"My husband is at home, and home is where he will stay, until I don't have a job and anything else to sell." How to say 'I love you' Dr. Karen Williams, a specialist in physical medication and rehabilitation, tells this story about Andy's progress during the past two years. "The first time I saw him do something purposeful was right before we took him home. Terry told me Andy could lift his thumb. I didn't believe it. She told him, 'Come on, Andy, pick up your thumb for Dr. Williams.' We waited and waited, but nothing happened. 'Come on, Andy,' she kept saying, but he didn't move. I started to feel bad for her, and I was just about to say, 'Let's not push him, Terry,' when suddenly, up went the thumb." The anecdote illustrates how difficult it can be to assess the progress of people who have suffered injury to the brain, Williams said. "Has there been significant progress? By my standards, yes. People make baby steps after this type of injury - not leaps and bounds. "We have evidence he is aware of some things, but it's inconsistent. How much he is comprehending, we don't know," Williams said. Behind his passive face, Williams said, Andy could be crying out. "That's something we may never know. My heart goes out to Terry... but if it wasn't for her, her husband would be in a nursing home somewhere, or maybe dead from an infection." "When he came home he couldn't say anything at all," Terry said. "But in the last two weeks he's said a lot of things. He said 'banana, vanilla and rum.' We figure he wants a banana daiquiri.' That's a long way from saying "I love you," Terry said, but that doesn't mean he can't send the message. Three blinks means "I love you," she said, "and sometimes he even puckers up for a kiss." Terry's determination has caught the attention of several members of Congress, among Petersburg and Florida Sens. Bob Graham and Connie Mack. A flurry of letters have been written, but to no avail. Young has petitioned the Department of Health and Human Services for a review of the Cox case but has not received a response. He also has asked the Department of Defense to determine how many veterans find themselves in a similar plight, and to calculate what it would cost to keep them on CHAMPUS coverage. The agency has not responded. CHAMPUS and Medicare once provided comparable coverage, but no longer, according to a Washington-based group that lobbies for military families. "A number of military families are in for a shock" when medical coverage shifts from CHAMPUS to Medicare at age 65, said Sydney Hickey, associate director of the National Military Family Association. "It's not uniquely a military problem," she said. "Medicare benefits in general are not as good as CHAMPUS benefits, or the nefits included in any plan oftered by most any employer." The shock is especially sharp for many military families, Hickey said, "because we're taught from the beginning that we'll be taken care of. It's more than just the dollars. It's a feeling of abandonment. Friends of the Cox_family haven't abandoned them. They've established a trust fund for donations at the Citizens and Southern National Bank of Florida. But to Terry Cox, the issue seems simple. Andy earned the health care, got it and was benefiting from it. Then it was taken away. Wallace, the family physician, agrees. "It's sad. You start to see improvement, then the rug is pulled because of some bureaucratic nonsense. He should never have been pulled off CHAMPUS. She's not asking for anything more than what he needs. So why can't there be an exception? "Terry and her mother have made tremendous sacrifices. I wonder how many other people are out there, like Andy, without THE WASHINGTON POST THE FEDERAL PAGE WEDNESDAY, JUNE 26, 1991 A17 Veterans Battle an Obscure Medical-Care Gap Pentagon's Huge Health Insurance Program Is Said to Contain a Government Catch-22' The first bill arrived a week before Christmas and told Terry Cox that she and her quadriplegic husband, an Army veteran, owed the federal government $144,000. The second bill arrived in January. It asked for another $4,500. Cox, a travel agent in St. Petersburg, Fla., was stunned. When she married Andy Cox four years earlier, he assured her: "You'll never have to worry about me. I'm retired military. They'll take care of me." But with her husband permanently disabled by a fall and requiring round-the-clock nursing, the Pentagon's $3.2 billion insurance program covering military families and retirees to age 65 was demanding payment. Cox, 54, who had spent 22 years on active duty before he left the Army in 