[House Hearing, 111 Congress]
[From the U.S. Government Publishing Office]
BUILDING THE CRITICAL HEALTH INFRASTRUCTURE FOR
VETERANS IN JACKSONVILLE, FLORIDA
=======================================================================
FIELD HEARING
before the
COMMITTEE ON VETERANS' AFFAIRS
U.S. HOUSE OF REPRESENTATIVES
ONE HUNDRED ELEVENTH CONGRESS
FIRST SESSION
__________
APRIL 20, 2009
FIELD HEARING HELD IN JACKSONVILLE, FL
__________
Serial No. 111-11
__________
Printed for the use of the Committee on Veterans' Affairs
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COMMITTEE ON VETERANS' AFFAIRS
BOB FILNER, California, Chairman
CORRINE BROWN, Florida STEVE BUYER, Indiana, Ranking
VIC SNYDER, Arkansas CLIFF STEARNS, Florida
MICHAEL H. MICHAUD, Maine JERRY MORAN, Kansas
STEPHANIE HERSETH SANDLIN, South HENRY E. BROWN, JR., South
Dakota Carolina
HARRY E. MITCHELL, Arizona JEFF MILLER, Florida
JOHN J. HALL, New York JOHN BOOZMAN, Arkansas
DEBORAH L. HALVORSON, Illinois BRIAN P. BILBRAY, California
THOMAS S.P. PERRIELLO, Virginia DOUG LAMBORN, Colorado
HARRY TEAGUE, New Mexico GUS M. BILIRAKIS, Florida
CIRO D. RODRIGUEZ, Texas VERN BUCHANAN, Florida
JOE DONNELLY, Indiana DAVID P. ROE, Tennessee
JERRY McNERNEY, California
ZACHARY T. SPACE, Ohio
TIMOTHY J. WALZ, Minnesota
JOHN H. ADLER, New Jersey
ANN KIRKPATRICK, Arizona
GLENN C. NYE, Virginia
Malcom A. Shorter, Staff Director
Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public
hearing records of the Committee on Veterans' Affairs are also
published in electronic form. The printed hearing record remains the
official version. Because electronic submissions are used to prepare
both printed and electronic versions of the hearing record, the process
of converting between various electronic formats may introduce
unintentional errors or omissions. Such occurrences are inherent in the
current publication process and should diminish as the process is
further refined.
C O N T E N T S
__________
April 20, 2009
Page
Building the Critical Health Infrastructure for Veterans in
Jacksonville, Florida.......................................... 1
OPENING STATEMENTS
Chairman Bob Filner.............................................. 1
Prepared statement of Chairman Filner........................ 44
Hon. Steve Buyer, Ranking Republican Member...................... 3
Prepared statement of Congressman Buyer...................... 44
Hon. Corrine Brown............................................... 7
Hon. Ander Crenshaw.............................................. 8
WITNESSES
U.S. Department of Veterans Affairs:
Robert L. Neary, Jr., Director, Service Delivery Office,
Office of Construction and Facilities Management........... 30
Prepared statement of Mr. Neary.......................... 50
Reginald M. Lawrence, SRCT, CPP, Team Leader, Jacksonville, Vet
Center, Readjustment Counseling Service, Veterans Health
Administration................................................. 32
Prepared statement of Mr. Lawrence........................... 51
______
Disabled American Veterans, Guy Diffenbaugh, Commander,
Jacksonville, FL, Chapter 1.................................... 17
Prepared statement of Mr. Diffenbaugh........................ 46
Duval County School Board Member, District 1, Jacksonville, FL,
Colonel Stan Jordan, USA (Ret.)................................ 25
Prepared statement of Colonel Jordan......................... 50
Jacksonville, FL, City of, Military Affairs, Veterans and
Disabled Services Division, Gunnery Sergeant Herschel Allen,
USMC (Ret.), Duval County Veteran Service Officer/Veteran
Service Officer Supervisor..................................... 10
Prepared statement of Sergeant Allen......................... 45
Jacksonville, FL, National Cemetery Advisory Committee, Corporal
Daniel V. Hughes, Sr., USMC (Ret.), Chairman................... 23
Prepared statement of Corporal Hughes........................ 48
Montford Point Marine Association, Master Sergeant James H.
Tippins, USMC (Ret.), President, Chapter 29, Jacksonville, FL.. 18
Prepared statement of Sergeant Tippins....................... 47
Northeast Florida Veterans Council, Jacksonville, FL, Hallie
Williams-Bey, Chairman......................................... 16
Prepared statement of Mr. Williams-Bey....................... 46
Wallace, Stephen, President, Florida Community College at
Jacksonville, FL............................................... 6
BUILDING THE CRITICAL HEALTH INFRASTRUCTURE FOR
VETERANS IN JACKSONVILLE, FLORIDA
----------
MONDAY, APRIL 20, 2009
U.S. House of Representatives,
Committee on Veterans' Affairs,
Washington, DC.
The Committee met, pursuant to notice, at 12:25 p.m., at
the Donald T. Martin Center for College Services, 501 W. State
Street, Jacksonville, Florida, Hon. Bob Filner [Chairman of the
Committee] presiding.
Present: Representatives Filner, Brown of Florida, and
Buyer.
Also Present: Representative Crenshaw.
OPENING STATEMENT OF CHAIRMAN FILNER
The Chairman. Good morning everybody.
My name is Bob Filner. I am Chairman of the House Veterans'
Affairs Committee, and we are so excited to be here in
Jacksonville for the hearing to address the critical health
infrastructure of the Department of Veterans Affairs.
We have two housekeeping items to attend to before we get
started. I need to ask unanimous consent that our colleague,
Mr. Crenshaw, be invited to sit with the full Committee today.
Ms. Brown of Florida. Without objection.
The Chairman. Hearing no objection, so ordered.
Thank you for being here. I know you have a district
surrounding us, and I thank you so much for being here today. I
also ask unanimous consent that all Members may have 5
legislative days in which to revise and extend their remarks.
Hearing no objection, so ordered.
Of course, we thank the Florida College for their
hospitality in hosting the event. We have been invited to hold
this hearing by Congresswoman Brown. She is, of course, on the
Committee and she is the second person in line of seniority. We
came to the House together in 1992, but when I say Ms. Brown,
invited us, I mean, that an invitation implies a choice. When
Ms. Brown invites you, you don't have a choice.
You have a real tenacious Congresswoman in the Congress. I
think you know that. She doesn't take ``no'' for an answer.
Generally, the Ranking Member and I go different places,
but we are all here together because of Ms. Brown.
Thank you, Mr. Buyer, for being here. It is not always the
case that both parties send people to a field hearing, and we
are so glad that Mr. Crenshaw and Mr. Buyer are here along with
Ms. Brown.
As part of our job, we have oversight of the U.S.
Department of Veterans Affairs (VA) and we want to make sure
that the resources are in place to meet the needs of our
veterans--no matter where they are located. We are doing a lot
of oversight with the new veterans from Iraq and Afghanistan,
and we expect an influx of hundreds of thousands of veterans as
that war is drawn down this year.
But we have veterans from World War II, Korea, Vietnam, and
the first Persian Gulf War. We cannot forget about them. We owe
every one of our veterans the highest quality treatment and the
best access to care.
I see there are two men over here who are wearing hats,
representing the Filipino World War II veterans. I happen to
know them from other cities where they have lived. I want to
acknowledge that the Filipinos were drafted into World War II
and helped us win the war in the Pacific. We would not have won
it so quickly without them.
After they got their independence in 1946, the Congress at
the time said, all the benefits we promised you, that is the
responsibility of the new Philippine government. For 62 years,
they have been trying to get the benefits that have been
denied, and a few weeks ago, Congress passed a law which gives
them pension and health care benefits as a way to say thank
you, even though it is 6 decades later. Thank you and we are
glad we were able to finally give you the justice that you
deserve and fought so hard for.
We do know that the VA has made some progress locally on
the health infrastructure with the new Gainesville Tower
Project. We would not have had that without the effort of Ms.
Brown. The new bed tower will correct deficiencies in patient
privacy. There are over 245,000 square feet with four floors
that will house 226 single-bed patient rooms with private baths
and a ground floor to house supportive services.
We have a lot of challenges in Jacksonville. The veterans
here have been waiting for more than a decade for a replacement
outpatient clinic in this city. This is not acceptable to Ms.
Brown. It is not acceptable to me and certainly not acceptable
to this Committee. We authorized the new facility almost 10
years ago, and I think our veterans deserve better than that.
Under the leadership of Ms. Brown, there was a meeting this
morning of all the stakeholders to try to work out the
location, price, and the memorandum of understandings that are
necessary. I met with the group from Shands and the VA to try
to further that process along. Ms. Brown and I will be talking
to the new Secretary of the Department of Veterans Affairs to
try to further move the process.
We have this hearing at a time of enormous optimism and
promise for new direction. We do have a new Administration and
a new Secretary of VA. While serving in Vietnam and as Army
Chief of Staff, Secretary Shinseki was always known as a
``soldier's soldier''--always caring for his people. I am now
calling him a ``veteran's veteran'' because he understands what
is going on and I believe that by working with this Committee,
we will make further strides in the quality of care for all of
our veterans.
We are looking forward to hearing from all of the witnesses
today. We also will have an open session to hear about some
general issues that any of you would like to bring to our
attention. We will go by our normal procedure, which is to
recognize our Ranking Member, Mr. Buyer, and then we will hear
from both Ms. Brown and Mr. Crenshaw.
Mr. Buyer.
[The prepared statement of Chairman Filner appears on p.
44.]
OPENING STATEMENT OF HON. STEVE BUYER
Mr. Buyer. By way of a parliamentary inquiry, this is a
formal Congressional hearing, even though we are in
Jacksonville, is that not correct?
The Chairman. Yes, sir.
Mr. Buyer. So witnesses, there has been an exchange of
witness lists, and witnesses have been vetted, as I understand,
by both staffs; is that not correct, Mr. Chairman?
The Chairman. Yes, sir.
Mr. Buyer. I am not aware of procedures within the
protocols of Congress for there to be an open microphone other
than individuals of whom are named witnesses. Are you aware of
such procedures?
The Chairman. We felt that given the fact that this is a
public hearing, the veterans who are interested in what is
going on, would have a chance after the formal hearing is over
to express their opinions. We can adjourn the formal hearing
before we begin the open forum, but we want to hear from the
public. We will have the hearing, and then we will conclude it
and have the open microphone session.
Mr. Buyer. Okay. Thank you very much. Appreciate your
answers to the inquiry. Thank you.
Mr. Chairman, it is a pleasure to be here.
And ladies and gentlemen, Jacksonville, my association with
the south and the southeast is, my family is from Charleston,
South Carolina. Even though my father was from Indiana, he went
to The Citadel. My brother went to The Citadel. I didn't have a
choice in life. I am a graduate of The Citadel, and so I have a
lot of friends and a lot of relatives in this part of the
country. And when the three of us, Corinne and the Chairman and
I, came to Congress together, we also were joined by Tilly
Fowler. And you know it was pretty easy to take Tilly Fowler.
She is an extraordinary lady with a lot of great attributes,
and so it is a pleasure for me to be here in Jacksonville, not
only the hometown of Corinne Brown and Ander Crenshaw, but also
of Tilly, and it is a pleasure to serve with both of these
Representatives from your hometown.
Corinne is an interesting personality. She is very
pugnacious. So when she gets hold of an issue, she just doesn't
let go, and right or wrong, she is not going to let go. And I
give her much credit in our efforts 3 years ago relative to the
Orlando Hospital, along with John Mica and Ander and others,
but at the final meetings, Corinne was there in the room, and
her voice was heard.
I also want to extend my pleasure for the leadership of
Ander Crenshaw. The synergies that you have here, that you get
to take advantage of is, you have, in Florida, you must have
five or six Members on the authorizing Committee of VA. And
then Ander Crenshaw and Bill Young, and you have some others
here on the Appropriations Committee. And so it is really--I
just want to take a moment to thank Ander for what he does for
you. It is one thing to get it authorized, and then you have to
get it funded.
So when you think about the new, Jacksonville National
Cemetery, Ander Crenshaw was there to be able to deliver the
$29 million to make this a reality, and now you have this 525-
acre cemetery which has now been opened for burial, and so I
want to thank Ander for his efforts.
I also want to thank him for--I wish all Members of
Congress would do this, your annual Veterans Recognition
Ceremony, and you had over 2,000 veterans go through that. So I
want to thank you for that.
I also want to extend a warm welcome to everyone here in
attendance. Our Deputy Ranking Member, Cliff Stearns, he could
not be here with us today but wanted to thank the staff and
others who are here. He was not able to participate. Cliff is a
long-standing leader on the Committee, and he is a steadfast
advocate for veterans. He has also actively called for a new
Regional health care Center in Marion County and expansion of
the VA hospital in Gainesville. For years he has been working
on these projects, and we have now broken ground, and I know he
looks forward to seeing both these projects come to fruition.
I also appreciate we are having this hearing to discuss how
the VA is moving forward to expand services and meet the needs
of veterans who live here in the Jacksonville area. New
technologies make it possible to provide more diagnostic,
specialty, and surgery services in an outpatient setting rather
than a hospital. To maximize the use of these advances and
bring a broad array of specialized services closer to where
veterans live, the VA is moving from the clinics to the new
Ambulatory Care Centers.
And so I want to reference we have a joint ambulatory care;
it is not necessarily called the center, but it is kind of a
model that we are now moving off of in Pensacola, and I want to
credit Mr. Jeff Miller for his leadership in assisting the VA
to do this. And then the Chairman went down to, they call it
deep Texas, down at Harlingen, and I also went to deep Texas.
So the two of us went at two different times, and we were able
to then come together and work with the VA in the introduction
of these Ambulatory Care Centers, and so we are trying to
create these synergies of excellence.
And as you all know, the current Jacksonville, VA, clinic
is located next to the University of Florida Health Science
Center at Shands Hospital. The North Florida VA health care
Center has a strong and meaningful affiliation with the
University of Florida. And the VA expansion of the current site
with the collaborative partnership could yield substantial
benefits for veterans.
I understand there is progress finally being made, and
hopefully there is a way forward to build on these synergies
that I was referring to that exist between the VA and a
university.
Sharing is not a new concept. VA has been sharing human
capital for years and its affiliation among our Nation's
teaching universities. In Charleston, South Carolina, there is
a tremendous opportunity for the VA to replace its aging
hospital with a mutually beneficial agreement to share
facilities and integrate the delivery of veterans health care
with the new Medical University South Carolina Hospital. This
approach to shared facilities, which I take great pride in
developing, is now being referred to as the Charleston model
within the VA.
This is a model that can be replicated and changed,
depending upon the availability of services in a particular
environment. So I want to thank the Chairman in his efforts, as
we look at different communities, how do we build up these
synergies without being multiplicious or duplicative.
Because I truly believe that collaboration, whether it is
between the VA, the U.S. Department of Defense, medical
affiliates, State partnerships, or other private sector
entities, it is a powerful, powerful tool for the VA to
leverage to ensure that our veterans have the greatest access
to the most advanced medicine and medical technology.
As we look at the future development to VA, it is also
vital that the VA establish strategic and long-term plans for
energy sustainability, especially here in the Sunshine State.
The VA must consider the use of a solar energy to power the VA
health care facilities. I am very pleased with the new
Secretary. The VA is planning to fund at least four feasibility
studies for solar voltaic in its medical facilities, including
four sites near the State of Florida. It will include Orlando,
Bay Pines, Tampa, and Miami.
In closing, I would like to thank all of our witnesses for
appearing before our Committee today. Again, on behalf of Cliff
Stearns, I want to recognize Stan Jordan, retired Army colonel
and member of the Duval County School Board. Also, Colonel
Jordan was a former member of the Florida House of
Representatives and Chairman of the Florida's House Committee
on Military and Veterans' Affairs.
I would also like to thank Dan Hughes, Chairman of the
Jacksonville National Cemetery Advisory Committee, for being
with us here today and for his volunteer service on our
colleague John Mica's Veterans Advisory Committee. It is
important we listen to all these views, and I thank the
Chairman for his time.
[The prepared statement of Congressman Buyer appears on
p. 44.]
The Chairman. Thank you, Mr. Buyer.
As I said, we are here at the invitation or insistence of
Ms. Brown.
Ms. Brown, please proceed--let us know what is on your
mind.
Ms. Brown of Florida. Thank you, Mr. Chairman, and before I
begin, I would like to yield 1 minute, without objection, to
Dr. Wallace, who is President of Florida's Community College
but soon to be the Florida State College of Jacksonville to
give greetings to the Committee and the audience, the VA.
The Chairman. Please.
STATEMENT OF STEVEN WALLACE, PRESIDENT, FLORIDA COMMUNITY
COLLEGE AT JACKSONVILLE, FLORIDA
Mr. Wallace. Thank you, Congresswoman. On behalf of Florida
Community College, soon to be Florida State College, it is our
honor to welcome you here today.
Chairman Filner, Congressman Buyer, our two famous favorite
Members of Congress, Congresswoman Brown and Congressman
Crenshaw, it is always a pleasure to have you in our
facilities.
I want to make just a note because many people don't know
this and it is a point of great pride, but this is a perfect
venue for your hearing today. Of the 1,600 community colleges
in America, Florida Community College is proud to have the
largest veterans program in the country, and we will continue
to support our active-duty military and veterans in wondrous
new ways.
We recently hired retired Rear Admiral Jim Stevenson to
lead our Military Education Institute, and we are expanding our
services for servicemembers and veterans every day.
And so we welcome you here, and we certainly appreciate
your service to our veterans.
The Chairman. I just want to thank you again for having the
hearing here today. I would like you to comment, if you will,
on the new GI Bill for the 21st century. You all know how
important the GI Bill was after World War II. I am a
beneficiary of it. My Dad came back from World War II and was
able to get some education and buy a house for the first time
in our family's history.
Unfortunately, those benefits have declined in value over
the years.
What we wanted to do for the new veterans is to try to pay
for the full cost of college, plus a stipend. We also changed
the housing loan program so that it is more up-to-date and
accessible.
