There were two episodes last night. I am covering "Square One" tonight.
You might remember last week the deal was a hurricane was about to hit. It hit. Grayson's house is standing but badly damaged and he had to move in with Jules. As their therapist had predicted last time, they would have problems when they moved in together.
Wedding plans continued. Neither Jules nor Grayson wants Stan in the wedding but he was able to walk the distance Ellie required and we all know Ellie always gets her way.
Maybe because she is a great lover?
It turns out that she destroyed a successful man who ended up being one of the best bums Lori ever slept with. They were bound and determined to find out who was better in bed and they call the guy and he goes with Ellie.
Lori is upset.
Throughout all the drama, Jules is planning Thanksgiving. She explains that they were unable to have it last fall. (An inside joke -- ABC wouldn't air Cougar Town then so they didn't do their annual Thanksgiving episode.)
This was the more laid back of the two episodes. I will cover the second one tomorrow.
In terms of Jules and Grayson, the main point was that Jules needed to be more open with him.
One other detail, Bobby's boat was harmed in the hurricane so he's currently living at Jules' as well.
Now this is C.I.'s "Iraq snapshot:"
Wednesday,
May 16, 2012. Chaos and violence continue, Nouri wants his
'accomplishments' acknowledged (if only there was one to point to),
State of Law insists a conspiracy is a foot!, a US House Veterans
Affairs Subcommittee hears that a change VA wants to make will actually
hurt disabled veterans, and more.
"Our
nation's commitment to restoring the capabilities of disabled veterans
struggling with devasting combat wounds resulting in the loss of limb
began with the Civil War," declared US House Rep Ann Marie Buerkle this
morning shortly after she brought the House Veterans Affairs
Subcommittee on Health to order. "Restoring these veterans to wholeness
was a core impetus behind the creation of the Department of Veteran
Affairs and then, now, it continues to play a vital role in the
Department's mission."
Buerkle is the Chair of
the Subcommittee and this morning's hearing was entitled "Optimizing
Care for Veterans With Prosthetics." Chair Burerkle also noted,
"Following WWII, 1945, veterans disatisfied with the quality of VA
prosthetic care stormed the Capitol in protest. " How is the care
today? To answer that question, the Subcommittee heard from
four panels. Gulf War Veteran John Register and Vietnam Veteran Jim
Mayer. Disabled American Veterans' Joy Ilem, American Orthotic & Prosthetic Association's Michael Oros, Paralyzed Veterans of America's Alethea Predeoux and Southeast Wounded Warrior Project's
Jonathan Pruden. The third panel was the VA's Office of Inspector
General's Linda Halliday accompanied by Nicholas Dahl, Kent Wrathall
and Dr. John D. Daigh Jr. and Dr. Robert Yang. The fourth panel was the
VHA's Dr. Lucille Beck accompanied by Dr. Joe Webster, Dr. Joe Miller
and Norbert Doyle. Some of the issues were outlined in the Ranking
Member's opening remarks.
Ranking
Member Mike Michaud: I've said it on this Committee before, but what
seems to be the case, there is little accountability in management and,
once again, procurement procedures and policies were not in place or not
followed in managing nearly $2 billion worth of prosthetics and sensor
aids. The VA, in the last year's budget submission, claims $355 million
in savings in the Fiscal Year 2012 and 2013 due to aquistions
improvements. But if the VA can't follow its own policies and
procedures, how much faith can we have in the claim of acquisition
savings? I hope the VA can help us understand today what accountability
we should expect and to make certain that the VA does not continue to
overpay for prosthetics in the future, that taxpayers and veterans
receive the best value for their devices, and for management to ensure
that the prosthetics and sensor aids services is fully meeting veterans
needs. Finally, it has come to my attention that VA has proposed
changes in the procurement of prosthetics and that there is a high
degree of concern among some of our witnesses today as to the
effectiveness of these changes. I look forward to hearing from the VA on
these changes as well.
