Stars & Stripes - 03.02.18

Volume 10, No. 12 ©SS 2018

FRIDAY, MARCH 2, 2018

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Troubled transition Tricare changes endanger autism therapy services for military families Page 2

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COVER STORY

Tricare overhaul ‘life-altering’ for families Processing woes threaten vital therapy for autistic children

BY DIANNA CAHN Stars and Stripes

WASHINGTON — The letters, as if coordinated, began going out the third week in January.

First Anchorage, Alaska, then Jacksonville, Fla. Soon, military families in Texas and Alabama hubs received notices, too.

Despite months of preparation, the 2018 overhaul of the military health insurance company Tricare was not going smoothly, the letters from service providers explained. Tricare’s new management companies were not reimbursing providers and were not responding adequately to phone calls, emails or online submissions.

So therapy clinics like Bloom Behavioral Solutions in Jacksonville, Integrated Solutions in San Antonio and A Perfect Fit, AK near Anchorage, which offer behavioral therapies for children with autism and other challenges, were finding themselves without recourse — unable to cover the costs of the expensive therapies for children of military families. Services would have to be slashed, each letter said.

“Despite all our efforts to maintain services without Tricare reimbursement, we are at a point at which we can no longer continue to provide ongoing services for Tricare beneficiaries for which we are not paid,” Bloom Behavioral wrote on Jan. 19. “Beginning on Wed. Jan. 24, we will have to put all services for Tricare beneficiaries on hold.”

For parents, the news was stunning.

These therapies are not simply beneficial; they give their children skills to cope with everyday life. Losing them could be devastating for a child’s progress.

“I walked into the clinic room and there were parents in tears,” said Mary Nelson, a Coast Guard wife whose 7-year-old receives hours of behavioral therapy each week at Bloom.

“Everything changed so abruptly. This is life-altering for these kids.”

In Alaska, Jeri Romesha received a similar letter Jan. 17 from A Perfect Fit, AK, the center where her daughter, 6, and her son, 3, receive a total of 30 hours of therapy per week.

Military Spouse Magazine and Chasing Dragonflies by Karyn

Coast Guard Petty Officer 1st Class James Nelson holds his youngest son, Coleman, and his wife, Mary, holds their middle son, Wyatt, who is autistic, in Clearwater, Fla., in spring 2017. Mary Nelson said problems with Tricare following Jan. 1 changes have forced Wyatt’s behavioral therapy center to slash services.

Romesha, whose husband is a senior master sergeant at Joint Base Elmendorf Richardson in Anchorage, started pounding the phones. First she called HealthNet Federal Services, which took over the Tricare West contract Jan. 1. But after hours on hold and no way to leave a message without giving her entire Social Security number, Romesha took a different tack.

She reached out to HealthNet contacts she had through her work as a Transition Assistance Program manager on base. By chance, one of them was a regional director.

“Services for my kids are being canceled and stopped because of these problems,” Romesha told him. “This is not the way to do business.”

The director stepped in, and the providers got paid, Romesha said. “Frankly, we got lucky. If I hadn’t reached out to the connections I had, we wouldn’t have services now.”

Across the country, parents and pro-

viders say they are facing overwhelming obstacles to sustaining services under Tricare following the Jan. 1 reorganization that included merging Tricare East and Tricare South and changing contracts for Tricare East and West.

Servicemembers and family members have reported difficulties connecting to online systems and hourslong waits to speak to customer service. Parents and providers said they learned more from each other in online forums than from attempts to reach their insurance representatives.

Meanwhile, providers say reimbursements are patchy, they are slow to be approved, many providers are being reimbursed at rates of less-qualified professionals, and the management companies — Humana Military in Tricare East and HealthNet in Tricare West — are slow to correct errors and to address problems.

SEE PAGE 3

Photo courtesy of Jeri Romesha

Certified behavioral analysis therapist Sheena Rae works with Jase at A Perfect Fit, AK, where he gets help learning to express himself.

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COVER STORY FROM PAGE 2

The Defense Health Agency says it is aware of the problems, particularly in Tricare East, and it has established a joint DHA/Humana Autism Task Force to resolve issues. It also says many of the problems have been corrected or are being resolved.

But providers say that while claims that go through without error are being processed more quickly, many of the issues still persist — including frequent errors in processing, payment rates and full reimbursements.

Bloom is among several companies that managed to continue some services by taking out expensive, urgent, high-interest loans. But that’s not sustainable for very long.

“It’s a mess,” said Amila Smith, a partner at a Compass Behavioral in Atlanta, who is concerned that if things don’t get better, the company will have to opt out of Tricare. Her company took out a loan as well.

“We don’t want to interrupt services,” she said. “A lot of our clients we have had for several years and we’ve made such good strides for them.

But we can’t keep borrowing money to run the business.”

Anything but smooth In rolling out Tricare’s largest overhaul in two decades, the military consolidated its massive health care program from three regions into two, keeping Tricare West intact and merging north and south into a single Tricare East Region. New management contractors were brought in for both regions.

Months before the rollout, providers said they sent their rosters and credentials to the new companies to ensure a smooth transition.

But the Jan. 1 transition was anything but smooth.

Some providers did not get their credentials. Referrals weren’t going through, and soon problems emerged with claims processing.

