By Tiffany Shedd

I have been writing a fair bit about health care and health care reform lately on this blog.  It’s important that we know what’s going on with our benefits and how those changes will affect the care out loved ones receive.

As of April 1, Tricare is implementing new reimbursement rates for applied behavioral analysis services (ABA). These changes will affect more than 10,500 families, and 16,000 additional families who are eligible to receive these services. According to Tricare, the ABA coverage and benefits are not changing, but the rates that providers receive are being adjusted and will be evaluated and adjusted on a yearly basis.

This rate cut is up to 15 percent of reimbursement to your providers.

For those of us unfamiliar with ABA services and those providing this service, here’s a very brief overview of what it involves and what is involved in being qualified to render these services.

Currently there are no "official" standards for certifying or licensing applied behavior analysts nationwide. Some states, however, have certification or registration procedures for behavior analysts (e.g., Florida, California), and the field has identified the following formal training and competencies required of professionals in behavior analysis.

It is by and large an unregulated profession. That being said, there are providers who do amazing work with patients and have brought about a lot of progress that is invaluable to them and their families. Some of these providers have helped vastly change the lives of those who use this therapy, whether it’s helping a non-verbal dependent better express their needs and wants to their caregivers or help with behavioral and sensory issues, like being able to get a haircut without having a total meltdown.

While these milestones may sound like small things, they are big steps forward for families with autism. So, it is essential to give families access to quality providers.

What does a 15 percent rate cut look like to providers? Before April 1, providers were being reimbursed on a sliding scale based on their level of education and degrees. A provider with a PhD or master’s degree was being reimbursed at a rate of $125, while those with bachelor’s degrees or technicians with a high school diploma were being reimbursed $75 and $50 respectively.

A 15 percent rate decrease would mean PhDs earn $114, holders of master’s degrees $107, $67 for a bachelor’s degree provider, and only $40 for a technician with a high school diploma.

What does this mean for you if you use these services? You could see a decrease in providers willing to accept Tricare as a method of payment. You could also see more out of pocket spending in order to stay with providers you already see. If you already have trouble finding quality providers in your area, this is not going to help you. The quality of available providers may drop as well.

As I said before, this new rate decrease is going into effect. We can’t do anything about it right now. It will be re-evaluated over the next year, so that means your experiences under this new system will be very valuable in demonstrating how this decrease hurts or helps Tricare patients.

Keep records and notes about how this rate change affects you and your family. Write to your representatives. Congress was actually opposed to this particular change, so your representatives need to know and be reminded that you are out there and being affected by this.

Don’t just complain about it on Facebook to your friends or spouse group. Go to Tricare’s Facebook page and let them know what you think. Be specific. Tell them if your child is no longer making the improvements they made with a previous provider who no longer accepts Tricare.

Let them know if the only providers in your area aren’t as qualified as you would like. And as always, stay up to date on any changes that Tricare is making to programs and benefits. For those of us in the EFMP program, small changes can mean big changes in our lives.

Do you ever think, you don’t really want a job, you just want to make the world a better place?

There’s an app for that. Actually, an organization that is busy connecting good ideas with the people and organizations that can make them happen.

The Idealist is an organization that is doing good, all over the world. And they want you to help.

The outfit started out as a nonprofit career center of sorts that helped people find ways to work and volunteer in the social sector. Now, they help people volunteer, work and find internships not only helping others, but doing good for animals, plants, the environment, loving everyone, everywhere. The staff group photo on their website looks like they have a heck of a fun time doing it too.

Are you changing careers? Moving toward work in nonprofit or with social justice issues? This should be your first stop.

Looking for a worthy organization to volunteer with? They have thousands of listings around the world, and include not just organizations but events you can help with or attend.

You can even learn more about your fellow do-gooders through the people profile pages at Idealist and link up and share ideas.

Idealist has postings from more than 100,000 organizations and 1.4 million monthly visitors to their site. With that large of an audience, Idealist is certain you can find a place where your best ideas can be put to good use.

Check out Idealist at www.idealist.org

By Amy Neilsen

I recently interviewed with an organization I respect, and does what I want to do with the population of people I want to help.