A
proposed change that's bothering some veterans? What proposal is
Ranking Member Michaud speaking of? On the second panel, Jonathan
Pruden explained the proposal (and here we're using his opening written
remarks which differ some what from what he delivered):
Under
current practice, VA physicians and prosthetists are able to see a
veteran, make a determination regarding the most appropriate type of
prosthetic equipment for a veteran, and relay that information to a
Prosthetics Service purchasing officer to complete a purchase-order to
obtain the needed item. Those purchasing officers exclusively handle
prosthetics' purchases, and are specialists in ordering medical
equipment specified by health care providers. A major change that the
Veterans Health Administration intends to institute on July 30th, would
require that any prosthetic item whose cost exceeds $3000 -- to include
such essential items as limbs, wheelchairs and limb-repair components –
must be procured by a contracting officer. This is not simply a matter
of substituting a generalist for a specialist. Under the proposed
change, these contracting officers would use a labor-intensive system
(the Electronic Contract Management System (eCMS)) designed to achieve
cost savings. That system, designed for high-dollar bulk-procurement
purchases that benefit from using the Government's purchasing power,
requires over 300 individual steps to manually process a purchasing
order. While well-suited for buying widgets, the system was neither
designed for nor well-suited to procuring highly specific,
individualized medical equipment. Ill-suited to prosthetics, this new
process would also require increased coordination between clinicians and
off-site contracting officers who would be responsible for purchasing
everything from light bulbs to now highly specific prosthetic legs.
This
is not a small change. Moreover, it not only increases the margin for
error but also the potential for prolonged, delaying "back-and-forth,"
with the likelihood of clinicians having to justify why a more expensive
wheelchair is clinically necessary when a seemingly-similar less-
costly model exists. We see no prospect that this planned change in
prosthetics procurement holds any promise for improving service to the
warrior. Instead, it almost certainly threatens greater delay in VA's
ability to provide severely wounded warriors needed prosthetic devices.
This
would be "the wrong path" Iraq War veteran Jonathan Pruden stated. He
was injured in a July 1, 2003 Baghdad bombing resulting in multiple
surgeries including the amputation of his right leg. This next excerpt
is from his oral testimony.
Jonathan
Pruden: Under the change, only a contracting officer could procure a
prosthetic item costing more than $3,000. This policy would effect
essential items including most limbs like mine and wheel chairs. It
would require the use of a system designed for bulk procurement
purchases that involves manually processing over three hundred -- that's
300 -- individual steps to develop a purchase order. This system may
be great for buying cinder blocks and light bulbs but it is certainly
not appropriate for providing timely and appropriate medical care.
Equally troubling, this change offers no promise of improving service to
the warrior. Instead, it would mean greater delays. The change could
realize modest savings but at what cost? A warrior needing a new leg or
wheel chair should not have to wait longer than is absolutely
necessary. I know warriors who have stayed home from our events, stay
home from school, from work, can't play ball with their kids or live
in chronic pain while they wait for a new prosthesis. I know first
hand what it's like to not be able to put my son into the crib while I'm
waiting for a new prosthetic, to live in chronic pain and to have my
daughter ask my wife once again, "Why can't Daddy come and walk with
us?" With VA moving ahead on changing procurement practices, wounded
warriors need this Committee's help. A prosthetic limb is not a mass
produced widget. Prosthetics are specialized, medical equipment that
should be prescribed by a clinician and promptly delivered to the
veteran. We urge this Committee to direct VA to stop implementation of
this change in prosthetic procurement.
We'll note this exchange from the second panel.
Chair
Ann Marie Buerkle: Mr. Pruden, in you testimony, you talked about how
VA prosthetic research has lagged in recent years. Now Mr. Oros talked
about outcomes but I think you're talking more generally in terms of the
research. What impact -- and I shouldn't speak for you. I should let
you say what research you were referring to. And then, if you could,
after you tell us that piece, what impact has that had on veterans and
the service that they need?
