Naval Service Medical News (NSMN) 96-07

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Public Affairs-Naval Service Medical News (NSMN) (96-07)

HEADLINES AND GENERAL INTEREST STORIES THIS WEEK:
(960074) -Payment Rules Change 1 March

(960075) -Branch Clinic at Andrews Goes from Beyond Bad to Great
(960076) -Corpsman Selected as Regional Shore Sailor of the Year
(960077) -Black History Month Highlights Nurse's Achievements
(960078) -Navy Nurse Recognized by Texas Society of the DAR
(960079) -Navy PA Takes Recruiting's 'Adventure' Slogan to Heart
(960080) -Blind Vet Overcomes the Odds

(960081) -At USNH Yokosuka, Japanese 'Intern' Program Welcomed
(960082) -New Defense Bill Calls for Separating Those with HIV
(960083) -TRICARE Questions and Answers
(960084) -HEALTHWATCH: A Fit Force Foregoes Tobacco

HEADLINE: Payment Rules Change 1 March

MEDDEN AFFAIRS Great Lakes, IL (NSMN) — Effective 1 March,
the Naval Office of Medical /Dental Affairs (MEDDEN Affairs) will
begin phasing in payment reforms for active duty Navy and Marine
Corps outpatient medical claims, as required by law. The
outpatient change reforms, as published in the Federal Register,
are designed as a follow-on program for active duty inpatient
pricing system based on CHAMPUS guidelines.

Outpatient medical claims will be priced at this activity
according to the CHAMPUS Maximum Allowable Charges (CMAC) in
order to pay claims in accordance with current CHAMPUS payment
rules. The allowable charge for authorized Nonnaval Health Care
received from a participating or non-participating provider shall
be the lower of the billed charge or the local CMAC charge for
the care rendered. Health care providers who have provided
services for active duty Navy and Marine Corps members were
notified in writing of this upcoming change.

All outpatient medical claims need to be submitted for
processing on a Health Care Financing Administration (HCFA) -1500
form, along with a completed Nonnaval Health Care Claim Form
(NAVMED 6320/10) . The policies for authorizing care and payment
under the Nonnaval Health Care Program remain unchanged.
Statutory constraints do not permit providers to bill active duty
members for any differences in billed charges and the CMAC rates.
Dental claims are currently excluded from this process.

If active duty members experience difficulty with resolving
claims or have other questions regarding the bill payment
process, they should contact a Customer Service Representative at
MEDDEN Affairs by calling 1 800 876-1131 and pushing #1 in the
customer menu.
Story provided by MEDDEN Affairs

-C7SW-

HEADLINE: Branch Clinic at Andrews Goes from Beyond Bad to Great

BMC Andrews, MD (NSMN) — Staff members at Branch Medical
Clinic Andrews, located at the Naval Air Facility aboard Andrews
Air Force Base in Maryland, have vastly improved the quality of
care and customer service they provide to the men and women who
fly aircraft for the U.S. Navy and Naval Reserve. According to
many accounts, the clinic, which is responsible for conducting
the flight physicals of almost every naval aviator and air
crewman in the Washington, DC, area, was in chaos as late as
1993.

Things began to change in November 1993. CAPT James L.
Laubach, MC, USNR, senior medical officer at the clinic, called
in the clinic staff to solve the problems. Every person, from
all levels of the chain of command, offered suggestions and
offered their professional expertise.

"It was a joint venture by the whole staff, " said HMCM
Victor Harshbarger, USNR-TAR, the clinic's command master chief.
"The people who do the job know where the hangups are. They now
what slows their job down. " Analyzing the standard operating
procedure of the clinic, staff members checked for and found
other kinks. Then they worked out ways to straighten them all
out.

"Two years ago we had a 2, 000 physical backlog. Right now
we have about 85 currently in processing, " said Harshbarger .

