FSJ: MED’s Focus on Clearances and Restricting Access to SNEA #NotSupportForFamilies

We’ve blogged previously about the problems encountered by Foreign Service families with the State Department’s Bureau of Medical Services (see StateDept’s MED Services Drive Employees with Special Needs #FSKids Nuts; Also @StateDept’s Blackhole of Pain Inside the Bureau of Medical Services (MED). The latest issue of the Foreign Service Journal features a piece by James Brush who previously worked as a child psychologist at the State Department.

Via FSJ: James Brush, Ph.D., is a child and adolescent psychologist in private practice in Washington, D.C. He worked at the State Department as a child psychologist with the Child and Family Program division of MED Mental Health from January 2013 through March 2016. Prior to his work at State, he had a private practice in Cincinnati, Ohio, for 26 years. A past president of the Ohio Psychological Association, he continues to be involved as a committee chair. 

Below is an excerpt from The Demise of MED’s Child and Family Program (FSJ)

The Child and Family Program within the Bureau of Medical Services’ Mental Health program was constituted in 2013, when the full team was finally in place after years of planning. I was brought onto the team as one of two child psychologists. By March, we had on board a child psychiatrist director, two child psychologists and three clinical social workers who had experience in treating and managing the needs of children and adolescents.

I was on the ground floor of this program, and our mission was both exciting and challenging. This was the first extensive effort within the State Department to support the specific mental health and developmental needs of children, adolescents and their families living abroad.
[…]
By 2015, three of the psychiatrists who were opposed to the CFP functioning as a comprehensive support program ended up having leadership roles in MED. Dr. Stephen Young took over as the director of mental health. Dr. Kathy Gallardo took over as deputy director of mental health, and Dr. Aleen Grabow was brought in as a child psychiatric consultant. Together, they worked toward limiting the scope of the CFP, limiting the SNEA program and reducing the opportunities for families with disabled children through more restrictive use of child mental health clearances.

Within a year of their tenure in leadership, we lost our child psychiatrist director, the two child psychologists and one clinical social worker. I and the other providers left because Drs. Young and Gallardo changed the mission and scope of the CFP. It became an unpleasant place in which to work, with the emphasis being on clearances and restricting access to SNEA. Support for families was no longer the focus. Rather, support services were being cut and the clearance process was being used to restrict the opportunities of those with disabled children.

The program is now a skeleton of what it was previously, with only one social worker, one child psychologist and one retired Foreign Service psychiatrist. Telemedicine is forbidden. The program now basically performs an administrative function, processing clearances and SNEA requests.

Read the entire piece here.

We understand that State/OIG is aware of some allegations related to the special needs education allowance (SNEA) and is doing “exploratory work”. Well, Dr. Brush’s account should be instructive.  This is not one of the employees battling the bureaucracy on behalf of their children, this is one of the people who used to work at MED.

While we might be tempted to think that the troubling response could be some form of retaliation for blowing this issue up in the media, it is hard to imagine that MED’s policy and focus on restricting access to SNEA and the medical clearance do not have the full blessings of the State Department leadership all the way to the 7th Floor. After all, if State really wanted to resolve these cases, it would have worked with these FS families to accommodate their needs, avoid forcing people into taking loans to pay/repay for special ed needs expenses, and it would have afforded families an appeals process (IT. DOESN’T).

And they certainly would not/not have threatened people who pursue this issue, right? RIGHT?

Perhaps, this is what they mean when they talk about the new Department of Swagger? Take it or leave?

(Thought bubble: How long before the proponents of this policy get promotions, Superior Honor Awards or Presidential Rank Awards?)

While the State Department has lifted the hiring freeze, and the A-100 classes are no longer on a hit and miss schedule, it is not clear to us what the new secretary of state’s position on the previously planned 8% shrinkage of the agency workforce. If that was a WH imperative as opposed to Tillerson’s, it would be hard to imagine Secretary Pompeo going against it.

The CRS report on the Department of State, Foreign Operations and Related Programs: FY2019 Budget and Appropriations dated April 18, 2018 and updated on August 9, 2018 notes the following:

The Department of State released guidance in May 2018 lifting the hiring freeze and allowing the department to increase staffing to December 31, 2017, levels. Subsequent press reports indicate that the department intends to hire 454 new employees beyond end of year 2017 levels but also suggest that hiring must be circumscribed by previous commitments former Secretary of State Rex Tillerson made to reduce its workforce by 8%.

So this brings us to the “take it or leave” scenario for FS employees with special needs children. Since these kids are given limited medical clearances with no appeals (which precludes most if not all overseas assignments), Foreign Service families will be forced to serve either in domestic assignments in order to stay together; serve separately with employees going overseas, while their families stay in the United States, or employees may opt to pay everything out of pocket and not ask for SNEA to avoid getting snared in MED’s clutches.

Begs the questions: 1) How many career employees would stay on when their employer talk the talk about supporting FS families but know it’s just a gum chewing exercise? And 2)  Is this what a slow walk to 8% looks like??

By the way, if there’s an alternate reasonable explanation for all this that does not require our relocation to the parallel universe, Earth, Too, send us an email, we’d love a good chat.

 

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@StateDept’s Blackhole of Pain Inside the Bureau of Medical Services (MED)

Posted: 12:46 am  PT

 

We previously blogged about the ongoing problems encountered by Foreign Service families with special needs children when dealing with the State Department’s Bureau of Medical Services (MED) (see @StateDept’s Mental Health Services Drive Employees with Special Needs #FSKids Nuts).  Note that as employees prepare for the summer job rotation, MED will be reviewing the medical clearances of employees and family members in preparation for their transfer.  Whatever is the number that is now stuck in MED’s labyrinth, expect that number to go up with the upcoming rotations as kids with special needs are snared in the system that is supposed to help but instead has caused so much disruption and pain.

We understand that medical clearance decisions can be appealed to a panel of three doctors. But we’ve been informed that one of the three in this review panel is the reviewing officer of the the other two. We’d like to know how many cases that come before this review panel are decided in complete agreement by all panel members, and how many cases are decided by the two panel members against the decision of the third panel member/rating official? Perhaps something for the congressional oversight panels to look into? Or something to FOIA if this is going the class action route.

Congress should also look into State’s Medical Services perspective on risk. Would it surprise us all if State/MED doesn’t want to take any? State/MED’s mission is “to safeguard and promote the health and well-being of America’s diplomatic community.”  Does that mean keep everyone with the slightest issue inside the United States instead of sending them on overseas assignments? Bad things can happen just the same in the United States – but of course, MED won’t be responsible when employees are on domestic assignments. It is responsible once employees/family members are overseas. So again, what is State/MED’s perspective on risk, and how much does this inform its decision on the medical clearances issued to FS employees, spouses and their kids?

FP’s Robbie Gramer recently had a lengthy piece on FS families in State’s medical labyrinth. It is quite a read, and don’t miss the quotes.

