THE EXAMINER

Volume 17, No. 3 March 2009

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Robert E. Bush Naval Hospital

“Serving with Pride and Professionalism”

You have the right toexpress your concerns

about patient safety and qual-ity of care.

There are several avenuesopen to you:

* Through the ICE web-site.

* Through the NavalHospital Customer CommentCards.

* The Hospital’s CustomerRelations Officer at 760-830-2475, or any of the CustomerRelations representatives inthe hospital’s clinics.

Or Directly to the JointCommission via:

E-mail atcomplaint@jointcomission.org

Fax:Office of Quality Monitoring630-792-5636

Mail:Office of Quality MonitoringThe Joint CommissionOak Renasissance BoulevardOakbrook Terrace, IL 60181

http://www.med.navy.mil/sites/nhtp/pages/default.aspx

An Award Winning Publication

Bush Family, Friends Visit Hospital

Friends and family recently took a tour and visited the staff of the Robert E. Bush Naval Hospital. Standingin front of the Portrait of Robert E. Bush from left to right are Patty Turner, Chuck Huhta, Barbara Hamal,Ursula Huhta, Mick and Betty Bush. Captain Don C. B. Albia, Commanding Officer, Naval HospitalTwentynine Palms is far right.

New doctor? Make the mostof your first visit

By Brian P. SmithTriWest Healthcare Alliance

During your first visitto a new doctor, thereis a good reason theysuggest you arrive at

least 15 minutes early for yourappointment.

There will be a clipboard. Andthere will be forms.

Giving your doctor informa-tion about your health allowsyou to be an active participantin your health care. You are vis-iting a health professionalbecause of their medical knowl-edge; until your appointment,your doctors and nurses mightnot know anything about you.Clear communication with yourhealth care providers can helpensure that before the appoint-ment is over, you have yourquestions answered and that youcan answer any they may havebased on the information you’veprovided.

For information about TRI-

Continued on page 7

Patient SafetyAwareness Weekwill be recognizedthe week of 8

through 14 March 2009.The week is a time to pro-vide education and raiseawareness for improvingpatient safety.

See page 3

Happy Birthday Medical Corps

Established March 3, 1871

By Martha Hunt, MAHealth Promotion and Wellness

If you are over age 50 youhave a 50 percent chance ofhaving a pre-cancerouspolyp or growth in your

colon. Besides that fact, thereare two other reasons why youmay need a colonoscopy whichis a form of colon cancer screen-ing. First of all, a colonoscopywill help test for and maybehelp prevent colorectal cancer.Secondly, when you access theage or risk appropriate annualscreening that you need, youbring funds into the NavalHospital so that we can continueto offer the same high qualitycare we now provide.Remember, there is no freelunch in life and when you donot access the annual tests need-ed for your gender and age, thennot only are you putting yourhealth at risk but Navy Medicinecan then cut our budget impact-

ing the staffing and services weoffer.

What is a colonoscopy?Colonoscopy examines theentire colon with the use of aflexible tube with a camera atone end. The test generally lastsabout 30 minutes, is safe andusually painless. There may besome discomfort, but you areusually given a sedative to helpyou to relax. Colonoscopy isusually needed only once every10 years if the test results arenormal.

Colonoscopy detects more than95 percent of early colon cancer.Colonoscopy is the only test thatcan also prevent cancer becausethe doctor can remove polyps --small growths that may developinto cancer if left alone -- beforethey turn into cancer. Othercolon cancer screening tests donot examine the colon as thor-oughly or remove polyps.

What are the risk factors forcolon cancer? Being over age 50is the leading risk factor for

colon cancer as more than 90percent of colon cancers occurafter age fifty. Also, if you haveever had anyone in your familywith colon cancer, your risk isvery high. If you have a familymember with colon cancer, yourprovider may even suggest acolonoscopy well before agefifty.

Other risks for colon cancerinclude tobacco use, obesity,being either African Americanor of Ashkenazi (EasternEuropean) Jewish ancestry.Having other colon diseasessuch as Ulcerative colitis orCrohn’s disease may alsoincrease your risk of developingcolon cancer.

There are other tests for coloncancer screening that are avail-able besides colonoscopy. Fecal

Occult Blood Test (FOBT) andFecal Immunochemical Test(FIT) Tests are tests that checkfor hidden blood in the stool.This test should be done everyyear. Sigmoidoscopy is a testsimilar to colonoscopy butbecause it examines less thanhalf of the colon (not the entirecolon as colonoscopy does), itcan miss some cancer. This testshould be done every five years.

