Lies and Smokescreens from The Department of Defense and TRICARE Management Activity

A few days ago I received a copy of the Complaint (lawsuit) filed in US District Court in Washington, DC, against the United States Government, the Department of Defense, Tricare Management Activity, and Secretary of Defense Robert M. Gates. You can read the Complaint HERE. Most of the letters cited in the complaint can be found in the Documents section here on Autism Salutes (scroll down on the left side).

As a parent who worked on and continually wrote about what was happening with the legislative efforts mentioned in the Complaint, I have been very aware for years that the reason the DoD set up the ECHO program the way they did was to avoid paying for the expensive therapy that benefit our children with autism. That would be ABA therapy.

Since the Complaint was filed in US District Court, TRICARE Management Activity issued a letter on June 30, 2010, to the CEO’s of all its’ contractor’s, one of which is Humana. You can read the letter HERE. The letter stated that TMA was reviewing its policy on whether or not they would provide ABA under the basic Tricare program and that they expected to have this review completed by September 20, 2010. The letter also stated the contractor’s for TMA were to hold in abeyance until the review was completed; claims filed and authorization requests, for ABA. That means NO MORE DENIAL LETTERS for claims or authorization requests are to be SENT until the review is complete. Keep in mind, the letter from TMA was issued June 30th. On July 8, 2010, a denial letter was issued by one of TMA’s healthcare contractor’s.

All I can think of after reading the Complaint is that what the DoD has gotten away with, for YEARS, is criminal. There has been a complete lack of “checks and balances”. I’ll tell you honestly, I think the DoD under estimated military spouses and members who have spoken up to bring this about. I also think they have under estimated parents of children with autism across the ranks, and when I say that I mean those in the civilian world as well. We don’t put up with perfidy, and we certainly don’t tolerate crimes against humanity, which is exactly what has been committed by the DoD, and against CHILDREN! As a good friend of mine stated in a comment post the other day, “the genie is out of the bottle”.



I am of the belief that those in government who have not supported our military families who have dependents with autism, these two “gentlemen” (pictured to the left), and the CEO’s of the healthcare contractor’s for TMA, should all be brought up on UCMJ charges or the civilian equivalent of such. Should this happen, they should each be sentenced to one year in the Brig or Prison for each child they; denied a claim for, denied an authorization for, and the number of years collectively that a child was not able to access ABA under their “ECHO” program because providers were not available under the program. Essentially, a life sentence for each of them; that’s what they’ve done to countless children, sentenced them to a life in the prison of autism.

This time, there is no more smoke screen, and the letter from TMA to the contractor’s was nothing more than that. If it was anything more, then every single employer at every Tricare contracted healthcare organization would be aware of what they had been instructed to do by DoD and TMA, and yet 20 days later they still don’t have a clue.

Yes indeed, "the genie is out of the bottle".

Military Parents: We Will Not Back Down!!!

Editor's Note: We parents will not back down because this is who we're fighting for; our children.

Yesterday morning I had the honor of being a guest on Curt and Kim Linderman's radio show on Autism One Radio; Linderman Live. You can listen to the archive of the show HERE

During the show we discussed the class action lawsuit being brought against the U.S. Government, The Department of Defense, Tricare Management Activity, and the Secretary of Defense. You can read some of the background HERE. We also discussed the reasons for the lawsuit and the challenges that military families who have children with autism face. It's an intense and vast topic of discussion and there is no way we could hit on everything that needs to be talked about in one hour. There will be more to come.

I talked to a few people yesterday who felt that we may have hit a little hard on the DoD, and I openly disagree, and I'll tell you why. Back in 2008 after the "Green Our Vaccines" Rally there was a video circulating on YouTube showing photo clips of the Rally with the backdrop music of THIS Now I am not going to convolute this issue with causation, but I so wanted to go to the Rally. I was deeply moved by this song on many different levels. Treatment works. ABA works and improves the functioning of children with autism, and YES can be the catalyst to RECOVERY. Yes, it can and does happen. I will not just shut up and sing the praises of our medical care like the DoD would have me. And, after what my own family has endured, and what I see and hear other families going through on a daily basis fighting for their kids, yes a daily basis; I am not ready to make nice, nor will I be until our Government does the right thing by our families and our children with autism. When they are ready to demonstrate a little integrity and do the right thing and move ABA under the Basic Tricare Program, I may be willing to forgive, but I will NEVER forget.

If you haven't already, please check out the Military Affidavits section at the top left of Autism Salutes, find the appropriate one and email it to Brendan Frey, Esq. at bfrey@manteselaw.com by July 15 at the latest.

One last thing. If no one wants to pay for this, then as I said on the show yesterday, maybe someone needs to figure out what the hell is causing an epidemic of autism.

