[House Report 106-1041]
[From the U.S. Government Publishing Office]
Union Calendar No. 603
106th Congress, 2d Session - - - - - - - - House Report 106-1041
ACTIVITIES REPORT
of the
COMMITTEE ON VETERANS' AFFAIRS
HOUSE OF REPRESENTATIVES
ONE HUNDRED SIXTH CONGRESS
__________
first session
Convened January 6, 1999
Adjourned November 22, 1999
second session
Convened January 24, 2000
Adjourned December 15, 2000
January 2, 2001--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
__________
U.S. GOVERNMENT PRINTING OFFICE
89-006 WASHINGTON : 2001
COMMITTEE ON VETERANS' AFFAIRS
BOB STUMP, Arizona, Chairman
CHRISTOPHER H. SMITH, New Jersey LANE EVANS, Illinois
MICHAEL BILIRAKIS, Florida BOB FILNER, California
FLOYD SPENCE, South Carolina LUIS V. GUTIERREZ, Illinois
TERRY EVERETT, Alabama CORRINE BROWN, Florida
STEVE BUYER, Indiana MICHAEL F. DOYLE, Pennsylvania
JACK QUINN, New York COLLIN C. PETERSON, Minnesota
CLIFF STEARNS, Florida JULIA CARSON, Indiana
JERRY MORAN, Kansas SILVESTRE REYES, Texas
J.D. HAYWORTH, Arizona VIC SNYDER, Arkansas
HELEN CHENOWETH-HAGE, Idaho CIRO D. RODRIGUEZ, Texas
RAY La HOOD, Illinois RONNIE SHOWS, Mississippi
JAMES V. HANSEN, Utah SHELLEY BERKLEY, Nevada
HOWARD P. (BUCK) McKEON, California BARON P. HILL, Indiana
JIM GIBBONS, Nevada TOM UDALL, New Mexico
MICHAEL K. SIMPSON, Idaho
RICHARD H. BAKER, Louisiana
Carl D. Commenator, Chief Counsel and Staff Director
__________
SUBCOMMITTEE ON HEALTH
CLIFF STEARNS, Florida, Chairman
CHRISTOPHER H. SMITH, New Jersey LUIS V. GUTIERREZ, Illinois
MICHAEL BILIRAKIS, Florida MICHAEL F. DOYLE, Pennsylvania
JERRY MORAN, Kansas COLLIN C. PETERSON, Minnesota
HELEN CHENOWETH-HAGE, Idaho JULIA CARSON, Indiana
HOWARD P. (BUCK) McKEON, California VIC SNYDER, Arkansas
MICHAEL K. SIMPSON, Idaho CIRO D. RODRIGUEZ, Texas
RICHARD H. BAKER, Louisiana RONNIE SHOWS, Mississippi
__________
SUBCOMMITTEE ON BENEFITS
JACK QUINN, New York, Chairman
J.D. HAYWORTH, Arizona BOB FILNER, California
RAY La HOOD, Illinois SILVESTRE REYES, Texas
JAMES V. HANSEN, Utah SHELLEY BERKLEY, Nevada
JIM GIBBONS, Nevada LANE EVANS, Illinois
__________
SUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS
TERRY EVERETT, Alabama, Chairman
BOB STUMP, Arizona CORRINE BROWN, Florida
FLOYD SPENCE, South Carolina BARON P. HILL, Indiana
STEVE BUYER, Indiana TOM UDALL, New Mexico
(ii)
?
Committee Staff
Carl D. Commenator, Chief Counsel and Staff Director
Patrick E. Ryan, Deputy Chief Counsel
Kingston E. Smith, General Counsel and Staff Director, Subcommittee on
Oversight and Investigations
Daniel G. Amon, Press Secretary
John M. Bradley, Staff Director, Subcommittee on Health
Bernadine Dotson, Staff Assistant
Charles M. Durishin, Democratic Staff Director
Susan C. Edgerton, Democratic Staff Director, Subcommittee on Health
Ann Hendricks, Staff Assistant, Subcommittee on Oversight and
Investigations
William T. Houchins, Democratic Professional Staff Member
Darryl W. Kehrer, Staff Director, Subcommittee on Benefits
Elizabeth A. Kilker, Democratic Executive Assistant, Subcommittee on
Benefits
Steve Kirkland, Systems Administrator
Alicemary O. Leach, Investigative Counsel, Subcommittee on Oversight
and Investigations
Mary Ellen Mc Carthy, Democratic Professional Staff Member
Sandra K. McClellan, Democratic Executive Assistant, Subcommittee on
Health
Mary Stevens McDermott, Administrative and Financial Assistant
Paige E. McManus, Professional Staff Member, Subcommittee on Benefits
Jeanne M. McNally, Legislative Coordinator
Thomas A. O'Donnell, Democratic Professional Staff Member
Juliana B. Perry, Staff Assistant
Sarah A. Shigley, Professional Staff Member, Subcommittee on Health
Deborah A. Smith, Democratic Administrative Assistant/Executive
Assistant, Subcommittee Oversight and Investigations
Jeremiah B. Tan, Printing Clerk
Arthur K. Wu, Professional Staff Member, Subcommittee on Oversight and
Investigations
(iii)
LETTER OF SUBMITTAL
----------
House of Representatives,
Committee on Veterans' Affairs,
Washington, DC, January 2, 2001
Hon. Jeff Trandahl,
Clerk, House of Representatives,
Washington, D.C.
Dear Mr. Trandahl:
In accordance with Clause 1(d) of Rule XI of the Rules of
the House of Representatives, I submit herewith the report of
the Committee on Veterans' Affairs setting forth its activities
in reviewing and studying the application, administration, and
execution of those laws, the subject matter of which is within
the jurisdiction of our committee.
Bob Stump,
Chairman
FOREWORD
----------
The 106th Congress made far-reaching improvements to the
benefit programs serving our Nation's 24 million veterans. An
increased focus on meeting veterans' requests for authorized
benefits and services resulted in record numbers of veterans
drawing disability compensation or using the VA health care
system. Looking toward the future, Congress initiated laws
authorizing an expansion of VA's long-term health care system
and making the Montgomery GI Bill (MGIB) educational assistance
program more meaningful to entitled veterans seeking broader
knowledge or advanced skills. Although much remains to be done,
the American people can take pride that important issues have
been identified and addressed by the 106th Congress, and that
the groundwork has been laid for even greater progress in
future Congresses.
Almost as important as the design and authorization of
programs is the need to examine them and provide the necessary
resources to ensure that veterans are served as the Congress
intended. While continuing the vigorous oversight that it began
by establishing the Subcommittee on Oversight and
Investigations in the 105th Congress, the VA Committee in the
106th Congress took unprecedented action to advocate increased
funding for veterans programs.
At the beginning of the 106th Congress, the Administration
submitted a VA budget that proposed to fund veterans medical
care at the previous year's level. After examining the funding
needs and shortfalls in the Administration's budget, the VA
Committee recommended a $1.7 billion (9.6 percent) increase in
veterans medical care funding for fiscal year 2000 that the
Congress ultimately provided. In the second session, Congress
approved a further increase of $1.4 billion, so that budget
authority for veterans medical care increased by a total of
$3.1 billion from $17.8 to $20.9 billion. Outlays for spending
for disability compensation, educational assistance and other
benefit programs rose by more than $2.3 billion (10 percent)
during this Congress. Outlays for veterans medical care
spending are projected to rise by another $1.5 billion in
fiscal year 2001, for a three-year increase of $3.9 billion (22
percent). The increased spending will help to meet the
increased demand for VA health care by veterans with service-
connected disabilities and those who cannot afford to obtain
health care through other means. These amounts would also
provide funds requested to implement the health care expansions
authorized in the Veterans Millenium Health Care and Benefits
Act, Public Law 106-117.
The 106th Congress was also confronted with a VA health
care system that was attempting to shed its historic role as a
provider of long-term care at a time when World War II
veterans' demand for such care is expected to peak. Despite
significant improvements in delivering care on an ambulatory
basis, and despite its own pioneering work in caring for
chronically ill, elderly and disabled veterans, a long-awaited
federal advisory committee report on the future of VA long-term
care failed to address several of the major issues on access
and equity which the advisory committee had been charged to
study. As a result of the advisory committee's failure to
recommend how to establish priorities and reasonable cost-
sharing mechanisms, it fell to Congress to set out fundamental
principles for VA long-term care policy. It did so with the
enactment of the Veterans Millennium Health Care and Benefits
Act.
This Act:
Requires the Secretary of Veterans Affairs
to operate and maintain extended care programs, to
include geriatric evaluations, VA and community-based
nursing home care, domiciliary care, adult day health
care, respite care, and such alternatives to
institutional care as the Secretary considers
reasonable and appropriate.
Requires the Secretary of Veterans Affairs
to maintain nationally the level of ``in-house''
extended care services provided as of September 30,
1998.
Requires the Secretary of Veterans Affairs,
through 2003, to provide: (a) needed nursing home care
for veterans who are 70 percent service-connected or in
need of such care for a service-connected condition;
and (b) veterans who are enrolled for VA care with
alternatives to institutionalized care.
Requires the Secretary of Veterans Affairs
to establish a co-payment policy applicable to extended
care of more than 21 days in a year in the case of care
furnished to a veteran who has no compensable service-
connected disability, and whose income is above the
pension level.
Additionally, this Act contained a number of other health
care policy enhancements, benefit improvements, authorizations
and requirements. These provisions:
Authorize the Secretary of Veterans Affairs
to make payments for emergency care on behalf of
uninsured enrolled veterans and to require that a
veteran has received VA care within a two-year period
of a medical emergency to be eligible.
Establish a specific eligibility for VA
health care for a veteran who was awarded the Purple
Heart.
Establish a specific eligibility, subject to
the terms of a memorandum of understanding between the
Department of Defense and Department of Veterans
Affairs, for a veteran who has retired from military
service, is eligible for care under the TRICARE
program, and is not otherwise eligible for priority VA
care.
Require the Secretary of Veterans Affairs to
establish a mechanism for augmenting the provision of
specialized mental health services, with particular
emphasis on programs for the treatment of post-
traumatic stress disorder and substance-use disorder.
Authorize the Secretary of Veterans Affairs
to: (1) increase the $2 drug co-payment amount; (2)
establish a maximum annual and monthly payment
applicable to veterans with multiple outpatient
prescriptions; and (3) revise co-payments on outpatient
care for ``higher-income'' veterans.
Authorize the establishment of non-profit
corporations at any VA medical center to facilitate
education and training as well as research.
Revise the priority system for the award of
grants under the State home construction program to:
(1) provide a higher priority for renovation projects
than accorded under current law (with highest priority
for projects to remedy life-safety problems); and (2)
in the case of applications for bed-producing projects,
provide priority based on the relative need for adding
new beds (with higher priority to States with great
need vs. those with moderate or limited need, and
taking into account existing VA and community nursing
home beds).
Expand VA's authority to enter into
enhanced-use leases by: (1) authorizing VA to enter
into a long-term lease of property when that would
enable it to apply the proceeds of the lease to
demonstrably improve services in that geographic area;
(2) extending the duration of such a lease term for up
to 75 years; and (3) providing that funds from
enhanced-use leases shall be deposited in a new Health
Services Improvement Fund.
Authorize reprogramming to provide a
domiciliary in Orlando, Florida, using previously
appropriated funds and construction of a surgical
addition at the Kansas City, Missouri, VA Medical
Center; a long-term care facility at the Lebanon,
Pennsylvania, VA Medical Center; renovations at VA
medical centers in both Fargo, North Dakota, and
Atlanta, Georgia; and demolition of buildings at the
Leavenworth, Kansas, VA Medical Center.
Authorize leases of an outpatient clinic in
Lubbock, Texas, and of a research building in San
Diego, California.
Authorize the payment of dependency and
indemnity compensation to the surviving spouses of
certain former prisoners of war who were rated totally
disabled due to any service-connected cause for a
period of one or more years immediately prior to death.
Restore, following termination of a
remarriage, eligibility for CHAMPVA medical care,
education, and housing loans to surviving spouses who
lost eligibility for these benefits as the result of a
remarriage. These same spouses regained dependency and
indemnity compensation eligibility, but not these
related benefits, as the result of legislation enacted
in 1998.
Expand the fundraising authorities of the
American Battle Monuments Commission (ABMC) to expedite
the establishment of the World War II Memorial in the
District of Columbia and ensure that adequate funds are
available for the repair and long-term maintenance of
the Memorial. To assure that groundbreaking,
construction, and dedication of the Memorial are
completed on a timely basis, the ABMC would be
authorized to borrow up to $65 million from the U.S.
Treasury.
Direct the Secretary of Veterans Affairs to
obligate Advance Planning Funds during fiscal year 2000
to establish six additional national cemeteries for
veterans.
Extend authorization for VA and Department
of Labor programs which assist homeless veterans.
In the 2nd Session of the 106th Congress, the VA Committee
devised a plan in compliance with Congressional Budget Act
requirements to make a number of improvements in the
educational assistance programs (Montgomery GI Bill and the
Survivors' and Dependents' Educational Assistance program).
Major provisions of the Veterans Benefits and Health Care
Improvement Act of 2000 (Public Law 106-419) would:
Increase, effective November 1, 2000, the
All-Volunteer Force Educational Assistance Program
basic benefit (commonly referred to as the Montgomery
GI Bill or MGIB) to $650 per month for a three-year
period of service and $528 per month for a two-year
period of service.
Permit certain Post-Vietnam Era Veterans'
Educational Assistance program (VEAP) participants to
enroll in the Montgomery GI Bill program.
Permit servicemembers to ``buy up'' their
MGIB basic benefit by making an after-tax contribution
of up to $600 which would provide up to $5,400 in
additional benefits over 36 months of entitlement, or
an additional $150 per month.
Increase, effective November 1, 2000, the
basic educational allowance for survivors and
dependents to $588 per month, with annual cost-of-
living adjustments.
Allow monthly educational assistance
benefits to be paid between term, quarter, or semester
intervals of up to eight weeks.
Allow veterans', survivors' and dependents'
educational assistance to be used to pay for up to
$2,000 in fees for civilian occupational licensing or
certification examinations.
The Veterans Benefits and Health Care Improvement Act of
2000 would also:
Authorize annual ``national'' comparability
pay raises for VA nurses on par with that of other
federal employees.
Revise the annual nurses locality pay survey
process.
Provide for nurse participation in policy
and decision-making at network and medical center
levels.
Revise and increase rates of special pay
provided to dentists employed by the Veterans Health
Administration.
Authorize increased salaries for VA
pharmacists and increase the role of physician
assistants on all matters relating to employment and
utilization of physician assistants within VA.
Require that VA enter into a contract with
an appropriate entity to carry out a new study on post-
traumatic stress disorder independent of VA, to follow
up the study conducted under section 102 of Public Law
98-160.
Authorize VA to furnish veterans and others
accompanying veterans with temporary lodging (such as
``Fisher Houses'') in connection with treatment or
other services.
Provide for transfer of land at four current
or former VA medical centers (Allen Park, Michigan;
Fort Lyon, Colorado; Dublin, Georgia; and Miles City,
Montana) to local authorities or land owners for
redevelopment.
Provide that a stroke or heart attack that
is incurred or aggravated during inactive duty training
by a member of a reserve component in the performance
of duty while performing inactive duty training shall
be considered to be service-connected for purposes of
benefits under laws administered by the Secretary of
Veterans Affairs.
Make women veterans eligible for special
monthly compensation due to the service-connected loss
of one or both breasts, including loss by mastectomy.
Increase the amount of resources an
incompetent veteran with no dependents being provided
institutional care without charge by VA or a state may
retain and still qualify for payment of benefits, from
$1,500 to five times the benefit amount payable to a
service-disabled veteran.
Increase the maximum amount of coverage
available through the Servicemembers' Group Life
Insurance program and the Veterans' Group Life
Insurance program from $200,000 to $250,000.
Add recently separated veterans (veterans
who have been discharged or released from active duty
within a one-year period) to the definition of veterans
to whom federal contractors and subcontractors must
extend affirmative action to employ and advance.
Extend eligibility for benefits normally
provided only to veterans of the United States armed
forces to Philippine Commonwealth Army veterans who
reside in the United States who have either become
citizens of the United States or have been lawfully
admitted for permanent residence in the United States.
Provide health care, vocational training,
and monetary allowances to the children of women
Vietnam veterans who suffer from certain birth defects.
The VA Committee has a long tradition of actively
overseeing the programs which it authorizes and obtaining the
views of affected veterans and their representatives on needed
legislative changes. During the 106th Congress, it became
apparent that a line of decisions by the United States Court of
Appeals for Veterans Claims was resulting in fundamental
changes to the informal nature of the system for adjudicating
claims for veterans benefits. Although the Department of
Veterans Affairs proposed to address the issues raised by this
line of decisions through a regulatory proposal, the VA
Committee decided that a legislative pronouncement would
provide a more acceptable solution.