“We were prepared for this merger,” said Bloom Behavioral Solutions co-founder and CEO Genevieve Covington.

“We had everything signed well before (the transition).

My business partner and I had been saving for a two-tothree-week delay. But nobody

Photos courtesy of Mandy Farmer

Above: Evan, 7, who has autism, beams after opening a package of muffins by himself for the first time in an undated photo. His mother, Mandy Farmer, said the therapy services for her son that helped him learn these skills have been cut in half due to glitches in the Tricare overhaul Jan. 1.

Left: Registered behavior technician Annalise Dzyak works with Evan, then 5, on his skills two years ago. could have prepared for this situation.”

Providers complain that the website would not allow verification of basic information like names of providers, authorization to provide service to clients or corrections to erroneously processed claims.

Covington said her center went from having six boardcertified behavioral analysis therapists to four, when Humana failed to credential two of them. That automatically cut back on their ability to serve clients.

Humana also was failing to pay out properly and was mislabeling the coverages or levels of certifications, several providers said. Trying to rectify those errors amounted to dozens of hours per week on the phone.

In one instance, Covington said, Humana processed one of two siblings receiving dozens of hours of applied behavioral analysis per week as out-of-network and the other as in-network. The active-duty parents were charged hundreds of dol-

lars per day for services that are supposed to be covered.

The company, unsure which services would be reimbursed, put salaried therapists on hourly rates and cut back on hours. After warning parents they might have to cut services to all Tricare patients, the company took out a loan.

In Georgia, Smith said her company was told in January that their paperwork was not valid because Humana had not yet begun operations. Their provider representative told them she’d look into it, Smith said, but did not get back to them for weeks.

With more than 50 Tricare patients and similar problems with processing and payment errors, lack of credentialing and an improper fee schedule, Smith’s company, Compass, was struggling.

Meanwhile, parents said they could not get answers on copayment increases and spent hours trying to reach customer service Similar things were happening with HealthNet, although

the Defense Health Agency says those problems are less severe.

At A Perfect Fit, therapist Kelly Forestal cut back her work hours so the company could pay its more junior registered behavioral technicians and keep services running.

“Thank goodness the technicians continued to work,” Forestal said. “If we had gotten to the point where we had to terminate their services, too, that could have been disastrous.”

Forestal said HealthNet rectified many of the issues after one of its local officers stepped in, but it is still paying lower rates for applied behavioral analysis professionals, which she worries could force companies like hers out of Tricare.

Right now, she said, she’s less worried about the money than about ensuring the kids get the therapy they need.

“For a lot of kids … therapy is part of their routine,” she said. “When we take their routine away, it’s really confusing for them. So it not only takes away all those learning oppor-

tunities they otherwise would have gotten, that change in routine can really destabilize their learning and cause a lot of problem behaviors.”

‘Nobody cares’ When she realized that problems with Tricare were happening around the country, Mandy Farmer fumed. How was it that she was getting calls weeks into the rollout of the Tricare changes saying that the new management company needed more information before it could approve her son’s provider? How could Tricare and the Defense Health Agency, or DHA, spend months preparing for the 2018 transition and still get it so wrong?

This wasn’t the first time Farmer has had Tricare problems, but she said she had never seen it this bad. The Air Force wife and advocate for parents of autistic kids penned a scathing post on her blog “From Motherhood.”

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MILITARY/COVER STORY

Navy sends 2 destroyers into Black Sea region

BY SCOTT WYLAND Stars and Stripes

Two American destroyers sailed into the Black Sea recently, the first time since 2014 that more than one U.S. warship has operated in this tense region other than in an exercise.

The destroyers USS Ross and USS Carney are patrolling the sea to help maintain regional security and stability, the Navy said.

“Our decision to have two ships simultaneously operate in the Black Sea is proactive, not reactive,” said Vice Adm. Christopher Grady, 6th Fleet commander, in a statement Sunday. “We operate at the tempo and timing of our

choosing in this strategically important region.”

Russia has viewed U.S. ships transiting these international waters as provocative ever since Moscow annexed Ukraine’s Crimean Peninsula in 2014.

The U.S. is sending a message that it will defend its allies, uphold maritime laws and protect its offshore interests in Europe and Asia, said Jim Holmes, Naval War College professor of strategy.

“We’re putting Russia on notice in the Black Sea and China on notice in the South China Sea that we will not be deterred from going into those waters, and doing so in force,” Holmes said.

The U.S. has sent destroyers

FROM PAGE 3

“I’m either going to cry or punch someone,” she wrote. “Military families all over the country are receiving notice that services for their autistic children will cease because Tricare’s new contractors are not paying providers. Tricare knows. The Defense Health Agency knows. Everybody knows. Nobody cares.”

“Is it just me, or is this a smart way for them to save a lot of money?” asked Farmer, whose husband is an Air Force colonel at Ellsworth Air Force Base near Rapid City, S.D. Farmer has a child struggling with autism who has benefited greatly from behavioral therapies that the family could not afford without insurance.

Her son, Evan, 7, was getting 10 hours of behavioral therapy per week for severe aggression. He had three therapists who worked with him on skills for coping and sharing and on being around his siblings without acting out. The biggest thing were community outings with the therapist, who would help him learn to cope in strange or public places.

