The sequel

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

AT THE WHITE HOUSE TODAY, THESE REPORTERS OBSERVED CELEBRITY IN CHIEF BARRY O GETTING INTO WARDROBE AND REVIEWING HIS SCRIPT FOR THE DAY.

"ARNE DUNCAN MAKES THE WORST COFFEE!" BARRY O SNARLED SPITTING OUT A MOUTHFUL. "DO YOU WANT TO HEAR TODAY'S SCRIPT?"

ON THE HEELS OF YESTERDAY'S SCARE TACTIC OF NO SOCIAL SECURITY CHECKS IF I DON'T GET MY WAY, BARRY O INTENDS TO APPEAR BEFORE THE PUBLIC LATER TODAY AND EXPLAIN THAT IF THE DEFICIT IS NOT ADDRESSED BY THE START OF NEXT MONTH, THE FEDERAL GOVERNMENT WILL BE REQUIRED TO EXECUTE THE TOOTH FAIRY.

"WE JUST CAN'T AFFORD HER AND ALL HER QUARTERS, DOLLARS AND ALL OF THAT, WE CAN'T AFFORD IT! I NEED THE BODICE OF MY SLIP RIPPED! PEOPLE! I NEED THE BODICE OF MY SLIP RIPPED! WHERE IS THE STITCH BITCH! STITCH BITCH!"



FROM THE TCI WIRE:

Debbie Schulz: Steven's life has changed since his injury and, of course, my life has too. I had been working as a special education teacher when he was injured. My husband and I, 51 and 49 [years-old], were preparing to become empty nesters. Instead, I became Steven's primary caregiver, advocate, lifeskills coach, chauffer, secretary, bookkeeper, teacher, drill instructor, medical assistant, physical-occupational-speech therapist and on and on. Leaving the workforce has created a financial hardship and our world and that of our then-18-year-old daughter and 15-year-old son has changed profoundly.

Debbie Schulz is the mother of Steven K. Schulz who was serving in Iraq when he was severely injured in a Falluja attack on April 19, 2005. She was testifying to the House Veterans Subcommittee on yesterday afternoon.

"Four months ago today, this Subcommittee held our first hearing of the year to discuss why the Department of Veterans Affairs (VA) had failed to implement the caregiver assistance program as required by Public Law 111-163," declared Subcommittee Chair Ann Marie Buerkle yesterday afternoon. "At that hearing, it was clear to me that VA must go back and address serious deficiencies with the Department's initial implementation plan, particularly the strict eligibility requirements, and get this important program up and running." The Subcommittee heard from three panels, Debbie Shulz was the first panel, Wounded Warrior Project's Anna Freese and VA Caregiver Support Coordinators Cheryl Cox and Mary Fullerton made up the second panel while the third was composed of the VA's Deborah Amdur with Keith A. Welsh.

As Ranking Member Michael Michaud explained, the hearing was a follow up to the March 11th hearing by the Subcommittee. On the Senate side, the Senate Veterans Affairs Committee March 2nd hearing (covered in that day's snapshot and Kat covered it in "Burr promises VA 'one hell of a fight'" and Ava covered it at Trina's site with "The VA still can't get it together"). What both Senate and House Committees learned in the two March hearings was that they had passed legislation that was very different from what the VA was implementing. Senator Patty Murray, Chair of the Senate Veterans Affairs Committee, noted, "VA's plan on the caregivers issue was overdue and once submitted it hardly resembled the billt hat unanimously cleared this Congress. Three weeks ago, my Committee staff requested information on how that plan was developed and to date no information has been provided. Rather than following the law, the administration set forth some overly stringent rules, bureaucratic hurdles, that would essentially deny help to caregivers."

Schulz explained she was now rated by the VA for providing 40 hours a week of caregiving. She probably does a great deal more than that but it's not recognized. She did want it understood that when a wounded veteran returns, there's nothing so simple as 40 hours a week of care. She reviewed how, in her case, a great deal of time was taken with reorienting and dealing with confusing on the part of her son as to where he was and what was going on. There were sleep and other issues that had to be addressed including bathroom issues and the first weeks contained a great deal of work on reorientation. It's an important point but it's sad that she had to underscore it. A veteran with no apparent disabilities or challenges will need time to reorient themselves and they may require help on that. That a wounded veteran would need it should have been obvious to the VA with no caregiver having to point it out.

"I couldn't understand that," Debbie Schulz told the Subcommittee of disparities for caregivers and gave an example of "another caregiver" in Texas who cares for her son suffering from TBI with a spinal cord injury and unable to transfer himself out of his wheel chair is judged of doing only 25 hours of care a week. "How can that be right?" Schultz wondered.

