washingtonscene DoD and the VA have made progress

toward increasing the number of behavior- al health care providers, but timely access to qualified, appropriate mental health in- tervention and treatment remains difficult in many DoD and VA health care facilities. The shortage of mental health care provid- ers results in increased referrals to civilian providers, many of whom have little knowl- edge or understanding of military culture and the unique needs of military families. Specialized training and military cultural- awareness programs should be expanded for community providers to improve effi- ciency when working with servicemembers and veterans and their families. The health and well-being of the all-

volunteer force has never been more criti- cal. DoD and the VA must have viable and effective systems of care and support that address all warrior physical, mental, and emotional issues, including managing pain, substance use, and complex trauma condi- tions. Senior commanders must continue to strengthen efforts to establish a command climate that eliminates stigma associated with seeking mental health care. Establish- ing a culture that encourages individuals to seek help as an act of strength rather than as a sign of weakness is central to trans- forming the willingness of servicemembers to seek treatment.

Guard/Reserve health care Seek enactment of legislation to correct inequities and gaps in subsidized cover- age for guardmembers and reservists and their families, including “gray area” retirees who have not yet attained age 60. Provide members of the Selected Reserve the option of having the government subsidize con- tinuation of civilian family coverage during call-ups — just as the government already provides up to 24 months of Federal Em- ployee Health Benefits Program premium coverage for activated federal workers.

Consider revamping all reserve health

care programs under a single, more equi- table umbrella to improve consistency and continuity of coverage as these members move to and from active duty and age through current eligibility categories.

Pharmacy issues Work with DoD and Congress to maintain a comprehensive uniform pharmacy ben- efit with a robust formulary that preserves beneficiary options to obtain specific phar- maceuticals determined necessary by their providers. Promote positive incentives that save money for both beneficiaries and the government. MOAA will strive to maximize beneficiary choice, minimize beneficiary costs, and help educate beneficiaries and providers to make the best use of the vari- ous TRICARE pharmacy options.

Access to VA health care The VA must aggressively implement re- forms to assure timely access to the quality care most enrolled veterans experience. Changes in leadership in some facilities, recruitment of separating DoD medical professionals, upgrades of clinical space, and an overhaul of the out-of-date schedul- ing system are needed. MOAA supports a comprehensive, strategic plan for VA health care delivery in the 21st century. The VA must double down on efforts to

improve mental health care delivery and address the number of veteran suicides. The VA and DoD need to strengthen their col- laboration in delivering long-term medical and benefits counseling and caregiver sup- port for catastrophically disabled veterans. To sustain VA services to the nation’s

veterans, two-year funding across all VA accounts must be enacted. MOAA will con- tinue to be watchful against any initiative that would force dual-eligible beneficiaries, solely as a cost-savings measure, to choose between the DoD and VA health systems.

JANUARY 2016 MILITARY OFFICER 45