The treatment is very methodical — training an autistic child through

JAMES R. TURNER /Courtesy of the U.S. Navy

Ship’s Serviceman Seaman Darnell Thomas mans a .50-caliber machine gun aboard the guidedmissile destroyer USS Carney while mooring in Varna, Bulgaria, on Feb. 18. into the Black Sea more often in the past year as Russia has deployed more naval forces.

But the last time two U.S. warships conducted a security patrol there was during the 2014 Sochi Winter Olympics, just before Russia annexed Crimea.

Two warships have been present in the Black Sea for

consequences and patterns, like taking toys away if they behave badly and giving them back one at a time as they behave well.

Before therapy, Evan had dozens of incidents per day, Farmer said. Now he has one or two per week.

But when two of his three therapists had to stop working with him last month because of the Tricare problems, he lost six of his 12 hours of therapy, and his schedule changed as his provider struggled to keep services going.

For an autistic child who thrives on structure and predictable planning, the sudden changes were overwhelming.

It is “yanking the rug out from under them,” said Farmer. “It’s devastating to families.”

‘A number of challenges’ In a statement, the DHA said it was aware of the problems in credentialing providers and paying out claims — particularly for services to specialneeds patients receiving applied behavioral analysis for autism-spectrum disorders. It committed to resolving the issue and to overseeing Humana’s

multinational exercises, such as last year’s Sea Breeze and Sea Shield.

Beefing up patrols is a way of telling adversaries the Navy has bounced back after some high-profile accidents, Holmes said. The destroyers USS John S. McCain and USS Fitzgerald collided with commercial ships in separate incidents last

performance closely.

“Resolving the issues families are facing is our highest priority,” the statement said.

It also outlined improvements, including adding a special customer service number for applied behavioral analysis providers and additional training for customer service representatives. It has held three provider webinars and said applied behavioral analysis provider credentialing now takes an average of 17 days and that work is being done to reduce that to seven.

“All errors inappropriately denying ABA (applied behavioral analysis) provider claims were corrected as of Jan. 25,” the statement said. “All claims are now processing correctly and all prior claims that were processed incorrectly have been reprocessed with no action needed by the provider. Claims from ABA providers are now processing and being paid in an average of seven to 10 days.”

But providers such as Covington and Smith say that while claims processing time has improved, problems continue.

Providers say they still must spend hours on the phone to get errors corrected, and many still are not getting

year, resulting in the deaths of 17 sailors and forcing the Navy to review many of its procedures.

“Yes, we have some remedial work to do on the fundamentals, but we won’t surrender our ideals or interests while we do it,” Holmes said. wyland.scott@stripes.com Twitter: @wylandstripes

fixed. They are still owed reimbursements, and problems with credentials remain.

Covington said she lost another board-certified therapist recently because of the instability.

Smith said that after two meetings with a Humana supervisor to try to get credentials for one of her therapists, she wrote to the DHA to say she had to turn away one of her patients because she couldn’t get the child’s therapist credentialed. The DHA responded with an offer to assign another provider for the child rather than resolving the underlying Tricare issue.

With a 70 percent caseload through Tricare, Smith worried that if issues continued, Tricare would put her out of business.

For parents, the confusion remains.

Many are receiving only partial services, and they worry about the short- and long-term consequences for their children.

“We need to get the word out there,” Mary Nelson said. “These families are suffering.” cahn.dianna@stripes.com Twitter: @DiannaCahn

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MILITARY

Added incentive

Navy offers enticements for sailors to extend tours in Japan, Guam, Spain

BY WYATT OLSON CAITLIN DOORNBOS

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Stars and Stripes

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he Navy on Feb. 21 announced new incentives that include allowing first-term enlisted sailors to have their families with them overseas to make longer sea duties in Japan, Guam and Spain more enticing.

Effective immediately, firstterm sailors E-3 and below can bring family members to overseas locations where dependents are authorized.

There are about 3,800 sailors in those grades in Japan and about 400 in Guam, the Navy said.

The Navy’s forward-deployed fleet in the Pacific has been under a microscope since back-to-back collisions of destroyers last year left 17 sailors dead.

Reports by the U.S. Government Accountability Office and the Navy have documented numerous deficiencies in the forward-deployed fleet, including insufficient manning and training, delayed maintenance and general sailor fatigue from overwork.

The Navy is in the process of instituting reforms to address those problems.

Seaman Legree Hairston, an aviation ordnanceman on the USS Ronald Reagan, said accompanied tours for E-3 sailors and below would bolster morale for those experiencing life abroad for the first time. “I would find things easier — I wouldn’t be so stressed out,” said Hairston, who has been stationed in Yokosuka, Japan for just a few months. “I wouldn’t miss home so much.”

Another incentive announced Feb. 21 calls on sailors to extend their sea duty in Japan, Guam and Spain voluntarily to a minimum of four years. Those sailors will have any remaining sea time on their prescribed tour length waived and would be guaranteed shore duty for their next assigned tour.

Petty Officer 3rd Class Amaechi McMillan, a culinary

TYLER PRESTON /Courtesy of the U.S. Navy

Sailors man the rails as the guided missile destroyer USS Howard departs Fleet Activities Sasebo, Japan, on Nov. 15. The Navy is allowing first-term enlisted sailors to have their families with them overseas in hopes of improving the forward-deployed fleet. specialist aboard the Ronald Reagan who’s set to transfer this summer, said he would have extended his tour in Japan in exchange for shore duty on his next rotation if he had the opportunity. “It is beneficial to someone in my shoes because in my rate, you don’t get shore duty until [you have served] five years,” he said.