Jonathan
Pruden: VA has-has stepped up in a number of capacties in the past few
years. But, as Mr. Mayer pointed out earlier, DoD has taken the lead
on the development of the DEKA Arm [a project DoD and the VA work on
together] and all of these advanced techonology things. In years past,
VA has been -- One of its key roles and one of the reasons it exists is
to provide specialized medical equipment for our combat wounded, for our
veterans. And VA really needs to have the capacity and the focus on
research for durable medical equipment when DoD and Global War on Terror
Dollars go away. And this also ties into the discusssions about the
centers of excellence at Walter Reed, Brooke Army Medical Center and so
forth. When these dollars go away, those DoD facilities will certainly
scale back their capacity both for rehabilitation and for research. And
what we're calling for is for VA through the amputee system of care
and enhancements and research to be prepared to meet the needs as DoD
scales back.
Chair
Ann Marie Buerkle: Thank you. Miss Predeoux, I'm extremely concerned
with regards to your comments about the filing system being outdated and
the backlog that it creates. Could you comment on that for us?
Alethea
Predeoux: Yes, in my written statement with the filing system, it
refers to medical records in one VA medical center. And if, for
instance, one veteran was to relocate -- For example, our director of
benefits relocated to this area from San Diego and it took quite a bit
of time for the medical records to be delivered from San Diego to DC
simply because there's not one central system in which all the medical
centers are able to locate and actually view the medical records of a
veteran. And as the panel before us testified, it's not just a wait
time, it's a matter of being able to be comfortable and actually to be
mobil.
Noting that
Wounded Warrior was favoring a freeze on VA's proposed change, Ranking
Member Michaud asked Oros, "Do you think we should ask the VA to freeze
the reorganization? Bringing everthing in house?" Oros responded,
"Absolutely. Absolutely." US House Rep Gus Bilirakis wanted to know
about the real life effects if VA went through with their change in
procurement?
Jonathan
Pruden: Under the current system, there are safeguards in place to
ensure that VA is being fiscally responsible. And it can take a month,
two months. Some of this is predicated on the clinical needs of the
patient and the availablility of the product in their area which is
appropriate. Our real concern is that -- is that with the new system,
it would be supposition but it may take months and months longer to get
purchase orders for needed equipment. And the veterans should not have
to wait and the clinician's hands should not be tied. If they feel that
a device is appropriate and going to provide the best care for a
warrior, they should be able to prescribe that device. I have had the
opportunity to speak with over a dozen VA clinicians and prosthetists
who are currently serving in several former chiefs of prosthetics. And
every single one of them said that they share our concerns about the
ability to remain timely and potential delays in veterans receiving
needed prosthetic devices under this new system. Dr. Bechel and she'll
say that, 'One of the things that we're going to consider is if a device
is generally available and interchangeable. Then it will fall under
the federal acquisition regulations.' Who is determining what is
generally available and interchangeable? It's going to be somebody in
acquisitions , not a physician, not a clinician who has the patient's
best interest at heart. And that -- that's our real concern.
That's
one of the main points from the hearing. Time permitting, we may cover
some other issues or go deeper into this one in another snapshot.
From
the House to the Senate, Senator Patty Murray is the Chair of the
Senate Veterans Affairs Committee and the Committee issued the following
today:
FOR IMMEDIATE RELEASE
Wednesday, May 16, 2012
Contact: Murray Press Office
(202) 224-2834
Senator Murray's Statement on Sweeping Army-Wide Review of Behavioral Health Evaluations and Diagnoses
Investigations Will Review Mental Health Diagnoses Since 2001
(Washington,
D.C.) -- Today, U.S. Senator Patty Murray, Chairman of the Senate
Veterans Affairs Committee, released the following statement after the
Army announced that they will begin a comprehensive, Army-wide review of
soldier behavioral health diagnoses and evaluations since 2001. This
major announcement comes after Senator Murray spurred an investigation
into inconsistencies in diagnoses at Joint Base Lewis-McChord in her
home state of Washington. The Army has since returned PTSD diagnoses to
over 100 servicemembers that sought treatment there. Murray has
repeatedly pushed Army leadership to investigate whether problems
similar to those at Madigan were being seen at Army bases across the
country.
For more information on the Army's announcement visit:
"The
Army clearly realizes they have a nationwide, systematic problem on
their hands. I credit them with taking action, but it will be essential
that this vast and truly historic review is done the right way. That
means continued engagement from Army leadership at the highest levels,
prompt attention to the problems of servicemembers identified during the
review, and not only the identification of problems but quick action to
implement and enforce solutions.
