[Senate Hearing 109-636]
[From the U.S. Government Publishing Office]
S. Hrg. 109-636
THE LEGISLATIVE PRESENTATION OF PARALYZED VETERANS OF AMERICA, THE
BLINDED VETERANS OF AMERICA, THE NON-COMMISSIONED OFFICERS ASSOCIATION,
THE MILITARY ORDER OF THE PURPLE HEART, AND THE JEWISH WAR VETERANS OF
THE USA
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HEARING
BEFORE THE
COMMITTEE ON VETERANS' AFFAIRS
UNITED STATES SENATE
ONE HUNDRED NINTH CONGRESS
SECOND SESSION
__________
MARCH 9, 2006
__________
Printed for the use of the Committee on Veterans' Affairs
Available via the World Wide Web: http://www.access.gpo.gov/congress/
senate
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28-174 PDF WASHINGTON : 2006
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COMMITTEE ON VETERANS' AFFAIRS
Larry E. Craig, Idaho, Chairman
Arlen Specter, Pennsylvania Daniel K. Akaka, Ranking Member,
Kay Bailey Hutchison, Texas Hawaii
Lindsey O. Graham, South Carolina John D. Rockefeller IV, West
Richard M. Burr, North Carolina Virginia
John Ensign, Nevada James M. Jeffords, (I) Vermont
John Thune, South Dakota Patty Murray, Washington
Johnny Isakson, Georgia Barack Obama, Illinois
Ken Salazar, Colorado
Lupe Wissel, Majority Staff Director
D. Noelani Kalipi, Minority Staff Director
C O N T E N T S
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March 9, 2006
SENATORS
Page
Craig, Hon. Larry E., Chairman, U.S. Senator from Idaho.......... 1
Akaka, Hon. Daniel K., Ranking Member, U.S. Senator from Hawaii.. 3
Salazar, Hon. Ken, U.S. Senator from Colorado.................... 5
Burr, Hon. Richard M., U.S. Senator from North Carolina.......... 51
WITNESSES
Pleva, Randy L., Sr., National President, Paralyzed Veterans of
America........................................................ 7
Prepared statement........................................... 9
Belote, Larry, National President, Blinded Veterans Association.. 13
Prepared statement........................................... 16
Magidson, David L., National Commander, Jewish War Veterans of
the United States of America................................... 28
Prepared statement........................................... 30
Schneider, Richard C., Executive Officer for Governmental
Affairs, Non-Commissioned Officers Association................. 38
Prepared statement........................................... 40
Randles, James, National Commander, Military Order of the Purple
Heart of the U.S.A., Inc....................................... 47
Prepared statement........................................... 49
APPENDIX
Stroup, Theodore G., Vice President, Association of the United
States Army, prepared statement................................ 55
THE LEGISLATIVE PRESENTATION OF PARALYZED VETERANS OF AMERICA, THE
BLINDED VETERANS OF AMERICA, THE NON-COMMISSIONED OFFICERS ASSOCIATION,
THE MILITARY ORDER OF THE PURPLE HEART, AND THE JEWISH WAR VETERANS OF
THE USA
----------
THURSDAY, MARCH 9, 2006
U.S. Senate,
Committee on Veterans' Affairs,
Washington, DC.
The Committee met, pursuant to notice, at 10:03 a.m., in
room SD-G50, Dirksen Senate Office Building, Hon. Larry E.
Craig, Chairman of the Committee, presiding.
Present: Senators Craig, Burr, Akaka, and Salazar.
OPENING STATEMENT OF HON. LARRY E. CRAIG,
CHAIRMAN, U.S. SENATOR FROM IDAHO
Chairman Craig. Good morning, ladies and gentlemen. The
Committee on Veterans' Affairs will come to order.
It is my pleasure to welcome all of you. Your presence here
today is a strong showing for your commitment and your advocacy
to America's veterans. I am pleased that many of you have
traveled great distances to carry on this tradition. I
understand that several people who are here today have made
that trip from my home State of Idaho, and I am going to offer
them a very special welcome. Any Idahoans in the crowd?
Maybe that trip was just a little too long.
[Laughter.]
This past year has been an extremely gratifying one for me.
My first as Chairman of the Veterans' Affairs Committee. I
sincerely believe that this Committee and its Members, while
sometimes differing in approaches, are all united in one common
mission: ensuring that our Nation's veterans, particularly
veterans wounded in the line of duty, receive the highest
quality of health care and benefits that they need.
By any measure, we have had a busy and a productive first
session, convening 21 hearings here in Washington, 9 field
hearings, 4 mark-ups. More importantly, Committee-related
activities have led to several important accomplishments.
About a year ago, I walked into my office to meet three
marvelous young veterans of Operation Iraqi Freedom. One was
missing a leg, another was missing both legs, and the third
could no longer see. They brought me a legislative proposal to
create a new insurance benefit for those who had suffered
traumatic injuries such as theirs; mind you, a proposal not for
them, but for their friends, for their comrades. I was
impressed with their selflessness.
With Senator Akaka on board, I immediately took to the
floor of the Senate with their proposal. With VSO support, many
of you in this room supported us, it was signed into law a few
weeks later, and there is a result there we can now measure and
be proud of. As of last week, VA has paid almost 1,500
traumatically injured servicemembers from OIF and OEF.
[Applause.]
Thank you. These are young men and women with amputations,
severe burns, total blindness, total deafness, paralysis, and a
host of other disabilities, all of them sustained in defense of
all of us. Going forward, wounded warrior insurance will fill a
gap in financial help faced by these heroes and their families
during convalescence.
Before I close, let me touch on what has consumed much of
our attention of late, and that of course is something you are
here to talk about today, the 2007 VA budget. I believe this
record budget request is extraordinary, and shows that in this
fiscal austere time the President has chosen to make veterans
once again a top priority.
In fact, I just came from an early morning hearing on the
Department of Agriculture's budget. That budget was cut by over
$4 billion in real dollars from last year, and that is true of
many budgets across our country and across our government.
I just came down from a hearing that is going on just above
us, with Secretary Rice and Secretary Rumsfeld asking for a
substantial supplemental to make sure that our men and women in
uniform who are standing in harm's way at this moment are
appropriately served.
The VA budget, by its current track, will double nearly
every 6 years, and will soon collide with spending demands in
all other areas of government. Although we may wish that VA
funding existed in a vacuum, we all know it doesn't. Many of
you have been here year after year, fighting for those you
believe in and fighting for America's veterans, and this
Committee will not take second place in that similar fight.
As I am sure everyone is aware, the President proposed one
way for us to help in this fiscal austere time by asking
priorities sevens and eights, with no service-related
disabilities, to contribute about $21 per month to enroll in
the VA health care system and to pay about $15 for a 30-day
supply of medicine. Although I personally find this proposal
reasonable, I know that many of you have voiced opposition;
certainly many on this Committee have.
So I must reiterate my hope that your organizations and
others will engage this Committee in a serious and candid
discussion, if not about the President's proposals, then about
other options. It is our collective responsibility to sustain
this unparalleled VA health care system into the future. If we
begin addressing these issues now, we can help assure that
future veterans will not be faced with even bigger challenges
and more radical changes to meet those challenges.
Personally, I do not want to pass this issue on to the next
guy or the next chairman. I want to pass on to tomorrow's
veterans what we can collectively create for the future,
because we know what we have done together is good. We have, by
our investment and your advocacy--and I say ``ours,'' the
American taxpayers' investment--we have created one of the
number one health care delivery systems in the world for
America's veterans.
I hope you agree with my goals. I think they are shared by
everyone. I think the next few years will be ones of progress
and wisdom in handling veterans' issues. I look forward to
hearing your testimony and a continued dialogue with you, your
organizations, about the many important issues concerning
veterans today.
Certainly in the spirit of that I once again extend a warm
welcome to all of you for joining us today. And before I
introduce our panel of the morning, let me turn to my colleague
and Ranking Member on the Committee for any opening remarks he
would like to make, Senator Danny Akaka.
Senator Akaka.
STATEMENT OF HON. DANIEL K. AKAKA, RANKING MEMBER, U.S. SENATOR
FROM HAWAII
Senator Akaka. Thank you, Mr. Chairman. It is certainly a
pleasure to be with all of you today, and I want to add my
welcome along with yours, Mr. Chairman, to all of you who have
come this morning.
I want to thank the organizations here today, as well as
all the veterans and their families who have made the journey
to the Nation's Capital to express their concerns. This is,
without question, truly democracy in action. Your organizations
have a proud tradition of public service. This Committee relies
heavily on your concerns and your agendas for the coming year.
I want to welcome Dr. Roy Kekahuna from the Blinded
Veterans Association, who is from Hawaii. If you are here, will
you raise your hand, Roy? Oh, there you go. Thank you so much
for being here.
[Applause.]
I remember last month, Roy, that you testified before this
Committee during the field hearings in our home State of
Hawaii. After reviewing your testimony, I share many of your
concerns and priorities.
During this time last year, many of us here in Congress
were sounding the alarm that the VA budget was facing a crisis
situation, and many months later the Administration
acknowledged this fact, and Congress took action to provide
emergency funding. I want to say that Chairman Craig kept his
promise and was a driving force behind the emergency funding. I
applaud him for his efforts.
When we started working together last year, we pledged to
work in a bipartisan manner, and without question we have done
so. There are times, however, when we agree to disagree. We
both agree that veterans deserve to have the best health care
services and benefits, though sometimes disagree on how we pay
for it.
I want to be clear, however, that we have the same goal,
and that is to ensure that VA is provided with the resources to
provide quality care and service to our Nation's veterans. I
remain dedicated to ensuring that VA has the resources and
needs to care for our veterans. We must learn a lesson from
last year's budget crisis and do everything we can to ensure
that veterans and their families have access to the health care
and benefits they have earned.
VA's budget has increased over the past 6 years, as it
should. The cost of caring for our veterans is, in my opinion,
a cost of war. If the Department of Defense's budget can grow
as it has and be funded yearly out of supplementals, it only
makes sense that VA's budget needs to grow equally as well. It
is no secret that each servicemember that is funded out of DOD
will eventually be seeking services from VA. It follows, then,
that if DOD's budget grows steadily, VA's budget must grow
steadily as well.
For me it is a matter of priorities. We must stand by our
veterans and ensure that they receive the care and services
that they have earned through their service to our country, and
we must ensure that we care for all veterans. We cannot fund
the VA system out of the pockets of the middle-income veterans,
as many of these men and women make only as little as $26,902 a
year. Higher co-payments and enrollment fees I feel are not
justified.
To date, over a quarter of a million veterans have been
excluded from VA health care. Over 700 veterans in Hawaii have
knocked on the doors of VA, asking for care, only to be denied.
We must work to overturn this Administration's decision and
open the VA system up to those who need it.
I also am concerned about the VA research program being
slated for a cut under this budget. Since its inception, the VA
research program has made landmark contributions to the welfare
of not only veterans but the entire Nation, illustrating the
unique importance of keeping it adequately funded. With
thousands of military personnel engaged in conflict overseas,
it is vital that Congress invest in research that could have a
direct impact on their post-deployment quality of life.
With regard to the VBA budget, I am concerned whether or
not this budget provides an adequate level of staffing for
compensation claims rating. VA must be ready to adjudicate
claims in a timely and accurate manner. Our veterans and their
families deserve nothing less.
[Applause.]
I will continue to oppose efforts to reduce veterans'
compensation as we say with the ill-fated PTSC review. Now the
Institute of Medicine and the Veterans' Disability Benefits
Commission are reviewing veterans' disability compensation. It
is my hope that these groups will recommend new ways for
Congress to improve benefits, and not call for cuts in current
benefits.
My next priority is near and dear to my heart. As a veteran
of World War II, I owe a great deal of where I am today to the
GI Bill educational benefits I used as a young man. I should
tell you in those days I received $113 a month, and it was good
enough to take care of my needs and pay for all of my tuition.
With this in mind, I will continue to look for ways to enhance
and modernize educational benefits to more adequately prepare
veterans for the new challenges of our economy.
In closing, I would like to once again thank all of you for
being here today. Your service and your dedication to this
Nation and its veterans are unquestionable. I look forward to
your presentation and working with you in the future.
Thank you very much, Mr. Chairman.
[Applause.]
Chairman Craig. Danny, thank you very much.
Now let's turn to Senator Ken Salazar of Colorado for any
opening statement Ken may have.
STATEMENT OF HON. KEN SALAZAR, U.S. SENATOR FROM COLORADO
Senator Salazar. Thank you, Chairman Craig and Ranking
Member Akaka. I appreciate the fact that you hold these
hearings, and I also appreciate the leadership that you provide
in this U.S. Senate and this Committee. I think the kinds of
hearings that we have, including the one here today,
demonstrate the kind of leadership that we have from both you,
Mr. Chairman, as well as Senator Akaka, our Ranking Member.
I want to thank the members of the Paralyzed Veterans of
America, the Blinded Veterans of America, the Non-Commissioned
Officers Association, the Military Order of the Purple Heart,
and the Jewish War Veterans of the USA, for coming to our
Nation's capital today to talk about these critical issues. You
are the reason we are here today, and you are the reason we
work hard every day to ensure our veterans receive the best
services our government can provide.
I want to also point out that in the audience today, from
the Mountain States Chapter of the PVA, we have Jared Musik and
Mark Shepherd, Sr., if they can show where they are. Join me in
giving them a----
As we discuss the President's fiscal year 2007 budget
proposal for the VA, there are a number of important issues
which we need to examine in Congress. First and foremost, we
need to do everything we can to ensure that funding for
veterans' health care and services is there, not only for this
year but for every year into the future. That is why last
year's $1.2 billion shortfall for VA health care was so
troubling, and it was a very good thing that Senator Craig,
Senator Murray, Senator Akaka, and the rest of this Committee
worked to restore the funding that was needed.
It is also why several of my colleagues and I have asked
the Government Accountability Office to examine the process by
which VA determines its budget requests every year. It still
puzzles me as to why we ended up with the kind of shortfall
that we ended up with last year. We are awaiting the final
findings of that inquiry, and we will work to do everything we
can to see that the problems are identified and addressed.
We see the symptoms of those problems in other efforts to
generate revenue and to decrease costs by establishing
enrollment fees and doubling prescription drug co-payments for
Priority Seven and Eight veterans. While I certainly understand
the need to focus our service on those veterans who need it
most, I firmly believe that the promise we made to our Nation's
veterans obligates us to do everything we can to ensure that
all veterans receive the services that they have earned.
[Applause.]
For that reason, I oppose the President's proposal, and
will work with my colleagues to see whether we can readdress
them and turn them back.
More troubling, however, is the recent revelation that the
budget projects dramatic cuts in VA funding in the out-years.
For sure, as Senator Craig said earlier, we have a proposed
budget for next year which appears to give us about a 9 percent
increase, but when you look out at the out-years, there are
concerns that we should all be focused on.
Recent documents that have been shown from the
Administration, from the White House, seem to assume that
funding for VA health care would increase by 9 to 11 percent
for fiscal year 2008, and then after that there would be cuts
for the next 3 years in a row. We need to make sure that we
have a sustained and long-term commitment for the funding for
VA health care, which is the kind of sustained commitment that
I hear both Senator Craig and the Members of this Committee
talking about.
The answer, in my view, to dealing with some of these
issues concerning the budget is to take it out of the whimsical
annual atmosphere of Washington, D.C. and our budgeting
process, and to make mandatory funding for VA health care.
[Applause.]
I am a cosponsor of legislation that would make that goal a
reality, and I will work to see that it becomes law.
Finally, I want to talk about an issue that is near and
dear to my heart and to the State of Colorado, and to all of us
from places like Idaho and South Dakota and other places that
are rural in nature, where you have to travel sometimes
hundreds of miles to receive health care. Too often our Nation
has focused, I believe, on policies in urban areas, that we
sometimes forget the serious obstacles that exist for rural
veterans seeking to obtain services they need and deserve.
Many veterans in my State of Colorado, both the northwest
and the northeast, have to travel several hundred miles in
order to get their medical care. Sometimes the round trip is
500 miles. This is not a choice that we ought to require any
veteran to ever have to make. We need policies that recognize
and address these challenges now, and I look forward to working
to address the needs of veterans in rural America in this
Congress.
Finally, Mr. Chairman and Senator Akaka, and to all of you
who are assembled here, I sit here in my seat today as a U.S.
Senator because so many members of my family have given both
their life and their service to this country over many wars,
and I don't take the freedom that we have here in America at
all for granted, nor does this Committee. And I think that is
why this Committee does the great work that it does, in a
bipartisan way, to try to address the real needs of our
veterans.
We have an additional challenge that we have to confront
now because we face the reality of so many returning veterans
from Iraq and Afghanistan. This Committee will do its best, I
am certain, to make sure that those needs are addressed.
Thank you very much, Mr. Chairman.
[Applause.]
Chairman Craig. Ken, thank you very much. And to our
panelists, thank you for your patience. We do appreciate you
being here, and let me introduce our panelists and ask them to
begin.
Randy Pleva is the National President for the Paralyzed
Veterans of America. Welcome, Randy.
Mr. Pleva. Thank you, sir.
Chairman Craig. Larry Belote, who serves as the National
President of the Blinded Veterans Association.
David Magidson, welcome.
Mr. Magidson. Thank you, sir.
Chairman Craig. We didn't think you were going to make it.
Mr. Magidson. No, I was here. I was sitting over there. I
didn't know I was to sit up here, but I do now.
Chairman Craig. Well, we are glad you are here, the
National Commander for the Jewish War Veterans.
And representing the Military Order of the Purple Heart is
its National Commander, James Randles. Thank you very much for
being here.
And, let's see, we have had a change. Richard Schneider,
who is with us today, who is President and Chief Executive
Officer for the Non-Commissioned Officers Association. Richard,
thank you very much for being here.
Randy, we will start with you. Please proceed.
STATEMENT OF RANDY L. PLEVA, SR., NATIONAL PRESIDENT, PARALYZED
VETERANS OF AMERICA
Mr. Pleva. Thank you, sir. Mr. Chairman and Members of the
Committee, as you well know, I am Randy Pleva, the National
President of Paralyzed Veterans of America, and behind me are
PVA's elected leaders of our chapters, legislation and advocacy
directors. They represent all of our members in all 50 States
and Puerto Rico.
Chairman Craig and Ranking Minority Member Akaka, you kind
of took the wind out my sails here with all the support that
you have shown through the years. Believe me, sir, I am so
thankful that you gave us this time for us to talk to this
Committee. The reason I say that is because I know of the
support that you have given veterans. But, sir, there are still
people out there that don't share what you share, sir.
For over 50 years the veterans' service organizations have
been coming and testifying in front of Congress, voicing their
concerns, voicing needing money for veterans, and a lot of
times, sir, it has fallen on deaf ears. It really has.
And today some people that feel like veterans have too much
already, I would like for them to take a look in this room,
because I tell you the price of freedom has a very heavy price.
It really does. Just look at the wheelchairs, and people that
live on a daily basis with the scars and the horrors of war
that they carry on.
Also for the last 50 years, like I said, the veterans have
come to the table to ask, and sometimes, Mr. Chairman, they
have received crumbs off that table, the table of plenty. They
really have. Veterans have protected that table, and to this
day, with the--well, for example, the increase of co-payments
and enrollment fees, PVA strongly opposes these proposals and
we ask Congress to reject these items.
Also, sir, we are very appreciative that the nonservice-
connected veterans with a catastrophic disability are already
included in Category Four, but you know what? They still pay
the co-payments. And they have to pay for the meds, and they
have to pay for their in-patient and their out-patient care.
That sometimes is just overwhelming and very costly. Again, Mr.
Chairman, to me, I don't think that's a priority at all, I
really don't.
Another concern, I know that Senator Akaka mentioned it,
was on research. You know, one of these days we would kind of
like to see wheelchairs be a thing of the past, but as long as
they keep cutting the funds for research, that will never
happen. It won't. It will just never happen.
Another concern that we have, sir, is with the SCI, the
spinal cord injury physicians and nurses that we have in our VA
hospitals. The VA has to come up with something, with
substantial incentives and bonuses to keep these people.
When I was in Texas, I visited the hospital and talked with
a young lady who has been a quadriplegic, high level
quadriplegic, for 20 years. Came in for a 10-minute procedure,
10 minutes, and that lady had been in there for 90 days because
over a 10-minute period no one knew how to handle her and her
skin broke down. That is just unacceptable, sir. It really is.
Ninety days that she was away from her family, when she thought
she would be home within a half-hour of that procedure.
These are concerns that we have, sir. These are things that
really concern our members and our organization.
Also, we have a lot of World War II veterans that have been
pushing these chairs for 60 years, and who desperately need
long-term care. And we would really ask that any legislation--
reject anything, sir, that would reduce long-term care. Of
course, we are not getting any younger ourselves. And as far as
staffing, the beds, things of this nature, we just hope that
people would reconsider.
And also, sir, we have another concern, and that is the VA
contract health care out there, the providers. Just with the
trouble I was telling you about, that we have trouble with our
spinal cord doctors and nurses and the VA may take us out to
someone that wouldn't be qualified to take care of us.
Mr. Chairman, I know we only have 5 minutes, sir, and I
don't mean to cry wolf or anything of that nature. But, Mr.
Chairman, I have a very serious concern, after talking to some
of the people on the Hill, not like yourself, but you know a
lot of these people--and I know you have heard this before--but
they gave their all. I am sorry. They gave their all and, you
know, Senator, it is like some people look you in the face and
they are not afraid to tell you, ``So what? So what? Who
cares?'' And that really disturbs me because, sir, I am not a
smart man. I am no college graduate, but I know right is right
and wrong is wrong.
And these people that are sevens and eights, you know what?
They left their families, they left their jobs. They put their
life on the line.
And I am telling you, sir, that is not--again, it is not--I
hear gray areas. It is black and white, just that simple. And,
Senator, again, I have these concerns. I see my time is up, but
I appreciate you listening to us. Thank you ever so much, sir,
for having this hearing. Thank you.
[The prepared statement of Mr. Pleva follows:]
Prepared Statement of Randy L. Pleva, Sr., National President,
Paralyzed Veterans of America
Mr. Chairman and Members of the committee, Paralyzed Veterans of
America (PVA) appreciates this opportunity to present our legislative
priorities for 2006 and this session of the Congress. PVA would like to
thank you Chairman Craig and Ranking Member Akaka for allowing us to
continue to present our testimony with PVA leadership and members in
attendance. It is a great way for us to participate in the legislative
process.
I would also like to thank you both for recognizing the
accomplishments of The Independent Budget over the last 20 years by
attending our anniversary reception recently.