How can you lower your riskof developing colon cancer?Stop using tobacco. Talk to yourprovider about accessing med-ications for tobacco cessation ifyou prefer to use the meds avail-able. The formal tobacco cessa-tion class is no longer mandato-ry but Health Promotions is stillavailable to help you throughthe process of becoming tobacco

free. You can call health promo-tions at 830-2814 for moreinformation. Maintain a healthyweight and exercise regularlywith at least 30 minutes of mod-erate physical activity (such as abrisk walk) at least 5 days aweek. Also, eating a diet high infruits and vegetables will helpprevent colon cancer.

If you have any of the risk fac-tors for colon cancer, ask yourregular doctor about colon can-cer screening. And remember,the more age and risk appropri-ate annual testing you takeadvantage of, the better yourhealth and the more funds aregiven to the naval hospital. Thisincreased funding then allows usto maintain or expand thestaffing and services we offer.

2 -- The Examiner -- March 2009

Published by Hi-Desert Publishing, a private firm in no way connected with the Department of Defense, the UnitedStates Marine Corps, United States Navy or Naval Hospital, Twentynine Palms under exclusive written contract withthe Marine Air Ground Task Force Training Command. The appearance of advertising in this publication, includinginserts or supplements, does not constitute endorsement by the Department of Defense, the United States MarineCorps, the United States Navy or Hi-Desert Publishing of the products or services advertised. Everything advertisedin this publication shall be made available for purchase, use, or patronage without regard to race, color, religion, sex,national origin, age, marital status, physical handicap, political affiliation, or any other non-merit factor of the pur-chaser, user or patron. If a violation or rejection of this equal opportunity policy by an advertiser is confirmed, thepublisher shall refuse to print advertising from that source until the violation is corrected. Editorial content is preparedby the Public Affairs Office, Naval Hospital, Twentynine Palms, Calif.

Commanding OfficerCaptain Don Cenon B. Albia, MSC, USN

Executive OfficerCaptain Bruce Laverty, MC, USN

Command Master ChiefHMCM (FMF) Kevin Hughes, USN

Public Affairs Officer/EditorDan Barber

Public Affairs AssistantSK1 Kimberly Blain-Sweet

Command OmbudsmanLacy Richey

Care Line 830-2716Cell Phone (760) 910-2050

The Examiner welcomes your comments and suggestions concerning the publication. Deadline for submission ofarticles is the 15th of each month for the following month’s edition. Any format is welcome, however, the preferredmethod of submission is by e-mail or by computer disk.

How to reach us...Commanding Officer Naval HospitalPublic Affairs OfficeBox 788250 MAGTFTCTwentynine Palms, CA 92278-8250Com: (760) 830-2362DSN: 230-2362FAX: (760) 830-2385E-mail: d.barber@nhtp.med.navy.milHi-Desert Publishing Company56445 Twentynine Palms HighwayYucca Valley, CA 92284Com: (760) 365-3315FAX: (760) 365-8686

Colon Cancer Screening Saves Lives...It Can Save Yours

Getting to Know Desert Critters

By Martha Hunt, MA Health PromotionsRobert E. Bush Naval Hospital

Most of the dangerous creatures of Morongo Basin havebeen tucked away hibernating for the last few months.However, as spring is quickly approaching, the desert andits creatures will be re-awakening to begin the cycle of

life again. If you have been in Twentynine Palms for a while, some of these

may not be so scary anymore. If you are new to Twentynine Palms,you think that everything that crawls, slithers, creeps or flies is goingto either kill you or leave you maimed for life. Here is a briefoverview of some of these critters, which in the end are not so scaryafter all when you learn how to avoid them.

The best form of critter prevention is to stay away from them, toeliminate all inviting, homey spots around your home such as piles oflumber and debris, and to seal all cracks and crevices that they can useto crawl into your home. A little spackle and paint does wonders as faras sealing tiny cracks and holes where the critters can enter yourhome.

Most critters, either poisonous or semi-poisonous, prefer nice dark,quiet, undisturbed places such as out buildings, wood or debris piles,closets, attics, etc. and they usually only wander out of these spaceswhen they are hungry. In fact, most critter/ human contact is purelyaccidental on both parts, resulting in the critter biting out of fear.