"This
comprehensive review is born out of a review I helped initiate in my
home state that has already returned PTSD diagnoses to over 100
servicemembers since the beginning of this year. That review has been
successful because the Army identified and reached out to affected
servicemembers and veterans, conducted reevaluations using the
appropriate tools and best practices, and was made a priority by top
military leaders. This nationwide review must be given the same
attention from leadership in order to succeed.
"But
the bottom line is that the Army needs to fix the inconsistencies we
have seen in diagnosing the invisible wounds of war. Out of this
review, the Army needs to provide a uniform mental health policy so that
service members are given the care they need.
"This
is an issue that affects every aspect of the lives of those returning
from Iraq and Afghanistan. Without proper mental health treatment we
will continue [to] see see servicemembers struggle to readust to family
life, contine to self-medicate, and in far too many cases, take their
own lives.
"Servicemembers, veterans, and
their families should never have to wade through an unending
bureaucratic process to get proper access to care. The Army has an
extrordinary opportunity to go back, correct the mistakes of the past,
and ensure that they are not repeated."
###
Matt McAlvanah
Communications Director
U.S. Senator Patty Murray
202-224-2834 - press office
202--224-0228 - direct
Yesterday the Presidency of the Republic of Iraq's website deleted the image of Vice President Tareq al-Hashemi. Alsumaria reports
that the deletion is being blamed on a "technical issue" and that they
are in the process of rolling out a new website design. Though some
worried this might mean that al-Hashemi had been stripped of his post,
others no doubt found it shocking that the Presidency still has a web
domain. The Ministy of Higher Education & Scientific Research has lost its domain as has the Ministry of Trade. and the Ministry of Displacement and Migration and the Ministry of Culture and . . .
Due
to Nouri al-Maliki's targeting of Tareq al-Hashemi, some were worried
about the disappearnace. At this point, the President's office is
insisting it was merely a "technical issue." Nouri targeted al-Hashemi
at the same time he did Deputy Prime Minister Saleh al-Mutlaq. He
wanted al-Mutlaq stripped of his post for the 'crime' of telling CNN
that Nouri was becoming a dictator. Nouri always feels the need to
punish truth tellers.
For an overview of the political crisis, we'll note this from Marina Ottaway and Danial Kaysi's [PDF format warning] "The State Of Iraq" (Carnegie Endowment for International Peace) reviewed events and noted:
Within
days of the official ceremonies marking the end of the U.S. mission in
Iraq, Prime Minister Nouri al-Maliki moved to indict Vice President
Tariq al-Hashemi on terrorism charges and sought to remove Deputy Prime
Minister Saleh al-Mutlaq from his position, triggering a major political
crisis that fully revealed Iraq as an unstable, undemocractic country
governed by raw competition for power and barely affected by
institutional arrangements. Large-scale violence immediately flared up
again, with a series of terrorist attacks against mostly Shi'i targets
reminiscent of the worst days of 2006.
But there is
more to the crisis than an escalation of violence. The tenuous
political agreement among parties and factions reached at the end of
2010 has collapsed. The government of national unity has stopped
functioning, and provinces that want to become regions with autonomous
power comparable to Kurdistan's are putting increasing pressure on the
central government. Unless a new political agreement is reached soon,
Iraq may plunge into civil war or split apart.
Alsumaria reports that an Iraqiya offshoot, White Iraqiya, is stating al-Mutalq will be at a Council of Ministers meeting next week. Ali Hussein (Al Mada) offers
a column on the drama of Nouri and Saleh and notes that, throughout,
there was always the pretense of shedding tears over how this was
preventing the people's business. Iraqiya made clear that they are fine with the various names tossed around as possible replacements for Nouri. Alsumaria reports
that Nouri's political slate, State of Law, is insisting that there's a
conspiracy to replace Nouri and that KRG President Massoud Barzani is
behind the conspiracy. In addition, Nouri says that his achievements should not be overlooked.
