My UnOrthodox Life- Trainwreck or Triumph?

By now, if you are in any way connected to Jewish life, you have heard of the Netflix reality show, My Unorthodox Life. I’ve seen several polemic opinion pieces about it written by people who have not actually seen the show. Rabbi Yonason Goldson, for instance, even made the bold proclamation, “I have absolutely no intention of watching the new Netflix series My Unorthodox Life.” They have no first-hand familiarity of any of the cast members’ character traits, nor do they know the characters’ personal backgrounds.

I agree with much of the written criticism of the show, but it is dangerous when writers, and individuals in general, criticize things we haven’t seen for ourselves, and we Jews, who have to fend off baseless criticism from all directions lately, should know better.

As a military family, we have been posted all around the world, so my husband, our four sons, and I have established a strong connection with Chabad communities who have embraced us, and we straddle the worlds of very modern secular and very traditionally observant.

I first heard of the show from a Jewish Instagram account that I follow, and I immediately pulled it up on my laptop to see what the fuss was about. I generally don’t watch this genre of reality tv, so that, in and of itself, might have kept me from tuning in, but the stars of the show are Jewish, and I will watch, read, or listen to, anything Jewish, and curiosity got the best of me. I grew up in a Reform Jewish synagogue, but have become increasingly more observant in my adult life.

I watched less than a minute before judging it as a trainwreck, reality tv at its best, and worst. So bad, it’s good. So absurdly disturbing, but also intriguing and compelling in many ways. Julia Haart seems to have gone from frum to flaunting in an extremely obnoxious, over-the-top fashion.

However, if you watch the show you’ll see, while a lot of the time Haart is very critical of the community she left, she also celebrates her son who is still frum and figuring out how he wants to be and how he wants to live his life, and she remains friends with her ex-husband, who is still religiously observant. She provides kosher meals for her observant family members, and is deeply respectful to everyone in her life, whether they are modest, traditional, and deeply observant, or theatrical and modern.

When you look beyond the chutzpah and theatrics, Haart truly has a heart of gold. She loves her family deeply and extends herself to young people to help them reach their full potential personally and professionally. She’s doing really good work.

Of course the show is full of drama and criticism of Haart’s personal former community, but it also presents people (her daughter and son-in-law, and her sons) balancing an observant life with a modern life. She clearly suffered trauma in the ultra-orthodox world of her upbringing, but it’s important for people to know that her former community is only one group in a vast spectrum of the strict Hassidic and Orthodox Jewish life. She felt that world was restricting her, so she left it behind to create a new life for herself. Her accomplishments are colossal and her menschiness is busting at the seams of her couture accoutrements. I recommend that you watch the show with a careful, critical, inquisitive mind, and you will learn that there are many ways to be Jewish. I look forward to reading more about her story.

In this wild series of 9 episodes, look beyond the enormous ostentation and you’ll see that the message is clear and solidly Jewish: Love thy neighbor as thyself.

#MyUnorthodoxLife #MilitaryBlog #Jewish #Jewishblog #StlJewishLight #RabbiYonasonGoldson @yonasongoldson #lovethyneighborasthyself #jewishblog #Netflix #Brazen #brazenbyjuliahaart

@netflix @JuliaHaart
@EliteWorldGrp @batshevahaart @miriamhaart

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Alert: Food Assistance For Military Families

Greetings!

Do you have children who aren’t receiving meals at school due to virtual learning? Are you in a military family and curious about how to access food support for your children?
 
On Wednesday, April 28, our partners at the Food Research & Action Center will join us, the Military Family Advisory Network, in providing insight into the Pandemic Electronic Benefits Transfer and summer feeding programs. These programs have made adjustments to ensure that support is reaching families in need and that more families than ever are eligible to access food assistance.

Register for the event.