Military Families vs. United States Government, DoD, TMA, and Secretary of Defense

Military Families vs. United States of America, U.S. Department of Defense, TRICARE Management Activity, and Secretary of Defense Robert M. Gates

It does not feel good to bring a lawsuit against the very country and government that you took an oath to serve and protect, and knowing that to uphold that oath might possibly come at the expense of your own life. On the flip side, our families who take the oath to serve and protect this great country expect our government, to provide the medical care and family supports that our families require to, uphold our oath to serve and protect our great nation.

In spite of the lack of medical care and family supports, our men and women in uniform have upheld their oath. In spite of the lack of medical care and family supports, our spouses have held down the home fronts’ . We have upheld our end of the oath and in doing so we all have paid a heavy price, but none heavier than the price our children have paid. Over the years I have spoken with many service members who have been wounded in action; “wounded warriors’. Every single one of them has told me that what they have endured pales in comparison to what our children with autism endure. Our government has failed to provide medical care, and our military dependent children with autism have been the ones left laying wounded on the battlefield. The very government we swore to protect could care less, and we have simply had enough.

In the summer of 2005 TRICARE implemented the Extended Care Health Option (ECHO) Program, and acceptance into this program is the only way a military dependent child with autism can receive medically necessary Applied Behavior Analysis (ABA). Keep in mind the child must be accepted into this program and that determination is made by someone sitting behind a desk that has never met, let alone examined, your child. If your child is accepted into ECHO, there is no guarantee that they will receive ABA as the child’s program must be run and/or overseen by a BCBA or a BCABA who is a TRICARE provider. We all know BCBA’s and BCABA’s and are in high demand and short supply. To top all this off, TRICARE capped the annual benefit for ABA at $36,000. Retiree’s dependents are not eligible for ECHO, nor are those not on active duty, in the Guard and Reserve even though they are in most cases eligible to receive basic TRICARE benefits or have the option to purchase them as one would regular health insurance.

On June 24, 2010 I received a letter HERE put forth by Mantese, Honigman, Rossman & Williamson, P.C.(please see the affidavits listed at the end for one to print and sign – they have been further revised) I’ve been waiting a very long time to see this come about for our military dependent children with autism. What far too many don’t understand is that yes, on paper, our kids have the ABA benefit, but what most don’t realize is that consistently over the past five years, less than 10% of dependents with autism are enrolled in ECHO because of a laborious enrollment process, and confused people charged with not only getting the information out, but the enrollment process as well.

My feeling, simply speaking as a parent, is that TRICARE is just fine with that. It lowers their expenses by decreasing paid claims, and increases their bottom line. That makes the Department of Defense happy because we all know that no one wants to pay for medically necessary care related to autism. If you read the letter sent to military families from the Attorney’s you will see that the DoD claims that TRICARE Management Activity (TMA) “has not made a formal policy determination as to whether ABA services might be covered as a Basic [Tricare] Program medical benefit”.

Like I said, I’m just speaking as a parent, and one who has had a few conversations of her own with the General quoted in the letter from the Attorney’s, but I can not think of any way to make a more formal statement than DoD and TMA already have. TMA has clearly stated in their Policy Manual for YEARS that ABA is only available as a “special education benefit” through acceptance into the ECHO Program, which is completely separate from the basic TRICARE benefits. Any change to the TMA Policy Manual must be done through the National Defense Authorization Act (NDAA), and that requires legislation being passed typically in both the House and Senate and then the House and Senate versions are essentially meshed to provide something everyone is happy with that the President then signs into law. This happens every year; it is how we got an increase of $2,500 a month to $36,000 a year for ABA, and exactly why we have continually asked Congressional leaders to introduce and get passed, language that would move the ABA treatment under the basic TRICARE program, and do away with the annual cap. Forgive my sarcastic and somewhat jaded tone, but phaleeeze… The DoD just wants the Berge case dismissed because if it is, then the DoD won’t face the risk of having to compensate military families for what they should have been providing all along, which is access to medically necessary treatment for autism without the discrimination of the ECHO Program, equal access for Retiree’s dependents, and the option for Guard and Reserve to access these benefits as well.

There are four affidavits available for you to review; one for spouse’s of active duty members, one for spouse’s of retiree’s, one for active duty members, one for retired members, and one for members and spouses of the Reserve's and National Guard. Those are all located in the Military Affidavits section at the top left of Autism Salutes. If you can truthfully attest to and sign one of these affidavits, please do so and return it by July 5, 2010, to:

Brendan Frye, Esq.
Mantese, Honigman, Rossman, and Williamson, P.C.
1361 E. Big Beaver
Troy, MI 48083

Or email it to: bfrey@manteselaw.com

The Department of Defense has already had an opportunity to correct this situation, multiple opportunities in fact, and the same is true for Tricare Management Activity. This is an opportunity for all military families who have dependents with autism to have their voices heard on behalf of all our children. As a parent who has lived this nightmare and been contacted by so many who have lived the same, at this point, I would trust a judge before I would trust the DoD and TMA. DoD and TMA left my boys on the battlefield. I had to go retrieve them on my own.