Following public hearings and meetings with veterans
service organization representatives and VA officials, the
leadership of the VA Committee introduced H.R. 4864, a bill
entitled the ``Veterans Claims Assistance Act of 2000''. A
compromise version of this measure was considered and adopted
by both the House and Senate at the close of the 106th Congress
(Public Law 106-475). In brief, the Act would require the
Secretary of Veterans Affairs to make reasonable efforts to
assist veterans in obtaining evidence and information needed to
substantiate their claims for benefits. A veteran would still
have the responsibility to present and support a claim for
benefits with information or evidence in the veteran's
possession or which the Secretary determines the veteran should
obtain. However, the Secretary would be required to obtain
relevant information in the government's possession and to
provide a medical opinion or examination in certain
circumstances.
The VA Committee's Ranking Minority Member during the 106th
Congress was the Honorable Lane Evans. I wish to thank him for
his leadership and bipartisan cooperation in accomplishing our
objectives in both sessions. I also wish to thank the
subcommittee chairmen and ranking minority members for their
essential legislative and oversight activities. Our
subcommittee leaders were: for the Subcommittee on Health, the
Honorable Cliff Stearns, Chairman, and the Honorable Luis
Gutierrez, Ranking Minority Member; for the Subcommittee on
Benefits, the Honorable Jack Quinn, Chairman, and the Honorable
Bob Filner, Ranking Minority Member; and for the Subcommittee
on Oversight and Investigations, the Honorable Terry Everett,
Chairman, and the Honorable Corrine Brown, Ranking Minority
Member.
During the 106th Congress, the House and Senate Committees
on Veterans' Affairs continued their long tradition of working
together on behalf of veterans. We added the important
provisions described above to the body of veterans law.
Therefore, I thank our Senate Committee on Veterans' Affairs
counterparts, the Honorable Alan Specter, Chairman, and the
Honorable John D. Rockefeller, Ranking Minority Member, for
their hard work on so much legislation.
I also appreciate the yeoman's work the Committee staff has
done in ensuring smooth day-to-day operations and effective
support for Members.
Having the opportunity to help fulfill America's obligation
to the courageous men and women who served in the Armed Forces
was truly a special privilege for me. As Chairman of the House
Committee on Veterans' Affairs, I endeavored to uphold the VA
Committee's tradition of bipartisan accomplishment on behalf of
veterans. While new rules adopted in 1994 limited my tenure as
chairman to six years, I believe we made significant progress
on many fronts. Everyone involved with the legislative process
can be proud of the success we had, including but not limited
to, the veterans service organizations, Members of Congress who
introduced legislation affecting veterans benefits, Department
of Veterans Affairs officials, various VA employee groups and
representatives, and individual veterans who took the time to
contact the Committee and Members' offices about their
concerns.
Bob Stump,
Chairman
C O N T E N T S
----------
Page
Jurisdiction of the House Committee on Veterans' Affairs......... 1
Veterans programs:
Department of Veterans Affairs............................... 2
Veterans Health Administration........................... 3
Medical care......................................... 3
Medical and prosthetic research...................... 4
Veterans Benefits Administration......................... 5
Compensation and pension............................. 5
Insurance............................................ 5
Education............................................ 6
Home loan assistance................................. 6
State cemetery grants program........................ 6
National Cemetery Administration......................... 6
Department of Labor.......................................... 7
American Battle Monuments Commission......................... 8
Messages from the President and other Executive Branch
communications................................................. 10
Summary of action by the Committee on Veterans' Affairs.......... 21
Hearings and Executive Sessions.................................. 23
Legislation enacted into law:
Public Law 106-83............................................ 29
Public Law 106-117........................................... 29
Public Law 106-118........................................... 35
Public Law 106-142........................................... 40
Public Law 106-413........................................... 40
Public Law 106-419........................................... 41
Public Law 106-475........................................... 47
Activities of the subcommittees:
Subcommittee on Health....................................... 49
Subcommittee on Benefits..................................... 58
Subcommittee on Oversight and Investigations................. 66
Committee web site............................................... 81
Oversight Plan for 106th Congress................................ 83
Subcommittee on Health....................................... 83
Subcommittee on Benefits..................................... 86
Subcommittee on Oversight and Investigations................. 88
Report on the budget for fiscal year 2000........................ 92
Report on the budget for fiscal year 2001........................ 129
Statistical data--war veterans and dependents.................... 137
Calendar No. 603
106th Congress Report
HOUSE OF REPRESENTATIVES
2d Session 106-1041
======================================================================
ACTIVITIES OF THE COMMITTEE ON VETERANS' AFFAIRS FOR THE 106TH CONGRESS
_______
January 2, 2001--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Stump, from the Committee on Veterans' Affairs, pursuant to Clause
1(d) of Rule XI, submitted the following
R E P O R T
Jurisdiction
Rule X of the Rules of the House of Representatives
establishes the standing committees of the House and their
jurisdiction. Under that rule, all bills, resolutions, and
other matters relating to the subjects within the jurisdiction
of any standing committee shall be referred to such committee.
Clause 1(r) of Rule X establishes the jurisdiction of the
Committee on Veterans' Affairs as follows:
(1) Veterans' measures generally.
(2) Cemeteries of the United States in which veterans
of any war or conflict are or may be buried, whether in
the United States or abroad (except cemeteries
administered by the Secretary of the Interior).
(3) Compensation, vocational rehabilitation, and
education of veterans.
(4) Life insurance issued by the Government on
account of service in the Armed Forces.
(5) Pensions of all the wars of the United States,
general and special.
(6) Readjustment of servicemen to civil life.
(7) Soldiers' and sailors' civil relief.
(8)Veterans' hospitals, medical care, and treatment
of veterans.
This Committee was established January 2, 1947, as a part
of the Legislative Reorganization Act of 1946 (60 Stat. 812),
and was vested with jurisdiction formerly exercised by the
Committee on World War Veterans' Legislation, Invalid Pensions,
and Pensions. Jurisdiction over veterans' cemeteries
administered by the Department of Defense was transferred from
the Committee on Interior and Insular Affairs on October 20,
1967, by H. Res. 241, 90th Congress.
Veterans Programs
DEPARTMENT OF VETERANS AFFAIRS
President Herbert Hoover issued an executive order on July
21, 1930 creating the Veterans Administration. At that time, VA
had 54 hospitals and 31,600 employees. There were 4.7 million
veterans. President Ronald Reagan signed legislation on October
25, 1988 creating the Department of Veterans Affairs (VA),
which assumed responsibility from the Veterans Administration
for the mission of providing federal benefits to veterans and
their dependents.
VA carries out its missions nationwide in three
administrations. The Veterans Health Administration (VHA) is
responsible for veterans' health care programs. The Veterans
Benefits Administration (VBA) is responsible for the
compensation, pension, vocational rehabilitation, education
assistance, home loan guaranty and insurance programs. The
National Cemetery Administration (NCA) is responsible for all
national cemeteries, except Arlington National Cemetery. A
Board of Veterans' Appeals (BVA) provides final decisions for
the Secretary on appeals of veterans benefits claims.
As of September 30, 2000, VA had 219,547 employees. Among
all the departments and agencies of the federal government,
only the Department of Defense has a larger work force. Of the
total number of VA employees, the Veterans Health
Administration has 198,941, the Veterans Benefits
Administration has 11,932, the National Cemetery System has
1,458, and the Veterans Canteen Service has 3,285. The
remaining 3,931 employees are in various staff offices. About
27 percent of VA's employees are veterans, which makes VA a
leading employer of veterans. Since the formation of the
Department, the Secretaries of Veterans Affairs have been: Hon.
Edward J. Derwinski, 1989-1992; Hon. Jesse Brown, 1993-1997;
and Hon. Togo D. West, Jr. 1998-2000.
In its current five-year strategic plan issued September
29, 2000, VA's vision for the future is stated as follows:
As the Department of Veterans Affairs heads into the
21st century, we will strive to meet the needs of the
Nation's veterans and their families today and
tomorrow. We will become an even more veteran-focused
organization, functioning as a single, comprehensive
provider of seamless service to the men and women who
have served our Nation. We will continuously benchmark
the quality and delivery of our service with the best
in business and use innovative means and high
technology to deliver world-class service. We will
foster partnerships with veterans organizations and
other stakeholders making them part of the
decisionmaking process. We will cultivate a dedicated
VA workforce of highly skilled employees who
understand, believe in, and take pride in our vitally
important mission.
The veteran population was approximately 24.4 million on
July 1, 2000. About 76 of every 100 veterans served during
defined periods of armed hostilities. Altogether, approximately
70 million veterans, dependents and survivors of deceased
veterans--more than one-fourth of the nation's population--are
potentially eligible for VA benefits and services.
Veterans Health Administration
VA's largest and most visible component is its direct
health care system. The system today has 174 medical centers,
with at least one in each of the 48 contiguous states, Puerto
Rico, and the District of Columbia, and with small VA inpatient
bed complements in Alaska and Hawaii at military treatment
facilities. In recent years, a concerted effort has been made
to move veterans health care away from the traditional ``bricks
and mortar'' approach to health care. Accordingly, only one new
VA hospital--in West Palm Beach, Florida--has been constructed
since the mid-1990s.
In addition to its medical centers, VA now operates 599
community-based outpatient clinics, with more than 100 new ones
in various stages of planning. Efforts to streamline and
simplify care and to revise facility missions accordingly have
led to integration of a number of medical centers in common
proximity. Twenty-six ``systems of care'' (several medical
centers and clinics under one management group) have been
organized from 54 of these VA medical centers and their
clinics. With the advent of VA's ``Capital Assets Realignment
for Enhanced Services'' (CARES) initiative, the Committee
expects restructuring and reorienting of VA health systems to
continue unabated, improving veterans' access by making VA more
convenient to veterans and by promoting more efficient health
care services.
Medical Care
In 1999, with less than 25,000 average operating acute
hospital beds VA treated 662,574 inpatients, 89,217 veterans in
nursing home care units or in community nursing facilities, and
21,371 veterans in home and other community care programs. VA's
outpatient clinics registered nearly 37 million visits by
veterans in 1999. Altogether, 3.61 million veterans received
care under VA auspices in 1999.
Across the nation, VA is currently affiliated with 107
medical schools, 55 dental schools, and over 1,000 other
schools offering students allied and associated education
degrees or certificates in 40 health professions disciplines.
More than one-half of all practicing physicians in the United
States receive at least part of their clinical educational
experiences in the VA health care system. In 1999,
approximately 90,000 health care professionals received
training in VA medical centers.
Since 1979, through its Readjustment Counseling Service, VA
has operated Vietnam Veteran Outreach Centers (Vet Centers)
that provide readjustment counseling services to Vietnam-era
veterans. After the experience of the Persian Gulf War, and
reflecting on the aftermath of Vietnam, Congress extended
eligibility for Vet Center counseling to Gulf War veterans and
to veterans who served during other periods of U.S. armed
forces action following the Vietnam era, principally in
Lebanon, Grenada and Panama. Additionally, Public Law 104-262
expands eligibility for Vet Center counseling to combat
veterans of conflicts prior to the Vietnam era. However, Public
Law 106-117 establishes a deadline of January 1, 2004 for non-
theater, Vietnam-era veterans seeking VA readjustment
counseling.
Currently, there are 206 Vet Centers nationwide.
Approximately 1.5 million veterans have visited Vet Centers
since the program began. Counseling is provided for a variety
of reasons, including adjustment and employment problems,
domestic difficulties, and post-traumatic stress disorder
(PTSD). VA also conducts a variety of specialized programs
including compensated work therapy to provide veterans with job
skills and training and rehabilitative residencies to assist
homeless veterans. Both substance-use disorder rehabilitation
and PTSD outreach programs continue to be expanded.
In operating its health care facilities, VA benefits from
the contributions of time and energy of volunteers from all
walks of life. More than 104,000 volunteers through VA's
Voluntary Service donate more than 13 million hours of service
each year to bring companionship, comfort and concern to
hospitalized veterans and the millions of veterans who utilize
VA outpatient clinics.
Medical and Prosthetic Research
In concert with operating a nationwide health care system,
VA carries out an extensive array of research targeted to the
special needs of veterans but relevant as well to defining the
medical standard of care in general. Among VA's major emphases
are research into aging, chronic diseases, mental illnesses,
substance-use disorders, sensory losses, and trauma-related
illnesses. Its research programs are nationally recognized and
have made important contributions in virtually every area of
medicine and health.
Historically, VA researchers played key roles in innovating
and improving artificial limbs, eradicating tuberculosis, and
in developing the cardiac pacemaker, the Computerized
Tomographic (CT) scanner and magnetic resonance imager (MRI).
The first kidney transplant in the United States was performed
at a VA medical facility, and VA researchers pioneered the
first successful drug treatments for high blood pressure and
schizophrenia. The ``Seattle Foot'' was created by a VA
researcher to give below-the-knee amputees the adaptive ability
to walk, run and even jump. VA contributions to medical
knowledge have won VA scientists many prestigious awards,
including six Lasker Awards and three Nobel Prizes.
Advances by VA researchers in the past two years include
findings from several major clinical trials. One VA study found
that colon cancer screening with colonoscopy is more effective
than the more widely used sigmoidoscopy. Another found that
raising levels of high-density lipoproteins--so-called ``good
cholesterol''--lowers the risk of heart disease. Results of
another VA study may significantly reduce costs of treating
anemia in patients with kidney failure. A new VA study to be
conducted with the Department of Defense is testing a cognitive
behavioral treatment for post-traumatic stress disorder in
women veterans.
Also, VA researchers are assessing the prevalence of
amyotrophic lateral sclerosis (``Lou Gehrig's Disease'') among
Persian Gulf War veterans. Two other studies underway are
testing the effectiveness of treatments for fatigue, muscle and
joint pain, and memory and thinking problems reported by some
veterans of the Gulf War. VA scientists are also assessing a
vaccine for shingles, a painful skin infection that occurs in
over 500,000 Americans each year.
VA research has led to new strategies for treating chronic
pain and diabetes. VA scientists discovered new information
about the area of the brain that controls muscle movement,
offering hope for spinal cord injury and stroke care. VA
research has revealed the cause of narcolepsy. Other recent
advances by VA scientists include the identification of a
cellular pathway that may serve to help people with liver
diseases; the discovery of a gene that works as an ``on-off''
switch for insulin production; the development of more
effective AIDS drugs, including an international trial with
Canadian and British researchers, and the successful use of a
synthetic hormone to reverse the growth of kidney tumors.
Veterans Benefits Administration
The Veterans Benefits Administration (VBA) is responsible
for administering and delivering benefits and services to
eligible veterans and certain survivors and dependents. VBA
operates 57 regional offices throughout the United States,
Puerto Rico and the Republic of the Philippines. The regional
offices have been realigned into nine Service Delivery
Networks, which manage goals, performance measures, and share
responsibility for mission accomplishment within their
geographic area. VBA programs include disability compensation
and pension, education, life insurance, home loan guaranty, and
vocational rehabilitation and counseling.
Compensation and Pension
More than 2.6 million veterans receive disability
compensation or pension payments from VBA. Some 598,534
surviving spouses, children and parents of deceased veterans
are being paid survivor compensation or death pension benefits.
Their disability and death compensation and pension payments
were more than $20 billion for fiscal year 2000.
Insurance
VA operates one of the largest life insurance programs in
the world and the seventh largest in the United States. VA
administers seven life insurance programs under which 2.2
million policies with a value of $23.4 billion remained in
force at the end of fiscal year 1998. In addition, VA
supervises the Servicemembers' Group Life Insurance and
Veterans' Group Life Insurance programs, which provide some
$465 billion in insurance coverage to approximately 2.7 million
veterans and members of the uniformed services. The 2000 GI
life insurance dividend will return almost $712 million to more
than 1.8 million policyholders.
Education
Since 1944, when the first GI Bill became law, more than 20
million beneficiaries have participated in GI Bill education
and training programs. This includes 7.8 million World War II
veterans, 2.3 million Korean War veterans, and 8.2 million
post-Korean and Vietnam era veterans, and active duty
personnel. Proportionally, Vietnam era veterans were the
greatest participants in GI Bill training. Approximately 76
percent of those eligible took training, compared with 50.5
percent for World War II veterans and 48.4 percent for Korean
era veterans. The All-Volunteer Force Educational Assistance
Program provides benefits for veterans, service personnel, and
members of the Selected Reserve who train under the Montgomery
GI Bill. In fiscal year 2000, 265,940 veterans, 72,375 service
personnel and 71,300 reservists received those benefits. Since
the enactment of the Servicemen's Readjustment Act of 1944, the
cost of educational benefits has totaled more than $73 billion.
