Thursday, March 12, 2015

AF general shatters both gender, racial barriers

By Martha Lockwood, Air Force News Service / Published March 12, 2015

FORT GEORGE G. MEADE, Md. (AFNS) -- Born about the time the Tuskegee Airmen were earning their reputation over the skies of North Africa and Italy, Marcelite Harris would go on to break a number of racial and gender barriers during an illustrious Air Force career.

Harris was born Jan. 16, 1943, in Houston and attended Spelman College in Atlanta, where she earned a bachelor's degree in speech and drama in 1964. She then attended Officer Training School at Lackland Air Force Base, Texas, where she was commissioned a second lieutenant in 1965.

During the early days of her career, Harris held assignments as an administrative officer in California and West Germany, before transitioning into the maintenance field by attending the aircraft maintenance officer's course at Chanute Air Force Base, Illinois, and graduating as the first female aircraft maintenance officer.

Her first assignment as a maintenance officer was to support the Vietnam War as a maintenance supervisor with the 49th Tactical Fighter Squadron at Korat Royal Thai Air Base, Thailand. After stints back in California and Washington, D.C., Harris broke another barrier as one of the first women to be an air officer commanding at the U.S. Air Force Academy in Colorado Springs, Colorado.

After commanding an avionics maintenance squadron and a field maintenance squadron, both in Kansas, and a director of maintenance in Okinawa, Japan, Harris would make another first - this time as the first woman deputy commander for maintenance.

But her biggest accomplishment lay ahead, when in 1991, Harris became the first female African-American general, when she pinned on her first star as the vice commander of the Oklahoma Center Air Logistics Center.

Harris retired from the Air Force in early 1997, where she had been serving as the director of maintenance, deputy chief of staff for logistics, Headquarters Air Force. At that time, she was the highest ranking female officer in the Air Force and the highest ranking African-American female within the Defense Department.

Harris continues to contribute to the Air Force even after her retirement. In 2010, President Barack Obama appointed her a member of the Board of Visitors for the U.S. Air Force Academy. As a board member, she inquiries into the morale, discipline, curriculum and other matters deemed appropriate. The board submits reports to the secretary of Defense and the Committees on Armed Services of the Senate and Congress via the secretary of the Air Force.

As she continues to serve the Air Force she serves her community. She is a member of the National Association for the Advancement of Colored People and Delta Sigma Theta Sorority, Inc. For her works, in 2010 she was nationally recognized by the Black Girls Rock Foundation with the Trailblazer Award.

Defense Health Agency: Compound Drug Policy to Improve Patient Safety

By Army Sgt. 1st Class Tyrone C. Marshall Jr.
DoD News, Defense Media Activity

WASHINGTON, March 12, 2015 – The Defense Health Agency will begin applying current rules for prescription drug claims to compound drug ingredients, in the interest of protecting Defense Department beneficiaries, a senior health official said March 9 in Falls Church, Virginia.

During an interview with DoD News, Army Maj. Gen. Richard W. Thomas, chief medical officer and director of health care operations for the Defense Health Agency, addressed the perception some people may have that there will be a major policy change regarding compound drugs, those that contain two or more ingredients mixed together by a pharmacist.

“The changes really are not so much a policy change as really just us enforcing the regulatory guidance that we already have on our books,” he said.

“The Defense Health Agency’s No. 1 priority,” Thomas said, “is to ensure quality and safe care for all of our beneficiaries.”

Upcoming Changes

Beginning May 1, TRICARE plans to implement a screening process to ensure it covers all ingredients of a compound drug claim. TRICARE will still cover most compound drugs, and will allow pharmacists to substitute with approved ingredients to keep the process as smooth as possible. Recent system changes by the department’s pharmacy contractor allow greater visibility of these ingredients, and the ability to screen them individually.

Additionally, according to TRICARE, beneficiaries will also have the opportunity to request a prior authorization and appeal a decision to deny a compound drug claim, with appeals processed in a timely manner to support the beneficiary.

Compounding Drugs

The general explained what constitutes a compound drug and some of their practical applications in medicine.

