NASA Scientific and Technical Aerospace Reports

their family members, retired military personnel and their family members, and surviving family members of deceased
military personnel. Eligible beneficiaries access health care services through the TRICARE program. Mental health care, as
well as other forms of health care under TRICARE, is delivered through the direct care system, which consists of
military-owned treatment facilities (clinics and hospitals), and the purchased-care system, which consists of coverage for care
rendered in the civilian sector. TRICARE provides coverage for most medically necessary mental health care services,
including those delivered in inpatient, outpatient, and partial hospitalization settings by qualified providers. In response to the
National Defense Authorization Act (NDAA) for Fiscal Year 2001, the Department of Defense implemented a 1-year
demonstration project designed to expand access to mental health services by easing TRICARE restrictions on services
provided by licensed or certified mental health counselors (LMHCs). Currently, LMHCs must meet several eligibility and
administrative requirements to serve as authorized TRICARE providers, including documentation of referral and supervision
from a physician. Under the demonstration project, LMHCs who met the TRICARE eligibility requirements were allowed to
provide services to covered beneficiaries without referral by physicians or adherence to supervisory requirements. In the
NDAA, Congress requested an evaluation of the demonstration’s impact on utilization, costs, and patient outcomes. This
report describes the evaluation efforts by the RAND Corporation and presents findings based on several sources of data. The
report is organized according to specific responses to the evaluation’s objectives outlined in the FY01 NDAA and is intended
to be included in the sponsor’s final report to Congress.
DTIC
Cost Analysis; Mental Health; Policies
20060001887 RAND Corp., Santa Monica, CA USA
Placing a Value on the Health Care Benefit for Active-Duty Personnel
Hosek, James; Mattock, Michael; Schoenbaum, Michael; Eiseman, Elizabeth; Jan. 1, 2005; 64 pp.; In English; Original
contains color illustrations
Contract(s)/Grant(s): DASW01-01-C-0004
Report No.(s): AD-A440447; No Copyright; Avail.: Defense Technical Information Center (DTIC)
The availability of health care for active-duty military personnel and their families is a fundamental component of the
services’ commitment to support their personnel. However, military health care benefits are not routinely counted as an
element of military compensation in reports given to individual members, nor in comparisons of military versus civilian
compensation. This may be because military health care benefits are provided in such a way that it is difficult to account for
the value accruing to individuals. For many military families, health care is received in-kind, that is, the family pays no health
insurance premium and pays nothing for the care and prescriptions received at military treatment facilities. However, unlike
some other benefits that are received in-kind, such as housing, there is no corresponding allowance for members who ‘opt out’
of the system; indeed, individual military members are not allowed to opt out of the military health care system. In addition,
members are selected to enter the military based on their health, and, as it is for other young adults, the demand for health
care is considerably less than it is for the elderly. Thus, younger members may not fully appreciate the value of their health
care coverage. Despite these factors, the authors argue that the military health care system represents a substantial benefit to
military members and families, largely freeing them from concern about receiving health care when the need arises. The
purpose of this research is to consider how a reasonable monetary value might be attached to the military health care benefit
from the perspective of the active-duty service member and his or her family. Including the value of the health care benefit
as an element of military compensation would make military/civilian pay and benefit comparisons more comprehensive and
accurate, and bring greater visibility to the value of the health care benefits to members.
DTIC
Economic Analysis; Economics; Health; Medical Services; Military Personnel; Personnel
20060001900 Uniformed Services Univ. of the Health Sciences, Bethesda, MD USA
Sex Differences and the Effects of Stress on Subsequent Opioid Consumption in Adult Rats Following Adolescent
Nicotine Exposure: A Psychopharmacologic Examination of the Gateway Hypothesis
Klein, Laura C.; Jan. 1, 1997; 174 pp.; In English
Report No.(s): AD-A440503; No Copyright; Avail.: CASI: A08, Hardcopy
The present experiment examined effects of nicotine administration during adolescence on subsequent opioid
consumption in male and female rats. Forty-one day old rats received saline (n =40), 6 mg nicotine/kg/day (n =40), or 12 mg
nicotine/kg/day (n =40) by osmotic mini%pump for 24 hours/day for 19 days. After a 7-day cessation period, consumption
of fentanyl-HCl solution was evaluated for 4 weeks. Throughout the opioid consumption phase, rats received either 20 minutes
of immobilization stress (a = 60) or no-stress (a =60) prior to opioid availability. Body weight, food, and water consumption
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