@StateDept’s Mental Health Services Drive Employees with Special Needs #FSKids Nuts

Posted: 12:26 pm ET

 

The Department of Defense Education Activity (DoDEA) operates 168 schools in 8 districts located in 11 foreign countries, seven states, Guam, and Puerto Rico. All schools within DoDEA are fully accredited by U.S. accreditation agencies. Approximately 8,700 educators serve more than 73,000 DoDEA students. This is what it says on special education:

Special education is specially designed instruction, support, and services provided to students with an identified disability requiring an individually designed instructional program to meet their unique learning needs. The purpose of special education is to enable students to successfully develop to their fullest potential by providing a free appropriate public education in compliance with the Individuals with Disabilities Education Act (IDEA) as implemented by DoD Instruction 1342.12, “Provision of Early Intervention and Special Education Services to Eligible DoD Dependents.”

In DoDEA, special education and related services are available to eligible students, ages 3 through 21 years of age. To be eligible for special education: the child must have an identified disability; the disability must adversely (negatively) affect the child’s educational performance; and the child must require a specially designed instructional program. DoDEA recognizes clearly defined categories of disabilities with specific criteria for determining eligibility such as physical, communication, emotional and learning impairment, and development delay.

The State Department does not have its own schools so Foreign Service children go to local schools and avail of local school services. Is the State Department required to meet the requirements of the Individuals with Disabilities Education Improvement Act (IDEIA) with regard to the education of special needs children overseas? Here is what state.gov says:

No. The Individuals with Disabilities Education Act (IDEA) and its 2004 reauthorization, the Individuals with Disabilities Education Improvement Act (IDEIA), are federal funding laws ensuring a free and appropriate education to children with disabilities in the United States. IDEA/IDEIA governs how states and public agencies provide early intervention, special education and related services to eligible children and youth. While existing law does not require DOS to replicate what a public school would provide to a student in the United States, our goal is to approximate what a child would receive in a good US public school system. Per the Overseas Differentials and Allowances Act and the Department of State Standard Regulations (DSSR), the IDEA/IDEIA framework is the basis for the allowable reimbursable services for the Special Needs Education Allowance (SNEA). DOS is committed to assisting employees in meeting the necessary expenses incurred when deployed overseas in providing adequate education for their school-age children. The education allowances are designed to assist parents in defraying those costs necessary to obtain educational services which are ordinarily provided free of charge by public schools in the United States.

Prior to 2013, we understand that the State department took a flexible, supportive approach that ensures support for dependents while creating maximum flexibility for Foreign Service employees to serve overseas. In October 2013, SNEA management was switched to the then newly created Child and Family Programs (CFP).

The Department’s Standardized Regulations or DSSR was also amended to state that “There must be a formal Individual Education Plan (IEP) or equivalent prepared by a professional medical or educational expert which delineates the educational services required to provide for the child’s special needs.  Reimbursement may only be for those services provided for in the IEP which are actually required, as opposed to those services which a parent or school may recommend as desirable.”

Between 2013 and early 2017, we were informed that “SNEA benefits are reined back dramatically.”  Previously authorized uses were  either denied or dramatically restricted.  One parent told us, “No explanations or justifications are provided for the change in policy despite many requests.  At the same time, parents are increasingly challenged by CFP staff, often rudely, about the way in which they plan to educate their children overseas.”  A direct suggestion that the parent curtail his/her assignment was not unheard of.

That suggestion may become more real for parents of approximately 1400 special needs children in the Foreign Service. We understand that in spring 2017, the Office of Allowances formally ruled that 1) based on DSSR language the only dependents who can receive SNEA are those specifically given a MED clearance that allows them to reside full time at post; and 2) No other clearance is sufficient (such as a Class 6 that allows for a child to reside at post outside of the school year in a boarding school situation).

What was the result of this official determination? Apparently, MED started “aggressively” issuing Class 5 clearances to children with educational, mental health and other disabilities even though there are many/many overseas posts where services have been and could be provided to successfully support such children.  It was reported to us that when challenged, MED doesn’t back down, claiming that their decisions are in the best interests of the child since “everyone knows” that only the “mildest” of special needs can be met in an overseas school situation.

Class 5 medical clearance means  domestic only assignment and it is supposedly issued “to those with complex medical conditions.”

For the FS employees with approximately 1400 special needs kids, a Class 5 medical clearance for a family members potentially means 1) DC/domestic assignments for the foreseeable future only; 2) an overseas assignment that leaves the family at home on a voluntary separation, or 3) back to back to back unaccompanied assignment to priority posts while the family stays behind in the United States on a voluntary separation.  We understand that not all these kids are given Class 5 clearance now but as their clearance gets reviewed, families anticipate that the numbers will continue to grow.

“It appears that any child deemed to have “moderate to severe” needs is being given a Class 5 at the time a MED clearance review is triggered.”

When we inquire about potential issues with the SNEA funds, our source speaking on background told us that SNEA has “always been under the administration of MED, and SNEA spending could only be reimbursed after approval by MED authorities.”  We were told that previously, in some cases SNEA was allowed to be used “for therapies that some would argue were either non-traditional or perhaps not fully established as effective” so the source said it is understandable to see the need to standardize the application of SNEA when the Child and Family Programs (CFP) was created and took over management of SNEA. But the source also said “it doesn’t explain the inflexibility CFP staff have employed since” when dealing with families with special needs FS kids.

Who’s doing this and why? Families are pointing at the MED/MHS (Mental Health Services), which oversees the Child and Family Programs (CFP) in the State Department’s MED org chart.  That office is headed by Dr. Kathy Gallardo, the former Deputy Director and now Director in MED/MHS. She reports to Dr. Charles Rosenfarb who is currently the Medical Director of the Bureau of Medical Services. Dr. Rosenfarb reports to the Under Secretary of Management, an office that sits currently vacant and is overseen by the “M Coordinator” and Acting DGHR Bill Todd, who in turn reports to somebody inside Secretary Tillerson’s 7th Floor bubble.

As to why? Well, no one seems exactly sure why. The State Department does not talk to this blog anymore for juvenile reasons but we cannot overlook the elephant in the room. The State Department is looking to cut cost across the board. We expect that it will be looking at everything and inside every cupboard to come up with its desired 37% cuts.  How many families will endure the separation with employees deploying overseas, and families staying behind because their special needs children are not authorized to be overseas?  Last year, Bloomberg  reported that Secretary Tillerson was seeking a 9% cut in State Department staffing with majority of the job cuts, about 1,700, through attrition, while the remaining 600 will be done via buyouts.

So in the case of the special needs FS kids, the State Department is potentially hitting two birds with one big rock? Anyone at State/MED wants to chat, we’re happy to talk and update this post.