PVA's budget recommendations are part of the joint policy
statements contained in this year's Independent Budget. They are the
combined recommendations of AMVETS, Disabled American Veterans, PVA and
Veterans of Foreign Wars. This year, PVA and our fellow VSOs are proud
to mark the 20th Anniversary of this joint effort presenting budget and
policy direction to the Congress and the Administration for all
benefits and services provided to the veterans of this Nation.
fiscal year 2007 va health care budget
With regard to the Administration's budget proposal, PVA is pleased
to see that for the first time, a reasonable starting point was offered
by the President to fund the VA health care system. For fiscal year
2007, the Administration has requested $31.5 billion for veterans'
health care, a $2.8 billion increase over the fiscal year 2006
appropriation. Although this is a significant step forward, we still
have some concerns about proposals contained within the request, as I
will later explain. The Independent Budget for fiscal year 2007
recommends approximately $32.4 billion for veterans' health care, an
increase of $3.7 billion over the fiscal year 2006 appropriation and
about $900 million over the Administration's request.
We believe that the recommendations of The Independent Budget have
been validated once again this year as the Administration indicated
that it will actually take $25.5 billion to fund Medical Services, an
amount very close to what we recommend. However, they only request
$24.7 billion in appropriated dollars. The Administration hopes to
raise an additional $800 million by instituting the new enrollment fee
and the increase in prescription drug co-payments to achieve the
necessary funding level.
I would like to single out this particular budget and policy
recommendation that continues to receive a great deal of attention,
both in the veterans' community and in the Congress. As it has for the
past 3 years, the Administration is insisting on more than doubling
fees for prescription co-payments and instituting an annual $250
enrollment fee for certain veterans in the lower eligibility
categories.
I would like to take a moment to explain why PVA objects to the
proposal. I would also like to explain why we believe this
recommendation, if approved, will have a serious impact on many
veterans with catastrophic disabilities whose only main health care
resource is the VA health care system.
VA has cared for veterans with nonservice-connected disabilities
for a long time. This is not a new phenomenon authorized by eligibility
reform in 1996. Veterans health facilities admitted nonservice-
connected veterans in large numbers following World War I. The Congress
and the VA admitted the nonservice-connected, not just the poor and
indigent, in large numbers as the VA health care system grew in size
and scope through the middle of the 20th Century and beyond. VA used
the rationale that its facilities were there to serve veterans who,
because of nonavailability of comparable services, access, or cost,
found VA a reasonable or unique resource for health care services they
could not find elsewhere.
VA opened its doors to these veterans for many reasons, the main
one being these men and women had served their country just as
honorably as anyone else who had worn the uniform. They deserved no
less.
Prior to 1986, all veterans, service-connected and nonservice-
connected, over the age of 65 were eligible for VA health care. In
1986, Congress approved legislation which divided the veteran
population into three eligibility categories. In 1996, Congress again
revised that legislation with a system of seven priority ratings for
enrollment. Within that context, PVA worked hard to ensure that those
veterans with catastrophic disabilities, no matter if those
disabilities were service-connected or nonservice-connected would have
a higher enrollment category. If the three implied missions of the VA
health care system were to provide for the service disabled, the
indigent and those with special needs, the catastrophically disabled
certainly fit in the latter priority Ranking. The VA had an obligation
to provide care for these veterans. The specialized services, such as
spinal cord injury care, unique to VA, should be there to serve them.
To protect their enrollment status, veterans with catastrophic
disabilities were allowed to enroll in Category Four even though their
disabilities were nonservice-connected and regardless of their incomes.
However, unlike other Category Four veterans, if they would otherwise
have been in Category Seven or Eight, they would still be required to
pay all fees and co-payments, just as others in those categories do now
for every service they receive from VA.
PVA believes this is unjust. VA recognizes their unique specialized
status on one hand by providing specialized service for them in
accordance with its mission to provide for special needs. The system
then makes them pay for those services.
These veterans are not casual users of VA health care services.
Because of the nature of their disabilities they require a lot of care
and a lifetime of services. Private insurers and providers do not offer
the kind of sustaining care for spinal cord injury found at VA even if
the veteran is employed and has access to those services. Other Federal
or state health programs fall far short of VA. In most instances, VA is
the only and the best resource for a veteran with a spinal cord injury
and yet, these veterans, supposedly placed in a priority enrollment
category, have to pay fees and co-payments for every service they
receive as though they had no priority at all.
The Administration's new fees and new enrollment payments add even
higher burdens to penalize these veterans for seeking the only source
of the health care they need.
We strongly urge the committee to correct this financial penalty.
If a veteran is in Category Four because of a catastrophic disability,
then treat that veteran like all other Category Fours and exempt him or
her from fees and co-payments.
Our health care recommendation does not include additional money to
provide for the health care needs of Category 8 veterans being denied
enrollment into the system. However, it is included in our bottom line
for total discretionary dollars needed by the VA to provide health care
to all eligible veterans. Despite our clear desire to have the VA
health care system open to these veterans, Congress and the
Administration have shown little desire to overturn this policy
decision. The VA estimates that a total of over 1,000,000 Category 8
veterans will have been denied enrollment into the VA health care
system by fiscal year 2007. Assuming a utilization rate of 20 percent,
we believe that it would take approximately $684 million to meet the
health care needs of these veterans, if the system were reopened. We
believe that the system should be reopened to these veterans and this
money appropriated on top of our medical care recommendation for this
purpose.
Despite a reasonable request this year, the budget and
appropriations process over the last number of years demonstrates
conclusively how the VA labors under the uncertainty of how much money
it is going to get and when it is going to get it. In order to address
this problem, PVA, in accordance with the recommendation of The
Independent Budget, proposes that funding for veterans' health care be
removed from the discretionary budget process and be made mandatory.
medical, prosthetic, and rehabilitation research
For Medical and Prosthetic Research, the Administration has
recommended $399 million, a cut of approximately $13 million below the
fiscal year 2006 appropriation. The Independent Budget recommends $460
million. Research is a vital part of veterans' health care, and an
essential mission for our national health care system. VA research has
been grossly underfunded in comparison to the growth rate of other
Federal research initiatives. We call on Congress to finally correct
this oversight.
We also believe that additional funding needs to be provided for
rehabilitation research. The development of new and better techniques
allows catastrophically disabled veterans to become more active and
independent in society. Furthermore, advanced rehabilitation can only
lead to a happier and healthier life for these men and women.
One particular program that is currently taking place that we
believe will be highly successful is the Spinal Cord Injury--Vocational
Rehabilitation Program (SCI-VIP). This is a new 5-year research project
that will attempt to greatly improve the employment rate of veterans
with spinal cord injury. It will be conducted at four spinal cord
injury/dysfunction (SCI/D) centers--Dallas, Milwaukee, San Diego and
Cleveland--with control groups at the Houston SCI center and at the
Hines SCI center in Chicago. In short, the project will inject
vocational rehabilitation counselors (VRC) directly into the medical
rehabilitation process to provide ``hands-on'' vocational assistance
throughout rehabilitation. The VRCs will make employment a priority
component of the rehabilitation process.
PVA has strongly supported this concept since it was first proposed
by Dr. Lisa Ottomanelli at the Dallas SCI Center. We hope that the VA
will see fit to expand this program to benefit spinal cord injured
veterans across the country. We would also urge the Congress to make
available additional funds within the research program to support this
project.
physician and nurse shortage
PVA is concerned that the VA continues to experience a serious
shortage of qualified, board certified spinal cord injury (SCI)
physicians, making it difficult to fill the role of chief of an SCI/D
service. Several major SCI/D programs are under acting management with
resultant delays in policy development and a loss of continuity of
care. In some VA hospitals the recruitment for a new chief of service
has been inordinately prolonged with acting chiefs assigned for
indefinite time periods.
We are even more concerned about the continuing shortage of nurses,
particularly in spinal cord injury units. PVA believes that the basic
salary for nurses who provide bedside care to SCI veterans is too low
to be competitive with community hospitals. This leads to high
attrition rates as these nurses seek better pay in the community.
Recruitment and retention bonuses have been effective at several
SCI centers, resulting in an improvement in the quality of care for
veterans as well as the overall morale of the nursing staff.
Unfortunately, these are localized efforts by the individual VA medical
facilities. We believe that the Veterans Health Administration (VHA)
should authorize substantial recruitment incentives and bonuses.
PVA calls on Congress to conduct more oversight of the VHA in
meeting its nurse staffing requirements for SCI units as outlined in
VHA Directive 2005-001. Currently nurse staffing numbers do not reflect
an accurate picture of bedside nursing care provided because
administrative nurses, non-bedside specialty nurses, and light-duty
staff are counted as part of the total number of nurses providing
bedside care. Furthermore, not all SCI centers are in full compliance
with the regulation for the staffing ratio of professional nurses to
other nursing personnel. With proper congressional oversight, these
mistakes can be corrected.
long-term care and assisted living
PVA is concerned with recent trends to reduce the ability of the VA
to provide long-term care to a rapidly aging veterans population. We
strongly oppose any proposal that would repeal the statute that
requires the VA maintain bed and staffing levels at the same level
established by P.L. 106-117, the ``Veterans Millennium Health Care and
Benefits Act.'' Despite an aging veteran population and passage of P.L.
106-117, the VA has continuously failed to maintain its 1998 VA nursing
home required average daily census (ADC) mandate of 13,391. VA's
average daily census (ADC) for VA nursing homes has continued to
decline since 1998 and is projected to decrease to a new low of 9,795
in fiscal year 2006. The VA is ignoring the law by serving fewer and
fewer veterans in its nursing home care program.
PVA was deeply troubled by efforts in Congress last year to
eliminate the mandatory ADC requirement contained in the Millennium
Health Care bill. This proposed change is not driven by current or
future veteran nursing home care demand. In fact, the General
Accounting Office (GAO) reported ``the numbers of aging veterans is
increasing rapidly, and those who are 85 years old and older, who have
increased need for nursing home care, are expected to increase from
approximately 870,000 to 1.3 million over the next decade.''
PVA strongly feels that the repeal of the capacity mandate will
adversely affect veterans and is a step toward allowing VA to reduce
its current nursing home capacity. This is not the time for reducing VA
nursing home capacity with increased veteran demand looming on the near
horizon. We hope that this Committee will reject any such legislation.
Furthermore, we urge the Committee to conduct aggressive oversight to
ensure that the VA is fulfilling its statutory obligation to provide
long-term care.
We believe that assisted living can be a viable alternative to
nursing home care for many of America's aging veterans who require
assistance with the activities of daily living (ADL) or the
instrumental activities of daily living (IADL). Assisted living offers
a combination of individualized services, which may include meals,
personal assistance, and recreation provided in a home-like setting.
Congress should consider providing an assisted living benefit to
veterans as an alternative to nursing home care. Likewise, Congress
should authorize the VA to expand its Assisted Living Pilot Program
(ALPP) to include an initiative in each VA Veterans Integrated Service
Network (VISN). This expanded effort will allow VA to gather important
regional program cost and quality information.
Congress should call upon VA to conduct a cost and quality
comparison study that compares the ALPP experience to cost and quality
information it has compiled for VA nursing home care, community
contract nursing home care, and state veterans nursing home care. When
completed, this long-term care program cost comparison study should be
made available to Congress and veterans service organizations.
multiple sclerosis (ms) and parkinsons centers of excellence
The VA appropriations subcommittees in the House and Senate
inserted language in their VA funding reports for fiscal year 2001
requiring VA to establish centers of excellence to conduct research and
study in the field of neurodegenerative diseases. With that
instruction, VA identified two fields of inquiry for the centers with
particular bearing on medical conditions prevalent in the veteran
population, Parkinsons Disease and Multiple Sclerosis. The VA,
subsequently, on two different tracks, proceeded to establish the
centers of excellence starting first with the Parkinsons Centers and
later with the two MS Centers.
PVA has expressed concern that the centers, established only
through VA good faith and resources available in any one budget cycle
could eventually be in jeopardy. Therefore, last year an effort was
launched to take what was only an authorization or recommendation for
the centers and actually codify them. The House of Representatives
approved H.R. 1220 which addressed the codification of the Parkinsons
centers. Senator Daniel Akaka introduced S. 1537 which would codify
both Parkinsons and MS Centers.
When both the House and Senate Appropriations Subcommittees
directed VA to establish these centers they made no distinction between
them. The report language in both Appropriations bills only directed VA
to establish centers of excellence in neurodegenerative diseases to
spur the Department along in research and treatment in this overall
field of medicine. While studying uniquely different diseases, both
Parkinsons and MS Centers serve together in the overall study of
neuroscience. It would be inappropriate in our view to put the centers
on separate tracks, codifying one and not the other.
We urge the committee to adopt legislation which can address and
codify these centers in Title 38 U.S.C. once and for all.
contract care coordination
I would like to address a trend that we believe could have a
substantial negative impact on the VA health care system. We have
serious concerns about the contract care coordination pilot program
authorized in P.L. 109-114, the ``Military Construction, Military
Quality of Life and Veterans Affairs Appropriations Act of 2006.'' The
conference report accompanying this law requires the VA to establish a
comprehensive managed care demonstration project in at least three
Veterans Integrated Service Networks (VISNs). We oppose the VA's
planned approach to this new requirement to establish additional,
parallel contract programs on a broad scale.
VA's approach to this requirement seeks to contract health care
services provided by non-VA providers on a broad basis. This only
serves to dilute the quality and quantity of VA services for new as
well as existing veteran patients. Ultimately, contract care is not
more cost-effective or cost-efficient than care provided by the VA, and
we certainly do not believe that the VA will find the same level of
high-quality care in the private sector. There is no reason for VA to
move into this arena on a broad basis.
The Secretary of Veterans Affairs, Jim Nicholson, recently
testified to the remarkable success of the VA health care system and
the positive media that it has recently received as a result of this
success. He explained that it is a model for the rest of the country
and private industry. In fact, Secretary Nicholson stated before the
House Committee on Veterans' Affairs at a hearing on February 8, 2006
that ``for the sixth consecutive year, VA set the public and private
sector benchmark for health care satisfaction based on the American
Customer Satisfaction Index survey.'' This is true because the VA
health care system operates as a fully integrated, government managed
health care system.
benefits recommendations
PVA would like to offer a few improvements to benefits provided by
the VA. PVA members are the number one beneficiary of the Special
Adaptive Housing (SAH) grant and the adaptive automobile grant.
Unfortunately, periodic increases in these grants have not kept pace
with inflation. For both the SAH grant and the adaptive automobile
grant, we believe that an automatic annual adjustment indexed to the
rising cost-of-living should be applied. Furthermore, in accordance
with the recommendation of The Independent Budget, the adaptive
automobile grant should be increased to 80 percent of the average cost
of a new vehicle to meet the original intent of Congress.
PVA would also like to recommend a change in the compensation
provisions outlined in Title 38, Section 5111. Under current law, the
effective date for a veteran's finding of service connection is the day
after his or her date of military discharge. However, the effective
date for his or her VA compensation payments is the first day of the
month following the month when that service connection was granted.
Because the veteran's compensation payment for a given month is not
made until the end of the month, he or she could lose up to an entire
months worth of pay under this current provision.
As an example, if SGT John Smith is medically retired on 01/31/06
from the Army for a C4 spinal cord injury from a sniper bullet, then
his effective date for benefits is 02/01/06. However, his effective
date for compensation payment is 03/01/06, and he would not receive his
first payment until 03/31/06. Current law does not allow him to be
compensated for the month of February in this case. We believe the law
should be changed to make the veteran's effective date of service
connection and effective date for compensation payment the same.
PVA appreciates the opportunity to present our legislative
priorities and concerns for the second session of the 109th Congress.
We look forward to working with the Committee to ensure that adequate
resources are provided to the VA health care system so that eligible
veterans can receive the care that they have earned and deserve. We
also hope that this Committee will take the opportunity to make
meaningful improvements to the benefits that veterans rely on.
Mr. Chairman, I would like to thank you again for the opportunity
to testify. I would be happy to answer any questions that you might
have.
Chairman Craig. Randy, thank you.
Larry, please proceed.
STATEMENT OF LARRY BELOTE, NATIONAL PRESIDENT, BLINDED VETERANS
ASSOCIATION
Mr. Belote. Yes, sir. On behalf of the Blinded Veterans
Association, I want to thank you for allowing us this
opportunity to testify today. Am I supposed to ask, can we have
our testimony entered into the record, the written testimony?
Chairman Craig. Without objection, all statements and any
accompanying material will be a part of the official record.
Thank you.
Mr. Belote. Thank you, sir. The Blinded Veterans
Association has a long history, and is the only congressionally
chartered organization specifically set up to serve blinded
veterans and their families. This month is when we are going to
celebrate our 61st year of continuous service in doing that.
I think what that has resulted in is, we have a unique
insight into the needs and services that we require from the
Department of Veterans Affairs. There are three things about
us, I think, that cause that.
Number one, we are providers of the services. We see what
the people need on a daily basis. We are working now with the
OIF/OEF veterans, Ryan Wolfer Hall, and we are working with
them in the BAMC, at Brooks Army Medical Center in San Antonio,
for example. We are on conference calls with them and their
families to give them support.
The people on our board are actively involved in the local
community, State level. And we are staying involved, trying to
share the learning experiences that we had overcoming sight
loss, so it makes the road a little easier for these fellows
and ladies when they come back to get back on their feet and
restore their functioning and become active members of society.
We are also consumers. Obviously we use the benefits and
goods of the VA to get back on our feet. Many of us have used
the educational benefits, the rehab services, to become
lawyers, physician's assistants, ministers. The people on our
board all have achieved great heights because of the VA and the
services we were provided to get us back on our feet, and we
want to make sure that happens to the veterans following us.
The last thing that we are, and this is very important, we
are also taxpayers. We are taxpayers, and we want to make sure
it is not always how much we get, it is how much we spend and
how we spend it. We want to ensure, as taxpayers, that the VA
spends the money they get in the best way possible to meet our
needs, and not spending it on something else that doesn't meet
our needs but trying to sell it that way.
I want to now move into our legislative thing, and we want
to only focus on three issues today. We provided our written
testimony, which is quite, quite in depth.
The first one, I want to thank the Chairman and the
Committee, and especially Senator Salazar, for helping us get
our BROS, our Blind Rehab Outpatient Specialist legislation
through the Senate, and it is now over at the House. This is an
important part of our saving money, because we believe that
having outpatient services, an outpatient model of service
delivery goes a long way toward saving money over brick-and-
mortar facilities which have been the historical way of
providing services.
The second thing I want to bring up, and this directly
relates to OIF/OEF veterans, is the paired organ legislation.
Here we are seeking changes in the existing law which simply
correct some inaccuracies in there which cause some
restrictions that treat a blinded veteran differently than a
Social Security recipient when it comes to determining
disability.
Right now there are about 78 veterans from the OIF/OEF
conflicts who are blind in one eye. This legislation would be
something directly related to compensating them down the road,
so we think it is very important. Right now we have over 70
bipartisan cosigners in the House, and we are seeking cosigners
in the Senate, and we are hoping that someone will be able to
step up to the plate and help us on this important legislation.
We stand ready to clarify and to make it clear and work as your
extenders to understand what this all means.
The third piece of legislation is actually a resolution
which I think nobody can object to, since it costs nothing. We
have a strong feeling that the white cane/guide dog law needs
to be--not law--Resolution 71 should be supported and passed.
This gives notice to the States that the Senate, the House,
supports them putting in their driver's license handbooks
language that says, ``When you see someone who is blind, with a
dog or with a cane, pay extra caution.'' All the States have
this in their laws but it is not in their handbooks.
And we think by seeing that--three of our Members almost
got run over here, somebody turning right as we were trying to
cross the street. Obviously they didn't know what the white
cane was. Perhaps this could be helped in the future if we had
this in the State handbooks. Again, it is free.
And we need a continuum of care. The best example I can
give you of a continuum of care, and let's use an Iraqi veteran
right now in San Antonio in the BAMC. A soldier from
Mississippi is there receiving his rehab. He is totally blind,
terribly injured. The VA blind rehab specialist, Bob Cozel, is
going over to the BAMC, providing him rehab while he is active
duty. He is teaching him how to use a cane. He wouldn't have a
cane, he wouldn't have a talking watch to tell what time it
was, if the VA hadn't gone over there and provided these
support services.
So we are already working before, in the continuum of care.
When he gets through with BAMC, he will come out, he will
become part of the VA, he will go into a blind rehab center.
When he gets out, this BROS position we are trying to get
passed would take over the case and provide service to him back
at his home, teaching him how to use the bus, get around, help
him with his adjustment. When he gets into voc rehab, they
continue to follow him. When he gets a job, they continue to
follow him, help him with his adjustment to the workplace.
So we think these positions are very important in the
field, and many areas of the country have no regional rehab
services. So if veterans live in different areas, these
positions will make a big difference in their lives, and we
hope that it passes the whole Congress.
The other example of continuum of care is the elderly
veteran who the doctor refers because he is a diabetic and
can't see his medications, can't read his insulin syringes. He
needs someone who knows about blindness and the devises and
things, to get him hooked into the talking blood glucose
monitors, the magnifiers, the low vision optometrist, to keep
him in his home, so he doesn't end up having a fall or being
unnecessarily admitted to the hospital or, God forbid, being
put into a long-term facility unnecessarily.
These services in the local community we believe are very
cost effective and will save money, and that is what we want,
is to save money, looking at better ways to do things. We want
the system to be a risk management model, where we are looking
at solving problems in the field, solving risks, the right
service at the right time with the right intervention.
It is not a good continuum of care for someone to be simply
told, ``There is nothing we can do for you locally. You are
going to have to be put on a waiting list to go to a blind
rehab center, and we don't know when you are going to get in,
but you are just going to have to hold on until you go.'' We
have found that inadequate and a very poor way of using money
in the VA.
[Applause.]
We think that when it comes to blind rehab services----
Chairman Craig. We didn't cut you off, Larry. You are doing
fine, but we would appreciate it if you would wrap up. Thank
you.
Mr. Belote. Yes, sir. Thank you for this opportunity, and
if you have some questions, I will be glad to address those.
Chairman Craig. Thank you very much, Larry.
Mr. Belote. Thank you, sir.
[The prepared statement of Mr. Belote follows:]
Prepared Statement of Larry Belote, National President,
Blinded Veterans Association
Mr. Chairman and Members of the Senate Veterans' Affairs Committee,
on behalf of the Blinded Veterans Association (BVA), thank you for this
opportunity to present BVA's legislative priorities for 2006. We
believe it is imperative that Members of this Committee work in a
bipartisan manner during the second session of the 109th Congress. We
all strive for the same goal, that of improving access to a high
quality, fully integrated system of health care and benefits for
America's veterans.
The Blinded Veterans Association is the only congressionally
chartered Veterans Service Organization exclusively dedicated to
serving the needs of our Nation's blinded veterans and their families.
Since the end of World War II, when a small group of blinded veterans
formed BVA, our Association has grown to include blinded veterans from
several wars and conflicts, and we will soon celebrate in March our
61st anniversary of continuous service to America's blinded veterans.
It is vital that our issues and advice be included in this process so
that we all can make a positive difference in the quality of life for
the men and women who have sacrificed so much for our freedom.
BVA would like this Committee to know that the Walter Reed Army
Medical Center staff alone has treated approximately 120 soldiers with
either blindness or significant visual injuries. Twenty-seven of these
soldiers have attended one of the ten VA Blind Centers, and others are
in the process of being referred for admission. Seventy-eight
servicemembers, according to Veterans Benefits Administration (VBA)
data, are service connected for total blindness in one eye from
Operation Enduring Freedom (OEF) or Operation Iraqi Freedom (OIF)
injuries. When BVA representatives meet with these brave soldiers who
have suffered catastrophic, life-altering injuries, the latter ask what
services and benefits are going to be there to help them recover.