“Compound pharmacy or compound drugs are actually very commonly used,” Thomas said. “These can be anything that includes an alteration or a change to an ingredient within a medication.

“For example,” he said, “if you’re going to give a child a flavored cough syrup, that would be compounding, because you’re adding an ingredient to make it taste better for the child.”

What people often think of when referring to compound agents are pain creams, Thomas said, and the ointments used for scars. This often includes topical creams or ointments people apply to their skin.

Safety is Paramount

In 2012, Thomas said, the department’s pharmacy contractor completed a system upgrade that allows the department to see specific types of compounds and the ingredients in the compounding drugs.

“They ran a list,” he said, “and we could see the ingredients in these compound agents -- they were not all approved [by the U.S. Food and Drug Administration] or proven to be safe and effective.”

Thomas also noted that a Government Accountability Office report from October 2014 indicated DHA was not in compliance with its own regulation to provide only FDA-approved medicine to its beneficiaries.

“We must be in compliance with the law,” he said. So, over time, what the agency has done is enforce the industry standard to ensure the ingredients in compounding agents have been proven safe and effective, Thomas said.

The general said DHA plans to ensure it is fully in compliance with existing policy and existing regulatory guidance.

“Safety is a paramount interest to us,” Thomas said. The No. 1 goal is to ensure that people receive medications proven safe and effective, he added.

Stewardship of Taxpayer Dollars

Thomas noted another aspect of enforcing the existing policies is DHA and the department’s obligation to be responsible stewards of taxpayer dollars -- about 10 percent of the DoD budget goes to medical care for all its beneficiaries.

“The past year or so,” he said, “what we’ve found is … we’re paying a lot more for these ingredients and there’s no medical or scientific evidence that they’re actually effective.”

Turning to cost, Thomas said the group of topical compounding agents specifically designed to treat pain are where the biggest increase is seen.

“I’ll give you some examples,” he said. “In fiscal year ’04, the DoD paid about $5 million for the year. By fiscal year ’14, it exceeded $514 million, and for fiscal year ’15, we’re on track to exceed $2 billion in expenditures just for compound agents.”

Significantly, he said, these compounded drugs make up only 0.5 percent of the total number of prescriptions provided through Tricare.

“However, it’s more than 20 percent of our total pharmacy expenditures,” Thomas said, “so you see a huge increase in the expenditures there.”

The Way Ahead

“We want to make sure we’re doing the right thing by our patients, so we have a Pharmacy and Therapeutics Committee that makes recommendations on drugs that TRICARE covers,” he said. “We also discussed compound drugs with the Beneficiary Advisory Panel for input on which way we should go with this, and how any change would affect our beneficiaries.”

“We solicit public feedback and we can have these open, transparent discussions, not only with members of the industries themselves, but also our beneficiaries are represented there,” Thomas said.

“There’s a lot of interest in compounded pharmacy, and I understand it,” he said. “As a physician, I like compounded drugs. They’re common used, and I prescribe compounds for my patients when it’s appropriate. So we’re not talking about eliminating compounded agents at all.”

Balancing Cost Versus Safety

Thomas said DHA’s goal is to be transparent as it communicates with all its beneficiaries through “aggressive” outreach.

“We’re actually talking about using the systems already in place -- which we already have on our book,” he said, “and actually enforcing the current guidance to make sure that the medications that we give you, your [families and] your children are safe and effective.

Alaska Air Guardsmen rescue snowmachiner

by Sgt. Marisa Lindsay
Alaska National Guard Public Affairs

3/12/2015 - JOINT BASE ELMENDORF-RICHARDSON, Alaska -- Airmen with the Alaska Air National Guard's 210th, 211th and 212th Rescue Squadrons rescued a 65-year-old man who was injured while snowmachining near the Tanana River, approximately 24 miles southwest of Fairbanks, March 8.

Alaska State Troopers notified the Alaska Rescue Coordination Center around 10 p.m. Saturday after Troopers relayed a cellphone call from the distressed.

According to the RCC, Alaska State Troopers and LifeMed were unable to execute the mission because of the terrain and time restrictions.

The rough terrain and remote location of the individual made the situation a good candidate for the Alaska National Guard's unique hoisting and air-refueling capabilities.