Presumably, Nouri doesn't mean for people to look at the potable water
issue. Though Nouri's been prime minister since 2006, potable water
is still an aspiration in Iraq. The cholera season will soon, once
again, be upon Iraq. Al Mada reports that only 15% of Nineveh Province are serviced by networks of potable water.
Not a ringing endorsement. May 7th, the Iraqi government acknowledged that it can't protect the people, Al Rafidayn reported
that Nouri's agreed to allow every Iraqi household to keep one gun
provided they register it with the nearest police department. Dar Addustour added that Nouri's spokesperson Ali al-Dabbagh has explained the one gun can be either a rifle or a pistol. Al Sabaah noted that the Ministry of the Interior will issue guidelines on how the new procedure will be implemented. Kitabat explained that the current policy had been for the Iraqi forces to confiscate any weapon they found during a house raid. May 10th, the pushback began. Alsumaria reported
that State of Law MP Shirwan Waeli is questioning the wisdom of the
decision and stating State of Law shouldn't be giving legitimacy to
arming people and that, futhermore, it suggests that the government is
unable to protect Iraqis so it is now the direct responsibility of the
citizens to protect themselves. Supporters argue that the move was an
attempt to limit guns and that the one-gun rule will greatly reduce the
number of firearms in each home. Alsumaria noted
that objections to Nouri's one-gun policy are also coming from the
Islamic Supreme Council of Iraq and the Kurdistan Alliance. Ala
Talabani, spokesperson for the Kurdistan Alliance, spoke publicly today
about the issue and declared that they fear making each household
register their one gun with the nearest police station in their areas
will provide temptation for corruption. Talabani also states that
they fear the rule could lead to an increase in so-called 'honor'
killings as well as an increase in domestic violence. Mustafa Habib (Niqash) reports:
But
a source inside the Ministry of Interior said the authorities actually
felt this was an acknowledgement of the reality in Iraq, an idea that
would allow them to better control security inside the country. By
getting locals to register their firearms, the government would get a
better idea of what kinds of weapons were in the country and how many
there were.
Up
until recently, the right to own a firearm in Iraq was reserved for
members of the security forces and those in certain other professions.
However, in reality, it would be fair to say that most Iraqi households
own at least one gun, whether permitted or not.
UPI notes, "A
prison that Iraq's government said it closed a year ago is still open
and being used for torture and unlawful detentions, a human rights group
said Tuesday." Al Mada notes Human Rights Watch published their report
yesterday and that the secret prisons are in the Green Zone, one of
which is Camp Honor which the government insists was closed. Mohammed Tawfeeq and CNN quote
Human Rights Watch's Joe Stork stating "It's a matter of grave concern
that Iraqis in so many walks of life, officials included, are afraid
for their own well-being and fear great harm if they discuss allegations
of serious human rights abuses." Al Arabiya adds,
"The rights group called for Baghdad to start an independent
investigation into allegations of torture and mistreatment, as well as
other issues, at Camp Honor and other jails." Ahram Online explains:
The
HRW report cited testimonies and acknowledgments by former prisoners,
lawyers, parliamentarians, family members, government and security
officials. Based on the interviews, HRW concluded that the Iraqi
government carries out mass arrests, illegally detaining hundreds of
citizens, dozens of them transferred to Camp Honor.
Two
particular waves of mass arrests were mentioned in HRW's account. The
first occurred in October and November 2011 when officials and officers
were targeted. Those were allegedly Baath Party and Saddam Hussein
loyalists and were ordered detained directly through Prime Minister
Nouri Al-Maliki's military office.
The
"Baathist arrests" were supposedly to round up plotters against Iraq's
regime. Testimonies said those released were forced to sign pledges
against public criticism of the government as well as false confessions.
Threats of torture (or further torture), family member raping and
prolonging imprisonment preceded the signings.
The
second wave of arrests was prior to the March 2012 Arab summit in
Baghdad. This wave was preemptive, an effort to secure the summit not
hosted in Baghdad for decades because of insecurity, claimed now to be
secure by Iraq's government.