Additionally, sailors extending their tours by a year or more will be given preferential consideration for announced billets in the Career Management System/Interactive Detailing, a web-based system used to view and apply for jobs.

“If multiple preferential applications are made for the same advertised billet, the best qualified member will be selected,” the Navy said.

Seaman Apprentice Yunior Castano Perez, a hospital apprentice at Yokosuka Naval

Base, Japan, said having a better chance of getting his desired duty station would persuade him to double his current twoyear tour.

“I would like to pick somewhere outside the U.S. to get to explore,” he said. “I want to see the world.”

Sailors who extend their tours for at least a year will still have the option to receive Sea Duty Incentive Pay, the Navy said.

The armed forces-wide Overseas Tour Extension Incentive Program also remains an option for eligible sailors.

“Our goal is to reward those sailors who volunteer to extend to meet the demands from the fleet,” said Rear Adm. John Meier, director of the Career Management Department for the Navy Personnel Command.

“In addition to the incentives already in place, which remain options for sailors who meet ex-

tension criteria, these additional incentives should make it easier for sailors who make the decision to extend.”

For some sailors, the incentives may not be enough. Petty Officer 2nd Class Meagan Yarger is already on shore duty at the Naval Computer and Telecommunications Station Yokosuka. She said she is not happy overseas and would not extend her current three-year tour.

“I’ll still be leaving. I can’t talk to [Japanese-speaking] neighbors; I don’t like using yen,” she said. “The Navy is not for me.”

During a talk in January with sailors and family members at Yokosuka Naval Station in Japan, Vice Adm. Robert Burke, chief of naval personnel and deputy chief of naval operations, said tour lengths of four years could become mandatory.

Many overseas tours for military personnel are capped at two or three years and that has contributed to the forward fleet’s crisis.

“A sailor gets [to Japan and] they’re taking 14 to 18 months to learn their training and then maybe doing their job for a short month’s period of time before it’s time for them to move again,” Burke said. “That puts the commands in a state of continuously having to train up their people and not having a seasoned, experienced crew that can train up the new junior folks.”

Sailors interested in any of the incentives must request an extension 14 to 18 months before their projected rotation date, the Navy said.

Stars and Stripes reporter Tyler Hlavac contributed to this report. olson.wyatt@stripes.com doornbos.caitlin@stripes.com

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2018 Army Relief Campaign kicks off

by Laura Levering | Fort Gordon Public Affairs Office FORT GORDON, Ga. –When Spc. Nathaniel Land’s vehicle broke down, he and his wife were financially strapped and could not risk going without a vehicle. Their disabled daughter’s wellbeing depended on reliable transportation.

So he reached out to Melissa Smith, Fort Gordon Army Emergency Relief officer.

“Within hours, we had the ability to have that vehicle fixed so that we could be able to transport her to appointments and wherever my wife needed to take her,” said Land, medical laboratory specialist with Company B, Dwight D. Eisenhower Army Medical Center.

Land shared his story during the Fort Gordon Army Community Service 2018 AER Campaign kickoff Tuesday at Gordon’s Conference and Catering Center. This year’s theme is “There for Those Who Serve: A Legacy of Caring – 76 Years of Soldiers Helping Soldiers.”

Land is among millions of Soldiers who have received financial assistance during times of need thanks to the generosity of donors.

Fort Gordon Garrison Command Sgt. Maj. Charlie Bryant Jr. said the AER campaign accomplishes several objectives.

“It increases the awareness about AER for Soldiers and their family members, it gets the word out so Army personnel know how to apply for assistance, it informs supporters how their contributions are used, and it raises funds to go back into AER,” Bryant said.

Since its inception in 1942, AER has provided more than $1.8 billion in financial assistance to more than 3.7 million Soldiers. Locally, Fort Gordon AER provided $644,615.40 in financial assistance to 469 Soldiers and their families in 2017.

Worldwide, in 2017, 13,792 families received assistance with rent/mortgage; 10,490 Soldiers received assistance with paying utility bills; 5,729 Soldiers had automobile repairs; and 20 newborns with medical issues received cranial

Sgt. 1st Class Romeo Belunta, 513th Military Intelligence Brigade, fills out a form to donate to the Army Emergency Relief fund. This year’s fundraising effort is to begin March 1 and run through May 15.

Bill Bengtson / Fort Gordon Public Affairs Office

helmets. Other categories of assistance included emergency travel, funeral expenses, major appliance replacement, and more.

AER also has a scholarship program in which $8.8 million was granted in scholarships to 2,502 dependent children and 606 spouses in 2017. $183,960 of that amount was given to 54 dependent children and spouses at Fort Gordon. Lynette Griffin, wife of an Army retiree, benefited from the program in 2010.

Griffin, a dental hygienist at DDEAMC, said AER played a major role in helping her obtain a bachelor’s of science in public health. With a son in college and a daughter heading to college the following year, Griffin had put her career ambitions on hold. Then while flipping through a magazine, she saw an ad for AER and decided to inquire about the scholarship program. She applied and to her surprise was granted a scholarship.