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Microwaving U.S. Embassy Moscow: Oral History From FSOs James Schumaker and William A. Brown

Posted: 12:40 am  ET
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We recently blogged about the attacks on American diplomats in Havana (see U.S. Diplomats in Cuba Sonic Attacks: As Serious as Mild TBI/Central Nervous System Damage? 16 USG Employees in “Sonic Attack” and More on The Secret History of Diplomats and Invisible Weapons 

Via the Association for Diplomatic Studies and Training (ADST) Oral History:

U.S. relations with Moscow through the decades have been problematic at best while the embassy itself has been the subject of spy scandals, eavesdropping and other Cold War intrigue. One of the strangest episodes was revealed in the 1970s, when the U.S. confirmed that the USSR had been beaming microwaves at the embassy for the past 15 years. One concern was that the Soviets were trying to inflict physical harm on the Americans working there.

Moscow, US Embassy and Chalyapin house

Old U.S. Embassy Moscow — By NVO (Own work by the original uploader) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], via Wikimedia Commons

Microwaving Embassy Moscow brought back a flood of memories to James Schumaker, who served most of his career in the USSR and later Russia and Ukraine. In this account, he describes how U.S. Ambassador to the USSR Walter Stoessel threatened to resign, the widespread concern many Americans posted at the embassy had regarding potential health problems, especially when two ambassadors died of cancer, and his own experience with Chronic Lymphocytic Leukemia.

James Schumaker:  The existence of the microwave problem had been kept under wraps for years, first because no one knew that there might be health consequences, and later, according to unconfirmed reports, because Henry Kissinger wanted to avoid damaging chances for détente.  When Ambassador Stoessel (seen at left) learned about the problem, he threatened to resign unless the Embassy community was told.  As a result, the microwave story was finally made public in a press conference called by the Ambassador.

In the wake of Ambassador Stoessel’s announcement, many in the Embassy community felt betrayed about being kept in the dark for so long, and still more were anxious about the effect the microwaves might be having.  Some thought that the microwaves were used by the Soviets to activate the numerous listening devices they had emplaced in the building prior to American occupancy.

Others believed that they were a jamming signal designed to foil our own electronic snooping devices (a highly classified report that came out in the 1970s leaned to this interpretation, and this is what the Soviets told us as well).  Still others thought that the Soviets, who apparently knew a lot more about microwaves than we did, were using them to affect the mental states of Embassy employees.
[…]
For the most part, I was blissfully unconcerned about the microwave controversy.  At the time, it seemed to me that it was an issue taken more seriously by Embassy spouses, who were afraid for their children, than by the Embassy leadership, which in fact was in the crosshairs of whatever the microwaves might be doing.

Periodically, I would see Soviet technicians standing side by side with American techs on the upper floors of the Chancery.  They were measuring ambient levels of microwave radiation.  Naturally, the Soviet equipment didn’t find anything, while ours did.  I thought it was funny at the time.  Screens were put up on the Chancery windows, which were said to diminish the amount of microwave emanations getting into the Embassy.  I didn’t think much about that, either.  I just continued to do my work and not think about the possible consequences.

Microwaves continued to be beamed at the Embassy throughout my tour, and, though the levels went up and down over the years, emanating first from one, and then two locations, the microwaving of the Embassy continued until at least 1988.  Over the years, thousands of Americans were exposed.

Shortly after my tour was over, I found out that my cavalier attitude toward the microwave issue was not at all justified, at least in my own personal case.  Med informed me in late 1979 that my own white cell count was much higher than normal, and advised me to continue testing.  In 1985, my white cell count got high enough for MED to recommend that I see a hematologist, so I went to a local doctor in San Clemente, Dr. Tsang P. Fong.

He did a bone marrow test (the one where they hammer a spike into the pelvic bone – very uncomfortable).  The test confirmed that I had Chronic Lymphocytic Leukemia (CLL) stage zero, but that chemotherapy was not advisable, since I had no symptoms and the cure would be worse than the disease.
[…]
I determined to fight the disease as best I could by leading a healthy lifestyle, although, paradoxically, I then volunteered for a high-risk assignment to Kabul in 1988.  Perhaps in the back of my mind I had this feeling that I could take more risks, since I didn’t have very long to live anyway — a kind of “who cares?” illogical approach that has gotten me through many crises in life.  State Medical knew about the CLL diagnosis and downgraded me to a “2” Medical clearance, but didn’t stop me from going overseas, mainly because the jobs I was volunteering for often had no takers.

Read in full James Schumaker’s account here.

William Andreas Brown discusses the widespread concern among Americans working at the embassy at the time and their anger at the State Department for its lack of transparency on the issue. Excerpted from his Oral History interview conducted by Charles Stuart Kennedy beginning in November 1998.

William Andreas Brown: I have to tell you what a shock it was in about 1972 or 1973 to wake up to the great, microwave scandal and to find that Secretary of State Henry Kissinger and his associates had kept from us the fact that for years we had been bombarded by microwave apparatuses, directed straight at the embassy in Moscow. I remember being one of a small group of officers in 1972 or 1973 when news of this development broke. We raised our voices in despair, dissent, and so forth.

We were finally ushered into a room where Larry Eagleburger, Kissinger’s Special Assistant at the time, briefed us and made some sort of presentation, assuring us that steps would be taken, and so forth. He said that medical studies were under way, and the evidence thus far was that these microwaves had not been deleterious to our health.

This was somewhat reassuring until, at the end of the meeting, Larry Eagleburger said, “Now, rip up all of your notes and give them to me. Nobody can leave with notes on this discussion.” One said to oneself: “What in the hell is going on here?”

It turned out that the Soviets had been bombarding us with microwaves, beginning in about 1964 or 1965. Why they had done this remained a mystery. How they had bombarded our embassy remained somewhat of a mystery, as well as why they had done so. Also a mystery was what was the response. We were furious. We felt betrayed by the leadership of the Department of State and by the Secretary of State himself…I’m speaking now of the microwave radiation scandal, as I would call it, of the early 1970s, which harked back to the early 1960s.

Many of us who had served in the embassy felt betrayed as people who had put so much into our efforts and who had volunteered to serve in Moscow. We probably would have volunteered anyway to serve in Moscow, even if we had known about this. However, we learned only years later that this had happened and that information on it had been kept from us. Foreign Service physical examinations routinely include a blood test.

Unbeknownst to us, the Department of State was testing our blood to see what, if anything had happened to us as a result of the microwave radiation. This was a pretty jolting realization.

Q: Before we leave that matter, was consideration ever given to our saying to the Soviets: “If you keep up this nonsense, we will close our embassy in Moscow?” 

BROWN: Or, we could say, if the Soviets kept up this nonsense, we would do exactly the same thing to the Soviet Embassy in Washington. But, oh, no, that would have been nasty, and nothing like that was done. We felt pretty strongly about this. It affected morale and assignments to positions in the embassy.

Q: What was the purpose of what has to be regarded as this campaign by Soviet authorities against the health of members of the staff of the American embassy in Moscow

BROWN: This takes you into realms that I’m really not qualified to discuss. I was aware of various theories and of measures and countermeasures that might be taken. However, the point is that microwave emissions were being beamed at us. This point came home to me particularly one day when a visiting technician from the State Department came with equipment and said, “Do you mind if I set this up in your office?”

