FEDERAL HEALTH UPDATE
October 3, 2008Produced by Kate Connelly Theroux in collaboration with the Institute of Federal Health Care (IFHC) To subscribe, please visit http://fedhealthinst.org/subscriber.cfm. Sponsored by
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Congressional Schedule
The questionnaires—one for wounded, ill or injured service members and one for their family members—are available on the Military Health System Web site beginning Oct. 2, 2008, and will remain open for completion until Oct. 15. Both questionnaires ask for feedback concerning a service member’s experience and satisfaction with the care he or she has received since becoming wounded, ill or injured. To encourage honest and specific answers, all questionnaire responses are anonymous. Questionnaire results and analysis should be available on the MHS Web site in November 2008. These questionnaires are part of Defense Secretary Robert Gates’ commitment to supporting wounded, ill and injured service members and to ensuring that their care is DoD’s top priority. The MHS hopes that by listening to the opinions of wounded, ill or injured service members and their families, it will be in a better position to meet their needs and expectations. http://www.tricare.mil/Pressroom/News.aspx?fid=461
TRICARE is partnering with the Defense Commissary Agency (DeCA), Military OneSource and the Army and Air Force Exchange Service (AAFES) to raise awareness of childhood overweight and obesity issues. The “Healthy Youth for a Healthy Future” initiative was launched by the Department of Health and Human Services (HHS). Traditionally the first Monday in October, Children’s Health Month includes National Child Health Day on Oct. 6. This year’s focus is on childhood obesity. According to the Public Health Service Surgeon General, obese children are more likely than children of normal weight to become overweight or obese adults. Overweight or obese adults are more at risk for several health problems, including heart disease, type 2 diabetes, stroke, several types of cancer, and osteoarthritis. The “Healthy Youth for a Healthy Future” campaign supports the Surgeon General’s efforts to encourage children to stay active, have healthy eating habits, and make healthy choices. The campaign is geared toward ongoing efforts to raise awareness of childhood obesity and encourage children to eat right and exercise, and information about those efforts is available on the new page. From articles and video messages, to links, games and “widgets,” it is designed to offer something for users of all ages at http://www.tricare.mil/getfit. Partner initiatives include a special childhood obesity “Dietitian’s Voice” column at http://www.commissaries.com. Military families can also get additional information on losing weight, getting in shape and maintaining good health at the DeCA Web site, including advice-packed columns, recipes and an open question and answer forum. AAFES is also encouraging healthy food choices in its food courts and plans to keep the effort going in November through special coupon offers in shopper circulars. Resources to better educate and assist parents in the battle against obesity are available on http://www.militaryonesource.com. To get information and “Take the Pledge” to help prevent childhood obesity, please visit http://www.surgeongeneral.gov/obesityprevention/. http://www.tricare.mil/Pressroom/News.aspx?fid=460
Fisher Houses provide respite and accommodations for families of active and retired military patients who have been admitted for medical care. Fisher House II will mark the fifth house donated to the Navy by the Fisher House Foundation and will more than double the number of available rooms for families at Naval Medical Center San Diego. Built adjacent to Fisher House I, Fisher House II is an 8,000 square-foot, two-story house that is fully furnished and accessible under American Disabilities Act regulations. It provides private bedrooms, a common kitchen, living room, dining room and laundry room. In addition, Fisher House II will offer wireless Internet access and cable service. The ground-breaking ceremony for Fisher House II was held on June 15, 2007. During the ceremony, David A. Coker, president of the Fisher House Foundation, recognized the contributions of two major donors for the $4 million project: TriWest Health Care Alliance and T. Boone Pickens, chairman and chief executive officer of BP Capital. The original Fisher House was built 1992 and offers eight rooms for families. Fisher House Foundation is a supporter of America Supports You, a Defense Department program connecting citizens and companies with service members and their families serving at home and abroad.
