Burke, PhD, of Bethesda, Md.  Associate professor and chair of the Department of Health Services Management and Leadership, and director of the Wertlieb Educational Institute for Long-Term Care Management at George Washington University. 
    • Bonnie Carroll of Anchorage, Alaska.  National director for Tragedy Assistance Programs for Survivors (TAPS), the national veterans’ service organization that provides peer support, grief and trauma resources and information, casualty casework assistance and crisis intervention for veterans and their families.  An Air Force reservist, she previously served as the deputy senior advisor for programs in the Ministry of Communications, Coalition Provisional Authority, in Baghdad, Iraq, and as the deputy White House liaison for VA. 
    • Dr. Ronald Blanck of Fenwick Island, Del.  Vice chairman of Martin, Blanck and Associates.  Prior to joining the firm in June 2006, Dr. Blanck served as president of the University of North Texas Health Science Center at Fort Worth, Texas, from August 2000 until June 2006.  He is an Army veteran, finishing his career as the Surgeon General of the Army and commander of the U.S. Army Medical Command. 
    • Denise Turner Lott of Jackson, Miss.  Administrative judge with the Mississippi Workers’ Compensation Commission since November 1988.  She is currently senior judge and is the first woman to hold that position. She was engaged in private law practice with an emphasis on disability claims before joining the commission as a staff attorney. 
    • Edward R. Reese Jr. of Washington, D.C.  National service director for the 1.3 million-member Disabled American Veterans.  A disabled Army veteran of the Gulf War, Reese works at DAV’s National Service and Legislative Headquarters in Washington. 
    • Dr. Richard T. Katz of St. Louis.  Professor of clinical neurology at Washington University School of Medicine with an appointment to the Barnes Jewish Hospital.  He is a primary reviewer of several different medical journals and has interests in evaluation of disability and assessment of pain.

   http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1571

  • The University of Pittsburgh School of Medicine is conducting a research study to determine the efficacy of two therapies for sleep problems related to post-deployment stress disorder. The study will seek to determine if these therapies can reduce insomnia and nightmares.

    Researchers are looking for military veterans over the age of 18 who have problems falling asleep, staying asleep or feel poorly rested after an adequate amount of sleep and have nightmares. Participants in the study will receive a physical examination and participate in a sleep study. They will be compensated up to $275 for their time.

    Post-deployment stress symptoms that persist for more than one month after a highly stressful event are prevalent in military veterans. These reactions include flashbacks, nightmares, feelings of detachment from others, sleep disturbances and efforts to avoid people and places associated with the stressful event. Nightmares and insomnia are often resistant to traditional PTSD treatments, such as cognitive behavioral therapy and medication. 

    For more information or to see if you qualify for this research study, call Abdul Hakim at 412-246-6409 or view the Web site at www.veteranssleep.pitt.edu.

  • The Department of Veterans Affairs (VA) and the Washington Nationals teamed up for a major league salute to veterans on Sept. 19, 2008.

    VA and the Nationals paid special tribute to prisoners of war and service personnel missing in action in honor of National POW/MIA Recognition Day.  The team will also displayed VA public service announcements highlighting the Department’s services for veterans.

Health Care News

  • The National Institute of Environmental Health Sciences (NIEHS) awarded three new grants totaling $21.25 million over a five-year period to study how environmental factors contribute to the cause, prevention and treatment of Parkinson's disease and other related disorders.

    Parkinson's disease is a neurodegenerative disorder that affects nerve cells, or neurons, in several parts of the brain, including neurons that use the chemical messenger dopamine to control muscle movement. More than one million Americans suffer from Parkinson's disease, with approximately 60,000 new cases reported each year. The average age of onset is 60 years, though people have been diagnosed as young as 18.

    The five-year grants are being awarded as part of the NIEHS' Centers for Neurodegeneration Science (CNS) announcement issued in 2007. The CNS program builds on the previous successes of the NIEHS Collaborative Centers for Parkinson's Disease Environmental Research. Each center has assembled an interdisciplinary team of investigators that are working on several tightly connected research projects related to Parkinson's disease.