#military #militaryfoodinsecurity #militarfamily #militaryhunger #militaryfoodassistance #milfam #MFAN #foodhelp #militaryevent #militarygiftcard #giftcard #FoodResearch&ActionCenter #militaryblog #militaryfamilyblog #milfamblog #militaryfamilyhelp #FRAC #covid19foodinsecurity #militaryfoodpantry

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We Need You: Join The 1 Million Meals Challenge

Greetings!
No military family should ever have to worry about how they are going to afford their next meal. But that is the reality for 1 in 8 of the military families who responded to our survey before the COVID-19 pandemic. Be a part of the solution! Join CBS Evening News anchor Norah O’Donnell and MFAN President and Executive Director Shannon Razsadin during our Facebook Live on Wednesday, April 21, 1 p.m. Eastern time, to learn more about our efforts.
RSVP
With the help of our partners and supporters, like you, MFAN is kicking off our 1 Million Meals Challenge. Our goal is to distribute 1 million meals to military families in need. Throughout the year, we are hosting food distribution events in areas of the country where food insecurity among military families is high. But this is about more than meals. We’re combining this immediate support with connecting families with resources and ongoing research to inform our long-term efforts to combat food insecurity among military families. There is more work to do, and we’re excited and grateful to have your support.
DONATE TO PROVIDE MORE MEALS
The Military Family Advisory Network is the authentic voice of the modern military family and the bridge that connects military families to the resources, people, and information they depend on to successfully navigate all phases of military life. To learn more about MFAN, visit www.militaryfamilyadvisorynetwork.org.

#milfam #Militaryfamilies #militaryblog #Militaryfamilyblog #Hunger #militaryfamilyfoodinsecurity #militaryfoodinsecurity #foodinsecurity #navylife #armylife #marinecorpslife #militaryfamilylife #militaryfamilyhunger #milspouse #militaryfamilyadvisorynetwork #mfan

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Military Families in Texas Lead Nation in Food Insecurity

Military families in Texas lead nation in food insecurity in second national survey

New study reveals startling trends about military food insecurity, finances, health, and community

WASHINGTON — A new report released today by the Military Family Advisory Network (MFAN) revealed that food insecurity rates for military families stationed in Texas are among the highest of its national participants. According to the study, one in six military family respondents in Texas are experiencing low food security or hunger, and respondents indicate that they were more likely to not eat than to seek out food assistance services.

“First I would eat cat food. Then I learned to go to the food bank,” said one military spouse who responded to MFAN’s Military Family Support Programming Survey, which utilized the USDA Six-Item Short Form Food Security Scale to assess food insecurity among respondents. Another active duty spouse said, “I give more (food) to my husband because he needs the energy to go to work almost every day.”

MFAN’s State of Texas Report distills experiences from Texas respondents from MFAN’s national survey, which included 7,785 military and veteran respondents from all 50 states, 22 countries, and two U.S. territories. The largest demographic group of respondents was from Texas. The U.S. military is an integral part of the Texas economy — the economic impact of military installations in the state of Texas was $123.6 billion in 2019. With 15 military installations, and as home to Army Futures Command, Texas has a vested interest in being viewed as the best home for military service members and their families.

“No military family should have to worry about where their next meal is coming from,” said Shannon Razsadin, executive director for MFAN. “These heartbreaking accounts paint a vivid picture into the daily challenges military families in this country are facing. But we know these challenges don’t occur in a vacuum – our research also uncovered some startling connections about how food insecurity is closely linked with other aspects of family life, including family finances, mental health, and substance abuse.”

Additional key survey findings include:

  • Households with more people living in them had higher rates of food insecurity. Nearly one-fifth (17.7%) of Texas respondents with five or more in their households reported experiencing food insecurity.
  • More than three-quarters of Texas respondents (76.8%) reported that they carry debt and about one-third of active duty (32.6%) and veteran (34.6%) families in Texas reported having no emergency savings.
  • 15.3% of active duty spouses in Texas indicated they had suicidal thoughts in the past two years. This is 2.4% higher than active duty spouses in other states (12.9%).
  • 61.5% of Texas respondents believe alcohol use is a problem within the military community. 21.6% of active duty spouses responded that they were concerned about alcohol use within their immediate family.

Over the next two years, MFAN will team up with H-E-B, the University of Texas at Austin, Kendra Scott, National Military Family Association, Nexstar, USO, and more to meet immediate needs and uncover underlying causes of food insecurity among military families. MFAN is committed to working with local communities, organizations, and leaders across the state of Texas to understand the underlying causes and deploy solutions to food insecurity. In January 2021, MFAN will host an advisory council meeting with leaders across industries and throughout the state of Texas to inform this important work.