“This program helped our family a lot,” Griffin said. “I didn’t have to pay for anything.”

Now Griffin shares copies of the magazine and her story with Soldiers every opportunity she gets.

Rina Powell, senior director of Resource Development, United Way, Central Savannah Rivera Area, emphasized the importance of sharing

information about AER with others. “ The number one reason people do not give is they were not asked to give,” Powell said.

Powell has been working in the nonprofit sector nearly 30 years and said she is amazed at how many ways AER can help individuals.

“If you don’t know some of the programs, spend time with Melissa,” Powell said. “Let her share some of that information with you because I think that would really open your heart, and in some cases you have no idea how much those needs are out there.”

Last year Fort Gordon raised $101,906.50. This year’s goal is $100.000, but Powell believes the installation can surpass it.

“Listening to some of the statistics of the services you’ve offered and the outreach is amazing, and y’all should be very proud,” Powell said.

The 2018 AER campaign runs through May 15.

To make a donation or learn more, contact your unit project officer or visit www.aerhq.org. -end-

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Troops have chance at Masters badges

by Laura Levering | Fort Gordon Public Affairs Office FORT GORDON, Ga. – It is one of the most elite sporting events and said to be played on some of the most pristine grounds in the world. And like every year, countless sports enthusiasts and curious spectators alike will try to get an entry pass. But only a limited number will succeed.

“The Masters Golf Tournament is the first major [events] of the year in professional golf and is one of, if not the most, highly renowned and prestigious golf tournaments in the world,” said Patricia Camacho, action officer for Support Services Division, Directorate of Family and Morale, Welfare and Recreation.

The 2018 Masters Golf Tournament will be played April 5-8 at Augusta National Golf Club in Augusta, and local Servicemembers have a shot at going.

Series badges will be made available all four tournament days thanks to a longstanding partnership with Augusta National, which sets aside a limited number of badges for Servicemembers.

The Masters Credentials Committee has offered 100 series badges for purchase to Fort Gordon’s DFMWR. Badges purchased by DFMWR will be broken down into one-day access to increase the number of Servicemembers able to attend to 400.

Badges will be sold for $99 per day. A lottery will be held to determine who can purchase badges. If selected, winners must pay the $99 badge fee. Badges cannot be resold or given away.

Applications will be available beginning Feb. 26, 8 a.m. to 4 p.m., Monday through Friday, at MWR Headquarters in Building 28320 on Lane Avenue.

The deadline for submitting an application is March 16 at 4 p.m.

Active duty Servicemembers assigned to Fort Gordon, either on permanent orders or temporary duty assignment (non-initial entry training), and Gillem Enclave (Title 10) are the only personnel eligible to participate in the lottery. Servicemembers must be physically present at Fort Gordon at the time of registration, pickup, and badge return. All that is needed when applying is an active duty military ID card.

“Eligible personnel are required to complete an application form in person during the registration period,” Camacho said.

A drawing will be held on March 19 at 1 p.m. in Building 28320. Applicants do not need to be present for the drawing, but it is up to each applicant to check the winner’s list. A list of winning names for each round will be posted in Building 28320 on March

Directorate of Family and Morale, Welfare and Recreation graphic

20. Applicants should check the list or call (706) 7918204/2611/2012 for verification of selection.

Since it is likely that there will be more applications than there are badges, and there may be last minute cancellations, additional names will be drawn for each day and placed on a stand-by list.

Badges must be paid for in person by March 27 at 4 p.m. Personnel who have not paid will forfeit their right to purchase a badge, and alternates will be notified March 28. There will be no refunds.

Selected personnel must pick up their badge from Building 28320 between 6 and 9:30 a.m. on the day of their chosen round. Badges for round one (April 5) may be picked up the day prior (April 4) between 8 a.m. and 4 p.m. Early pickup does not apply to other days. Badges must be returned on the same day by 9 p.m. The exception is April 9, which must be returned by 4 p.m.

From avid golf fans to Servicemembers who merely want to experience something different, Camacho encourages everyone to apply.

“Masters tickets are amongst the toughest tickets to get in all of sports year in and out,” Camacho said.

“It is a once-in-a-lifetime experience.”

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MILITARY

JOSHUA FULTON /Courtesy of the U.S. Navy

The Sri Lanka navy band performs as the USNS Fall River arrives in Hambantota for Pacific Partnership 2017. The Fall River will head to Malaysia, Palau, Thailand and Yap for the 2018 exercise.

Exercise to send US to Sri Lanka, Vietnam ‘ The challenges we

BY T YLER HLAVAC Stars and Stripes

The Asia-Pacific’s largest humanitarian assistance and disaster-relief preparedness mission is returning to Vietnam and Sri Lanka as the United States continues to cultivate partnerships in the region.

During this year’s Pacific Partnership exercise, which runs through June, the Navy hospital ship USNS Mercy will travel to Indonesia, Malaysia, Sri Lanka and Vietnam while the USNS Fall River heads to Malaysia, Palau, Thailand and Yap in Micronesia. Events will include civic-action projects, community health exchanges, medical symposiums and disaster-response training.

More than 800 personnel from the Navy and other countries are involved in the mission, which began in response to a deadly tsunami that ravaged parts of the region in 2004.

This marks the second year Pacific Partnership will visit Sri Lanka, whose location next to a critical sea lane attracts both the U.S. and China.