The two scariest spiders in this area are the Black Widow and BrownRecluse spiders. While it’s correct that there are no true BrownRecluses here in Morongo Basin, their first cousins live here, and atfirst glance can be mistaken for a true Brown Recluse. This cousin ofthe Brown Recluse also causes necrotising bites and so should also beviewed as potentially dangerous. A necrotizing bite is a bite that does-n’t heal and continues to fester and spread from the original bite spot.Brown Recluse bites can take up to two months to heal and need to bekept clean like any open wound.

Continued on page 7

By Shari LopatinTriWest Healthcare Alliance

Whether gone fortwo months ortwo years, return-ing from combat

is grueling.Service members readjusting

back into society need time torecover from the stress of a

highly charged war zone. Mostadapt well after some time;however, if problems continueand interfere with daily activi-ties, it's time to seek help from ahealthcare professional.

If these individuals don’t findhelp when they or a familymember suspect a problem, theirsymptoms may worsen, causinga spiral of reckless or self-destructive behavior, domestic

problems, career challenges andeven death.

TRICARE offers behavioralhealth benefits for eligible bene-ficiaries who need it.Beneficiaries enrolled in TRI-CARE Prime may receive thefirst eight behavioral healthcareoutpatient visits per fiscal year(Oct. 1 - Sept. 30) from a TRI-CARE network provider with-out prior authorization from

their regional contractor. Active duty service members

(ADSMs) should always seekcare first at a military treatmentfacility (MTF), when available.ADSMs must have a referralfrom their primary care manager(PCM) and have prior authori-zation from their regional con-tractor before seeking behav-ioral healthcare services outsidethe MTF. ADSMs enrolled inTRICARE Prime Remote maycall TriWest to help obtainauthorization for civilian behav-ioral health care.

TriWest Healthcare Allianceoffers a number of additionalresources for service membersand families throughoutTRICARE's west region whoare coping with depression,PTSD or other post-combatstruggles:

* “Help From Home” VideoSeries: Available at no cost viastreaming video or as a 2-DVDset on www.triwest.com, thisseries offers advice from behav-ioral health experts who are alsocombat veterans and militaryfamilies that have coped witheffects of PTSD. Find it atwww.triwest.com> beneficiaryservices>behavioralhealth>Help From Home.

* Behavioral Health Portal atwww.triwest.com: Find articlesand links to additional resourceson a variety of topics spanningfrom children’s behavioralissues to dealing with depres-sion or suicide. Find it at

www.triwest.com>beneficiary>behavioral health

* TriWest Crisis Line (1-888-284-3743): Accredited by theAmerican Association ofSuicidology and staffed withspecially trained clinicians, thissupport line is available 24hours a day, seven days a weekfor anyone struggling withdepression, PTSD or thoughts ofsuicide, including family mem-bers concerned about thesesigns in a loved one.

* Suicide Prevention ActionNetwork (SPAN) USABrochure: What You Need toKnow about Warning Signs andGetting Help: Information aboutthe signs of depression or otherconcerns that may lead to sui-cide. Find it atwww.triwest.com>beneficiary>handbooks and brochures/

Here are a few additionalplaces to find help, separatefrom TriWest:

* The National ResourceDirectory: Links to resourcesfor recovering service members,veterans, their families and care-givers at www.nationalre-sourcedirectory.org.

* National Suicide PreventionLifeline: 1-800-273-TALK(273-8255).

*This is not a detailed list ofbenefits. For more comprehen-sive information about behav-ioral health support or benefits,visit www.triwest.com or call 1-888-TRIWEST (874-9378).

The Examiner -- March 2009 -- 3

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Dealing with Post-Combat Issues

Mental health resources for service members and families

Patient Safety Awareness Important to Naval Hospital

Patient Safety Awareness Week will be recognized the week of 8 through 14 March 2009.The week is a time to provide education and raise awareness for improving patient safe-ty. This year the theme is “A prescription for patient safety -- one partnership, oneteam.” Educational activities are centered on educating patients on how to become

involved in their own health care, as well as working with hospitals to build partnerships withtheir patient community.

Throughout Naval Hospital Twentynine Palms and the Branch Clinics you will find informa-tion about the Ask Me Program offered through Tricare. The program introduces five steps tosafer health care. The program encourages patients to use five steps to help make health caresafer. The five steps are:

1. Speak up if you have questions or concerns.2. Keep a list of ALL the medicines you take.3. Make sure you get the results of any test procedure.4. Talk with your doctor and health care team about your options if you need hospital care.5. Make sure you understand what will happen if you need surgery.

