[Congressional Record Volume 148, Number 140 (Monday, October 28, 2002)]
[Senate]
[Pages S10797-S10798]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  VETERANS LONG-TERM CARE AND MEDICAL PROGRAMS ENHANCEMENT ACT OF 2002

 Mr. ROCKEFELLER. Mr. President, I am sincerely disappointed 
about the placing of an anonymous hold on S. 2043, the ``Veterans Long-
Term Care and Medical Programs Enhancement Act of 2002.''
  There is no apparent reason why this important piece of legislation 
should be held up at this time. It was developed in a bipartisan manner 
and encompasses many vital pieces of legislation from both sides of the 
aisle. It is my sincere hope that the Senator responsible for this hold 
will realize that this is certainly not the time to be playing politics 
with legislation that affects our Nation's veterans.
  I would like to share with my colleagues some of the key provisions 
of S. 2043 that seek to improve the accessibility and quality of the VA 
health care system.
  The centerpiece of this bill is an effort to make VA's prescription 
drug copayment policy a bit more equitable for lower-income veterans. 
Mr. President, currently, veterans with incomes of less than $24,000 a 
year are exempt from copayments for most VA health care services. 
However, when it comes to prescription drugs, the income threshold for 
exemption is about $9,000 a year. This bill would raise the exemption 
level for prescription copayments to make them the same as other VA 
health care copayments.

[[Page S10798]]

  Veterans earning just over $9,000--which is well below the poverty 
threshold, are required to make prescription copayments. These 
copayments place an enormous financial burden on our poorest veterans. 
To compound this problem, earlier this year, the Department of Veterans 
Affairs increased the copayment for prescription drugs from $2 to $7 
per 30-day prescription.
  Most of the veterans who will benefit from this provision are older, 
are on fixed incomes, and are on many different medications, each 
requiring a separate copayment. Most of them have no health insurance 
except for Medicare and so they must depend upon the VA for their 
medications. With the lack of a Medicare drug benefit, these veterans 
are now faced with a 350 percent increase in what they must pay for 
life-sustaining medications.
  Imagine the situation of a veteran with an income of about $10,000 a 
year who takes ten medications a month and it is not at all unusual for 
an elderly person to take that many medications. With the increase in 
the prescription copayment rate, that veteran now has to allocate over 
8 percent of this annual income just to pay for prescription drugs. And 
although the $7 per prescription charge may seem like an insignificant 
amount to some, I can assure my colleagues that to the veteran and his 
family living on a very limited income, it is quite significant.
  Of particular note, S. 2043 also contains mental health care 
provisions--a key element of caring for those who have served on the 
battlefield--that would ensure currently successful programs across the 
country continue to get necessity funding. Congress previously enacted 
a provision to designate $15 million in VA funding specifically to help 
medical facilities improve care for veterans with substance abuse 
disorders and PTSD. The funds for these mental health grant programs, 
mandated by the Veterans Millennium Benefits and Health Care Act of 
1999, will soon revert to a general fund.
  Despite the slow start, this funding has already increased the PTSD 
and substance abuse disorder treatment programs available to veterans. 
More than 100 staff have been hired in 18 of VA's 21 service networks 
to treat substance abuse disorders. Nine new programs--in Baltimore, 
Maryland; Atlanta, Georgia; San Francisco, California; and Dayton, Ohio 
among others--have initiated or intensified opioid substitution 
programs for veterans who have not responded well to drug-free 
treatment regimens. Other new programs, such as those in Tampa, FL; 
Cincinnati, OH; Columbia, MO; and Loma Linda, CA put special emphasis 
on treating veterans with more complex conditions that include PTSD and 
substance abuse. The additional funding has enabled VA to develop 
better outpatient substance abuse and PTSD treatment programs, 
outpatient dual-diagnosis programs, more PTSD community clinical teams, 
and more residential substance abuse disorder rehabilitation programs. 
The legislation being blocked in the Senate would ensure that this 
funding remained ``protected'' for three more years, and would increase 
the total amount of funding identified specifically for treatment of 
substance abuse disorders and PTSD from $15 million to $25 million.
  Additionally, the bill contains authorization for four construction 
projects. Two of these projects are much-needed seismic corrections for 
VA Medical Centers in the state of California. I think all of my 
colleagues would agree that no veteran should ever be endangered by 
aging infrastructure while in the care of VA should a natural disaster, 
such as an earthquake, occur. I thank Senator Boxer for her leadership 
on the construction issue. The remaining two construction projects in 
S. 2043 are for nursing homes. One of these homes is in Beckley, WV, of 
which the design plans have already been made. I am proud to be 
involved in helping to bring a long-term care facility to the veterans 
of my home State who have been in need of such a home for quite some 
time now. The other nursing home project is in Lebanon, PA.
  S. 2043 would also fix a longstanding problem faced by VA's retired 
nurses. Last December, Congress passed the Department of Veterans 
Affairs Health Care Programs Enhancement Act of 2001. Enacted as Public 
Law 107-135, this legislation gave VA several tools to respond to the 
looming nurse crisis. In addition, it altered how part-time service 
performed by certain title 38 employees would be considered when 
granting retirement credit.
  Previously, the law required that title 38 employees' part-time 
services prior to April 7, 1986, be prorated when calculating 
retirement annuities, resulting in lower annuities for these employees. 
Section 132 of the VA Health Programs Enhancement Act was intended to 
exempt all previously retired registered nurses, physician assistants, 
and expanded-function dental auxiliaries from this requirement. 
However, the Office of Personnel Management has interpreted this 
provision to only apply to those health care professionals who retire 
after its enactment date.
  The legislation being blocked in the Senate would require OPM to 
comply with the original intent of the VA Health Programs Enhancement 
Act, and therefore to recalculate the annuities for these retired 
health care professionals. This clarification would not extend 
retirement benefits retroactively to the date of retirement, but would 
ensure that annuities are calculated fairly from now on for eligible 
employees who retired between April 7, 1986, and January 23, 2002.
  Mr. President, the legislation would also provide transfer rights for 
hourly rate Veterans Canteen Service, VCS, employees to title 5 VA 
positions through internal competitive procedures. VCS hourly employees 
are federal employees hired under the authority of 38 U.S.C. 7802. 
While this authority provides many of the same benefits that title 5 
federal employees enjoy, (i.e., workers compensation, health benefits, 
retirement, and veterans preference) there are benefits to which they 
are not entitled. For example, VCS hourly employees do not have the 
same transfer rights to other VA positions that VCS managers have.
  As a result, VCS hourly employees applying for VA food service 
positions, VA housekeeping positions, and other VA positions--positions 
for which they are well qualified--are not treated as internal 
competitive service candidates. Their years of service are irrelevant, 
as they cannot easily transfer to another job at VA without first going 
through civil service competitions. This legislation would change that 
and allow them to compete equally with other VA candidates. I wish to 
thank the American Federation of Government Employees for bringing this 
issue to my attention and for the assistance and leadership that they 
provided.
  S. 2043 will help thousands of veterans across America, in a variety 
of ways. We cannot turn our backs on those who have sacrificed so much 
for this country. I strongly urge my colleagues to support this 
legislation.

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