I would like to know if you are going to be able to handle
the increased number of veterans, and if you are satisfied with
the formulas? Are you aware of the formulas that we will pay
the tuition, and how is that going to work out for the college?
Mr. Wallace. Thank you for that question, Mr. Chairman.
The Chairman. I didn't mean to surprise you, but I think it
is important for your institution to be aware and prepared for
the veterans coming home. The servicemembers coming back can
assign their benefits in the future to their spouse or their
children.
Mr. Wallace. Right. Thank you, Mr. Chairman.
We are paying a tremendous amount of attention to this. We
see it as a phenomenal opportunity to elevate our assistance to
veterans; in some cases, active-duty military, spouses, family
members. We have a task force that is going through a massive
redesign of our already very, very substantial and significant
service. We are expecting to be inundated with veterans taking
advantage of the new benefits, spouses, family members, and we
will be fully in position to receive them in August when we
expect that flow to begin, but we could not possibly be taking
this opportunity and this responsibility more seriously.
The Chairman. Is the tuition reimbursement going to meet
your actual expenses?
Mr. Wallace. Yes, Mr. Chairman, that won't be a problem. In
Florida public education, we have among the lowest tuition
rates in America. So it is well covered.
The Chairman. What you take pride in, and I want to say
this to Mr. Crenshaw and also to Ms. Brown, may cause a problem
in that the formula that was passed. The tuition grant will be
based on the highest, public university in the State. This will
mean that if somebody wants to go to a higher tuition school
that because your tuition at State schools is subsidized, we
may not meet the real expenses of lower tuition States. In
California, Florida, or other States where there is a tradition
of real support for public colleges, that support is going to
work against the stipend. We are not going to try and change it
for this year because we want to get it started, but please
keep us informed. You said you had other programs and I suspect
they cost more than the tuition is actually going to cover.
Mr. Wallace. Yes, sir.
The Chairman. We need to know how the new GI Bill affects
all of the States because we may want to make some changes next
year. Keep in touch with us please.
Mr. Wallace. We will do so.
The Chairman. It is going to be an exciting time.
Ms. Brown, I am sorry to interrupt you.
OPENING STATEMENT OF HON. CORRINE BROWN
Ms. Brown of Florida. No, no, that is a very good question,
and I want to also give greetings to Sandra, who has worked on
veterans issues and is a member of the school board and a State
legislator and for a long time worked very closely on getting
the cemetery and other issues here in Jacksonville.
And also with us today is Art Graham who is on the City
Council, and I spoke to him last night about the VA hearing,
and he is here today.
So, thank you, Mr. Graham.
First of all, let me thank the Chairman for holding this
hearing. I know it is a tremendous sacrifice for people to take
time from your district during this work period and to come
here, and you know, you can extend the invitation, but there
has to be a follow-up, and I want to thank him and Mr. Buyer
and Mr. Crenshaw for coming here to this hearing today.
And one of the things I like about being on the VA
Committee, and I have been on there for 16 years, I really do
believe it is one team, one fight, and we are here for
veterans, and we work together, and it is not any of this
Democratic or Republican thing. It is just all for the veterans
on this particular Committee. And I want to thank the Chairman
for the largest increase in the health care budget in the
history of the Department of Veterans Affairs, and I am just
really pleased that you are here and when we leave
Jacksonville; we are going to go down to Orlando and take a
look at the issues down there also.
I am pleased that all of the witnesses are here to discuss
the infrastructure of the veterans in Jacksonville.
One of the things that, you know, we have more and more
veterans moving to Jacksonville because of our beautiful
climate and the cost of living, and that kind of works against
us in the sense that we are growing, so we need to make sure
that the VA keeps up with the growth of our veterans.
Many times veterans come to me, and they are concerned
about how long they have to wait and the kinds of services they
are getting, and basically, the services are good, but with the
growth, we have to make sure that we put the infrastructure in
place to take care of those needs. And I think we have a good
team here with the VA and the regional people in VA, and they
are going to work with us to make sure that it happens.
I want to mention something about that cemetery because I
worked on the Committee to get it authorized, and you have to
get it authorized before you get it funded. And one of the
things that was really interesting is that it is a form, and so
we had to make sure that we got the people in the Miami area
taking care because they had over a million veterans in that
area. We had to get the expansion of the existing facilities in
Bushnell, and then Jacksonville was in line, and so we had to
do all those things before we were eligible to have a cemetery
in this area, so I was very happy to do that.
I want to close with a statement of the first President of
the United States, George Washington: ``The willingness with
which our young people are likely to serve in any war, no
matter how justified, shall be directly proportional as to how
they perceive the veterans of earlier wars are treated and
appreciated by their country.''
The people here in Florida are the best people, and I am
pleased to have this hearing with my constituents and the VA to
hear their views and to listen to how we can work together to
improve the services for the veterans here in the area and, of
course, in the State of Florida and really in the country. So
``one team, one fight'' really does exemplify the Committee.
The Chairman. Thank you, Ms. Brown.
We stopped at a nearby clinic on the way over here, and the
director said there is a waiting list of 400 veterans. We have
a lot of work to do.
Mr. Crenshaw, thank you for joining us today.
OPENING STATEMENT OF HON. ANDER CRENSHAW
Mr. Crenshaw. Thank you, Mr. Chairman.
Before I say anything, I want to--I listened to Ranking
Member Buyer mention Tilly Fowler. I just want to make people
aware of the fact that tonight, at 7:00 p.m., there is going to
be a dedication of a memorial to former Representative Tilly
Fowler, and I am sure that if you don't know about it, they
would love to have you be there. They have a memorial that has
been in the newspaper, and I think it is down on the river
right by the YMCA. And any of the Members here or certainly
anybody in the audience, Tilly was a great lady, as the Ranking
Member pointed out, and they have all served together. So it is
fitting tonight that this memorial is going to be dedicated. I
just want to make everyone aware of that.
Mr. Buyer. I hate to interrupt, but all of us know, that
worked with Tilly, and I want the community to know you know
her and you have your own perceptions of her. With regard to
helping our country, her leadership was extraordinary. The
Navy, in order to have a two-port blue-water Navy, she was such
an extraordinary advocate that, when the JFK is replaced, and
now they are trying to find a home port for the Herbert Walker
Bush nuclear carrier. These facilities have to be prepared to
receive a new carrier, and there is so much work in
infrastructure investment that must be done in order for that
to happen. Tilly Fowler started working on this issue in the
mid-nineties. So long before; it is a 15-year, 20-year tale to
prepare for something like this, and so now when you have the
Secretary of Defense make this recent announcement that to
bring a nuclear class carrier here to Mayport, I would like the
community to know this is a big deal. And it now rests upon the
shoulders of Ander Crenshaw, and so it is going to take a $100
million at the first baseline. It could be a lot more before we
are done to prepare for that because we have to have a backup
maintenance facility be able to handle something like this.
But I just want you to know, I give a lot of credit to you
and Ander, but Tilly laid a real base and foundation there for
the community, and I know a lot of people have made a
tremendous amount of effort. I yield back.
Mr. Crenshaw. Thank you very much, but I just simply want
to add my words of welcome to the Chairman, the Ranking Member
for being here today. As some of you all understand, it is a
pretty big deal to have those folks travel to come to a field
hearing like this.
I certainly want to add my words of welcome. I want to
thank my colleague, Congresswoman Brown, for proposing to have
this and encouraging the Chairman and the Ranking Member to
show up and be here.
As she said, you know, when it comes to issues about
veterans, it is ``one team, one fight,'' and I think
particularly with Corinne and I, when it affects northeast
Florida in particular, affects veterans, it is ``one team, one
fight,'' and I am proud to work with her to do the things we
have been able to do.
I certainly want to thank the distinguished panel that is
going to be here to testify. We appreciate you taking the time.
As the Chairman mentioned, I am not a Member of the Veterans'
Affairs Committee, but I am a Member of the Appropriations
Committee. And the main work that I do is on the Subcommittee
called Military Construction and Veterans Affairs. And as
Ranking Member Buyer mentioned, the $500 million that is going
to be needed to upgrade Mayport to make it capable of home
porting a nuclear carrier will go through my Subcommittee. And
I am going to work as hard as I can. This year will be a $100
million to begin the dredging and begin some of the work
upgrades, but I will continue to work on that.
But in particular as it relates to veterans, all the
funding that has been mentioned comes through our Subcommittee,
and I was proud last year to be a cosponsor of that legislation
that led to the largest increase in veterans funding in the
history of our country.
And so I will continue to work with my colleague, Corinne
Brown, certainly with the Chairman and the Ranking Member on
the authorizing side. We have a unique opportunity here in
Jacksonville because we have Cliff Stearns and Congresswoman
Brown that sit on the authorizing Committee, and then I sit on
the Appropriations Committee. So we can work together, which I
think is a great advantage for our northeast Florida community,
and so we will continue to work together.
And finally, just let me say, being in the presence of all
you veterans because I do so much of the work in Washington
related to the military, related to veterans, and so when I
travel, whether I am in Jacksonville or traveling to some far-
off part of the world to oversee our military bases, some
40,000 square miles, worth about half a trillion dollars, or
meet with veterans groups around, I am always reminded, I don't
think I need to remind you all, that the greatness of America
really has been drawn from the blood and the sacrifice of the
people who have gone before us as well as the people that
defend us today.
So I thank you all for being here.
Thank you, Mr. Chairman for allowing me to be part of this.
I look forward to hearing from you all, so that when we go back
to Washington and begin to write the budget for the VA,
Veterans Affairs, for 2010, I will have some firsthand
knowledge.
Maybe just in parting, just let me say, I may have to leave
a little early today. I have my BlackBerry, and any minute now,
I am going to become a grandfather for the second time. My
daughter is in the hospital now, and if I slip out a little bit
early, that is to welcome my newest granddaughter into the
world today.
But Mr. Chairman, thank you for inviting me to be here
today.
The Chairman. Thank you.
Give me a note to that effect.
Our first witness will be Herschel Allen, who is the Duval
County Veteran Service Officer, Veteran Service Officer
Supervisor for the City of Jacksonville.
Thank you for being here today, and we are looking forward
to your testimony. Your written statement will be made a part
of the record.
You are recognized. Thank you for being here.
STATEMENT OF GUNNERY SERGEANT HERSCHEL ALLEN, USMC (RET.),
DUVAL COUNTY VETERAN SERVICE OFFICER/VETERAN SERVICE OFFICER
SUPERVISOR, CITY OF JACKSONVILLE, FL, MILITARY AFFAIRS,
VETERANS AND DISABLED SERVICES DIVISION
Sergeant Allen. Thank you, Mr. Chairman, and Congressmen.
I have had about 3 days to prepare for this since I was
told I was to testify, but that is okay. I enjoy talking about
it and letting my peace be known.
I was born and raised here in Jacksonville, graduated in
1960, enrolled in the Marine Corps, was stationed all over the
world; of course, the tour in Vietnam where I was awarded the
combat action ribbon, among other awards. So I am well aware of
the current crisis for veterans and what they went through, are
going through, and will go through in the future, especially
the many problems that change people.
My present duty, I have been the supervisor of the Duval
County, City of Jacksonville, Veteran Services Division for 15
years.
I guess the Committee is probably well aware of it, maybe
the members of the audience are not, but the clinic here in
Jacksonville, the caseload, just the first quarter of this
year, 15,423 leads. The pharmacy has seen over 25,000. The
teams have gone from two teams to now they are looking for a
fourth team. Each doctor has over 4,400 patients, but the cost
per patient remains low as compared to the private sector, and
the confidence and the ability of people who visit it is very
high. Through the years, they have done a superb job with the
resources they have.
Myself, 15 years ago, I would not go to the VA. Now that is
my choice. It is better actually. I can track here or with
Aetna. I prefer the VA. They are very good, especially on
preventive maintenance and the medicine. They want to check you
out and find out what is wrong with you before it happens.
The location, however, is not good at all, not acceptable.
That area is very congested with the Shands facility all around
it. The parking is ridiculous. They do try to have a little
cart thing back and forth. Some people, especially the
disabled, are not going to be able to climb into those little
golf carts.
It is a high-crime area. I pulled up, on the City of
Jacksonville Web site, in the last 6 months in that area there
have been 15 assault and batteries; 22 burglaries; 7 robberies;
46 thefts; 10 vehicle thefts; 7 vandalisms. The people who work
there don't like being there either.
There is no central location for that clinic. The main
clinic is there. The eye clinic is over in the twin towers. The
Surgi-Center is way off of JTB. The VA is now looking for some
more leased land to put another team. Of course, those folks
would have to go back to the main clinic if they had to have
any prescriptions filled.
Distance, 45 minutes was VA's standard. They want all
veterans to be within 45 minutes of an inpatient facility. If
you live right here right now, to go to a VA facility in either
Gainesville, unless you break the speed limit, you are not
going to make it any less than 1 hour, 15 minutes/20 minutes.
It is impossible. So we don't fall within that standard. Of
course, Orlando has got the other hospital. Figure that out.
Transportation to the medical centers, the Disabled
American Veterans (DAV) does run vans. However, the disabled
have a very hard time.
The size of the proposed clinic they have now, even if it
was built today, would be inadequate. We are receiving veterans
in this county. About 210 DD-214s per month come into my
office, which means those are folks the VA doesn't know about.
The VA only counts members or those that they are giving
benefits to, like 95,000. There are over 177,000 here and going
up. The clinic that they have proposed now is not going to be
adequate.
The concerns I hear from some of the veterans that I see on
a daily basis are: The clinic is too spread out. There is no
hospital close by. It is difficult to get to the hospital.
There is a long wait time here at the clinic. I have served
more than 10 years since it was proposed, and what is going to
happen this summer when category 8s are allowed into the
medical system.
The veterans' interests are not being met. The largest city
in the United States. We have land available around this county
to put a larger facility, rather than smack dab downtown where
it should not be.
Too much rhetoric, not enough action. You people have the
authority and the power to make it right and change it, and we
would hope and pray that you guys do the right thing.
Thank you very much.
[The prepared statement of Gunnery Sergeant Allen appears
on p. 45.]
The Chairman. Sergeant Allen, just a chance to ask some
questions, if you don't mind.
Sergeant Allen. I don't mind at all.
The Chairman. Don't turn your back on this Committee.
Ms. Brown.
Ms. Brown of Florida. I have a question. Because,
obviously, you work for the City of Jacksonville, you know that
the city has been working with Shands and Gainesville to come
up with the location for this clinic, and you mentioned that
there was a hospital in Gainesville--I mean, in Orlando. We
have been working on that for 25 years, and it is not in the
ground yet. So it takes forever for the VA to come up with a
project and go through all of the procedures.
Now this project that we have is almost ready to go, and
the City of Jacksonville helped with developing the land. It
was a partnership between Shands, Gainesville, University of
Florida, and the VA. So I don't understand, and there is a need
for these veterans that live in this community right here and
now. So I don't understand what we are talking about. A
different location, then you are talking about another 20
years. It takes the VA forever to build a facility.
Sergeant Allen. About 4 years ago, I had the people from
the clinic, from Gainesville, and Central Office in Washington,
down at a 13-acre site on the west side, beautiful wooded
location, was perfect, transportation, sewer, electric,
everything together. Central Office, Washington, says great.
Two weeks later, a phone call says, we can't do it. It needs to
be kept downtown.
Ms. Brown of Florida. Yes, I know, I want it downtown
because that is where a lot of veterans live. I don't know
anything about the facility on the Westside. I didn't make the
decision on the location. The VA made the decision on the
location, and it is supposed to have been a partnership. I want
to hear your comments, but the City of Jacksonville, the City
of Jacksonville was involved in this negotiation.
Sergeant Allen. I am not speaking for the City of
Jacksonville. I am speaking for veterans.
Ms. Brown of Florida. I hear what you are saying. Do you
know how long it takes for a project to be completed? The
project in Orlando, the hospital, is a 25-year project. I have
been in Congress for 17 years, and it still does not exist, and
it will be another 3 to 5 years for that hospital.
Sergeant Allen. Whose fault is that?
Ms. Brown of Florida. You tell me.
Sergeant Allen. We can't make laws, pass legislation and
create our own appropriations. That is you guys, not us. You
wanted our input, and that is what it is.
Ms. Brown of Florida. Let's be clear, the authorization is
done. The appropriation is done. Maybe we can find out from the
VA why it takes them so long. The money is there.
Sergeant Allen. I don't know. I really don't. You wanted to
know the concerns. I see veterans every day and on the weekends
and evenings. I am letting you know what I have seen and what
their concerns are. That is what you wanted, isn't that
correct?
Ms. Brown of Florida. That is still what I want, sir, but
what I am saying is, as far as the facility is concerned, I had
nothing to do with the decision----
Sergeant Allen. I didn't say you did.
Ms. Brown of Florida. I did not, but you said you showed
them a facility on the Westside that was----
Sergeant Allen. Property, not a facility.
Ms. Brown of Florida. Well, it was the same thing as the
cemetery. People wanted it in a different place, and the VA
made the decision based on whatever criteria they make off the
needs and how many veterans are in the area. And the
transportation and all of those factors are considered.
Sergeant Allen. Ten years from now, it needs to expand the
facility downtown.
Ms. Brown of Florida. Ten years from now, we can go with a
plan B, but it will be 10 years before we get anything up. That
is the problem. We need design build. We need to expedite
projects.
The Chairman. Okay.
Thank you, Ms. Brown.
Mr. Crenshaw, any questions?
Mr. Buyer.
Mr. Buyer. Gunny.
Sergeant Allen. Sir, can I go back now? Are you going to
ask some questions?
Mr. Buyer. I have never seen a gunny turn his back on
anything. So you didn't do that. What you did is spoke like a
gunny. You stood up, you had what you had to say, and by God,
that is what it is. We are going to move on.
I don't know what it is about the Marine Corps. They get
you guys, and you all come out the same. There is something
about a gunny sergeant, all the ranks in the military, and I am
a Colonel, but there is something about--when I am around a
gunny, they just make me nervous.