In October, the USS Nimitz and its strike group made a port call on the capital, Colombo, becoming the first U.S. aircraft carrier to do so in three decades.

This year’s Sri Lanka stop will be

face with natural and manmade disasters do not respect borders or national sovereignty.

’

Rear Adm. Don Gabrielson commander of Task Force 73

H ANK G ETTYS/Courtesy of the U.S. Navy

The USNS Mercy steams in the Pacific Ocean after completing Pacific Partnership 2016. The Mercy will go to Indonesia, Malaysia, Sri Lanka and Vietnam for this year’s Pacific Partnership. similar to 2017’s mission, said Task Force 73 spokesman Lt. Cmdr. Arlo Abrahamson.

“The scope of engagements is on a similar scale with a variety of medical, civil engineering products and community engagements over the course of two weeks,” he said.

The U.S. is also pursuing closer ties with Vietnam, which hotly contests Chinese territorial claims in the South China Sea. China has built up and

militarized artificial islands in parts of the sea that Vietnam and other nations depend on for fishing and commerce.

Abrahamson said the Mercy’s Vietnam visit will come sometime after March, when the USS Carl Vinson is expected to stop in Danang, becoming the first U.S. carrier to do so since the Vietnam War. A multinational response is necessary when dealing with disasters that aren’t confined to a nation’s border,

said Rear Adm. Don Gabrielson, who serves as commander of Task Force 73 and the executive agent for the mission.

“The challenges we face with natural and manmade disasters do not respect borders or national sovereignty,” he said in a Navy statement. “This dynamic mission enables many nations and subject matter experts to come together to pursue solutions to complex problems while enhancing preparations for disaster emergencies that reduce the severity of their impact.”

Pacific Partnership is slated to wrap up in June with the Mercy conducting a brief goodwill visit to Tokyo, Abrahamson said. hlavac.tyler@stripes.com

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MILITARY

Congress focuses on VA caregiver benefits

BY NIKKI WENTLING Stars and Stripes

WASHINGTON — Congress is getting closer to finding a way to give more help to caregivers of veterans injured before the 9/11 terrorist attacks. It took seven years of pressure from advocates to get to this point.

Groups pushing lawmakers to end what they call an unfair discrepancy between veterans injured before and after 9/11 contend negotiations — stalled for years because of the high cost of expanding benefits to more families — are coming to a critical point.

“Everybody is talking about how to do this rather than questioning whether we should,” said Adrian Atizado, deputy national legislative director with Disabled American Veterans.

In 2010, Congress created the Department of Veterans Affairs caregiver program for veterans who sustained serious injuries after 9/11. About

26,000 caregivers in the program receive monthly stipends as well as other benefits such as medical training, counseling and respite care.

But spouses such as Jason Courneen — who has been caring for his wife for two decades — don’t meet the criteria for assistance. Alexis Courneen suffered a traumatic brain injury while serving in the Coast Guard in 1998.

Jason Courneen said he felt “isolated” and had to learn by himself the skills necessary to be a caregiver.

Major veterans organizations — such as Disabled American Veterans, the Elizabeth Dole Foundation and The American Legion — have been fighting to expand benefits to all veteran caregivers. In December, a handful of groups presented lawmakers with a printed petition containing 182,000 signatures of people supportive of the expansion.

Rep. Phil Roe, R-Tenn., chairman of the House Veterans’ Affairs Commit-

tee, is working on his own legislation to expand the program, using input from the VA. The next step is a roundtable discussion on the legislation scheduled for Tuesday with House and Senate lawmakers.

The Senate’s version is included in a larger VA reform bill that’s been stalled since November. Instead of opening up the program to everyone at once, the measure would first make benefits available to veterans injured before May 7, 1975 — with the intent to immediately get help to all caregivers of Vietnam War-era veterans. Two years later, veterans who served between 1975 and 2001 would be eligible.

The Congressional Budget Office estimated the measure would cost $3.4 billion over five years to implement. Officials with President Donald Trump’s administration told Congress last month that the White House couldn’t support the expansion because of fiscal restraints.

VA Secretary David Shulkin explained another option to lawmakers in February. He proposed limiting eligibility for the caregivers program to the most severely injured and ill veterans in order to expand it to veterans of all eras without inflating costs. Under his plan, eligibility would be restricted to veterans with the highest clinical need, who require help with at least three activities of daily living, such as eating, bathing and dressing.

The 26,000 caregivers in the program should still receive the benefit with the old rules, Shulkin said, but the new rules would apply to all new enrollees.

Atizado said Disabled American Veterans would support any proposal that allows more caregivers to receive assistance but added the group would continue fighting until help is available to all veteran caregivers who need it. wentling.nikki@stripes.com Twitter: @nikkiwentling

Vicenza survey cites employment woes as top issue

BY NANCY MONTGOMERY Stars and Stripes

VICENZA, Italy — Respondents to a survey at the Army garrison here see unemployment and lost career opportunities as the top social problems, according to a recent survey.

More than 67 percent of the 685 people who took the survey on quality of life at U.S. Army Garrison Italy identified those issues as a major concern — findings that largely correspond with national surveys on military families.

“Work-life” imbalance drew the second-most responses at nearly 51 percent, followed closely by financial issues, according to the survey.