HM2 Sara Shacklett, a corpsman who earned her caduceus by
on-the-job training at almost every task in the clinic in 1993,
described it then as a "totally chaotic mess. " Now, just
returning from AVT school, she says, "everything has been turned
around. Things are running smoothly, and morale is a lot
better. "

Story by J02 Roy DeCoster, National Naval Medical Center Bethesda

-USN-

HEADLINE: Corpsman Selected as Regional Shore Sailor of the Year

NMC San Diego (NSMN) — HMl Galen Carlos Nelson, Naval
Medical Center San Diego's Sailor of the Year, has been named the
Commander Naval Base San Diego Shore Sailor of the Year,
announced officials.

"I was stunned, " said Nelson, a native of Oklahoma City who
has served in the Navy for 15 years. His naval career has taken
him from duty aboard USS SARATOGA (CV 60) to a tour with the
Marines at Cherry Point, NC. But when asked what his favorite
duty station was, he replied, "Every one of them. " Nelson is
currently assigned as leading petty officer. General Surgery
Department .

Nelson has applied to the Physician Assistant Program. If
accepted, it will bring him one step closer to his dream of
becoming a doctor.

"I'm always trying to find out why things happen. Maybe I
could go into research and find the cure to a devastating disease
like cancer, " he said. "I want to make a difference. "

According to COMANVBASE officials, winning the title of

Sailor of the Year brings a number of prizes and privileges to
the honoree. Even before the latest rewards, Nelson said, "The
Navy has been very good to me. They even provided me a wife. "
He met his wife, Cheryl, when he was stationed at Naval Hospital
Great Lakes in Illinois.

In addition to his military duties. Nelson is very active in
his church, the United Fellowship Tabernacle Church in San Diego,
where he serves as deacon and minister of music. "Religion and
music have always been very important to me, " he explained. He
is co-director for the Naval Medical Center Choir and Gospel
Chorus, in which he also sings.

Now, halfway toward achieving his goal of making Chief of
Naval Operations Sailor of the Year, Nelson will travel to Hawaii
in April to compete for the title of Commander in Chief Pacific
Fleet Sailor of the year. The winner of that competition will
vie for CNO Sailor of the Year in Washington, DC, later this
year.

Story by Pat Kelly, Naval Medical Center San Diego

-USN-

HEADLINE: Black History Month Highlights Nurse's Achievements

NAVHOSP Jacksonville, FL (NSMN) — This year's theme for
Black History Month is "African-American Women: Yesterday,
Today, and Tomorrow. " One of the many African-American women
making a difference in society today is Navy Nurse Corps officer
CDR Vathrice Hartwell, a clinical nurse specialist at Naval
Hospital Jacksonville. She serves as an expert resource for
nurses in the critical care and medical nursing departments at
the hospital, to which she reported in January 1994. She is the
clinical supervisor for approximately 40 nurses.

After graduating from Northeast Louisiana with a bachelor of
science in nursing degree, Hartwell went to work as a staff nurse
in a large, metropolitan teaching hospital, where she stayed for
three years. "It was grueling, " said Hartwell. "The hours were
long; the work constant; and there were a lot of patients. After
a while, I, like many nurses, needed a change. "

Hartwell' s "change" came by putting on a Navy Nurse Corps
uniform. She was commissioned in 1979 and embarked on a
successful career that ' s taken her around the world.

Hartwell said she believes Black History Month is important
because it, as other months dedicated to honoring the
contributions of minorities, makes people focus on those
contributions .

"I, like a lot of others, hope that in the future we won't
have the need for a specific month to recognize minorities '
contributions to history. It would be great if we recognize each
individual for what they bring collectively to society and still
let them have their uniqueness . You see children do it everyday
and wonder why we, as adults, cannot, " said Hartwell.
Story by J02 C.L. Brinkman, Naval Hospital Jacksonville

-USN-

HEADLINE: Navy Nurse Recognized by Texas Society of the DAR

BUMED Washington (NSMN) — It's been an exciting year for

Navy LCDR Linda Ireland, NC, who is currently assigned as the
first Navy Nurse Corps officer to fill a billet at the
Global Patient Movement Requirements Center (GPMRC) , a part of
the U.S. Transportation Command at Scott Air Force Base, IL. She
reported to TRANSCOM after graduation from the Air Force School
of Aerospace Medicine in San Antonio last February . She made the
news then because she was also the honor graduate for Flight
Nursing Class 95-02-27, selected because of her "dynamic
combination of scholastic achievement, personality and
leadership" by the school's faculty.