I think it goes all the way back, I was 17-years-old, at
Parris Island, and the gunny sergeant made me pull fire watch.
And I didn't understand why I had to do fire watch, you know,
from 2:00 a.m. to 4:00 a.m., and it was my turn. I didn't
understand, and in the morning, before we went to formation, I
went over, and I waited for the gunny to come out of his room.
And I saw the gunny, and said, gunny, this thing about fire
watch, I have an idea about how we can improve that system.
Sergeant Allen. Is this a true story?
Mr. Buyer. This is a true story. I am an ideas guy, always
have been, but I want you to know what the gunny did. I pulled
fire watch for 2 weeks, every night, and I learned what fire
watch was about. It wasn't about watching for fire, you know,
but I tell you what, I just love gunnies so I love your
testimony, and I love your candor. And that is what we love
about gunny sergeants; it is your candor.
We have on the Committee with us a master sergeant, United
States Marine Corps, veteran of Iraq, who lost the lower part
of his leg. He remains on active duty. He lost that lower part
of his leg and then went back into Iraq looking for the son of
a bitch.
Sergeant Allen. That is right.
Mr. Buyer. Let me ask, what I love about your job is that
you work with veterans every day, and you don't have an 8-to-5
job because it is wherever they see you. You can be on the
street, you can be in the store, it can be coming out of
church, and they are going to grab you, because everybody knows
you. You are their advocate.
So with regard to, because you touch them every day, what
are your recommendations to us with regard to how we get--how
are we doing on getting information out there with regard to
benefits, and tell me a little bit about your IT systems, on
how well you are being financed with the updated equipment.
Sergeant Allen. Well, I will answer the second one first.
When I got into this job in 1994, all the claims, everything,
was done by hand. A lot of the benefits had a lot of mistakes.
I got with an IT person, and we developed a system. It is all
done electronically, and people come down to our office, sit
down, they don't fill out any forms. We do it on a computer,
and we are the only office in the world that files
electronically. They sign a signature pad, and boom, it is
there. But that was all funded through the city, just the city,
period.
Mr. Buyer. So when you do that electronic format, are you
able to send that directly to the VA?
Sergeant Allen. Yes, sir. If it is lost in the building, we
go back to the date of claim, of when they got it, it is
fantastic. We have been doing that for about 10 years now.
Since they moved the pensions to our Pension Management Center
in Philadelphia, I am trying to get with those folks so we can
file pensions the same way. But it is all funded by the City of
Jacksonville. Of course, most other counties in Florida and
some other States found out about it and copied that and were
able to use it.
As far as getting the word out, I don't think the VA does a
very good job. The way the bill before Congress right now, I
think it is called Veterans Outreach of 2007 or something,
where they would really help fund the idea already, assisted
living facilities, veterans service organizations, different
groups and communities, to let people know what is available.
Matter of fact, this morning, a Korean and Vietnam Wars
veteran who worked for the city for 30 years. I see him in the
morning when I get in between 5:30, quarter of 6:00. By about
6:00, I step out and buy a cup of coffee. He walks by. His name
is Jerry. By the summer, he starts growing his white beard, and
by December, he looks just like Santa Claus. I said, Jerry,
weren't you in the military? He said, yeah. I said, did you
retire? He said, I guess so, they gave me some papers, told me
don't come back. I said, yeah, you are retired. I said you get
anything from VA? No. I said, what kind of disabilities do you
have? He named off just about every presumptive disability that
Agent Orange has. I said, why don't you file a claim with the
VA? I didn't know I could. He worked for the city for 30 years.
Our office is downstairs. I go out just, people like that----
Mr. Buyer. What more can we do with regard to getting
information out on the availability of benefits.
Sergeant Allen. I would like to see each major city that
has a newspaper at least once a week, out on Sundays, has some
kind of veterans issue. For a while, I was going on channel 2--
--
Mr. Buyer. A service announcement?
Sergeant Allen. I don't even watch that myself, but those
kind of things, anything they can do.
Congressman Crenshaw, I know I have seen some of the things
he has put out periodically, tries to know about some of these
issues, not just Federal, but also State and local benefits out
there for veterans.
But I don't know. I don't know the answer. I keep trying.
Every time I see somebody, are you a veteran, you look like a
veteran; I tell everybody that works for me, church groups,
organization, whatever you belong to, try to get the word out.
Mr. Buyer. Gunny, I want to thank you for your leadership.
Please extend my appreciation to the City of Jacksonville and
the Unigov to finance that, because what you are doing here is
not happening and it is not replicated by the country. This
electronic format is extremely helpful to the VA. So thank you
for your leadership. I yield back.
The Chairman. Thank you. We thank you for your testimony.
More importantly, we thank you for your work every day with
veterans, and we will try to give you some more help in that
outreach. We appreciate your testimony.
Sergeant Allen. Thank you. We appreciate what you have
done. We just, please, do more if you can, please.
The Chairman. Okay, thank you. This concludes the first
panel. The next panel is comprised of three people. If you will
all come forward for panel two.
Hallie Williams-Bey is the Chairman of the Northeast
Florida Veterans Council. Guy Diffenbaugh is the commander of
the Jacksonville Chapter 1 Disabled American Veterans. Sergeant
Tippins is the president of Chapter 29 of the Montford Point
Marine Association.
Ms. Brown of Florida. Mr. Chairman, I just want to announce
that Ms. Griffiths, ADR Griffiths, is here from Senator
Martinez's office.
The Chairman. Thank you for being here. We thank the
Senator for his interest.
Well, we will recognize each of you for 5 minutes, and then
we will open it up for questions.
STATEMENTS OF HALLIE WILLIAMS-BEY, CHAIRMAN, NORTHEAST FLORIDA
VETERANS COUNCIL, JACKSONVILLE, FL; GUY DIFFENBAUGH, COMMANDER,
JACKSONVILLE, FL, CHAPTER 1, DISABLED AMERICAN VETERANS; AND
MASTER SERGEANT JAMES H. TIPPINS, USMC (RET.), PRESIDENT,
CHAPTER 29, JACKSONVILLE, FL, MONTFORD POINT MARINE ASSOCIATION
STATEMENT OF HALLIE WILLIAMS-BEY
Mr. Williams-Bey. My name is Hallie Williams-Bey.
I am a Marine Corps Vietnam veteran staff sergeant.
Ms. Brown of Florida. Can you pull that microphone closer
to you, please?
Mr. Williams-Bey. My name is Hallie Williams-Bey. I am
former staff sergeant, who served in Vietnam from 1968-69 in
the Marine Corps. I have been involved in many local veterans
service organizations for about 27 years.
As a military veteran, I have been going back and forth to
my private physician for many years. In 2000, I found I had
prostate cancer. I went to the local VA clinic, and was told it
would take me 2 years to even see a doctor in the Lake City VA
Clinic.
During this time, I went to my private physician, and
started the healing process with hormone treatments, seed
implants and radiation treatments. By the time I went to my
scheduled appointment at the VA in Lake City, they told me,
there was no sign of cancer, and my disability went from 100
percent to 10 percent.
Since that I time, I have been very active helping other
veterans and organizations. I am proud that we will have a VA
clinic, as Congresswoman Brown stated, and can build in the
current location now because we don't have a clinic at this
time. The current VA clinic is overcrowded; there are many
hours for waiting and if you miss an appointment, you might
have to wait another 2 years to see a doctor.
Jacksonville is a big place and there are a lot of places
to build a new clinic, but we need to start somewhere. We can
start with Shands/UNF and build on the current location and use
their facility until we out-grow that space. We do not need to
put off again, we need a clinic now. The veterans have
experience in the ``hurry up and wait procedure'' while nothing
ever happens.
Like Congressman Buyer said, we know about ``fire watch''
and we are still doing fire watch right now. A lot of us are
back in America from combat, but we are still missing from
American decisions. We are missing from Washington, DC, agendas
and nothing is happening to improve our service.
We have too many civilians working for different programs
every day, and they don't represent the veterans. We have more
people in the VA clinic who are not veterans, and they have no
sympathy for our veterans.
Mr. Herschel Allen has helped many veterans with our
benefits. He works for the City of Jacksonville, but he does
more outside the City of Jacksonville for veterans. Once again,
politics plays a way everything is done.
My main concern here today is to represent different
organizations to encourage the Committee to build a clinic now
at its current location. We don't have time to wait 10, 15 to
20 years. A lot of us won't be alive.
Congresswoman Brown, I met her before when she was a State
Representative, and I have known her for many years. She has
encouraged me to participate with many veterans organizations
and in my current position now as Chairman of the Northeast
Florida Veterans Council.
We both care about veterans issues and concerns, and if we
don't represent them, who is going to represent them?
Thank you.
[The prepared statement of Mr. Williams-Bey appears on p.
46.]
The Chairman. Thank you, sir.
Mr. Diffenbaugh.
STATEMENT OF GUY DIFFENBAUGH
Mr. Diffenbaugh. Yes, sir.
Mr. Chairman, Congresswoman Brown, Congressmen Crenshaw and
Buyer.
I am pleased to be here and honored to be here today
speaking to you. I want to thank you, first of all, for the
support on behalf of all our veterans and support for funding
our programs.
The DAV and other veterans service organizations previously
have made you guys aware of the issues concerning veterans'
appropriations, so I will not reiterate those issues and only
go to the issues pertaining to the health care infrastructure
here in Jacksonville, Florida.
In preparing to come speak with you, I went to the VA and
asked for data where I could present a good factual case to
you. I was told I was not privy to that, and that it would be
handled by the Veterans Integrated Service Network (VISN). So
my data comes from my personal experience with my organization
and other veterans organizations and from a little bit of
research I did on my PC.
I am in the VA health care system. I receive excellent
care. I can't complain about that. I can tell you, though, that
we are crowded here in Jacksonville, Florida, at our outpatient
clinic. Excuse me, I have to kind of go by my statement because
of the nature of my disability.
We were supposed to have a new clinic operational by the
fall of 2005. Increased size and some services currently only
at the VA medical centers in Jacksonville and Lake City are
supposed to be incorporated in the clinic, and I guess,
according to that new model that y'all were speaking of, but
our present clinic is not large enough to adequately support
the veterans using it. Our parking situation extends for city
blocks to include a dirt lot. I spoke yesterday with a veteran
that had fallen because of a pothole in the parking lot. So it
is really inadequate.
An additional factor of concern is, and our organization
has expressed this concern, allowing category 8 veterans into
the health care system that it is not designed to handle. With
the VA estimate of 1,300 veterans in the North Florida/South
Georgia VA health care system alone, though 100,000 have signed
up and are on the waiting list, we would have an unacceptable
degradation of delivery of health care in Jacksonville,
Florida.
According to the Department of Veterans Affairs' annual
report, dated 31 December 2008, Duval County has the fifth
largest veteran population in the State and is the only county
of significant veteran population density without a VA medical
center in close proximity. We must travel one-plus hours to
reach Lake City, one and a half hours to reach Gainesville. The
DAV provides 15 passenger vans to transport to hospitals around
the county. My chapter has purchased two of them, one for
transport to Gainesville, one for transport to Lake City. Those
vans are full 5 days a week, and there is a waiting list.
Although Jacksonville may have the fifth largest
concentration of veterans in Florida, I think it stands to
reason that with the massive rate of deaths of World War II
vets that have retired in South Florida and the fact that our
area has the largest military presence, that this population
will grow and we are the only significant population of
veterans in the State that doesn't have a medical center.
We need a full service medical center in our area. It is
time to take action. We are already 4 years behind the
announced opening date. As Congresswoman Brown said, in the
summer of 2006, referring to the impasse, ``we need to work out
the issues so this doesn't go on for years'' and ``another
impasse over another VA project in the Orlando area delayed it
for 25 years.''
The Committee is well aware of the DAV's position on
veterans' entitlements. On 24 February 2009, our National
Commander addressed a Joint Congressional Hearing, at which I
was present, and made you aware of these things, and the
Committee was in agreement on the issues from advanced
appropriation and entitlements. Since there is agreement, the
only missing component is action. So on behalf of all veterans,
I ask you to make a decision this year and put action behind
it.
[The prepared statement of Mr. Diffenbaugh appears on p.
46.]
The Chairman. Thank you, sir.
Sergeant Tippins.
STATEMENT OF MASTER SERGEANT JAMES H. TIPPINS, USMC (RET.)
Sergeant Tippins. Yes, Chairman, Chairman Filner and
Representatives Brown, Buyer, and Crenshaw.
Welcome to Jacksonville. I am a patient at the Jacksonville
facility. And you know, in my opinion, the staff do a good job
based on the facilities and the amount of patients that they
are dealing with. And you have to understand that the
conditions are not conducive to the amount of patients because
of lack of facilities, and we are in dire need of facilities,
and I think everybody is aware of that.
The problems that I personally encountered at the facility
at the VA here in Jacksonville, I located from California back
to Jacksonville, and it was obvious in the beginning that there
is no real continuity in facilities from State to State. They
change, and I guess that has a lot to do with area, location,
and so forth. There is no continuity in the VA services.
Here it is very difficult to get specialty care. I was, I
am a prostate cancer survivor. I came here. There is no
urologist on staff at the Gainesville hospital, so my PSA level
went up to 29. So I am very thankful to be sitting here today
because I had TRICARE for life and was able to go to Shands
facility and get the treatment.
And I talked to a lot of veterans that have this problem of
getting into specialty clinics, and by the location of the
hospital being an hour and a half, 2 hours away, transportation
is difficult. And it is something that really there is a dire
need to get a hospital in this location. And I am sure that you
will work, are working hard to meet that challenge.
I visited the Veterans of Foreign Wars 4761, American
Legion Post 197, Montford Point Marines Chapter 29, to get the
input from veterans at these organizations because of all of
the problems. In summary, there is a lot of frustration for
getting into the VA system because a lot of the clerks are
insensitive to the needs of veterans, and the reason for their
insensitivity, I am not sure, but they could be trained to be
sensitive to the needs.
I--that was the major problem. With any problem, there
should be some type of solution, and I think, if the VA would
work with the services during the transition period and make
aware to the vets, to future vets, that these facilities are
available, and their records are transferred, because getting
the records is a big major problem. The records get lost. You
have various claims. You can't prove them because there are no
medical records. These things could be resolved in this time of
technology if they would ensure doing your project during the
transition period, that these records are available for the
patient to be transferred to the VA facilities in the location.
The emergency care necessary is almost nil in this area.
There is no emergency facility. You have to go to Gainesville,
and that is a problem.
In closing, I would like to, from President Geeter, the
Montford Point Marine Association, who met with Congresswoman
Brown in Washington, and he would like for me to pass on his
greetings. Thank you very much.
[The prepared statement of Mr. Tippins appears on p. 47.]
The Chairman. Thank you, sir.
Thank you to all of you.
Ms. Brown.
Ms. Brown of Florida. Yes, sir.
I first want to thank all three of you for your service and
coming to make your testimony today.
We have been working on the Committee to get a seamless
transition between the military and the VA. Like you said, the
records are there. They are available, and there is no reason
why there should be a delay. I mean, it should be automatic; as
soon as you leave the military, part of your transfer papers
should be your VA papers. And so the Committee is working on
that, and I want you to know that. We are also working to make
sure that we move forward. We know that we are a very large
area. There is a large military presence growing. We need a
hospital, but we need a clinic right now, here and now, and not
5 years or 10 years from now. So we will resolve this issue
quickly.
Mr. Chairman, thank you.
The Chairman. Thank you.
Mr. Crenshaw, do you have any questions?
Mr. Buyer.
Mr. Buyer. I want to thank you for your testimony.
One of the questions I had is about public transportation.
Can you tell me about the availability of public transportation
in being able to get back and forth to the clinics and
hospitals?
Mr. Diffenbaugh. To where?
Mr. Buyer. You tell me. You have your clinics, and you have
your hospitals.
Mr. Williams-Bey. The current place where the clinic is
right now has many problems such as limited public
transportation, limited parking for disabled veterans. The new
clinic should be expanded to address these issues. The current
off-site facility, such as the Salisbury Road clinic, has
limited parking and no public transportation. On Valley Road,
there is nothing out there. The eye doctor is in a building
with Shands physicians, where there is limited parking and
public transportation.
So the public transportation is the main issue of getting
the veterans to the clinic. If somehow the clinic stays where
it is at now, public transportation is going to be our main
issue.
The current Shands employees are going to need training in
understanding veterans issues and sensitivity to doctors,
nurses and new surroundings.
Sergeant Tippins. I think transportation to Gainesville and
Lake City is the major issue. It is an hour and a half drive to
those facilities.
Ms. Brown of Florida. One hour and 15 minutes.
Sergeant Tippins. Okay.
Ms. Brown of Florida. But you are right. So the major
transportation problem is that there is no hospital in this
area, and so they have to go to Gainesville, or they have to go
to Lake City. That is the major problem, and then the other one
is, you mentioned there is no emergency care for the veterans
in this area. I mean, we are one of the fifth busiest areas in
the country, so this is something that we need to have the VA--
they are going to testify later and give us an update on what
we are doing to solve some of these problems, but
transportation, we have a very good bus system, even though we
are one of the largest cities in the United States, but that
transportation won't take you to Gainesville or Lake City.
Mr. Buyer. All right. Thank you.
Mr. Diffenbaugh. We are allowed to go to any hospital in
the area and then the VA makes a decision as to whether you
stay there or whether you go to Gainesville. So that is
available. Personally, if I can do it, I will go to Gainesville
because I can get to Gainesville and be seen before I am seen
in an emergency room here in Jacksonville, Florida.
Mr. Buyer. Two other issues I just want to touch on. One is
you know back in 2003 when the Capital Asset Realignment for
Enhanced Services (CARES) report came out and one of the
recommendations was the reduction or downsizing at Lake City,
Ander Crenshaw here took a real leadership role in working with
the Secretary so that none of that downsizing had occurred. So
I want you to know and remember that.
The other point I would like to make is in your testimony,
Mr. Diffenbaugh, you made reference to a concern that you have
with regard to opening up the health system to all category 8s.