Recent research has also found that individuals with Traumatic Brain
Injury have about a 20 percent occurrence of visual field loss, with
over 2,000 TBI's from OIF, this suggests that the numbers mentioned
above needing low vision screening and services will grow. It should be
obvious to Members of this Committee that a new generation of young
blinded veterans is returning home from Afghanistan and Iraq, and that
our combined efforts will be extraordinarily important. We must insure
that we fully support them with the continuum of care and blind
rehabilitative resources necessary during their transition from active
duty to veteran status.
Mr. Chairman, we feel compelled to alert this Committee to what we
believe to be a significant failure or flaw in the ``Seamless
Transition'' for visually impaired or blinded servicemembers. We
learned that servicemembers who have lost total vision in one eye are
not always being referred to VA for low vision assessment or services.
We believe many of these individuals most likely have some visual
impairment in their remaining eye and should receive a comprehensive
low vision assessment by VA to determine if they meet the definition of
legal blindness. Such a determination would make a substantial
difference in the benefits and services for which they would be
eligible for through VA. Even if they do not meet the definition of
legal blindness, studies have revealed individuals with only vision in
one eye, have functional loss of 30 percent of their visual field,
which VA rehabilitation services could be of assistance in training
them to compensate for this loss.
Throughout our 61 years of service, BVA has closely monitored VA's
capacity to deliver high-quality rehabilitative services in a timely
manner. Currently, approximately 41,700 blinded veterans are enrolled
in VA. Demographic research projects that by the year 2010 there will
be almost 55,000 veterans with blindness or significant low vision
impairments enrolled. Census Bureau data, however, reveals that there
are some 167,000 legally blind veterans in the United States. Research
on blind and low vision Americans show they are at risk of falls, or
making medication mistakes, resulting in costly hospital admissions
every year, and of losing their independence to live at home. Falls are
the sixth leading cause of death in senior citizens and a contributing
factor to 40 percent of all nursing home admissions with annual Federal
costs over $45,000 for each nursing home bed. According to Framingham
Eye Study, 18 percent of all hip fractures among senior citizens--about
63,000 hip fractures a year--are attributable to vision impairment. The
cost of medical-surgical treatment for every hip fracture is over
$39,000, if outpatient rehabilitation services prevented even 20
percent of these hip fractures, the annual Federal savings in health
care costs would be over $441 million.
critical issues
Mr. Chairman, 2 years ago BVA presented grave concerns about
waiting lists of more than 2,500 blinded veterans awaiting entrance
into one of 10 VA Blind Rehabilitation Centers (BRCs) across the
country. Thanks to the previous Chairman of the Subcommittee on Health
of the House Veterans Affairs Committee at that time, the General
Accountability Office (GAO) investigated the VA blind rehabilitation
program at every level. GAO then testified before this Committee on
July 22, 2004 regarding the status of VA services for the blind.
BVA was grateful to the House Committee for holding that hearing to
receive the report of GAO, but we are here to report that while some
progress has been made in reducing the waiting lists and times for
admission, there are still 1,212 blinded veterans waiting an average of
almost 19 weeks to enter one of these ten BRCs. Since then, the VA
Visual Impairment Advisory Board (VIAB) has continued to evaluate VA's
progress in implementing the recommendations of GAO. At the request of
the VHA National Leadership Board (NLB) Health Services Committee, VIAB
commissioned a Gap Analysis to determine where VA currently has vision
rehabilitation service and where there are gaps in service delivery.
Additionally, cost estimates were requested to determine funding needed
to close the gaps identified.
VIAB is an interdisciplinary board that includes health care
providers, the Blinded Veterans Association, rehabilitation research,
prosthetics, and VA network representatives. Due to the increasing age
of our veteran population and the known prevalence of age-related
visual impairment, VIAB has identified the need for a uniform national
standard of care. Along with the GAO report, VIAB also identified a
need for increased outpatient blind rehab services. The Gap Analysis,
mentioned above, revealed many areas of the country offer no outpatient
vision rehabilitation services. There is a need to develop and
implement a full continuum of vision rehabilitation care that augments
the services already in place for legally blind veterans. The report
envisioned the development of a full spectrum of visual impairment
services.
To achieve such an objective, the GAO Testimony, the VIAB Report,
and the VA Gap Analysis all strongly recommended the expansion of the
Blind Rehabilitative Outpatient Service (BROS) program. As an example,
Mr. Chairman, the BROS located nearest to us here, servicing both
Baltimore and Washington, DC, has met with every newly blinded
servicemember at Walter Reed Army Medical Center and the National Naval
Medical Center in Bethesda, Maryland. This single BROS is from the
Baltimore VA Medical Center, where approximately 512 blinded veterans
are already enrolled and who need his services. The Washington DC VA
Medical Center, with 541 blind veterans, has no BROS and has depended
on the Baltimore BROS. Only after almost 3 years of OIF/OEF causalities
has a new part-time FTEE been established for both Walter Reed and for
the Washington, DC VA Medical Center. It is time for all blinded
veterans to receive the right service, at the right place, at the right
time, without long delays because of tight budgets.
This early intervention is critical for both the soldier and family
members in starting the process of learning about blind rehabilitation,
which includes an introduction to early blind rehabilitation skills.
The success of the process of adapting to traumatic blindness is
dependent upon a seamless transition from Department of Defense Medical
Treatment Facilities to VA Blind Centers. Despite some successes, BVA
has found serious problems with three of the four VA Poly Trauma
Centers of Excellence during the past year where there is no BROS on
staff to facilitate the vital blind rehabilitation training that OIF
soldiers should experience when they transfer to these centers. Only
recently, after persistent questioning of the Veterans Health
Administration (VHA), did they begin to advertise for a BROS FTEE.
These visits are crucial to the continuum of care for returning
veterans. Such visits encourage the veterans to continue using the
skills learned and to adapt to new changes in prosthetics and
constantly evolving adaptive equipment.
More than a year ago VIAB presented a proposal to the Health System
Committee of the National Leadership Board (NLB). The proposal directed
all Veteran Integrated Service Networks (VISNs) to implement a full
continuum of care for visually impaired and blind veterans. The
Committee received the proposal very positively and has recently issued
a report in November 2005 on the Financial Projections for the
Expansion of Low Vision Services in the VA's Continuum of Care from the
gap analysis. We are very pleased that as recently as Jan. 17, 2006,
the Health Services Committee unanimously endorsed the full
recommendations of VIAB, including the Gap Analysis and cost estimates.
The recommendation for the full continuum of vision rehabilitation
services has now been referred to the Finance Committee of the NLB to
attempt to identify funding to implement the proposal. BVA supports the
broad scope of this proposal and, as outlined further in this document,
we request your oversight assistance in insuring that action is taken
on these recommendations. Mr. Chairman, BVA believes the only way these
recommendations can be implemented is for additional funding to be
included in the VA fiscal year 2007 Appropriation directed for this
initiative. We respectfully request additional funding be included in
the ``Views & Estimates'' you will be submitting to the Committee on
the Budget. VIAB does not dictate to the VISNs how this continuum of
care should be implemented. BVA would point to successful VA models of
unique programs across the country, such as the 60 percent increased
utilization of contracting out Computer Assisted Training (CAT) for
visually impaired veterans. Although these programs have contributed to
the decrease in the veteran BRC waiting lists, there still needs to be
further improvements. Additionally, the provision of a full continuum
of Vision Rehabilitation Services is now included in the Network Five-
Year Strategic Plans.
The independent Capital Asset Realignment for Enhanced Services
(CARES) Commission recommended the establishment of new BRCs in VISN 16
and VISN 22. These centers have not yet opened. In 2005, another VAMC
hosting a BRC was targeted for closure. A final decision regarding the
VA medical center in Waco, Texas, is under review by an outside
contractor. In light of the Hurricane Katrina devastation to the
Biloxi, Mississippi VA Medical Center, where one of the new BRCs was to
be constructed as recommended by the CARES report, BVA would suggest
that it would be more prudent and cost effective to expand the BRC
currently located in Waco. This facility would then handle the
projected increased vision rehab workload in VISN 16. Of course, it
would be necessary to keep the Waco VAMC open, which would run contrary
to the recommendation of the CARES report.
Another recommendation set forth by the Commission states: ``VA
should develop new opportunities to provide blind rehabilitation in
outpatient settings close to veterans' homes.'' GAO made a similarly
strong recommendation in its testimony, indicating that when VA and GAO
reviewed the waiting list of 1,500 veterans pending admission to BRCs,
21 percent of them could potentially be served if local BROS were
available. Mr. Chairman, BVA appreciated the passage of ``The Blinded
Veterans Continuum of Care Act of 2005'' (S. 1190) last session that
would increase VA's ability to staff thirty-five new BROS personnel in
many facilities where none currently exist. We are extremely grateful
to Senator Salazar for introducing this vital legislation. Clearly,
BROS provide a cost-effective model of outpatient service delivery.
BVA strongly supports the concept of assured funding for veterans.
Our support was strengthened after the admission last June that VA was
insufficiently funded by more than $1.2 billion in fiscal year 2005 and
$1.9 billion in fiscal year 2006 because of the current funding model
process. This admission and revelation were not surprising to the
VSO's. They did, however, appear surprising to those in Congress who
have been content with the current discretionary process. The
Independent Budget (IB) has, for many years made accurate funding
projections for the amount really needed for VA health care. IB members
had projected the shortfall long before last March. As always when such
shortfalls occur, veterans waiting times grew, veterans appointment
lists expanded, and the bureaucracy pointed fingers at who was to
blame. The reality is that discretionary funding leaves more room for
partisan politics than it does for health care for veterans. As a
member of the Partnership for Veterans Health Care Budget Reform, our
membership strongly believes that Members of Congress must change the
current modeling system that constantly leads to shortfalls. The
Partnership supports moving VA health care from a discretionary to an
assured funding method with a new model to prevent the shortages that
occurred during the first session of this Congress. Assured funding
would neither change the current eligibility requirements nor create a
new entitlement benefit program. It would rather create a formula that
would ensure necessary appropriations each year based on current
enrollment, and the annual increased inflationary costs associated with
the provision of excellent medical care.
The lack of predictability and accountability of the modeling used
for the VA budget process allows only the status quo at best. The
consequences can only be long waiting lists, decreased access, and risk
of damage to the high quality of care that VA has built. If VISNs are
receiving their budgets at the start of the second quarter through a
fiscal year, and are not sure when the year's funding will really be
passed by Congress, why would they invest in any type of new
initiative, never knowing when the money will catch up, or if any will
be there during that budget year? Assured funding and implementation of
a full continuum of care for blind and visually impaired veterans are
inextricably linked.
background
We are all painfully aware of the aging veteran population and the
increasing need and demand for health care services associated with
aging. Mr. Chairman, aging is the single best predictor for blindness
or severe visual impairment. As the overall population of veterans
ages, more and more of them are losing their vision, requiring
rehabilitative services. Because of all the other chronic medical
problems associated with aging, more and more members of our blinded
veteran population are either unable or unwilling to leave home to
attend a comprehensive residential BRC. The primary obstacle is the
fact that enrolling in the BRC often necessitates traveling hundreds of
miles to the nearest facility. The Gap Analysis survey found that 47.4
percent of the older veterans on VIST rolls who would benefit from
blind rehabilitation training actually declined to attend one of the
ten blind centers. A common reason for a refusal to attend a BRC is a
serious health problem or disability of a spouse. Consequently, the
blinded veteran who has often been a long-term recipient of care
himself/herself becomes, out of urgency and necessity, the primary
caregiver. In such instances it is impossible for the blinded veteran
to spend several weeks in an inpatient residential blind rehabilitation
program.
Mr. Chairman, there is absolutely no question that comprehensive
residential BRCs provide the most ideal environment to maximize a
blinded veteran's opportunity to develop a healthy and wholesome
attitude about his/her blindness and acquire the essential adaptive
skills to overcome the many social and physical challenges of
blindness. This is especially true for newly blinded young veterans
such as those now returning from Iraq and Afghanistan. The BRC becomes
even more important for many of these blinded servicemembers because
they suffer from multiple traumas that include traumatic brain injury,
amputations, and sensory loss. The training can also be advantageous to
older veterans since intense repetitive training is often necessary to
learn new skills. The BRC can bring the entire array of specialty care
to bear on these severely wounded servicemembers, optimizing their
rehabilitation outcomes and encouraging a successful reintegration with
their families and communities. Frankly, Mr. Chairman, there is no
better environment to facilitate the emotional adjustment to the severe
trauma associated with loss of vision and to provide comprehensive
initial blind rehabilitation.
current services
Mr. Chairman, I will now briefly describe each of the essential
components offered by VA Blind Rehabilitation Service and the
challenges each is facing. We believe strongly that each of these
services is an integral part of the full continuum of blind
rehabilitation services that VA should strive to provide.
A. Blind Rehabilitation Centers
VA currently operates ten comprehensive residential Blind
Rehabilitation Centers across the country. The first blind center was
established at the VA Hospital at Hines, Illinois, in 1948. Nine
additional BRCs have been established and strategically placed within
the VA system. The sites include VAMCs in Palo Alto, California (1967);
West Haven, Connecticut (1969); American Lake, Washington (1971); Waco,
Texas (1974); Birmingham, Alabama (1982); San Juan, Puerto Rico (1990);
Tucson, Arizona (1994); Augusta, Georgia (1996); and West Palm Beach,
Florida (2000). The mission of each BRC is to address the expressed
needs of blinded veterans so they may successfully reintegrate back
into a community and family environment. To accomplish this mission,
BRCs offer a comprehensive and individualized training program
accompanied by services deemed necessary for a person to achieve a
realistic level of independence. The environment is residential but
located within a VA facility in order to provide medical services to
blinded veterans while they participate in the rehabilitation process.
Approximately 1,212 blinded veterans are waiting an average of more
than 19 weeks to be admitted into one of these ten BRCs. The good news
this year, however, is that the number has declined from the 1,500 in
March 2004. Unfortunately, a majority of even the simplest services are
not yet routinely made available at the local level. The recent Gap
Analysis found that only 14 medical centers reported being able to
provide advanced low vision care. Only 26 said they could provide
intermediate low vision care. Some 78 facilities reported only basic or
no outpatient services for blindness or low vision care! For the more
than 30 percent of the blinded veterans who do attend a comprehensive
BRC, there is usually no continuum of outpatient care when they return
home. In order to preserve the integrity of these BRCs, more outpatient
and local services must be provided.
B. Visual Impairment Services Team (VIST)
The mission of each VIST program is to provide blinded veterans
with the highest quality of adjustment to vision loss services and
blind rehabilitation training. To accomplish this mission, VIST will
establish mechanisms to maximize the identification of blinded veterans
and to offer a review of benefits and services for which they are
eligible. The VIST concept was created in order to coordinate the
delivery of comprehensive medical and rehabilitative services for a
blinded veteran. The ``teams'' were created in 1967. In 1978, VA
established six full-time VIST Coordinator positions. Currently, the VA
system employs 93 full-time VIST Coordinators who usually work alone to
take care of an average of 375 veterans. The VIST Coordinators serve as
the case managers for the known 41,700 blinded veterans nationwide, a
number that is estimated to increase to 54,000 within 10 years.
VIST personnel associated with a given VIST Coordinator are in the
unique position of providing comprehensive case management services for
the returning blinded OEF and OIF servicemembers for the remainder of
their lives. They can assist not only the newly blinded veteran but
also his/her family with timely and important information that
facilitates psychosocial adjustment. The ideal of a seamless transition
from DOD to VHA is best achieved through the dedication of VIST and
BROS personnel.
A few of the VIST Coordinators have been very aggressive in
identifying local resources capable of delivering needed services to
blinded veterans in their homes. Regrettably, only a few are managing
such dynamic VIST programs. The majority of the Coordinators rely on
the BRC because many have no local BROS orientation or mobility
services. If the veteran is unable to attend a BRC program, he/she goes
without service in those circumstances. We find also that many rural
remote regions have no local private blind services of any kind,
leaving the veteran with no options. Full implementation of the
continuum of vision rehabilitation services should remedy this
shortcoming. Given the increasing numbers of severely visually impaired
and blinded veterans, BVA believes and has always maintained that any
VA facility that has 150 or more blinded veterans on its rolls should
have a full-time VIST Coordinator. BVA has found that the lack of VIST
services is often due to the actions of local facility managers who
seek to avoid the cost of even one FTEE position. In such cases
management has insisted that part-time positions manage these duties
along with other collateral duties.
C. Blind Rehabilitation Outpatient Specialist (BROS)
The other highly specialized outpatient program offered by BRS is
the BROS program. This relatively new (at least for BRS) approach to
the delivery of services is provided to blinded veterans who cannot
attend a BRC program. Veterans who attended a BRC and who would
otherwise lack continuum of care follow-up are also beneficiaries of
the program. Such veterans in the latter case often require some
additional training due to changes in adaptive equipment or technology
advances. Ten years ago, VA BRS did not possess the workforce to carry
out effective follow-up to assess how effectively the veteran had
transferred the newly learned skills to his/her home environment.
Fourteen BROS were hired in 1995-1996, while a relatively small number
of professionals, the creation of these initial BROS positions provided
VA with an excellent opportunity to provide accessible, cost effective,
quality outpatient blind rehabilitation services. The number of BROS
has increased to 24 since the original appropriation.
The BROS is a highly qualified professional who, ideally, is dually
certified; that is, he/she has a dual Masters degree both in
Orientation and Mobility (living skills and manual skills) and
Rehabilitation Teaching. In the absence of such dually credentialed
professionals, masters level blind rehabilitation specialists should be
selected for these positions and receive extensive cross training at
one of the BRCs. Such training prepares these individuals to provide
the full range of mobility, living, and adaptive manual skills that are
essential in the veteran's home environment.
The delivery of such outpatient rehabilitative service is the most
cost efficient method for those veterans who have rehabilitation needs
but are unable to attend the residential program to receive care.
Surveys in the Gap Analysis found that some medical centers were paying
$90 per hour ($450 daily) for private blind training when it was
available. Some centers had an average annual expenditure of more than
$70,000 for contracted private blind services. Veterans must not be
denied essential rehabilitative outpatient services simply to save a
few dollars up front.
The rapidly growing older blinded veteran population, as mentioned
previously, is clearly the therapeutic target for this type of service
delivery. The highly skilled BROS professionals conduct comprehensive
assessments of the newly identified blinded veteran's needs to
determine if referral to a residential BRC is necessary. If residential
training is the appropriate response, the BROS may also provide some
initial training before admission, potentially reducing the length of
stay in the BRC. Since it is more efficient to provide as much care as
possible in an outpatient setting, according to GAO testimony is a
statement that 21 percent of all veterans on waiting lists for
admission to a BRC could receive care through local blind outpatient
services. Under CARES, each admission to a BRC costs $28,900 per
veteran therefore, even 240 veterans a year were instead provided local
VIST/BROS services, the internal BRC inpatient cost saving would be an
estimated $7,900,000 yearly.
D. Computer Access Training (CAT)
Because of the fiscal year 1995 VA appropriation of special funds
earmarked for VA BRS, monies were made available to establish Computer
Access Training (CAT) programs at the five major blind rehabilitation
centers. Over the intervening years, CAT programs have been established
at the remaining five BRCs. However, the demand for admission to these
programs has dramatically increased to the point that an eligible
blinded veteran has been waiting a year or more to be admitted. There
are approximately 396 blinded veterans presently waiting for more than
21 weeks to attend a blind center for both rehabilitative and CAT
``dual'' training. The problem is that many veterans live in rural and
remote regions where local services are not available. They must attend
a blind center or be left without training.
Having to admit a blinded veteran to an inpatient VA BRC for this
specialized computer training, which includes housing the blinded
veteran in a hospital bed, is unnecessarily expensive. The good news is
that, despite all of the obstacles, local training has increased. On
May 5, 2004, 674 veterans were waiting for admission to a BRC for CAT
training. This list was reduced by local CAT contracted services for
520 of these veterans by August 1, 2004. This successful result is due
in large part to the GAO study of VA BRS service delivery and its
subsequent recommendations. It involves the referring of most blinded
veterans to local resources, if they can be appropriately located, for
CAT training. The reduction in the BRC waiting lists from more than
2,500 veterans in 2003 to 1,212 at present involves a more effective
utilization of CAT resources. Some BRCs have been, correspondingly,
returning beds previously dedicated to CAT training back to the basic
adjustment program. Continuing to contract services in a similar
manner, greater progress could be achieved in decreasing the long
waiting times for younger veterans who require the full services of the
blind centers.
E. Visual Impairment Services Outpatient Rehabilitation (VISOR)
In 2000, VA Stars and Stripes Healthcare Network 4 initiated a
revolutionary program to deliver services: Pre-admission home
assessments complimented by post-completion home follow-up. An
outpatient, 9-day rehabilitation program called Visual Impairment
Services Outpatient Rehabilitation Program (VISOR) offers skills
training, orientation and mobility, and low vision therapy. This new
approach combines the features of a residential program with those of
outpatient service delivery. A VIST Coordinator, with low vision
credentials, manages the program. Staff consists of certified
Orientation and Mobility Specialists, Rehabilitation Teachers and Low
Vision Therapists.
VISOR is currently located at the VAMC in Lebanon, Pennsylvania,
and treats patients in Network 4. This service outside the box delivery
model is noteworthy. Patient satisfaction with the program is nearly
100 percent, according to the VA Outcomes Project. Two current
documents, Gap Analysis: Vision Rehabilitation Services for Veterans
Final Report (Atlanta VA Rehabilitation R & D Center of Excellence for
Veterans with Vision Loss), and The Low Vision Services in the VA's
Continuum of Care for Veterans with Visual Impairment (VIAB Final
Report), recommend that this delivery model should be considered for
replication within each Network. The program uses hospital beds to
house veterans. The beds do not require 24-hour nursing coverage and
are similar to staying in a hotel. Emergency care is available within
the VAMC. The expenses associated with expanding this new cost-
effective outpatient rehabilitation program from one facility to 11
facilities would be $5,474,733 for the initial year. Annual recurring
costs to maintain these 11 programs, however, would be $4,700,883. This
recurring cost works out to $427,353 per VISOR facility for all
staffing, equipment, office supplies, and training. VISOR's annually
projected caseload of 550 veterans (50 per VISOR facility) would cost
an estimated at $8,545 per veteran, one-third of the $28,900 for a
month at one of the BRCs.
The VISOR program is providing functional outcome data to the
Outcomes Project and will make possible the comparison of functional
outcomes derived from this approach with that of the more traditional
residential BRC. Early functional outcome data indicates that the
approach is very effective. Profiles gathered from early data suggest
that visually impaired elderly veterans relatively free from the health
burdens typically seen in veterans attending the traditional BRC and
who have relatively high degrees of residual vision, benefit the most
from this rehabilitation approach. VA should be supported in its
national leadership role in the field of blind rehabilitation services
and must continue to explore additional alternatives in addressing the
needs of blinded veterans.