I have personal experience receiving benefits and services from this organization when we first retired from the Navy. At that point, we had two young children, a full-time student dad, and I was a full-time stay-at-home mom. This organization works with families receiving federal and state benefits to have better access to additional resources offered by other local organizations. They are not only a source for monetary benefits but also a clearing house for health and wellbeing resources.

It was my first interview in more than ten years. The interview went well. There are three candidates and they have two slots to fill.

I also learned that this office hires interns from the master’s program I eventually want to attend  and that they have a student starting next week. Note to self: See if I can meet the student and find out how they like the program.

I learned that interviewing at age 45 is very different, and very similar, to interviewing at 25. On the drive home I was still kicking myself for talking too much about what I can get out of this partnership, and not enough about what they are looking for and how I can fill that for them.

What I also discovered was the ability to step back from berating myself to say, look at what information I did get out of this meeting and how I can use it to further my path.

Regardless of whether I get this job, I met two really interesting women who are good resources for me to know. One of the women has such a glowing passion for the women she employs and the women she assists in their most vulnerable times it veritably seeps through her pores. Seeing her passion was almost overwhelming. Her spark is tangible. I want to have her focus.

I also met a woman who started her career path at exactly the same place and age in life that I am today. We are both starting later in life, with more life experience, and more than a little fear of 'can I get this done with enough time to still make an impact on the lives of those I want to touch'. She is doing what I want to eventually do, more or less. At more or less my age.

That was a huge nugget from today. That this, this school, this career number four or five, this new me; nay I say this culmination of my paths into one, is possible. And, look there is a living breathing example of someone who has done it!

These are all more stepping stones in the path I am making for myself. The more information I can gather, the more paths I can find to follow, the more options I make for myself to find exactly how to disseminate the information I want to get out.

By Christine Cioppa

Nearly half of active duty service members regularly chug four or five drinks at a time, qualifying as “binge drinkers.”

More specifically, women qualify as binge drinkers if they down four or more drinks and men if they down five or more drinks in a two hour period. The latest statistics available, published by the National Institute on Drug Abuse, show that 20 to 27 percent of military personnel binge weekly. The problem is, many are drinking to relieve stress without realizing drinking can increase stress further.

Rajita Sinha, PhD and director of the Yale Stress Center at Yale University School of Medicine, Rajita Sinha, says binge drinking stimulates the stress hormone.

“The more you drink, the more stress hormone is released in the body,” she said.

So, alcohol may initially calm a drinker when one to two drinks is the norm. But, when that person drinks more and more, heading into binge-drink territory, the alcohol erodes a person’s ability to cope. The high levels of alcohol cause stress, which leads to drinking again to relieve stress. Which causes more stress. It becomes a vicious cycle.

“You may start off drinking for stress after a hard day’s work. You might increase your drinking level from two to four or three to four. If that starts to happen more frequently, and you don’t realize it, you start getting into a rut and a pattern. Really what is happening, the body actually needs more to feel the effects, and stress plays a role in that,” Sinha says.

This then can negatively affect the family. Binge drinkers may be prone to “emotional re-activity” and be more irritable, restless, and have a shorter temper. Bingers may also steer away from people with healthier coping strategies, and stick with the guzzlers, becoming the coping culture.

To get the body primed for better coping, some drinkers can cut down to light drinking. Some may need to quit if that’s too hard. Sinha has found that spouses can help by offering support once that person recognizes alcohol’s role in increasing stress.

“Spouses or partners can be very helpful in keeping people on track. Reminding them,” she said, especially when their spouse wants just one more drink.  

“The heavier one’s pattern is, the harder it is to go down to a lighter pattern,” Sinha said. And for those who quit, the struggle of being sober and building a life without alcohol can be challenging, she says. Spouses can help there, too.

“At the end of the day, alcohol is a pharmacologic substance. It goes everywhere in every cell. We don’t think about it that way because it is socially acceptable; it's legal. It is something that makes us feel good. People do it commonly,” Sinha says. "The good news is that there are lots of ways to take back control over alcohol."