Mr. Diffenbaugh. Yes.
Mr. Buyer. I want to assure you that I am in total
agreement that we cannot have any--you use the word
degradation. I am in total agreement. We have to be able to--
the system has to be able to receive, and we are having some
struggles, and that is why there is this incremental opening of
the category 8s, and I have been one of the chief opponents--or
actually advocates of the VA taking care of the core
constituency, and I guess it is our military values. We place
our disabled ahead of the line and we have a system of
priorities within the VA, yet some want to advocate that, well,
everybody should be treated the same. Well, then that is
counter to our values and others that don't understand our
military values can't figure out why we act like this, right?
And so I just want to say to you, sir, let me thank you for
that. That is a bold statement for you to say. It is bold
because when you make a statement like this, people will attack
you for it, and the people who will attack you for it don't
understand the value system that we in the military share. It
is our bond, it is our common bond.
Mr. Diffenbaugh. Well, thank you.
Ms. Brown of Florida. Mr. Buyer, would you yield for----
Mr. Buyer. Yes, ma'am.
Ms. Brown of Florida. I want to clarify something. The key
to Lake City, is that it is a regional hospital, and it was
ludicrous to close it because they served veterans from Georgia
and Alabama, and that was one of the reasons. It just didn't
serve--if you go into that VA hospital there you will find more
people there from Georgia and other places.
Mr. Buyer. I don't recall it as a closing. There was a
reduction. They were going to be removing some important
components of the hospital, and Ander was pretty persistent. I
yield back.
Ms. Brown of Florida. There was a team effort.
Mr. Buyer. Yes, ma'am. I don't care who--I don't remember
you coming to me. I do remember Ander coming to me.
Mr. Diffenbaugh. Lake City also takes a lot of care of
long-term patients that it will break your heart to see.
Ms. Brown of Florida. I didn't talk to you. We worked
together on it. I just want you to know that, and I want to
point out it was a regional hospital. It didn't just serve
Jacksonville because most of the patients here go to
Gainesville to a large extent. They don't go to Lake City. They
go to Gainesville.
Mr. Diffenbaugh. The vans to Lake City are full though
every day.
The Chairman. Let me thank you for your testimony, and the
DAV of course does an incredible job around the Nation with its
transportation help. We thank the DAV for that, and we thank
you and appreciate the personal stories that you have shared.
I assume, Mr. Williams, you are a veteran of Vietnam?
Mr. Williams-Bey. Yes, I am.
The Chairman. You probably assume your cancer comes from
exposure to Agent Orange.
Mr. Williams-Bey. That is what I was told, yes.
The Chairman. How many veterans in the audience served in
Vietnam? I want to thank you all for your service and we
apologize for the way we, as a society, treated you all when
you came home. People who were opposed to that war, including
myself, did not distinguish between the war and the warrior. We
did not welcome you home, we did not give you the treatment
that you deserved, or the care. With Agent Orange, especially
the government denied and denied and denied that there was
anything wrong. Then set up this whole system that states you
have to have your boots on the ground at a certain place and
prove that Agent Orange was sprayed. We have introduced
legislation, which you may be aware of, that will cover all who
were exposed to Agent Orange. I think the Vietnam veterans have
fought the Agent Orange issue long enough.
My motto has been if you were there, we should care. I have
legislation that says we must honor all Agent Orange claims.
You have been fighting this for decades and I think you
suffered more from the fight against the bureaucracy than you
did in your original combat. We need to end that fight for you
all and grant those claims. We need to waive the requirement
that your boots had to be on the ground to be compensated for
exposure to Agent Orange. I don't care if you were in the blue
waters off the coast, in the blue skies up above, Thailand,
Laos, Cambodia, or Guam. You know where the trans-shipment
places were in the States where the Agent Orange was shipped
and, therefore, you had possible exposure. Why should you have
to go through so much bureaucracy proving you were exposed? We
know of enough anecdotal evidence. Our goal is to try to
streamline the process.
We have a backlog of over 800,000 disability claims in the
system. I suspect a quarter of those or more are the Vietnam
claims. That would get those claims off the books. We are
working so you don't have that frustration that I heard in your
voice. I have heard that frustration all around the country.
Mr. Williams-Bey. I just want to add something. There is
not a year that goes by, or a day that I am not proud to be a
Vietnam veteran. All of us have some kind of problem or medical
issues such as cancer, prostate, diabetes, loss of limbs, legs
or other injuries. Sometimes we don't receive one cent from the
VA, but we trust our private physicians.
The Chairman. I understand your disability was reduced,
which is criminal. We are going to try to honor you with what
the Nation should have done.
Mr. Williams-Bey. Thank you.
The Chairman. Please let us know, and Corinne will keep in
touch because we will need your support sometime on that, too.
As I travel around the country, I am even more honored to
be the Chairman of this Committee. It gives me a chance to meet
people all over the Nation and hear their stories and it helps
us understand our debt to you all. When I look at the placement
of facilities, which is an issue almost everywhere, I have
found that the system is not perfect. A guiding principle that
I have sought, and it is not always apparent to those who use
the facilities every day, is that when you have the synergy or
the mutual help of a lot of different institutions, it helps
for the care of the veteran.
I was over at Shands today and at the clinic and I saw
students from the university. When you have the university, the
private hospital, and the VA hospital in one central location,
plus public transportation, these things together allow for
better care for the veteran. All of the institutions reinforce
each other.
I think this is a key element for quality health care
delivery. If you put a facility where there are no other
institutions around, you don't get that personal day-to-day
kind of movement that I see in place all over the country. It
really helps the veteran.
I think that is a criterion that we ought to be looking at
very closely. It sounded like you all agreed with that and just
like Mr. Buyer referenced that public transportation is a key
element here. You have to keep that in mind.
Just in closing to this panel, I heard a lot of frustration
in your voices as you tried to help us understand what you are
experiencing. I hear that all over the Nation. Many people
think that VA means ``veterans adversary.'' It should mean
``veterans advocate.'' We are trying, with these hearings, to
make that transformation. I think the new Secretary talks about
a transformation of the VA, and this is one of the things he is
talking about.
The people who work for the VA, 99 percent of them, are
there for a good reason. They are working hard every day. They
don't always have the resources that they need, so they get
frustrated. Some of the Agent Orange issues they hear every
day. Instead of being empathetic they get hostile and tell you
they don't want to deal with you. We need to reinvigorate the
workforce, raise their morale, let them know their resources
are going to be there so they can do their job, and have the
confidence of the veteran of a system that is really
responsive. Your testimony will help us. You are involved in
organizations for the benefit of veterans and we thank you. We
will try to respond to what you have said today.
Thank you so much.
Ms. Brown of Florida. Mr. Chairman, as the next panel comes
up, Secretary Brown's motto used to be putting veterans first,
and I think we need to continue to implement that.
The Chairman. Thank you all. We will now have the third
panel join us. We have Daniel Hughes, who is the Chairman of
the Jacksonville National Cemetery Advisory Committee, and Stan
Jordan is Duval County School Board member for the First
District.
We welcome you. I see your ranks are in front of you,
Corporal Hughes and Colonel Jordan. I thought you were the
Colonel.
Corporal Hughes, please proceed.
STATEMENTS OF CORPORAL DANIEL V. HUGHES, SR., USMC (RET.),
CHAIRMAN, JACKSONVILLE, FL, NATIONAL CEMETERY ADVISORY
COMMITTEE; AND COLONEL STAN JORDAN, USA (RET.), DUVAL COUNTY
SCHOOL BOARD MEMBER, DISTRICT 1, JACKSONVILLE, FL
STATEMENT OF CORPORAL DANIEL V. HUGHES, SR., USMC (RET.)
Corporal Hughes. Thank you. My name is Daniel V. Hughes,
USMC (Ret.), 1 Wildwood Place, Palm Coast, Florida.
I served on Congressman John Mica's Committee on Veterans'
Affairs as a volunteer. I have been helping veterans for 38
years. The issue of health care and facility management is of
great importance and concern to our veterans and families.
The Marine Corps has given me respect, honesty, integrity.
This is the Code that I run my life by. Our servicemen and -
women and their families deserve the best we can give them for
their sacrifices.
For the record, I address health issues of great importance
to our veterans and their families in my report.
I want to thank the Committee and welcome you all to sunny
Florida, but it is cloudy today. Please accept my thanks for
allowing me to speak before you today.
One of the biggest problems we are having at all our VA
facilities is acquiring better doctors, staff to meet the
demand. At this time, the system is struggling to care for our
veterans. Our clinics and our hospitals do the best that they
can with the budget they have to work with. That is not enough.
Our veterans deserve better.
Due to budget shortages, we leave ourselves open for
mistakes which then result in lawsuits. To eliminate the above
we must acquire the best of doctors, pay them well so that they
will stay and give our veterans the service they deserve. We
must also purchase the best medical equipment that is out in
the market.
Our terminally ill veterans must travel a long distance for
care at our hospitals and clinics. A lot of these veterans
depend on Disabled American Veterans, DAV, van or friends to
transport them the distance to receive their care.
We veterans that live in the northeast section of Florida
must either travel to Gainesville, Orlando or Lake City for
hospital care. If you are terminally ill, it makes for a very
rough day. A new hospital located in the Jacksonville area is
badly needed.
I now want to talk about a very serious illness, a dreadful
disease to our older veterans, and this is Alzheimer's. All of
our nursing homes should have in its facility an Alzheimer's
unit. It should be a lock-down unit along with specially
trained volunteers and nurses. A lack of this service in our VA
system has forced a lot of our veterans into private nursing
homes. We are blessed at this time to have received a new
nursing home at Gulfport Village with an Alzheimer's unit in
it. We as veterans would like to thank you for this blessing.
Those nursing homes without an Alzheimer's unit must be
reassessed so as to incorporate such a unit to better serve our
veterans with this terrible disease.
At this present time, Tampa has a hundred on the waiting
list to get into its Alzheimer's unit. That is awesome. I had
to travel to Bay Pines with a veteran that had no one. Emory
Bennett, who has no lock-down unit, could not accept him.
My wife and I traveled 350 miles twice a month to visit
that veteran. He served with Patton, World War II, an honored
veteran. He passed away in Bay Pines.
In summary, those of us that have served our country, past,
present, ask our representatives serving on the prestigious
Veterans' Affairs Committee to please continue to work in
improving our health care needs. The system is good but it has
some cracks in it.
As veterans we continue to put our lives on the line for a
just cause that is dear to our hearts, and that is freedom, the
freedoms that have made this country great now and in the
future.
Many years ago a promise was made to our veterans. That
promise must be kept. To this day, many veterans and their
families have given the supreme sacrifice and received
permanent traumatic injuries that last a lifetime.
God bless our veterans and God bless our country.
I want to add that most of our injuries coming in from
Iraq, Afghanistan are very, very serious. Our clinic in Daytona
Beach, where I am a disabled vet at, imagine, 800 a day walking
through the door. No room to expand, no psychologist, no room
for someone to come in with problems to sit down and get care.
This must be addressed.
I want to leave you with those thoughts. I want to thank
you for your prestigious service, and I know that in serving--
my brother served 20 years in Congress and we are very close. I
served as a volunteer for 20 years, and I want to say that the
job you do is well appreciated out here but we have to continue
to do more to take care of our veterans.
Thank you.
[The prepared statement of Corporal Hughes appears on p.
48.]
The Chairman. Thank you. Colonel Jordan.
STATEMENT OF COLONEL STAN JORDAN, USA (RET.)
Colonel Jordan. Thank you, Mr. Chairman and Members of the
Committee. Welcome to the sunny State of Florida except for
today.
Congresswoman Brown opened up this session with a quote
from George Washington, and, Mr. Chairman, you even alluded to
a respect level for the military back during the Vietnam era. I
bring you good news. I want to share with you some things that
we can do that don't cost money because I am going to share
with you some things that we can do--we talk about
infrastructure, and we talk about veterans service. One of the
greatest areas of need in my opinion is that we respect, honor,
dignity and recognition of courage to our veterans.
I want to share with you a few things. I am a retired
military person. I had the honor of being, as the Chairman and
Congressman Buyer stated, Chairman of the Military Affairs for
6 years in the Florida House of Representatives and of course
like you, you are trying to put 10 pounds in a 2-pound sack and
the needs are so great and the resources are few. And we do
have a lot but one of the greatest things that we can do for
our veterans is elevate the level of recognition and respect,
and let me share with you a couple of things that you can do.
I had the honor of passing a piece of legislation for
veterans--and I had the honor of designing them, the military
license plates for the State of Florida and the military. I
even brought this. Mr. Chairman, I even brought this so you
guys could see how good these look. I wanted to show you some
of the license plates that we have designed. This is voluntary,
doesn't cost the taxpayers $1. We get $25 extra for these
license plates and I will show them to everyone--if any
veterans out there haven't bought one, I want you to get one.
You pay in addition to your license plate, you pay this extra
money and it goes to the nursing homes in the State of Florida
for veterans. We have raised millions of dollars at no cost to
the taxpayer, and it is another way of expressing pride in the
military. You don't have to be in the military to have one of
these. You could have a son or daughter or uncle or granddaddy,
and these are some of the things that we can do.
I made part of my testimony, my last newsletter as a member
of the House of Representatives, and on the back I show you
these license plates and I show you how much money we have
raised by branch of service. And the Army is number one. I just
want to make sure I get that in the record. I am about as
unbiased as anybody can be when it comes to the military.
We have, Mr. Chairman, also one of the things that, and
Members of the Committee, and I hope that you will take your
leadership and share some of these as you go around the country
because there are things that we can do for the mental health
infrastructure and the appreciation infrastructure of the
military that aren't being done.
In the Florida House of Representatives we set up what we
call Military Appreciation Day, where we took about and hour
and a half in the chamber and saluted the military, all
branches, all members who have served, all people who had a
relative that served, and we tape these programs and we put
them, we have a Web site called Floridasalutes.com and on
Veterans Day and on the 4th of July, with no cost to the
taxpayer, these appreciation salutes are shown on Florida
channel all over the State of Florida where millions of people
have had the opportunity to see this and they have responded
very positively with it.
Now, let me tell you, I have brought back from the House of
Representatives, where as Chairman of the Military Affairs, in
this Committee, during my tour here, I wrote 5,000 letters to
every deceased veterans family in this area. Every day we would
go through obituaries and if they served at any time in any
branch we would write a letter letting them know that their
loved one's service has not gone unnoticed. The response we get
back from families during that critical moment of having to
provide the last service to a military person is unbelievable,
and it didn't cost anything but a postage stamp.
Today as a school board member--we have term limits. I
finished my 8 years in the Florida House of Representatives. As
a school board member--I am the military liaison person for the
school board--I have written already over 350 letters to people
in this community on behalf or our 125,000 children in this
district saying thank you for your loved one's service.
These are things that money can't buy. It is showing that
outreach and respect and dignity, and while I said in my
statement to you, and I provided you with a copy of this
newsletter, I hope that you will be able to watch some of the
things we have done in Floridasalutes.com but let me end with
kind of a contradictory statement. I said I wasn't going to ask
you for anything. I just want you to provide leadership around
the country and share these ideas that I have shared with you
that we are doing.
I do want to ask you for something. We have a wonderful
cemetery, military cemetery, in northeast Florida and as a
school board member, as a former House member in the State and
a veteran, I would like to ask you, would you to consider
somehow that in our veterans cemetery that we could have an
auditorium so that children on field trips could come to that
cemetery, not where the deceased are, but where the living
republic is founded, and maybe see a panorama presentation of
the military and its sacrifice and its courage and the selfless
service it has rendered to this country.
Because Mr. Chairman, Members of the Committee, the bending
of a twig starts young. You don't shape a 16-year-old tree. You
have to shape it when it is a twig and if we are going to pass
on the rich heritage of this country that has been preserved by
the establishment of a strong military to keep us free, as
Congresswoman Brown alluded to in George Washington's
statement, we have to transfer this compassion and this
appreciation to our young people, and I can see right now young
people going to a field trip at the National Cemetery and
sitting down in an auditorium and seeing a panorama
presentation of what this military means to America.
And, Mr. Chairman, the last thing I did, 3 weeks ago, I
passed an agenda item on the school board, and this one has
gotten unbelievable community response, where the World War II
veterans and the Korean conflict veterans, if they did not get
a chance to finish high school, that we reward them a high
school diploma at the place of their choosing, at the high
school that they would have graduated from should they want to
do or at the school board meeting, live in color, or we will go
to the nursing home or wherever they want it to be and we will
give them that high school diploma and if you could just use a
little bit of psychopictography and put together the picture of
a high school graduation and then here comes granddaddy across
the stage to get his diploma, that he gave up his future, he
gave all of his tomorrows so that we might have today. I think
that is the kind of dignity that I would like to see put into
the protocol of military.
Mr. Chairman, I hope I haven't taken too long. I overshot
the runway on my time. I got barbed wire fence in my landing
gear, but I thank you for your opportunity to appear before
you. I am honored. I have had a lot of honors in my life, and
this will be cherished as one of the highest. Thank you, sir.
[The prepared statement of Colonel Jordan appears on p. 50.
The newsletter is being retained in the Committee files.]
The Chairman. We thank you both for your eloquent
testimonies and very good suggestions. Thank you. Ms. Brown.
Mr. Crenshaw.
Mr. Crenshaw. Maybe just one question, and again thank you
all, as well as all the witnesses, for your testimony. I know
both of you gentlemen were involved in the National Cemetery,
and one of the issues we are still dealing with is the kind of
transportation aspect, because we are hoping someday to have an
interchange on Interstate 95 which will make it a whole lot
more accessible. But I would love to hear your comments on that
aspect as well as any early thoughts you have because the way
the construction is working, it has been fast tracked. They
have taken 10 acres and are actually having ceremonies now. The
total buildout will be sometime in the coming and I think it is
appropriate, Mr. Jordan, as you mentioned, maybe there is a way
with some private funds to actually bring about awareness in
terms of just education and awareness that we might have
additional memorials that will be above and beyond what the
National Cemetery will have. But could you comment on that? We
have Congresswoman Brown, who is also on the Transportation
Committee so maybe an opportunity, your thoughts on the
transportation aspect as well as what your sense is as you talk
to people early on about the National Cemetery and how that is
working out.