F. Visual Impairment Center to Optimize Remaining Sight (VICTORS)
Another important model of service delivery that does not fall
under VA Blind Rehabilitation Service is the VICTORS program. The
Visual Impairment Center To Optimize Remaining Sight (VICTORS) is an
innovative program operated by VA Optometry Service. This is a special
program designed to provide low vision services to veterans who, though
not legally blind, suffer from severe visual impairments. Generally,
veterans must have a visual acuity of 20 over 70 or less to be
considered for this service. The program is typically a very short
(five-day) inpatient experience in which the veteran undergoes a
comprehensive low vision evaluation. Appropriate low vision devices are
then prescribed, accompanied by necessary training with the devices. It
should be noted that one of the VICTORS programs has converted to a two
and one-half day outpatient program and utilizes hospital beds for
veterans who live too far away from the facility to commute daily.
VICTORS has achieved the same outcomes and objectives as its
inpatient counterpart. Veterans who are in most need of these programs
are those who may be employed, but, because of failing vision, feel
they cannot continue. The program enables such individuals to maintain
their employment and retain full independence in their lives.
Unfortunately, Mr. Chairman, there are only three such programs
currently within VHA. VIAB has recommended one VICTOR center in each
Network where no programs exist. This would result in creating eleven
of these special programs. We submit that there is a critical need for
these programs to assist veterans in their quest to remain in the
workforce. In fact, the expansion of VICTORS could further assist
severely visually impaired (legally blind) or blinded veterans who have
already attended a residential BRC, received low vision aids, and who
now require only modifications. The effectiveness of new technology
aids could be reviewed and researched. New prescriptions could be
written when appropriate. Consequently, veterans would avoid the
necessity of readmission to the much more expensive BRC for such
reviews and evaluations.
effects of vera on rehabilitation
BRCs are admittedly resource intensive and costly. Currently, these
programs are being viewed as potential revenue sources under the
Veterans Equitable Resource Allocation (VERA) model. As previously
mentioned, BVA is pleased with the introduction of VERA 10 as recently
modified. Instead of a blanket rate of $42,000 for the higher
reimbursement rate, BRCs will now be reimbursed in Group 7 at $29,737.
A great deal of gaming occurred because of the high variance between
the high and basic reimbursement rates.
If these services are necessary, they should be provided in either
a hospital environment or, even more appropriately, in the blinded
veterans' home areas. More focused outpatient programs using hospital
beds are not reimbursed at the higher rate. The incentive is to admit
blinded veterans to the inpatient bed at the BRC. When BRCs institute
shorter programs, veterans are shortchanged. Programs such as VISOR and
VICTORS admit a population with typically high residual vision (usually
macular degeneration) and few, if any, co-morbidities. BVA recommends
that these services should be funded and provided in the local area.
Our concerns are especially relevant now that DOD Military Training
Facilities are referring more young service personnel who have been
blinded totally and who need the comprehensive residential BRC program.
The rehabilitative needs of this new population cannot be serviced in
so-called short programs. There is no question that much longer stays
should and must be anticipated for these very special veterans.
Shortcuts for reimbursement advantages cannot be tolerated.
The inability to track funds allocated to the Networks through VERA
is another frustrating aspect of the funding issue. It is even more
difficult, if not impossible, to track dollars allocated to the
individual facility within the Network. Dollars allocated to the host
facilities are not fenced or earmarked for blind rehabilitation.
Consequently, facility directors and BRC managers cannot determine how
much funding they have received to operate these special programs.
The decentralized resource allocation practice provides an apparent
lump sum to each facility from which they have the discretion and
responsibility to operate all the programs and services assigned to
that facility. Mr. Chairman, there must be a more clearly defined
method for tracking these resources to insure that the specialized
programs for which the Network and facilities are receiving the high
reimbursement rate are indeed being utilized for those purposes.
Theoretically, VERA provides Networks with sufficient funds to operate
the special disabilities programs. Unfortunately, BRCs are continually
required to share in facility FTEE reductions or freezes because of
funding shortfalls. Field managers strenuously resist demanding this
degree of accountability. They complain that this will infringe upon
their flexibility as managers to establish priorities and carry out
their assigned missions. Priority has been given to establishing
greater capacity for outpatient services and new Community Based
Outpatient Clinics (CBOCs) at the expense of tertiary care capacity.
oversight
Mr. Chairman, as previously mentioned, the last oversight hearing
by the House Committee was held on July 22, 2004 to receive GAO's
report on VA blind rehabilitation services. The comprehensive report
examined the history and future issues surrounding such services to
veterans. Consistent with BVA's concerns, GAO found that there were
serious inconsistencies from BRC to BRC as to how waiting lists were
managed and waiting times calculated. They found that several BRCs were
not complying with program office directions and policies. Regarding
the current delivery models, we can point to the GAO and VIAB
recommendations that there must be greater utilization of outpatient
services in new BROS and VISOR programs, along with supporting changes
occurring in the CAT program.
BVA believes that significant progress has been achieved following
the release of the GAO reports, but we are concerned that resistance
remains among some management employees. Starting with VHA, the
National Leadership Board, and the Medical Center Director level, a
clear goal should exist to provide high quality, cost-effective blind
rehabilitation services in the continuum to which we have continually
referred. We have pointed out in the past that a culture change must
occur if BRS is to modernize in delivering cost-effective, appropriate
outpatient blind rehabilitation services. Therefore, Mr. Chairman, we
believe it is essential for this Committee to investigate issues
presented today, and to hold a follow-up hearing in the future to
assess VA's progress in implementing the VIAB and GAO recommendations.
department of veterans affairs fiscal year 2007 budget request
The Office of Management and Budget's fiscal year 2005 and fiscal
year 2006 budget requests are prime examples of the urgent need for
assured funding. The gaming must end, and old models that do not
include the current thousands of returning OEF and OIF servicemembers
requiring care must be changed. BVA urges the members of these
Committees to support a new model that would assure adequate funding.
Further hearings could then be limited to the budgetary issues only.
As in years past, we are deeply concerned the fiscal year 2006
budget request fell short by $1.9 billion, and we once again predict
inadequacy in the fiscal year 2007 budget requirements to adequately
address the health care needs of an aging veteran population. We all
heard Under Secretary for Health Dr. Perlin when he testified last
summer that VHA needed a $1.9 billion increase for fiscal year 2006,
plus another $1 billion just to maintain current services once all the
increased co-payments and other gimmicks were subtracted. As in past
years, VA is being forced to rely more heavily on first and third-party
collections to substitute for appropriation. These collections always
fall short of their estimates.
To project a subsequent year's budget, the current discretionary
appropriations process subjects' veterans health care to numerous
political agendas rather than to (1) a real model calculated on the
number of veterans currently enrolled this year, (2) an index for
inflation, and (3) an average cost for each veteran using VA health
care.
The fiscal year 2006 Military Construction and Veterans Affairs
Appropriations bill allows for $1.2 billion in emergency funds to make
up for shortfalls if they occur. BVA questions why, if the defenders of
the status quo discretionary funding system are so sure of budget needs
each year, is emergency funding even required? Why would implementation
of a new model of assured funding be less attractive?
Clearly, there will be insufficient funds to enable VA to implement
the full continuum of vision rehabilitation care as recommended by GAO
and VIAB if the traditional discretionary modeling process continues.
The fact is that because of the problems that occurred with the fiscal
year 2006 budget process, some medical centers are already freezing
levels of staffing and are not hiring replacements. Therefore, it is
highly unlikely that medical centers will be able to consider hiring
new employees qualified to provide vision rehab services. Local travel
and educational funding are also being slashed as a result of the
fiscal year 2006 budget.
Given the current budget climate, VA medical facilities will almost
certainly restrict or eliminate the use of funding to contract for
local fee services, again negatively affecting provision of a continuum
of vision rehabilitation services. BVA is gravely concerned that
funding for essential prosthetic services and equipment will be
severely curtailed with this budget modeling process. Medical centers
will, out of necessity and within the culture of cost efficiency,
continue to confine operations rather than create new programs. This
will affect not only blinded veterans but all disabled veterans. The
President's fiscal year 2007 budget request will again prevent Category
8 veterans from being able to utilize VA, keeping thousands away from
the VA health care system. The most interesting thing about this
approach is that veterans with the least health care burden--those
working and with their own health insurance who bring their own medical
care dollars into the system--are the ones who will be denied access.
Focusing solely on the so-called core veterans will certainly
compromise VHA's ability to provide the full scope of preventive and
acute care services. Those in the so-called core group benefit
tremendously from the specialized services provided by VA, but they
also need the full array of basic healthcare services. While Members of
Congress decry the budgetary shortages last summer, the House and
Senate have repeatedly failed to provide a new model of assured
adequate appropriations to sufficiently fund the VA health care system.
Responsibility for the constant under funding of VA health care through
the discretionary process rests with both past and present Presidential
administrations and the Congress.
Mr. Chairman, service in the Armed Forces of the United States must
count for something more than a few laudatory speeches each year. Care
for America's veterans must be one of our country's highest priorities.
Clearly, the President wants to care for the heroes returning from
Afghanistan and Iraq, but it must not be accomplished at the expense of
those who have served in previous wars and conflicts. Similarly, we
cannot forget about those who served honorably but did not have to be
deployed into harm's Way, or who did not suffer traumatic emotional or
physical disabilities as a direct result of their service. No matter
what their circumstance, many have served our Nation and now need help.
National policy must recognize that care of our veterans is an integral
component of national defense.
BVA is also deeply disturbed by the proposed change in eligibility
criteria for long-term care. The change would result in the elimination
of substantial numbers of nursing home beds within VA and, even more
importantly, substantially reduce the per diem payments currently made
by VA to state veterans homes. The state veterans' homes have been
extraordinarily successful. They have been important partners in VA's
ability to provide long-term care. This change may very well cause
veterans currently in state veterans' homes to be discharged. It is
highly unlikely that the states can make up for the loss of the VA
payments. Paradoxically, if funding remains the only driving force
behind care, then funding issues will drive the culture of VA long-term
care. Creation of the innovative programs that utilize technology and
human resources will be de-emphasized.
What is most alarming Mr. Chairman, is that the current budgetary
situation as I have described in terms of the blinded veterans, so
called efficiencies saving games that can not be shown to GAO,
profoundly negatively impact the budget, and results in shortages every
year. The continuously negative budgets will influence the specialized
programs for blinded veterans and will be reflected in other special
disabilities programs that must fight for every single dollar. If VHA
is not fiscally healthy, the specialized programs for the core veterans
will not be healthy either.
veterans benefits administration
VBA is also facing major problems. After a few years in which the
number of claims pending decreased, there has been a reversal. Some
400,000 are now in a logjam. BVA is painfully aware of the chronic
backlogs for claims pending before VBA and the Board of Veterans
Appeals, and the years of promises that the system is going to be
fixed. Once again, this budget fails to provide the necessary resources
to adequately assist VBA in its efforts to reduce these unconscionable
backlogs. Veterans are literally waiting two or 3 years for claims to
be adjudicated or appeals to be resolved. Shortages of qualified
adjudication officials and rating specialists have resulted in
inaccurate decisions leading to more appeals. Clearly, if claims were
properly developed at the local VA Regional Office (VARO), the number
of appeals would drop dramatically. Unfortunately, the VAROs are not
doing a good job of assisting veterans in developing their claims.
It is disconcerting that some blame the veterans and the VSO
service officers for filing too many claims. Recent articles have
revealed that a large percentage of phone calls from veterans to VA
requesting information on benefits are answered incorrectly more than
25 percent of the time. The government should not depend on the VSOs to
do their job of instructing veterans properly on the benefits they have
earned. More resources are sorely needed to improve staffing and
provide new computer systems that integrate servicemembers' medical
records into both the VBA and VHA information technology processing
system.
BVA members have been alarmed over many statements made over the
past year that suggest or make accusations that veterans who are
disabled are receiving too much compensation and therefore don't want
to work. Public remarks that it is very easy in the current employment
market to be employed imply that the disabled veteran must be lazy or
uninterested in finding work! Recent multiple research studies have
indicated that the labor force and employment trends for the disabled
population have not been consistent with the trends of the non-disabled
workforce population. The labor force rate of participation increased
for the non-disabled population from 1970 to 2000 while it decreased
for the disabled population.
The employment rate of the disabled did in fact decrease from 26
percent in 1996 to 19.5 percent in 2003. In addition, labor market
earnings research during the past two decades has consistently found
that the disabled earn less than non-disabled workers with many working
at minimum wage jobs that offer few benefits. Literature reviews reveal
that disabled persons suffer lost earnings capacity and that such loss
of capacity is affected even further by such factors as age, education,
and socioeconomic characteristics. The National Institute on Disability
and Rehabilitation Research found that for people with no disability,
the likelihood of having a job or business is 82.1 percent. For people
with a mild disability, the employment rate is 76.9 percent. For those
using a cane, crutches, or a walker, the rate is 27.5 percent while
those relying on a wheelchair for mobility were able to find employment
in 22 percent of the cases. For individuals with visual impairments
(unable to read letters), the employment rate is only 30.8 percent.
Instead of trying to develop plans to prevent disabled veterans from
receiving compensation benefits, we recommend that the Members of this
Committee first look at what can be done to improve vocational,
rehabilitative, and educational programs or benefits for those needing
assistance in finding employment. The incorrect assumption is that
simply because the United States has gone from an agricultural or
industrial-centered economy to one highlighted by telecommunications,
high technology, and automation, the employment field is now level for
every disabled person. A recent 55-page report from the Office of
Personnel Management also revealed that the number of veterans employed
in the Federal Government in 1994 (558,347 or 28 percent of the Federal
workforce), decreased over the subsequent 10 years (453,793 or 25.1
percent) in 2004. If the aforementioned assumptions and assertions
statements were even remotely true, the employment rates for the
disabled would not have decreased since 1994.
BVA members also believe that disability benefits should cover loss
of earnings and include compensation for quality of life. Because of
the injuries they have sustained, veterans who have suffered
catastrophically and have lost mobility, and independent ability to
perform routine daily tasks, and opportunities for social interaction
should receive benefits that include compensation for the change in
their quality of life.
independent budget
BVA is very proud to again endorse the Independent Budget, prepared
by four of the major VSOs: AMVETS, Disabled American Veterans,
Paralyzed Veterans of America, and Veterans of Foreign Wars. This is
the 21st consecutive year that BVA has endorsed the IB. Along with many
other VSO's; we participated in the preparatory sessions and provided
input to the formulation of this extremely important document. We trust
that this Committee will read the document carefully. It contains many
important and constructive suggestions regarding VA health care
delivery. The IB outlines a clear blueprint for addressing VA medical
care delivery, including policy decisions and funding. BVA believes
that these suggestions are very sound and that they should receive
serious consideration as the budget process moves forward.
The fiscal year 2007 budget must keep pace with the increased
medical costs in salaries, benefits, goods, and services utilized. The
recently passed fiscal year 2006 appropriations included $3.3 billion
for operating and maintaining VA medical facilities, $464 million less
than the 2005 level. While the medical and prosthetics research budget
for fiscal year 2006 did include $412 million, a $10 million increase
over 2005, BVA is concerned that the fiscal year 2007 budget will not
keep pace with the urgent needs for expansion in this area.
Additionally, the recommended funding level must also enable VA to more
adequately fund congressionally mandated initiatives. It is vital to
VHA's mission to have the research funding necessary for continued
medical advances. These funds are critical to VHA's ability to attract
and retain clinicians who are seeking the opportunity to conduct
research in prosthetics.
prosthetic service
As reported last year, BVA is very pleased with the outcome of the
Prosthetic Clinical Management Program (PCMP) as it affects visually
impaired and blinded veterans. The stated focus of the PCMP is the
quality of prescriptions rather than only the dollars expended for the
prescriptions.
The driving activity behind PCMP is the establishment of work
groups composed of clinicians to review the prescription practices
associated with an individual prosthetic device. As a result of efforts
by BVA, DAV, and PVA, consumers were allowed to be members of the work
groups. Were it not for the fact that BVA had an opportunity to
actively participate in the work groups related to aids and appliances
for the blind, visually impaired and blinded veterans would not have
faired very well. The work groups have been tasked with developing
specifications for the device in question and recommendations for
issuance. The intent of the specification development is to facilitate
the establishment of national contracts for a device if the majority of
the devices are procured from one vendor.
BVA has some reservations regarding the potential for
standardization that works on the premise that one size fits all.
Severely disabled veterans need to be treated as individuals with
unique needs who might not always benefit from a standard device. The
opportunity must exist for clinicians to prescribe items not on
national contract, even if they are more expensive, without fear of
reprisal from local or Network management. The effort to standardize
the purchasing practices of VHA with respect to prosthetic services has
been successful in large part to centralized funding for prosthetics.
The combination of centralized funding and improved prescription
practices has clearly enhanced disabled veterans access to high quality
state-of-the-art Prosthetic Sensory Aids and Appliances. Mr. Chairman,
we do wish to commend PSAS for their outstanding efforts overall to
insure a seamless transition for servicemembers transitioning from DOD
to VA.
va medical and prosthetics research
BVA supports the Friends of VA Medical Care and Health Research
(FOVA) request for $460 million for fiscal year 2007 for investments in
veteran-centered research projects at VA. Such projects in the past
have led to an explosion of knowledge that has advanced the
understanding of many diseases and unlocked strategies for prevention,
treatment, and cures. Additional funding is needed to take advantage of
the burgeoning opportunities to improve quality of life for our
veterans and the Nation as a whole. VA must concurrently address the
needs of its longstanding patient base as well as the evolving
challenges being presented by our newest veterans. With these funds, it
is expected that VA would pursue the following in fiscal year 2007:
prosthetics, PTSD, depression, neuromuscular diseases, and other
specialized research. This funding level would also allow for an
increase in funding for Rehabilitation Research & Development so
desperately needed during this period of war. It would also allow the
continuation of several RR&D initiatives in the area of retinal
implants and/or prostheses.
BVA feels strongly that legislation should be initiated that would
require the National Institutes of Health (NIH) to pay VA for the
indirect cost of NIH-funded research grants. Currently, NIH pays for
the indirect cost to almost everyone receiving NIH grants except for
VA. Consequently, VA must utilize medical care dollars to cover the
indirect costs. These are funds that could be used to provide medical
care to veterans. We believe that this policy is grossly unfair to sick
and disabled veterans in need of medical care and to a health care
system already forced to operate with constrained funding. NIH has
refused every effort by VA to seek payment for these indirect costs. We
therefore believe that legislative action is required.
other legislative priorities
BVA believes these issues are vital to the survival of VA and to
services and benefits for blinded veterans. Some of these issues are
unique to veterans and others are applicable to all blind Americans.
A. BVA strongly encourages passage of H.R. 515, The Assured Funding
for Veteran's Health Care Act of 2005, which will institute mandatory
funding for VA health care. We would encourage this committee to have a
hearing on this issue.
B. Authorizing VA to retain third-party collection should be viewed
as a supplement to, and not as a substitute, for Federal funding.
Veterans and their insurance companies should not be required to pay
for veterans' health care as this is clearly a moral obligation and a
responsibility of the Federal Government.
C. BVA, along with the veterans and military organizations,
supports legislation stopping the offset between the Survivor Benefit
Plan (SBP) and Dependency and Indemnity Compensation (DIC). SBP is
purchased by the retiree and is intended to provide a portion of
retired pay to the survivor. DIC is a special indemnity compensation
paid to the survivor when a member's service causes his or her
premature death. In such cases, the VA indemnity compensation should be
added to the SBP the retiree paid for, not substituted for it. It is
also noteworthy as a matter of equity that surviving spouses of Federal
civilian retirees who are disabled veterans, and who die of military
service-connected causes, can receive DIC without losing any of their
purchased Federal civilian SBP benefits.
D. BVA requests that this Committee hold a hearing on ``The
Disabled Veterans Equity Act'' (H.R. 2963), which currently has 70
bipartisan co-sponsors. In 2002, Congress passed and the President
signed P.L. 107-330. The law included a provision (Section 103) to
correct a similar deficiency in the Paired Organ law. Currently, a
veteran, who is service connected for loss of vision in one eye due to
injury or illness incurred on active duty is denied additional
disability compensation if they become legally blind in the remaining
eye. Because the Paired Organ section on vision did not address the
legally accepted definition of blindness, (visual acuity 20/200, or
loss of field of vision to 20 degrees), some veterans are denied an
increase in compensation if they become legally blinded in both eyes.
This change in the law would only affect a small percentage of the
13,109 veterans who are service connected for loss of vision in one
eye. We would argue that for the veteran with blindness in one eye who
subsequently loses vision in his/her remaining eye, full paired organ
benefits should not be denied. Research reveals that less than 5
percent of the current service-connected veterans for loss of vision in
one eye would eventually lose vision in the remaining eye.
E. BVA strongly encourages Congress to adopt legislation that would
provide full concurrent receipt for all military retirees who have
suffered service-connected disabilities The VSOs responsible for
development of the Independent Budget have urged Congress to correct
this serious inequity. Congress should enact legislation that repeals
the inequitable requirement that veterans' military retired pay based
on longevity be offset by an amount equal to their VA disability
compensation.
F. BVA strongly supports the provision of a full Cost of Living
Adjustment (COLA) for veterans receiving disability compensation and
surviving spouses and dependent children receiving DIC. Further, we
support this COLA being made effective December 1, 2006.
G. BVA encourages the U.S. Senate to adopt legislation introduced
by Senator Specter. ``The FAIR Act'' (S. 852) establishes a national
trust fund that would provide equitable compensation to Americans
suffering from illnesses caused by exposure to asbestos. The national
trust fund would replace the current tort system that is clearly broken
and causes many disabled veterans to wait many years before ever
receiving any compensation for suffering caused by asbestos exposure.
H. Medicare subvention is an issue critical to the future funding
of VA health care programs. Considerable discussion of this issue has
occurred over the years, with strong resistance coming particularly
from the House Ways and Means Committee regarding a pilot Medicare
subvention demonstration project for VA. We trust that legislative
language can be crafted this year to move this legislation through the
109th Congress. Authorizing VA to bill Medicare for covered services
provided to certain veterans seems to be a win-win situation. VA
benefits from additional revenue to supplement core appropriations. The
Medicare trust fund benefits at the same time since VA will be
reimbursed at a discounted rate.
I. As evidenced by the vital emergency role that the VA played
during the past hurricane season, VA should have the funding necessary
to respond in the event of either a natural or terrorist attack. In
addition, as the Federal Government seeks to strengthen homeland
security, VA should receive an appropriate share of resources dedicated
to this purpose. The importance of the VA's capacity to respond with
medical and human resources in times of national emergency cannot be
underestimated.