I said, “Okay, but why here? Why in my office?” He said, “Because actually there are at least two beams being directed at the embassy. One comes in from the front of the embassy building, and one comes in from that great, white building over there, which is called the ‘White House.’  You know, where the Russian Parliament meets.”…

“One beam comes this way, and the two beams intersect right here at your desk. So I’d like to set this up.” I thought: “My God! It makes you think.” But the Soviets weren’t turning these beams off. This was a disturbing development. As I said, it affected assignments to positions in the embassy in Moscow, as well as other things.

Read in full William Andreas Brown’s interview here.

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16 USG Employees in “Sonic Attack” and More on The Secret History of Diplomats and Invisible Weapons

Posted: 3:33 am  ET
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On August 24, during the Daily Press Briefing, the State Department Spokesperson Heather Nauert confirmed that 16 USG employees were affected by the “sonic attack.”

We only now have the confirmation of the number of Americans who have been affected by this. We can confirm that at least 16 U.S. Government employees, members of our embassy community, have experienced some kind of symptoms. They have been provided medical treatment in the United States as well as in Cuba. We take this situation extremely seriously. We are trying to provide them the help, the medical care, the treatment, and the support that they need and the support that they deserve.

It is not clear at this time if this number includes family members. We are aware of at least one spouse who was reportedly affected by this attack, was medevaced with the employee-spouse, and both were reassigned elsewhere.

The spox also said that “The incidents are no longer occurring.”  A reporter asked “so if we haven’t found a device and we don’t know who did it, and we’re talking about symptoms that are not, like, “Ow,” no longer ow; we’re talking about things that have – that developed over time, how do we – how do we know that this isn’t ongoing?”

The spox gave a very unsatisfying answer as follows: “How do we know that it’s not – because we talk with our staff and we talk with the medical professionals.”

Below is a piece by Sharon Weinberger from her book, The Imagineers of War: The Untold Story of DARPA, the Pentagon Agency that Changed the World via FP:

In 1965, medical workers began showing up at the American embassy in Moscow, drawing blood from the employees inside. The American diplomats were told that doctors were looking for possible exposure to a new type of virus, something not unexpected in a country known for its frigid winters.

It was all a lie. The Moscow Viral Study, as it was called, was the cover story for the American government’s top secret investigation into the effects of microwave radiation on humans.
[…]
A State Department doctor in charge of the blood tests, Cecil Jacobson, asserted that there had been some chromosomal changes, but none of the scientific reviews of his work seemed to back his view. Jacobson achieved infamy in later years, not for the Moscow Signal, but for fraud related to his fertility work. Among other misdeeds, he was sent to prison for impregnating possibly dozens of unsuspecting patients with his own sperm, rather than that of screened anonymous donors as they were expecting.

Richard Cesaro never attained that level of personal notoriety, but he asserted, even after he retired, that the Moscow Signal remained an open question. “I look at it as still a major, serious, unsettled threat to the security of the United States,” he said, when interviewed about it nearly two decades later. “If you really make the breakthrough, you’ve got something better than any bomb ever built, because when you finally come down the line you’re talking about controlling people’s minds.”

Perhaps, but Pandora resonated for years as the secrecy surrounding the project generated public paranoia and distrust of government research on radiation safety. Project Pandora was often cited as proof that the government knew more about the health effects of electro- magnetic radiation than it was letting on. The government did finally inform embassy personnel in the 1970s about the microwave radiation, prompting, not surprisingly, a slew of lawsuits.

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U.S. Diplomats in Cuba Sonic Attacks: As Serious as Mild TBI/Central Nervous System Damage?

Posted: 2:49 am ET
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CBS News updated its reporting on the “sonic attacks” on U.S. and Canadian diplomats in Havana, Cuba. CBS News said that a U.S. doctor who evaluated American and Canadian diplomats working in Havana diagnosed them with conditions as serious as mild traumatic brain injury, and with likely damage to the central nervous system.  “The diplomats complained about symptoms ranging from hearing loss and nausea to headaches and balance disorders after the State Department said “incidents” began affecting them beginning in late 2016. A source familiar with these incidents says officials are investigating whether the diplomats were targets of a type of sonic attack directed at their homes, which were provided by the Cuban government. The source says reports of more attacks affecting U.S. embassy workers on the island continue.”  The report says that the University of Miami Health System confirmed that their physicians were “consulted” by State on its diplomats in Cuba.

Question about these affected diplomats were asked during the State Department’s Daily Press Briefing on August 23, but there were no good answers as to how many embassy employees were affected.  If the attacks were directed at their homes, how many family members were similarly affected? Are these attacks continuing to this day? What happens if these attacks result in permanent disability like hearing loss for family members who are not employed?  Most notably, when the health of employees and family members are damaged by these attacks, are they extended medical expense assistance even when they are not hospitalized?

Per 16 FAM 520, the individual employee is responsible for all medical expenses related to outpatient care, except when associated with a hospitalization as defined by the insurance company’s Explanation of Benefits (EOB), i.e., the insurance company makes the determination.  Also note the following:

  • U.S. Government agencies that participate in the Department of State Medical and Health Program serve as secondary payers (with the exception of deductibles and other limitations as noted in 16 FAM 531) for inpatient hospital and related outpatient medical expenses of employees and eligible family members who are covered by medical insurance where certain conditions are met.
  • An individual without medical insurance or whose insurer refuses to act as a primary payer is responsible for all medical expenses.
  • The same regs say that “in the event of a medical emergency, the Office of Medical Services or a Foreign Service medical provider may authorize issuance of Form DS-3067, Authorization for Medical Services for Employees and/or Dependents, to secure admission to a hospital located abroad or in the United States while on medical travel provided the employee signs a repayment agreement.   Reimbursement may be made directly or through payroll deductions from the employee’s salary.”

Via DPB | August 23, 2016:

QUESTION: Listen, how concerned is the State Department about these diplomats, who medical records show have brain damage? Are there any that are still in Cuba that have been affected by this who have asked the State Department to leave?

MS NAUERT: So some have – some we have – some we asked to leave because their condition necessitated that, and they left – wanted to – mutually agreed upon – left that country because of the situation, because of the symptoms that they were experiencing. There were others that have chosen to stay there and some of them are still there. Does that answer your question?

QUESTION: It does, but I want to ask you: Does the U.S. embassy have a current medical officer permanently based in Havana to address these incidents?

MS NAUERT: I know that we have had our U.S. Government employees go to Miami, Florida where they had – some of them had been medically evacuated in order to receive medical treatment and testing. I know —

QUESTION: But is there a medical officer at the embassy?

MS NAUERT: May I – look, could I – could I finish what I’m saying? I also know that we have brought medical professionals to our staff in Cuba to be able to treat them, to be able to test them. The best equipment is not going to necessarily be on the ground in Cuba. We are bringing people to the best medical experts on the mainland in the United States. Is there an actual medical officer? I don’t know the answer to that. I can look into that and see if I can get you an answer. Okay?
[…]
QUESTION: Well, there were some reports as well that this started in December of 2016. Two questions actually: Can you confirm whether or not these attacks are continuing to this day? And can you confirm whether or not there were any actions that were being – that the U.S. Government took – let me rephrase – did the U.S. Government not respond until February of this year?