Most of the respondents — more than 60 percent — were women, and more than 40 percent were family members. The majority were in their 20s and 30s with college degrees, two cars and one or more children.

More than half of respondents said deployments and training caused family problems. More than a third checked off infidelity as one of

PAOLO BOVO/Courtesy of the U.S. Army

Soldiers attend an Expert Infantryman Badge ceremony at Caserma D el Din, Vicenza, Italy, on Feb. 15. A recent survey found spouse employment issues are among residents’ major concerns. the garrison’s family problems.

The idea of the survey was to get a sense of what the community needed in order to guide “how best to take limited resources and apply them to make a better community,” said Col. Erik Berdy, garrison commander, at a town hall meeting last month.

The 50-question survey, said to be the first one presented by the garrison, was offered from Jan. 8 to Feb. 8. Officials reached out on social media, in

the base newspaper and other outlets, offering free lunches and prizes to draw responses from the population of some 15,000 soldiers, civilians, family members and retirees.

Family members are the largest component, with about 5,800 attached to the garrison as of last year, compared with about 3,800 personnel on active duty.

The respondents identified a host of health concerns — alcohol and tobacco use, stress,

depression and toxic leadership. The majority said they’d discuss their problems with a friend rather than a counselor or the chain of command.

Only 6 percent listed “engaged senior leaders” as a strength of the installation.

Some concerns listed by participants may be difficult to address. For instance, the garrison can’t change training and deployment schedules or provide more appointments at the health center or dental clinic, which fall under different commands.

Unemployment and underemployment are top problems for military spouses worldwide, according to a 2017 survey by the U.S. Chamber of Commerce Foundation.

Military spouses, more than 92 percent of whom are women, sacrifice their careers to frequent moves, often to installations outside urban areas with few employment opportunities.

Almost half of spouses are unemployed, and many of the employed said they worked part-time or seasonally, although they’d prefer full-time work, according to the national

survey. They said that a lack of two incomes caused stress and financial difficulty.

Military spouses are more highly educated than the general U.S. working population, the survey found. More than two-thirds said their skills and education were not being utilized.

Employment for spouses in Italy is especially difficult. It is governed by the status of forces agreement between the U.S. and Italy, which is much more restrictive than in Germany and many other countries.

Family members must relinquish their SOFA privileges to obtain an Italian work permit, which denies them access to many base facilities and makes them subject to Italian taxes and legal jurisdiction.

There is no pending renegotiation of the SOFA. Berdy said that garrison officials had made a trip to Rome to “formally engage” with U.S. and Italian SOFA counterparts to ask that the rules be less restrictive. “They’re fully aware of our position,” Berdy said. montgomery.nancy@stripes.com Twitter: @montgomerynance

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MILITARY

Soldier says destiny brought her to serve at Camp Casey, South Korea

BY M ARCUS FICHTL Stars and Stripes

CAMP CASEY, South Korea — Second Lt. Sarah Casey shares a name with her duty station, a small artillery outpost near the Korean Demilitarized Zone.

The artillery platoon leader from Collierville, Tenn., played along with the ribbing when folks greeted her with comments like, “Casey at Casey!” after glancing at her name tape. Until January, when she revealed her secret.

The camp was named in honor of her great-uncle, Maj. Hugh B. Casey, a World War II veteran killed in the Korean War who was awarded two Silver Stars during the liberation of the Philippines.

“I’m not here to say, ‘Hi, I’m Sarah Casey at Camp Casey,’ ” she said. “I think it’s important to remember the sacrifices of all those who came before us; that’s what the real story is to me.”

Sarah Casey was 26 when she arrived in South Korea — the same age her greatuncle was when he lost his life. She said her path to Camp Casey was destined.

“I’m one of those people who believes everything happens for a reason,” she said.

The same war Hugh Casey’s actions during the Korean War, which broke out in 1950, earned him

two battlefield promotions and a third Silver Star.

He was among the first to relieve beleaguered United Nations troops, and he experienced the war’s high points during the drive north and its lows while escaping the Chinese at Hungnam beachhead.

During a counterSarah Casey offensive against Chinese forces near Suwon, just south of Seoul, he led a task force of 7th Infantry Hugh Casey Regiment soldiers deep into enemy territory. He was leading a company on a hill 700 yards from Chinese lines when the Communists opened fire on an American patrol, United Press International reported Feb. 5, 1951. “(Hugh) Casey ordered his men to fix bayonets, and they charged the entire 700 yards into the enemy force, killing 60 in a furious melee of stabbing, grenading and close

Max D. Lederer Jr., Publisher Terry Leonard, Editor Robert H. Reid, Senior Managing Editor Tina Croley, Managing Editor for Content Doreen Wright, U.S. Edition Editor Michael Davidson, Revenue Director CONTACT US 529 14th Street NW, Suite 350, Washington, D.C. 20045-1301 Email: stripesweekly@stripes.com Editorial: (202) 761-0900 Advertising: (202) 761-0910 Michael Davidson, Weekly Partnership Director: davidson.michael@stripes.com Additional contact information: stripes.com

quarter rifle fire,” the report said.

On Jan. 11, 1952, he became one of the more than 40,000 Americans who gave their lives during the war.

A small plane he was riding in crashed into a hill overlooking a temporary camp. Within weeks, the small base was renamed in his honor.