The faculty was mighty impressed with Ireland, because they
thought of her again when it came time to nominate a
representative to receive recognition from the Texas Society of
the Daughters of the American Revolution. Every year, the
society holds a Presidents ' Day luncheon in honor of George
Washington, where they present awards to local people who reflect
the noble attributes of our first President in the areas of
government service, military leadership and citizenship.

The society presents a Texas Armed Services Award to each
base's representative. Ireland represented Brooks Air Force
Base, where the Air Force School of Aerospace Medicine housed.
In an area of the country dominated by the Air Force, Ireland was
the only Navy person to receive the award, which was given in
recognition of her selection by the school ' s faculty as honor
graduate of the year from among the half-dozen or so classes
graduated during 1995.

Congratulations , Lieutenant Commander Ireland, for being
such an outstanding Navy Nurse and representing the Navy so well
in Air Force country!

Story by Mrs. Liz Lavallee, Bureau of Medicine and Surgery

-USN-

HEADLINE: Navy PA Takes Recruiting's 'Adventure' Slogan to Heart

NAVHOSP Twentynine Palms, CA (NSMN) — When ENS Norman K.
Moser, MSC, graduated from Del Campo High School in Fair Oaks,
CA, and entered the Navy in May of 1976, he did so with the
expectation of experiencing great adventures as advertised by
Navy Recruiting in their slogan "... it's just not a job, but an
adventure. "

An adventure is just what Moser experienced over the next
few years, surviving and thriving as an apprentice boatswains
mate, then moving on to become a quartermaster second class, then
a SEAL, and now in his current job as a Physician Assistant at
Naval Hospital Twentynine Palms.

His career path headed toward medicine during his tour of
duty with SEAL TEAM THREE, when then QM2 Moser was injured. "I
decided to learn something about medicine so I would know what
the doctors, nurses and corpsmen were doing to me, so I requested
to change my rate to hospital corpsman and attend school at the
Naval School of Health Sciences at San Diego, " he said.

Moser completed the school and became an HM2 upon graduation
in June of 1988. Then he went on to earn his bachelor of
science, physician assistant, degree from George Washington
University in 1994 and received a commission in the Medical

Service Corps.

Moser was assigned to Naval Hospital Twentynine Palms in
1995 and went to work further learning and excelling at his new
job in Staff Sick Call, Military Sick Call, Occupational Health
and Family Practice Clinic. Moser 's plans for the future include
helping his wife Janet through medical school and working on
advancing his own education in medicine. With Moser 's history,
who can tell where he will be next year. Right now he is serving
the Marines at the Marine Corps Air Ground Combat Center Military
Sick Call.

Story by Mr. Dan Barber, Naval Hospital Twentynine Palms

-USN-

HEADLINE: Blind Vet Overcomes the Odds

NAVHOSP Cajnp Pendleton, CA (NSMN) — Mr. Steven Ellwood, a
darkroom technician in the X-ray Department at Naval Hospital
Camp Pendleton, has spent many years adjusting to being blind.
In March 1969 he joined the U.S. Army to work on helicopters as a
crew chief. To his dismay, he was unable to pass the flight
physical because he wore glasses.

Ellwood was reassigned and trained as a recoilless rifleman
and demolition technician for the Army's I Corps. Less than a
year later, while serving in Vietnam, he was blinded during
combat. Refusing to let fate slow him down, Ellwood made the
best of his circumstances by mastering the science of darkroom
developing. His blindness turned out to be an advantage in the
darkroom, since he now has become quite an expert at navigating
in the dark .