1977, was the victim of a little-known gap in the Pentagon's giant Civilian Health and Medical Program of the Uniformed Services, the insurance plan known to its 9.2 million beneficiaries by the acronym CHAMPUS. Because his disability qualified him for Medicare coverage, the Defense Department declared he was no longer eligible for the broader protection offered under CHAMPUS. And, because he was under age 65, Cox did not qualify for any of the commercial "medigap" policies that could have helped make up the difference. "A government Catch-22," was the way Terry Cox described her plight. "I couldn't believe it and I panicked." Her initial protests had little impact. But after months of arguing, and declaring herself bankrupt in the process, Cox may be on the verge of closing a loophole that the Pentagon says affects 37,300 disabled CHAMPUS beneficiaries. Rep. C.W. Bill Young (R-Fla.), a member of the Appropriations Committee, recently added $20 million to care for disabled service personnel to a defense appropriatious bill that passed the House. Sen. Daniel K. Inouye (D-Hawaii) has sponsored even more sweeping relief legislation in the Senate. Both appropriation and authorizing legislation are needed before the issue can be resolved, but Cox and her By JAMES MARTINEZ ST. PETERSBURG Armed "I would never have thought that President Bush signed the mea- "I'm happy, but I'll never get back It began in 1987 when her hus- 'My husband served his country for 22 years and was always promised his country would take care of him. I was going to see to it they The Coxes soon learned of a lit-kept that promise." treatment were high but his mili- tle-known provision in the 1972 law That loophole says that if totally Cox, 54, who remains almost "You get to keep your health they kept that promise." Cox's fight took on even greater She fired off letters to President Edith Smith of Springfield, Va., Every week, Smith made visits to "I must have visited about 200 "It was an educating process for More than 130 cosponsors even- "Terry Cox not only raised the But Cox is still not satisfied, even Her next goal is to work for legis- "I've still got my list of congress- I am writing as a follow-up to your previous correspondence to Mr. Bruce Nitsche, National Director of Voluntary Services, as well as our previous conversation regarding H.R. 467, a bill to allow certain military retirees to retain their CHAMPUS eligibility in certain circumstances. I am enclosing a copy of the Disabled American Veterans (DAV) Resolution No. 353, "Supporting Retention of CHAMPUS Eligibility for Certain Severely Disabled Veterans When Becoming Eligible for Medicare Coverage" which was adopted by the delegates to our most recently concluded National Convention in New Orleans, Louisiana. This resolution is now a part of the DAV's legislative program and, when appropriate, will be actively supported by the DAV in our dealings with members of Congress. I am hopeful that this responds to your concern and that action will be forthcoming to remedy the situation you and many others find yourself in. DWG: PY Sincerely, on @. Gonna DAVID W. GORMAN Assistant National Legislative Director for Medical Affairs RESOLUTION NO. 353 SUPPORTING RETENTION OF CHAMPUS ELIGIBILITY FOR WHEREAS, military retirees are eligible for medical benefits under the Department of Defense (DoD) Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); and WHEREAS, many military retirees are unable to utilize military treatment facilities for their health care needs due to chronic underfunding of the military health care system as well as recent base closings; and WHEREAS, many military retirees must therefore rely on CHAMPUS to provide needed medical benefits; and WHEREAS, CHAMPUS benefits automatically terminate and eligibility to Medicare occurs when an individual attains age 65, or if prior to age 65, meets the disability requirements for benefits under Title XVIII of Social Security; and WHEREAS, many life sustaining and enhancing medical services, such as home health care benefits, provided by CHAMPUS, are often not provided by Medicare thereby creating a void for the provision of critically needed services; NOW THEREFORE, BE IT RESOLVED that the Disabled American Veterans in National Convention assembled in New Orleans, Louisiana, July 28-August 1, 1991, seeks the enactment of legislation to provide that certain catastrophically disabled military retirees are able to retain CHAMPUS benefits and that CHAMPUS would serve as secondary carrier to provide for those health care services not covered by |