About MFAN: The Military Family Advisory Network is a nonprofit dedicated to building a community of military and veteran families at home and abroad who are well-informed about the resources designed to serve them, equipped with tools for success, connected to leaders who serve the military family community and embraced by the public. To learn more about MFAN, visit www.militaryfamilyadvisorynetwork.org.

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Camp Lejeune’s Toxic Exposure Victims can Claim VA benefits and compensation

Guest Post:

Toxic contamination has been identified as an epidemic at most of the U.S. military bases. Toxins arise as a result of military-related operations as well as natural or industrial sources. It has been observed that merely living on or in the vicinity of a military base results in exposure to harmful toxins that eventually poison the military service personnel and their families. Studies conducted among veteran populations have shown a higher incidence of certain cancers due to their heightened exposure to environmental toxins.  The Department of Veterans Affairs offers several benefits to veterans who demonstrate a link between their illness and service in the military. 

Camp Lejeune is a military community with high concentrations of environmental toxins and associated illnesses. The base was home to nearly 170,000 active duty military service members, civilian employees, retirees, and their families between the years 1953 and 1987. The residents, workers, and Naval personnel at Camp Lejeune who were exposed to contaminants are at an increased risk of developing kidney cancer, multiple myeloma, leukemia, birth defects, and other adverse health effects.

Advocacy in the support of these veterans and their families can not only decrease the hazards military communities are often exposed to but also increase the chances of recovery in case of illness or damage. 

Former military personnel and their families who served at the Camp Lejeune deserve rightful compensation

Military veterans are eligible to receive medical care and disability compensation from the United States Department of Veterans Affairs (VA) for their service-connected medical conditions. The VA has set up a presumptive military service connection for the veterans, national guard members, and reservists who served at Camp Lejeune between August 1, 1953, and December 31, 1987, and developed any of the conditions associated with toxic exposure.

Veterans who served at Camp Lejeune can receive two kinds of benefits including:

VA health care facilities

Financial compensation in the form of payments

As per the Caring for Camp Lejeune Families Act, 2012, those veterans who served at Camp Lejuene for a total period of 30 days between August 1, 1953, and December 31, 1987, are eligible to receive healthcare benefits from the VA. Veterans with any of the exposure-related conditions are treated free of cost and a co-pay option will be provided for other health problems. Veteran’s family members who resided along with them at Camp Lejeune are also eligible to receive out-of-pocket medical expenses associated with the covered health conditions.

Camp Lejeune veterans and their families can file a claim to receive disability compensation if they believe their health problems are linked to their toxic exposure years back while serving at the base. Veterans are given a disability rating depending on the severity of their condition so that they receive payments ranging from $133-$3,447 every month. They need to provide evidence of service in the form of documents such as military records showing Camp Lejeune service for at least 30 days and medical records stating any of the presumptive illnesses mentioned by the VA. These payments help to supplement income for veterans and their families who are likely to have reduced earning potential because of their injuries. Additionally, the disabled veteran can avail free health care for service-connected illness at any VA hospital or clinic throughout the country. Therefore, we can say that the benefits received through the VA are the most likely way for veterans to recover from their toxic exposure injuries.

This is a sponsored post: At Environmental Litigation Group, P.C., we provide legal assistance to toxic exposure victims and we can help veterans who were posted at Camp Lejeune receive a fair amount of compensation for the serious injuries caused by their service-related exposure. 

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United States Tax Requirements for non-Citizen Resellers on Amazon

Guest Post

By Ines Zemelman. Founder of Taxes for Expats

One of the many ways in which the world is smaller thanks to technology is the ease with which a non-US seller can sell products in the United States. Amazon.com is among the easiest of ways to do this. Like almost every business venture, there are tax consequences to consider. The impact on a seller’s taxes depends on a few things, including whether the seller is a business or an individual, and on whether there is a tax treaty agreed between the seller’s country of residence and the United States.

