On May 22, the U.S. Senate passed a version of the National Defense Authorization Act for FY 2004 (S. 1050) with a 98-1 vote; the House version of the bill (H.R. 1588) also was approved, 361-68. Both bills authorize more than $400 billion in appropriations for defense, military construction and defense-related work for the Department of Energy and military health programs.
With respect to the inclusion of chiropractic care in the military, the two bills offer somewhat differing language, according to Jon Hymes, American Chiropractic Association (ACA) vice president of government relations:
"The bills are different in terms of provisions: Each reflects the interests of its respective committee; and each lobbying body will appoint those whom can intelligently 'reconcile' the bills.
"Although the [Senate] bill does not contain the chiropractic care acceleration provision approved by the House or the increased funding, it does contain report language included in response to specific concerns raised by the ACA and ACC [Association of Chiropractic Colleges] about the DoD's delayed implementation. The ACA and ACC worked closely with Senator Jim Talent (R-MO), a member of the Armed Services Committee, on the report language.
"Both chambers have passed a version, and both address implementation raised in lobby efforts. Efforts will be directed toward the House language being included in the final version, which may ultimately be forwarded to the president for final signature; we are keeping watch."
No timetable has yet been announced for a House-Senate conference to reconcile the differences between H.R. 1588 and S.1050 and prepare a final version of the bill for consideration. ACA and ACC lobbyists are preparing a strategy that will include aggressive grassroots activities targeting key conferees to encourage the Senate to accept the statutory language and increased funding level in H.R. 1588.
A key factor in the House bill is that it "shortens the timeline for full implementation of the chiropractic program in the U.S. Armed Forces to October 1, 2005," emphasized Michael S. McLean, DC, ICA board member and chair of the ICA 2001-2003 Legislative Committee. "If passed, H.R. 1588 means that new funds will be spent deploying chiropractic providers, more service personnel will be under chiropractic care and the status of chiropractic in this important segment of our national infrastructure will be brought to the full maturity it deserves, much quicker than previously provided for."
The House bill includes $18 million in funding for implementation of chiropractic benefits throughout the military health care system in 2004 - $6 million more than the amount requested by President Bush for the program.
SASC Report to Accompany Senate Version
As Mr. Hymes noted, a report from the Senate Armed Services Committee accompanies S. 1050. The report urges the following:
The [Senate Armed Services] committee is concerned about effective implementation of the chiropractic health program in the Department of Defense. The committee understands that the Chiropractic Oversight Advisory Committee, which was created to provide advice to the Secretary of Defense on the development and implementation of this program, has not met in over one year. The committee encourages the Department of Defense to continue to seek the advice and expertise of the Chiropractic Oversight Advisory Committee, as implementation of the chiropractic health care program continues throughout the military health care system.
The committee encourages the Department to accelerate the number of military treatment facilities that provide chiropractic care to active duty service members. Accordingly, the committee directs that the Department provide the chiropractic benefit at no fewer than 45 sites by the end of fiscal year 2004. The Department should make information readily available to members of the military concerning access to chiropractic services.
Further, every effort should be made by the Department to recognize chiropractors as the health care professionals that they are. The committee recommends that chiropractors, given their extensive medical training, should report to a physician rather than a physician's assistant or other specialty practitioner.
Prior to the bill's passage, Rep. Duncan Hunter (R-CA) and the chairman of the Total Force Subcommittee, Rep. John McHugh (R-NY), urged each congressperson in writing to support the "array of initiatives that improve the quality of the worldwide health care benefit for the men and women of our armed forces."
Rep. Ed Schrock (R-VA) worked closely with and was praised by both the ACA and the ICA. The ACA termed his leadership "essential" to the May 14 committee passage of the bill; Dr. McLean was noted by the ICA to have worked "in close cooperation" with Rep. Schrock toward passage.
ACA President Daryl Wills, DC, commented on the passage of the bills: "This is a victory for our troops. After taking a close look at the impact on readiness and overall health, the U.S. House of Representatives voted to speed implementation of the chiropractic care services that America's military personnel want and need." He also thanked Sen. Talent and Reps. Hunter, McHugh and Schrock for their "leadership and unwavering commitment to the well-being of America's servicepersons."
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