J. BVA urges Members of the Congress to support passage of Senate
Concurrent Resolution (S. Con. Res. 71), introduced by Senator Inouye,
Senator Salazar, and Ranking Member Senator Akaka, it was adopted by
the House of Representatives in June 2004, (H. Con. Res. 56). The
resolution failed last year because there was no companion resolution
on the Senate Transportation Committee. S. Con. Res. 71 states ``that
it is the sense of the Congress that each State should require any
candidate for a driver's license candidates to demonstrate, as a
condition of obtaining a driver's license, an ability to associate the
use of the white cane and guide dog with visually impaired individuals
and to exercise great caution when driving in proximity of a
potentially visually impaired individual.'' We are grateful to Senator
Akaka and Senator Salazar for introducing this important resolution
again, and urge Members to co-sponsor this as method of improving
pedestrian safety. We are pleased that companion H Con. Resolution 235
was introduced again in the House Transportation Committee and already
has twelve co-sponsors.
K. As mentioned previously, aging is the single best predictor of
blindness or severe visual impairment. Veterans are not the only ones
who are growing old and losing their sight. BVA encourages Congress to
enact legislation to fund categorical programs for the professional
preparation of education and rehabilitation personnel serving people
who are severely visually impaired and blind. There is a shortage of
trained professionals in the field of blindness. The shortage may very
well be further aggravated as a result of the President's fiscal year
2007 budget request. Contained within the request is a Department of
Education, Rehabilitation Services Administration (RSA) initiative that
would cut back on funding support for personnel preparations programs.
L. The Blinded Veterans Association has many members in Puerto Rico
who served honorably in the U.S. Armed Services. BVA therefore
encourages Congress to adopt legislation that would define the
political status options available to the U.S. citizens of Puerto Rico
and authorize a plebiscite to provide the opportunity for Puerto Ricans
to make an informed decision regarding the island's future.
M. Once again this year, BVA urges this Committee to introduce
legislation that would amend the Beneficiary Travel Regulation in Title
38. We believe that the law needs to be changed to allow VA to pay
travel for catastrophically disabled veterans who are accepted to one
of the VA special disabilities programs and who are not currently
eligible for travel benefits. These veterans are already required to
pay the Social Security Administration co-payment as well as a daily
per diem rate during the rehabilitation experience. Adding the burden
of paying their own travel, usually air transportation, serves as a
strong disincentive for these veterans to take advantage of the world
class service offered by VA.
N. BVA absolutely opposes any legislative initiative that would
change the current Line of Duty standard for determining Service
Connection to Performance of Duty.
conclusion
Once again, Mr. Chairman, thank you for this opportunity to present
BVA's legislative priorities for 2006. BVA is extremely proud of our 61
years of continuous service to blinded veterans and all of the
accomplishments we have enjoyed. The future strength of our Nation
depends on the willingness of young men and women to serve in our
military, and that depends in part on the willingness of our government
to meet its obligation to them as veterans.
When BVA representatives meet the young servicemembers from OEF and
OIF at Military Treatment Facilities, one of the first questions asked
is the following: ``Is VA going to be able to provide me with the long-
term rehabilitation that I will need to adjust to my blindness?'' We
would like to ask that question of the members in this room. Again, Mr.
Chairman, thank you for this opportunity. I will gladly answer any
questions you or other Members of this Committee may have.
STATEMENT OF DAVID L. MAGIDSON, NATIONAL COMMANDER, JEWISH WAR
VETERANS OF THE UNITED STATES OF AMERICA
Mr. Magidson. If I might, Senators, fellow veterans----
Chairman Craig. David, please proceed.
Mr. Magidson. Yes, sir, if I might. Thank you.
Everyone has talked about specifics and we have specifics
in the record. I could talk about, I am from Florida and we
could talk about the VA Hospital in Palm Beach, where we are
told that the money that is used for capital has to be paid
into salaries, and they have no money in capital, and this is
supplemental budget. Or we can be walking around Congress, and
we bump into the paralyzed veterans and be told that they do
not have any parking in order to go to the hospital. But we are
going to be talking in general because I want to talk about who
we are and why we are here, if I might.
We are the Jewish War Veterans. We are the oldest active
veterans' organization in our country, founded in 1896 by
veterans of the Civil War to put to rest the lie that Jews did
not fight in the conflagration. We did, by the thousands, and
we still do.
Let me, if I might, read a letter that we received from a
young girl from Arizona. We are all throughout the United
States. And she says, to get the tenor of why we are here:
``I am a student in the 8th grade at Copper Ridge Middle
School in Scottsdale, Arizona. All of the social studies
classes are meant to write a letter to any veterans'
organization of our choice, and I selected the Jewish War
Veterans. I am Jewish.''
``I never really thought about people who fought in wars,
and never thought that people would have fought and died to
protect the U.S.A. You made me begin to think about how lucky
we are to live in America and have all the freedom that we have
today.''
``I also didn't realize how many American soldiers have
died in so many wars over the past 100 years, not only fighting
for our freedom but for the freedom of other countries, too.
Because I am Jewish, I know that if Hitler hadn't been beaten
in World War II, then maybe I wouldn't be here today, or my
parents or my grandparents. I see things on TV about what
happened to so many people during Hitler's rule, and it really
makes me sad.''
``I would like to thank you and all of the veterans for
fighting so bravely for our country and keeping us free and
safe. I hope the government takes care of all of the veterans
and everybody remembers to always keep thanking you for
everything you have done.''
``I hope I never have to fight in a war, but if I do, I
hope I can be as brave as all of you were. Please read this
letter to all of the Jewish veterans and all veterans, so that
they know how much I want to thank them for keeping me safe.''
I think that is what we are about.
Let me just get a little personal at this time. My son,
Captain Ben Magidson, just returned from Afghanistan after 1
year, and three-and-a-half years of active duty in the United
States Army. He was at Scofield Barracks, and then with the
25th ID over at Afghanistan.
He was taking something out of his duffle bag and I asked
him what it was. He said it was a Bronze Star. I swelled with
pride, but then I realized what sadness and pain come with it.
Ben to me is a representative of the hundreds and thousands of
our men and women, parents and children, who went into combat
and are now coming home.
To the Administration and Congress people who sent them in
harm's way, never leave a veteran behind. And to the veterans'
organizations such as ours, we have the eternal responsibility
of assuring that no veteran will be left behind. For health
care, for education, for housing, please never leave a veteran
behind, and keep it with you when you consider what we should
do, because we agree with everything that is being said
specifically.
And thank you very much, Mr. Chairman, sir.
[The prepared statement of Mr. Magidson follows:]
Prepared Statement of David L. Magidson, National Commander, Jewish War
Veterans of the United States of America
Chairman Craig, Ranking Member Akaka, Members of the Senate
Committee on Veteran Affairs, and Members of the House Committee on
Veterans Affairs who are present, my fellow veterans and friends, I am
David L. Magidson, the National Commander of the Jewish War Veterans of
the U.S.A. (JWV). JWV is Congressionally Chartered and also provides
counseling and assistance to members encountering problems dealing with
the Department of Defense (DoD), the Department of Veterans Affairs
(VA), and other government agencies. JWV is an active participant in
The Military Coalition, a group of over 30 military associations and
veterans' organizations representing over five million active duty,
reserve and retired uniformed service personnel and veterans on Capitol
Hill.
I am accompanied today by the Chairman of our Coordinating
Committee, PNC Robert M. Zweiman, who is also JWV's International
Liaison, the President of our Ladies Auxiliary, Arlene Kaplan, the
President of our National Museum of American Jewish Military History,
PNC Jack Berman, Chairman of our National Executive Committee, PNC
David Hymes and the Director of our National Service Office Program,
PDC Ralph Bell, and our National Executive Director, Colonel Herb
Rosenbleeth. In the audience today are those JWV members who are here
to meet with their Senators and Representatives as part of JWV's
Capitol Hill Action Day.
Members of the committee, it was a singular honor for me to present
the JWV Medal of Merit to Senator Patty Murray (WA), at our
Congressional Reception yesterday evening, in recognition of her truly
outstanding work for America's veterans. It was equally rewarding to
JWV to have so many of you participate with us!
Mr. Chairman, next week, on March 15th to be exact, we at JWV will
celebrate JWV's 110th birthday. For these 110 years, JWV has advocated
a strong national defense and a just and fair recognition and
compensation for veterans. The Jewish War Veterans of the USA prides
itself in being in the forefront among our Nation's civic and veterans
groups in supporting the well-earned rights of veterans, in promoting
American democratic principles, in defending universal Jewish causes
and in vigorously opposing bigotry, anti-Semitism and terrorism both
here and abroad. Today, even more than ever before, we stand for these
principles. The Jewish War Veterans of the U.S.A. represents a proud
tradition of patriotism and service to the United States of America.
As the National Commander of the Jewish War Veterans of the USA
(JWV), I thank you for the opportunity to present the views of our
100,000 members on issues under the jurisdiction of your committee. At
the conclusion of JWV's 110th National Convention in San Diego, CA our
convention delegates adopted our resolutions for the 109th Congress.
These mandates establish the legislative agenda for JWV during my year
as National Commander.
JWV believes Congress has a unique obligation to ensure that
veterans' benefits are regularly reviewed and improved to keep pace
with the needs of all veterans in a changing social and economic
environment. JWV salutes the Chairmen and Members of both the Senate
and the House Veterans' Affairs Committee for the landmark veterans'
legislation enacted over the past several years. Eligibility
improvement, patient enrollment, long-term care, access to emergency
care, enhanced VA/DoD sharing, improved preference rights of veterans
in the Federal Government and other initiatives recognize the debt this
country owes to those who have faithfully served our country.
We must improve access to veterans' health care, increase
timeliness in the benefit claims process, and enhance access to
national cemeteries and to state cemeteries for all veterans.
no government funding
The Jewish War Veterans of the USA, Inc. does not receive any
grants or contracts from the Federal Government.
va budget for 2007
The Administration's budget submission calls for a veterans' health
care budget of $34.3 billion, ``an increase of $3.5 billion more than
2006'', according to a VA release on the budget. While this seems like
a big increase, this budget proposal does not request enough to meet
the Federal Government's obligation to veterans. In fact, this budget
will force increasing numbers of veterans out of the health care
system. Both the Administration and the VA have repeatedly
underestimated the number and severity of wounded servicemembers
returning from Iraq and Afghanistan, thereby repeatedly requiring
supplemental appropriation requests.
The proposed VA budget for 2007 is another attempt to drive down
demand, to further drive Priority 7 and 8 veterans out of the system.
This is in addition to the more than a quarter of a million veterans
who have already been shut out of the VA health care system. Denying
earned benefits to eligible veterans is no way to solve the problems
resulting from an inadequate budget.
mandatory funding for the va
JWV's major legislative goal is the passage of Mandatory Funding
for the VA, thus providing an assured adequate level of funding for
veterans' health care. This legislation would require the Secretary of
the Treasury to make available to the Secretary of Veteran Affairs for
programs, functions, and activities of the Veterans Health
Administration for fiscal year 2007, 130 percent of the amount
obligated during fiscal year 2005. The current bill numbers are S. 331
and H.R. 515.
The Jewish War Veterans of the USA strongly endorses and supports
the efforts of Senator Johnson and Congressman Evans and other Members
of Congress to provide required funding for veterans' health needs
through these measures.
The Jewish War Veterans of the USA agrees in the strongest possible
terms with these friends of veterans' contention that ``We can no
longer allow the VA to be hostage to the Administration's misplaced
priorities and the follies of the Congressional budget process. This
bill would place veterans' health care on par with all major Federal
health care programs by determining resources based on programmatic
need rather than politics and budgetary gimmicks.''
Under the current system, funding for veterans' health care is
subject to reduction at any time due to political and programmatic
pressures to take money earmarked for the care of those who have served
the country, many on the field of battle, and divert those funds to
other programs. In this way, the most deserving among us, those who
have fought to defend our basic freedoms, are often denied the care
which they have earned, which they have been promised, and which they
deserve.
The lack of prompt access to the care they deserve and have earned
is not acceptable. As the wounded come home in ever-increasing numbers
from the battlefields of Iraq and Afghanistan, the problem will only
worsen in the years to come. Therefore, it is imperative that all those
who honor our brave fighting men and women come together to support
Senator Tim Johnson's and Rep. Lane Evans' efforts.
It is not enough to mouth support for our current troops and those
who fought the brave fight before them. We must all support mandatory
funding to ensure their future needs as set out in the legislation
proposed by our friends. The Jewish War Veterans of the USA urges
everyone to contact his/her senators and representatives to urge their
support for these bills. Our country owes health care to our veterans
who must not be dependent on the whims of the political process to get
the benefits they have earned.
user fees
The Administration's budget calls for increasing veterans'
prescription co-payments from $8.00 to $15.00 and proposes an annual
$250.00 VA health care user fee for Priority Groups 7 and 8. There are
many veterans in these groups who have several prescriptions, sometimes
ten or more, each month. Doubling their co-payments is too much for
many of them to handle.
JWV adamantly opposes these proposals!
post-traumatic stress disorder
JWV is also focusing on legislation to improve programs for the
identification and treatment of post-deployment mental health
conditions, including post-traumatic stress disorder, in veterans and
members of the Armed Forces. The current bill number is H.R. 1588,
introduced by Congressman Evans.
the military coalition
JWV continues to be a proud member and active participant of the
Military Coalition (TMC). PNC Bob Zweiman, JWV's Chairman of the
Coordinating Committee, serves on the Board of Directors of the
Coalition and our National Executive Director, Colonel Herb
Rosenbleeth, USA (Ret), serves as JWV's Washington representative and
as Co-Chair of the Coalition Membership and Nominations Committee.
JWV requests that the House and Senate Committees on Veterans'
Affairs do everything possible to fulfill the legislative priorities of
the Military Coalition which are applicable to your committees. These
positions are well thought out and are clearly in the best interests of
our military personnel, our veterans and our Nation's security.
priority group 8 veterans
Since January 17, 2003, access to Department of Veterans Affairs
(VA) care for new Priority 8 veterans has been prohibited. More than
260,000 veterans have applied to receive VA health care but have been
turned away because of the cost-cutting decision to limit veterans'
access to VA hospitals, clinics and medications. Citing the words of
our National Commander, David L. Magidson: ``There is no reason for the
VA to deny health care to veterans who have served our country
honorably. We should never leave any veteran behind.''
support for the national guard and reserve
The Jewish War Veterans of the USA recognizes the National Guard
and Reserve as being essential to the strength of our Nation and the
well-being of our communities.
In the highest American tradition, the patriotic men and women of
the National Guard and Reserve serve voluntarily in an honorable and
vital profession. They train to respond to their community and their
country in time of need. They deserve the support of every segment of
our society.
If these volunteer forces are to continue to serve our Nation,
increased public understanding is required of the essential role of the
National Guard and Reserve in preserving our national security. Their
members must have the cooperation of all American employers in
encouraging employee participation in National Guard and Reserve
training programs.
The Jewish War Veterans of the USA encourages all employers to
pledge that:
1. Employment will not be denied because of service in the National
Guard or Reserve;
2. Employee job and career opportunities will not be limited or
reduced because of service in the National Guard or Reserve;
3. Employees will be granted leaves of absence for military
training in the National Guard or Reserve, consistent with existing
laws, without sacrifice of vacation;
4. Employers must recognize that their employees' rights must be
protected when their workers are activated in the war against
terrorism, regardless of whether that activation was for State or
Federal service; and
5. Leading by example, the Jewish War Veterans of the USA, as an
employer, has signed a pledge under the auspices of the National
Committee for the Employer Support of the Guard and Reserve, to be a
good employer. We ask our members who are employers to do so as well.
The Jewish War Veterans of the USA demands that all members of the
National Guard and Reserves be treated as equal partners in America's
total force structure entitled to all of the rights and benefits
afforded to those in the active components and that they be equipped
with all assets necessary to perform their mission.
welcome home gi bill
The Jewish War Veterans of the USA enthusiastically supports a new
veterans' rights bill now known as the ``Welcome Home GI Bill'' as
``must'' legislation currently pending before the Congress. Our Nation
owes a debt of gratitude to all who are currently serving as they
protect our Nation from the ravages of terrorism. This bill will go far
in paying this Nation's debt to our brave men and women in uniform.
The bill should provide benefits to anyone who has served at least
six consecutive months in a combat zone since 9/11 or was injured as a
result of his/her service regardless of duty station. This bill must
address the areas of improved health care, education, job-training
assistance and housing, and include a tax-free $5,000 down payment on a
home in addition to other existing VA home loan guarantees.
One of the most important aspects of any bill is that it ensures
benefits for all who have served, not just for members of the active
duty component. Under the current benefits structure, those benefits
due to Reserve and National Guard troops are far fewer than those given
to members of the active duty components. This disparity has resulted
in a system wherein the National Guard and Reserve troops have come to
be treated as second-class citizens even as they are putting their
lives on the line to defend our country in the same way as the active
duty personnel.
The Jewish War Veterans of the USA urges the Congress to pass
appropriate legislation immediately.
presumption of service-connection for gulf war veterans
A well known study conducted in the state of Kansas on the Gulf War
veterans found that certain medical conditions exist among Gulf War
veterans that do not exist in non-Gulf War veterans.
The National Gulf War Resource Center can substantiate and confirm
that these medical conditions exist among Gulf War veterans. The U.S.
Army Medical Research Institute of Chemical Defense also conducted
studies that support the premise that low-level Sarin exposure causes
long-term health effects. The studies reveal abnormal changes in the
brain as well as suppression of the immune system in laboratory
testing. The Government Accountability Office has estimated that as
many as 35,000 U.S. military personnel may have been exposed to nerve
agents released from the demolition of an Iraqi munitions storage
complex at Khamisiyah.
The Jewish War Veterans of the USA urges that the U.S. Department
of Veterans Affairs recognize the following medical conditions as a
presumptively service-connected for Gulf War veterans: Skin
Condition(s) other than Skin Cancer, Stomach or Intestinal
Condition(s), Depression, Arthritis, Migraine Headaches, Bronchitis,
Asthma, Heart Diseases, Lung Diseases, Thyroid Condition(s), Seizures,
Disease of the Nervous System, and any other related conditions.
The Jewish War Veterans of the USA also requests that the Secretary
of Veterans Affairs add the aforementioned illnesses to the list of
presumptions of service-connection for Gulf War veterans under P.L.
103-446.
women in the military
Sexual assaults have not been eliminated in Department of Defense
facilities. These assaults have taken place at such bases as the Air
Force Academy in Colorado Springs and have become only too common in
war zones such as Afghanistan and Iraq.
The military fails to recognize that women have become a major
source of military strength at the war fronts and make up a
considerable percent of students at the academies. As proof of the
destructive effects of assaults we now know that over 40 percent of our
homeless women veterans were victims of such assaults.
Women in the Military are giving their lives for their country just
as well as are men. By June, 2005 there were over 40 women's deaths
reported in Iraq and Afghanistan and the number is growing rapidly.
The Jewish War Veterans of the USA acknowledges that women in the
military are frequently not given fair treatment at the resulting
hearings. The Jewish War Veterans of the USA demands that adequate
measures be taken to give women a proper degree of respect and when
these measures are violated that a fair and just hearing be convened
without any derogatory fanfare surrounding such hearings. The military
must take measures to ensure that women are not intimidated so that
they hide these assaults.
meeting the special needs of women veterans
The Jewish War Veterans of the USA (JWV) recognizes that there are
service-related problems unique to the woman veteran which continues to
be inadequately met by the Department of Veteran Affairs. JWV supports
the allocation of VA resources to fully fund women's centers at all
major VA medical facilities and provide specially trained medical
professionals at each veteran's outreach clinic. The services required
include access to gynecologists, mammograms, mental health and rape
counselors, as well as PTSD and Agent Orange screening.
state veterans homes
State veteran homes were founded for Civil War veterans in the late
1800s and have served veterans for over 100 years. Under the provision
of Title 38, United States Code, the United States Department of
Veterans Affairs (VA) is authorized to make aid payments to states
maintaining state veteran homes subject to the provision of 38 CFR
18.13, Part 3, Section 51.40 (1).
Currently there are 119 state veteran homes operating in a total of
48 states and territories, providing hospital, skilled nursing, skilled
rehabilitation, long-term care, Alzheimer's care, domiciliary care,
respite care, and end of life care to veterans and their families.
The VA promotes the care and treatment of veterans in state veteran
homes as one means to attain the goal of developing and maintaining the
highest possible quality of patient care for eligible veterans. The VA
can increase its share of state home per diem to 50 percent of the
national average cost of providing care in a state veteran home.
Title 38, United States Code, authorizes the State Home
Construction Grant Program which is funded by VA at 65 percent of total
costs for construction of new state veteran home and renovation of
existing facilities. The VA has not even kept pace with states' grant
applications for construction of new state veteran homes and renovation
projects, which VA itself considers to be top priority projects.
Furthermore, Title 38, United States Code, authorizes VA to make
per diem payments for veterans residing in state veteran homes, and the
State Veteran Home Program is recognized as a low cost alternative
among all nursing care alternatives available to VA.
Recognizing the growing long-term health care needs of older
veterans, the State Veterans Home Program must continue to be a vital
health care provider and a low cost but high quality alternative for
veterans needing long-term nursing care.
The Jewish War Veterans of the USA fully supports the legislative
objectives of the National Association of State Veteran Homes (NASVH)
that the States receive from VA a per diem payment for veteran
residents that equals 50 percent of the national average cost of
providing care in a state veteran home.
The Jewish War Veterans of the USA urges the Congress of the United
States to fully fund state veterans home construction grant priority
one projects for fiscal year 2006 and we urge the President and
Congress to pledge their full support to the State Veteran Home Program
as it is the most cost-effective nursing care alternative available to
VA.
the independent budget
Jewish War Veterans is an endorser of the Independent Budget and we
want to continue to emphasize the following points from the writers of
this document:
Veterans must not have to wait for benefits to which they
are entitled.
Veterans must be ensured access to high-quality medical
care.
Veterans must be guaranteed access to the full continuum
of health-care services, including long-term care.
Veterans must be assured burial in state or national
cemeteries in every state.
Specialized care must remain the focus of the Department
of Veterans Affairs (VA) medical system.
VA's mission to support the military medical system in
time of war or national emergency is essential to the Nation's
security.
VA's mission to conduct medical and prosthetics research
in areas of veterans' special needs is critical to the integrity of the
veteran's health-care system and to the advancement of American
medicine.
VA's mission to support health professional education is
vital to the health of all Americans.
back-up to dod
VA Hospitals must be adequately funded, staffed and equipped to
perform their vital role as this Nation's only back-up for DoD medical
facilities. U.S. military personnel could possibly suffer casualties
exceeding the capacity of the combined military medical treatment
facilities.
In such a case, the VA would be vital to the Nation. JWV strongly
urges the Congress to fund the VA to handle this potential workload.
homeland security
In addition to being the back-up for DoD, VA medical facilities are
the Nation's primary medical resource for Homeland Security. Should
there be another catastrophic terrorist attack, especially in more than
one location as occurred on 9/11, the VA would be utilized by the
Department of Homeland Security.