Initial Considerations 

There is a significant difference in United States tax impacts depending on how a non-resident alien sells their merchandise. Is the sale made:

  • via a non-United States company?
  • via a United States LLC that is registered in the merchant’s name?
  • by an individual non-resident alien (NRA)?

It is also important to determine if the seller’s country of residence has an agreed tax treaty in place between them and the United States.

We can examine the United States tax implications for each possible scenario.

The Merchant’s Country of Residence Has an Agreed Tax Treaty

For sellers living in one of the countries with an agreed tax treaty, there are three scenarios:

Non-resident alien selling as an individual

  1. Request an Individual Tax Identification Number (ITIN)
  2. Use form W8-BEN to claim treaty benefits. Although Amazon’s fees are still applicable, this form enables the exemption from tax withholding on sales proceeds. This form is submitted directly to Amazon.
  3. Amazon will send a form 1099K for the tax year if the merchant’s sales exceed 200 transactions and USD 20,000.
  4. The seller must file a form 1040NR, but the tax treaty should exempt the sales income from tax. There is a specific schedule that must be filed with the 1040NR tax return to claim this exemption. This schedule is often done incorrectly, even by professionals who aren’t familiar with the details of tax treaties. Using a specialist tax preparer like Taxes for Expats is recommended.
  5. If the threshold for issuing a 1099K was not met and it was not issued by Amazon, then form 1040NR does not need to be submitted.

Selling Through a United States LLC Registered In the Seller’s Name

  1. Request an Individual Tax Identification Number (ITIN) for the seller
  2. Request an Employer Identification Number (EIN) for their LLC
  3. Submit form W-9 on behalf of the LLC. This provides the Employer Identification Number to Amazon. They will not apply withholding.
  4. United States reporting requirements for non-resident alien owners of United States LLCs are complex. A professional like Taxes for Expats can help prepare the necessary forms.
  5. The United States LLC is classified as a “disregarded entity,” which qualifies for treaty benefits identical to those for individuals.
  6. The LLC files form 1040NR. This schedule is often done incorrectly, even by professionals who aren’t familiar with the details of tax treaties. Using a specialist tax preparer like Taxes for Expats is recommended.

Selling Through a non-United States Corporation With a Tax Treaty

  1. The corporation requests an Employer Identification Number (EIN).
  2. Use form W8-BEN-E to claim the treaty benefits. Although Amazon’s fees are still applicable, this form enables the exemption from withholding on sales proceeds. This form is submitted directly to Amazon.
  3. At the end of the tax year, submit form 1120-F to the IRS. Assuming the tax treaty allows for the exemption, no United States tax will be due. Again, many tax preparers are not familiar with these forms – so using a specialist tax preparer like Taxes for Expats is recommended.

Why a United States Tax Return With No Tax Due?

Many taxpayers will wonder why they must file a United States tax return if there is no withholding and no tax due because of the treaty exemptions.

Although there is no tax obligation and no withholding to claim a refund against, the income is still reported to the Internal Revenue Service (IRS) by Amazon. Without the filed return and the appropriate forms to claim the exemption, the IRS will not know the income is exempt and will consider it taxable. They will send the seller a bill for the tax to the address on file at Amazon.

The Merchant’s Country of Residence Does Not Have an Agreed Tax Treaty

For sellers who live in one of the countries without an agreed tax treaty, the scenarios and procedures are virtually identical to those described above. The obvious difference being that the exemptions allowed by the tax treaty will not be available. Because these exemptions do not apply, 30% tax withholding will be taken by Amazon from the merchant’s sales. But not to worry, usually a portion of this can be refunded when the seller submits their annual tax return to the IRS.

Why a United States Tax Return if Tax Was Withheld?

If tax was withheld by Amazon, why does the seller need to file a US tax return? United States tax law is complicated, and the tax owed is almost always different than the amount withheld. Fortunately, it is usually lower than the amount withheld due to deductions for selling expenses.