Information regarding each step is included in brochures located throughout the hospital andBranch Clinics. Take a moment to read this information prior to speaking with your physician.Be prepared to ask any questions you may have. The Ask Me Program also encourages patientsto create a checklist to remember concerns or questions that may be asked. Use these five stepsand the checklist to become actively involved in your health care. Communication has beenidentified as having a very important role in healthcare. The communication process mustinclude the patient and family as well as staff members. The more patients become involved intheir health care, the safer that health care will be.

During Patient Safety Awareness Week, information will be posted throughout the hospital toraise awareness of patient safety. Everyone plays a large role in patient safety. Just as everystaff member of Naval Hospital Twentynine Palms plays an important part in patient safety, youas the patient play an important role as well. We encourage you to help us provide you thesafest care possible. We welcome your questions and comments.

Life’s Lesson...One advantage of getting old -- Things you buy nowwon’t wear out.

4 -- The Examiner -- March 2009

Super Stars...

HM2 Seth Bryan, Education and Training receives a special thanksfor his participation in the Health Information Forum held at theCombat Center.

HM2 Billy Busby, Physical Therapy, receives a special thanks forhis participation in the Health Information Forum held at theCombat Center.

HM2 Robert Hartley receives a special thanks for his participationin the Health Information Forum held at the Combat Center.

HM2 Jose Mata, Health Care Operations, receives a special thanksfor his participation in the Health Information Forum held at theCombat Center..

CS2 Christopher Lowery, Food Services, receives a special thanksfor his participation in the Health Information Forum held at theCombat Center.

HM3 Erika Abarca, receives aLetter of Appreciation from theCO of the USNS Mercy.

HM2 Fernando Bobadilla,Mental Health, receives hisfourth Good Conduct Award.

CS2 (AW) Kaydine Erskine,Food Services, receives herthird Navy and Marine CorpsAchievement Medal.

YN3 Brandon Dobbs, Manpower, receives a special thanks for hisparticipation in the Health Information Forum held at the CombatCenter.

The Examiner -- March 2009 -- 5

HM3 Phillip Miller, Education and Training, receives a specialthanks for his participation in the Health Information Forum heldat the Combat Center.

HM3 Jason Mitchell, Security Department, receives a special thanksfor his participation in the Health Information Forum held at theCombat Center.

HM2 Raymundo Romero, Education and Training, receives a spe-cial thanks for his participation in the Health Information Forumheld at the Combat Center.

HM2 Maria Morales, Pharmacy receives a special thanks for herparticipation in the Health Information Forum held at the CombatCenter.

HM3 William Roots, Main Operating Room, receives a specialthanks for his participation in the Health Information Forum heldat the Combat Center.

HM2 Clifford Salviejo, Human Resources, receives a special thanksfor his participation in the Health Information Forum held at theCombat Center.

HN Marcella Lillis, MainOperating Room, receives aLetter of Appreciation from theCO of the USNS Mercy.

CS3 Giam Magpayo, FoodServices, receives a Letter ofAppreciation from the CO ofthe USS Boxer.

HN Meghan Moore, receivesher first Good Conduct Medal.

By Tyler PattersonTriWest Healthcare Alliance

Has your Primary CareManager (PCM)decided to refer youfor specialty health

care? TriWest HealthcareAlliance, the West Region TRI-CARE administrator, offers apowerful, easy-to-use onlinetool to help you schedule yourspecialty appointment morequickly than ever before:QuickAlert.

QuickAlert, TriWest’s auto-mated authorization and referralstatus notification system, e-mails you a notice that yourrequest has been processed andprovides a link for you to viewthe result online. This meansthat instead of waiting for noti-fication by mail, you may pro-ceed with scheduling your spe-cialty care appointment (ifapproved) within one day of

your request being processed.To use QuickAlert to set your

appointment faster:1. Obtain a referral request.

Your PCM will send this toTriWest.

2. Register onwww.triwest.com, or just log inif you’re already registered.Registered users are automati-cally enrolled in QuickAlert.

3. Set your QuickAlert prefer-ences. Once logged in to yoursecure www.triwest.comaccount, you can change yourpreferences to have QuickAlertssent to the e-mail address ofyour choice.

4. Schedule your appointmentonce you receive a QuickAlerte-mail notice that your referralis approved. Use the recom-mended provider, or select aprovider of your choice fromthe online provider directory atwww.triwest.com.