Alsumaria reports a Kirkuk roadside bombing injured one police officer and the burned corpse of 1 young man was discovered in Kirkuk "handcuffed and blindfolded." Xinhua notes
that a Jalawla roadside bombing left four police officers injured, a
garage continer bombing in Jalawla left a young boy injured, a Baghdad
construction cite bombing left three construction workers wounded. In
addition, KUNA adds,
"Up to three Iraqis were killed and 11 others suffered injuries violent
incidents close to the nothern cities of Kukuk and Mosul on Tuesday."
Noting 96 deaths from violence in Iraq so far this month, Iraq Body Count
notes 10 dead yesterday: "Mosul: 2 by gunfire. Shirqat: 2 by gunfire, 1
body. Al-Zaeraiah: 2 Sahwa members by fungire. Taza: 2 bodies found
in grave. Mosul: 1 by mortars."
Meanwhile some of the targeted in Iraq do get out of alive. Suheil Damouny (SBS' World News Australia, link is text and video) reports
that a group of Iraqi Palestinians have made it to Sydney where they
have family, "They say they have suffered great human rights violations
in Iraq, especially since the fall of Saddam Hussein in 2003."
Suheil
Damouny: Almost as soon as the government fell in 2003, Iraqis wanted
Palestinians out -- anywhere, except Iraq. Human rights groups are
still cataloguing the intense harassment, kidnappings and even murders.
Shia landlords wanted to reclaim properties Saddam's government had
forced them to rent to Palestinians virtually for free.
Shhadi
Ameen Badwan: They would come to our homes and draw a noose on the
door, saying that they will hang us if we do not leave. We were targeted
as Palestinians. They would say that the buildings we live in are
theirs. They say that Iraqi families are living on the streets while we
are living in buildings. They say they do not want us there at all and
we have to leave.
Suheil
Damouny: Subhi and his wife left Iraq with their daughter in 2007.
They left behind a son. His fate? Still unknown, another kidnapped in
Iraq in 2006 presumed dead.
Rihaneh
Ibrahim Khalil Badwan: They too my son. They took him from the shop
and he was never seen again! Until now I have not seen him. The Mehdi
Army took him. We were humiliated. How many times have we been
displaced! From Palestine we were kicked out. They do not want us in
Iraq. We went to Syria and look what happened there.
Suheil
Damouny: They made their way into Syria using forged Iraqi documents.
In Damascus, left with nothing, they turned themselves in. They were
then sent back to the border where they remained in barren refugee camps
for five years. It was as far as they could go. No country would let
them in.
Subhi
Ameen Badwan: For Palestinians, this card, our passports, wouldn't
even allow us to travel for 20 metres. They would fight us simply based
on this Iraqi card. Once someone is idnetified as a Palestinian we
would be kidnapped, then they would demand ransom money.
Suheil Damouny: Amnesty International's Graham Thom visited the camp. The conditions were appalling.
Graham
Thom: There were scorpians, there were snake bites. And, again, these
camps were on the sides of busy highways and so we had small children
who were being run over and killed by trucks in the middle of the
desert.
Lastly, Peter Van Buren works for the US State Dept. He wrote We Meant Well: How I Helped Lose the Battle for the Hearts and Minds of the Iraqi People. He's a whistle blower. And the administration has gone after him like crazy. A friend asked that we note Kim Zetter's "ACLU Warns State Dept. Against Firing Worker Who Criticized Government" (Wired):
The American Civil Liberties Union has come to the defense of a former State Department employee who looks likely to be fired for blogging and writing critically about the reconstruction efforts in Iraq. The ACLU says doing so would violate the constitutional rights of veteran State Department employee Peter Van Buren, according to a letter the group sent the government on Tuesday. The letter further accuses the government of unlawful retaliation against Van Buren for publishing critical comments about U.S. foreign policy on his personal blog last year. "The Supreme Court has repeatedly held that public employees retain their First Amendment rights even when speaking about issues directly related to their employment, as long as they are speaking as private citizens," and as long as they're writing about matters of public concern, the ACLU wrote in its letter (.pdf). "There can be no dispute that the subject matter of Mr. Van Buren's book, blog posts, and news articles -- the reconstruction effort in Iraq -- is a matter of immense public concern." |