Already, VA hospitals are preparing to handle mass casualties as
well as victims of chemical, biological or radiological attack. JWV
urges the Congress to fully recognize this mission of the VA and to
fund the VA accordingly.
veterans health administration
With young American servicemembers continuing to answer the
Nation's call to arms in every corner of the globe, we must now, more
than ever, work together to honor their sacrifices. Those men and women
who return from battle with career ending injuries and life changing
memories will turn to VA for their health care; health care they have
earned through their service to this country. VA must be funded at
levels that will ensure that all enrolled eligible veterans receive
quality health care in a timely manner.
Today, there are nearly 26 million veterans. As more veterans
choose to use VA as their primary health care provider (over 8 million
veterans enrolled or waiting to enroll), the strain on the system
continues to grow. JWV fully supported the enactment of Public Law
(P.L.) 104-262, the Veteran's Healthcare Eligibility Reform Act that
established an enrollment system and uniform benefits package in the VA
health care system. All eligible veterans should again be entitled to
enroll. Veterans recognize that VHA provides affordable quality care
that they cannot receive anywhere else.
third party reimbursement and medical care collections funds
Many veterans, especially those in Priority Groups 7 and 8, have
private health insurance through employment and many of those veterans
would choose VA as their primary health care provider were they able to
do so. VHA is now authorized to bill most fee-for-service and point-of-
service insurance carriers, such as Blue Cross/Blue Shield. Not so with
Health Maintenance Organizations (HMOs) and Preferred Provider
Organizations (PPOs). These payers simply reject VHA claims for
reimbursement as ``out of network''. If these providers are Federal
contractors, they should not be allowed to reject VA care as part of
their network.
As do all working citizens, veterans pay into the Medicare system
without choice. A portion of each earned dollar is allocated to the
Medicare Trust Fund and although veterans must pay into the Medicare
system they cannot use their Medicare benefits at any VA health care
facility. VA cannot bill Medicare for the treatment of Medicare
eligible veterans' nonservice-connected medical conditions. JWV does
not agree with this policy and supports Medicare reimbursement for VHA
for the treatment of nonservice-connected medical conditions of
enrolled Medicare-eligible veterans. As a Medicare provider, VHA would
be authorized to bill and collect allowable third-party reimbursements
from the Medicare Trust Fund for the treatment of nonservice-connected
medical conditions of enrolled Medicare-eligible veterans.
long-term care
JWV believes that VA should take its responsibility to America's
aging veterans seriously and provide the care mandated by Congress.
Congress should do its part and provide adequate funding to VA to
implement its mandates.
asbestos trust fund
The Jewish War Veterans of the USA supports the establishment of a
Trust Fund that would include veterans, their dependents and survivors
which will ensure that claimants are adequately compensated for the
illnesses and deaths arising out of their exposure to asbestos.
Moreover, we believe it is only appropriate that any payments received
from such Fund be in addition to and not offset by any compensation
received from the Department of Veteran Affairs for service-connected
disability.
JWV supports the Fairness in Asbestos Injury Resolution (FAIR ACT)
(S. 852) that will establish a Trust Fund for victims, including
veterans, who were exposed to asbestos during their military service.
The FAIR Act offers sick veterans a way to receive the compensation
they deserve. Presently, it is difficult for veterans to turn to the
courts for help with their asbestos related medical costs. Veterans are
barred by law from suing their employer (the Federal Government) for
compensation. By taking asbestos claims out of the court system, the
FAIR Act will ensure veterans will have a speedy and just avenue for
receiving compensation.
senate action on flag amendment
Mr. Chairman, JWV strongly supports the passage of the Flag
Amendment, Senate Joint Resolution [S.J. Res.] 12, which is now only
one vote away from approval.
JWV asks those in the Senate who have not yet endorsed the
Amendment protecting our flag to do so immediately! Let's move the
amendment to the states for ratification!
veterans benefits administration
The Department of Veterans Affairs has a statutory responsibility
to ensure the welfare of the Nation's veterans, their families, and
survivors. Each year, the 58 regional offices of the Veterans Benefits
Administration (VBA) receive over 100,000 new and reopened benefits
claims. A majority of these claims involve multiple issues that are
legally and medically complex and time consuming to adjudicate. Whether
a case is complex or simple, these offices are expected to develop and
adjudicate veterans' and survivors' claims in a fair, legally proper,
and timely manner.
VBA has, over the last 3 years, begun aligning its policies and
procedures and has directed most of the regional offices' time and
effort toward reducing claims processing time and reducing the backlog
of pending claims. Achievement of former VA Secretary Principi's stated
goal of 100 days to process a claim, on average, and a backlog of
250,000 pending claims has been and continues to be VBA's number one
priority. To fulfill mandated production quotas, regional office
management and adjudicators have been put in the difficult and
unenviable position of having to choose between deciding thousands of
cases as quickly as possible or going through more time consuming steps
and provide the claimant full due process.
Unfortunately for thousands of veterans and their families, their
rights have been subordinated to bureaucratic convenience for the sake
of an arbitrary administrative goal. This persistent disregard of the
law prompted thousands to file otherwise unnecessary appeals. Since
judicial review of veterans' claims was enacted in 1988, of those cases
appealed to the United States Court of Appeals for Veterans Claims
(CAVC), the remand rate has been above seventy percent. In a series of
precedent setting decisions by the CAVC and the United States Court of
Appeals for the Federal Circuit, the courts have invalidated a number
of longstanding VA policies and regulations because they were not
consistent with the statute. In response to these decisions, VBA, less
than a month ago, provided the regional offices with revised templates
to conform to the directives of the court.
These court decisions added thousands of cases to regional office
pending workloads, since they require the review and reworking of tens
of thousands of completed and pending claims. As of February 25, 2006,
the number of pending rating claims was 370,428 with a total of pending
workload (including non-rating claims) of 580,378. While the number of
claims has been increasing, the percentage of claims appealed has also
increased. As of February 25, 2006, the number of appeals pending in
the regional offices was 152,303. Data on regional office performance
appear to contradict VBA's description of improvements in service to
veterans.
JWV urges the Committee Chairmen and Secretary of the VA to give
this issue their highest attention possible.
concurrent receipt
JWV greatly appreciates Congress' action to date, but strongly
urges Congressional leaders and Members to be sensitive to the
thousands of disabled retirees who are not yet included in concurrent
receipt legislation enacted over the past years. Specifically, as a
priority, JWV urges the Congress to expand combat-related special
compensation to disabled retirees who were not allowed to serve 20
years solely because of combat-related disabilities.
Additionally, JWV urges the Congress to ensure the Veterans'
Disability Benefits Commission protects the principles guiding the DoD
disability retirement program and VA disability compensation system.
JWV applauds the Congress for all of the work that resulted in the
landmark provisions in the fiscal year 2004 National Defense
Authorization Act that expand combat related special compensation to
all retirees with combat-related disabilities and authorizes--for the
first time ever--concurrent receipt of retired pay and veterans'
disability compensation for retirees with disabilities of at least 50
percent. The fiscal year 2005 National Defense Authorization Act
provided additional relief to those with disabilities rated at 100
percent by immediately authorizing these retirees full concurrent
receipt, effective January 2005. Disabled retirees everywhere are
extremely grateful for this action to reverse an unfair practice that
has disadvantaged disabled retirees for over a century.
While the concurrent receipt provisions enacted by Congress benefit
tens of thousands of disabled retirees, a greater number are still
excluded from the same program that eliminated the disability offset
for those with 50 percent or higher disabilities. The fiscal challenge
notwithstanding, the principle behind eliminating the disability offset
for those with disabilities of 50 percent is just as valid for those
with 40 percent and below, and JWV urges Congress to be sensitive to
the thousands of disabled retirees who are excluded from current
provisions.
As a priority, JWV asks the Congress to consider those who had
their careers cut short because they became disabled by combat, or
combat-related events, and were medically retired before they could
complete their careers. For these retirees, the disability offset still
exists and it is difficult to explain to a lengthy career
servicemember, disabled in combat, why his or her service (perhaps as
much as 19 years) seems to have had no value. JWV urges the Congress to
expand Combat Related Special Compensation to those medically retirees
who had less than 20 years of service.
filipino veterans
The Jewish War Veterans fully supports the passage of H.R. 302 and
S. 146, the ``Filipino Veterans Equity Act'' introduced by Congressmen
Issa and Filner in the House and Senator Inouye in the Senate. This
legislation will restore to all Filipino World War II veterans their
benefits that were rescinded by Congress in 1946.
It is sixty years since the war in the Pacific ended. Sixty long
years in which the Filipino World War II veterans and their sons and
daughters have waited for equity. These are the soldiers who lived in a
territory of the United States, who were drafted into service by
President Franklin D. Roosevelt, and who fought along side American
forces in the titanic battles of World War II--Bataan and Corrigidor.
Their courage and bravery must be recognized.
Progress was made in the 108th session of Congress with the passage
of legislation to improve health care and compensation for Filipino
World War II veterans living in the United States. The Jewish War
Veterans applauds this action and urges Congress to pass further
legislation that lives up to the promises made to Filipino World War II
veterans.
Bills introduced in the 108th Congress to grant benefits to
Filipino World War II veterans were supported by 21 Senators and 207
Congress Members. The bills in the 109th session are quickly gaining
co-sponsors. The Jewish War Veterans urges Congress to pass both
bills--H.R. 302 and S. 146.
ex-prisoners of war
Mr. Chairman, JWV asks the Committees' support for our ex-prisoners
of war! Illness such as diabetes and osteoporosis should be presumed to
be service connected for ex-POWs as they are Vietnam Veterans.
JWV supports the passage of H.R. 1598 and S. 1271 which would
accomplish the above goals.
pow-mias
There is one issue that has long been the focus of our attention,
and that is the POW/MIA accounting issue. Initially begun with sole
focus on those missing and unaccounted for from the Vietnam War, the
effort has expanded dramatically over the years since President Reagan
raised the priority, thanks in no small measure to the National League
of POW/MIA Families, our JWV and other veteran-related NGO's. We in the
JWV fully support the POW/MIA families who have remained vigilant and
serve as the conscience of our Nation in this regard.
We urge Congress to give thoughtful oversight to this issue of
national concern. Together, we must work to ensure that assets and
resources needed are in place to account for those who serve--past,
present and future. Our commitment to the principles of the POW/MIA
mission is a signal to the world that we, as a Nation stand fully with
those who are fighting for the cause of freedom and against terrorism
around the world.
national cemetery administration (nca)
The National Cemetery Administration (NCA) is charged with meeting
the interment needs of the Nation's veterans and their dependents.
There are approximately 14,200 acres within established installations
in NCA. Just over half are undeveloped and, with available gravesites
in developed acreage, have the potential to provide more than 3.6
million gravesites. More than 301,050 full-casket gravesites, 58,500
in-ground gravesites for cremated remains, and 37,900 columbarium
niches are available in already developed acreage in our 120 national
cemeteries. JWV commends the NCA in its efforts to meet its
accessibility goal of 90 percent of all veterans living within 75 miles
of open national or state Veterans cemeteries.
conclusion
Senator Craig and Senator Akaka, on behalf of the Jewish War
Veterans of the USA, we sincerely thank you for scheduling our
presentation at a time when our National Executive Committee members
will be present.
At our annual national conventions our members work diligently to
develop our legislative priorities. Our dedicated resolutions chairman,
PNC Michael Berman, works hard to develop our resolutions and to bring
them before our convention delegates. Following further fine-tuning by
our convention delegates, our resolutions are finalized, and become our
legislative priorities for the coming year. We thank you for the
opportunity to present them to you today.
Chairman Craig. David, thank you very much.
Now let us turn to Richard Schneider, Executive Officer for
Governmental Affairs, Non-Commissioned Officers Association.
STATEMENT OF RICHARD C. SCHNEIDER, EXECUTIVE OFFICER FOR
GOVERNMENTAL AFFAIRS, NON-COMMISSIONED OFFICERS ASSOCIATION
Mr. Schneider. Thank you very much, Chairman Craig, Ranking
Member Akaka, Members of the Committee. It is a great
opportunity to be here, and I want to say something about this
Committee. You have made a difference with your leadership in
representing veterans since you have come into office and made
this a responsible, responsive Committee to the veterans of
America, and we thank you for that.
I will also tell you we don't always agree with everything
that is going on, and that is our job, to come here and tell
you that. We don't agree that the budget is adequate. We don't
agree it was adequate in 2006. We don't believe the proposed
budget is adequate in 2007. And we question the management
efficiencies that are part of that budget, and we question the
number, and we articulate that it is probably going to be low,
and that is a tragedy.
Mr. Salazar mentioned that there is going to be a planning
of the budget, and it is going to start to spiral down after
2008. Well, I will tell you something, sir. That budget cannot
go down after 2008 because medical costs are going up, and you
still have all of these veterans behind me and those coming
today who you have to take care of. So we need to look at that
budget.
And I will tell you something, sir. We are not that old
that we are forgetting who we are and what we are, and by that
I mean it was only two or three years ago when a former
Secretary of VA told us, ``You will have Medicare Plus Choice
to take care of the sevens and eights, and we are working
that.'' Well, that has gone down the tube somewhere, and we
would like to see it resurrected, and we would like to see this
Committee ask the question, ``What about Medicare Plus Choice
that you said was coming?''
We would also like to know, what about TRICARE
reimbursement? Why aren't we collecting more money from TRICARE
and the DOD for the services that are being provided? Maybe
there are ways to bring additional money into the VA without
trying to put co-payments on the backs of the veterans who
served America.
In that regard, sir, I would tell you we met with the
Secretary of VA and we met with the Secretary of Health and
Human Services less than 10 days ago, and we asked the question
about Medicare Plus Choice. The Secretary of Health and Human
Services said, ``That is not our job. That is Congress's job.
Go ask them.'' And so we are here today and we are asking that
question. We would like you to tell us.
But you know we are here for a number of reasons, and some
of the reasons we are here for is to talk about the issues that
most concern us. Mr. Akaka addressed the GI Bill and what it
meant for him to continue in his life and career.
Well, we recognize as an enlisted organization of non-
commissioned petty officers and all enlisted grades of the
active, the Guard, and the Reserve, that we have on active duty
today, active duty people who have served continuously from the
era of the VEEP educational program, who were counseled not to
sign up for VEEP and, as a result of not signing up, have never
become eligible for the Montgomery GI Bill, and we believe that
is a tragedy. We would like to see an open season for VEEP
people in the service who would have been eligible, who either
established or didn't establish an account, to have an
opportunity to sign up for the Montgomery GI Bill.
We would also like to look at the Armed Services side and
look at the Guard and Reservists who come into the service, who
go and are deployed, come back with a tremendous benefit, but
if they opt to go after the education, they leave the benefit
on the table. They don't carry it with them. It is not
portable. It terminates when they terminate their Reserve and
Guard commitment, and by God, we think that is wrong. We think
they ought to have the same opportunity that Mr. Akaka and all
of us had with our GI Bill.
We would also like to recognize and speak for a moment
about DIC and SBP offset. By God, there shouldn't be an offset.
That is a tragedy.
If one of these people who took SBP while they were on
active duty and later qualify for DIC, either lose their SBP
benefit--they don't lose it. Now, get this technical
apportionment. OK? If their DIC payment is higher than their
SBP, they get a refund of all of the premiums that they paid in
for the benefit that they wanted to have for their families. A
refund.
That is not what they asked for. They paid in. They wanted
a payment from their SBP account for their survivors. DIC only
happened because something that happened to them in the
military service from which they would later die qualified them
for a DIC payment. And if the DIC payment is lower than the
SBP, then they get the difference from SBP and they get a
refund of some of the premiums that they paid.
We believe that is wrong. They ought to receive SBP and
they ought to receive their DIC benefit, and we argue that
position, and we bring it to your attention today.
We can go on, and I have got a red light. I hate red
lights. I tend to ignore them except when I am driving.
Mr. Randles. I am not yielding any of my time.
Mr. Schneider. All right, don't yield any of your time.
But I would go back and I would say, sir, we appreciate who
you people are. We appreciate what you do. We have a number of
concerns, and I would like to just mention two, and then I will
stop.
The Asbestos Trust Fund, we want that passed. We want the
people who served not only years ago, but who have been exposed
to asbestos right in that five-sided building across town, and
in Iraq in the past year, to have the opportunities of that
Asbestos Trust Fund if they need it. We want that done.
The other thing we want done is, we don't want anyone--and
I almost said the nasty word--pulling some horse pooky trick
and doing something that would change VA's ability to buy
discounted drugs, and move them up in their purchase price of
drugs for the Department of Veterans Affairs and for all
veterans by bringing the opportunity to Medicare-eligible.
We have nothing against Medicare-eligible, but we don't
want the Federal Supply Schedule reviewed with the impact being
we are going to change the Federal Supply Schedule and adjust
the cost, which is then going to increase the co-payments all
the way around. And in case you didn't get my earlier point, no
co-payments.
[The prepared statement of Mr. Schneider follows:]
Prepared Statement of Richard C. Schneider, Executive Officer for
Governmental Affairs, Non-Commissioned Officers Association
Chairman Craig, Ranking Minority Member Akaka and Members of the
Senate Committee on Veterans Affairs, the Non-Commissioned Officers
Association of the USA (NCOA) is very appreciative for the opportunity
to formally present its 2006 Legislative Agenda to the Senate Committee
on Veterans Affairs. The fact that the leadership of this Committee
determined on short notice to provide this hearing opportunity when the
concept of an historical Joint Hearing was abandoned is in the judgment
of NCOA indicative of your support of America's veterans, their
families and survivors.
I am Gene Overstreet, 12th Sergeant Major of the United States
Marine Corps (Retired), President and Chief Executive Officer of the
Non-Commissioned Officers Association. I am joined today by CMSgt
Richard C. Schneider, USAF (Retired), NCOA Executive Director of
Government Affairs; and MSG Matthew H. Dailey, USA (Retired), Military
Affairs Associate of the Association's National Capital Office.
introduction
NCOA is privileged to represent active duty enlisted servicemembers
of all military services, the United States Coast Guard, associated
Guard and Reserve Forces as well as veterans of all components. We are
in 2006 ever cognizant and vigilant of the sacrifices associated with
duty in the Uniformed Services of the United States of America during
the Global War on Terrorism.
NCOA representation of enlisted members from all services and
components makes it unique and enables it to provide a full and
comprehensive perspective on active duty, veteran and survivor issues
for the Administration and this Congress.
The Association provides for these members and their families
through every stage of their military career from enlistment to
eventual separation, retirement and on to their final military honors
rendered on behalf of a grateful Nation. The Association defines well
its membership service as cradle, or enlistment, to grave and than
continues to provide services to the veterans surviving family members.
NCOA is guided in its legislative role by resolutions adopted
annually by its worldwide membership. We take those resolutions very
seriously recognizing vital responsibilities to be in the forefront of
issues impacting the large numbers of active duty, Guard and Reserve
members currently in harm's way deployed around the world in America's
War against Terrorism. In military parlance, this non-commissioned
officer leadership team is standing on point here on Capitol Hill to
articulate entitlement issues, protecting benefits as necessary,
extending value to those benefits that have failed to keep pace in a
21st Century America, and last, to achieve new entitlements to meet the
needs of today's warriors and their family members. The promises of a
grateful Nation must be honored and held sacred by its institutions for
those who risk their very lives fulfilling their commitment to America.
The words of the Oath of Military Enlistment are simple but provide
the very essence of service for every military man and woman by their
ultimate declaration. These twelve words are the same for all who
answer the Clarion Call to Duty:
``. . . to support and defend the Constitution of the United States
of America.''
Please note that in the Enlistment oath there is no qualifying
comment or words such as funds and resources permitting. There is the
belief by those who serve that they will have the finest war fighting
equipment, support services, health care, and all necessary
institutional support while on active duty to include active and
veteran health care support and should they fall in the line of duty
the institutional support of a grateful Nation for their survivors.
Granted, the War on Terrorism is somewhat different than a conventional
war, but the words finest war fighting equipment has certainly been
questioned and challenged not only by deployed personnel but by this
Congress on the issues of personnel body armor and adequately armored
vehicles.
We are also pleased for the spaciousness of this meeting assembly
that allows you to look into the faces of active duty members and
veterans who served in every national conflict and attend this hearing
to support their organization's comments on veteran needs presented in
their Legislative recommendations. There is no doubt that in this room
there are those who could speak of their own personal experiences and
question the adequacy and timeliness of benefit claim processing,
challenge whether or not the discretionary VA health budget is adequate
based on their access to needed specialized health care services or
just plain primary care clinic appointments. I am humbled at the
opportunity to raise my voice on their behalf and like you, I am so
very proud of each man and woman who has worn a service uniform of this
great Nation.
Military members deployed or stationed around the world today leave
on the home front their spouses and family members. These marvelous
military families live with not only the heartbreak and frustration of
separation but the reality that separation may be compounded by
sacrifices of overbearing personal consequence. Daily the news media
brings in real time the sights, sounds and horrors being experienced by
military members to the living rooms of their spouses and children.
Soldiers are vividly seen weeping over a dead or wounded comrade and
are joined countless thousands of miles away by the emotion and tears
of family and friends who share the wounding or loss of an American
Patriot.
The Association makes note that Non-Commissioned Officers
Association is a member of The Military Coalition, a forum of
nationally prominent uniformed services and veterans' organizations
that shares collective views on veteran and active duty issues. The
Association is also a veteran organizational supporter of the 2007
Independent Budget.
va fiscal appropriations
The past twelve fiscal years of funding for the programs of the
Department of Veterans Affairs have been characterized by five (5)
years where fiscal growth was nearly steady state yielding an increase
of less that 3 percent. Following those early years were by 6 years
including the past fiscal year of notable budget growth which while
significant paled in comparison to the events of a nearly completed
decade in which the number of veteran users and medical cost increases
outpaced budget gains.
fiscal year 2006 appropriation
NCOA recognizes that the availability of an adequate annual
appropriated budget for the Department of Veterans Affairs directly
impacts VA programs and the legislative priorities approved by
Congress. It was evident to veteran service organizations that the
Department's current fiscal year 2006 Budget would be inadequate
without additional appropriations.
Today, GAO-06-359R issued on February 1, 2006, Subject: Limited
Support for VA's Efficiency Savings has brought into serious question
budget assumptions used by the VA in formulating its Appropriated
Budget for the past three fiscal years. It appears from this report
that the documented creative accounting of Management Efficiencies
totaling billions of dollars used to offset and directly lower the VA
budget requirement in support of veteran health care in the current
operating year was flawed. Those same management efficiencies
contributed to the development of the VA fiscal year 2007 Proposed
Budget.
fiscal year 2007 appropriation
NCOA supports Mandatory Funding for Veteran Health Care. All
veterans that Congress approved as eligible and VA approved for health
care enrollment should be included in the Mandatory Appropriated Budget
Process.
The fiscal year 2007 Budget is signaled as representing the largest
proposed increase in health care appropriation, an increase over fiscal
year 2006 of $3.5 billion. NCOA reserves comment in lieu of the high
probability that VA health care may have been inappropriately limited
by cost efficiencies that masked actual fiscal requirements for health
care approved for the past year (re: GAO 06-359R).
The Proposed 2007 Budget Request again advances increased proposed
pharmacy co-pays and enrollment fees.