    The three grantees include:

    • Gary Miller, Ph.D., Emory University, Atlanta. Dr. Miller and his team will examine how environmental and genetic factors interact to alter functions in dopamine neurons. In addition, the Emory team will attempt to develop new biomarkers in the blood that will help identify people who may be at risk for developing Parkinson's disease.
    • Marie-Françoise Chesselet, M.D., Ph.D., University of California, Los Angeles. 
      The researchers at UCLA will use an integrated, multidisciplinary approach to identify additional agricultural pesticides that are disrupting molecular pathways and determine whether these also increase the risk of Parkinson's. Their work is expected to shed light on the pathological processes involved in sporadic Parkinson's disease, the most frequent form of the disorder, and could have public health implications for precautions in the use of some pesticides.
    • Stuart Lipton, M.D., Ph.D., Burnham Institute for Medical Research, La Jolla, Calif. 
      Investigators at the Burnham Institute will explore how environmental toxicants may contribute to Parkinson's disease by producing free radical stress that mimics or enhances the effects of known genetic mutations.
  • The U.S. Food and Drug Administration (FDA) announced that it has approved an immune globulin product called Gamunex for the treatment of chronic inflammatory demyelinating polyneuropathy (CIDP), a rare autoimmune disorder characterized by progressive weakness and impaired sensory function in the legs and arms.

    The FDA designated Gamunex, manufactured by Talecris Biotherapeutics Inc. of Research Triangle Park, N.C., as an orphan drug to treat CIDP. The orphan drug designation provides manufacturers with financial incentives to develop treatments for rare diseases, those affecting fewer than 200,000 people in the United States.

    CIDP, which affects about 25,000 people in the United States, is caused by an immune system attack on the body's peripheral nervous system. The effects of CIDP—progressive muscle weakness, loss of deep tendon reflexes, tingling, and numbness—are caused by damage to the strong, fatty material that covers and protects the nerve fibers, called the myelin sheath.

    Immune globulin (antibody) products are obtained from pooled human blood plasma, which contains antibodies that fight infections. These products are often given to patients with compromised immune systems, who are at increased risk for certain infectious disease. They are also used to adjust the immune response in certain autoimmune diseases.

    Researchers think it is likely that Gamunex helps improve muscle function in patients with CIDP by modulating the immune system's response to the inflammation that damages the myelin sheaths, but the exact mechanism is not known.

    The FDA based its approval of Gamunex on clinical trials that showed Gamunex was effective at improving certain motor functions for up to 48 weeks after the initial treatment.  Researchers used the Inflammatory Neuropathy Cause and Treatment scale (INCAT) to measure a patient's ability to perform tasks such as walking and motor tasks for the hands.

    The trials showed improved CIDP patient INCAT scores for muscle function after receiving Gamunex every three weeks for a 24-week period. Twenty-eight of 59 patients treated with Gamunex had improved INCAT scores compared to 13 of 58 patients treated with placebo.  In addition, patients with improved INCAT scores participated in a follow-up trial for an additional 24 weeks. Eighty-six percent of the patients who continued to receive Gamunex maintained their improved INCAT scores compared to 61 percent of the patients who received placebo during the follow-up trial.  http://www.fda.gov/bbs/topics/NEWS/2008/NEW01884.html

  • The Institute of Medicine (IOM) members Robert J. Lefkowitz of Duke University Medical Center and Bert W. O'Malley of Baylor College of Medicine were awarded the 2007 National Medal of Science. The award, which was established by the 86th Congress in 1959, is given to individuals "deserving of special recognition by reason of their outstanding contributions to knowledge in the physical, biological, mathematical, or engineering sciences." It is the nation's highest honor for science and technology.

    IOM member Roscoe O. Brady of the National Institutes of Health was awarded a 2007 National Medal of Technology and Innovation, the nation's highest honor for technological achievement, honoring America's leading innovators. The Medal recognizes "those who have made lasting contributions to America's competitiveness, standard of living, and quality of life through technological innovation, and ... those who have made substantial contributions to strengthening the Nation's technological workforce." Recipients of both medals will be honored at a White House ceremony on Sept. 29, 2008.

  • The NIH has developed a new Web site for the extramural research community outlining the agency's response to national disasters and other emergencies. The site includes guidance, notices, and other information of particular relevance to investigators and their institutions, as well as links to similar emergency response resources from other federal agencies. In an emergency, the NIH's immediate response is to protect the health and safety of people and animals in the programs it oversees, and to preserve the health of the biomedical research enterprise in the area affected by the emergency.  To view the new Web site, please visit http://grants.nih.gov/grants/natural_disasters.htm
  • According to the Associated Press, the Food and Drug Administration (FDA) has hired more than 1,300 professional staffers, including chemists, biologists, pharmacologists, statisticians, medical officers, microbiologists and field inspectors, to help the agency better protect the public health amid rapid technological and scientific change.

    The staffing drive, launched just five months ago, will result in an estimated 10 percent increase in the FDA's work force. Officials expect that the new hires will provide critical expertise after years of losing valuable medical and scientific people who took industry jobs or went into retirement. The exodus came as the agency struggled to cope with a string of drug and food safety problems that damaged its reputation.

