Ask for help, he sends the Feds

BULLY BOY PRESS & CEDRIC'S BIG MIX -- THE KOOL-AID TABLE

CELEBRITY IN CHIEF BARRY O, DESPERATE FOR NEW HEADLINES, IS REFASHIONING HIMSELF. CAROLINE JAMIESON WROTE TO BARRY SEEKING HELP WITH HER HUSBAND HERVE FONKOU TAKEOULO'S IMMIGRATION STATUS AND THE WHITE HOUSE DISPATCHED FEDERAL AGENTS TO THE WOMAN'S HOME TO HAUL OFF HER HUSBAND IN HAND CUFFS.

REACHED FOR COMMENT BY THESE REPORTERS, BARRY O EXPLAINED, "SNITCH IS THE NEW ROCK STAR. SNITCH IS THE OCCUPATION FOR THE 2010s, TRUST ME. AND I WANTED TO GET IN ON THE CRAZE. IT'S A HOT-HOT PROFESSION AND OH-SO-SEXY. HAVE YOU SEEN ADRIAN LAMO? HE'S SO SEXY, I'D GO DOWN ON HIM UNTIL HIS PUBES TICKLED MY NOSE. THERE'S NOTHING HOTTER THAN A SNITCH! YOU KNOW MICHELLE'S MAMA CHEATED ON HER TAXES. I'M THINKING OF TURNING HER IN TOO!"


FROM THE TCI WIRE:

Let's switch over to the US. Senator Daniel Akaka is the Chair of the Senate Veterans Affairs Committee. His office notes:

AKAKA AND BIPARTISAN COMMITTEE MEMBERS URGE INCREASED VA/DOD COORDINATION FOR TRAUMATIC BRAIN INJURY

Senators call for specific actions from Departments of Defense and Veterans Affairs

WASHINGTON, D.C. – In a letter to the secretaries of Defense and Veterans Affairs sent yesterday, Senate Veterans' Affairs Committee Chairman Daniel K. Akaka (D-Hawaii) and a bipartisan group of Veterans' Affairs and Armed Services committee members urged stronger coordination and better follow up on traumatic brain injury (TBI).

"For the past nine years we have been a nation at war, and traumatic brain injury has become the signature wound. The Departments of Defense and Veterans Affairs have taken commendable steps to understand and treat TBI, but they must improve collaboration and share what they have learned. Veterans and their families should not have to wait nearly a decade for the government to adapt to the needs of the wounded," said Akaka.

The Senators called for specific improvements from Secretary of Defense Robert Gates and Secretary of Veterans Affairs Eric Shinseki, including:

• Prompt action to finalize and implement DOD's draft policy mandating evaluation and rest periods for individuals with TBI, and to ensure that existing policies are being adhered to by each military service branch;
• Action to ensure documentation of TBI and follow-up during Post-Deployment Health Assessments and Reassessments;
• Expedited establishment of DOD centers of excellence for military eye injuries, and for hearing loss and amputations;
• Quicker progress to make VA/DOD collaboration and data transfers more robust, comprehensive, and seamless; and
• Making full use of authority granted by Congress for VA to partner with state, local, and community providers to improve access to care and reduce the burden on veterans receiving treatment for TBI, and their family members.

Last month, the Veterans' Affairs Committee held an oversight hearing on the state of care for troops and veterans suffering from TBI. In January 2008, Congress passed provisions authored by Chairman Akaka and approved by the Veterans' Affairs Committee to reform VA/DOD collaboration and care related to TBI as part of the National Defense Authorization Act. Akaka continues to work with committee members and others to ensure effective implementation.

To view the letter, click here: LINK

-END-

Kawika Riley

Communications Director and Legislative Assistant

U.S. Senate Committee on Veterans' Affairs

Senator Daniel K. Akaka (D-Hawaii), Chairman

http://veterans.senate.gov

In addition, Wednesday the Senate Veterans Affairs Committee held a hearing which Chair Akaka brought to order noting, "Today we will discuss VA health care in rural areas. Rural settings are some of the most difficult for VA and other government agencies to deliver care. I beieve, and I know many of my colleagues on this Committee share the view, that we must utilize all the tools at our disposal in order to provice access to care and services for veterans in rural and remote locations." We covered the first panel in Wednesday's snapshot and we'll grab the second panel now. The second panel was made up of Brig Gen Deborah McManus, Yuckon-Kuskokwim Health Corporation's Dan Winkelman, the VA's William Schoenhard, the VA's Verdie Bowen and Dr. Robert Jesse (Dr. Jesse also appeared on the first panel). This section of the hearing was chaired by Alaska Senator Mark Begich. Verdie Bowen explained that it could be difficult getting veterans to register for the programs and Dan Wikelman noted obstacles for rural areas including access to basic services and the cost of them. As Brig Gen McManus noted, there are areas in Alaska that, forget the internet, do not even have phone service.