5. Notify TriWest at 1-866-876-2383 of your appointment.

Have your appointment date,tracking number and Sponsor’sSSN ready, and remember tonotify TriWest again if youreschedule your appointment.TriWest will then help to ensurethat your consultation and testresults are returned to yourPCM in a timely manner.

Without QuickAlert, once yourdoctor issues a referral you willreceive an authorization letter inapproximately seven days. Atthat time you can schedule yourappointment.

QuickAlert is free to use anddoes not disclose any personalinformation; it simply lets youknow the status of your requestis available for viewing online.Once you log on, you'll be ableto see whether your request forauthorization or referral hasbeen approved. For your con-venience, your e-mail notifica-tion will contain a direct link tothe login page.

Whether enrolled inQuickAlert or not, you will con-tinue to receive written notifica-tion by standard mail. Asalways, you are welcome tocontact TriWest at 1-888-TRI-WEST (874-9378) with anyquestions about your authoriza-tion or referral status.

Whether you are in school or not, Spring Break is a fun time to look forwardto for all! So what’s the plan for this year? There are so many things tochoose from... the beach, the slopes, out of town/country vacation, orrelaxing at home. Whatever it is you decide to do, be prepared.

1. Plan to get stuck in traffic - Pack the vehicle with snacks, water, phone charger forthe car, games for the kids, fill up the gas, and make sure your insurance is up to dateand the registration is easy to find.

2. Plan on your activities - Here are some suggestions for some places you might go:The beach - sunscreen, water, towel, change of clothes and shoes, and a small first aidkit, and know the flag conditions for the water.

Red -- Stay out of the water, strong undertow and riptidesYellow -- Use Caution, some undertow and riptides possibleBlue -- Calm water, swim safely

3. The slopes - sunscreen, water, insurance card, over the counter pain reliever.4. Out of country - Passport, translation dictionary, a list of important laws to read oon

the ride there, conservative clothing (no flashy jewelry), insurance requirements.Of course, these are merely four out of an infinite number of activities for Spring

Break. The best way to have fun is to be well prepared. Remember to use caution whendrinking alcohol, and always have a plan before your night starts. Know where you planto go, who is in your group, who is driving home or if you’re taking a cab, and the nameof your hotel.

Groups are safer than going solo, and if a situation doesn’t seem right, it probably isn’t.So, whether you are in a different city, state, or country, it’s better to err on the side ofcaution. Remember to check your surroundings before using the ATM, and don’t walkaround with a ton of cash.

Other safety suggestions can be found in droves online. Do the right thing and prepare,review and plan your activities and you’re sure to have a fun, safe and memorableSpring Break 2009!

Enjoy!

6 -- The Examiner -- March 2009

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Ombudsman Corner

Oh Yeah! Spring Break!

TRICARE UpdateSpecialty Care Authorization and Referral Process

Life’s Lesson...

Secret about growing old...forget the health food, Ineed all the preservatives Ican get!

The Examiner -- March 2009 -- 7

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CARE coverage, referrals and authorizations or for an online providerlocator, visit TriWest Healthcare Alliance’s Beneficiary Services sec-tion at www.triwest.com. Health care for active duty service memberswill be coordinated through a primary care manager (PCM), who willalso manage required referrals and authorizations.

Whether you are seeing a health professional for a specific issue oras a preventive check-up or exam, you will have to answer somequestions about your health and your lifestyle. This information willhelp your doctors and nurses plan your care, so it is important thatyou are complete and honest. When it comes time to fill out and signthose forms, your provider or the office staff should be able to answerany questions you might have.

Your personal information: In order to file claims correctly, and fortheir own records, providers will need your contact and personalinformation, including your Social Security Number, and will alsoneed information about your TRICARE sponsor.

Your health history: Save time in the doctor’s office by writing outyour health history before your appointment. Be sure to include:

o Current medical concernso Allergieso Hospitalizationso Immunizationso Medications (prescription and non-prescription)o Exercise and physical activityo Tobacco and alcohol useo Family health historyPrivacy and protected health information: By law, health care

providers must protect your personal health information and mustmake you aware of your privacy rights. You may also be asked toallow the provider to share your information with other providersinvolved with your health care.

Statement of patient responsibility: Civilian providers who acceptTRICARE may ask you to acknowledge that you will be financiallyresponsible for any charges not covered by TRICARE. This will notauthorize the provider to charge you any additional amount beyondwhat is allowable under your TRICARE coverage. A list of copaysand cost-shares for TRICARE-covered services can be found atwww.tricare.mil/tricarecost.