Part of the determination of how much care is being provided is supposedly based upon a home visit (it's not clear whether that's the case or not and that's a failure on the VA's part -- it is supposed to be part of the determination).

Ranking Member Michael Michaud: You mentioned that the home visit wasn't what you expected it to be. What did you expect the home visit to be? And why -- is there anything that stuck out that they did that they should not have done?

Debbie Schulz: Well my understanding of the home visit was to make sure that the home was appropriate and to also assess my needs as well as Steven's needs. And being a social worker in another life, I know sort of how assessments should go so that may have jaded me. But he came in and didn't know who the veteran was. He thought I was the veteran at first. And I was like, "No, Steven." So he had not read the chart which was sort of a red flag to me. The second thing was after he's doing, going through making sure I know about infection control, nutrition, all these things that I've been doing for six years now, and Steven has obviously been healthy and happy and at a good weight -- not overweight or underweight, then he asks me if I know about catheter care? And Steven has never been at home with a catheter. Now for some veterans, that's an issue and I would need to know that. But I would like the VA to realize that those home visits are a real chance to come out and see what the needs of the veteran and the caregiver are. That's what I was expecting.

[. . .]

Ranking Member Michael Michaud: My last question, if you had to make one change within the system what would be the change that you would suggest?

Debbie Schulz: One change? You're going to limit me. I think I would really tighten up those disparities so that that artifical cap of hours because there are a lot of veterans that need more than 40 hours and what are we doing for them and how can you -- I mean that disparity is so discouraging. And so really working on that rule to get that right. So that it's not an artificial and so it's right across the country.

Chair Buerkle asked Wounded Warriors Project's Anna Frese, "What if you could change one thing with this program, where do you see a deficiancy or something that needs to be changed?"

Anna Frese: I think one of the issues is one that Debbie -- Ms. Schulz mentioned previously in dealing with the determination of the stipend and the range of hours. So I won't be redundant on that but I think that's something that attention definitately needs to be brought to. I think the second thing is the elegibility, the mental health elegibility criteria. The IFR [interim final rule] sets a much higher standard for elegibility with the current GAF score [a measure to assess functioning] in cases involving psychological trauma or other mental health conditions then for any other condition and there seems to be a disparity in the needs for a mental health compared to the different physical disabilities that others may be having. The amount of hours the family caregivers are providing regardless of either a physical disability or a mental health condition remain the same. There is a need there. I also here from others because seeing that GAF score and eligibility criteria, it has dissuaded many from applying -- just not understanding that they still might be eligible -- and it also can create a misunderstanding with some of the VA professionals that they work with. The education with that eligiblity criteria would be greatly helpful for the family members applying but also for some of the VA personnel that come into contact with the families where there is a need and they would benefit from this program.

We could highlight more of Frese with no problem but I'm not interested in the VA witnesses. I couldn't tell whether US House Rep Dan Benishek grasped that their very, very smiley face presentation or whether he bought into it. But when family members are telling you there's a problem and the VA's insisting that there's not, it may not be an issue of problems in one area of the country, it may be that the VA is putting a happy stamp on what's actually going on.

I found it appalling that Cheryl Cox and Mary Fullerton were asked about anyone being turned down but were not expected to explain why they were turned down -- either those specific unnamed people or families in general and in abstract. Cox spoke of one family that was turned down. And they were fine with it, she swore. Really? Can you think of anything you've ever applied for -- be it a loan, a college, a job, whatever -- that you were turned down for and you were happy? Fullerton apparently has had many more turn downs -- no one thought to ask her for a number but she was speaking in plural terms -- and if they wanted to appeal, she insisted, they knew she would be happy to help them.

If they wanted to appeal the person they chiefly interacted with before would be in charge of the appeal? How fair does that seem? Would you waste your time appealing in such a case? I don't think most people would unless they had the time to really fight.

I'm not interested in the garbage the VA spewed and, not being a member of the Subcomittee, I don't have to pretend to be. I thought the Chair and the Ranking Member did a strong job. Other than that, the only bright spot was when US House Rep Phil Roe (also a medical doctor) showed up and asked questions near the end of the second panel. Still on veterans issues, Senator Patty Murray's office notes the following:

VETERANS: Murray to Hold Hearing to Discuss Closing the Gaps in VA's Mental Health Care

(Washington, D.C.) --Thursday, July 14th, U.S. Senator Patty Murray, Chairman of the Senate Veterans' Affairs Committee, will hold a hearing to discuss access to mental health care services, including waiting times and staffing levels, outreach to veterans, integration of mental health care into primary care, suicide prevention and problems identified by VAOIG at mental health residential rehabilitation treatment programs. During the hearing, the committee will question professionals from the VA's various mental health programs, a Veterans Council Representative for the National Alliance for the Mentally Ill, the caregiver and spouse of U.S. Army Sgt. Loyd Sawyer, the Assistant Inspector General for Health Care, and the head of a private sector health care delivery system. A full list of witnesses is available HERE.