Chair Mark Begich: [. . .] General, I know you with your work with women veterans -- and I know the coordination that you're doing there -- even within women veterans, it's a small, I want to say it's about a third of them are signed up or taking advantadge. Can you elaborate a little on what you think and maybe following up a little bit on Mr. Bowen's comments regarding how hard it is to register. What are you finding specifically in the area with women veterans? I know it's a concern for me, I know it's a concern for Senator [Patty] Murray. Give me a little bit of thought on that.

Brig Gen Deborah McManus: Well when we look at our women -- female -- women veteran population, a lot of them are from the older wars and I think there's a cultural issue there. Many of them, they were in subordinate roles or support roles and their service was not greatly appreciated when they returned to the States. And also, a lot of them experienced Military Sexual Trauma whether its rape, sexual assault or harassment and so there was a fear of seeking help through the system so a lot of them just faded away. However, I think, it's different with our current OEF/OIF veterans. There are mechanisms so that they can report it and receive help. And a lot of times women do not recognize they're veterans and women have traditionally been in a caregiver role so I think there's a cultural issue but there's an education issue and when we did that veterans -- women veterans outreach campaign in November of '09 last year, we did see an increase in enrollment and use of services. 300 women additionally enrolled and 400 seeking services. So I think it's a routine, education system, let women know, they are vets too, they have earned these rights and these are their benefits. And a lot of them have female specific health care needs. So now they understand that the VA facilities can provide services in those areas as well.

Chair Mark Begich: Very good. Let me, if I can move over to this side, to either one of you who'd answer, is there more that the VA can do? And as an example was just given, how the outreach was done to increase the amount of women who recognized that they have benefits available to them but not be taking them for a variety of reasons as just described. Do you have any thoughts on that, Dr. -- Dr. Jesse then?

Dr. Robert Jesse: Mmm. A couple of things. I think the issues that have been brought up are really important. We've historically, in the health care side, measured access by wait times to clinic visits or wait times --

Chair Mark Begich: How many came through? How long they waited?

Dr. Robert Jesse: How long they waited. And-and all that's irrelevant if they don't know that they are entitled to services, they can't access those services, uh, they can't get to us, we're not connected to them in one way or another. And particularly as we move to our new models of care if you will where, uh, we're not talking about episodic access as a driving function but actually connectivity, that front end engagement becomes absolutely crucial. And we-we have an awful lot of effort going on trying to understand this now. Why don't people declare themselves as veterans on forms? Why-why can we repeatedly send people information and they just don't act upon it? Our assumption is, "Well, we sent it to you and you should have acted on it." And the simple answer is peope should probably be enrolled when they swear into the military. I mean we talk about seemless transition and there is a lot of discussion going on with -- between VA and Department of Defense, how do we best effect that? And I can only say that, again, this is the Secretary's, one of his top priorities and he understands these issues probably better than-than any of our leadership in prior years. So we are trying to understand this. We are trying to make it easier. But there are complex issues here. In terms of the women's issues, this gets, again, really interesting because historically we measure what we do in health care statistically, we look at quality statistically. But whenever we try and look at women's health issues, the numbers aren't big enough to make sense of the statistics and what we've really learned from this is we-we have to treat each individual as a [. . . "end"?] of one and try and understand how we can manage their health care needs in much more specific manner. And so the VA in the past several of years has done a lot of that, every VA facility now has women's health coordinators. We do have an office for women's issues that's very proactive in-in-in trying to develop these -- The issue of Military Sexual Trauma are extremely complex. Just to get them coming forward, I think, is, uhm, is happening because the discussion is coming out into the open. And again, we're-we're-we're willing to accept any help, any advice and we see these as very important issues and are trying to deal with them.