MinuteClinics in Oklahoma City, Austin and Dallas-Fort Worth also have been added. The clinics diagnose, treat and write prescriptions for common family illnesses and provide vaccinations, as well as administer wellness exams. Humana Military Healthcare Services is the Department of Defense contractor for the administration of the TRICARE program in the South region, which serves about 2.8 million active duty and retired military and their families in Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Oklahoma, South Carolina, Tennessee and Texas. http://www.bizjournals.com/houston/stories/2008/09/29/daily21.html
The contract provides for premium-free dental health care services to active duty service members (ADSMs) referred from military dental treatment facilities (DTFs) for civilian care, as well as dental coverage for those ADSMs under the Remote Active Duty Dental Program. The remote program provides dental health care to ADSMs who have a duty location and residence farther than 50 miles from a military dental facility. Reservists and National Guard members who are on orders to active duty for a period of more than 30 continuous days are considered ADSMs from their initial activation date. In certain circumstances, service members no longer on active duty may also be eligible for coverage when injured while serving on orders. Many features of the new contract, which is slated to begin services Aug. 1, 2009, are currently handled by the Military Member Support Office (MMSO) under TRICARE Management Activity (TMA). Establishing a network of providers is new under the contract. The performance period includes a base year and five one-year option periods with a total value of $667,698,420.00 if all options are exercised. The contract includes associated administrative services such as customer service, provider reimbursement and education. Source selection procedures in accordance with the Federal Acquisition Regulation were used to determine the successful offeror. http://www.tricare.mil/Pressroom/News.aspx?fid=459
Mandry-Schwartz was honored for her role in strengthening the relationship between Paralyzed Veterans and Health Net. Two years ago, Health Net made a commitment to be a national sponso of the 26th National Veterans Wheelchair. Through the advocacy of Mandry-Schwartz, Health Net became the first corporate sponsor to underwrite the inaugural Paralyzed Veterans Vocational Rehabilitation Center in Richmond that is helping to provide disabled veterans with the tools they need to re-enter the job market following life-altering injuries. Mandry-Schwartz has more than 28 years’ experience as a registered nurse in a variety of health care settings, holding positions of staff nurse, operating room educator, operating room/post anesthesia care unit director, and quality improvement director. She has served on the Board of Directors of United Service Organizations (USO), the Armed Services YMCA (ASYMCA) and National Military Family Association (NMFA). She also was a commissioner on the President’s Task Force to Improve Health Care Delivery for Our Nation’s Veterans. Created by PVA’s Board of Directors in 1992, the award recognizes an individual’s significant contribution toward furthering the goals and mission of Paralyzed Veterans by working within his or her corporation on behalf of corporate support of the veterans’ service organization.
The DRMRP research topic areas include:
Three funding mechanisms — Hypothesis Development Awards, Advanced Technology/Therapeutic Development Awards and Clinical Trial Awards — will be applied to each of the research topic areas. To learn more, please visit http://cdmrp.army.mil/funding/drmrp.htm.
The Veterans History Project, created in 2000 by Congress to record the firsthand accounts of American service personnel in major conflicts, relies on volunteers such as those from the health plan to gather and preserve stories of wartime service. Stories are being collected through personal narratives (audio and video-taped interviews, as well as written memoirs), correspondence, and visual materials (photographs, drawings or scrapbooks). The project’s primary focus is on U.S. veterans’ accounts from the following wars:
As part of the project, the team from the US Family Health Plan at Saint Vincent Catholic Medical Centers intends to interview veterans from the Asian-American community in the New York City area. Other area veterans interested in being interviewed by the US Family Health Plan for the ongoing Veterans History Project may call Gilberto Ron of the Plan at 212-356-4902. The service is free of charge and the veteran will receive a copy of the recorded session to keep as part of their family history.