WHO: U.S. Senator Patty Murray, Chairman Senate Veterans' Affairs Committee

WHAT: Hearing to discuss VA's mental health care services

WHEN: Thursday, July 14th, 2011
10:00 AM ET

WHERE: Russell Senate Office Building
Room 418
Washington, D.C.

The editorial board of the Intelligencer and Wheeling News-Register notes US President Barack Obama's claims that combat operations ended August 31, 2010 in Iraq and that all troops will be out of Iraq at the end of this year, "None of it is true. Fifty thousand U.S. troops remain in Iraq. Combat deaths, including that of an Elm Grove native in late June, continue to occur regularly. And U.S. officials have said they are willing to keep combat troops in Iraq after the Jan. 31 withdrawal 'deadline,' if the government in Baghdad approves. But even if all troops are pulled out, the U.S. military role in Iraq will continue for years, perhaps decades, under an Obama administration plan." And the editorial board becomes one of the first in the country to explain the backup plan if Iraq doesn't agree to extend the US presence in Iraq under a SOFA or similar arrangement. They do so by using the public hearings in which the State Dept testifies. This isn't a secret, why so much of the media has treated it as such is a question to ask. But the editorial board walks you through how the war continues. Chris Toensing (Foreign Policy In Focus via Antiwar.com) notes that while extension "is a burning political issue" in Iraq, "there's precious little debate in Washington on the date for withdrawal. Even though President Barack Obama campaigned on a pledge to leave Iraq, his administration isn't telling Maliki that the troops are decamping come what may." Toensing offers his take on what the US government was hoping for and what Nouri al-Maliki was hoping for back in 2008 (in the final days of the Bush administration) when both signed off on the SOFA:

Washington wagered that Maliki would widen his coalition to embrace enough political opponents that his government would be stable without an American prop. The Iraqi premier gambled that, with U.S. funding and training, his security forces would grow strong enough to defeat his domestic foes by the end of 2011.

Both bets were foolish, but Washinton's was more so. Maliki and his circle have no serious record of concilatory politics, and indeed have played upon and exacerbated the country's sectarian, ethnic, and ideological divides to remain in office. In such partisan maneuvers, they have felt secure in the knowledge that tens of thousands of heavily armed Americans are their formidable first line of defense.

How might an extenions go over within the US? Timothy Monroe Bledsoe writes the Augusta Chronicle to share his thoughts on such an outcome, "Now, the overpaid, underworked and clueless government officials in Washington, D.C., are continuing to force tens of thousands of American Troops into harm's way for absolutely no good reason! It is well past time for our so-called government officials to stop being war-mongers and bring all our troops home to safety and to their families, where they all belong."


However, the US government has a different focus. Al Mada reports that Iraqi government sources confirm US Secretary of Defense Leon Panetta's visit to Iraq was about extending the presence of US troops in the country. Al Mada reports he was told that at Iraqi President Jalal Talabani's house last Saturday, political blocs signed onto an agreement to provide an answer as to whether or not to request the US military to stay beyond 2011 and to provide that answer within two weeks. MP Ibrahim Rikabi tells the paper that Panetta was most focused on what number of US troops would remain in Iraq and that other concerns included "Iranian extremists in Iraq." The article also references the memorandum between the US and Iraqi governments which Al Mada reported on yesterday -- a working memo which would allow US forces to remain in Iraq through the end of 2016. The World Tribune notes the two week deal but says Nouri has stated it will be August before any request is or is not made.

Of the two-week arrangement, Laith Hammoudi, Roy Gutman and Nancy A. Youssef (McClatchy Newspapers) report, "Yet Iraq's political impasse appeared no closer to resolution after Panetta met Prime Minister Nouri al Maliki and other Iraqi leaders. Over the weekend, during heated, top-level talks that lasted about four hours on Saturday, Maliki was unable to secure the agreement of Ayad Allawi, his key political rival, for a decision on whether to ask the U.S. to keep any of the 46,000 troops still in the country — all of whom are due to depart by Dec. 31 under a security agreement. Instead, the Iraqi leaders agreed only to meet again in two weeks and hold lower level talks in the meantime."

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