Chair Mark Begich: Do you -- So obviously for, if the General has some ideas, she'll be able to share them with you and you'll? That's good. I'll leave that to you two to go forward. Let me kind of narrow down if I can on one and that's the Rural Health Project. Mr. Winkleman laid out some concerns and I know you've heard from me more than once on this issue. The idea, and I think you had three suggestions, but I want to take it to a little broader and maybe, Dr. Schoenhard, if you could respond to this and that is, maybe be a little bold here, the effort and the idea is good. I don't think anybody disagrees with that. The implementation is the struggle. And it sounds like, based on the testimony, there might have been some linkages in the front end that might not have been put together as well and now we're trying to kind of patch it as we go along. I'm wondering if it's better to kind of freeze frame for a second on it and say, "Okay, let's sit down with our rural health care providers who've been in the business for years and have figured out how to deliver to the most remote areas of the world, in a lot of ways, health care and how to restart it"; rather than I think what's happening, the sense I get, I may be wrong about this but I hear from so many different people, it's almost like we are trying to patch a little issue here and patch a little issue when really maybe what we really need is to freeze frame it, stop it, step back, what's the right approach? Bring some of the people who've been in the field say what's the should we do differently? Just the fact that you have to go get -- opt in through another type of system before you're really in? You know, I can only tell you from my experience and Dan [Winkelman] has much more experience around this for rural individuals who live in rural areas for most of their life, that's just another piece of paper they're not going to read. They're just -- I don't want to say they give up, but they do less. Is there -- Is that too bold of an opportunity? I'm just trying to -- It seems like every time I talk about this issue it's like almost starting a knot and moving the knot . Give me your thoughts on that.

William Schoenhard: Yes, Senator. I think the numbers on that speak for themselves. We obviously are struggling with getting veterans to sign up for this program. At this point, only 21% in the pilot have signed up and, of that, very few have asked for primary care authorization or mental health consulations. So I think the numbers speak for themselves. We need to improve. We have hired a

company to do a focus group to understand better why we haven't had more success in enrolling veterans but we welcome what Mr. Winkelman, Mr. Bowman have shared today. I think we need to sit down and understand together because IHS has assets on the ground, they are in the communities. They understand well what is needed there much better than anyone else that would be in a distant location with VA or anywhere else. And we should collaborate. And I think your suggestion that we freeze frame, we were talking a lit bit during the break, during the recess --

[Laughing] That was strategically done, you know that.

Yes, sir. We had good conversation and I welcome undertaking the discussion of the three recomendations that were shared and see how to better serve and better get veterans engaged with IHS in these locations.

Turning from veterans to service members, from Wednesday's snapshot: "For the month of April, the US Army announced yesterday, they can confirm 4 suicides among active-duty service memberrs with six still being investigated and there are nine ongoing investigations into May deaths. For the reserves, the US Army said there 7 suicides in April and 2 in May with ten more still being investigated." Jaime Tarabay reported yesterday on army suicides for Morning Edition (NPR -- link has text and audio):

Mr. EDWARD COLLEY: I'm Ed Colley. I'm the father of Stephen Colley, Private First Class, United States Army. Stephen committed suicide three years ago in May of 2007.

TARABAY: The last time Colley saw his son was at a family gathering in April 2007. Stephen, a helicopter mechanic, had been back in the country for about five months since a tour in Iraq. Colley says Stephen was detached. He spent the days watching cartoons. He fought with his wife.

TARABAY: From there it was a downhill stumble, struggling in a work environment an Army investigation later called hostile. On May 16, 2007, home alone, Stephen Colley argued with his wife through text messages. Edward Colley says at one point his son asked her if there was rope in the storage shed.

Mr. COLLEY: He had texted his wife that suicide was an option. She immediately called the appropriate folks at the base, but Stephen - unfortunately in this case, Stephen was a very, very smart boy. And he had figured out how to make sure that nobody else would interfere with his plan.

TARABAY: The plan was to overdose on medication and then hang himself from a tree. He was 22 years old. The military ruled his death a suicide. But for Edward Colley the hardest thing about his son's death is he believes it could've been prevented. The day before he killed himself, Stephen Colley took an Army mental health assessment - multiple choice questions, including some about intent to harm yourself. There were four possible answers.

Mr. COLLEY: And he picked the most severe, that he was thinking about committing suicide more than half the time.

TARABAY: And instead of acting on that information, the social worker who did Stephen Colley's assessment put him down for a sleep study in three weeks' time. The Army's own investigation said the established procedures failed to address his mental condition.

RECOMMENDED: "Iraq snapshot"
"Is it mental illness or a sane reaction?"
"Funding Iraq? Why?"
"I Hate The War"
"Cucumber Salad in the Kitchen"
"The Great Recession"
"And now I endorse Laura Welles for governor"
"Repeat the mantra"
"Bloom is off the rose"
"Marisa"
"Bully Alone"
"trust the book, not the author"
"jolie's new film"
"No recovery"
"Lynne Stewart and Ralph Poynter"
"Joanna Newsom and Day 59"
"The Gulf Disaster"
"NPR busts Thad Allen"
"Don't call him Keith Kos anymore!"
"Man's Favorite Sport?"
"The gloss comes off"
"Clarifing"
"Idiot of the Week, Roy Gutman and more"
"Roy Gutman"
"THIS JUST IN! RECOVERY SUMMER HITS THE ROAD!"
"Tuning up for summer"