To summarize:

  • Amazon withholds 30% of sales, but does not adjust for expenses like their seller fees, cost of goods sold (COGS), credit card fees, etc.
  • By filing a United States tax return, the seller calculates and presents to the IRS the actual tax they owe, which is based on net income as opposed to gross income.
  • The 30% withholding rate is a drastically simplified number that ensures sufficient tax is withheld.
  • United States tax rates are incremental, beginning with 10% and increasing to 30%, which is the maximum for non-resident aliens. Submitting a United States tax return allows the excess withholding to be refunded.

Professional Tax Preparation

Tax law is complicated, especially when dealing with international treaties. Engaging the services of a professional who specializes in international tax law is almost always the right choice.

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Intimate Partner Violence Plagued Military Couples Even Before Quarantine

MFAN Survey Finds Military Families Overwhelmingly Aware of Domestic Violence in their Neighborhoods & Social Circles  

WASHINGTON — Quarantining at home through the stressors of COVID-19 has amplified issues in already problematic relationships, leading to a surge in domestic violence reporting nationwide. However, even before the pandemic, 81% of military community respondents to MFAN’s 2019 Military Family Support Programming Survey said they were aware of intimate partner violence in their neighborhoods and social circles.  

“It’s really common. We’ve had multiple cases of domestic violence just in our neighborhood this year,” said the spouse of an Air Force active duty member. 

Intimate Partner Violence (IPV) is defined by the Centers for Disease Control and Prevention (CDC) as …abuse or aggression that occurs in a close relationship. According to the CDC, intimate partner refers to both current and former spouses and dating partners and includes four types of behavior: physical violence; sexual violence; stalking; and psychological aggression. 

This is the first year MFAN’s support programming survey, presented by Cerner Government Services, has explored the issue, after recognizing a need for more information from military families. 

“For years now, we have heard anecdotes from our Advisors and others in the community about Intimate Partner Violence,” said MFAN’s Executive Director Shannon Razsadin. “We felt it was critical that we collect data on this issue, so that leaders and policy makers will be able to make decisions that honor and protect the health and safety of everyone in the community.”  

Respondents reported that intimate partner violence is overlooked and hidden in the military community. MFAN’s data also showed that those who sought assistance were more likely to: 

  • Range in rank from E4 to E6, if they were active duty family members 
  • Carry more debt 
  • Be concerned with their own or a family member’s alcohol use 
  • Rate as more lonely on the UCLA Loneliness scale 
  • Have considered suicide in the past two years 

“Reporting the abuse jeopardizes the service member’s career, therefore jeopardizing the woman and her family’s livelihood. A difficult choice to make: report abuse knowing your husband will lose his job or suffer to keep food on the table? There is no easy solution. That is awful,” said the spouse of a Navy active duty service member. 

MFAN recommends that policy makers look for ways to increase communication with military and veteran families about available online and virtual resources; encourage connections with others, especially virtually, as isolation is a tactic of abusers; and reduce barriers for military spouses to seek financial or health care benefits if they or their children are experiencing abuse.  

“I’m not by any means a violent person, but I have wanted to strike both of my wives after I came back from tours because I was so angry at the world,” a National Guard and Reserve member said. “I never did, but it was really disturbing how much I wanted to. That’s what made me start counseling.”  

More information about MFAN’s survey methods and demographics can be found here: https://militaryfamilyadvisorynetwork.org/survey-methods/  

In light of the pandemic and the upcoming National Defense Authorization Act (NDAA) mark-up, MFAN expedited the release of the survey findings. Data related to food insecurity; finances and emergency savings; loneliness and community; and mental health and telehealth have already been released.  Data on the stressors associated with military moves will be available June 17. The entire survey will be released during an online event on June 23, featuring expert panel discussions and video narratives from military family members who are personally impacted by each issue.  

Cerner Government Services, Inc., a wholly owned subsidiary of Cerner Corporation, sponsored the 2019 Survey, which provides the most rigorous, comprehensive understanding of the needs of military and veteran families in areas that are further impacted by the pandemic, such as financial readiness, mental health, food insecurity, moving and housing, utilization of telehealth options, and intimate partner violence. 

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About MFAN: The Military Family Advisory Network is the authentic voice of the modern military family and the bridge that connects military families to the resources, people and information they depend on to successfully navigate all phases of military life. To learn more about MFAN, visit www.militaryfamilyadvisorynetwork.org. 