Corporal Hughes. The National Cemetery is becoming very
busy. It is absolutely beautiful given the first phase, which
is a temporary phase. The road to the cemetery is awesome, and
long. It is 22 miles from I95. A new proposed road located on
Pecan Drive, which is the next exit north of the airport road.
The distance to the National Cemetery would be 6 miles versus
20 miles. But the biggest aspect of that is, and this is with
all of our National cemeteries when we locate national
cemeteries, we seem to have the tendency to putting cemeteries
out in the middle of these large fields with nothing around
them. The new road proposal would give our National Cemetery in
Jacksonville and our veterans, the service that the families
are looking for and need in that hour of need, which is very
sorrowful, and that is transportation by air, motels,
restaurants, and a beautiful way into the National Cemetery.
I want to say that the traffic on Lannie Road, where nine
funerals a day, nine hearses running down Lannie Road, which is
a residential road, very small, and past the prison, past the
prison farm and then a detention, a youth center, before you
get to the National Cemetery, not a very good sight. The new
road will open up not only for the City of Jacksonville the
beauty, but to a service to our veterans.
I want to touch on base just not the new road which I have
given proposals to our Congressman, Congressman Crenshaw, and
the balance of our Congressmen in the area, the second proposal
is the construction at our Jacksonville National Cemetery.
We are stymied at this time to do nothing at that National
Cemetery because of the safety aspect of the Lannie Road, the
safety aspect is bad. We are limited at this time on any
ceremonies at the National Cemetery.
One funeral just fills the parking out on to the road, and
it creates a safety hazard.
I want to touch base on another, which is the school
children. My dream at the National Cemetery is our children
today aren't educated in reference to where their freedom comes
from, and I want to say to you as prestigious Members of our
Veterans' Affairs Committee our children need to be educated.
They need to know where their freedom comes from, and education
on, a half day's trip to the National Cemetery for our children
would be so great. A museum possibly and a structure at our
National Cemetery to educate them.
That is my other dream, along with other dreams for
veterans. I work constantly, day in and day out, on veterans
issues, with my own Congressman John Mica. I am constantly in
touch with John about veterans.
Thank you so much. Thank you for the question, Congressman
Crenshaw.
Colonel Jordan. Mr. Chairman, may I? On the road issue we
are missing one of the greatest opportunities to share what a
great job the Congress and the President and the people have
done for northeast Florida and southeast Georgia by not being
on I-95. You know, Arlington Cemetery it says Arlington
Cemetery. We are missing that. If you want to see how big Duval
County is, try to get to the cemetery. It is unbelievable. You
think you are driving to El Paso. It is a long way.
And if we are missing--one of the reasons that we wanted
this site so greatly is so that we could capitalize and use the
synergism of the airport with its rental cars and its air hub
and its transportation and its hotels and restaurants. The way
it is worked now you have to go around forever to get there and
it would be a tremendous opportunity for us if we could have I-
95 signs at Jacksonville National Cemetery.
I can't state strongly enough my compassion, feelings about
having this auditorium. Please, please, if you will, consider
that as an option because our young people are our future, and,
Mr. Chairman, if I may, I would like to end with this one
comment. This is will complete my comments to you unless you
have questions. William Jennings Bryan, the great orator, said
you may never know to whom you are speaking when you speak to a
child. I share the need to know what the great military and the
preservation of this free republic is all about.
Thank you.
The Chairman. Thank you. Mr. Buyer.
Mr. Buyer. Thank you. It is refreshing to hear you talk
about initiatives that can be done at the local level, which
honor and support our veterans, and that is what you have done.
I want to thank you.
I am going to give you my business card. So when this panel
is excused, Colonel, if you can come up and grab this. I would
like for you to send me the legislation that was used here in
the State of Florida with regard to the license plates, and I
will take your initiative and we are going to do it in Indiana.
Okay.
Colonel Jordan. Would you also give the World War II and
the Korean veterans a high school diploma?
Mr. Buyer. Whatever you want to give me, you send me. Would
you please do that?
The other thing I am going to ask is the Committee, the
Chairman is taking the Committee on to Orlando. I am going to
stay here in town and John Ander Crenshaw is honoring Tillie
Fowler tonight and I just checked with my schedule and I have
time if, Ander, if you permit me, with permission--I am not
asking you to join me but I would like to go out and see the
National Cemetery. Is that okay?
Mr. Crenshaw. It would be great.
Mr. Buyer. Are you free in the morning?
Corporal Hughes. Yes, sir.
Mr. Buyer. All right. I am going to give you my phone
number. And I would like for you to be--let's stay in touch. I
am staying at the Hyatt Regency. What time do you get up in the
morning?
Corporal Hughes. Five o'clock.
Mr. Buyer. I am not sure I even move at five o'clock in the
morning.
Corporal Hughes. And that is 7 days a week.
Mr. Buyer. Corporal, you are showing off. Well, let's
contact--we will contact and work out a time. I am going to go
out and see the cemetery, and perhaps we can understand Ander's
challenges.
Corporal Hughes. I am delivering a check today which I
received this week in Tallahassee. I do want to say that one of
our organizations donated $100,000 to the Veterans Affairs for
the State of Florida. They were amazed at that check. They
said, my God, we could do so much for this with the Veterans
Affairs, and they turned around and gave me a check for $3,000
for the National Cemetery for a project, and thank you. Thank
you.
Mr. Buyer. Thank you very much. I yield back.
The Chairman. We thank you both so much, and we will be in
touch with both of you.
The last panel for today is the Department of Veterans
Affairs. We have Robert Neary, Jr., who is the Director of the
Service Delivery Office, Office of Construction and Facilities
Management for the U.S. Department of Veterans Affairs,
accompanied by Tom Cappello, Director of the North Florida/
South Georgia Veterans Health System, and Reginald M. Lawrence,
SRCT, CPP, Team Leader of the Jacksonville Vet Center,
Readjustment Counseling Service, Veterans Health
Administration, of the U.S. Department of Veterans Affairs.
I hope you gentlemen will take advantage of having heard
some of the earlier testimony and instead of just reading your
prepared testimony, I hope you will deal with some of the
issues that have come up also.
Mr. Neary, thank you for being here today.
STATEMENT OF ROBERT L. NEARY, JR., DIRECTOR, SERVICE DELIVERY
OFFICE, OFFICE OF CONSTRUCTION AND FACILITIES MANAGEMENT, U.S.
DEPARTMENT OF VETERANS AFFAIRS; ACCOMPANIED BY THOMAS A.
CAPPELLO, MPH, FACHE, DIRECTOR, NORTH FLORIDA/SOUTH GEORGIA
VETERANS HEALTH SYSTEM, VETERANS HEALTH ADMINISTRATION, U.S.
DEPARTMENT OF VETERANS AFFAIRS; AND REGINALD M. LAWRENCE, SRCT,
CPP, TEAM LEADER, JACKSONVILLE, VET CENTER, READJUSTMENT
COUNSELING SERVICE, VETERANS HEALTH ADMINISTRATION, U.S.
DEPARTMENT OF VETERANS AFFAIRS
STATEMENT OF ROBERT L. NEARY, JR.
Mr. Neary. Mr. Chairman, thank you and Ranking Member
Buyer, Ms. Brown. I am pleased to be here today along with my
colleagues to appear before the Committee to discuss the
progress that is being made to improve----
Ms. Brown of Florida. I am sorry, but could you put the
microphone a little closer to you.
Mr. Neary. To provide an update to the Committee and to the
veterans community on the status of major construction projects
currently under construction in Gainesville and here in
Jacksonville at the cemetery and to touch on some of the other
issues that the other witnesses have raised and the Committee
have raised, and as you mentioned, I am joined by Reginald
Lawrence, the Team Leader at the Vet Center here, and Tom
Cappello, the Director of the North Florida/South Georgia
Health System.
In August of 2008, VA began construction of a new patient
bed tower at the North Florida/South Georgia facility in
Gainesville. This new five-story tower will provide for private
patient rooms for 226 veterans, with private toilet and bathing
facilities. The patient bedrooms will occupy four floors, with
supporting services in this 245,000-square foot building on the
ground floor.
The facility will provide state-of-the-art patient
bedrooms. Currently most of the bedrooms at the Gainesville VA
include two or more patients. The new rooms will enable greater
patient privacy, better opportunity for patients to interact
with their families and caregivers, and better prevent
infections.
Funding in the amount of $136.7 million was appropriated by
the Congress for this facility, which is, as I say, under
construction and approximately 15 percent complete. We expect
completion in April of 2011. We have a couple of boards up over
here on the Committee's right. I would encourage the Committee
Members and staff and members of the audience to get a closer
look at the end of the hearing if they would like.
It was also mentioned by Mr. Crenshaw, the VA recently
opened a new National Cemetery in Jacksonville for burials.
This was accomplished through the development of a small
portion of the property. The design of the larger first phase
of buildout for the new cemetery was recently completed and is
undergoing its final design review right now. We anticipate
awarding a construction contract in August of this year, to be
completed in the summer of 2011. Approximately 50 acres will be
developed to accommodate burials for 10 years. This will
include approximately 7,500 grave sites for casket internments,
a 4,500 niche columbarium, 500 in-ground sites for cremated
remains, along with an administration public information
center, to include an electronic grave site locator, a memorial
walkway, and necessary maintenance facilities.
This project totaled $22.4 million, which has been
appropriated and is ready to be obligated, as I say, this
summer.
Ms. Brown and the Chairman and Members, a number of
witnesses have referenced plans to establish a new clinic here
in Jacksonville. We appreciate Ms. Brown's facilitating a
discussion earlier this morning with representatives from
Shands and the city, and the Chairman joined us for a while
toward the end. We have encountered serious challenges as we
move forward on this project, but we believe we made some
progress this morning. We look forward to pressing on and
hopefully bring those issues to conclusion quickly and get
moving with what I think everybody recognizes is a very needed
project.
These projects demonstrate the Nation's commitment to care
for our veteran heroes, not only in Gainesville and
Jacksonville but across the country. New and improved
facilities for veterans are in design or construction. Since
2004, $5.6 billion have been appropriated by the Congress for
the Department's major construction program, with over 50 major
projects having received funding to provide new facilities and
improve or expand existing ones.
We look forward to completing the projects here and in
Gainesville as well as around the country, and we would be
pleased to answer questions that the Committee may have, and I
believe my colleague from the Vet Center has a statement as
well.
[The prepared statement of Mr. Neary appears on p. 50.]
STATEMENT OF REGINALD M. LAWRENCE, SRCT, CPP
Mr. Lawrence. Good afternoon, Congressman Filner, Ranking
Member Buyer, Congresswoman Brown, other Members of the
Committee who are not present.
I appreciate the opportunity to appear before you today to
discuss the role of the Jacksonville Vet Center in building the
critical health infrastructure for veterans in Jacksonville and
North Florida, South Georgia.
I also extend to you a warm greeting from Dr. Alphonso R.
Batres, Chief Officer of Readjustment and Counseling Service in
Washington, DC.
And also, again, as Mr. Neary said, accompanied by Mr.
Thomas Cappello, Director of the Gainesville VA Medical Center.
I have tailored my remarks to include not only Jacksonville
but North Florida and South Georgia as well, since our care for
veterans and their families extend to multiple counties in both
States. Prior to the opening of the Gainesville Center in 2007,
the Jacksonville Vet Center served 14 counties in North
Florida, two counties in South Georgia. We currently serve 11
counties in North Florida, including Duval, Bradford, Baker,
Clay, Columbia, Flagler, Nassau, Putnam, St. Johns, Volusia,
and Union Counties, and two in South Georgia, Camden and
Charlton Counties. We estimate the total veteran population in
the area at just over 250,000. In Duval County alone we
estimate the veteran population at approximately 150,000, if
not higher. In fiscal year 2008, we recorded 4,726 visits for
direct service, totaling 3,063 hours of client contact, 7,764
hours of core staff employment, meaning those are the hours
that are actually worked by the members of the Jacksonville Vet
Center team. We also provided counseling services to 493
veterans of Operation Enduring Freedom (OEF) and Operation
Iraqi Freedom (OIF) in fiscal year 2008.
Since Vet Centers were enacted by law in 1979, the
Jacksonville Vet Center has provided readjustment counseling to
over 35,800 veterans. We have documented an average of 400
visits per year since our initial opening in March 1980. The
core mission of Vet Centers is to provide readjustment
counseling and outreach services to veterans exposed to war
trauma in armed combat theaters of operations. Our Vet Center
provides a wide range of services with a holistic approach to
aid the returning and post-deployed combat veteran with the
ability to transcend the emotional and psychological traumas of
war and to reintegrate themselves into their communities
successfully.
Our focus on successfully enabling this transition entails
a full examination of their post military, economic, social,
and family needs. Our role is central to meeting the ongoing
health care needs of post-deployed veterans in conjunction with
the VA North Florida/South Georgia Veterans Health System. The
Jacksonville Vet Center provides professional services for
post-traumatic stress disorder (PTSD) and other war-related
issues through individual, group, marital, and family
counseling, along with substance abuse, military sexual trauma,
and bereavement counseling. In addition, we provide counseling
to homeless veterans, veterans seeking employment, and veterans
with crisis intervention needs. We have a direct referral
system for VA benefits information and assistance to other
agencies in the community.
A special feature of our services to veterans is our Fee
Contracts Program, which is designed to provide counseling
services to veterans with PTSD in rural areas and to those
veterans who are either having financial difficulties or
transportation problems in accessing VA services. The program
allows direct counseling and treatment by private professionals
who contract with the Vet Center for these services. This
program is operational in St. Augustine and Daytona Beach,
Florida.
We have collaborated very effectively with existing VA
programs and other community-based programs by establishing
memoranda of understanding upon referrals to our Vet Center to
address specific needs of veterans. For example, we have a
program for veterans referred to us by the Northeast Florida
Safety Council for Veterans cited for DUI. This arrangement
allows us to assess these veterans who may not otherwise be
seeking services from a Vet Center or a VA facility for PTSD or
other conditions. We have seen recent studies that have found a
disproportionate rate of returning veterans who have been cited
for DUI.
Another core mission of the Jacksonville Vet Center is to
provide outreach services to veterans and community-based
organizations to inform them of Vet Center and VA services. In
2005, the Jacksonville Vet Center hired an OEF/OIF Outreach
Specialist. The position is for an Operation Enduring Freedom
or Operation Iraqi Freedom veteran who will conduct outreach to
active duty, National Guard and Reserve units to inform them
and their families of available VA services. Since 2003, we
have served over 2,200 OEF/OIF veterans and their families at
the Jacksonville Vet Center.
We also provide bereavement counseling to family members of
military personnel who lost their lives while on active duty.
Thus far, we have provided bereavement counseling services to
15 families of OEF/OIF veterans in our area.
Historically, the Vet Center provides veterans a point of
contact to access the VA health care system and benefits
program. We welcome the opportunity to be part of building the
critical health care infrastructure for veterans in
Jacksonville. We remain committed to keeping the promise of
providing the highest quality care to veterans and their
families at the Jacksonville Vet Center.
Thank you, Mr. Chairman and Members of the Committee, for
allowing me to appear today. I will be happy to answer any
questions that you may have at this time.
[The prepared statement of Mr. Lawrence appears on p. 51.]
The Chairman. Thank you. Ms. Brown.
Ms. Brown of Florida. First of all, thank you, Mr.
Lawrence, and the other members for your service and your
commitments, and I have a few questions.
We heard a lot today but we haven't had any real discussion
about the problems we have providing mental health services to
the veterans, those services related to drugs or alcohol, and
it is a problem, and the homeless vets, all of it goes
together. One-third of the people on the streets who are
homeless are veterans, and so to me that means the system is
not working. And so the question is how do we work, do we work
with other organizations or how do we provide the mental health
services in the area?
Mr. Cappello. Well, a couple things, I would like to
respond. One of the things is when I arrived in Gainesville 2
years ago, one of the things I identified quickly is that we
were underserving the population up here in Jacksonville, and
to that end, with the moneys that have been provided to enhance
mental health services, we are attempting to develop basically
a mental health clinic up here in Gainesville--in Jacksonville.
In fact, we are looking for square footage now which, to site
that unit, would also be collocated with a group from
psychiatry that would be developing a program for OEF/OIF vets
up here in Jacksonville.
So I do recognize what you are saying about the amount of
services we need up here. We are working to get those, and with
regard to the homeless services, we do partner with community
agencies to provide housing for homeless veterans, and that is
also--we have some of those contracts up here in Jacksonville
and we are looking to expand them and to expand our homeless
services in this area.
Ms. Brown of Florida. But you know providing services for
the homeless is not just providing a place. They need
counseling, they need--you know, it is a whole list of stuff
that they need.
Mr. Cappello. Right. The Homeless Services Program is
directed to do that, and we are trying to expand that up here.
Ms. Brown of Florida. There has been some discussion, a lot
of discussion. It seems as if there is a need for a hospital in
this area, a hospital, not a clinic. We need a clinic right
now. I mean the CARES Commission said we needed it 10 years ago
and it is not going to take us another 15 years to do it. But
there is a lot of discussion as to that we need a hospital in
this area. What are some of the factors that go into
determining why an area should have a hospital? I mean, because
we are much larger than some of the areas as far as the number
of retirees in our area and we have three major military
facilities right here. So what are some of the factors, and
while you are doing that I mean there was some discussion about
the cemetery that I am happy that we have and then there some
discussion about the road. You have to get the cemetery before
you get the road and you work on the road and the other things
that go with it. Now we have the cemetery and I think it is
crucial. I mean to push for the cemetery, but if we need a road
then you know you all should come and request it.
Mr. Neary. Let me begin a response and maybe Tom would like
to join in. The VA, as you know, has conducted a series of
studies that for the most part were completed in 2004, a
Capital Assessment Realignment for Enhanced Services Study.