Home Loan Assistance
VA's loan guaranty program has benefited more than 16
million veterans and their dependents. From this program's
establishment as part of the original GI Bill in 1944 through
the end of fiscal year 1999, VA home loan guaranties totaled
more than $653 billion. In 2000, VA guaranteed 199,160 loans
valued at $23.3 billion and assisted 469 disabled veterans with
grants totaling more than $18.1 million for specially adapted
housing.
State Cemetery Grants Program
The Department of Veterans Affairs State Cemetery Grants
Program (SCGP) was established in 1978 to complement VA's
National Cemetery Administration. The program assists states in
providing gravesites for veterans in those areas where VA's
national cemeteries cannot fully satisfy their burial needs.
Grants may be used only for the purpose of establishing,
expanding, or improving veterans cemeteries that are owned and
operated by a state or U.S. territory. Aid can be granted only
to states or U.S. territories. VA cannot provide grants to
private organizations, counties, cities or other government
agencies.
During fiscal year 2000, the SCGP awarded seven new grants
and seven grant increases for a total amount of $20,251,638, a
record amount for one year. Currently, 27 states and
territories have been awarded grants through the SCGP.
Currently, states operate 42 cemeteries that the program has
assisted.
National Cemetery Administration
Since 1973, when VA assumed responsibility for the National
Cemetery Administration (NCA), 17 new cemeteries have been
established. Today the system comprises 119 cemeteries in 39
states and Puerto Rico. Of these, 61 have available, unassigned
gravesites for the burial of both casketed and cremated
remains; 31 will only accept cremated remains and the remains
of family members for interment in the same gravesite as a
previously deceased family member; and 27 will only perform
interments of family members in the same gravesite as a
previously deceased family member. Additionally, NCA oversees
33 soldiers' lots, monument sites and confederate cemeteries.
During the period 1997 to 2000, VA opened five new national
cemeteries: Tacoma National Cemetery in the Seattle/Tacoma,
Washington area; Saratoga National Cemetery, near Albany, New
York; Abraham Lincoln National Cemetery near Chicago, Illinois;
Dallas-Ft. Worth National Cemetery to serve veterans in north
and central Texas; and Ohio Western Reserve National Cemetery,
near Cleveland, Ohio. The opening of five new national
cemeteries within four years is unprecedented since the Civil
War.
In response to section 611(c) of the Veterans Millennium
Health Care and Benefits Act of 1999, Public Law 106-117, VA is
continuing to actively pursue the development of new cemeteries
in those metropolitan areas that are presently not served by a
national cemetery. VA has identified six areas for the
establishment of a new national cemetery. These areas are:
Atlanta, Georgia; Detroit, Michigan; Fort Sill, Oklahoma;
Miami, Florida; Pittsburgh, Pennsylvania; and Sacramento,
California.
As required by the Millennium Act of 1999, an independent
study will be conducted to identify the other geographic areas
with the greatest concentration of veterans whose burial needs
are not served by a national or state veterans cemetery, as
well as the number of additional cemeteries required through
2020. Interments in national cemeteries are expected to
increase from 82,700 in fiscal year 2000 to more than 117,000
in 2008.
Since July 30, 1973, total acreage in the National Cemetery
Administration has increased from 4,139 acres to over 13,000
acres. The number of occupied graves maintained is projected to
increase from 2,380,500 in fiscal year 2000 to over 2,998,100
in 2008. In fiscal year 2000, VA provided over 336,000
headstones and markers to mark the graves of veterans buried in
private, state veterans, military/post, and national
cemeteries.
DEPARTMENT OF LABOR
Veterans' Employment and Training Service
The Department of Labor (DOL) engages in a variety of
activities to assist veterans obtain a job or the training and
other employment development services they need to become
employable. In accordance with Chapter 41 of title 38, United
States Code, the highest priority is given to disabled veterans
and veterans of the Vietnam era.
The Assistant Secretary for Veterans' Employment and
Training (ASVET) is the principal advisor to the Secretary of
Labor regarding DOL policies and programs to meet the
employment and training needs of veterans, to protect the
reemployment rights of protected individuals in the uniformed
services, and to facilitate the transition of military
servicemembers to the civilian work force. The Office of the
ASVET, through the Veterans' Employment and Training Service
(VETS), administers grants to states and local government
entities primarily to support veterans' employment specialist
staffing, provides reemployment rights complaint investigation
and mediation services, formulates and implements interagency
agreements to ensure the seamless provision of services to
veterans, provides technical assistance and training to
veterans services providers' staff, monitors the performance of
state job service agencies for veterans, conducts pilot
projects to develop and test new approaches to serving
veterans, and conducts pilot projects for veterans' hiring by
public and private sector employers.
The field staff of the VETS is stationed in a nationwide
network of regional, state and area offices. There is at least
one VETS representative in every state and DOL Regional Office
(Boston, New York, Philadelphia, Atlanta, Chicago, Dallas,
Kansas City, Denver, San Francisco, and Seattle). Other than
the regional office staff, most VETS staff are located in state
job service agency offices.
The major activities and programs for veterans, Reservists,
National Guard members, and transitioners conducted by the
Office of the ASVET are: the Job Service and One Stop Service
Centers, the Disabled Veterans Outreach Program, the Transition
Assistance Program, Unemployment Compensation for Ex-
servicemembers, Veterans Affirmative Action, training under the
Job Training Partnership Act, Reemployment Rights, Veterans'
Preference and Federal Contractor Non-Compliance Complaints,
and the National Veterans' Training Institute.
AMERICAN BATTLE MONUMENTS COMMISSION
The American Battle Monuments Commission (ABMC), created by
an Act of Congress in 1923 (title 36, section 2102, U.S. Code)
is a federal agency responsible for the construction and
permanent maintenance of military cemeteries and memorials on
foreign soil, as well as for certain memorials in the United
States. Its principal functions are to commemorate, through the
erection and maintenance of suitable memorial shrines, the
sacrifices and achievements of the American armed forces where
they have served since April 6, 1917; to design, construct,
operate, and maintain permanent American military burial
grounds and memorials in foreign countries; to control the
design and construction on foreign soil of U.S. military
monuments and markers by other U.S. citizens and organizations,
both public and private; and to encourage U.S. governmental
agencies and private individuals and organizations to maintain
adequately the monuments and markers erected by them on foreign
soils.
In performance of these functions, ABMC administers,
operates and maintains 24 permanent American military cemetery
memorials and 52 monuments, memorials, markers and separate
chapels in fourteen foreign countries, the Commonwealth of the
Northern Mariana Islands, Gibraltar, and four memorials in the
United States. When directed by Congress, the Commission
develops and erects national military monuments in the United
States, such as the Korean War Veterans Memorial and the World
War II Memorial. ABMC also provides information and assistance,
on request, to relatives and friends of the war dead interred
or commemorated at its facilities.
Interred in the cemeteries are 124,914 U.S. war dead--750
from the Mexican War, 30,921 from World War I, and 93,243 from
World War II. Additionally, 6,573 American veterans and others
are interred in the Mexico City and Corozal cemeteries. The
Mexico City cemetery and those of the World Wars are closed to
future burials except for the remains of U.S. war dead yet to
be found in the battle areas of World Wars I and II. In
addition to burials at the cemeteries overseas, 94,132 U.S.
servicemembers of the World Wars, Korea, and Vietnam are
commemorated individually by name on the Tablets of the Missing
at cemetery memorials and at three memorials on U.S. soil.
MESSAGES FROM THE PRESIDENT AND EXECUTIVE COMMUNICATIONS
Feb. 2, 1999:
A letter from the Director, National Legislative
Commission, the American Legion, transmitting the proceedings
of the 79th National Convention of the American Legion, held in
Orlando, Florida from September 2, 3 and 4, 1997 as well as a
financial statement and independent audit, pursuant to 36
U.S.C. 49.
Feb. 2, 1999:
A letter from the Director, Office of Regulations
Management, Department of Veterans Affairs, transmitting the
Department's final rule--Additional Disability or Death Due to
Hospital Care, Medical or Surgical Treatment, Examination, or
Training and Rehabilitation Services (RIN: 2900-AJ04) Received
January 11, 1999, pursuant to 5 U.S.C. 801(a)(1)(A).
Feb. 9, 1999:
A communication from the President of the United States,
transmitting a report entitled the ``1999 National Drug Control
Strategy''
Feb. 23, 1999:
A letter from the Director, Office of Regulations
Management, Department of Veterans Affairs, transmitting the
Department's final rule--Board of Veterans' Appeals: Rules of
Practice Revision of Decisions on Grounds of C1ear and
Unmistakable Error (RIN: 2900-AJ15) Received January 20, 1999,
pursuant to 5 U.S.C. 801(a)(1)(A).
Mar. 3, 1999:
A letter from the Director, Office of Regulations
Management, Office of General Counsel, Department of Veterans
Affairs, transmitting the Department's final rule--Board of
Veterans' Appeals: Rules of Practice--Notification of
Representatives in Connection with Motions for Revision of
Decisions on Grounds of Clear and Unmistakable Error (RIN:
2900-AJ75) Received February 22, 1999, pursuant to 5 U.S.C.
801(a)(1)(A).
Apr. 19, 1999:
A letter from the Assistant Secretary of Defense, for
Health Affairs, Department of Defense, transmitting an annual
report to Congress on outreach to Gulf War veterans, revision
of Physical Evaluation Board criteria, and review of records
and reevaluation of the ratings of previously discharged Gulf
War veterans.
Apr. 20, 1999:
A letter from the General Counsel of the Department of
Defense, transmitting a draft of proposed legislation to
authorize appropriations for fiscal years 2000 and 2001 for
military activities of the Department of Defense, to prescribe
military personnel strengths for fiscal years 2000 and 2001,
and for other purposes.
May 3, 1999:
A letter from the Principal Deputy Assistant Secretary for
Congressional Affairs, Department of Veterans Affairs,
transmitting a draft of proposed legislation to amend title 38,
United States Code, to authorize VA to furnish the Department
of Defense with drug and alcohol treatment resources.
May 10, 1999:
A letter from the Director, Office of Regulations
Management, Department of Veterans Affairs, transmitting the
Department's final rule--Loan Guaranty: Requirements for
Interest Rate Reduction Refinancing Loans (RIN: 2900-A192)
Received April 21, 1999, pursuant to 5 U.S.C. 801(a)(1)(A).
May 10, 1999:
A letter from the Secretary of Labor, transmitting the
Uniformed Services Employment and Reemployment Rights Act of
1994 (USERRA) Annual Report to Congress for Fiscal Year 1998.
May 12, 1999:
A letter from the Principal Deputy Assistant Secretary for
Congressional Affairs, Department of Veterans Affairs,
transmitting a draR of proposed legislation to provide a
temporary authority for the use of voluntary separation
incentives by the Department of Veterans Affairs to reduce
employment levels, restructure staff, and for other purposes.
May 13, 1999:
A letter from the Director, Office of Regulations
Management, Department of Veterans Affairs, transmitting the
Department's final rule--Claims and Effective Dates for the
Award of Educational Assistance (RIN: 2900-AH76) Received May
4, 1999, pursuant to 5 U.S.C. 801 (a)(1)(A).
May 13, 1999:
A letter from the Director, Office of Regulations
Management (02D), Department of Veterans Affairs, transmitting
the Department's final rule--Estimated Economic Impact Due to
Implementation of Reasonable Charges--Received April 22, 1999,
pursuant to 5 U.S.C. 801(a)(1)(A).
June 7, 1999:
A letter from the Veterans Benefits Administration,
Veterans Affairs, transmitting the Department's final rule--
Reservists Education: Increase in Educational Assistance Rates
(RIN: 2900-AJ38) Received May 13, 1999, pursuant to 5 U.S.C.
801(a)(1)(A).
June 7, 1999:
A letter from the Secretary of Defense, transmitting a
report on the results of research conducted and the plan
addressing the health consequences of military service in the
Gulf War.
June 8, 1999:
A letter from the Principal Deputy Assistant Secretary for
Congressional Affairs, Department of Veterans Affairs,
transmitting a draft of proposed legislation to amend title 38,
United States Code, to authorize a cost-of-living adjustment in
the rates of disability compensation for veterans with service-
connected disabilities and dependency and indemnity
compensation for survivors of such veterans, to authorize
payment of these benefits at full rates for certain Filipinos
who reside in the United States, to make improvements in
veterans home loan guaranty programs, to make permanent certain
temporary authorities.
June 14, 1999:
A letter from the Director, Office of Regulations
Management, Veterans Benefits Administration, Department of
Veterans Affairs, transmitting the Department's final rule--
Service Connection of Dental Conditions for Treatment Purposes
(RIN: 2900-AH41) Received June 3, 1999, pursuant to 5 U.S.C 801
(a)(1)(A).
June 14, 1999:
A letter from the Director, Office of Regulations
Management, Veterans Benefits Administration, Department of
Veterans Affairs, transmitting Department's final rule--
Surviving spouse's benefit for month of veteran's death (RIN:
2900-AJ64) Received June 3, 1999, pursuant to 5 U.S.C.
801(a)(1)(A).
June 23, 1999:
A letter from the Director, Office of Regulations
Management, National Cemetery Administration, Department of
Veterans Affairs, transmitting the Department's final rule--
National Cemetery Administration; Title Changes (RIN: 2900-
AJ79) Received June 7. 1999, pursuant to 5 U.S.C. 801(a)(1)(A).
June 24, 1999:
A letter from the Director, Office of Regulations
Management, Veterans Benefits Administration, Department of
Veterans Affairs, transmitting the Department's final rule--
Schedule for Rating Disabilities; Diseases of the Ear and Other
Sense Organs (RIN: 2900-AF22) Received May 11, 1999, pursuant
to 5 U.S.C. 801 (a)(1)(A).
July 12, 1999:
A letter from the Director, Office of Regulations
Management, Department of Veterans Affairs, transmitting the
Department's final rule--VA Acquisition Regulation: Improper
Business Practices and Personal Conflicts of Interest and
Solicitation Provisions and Contract Clauses (RIN: 2900-AJ06)
Received June 1, 1999, pursuant to 5 U.S.C. 801(a)(1)(A).
July 12, 1999:
A letter from the Director, Office of Regulations
Management, Veterans Benefits, Department of Veterans Affairs,
transmitting the Department's final rule--Reinstatement of
Benefits Eligibility Based Upon Terminated Marital
Relationships (RIN: 2900-AJ53) Received June 7, 1999, pursuant
to 5 U.S.C. 801 (a)(1)(A).
July 12, 1999:
A letter from the Secretary of Health and Human Services,
transmitting a Memorandum which serves as the ``Implementation
Plan for Veterans Subvention''.
July 19, 1999:
A letter from the Director, Office of Regulations
Management, Department of Veterans Affairs, transmitting the
Department's final rule--Veterans Education: Increase in
Educational Assistance Rates (RIN: 2900-AJ37) Received June 14,
1999, pursuant to 5 U.S.C. 801(a)(1)(A).
July 29, 1999:
A letter from the Secretary of Education, Secretary of
Veterans Affairs, transmitting a report on the progress of
developing and implementing procedures for cancellations and
deferments of federal student loans for eligible disabled
veterans.
Aug. 3, 1999:
A letter from the Secretary of Veterans Affairs,
transmitting a response to the Report of the Congressional
Commission on Servicemembers and Veterans Transition
Assistance.
Aug. 4, 1999:
A letter from the Director, Office of Regulations
Management, Veterans Benefits Administration, Department of
Veterans Affairs, transmitting the Department's final rule--
Veterans Education: Effective Date for Reducing Educational
Assistance (RIN: 2900-AJ39) Received July 20, 1999, pursuant to
5 U.S.C. 801 (a)(1)(A).
Aug. 4, 1999:
A letter from the Director, Office of Regulations
Management, Department of Veterans Affairs, transmitting the
Department's final rule--VA Acquisition Regulation: Taxes (RIN:
2900-AJ32) Received July 13, 1999, pursuant to 5 U.S.C.
801(a)(1)(A).
Aug. 5, 1999:
A letter from the Director, Office of Regulations
Management, Veterans Benefits Administration, Department of
Veterans Affairs, transmitting the Department's final rule--
Pension Benefits (RIN: 2900-AJ50) Received June 21, 1999,
pursuant to 5 U.S.C. 801 (a)(1)(A).
Aug. 5, 1999:
A letter from the Director, Office of Regulations
Management, Veterans Benefits Administration, Department of
Veterans Affairs, transmitting the Department's final rule--
Direct Service Connection (Post-traumatic Stress Disorder)
(RIN: 2900-A197) Received June 21, 1999, pursuant to S U.S.C.
801(a)(1)(A).
Aug. 5, 1999:
A letter from the Director, Office of Regulations
Management, Department of Veterans Affairs, transmitting the
Department's final rule--VA Acquisition Regulation: Bonds and
Insurance (RIN: 2900-AJ47) Received July 27, 1999, pursuant to
5 U.S.C. 801 (a)(1)(A).
Aug. 5, 1999:
A letter from the Director, Office of Regulations
Management, Veterans Benefits Administration, Department of
Veterans Affairs, transmitting the Department's final rule--
Schedule for Rating Disabilities; Fibromyalgia (RIN: 2900-AH05)
Received June 17, 1999, pursuant to 5 U.S.C. 801(a)(1)(A).