A large white cross was placed at the crash site in his memory.

In January — 66 years to the day that Casey lost his life — his great-niece laid a wreath at the base of that cross. While walking up the steep hill, she said she was filled with emotion as she passed the remnants of Korean War-era fighting positions.

“I got mad, angry and then I just got sad,” she said, thinking about the cost of war.

Sarah Casey — who leads 18 troops and four Multiple Launch Rocket Systems as a member of the 210th Field Artillery Brigade — is technically involved in the same war as her great-uncle. Conflict on the Korean Peninsula ended in 1953 with an armistice, not a peace treaty. She’s one of about 28,500 U.S. troops still manning stations south of the DMZ.

Sharing memories The Korea posting prompted Sarah Casey to delve into her family’s old journals, newspaper clippings and her greatuncle’s last letters home. She

This publication is a compilation of stories from Stars and Stripes, the editorially independent newspaper authorized by the Department of Defense for members of the military community. The contents of Stars and Stripes are unofficial, and are not to be considered as the official views of, or endorsed by, the U.S. government, including the Defense Department or the military services. The U.S. Edition of Stars and Stripes is published jointly by Stars and Stripes and this newspaper.

The appearance of advertising in this publication, including inserts or supplements, does not constitute endorsement by the DOD or Stars and Stripes of the products or services advertised.

Products or services advertised in this publication shall be made available for purchase, use, or patronage without regard to race, color, religion, sex, national origin, age, marital status, physical handicap, political affiliation, or any other nonmerit factor of the purchaser, user, or patron.

© Stars and Stripes, 2018

PHOTOS

BY

JAMES G RIFFIN /Courtesy of the U.S. Army

Second Lt. Sarah Casey places a wreath at the foot of a cross on the 66th anniversary of the death of her great-uncle, Maj. Hugh B. Casey, at Camp Casey, South Korea, on Jan. 11. has transcribed and digitized them for posterity.

In one letter to his mother and father, Casey wrote, “I don’t know if I told you this lately, but you’re the greatest parents in the world and I’m so thankful and blessed to have you.”

She has also been reading old love letters her greatgrandfather, Maj. Gen. Hugh J. Casey, sent to his wife during World War II. He served alongside her great-uncle during the Philippines campaign, during which the elder Casey served as Gen. Douglas MacArthur’s chief engineer.

Sarah Casey also shared a trove of photos of the family reunited in Japan between the two wars. She said she possesses the same love of family and duty as her forefathers.

“I like to think characteristics like that are passed generation to generation,” she said.

She didn’t believe her story would resonate with anyone outside of her family, until a photo of her laying the wreath was posted on Camp Casey’s official Facebook page. The positive, supportive comments were overwhelming.

“The memories you get

Casey kneels at the base of the cross that marks the site where Maj. Hugh B. Casey’s plane crashed. to share with the people in the military are completely unique — something you can’t match anywhere else,” she said of the thousands of troops who have called Camp Casey their temporary home.

“To know people are forming bonds at this place is very heartwarming.” fichtl.marcus@stripes.com Twitter: @marcusfichtl

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Fri Mar 2 8pm Dixie Dregs Bell Auditorium $49.50-$74.50. Call 877-4AUGTIX or visit georgialinatix.com.

7:30pm Elevate the Stage James Brown Arena This event is a championship-style gymnastics competition for NCAA and Junior Olympic athletes. The 10-time national champion Georgia Gymdogs will play neutral site host to out-ofconference opponents Nebraska, Stanford and Illinois. $15-$20. Call 877-4AUGTIX or visit georgialinatix.com.

Sat Mar 3 7am - 2pm Attic Sale Augusta Exchange Club Fairgrounds A sale of gently used items, including household goods, clothing, furniture, electronics, appliances, books, toys and more. Free admission. A free community health fair will be held at the same time.

Call 706-736-0033 or visit jlaugusta.org.

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5pm - 7pm Whine and Cheese for Rescues Vineyard Wine Market This evening, including an art show and sale, benefits local animal rescues. $20 for the wine tasting. Call 706-8632067, email doxydog@att.net or visit pawprintsfoundation.org.

Sun Mar 4

2pm Wine, Women & Shoes Bell Auditorium A benefit for the Ronald McDonald House Charities of Augusta that includes shopping, a wine tasting, food, a fashion show and more. $75-$125.

Visit winewomenandshoes.com/event/ augusta or call 706-724-5901.

Mon Mar 5

7pm Columbia County Democratic Party Meeting

Columbia County Government Center Auditorium, Building A The Columbia County Democratic Party invites the public to its monthly meetings, held on the first Monday of every month (unless it’s a holiday).

10am - 11pm AgamaCon Candidate for representative District Weeks Center, Aiken 12 will be the speaker. Social time AgamaCon, short for Artists Gamers takes place before the meetings at and Anime Members Association 6:30 p.m. For information, contact Convention, includes cosplay, a vendors columbiacntydems@aol.com. Visit hall, an artist alley and panel discussions facebook.com/columbiacntydemocrats on everything from Dungeons & for updated information, or call 706-414Dragons to “Rick & Morty.” Continues 10 5558. The April meeting will take place a.m. to 4 p.m. March 4. Two-day badge, April 10. $30; children 10 and under get in free.

Visit agamacon.com or facebook.com/ agamacon.

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