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Military Families Struggled to Access Mental Health Care- Even Before the Pandemic

MFAN Survey Finds that Military Families are Interested in Receiving Care Through Telehealth 

WASHINGTON — In newly released data, only half of the military and veteran family members who responded to MFAN’s 2019 Military Family Support Programming Survey, presented by Cerner Government Services, said they could easily access mental health care and their biggest obstacle was not having enough appointments available.

With the COVID-19 virus impacting how behavioral health care providers can see patients and deliver services, anecdotes about military and veteran family members having even less access to providers and appointments are surfacing, especially overseas. Fortunately, more than one-third of active duty family survey respondents said they would be likely or very likely to use telehealth options if such options were available.

“This is my first time to be stationed abroad, and getting referrals to access mental health care was difficult enough and took many months and excessive red tape, even as someone in the Exceptional Family Member Program,” said Emily Gerson, a military spouse currently living in England. “But during the pandemic, I was no longer able to see my regular civilian mental health providers since they were only offering appointments via telemedicine and were told Tricare wouldn’t reimburse them. People on base didn’t have any answers other than they were aware of the issue for overseas dependents and were working on it. I had to spend weeks advocating for myself and looking for answers and solutions, which was incredibly disheartening and stressful during a global crisis — a time when people need access to mental health care more than ever.”

 Changes due to the pandemic, including the delay in military moves, forced isolation, and unemployment rates skyrocketing, are sources of added stress for military families. Telehealth offers a viable, and necessary, option for mental health treatment during this global pandemic and beyond, and MFAN’s survey responses show that military families are open to receiving care through unconventional methods.

“In light of the global pandemic and Mental Health Month, MFAN opted to expedite the release of these findings,” said MFAN’s Executive Director Shannon Razsadin. “Our survey, which was fielded before COVID-19, found that military families experienced difficulty scheduling mental health care appointments. That’s something we never want to hear,  and we are concerned about the additional barriers caused by COVID-19. We look forward to an expanded dialogue on how we can reduce red tape for military families globally so that everyone has access to the mental health support they want and need.”

More information about the survey methods and demographics can be found here: https://militaryfamilyadvisorynetwork.org/military-family-support-programmingsurvey

The entire survey will be released at an event on July 17, 2020, featuring expert panel discussions and video narratives from military family members around the country who are personally impacted by each issue.

Cerner Government Services, Inc., a wholly-owned subsidiary of Cerner Corporation, sponsored the 2019 survey data which provides the most rigorous, comprehensive understanding of the needs of military and veteran families in areas that are further impacted by the pandemic, such as financial readiness, mental health, food insecurity, moving and housing, utilization of telehealth options, and intimate partner violence.

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About MFAN: The Military Family Advisory Network is the authentic voice of the modern military family and the bridge that connects military families to the resources, people, and information they depend on to successfully navigate all phases of military life. To learn more about MFAN, visit www.militaryfamilyadvisorynetwork.org.

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Military Support Town Hall Meeting

Friday, March 27

White House Update, Featuring Special Guest:
Jenny Korn
Deputy Assistant to the President
Deputy Director for the White House Office of Public Liaison

Part 1: Early Childhood Education

Supporting Early Child Care and Education During the COVID-19 Crisis

3:00 – 4:00 PM ET

Moderator: 
Patty Barron
Director, Family Readiness
Association of the U.S. Army

Panelists:
Sabrina Huda
Project Director
Sesame Workshop

Carolyn Stevens
Director, Office of Military Family Policy
Department of Defense

Julia Yeary, ACSW, LCSW, IMH-E
Director of Military Family Projects
ZERO TO THREE

Part 2: Child Care

Moderator: 
Barbara Thompson
Former, Director Office of Military Family Readiness Policy

Panelists:
Lynette Fraga, Ph.D.
Executive Director
Child Care Aware of America

Ray Girn
Chief Executive Officer
Higher Ground Education

Carolyn Stevens
Director, Office of Military Family Policy
Department of Defense

Charlie Williams
Chief Operating Officer and Chief Programs Officer
Armed Services YMCA

Tuesday, March 31 

Supporting Defense-Impacted Businesses and the Defense Supply Chain During the COVID-19 Crisis

3:00 – 4:00 PM ET

Stay Tuned for Registration & Speaker Announcements! 