Sept. 8, 1999:
A letter from the Director, Office of Regulations
Management, Veterans Health Administration, Department of
Veterans Affairs, transmitting the Department's final rule--
Reconsideration of Denied Claims (RIN: 2900-AJ03) Received
August 16, 1999, pursuant to 5 U.S.C. 801(a)(1)(A).
Sept. 8, 1999:
A letter from the Director, Office of Regulations
Management, Veterans Benefits Administration, Department of
Veterans Affairs, transmitting the Department's final rule--
Veterans Education: Increased Allowances for the Educational
Assistance Test Program (RIN: 2900-AJ40) Received August 16,
1999, pursuant to 5 U.S.C. 801(a)(1)(A).
Sept. 13, 1999:
A letter from the Director, Office of Regulations
Management, Office of General Counsel, Department of Veterans
Affairs, transmitting the Department's final rule--Delegations
of Authority; Tort Claims (RIN: 2900-AJ31) Received September
3, 1999, pursuant to 5 U.S.C. 801(a)(1)(A).
Sept. 29, 1999:
A letter from the Secretary of Labor, transmitting the
Secretary's annual report on employment and training programs,
pursuant to 29 U.S.C. 1579(d).
Sept. 29, 1999:
A letter from the Director, Office of Regulations
Management, Department of Veterans Affairs, transmitting the
Department's final rule--Veterans Education: Montgomery GI
Bill--Active Duty; Administrative Error (RIN: 2900-AJ70)
Received September 24, 1999, pursuant to 5 U.S.C. 801(a)(1)(A).
Oct. 1, 1999:
A letter from the Director, Office of Regulations
Management, Veterans Benefits Administration, Department of
Veterans Affairs, transmitting the Department's final rule--
Advance Payments and Lump-Sum Payments of Educational
Assistance; Miscellaneous Nonsubstantive Changes (RIN: 2900-
A131) Received September 28, 1999, pursuant to 5 U.S.C.
801(a)(1)(A).
Oct. 6, 1999:
A letter from the Principal Deputy Assistant Secretary for
Congressional Affairs, Department of Veterans Affairs,
transmitting a draft bill to authorize major facility projects
and lease programs for Fiscal Year 2000.
Oct. 12, 1999:
A letter from the Director, Office of Regulations
Management, Veterans Health Administration, Department of
Veterans Affairs, transmitting the Department's final rule--
Enrollment-Provision of Hospital and Outpatient Care to
Veterans (RIN: 2900-AJ18) Received October 6, 1999, pursuant to
5 U.S.C. 801(a)(1)(A).
Oct. 12, 1999:
A letter from the Director, Office of Regulations
Management, Veterans Benefits Administration, Department of
Veterans Affairs, transmitting the Department's final rule--
Returned and Canceled Checks (RIN: 2900-AJ61) Received October
6, 1999, pursuant to 5 U.S.C. 801(a)(1)(A).
Oct. 18, 1999:
A letter from the Health Affairs, Assistant Secretary of
Defense, transmitting a report regarding the appropriate health
care for Gulf War veterans who suffer from a Gulf War illness.
Oct. 20, 1999:
A letter from the Principal Deputy Assistant Secretary for
Congressional Affairs, Department of Veterans Affairs,
transmitting a draft of proposed legislation entitled,
``Veterans Programs Improvement Act of 1999''.
Jan. 27, 2000:
A letter from the the Executive Secretary, the Disabled
American Veterans, transmitting the 1999 National Convention
proceedings of the Disabled American Veterans, pursuant to 36
U.S.C. 90i and 44 U.S.C. 1332.
Jan. 27, 2000:
A letter from the Director, Office of Regulations
Management, Veterans Health Administration, Department of
Veterans Affairs, transmitting the Department's final rule--Per
Diem for Nursing Home Care of Veterans in State Homes (RIN:
2900-AE87) Received January 3, 2000, pursuant to 5 U.S.C.
801(a)(1)(A).
Jan. 27, 2000:
A letter from the Director, Office of Regulations
Management, Department of Veterans Affairs, transmitting the
Department's final rule--VA Acquisition Regulation: Simplified
Acquisition Procedures (RIN: 2900-AJ16) Received December 13,
1999, pursuant to 5 U.S.C. 801 (a)(1)(A).
Jan. 27, 2000:
A letter from the Director, Office of Regulations
Management, Board of Veterans' Appeals, Department of Veterans
Affairs, transmitting the Department's final rule--Rules of
Practice: Title Change (RIN: 2900-AJ57) Received January 7,
2000, pursuant to 5 U.S.C. 801(a)(1)(A).
Feb. 1, 2000:
A letter from the The American Legion, transmitting the
proceedings of the 81st National Convention of the American
Legion, held in Anaheim, California from September 7, 8 and 9,
1999 as well as a report on the Organization's activities for
the year preceding the Convention, pursuant to 36 U.S.C. 49.
Feb. 14, 2000:
A letter from the Director, Office of Regulations
Management, Board of Veterans' Appeals, Department of Veterans
Affairs, transmitting the Department's final rule--Board of
Veterans' Appeals: Rules of Practice--Revision of Decisions on
Grounds of Clear and Unmistakeable Error; Clarification (RIN:
2900-AJ98) Received January 5, 2000, pursuant to 5 U.S.C. 801
(a)(1)(A).
Feb. 29, 2000:
A letter from the Secretaries of Defense and Veterans
Affairs, Departments of Defense and Veterans Affairs,
transmitting a report on the implementation of the health
resources sharing portion of the ``Department of Veterans
Affairs and Department of Defense Health Resources Sharing and
Emergency Operations Act''. pursuant to 38 U.S.C. 8111(f).
Feb. 29, 2000:
A letter from the Secretary of Veterans Affairs and
Secretary of Defense, transmitting the report for Fiscal Year
1998 regarding the implementation of the health resources
sharing portion of the ``Department of Veterans Affairs and
Department of Defense Health Resources Sharing and Emergency
Operations Act''.
Mar. 13, 2000:
A letter from the Director, Office of Regulations
Management, Veterans Benefits Administration, Department of
Veterans Affairs, transmitting the Department's final rule--
National Service Life Insurance (RIN: 2900-AJ78) Received
February 14, 2000, pursuant to 5 U.S.C. 801 (a)(1)(A).
Mar. 14, 2000:
A letter from the Secretary of Veterans Affairs,
transmitting the FY 1998 annual report, pursuant to 31 U.S.C.
3512(c)(3).
Mar. 15, 2000:
A letter from the Director, Office of Personnel Management,
transmitting the annual report on employment and training
programs for veterans during program year 1998 (October 1, 1997
through September 1, 1998), pursuant to 38 U.S.C. 2009(b).
Mar. 20, 2000:
A letter from the Acting General Counsel, Department of
Defense, transmitting a proposal of draft legislation, ``To
authorize appropriations for fiscal year 2001 for military
activities of the Department of Defense, to prescribe military
personnel strengths for fiscal year 2001, and for other
purposes.''.
Mar. 21, 2000:
A letter from the Director, Office of Regulations
Management, Department of Veterans Affairs, transmitting the
Department's final rule--DIC Benefits for Survivors of Certain
Veterans Rated Totally Disabled at Death (RIN: 2900-AJ65)
Received January 2O, 200O, pursuant to 5 U.S.C. 801(a)(1)(A).
Mar. 28, 2000:
A letter from the Director, Office of Regulations
Management, Department of Veterans Affairs, transmitting the
Department's final rule--Child; Educational Institution (RIN:
2900-AJ54) Received March 6, 2000, pursuant to 5 U.S.C. 801
(a)(1)(A).
Apr. 4, 2000:
A letter from the Under Secretary, Personnel and Readiness,
Department of Defense, transmitting the response to the Report
of the Congressional Commission on Servicemembers and Veterans
Transitions Assistance.
Apr. 4, 2000:
A letter from the Secretary of Defense, transmitting the
report entitled, ``Outreach to Gulf War Veterans''.
Apr. 6, 2000:
A letter from the Director, Office of Regulations
Management, Veterans Benefits Administration, Department of
Veterans Affairs, transmitting the Department's final rule--
Eligibility Criteria for the Montgomery GI Bill--Active Duty
and Other Miscellaneous Issues (RIN: 2900-A163) Received
February 8, 2000, pursuant to 5 U.S.C. 801(a)(1)(A).
Apr. 12, 2000:
A letter from the Assistant Secretary for Planning and
Analysis, Department of Veterans Affairs, transmitting a draft
bill entitled, ``Veterans' Compensation Cost-of-Living
Adjustment Act of 2000''.
May 2, 2000:
A letter from the Director, Office of Management and
Budget, Department of Veterans Affairs, transmitting the
Department's final rule--Appeals Regulations and Rules of
Practice--Case Docketing (RIN: 2900-AJ72) Received March 16,
2000, pursuant to 5 U.S.C. 801(a)(1)(A).
May 2, 2000:
A letter from the Director, Office of Regulations
Management, Veterans Benefits Administration, Department of
Veterans Affairs, transmitting the Department's final rule--
Veterans Education: Increased Allowances for the Educational
Assistance Test Program (RIN: 2900-AJ87) Received March 16,
2000, pursuant to 5 U.S.C. 801(a)(1)(A).
May 2, 2000:
A letter from the Director, Office of Regulations
Management, Veterans Benefits Administration, Department of
Veterans Affairs, transmitting the Department's final rule--
Eligibility Reporting Requirements (RIN: 2900-AJ09) Received
March 24, 2000, pursuant to 5 U.S.C. 801(a)(1)(A).
May 4, 2000:
A letter from the Director, Veterans Benefits
Administration, Department of Veterans Affairs, transmitting
the Department's final rule--Criteria for Approving Flight
Courses for Educational Assistance Programs (RIN: 2900-A176)
Received March 7, 200O, pursuant to 5 U.S.C. 801 (a)(1)(A).
May 17, 2000:
A letter from the Director, Office of Regulations
Management, Veterans Benefits Administration, Department of
Veterans Affairs, transmitting the Department's final rule--
Modified Eligibility Criteria for the Montgomery G.I. Bill--
Active Duty (RIN: 2900-AJ69) Received April 17, 200O, pursuant
to 5 U.S.C. 801 (a)(1)(A).
May 18, 2000:
A letter from the the Legislative Special Assistant, the
Veterans of Foreign Wars of the U.S., transmitting proceedings
of the 100th National Convention of the Veterans of Foreign
Wars of the United States, held in Kansas City, Missouri,
August 15-2O, 1999, pursuant to 36 U.S.C. 118 and 44 U.S.C.
1332.
May 23, 2000:
A letter from the the Legislative Special Assistant, the
Veterans of Foreign Wars of the U.S., transmitting proceedings
of the 99th National Convention of the Veterans of Foreign Wars
of the United States, held in San Antonio, Texas, August 29-
September 4, 199B, pursuant to 36 U.S.C. 118 and 44 U.S.C.
1332.
May 25, 2000:
A letter from the Assistant Secretary for Planning and
Analysis, Department of Veterans Affairs, transmitting a draft
bill to amend title 38, United States Code, to designate
members of the Board of Veterans' Appeals (Board) as veterans
law judges and to clarify the beginning of the period in which
Board decisions can be appealed to the United States Court of
Appeals for Veterans Claims (Court).
June 6, 2000:
A letter from the Secretary of Labor, transmitting a report
entitled, ``Uniformed Services Employment and Reemployment
Rights Act of 1994 (USERA) Annual Report to Congress For Fiscal
Year 1999''.
June 28, 2000:
A letter from the Assistant Secretary for Planning and
Analysis, Department of Veterans Affairs, transmitting the
Fiscal Year 2000 Veterans Equitable Resource Allocation (VERA).
July 11, 2000:
A letter from the Director, Office of Regulations
Management, Department of Veterans Affairs, transmitting the
Department's final rule--Children suffering from Spina Bifida
who are Children of Vietnam Veterans (RIN: 2900-AJ25) Received
June 2, 2000, pursuant to 5 U.S.C. 801 (a)(1)(A).
July 11, 2000:
A letter from the Assistant Secretary for Planning and
Analysis, Department of Veterans Affairs, transmitting a draft
bill, ``To amend chapter 37 of title 38, United States Code, to
extend the program for making direct housing loans to Native
American Veterans, to repeal little-used loan authorities, to
make technical amendments to the guaranteed housing loan
program for veterans. and for other purposes''.
July 11, 2000:
A letter from the Assistant Secretary for Planning and
Analysis, Department of Veterans Affairs, transmitting a draft
bill, ``To authorize major medical facility projects for the
Department of Veterans Affairs for Fiscal Year 2001 and for
other purposes''.
July 11, 2000:
A letter from the Assistant Secretary for Planning and
Analysis, Department of Veterans Affairs, transmitting a draft
bill entitled, ``Enhanced Veterans' Education Benefits Act of
2000''.
July 19, 2000:
A letter from the Director, Office of Regulations
Management, Department of Veterans Affairs, transmitting the
Department's final rule--The Veterans Millennium Health Care
and Benefits Act (RIN: 2900-AK04) Received July 7, 2000,
pursuant to 5 U.S.C. 801(a)(1)(A).
July 24, 2000:
A letter from the Secretary of Veterans Affairs,
transmitting a report covering the disposition of cases granted
relief from administrative error, overpayment and forfeiture by
the Administrator in 1999, pursuant to 38 U.S.C. 210(c)(3)(B).
July 25, 2000:
A letter from the Director, Office of Regulations
Management, Department of Veterans Affairs, transmitting the
Department's final rule--Increase in Rates Payable Under the
Montgomery GI Bill--Active Duty (RIN: 2900-AJ89) Received July
19, 2000, pursuant to 5 U.S.C. 801(a)(1)(A).
July 25, 2000:
A letter from the Commissioner of Social Security,
transmitting a draft bill to make amendments to the
Supplemental Security Income (SSI) program in support of the
President's fiscal year 2001 budget with respect to the Social
Security Administration.
Sept. 6, 2000:
A letter from the Secretary of Labor, transmitting the
annual report on employment and training programs for veterans
during program year 1998 (July 1, 1998 through June 30, 1998)
and fiscal year 1999 (October 1, 1998 through September 30,
1999), pursuant to 38 U.S.C. 2009(b).
Sept. 6, 2000:
A letter from the Director, Office of Regulations
Management, Veterans Benefits Administration, Department of
Veterans Affairs, transmitting the Department's final rule--
Veterans Training: Vocational Rehabilitation Subsistence
Allowance Rates (RIN: 2900-A174) Received August 23, 2000,
pursuant to 5 U.S.C. 801 (a)(1)(A).
Sept. 14, 2000:
A letter from the Director, Office of Regulations
Management, Veterans Benefits Administration, Department of
Veterans Affairs, transmitting the Department's final rule--
Increase in Rates Payable Under the Montgomery GI Bill--Active
Duty (RIN: 2900-Al89) Received September 8, 2000, pursuant to 5
U.S.C. 801(a)(1)(A).
Sept. 18, 2000:
A letter from the Director, Office of Regulations
Management, Department of Veterans Affairs, transmitting the
Department's final rule--Appeals Regulations: Title for Members
of the Board of Veterans' Appeals (RIN: 2900-AK14) Received
September 11, 2000, pursuant to 5 U.S.C. 801(a)(1)(A).
Sept. 19, 2000:
A letter from the Director, Office of Regulations
Management, Department of Veterans Affairs, transmitting the
Department's final rule--Cash Values for National Service Life
Insurance (NSLI) and Veterans Special Life Insurance Term-
Capped Policies (RIN: 2900-AJ35) Received September 11, 2000,
pursuant to 5 U.S.C. 801(a)(1)(A).
SUMMARY OF VETERANS' AFFAIRS COMMITTEE ACTION
BILLS AND RESOLUTIONS REFERRED AND HEARINGS / EXECUTIVE SESSIONS CONDUCTED
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Congress
-------------------------------------------------------------------------------------------------------------------------------------------------------
88th 89th 90th 91st 92d 93d 94th 95th 96th 97th 98th 99th 100th 101st 102d 103d 104th 105th 106th
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Bills and resolutions referred.......... 508 791 685 740 693 839 719 709 339 273 229 198 147 194 215 174 128 134 147
Hearing sessions........................ 50 71 46 43 37 44 58 72 84 89 71 76 44 72 67 71 39 56 65
Meetings and mark-up sessions........... 21 32 13 27 21 16 30 26 19 18 16 20 16 26 20 23 19 18 13
Bills reported.......................... 41 47 \8\ 19 34 26 \9\ 14 23 32 11 16 15 17 14 33 21 25 15 15 10
Bills in House.......................... \5\ 5 \6\ 4 4 1 4 1 ...... 1 1 1 3 3 1 4 3 11 ...... ...... 1
Pending in Senate committees............ 7 \7\ 12 3 9 7 2 \10\ 9 17 3 6 6 8 9 23 7 11 10 1 1
Bills on Senate Calendar or in Senate... ...... 1 ...... ...... ...... ...... ...... 1 1 1 ...... 1 3 1 3 3 ...... ...... ......