That laid out a roadmap for facility improvements and
expansions that we have been following. Those studies did not
identify Jacksonville as the site of a future VA medical
center, VA hospital. Obviously as we have heard here today,
things change, increasing numbers of veterans coming to the VA
and the VA needs over time to be attuned to that, not rely on
studies from the past but to maintain contemporary
understanding and knowledge of what the requirements are and
address the future through those analyses.
Ms. Brown of Florida. You know there was some discussion
about the location of the cemetery. I mean the factors go in to
you all deciding where to put a cemetery or facility? What are
some of those factors?
Mr. Neary. I can't necessarily speak with too much
authority, but I believe the National Cemetery Administration
currently has a policy that their objective is to have any
national cemetery within 75 miles of all veterans.
Ms. Brown of Florida. Absolutely, and the problem was
initially Miami. They had to go to Bushnell and we had to
expand Bushnell before we could even get a cemetery in the
Jacksonville area because you had to go according to the
population, and there were a million veterans in the Miami area
that were not able to get to any cemetery.
Mr. Neary. Correct.
Ms. Brown of Florida. I understand that part of it, but the
question was the location. There are some factors, and I guess
we can get that from that group to give us what are some of the
factors that you all consider when you decide on a cemetery.
Mr. Neary. On a specific site on a cemetery?
Ms. Brown of Florida. Yes.
Mr. Neary. We will arrange to provide that for the record
if you don't mind.
[The VA subsequently provided the following information:]
VA's policy is to establish new national cemeteries in areas that
have the largest number of veterans who do have a burial option in a
national or State cemetery within a reasonable distance of their
residence. The current policy defines ``reasonable distance'' as 75
miles based on experience and data. VA data show that over 80 percent
of those interred in national cemeteries resided within 75 miles of the
cemetery at the time of their death. The current policy also sets an
unserved veteran population threshold of 170,000 as the trigger for a
new national cemetery. Results of the Future Burial Needs Study that
was mandated by Congress in the Millennium Health Care and Benefits Act
of 1999 indicated several large areas of unserved veterans (170,000 and
above) would exist at the beginning of the 21st century, including two
areas in Florida; Jacksonville and Sarasota.
Office of Construction Management
National Cemetery Administration
Department of Veterans Affairs
Basic Considerations National Cemetery Site Selection
Proximity--The site should be located as close as
possible to the densest veteran population in the area under
consideration. Not only actual distance, but travel time to the
site is considered.
Size--Sufficient acreage must be available to provide
gravesite for at least a 40-year projection. Interment rates
and acreage requirements are projected based upon veteran
population within a 75-mile radius of a projected site.
Shape--Uniform boundaries, undivided by roads or
easements, with generally square or rectangular shapes are
desired. Irregularly shaped sites are more difficult to access
and less efficient to access and less efficient to design and
develop.
Accessibility--The site should be readily accessible
via highways and major public roadways. Close proximity to
highway interchanges and public transportation is desirable.
Road quality of access highways is also considered.
Utilities & Water--Availability of public utilities
(electricity, water, sewer, gas) are important. However, on
site septic systems and on site potable water wells or ponds
are acceptable. An adequate water supply for irrigation is of
primary importance.
Surrounding Land Use--Site adjacent to visually
objectionable, loud noise, high traffic, or other nuisance
elements should be avoided. Both current and projected adjacent
land use is considered.
Soils--Should be of a quality that will provide
adequate topsoil for growing turf; should have adequate
stability for constructing roads and buildings; should be well
drained; and should be free of shallow depth groundwater. There
should be no sub-surface obstructions or hazardous waste
present.
Topography--Comparatively level to rolling terrain is
desirable for areas to be developed. The grade of burial areas
should be in the 2 to 5 percent range. There should be no sub-
surface obstructions or hazardous waste present.
Aesthetics--Existing site amenities such as pleasant
views and quality vegetative cover are favorable.
Restrictions to Development--The presence of man-made
elements such as cultural/historic/archaeological elements,
utility easements, rights-of-way, or mineral rights can hamper
or legally prevent development. Presence of endangered species,
historic artifacts, and/or wetland areas limit or preclude
cemetery development.
Ms. Brown of Florida. Yes, that is fine.
Then let's go to the clinic. What are some of those factors
that you consider when you consider location of a clinic? I
mean someone mentioned that you want it in a certain area, but
what kind of transportation is in the area, how many veterans
live in that core area. I mean there is a list of criteria that
you all use when you all decide on putting a location. Members
of Congress don't tell you where to put it. You have a formula.
Mr. Neary. We have a series of factors that we evaluate the
sites against, to include access to veterans through public
transportation, constructability of the site, the availability
within the surrounding area of amenities, if you will, places
for veterans to come to the clinic and their families to eat,
and those sorts of things. We will be glad to provide that to
you if you would like to see that.
[The VA subsequently provided the following information:]
SITE SURVEY
EVALUATION FACTOR DEFINITIONS
OUTPATIENT CLINIC
KEY VALUES
Outstanding
(9-10)
Acceptable
(7-8.9)
Minimal
(5-6.9)
Unacceptable
(0-4.9)
1. COMPATIBILITY OF SURROUNDING AREA
1.1 Location to Nearest Emergency Response Service
O--Nearest emergency response is located within 1 mile of a major
hospital.
A-- Nearest emergency response is located within 3 miles of a major
hospital.
M-- Nearest emergency response is located within 5 miles of a major
hospital.
U--Nearest emergency response is located more than 5 miles of a
major hospital.
1.2 Site Adjacencies
O--Site is located in a quiet area with little or no noise
disturbing the clinic setting from the street or surrounding
neighborhood. Adjacencies consist of attractive, like new office
buildings. Surrounding neighborhood is compatible to clinic setting.
A--Site is located in an area that may have some noise factors
intruding from neighboring areas, but which are not disturbing to the
clinic setting. Adjacencies consist of a mix of new and old office
buildings and some light industrial facilities. Surrounding
neighborhood is compatible to clinic setting.
M--Site is located in an area with some noises coming from
neighboring areas that may be disturbing to the clinic setting.
Adjacencies consist of older office buildings and light industrial
facilities. Surrounding neighborhood is generally compatible to clinic
setting.
U--Site is located in a very noisy area that is disturbing to the
clinic setting. Adjacencies consist of unattractive buildings and
medium/heavy industrial facilities. The neighborhood is run down and
includes businesses not compatible with the clinic setting.
1.3 Aesthetic Quality and Zoning
O--Site is in a pleasantly landscaped office park with
predominantly office buildings housing professional-type businesses of
high aesthetic quality. The site is zoned appropriately to include
medical facilities.
A--Site is in a landscaped mixed business/light industrial area of
office-type buildings, both professional and service oriented with
medium aesthetic quality. Site zoning is mixed, but includes medical
facilities.
M--Site is in a mixed light/medium industrial area, and zoning is
mixed and does not necessarily include medical facilities.
U--Site is in a heavy industrial area and would have to be rezoned
to include medical facilities.
1.4 Location to Hospital
O--Site is located within 3 miles of a major hospital.
A--Site is located within 5 miles of a major hospital.
M--Site is located within 8 miles of a major hospital.
U--Site is located more than 8 miles from a major hospital.
1.5 Location of Majority Veteran Population/Catchment Area
O--Site is located in an area where the majority of the veteran
population lives. Veterans who must travel a distance are very familiar
with the area where the site is located and will not have a problem
finding the site.
A--Site is located in an area where a large veteran population
lives and/or works. Veterans who must travel a distance will not have a
problem finding the site.
U--Site is located in an area where veterans do not generally live
or work. Veterans who must travel a distance will not be familiar with
the area.
2. ACCESSIBILITY
2.1 Access to Major Highways
O--Major highway and/or highway interchanges are directly
accessible to the site. The site is visible to the highway. The address
is known to the community, and patients and visitors would have no
trouble finding the building via major highways.
A--Site is located on a main traffic artery, with highway
interchanges between 1 and 2 miles away. The site address is known to
the community, and patients and visitors would have no trouble finding
the building.
M--Site is located on secondary artery. Highway interchanges are no
more than 3 miles away. Patients and visitors would some have
difficulty finding the building.
U--Site is located on an isolated street. Highway interchanges are
more than 5 miles away. Patients and visitors would have difficulty
finding the building.
2.2 Public Transportation
O--A bus route is available with bus schedules providing service
regularly throughout the business day. Pedestrians would be dropped off
in front of the VA building.
A--A bus route is available with bus schedules providing service at
intervals during the business day. Pedestrians would have a one block
to walk to enter the VA building.
M--A bus route is available; however the bus schedule is sporadic.
Pedestrians would have at least a two-block walk to enter the VA
building.
U--No bus service available.
2.3 Eating and Shopping
O--The site is located nearby to a number of restaurants and fast-
food establishments, a market, shopping mall, bank, cleaners, a drug
store or the like, so that patients, visitors and employees have access
without the use of a car, and have a variety of establishments to
choose from. There is also a movie theatre or other type of
entertainment available.
A--The site is located within a 5-minute drive by car to a number
of eating establishments, and a shopping center with some diverse
businesses, such as a bank, cleaners and drug store. Some type of
entertainment is available.
M--The site is located within a 10-minute drive by car to eating
establishments, shopping areas, and entertainment.
U--The site is located so that patients, visitors and employees
must drive more than 10 minutes from the site to eating establishments,
shopping areas, entertainment.
2.3 Access/Egress
O--Located on a divided highway with traffic signals and turning
lanes in both directions.
A--Traffic signals with turning lanes in both directions.
M--Traffic signals without turning lanes.
U--No traffic signals.
3. MAN-MADE CONDITIONS
3.1 Shape/Topography of Site
O--The parcel is flat and shaped (square or rectangular, uniform
boundaries, undivided by roads, contiguous parcels) to allow the
maximum developable acreage to provide green space and landscaping
around all parking lots and building. The front of the parcel offers
full visibility of the building from the street and provides a
conspicuous frontage, which is in harmony with the entire piece of
property. Location of site provides access from two sides of the
building and allows traffic to enter and exit from two curb cuts.
A--The parcel is flat and shaped to provide more than moderate
developable acreage, meets the requirements for green space and
landscaping, and will comfortably provide for building footprint,
parking and commercial traffic to the loading dock. Location of site
allows traffic to enter and exit from two curb cuts.
M--The site provides minimal green space and landscaping.
Topography is generally flat, but contains some differences in level
where patients/employees/visitors will travel. The shape restricts the
developable acreage, but there is a safe flow of traffic to serve
entrances and exits. The site offers only the minimum acreage
requested.
U--The site provides minimal green space. Topography is not flat
and contains many differences in the terrain that would make it
difficult for patients, visitors and employees to travel. The shape
severely restricts the developable acreage (too long and narrow,
irregular boundaries, non-contiguous). The site offers less than the
12-15-acre minimum.
3.2 Utilities (electric, gas, water, sewer, telephone)
O--All utilities are available to the site. There are no easements
or legal restrictions prohibiting the start of construction.
A--Most utilities are available to the site. Obtaining the
remaining utility easements are in process and will not impact the
start of construction. No other legal restrictions are pending.
M--Site does not have all utilities and it will take approximately
60 to 90 days to get utility easements approved to the site, which may
impact the start of construction.
U--Site does not have all utilities and it will take at least 6
months to get utility easements approved to the site, which will impact
the start of construction.
4. Natural Conditions
4.1 Site Characteristics
O--Site is not in the 100-year flood plain and contains no wetlands
to allow for maximum, unrestricted, developable acreage. There are no
natural restrictions, and the landscape is attractive and unspoiled.
A--Site is not in the 100-year flood plain and contains no
wetlands. The site may contain a few natural restrictions, but allows
for more than moderately developable acreage. The landscape is
attractive.
M--Site is in the 100-year flood plain, but can be mitigated and
approved by FEMA.
U--Site is in the 100-year flood plain and contains wetlands and is
unsuitable for construction.
4.2 Environmental Issues
O--There are no known environmental issues on this site.
A--There are minor known environmental issues, but they can easily
be mitigated to provide a clean site.
M--Known environmental issues that would require major mitigation
and would be time consuming to correct.
U--Known environmental issues are of such magnitude as to render
the site unsuitable for construction.
4.3 Elevation Above Flood Plain
O--No flood plain issues.
A--Flood plain issues can be mitigated per FEMA requirements.
Ms. Brown of Florida. Yes, sir, I would.
Mr. Filner, thank you.
The Chairman. Thank you. Mr. Buyer.
Mr. Buyer. Mr. Neary, I would like to share with you, as I
also travel around the country, there are demands in certain
areas, especially, sometimes it comes from my good friends and
comrades, about the need, ``I must have a hospital,'' and
``what the request really is''--this is in my judgment--it's
not necessarily the need for the hospital. It is the need that
a veteran with a particular disability, illness or disease has
access to care. When I hear that, that is how I interpret it.
So, no differently than how the Chairman and I worked
together to resolve this issue in Deep Texas. The issue in Deep
Texas was that the entire community was in demand but never had
a VA hospital in Deep Texas, right?
Mr. Neary. Right.
Mr. Buyer. So how do we solve this, and then you find out
you have all these regional challenges and biases and
prejudices, San Antonio versus us down here, nobody cares about
us and there are all these regional things that you don't even
think about.
And I just want you to, this is in my opinion. This trend
line of moving toward the ambulatory care centers as we go in
and we look at the communities, and we see what is available in
the communities with regard to how we can take advantage of
what medical technologies are in the communities so we are not
duplicative, and whether that can be contracted so we are not
redundant. I think that building these ambulatory care centers
and doing your contract on inpatient care, where it makes
sense, rather than building these behemoth medical hospitals of
the past, I think your trend is correct. That is just my
opinion.
So as you look at Jacksonville now, I think what I am
taking away from this are veterans organizations, and in
particular Ms. Brown, whose patience is strained, when you look
at when the clinic was first authorized to where we are today,
I don't want to go to the past. I want you to now look toward
the future. Speaking now, representing the VA, are you in a
comfort zone that there is now a way ahead for us to be able to
fund, and for you to be able to build, an ambulatory care
center and contract this?
Mr. Neary. The obstacles that we faced have been sort of
real estate in nature for the most part and we have made
progress. We have been some distance apart, but I think we have
made progress. There is more work to be done. From what I heard
this morning it seems to me that there is the opportunity to
reach agreement on those issues.
You mentioned the Veterans Health Administration's
Harlingen, Texas situation. Harlingen is quite different than
Jacksonville, but I think as you pointed out with health care
technologies, pharmaceuticals evolving over the years, what is
done in an outpatient setting can meet the needs of, in
Harlingen's case, 95 percent of the people who come to the VA,
who are driving to San Antonio 5 hours for outpatient specialty
care, and with the health care center that is going to be put
in Harlingen, that problem is alleviated.
Mr. Buyer. This model that I am referring to has elasticity
because it is dependent upon the synergies of excellence in
whatever community in the country. So I understand that. I
understand this isn't like Harlingen. That is what I loved when
we developed the Charleston model about how we take advantage
of the synergies.
So now I am going to lock you down, okay, I am going to
lock you down. In your testimony is that real estate is what
was delaying that project, but your testimony here to me right
now and this Committee is that those issues have now been
resolved?
Mr. Neary. No, they have not been resolved.
Mr. Buyer. Then clarify that to me.
Mr. Neary. I think we have probably clarified our different
positions somewhat in our discussions with the Shands
organization and it would appear from discussions today that
reaching resolution would be achievable.
Mr. Buyer. Okay, then give me a timeline.
Mr. Neary. We have committed to meet soon with the Shands
attorneys and real estate folks, and I would guess that those
contacts can happen within the next week or two, and then over
the course of those discussions, which is hard to predict a
timeline. Our interest is in getting resolution as rapidly as
possible. So we hope within the next 30 to 45 days we would
have that resolution.
Mr. Buyer. All right. That is encouraging.
Ms. Brown of Florida. If the gentleman would yield for one
quick second, because one of the things that sometimes is a
challenge is that if you don't have the authorization, and you
have that, and if you don't have the money, you have that. So
those are not factors?
Mr. Neary. Those are not factors. The real estate issue I
am talking about, though, are difficult issues that we need to
reach agreement on.
Mr. Buyer. I know my time has expired, Mr. Chairman, but if
I may. The real estate challenges, when you said that,
immediately it just rushed into my head, were the challenges
that I had to endure with Ms. Brown, and Mr. Filner had to
endure equally with the Orlando hospital, all right. Real
estate challenges, the purchase of that real estate, you know
exactly what I am talking about. Took a very long time.
Ms. Brown of Florida. Twenty-five years.
Mr. Buyer. It took a long time and a lot of people had
their own ideas and great interest on where they think you
should buy it.
Mr. Neary. Correct.
Mr. Buyer. Well, I am glad, I am glad that you have that.
The other question I have is with regard to the security
requirements for contracts to build the VA outpatient clinics.
I am starting to hear as we do this, have the contractor build,
we lease, that in order for us to be able to attract developers
and to have competitive bids that these new security
requirements are placing great stress on our ability to attract
the developer because of reuse. So can you help clarify this
for me?
Mr. Neary. Sure. First, for the other Members of the
Committee's benefit, after 9/11 the VA and other government
agencies who had not paid a lot of attention to some of these
kind of security threats developed a set of criteria to apply
to VA facilities, whether they were considered mission-critical
facilities that we would want to be sure remain in operation
after an event or whether they were life safety, where you
would want to protect the occupants of the building.
We have implemented a variety of features in our
facilities, in our new facilities, including setbacks and
facilities for sustainability over time. We have not received
very much pushback at all from developers, and we have not been
seeing a diminishing number of people competing for our
projects. We have been contacted by some developers, one or two
that I can recall, who feel that the amount of investment that
they are required to make to implement these features then
require a longer time to recoup from the building and since we
don't have authority to lease for 20 years, they have a
business problem they have to deal with.
Mr. Buyer. Does that change our model?