For tips on reducing alcohol consumption, head over to Recovery.org and the National Institute on Alcohol Abuse and Alcoholism for more information.

Looking for summer employment? You should be hitting the pavement, now.

Summer internships and more competitive positions that are career boosters, rather than simple hourly wage fillers, tend to have earlier deadlines and stricter applicant requirements. If you are switching careers or currently in school earning your degree, you should begin looking for these resume building experiences long before the summer sun starts to sweat.

Aboutcareers.com also suggests putting your networking skills to work to land a summer position, especially if you are looking for resume building work rather than a permanent position. Businesses may need help to fill in during staff vacation time or extra help during the busy summer months. Network with friends and neighbors to be the first to apply for positions that may not even be advertised yet.

If you just need a job for the summer, expect to have a lot of competition, and not just from teenagers.

In states like New Mexico where recent layoffs left thousands of people without jobs the need for work is overwhelming. USA Today reported that 10,000 applicants applied for 290 jobs at a newly-opened Cheesecake Factory restaurant.

If you live near summer vacation destinations, your job search should be slightly easier. Theme parks, restaurants, mini-golf courses and retailers near beaches and tourist attractions have already hung the "now hiring" sign out front.

Industry analysts suggest that adult applicants may face competition from teens looking for summer work, but that hiring managers are continuing a trend of hiring the adults versus the teens.

Renée Ward, founder of job-focused website Teens4Hire.org. told USA Today that given the choice of hiring a youth or an adult, most employers "will go with the more mature person, because they feel there is less that they have to do to train them," she says.

Also, fewer teens are also looking for summer jobs.

Slate.com reports that from the 1950s through the 1990s, between 45 and 60 percent of teenagers had summer jobs. Today, just one in four American teens have held a summer job.

Experts suggest that teens are leaving the marketplace in search of volunteer work, unpaid internships and academic studies that will boost their college resume rather than their work experience.

Many of us have asked ourselves that question for years. Do we (I say “we” meaning the active-duty member and the spouse, since it is a joint decision) leave at 20 years? Stay in for 25? Retire after three years at the highest rank?

Or just forget about retirement altogether and leave the military after five years, or 10?

Leaving the military, especially for retirement, is like having a baby. There’s never going to be a perfect time to do it. For most people, the question of when to leave the military revolves around two issues: money, and what to do with the next phase of life.

The reality is, there’s probably never going to be enough money or the perfect job offer.

My husband came very close to getting out of the military in 2002, when he had 12 years of service. He didn’t really know what he wanted to do in the real world, so he stayed.

In 2006, when he had 16 years in, we bought a house in Florida and decided we would stay put until he hit 20 and then retire there.

Nine years and four PCS moves later, he finally dropped the paperwork.

My husband and I are the same age and I’ve been married to him since he joined the Army 25 years ago.

That is more than half our lives.  I’ll say that again: We have spent more than half our lives in the military world.

At first we stayed because he loved his job and the people he worked with. He still does, but as time went on so did the toll on his body, both our psyches and our family. Still, there was nothing enticing enough outside the military to make us leave.

Now, he’ll retire in August of this year after 26 years. There still isn’t necessarily anything especially enticing outside the military, but there’s not much challenge left for him here on the inside, either.

My husband’s boss asked him why we wanted to retire.

The reply: “Because it’s time.”

His boss told him that was all he needed to hear.

How will you know when it’s time to retire?

Don’t worry. You’ll know. Because, it’ll be time.

So, we’ve talked about my deep-seated hatred of group projects, right? And if we have, I’m sure I’ve also mentioned that 75 percent of my classes this semester include group work.

Sigh.

One of those classes revolves around database management. Now, those are words that I understand individually. Hell, I even understand what they mean as a combination.

I do not, however, understand how to manage a database, let alone create one from scratch. Our group project for that class is to pitch our group’s database solution to a company that, for some reason I don’t understand, is currently database solution-less.