Recommitted............................. ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ......
Bills vetoed............................ ...... ...... ...... ...... 2 1 ...... ...... 1 ...... ...... ...... ...... ...... ...... ...... ...... ...... ......
Bills passed over veto.................. ...... ...... ...... ...... ...... 1 ...... ...... 1 ...... ...... ...... ...... ...... ...... ...... ...... ...... ......
Laws enacted............................ 29 30 15 24 15 15 15 13 6 8 8 6 4 8 24 15 6 6 10
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ Including 4 bills enacted as amendment in other legislation; 1 left in House when similar Senate bill returned to Senate; and 1 similar to another bill enacted (Public Law 87-645).
\2\ Includes 2 bills enacted as amendments to other bills.
\3\ Includes 1 bill enacted as amendment to another bill.
\4\ Some laws include the substance of more than 1 bill reported separately. 39 separately reported bills were enacted, 7 as amendments to other legislation.
\5\ Provisions of 3 of these bills were passed by the House as separate bills, and the provisions of 1 bill were included as an amendment to another bill which became public law.
\6\ \7\ One bill in a Senate committee had purpose accomplished administratively; 5 other were enacted as sections of another bill; and portions of 1 bill left in the House were enacted as
part of another bill.
\8\ Includes S.J. Res. 197 making technical correction to law, which was brought to House floor for immediate consideration and passage by unanimous consent.
\9\ The difference in number of bills reported (14) and laws enacted (15) is due to the fact that S. 3705 did not go to the House Committee. However, the subject matter was included in H.R.
12628.
\10\ Includes H.R. 9576 subject matter of which was contained in S. 969, passed in lieu.
HEARINGS AND EXECUTIVE SESSIONS
(All hearings and executive sessions of the Committee are
held in the Committee hearing room, Room 334, Cannon House
Office Building unless otherwise designated.)
February 3, 1999. OPEN. 4:00 p.m. Full Committee. Meeting.
Organizational and Oversight Plan.
February 11, 1999. OPEN. 9:30 a.m. Full Committee. Hearing.
Department of Veterans Affairs Budget Request for Fiscal Year
2000. (Serial No. 106-1)
February 23, 1999. OPEN. 11:00 a.m. Full Committee.
Hearing. To Receive the Report of the Congressional Commission
on Servicemembers and Veterans Transition Assistance. (Serial
No. 106-2)
February 24, 1999. OPEN. 10:00 a.m. Subcommittee on Health.
Hearing. VA Medical Care Budget for FY 2000. (Serial No. 106-3)
February 24, 1999. OPEN. 10:00 a.m. Subcommittee on
Benefits. Hearing. Fiscal Year 2000 Budget for the Department
of Labor Veterans' Employment and Training Service (VETS).
(Serial No. 106-4)
February 25, 1999. OPEN. 9:30 a.m. House and Senate
Veterans' Affairs Committees. Joint Hearing. Room 345 Cannon
HOB. The 1999 legislative priorities of the Military Order of
the Purple Heart, Fleet Reserve Association, The Retired
Enlisted Association, Gold Star Wives of America and Air Force
Sergeants Association.
March 2, 1999. OPEN. 9:30 a.m. House and Senate Veterans'
Affairs Committees. Joint Hearing. Room 345 Cannon HOB. The
1999 legislative priorities of the Veterans of Foreign Wars.
March 4, 1999. OPEN. 9:30 a.m. House and Senate Veterans'
Affairs Committees. Joint Hearing. Room 345 Cannon HOB. The
1999 legislative priorities of the Veterans of World War 1,
Jewish War Veterans, Paralyzed Veterans of America, Blinded
Veterans Association and Non Commissioned Officers Association.
March 10, 1999. OPEN. 10:00 a.m. Subcommittee on Health.
Hearing. VHA Capital Asset Management. (Serial No. 106-5)
March 11, 1999. OPEN. 1:30 p.m. Full Committee. Meeting.
Approve the Committee's View and Estimates of the
Administration's Fiscal Year 2000 Budget.
March 11, 1999. OPEN. 9:30 a.m. Subcommittee on Oversight
and Investigations. Hearing. Whistleblowing and Retaliation in
the Department of Veterans Affairs. (Serial No. 106-6)
March 17, 1999. OPEN. 10:00 a.m. House and Senate Veterans'
Affairs Committees. Joint Hearing. Room 345 Cannon HOB. The
1999 legislative priorities of the Disabled American Veterans.
March 18, 1999. OPEN. 2:30 p.m. Full Committee. Markup.
H.R. 70.
March 24, 1999. OPEN. 10:00 a.m. House and Senate Veterans'
Affairs Committees. Joint Hearing. Room 345 Cannon HOB. The
1999 legislative priorities of the AMVETS, American ExPrisoners
of War, Vietnam Veterans of America and The Retired Officers
Association.
March 25, 1999. OPEN. 9:30 a.m. Subcommittee on Oversight
and Investigations. Hearing. Management of the Federal
Employees' Compensation Act Program at the Department of
Veterans Affairs. (Serial No. 106-7)
March 25, 1999. OPEN. 10:00 a.m. Subcommittee on Benefits.
Hearing. Room 340 Cannon HOB. Oversight on the Veterans
Benefits Administration. (Serial No. 106-8)
April 15, 1999. OPEN. 9:30 a.m. Subcommittee on Oversight
and Investigations. Hearing. Department of Veterans Affairs
Year 2000 (Y2K) Readiness. (Serial No. 106-9)
April 21, 1999. OPEN. 10:00 a.m. Subcommittee on Oversight
and investigations and Subcommittee on Health. Joint Hearing.
Suspension of Medical Research at West Los Angeles and
Sepulveda VA Medical Facilities and Informed Consent and
Patient Safety in VA Medical Research. (Serial No. 106-10)
April 21 and May 20, 1999. OPEN. 10:00 a.m. Subcommittee on
Benefits. Hearing. Room 340 Cannon HOB. H.R. 1071, the
Montgomery GI Bill Improvements Act of 1999, and H.R. 1182, the
Servicemembers Educational Opportunity Act of 1999. (Serial No.
106-11)
April 22, 1999. OPEN. 9:30 a.m. Subcommittee on Health.
Hearing. VA Long-Term Care. (Serial No. 106-12)
May 19, 1999. OPEN. 10:00 a.m. Subcommittee on Health.
Hearing. Veterans' Millennium Health Care Act. (Serial No. 106-
13)
May 20, 1999. OPEN. 10:00 a.m. Subcommittee on Oversight
and Investigations. Hearing. Room 340 Cannon HOB. National and
State Veterans' Cemeteries. (Serial No. 106-14)
June 9, 1999. OPEN. 10:00 a.m. Subcommittee on Health.
Markup. Draft Veterans' Millennium Health Care Act.
June 10, 1999. OPEN. 10:00 a.m. Subcommittee on Benefits.
Hearing. H.R. 605, Court of Appeals for Veterans Claims Act of
1999; H.R. 690, Relating to Bronchiolo-alveolar Carcinoma; H.R.
708, Surviving Spouses Benefit Restoration Act; H.R. 784,
Regarding Dependency and Indemnity Compensation for Surviving
Spouses of Certain Former Prisoners of War; H.R. 1214,
Veterans' Claims Adjudication Improvement Act of 1999; and H.R.
1765, Veterans' Compensation Cost-of-Living Adjustment Act of
1999. (Serial No. 106-15)
June 16, 1999. OPEN. 10:30 a.m. Subcommittee on Benefits.
Hearing. H.R. 1247, the World War 11 Memorial; H.R.1476, the
National Cemetery Act of 1999; H.R. 1484, Authorization of
Appropriations for Homeless Veterans Projects; H.R. 1603, the
Selected Reserve Housing Loan Fairness Act of 1999; H.R. 1663,
the Medal of Honor Memorial Act; and H.R. 2040, the Veterans'
Cemetery Assessment Act of 1999. (Serial No. 106-16)
June 17, 1999. OPEN. 10:00 a.m. Subcommittee on Benefits.
Markup. Draft Veterans Benefits improvement Act of 1999.
June 23, 1999. OPEN. 10:00 a.m. Full Committee. Markup.
H.R. 2116, H.R. 2280 and H.J. Res. 34.
June 24, 1999. OPEN. 10:00 a.m. Subcommittee on Oversight
and Investigations. Hearing. Effectiveness of Federal Homeless
Veterans Programs. (Serial No. 106-17)
June 30, 1999. OPEN. 10:00 a.m. Subcommittee on Health.
Hearing. Cost Estimates for H.R. 2116, the Veterans' Millennium
Health Care Act. (Serial No. 106-18)
July 15, 1999. OPEN. 9:30 a.m. Subcommittee on Health.
Hearing. VA's Experience in Implementing Patient Enrollment
Under Public Law 104-262. (Serial No. 106-19)
July 15, 1999. OPEN. 1:00 p.m. Full Committee. Markup. H.R.
2116.
July 22, 1999. OPEN. 10:00 a.m. Subcommittee on Oversight
and Investigations. Hearing. VA's Capital Assets Realignment
Plan for Enhancing Services to Veterans. (Serial No. 106-20)
July 29, 1999. OPEN. 10:00 a.m. Subcommittee on Oversight
and Investigations. Hearing. Effectiveness and Strategic
Planning of Veterans' Employment and Training Service Program.
(Serial No. 106-21)
September 9, 1999. OPEN. 10:00 a.m. Subcommittee on
Benefits. Hearing. Veterans' Employment regarding Civilian
Gedentialing Requirements for Military Job Skills. (Serial No.
106-22)
September 22, 1999. OPEN. 10:00 a.m. Full Committee.
Markup. H.J. Res. 65 and H.R. 1663.
September 23, 1999. OPEN. 10:00 a.m. Subcommittee on
Oversight and Investigations. Hearing. VA Financial Management:
Reducing Fraud and Increasing Collections. (Serial No. 106-23)
September 28, 1999. OPEN. 9:30 a.m. House and Senate
Veterans Affairs Committees. Joint Hearing. Room 345 Cannon
HOB. The 1999 legislative priorities of The American Legion.
September 30, 1999. OPEN. 10:00 a.m. Subcommittee on Over
sight and Investigations. Hearing. Department of Veterans
Affairs Office of Resolution Management and the Office of
Employment Discrimination Complaint Adjudication. (Serial No.
106-24)
October 26, 1999. OPEN. 10:00 a.m. Subcommittee on Benefits
Hearing. Persian Gulf War Veterans Issues. (Serial No 106-25)
October 28, 1999. OPEN. 9:00 a.m. Subcommittee on Benefits.
Hearing. Draft Legislative Concepts for 21st Century Veterans'
Employment and Training Legislation, H.R. 364, Draft
Legislative Concepts for Miscellaneous VA Education Programs,
and H.R. 625. (Serial No. 106-26)
October 28, 1999. OPEN. 10:00 a.m. Subcommittee on
Oversight and Investigations. Hearing. Hearing V on Year 2000
Readiness in the Department of Veterans Affairs. (Serial No.
106-27)
November 16, 1999. OPEN. 2:00 p.m. Subcommittee on Health
and Subcommittee on Oversight and Investigations. Joint
Hearing. Possible Health Effects of Pyridostigmine Bromide on
Persian Gulf War Veterans. (Serial No. 106-28)
February 9, 2000. OPEN. 10:20 a.m. Subcommittee on Health
and Subcommittee on Health and the Environment and Subcommittee
on Oversight and Investigations, Committee on Commerce. Joint
Hearing. Room 2123 Rayburn HOB. Medical Errors: Improving
Quality of Care and Consumer Information. (Serial No. 106-29)
February 17, 2000. OPEN. 9:30 a.m. Full Committee. Hearing.
The Department of Veterans Affairs Budget Request for Fiscal
Year 2001. (Serial No. 106-30)
March 1, 2000. OPEN. 10:00 a.m. House and Senate Veterans
Affairs Committees. Joint Hearing. Room 345 Cannon HOB. The
2000 legislative priorities of the Disabled American Veterans.
March 2, 2000. OPEN. 10:00 a.m. House and Senate Veterans
Affairs Committees. Joint Hearing. Room 345 Cannon HOB. The
2000 legislative priorities of the Non Commissioned Officers
Association, Jewish War Veterans, Paralyzed Veterans of
America, and Blinded Veterans Association.
March 7, 2000. OPEN. 9:30 a.m. House and Senate Veterans
Affairs Committees. Joint Hearing. Room 345 Cannon HOB. The
2000 legislative priorities of The Retired Enlisted
Association, Gold Star Wives of America, Military Order of the
Purple Heart, Air Force Sergeants Association and Fleet Reserve
Association.
March 9, 2000. OPEN. 10:00 a.m. Subcommittee on Benefits
and Subcommittee on Health. Joint Hearing. Room 345 Cannon HOB.
Homeless Veterans' Issues. (Serial No. 106-31)
March 14, 2000. OPEN. 10:00 a.m. Subcommittee on Benefits
and Subcommittee on Government Programs and Oversight,
Committee on Small Business. Hearing. B363 Rayburn HOB.
Implementation of Public Law 106-50, the Veterans
Entrepreneurship and Small Business Development Act of 1999.
March 15, 2000. OPEN. 10:00 a.m. House and Senate Veterans
Affairs Committees. Joint Hearing. Room 345 Cannon HOB. The
2000 legislative priorities of the Veterans of Foreign Wars.
March 16, 2000. OPEN. 10:00 a.m. Subcommittee on Oversight
and Investigations. Hearing. Department of Veterans Affairs
Loan Guaranty Service. (Serial No. 106-33)
March 22, 2000. OPEN. 10:00 a.m. House and Senate Veterans
Affairs Committees. Joint Hearing. Room 345 Cannon HOB. The
2000 legislative priorities of the National Association of
State Directors of Veterans Affairs, the Vietnam Veterans of
America, The Retired Officers Association, American ExPrisoners
of War and AMVETS.
March 23, 2000. OPEN. 9:30 a.m. Subcommittee on Benefits.
Hearing. Well-Grounded Claims and H.R. 3193, the Duty to Assist
Veterans Act of 1999. (Serial No. 106-34)
April 5, 2000. OPEN. 10:00 a.m. Subcommittee on Health.
Hearing. VA Capital Asset Planning. (Serial No. 106-35)
April 12, 2000. OPEN. 10:00 a.m. Subcommittee on health.
Hearing. The Status of Recruitment, Retention and Compensation
of the VA Health Care Workforce. (Serial No. 106-36)
April 13, 2000. OPEN. 10:00 a.m. Subcommittee on Benefits.
Hearing. VA Adjudication of Hepatitis C Claims, and H.R. 1020,
H.R. 3816, H.R. 3998 and H.R. 4131. (Serial No. 106-37)
May 11, 2000. OPEN. 10:00 a.m. Full Committee. Markup. H.R.
4268, Veterans and Dependents Millennium Education Act.
May 11, 2000. OPEN. 11:00 a.m. Subcommittee on Oversight
and Investigations. Hearing. Department of Veterans Affairs
Information Technology Program. (Serial No. 106-38)
May 17, 2000. OPEN. 10:00 a.m. Subcommittee on Health.
Hearing. Department of Veterans Affairs/Department of Defense
Health Care Sharing. (Serial No. 106-39)
May 18, 2000. OPEN. 10:00 a.m. Subcommittee on Oversight
and Investigations. Hearing. Department of Veterans Affairs
Disability Claims Processing. (Serial No. 106-40)
May 25, 2000. OPEN. 10:00 a.m. Subcommittee on Oversight
and Investigations. Hearing. Joint Procurement of
Pharmaceuticals by the Department of Veterans Affairs and the
Department of Defense.
June 1, 2000. OPEN. 10:00 a.m. Marion, Indiana.
Subcommittee on Oversight and Investigations. Field Hearing.
Hearing on Quality of Care, Patient and Employee Safety, and
Management Effectiveness at the Marion VA Medical Center.
June 8, 2000. OPEN. 10:00 a.m. Subcommittee on Oversight
and Investigations. Hearing. Women Veterans Issues.
July 12, 2000. OPEN. 10:00 a.m. Subcommittee on Benefits.
Hearing. H.R. 4765, the 21st Century Veterans Employment and
Training Act and H.R. 3256, Veterans' Right to Know Act.
July 13, 2000. OPEN. 9:00 a.m. Subcommittee on Benefits.
Hearing. H.R. 4765, 21st Century Veterans Employment and
Training Act and H.R. 3256, Veterans' Right to Know Act.
July 18, 2000. OPEN. 10:00 a.m. Subcommittee on Benefits.