Eligible family members of Guard and Reserve personnel activated for more than 30 days under federal orders in support of a contingency operation are made eligible for TRICARE Standard and TRICARE Extra, which have annual deductibles. While they may be eligible to enroll into TRICARE Prime or TRICARE Prime Remote for Active Duty Family Members, which have no deductibles, many may choose to stay with TRICARE Standard or Extra. Guard or Reserve families often meet annual deductibles under their commercial plans before they are activated. Waiving the TRICARE Standard and Extra deductibles means eligible families will not have to pay additional deductibles under TRICARE. The annual deductible for Standard and Extra is $300 for families. The published regulation also contains provisions that make it easier for Reserve and Guard members to continue to see their family physicians by potentially increasing the amount that can be paid to out-of-network health care providers. http://www.tricare.mil/Pressroom/News.aspx?fid=462
The top-level sponsors are Help Hospitalized Veterans, Veterans Canteen Service, American Optometric Association, Booz Allen Hamilton, Challenged America, Marchon, TriWest Healthcare Alliance, Cisco, Invacare and Top End. The event is open to 100 recently injured veterans who have spinal cord injuries, traumatic brain injuries, certain neurological conditions, amputations, other mobility impairments, or post-traumatic stress disorder. The National Veterans Summer Sports Clinic began Sept. 28 and runs through Oct. 3 at several venues in the San Diego area. Events include sailing, cycling, surfing, kayaking and track and field events. The sports clinic is the fifth national rehabilitation event offered by VA to promote the healing of body, mind and spirit. VA’s other rehabilitation events are the National Disabled Veterans Winter Sports Clinic, the National Veterans Wheelchair Games, the National Veterans Golden Age Games and the National Veterans Creative Arts Festival. For more information about the National Veterans Summer Sports Clinic, visit the event’s Web site at www.summersportsclinic.va.gov.
The VA Healthcare Network Upstate New York, including the Albany, Bath, Buffalo, Canandaigua and Syracuse VA Medical Centers and 29 community-based outpatient clinics, received the 2008 Kenneth Kizer Quality Award. The Kizer award is the highest award awarded by the Veterans Health Administration for outstanding patient-care results based on performance measures. The award is open to each of the 21 VA networks. The award is based on a 50-page application that considers leadership, strategic planning, customer focus, information and analysis, staff focus, process management and organizational results. Contenders must demonstrate sustained improvements in measurable results over a four- to five-year period, as well as performance that compares favorably to the best VA and private sector health care providers. The $500,000 must be earmarked to fund initiatives that will improve quality of care. VA Healthcare Network Upstate New York previously received the award in 1999, 2001 and 2003. http://www.bizjournals.com/buffalo/stories/2008/09/29/daily6.html
Kizer, who was VA undersecretary for health and chief executive officer of the Veterans Health Administration from 1994-1999, is now chair of Medsphere Systems Corporation in California. He is credited with reorganization of the VA health care system, decentralizing operational decisionmaking and implementing equitable resource allocation, universal primary care, performance measurement, a pharmacy benefit program and a computerized patient record system, among other accomplishments. After working at VA, Kizer served as president and chief executive officer of the National Quality Forum in Washington, D.C., from 1999-2005. While there, he developed a unique public-private partnership of more than 300 organizations representing all segments of the health care industry to bring consensus on standards for measuring and reporting health care quality. A graduate of the University of California at Los Angeles, Kizer is certified in preventive medicine, as well as medical toxicology, emergency medicine and medical management. His long history of medical and public health service includes service as Navy medical officer, director of the Emergency Medical Services Authority for the state of California; chair of the board of directors of the California Wellness Foundation; and chief deputy director of Preventive Health Services and chief of Public Health Programs for the state of California's Department of Health Services. Kizer is a member of the Institute of Medicine and among numerous honors was given the Distinguished Service Medal for "distinguished work in veterans' health care" by the American Legion in 2007. He was selected as one of the 100 Most Powerful People in Health Care by Modern Healthcare magazine in 2002, 2003, 2004 and 2005. http://www.redorbit.com/news/display/?id=1573735