NCOA Opposes Increased Co-Pays and Enrollment Fees
We take exception to those who would comment on how well off
financially MOST veterans and military retirees are that they could
well afford the modest increases proposed. We also note that many
military retirees take reduced Survivor Benefit Program (SBP) premium
based benefits or fail to enroll in the program for any survivor
benefits because their retired pay is at that level that their personal
fiscal reality dictates that every retirement penny is needed just to
live. That decision to delay the security of their surviving families
has many of them still at risk today.
Proposed increase in the existing pharmacy veteran co-payments of
$8.00 to $15.00 per month.--NCOA recognizes that many aging veterans on
fixed incomes could easily end up with a pharmacy co-payment costing an
additional $100.00 or more per month. An increase of just $20.00 per
month could dramatically negatively impact senior veterans.
And again a proposed enrollment or user fee of $250.00 for higher
income Priority Groups 7 and 8.--This Association will continue as in
the past to articulate that no ``user'' taxes in the form of any
enrollment fee be required of any veteran.
The authority for Veterans Health Care provided to returning
veterans from the war on terrorism for 2 years after their return. One
use of VHA health services for any reason makes them eligible for
continued enrollment for VA Health Care. NCOA supports that concept. At
the same time, NCOA recognizes that veterans from earlier conflicts
(WWII, Korea, Vietnam) or periods of service prior to the War on
Terrorism cannot easily be enrolled and based on circumstance may never
be enrolled unless VA succeeds in its enrollment fee plan or a Medicare
+ Choice Program for eligible veterans.
VA Medicare Subvention
A significant number of veterans are eligible for Medicare Health
Benefits based on credits earned during their years of employment.
These veterans by law cannot receive Medicare reimbursed health care
services for nonservice-connected care from the Veterans Health
Administration.
In 2002, VA proposed a VA Medicare + Choice Plan for
Medicare-eligible Priority Group 8 Veterans.
NCOA suggests that this Committee request that the
Secretaries of VA and Health and Human Services resurrect the promised
envisioned VA Medicare + Choice Plan for eligible Priority Group 7 and
8 veterans.
Recommendations:
That VA Appropriated Budget requires mandatory, vice
discretionary, funding for veterans health care programs.
That VHA work to secure and implement VA + Choice Medicare
health services for Priority 7 and 8 veterans for nonservice-connected
VA health care.
That VA implements its long-standing initiative to become
a TRICARE provider eligible for reimbursement for services provided.
seamless transition vital
One stop DoD/VA separation physical examination.
VA Benefits determination before discharge.
Detailing of military occupational exposures.
Consistent and equitable medical and physical evaluation
boards
Implement the Electronic Medical Record for military
personnel for use by DoD and VA throughout and following the member's
military service.
ACCESS to VA health care and benefits.
the transformation of vha remains incomplete
NCOA has long maintained before this Committee that the
transformation of VHA remains incomplete as long as Mental Health is
not fully integrated into its total health delivery system. The
projected $3.2 billion in the fiscal year 2007 VA Budget for Mental
health Services will significantly contribute to the NCOA envisioned
health care transformation within VHA.
NCOA strongly believes the future of VA Health Care demands the
dynamic expansion of Mental Health Programs into all primary medical
care clinics. Recent studies reveal mental health intervention starting
in the health care clinic can significantly reduce costs associated
with both medical intervention and use of prescription medications. The
completed Transformation will ultimately contribute to the direct
productivity and cost effectiveness of VA. This is the potential margin
in which the future VA can significantly capitalize on its existing
fiscal resources while reducing health care costs.
The Association applauded the VA Mental Health Strategic Plan
designed to improve mental health services in CBOCs and rebuild
substance abuse programs with $100 Million authorized in fiscal year
2005 and all Networks to receive Enhancement Funds in fiscal year 2006.
Mental Health professionals are transitioning into the CBOCs to provide
an integrated VA clinic concept, substance abuse (drug and alcohol)
programs, homeless veterans, rehabilitation programs, and geriatric
programs.
These programs will be effective if the mental health resource is a
full time practitioner in the CBOC and not used as a part time resource
to provide service at other locations, including other CBOCs, Homeless
Grant and per Diem Locations, and fill other VA service requirements.
Recommendations
Continue the resource commitment to fund and extend the
strategic mental health plan by the integration of mental health
professionals throughout VHA.
Backfill vacancies created by the movement of mental
health resources to CBOCs.
homeless veteran programs
Homeless Grant and Per Diem Programs
The VA Homeless Grant and Per Diem Program have effectively
established community based programs to furnish outreach, supportive
services, and transitional housing to homeless veterans. The program
provided 2,180 operational community beds in fiscal year 2000 and
through incremental increases a total of 7,820 beds in fiscal year
2005. NCOA recognizes the effectiveness of these 400 community based
programs approved and funded by VA.
VA has been effective in managing the growth of the HOMELESS Grant
and Per Diem program to ensure necessary support services are
available. It is time for the controlled growth to be expanded to
provide for these veterans. It is readily apparent that the Homeless
Veteran population now estimated in excess of 180,000 requires a ramp-
up in provider networks and support functions.
Priority for Homeless Veteran Providers in CARES/BRAC Decisions
The need for Community-Based Provider Support for Homeless Veterans
is apparent across the Nation as is the number of Federal locations
with surplus property that could be effectively used by communities to
develop Homeless Grant and Per Diem facilities. Every effort should be
made to give Community Homeless Veteran Programs priority in the reuse
designation of surplus community property. Likewise, these special
homeless veteran service programs should be given special fiscal
consideration in reduced lease contracts.
Dental Care for Homeless Veterans
Dental Care was authorized IAW 38 U.S.C. 2062 for certain homeless
veterans in approved VA programs. At issue are homeless veterans
resident at approved community locations across the Nation. Authority
for dental care lacks necessary funding to make the program a solid
reality.
Recommendations:
VA increase the annual number of homeless beds available
through the Community Grant and Per Diem Program over the next 5 years
to the existing authorization of $200 Million.
That CARES and BRAC decisions on excess Federal property
give exclusive priority to Community Homeless Veteran Providers and
that lease contacts be significantly below enhanced rates established
for the location.
That Home Dental Care programs be funded in the
Appropriated Budget cycle.
veterans benefits administration
Veteran Claim Processing
NCOA recognizes that current budget programs and number of full
time employees processing claims within the Veterans Benefits
Administration is inadequate to the task at hand. The Global War on
Terrorism and commitment of military forces is substantially
contributing to an increased workload in new claims. Concurrently, an
aging veteran population seeks reevaluation of deteriorating service
connected medical conditions and related secondary health issues that
further contribute to the claim process workload.
While significant initiatives have been developed to implement
improved information technology systems they have neither expedited the
management of the claim process, increased productivity through
technology, nor reduced errors through intelligent systems, or provided
needed time for the quality training of service representatives. A
recent sampling of responses to inquiries at VA Regional Offices
resulted in inappropriate responses to benefit eligibility questions
which could deter a veteran from pursuing a claim.
NCOA recommends immediate funding be provided to hire, train and
keep in place sufficient claim representatives to process the growing
number of claims both backlogged and those just arriving in the system.
Recommendations:
Accelerate recruitment and training to replace a growing
retirement eligible workforce.
Develop self-service computerized access to benefit and
entitlement processes via email where centralized work centers could
process the inquiries, respond to questions, or secure information for
continuation of the claim process.
NCOA strongly believes that time needs to be made
available for both quality training and supervisor review for quality
control.
VBA should determine the feasibility to have selected
retired VBA employees return to the workforce for a contract period
during which time new employees could be effectively trained and
integrated into claim production centers.
Retention of DIC Benefits after Remarriage
The 108th Congress authorized Dependency and Indemnity Compensation
(DIC) widows who remarry after age 57 to retain their DIC benefits.
This was a major change in policy, which previously did not permit
reinstatement of any DIC benefit if the DIC widow remarried. It also
established an arbitrary age of 57 where other similar Federal programs
allow remarriage at age 55. NCOA urges the Committees to change
reinstatement of this benefit for a widow(er) who remarries at age 55.
Recommendations:
That Congress provide authority to permit a DIC widow(er)
to remarry after the age of 55 (vice 57) and retain DIC status and
benefits.
Concurrent Receipt of DIC and SBP
It is time to end the fiscal offset of VA Survivor DIC from the DoD
Survivor Benefit program. NCOA believes that DIC and SBP entitlements
are separate and distinct programs. SBP represents an election by the
servicemember with concurrence by the member's spouse at time of
retirement for which a monthly premium is paid to provide a spousal
annuity. The DIC benefit is authorized based on the veteran's death
from a service-connected disability. Clearly, these two programs SBP
administered by the Department of Defense and DIC administered by the
Department of Veterans Affairs are separate and distinct entitlements
and each should be available without offset. The current offset is
widely regarded as a widow's tax reducing the military member's elected
SBP entitlement. NCOA urges the Committee to allow concurrent receipt
of these distinctly different entitlements.
Recommendation:
That DIC and SBP entitlements are provided the surviving
spouse without offset.
Revise DIC Payment Policy
DIC benefits are paid monthly for the preceding month. If the DIC
recipient dies at any time in the preceding month, that month's DIC
payment is recouped by the Department of Veterans Affairs. Example: VA
recoups the entire payment made for the month in which the recipient
died regardless of when the recipient died (the 1st day, 15 day or last
day of the month). VA, if notified of the death promptly, will make a
reverse electronic debit from the account of the electronic deposit.
This action has many times resulted in financial hardship caused by
former recipient's family members using all resources available to make
funeral and estate arrangements without awareness of the debit that
occurred. Similarly, written checks received and deposited to the
deceased member's account will inevitably result in an overpayment
collection notice. Most DIC recipients and their family members have
spent a life-time augmenting VA health care and the physical day-to-day
life style needs of their disabled veteran. Creating a negative
financial impact on the children and/or estate of a widow(er) of a
former disabled veteran is in NCOA judgment patently wrong.
Recommendation:
Allow the family (estate) of a widow(er) to retain the
entire month's DIC payment in which the recipient's death occurred.
educational benefits
Open Enrollment for VEAP-Era Non-Participants
A significant number of servicemembers who entered the military
during the Veterans Educational Assistance Program (VEAP) era initially
declined VEAP enrollment and remain on active duty and have no post-
service educational assistance. The Defense Manpower Data Center
reports that as of September 2004 that are 61,980 active duty
servicemembers in the force who declined VEAP upon entering military
service. They have not been given the same opportunity to enroll in the
Montgomery GI Bill (MGIB) as other VEAP-era entrants who actually
enrolled in VEAP.
The Association recognizes that there have been two opportunities
for VEAP enrollees to convert to the MGIB; however, there has never
been an opportunity for those who did not enroll in VEAP to do so. The
first VEAP conversion program was offered only to those enrolled in
VEAP with active accounts of at least $1.00. This conversion was
conducted from October 1996 through October 1997 and yielded
approximately 30,000 enrollees. A second VEAP conversion was authorized
for those enrolled in VEAP with zero-balance accounts from October 2000
to November 2001. 2,698 (2 percent) of the 108,792 eligible actually
enrolled in the MGIB. With such historically modest conversion numbers,
it is highly unlikely that an open-enrollment opportunity for this
group of career servicemembers would require more than a modest
projected increase in the MGIB fund. With the Nation at war, these
future veterans should be given the same opportunity to enroll (or
decline) the MGIB as all other servicemembers.
Recommendation:
That a one-time MGIB open-enrollment opportunity be
authorized for all servicemembers to include VEAP-era non-participants.
Removal of MGIB Delimiting Date
Many active duty members separate or retire from the military and
because of financial circumstances and need for employment to support
their families never use their Montgomery GI Bill entitlement. Their
education entitlement expires 10 years following separation from the
military. Members contribute $1,200 to be eligible for the MGIB. Many
of these veterans are only able to pursue educational programs or
special classes later in life when their own children are grown and
independent of parental financial support.
Recommendations:
That all military retirees have utilization of their MGIB
entitlement to a delimiting date equal to 10 years after separation
from service, or if higher, the number of years served in the military.
That veterans have access to the unused portion of their
$1,200.00 enrollment fee after the authorized delimiting period to
pursue educational endeavors.
Integrate MGIB Authority for Active, Guard, and Reserve
NCOA strongly recommends that the Montgomery GI Bill be
consolidated into a single Law to provide those educational benefits
deemed appropriate for members of the Active, Guard, and Reserve
personnel.
Having all educational entitlements in such a format would cause
review of entitlements, expanded benefits, benchmark benefits to cost
of education, parity between components, and reviews to be done
concurrently vice separate actions over an extended period of time.
Recommendation:
Consolidate all MGIB Programs within one Law.
conclusion
The Non-Commissioned Officers Association has appreciated this
opportunity to provide this Committee with the Association's 2006
Veteran Legislative Goals and comment on the VA fiscal year 2007 Budget
Request.
Your work is in fact the driving force to improving the lives of
the men and women who serve or have served their country in the armed
services. Your efforts signal that those who answer the call to protect
all American citizens by serving in the armed services is appreciated
and valued. Our Nation must reward freedom's protectors with
significant, substantive benefits. Your Committee in our judgment wears
the mantel that fulfills the promises of Lincoln and a grateful Nation
to care for those who have borne the battle . . .''
Chairman Craig, Ranking Minority Leader Akaka, and Members of the
Senate Veterans Committee, the Non-Commissioned Officers Association
requests that you maintain a comprehensive vision for veterans that by
necessity extend to programs that do not fall under your Committee's
jurisdiction but clearly impacts veterans and their survivors. As
advocates for veterans' issues, NCOA asks that you take an aggressive
leadership role on such issues as:
Concurrent Disabled Retired Pay
Authorize concurrent receipt of all military retired pay and VA
disability compensation without offset.
Authorize concurrent receipt for those veterans retired because of
physical disabilities prior to the completion of 20 years of military
service and those offered early retirement at 15 years of service as a
force reduction program.
Combat Related Special Compensation
Include Individual Unemployability in rating decisions for CRSC.
S. 852--Fairness in Asbestos Injury Resolution Act
As citizens and colleagues urge support of legislation in the
Senate (establishment of the Asbestos Trust Fund) to provide immediate
settlement for countless Americans including significant numbers of
military and DoD personnel exposed to asbestos and whose lives today or
in the future are terminal from medical conditions such as
mesothelioma, pneumoconiosis, pulmonary fibrosis, lung disease,
bronchogenic carcinoma, malignant mesothelioma. Naval personnel
historically have been associated with asbestos exposure resulting from
use in the construction of naval vessels for fire protection but in
recent years the Nation's military have been exposed to asbestos not
only on ships, but buildings including the Pentagon and barracks in
Iraq.
Codifying Burial Rules for Arlington National Cemetery
NCOA strongly believes that the existing rules for internment at
Arlington National Cemetery should be changed to allow burial of
retirement eligible reservists, without regard to an age limitation,
reservists on active or inactive duty for training, and their eligible
dependents family members should all be entitled to burial at ANC. It
is reprehensible to bar any reservist the right to be buried based on
an arbitrary age requirement or deny when the death results during an
authorized active or inactive training period. Members of the Reserve
Components need to be fully recognized as a vital element of the Armed
Forces and their training periods prepares them for war and other
hostilities where they are placed in harm's way. Recommend the
following provisions be so codified:
The burial entitlement of a retirement eligible member of
a Reserve Component who at the time of death was under 60 years of age
and who, but for age would have been eligible at the time of death for
retired pay under 1223 of Title 10 may be buried at ANC on the same
basis as the remains of members of the Armed Forces entitled to retired
pay under that chapter. The remains of the dependents of a member whose
remains are eligible for burial at ANC on the same basis as dependents
of members of the Armed Forces entitled to retired pay under such
chapter 1223.
The remains of member of a Reserve component or National
Guard of the Armed Forces who dies in the line of duty while on active
duty for training or inactive duty training my be buried at ANC on the
same basis as the remains of a member of the Armed Forces who dies
while on active duty. Provide for the remains of the dependents of a
member on the same basis as dependents of members of active duty.
100 Percent Disabled Veteran Space Available Travel
Seek and support legislation that will establish a Space Available
(Space A) category for 100 percent service connected disabled veterans
on military aircraft or government transportation afforded military
retirees
Thank you for the opportunity to present the Association's
legislative initiatives on behalf of the membership of the Non-
Commissioned Officers Association of the United States of America.
Chairman Craig. Richard, your message has been delivered,
very clearly.
Mr. Schneider. Thank you, sir.
Chairman Craig. Thank you so much. Now--and if you will all
notice, probably the good news is I am losing my voice, so you
won't have to put up with me much longer today--now let me turn
to James Randles, National Commander, Military Order of the
Purple Heart. Jim, welcome.
STATEMENT OF JAMES RANDLES, NATIONAL COMMANDER, MILITARY ORDER
OF THE PURPLE HEART OF THE U.S.A., INC.
Mr. Randles. Chairman Craig, Ranking Member Senator Akaka,
Members of the Committee, ladies and gentlemen, I always love
following an NCOA speaker because they have this eloquence with
their language, and they always get their point across because
somehow they never need a microphone.
[Laughter.]
I am proud to be here today in front of this distinguished
body on behalf of the members of the Military Order of the
Purple Heart. I am accompanied today by our National Service
Director, Jack Leonard, and our National Legislative Director,
Herschel Gober.
I would like to begin by thanking Congress for doing the
right thing by increasing the death gratuity and other benefits
for the servicemen and women who are serving our country in
uniform. This was one of our legislative goals from last year.
We cannot ask our military personnel to put themselves in
harm's way without committing to the welfare of their
survivors.
My next point is about adequate funding for the VA. I think
everybody has expressed their feelings and how their
organization feels, but we strongly support the independent
budget, and we have for years, that is presented to Congress
every year by the PVA and DAV and the VFW and the----
Mr. Schneider. AMVETS.
Mr. Randles [continuing]. AMVETS. Thank you. I had one of
those senior moments, Dick.
But I can best describe our support by repeating what I
told a group in February when I was up here, the Democratic
Senators that had us over, that when somebody in Congress has
asked me what I think the appropriate level for adequate
funding would be, I have to quote what my wife tells me every
year when I ask her what she wants for Christmas, and she says,
``I want it all.''
So that is the way I feel, how we should take care of--
because we are not just talking about the ones that are ``We
have been there, done that.'' We are talking about the ones
that are there now. And if the money is not there, what are we
going to do with them? You know, we send them over there, and
we have got to take care of them when they come back. You know,
serving in the military, and not just serving in war, you are
going to have casualties and you are going to have
disabilities, so we have to take care of the troops.
One of the points, and we of the Purple Heart support, and
we have fought this and we have discussed this several years in
our national convention, is Senate Bill 2157, which is the
award of the Purple Heart medal to those POWs who died in
captivity. We strongly support that issue, and we think because
of their suffering and so forth that they received while they
were interned and their subsequent death, because of that that
they deserve to receive the Purple Heart medal.
We also strongly support Senate Bill 558, which is of
course the proverbial concurrent receipt, and we have been
beating that one to death forever. I don't think I need to go
into a long explanation.
We also would like to ask that the Senate along with the
House, and the House has a bill, House Resolution 995, which
provides for the payment of combat-related service compensation
to the members of the Armed Forces who were retired prior to 20
years because of the disability they received while they were
in the service.
Dick talked about SBP and DIC offset. I am an example. I am
one of those guys at the table that falls into that category. I
retired in 1987. I took out the SBP at that time because I
wanted, if something happened to me, I wanted my wife to have
part of my retired pay. Personally, I think she deserves all of
it because she was just about as in the military as I was.
Well, we started looking at it, and SBP/DIC. Well, I have
got, I am 90 percent disabled from the VA. I have been
diagnosed with, perhaps I am coming down with diabetes now, as
a result of Agent Orange. So the chances of me dying from a
service-related disability are pretty good. Well, when you take
that money that I put in, and like Dick said, if I die from
that, she gets the choice, DIC or SBP, whichever is the
greater.
Well, I compound that with, she is a retired school teacher
in the State of Georgia, 32 years. She receives the State of
Georgia retired pay. They have a law in the State of Georgia
which I am dealing with in the State Legislature, that since
she is a retired school teacher, she cannot receive any of my
Social Security. So her only answer to me, her only response to
me after she heard all of this is, ``You can't die.''
[Laughter.]
I can't die until you change the law. So, you know, kind of
hurry, if you don't mind----
[Laughter.]
Mr. Randles [continuing]. Because I don't know. Getting on
the streets of Washington, you have got to watch where you walk
even when the light says go.
One of the issues that really gets to us is Senate Bill
1998. This is the Stolen Valor Act. I heard somebody tell me 1
day of statistics about the Vietnam veterans, that of the 1.6
million Vietnam veterans that served in Vietnam, 12 million of
them are left.
[Laughter.]
Now, I don't know how we did that, but we suddenly
multiplied. The Stolen Valor Act looks directly at those wanna-
bes--I can't call them anything but that--that want to be
recognized as wearing the Purple Heart medal, or the Silver
Star, or the Medal of Honor, or whatever.
I want to take them to--well, for the lack of an NCO term,
I want to take them to the mat. I want to put their rear ends
in jail because I don't think it is right. I don't think it
serves credibility for those of us who did serve and are
sitting in this room today, for some guy to go running around
out there saying he has got this, that, and the other thing,
and getting awards for it.
Let me give you an example. In Georgia, if you have a
Purple Heart, you get one free license plate for that car, for
a car in your house. You don't pay any taxes or anything. That
car is free. Well, if you say you have the Purple Heart, and
you can get the Purple Heart thing off the Internet, and show
it to the DMV, they have no idea whether you received the
Purple Heart or not. That constitutes fraud in my eyes, so I
want to put that little sucker in jail. I am upset about that.
Federal supply thing, I support what Dick said. You know, I
don't mind giving lower drugs, but I will be darned if I want
the veterans have to be the recipient of everybody else getting
lower cost of drugs. Find another way. You have just got to do
that.
Asbestos Trust Fund, we strongly support that you pass that
Asbestos Trust Fund. That is kind of like the wanna-bes. You
know, you have got the guy who says, ``Well, I was exposed to
asbestos,'' but he has no symptoms of any of the illnesses, and
the courts are clogged with those. That is the reason why it is
taking so long, and we need to take care of those people that
actually have disabilities because of their exposure to
asbestos, not because they think they have.
Thank you very much.
[The prepared statement of Mr. Randles follows:]
Prepared Statement of James Randles, National Commander,
Military Order of the Purple Heart of the U.S.A., Inc.
Chairman Craig, Ranking Member Senator Akaka, Members of the
committee, ladies and gentlemen:
I am James D. Randles, National Commander of the Military Order of
the Purple Heart (MOPH). It is an honor to appear before this
distinguished body on behalf of the members of MOPH. MOPH is unique
among veteran service organizations because our entire membership is
comprised entirely of combat-wounded veterans who shed their blood on
the battlefields of the world while serving America in uniform. For
their sacrifices they were awarded the Purple Heart Medal.
National Service Director Jack Leonard and National Legislative
Director Hershel Gober accompany me today.
