[Congressional Record Volume 142, Number 82 (Thursday, June 6, 1996)]
[Extensions of Remarks]
[Pages E1014-E1015]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  AUTHORIZATION OF MAJOR FACILITY PROJECTS AND MAJOR MEDICAL FACILITY 
      LEASES FOR DEPARTMENT OF VETERANS AFFAIRS, FISCAL YEAR 1997

                                 ______


                               speech of

                         HON. KAREN L. THURMAN

                               of florida

                    in the house of representatives

                         Tuesday, June 4, 1996

  Mr. THURMAN. Mr. Speaker, I rise today in support of the 
authorization of major facility projects and major medical facility 
leases for Department of Veterans Affairs, fiscal year 1997 (H.R. 
3376).
  Channeling funds to modernize and renovate existing VA medical 
facilities is good policy. Furthermore, I firmly believe that the VA 
should employ strategic planning tools when allocating resources to VA 
facilities. However, I must point out that, if Congress does not compel 
the VA to enact the plan outlined in this bill, it simply becomes 
another ineffectual study. The bill before us today does not go far 
enough. H.R. 3376 requires the VA to develop a 5-year strategic plan 
for its health care system without compelling them to enact it.
  For years, the VA has studied the problem of resource allocation and, 
accordingly, developed the Resource Planning and Management [RPM] 
system. The aim of the RPM was to better allocate resources among its 
medical facilities across the country. The RPM system classifies each 
patient into a clinical care group, calculates average facility costs 
per patient, and forecasts future workload. While the aim of the 1994 
measure was on target, the

[[Page E1015]]

results continue to be unsatisfactory. According to the GAO (March 19, 
1996), ``* * * although RPM lets VA identify inequities in resource 
distribution, VA has, so far, chosen not to use the system, to help 
ensure that resources are distributed more equitably.''
  In an April 13 interview with Florida Today, Department of Veterans 
Affairs Under Secretary for Health Kenneth Kizer admitted what the 
veterans in Florida, Georgia, Arizona, Nevada, North Carolina, 
Virginia, Washington, South Carolina, New Mexico, Hawaii, Alaska, New 
Hampshire, Colorado, Maine, and Vermont already know. In commenting 
about the current state of the VA health care system, Kizer observed, 
``Are resources equitably allocated in the VA now? The answer is no.''
  The facts speak for themselves. For example, between 1980 and 1990, 
my home State of Florida experienced an explosion of growth in its 
veterans population--a net increase of almost 350,000 veterans, or 96 
veterans per day. In contrast, between 1985 and 1990, the VA's budget 
allocation in the southern region--which includes Florida--showed no 
increase.
  Some States carry an unfair financial burden. While some may disagree 
about the cause of the veterans influx into various States, many agree, 
and the facts support, that some States shoulder the burden more than 
others. During debate of the fiscal year 1996 VA-HUD-independent 
agencies appropriations, Representative Lewis of California also agreed 
and stated, in our colloquy on the House floor, that the committee 
``has long been concerned abut the VA's resource methodology,'' and he 
recognized that there was an ``uneven access to VA care.''
  In March, Senators Graham and McCain attempted to address this 
problem by offering an amendment to the fiscal year 1996 omnibus 
appropriations bill (H.R. 3019) which called for more equitable 
distribution of money based on where veterans live when they receive 
care. Unfortunately, this provision was stripped from H.R. 3019 in 
conference.
  Requiring the VA to develop a plan to reallocate resources makes good 
sense--which is why I support H.R. 3376. Nevertheless, it does not go 
far enough. Congress needs to do more than ask for additional resource 
reallocation plans and, instead, compel the VA to implement those in 
which they have already invested. That is why on April 25 I introduced 
legislation (H.R. 3346) which would require the VA to develop a plan to 
link the allocation of its resources to facility workloads. This 
measure would require the VA to operate within the new 22 veterans 
integrated service networks [VISNs] and based on the RPM system--in 
which the VA has already invested a great deal of time and money. 
Moreover, H.R. 3346 would require the Secretary to implement the plan 
within 60 days of submitting it to Congress.
  While the provisions in H.R. 3376 relating to resource allocation 
differ slightly from H.R. 3346, they are certainly a movement in the 
right direction. But, I urge Congress to go wholeheartedly in that 
direction and give our Nation's veterans the health care they deserve. 
Addressing the chronic under-funding and fiscal inequities which exists 
in veterans' health care should be one of our utmost responsibilities.

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