The device, called the Human Influenza Virus Real-Time RT-PCR Detection and Characterization Panel (rRT-PCR Flu Panel), uses a molecular biology technique to detect flu virus and differentiate between seasonal and novel influenza. The device is used to isolate and amplify viral genetic material present in secretions taken from a patient’s nose or throat. The viral genetic material is labeled with fluorescent molecules, which are then detected and analyzed by a diagnostic instrument called the Applied Biosystems 7500 Fast Dx, also cleared by the FDA for diagnostic use simultaneously with the CDC’s rRT-PCR Flu Panel. The test panel and diagnostic system can detect and identify commonly circulating human influenza viruses as well as influenza A (H5N1) viruses. Results can be available within four hours and the system can test multiple samples at once. The test will be available to CDC-qualified laboratories for diagnosing influenza this fall and some laboratories will be able to obtain reagents (certain substances used in the testing process) at no cost. This test should help ensure the accuracy of influenza testing results among the different qualified laboratories that conduct influenza subtype testing. Since influenza viruses are always changing, test reagents need to be evaluated regularly against circulating viruses to ensure the sensitivity and specificity of the test to diagnose current influenza viruses. The CDC, Applied Biosystems of Foster City, Calif., and the Association of Public Health Laboratories collaborated on the development of this new test. State public health laboratories in Virginia, Iowa, California, Massachusetts, Wisconsin, and Washington performed clinical evaluations of the new flu panel. http://www.hhs.gov/news/press/2008pres/09/20080930a.html
The FDA analysis, undertaken after the agency received a higher than expected number of Adverse Event Reporting System reports of ALS in patients on statins, is based on data from 41 long-term controlled clinical trials. The results showed no increased incidence of the disease in patients treated with a statin compared with placebo. Statins — HMG-CoA-reductase inhibitors — are the most commonly-prescribed medications to treat elevated cholesterol levels in the United States. ALS is a fatal neurodegenerative condition with an overall annual incidence of 1 to 2 per 100,000 people in the general population. The incidence of ALS increases with age. Statins have also been shown to reduce the risk of heart disease in a wide variety of patients. Based on currently available information, health care professionals should not change their prescribing practices for statins and patients should not change their use of statins, The FDA is anticipating the completion of a case-control or epidemiological study of ALS and statin use that is being conducted by Dr. Lorene Nelson, Chief of the Division of Epidemiology, Stanford University School of Medicine, and colleagues at the Division of Research, Kaiser Permanente. Results from this study should be available within six to nine months. FDA is examining the feasibility of conducting additional epidemiologic studies to examine the incidence and clinical course of ALS in patients taking statins. http://www.fda.gov/bbs/topics/NEWS/2008/NEW01892.html
HHS Secretary Mike Leavitt and VA Secretary James Peake, M.D., announced the joint effort to provide essential consumer-directed home and community-based services to older Americans and veterans of all ages, as part of a Nursing Home Diversion (NHD) grants program. The new initiative builds on the similar missions of HHS and the VA with regard to caring for the populations they serve. In addition, Secretary Leavitt announced a $17 million investment to improve the delivery of home and community-based services to people with Alzheimer’s disease and their family caregivers. The new program will be administered by HHS’ Administration on Aging (AoA) in collaboration with the Veterans Health Administration. Under the program, $10.5 million is being provided by HHS through AoA, and $5.7 million by the states. VA estimates purchasing at least $3 million in veteran-directed home and community-based services for older veterans and for recently returned veterans with long-term care needs. The number of veterans over age 85 has tripled during the past decade, creating a significant expansion in the need for long term care. The $17 million for individuals with Alzheimer’s disease and their caregivers involves grants to 22 states under AoA’s Alzheimer’s disease demonstration programs. States were able to apply for two types of grants: Innovation Grants and Evidence-Based Program Grants. Innovation Grants will demonstrate new approaches to delivering services and supports, and the Evidence-Based Grants will support the replication of science-based interventions that have already proven to be effective at helping people with Alzheimer's disease and related disorders to continue to live in the community. To view the list of awards, please visit http://www.hhs.gov/news/press/2008pres/09/20080929a.html