Ellwood was not content with just doing a good job in the
darkroom; he wanted to become more involved in his department.
Involvement meant familiarizing himself with the Radiology
Department ' s daily correspondence ... a big task for a blind
person. We take for granted how easy it is for us to glance at
the myriad of notes, memos and directives passing over our desks
each day. Imagine if you had to find someone to read all of that
to you. Most likely you wouldn't bother, and you would just try
to pick up bits of information through the grapevine.

Steven Ellwood 's situation recently changed when a talking
computer was donated to the Radiology Department. On 17 January,
he became the first blind employee of Naval Hospital Camp
Pendleton to "read" the Plan of the Day (POD) .

"I was really jazzed when I heard the computer reading the
POD to me, " he said, as he loaded another memo onto his scanner.
Story by HM2 Jack Kovic, Naval Hospital Camp Pendleton

-USN-

HEADLINE: At USNH Yokosuka, Japanese 'Intern' Program Welcomed
USNH Yokosuka, Japan (NSMN) — Shortly after World War II,
American Occupation Forces used the former Imperial Japanese Navy
hospital as a 250-bed dispensary. In 1950, U.S. Naval Hospital
Yokosuka was established. At that time, Japanese medical
educators were attempting to reinforce their medical training
system. There were few hospital facilities and a limited supply
of medical educators.

In an effort to assist in the rejuvenation of a medical
infrastructure in Japan, an observership for select Japanese
medical students in the Armed Forces Hospitals was suggested.
After considerable discussion at local and Washington levels, the
Navy's Bureau of Medicine and Surgery agreed to cooperate in
establishing such a training program and directed the commanding
officer of USNH Yokosuka to implement the program.

By 1 May 1952, most of the details had been worked out and
seven selected candidates started intern training at U.S. Naval
Hospital Yokosuka. Since 1952, 343 "interns" have participated
and graduated from the Post-graduate Physicians Training Program
at the hospital.

Physicians participating in the program do not hold an
American medical licenses and, therefore, cannot practice patient
care independent of staff physicians . The training is endorsed
by the Director General, Health and Medical Affairs, Japan
Defense Agency, as an appropriate post-graduate year one training
program for graduates of Japanese medical schools.

During their year of service at the hospital, interns
provide life-saving medical communication with Japanese medical
treatment facilities. They also assist in communicating with the
large number of Japanese family members treated at the hospital .

Intern alumni who practice in Japan represent a network of
expertise. They provide assistance to hospital staff and
beneficiaries that is of incalculable value.

-USN-

HEADLINE: New Defense Bill Calls for Separating Those with HIV

AFNS Washington (NSMN) — Until now, military people who
tested HIV-positive could stay on active duty until they were too
sick to work or developed AIDS. The recently approved Fiscal
Year 1996 Defense Authorization Bill states that "a member of the
armed forces who is HIV-positive shall be separated. "

Under the new law, service members who test positive for the
human immunodeficiency virus face mandatory discharge or
retirement within six months. Lawmakers said the effective date
of the legislation will be determined from the date of the
enactment of the act . President Bill Clinton signed the defense
bill on 10 February.

"I believe, and the president believes that this is a poor
provision, " said Defense Secretary William Perry.

Perry said being HIV-positive is not a stigma, but rather a
disease and it should be treated as such.

When HIV-positive service members become ill, the services
medically retire them. "That ' s the way we deal with
HIV-positives . That ' s also the way we deal with people who
contract cancer. It ' s sensible and it ' s humane, " said Under
Secretary of Defense for Personnel and Readiness Edwin Dorn.