Anyway, when it came time to pick our part of the assignment, I chose to be the QA editor and create the marketing scheme and draft the legal statements and disclaimers. At first, I felt like I might have taken on too much. Then, one of the other team members uploaded the first document to be edited. For your reading pleasure, here is a sample of his submission:

            “Synthetic full backup is bit different than the other three backup methods. This method

            utilizes full backup files and differential (or incremental) backup files to create a new full

            backup file while in an offline mode. The advantage is this enables a single file restore

            when system restoration is required.”

Dude. Seriously? This guy explains system backup more easily than I can explain how to put on shoes.

This semester is going to make my GPA drop so hard it should be a bass line for Skrillex.

Employers are gearing up to hire military spouses at these job fairs, are you ready to give them your best?

Every month the U.S. Chamber of Commerce Foundation hosts military spouse only job fairs around the nation. The employers who attend know the great assets that military spouses can bring to their companies and they are there to hire.

Remember, dress for success, bring plenty of copies of your resume and don’t forget to register! These job fairs have a limit on the number of participants allowed and they fill up fast! Click on the link to register.

Good luck!

April 13

Washington D.C.

https://www.uschamberfoundation.org/event/dc-hiring-expo-washington-wizards-0

April 14

Patrick AFB, Fla.

https://www.uschamberfoundation.org/event/patrick-air-force-base-military-spouse-event

April 16

Orlando

https://www.uschamberfoundation.org/event/orlando-hiring-fair-0

April 21

New York City

https://www.uschamberfoundation.org/event/new-york-city-hiring-fair-0

April 25

Arlington, Texas

https://www.uschamberfoundation.org/event/arlington-hiring-expo-texas-rangers-0

May 3

Pittsburgh, PA

https://www.uschamberfoundation.org/event/pittsburgh-hiring-expo-pittsburgh-pirates

For a full list of military spouse job fairs through 2016, please visit: https://www.uschamberfoundation.org/events/hiringfairs?page=1

By Amy Nielsen

I want to help families stretch their benefits and dollars and improve their health. I want to teach people to return to simple, ancient techniques and use whole fresh foods to produce maximum nutrient digestion. I want to write a book that will teach families why these foods are important, and how to use them every single day.

And this is the short list of what I hope to achieve as I set upon building my non-traditional career.

Every step of my life as a military wife, as a child who traveled the globe with her family and as the mother of a medically complicated child has sent me down this path. Now, I want to teach others.

And, I am going to create a non-traditional career, in a non-traditional way. I need this journey to fit within my current lifestyle where my family comes at equal value. I want to be able to maximize our family time while still supporting my business and my passions.

Education doesn’t have to follow a standard path. However, we must be certified by someone to practice what we choose to preach. And I am creating a practice from the ground up.

My hope is that I will come out of this at the end with a master’s degree in nutrition and a license as a registered dietitian and nutritionist. In order to teach the people I want to teach, I will need to have not only a master’s degree, but I will also need to pass a state licensing exam.

In order to do that, I will need to focus on not only my non-traditional studies, but also work towards my traditional degree and license. I expect my journey to take between three and five years, depending on how things play out.

Luckily, I have already built a solid foundation of life experience.

First, I come from a long line of excellent home cooks who taught me well. And, I am a first generation American. The time I spent traveling as a child opened my eyes to smells, tastes and sights that most people will never experience. I spent as much time in Europe as in the U.S. between the ages 5 and 18. I have visited urban and rural China and India. I have eaten in the roadside stands of Mongolia and at the Four Seasons Hotel in Paris, at Mackie’s on the North Shore of Hawaii and at The Barking Crab in Boston. I can cook and always have been able too. I can taste too. 

I first tried to follow my passion as I headed to college. I considered hotel management but decided instead to follow my other passion, lighting design. Don’t get me wrong, I loved my career as a lighting designer, I had some great experiences and it is still my preferred art form. But I also wanted to do something with food. 

I wish then some of our family and friends had told me that it could be a super classy and high end career to be a micro hotelier or personal concierge, but alas, people kept their mouths shut, even while staying at these kinds of places and using these services regularly!