The contracts, with a minimum value of $25,000 in orders per contractor, were awarded to: Buccaneer, of Warrenton, Va.; Computer Sciences Corporation, Rockville, Md.; Dynanet, of Elkridge, Md.; Electronic Data Systems, Herndon, Va.; General Dynamics, Fairfax, Va.; Human Touch, McLean, Va.; IDL-Pragmatics, Vienna, Va.; Interactive Technology Solutions, Silver Spring, Md.; Telesis, Rockville, Md.; and Unisys, Reston, Va. The ten contractors will compete for data information technology task orders through this contract. The FDA has awarded three task orders under the ICT 21 contract for the design and migration of all systems applications to two new data centers, which will be the cornerstone of the FDA IT infrastructure and bioinformatics modernization for the next decade. The three task orders were awarded to:
All FDA software applications and hosting operations will transition to the new data centers over a two-year period. The resulting enhanced computing power and greater responsiveness will provide the FDA with the tools it needs to ensure that all products reaching the public are safer and more effective. http://www.fda.gov/bbs/topics/NEWS/2008/NEW01893.html
This annual award program evaluates and recognizes organizations that have workforce practices and policies beneficial to workers over 50. The U.S. Bureau of Labor Statistics projects that by 2016, one in three workers will be 50 or older— up from 28 percent of the workforce in 2007. NIH was recognized for its recruitment program, which uses a broad array of methods, including newspapers, the Internet, job fairs, scientific publications and referrals to reach qualified potential applicants. Varied training programs, health benefits, pension plans and flexible work arrangements also contributed to NIH’s selection as a top-performing employer for the over-50 age group. http://www.nih.gov/news/health/sep2008/od-30.htm
The first focuses on United States Postal Service letter carriers who volunteer to deliver medicines directly to residences in their communities during an emergency. In collaboration with the Department of Homeland Security, HHS issued an Emergency Use Authorization (EUA) allowing eligible letter carriers to receive kits containing small quantities of antibiotics for future use by them and other members of their households during an anthrax emergency. The Biomedical Advanced Research and Development Authority within HHS requested that FDA issue a EUA for this purpose. These antibiotics would help protect volunteers against contracting anthrax if, following an outdoor anthrax attack, the Postal Service were called upon to deliver the same life-saving antibiotics directly to homes across their community where people may have been exposed to the bacterium that causes anthrax. Although no imminent threat currently exists, these legal actions would enable FDA to issue a EUA. Secondly, HHS Secretary Mike Leavitt issued a declaration under the Public Readiness and Emergency Preparedness Act (PREP Act) that provides liability protection for activities related to developing, manufacturing, distributing, prescribing, dispensing, administering and using anthrax countermeasures in preparation for, and in response to, a potential anthrax attack. This includes entities such as large “big-box” retail stores, retail pharmacies, and other private sector businesses that help to deliver and distribute medicines. Providing liability protection to all involved in such efforts will help ensure their full participation and bolster response efforts. For more information, please visit http://www.hhs.gov/emergency.
The project will continue work started by the Johns Hopkins University in Baltimore and the Michigan Health & Hospital Association to implement a comprehensive unit-based patient safety program to help prevent infections related to the use of central line catheters. Often referred to as central venous catheters, central line catheters are tubes placed into a large vein in a patient's neck, chest or groin to administer medication or fluids or to collect blood samples. Each year, an estimated 250,000 cases of central line-associated bloodstream infections occur in hospitals in the United States, and an estimated 30,000 to 62,000 patients who get the infections die as a result, according to the Centers for Disease Control and Prevention. The comprehensive program, designed to survey and improve an intensive care unit's patient safety culture, was developed by researchers at the Johns Hopkins University and has been used in more than 100 ICUs in Michigan. The program includes tools to help health care professionals identify opportunities to reduce potential health care-associated infections and implement policies to make care safer. Within three months of implementation in Michigan, the program helped reduce infection rates to zero in more than 50 percent of participating hospitals. Under the new contract, the safety program will be implemented by statewide consortia in at least 10 different states. The consortia, which will be established as part of this project, will include members of state hospital associations, quality improvement organizations and public health agencies. The project will be funded through AHRQ's Accelerating Change and Transformation in Organizations and Networks initiative, an implementation model of field-based research designed to promote innovation in health care delivery by accelerating the diffusion of research into practice. http://www.ahrq.gov/news/press/pr2008/clabipr.htm
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