This committee is extremely important to MOPH and its members. We
look to you to represent the veterans of our country and to ensure that
all Members of Congress understand that America must keep its promises
to those men and women who have served and are now serving in uniform
if we are to maintain a viable military and continue to enjoy the
freedoms that we have. Veterans have earned their entitlements and
benefits.
I would like to begin by thanking Congress for doing the right
thing by increasing the death gratuity and other benefits for the
service men and women who are serving our country in uniform. This was
one of our legislative goals last year. We cannot ask military
personnel to put themselves in harm's way without committing to the
welfare of their survivors.
adequate funding for the va health administration
The Military Order of the Purple Heart (MOPH) is on record as
supporting the Independent Budget, which is developed and submitted to
Congress by the Veterans of Foreign Wars (VFW), Disabled American
Veterans (DAV), Paralyzed Veterans of America (PVA) and American
Veterans (AMVETS).
I am the third MOPH National Commander in a row to present as our
number one priority Adequate/Assured funding for the VA Health
Administration. MOPH joins our fellow VSOs in urging Congress to find a
long-term solution to the annual funding crisis at the VA. The VA
deserves a system that delivers funds on time to allow for long-term
planning. With the ongoing War on Terror and our servicemembers
returning home from war with medical conditions requiring treatment at
VA hospitals, the VA needs the capability to meet their needs. The
funding problem was demonstrated last year when the need to provide
$1.5 billion in emergency supplemental appropriations for fiscal year
2005 surfaced, and the need to amend the fiscal year 2006 budget with
an additional $1.977 billion. MOPH supports Senate Bill 331.
the award of the purple heart medal to those pows who died in
capitivity
The MOPH believes that those military personnel who suffered
hardships and wounds or illnesses while held in POW camps and died as a
result of their interment should be considered as combat casualties and
eligible for the award of the Purple Heart Medal. MOPH supports
legislation that has been introduced in both houses of Congress (H.R.
2369 and S. 2157) that would authorize the award.
retired pay restoration
MOPH is pleased that Congress has enacted legislation that
authorizes some military retirees to concurrently receive both full
military retired pay and any VA compensation to which they are
entitled. MOPH's position is that ALL those eligible for concurrent
receipt should receive it. MOPH supports Senate Bill 558.
combat military retired veterans
MOPH supports legislation to provide for the payment of Combat-
Related Special Compensation to members of the Armed Forces retired for
disability with less than 20 years of active military service. MOPH
supports H.R. 995.
survivor benefit plan (sbp) and dependency and indemnity compensation
(dic)
MOPH supports legislation that will repeal the requirement for the
reduction of SBP annuities by the amount of DIC compensation. Survivors
of retirees who die of service connected causes and paid into SBP, and
survivors of members killed on active duty, should receive both SBP and
DIC without the current dollar for dollar offset. MOPH support Senate
Bill 185.
stolen valor act of 2005
MOPH supports S. 1998. It is unfortunate, especially with our
country engaged in ongoing conflicts, that there are citizens in this
country who lie about the medals that they received while serving in
the military. This is not just an occurrence now and then but
regrettably it is a huge problem. This legislation would provide for
fines and imprisonment for those wannabees that dishonor the medals for
valor and the Purple Heart Medal and those brave men and women who have
legitimately received these medals. MOPH urges passage of this
legislation.
protecting the federal supply schdule (fss)
The VA purchases approximately 24,000 pharmaceutical products at
discounts ranging from 24 to 60 percent below drug manufacturers' most
favored non-Federal, non-retail customer pricing through the FSS.
Efforts have been made to open the FSS to other entities which would/
could have the effect of the VA losing the favorable pricing and cost
the VA hundreds of millions of dollars in unbudgeted funds, funds which
they do not have and would have to divert from medical services that
could deny veterans treatment. MOPH supports lower priced
pharmaceuticals for all Americans but not at the expense of veterans.
asbestos trust fund
Many of our Nation's veterans were exposed to asbestos during their
military service up until the mid-seventies when its use was
discontinued. There is data that indicates the 26 percent of all
mesothelioma cases, the most deadly form of this disease, are veterans.
Further 16 percent of all other lung cases and 13 percent of all
disabling lung disease cases again are veterans. Veterans cannot sue
their employer, the U.S. Government and getting their day in court is
difficult because most of the corporate manufacturers are bankrupt or
no longer exist. MOPH supports Senate Bill 852 which would create a
trust fund that would give just compensation to veterans. The current
court system is not working for veterans.
Mr. Chairman this concludes my testimony. I will be pleased to
answer your questions.
Chairman Craig. James, thank you very much for your
testimony. We are going to work hard to keep you alive.
Mr. Randles. Thank you, sir.
Chairman Craig. Again, let me thank all of you for your
testimony this morning. The reason in my opening statement I
challenged you all is not because this Committee and the
Members of the Committee are not going to work overtime to
deliver this budget and beyond. We are.
But the reason this year I couldn't walk away from a
revenue enhancement proposal is because I do believe it is time
once again that this community of interest and others begin to
look at that freight train coming down the track at us. And I
say that because, while this Congress has demonstrated its
willingness, and I think they have, to fund VA--year after year
they have outperformed Presidents and outperformed proposals in
almost all instances by some amount.
Why? Because of our commitment to veterans. I hope that is
not questioned. It may not have been at the level or it may not
have been where you wanted it, but it was almost always greater
than, for a variety of reasons. And the reason I say that is
because there are some tremendously looming statistics on the
horizon. For many here in this room they won't pertain, but for
many of you they will.
And that is a simple and obvious fact that both
conservative and liberal economists agree on, that if two norms
continue, and that is, a growing economy and a tax base for the
Federal Government that reflects about 14 percent of GDP, for
those who say, ``Well, we are not taxing enough,'' we are
taxing right now at a historic norm, that is between 14 and 16
percent GDP, and that is on an average that has spread across
time for a long while.
You find that if you tax too much above it, you begin to
impact the economy and growth and all of those things, and job
creation, so that has been a norm that, while we don't talk
about it a lot, we try to sustain. So if we sustain that norm
out there for another 20 years or 30 years, and of course we
assume the economy is going to grow, there is going to be new
jobs, therefore there will be new revenue. Right now we are
taking in more revenue, right now, than when the tax cuts, the
Bush tax cuts came along that I supported some years ago.
But having said all of that, by the year 2030 Social
Security and Medicare and Medicaid will consume all of the
Federal budget, all of it. Doesn't include you. Doesn't include
Defense. Doesn't include Agriculture and Interior and Commerce
and all of the other agencies of government, and Education. And
there are few in this city who disagree with that statement.
Now, that is 2030. That is a ways out there, but it isn't far.
And so no matter what we do this year, we are going to come
in at or above what the President has proposed, would be my
guess.
And I will support that and work to get it. But I am going
to progressively challenge all of you to look beyond where your
headlights are now shining. Why? In large part not for you, but
for those young men and women coming out of Iraq and
Afghanistan, and the future. Sustainability is what we are
talking about here, and that is tremendously important, I
think.
Thank you all for your testimony. Let me turn to Senator
Richard Burr for any comments he has, or questions. Richard,
thank you for joining us.
STATEMENT OF HON. RICHARD M. BURR, U.S. SENATOR
FROM NORTH CAROLINA
Senator Burr. Thank you. Thank you, Mr. Chairman. More
importantly, thank you for your leadership. And thank you to
those on the panel today for your service, and more
importantly, for your passion, and to those in the audience for
your service and your willingness to be here in support of
those individuals who testified.
Mr. Chairman, I can't not take the lead that you have
headed on, and that is the realities of what we deal with up
here. Let me say if all five of you had not come and suggested
that more was needed, then I would question why your
associations chose you to be their spokesperson. I have yet to
have anybody come to Washington, in the 12 years that I have
been here, and suggest that we provide enough funding. But I
have always expected that when I hear from you, I will see and
hear the examples that back up the need for additional monies.
I think it is safe to say that, as Chairman Craig has
already stated, every Member of this Committee is interested in
getting it right. We will never provide everything, but the
directional change that we have had in the last several years
is a positive one, one where I think Members are engaged in
education and, more importantly, the opportunity for you to
share with us those stories has been available.
I think without the leadership of the Chairman and the
Ranking Member, quite frankly we would not be here. We continue
to work to try to make sure the items that each of you covered,
which was sufficient funding, an efficient VA, one that did
supply the services that were needed, that we work in concert
with the Secretary and others at VA to make sure that in fact
we are trying to complete the package as best we can.
We need your help. The Chairman did a good job of
explaining what we see down the road as the fiscal challenges
of this country, and we have an obligation that spreads far
outside of the table you are at and the groups that are here,
and it does extend from this generation to the next.
We need the same passion you display on your issues to be
displayed on the fiscal crisis that the country is headed on.
Just like 5 years ago there may not have been on your list
asbestos as it related to your membership, today it is real, we
know it is, and you are passionate and you are vocal on it, so
should your interest in us reforming Medicare and Medicaid, so
should your interest in us finding something that is
sustainable for Social Security, because without it we are all
affected.
So I implore all of you today, help us with this challenge
that we have got. It is not Republican or Democrat, it is
American, and it will dictate our flexibility in the future.
Mr. Schneider, if I could end on one thing, the next time
you go to meet with the Secretary of HHS, would you come here
first and let us give you questions for him, versus----
Mr. Schneider. Let me tell you, I will be over here and I
will be looking for you when I go to see him again.
Senator Burr. I will assure you I will start on my list
today.
Mr. Schneider. Start it now.
Senator Burr. The one thing that it terrifies me to hear is
the territorial boundaries that seem to be established within
the Federal Government. We represent the Congress, but I think
that we stand beside the Administration regardless of what
party they are in because the two have to work together.
And what is an issue that may affect you and may be the
direct result of this Committee, I would hate for a Secretary
to say, ``I have no obligation, no responsibility. Go see the
people that matters.'' The welfare of the American people
should be the interest of Congress and the Administration,
regardless of who they are, and I will assure you this
Committee will always work to try to make sure that that level
of cooperation exists for you and for everybody.
Once again, I thank you five for your testimony.
Chairman Craig. Richard, thank you very much. That was well
spoken.
Let me close on this note: It is always amazing what you
find when you dig through the files. I am looking at a
Committee report from 1996 for the 1997 VA budget, and this is
a dialogue that I am having with then the Secretary of VA,
Jesse Brown. Many of you remember Jesse very well.
Jesse and the Clinton Administration had proposed a VA
budget not unlike this one, in the sense there was growth in it
but in the out-years there appeared to be a dramatic decline.
And of course history would suggest that never happened, but
what I found interesting is this, and I think the Secretary was
being tremendously honest when I asked him that question: ``How
do we sustain this budget? And in the out-years it turns flat
and it steeply declines. What is the Administration going to do
about it?''
Here is his response: ``The numbers that you have reflected
in that chart``--he is talking about a chart I was using at
that time--``do not have any policy behind them at this
point.'' He has basically said that each and every year
veterans will have a chance to come in and sit down and
negotiate a budget.
And I thought that is a pretty clear statement, when you
look back now at where we were then and where we are today,
because that is exactly what has happened. Veterans'
organizations like yours, advocates that you are, as well as
you do it, obviously changed all of that. That was then, and
that was 1996, and this is now, and we will work through it.
What I am going to ask of you in the coming year, as we get
beyond the budget and get the numbers in place, is to dialogue
with me and other Members about the future, not the 2008
budget, not the 2009 budget, but 2010 and beyond. We will ask
this Administration to squeeze the numbers hard, and they are
squeezing them now because they recognize the challenge.
Secretary Nicholson was as frustrated last year as this
Committee was angry about the numbers that he brought, that
fell out from under him very rapidly.
As a result of that, this Committee has asked him to report
back to us every quarter, and he is now doing that. We are
tracking dollars and cents and people and services and programs
on a quarterly basis, as is he.
That will give us a much more accurate reality check as we
move into budget cycles than the kind that we fell into last
year. That simply was no way to run an organization, and you
all know it. You have seen it, and some of you have spoken to
it today. What I am proposing to you is that at least as long
as I have my hands on the tiller, folks at VA are going to
hustle, and we are going to do everything we can to make sure
that the dollars we get are spent wisely and appropriately for
America's veterans.
So thank you all very much for being here today.
[Whereupon, at 11:14 a.m., the Committee was adjourned.]
A P P E N D I X
----------
Prepared Statement of Theodore G. Stroup, Vice President,
Association of the United States Army
Mr. Chairman and Members of the Committee:
Thank you for the opportunity to present the 2006 legislative
agenda of the Association of the United States Army (AUSA) as it deals
with veteran's issues. Both in personal testimony and through
submissions for the record, there exists a long-standing relationship
between AUSA and the Senate Committee on Veterans' Affairs. We are
honored that we have been asked to express our views on behalf of our
members and America's veterans.
The Association of the United States Army is a diverse organization
of over 100,000 members--active duty, Army Reserve, Army National
Guard, Department of the Army civilians, retirees and family members.
An overwhelming number of our members are entitled to veterans'
benefits of some type. Additionally, AUSA is unique in that it can
claim to be the only organization whose membership reflects every facet
of the Army family. Each October, at our Annual Meeting, our membership
has the opportunity to express its views through the consideration and
approval of resolutions for the following year. These resolutions
provide the base upon which the Association's leadership builds its
legislative agenda.
Each year, the AUSA statement before the committee seeks to stress
that America's veterans are not ungrateful. Much of the good done for
veterans in the past would have been impossible without the commitment
of many who serve on this committee and the tireless efforts of their
professional and personal staffs.
The inherently difficult nature of military service has never been
more self-evident than during the current conflict. While grateful for
the good things done for veterans, AUSA reminds our elected
representatives that we consider veterans benefits to have been duly
earned by those who have answered the Nation's call and placed
themselves at risk.
AUSA is heartened that Congress has expressed a commitment to
support America's veterans. Despite this, many are concerned that the
declining number of veterans in Congress might in some way lessen the
value this institution places on veterans and their service to the
Nation. We, at AUSA, do not share this opinion. AUSA is confident that
you--well-intentioned, patriotic men and women--will faithfully
represent the interests of America's veterans during fiscal
deliberations.
As elected representatives, you must be responsible stewards of the
Federal purse because each dollar emanates from the American taxpayer.
AUSA emphasizes that the Federal Government must remain true to the
promises made to her veterans. We understand that veterans' programs
are not above review, but always remember that the Nation must be there
for the country's veterans who answered the Nation's call.
Veterans seldom vote in a block, despite their numbers. This is one
reason AUSA seeks this forum to speak for its members about veterans'
issues. Our veterans have lived up to their part of the bargain; the
Congress must live up to the government's part.
Those who have volunteered to serve their country in uniform
deserve educational benefits that support their transition to civilian
life. It is imperative that the Montgomery GI Bill (MGIB) remain
relevant--that its benefit levels parallel the rising cost of
education.
Currently, educational benefits under the MGIB do not reflect
policy nor match benefits to service commitment. Basic benefits for
active duty troops authorized under Chapter 30 of Title 38 have not
kept pace with the rising costs of education and training.
AUSA strongly supports the goal to index the monthly MGIB stipend
to the average annual cost of a 4-year public college or university.
The proposal would benchmark the total benefit to about $37,000 and it
would be adjusted automatically each year based on a government index
of college costs. Since the MGIB for some time has been one of the
Services' best recruiting incentives, it is imperative that its buying
power remain comparable to education costs.
AUSA strongly encourages Congress to raise education benefits for
National Guard and Reserve servicemembers under Chapter 1606 of Title
10. For years, these benefits have only been adjusted for inflation.
Currently, Reserve GI Bill benefits have fallen to less than 29 percent
of the active duty benchmark. Additionally, Reserve benefits have no-
post service value as a veteran benefit, even though almost half of the
Select Reserve has served on lengthy combat tours since September 11.
Further, a transfer of the Reserve MGIB-Select Reserve authority from
Title 10 to Title 38 will permit proportional benefit adjustments in
the future.
AUSA applauds Congress' effort to address the gap by authorizing a
new MGIB program (Chapter 1607, Title 10 USC) for Guard and Reserve
members mobilized for more than 90 days in a contingency operation.
However, more than a year after the law was changed, the program has
still not been implemented.
AUSA also believes it's time to revisit the need to dock volunteer
force recruits $1200 of their first year's pay for the privilege of
serving their country on active duty. Government college loan programs
have no upfront payments; thus, it is difficult to accept any rationale
for our Nation's defenders to give up a substantial portion of their
first year's pay for MGIB eligibility.
Further, AUSA urges the committee to authorize greater flexibility
in MGIB usage by amending Title 38 to permit use of MGIB benefits for
up to 20 years post-separation or retirement in order to keep pace with
market demands and to encourage veterans to acquire lifetime skills and
knowledge during their working years.
AUSA strongly encourages Congress to allow all participants of
MGIB's predecessor, the Veteran's Education Assistance Program (VEAP),
as well as those servicemembers who were on active duty but did not
enroll in VEAP, to receive MGIB educational benefits. There are about
63,000 non-commissioned officers and officers bravely serving their
country in the war against terrorism at home and abroad in this
situation. However, when they exit the service, they will have no
education benefits to help them achieve their post-service goals like
all other veterans. These servicemembers should be given the
opportunity to take the MGIB or decline it.
AUSA continues to support giving MGIB participants who serve a full
military career the option of transferring their benefits to dependents
as a career retention initiative.
Members of the National Guard called to active duty under Title 32
in support of the current crisis do not receive veteran's status for
their active duty military time. Those called to active duty under
Title 10 do receive veteran's status. This inequity must be addressed.
Your support in allowing Guardmembers to earn veterans' status on equal
footing with their active duty and Reserve counterparts will send the
message that National Guard personnel are part of the Total Force.
Veterans' medical facilities must remain expert in the specialties
which most benefit our veterans. These specialties relate directly to
the ravages of war and are without peer in the civilian community.
Demand for VA health care still outpaces the capacity to deliver care
in a timely manner. AUSA believes that full funding should occur
through modifications to the current budget and appropriations process,
by using a mandatory funding mechanism or by some other changes in the
process that achieve the desired goal.
AUSA supports legislation that establishes a presumption of service
connection for veterans with Hepatitis C (HCV).
AUSA applauds the unprecedented and historic legislation which
authorized the unconditional concurrent receipt of retired pay and
veterans' disability compensation for retirees with disabilities of at
least 50 percent and the legislation that removed disabled retirees who
are rated as 100 percent from the 10-year phase-in period.
However, we cannot forget about the thousands of disabled retirees
left out by this legislative compromise. The principle behind
eliminating the disability offset for those with disabilities over 50
percent is just as valid for those 49 percent and below. AUSA urges
that the thousands of disabled veterans left out of recent legislation
be given equal treatment and that the disability offset be eliminated
completely.
Two other critical areas need to be addressed. For chapter 61
(disability) retirees who have more than 20 years of service, the
government recognizes that part of that retired pay is earned by
service, and part of it is extra compensation for the service-incurred
disability. The added amount for disability is still subject to offset
by any VA disability compensation, but the service-earned portion (at
2.5 percent of pay times years of service) is protected against such
offset.
AUSA believes that a member who is forced to retire short of 20
years of service because of a combat disability must be vested in the
service-earned share of retired pay at the same 2.5 percent per year of
service rate as members with 20+ years of service. This would avoid the
all or nothing inequity of the current 20-year threshold, while
recognizing that retired pay for those with few years of service is
almost all for disability rather than for service and therefore still
subject to the VA offset.
Recent legislation restored full retired pay for members designated
as unemployables in 6 years rather than 10 years as originally
legislated. While AUSA is appreciative of the accelerated schedule, we
would like to see the disability offset to retired pay end immediately.
Legislation provided in previous defense bills authorized Combat
Related Special Compensation (CRSC) for certain retirees with combat-
or operations-related disabilities. Unfortunately, CRSC has been slow
in implementation because of the requirement to connect retirees'
disabilities directly to combat, a combat-related event or combat-type
training. This validation requires retrieval of VA medical records, an
excruciatingly slow process. Many qualifying retirees are still waiting
for compensation authorized to them. AUSA urges the Committees to
authorize proper funding to ensure timely processing of any expected
increase in disabled veterans' claims for this or other reasons.
The rules for interment in Arlington National Cemetery (ANC) have
never been codified in public law. Twice the House has passed
legislation to codify rules for burial in Arlington National Cemetery.
However, the legislation has not passed in the Senate. AUSA supports a
negotiated settlement of differences between the House and Senate
concerning codification of rules for burial in Arlington National
Cemetery. Further gray area reservists eligible for military retirement
should be included among those eligible for interment at Arlington
National Cemetery.
AUSA is opposed to the Administration's request to impose an annual
deductible on veterans already enrolled in VA health care and the
proposed increase in the co-payment charged to many veterans for
prescription drugs.
AUSA supports continuing congressional efforts to help homeless
veterans find housing and other necessities, which would allow them to
re-enter the workforce and become productive citizens.
Terminally ill veterans who hold National Service Life Insurance
and U.S. Government Life Insurance should, upon application, be able to
receive benefits before death, as can holders of Servicemembers Group
Life Insurance and Veterans Group Life Insurance. AUSA supports
legislation to amend the U.S. Code appropriately.
Much more needs to be done to ensure that returning combat
veterans, as well as all other service men and women who complete their
term of service or retire from service receive timely access to VA
benefits and services. This issue encompasses developing and deploying
an interoperable, bi-directional and standards-based electronic medical
record; a one-stop separation physical supported by an electronic
separation document (DD-214); benefits determination before discharge;
sharing of information on occupational exposures from military
operations and related initiatives. AUSA strongly recommends
accelerated efforts to realize the goal of seamless transition plans
and programs.
We encourage the positive steps toward mutual cooperation taken
recently by the Department of Defense (DOD) and the VA. The closer we
can come to a seamless flow of a servicemember's personnel and health
files from service entry to burial, the more likely it will be that
former servicemembers receive all the benefits to which they are
entitled. AUSA supports closer DOD-VA collaboration and planning
including billing, accounting, IT systems, patient records, but not
total integration of facilities nor of VA/DOD healthcare systems.
AUSA strongly supports preservation of dual eligibility of
uniformed service retirees for VA and DOD healthcare systems. We
applaud Congress' opposition to ``forced choice'' in the past and
encourage you to hold the line in for the future.
AUSA recognizes that significant progress has been made in reducing
the unacceptably high numbers of backlogged disability claims. The key
to sustained improvement in claims processing rests on adequate funding
to attract and retain a quality workforce supported by investment in
information management and technology.
Your committee safeguards the treatment of America's veterans on
behalf of the Nation. AUSA knows that you take this responsibility
seriously and treat this privilege with the gratitude and respect it
deserves. Although your tenure is temporary, the impact of your actions
lasts as long as this country survives and affects directly the lives
of a precious American resource--her veterans. As you make your
decisions, do not forget the commitment made to America's veterans when
they accepted the challenges and answered the Nation's call to serve.
Thank you for the opportunity to submit testimony on behalf of the
members of the Association of the United States Army, their families,
and today's soldiers who are tomorrow's veterans.