The Alaska Air National Guard's 176th Wing accepted the mission and launched an HC-130 "King" refueling aircraft from the 211th Rescue Squadron and an HH-60 Pave Hawk helicopter from the 210th Rescue Squadron. Each had on board a team of Guardian Angel rescue personnel from the 212th Rescue Squadron, from Joint Base Elmendorf-Richardson.

Because of the poor visibility and the lack of a GPS locating device, the snowmachiners used a fire and flashlight in order to signal the helicopter.

"The HH-60 helicopter had to try multiple routes to get through the passes due to low ceilings and poor visibility," said Lt. Col. John Morse, deputy director for the 11th Air Force Rescue Coordination Center, Alaska Air National Guard. "The helicopter had to be refueled by the HC-130 a few times in flight before the team was able to find the survivor, hoist him to safety and get him to a medical facility."

The man was stabilized and hoisted onto the helicopter before being transported and arriving at the Fairbanks Memorial Hospital at 8:30 a.m. Sunday.

"It's important that people realize how important having a personal locator beacon is with the extreme weather and terrain that's experienced in Alaska," Morse said. "Have a trip plan, let someone know where you are going and when you'll be back and be prepared to spend multiple days out in the elements in the event your machine breaks down or you get lost."

The members of the 210th, 211th, and 212th Rescue Squadrons were awarded with one save for the mission.

Step Up, Step In: What’s a line of duty determination?

March 12, 2015

By Staff Sgt. Ryan Crane

During the last five years, the Air Force notified the families of 232 Airmen that their son or daughter died.

Although most anyone can tell you the military can be a dangerous job and being put in harm’s way is often just part of the commitment, the most disturbing part about that statistic is 212 of those Airmen died while off duty.

Even more upsetting is that because of the circumstances surrounding the deaths, some families were paid no benefits. In every case, the deciding factor came down to the line of duty determination.

A line of duty determination investigation is conducted anytime a member acquires a debilitating disease, incurs a significant injury or dies under unusual circumstances, according to Capt. Mikal Nuhn, U.S. Air Forces in Europe and Air Forces Africa judge advocate. The findings determine whether or not death benefits are paid.

“When a military member is seriously injured or dies, certain statutory rights or benefits accrue to the member or their family,” Nuhn explained. “But only if the disability or death was attributed to military service, and in the line of duty.”

There are four possible outcomes of an LOD determination:
1. Condition existed prior to service and was not aggravated by service.
2. In the line of duty, not due to servicemember’s own misconduct.
3. Not in the line of duty and not due to the servicemember’s own misconduct.
4. Not in the line of duty and due to the sevicemember’s own misconduct.

Nuhn explained how to avoid the fourth outcome in very simple terms.

“Always behave in a reasonably safe manner because your actions could have unintended negative consequences for your loved ones,” he said.

This doesn’t mean you shouldn’t take a trip to Switzerland to go bungee jumping or hit the slopes to shred some powder. As long as you take all safety precautions these activities would likely be considered “in the line of duty” and you or your family would receive benefits.

However, a scenario that would likely not provide death benefits to your family is one that involves alcohol. An example is when an Airman drives drunk and puts himself and his family at risk, even if it is not his intention.

Making good choices and taking personal responsibility are key. The wingman concept is a great safety net, but in the end, every individual is responsible for his or her actions and consequences.

“By definition, all mishaps are preventable,” said Master Sgt. James Musgrave, USAFE-AFAFRICA mishap prevention manager.

Accidents happen, but there are always ways to minimize or eliminate risk in everything you do.

“While the younger Airmen have a good portion of the mishaps, no age or rank is immune to mishaps,” Musgrave explained. “It’s more of a psychology issue than an age issue.  ‘It will never happen to me’ is a common jinx if the speaker is not risk conscious.”

As the Air Force Safety Center motto states: “Safety is no accident.”

“Be risk aware, not inattentive,” said Musgrave. “One of the leading factors of mishaps is inattention, which sometimes is a result of boredom or a perceived absence of a threat. If Airmen are aware of the risks, they can control the ones that are controllable.”
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