MS NAUERT: The first reported activity took place in late December of 2016. That is correct. I’ve confirmed that here before. When these things started to come in – and I’ve talked about this before – people reported a variety of symptoms. Not everyone has experienced the same type of – the same type of symptoms. So after the initial reports came in, then we started to get some other reports. And it took some time for people to be able to determine that yes, there is a pattern taking place here; yes, there is something going on. It’s much like – I would liken it to if you have an illness and you kind of maybe – you mention it to a colleague, you mention it to a doctor, but you don’t think anything of it. The doctor hears about somebody else who has maybe a different kind of symptom. It may not all be put together at the same time and say, “Aha. This must be it.” It takes some time for that information to come in.  But since that information started coming in, we take this very seriously – safety and security of Americans, which obviously includes U.S. Government officials and employees who are there on business. It is a huge priority for us and we’re trying to get them all the care that they need. Okay?

 

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EEOC Finds @StateDept Liable Under the Rehabilitation Act in US Embassy Kabul Medical Clearance Denial

Posted: 12:21 am ET
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This is a case where an FSO previously diagnosed with rheumatoid arthritis was granted a Class 2 medical clearance for an assignment at the US Embassy in Kabul, Afghanistan.  While at post, the FSO developed pericarditis and was hospitalized in Kabul in 2013; she was subsequently medevaced to Texas. The FSO was later told by State/MED that she retained her Class 2 Medical Clearance, but it was not Kabul-approved.  In August 2013, the FSO filed an EEO complaint alleging that the State Department discriminated against her on the basis of disability. The State Department’s decision  notes that in denying her clearance, its medical officers failed to conduct a sufficient individualized assessment of the risk posed by Complainant’s medical condition and its impact on her ability to return safely to Kabul.  It held “that there was no evidence that the medical officers and Medical Review Panel took into account the duration of the risk, the nature and severity of the potential harm, and the likelihood that the harm will occur or the imminence of the potential harm, as required by the law.”  It also concluded that MED“improperly denied Complainant a Class 2 medical clearance (Kabul-approved).”  The FSO on appeal asserted that she was not provided with full relief, including reasonable attorney’s fees and costs. In response to that appeal, the State Department noted that its final decision was, get this — “erroneously issued.”

Summary of Case via EEOC:

In September 2011, Complainant was assigned to work as an Administrative Officer at the Agency’s Embassy in Kabul, Afghanistan.  Complainant had been diagnosed with ongoing rheumatoid arthritis since 1999. In conjunction with her assignment to Kabul, Complainant was reviewed by the State Department’s Office of Medical Services (State/MED) for a medical clearance.  Complainant was granted a Class 2 (Kabul-approved) medical clearance 2 and she started her duties in Kabul.  While on leave from Kabul in the United States in June 2012, Complainant saw a doctor and was prescribed a new medication for her arthritis called Leflunomide. At the time, Complainant did not report that she was taking this new medication to Agency medical officials.

In April 2013, Complainant developed pericarditis which led to her hospitalization in Kabul.  At that time, her physicians at the hospital advised her to stop taking Leflunomide and she did so.  Upon her release from the hospital, Embassy medical officials made the decision to send Complainant back to the United States for an evaluation by her own physicians. On May 7, 2013, Complainant departed Kabul for El Paso, Texas.

Upon her return to El Paso, Complainant was examined by her own physician (“Complainant’s Physician”) for clearance to return to Kabul.  She provided documentation to the Agency’s Office of Medical Services indicating that her physician had no concerns with her return to Kabul. On May 31, 2013, Complainant was initially informed by the Agency’s physician (“Agency Physician”) that her medical clearance for Kabul would be renewed.

However, on June 3, 2013, the Agency Physician informed her that she retained her Class 2 Medical Clearance, but was not Kabul-approved.  Complainant was told that the reason for the denial of her clearance to return to Kabul was her use of Leflunomide, a drug banned by the Department of Defense for use by personnel assigned to Afghanistan.3  As Complainant had stopped using the medication since her April 2013 hospitalization, she appealed the denial of her medical clearance for Kabul.  Her appeal was denied by the Agency’s Medical Review Panel on the grounds that her cessation of Leflunomide was too recent. The Panel indicated that Complainant needed to show a period of at least 12 month of “clinical stability” before she could return to Kabul.  The Panel defined clinical stability as “the absence of systemic clinical manifestations of pericarditis and rheumatogic problems.”  There was some speculation that, because Leflunomide reduces resistance to infection, Complainant’s pericarditis may have resulted from its use.  Complainant then requested an Administrative Waiver to allow her to return to her position in Kabul.  That waiver was also denied on June 19, 2013.  Since May 2013, Complainant has been working from the Agency’s El Paso, Texas, Intelligence Center.

On August 22, 2013, Complainant filed an EEO complaint alleging that the Agency discriminated against her on the basis of disability (rheumatoid arthritis) when her “Return to Post Authorization” was not reinstated and she was prevented from returning to work at the U.S. Embassy in Kabul.

At the conclusion of the investigation, Complainant requested a hearing before an EEOC Administrative Judge (AJ).  However, on March 10, 2014, the Agency issued a final decision pursuant to 29 C.F.R. § 1614.110(b). In its decision, the Agency conceded the Complainant was an individual with a disability as defined by the Rehabilitation Act.  The Agency further determined that Complainant was an otherwise qualified individual with a disability, as she had been performing in the position in question in Kabul for the preceding two years, and had the requisite knowledge, experience, skill, and education to perform the position.

The Agency’s decision then noted that Complainant was denied a Class 2 Medical Clearance (Kabul-approved) because of the perceived risk of harm she posed to herself due to her recent use of the drug Leflunomide. As a result of this determination, Complainant was prevented from returning to her previously-approved assignment in Kabul.  The Agency’s decision went on to conclude that, in denying her clearance, its medical officers failed to conduct a sufficient individualized assessment of the risk posed by Complainant’s medical condition and its impact on her ability to return safely to Kabul.  Specifically, Agency held that there was no evidence that the medical officers and Medical Review Panel took into account the duration of the risk, the nature and severity of the potential harm, and the likelihood that the harm will occur or the imminence of the potential harm, as required by the law.  The Agency decision noted that medical opinions that supported Complainant ability to safely return to Kabul were improperly given little weight during the medical clearance determination.  Accordingly, the Agency’s final decision concluded that it improperly denied Complainant a Class 2 medical clearance (Kabul-approved).

Based on its finding that Agency medical staff had failed to provide Complainant with an individualized assessment, the Agency ordered the Office of Medical Services to go forward and actually conduct the required individualized assessment of Complainant’s medical condition and her ability to return to the Administrative Officer position at the Agency’s Embassy in Kabul without posing a significant risk of substantial harm to herself or others.

