The ACA will further its work with Congress this year to ensure that Capitol Hill continues its efforts to require the Department of Defense to comply fully with the law

With the first session of the 109th Congress behind us, it’s time to look ahead to the rest of 2006 and how we can build upon the legislative successes of the last several years. Regarding the inclusion of chiropractic care as part of the military health care benefit, Congress recently passed the Fiscal Year 2006 Department of Defense (DOD) authorization bill, which included language to require the US Air Force to complete implementation of chiropractic services at 11 additional sites.

Specifically, the bill, which President Bush signed on January 6, calls on the secretary of the Air Force to ensure that chiropractic health care services are available at 11 facilities previously slated to offer chiropractic care but that have not opened a clinic or made the benefit available on base. If the Air Force determines it is unnecessary or unfeasible to provide chiropractic health care services at any identified facility, the Air Force shall provide chiropractic services at an alternative site located off base. The Air Force has until September 30, 2006, to complete implementation at the 11 locations.

The 11 sites identified by Congress are:
• Bolling Air Force Base (AFB) Washington, DC;
• MacDill AFB, Florida;
• Hurlburt Field AFB, Florida;
• Nellis AFB, Nevada;
• Elmendorf AFB, Alaska;
• Luke AFB, Arizona;
• Maxwell AFB, Alabama;
• Randolph AFB, Texas;
• Robins AFB, Georgia;
• Kirtland AFB, New Mexico; and
• Pope AFB, North Carolina.

DOD Fails to Implement its Own Plan
The Air Force language contained in the Fiscal Year 2006 authorization bill, if signed by the president, would increase the number of military facilities with a chiropractor on duty from 42 to 53.

This latest congressional action comes on the heels of a September 2005 US Government Accountability Office (GAO) report on the status of chiropractic care in the armed forces. GAO, an official government watchdog agency, confirmed what the American Chiropractic Association (ACA) has been telling Congress all along: the DOD is not complying with current law and has failed to fully implement its own plan to provide chiropractic health care services to active-duty military personnel. In short, the GAO report clearly states that the Pentagon is falling far short of the spirit and letter of the law, which calls for chiropractic care to be available to all eligible active-duty military. To read the September 2005 GAO report on chiropractic in the military, or to read the ACA’s response, visit www.acatoday.com/government/dod.

Highlighted in the GAO report are three compelling pieces of evidence that clearly demonstrate that the DOD is not taking the congressional mandates seriously, and as a result is effectively violating current law.

First, the Pentagon’s implementation plan stated that a marketing and promotion program, which would include pamphlets and other materials, would be necessary to make active-duty personnel aware of the benefit. However, the DOD did not provide active-duty personnel with such materials. Furthermore, the implementation plan also called for close monitoring of the benefit to determine whether or not it meets the current needs of military personnel. The GAO points out that the DOD failed to monitor the program.

The result of these two DOD failures is this: Only half of all eligible active-duty military personnel have access to the chiropractic health care that they are entitled to under the law.
Second, although all 1.8 million active-duty military personnel are entitled to the chiropractic health care benefit, DOD provides chiropractic services at merely 42 of its 238 military treatment facilities located throughout the United States. Before the recent congressional action, there were no plans to develop additional treatment facilities that could provide chiropractic services.

The Fiscal Year 2004 National Defense Authorization Act specifically instructed DOD to provide this mandatory benefit at “no fewer than 45” sites, setting a floor rather than a ceiling for the number of facilities where chiropractic care must be available. Again, DOD has unilaterally, without any support in law, failed to provide care at a sufficient number of military treatment facilities. In fact, according to GAO, nearly 500,000 active-duty military personnel reside stateside in areas served by a military-treatment facility not offering chiropractic care.

No Chiropractic Care Overseas for Military
Furthermore, despite the recent deployment of active-duty military personnel in multiple theaters overseas, no overseas facilities provide chiropractic care. GAO estimates that approximately 246,000 active-duty military personnel are stationed overseas without access to the chiropractic health care services required by law to be provided. It is also important to note that chiropractic health care services are not provided to our active-duty Naval personnel on aircraft carriers or other ships patrolling in strategic areas of the world. In total, the GAO concluded that nearly 750,000 eligible active-duty personnel (stateside and overseas) are in areas served by a military treatment facility not offering chiropractic care.

Finally, and perhaps most revealing, the Pentagon agreed with the GAO findings of noncompliance, and issued a meager six-sentence comment on the GAO report findings. Throughout the GAO analysis of DoD’s compliance with the chiropractic care legal mandate, the Pentagon continuously demonstrated that it believed the benefit to be “discretionary” rather than mandatory, ignoring several congressional instructions to fully implement and accelerate this mandatory health care benefit plan.

In response to the GAO report, the ACA pushed for a provision in the House-passed version of the Defense Department authorization bill that instructed the Pentagon to develop a firm plan to make the chiropractic benefit available. Section 704 of the Fiscal Year 2006 National Defense Authorization bill passed the House of Representatives—a clear indication that many on Capitol Hill continue to give special priority to accelerating the availability of chiropractic care in the military.

This year, the ACA will further its work with Congress to ensure that Capitol Hill continues its efforts to require the DOD to comply fully with the law. We will not stop until chiropractic health care benefits are available to all active-duty military personnel, at facilities here in the United States and overseas.

National Chiropractic Legislative Conference
And while the ACA continues to fight on behalf of the chiropractic profession, individual doctors can make a difference, too, by lobbying for legislation guaranteeing that our nation’s heroes have access to chiropractic care.

For the 31st consecutive year, the ACA hosted the National Chiropractic Legislative Conference (NCLC) March 25–28 in Washington, DC. NCLC is the chiropractic profession’s most important public-policy and educational event. Past attendees include former US Secretary of Health and Human Services Tommy Thompson and House Speaker J. Dennis Hastert.

During NCLC, hundreds of DCs and chiropractic students from across the country meet with members of Congress to advocate on behalf of the chiropractic profession and chiropractic patients.

This year, NCLC attendees were on the front lines fighting to ensure full status and fair treatment in federal health programs—including Medicare, veterans programs, military programs, National Health Service Corps, and US Public Health Service—and campaigned for expansion of access, the safeguarding of physician status, and to secure funding for chiropractic research and education.

All DCs and chiropractic students were encouraged to attend NCLC—even newcomers to Capitol Hill. The ACA provides exclusive legislative briefing seminars, talking points, and information to prepare all attendees on what to expect at their meetings with members of Congress or their staff. For more information, visit www.aca-nclc.com.

Chiropractors inundated the halls of Congress, working to convince legislators that the profession's concerns should not be taken lightly. By working together, we can make a difference. CP

John Falardeau serves as the ACA’s vice president of government relations. He served previously as the director of federal and state government affairs for the Rubber Manufacturers Association. In addition, he spent 10 years as a senior assistant to two members of the US House of Representatives. He can be reached at jfalardeau@acatoday.org.