Markup. H.R. 4850, Veterans Benefits Act of 2000; and H.R.
4864, Veterans Claims Assistance Act of 2000.
July 20, 2000. OPEN. 10:00 a.m. Full Committee. Markup.
H.R. 4850, Veterans Benefits Act of 2000; and H.R. 4864,
Veterans Claims Assistance Act of 2000.
July 25, 2000. OPEN. 10:00 a.m. Subcommittee on Health.
Hearing. VA Pharmaceutical Procurement Policy.
July 27, 2000. OPEN. 10:00 a.m. Subcommittee on Oversight
and Investigations. Hearing. Patient Safety and Quality
Management in the Department of Veterans Affairs.
September 7, 2000. OPEN. 10:00 a.m. Subcommittee on Health.
Markup. H.R. 5109, Department of Veterans Affairs Health Care
Personnel Act of 2000.
September 13, 2000. OPEN. 10:30 a.m. Full Committee Markup.
H.R. 5109, Department of Veterans Affairs Health Care Personnel
Act of 2000.
September 21, 2000. OPEN. 10:00 a.m. Subcommittee on
Oversight and Investigations. Hearing. Follow-up Hearing on
VA's Information Technology Program.
September 26, 2000. OPEN. 9:30 a.m. House and Senate
Veterans Affairs Committees. Joint Hearing. Room 345 Cannon
HOB. The 2000 legislative priorities of The American Legion.
September 27, 2000. OPEN. 10:00 a.m. Subcommittee on
Oversight and Investigations. Hearing. 340 Cannon. Hearing on
Veterans Employment and Training Service (VETS) Program
Effectiveness and Strategic Planning.
September 27, 2000. OPEN. 10:00 a.m. Subcommittee on
Benefits. Hearing. Hearing on Licensing and Credentialing of
Military Job Skills for Civilian Employment.
September 28, 2000. OPEN. 10:00 a.m. Subcommittee on
Oversight and Investigations. Hearing on Human Subjects
Protections in VA Medical Research.
October 3, 2000. OPEN. 9:30 a.m. Subcommittee on Health.
Hearing on Chiropractic Services in the VA.
LEGISLATION ENACTED INTO LAW
Public Law 106-83
(H.R. 1663, AS AMENDED)
Title: A Act to recognize National Medal of Honor sites in
California, Indiana, and South Carolina.
Summary: H.R. 1663, as amended, would:
1. Recognize the following sites to honor recipients of
the Medal of Honor as National Medal of Honor sites: (1)
Riverside California--The memorial under construction at the
Riverside National Cemetery in Riverside, California, to be
dedicated on November 5, 1999; (2) Indianapolis, Indiana.--The
memorial at the White River State Park in Indianapolis,
Indiana, dedicated on May 28, 1999; (3) Mount Pleasant, South
Carolina.--The Congressional Medal of Honor Museum at Patriots
Point in Mount Pleasant, South Carolina, currently situated on
the ex-U.S.S. Yorktown (CV-6).
Effective date: Date of enactment.
Cost: The Congressional Budget Office estimates that the
cost of H.R. 1663 would have no effect on the federal budget
and would not affect direct spending or receipts. H.R. 1663
contains no intergovernmental or private-sector mandates as
defined in the Unfunded Mandates Reform Act of 1995 and would
not affect the budget of state, local, or tribal government.
Any costs to state or local governments as a result of
enactment of this bill would be incurred voluntarily.
Legislative history
Sep. 22, 1999: H.R.1663 ordered reported amended favorably
by the Committee on Veterans' Affairs.
Sep. 30, 1999: H.R.1663 reported amended by Committee on
Veterans' Affairs. H.Rept. 106-351.
Oct. 5, 1999: Passed the House amended under suspension by
vote of 424-0 (Roll No. 474).
Oct. 6, 1999: Referred to the Senate Committee on Armed
Services.
Oct. 20, 1999: Passed the Senate by unanimous consent.
Oct. 28, 1999: Signed by the President, Public Law 106-83.
------
Public Law 106-117
VETERANS MILLENNIUM HEALTH CARE AND BENEFITS ACT
(H.R. 2116, AS AMENDED)
Title: An Act to amend title 38, United States Code, to
establish a program of extended care services for veterans, to
make other improvements in health care programs of the
Department of Veterans Affairs, to enhance compensation,
memorial affairs, and housing programs of the Department of
Veterans Affairs, to improve retirement authorities applicable
to judges of the United States Court of Appeals for Veterans
Claims, and for other purposes.
Summary: H.R. 2116, as amended, would provide for the
following:
Title I - Access to Care
Subtitle A -- Long-term Care
1. Require the Secretary of Veterans Affairs to operate
and maintain extended care programs, to include geriatric
evaluations, VA and community-based nursing home care,
domiciliary care, adult day health care, respite care, and such
alternatives to institutional care as the Secretary considers
reasonable and appropriate.
2. Require the Secretary of Veterans Affairs to maintain
nationally the level of ``in-house'' extended care services
provided as of September 30, 1998.
3. Require the Secretary of Veterans Affairs, through
2003, to provide: (a) needed nursing home care for veterans who
are 70 percent service-connected or in need of such care for a
service-connected condition; and (b) veterans who are enrolled
for VA care with alternatives to institutionalized care.
4. Require the Secretary of Veterans Affairs to establish
a copayment policy applicable to extended care of more than 21
days in a year in the case of care furnished to a veteran who
has no compensable service-connected disability, and whose
income is above the pension level.
5. Require establishment of a revolving fund in the
Treasury in which to deposit copayments to be used to expand
extended care services.
6. Lift the six-month limit on VA providing adult day
health care, and authorize VA to furnish respite care services
under contract in veterans' homes or in any other setting.
7. Authorize VA to expand the scope of the State home
program to encompass all extended care services.
8. Require the Secretary of Veterans Affairs to conduct
pilot programs to determine the effectiveness of different
models of providing all-inclusive care to reduce the need for
institutionalizing patients.
9. Establish a pilot program, that would authorize the
Secretary of Veterans Affairs to provide assisted living
services through contract arrangements.
Subtitle B -- Other Access-to-care Matters
1. Authorize the Secretary of Veterans Affairs to make
payments for emergency care on behalf of uninsured enrolled
veterans and require that a veteran has received VA care within
a two-year period of a medical emergency to be eligible.
2. Establish a specific eligibility for VA health care
for a veteran who was awarded the Purple Heart.
3. Establish a specific eligibility, subject to the terms
of a memorandum of understanding between the Department of
Defense and Department of Veterans Affairs, for a veteran who
has retired from military service, is eligible for care under
the TRICARE program, and is not otherwise eligible for priority
VA care.
4. Lift the restriction in law on VA's treating (under
appropriate reimbursement arrangements) military members for
substance-use disorders other than during the last 30 days of
the member's period of service.
5. Require the Secretary of Veterans Affairs to operate a
sexual trauma program through December 31, 2004.
6. Require the Secretary of Veterans Affairs to establish
a mechanism for augmenting the provision of specialized mental
health services, with particular emphasis on programs for the
treatment of post-traumatic stress disorder and substance use
disorder.
Title II - Medical Program Administration
1. Authorize the Secretary of Veterans Affairs to: (1)
increase the $2 drug copayment amount; (2) establish a maximum
annual and monthly payment applicable to veterans with multiple
outpatient prescriptions; and (3) revise copayments on
outpatient care for ``higher-income'' veterans.
2. Establish a new fund in the Treasury in which VA is to
deposit receipts and collections under the new authorities in
the bill.
3. Provide that, of the monies collected and recovered by
VA, each facility is to receive that amount collected or
recovered on behalf of that facility.
4. Authorize the establishment of non-profit corporations
at any VA medical center to facilitate education and training
as well as research.
5. Extend the date by which Vietnam-era veterans must
apply to be eligible for readjustment counseling services
through December 31, 2003.
6. Extend for four years the requirement that VA operate
a program to evaluate the health status of Gulf War veterans'
dependents and continue to provide outreach to these veterans
through a newsletter.
7. Reestablish a VA Committee on post-traumatic stress
disorder.
8. Revise the priority system for the award of grants
under the State home construction program: (a) to provide a
higher priority for renovation projects than accorded under
current law (with highest priority for projects to remedy life-
safety problems); and (b) in the case of applications for bed-
producing projects, priority based on the relative need for
adding new beds (with higher priority to States with great need
vs. those with moderate or limited need, and taking into
account existing VA and community nursing home beds).
9. Expand VA's authority to enter into enhanced-use
leases by: (a) authorizing VA to enter into a long-term lease
of property when that would enable it to apply the proceeds of
the lease to demonstrably improve services in that geographic
area; (b) extending the duration of such a lease term for up to
75 years; and (c) providing that funds from enhanced-use leases
shall be deposited in a new Health Services Improvement Fund.
10. LProvide that VA may not employ a health care
professional if a State has terminated for cause that
individual's license, registration, or certification.
11. LRequire the Secretaries of the Departments of Veterans
Affairs and Defense to submit to Congress a report on
cooperation between the Departments on procurement of
pharmaceuticals and medical supplies.
12. LRequire that for one year VA, in making payments under
section 1728 of title 38, United States Code, use the payment
schedule in effect for such purposes as of July 31, 1999,
rather than the Participating Physician Fee Schedule under the
Medicare program.
Title III - Miscellaneous Medical Provisions
1. Require the Secretary of Veterans Affairs to report
and provide justification to Congress on, and defer for a
period, plans to close within any fiscal year more than one-
half the beds within certain bed sections of VA medical
centers.
2. Lift the restrictions on VA's canteen service relating
to sales for off-premises consumption and use.
3. Require the VA Under Secretary for Health, in
consultation with chiropractors, to establish a policy
regarding chiropractic treatment.
4. Designate the hospital replacement building under
construction at the Reno, Nevada Veterans Affairs Medical
Center as the ``Jack Streeter Building''.
Title IV - Construction and Facilities Matters
1. Authorize renovation to provide a domiciliary in
Orlando, Florida, using previously appropriated funds and
construction of a surgical addition at the Kansas City,
Missouri, VA Medical Center; a long-term care facility at the
Lebanon, Pennsylvania, VA Medical Center; renovations at VA
medical centers in both Fargo, North Dakota, and Atlanta,
Georgia; and demolition of buildings at the Leavenworth,
Kansas, Veterans Affairs Medical Center.
2. Authorize leases of an outpatient clinic in Lubbock,
Texas, and of a research building in San Diego, California.
3. Authorize appropriations for fiscal years 2000 and
2001 of $57.5 million for construction, and $2,178,500 for the
leases.
Title V - Benefits and Employment Matters
Subtitle A -- Compensation and DIC
1. Authorize the payment of dependency and indemnity
compensation to the surviving spouses of certain former
prisoners of war who were rated totally disabled due to any
service-connected cause for a period of one or more years
immediately prior to death.
2. Restore, following termination of a remarriage,
eligibility for CHAMPVA medical care, education, and housing
loans to surviving spouses who lost eligibility for these
benefits as the result of remarriage. These same spouses
regained dependency and indemnity compensation eligibility, but
not these related benefits, as the result of legislation
enacted in 1998.
3. Add bronchiolo-alveolar carcinoma, a rare form of lung
cancer not associated with tobacco use, to the list of diseases
presumed to be service-connected and thus compensable for
certain radiation-exposed veterans.
Subtitle B -- Employment
1. Clarify certain changes to the ``Veterans Employment
Opportunities Act of 1998'' (Public Law 105-338), to confer
competitive status on veterans hired under the Act, thereby
allowing them the opportunity to compete for internal
vacancies.
Title VI - Memorial Matters
Subtitle A -- American Battle Monuments Commission
1. Expand the fundraising authorities of the American
Battle Monuments Commission (ABMC) to expedite the
establishment of the World War II Memorial in the District of
Columbia and ensure that adequate funds are available for the
repair and long-term maintenance of the Memorial. To assure
that groundbreaking, construction, and dedication of the
Memorial are completed on a timely basis, the ABMC would be
authorized to borrow up to $65 million from the U.S. Treasury.
Subtitle B -- National Cemeteries
1. Direct the Secretary of Veterans Affairs to obligate
Advance Planning Funds during fiscal year 2000 to establish six
additional national cemeteries for veterans.
2. Authorize the Secretary of Veterans Affairs to use
flat grave markers at the Santa Fe National Cemetery in New
Mexico.
3. Require the Secretary of Veterans Affairs to conduct
an independent study on improvements to veterans' cemeteries.
Subtitle C -- Burial Benefits
1. Require the Secretary of Veterans Affairs to conduct
an independent study on burial benefits.
Title VII - Education and Housing Matters
Subtitle A -- Education Matters
1. Extend Montgomery GI Bill education benefits
eligibility for preparatory courses for college and graduate
school entrance examinations.
2. Extend Montgomery GI Bill eligibility to individuals
whose obligated period of service is interrupted in order to
accept a commission following successful completion of Officer
Training School.
3. Require the Secretary of Veterans Affairs, in
consultation with the Departments of Defense, Education, and
Labor, to provide a report to Congress on veterans' education
and vocational training benefits provided by the States.
Subtitle B -- Housing Matters
1. Extend VA's authority to provide eligibility for
members of the Selected Reserve for veterans housing loan
guaranties through 2007.
Title VIII - Department of Veterans Affairs
Administrative Matters
1. Require the Veterans Benefits Administration to
implement a quality assurance program that meets governmental
standards for internal control, separation of duties and
organizational independence.
2. Extend the authority of the Secretary of Veterans
Affairs to operate a Veterans Benefits Administration regional
office in the Republi of the Philippines through December 31,
2003.
3. Extend the Advisory Committee on Minority Veterans
through December 31, 2003.
Title IX - Homeless Veterans Programs
1. Authorize appropriations to the Department of Labor of
$10 million for fiscal year 2000, $15 million for fiscal year
2001, $20 million for fiscal year 2002, and $20 million for
fiscal year 2003, for the Homeless Veterans Reintegration
Program.
2. Extend VA's authority to furnish assistance to
homeless veterans through December 31, 2003.
3. Extend through September 30, 2003, VA's authority to
make grants (under the Homeless Veterans Comprehensive Service
Program Act of 1992, as amended) for new programs to combat
veteran homelessness, authorize grants to assist in expanding
existing programs, eliminate the limitation on grant support
for programs involving van procurement, and authorize annual
appropriations of $50 million to carry out the Act.
4. Direct the Secretary of Veterans Affairs, in
consultation with the Secretaries of Labor and Housing and
Urban Development, to submit a plan to evaluate the
effectiveness of programs to assist homeless veterans.
Title X - United States Court of Appeals for Veterans Claims
1. Make various modifications to the retirement and
survivor annuity programs applicable to judges of the United
States Court of Appeals for Veterans Claims, so as to encourage
staggered retirement and to be more consistent with those of
other federal judges.
Title XI - Voluntary Separation Incentive Program
1. Authorize the Secretary of Veterans Affairs to offer
employees voluntary separation incentives (``buyouts'') of up
to $25,000 in order to restructure or reduce positions and
functions identified in a plan designed to improve operating
efficiency.
Effective date: Date of Enactment.
Legislative history
July 15, 1999: H.R. 2116 ordered reported amended favorably
by the Committee on Veterans' Affairs.
July 16, 1999: H.R. 2116 reported amended by the Committee
on Veterans' Affairs H. Rept. 106-237.
Sep. 21, 1999: Passed the House amended under suspension by
vote of 369-46 (Roll No. 427).
Sep. 22, 1999: Referred to the Senate Committee on
Veterans' Affairs.
Nov. 5, 1999: Senate Committee on Veterans' Affairs
discharged by unanimous consent.
Nov. 5, 1999: Passed the Senate amended by unanimous
consent.
Nov. 5, 1999: Senate requested a Conference. Conferees
appointed: Specter, Thurmond and Rockefeller.
Nov. 8, 1999: Informal Conference meeting held.
Nov. 8, 1999: House disagreed to the Senate Amendments by
unanimous consent.
Nov. 8, 1999: House agreed to a Conference. Conferees
appointed: Stump, Smith (NJ), Quinn, Stearns, Evans, Brown (FL)
and Doyle.
Nov. 10, 1999: Conference meeting held. Conferees agreed to
file conference report.
Nov. 16, 1999: Conference report filed. H. Rept. 106-470.
Nov. 16, 1999: House agreed to the Conference report under
suspension by voice vote.
Nov. 19, 1999: Senate agreed to Conference report by
unanimous consent.
Nov. 30, 1999: Signed by the President, Public Law 106-117.
------
Public Law 106-118
VETERANS' COMPENSATION COST-OF-LIVING ADJUSTMENT ACT OF 1999
(H.R. 2280, AS AMENDED)
Title: An Act to amend title 38, United States Code, to
provide a cost-of-living adjustment in the rates of disability
compensation for veterans with service-connected disabilities
and the rates of dependency and indemnity compensation for
survivors of such veterans.