Mr. Neary. At this point in part because of the market we
are getting more and more companies wanting to compete for our
work now than ever before. So while some small number of
companies have raised that as a problem, the others have not.
Mr. Buyer. When I say change the model, when--okay, you
cannot contract any longer than 20. Is that a Congressional
mandate, is that in law or is that a secretarial?
Mr. Neary. I believe it is a General Services
Administration regulation. Whether it is in law or not I am not
sure.
Mr. Buyer. All right. Well, please, you to need to
communicate that if you have requirements that are upsetting a
delicate balance in the marketplace, you need to let people
know.
Ms. Brown of Florida. I did have a followup because I am on
Transportation and we handle general services, and I overall
have a problem with the way things are going right now and one
of the things I am going to ask Transportation to have a
hearing on is I don't really personally care for leasing, you
know, buying the building, leasing it for 20 years. I prefer
that the taxpayer own it and I don't know why we don't deal
more, to me it just makes more sense.
The Chairman. Either of you want to give a quick answer to
that or not?
Mr. Neary. The bottom line reason we don't build everything
is that we don't have enough money to do it.
Ms. Brown of Florida. Not everything, not everything.
Mr. Neary. We don't have the money to do it, but on the
other hand, in clinics, what will health care be like beyond 20
years from now? Do we really want to own a building that 20
years from now will probably be outdated and the health care
that is delivered may well have changed to the extent----
Ms. Brown of Florida. Well, how much could you as the owner
be opposed to if it is your building and you could sell it. I
mean it is our investment. I am not saying--but I think that is
something that we have need to have a hearing on at least to
bring in some of the developers because, for example, this
project, you have all of the money and everything and the
question is what kind of incentives or bonuses that we could
put in to say, okay, you are talking about 18 months or 3
months, how come we can't have that online in 12 months. We did
it when one of the bridges went down more than once and we were
able to get a project. We need to be able to put these
facilities online a lot quicker because we have so many elderly
veterans that need the services, I mean, you know.
Mr. Buyer. May I reclaim my time? Let me conclude with
this. I endorse what you are presently doing in having
developers build and us lease. We don't anticipate what health
care is going to be in 20 years, you said. You can use Corpus
Christi as a prime example. You own that clinic. It is
landlocked, you can't expand it. You can't do things you want
to do and medicine has changed today from what it was in the
1970s even.
So it gives us elasticity, it gives us the ability to adapt
in the future and it is almost like a Wal-Mart. Wal-Mart was
able to build and expand because they did this type of thing
quickly, and if we want to be able to open up that access and
do that around the country, I endorse what you are doing.
But I am pleased with regard to your testimony here in
Jacksonville. I yield back.
The Chairman. Thank you. Just a quick question, Mr.
Lawrence, if I may. Do all of the Vet Centers around the Nation
have an OEF/OIF coordinator or outreach person that you
described or was that your decision there?
Mr. Lawrence. No, sir. That comes out of Central Office of
Readjustment Counseling, with Dr. Batres. Most of the Vet
Centers now have what would be called outreach people aimed
specifically at OEF/OIF veterans returning to provide outreach
service and information about Vet Centers.
The Chairman. My general sense of the development of Vet
Centers, tell me if I am wrong or right here, is that they were
set up to deal with some of the issues that Vietnam veterans
raised.
Mr. Lawrence. That is--the original legislation, that was
Public Law 96-22.
The Chairman. There is a branding that Vietnam veterans
relate to or have over time. They know that is their center. I
am not sure that the newer veterans don't know what a Vet
Center is, at least compared to a clinic or a hospital, and it
seems to me we need something----
Mr. Lawrence. I like to think, Mr. Chairman, at the time
the legislation was enacted back in 1979, it was specifically
aimed at Vietnam Era veterans and the amount of work at that
particular time taken to get in that population not only with
the Vet Center but certainly within the VA system itself was
possibly part of the reason why a number of vets out of the
Vietnam era still have an attachment to the Vet Center. We have
expanded our eligibility criteria all the way back to World War
II now. We serve veterans from as early as World War II,
through now, to the most recent vets, in all the other wars and
interventions militarily that the U.S. has had since World War
II. The outreach effort is certainly geared toward all those
eligible veterans and again we continue to go back and revisit
new methods of recruiting not only the younger veteran but
maintaining services for the older veteran.
I think there is a strong affinity with Vet Centers from,
again, Vietnam veterans because the original legislation
required us to do that then.
The Chairman. Well, we thank you for all of your work.
Ms. Brown of Florida. I have one last question.
The Chairman. We need to get to the last part.
Ms. Brown of Florida. Yes, one question back to the
hospitals. It was mentioned earlier as far as the emergency
room is concerned that they have to go to maybe Gainesville or
Lake City to go to the hospital. My question, one of the things
that we have done, I think we have done it, for women veterans
is that they can kind of get, they can go to other places
because certain programs are not available at the veterans
facility. How do we have the emergency care in this area
because they are shaking their head, yes, they have to go to--
--
Mr. Cappello. Well, first of all if somebody has a medical
emergency, we advise veterans to go to the nearest hospital.
Ms. Brown of Florida. We reimburse them.
Mr. Cappello. Well, what happens then is after that care is
received, there is a determination made as to whether people
qualify for it and when veterans don't have any other means to
pay for it, we become the payer of last resort. So yes, we do
reimburse veterans for emergency care to the point of what we
call stabilization.
The Chairman. You have a regulation that states if a third
party insurer picked up any part of that cost, VA wouldn't pay
anything. The House has just passed legislation that closed
what I think is a big loophole that says we will pay whatever
has to be paid for that veteran who has an emergency need.
Mr. Cappello. That would be a very welcomed, you know,
enhancement for sure.
The Chairman. I am sorry I interrupted you.
Ms. Brown of Florida. Well, no. I am finished. I just think
that that emergency issue is a major issue here, you know.
Mr. Cappello. That is a major issue. It is not only here in
Gainesville but around the country. The veterans many times
don't get in ambulances because they know they will go to the
nearest medical center as opposed to the VA and many times
they, I think, take unnecessary chances by driving their cars
to the VA when they are having a medical emergency, and so I
think this program, while we are able to--now in the past we
weren't even able to pay at all for veterans that were
requiring care for something other than their service
connection, and so now we do have that ability and I think it
has produced a much safer situation for our veterans and
enabled them to get emergency care closer to their home.
Ms. Brown of Florida. I think this is something that we as
a Committee need to look into.
The Chairman. We thank all of you, and we thank all of the
panelists. We have some time to have an open microphone for
those who want to share their thoughts. We want to limit you to
a couple of minutes each. We will adjourn the formal part of
our hearing at this time to receive the public testimony.
[Whereupon, at 2:50 p.m., the Committee was adjourned.]
A P P E N D I X
----------
Opening Statement of Hon. Bob Filner, Chairman, Full Committee on
Veterans' Affairs
Good afternoon. I would like to thank the Florida Community College
for their hospitality in hosting this hearing today.
I thank everyone for attending this hearing and for your interest
in providing the veterans of Jacksonville the proper health care
infrastructure that they need.
The purpose of today's hearing is to provide general oversight and
to receive updates on the Gainesville Towers Project, a project which
would not have been possible without the efforts of Congresswoman
Brown.
As many people in this room know, the new bed tower will correct
the deficiencies in patient privacy.
To this end, the new bed tower will have 245,000 gross square feet.
The building will consist of four floors which will house 226 single-
bed patient rooms with private baths and a ground floor which will
house supportive services.
The contract for the bed tower was awarded in June of 2008, and the
construction will be completed in April of 2011. It is also my
understanding that about 10 percent of the construction has been
completed to date.
I look forward to hearing the testimony of the witnesses on our
panels and also look forward to leading a constructive discussion on
the progress of the bed tower.
Opening Statement of Hon. Steve Buyer, Ranking Republican Member, Full
Committee on Veterans' Affairs
Good Afternoon.
Mr. Chairman, it is a pleasure to be here in Jacksonville, the
hometown of our colleague Corrine Brown. Corrine and I came to Congress
in the same year and I have enjoyed serving with her over these years.
Ander Crenshaw, it is also good to see you here today. I know the
fourth District of Florida is well represented by my very good friend.
Ander has established himself in Congress as a respected voice on
defense issues and a champion for our men and women in uniform.
He has served on the Appropriations Subcommittee on Military
Construction and Veterans Affairs since his appointment to the
Appropriations Committee in the 108th Congress. Through his role on the
Appropriation's Committee, he has been instrumental in supporting
increased funding for the Department of Veterans Affairs (VA) and
securing funding for the acquisition and construction of the new
Jacksonville National Cemetery.
Many here may recognize him for his annual Veterans Recognition
Ceremonies. It is very meaningful to honor those who put themselves in
harms way to defend our freedom. And, I thank you for holding these
events and also the over 2,000 local veterans who have been honored for
their service to our country.
I also want to extend a warm welcome to everyone in attendance on
behalf of our deputy Ranking Member, Cliff Stearns. I know he wanted to
be here today, but unfortunately was unable to participate.
Cliff is a long-standing leader of this Committee and a steadfast
advocate for generous funding for veterans health care and earned
benefits, particularly education.
He has actively supported the call for a new regional health care
facility in Marion County and expansion of the VA Hospital in
Gainesville. For years he has been working on both these projects which
have broken ground and I know he looks forward to seeing both projects
come to fruition.
I appreciate that we are having this hearing to discuss how VA is
moving forward to expand services and meet the needs of veterans who
live in the Jacksonville area.
New technologies make it possible to provide more diagnostic,
specialty and surgery services in an outpatient setting, rather than a
hospital. To maximize the use of these advances and bring a broad array
of specialized services closer to where veterans live, the VA is moving
from clinics to new ``Ambulatory Care Centers'', like the one planned
for Jacksonville.
As all of you know, the current Jacksonville VA Clinic is located
next to the University of Florida's Health Science Center at Shand's
Hospital. The North Florida VA health care system has a strong and
meaningful affiliation with the University of Florida. And, VA
expansion at the current site with a collaborative partnership could
yield substantial benefits for veterans.
Sharing is not a new concept. VA has been sharing human capital for
years with its affiliations among our Nation's teaching universities.
In Charleston, SC, there is a tremendous opportunity for VA to
replace its aging hospital with a mutually beneficial agreement to
share facilities and integrate the delivery of veterans' health care
with the new Medical University of South Carolina (MUSC) hospital. This
approach to share facilities, which I take great pride in developing,
is now being referred to as ``The Charleston Model'' within the VA.
As we work with the VA and MUSC, we continue to see that their
goals are not that different and we can set a course to build a new
paradigm for cooperation that will be an example throughout the Nation.
I believe that collaboration whether it is between VA and DoD, VA
and its Medical Affiliates, or VA and other private-sector entities is
a powerful tool that VA must leverage to ensure that our veterans have
the greatest access to the most advanced medicine and medical
technology.
As we look at the future development of the VA, it is also vital
that the VA establish strategic and long-term plans for energy
sustainability. Especially here in the ``Sunshine State'', VA must
consider the use of solar energy to power VA health care facilities. I
am pleased that VA is planning to fund at least 24 feasibility studies
for solar photovoltaic systems in its medical facilities, including
four sites in Florida--Orlando, Bay Pines, Tampa and Miami.
I strongly encourage VA to consider solar and other energy
efficiencies in the developing projects in Gainesville and
Jacksonville.
In closing, I would like to thank all of our witnesses for
appearing before the Committee today. Again, on behalf of Cliff
Stearns, I want to recognize Stan Jordan--a retired Army Colonel and
member of the Duval County School Board. Colonel Jordan was a former
member of the Florida House of Representatives and Chairman of
Florida's House Committee on Military & Veterans' Affairs. I would also
like to thank Dan Hughes, Chairman of the Jacksonville National
Cemetery Advisory Committee for being here today.
It is important that we listen to the views of local veterans on
how VA is serving you and I look forward to hearing from all of our
witnesses.
Prepared Statement of Gunnery Sergeant Herschel Allen, USMC (Ret.),
Duval County Veteran Service Officer/Veteran Service Officer
Supervisor, City of Jacksonville, FL, Division of Military Affairs,
Veterans and Disabled Services Division
My credentials
past
present with duties
CARE commission
findings
proposals
results
Data on VAOPC Jax
vets seen daily
1st quarter 09 visits
1st quarter uniques
Future estimates
Duval County veteran data
receiving VA benefits
average increase
K.L.F. estimate
VAOPC location
congested
parking
crime
not centralized
size
leased
Veteran's concerns and thoughts
Questions?
Prepared Statement of Hallie Williams-Bey Chairman, Northeast Florida
Veterans Council, Jacksonville, FL
BUILDING THE CRITICAL HEALTH INFRASTRUCTURE FOR VETERANS IN
JACKSONVILLE, FLORIDA
A 6-year Prostate Cancer Survivor. . .
I was first told that I had Prostate Cancer by a private physician
in 2000. I began to talk to other Veterans and it was suggested to have
the VA check results also. I visited the local clinic where I
established my record and was later informed that I had a 2-year wait
for a Lake City appointment.
During this waiting period I used my private physician and started
hormone & radiation treatments and seed implantation. I submitted all
documents to the VA and was awarded 100 percent for 18 months. When I
finally went to the Lake City VA Hospital, there was no Cancer and, at
the end of 18 months, Disability was reduced to 10 percent and still is
now. I visit the local clinic two to four times a year since then and
up to the current year. The area is small and most times congested. I
have also been to the other clinic sites for medical services. The
parking becomes a real problem and some facilities don't even have
public transportation available.
There is a Shands Hospice facility across the street from the
current VA Clinic. Is it possible this could be used as a VA Clinic to
house all services and the empty lot to be used to develop a new
Hospice Center???
I was at the VA Clinic April 13, 2009 for lab work from 8 to 11 AM.
I did a personal survey with many Veterans present. We need a new
Clinic that is centrally located for public transportation and the
Handicap parking should be increased with more parking spaces and
please seriously consider hiring more Veterans than Civilians.
Currently serving as Chairman of the Northeast Florida Veterans
Council, representing 33 paid groups, but over 100+ local groups who
participate in Memorial Day, Veterans Day Observance and other Military
events; I am also a member of the following organizations:
American Legion Post 197--Past Post Commander (life member)--also
40&8 Passe Chef de Gare (chartered and life member)
Veterans of Foreign Wars Daniel ``Chappie'' James Post 4761--Past
Post Commander (life member)
Montford Point Marines Association--(Chaplain and life member)
FLA Chapter 7 DAV (Disabled American Veterans)--Legislative Officer
BRAVO (Brotherhood Rally for American Veterans Organizations)--Past
President
NABVETS (National Association of Black Veterans)--Life member
Dedicated Service . . . with Honor
Prepared Statement of Guy Diffenbaugh, Commander, Jacksonville, FL,
Chapter 1, Disabled American Veterans
Chairman Filner, Congresswoman Brown, and other present Members of
the Committee on Veterans' Affairs, my name is Guy Diffenbaugh,
Commander of Jacksonville Chapter 1 of the Disabled American Veterans
and I am honored to be here and give a statement concerning the
Building of a Critical Health Infrastructure for Veterans in
Jacksonville, Florida.
First I wish to thank you on behalf of all veterans for your
support and funding of veterans' programs.
The DAV and other Veteran Service Organizations have previously
made Congress aware of the issues concerning veterans' appropriations
so I will only reiterate those issues pertaining to health care and
specifically the concerns we have here in Jacksonville. I have asked
the VA for data to support my claims but was told I was not privy to
the same and that the VISN would present supporting data so I will
present information based upon my personal experience and that of
members of my organization, supported by some research done on my
personal computer.
I am in the VA health care system and find the care I receive
exceptional. I can assure you that, though these professionals provide
excellence, the system is crowded, especially in the Jacksonville
Outpatient Clinic. We were supposed to have a new clinic operational by
the fall of 2005. Increased size and some services currently available
only at the VA Medical Centers in Gainesville and Lake City are
supposed to be and should be incorporated in the new clinic as well as
adequate parking. Our present clinic is not large enough to adequately
support the veteran population and our parking extends for city blocks
to include a dirt lot.
An additional factor that our organization has expressed concern
for is allowing Category 8 veterans into the health care system that
was not designed to handle these veterans. With the VA estimate of 1300
new veterans in the North Florida South Georgia VA Health Care System
alone (though 100,000 have signed up and are on the waiting list) we
would have an unacceptable degradation to the delivery of health care.
According to the Florida Department of Veterans Affairs Annual
Report dated 31 December 2008, Duval County has the fifth largest
veteran population in the state and is the only county of significant
veteran population density without a VA Medical Center in close
proximity. We must travel 1+ hour for limited capability at Lake City
Medical Center and \1/2\-plus hour to reach the full service
Gainesville Medical Center. The DAV provides 15 passenger vans to
transport veterans to the hospitals. My Chapter has recently purchased
2 vans for transport to Lake City and Gainesville. These vans are full
5 days per week with waiting lists. Although the Jacksonville area may
be the 5th largest concentration of veterans in Florida it stands to
reason that with the massive rate of deaths of WWII veterans retired in
south Florida and the largest military presence in Florida being the
North Florida Southeast Georgia area (many of which love the area and
retire here) the Jacksonville area veteran population should in the
near future become the largest density in the state.
The VA needs to complete a full service clinic or medical center to
service our area. It's time to take action. We are already 4 years
beyond the announced opening date. As Congresswoman Brown said in the
summer of 2006, referring to the impasse, ``we need to work out the
issues so this doesn't go on for years'' and ``an impasse over another
VA project in the Orlando area delayed it for 25 years''. The Committee
is well aware of the DAV's position on veterans' entitlements. On 24
February 2009, our National Commander addressed a Joint Congressional
Hearing of the Committee for veterans Affairs in Washington, D.C., and
the Committee was in agreement on the issues from Advanced
Appropriation to Entitlements. Since there is agreement the only
missing component is action. On behalf of all veterans, I ask you to
make a decision this year and back it with action.