This appeal followed.  On appeal, Complainant did not challenge the findings by the Agency, but asserted that she was not provided with full relief, including reasonable attorney’s fees and costs.

In response to the appeal, the Agency noted that its final decision was erroneously issued in light of Complainant’s previous request for a hearing.  As such, the Agency argued that the final decision should be voided.  In response, Complainant argued that the final decision should not be considered void and the matter should not be remanded for a hearing.

EEOC ANALYSIS AND FINDINGS: Violation of Rehabilitation Act

As an initial matter, we find that Complainant’s statement on appeal constitutes a withdrawal of her earlier hearing request.  As such, we deny the Agency’s request to void its final decision.

In that decision, the Agency found that its medical staff failed to conduct a proper individualized assessment as required by the Rehabilitation Act when Complainant was prevented from returning to work at the U.S. Embassy in Kabul.  Complainant does not challenge the Agency’s findings in its final decision.  As such, we affirm the Agency’s specific findings.  However, the Agency did not expressly state that its actions constituted discrimination in violation of the Rehabilitation Act.

As evidenced by the Agency’s final decision, there is no dispute that Complainant is an individual with a disability who was otherwise qualified for the position in she had previously held in Kabul. In other words, she met the skill, experience, education and other job requirements to perform the duties of the position in Kabul, apart from the Agency’s decision to retract her medical clearance for work in Kabul.

The Agency noted in its findings in its own decision that Complainant’s Physician provided medical documentation that Complainant was no longer taking Leflunomide, the drug of concern, had not had flare-ups of her medical condition, and had embarked on a healthier lifestyle. However, the Agency conceded that Complainant’s supporting medical documentation was improperly “given little if any weight.”  The Agency also admitted in it decision that the denial of the Class 2 Medical Clearance was due to the “perceived risk of harm she posed to herself or others” and not on an actual risk.  Based on the record including the medical evidence provided by Complainant’s Physician, we find that Complainant has shown that she was qualified for the position in question in Kabul and was only prevented from doing so based on the Agency’s perception that she posed a safety risk.  This moves the burden of proof squarely to the Agency to prove that there is a significant risk of substantial harm. Massingill v. Dep’t. of Veterans Affairs, EEOC Appeal No. 01964890 (July 14, 2000).  See also, Branham v. Snow, 392 F.3d 896 (7th Cir. 2005) (“employer’s burden to show that an employee posed a direct threat to workplace safety that could not be eliminated by reasonable accommodation”); Hutton v. Elf Atochem N. America, 273 F.3d 884, 893 (9th Cir. 2001) (direct threat affirmative defense).

Here, as already noted, the Agency’s own decision concluded that Complainant was denied a Class 2 Medical Clearance because of perceived risk of harm she posed to herself or others.  Our regulations permit the Agency to deny job assignments on the basis of disability where such an assignment would pose a direct threat. See 29 C.F.R. § 1630.2(r). A “direct threat” is defined as a “significant risk of substantial harm” that cannot be eliminated or reduced by reasonable accommodation. Interpretive Guidance of Title 1 of the Americans with Disabilities Act, Appendix to 29 C.F.R. Part 1630, § 1630.2(r); Echazabal v. Chevron U.S.A., Inc. 536 U.S. 73 (2002); 29 C.F.R. § 1630.2(r).

The issue in finding direct threat is “not…whether a risk exists, but whether it is significant.” Bragdon v. Abbott, 524 U.S. at 649. A direct threat must be based on an individualized assessment of the individual that takes into account: (1) the duration of the risk, (2) the nature and severity of the potential harm, (3) the likelihood that the potential harm will occur, and (4) the imminence of the potential harm. Interpretive Guidance on Title I of the Americans With Disabilities Act, Appendix to 29 C.F.R. § 1630.2(r). The individual assessment must be based on a reasonable medical judgment that relies on the most current medical knowledge and/or on the best available objective evidence. Id. A determination of significant risk cannot be based merely on an employer’s subjective evaluation, or, except in cases of a most apparent nature, merely on medical reports.

The Agency held in its final decision that it “failed to conduct a sufficiently individualized assessment of the risk posed by Complainant’s medical condition, and its impact on her ability to return safely to Kabul.  There is no evidence that the following factors were taken into account: 1) the duration of the risk; 2) the nature and severity of the potential harm; 3) the likelihood that the potential harm will occur; and 4) the imminence of the potential harm.”  Based on the record and the Agency’s own findings in its decision, we determine that the Agency has not met its burden of establishing that Complainant’s return to Kabul would have posed a direct threat.  Accordingly, the Agency’s defense to denying Complainant the Class 2 Medical Clearance was not established, and the Agency is liable under the Rehabilitation Act.

As a result of this violation of the Rehabilitation Act, Complainant is entitled to make-whole relief, which the Agency did not provide her in its final decision.  First, the Agency should offer Complainant the assignment in Kabul if she chooses to return. See Nathan v. Department of Justice, EEOC Appeal No. 0720070014 (July 19, 2013) (awarding the complainant the position for which he applied following a determination that the agency violated the Rehabilitation Act when it medically disqualified him without an individualized assessment). In addition, Complainant correctly argues that she should be awarded reasonable attorney’s fees and legal costs for processing her EEO complaint, as well as the opportunity to support her claim for compensatory damages. Also, we find that the Agency provide training to relevant management highlighting the Agency’s obligations with respect to the Rehabilitation Act.

The EEOC concludes the case with a modification of the State Department’s  final decision and remanded the matter to the agency with the following order signed by Carlton M. Hadden on October 25, 2016.  The EEOC case file notes that compliance with the Commission’s corrective action is mandatory.

The Agency is ordered to take the following remedial action:

1. Within 60 calendar days from the date this decision is issued, the Agency shall offer Complainant an assignment in Kabul substantially similar to the one she lost. If Complainant rejects the offer of the assignment, the Agency shall use the date of rejection for purposes of back pay calculations as noted below.  If Complainant accepts the assignment, the Agency shall use the date Complainant assumes the assignment for purposes of back pay.

2. The issue of compensatory damages is REMANDED to the Agency. On remand, the Agency shall conduct a supplemental investigation on compensatory damages, including providing the Complainant an opportunity to submit evidence of pecuniary and non-pecuniary damages. For guidance on what evidence is necessary to prove pecuniary and non-pecuniary damages, the parties are directed to EEOC Enforcement Guidance: Compensatory and Punitive Damages Available Under § 102 of the Civil Rights Act of 1991 (July 14, 1992) (available at eeoc.gov.) The Agency shall complete the investigation and issue a final decision appealable to the EEOC determining the appropriate amount of damages within 150 calendar days after this decision is issued.

3. The Agency shall determine if Complainant is entitled to an award of back pay as a result of the denial of her return to her assignment in Kabul.  The Agency shall determine the appropriate amount of back pay, with interest, and other benefits due Complainant, pursuant to 29 C.F.R. § 1614.501, no later than sixty (60) calendar days after the date this decision is issued.  The Complainant shall cooperate in the Agency’s efforts to compute the amount of back pay and benefits due, and shall provide all relevant information requested by the Agency.  We note that the Agency should consider if there would have been a difference in locality pay and benefits to Complainant including but not limited to promotions or other incentives for an assignment in Kabul, Afghanistan.