Summary: H.R. 2280, as amended, would:
Authorize a cost-of-living adjustment in the rates of
service-connected disability compensation and dependency and
indemnity compensation of 2.4 percent effective December 1,
1999 for:
(1) LVeterans receiving compensation benefits for service-
connected disabilities;
(2) LSurviving spouses and children of veterans who died of
service-connected causes in receipt of dependency and indemnity
compensation (DIC);
(3) LEligible veterans and surviving spouses who require the
regular aid and attendance of another person in their day-to-
day activities;
(4) LEligible veterans in receipt of the housebound
allowance;
(5) LCertain veterans paid additional amounts for dependents;
(6) LVeterans whose service-connected disabilities require
the wearing or use of a prosthetic or orthopedic appliance
which tends to wear or tear the clothing (from $534 to $546);
and,
(7) LSpouses' housebound rate (from $105 to $107) monthly.
COMPENSATION AND DIC RATES EFFECTIVE DECEMBER 1, 1999
------------------------------------------------------------------------
Increase (monthly rate)
-------------------------
From To
------------------------------------------------------------------------
Percentage of disability or subsection under which payment
is authorized:
(a) 10 percent.............. $96 $98
(b) 20 percent.............. 184 188
(c) 30 percent.............. 282 288
(d) 40 percent.............. 404 413
(e) 50 percent.............. 576 589
(f) 60 percent.............. 726 743
(g) 70 percent.............. 916 937
(h) 80 percent.............. 1,062 1,087
(i) 90 percent.............. 1,196 1,224
(j) 100 percent............. 1,989 2,036
Higher statutory awards for certain multiple disabilities:
(k) (1) Additional monthly 75 76
payment for anatomical
loss, or loss of use
of, any of the
following: one foot,
one hand, blindness in
one eye (having light
perception only), one
or more creative
organs, both buttocks,
organic aphonia (with
constant inability to
communicate by speech),
deafness of both ears
(having absence of air
and bone conduction)--
for each loss..
(2) Limit for veterans 2,474 2,533
receiving payments
under (a) to (j) above.
(3) Limit for veterans 2,474 2,533
receiving benefits
under (l) below.
(4) Limit for veterans 2,729 2,794
receiving benefits
under (m).
(5) Limit for veterans 3,105 3,179
receiving benefits
under (n).
(l) Anatomical loss or loss 2,474 2,533
of use of both feet,
one foot and one hand,
blindness in both eyes
(5/200) visual acuity
or less), permanently
bedridden or so
helpless as to require
aid and attendance..
(m) Anatomical loss or loss 2,729 2,794
of use of both hands,
or of both legs, at a
level preventing
natural knee action
with prosthesis in
place or of 1 arm and 1
leg at a level
preventing natural knee
or elbow action with
prosthesis in place or
blind in both eyes,
either with light
perception only or
rendering veteran so
helpless as to require
aid and attendance..
Percentage of disability or subsection under which payment
is authorized:
(n) Anatomical loss of both 3,105 3,179
eyes or blindness with
no light perception or
loss of use of both
arms at a level
preventing natural
elbow action with
prosthesis in place or
anatomical loss of both
legs so near hip as to
prevent use of
prosthesis, or
anatomical loss of 1
arm and 1 leg so near
shoulder and hip to
prevent use of
prosthesis..
(o) Disability under 3,470 3,553
conditions entitling
veterans to two or more
of the rates provided
in (1) through (n), no
condition being
considered twice in the
determination, or
deafness rated at 60
percent or more
(impairment of either
or both ears service-
connected) in
combination with total
blindness (5/200 visual
acuity or less) or
deafness rated at 40
percent or total
deafness in one ear
(impairment of either
or both ears service-
connected) in
combination with
blindness having light
perception only or
anatomical loss of both
arms so near the
shoulder as to prevent
use of prosthesis..
(p) (1) If disabilities 3,470 3,553
exceed requirements of
any rates prescribed,
Secretary of Veterans
Affairs may allow next
higher rate or an
intermediate rate, but
in no case may
compensation exceed.
(2) Blindness in both 3,470 3,553
eyes (with 5/200 visual
acuity or less)
together with (a)
bilateral deafness
rated at 30 percent or
more disabling
(impairment of either
or both ears service-
connected) next higher
rate is payable, or (b)
service-connected total
deafness of one ear or
service-connected loss
or loss of use of an
extremity the next
intermediate rate is
payable, but in no
event may compensation
exceed.
(3) Blindness with only 3,470 3,553
light perception or
less with bilateral
deafness (hearing
impairment in either
one or both ears is
service-connected)
rated at 10 or 20
percent disabling, the
next intermediate rate
is payable, but in no
event may compensation
exceed.
(4) Anatomical loss or loss 3,470 3,553
of use of three
extremities, the next
higher rate in
paragraphs (l) to (n)
but in no event in
excess of.
(q) [This subsection
repealed by Public Law
90-493.].
(r) (1) If veteran entitled 1,490 1,525
to compensation under
(o) or to the maximum
rate under (p); or at
the rate between
subsections (n) and (o)
and under subsection
(k), and is in need of
regular aid and
attendance, he shall
receive a special
allowance of the amount
indicated at right for
aid and attendance in
addition to such rates..
(2) If the veteran, in 2,218 2,271
addition to need for
regular aid and
attendance is in need
of a higher level of
care, a special
allowance of the amount
indicated at right is
payable in addition to
(o) or (p) rate.
(s) Disability rated as 2,227 2,280
total, plus additional
disability
independently ratable
at 60 percent or over,
or permanently
housebound.
(t) [This subsection
repealed by Public Law
99-576.].
------------------------------------------------------------------------
In addition to basic compensation rates and/or statutory
awards to which the veteran may be entitled, dependency
allowances are payable to veterans who are rated at not less
than 30 percent disabled. The rates which follow are those
payable to veterans while rated totally disabled. If the
veteran is rated 30, 40, 50, 60, 70, 80 or 90 percent disabled,
dependency allowances are payable in an amount bearing the same
ratio to the amount specified below as the degree of disability
bears to total disability. For example, a veteran who is 50
percent disabled receives 50 percent of the amounts which
appear below.
COMPENSATION AND DIC RATES EFFECTIVE DECEMBER 1, 1999--Continued
------------------------------------------------------------------------
Increase (monthly rate)
-------------------------
From To
------------------------------------------------------------------------
If and while veteran is rated totally disabled
and--
Has a spouse.............................. $115 $117
Has a spouse and child.................... 197 201
Has no spouse, 1 child.................... 79 80
For each additional child................. 60 61
For each dependent parent................. 93 95
For each child age 18-22 attending school. 182 186
Has a spouse in nursing home or severely 217 222
disabled.................................
Has disabled, dependent adult child....... 217 222
------------------------------------------------------------------------
DEPENDENCY AND INDEMNITY COMPENSATION
The rates of dependency and indemnity compensation payable
with respect to service-related deaths occurring on and after
January 1, 1998, (and payable with respect to any service-
connected death if payments based on a veteran's rank would
result in a lesser payment) would be increased by 2.4 percent,
from $861 to $881 for the base rate, and from $187 to $191 for
the additional amount or ``kicker'' payable if the veteran
suffered from a service-connected disability rated as totally
disabling for a period of at least eight years immediately
preceding death.
The following table reflects increases provided for surviving
spouses of deceased veterans whose service-connected deaths
occurred prior to January 1, 1998, and who are not receiving
dependency and (DIC) payments under the new rate structure at a
higher rate:
------------------------------------------------------------------------
Increase (monthly rate)
Pay grade -------------------------
From To
------------------------------------------------------------------------
E-1-E6.................................... 861 881
E-7....................................... 890 911
E-8....................................... 940 962
E-9....................................... \1\980 \1\1,003
W-1....................................... 909 930
W-2....................................... 946 968
W-3....................................... 974 997
W-4....................................... 1,030 1,054
O-1....................................... 909 930
O-2....................................... 940 962
O-3....................................... 1,004 1,028
O-4....................................... 1,062 1,087
O-5....................................... 1,170 1,198
O-6....................................... 1,318 1,349
O-7....................................... 1,424 1,458
O-8....................................... 1,561 1,598
O-9....................................... 1,672 1,712
O-10...................................... \2\1,834 \2\1,878
------------------------------------------------------------------------
\1\ If the veteran served as Sergeant Major of the Army, Senior Enlisted
Advisor of the Navy, Chief Master Sergeant of the Air Force, Sergeant
Major of the Marine Corps, or Master Chief Petty Officer of the Coast
Guard, at the applicable time designated by section 1302 of this
title, the surviving spouse's rate shall be $1,082.
\2\ If the veteran served as Chairman or Vice-Chairman of the Joint
Chiefs of Staff, Chief of Staff of the Army, Chief of Naval
Operations, Chief of Staff of the Air Force, Commandant of the Marine
Corps or Commandant of the Coast Guard, at the applicable time
designated by section 1302 of this title, the surviving spouse's rate
shall be $2,013.
When there is no surviving spouse receiving dependency and
indemnity compensation, payment is made in equal shares to the
children of the deceased veteran. These rates are increased as
follows.
------------------------------------------------------------------------
Increase (monthly rate)
-------------------------
From To
------------------------------------------------------------------------
One child................................. $365 $373
Two children.............................. 526 538
Three children............................ 683 699
Each additional child..................... 133 136
------------------------------------------------------------------------
Effective date: December 1, 1999.
Cost: The Congressional Budget Office estimates that H.R.
2280,as amended, will add about $314 million to outlays in 2000
and about $377 million a year to outlays thereafter. However, a
cost of living adjustment equal to that payable to Social
Security recipients is assumed in the budget resolution
baseline, pursuant to section 257 of the Balanced Budget and
Emergency Act of 1997 (Public Law 105-33). As a result, the act
will have no budgetary effect relative to the baseline and
would have no pay-as-you-go impact.
Legislative history: Congressional Record, Vol. 145 (1999).
June 23, 1999: H.R. 2280 ordered reported amended favorably
by the Committee on Veterans' Affairs.
June 25, 1999: H.R. 2280 reported amended by the Committee
on Veterans' Affairs. H. Rept. 106-202.
June 29, 1999: Passed the House amended under suspension by
vote of 424-0 (Roll No. 257).
June 30, 1999: Referred to the Senate Committee on
Veterans' Affairs.
July 26, 1999: Senate Committee on Veterans' Affairs
discharged by unanimous consent
July 26, 1999: Passed Senate in lieu of S. 1393 with an
amendment by unanimous consent.
Nov. 9, 1999: House agreed to Senate amendment with
amendments pursuant to H. Res. 368.
Nov. 19, 1999: Senate agreed to the House amendments to the
Senate amendment by unanimous consent.
Nov. 30, 1999: Signed by the President, Public Law 106-118.
------
Public Law 106-142
COMMENDING THE WORLD WAR II VETERANS WHO FOUGHT IN THE BATTLE OF THE
BULGE
(H.J. RES. 65, AS AMENDED)
Title: A Act to Commend the World War II Veterans who
fought in the Battle of the Bulge, and for other purposes.
Summary: H.J. Res. 65, as amended, would:
1. Commend the veterans of service in the United States
Army who fought during World War II in the German Ardennes
offensive known as the Battle of the Bulge.
2. Honor those who gave their lives during that battle.
3. Authorize the President to issue a proclamation
calling upon the people of the United States to honor the
veterans of the Battle of the Bulge with appropriate programs,
ceremonies, and activities.
4. Call upon the President to reaffirm the bond of
friendship between the United States and both Belgium and
Luxembourg.
Effective date: Date of enactment.
Cost: The Congressional Budget Office estimates that the
cost of H.J. Res. 65 would have no effect on the federal budget
and would not affect direct spending or receipts. H.J. Res. 65
contains no intergovernmental or private sector mandates as
defined in the Unfunded Mandates Reform Act of 1995 and would
not affect the budget of state, local, or tribal governments.
Legislative history
Sep. 22, 1999: H.J. Res. 65 ordered reported amended
favorably by the Committee on Veterans' Affairs.
Sep. 30, 1999: H.J. Res. 65 reported amended by the
Committee on Veterans' Affairs. H. Rept. 106-352, Part I.
Oct. 5, 1999: Passed the House amended under suspension by
vote of 422-0. (Roll No. 475).
Oct. 6, 1999: Referred to the Senate Committee on the
Judiciary.
Nov. 2, 1999: Reported to the Senate by Senate Committee
on the Judiciary.
Nov. 19, 1999: Passed the Senate without amendments and
with a preamble by unanimous consent.
Dec. 7, 1999: Signed by the President, Public Law 106-142.
------
Public Law 106-413
VETERANS COMPENSATION COST-OF-LIVING ADJUSTMENT ACT OF 2000
(H.R. 4850, AS AMENDED)
Title: To provide a cost-of-living adjustment in rates of
compensation paid to veterans with service-connected
disabilites.
Summary: H.R. 4850, as amended, would:
1. Increase the rates, effective December 1, 2000, of
disability compensation for veterans with service-connected
disabilities and the rates of dependency and indemnity
compensation for survivors of certain disabled veterans.
2. Round down, to the next lower dollar amount, all
compensation and DIC benefits when the amount is not a whole
dollar amount.
Effective date: December 1, 2000.
Cost: The bill would have no budgetary effect relative to
the baseline as modified by the Balanced Budget Act of 1997.
Legislative history
July 20, 2000: H.R. 4850 ordered reported favorably by the
Committee on Veterans' Affairs.
July 24, 2000: H.R. 4850 reported by the Committee on
Veterans' Affairs. H. Rept. 106-783.
July 25, 2000: Passed the House under suspension by voice
vote.
July 25, 2000: Referred to the Senate Committee on
Veterans' Affairs.
Oct. 12, 2000: Senate Committee on Veterans' Affairs
discharged by unanimous consent.
Oct. 12, 2000: Passed the Senate with amendments and an
amendment to the Title by unanimous consent.
Oct. 12, 2000: Certain provisions incorporated. See. S.
1402, Title III, Subtitle A, Sections 301 and 302; and Subtitle
B, Section 313.
Oct. 17, 2000: House agreed to the Senate amendments under
suspension by voice vote.
Nov. 1, 2000: Signed by the President, Public Law 106-413.
------
Public Law 106-419
VETERANS BENEFITS AND HEALTH CARE IMPROVEMENT ACT OF 2000
(S. 1402, AS AMENDED)
Title: To amend title 38, United States Code, to increase
the rates of educational assistance under the Montgomery GI
Bill, to improve procedures for the adjustment of rates of pay
for nurses employed by the Department of Veterans Affairs, and
to make other improvements in veterans educational assistance,
health care, and benefits programs, and for other purposes.
Summary: S. 1402, as amended would:
Title I-Educational Assistance Provisions
Subtitle A-Montgomery GI Bill Educational Assistance
1. Increase, effective November 1, the All-Volunteer
Force Educational Assistance Program basic benefit (commonly
referred to as the Montgomery GI Bill or MGIB) to $650 per
month for a three-year period of service and $528 per month for
a two-year period of service.
2. Repeal the requirement that a servicemember obtain a
high school diploma or equivalency certificate prior to the
completion of the initial period of active duty as a condition
of eligibility for MGIB benefits.
3. Repeal the requirement that Montgomery GI Bill
entitlement is predicated on completing an initial obligated
period of service so that eligibility can be based on any
subsequent period of service.
4. Permit certain Post-Vietnam Era Veterans' Educational
Assistance program (VEAP) participants to enroll in the
Montgomery GI Bill program.
5. Permit servicemembers to ``buy up'' their MGIB basic
benefit by making an after-tax contribution of up to $600 which
would provide up to $5,400 in additional benefits over 36
months of entitlement, or an additional $150 per month.
Subtitle B-Survivors' and Dependents' Educational Assistance
1. Increase, effective November 1, the basic educational
allowance for survivors and dependents to $588 per month, with
annual cost-of-living adjustments.
2. Allow children eligible for survivors' and dependents'
educational assistance to choose the beginning date of their
eligibility period between the date on which a rating decision
is signed or the date of death and the date on which the
Secretary first finds the death service connected.
3. Permit the award of survivors' and dependents'
educational assistance payments to be retroactive to the date
of the entitling event, that is, the service-connected death or
award of a total and permanent disability rating.
4. Allow use of the survivors' and dependents'
educational assistance for preparatory courses for college and
graduate school entrance examination requirements.
Subtitle C-General Educational Assistance
1. Allow monthly educational assistance benefits to be
paid between term, quarter, or semester intervals of up to 8
weeks.
2. Allow veterans', survivors' and dependents'
educational assistance to be used to pay for up to $2,000 in
fees for civilian occupational licensing or certification
examinations; establish requirements regarding the use of such
entitlement and requirements for organizations or entities
offering licensing or certification tests; and establish a
seven-member VA Professional Certification and Licensing
Advisory Committee.
3. Increase the amount available for State Approving
Agencies for fiscal years 2001 and 2002 from $13 million to $14
million.