If the provision to give HIV-positive people an early exit
from active duty service is not changed by some other
legislation, separation will be "considered involuntary . " The
defense bill does not give specifics as to the extent HIV-
positive people will receive medical benefits and disability
pay.

story by TSgt David P. Masko, Air Force News Service

-USN-

HEADLINE: TRICARE Questions and Answers

BUMED Washington (NSMN) — As TRICARE comes on line across
the country, beginning last year and expected to be available
throughout the United States by May 1997, questions about this
Department of Defense managed health care program come up. Each
week, the Naval Service Medical News will include "TRICARE
Questions and Answers" to answer them.

Q: I am disabled, under the age of 65. Can I enroll in TRICARE?

A: Yes, beneficiaries who become Medicare eligible (under age
65) because of disability are eligible to enroll in TRICARE
Prime. Once these beneficiaries reach age 65 and lose CHAMPUS
eligibility, they may no longer remain enrolled in TRICARE Prime.

Q: How can I enroll in TRICARE Prime?

A: All active duty military personnel will be enrolled in
TRICARE Prime automatically and assigned a primary care manager.
When Prime is offered in their area, other categories of
beneficiaries can enroll on a voluntary basis either by visiting
or calling the local TRICARE Service Center.

If you have questions about TRICARE you 'd like answered in
this column, please contact the editor (see last paragraph on
ways to do so) .

-USN-

HEADLINE: HEALTHWATCH: A Fit Force Foregoes Tobacco

USNH Roosevelt Roads, PR (NSMN) — Tobacco products are a
major cause of cancer, heart disease and hundreds of thousands of
deaths per year. Many Navy men and women using tobacco products
have developed smoking or chewing habits and/or nicotine
addiction. Consequently, their performance, readiness capacity,
and overall health are at risk.

Puerto Rico's Smokeout Day is 16 February, for which U.S.
Naval Hospital Roosevelt Roads sponsored an information booth
with brochures, and performing carbon monoxide and pulmonary
function tests.

Currently, 40 million Americans have quit smoking. Some
smokers attended smoking cessation classes and some quit by
themselves. It may take several attempts to be successful.
Fortunately, the quitting process for tobacco is considerably
shorter than for alcohol and other drugs. Five percent of people
who quit by themselves succeed in quitting permanently . Using a
prescription of nicotine patches generates a 10 percent success
rate. By attending smoking cessation classes, the chances for
success jump up to 40 percent. Smokers should view each attempt
as a learning experience and a tool for the next try.

U.S. Naval Hospital Roosevelt Roads' Smoking Cessation
program has a 42.5 percent success rate, which is higher than the

national average. On 25 January, 21 smokers (the first 1996
program participants) courageously snuffed their last cigarettes
to symbolize their momentous "Quit Day. "

Smoking cessation classes commence regularly throughout the
year at many military medical treatment facilities or Family
Service Centers. Participation by Navy and Marine Corps active
duty personnel and family members is highly encouraged.

The following facts exemplify the type of information
educators present to program participants who are committed to
"kicking the habit . "

SUBHEAD: FACTS

— 390,000 Americans died as a result of smoking in 1985.
This represents one-fifth of all American deaths for that year.
Tobacco use is the single largest source of preventable morbidity
and mortality in the United States.

— 30 percent of all cancer deaths are attributable to
smoking, as are 21 percent of all coronary heart disease deaths,
18 percent of stroke deaths and 80 percent of deaths from chronic
obstructive pulmonary disease.

— Tobacco contains more than 3,800 different chemicals.
More than 50 of these substances have been identified as
carcinogens. Most of them cause irritation of the airways.

— Tobacco smoke contains harmful carbon monoxide. It mixes
within the blood's hemoglobin and displaces vital oxygen.

— Tobacco smoke acts synergistically with other pollutants
(such as asbestos) , thereby increasing the adverse effects of

pollutants .

— Studies on passive smoking link environmental tobacco
smoke to lung cancer in adults and respiratory illness in
children .

— Economic costs of smoking in the workplace include
increased absenteeism and productivity loss.

— Tobacco use usually begins at an early age due to peer
pressure from "friends. "

Story by Mr. Sammy Gomez, U.S. Naval Hospital Roosevelt Roads

-USN-