If there is a dispute regarding the exact amount of back pay and/or benefits, the Agency shall issue a check to the Complainant for the undisputed amount within sixty (60) calendar days of the date the Agency determines the amount it believes to be due.  The Complainant may petition for enforcement or clarification of the amount in dispute.  The petition for clarification or enforcement must be filed with the Compliance Officer, at the address referenced in the statement entitled “Implementation of the Commission’s Decision.”

4. Within sixty (60) days from the date this decision is issued, the Agency is ordered to provide at least eight (8) hours of training to the responsible officials covering their responsibilities under the Rehabilitation Act. The training shall cover the Agency’s obligations regarding the provision of reasonable accommodation, as well as its obligation to conduct an individualized assessment pursuant to the direct threat defense.

5. If Complainant has been represented by an attorney (as defined by 29 C.F.R. § 1614.501(e)(1)(iii)), she is entitled to an award of reasonable attorney’s fees and costs incurred in the processing of the complaint, including this appeal.  29 C.F.R. § 1614.501(e).  The award of attorney’s fees shall be paid by the Agency.  The attorney shall submit a verified statement of fees to the Agency — not to the Equal Employment Opportunity Commission, Office of Federal Operations — within sixty (60) calendar days of this decision is issued.  The Agency shall then process the claim for attorney’s fees in accordance with 29 C.F.R. § 1614.501.

The State Department was also ordered to post this order within 30 days of the date of the decision for a duration of 60 consecutive days.

The Agency is ordered to post at its Washington D.C. facility copies of the attached notice.  Copies of the notice, after being signed by the Agency’s duly authorized representative, shall be posted both in hard copy and electronic format by the Agency within 30 calendar days of the date this decision is issued, and shall remain posted for 60 consecutive days, in conspicuous places, including all places where notices to employees are customarily posted.  The Agency shall take reasonable steps to ensure that said notices are not altered, defaced, or covered by any other material.  The original signed notice is to be submitted to the Compliance Officer at the address cited in the paragraph entitled “Implementation of the Commission’s Decision,” within 10 calendar days of the expiration of the posting period.

 

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@StateDept Task Force For New Sexual Assault FAM Guidance – An Update

Posted: 12:57 am ET
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We’ve written about nine blogposts on sexual assaults and/or lack of clear sexual assault reporting guidance in the Foreign Service since August this year (see links below).   On November 22, the State Department finally directed a task force to create a new section in the Foreign Affairs Manual for sexual assault (see U/S For Management Directs Task Force to Create New Sexual Assault FAM Guidance).

Mindful that there are 35 days to go before a new administration takes office, we requested an update on the task force convened by “M” to craft the sexual assault guidance in the FAM.

A State Department spox sent us the following:

“The Department is committed to the work the taskforce is doing to create a sexual assault section for the FAM, work that will continue past inauguration day. Currently, the Department has policies and procedures relating to sexual harassment and workplace violence. Employees and their family members can receive assistance and advice from MED, DS and S/OCR on these issues.

 The taskforce is initially focused on establishing FAM definitions and will then build out the program, communications and training. The group has met with Peace Corps and will soon meet with DOD to understand what each has done on this issue. Both of those agencies dedicated several years to building their programs.

The taskforce includes members from MED, HR/ER and HR/DGHR, M staff and M/PRI, DS/DO/OSI and DS front office, S/OCR, and L. The group has also heard from a number of diplomatic community members at post who were eager to contribute ideas and offer feedback throughout the process. The group welcomes this contribution and feedback.”

 

So 35 days to go but we already know that the new guidance will not be ready until after January 20. We are pleased to hear that the taskforce is consulting with both DOD and Peace Corps who each has its separate reporting mechanism.  We are certain that the bureaucracy will continue to grind despite the transition but we do not want this to fall through the cracks.  If you are a member of the Foreign Service who provided feedback to this taskforce, and if you are a member of the FS community who considers an assault on one as an assault on all, you’ve got to keep asking until this gets done.

The Department’s Anti-Harassment Program is managed by the S/OCR, an office that reports directly to the Secretary of State. It conducts inquiries into allegations of sexual and discriminatory harassment in the Department.  It is not the appropriate office to handle sexual assault crimes. To initiate the EEO complaint process, regulations require that employees contact S/OCR or an EEO counselor within 45 calendar days of the alleged discriminatory act in order to preserve the right to file a formal complaint of discrimination with S/OCR. Email: socr_direct@state.gov.

The Department’s policy on workplace violence is governed by 3 FAM 4150, last updated in April 2012.

workplacev

Under Employees’ Responsibilities, the FAM provides the following guidance:

In the event of an immediately threatening or violent situation, all Department of State employees should:

(1) If the incident takes place in the United States, call 911 when there is an injury or an immediate risk of injury in the workplace;

(2) Alert the appropriate law enforcement or security office at his or her location when there is risk to his or her safety or the safety of others, injury, or immediate risk of injury. In the Washington, DC area dial extension 7-9111 or the appropriate telephone number for the law enforcement or security office at his or her location;

(3) Immediately report threatening or violent behavior to supervisors after securing emergency medical assistance as needed;

(4) Move to a safe area away from the individual(s) making threats or exhibiting violent behavior. Do not confront the individual or individual(s); and

(5) Take all threats and acts of violence seriously.

A close reading of this section on workplace violence, makes one think that perhaps the drafters were thinking of an employee “going postal”. This certainly provides no guidance for victims of sexual assault.  “Take all threats and acts of violence seriously,” of course, doesn’t make sense when one contemplates about a colleague who is also a rapist. It’s important to note that approximately 3 out of 4 of sexual assaults are committed by someone known to the victim; that “friend” or “buddy” is not going to threaten you that he’s going to assault or rape you before he commits the crime.

The workplace violence section has more guidance on what to do with an employee exhibiting violent behavior than what to do with the victims. Immediate actions recommended include review of “whether an independent medical exam should be offered” to the violent employee. Short-term and long-term responses include administrative leave; counseling from supervisor or higher management official; appropriate disciplinary action, up to and including separation; curtailment; and/or medical evacuation. All focused on the perpetrator of workplace violence.

Yes, the Department has policies and procedures relating to sexual harassment and workplace violence; and you can see that they are sorely lacking when it comes to addressing sexual assaults.

 

Sexual Assault Related posts:

 

 

 

U/S For Management Directs Task Force to Create New Sexual Assault FAM Guidance

Posted: 5:08 pm PT
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The message below addressing sexual assault was sent to all State Department employees on November 22, 2016.  Several copies landed in our inbox.  The State Department sent us a note that says they want to make absolutely sure that we have seen this, and gave us an “officially provided” copy.