Disclosure: I have no idea if our family will be included in the class action, but hell yes I am signing the active duty spouse affidavit. I was made aware of this situation because I have been involved in the legislation pertaining to the issues for almost 3 years, and my son went without medical care in the form of ABA for 3 years due to TMA and DoD policies.

Another Autism Awareness Month Comes To A Close

The contest has been extended until the 14th, next Friday, so please check back then for the winner! Your understanding is appreciated more than you will ever know.

Well, here we are. The last day of Autism Awareness Month 2010. I can’t think of a better way to end this month of more awareness than with a contest for a signed copy of Classic American Cuisine by Stephanie Hemenway.

Over the past year as I have gotten to know Stephanie much better, she has become a dear friend and a fellow autism mom who makes me proud! With each book she writes, Stephanie chooses an outreach project in the autism community that needs and deserves funding, and donates a portion of the sales from each book to that project.

There was only one book of Stephanie’s I could choose to contest off this month; The Autism Mom’s Survival Guide. Why, you ask? The outreach project Stephanie chose to support through the sales of Classic American Cuisine was The National Autism Association’s FOUND Safety Initiative.

Our children with autism wander and elope, and far too often the consequences are tragic as they were this month. Three year old Aiden Johnson, a child with autism, died of drowning on April 20th. Eric Lippmann, a 30 year old adult with autism was found on April 29th, his body washed up on a California beach. Eric had been missing for 8 days. Kevin Kwok, a 17 year old young man with autism was missing for nearly 24 hours before being found safe. Nadia Bloom, an 11 year old child with autism, went missing on Friday afternoon, April 9th. She was found alive almost 5 days later about a mile from her home, in an alligator filled swamp. Christian Dejons, a six year old little boy, went missing on the afternoon of Wednesday, April 7th. Christian was found hours later, drowned in a nearby lake.

This April Awareness Month has had some very fortunate families have their children returned to them safely, but other families with children or adults with autism had absolute tragic outcomes. I personally am glad that Autism Awareness month is over. We don’t need more awareness. We need help, our children need help, and we need solutions. The National Autism Associations FOUND Safety Initiative is one of many solutions, and we need more like it.

Classic American Cuisine is packed full of useful information for stocking your GFCF pantry. The recipes are so yummy; a few of my favorites? The Onion Rings, Roasted Potato Medley, Sandwich Bread, The Chicken Salad (reminds me of Waldorf Salad), The Breakfast Scramble, and of course The Decadent Fudge Brownies. With the exception of a few, the recipes have alternatives so they can be made corn, soy, and nut free.

Please enter a comment to win. The winner will be announced next Friday morning so make sure you check back. While you're waiting, hop on over to Stephanie’s site HERE and click on the picture to order your copy. Order one for yourself, a parent of a newly diagnosed child, or a friend. You’ll be making the difference between possible life and death for our children and their families.

DoD Slaps Military Spouses in the Face!!!!!

Ok. I've had enough. I've got to get this out so I can get back to my schoolwork. The decision of the Department of Defense (DoD) on Tuesday afternoon has me incredibly pissed off, along with alot of other military spouses I might add. This is not something that should go undiscussed or un-noticed.

A few years back the DoD established a program to help military spouses receive an education in a portable career field because the vast majority of our families move every 2 to 4 years. The program is called MyCAA, which stands for Career Advancement Account, and would provide a total of $6,000 in scholarship monies paid directly to your university. The payments are made on a term by term basis and there is a small amount of paper work that must be exchanged before the dispersal before each new term.

Great sounding program, right? We spouses thought so. Something to help us better help our own families, and quite honestly I know many of us viewed it as a thank you and recognition of OUR sacrifices for our spouses military service; something that far to often goes thankless and unrecognized.

Well, as of Tuesday afternoon at 4:00 p.m. EST, the DoD suspended the program indefinitely leaving thousands of military spouses worldwide with no way to pay for classes for their next term. They're either having to re-arrange classes such as I did (and take less than I intended), drop out all together, or pay out of pocket (which many of us can not afford to do) thus increasing our debt.

The DoD yanked the rug out from under our feet with no warning at all. It's a slap in the face!!! It also speaks to how little the DoD values or considers the sacrifices our spouses and our families make for the members service!!! You can read the announcement HERE There was no notice to those who had accounts already and were receiving MyCAA funding. No email. No nothing. I found out about it through a facebook military group I belong to for CRYING OUT LOUD!!!! Are you kidding me???