Claims submissions: If you use a provider outside of the TRICAREnetwork, you may be required to submit your own TRICARE claim.Refer to the Beneficiary Services section of www.triwest.com formore information. Simply choose ‘Claim Info’ on the left-side menu.

Maintain TRICARE eligibility: Keeping your personal informationup to date in the Defense Enrollment Eligibility Reporting System(DEERS) will help ensure that you keep your TRICARE eligibilityand that your claims will be processed smoothly and quickly. DEERSis a database of uniformed services members, their family members,and others who are eligible for military benefits, including TRICARE.Find more information on updating DEERS at www.tricare.mil/deers.

New doctor...Continued from page 1

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Spider and scorpion bites are rarely fatal, andwhen handled properly, can be easily treated aswell. Black Widow bites and scorpion stings feellike a pin-prick and progresses in pain andswelling until the whole area is red, warm, andswollen. The pain may spread to other parts of thebody and symptoms may also include nausea,sweating, convulsions and, in rare cases, death.

The only people seriously at risk from BlackWidow bites and scorpion stings are the veryyoung or old and those individuals with compro-mised immune systems. If you are bitten or stung,call your health care provider or poison controlnumber immediately and seek help.

A bite from a Brown Recluse may go unnoticedfor several hours before turning red, swelling andbeginning to blister. On rare occasions, a severebite from a Brown Recluse can cause the skin tonot just blister up, but to leave an open sore.Healing may take a month or longer and may leavea scar where the sore was. As with the BlackWidow bites, Brown Recluse bites should bepromptly treated to prevent further health risks.

Regarding snakes, don’t tease snakes! They bite

to defend themselves and the snake usually endsup paying for your teasing with its life. It has beenestimated that as many as half of all snakebites areprovoked by humans purposely scaring the snakes.Of those bites that are not provoked by people,most are below the knee and half are dry (meaningthat no venom was injected).

A good rule to follow in Morongo Basin is -- “ifit rattles, it’s poisonous.” Snakes who do not haverattles in Morongo Basin are either non-poisonousor semi-poisonous (they’ll just make you ill if bit-ten, not kill you).

If any snake bites you or someone you are with,seek medical help immediately! Keep the victimcalm, do not ice the wound and do not try to suckthe venom from it. Snakebites are rarely fatal, butall snake bite victims need medical assistance! Ifyou or someone around you is bitten, call 911immediately!

Remember that the best way to avoid the danger-ous creatures of Morongo Basin is to steer clear ofthem. Clean up the debris in your yard and get ridof those comfy hiding places that they live in. Sealall openings to your home and watch where youwalk in your yard or when hiking. These creatureswill try their best to avoid you and they are hopingyou do the same as well.

Desert Critters...

Continued from page 2

Hospital Lab Does Not Accept Outside Provider Requests

Since September of last year, the Naval Hospital Laboratory Department discontinuedthe acceptance of outside provider requests for all laboratory procedures.

This decision was based on a concern for patient safety and privacy.When your outside healthcare provider orders laboratory services for you, and you have

concerns about the laboratory selected, you can contract the TRICARE Service Centerhere in the hospital to ensure they are in the TriWest network. There are several satellitefacilities in the area that support local network providers and accept TRICARE patients.Or you can contact TriWest by calling 1-888-874-9378.

8 -- The Examiner -- March 2009

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CS2 Enrico Roque, FoodServices, receives Flag Letterof Commendation fromCommander Navy MedicineWest.

Lt. Willam Roulaine,Emergency MedicineDepartment receives a GoldStar in Lieu of a third Navyand Marine CorpsCommendation Medal.

FC2 Sarah Sweet, Security Department, receives a special thanksfor her participation in the recent Health Care Forum held at theCombat Center.

Lt. Kirsten Vesey, Audiologist, receives a special thanks for her par-ticipation in the recent Health Care Forum held at the CombatCenter.

Lt. Darcy Wright, Customer Relations Officer, receives a specialthanks for his participation in the recent Health Care Forum held atthe Combat Center.

CS3 Allan Villanueva, FoodServices, receives a Flag Letterof Commendation fromCommander Navy MedicineWest.

TheresaWeseman,left, receivesa Five YearFederalLength ofServiceAward. Audrey

Waters, right,receives aFive Year

FederalLength of

ServiceAward.