Prepared Statement of Master Sergeant James H. Tippins, USMC (Ret.),
President, Chapter 29, Jacksonville, FL, Montford Point Marine
Association
Honorable Representatives. I am James H. Tippins, a patient at the
Jacksonville, Florida VA Outpatient Clinic located at 1833 Boulevard
Street, Jacksonville, FL 32206.
In my opinion the clinic staff does an overall excellent job of
patient care and service based on the conditions that they are faced
with, such as the number of patients they are required to service from
South Georgia and North Florida, with the inadequate facilities
available. However I have TRICARE for Life and can go to other
hospitals, that is a blessing because I was diagnosed as having
prostate cancer, and the VA had no urologist available and my PSA
reading elevated to 29, and the only reason that I am here today is
that I had the option of TRICARE for life.
When you get into the local system and assigned to a team, the
primary care doctor usually will monitor your condition and accomplish
good patient care. The pharmacy and laboratory is excellent but is
regularly overcrowded due to the patient load, although the eye clinic
regularly has a 3-4 hour wait. Overall with the number of veterans
located in this area the present facilities need to be improved to
maintain and provide the patient health care.
As part of this presentation I visited the listed veteran's
organizations to get input from their membership to include in this
hearing.
1. VFW Post #4761
2. American Legion Post #197
3. Montford Point Marines Chapter #29
In summary, there is a major problem in getting health records from
active duty to the VA, has caused hardship and frustration in verifying
service connected disabilities. Suggestion if transition process
included getting the health records forwarded to the local VA with the
new technology this could be accomplished during the check out
procedure when released from active duty.
There is a problem getting specialty care at the Jacksonville
clinic and getting an appointment at Lake City or Gainesville hospital
is very difficult. Transportation to hospitals is not always available
to meet the scheduled appointments. Many veterans have physical
problems that develop after being released from active duty and proving
that the illness is service connected has been a major dilemma, such as
the Gulf War, hearing problems developed from serving in artillery,
joint troubles knees, legs, etc. These aliments normally don't
transpire until years later.
Emergency care is almost none existence at the local clinic and
getting to the hospitals for treatment 40 miles away could be better
served with a local hospital.
There has been a noticeable increase in the number of veterans in
the Jacksonville area seeking health care as promised by the government
for military service.
In conclusion the North Florida and South Georgia area need a
hospital to meet the increase need for VA health care. Although the
clinic achieve a commendable job with what's available to the local
staff.
Statement of Corporal Daniel V. Hughes, Sr., USMC (Ret.), Chairman,
Jacksonville, FL, National Cemetery Advisory Committee
I serve on Congressman John Mica's Committee on Veterans Affairs as
a volunteer. I have been helping veterans for 38 years. The issue of
health care and facility management is of great importance and concern
to our veterans and their families. The Marine Corps has given me
respect, honesty and integrity. That is the code that I run my life by.
Our service men and women and their families deserve the best we can
give them for their sacrifices.
For the record, I address health issues of great importance to our
veterans and their families in my report. I want to thank the Committee
and welcome you all too sunny Florida. Please accept my thanks for
allowing me to speak before you today.
Suicides: All Time High
There are as many suicides as there are men and women killed on the
battle field. The challenge is to get our soldiers to open up with
their problems. The majority of the suicides have occurred once the
troops have returned home. The need for trained psychiatrist in our
clinics is needed. Some of our clinics do not have this service or the
funds to acquire them.
Problem Statement: Active duty military personnel, Reservists and
National Guard units do not currently have access to ongoing programs
and services to help re-integrate them back into civilian and family
life. There is also a challenge in accessing confidential military
health and support services addressing the effects of Post-Traumatic
Stress Disorder (PTSD) and other psychological problems, which can
dramatically impact our troops and their families.
We need to provide the resources to assist our veterans in
transitioning from military life and help them replace the military
unit with the family unit. To accomplish this objective we need a
program to train and employ veterans who will assist in providing the
network of programs and resources that our transitioning heroes and
their families require.
24-Hour Help Hot Line
As a part of ongoing services a 24-Hour Hotline to assist our vets
and their families with urgent issues needs to be provided. This line
would be staffed by trained Veterans Crisis Counselors who will work
with the callers to guide them to the resources needed at that moment.
If emergency services intervention is required the Crises Counselors
will contact the required providers and stay on the phone with the
callers until help is secured.
Traumatic Brain Injury (TBI)
What is being done to assist veterans with Traumatic Brain Injuries
is an exploding problem. This most perplexing wound comes out of the
Afghanistan and Iraqi wars. Soldiers stationed in Afghanistan and Iraq
are constantly faced with the perils of improvised explosive devices
(IED's), rocket propelled grenades and land mines. The path of
destruction often leads to blindness, deafness and catastrophic
injuries and multiple amputations. In the past 6 years, officially
about 15 percent of all wounded vets have struggled with a traumatic
brain injury. At this time this number has increased substantially.
Answer: Every GI coming back from the war zone needs to be screened
and x-rayed along with a complete debriefing before being released back
into society. We need a special clinical department to care for these
men and women along with specially trained psychiatrists. TBI is
invisible to the naked eye. Over 20,000 cases have been reported. These
insidious wounds can plague those suffering for years. I want to thank
the Veterans Affairs Committee chaired by Representative Bob Filner for
the proposed bill H.R. 2199, which provides for mandatory screening. We
must continue to follow up with this effort, along with other
continuous treatments at our centers.
More emphasis needs to be put on present day health issues and
specialty doctors to handle these brain injuries. Today's health issues
are a little different from previous wars. Hands on management is
needed along with qualified staff as well as additional nurses to
handle the work load. Today we are faced with many serious medical
problems in our hospitals as well as our clinics. There is no reason to
have unsanitary issues in any of our health facilities. This is due to
a lack of supervision from management doctors on staff. To meet the
demand there is confusion and the outcome from this confusion is
mistakes, which are very serious in nature.
Most of our clinics are over run with veterans with serious health
problems, for example: Daytona Beach Clinic, which is a new facility
and has already had one expansion and needs another with 800 veterans a
day coming through the doors. A lack of money and staff has created
numerous problems.
Alzheimer's
I now want to talk about a very serious illness and that is
Alzheimer's. This disease has taken its toll on our older veterans. All
of our nursing homes should have in its facility an Alzheimer's unit.
It should be a locked down unit along with specially trained volunteers
and nurses.
The lack of this service in our VA system has forced a lot of our
veterans into private nursing homes. We are blessed at this time to
have received a new nursing home at Gulf World Village with an
Alzheimer's unit in it. We as veterans would like to thank you for this
blessing. Those nursing homes without an Alzheimer's unit must be
reassessed so as to incorporate such a unit to better service our
veterans with this terrible disease.
Qualified Doctors and Staff
One of the biggest problems we are having at all of our VA
facilities is acquiring better doctors and staff to meet the demand. At
this time the system is struggling to care for our veterans. Our
clinics and our hospitals do the best that they can with the budget
that they have to work with. That is not good enough. Our veterans
deserve better. Due to budget shortages, we leave ourselves open for
mistakes, which then result in lawsuits.
To eliminate the above we must acquire the best of doctors. Pay
them well, so that they will stay and give our veterans the service
they deserve. We must also purchase the best medical equipment that is
out in the market. Our terminally ill veterans must travel a long
distance for care at our hospitals and clinics. A lot of these patients
depend on the Disabled American Veterans (DAV) van or friends to
transport them the distance to receive their care. We veterans that
live in the northeast section of Florida must either travel to
Gainesville or Orlando for hospital care. If you are terminally ill it
makes for a very rough day. A new hospital located in the Jacksonville
area is badly needed.
Summary
In closing, those of us that have served our country, past and
present, ask our representatives serving on the prestigious Veterans
Affairs Committee to please continue the work in improving our health
care needs. The system is good, but it has some cracks that need to be
filled. As veterans, we continue to put our lives on the line for a
just cause that is so dear to our hearts, and that is freedom. The
freedoms that have made this country great now and in the future. Many
years ago a promise was made to our veterans, that promise must be
kept. To this day, many veterans and their families have given the
supreme sacrifice and received permanent traumatic injuries that last a
lifetime. God Bless our veterans and our country.
Thank you!
Yours through Veterans!
Prepared Statement of Colonel Stan Jordan, USA (Ret.) Duval County
School Board Member, District 1, Jacksonville, FL
Dear Mr. Chairman and Members of the House of Representatives:
My name is Stan Jordan. I am a retired Colonel of the United States
Army. I had the pleasure of serving as an Army Aviator and the military
gave me one of the finest educational opportunities available. I am
currently a member of the Duval County School Board where I serve as
military liaison for our community. During the past 8 years I served in
the Florida House of Representatives, of which 6 years I served as
Chairman of the Military and Veterans Affairs Committee.
As Chairman of the Committee we worked very closely with the U.S.
Congress to better serve the veteran community. A few examples are the
additional veteran homes in our State and the establishment of a
national Veterans Cemetery in Jacksonville.
My testimony will not include asking for anything for these are
times where leadership is tested for the level of creativity in the
challenge of doing more with less. Let me share a few examples of how
we continue to salute, honor and serve our veterans at no cost to the
taxpayers.
1. I had the privilege of sponsoring legislation to create
military license plates whereby $25.00 extra is paid for the
license plate. A copy of my final report to the community as a
member of the House of Representatives is attached so you can
see the distinctive and creative design of our military license
plates. They are well accepted by the military members,
families and supporters. The State of Florida has raised
millions of dollars for our veteran homes from this project.
2. Annually the Florida House of Representatives sponsors
Military Appreciation Day where all who have served and are
serving are honored. On page 2 of the Newsletter you can see a
sample of the programs provided. You can also go to
www.FloridaSalutes.com and see a video of the entire military
presentation. The Florida Channel shows these programs
statewide in their entirety every 4th of July and on November
11th as an ongoing salute to the Military. This military salute
lives on at no cost to the taxpayers and is an inspirational,
dignified example of what you can do by simply being creative.
3. As a School Board member, just 2 weeks ago I sponsored and
the Board passed a provision to give WWII and Korean conflict
Veterans a high school diploma if they did not get one during
their years of service. We further provided that they can go to
the high school graduation of their choice and walk across the
stage or come to our televised School Board Meeting to receive
their diploma. Again, a no cost provision for our Veterans,
which involves only a little bit of thank you time.
The above suggestions can be carried out by all communities and
States to continue raising the level of respect and honor those who
have served with courage, sacrifice and dignity. Thank you. I remain,
Respectfully yours.
[The attachment is being retained in the Committee files.]
Prepared Statement of Robert L. Neary, Jr., Director,
Service Delivery Office, Office of Construction and Facilities
Management, U.S. Department of Veterans Affairs
Mr. Chairman, Ranking Member Buyer and Members of the Committee. I
am pleased to appear before the Committee today to discuss the progress
that is being made to improve facilities at the Department of Veterans
Affairs Medical Center (VAMC) in Gainesville and at the new
Jacksonville VA National Cemetery. This hearing provides an opportunity
to update the Committee and members of the veteran community on the
status of the major construction project currently under construction
at Gainesville. First, let me introduce those joining me at the table
today, Mr. Reginald Lawrence, Team Leader at the Jacksonville Vet
Center that is part of the Veterans Health Administration Readjustment
Counseling Service, and Mr. Tom Cappello, Director of the North
Florida/South Georgia Veterans Health System.
In August of 2008, VA began construction on a new patient bed tower
at the North Florida South Georgia VA facility in Gainesville. This new
five-story tower will provide 226 private patient rooms with private
toilet and bathing facilities. The patient bedrooms will occupy four
floors. Patient care support services will be on the ground floor. In
total, 245,000 gross square feet of new construction will be provided.
This facility will provide state-of-the-art patient bedrooms.
Currently, most bedrooms in the Gainesville hospital have two or more
beds. The new rooms will enable greater patient privacy, a better
opportunity for patients to interact with their families and caregivers
and better prevent infections.
Funding in the amount of $136.7 million has been appropriated for
this facility. Construction is now ongoing with the project
approximately 15 percent complete. The project is scheduled to be
completed in April 2011.
The Department recently opened the new VA National Cemetery in
Jacksonville for burials. This was accomplished through the development
of a small portion of the property. The design of the larger first
phase of build-out for the new cemetery was recently completed and is
undergoing final design review. We anticipate awarding a construction
contract in August of this year. When completed in the summer of 2011,
approximately 50 acres will have been developed to accommodate burials
for 10 years. This will include approximately 7,500 gravesites for
casket interments, a 4,500 niche columbarium, 500 in-ground sites for
cremated remains along with an administration and public information
center with an electronic gravesite locator, a memorial walkway area
and necessary maintenance facilities. Funds totaling $22.4 million have
been appropriated for this new National Cemetery.
These projects demonstrate the Nation's commitment to care for our
veteran heroes. Not only in Gainesville and Jacksonville, but across
the country, new and improved facilities for veterans are in design or
construction. Since 2004, nearly $5.6 billion have been appropriated
for the Department's major construction program with over 50 major
projects receiving funding to provide new facilities and improve and
expand existing ones.
We look forward to completing the new Gainesville bed tower and the
Jacksonville cemetery as well as facilities at other locations, and we
will be pleased to answer questions the Committee may have.
Prepared Statement of Reginald M. Lawrence, SRCT, CPP, Team Leader,
Jacksonville, Vet Center, Readjustment Counseling Service,
Veterans Health Administration, U.S. Department of Veterans Affairs
Good Morning, Chairman Filner, Congresswoman Brown, and Members of
the Committee. I appreciate the opportunity to appear before you today
to discuss the role of the Jacksonville Vet Center in ``Building the
Critical Health Infrastructure for Veterans in Jacksonville and
Northeast Florida/Southeast Georgia.'' I also extend to you a warm
greeting from Dr. Alfonso R. Batres, Chief Officer of Readjustment
Counseling Service, Washington, DC. I am accompanied today by Mr.
Thomas Cappello, MPH, FACHE, Director of the North Florida/South
Georgia Veterans Health System and Mr. Robert Neary, Director of the
Service Delivery Office in the VA Office of Construction Management.
I have tailored my remarks to include not only Jacksonville, but
North Florida and South Georgia as well, since our care for veterans
and their families extends to multiple counties in both states. Prior
to the opening of the Gainesville Vet Center in 2007, the Jacksonville
Vet Center served 14 counties in North Florida, and two counties in
South Georgia. We currently serve 11 counties in North Florida,
including Duval, Bradford, Baker, Clay, Columbia, Flagler, Nassau,
Putnam, St. Johns, Volusia, and Union counties, and two in South
Georgia, including Camden and Charlton counties. We estimate the total
veteran population in the area at just over 250,000. In Duval County
alone, we estimate the veteran population at approximately 150,000. In
Fiscal Year (FY) 2008, we recorded 4,726 visits for direct service,
totaling 3,063 hours of client contact and 7,764 hours of core staff
employment. We also provided counseling services to 439 veterans of
Operation Enduring Freedom or Operation Iraqi Freedom (OEF/OIF).
Since Vet Centers were enacted by law in 1979, the Jacksonville Vet
Center has provided readjustment counseling to over 35,800 veterans. We
have documented an average of 4,800 visits per year since our initial
opening in March 1980. The core mission of our Vet Center is to provide
readjustment counseling and outreach services to veterans exposed to
war trauma in armed combat theaters of operations. Our Vet Center
provides a wide range of services with a holistic approach to aid the
returning and post-deployed combat veteran with the ability to
transcend the emotional and psychological traumas of war and to re-
integrate themselves back into their communities successfully. Our
focus on successfully enabling this transition entails a full
examination of their post-military, economic, social and family needs.
Our role is central to meeting the ongoing health care needs of post-
deployed Veterans in conjunction with the VA North Florida/South
Georgia Veterans Health System. The Jacksonville Vet Center provides
professional services for post-traumatic stress disorder (PTSD) and
other war-related issues through individual, group, marital and family
counseling, along with Substance Abuse, Military Sexual Trauma, and
Bereavement Counseling. In addition, we provide counseling to homeless
veterans, veterans seeking employment, and veterans with crisis
intervention needs. We have a direct referral system for VA benefits
information and assistance to other agencies in the community.
A special feature of our services to veterans is our Fee Contracts
Program, which is designed to provide counseling services for PTSD to
veterans in rural areas and to those experiencing either financial
difficulties or transportation problems in accessing VA services. The
program allows direct counseling and treatment by private professionals
who contract with our Vet Center for these services. This program is
operational in St. Augustine and Daytona Beach, Florida.
We have collaborated very effectively with existing VA programs and
other community-based programs by establishing ``Memoranda of
Understanding'' upon referrals to our Vet Center to address specific
needs of veterans. For example, we have a program for veterans referred
to us by the Northeast Florida Safety Council for veterans cited for
driving under the influence. This arrangement allows us to assess these
veterans, who may not otherwise be seeking services from a Vet Center
or another VA facility, for PTSD or other conditions. Recent studies
have found a disproportionate rate of returning veterans have been
cited for driving under the influence.
Another core mission of the Jacksonville Vet Center is to provide
Outreach Services to veterans and community-based organizations to
inform them of Vet Center and VA services. In 2005, the Jacksonville
Vet Center hired an OEF/OIF Outreach Specialist. The position is for an
OIF/OEF veteran who will conduct outreach to Active Duty, National
Guard and Reserve Units to inform them and their families of available
VA services. Since 2003, we have served over 2,200 OEF/OIF veterans and
their families at the Jacksonville Vet Center. We also provide
bereavement counseling to family members of military personnel who lost
their lives while on active duty. Thus far, we have provided
bereavement counseling services to 15 families of OEF/OIF veterans in
our service area.
Historically, the Jacksonville Vet Center provides veterans a point
of contact for access into the VA health care system and benefits
programs. We welcome the opportunity to be a part of ``Building the
Critical Health Infrastructure for Veterans'' in Jacksonville, Florida.
We remain committed to ``Keeping the Promise'' of providing the highest
quality care to veterans and their families at the Jacksonville Vet
Center. Thank you, Mr. Chairman and Members of the Committee, for
allowing me to appear today. I will be happy to answer any questions
that you or other Members of the Committee may have.