These are free events, but registration is required. Capacity is limited, however, so prompt registration is recommended. 

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Traumatic Brain Injury: A Military Crisis

Guest Post

BIAM infographic

 

Traumatic Brain Injury (TBI) represents a massive underserved personal and economic burden in the United States, with an estimated $80 billion in lifetime costs alone. According to the Centers for Disease Control and Prevention (CDC), from 2006-2014, the number of TBI-related emergency department visits, hospitalizations and deaths increased by 53% to 2.87 million, of which more than 837,000 events were among children.

TBI disproportionately affects vulnerable populations, particularly military service personnel, at an alarming rate. According toDefense and Veterans Brain Injury Center, from 2000-2019, more than 413,858 service members have been diagnosed with TBI with more than 15,000 cases of mixed severities in 2019 on its own. Recent news reports indicated more than 100 U.S. soldiers are suffering brain trauma after Iran’s missile strike on Al Asad Air Base in Western Iraq.

TBI Impact

TBI is often caused by a bump, blow or jolt to the head that disrupts normal function of the brain. According to the CDC, injuries related to blasts, objects hitting head and falls commonly occur to those in the military.

Severity of TBI can be mild and temporary, or severe and life-altering, presenting patients with many complications and comorbidities. Those affected often suffer from a cascade of life-altering health conditions, including movement and sensation, anxiety/depression, epilepsy, sleep deprivation, personality changes, alcohol or opioid abuse and memory loss. Among veterans with positive TBI screens in VA facilities, 80% indicate comorbid psychiatric diagnoses.

Healthcare System Difficult to Navigate

Upon diagnosis, individuals with TBI transition through many stages, from acute patient in the hospital, to long-term care in medical intervention and rehabilitation. Long-term care can range from weeks up to 20+ years of ongoing symptom management. During this time, individuals living with TBI require a wide array of medicine, including high use of anticonvulsants, opioids and muscle relaxants to antidepressants, antipsychotics and sleep medications.

To better address this staggering public health issue, the Department of Health and Human Services (HHS) must create a National TBI Registry to assist with prevention, surveillance, and to help develop a standardized level of care for individuals living with TBI. The current tracking system, which is decentralized and relies on states and regions to construct their own registries, is inadequate and leaves millions without resources to manage their TBI comorbidities.

Nationwide Centralized Registry Needed

A centralized comprehensive registry would collect data on individuals with TBI in the U.S. and include pertinent information like how they obtained a TBI, how they were treated, outcomes and long-term effects. This type of information would facilitate more – and better – prevention development, surveillance/tracking, and development of clinical trials for new innovative approaches to advance treatment options. It also would serve as a resource for individuals with brain injury and caregivers to better navigate the healthcare system for support. Ultimately, the goal is to find a cure, but in the meantime, there is progress to be made.

There is currently an experimental stem cell therapy in clinical trials that aims to treat paralysis, uncontrolled movements and other motor deficits that often accompany TBI. It is exactly this kind of research that should be accessible to everyone affected by motor deficits after brain injury.

I’m pleased to share that there was a Brain Injury Task Force Congressional Hearing on Capitol Hill this March, where Reps. Bill Pascrell Jr. (D-N.J.) and Don Bacon (R-Neb.) showed their support for one centralized TBI Registry. This proves the leaps and bounds we’re already making in the TBI space to improve care and ultimately save individuals with TBI from overspending on treatment options for their comorbid condition. TBIs are an epidemic amongst our service members and veterans, which deserve first-in-class care and treatment options – yet our current processes and infrastructure are falling short by a long shot when it comes to TBI knowledge and resource-sharing nationwide.

Written By: Stephanie A. Kolakowsky-Hayner, PhD, CBIST, FACRM; National TBI RegistryCoalition (or President Elect, American Congress of Rehabilitation Medicine)ISMMS headshot

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