Note number one: speak up if you think you have a rabbit hole career that you might like to try out! If you have family and friends who are in the business, talk to them! Ask them to intern with them, bug them for a job, offer to carry their suitcases. But be prepared to risk and just do it. If you take one thing away from this whole process it is that you have to stick your neck out.

Seven years after I began working in lighting design the company I worked for folded. I had to decide what I really wanted to do with my life, again.  

I took the summer off, got divorced, and went camping. I applied to and was accepted to a small culinary school with local connections. I learned very quickly that I was overqualified for the classes in technique and that I should have chosen a bigger school with better connections to the wider culinary world.

Granted, there were many world class chefs that were local connections who taught guest classes, but the drive of the school was to produce upper end sous chefs for the white tablecloth industry in the greater Boston metro area.

I did land a job doing kitchen stuff, as the assistant director of dining services at a multi-campus K-12 private school in Cambridge, Mass. It was sort of what I wanted to be doing. But not really. I loved being in the kitchen every day. But it wasn’t the sort of food thing I really wanted to do. 
 

Then I met a Sailor. Thanks, Universe.

And, I moved to Virginia. Then, life in the Navy with two children, three deployments, seven moves, retirement, two more moves and a new career for my husband happened.

And again, seven years later; what is it with seven years? I am finally starting back down this path again. This time older and wiser and more focused on the ways of the world. I think I had to live through this much life and see enough to be able to be ready to take the steps with the stick-to-it-ness I will need to come out the other side of this with the career I want to have.
 

Of course, I am also at the point in my life that if the universe tosses me another curve ball or a shinier baubble, I might just follow that too.

Now, I don’t want you to think that I spent my time as a Navy wife sitting on my dependapottomous. I met a bunch of really amazing spouses who opened my eyes to a whole bunch of life choices I wasn’t even aware were out there. I started learning more about herbology. I started changing how our family eats. I started reading the good, bad, and ugly, of all holistic health guru works. I started picking out who I had an affinity to and whose words rang true to me.

I didn’t know it then, but I was setting the seeds for this endeavor. 

By Christine Cioppa

Pregnant woman, and those trying to conceive, beware: you don’t have to be in a country where the birth-defect-causing Zika virus is found to be at risk for the virus. It can be passed along sexually by men who get infected from a mosquito bite while out of the country

And with PCS season and multiple, overseas, joint exercises coming in the next few months, there are a lot of military families that will be traveling to Zika infected areas.

What’s alarming is that the Zika virus may or may not produce symptoms. Only 20 percent of people who are infected feel sick (rash, fever, joint pain, red eye).

Currently, it’s not known if all pregnant women who are infected will pass it to the fetus. There are a lot of unknowns about the virus right now. For example, it’s known that the virus lasts about a week in the blood (and sometimes longer), but experts are not sure how long it lasts in semen.

The Centers for Disease Control and Prevention (CDC) currently has Zika Virus travel notices for the following areas:

Cape Verde

Caribbean

Central America

Mexico

Pacific Islands

South America

There is no vaccine or drug treatment yet for this virus. According to a memo this month from the Department of Defense Health Affairs, “Local mosquito vector transmission of Zika virus has not been documented in the continental United States, but Zika virus infections have been reported in travelers returning to the United States.”

If you’re pregnant, the CDC recommends that you: avoid travel to areas with the Zika virus, try to prevent mosquito bites (protective clothing, repellents, etc.) and try to prevent possible virus transmission from sex with an infected male. Got questions or concerns? Reach out to your healthcare provider. 

http://wwwnc.cdc.gov/travel/page/zika-information

http://www.cdc.gov/zika/transmission/index.html

http://www.cdc.gov/zika/pregnancy/protect-yourself.html#one

http://www.health.mil/Military-Health-Topics/Health-Readiness/Zika-Virus

http://www.cdc.gov/zika/prevention/index.html

http://www.cdc.gov/zika/transmission/sexual-transmission.html

http://www.cdc.gov/zika/symptoms/

http://www.med.navy.mil/sites/nmcphc/Documents/program-and-policy-support/Navy-Zika-InfoSheet.pdf