June 2005

The Chiropractic Coalition Legislative Day

compiled from reports by the WCA and ICA

Doctors attending the Chiropractic Coalition Legislative Day heard from a number of high profile legislators, including Sen. Orrin Hatch and Edward Kennedy. Yet, it was Lt. Col. Bernard Lambe, assistant to Adm. Richard A. Mayo, deputy director of TRICARE Management Activity who generated the most interest, even though he wasn't well known or instantly recognized.

His discussion of the history and status of chiropractic in the US military was definitely a highlight of the event, particularly since two members of the Chiropractic Coalition serve on the Chiropractic Advisory Committee of the Department of Defense (DoD): World Chiropractic Alliance President Terry A. Rondberg, DC, and International Chiropractors Association Board Member Michael S. McLean, DC.

The committee is "...charged with reviewing and evaluating implementation of the Chiropractic Health Care benefit and providing the Secretary of Defense and Congress with recommendations concerning the future of the benefit."

Lt. Col. Lamb gave a detailed history of the role of chiropractic in DoD health programs, noting that in 1994, Congress authorized a DoD demonstration project at 10 sites, for chiropractic services to active duty military members. The demonstration was eventually expanded to 13 sites.

The National Defense Authorization Act, for Fiscal Year 2001, authorized DoD to implement a permanent Chiropractic Health Care benefit for active duty members at designated Military Treatment Facilities (MTFs). Legislation included a Chiropractic Oversight Advisory Committee (OAC) to assist with determining the appropriate methodology for implementing the benefit. The OAC determined that the appropriate ratio of Doctors of Chiropractic to active duty members at a location would be based upon the number of chiropractic visits by active duty members during the demonstration project and the particular mission of the installation, such as jumping out of airplanes, driving a tank, desk job, etc.

Over the past four years, the Army, Navy and Air Force have established 42 chiropractic sites. In 2004, this translated to nearly 200,000 (actually 196,141) visits provided by 59 chiropractors. The benefit is authorized for active duty members at designated MTFs. Active duty members may also access the benefit by referral from their primary care manager to one of the designated sites. Expanding the Chiropractic Health Care benefit to cover military family members and military retirees would require a statutory change.

Lambe also spoke about the DoD's efforts to educate service personnel about the availability of chiropractic benefits, stating that, "feedback from the Services indicates that the benefit has been aggressively marketed at the designated MTFs, but there is an opportunity to do more. As a result, the DoD is initiating a marketing/communications plan that will focus on education and benefit awareness. Target audiences will include active duty members and military providers. This will be discussed in more detail in the newly formed Chiropractic Health Benefits Advisory Committee."

"We are very excited about the prospects for the new Chiropractic Health Benefits Advisory Committee and look forward to a positive dialogue," said Dr. McLean. "I am personally mindful that permanence for chiropractic in the military is best secured through commissioning of DCs. ICA remains firmly committed to military commissions for doctors of chiropractic in all branches of the US Armed Forces, and sees this new committee as an opportunity to push for this status," he stressed.

Dr. Rondberg added that he hopes to be able to avoid one of the major faults of the Veterans Affairs chiropractic program. "The failure of the chiropractors on the VA Committee to rally in support of direct access was a low point in our history. There shouldn't be a single DC willing to let chiropractic be made subservient to the medical profession. I know that Dr. McLean and I will fight hard against any gatekeeper recommendation, and for specific inclusion of subluxation correction as an integral part of the services provided by doctors of chiropractic in the DoD system."