The nice little announcement put out by the DoD linked above makes it sound as if you've already been accepted into the program and receiving aid, that you won't be affected. Nothing could be farther from the truth. Remember that little bit of paper work I mentioned above that had to be completed after registering for each term? What they should have stated is this: If you have already completed and received your certification award number for your upcoming term, you won't be affected. If this is not the case then you are shit out of luck until the program is re-instated.

The DoD could have evaluated the program and continued to provide funding until the evaluation was completed, warning us spouses that changes may be coming and providing us with options to explore for additional funding resources, should they be needed. The DoD could have given us at the very least a warning, say two weeks, that the program was going to be suspended indefinitely and providing us with the above mentioned information.

I am really angry that I had to scramble and make hasty decisions about what I was going to do for my next term. I am really angry for every single other spouse out there who has found themselves in the same situation. And what angers me the most is that I know many spouses who are parents of children with autism who were using this scholarship to return to school and obtain either a new degree or certification which would enable them to provide services to children with autism across the board. Some were working on obtaining their BCBA certification, some were seeking a Registered Dietician licensure, you get the idea. And one of those spouses was me.

As I said in a comment earlier, it's a good thing the bozo who made this decision isn't sitting across the table from me. He or she would have a freaking pie in their face. On second thought, I wouldn't dream of wasting a good pie on the likes of them.

Now if you'll excuse me I have to figure out how to return the textbook for the class that I dropped today because of all of this. It's supposed to arrive today.

Thanks for the slap in the face DoD. Gee, do I need to worry about my kids healthcare being taken away next? Because Tricare and it's uneven distribution of stated provided services across regions could certainly use an evaluation and adjustment.

Again, thanks for the slap in the face. And for anyone interested in joining the facebook group of Pissed Off Military Spouses started because of this issue - here is the link http://www.facebook.com/group.php?gid=309235428847&ref=mf

American Rally for Personal Rights!

American Rally for Personal Rights:
May 26 Grant Park Chicago

We believe in the rights to life, liberty, and personal security for ourselves and our children.

Wednesday, May 26, 2010

3:00 p.m. – 5:00 p.m.

Grant Park, Downtown Chicago

www.americanpersonalrightsrally.org

www.americanpersonalrights.org

We demand the universal human rights standard of informed consent for all medical interventions. Compulsory vaccination cannot be legally and morally justified.

We affirm...the sanctity of personal space the right to be left alone, and the freedom to make personal health care decisions guided by the professionals of our choosing.

We invite all people, families and organizations committed to protecting these fundamental rights to stand with us in downtown Chicago on May 26, 2010 at our inaugural rally, and to work with us after the event to support grassroots advocacy, education, and leadership in defense of our personal – individual, legal, moral, religious, civil, and human -- rights.

The American Personal Rights Rally coincides with Autism One and Generation Rescue's conference, Autism Redefined, May 24th through May 30, 2010 at the Westin O'Hare in Chicago. Please visit the Autism One site devoted to conference information.

Sneak Peek! Info for military families: There will be a military track this year with Lisa Rupe and myself presenting on various aspects of autism and the military.

Win A Copy Of "Classic American Cuisine"!!!

And The WINNER is Carrie!!! Carrie, Please email me your mailing addy. autismrr at gmail dot com. and CONGRATS!!!

Just in time for Christmas!

A few months back The Autism Mom Cooks Gluten-Free Casein-Free, Stephanie Hemenway herself, contacted me. We instantly connected, and I have to tell you, she is an amazing mom and person. So Stephanie wanted to send me a couple books to contest off for our military families who might need some new recipes or families who are new to the whole GFCF experience all together and have no idea how to start.

Stephanie is not only an autism mom, but a Gulf War veteran. She has a big place in her heart for our military children and families. You can visit Stephanie's website HERE

I checked the mail everyday, anxiously awaiting a little box from her. The day came. The box finally arrived, and in it were not just a couple cookbooks, but some samples as well. GFCF white bread that tastes just like regular white bread, is there such a thing? Oh my, yes, there most certainly is. My mouth couldn't believe what it was tasting!

The box from Stephanie also held a container loaded with a really special treat. GFCF brownies. I was tempted to pull a Kim Stagliano and go lock myself in a closet and eat them all myself, but I determined that just wouldn't be a fair thing to do. Darn it! So out they came to the table where six brownie deprived children sat, more than willing to consume. These six are not and never have been completely GFCF, so I'd say it was a pretty good assessment. They were begging for more. I took one bite, and my mouth was off to mouthgasm land. I kid you not! After that, the brownies disappeared, and I'm sure you can figure out where they went! ;)

Leave a comment to enter to win a copy of "Classic American Cuisine". The contest closes on Monday, so be sure to check back on Tuesday for the winner announcement! There will be more chances to win after Christmas and into the New Year!