    FDA officials said about 1,000 of the new hires have already started, with another 158 due to report later this month. An additional 160 have accepted offers and are going through background checks.

    Of the total 1,317 positions, 770 are new jobs and 547 are posts left vacant by people leaving the agency for other jobs or due to retirement.

    The FDA's budget is about $2.2 billion a year, with some $1.7 billion coming from taxpayers and the rest from industry user fees. About 40 percent of the positions are being funded with industry user fees, meaning those new hires will mainly be evaluating new drugs or medical devices and, in some cases, monitoring safety issues. http://news.yahoo.com/story//ap/20080911/ap_on_go_ot/fda_upgrade

  • The Centers for Medicare and Medicaid Services (CMS) launched Ask Medicare, a new initiative to help family caregivers—those who are family members or friends who help people with Medicare— access and use valuable healthcare information, services and resources. 

    More than 44 million Americans provide care to a loved one, friend or neighbor, valued in economic terms at $350 billion annually, according to a recent report by AARP.  The new initiative will provide a one-stop Web page for caregivers (www.medicare.gov/caregivers) that provides easy access to useful information about Medicare and other essential resources to help with caregiving.

    CMS launched the new caregiver initiative through a live Webcast hosted by Acting Administrator Kerry Weems. During the live online forum, national partner organizations, including HHS’ Administration on Aging, AARP and the National Alliance for Caregiving, joined CMS in answering questions from caregivers.

    According to Weems, most caregivers do not think of or identify themselves as caregivers, yet many of the resources available to them use that term.

    The Ask Medicare Web site will provide links to key partner organizations that assist caregivers and beneficiaries and present personal stories from caregivers in the community.  Support information and tools to help caregivers address common problems will also be available.  As part of the initiative, CMS will launch an e-newsletter for caregivers that will deliver information into subscribers’ email boxes.

  • The National Institute of Mental Health halted its plans to study a controversial procedure called chelation for the treatment of autism, the Associated Press reports. The therapy, commonly used for lead or mercury poisoning, involves injecting a man-made amino acid called EDTA into the veins in an effort to remove heavy metals from the body. Some who think that vaccines containing mercury trigger autism believe the therapy could treat the disorder. NIMH officials said the agency isn't confident in the safety of chelation, which critics have called an unethical experiment on kids. Research into the treatment had been on hold after a separate study last year connected a medication used in chelation to brain problems in rats. With the exception of some flu shots, childhood vaccines haven't contained mercury since 2001, and numerous studies have failed to find a link between vaccines and autism.
  • Ting-Kai Li, M.D., director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) since November 2002, announced that he will step down from his post and retire from federal service, effective Oct. 31, 2008. Kenneth R. Warren, Ph.D., the NIAAA deputy director since February 2008, will serve as acting director of the Institute while a search for a new Director is initiated.

    Under Dr. Li’s leadership, NIAAA implemented a rolling five-year strategic plan and achieved stability in NIAAA’s success rate for research grants and increased support for new investigators.  He engaged the NIAAA in the NIH Roadmap for Medical Research and emphasized a multi- and trans-disciplinary approach to alcohol research and the study of gene-environment interactions. In addition, Li guided the analysis of data showing that measures of an individual’s pattern of drinking are the best indicators of alcohol problems, in much the same way that numerical measurements of blood pressure, cholesterol and triglycerides relate to relative risk for cardiovascular disease.

    Born in Nanjing, China, Dr. Li earned his undergraduate degree from Northwestern University, his M.D. from Harvard University.

Reserve/Guard
  • The total number of Guard and Reserve currently on active duty has increased by 87 from the last report to 114,735.  The totals for each service are Army National Guard and Army Reserve, 88,109; Navy Reserve, 5,775; Air National Guard and Air Force Reserve, 12,132; Marine Corps Reserve, 7,981; and the Coast Guard Reserve, 738.  www.defenselink.mil