 

A Message from Under Secretary Pat Kennedy
November 22, 2016

Sexual assault is a serious crime.  It can traumatize victims and have a corrosive effect on the workplace.  The Department is determined to do all it can to prevent sexual assault, and, if it does occur, to support victims and bring the perpetrators to justice.  We are committed to effectively and sensitively responding to reports of sexual assault and to ensuring victims are treated with the care and respect they deserve.

The Department has policies and procedures relating to sexual harassment and workplace violence.  We recognize these policies may not address all issues specific to sexual assault and that sexual assault is more appropriately dealt with in its own FAM section.  At my direction, an inter-bureau taskforce is in the process of creating this new FAM section.  Among the issues the taskforce will take up are reporting processes, confidentiality, sexual assault response training, and potential conflict of interest issues.

As we work to complete a stand-alone sexual assault FAM section, it’s important to note that there are and have been policies and procedures in place to help employees and their family members who are sexually assaulted get the medical care they need and to bring perpetrators to justice.

Medical services are available at post, and personnel from the Bureau of Medical Services (MED) can also provide advice from Washington, DC.  Post’s Health Unit healthcare providers are the first responders for medical evaluation and treatment overseas and will abide by strict patient/provider confidentiality.  An employee or member of the Department community who has been sexually assaulted may also report the incident to MED’s Clinical Director (currently Dr. Behzad Shahbazian) at 202-663-2976 during business hours.  After hours and on weekends/holidays, victims may contact the MED Duty Officer at 202-262-9013 or via the Operations Center at 202-647-1512.

For reported sexual assaults that are committed by or against members of the Department community or occur within a COM facility or residence, RSOs serve as the law enforcement first responders.  Every reported sexual assault is handled as a criminal matter that may be prosecuted in the United States under federal extraterritorial laws.  For more guidance on the handling of such cases, see 16 STATE 56478.

If a victim overseas wants to report a sexual assault to law enforcement authorities, but prefers not to report it at post, he or she can contact the Office of Special Investigations (DS/DO/OSI), via telephone at 571-345-3146 or via email at DS-OSIDutyAgent@state.gov<mailto:DS-OSIDutyAgent@state.gov>.  The DS/DO/OSI duty agents are available 24 hours a day, seven days a week and can investigate an allegation independent of post management.  OSI agents have been trained to handle such cases and will work with the victim and can also provide information about the Victims’ Resource Advocacy Program available at vrap@state.gov<mailto:vrap@state.gov>.

Victims may also report sexual harassment directly to the Office of Civil Rights<http://socr.state.sbu/OCR/Default.aspx?ContentId=6666> (S/OCR) at http://snip.state.gov/f5h or via phone at 202-647-9295 and ask to speak with an Attorney-Adviser.  Pursuant to 3 FAM 1525, S/OCR oversees the Department’s compliance with anti-harassment laws and policies and conducts harassment inquiries.

The working group developing the new FAM section is consulting with other agencies about best practices in such areas as communication, training, and post-attack medical and mental health support and will integrate appropriate elements of these programs to ensure that the Department’s policies on sexual assault are victim centered and effective.

The Department’s position is clear: there is zero tolerance for any form of violence, including sexual assault, within our Department community. We understand these are sensitive and difficult situations, but we strongly encourage victims to come forward so the Department can take the appropriate steps to ensure the victim’s safety and bring the perpetrator to justice.

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Sexual Assault Related posts:

First Person: I did everything right. I filed a report the next business day … #FSassault

Posted: 12:55 am  ET
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I did everything right. I filed a report the next business day with RSO. The accused was removed from post shortly thereafter. 

My victimization didn’t really begin until I sought assistance 6 months later from MED when I arrived at my next post. MED sent me on a MEDEVAC to DC from my post to a facility that didn’t treat trauma and required I take a $60 taxi each way daily from Oakwood Falls Church where most of my colleagues from my unaccompanied post were staying due to long term training. 

MED refused to discharge me for weeks despite requests for relocation and a new treatment plan. I finally found my own providers online when the State Department didn’t provide a list of referrals prior to my discharge. 

Then, the MEDEVAC team advised me of their recommendation for a Class 5 medical clearance (domestic only) without ever speaking to my psychiatrist and without providing a reason. 

I filed appeals of my medical clearance without success all the way to the Director General. 

MED refused to assist with my PTSD claim for worker’s compensation despite the reported incident occurring at the U.S. Embassy in a warzone where we can’t leave the compound. 

My out of pocket medical expenses (therapist/ psychiatrist/medicine) would not be covered once my MEDEVAC ended. My housing was paid for at my post and my children were enrolled in the international school. We didn’t receive our HHE for 6 months after having someone else pack out our goods. 

Without access to the State Department system, it was nearly impossible to secure an onward assignment. I didn’t have contact information for my 360s and no access to my employee profile. I went house shopping in DC with a realtor and was advised there was no suitable housing for a family of my size at an amount I could afford. Washington, DC has bedroom occupancy regulations which made it difficult to accommodate. 

The State Department sent me to the brink of financial ruin. I took a huge pay cut, lost my paid housing, my kids lost their prestigious school, and my spouse lost job opportunities available at post all because I was a victim and sought assistance from MED.

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The account above is an unsolicited email from a Foreign Service employee who did not want us to use her name but wanted to share her story. She said she previously served in Israel, Iraq, Colombia, Venezuela, Georgia, and Afghanistan, all with a Class 1 medical clearance, meaning “worldwide available” for Foreign Service assignments. She told us she was also last promoted in 2015. 

According to her, Diplomatic Security asked if she wanted to go to the medical unit but she declined. Regarding the perpetrator, she said, “I have no verification that he is overseas with his family, but he is listed on the GAL [global address list] and so is his wife.”  She added, “He had also destroyed government property ✂️ and was highly intoxicated in the middle of the night when he was subdued by security. It apparently had no effect on his security clearance or medical clearance as he had the ability to serve overseas at his next post with his family.” 

She said that she chose to stay at her post in the warzone until the end of her tour so she would not lose her onward assignment. She arrived at her onward post in Europe and was  subsequently medically evacuated (MEDEVAC) after she contacted MED.

She told this blog, “I was never hospitalized. I was never a threat to myself or others. It is hard to believe that this is my life. The biggest issue I have is that I was never provided a reason as to why my clearance was denied other than a generic “best care is available in the U.S.” 

The post she was evacuated from is a European post with high level of medical care including English speaking therapists and psychiatrists. Post has a resident regional medical officer (RMO) and a resident regional medical officer/psychiatrist (RMO/P).

The FS employee told us she is on leave without pay and believed that her OWCP claim (Office of Workers’ Compensation Programs) for PTSD was one of the factors in the downgrading of her medical clearance.

She shared with us an OCWP letter in which “Under Accepted Event(s) That Are Factors of Employment” is this:

“– That while assigned to the US embassy in ✂️ from 2014-2015. you were sexually harassed and assaulted by a colleague who was under the influence of alcohol after checking on him at his room.” 

We hope to have a follow-up post on the MED – OCA – OCWP mess.

 

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