Reports/Policies

  • The GAO published “Environmental Health: EPA Efforts to Address Children's Health Issues Need Greater Focus, Direction, and Top-Level Commitment,” (GAO-08-1155T) on Sept. 16, 2008.  This report examines the work of the Office of Children's Health and convened the Children's Health Protection Advisory Committee (Advisory Committee) to provide advice and recommendations to assist in developing regulations, guidance, and policies to address children's health.  http://www.gao.gov/new.items/d081155t.pdf
  • A new report, “Evidence of Greater Health Care Needs Among Older Veterans of the Vietnam War,” on was published on Sept. 14, 2008.  The study examined self-rated health, impairments in activities of daily living, and treatment for eight health conditions among Vietnam War-era veterans, comparing those who served in Vietnam with those who served elsewhere. http://www.redorbit.com/news/display/?id=1554503
  • The GAO published “Health Information Technology: HHS Has Taken Important Steps to Address Privacy Principles and Challenges, Although More Work Remains,” (GAO-08-1138) on Sept. 17, 2008.  This report is a follow-up to its January 2007 report.  In that report, the GAO recommended that HHS identify milestones and assigning responsibility for integrating the outcomes of its privacy-related initiatives; ensure that key privacy principles are fully addressed; and address key challenges associated with the nationwide exchange of health information.  The GAO concluded that while work has been done, HHS needs to continue to work to fully protect the privacy of personal health information. http://www.gao.gov/new.items/d081138.pdf
  • The GAO published “Veterans' Benefits: Improvements Needed in VA's Training and Performance Management Systems,” (GAO-08-1126T) on Sept. 18, 2008.  http://www.gao.gov/new.items/d081126t.pdf

Legislation

  • H.R.6898 (introduced Sept. 15, 2008): To promote the adoption and meaningful use of health information technology, and for other purposes was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Science and Technology, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. 
    Sponsor: Representative Fortney Pete Stark [CA-13]
  • H.R.6901 (introduced Sept. 15, 2008): To amend the Public Health Service Act to provide for the establishment of a drug-free workplace information clearinghouse, to support residential methamphetamine treatment programs for pregnant and parenting women, to improve the prevention and treatment of methamphetamine addiction, and for other purposes was referred to the House Committee on Energy and Commerce. 
    Sponsor: Representative Darlene Hooley [OR-5]
  • H.R.6903 (introduced Sept. 15, 2008): To amend the Toxic Substances Control Act to reduce the health risks posed by asbestos-containing products and for other purposes was referred to the House Committee on Energy and Commerce. 
    Sponsor: Representative Gene Green [TX-29]
  • H.R.6905 (introduced Sept. 15, 2008): To amend the Public Health Service Act to improve the Nation's surveillance and reporting for diseases and conditions, and for other purposes was referred to the House Committee on Energy and Commerce. 
    Sponsor: Representative Lee Terry [NE-2]
  • H.R.6906 (introduced Sept. 15, 2008): To amend the Social Security Act and the Public Health Service Act to provide for sex education, substance abuse treatment and prevention and for other purposes was referred to the House Committee on Energy and Commerce. 
    Sponsor: Representative Anthony D. Weiner [NY-9]
  • H.R.6908 (introduced Sept. 16, 2008): To require that limitations and restrictions on coverage under group health plans be timely disclosed to group health plan sponsors and timely communicated to participants and beneficiaries under such plans in a form that is easily understandable was referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Labor, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. 
    Sponsor: Representative Michael C. Burgess [TX-26]
  • S.CON.RES.98 (introduced Sept. 15, 2008): A concurrent resolution expressing the sense of Congress on the need for a national AIDS strategy was referred to the Committee on Health, Education, Labor, and Pensions. 
    Sponsor: Senator Hillary Rodham Clinton [NY]
  • S.3487 (introduced Sept. 12, 2008): A bill to amend the National and Community Service Act of 1990 to expand and improve opportunities for service, and for other purposes was referred to the Committee on Health, Education, Labor, and Pensions. 
    Sponsor: Senator Edward M. Kennedy [MA]
  • S.3491 (introduced Sept. 16, 2008):  A bill to amend the Communications Act of 1934 to improve the effectiveness of rural health care support under section 254(h) of that Act was referred to the Committee on Commerce, Science, and Transportation. 
    Sponsor: Senator Ted Stevens [AK]
  • S.3502 (introduced Sept. 16, 2008): A bill to provide for the establishment of a task force to address the environmental health and safety risks posed to children, and for other purposes was referred to the Committee on Homeland Security and Governmental Affairs. 
    Sponsor: Senator Hillary Rodham Clinton [NY]

Hill Hearings

  • The House Veterans Affairs Committee will hold a hearing on Sept. 23, 2008, to examine media outreach to veterans.
  • The House Veterans Affairs Committee will hold a follow-up oversight hearing on Sept. 24, 2008, on G.I. Bill Implementation.
Meetings / Conferences

If you need further information on any of the items in the Federal Health Update, please contact Kate Connelly Theroux at (703) 447-3257 or by e-mail at katetheroux@fedhealthinst.org. To subscribe, please visit http://fedhealthinst.org/subscriber.cfm. To unsubscribe, please send an email to newsletter@fedhealthinst.org with UNSUBSCRIBE as the subject.

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