Title II-Health Provisions
Subtitle A-Personnel Matters
1. Authorize annual ``national'' comparability pay raises
for VA nurses on par with that of other federal employees.
2. Make optional annual locality survey processes for VA
nurse pay. Define ``triggers'' that indicate the need for
Directors to perform locality pay surveys for nurses such as
turnover, lag time, looming nurse shortage, to be defined in
criteria of Secretary; require communication to peer and senior
management of intent to survey; and report to Congress.
3. Eliminate sole discretion vested in facility directors
to make pay decisions; clarify that absence of nurse
recruitment or retention problem not be a basis for failure to
provide pay increases; prohibit ``negative pay adjustments'';
authorize use of independent survey results; and provide, to
extent practicable, for pay surveys to collect actual salary
and benefits data.
4. Provide for nurse participation in policy and
decision-making at network and medical center levels.
5. Revise and increase rates of special pay provided to
dentists employed by the Veterans Health Administration.
6. Add pharmacists to occupations that are exempt from
statutory caps on special salary rates.
7. Require the Under Secretary for Health to designate
physician assistants (PAs) to serve as consultants to the Under
Secretary and seek advice of PA consultants on all matters
relating to employment and utilization of PAs within VA.
8. Authorize temporary appointments of up to two years
for PAs who have successfully completed full course of training
and are pending certification.
9. Authorize temporary extensions of term appointments
for medical support personnel in VA-funded research.
10. LAuthorize the Secretary to waive state licensure
requirements for VA social workers while completing training.
11. LExtend and modify employee ``buyout'' legislation
through December 31, 2002.
Subtitle B-Military Service Issues
1. Provide a Sense of Congress Resolution urging VA to
document pertinent military experiences and exposures that may
contribute to a veterans' health status.
2. Require that VA enter into a contract with an
appropriate entity to carry out a new study on post-traumatic
stress disorder independent of VA, to follow up the study
conducted under section 102 of Public Law 98-160.
Subtitle C-Medical Administration
1. Authorize VA to furnish veterans and others
accompanying veterans with temporary lodging (such as ``Fisher
Houses'') in connection with treatment or other services.
2. Clarify VA establishment of VA outpatient clinics in
State veterans' homes.
3. Provide a Sense of Congress Resolution encouraging
expanded joint procurement of medical items to include
prescription drugs.
4. Facilitate enactment of the Veterans Millennium Health
Care and Benefits Act with technical and conforming changes.
Subtitle D-Construction Authorization
1. Authorize the Secretary to construct and authorize
appropriations of $120.9 million in fiscal year 2001 or 2002
for major construction (gero-psychiatric care building at the
Palo Alto, CA VA Medical Center [$26.6 million]; nursing home
at the Beckley, WV VA Medical Center [$9.5 million]; utility
plant at the Miami, FL VA Medical Center [$23.6 million--for
2001 only]; and seismic improvements project at the Long Beach,
CA VA Medical Center [$51.7 million]).
2. Authorize a previously appropriated [$14 million], but
not authorized, long-term psychiatric care facility at
Murfreesboro, TN VA Medical Center; and extend through 2002 a
previously authorized long-term care project at Lebanon, PA VA
Medical Center [$14.5million].
Subtitle E-Real Property Matters
1. Change the enhanced-use lease Congressional
notification period from 60 ``legislative'' days, to 90
``calendar'' days. It would also shorten the length of time VA
waits before entering into enhanced-use lease.
2. Release reversionary interest to State of Tennessee in
Johnson City (Mountain Home VA Medical Center) property
previously conveyed to Tennessee. (State has committed to
transfer the land for public park and recreation but cannot do
so without recision of government's reversionary interest.)
3. Transfer land at the former Allen Park, MI VA Medical
Center to Ford Motor Land Development Corporation. It would
also allow for environmental cleanup by VA (remediation of
hazardous material, etc.), and restoration of property to
precede transfer.
4. Transfer land at the Carl Vinson VA Medical Center,
Dublin, GA, to the State of Georgia.
5. Permit the land conveyance of Miles City, MT VA
Medical Center to Custer County, Montana. (Transfer will save
VA $500,000 for maintenance of facility, and provide funds to
expand veterans' access to care.)
6. Permit transfer of Fort Lyon, CO, VA Medical Center to
State of Colorado for use as state prison. (Conveyance to take
place only when arrangements made to protect interests of
patients and employees. Patients to be provided private or
other public care on same basis that care was provided by Ft.
Lyon. VA to maintain capacity for long term care as required by
law.)
Title III-Compensation, Insurance, Housing, Employment, and Memorial
Affairs Provisions
Subtitle A-Compensation Program Changes
1. Provide that a stroke or heart attack that is incurred
or aggravated by a member of a reserve component in the
performance of duty while performing inactive duty training
shall be considered to be service connected for purposes of
benefits under laws administered by the Secretary of Veterans
Affairs.
2. Make women veterans eligible for special monthly
compensation under section 1114(k) of title 38, United States
Code, due to the service-connected loss of one or both breasts,
including loss by mastectomy.
3. Provide compensation and health care benefits to
veterans injured as a result of participation in a VA
compensated work therapy program.
4. Increase the amount of resources an incompetent
veteran with no dependents may retain and still qualify for
payment of benefits from $1,500, to five times the benefit
amount payable to a service-disabled veteran rated as totally
disabled while being provided institutional care without charge
at VA's expense.
5. Require the Department of Defense to contract with the
National Academy of Sciences (NAS) to carry out periodic
reviews of the dose reconstruction program of the Defense
Threat Reduction Agency. The review would last 24 months and
culminate in a report detailing NAS' findings and
recommendations, if any, for a permanent review program.
Subtitle B-Life Insurance Matters
1. Cap Service Disabled Veterans' Life Insurance (SDVI)
premiums at the age 70 renewal rate; require VA to report to
Congress, not later than September 30, 2001, on plans to
liquidate unfunded liability in the SDVI program over the next
ten years.
2. Increase the maximum amount of coverage available
through the Servicemembers' Group Life Insurance program and
the Veterans' Group Life Insurance program from $200,000 to
$250,000.
3. Allow members of the Individual Ready Reserve who are
subject to involuntary call-up authority to enroll in the
Servicemembers' Group Life Insurance program.
Subtitle C-Housing and Employment Programs
1. Allow VA to make the maximum grant for specially
adapted housing in cases where title to the housing unit is not
vested solely in the veteran, if the veteran resides in the
housing unit.
2. Add recently separated veterans (veterans who have
been discharged or released from active duty within a one-year
period) to the definition of veterans to whom Federal
contractors and subcontractors must extend affirmative action
to employ and advance.
3. Require employers to grant an authorized leave of
absence for employees who are members of a reserve component to
participate in honor guards for funerals of veterans.
Subtitle D-Cemeteries and Memorial Affairs
1. Extend eligibility for burial in national cemeteries
to those Philippine Commonwealth Army veterans who die after
enactment of section 331 of this legislation who 1) have either
become citizens of the United States or have been lawfully
admitted for permanent residence, and 2) who reside in the
United States.
2. Provide a full-rate burial benefit and plot allowance
to Philippine Commonwealth Army veterans who, at the time of
death, 1) are citizens of the United States or have been
lawfully admitted for permanent residence and are residing in
the U.S. and 2) are receiving compensation for a service
connected disability or would have been eligible for VA pension
benefits had their service been deemed to have been active
military, naval, or air service.
3. Authorize VA to pay a plot allowance for burial of
veterans in State veterans' cemeteries even though the cemetery
allows burials of reservists who are not eligible for burial in
national cemeteries.
Title IV-Other Matters
1. Provide health care, vocational training, and monetary
allowances to the children of women Vietnam veterans who suffer
from certain birth defects.
2. Extend temporary authorities through fiscal year 2008
that would otherwise expire on September 30, 2002, including:
VA-enhanced loan asset authority guaranteeing the payment of
principal and interest on VA-issued certificates or other
securities; VA home loan fees of \3/4\ of one percent of the
total loan amount; procedures applicable to liquidation sales
on defaulted home loans guaranteed by VA; VA/Department of
Health and Human Services income verification authority through
which VA verifies the eligibility for, VA needs-based benefits
and VA means-tested medical care by gaining access to income
records of the Department of Health and Human Services/Social
Security Administration and the Internal Revenue Service;
limitation on payment of VA pension to veterans without
dependents who are receiving Medicaid-covered nursing home
care; VA's special committee relating to the care of the
seriously chronically mentally ill; and extend through 2005
VA's authority to establish nonprofit foundations to foster
research, education, or both, in VA medical centers.
3. Reinstate the requirements that the Secretary provide
periodic reports concerning equitable relief granted by the
Secretary to an individual beneficiary (expires December 31,
2004); work and activities of the Department; programs and
activities examined by the Advisory Committees on (1) former
prisoners of war and (2) women veterans (expires after biennial
reports submitted in 2003); operation of the Montgomery GI Bill
educational assistance program (expires December 31, 2004); and
activities of the Secretary's special medical advisory group
(expires December 31, 2004). The Secretary shall include with
any report that is required by law or by a joint explanatory
statement of a Congressional conference committee an estimate
of the cost of preparing the report.
Effective date: Date of enactment except the following
sections:
Sec. 101(a): November 1, 2000 and shall apply with respect
to educational assistance allowances paid under chapter 30 for
months after October 2000.
Section 102(a) through (d): November 1, 2000 and shall
apply with respect to educational assistance allowances paid
under chapter 35 for months after October 2000.
Section 102(f): Sections 3654 and 3687(d) as added by
amendments made by this section shall take effect with respect
to Fiscal Year 2002.
Section 105: May 1, 2001, with retroactive eligibility to
``buy up'' until July 31, 2001, for servicemembers separated
after enactment but prior to May 1, 2001.
Section 106: March 1, 2001
Section 107: January 1, 2000.
Section 301: December 1, 2000.
Section 322: First day of the first month that begins more
than 120 days after the date of enactment.
Section 401: First day of the first month beginning more
than one year after date of enactment, except as provided in
paragraph (2).
Section 405: Shall take effect with respect to funds
appropriated for Fiscal Year 2002.
Legislative history
July 20, 1999: Reported to the Senate. S. Rept. 106-114
July 26, 1999: Passed the Senate by unanimous consent.
July 27, 1999: Referred to the House Committee on Veterans'
Affairs, and in addition to the House Committee on Armed
Services.
May 23, 2000: Passed the House amended under suspension by
vote of 417-0 (Roll No. 220). [The House amendment consisted of
the text of H.R. 4268 as reported.]
May 24, 2000: Message on House action received in the
Senate and at the desk: House amendments to Senate bill.
Oct. 12, 2000: Senate concurred in the House amendments
with an amendment (SA 4314) and an amendment to the Title by
unanimous consent. (Note: Consists of certain provisions from
H.R. 284, H.R. 4268, H.R. 4850, H.R. 5109, S. 1076, S. 1810 and
S. 3011.)
Oct. 17, 2000: House agreed to the Senate amendments to the
House amendments under suspension by voice vote.
Nov. 1, 2000: Signed by the President, Public Law 106-419.
------
Public Law 106-475
VETERANS CLAIMS ASSISTANCE ACT OF 2000
(H.R. 4864, AS AMENDED)
Title: To amend title 38, United States Code, to reaffirm
and clarify the duty of the Secretary of Veterans Affairs to
assist claimants for benefits under laws administered by the
Secretary, and for other purposes.
Summary: H.R. 4864, as amended, would:
1. Define a ``claimant'' who would be eligible to receive
assistance from the Secretary as any person seeking veterans'
benefits.
2. Require the Secretary to furnish all instructions and
forms necessary when a request is made, or intent expressed, by
any person applying for veterans benefits.
3. Require the Secretary to notify the veteran of any
information or evidence needed in order to substantiate the
claim.
4. Eliminate the requirement that a claimant submit a
``well-grounded'' claim before the Secretary can assist in
obtaining evidence. (In the context of claims for service-
connected disability benefits, a ``well-grounded'' claim is one
that has evidence of in-service injury or disease, a diagnosis
of a current disability or disease, and a medical opinion that
the current disability or disease is related to the in-service
injury or disease).
5. Require the Secretary to make reasonable efforts to
assist a claimant and obtain evidence and relevant records that
the claimant identifies and authorizes the Secretary to obtain,
unless there is no reasonable possibility that assistance would
aid in substantiating the claim.
6. For service-connected disability compensation claims,
require the Secretary to 1) obtain existing service medical
records and other relevant records pertaining to the claimant's
active military, naval, or air service that are maintained by a
governmental entity if the claimant provides sufficient
information to locate them, and 2) provide a medical
examination or obtain a medical opinion when such an
examination (or opinion) is necessary to make a decision on the
claim.
7. Require other Federal agencies to furnish relevant
records to the Department at no cost to the claimant.
8. Require the Secretary to consider all information and
lay and medical evidence of record. The Secretary would be
required to give the benefit of the doubt to the claimant when
there is an approximate balance of positive and negative
evidence regarding an issue material to the determination of a
matter.
Effective date:
The changes made by the bill would apply to any claim filed
1) on or after date of enactment or 2) filed before date of
enactment and not final as of date of enactment. Also, any
claim decided on or after July 14, 1999, can be readjudicated
at the request of the claimant or on the Secretary's own motion
made within two years of enactment.
Cost: The Congressional Budget Office estimates that
implementing the bill would cost $4 million in 2001 and $7
million to $8 million annually thereafter. Because the bill
would not affect direct spending or receipts, pay-as-you-go
procedures would not apply.
Legislative history
July 20, 2000: H.R. 4864 ordered reported favorably, as
amended, by the Committee on Veterans' Affairs.
July 24, 2000: H.R. 4864 reported, as amended, by the
Committee on Veterans' Affairs. H. Rept. 106-781.
July 25, 2000: Passed the House, as amended, under
suspension by vote of 414-0 (Roll No. 432).
July 25, 2000: Referred to the Senate Committee on
Veterans' Affairs.
Sep. 25, 2000: Senate Committee on Veterans' Affairs
discharged by unanimous consent.
Sep. 25, 2000: Passed the Senate with an amendment by
unanimous consent.
Oct. 17, 2000: House agreed to the Senate amendment under
suspension by voice vote.
Nov. 9, 2000: Signed by the President, Public Law 106-475.
ACTIVITIES OF THE SUBCOMMITTEES
Subcommittee on Health
The Subcommittee on Health has legislative and oversight
jurisdiction over the Department of Veterans Affairs' health
care programs and the VA's health care delivery system (see
Oversight Plan for 106th Congress, p. 83).
Legislative Activities
First Session
On June 9, 1999, H.R. 2116, the Veterans Millennium Health
Care Act, was introduced in the House and marked up in the
Subcommittee on Health. Four years ago, this Committee
developed and held hearings on legislation to reform VA rules
governing eligibility for care. That eligibility reform
legislation, Public Law 104-262, paved the way for a major
shift from primary use of hospital-focused services to less
costly outpatient care. It also resulted in vastly improved
access to care for many veterans, particularly with respect to
VA's establishment of hundreds of community-based clinics.
Eligibility legislation was intended as an initial step on
a path to reform of the VA health care system. With H.R. 2116,
the VA Committee took another significant step in addressing
some major challenges for VA. This legislation tackled many of
the key issues discussed in hearings in the 105th Congress, and
offered a blueprint to better position VA to meet the pressing
needs of aging veterans in the new millennium. The bill had
four central themes: (1) to provide new direction to address
veterans' long-term care needs; (2) to expand veterans' access
to care; (3) to close gaps in current eligibility law; and (4)
to establish needed reforms to improve the VA health care
system. The legislation also included long-term care reforms
that would mandate VA to operate and maintain a national
program of extended care services including needed services for
50 percent service-connected veterans or extended care for
veterans in need of care for a service-connected condition.
Other provisions included improving access through facility
realignments, providing specific authority for VA care and
treatment of veterans who sustained injuries in combat
recognized by the award of the Purple Heart, and directing the
Secretary to establish more rational co-payments for Category
C, ``higher income'' veterans. The measure also would authorize
VA to reimburse uninsured veterans their emergency care costs
in private facilities, provided they were VA-enrolled, Category
A (Priority 1 through 6) veterans who had received VA care
within the previous 12 months.
A major provision of the ``Millennium Bill'' would require
VA to establish enhanced services programs to improve access
and quality of service provided at medical centers that no
longer can provide high quality, efficient care due to current
or projected need for service, an aging physical plant, or the
availability of convenient contract services in the community.
This provision would set the stage for major restructuring of
some unneeded facilities to enable VA to accelerate
restructuring for better quality, more convenient and more
accessible care for veterans.
This legislation also provided that if the United States
were successful in recouping costs incurred by the Government
attributable to tobacco-related illnesses, the VA would retain
the proportional amount of the funds attributable to VA for
providing care to veterans for tobacco-related illnesses. These
funds would be deposited in a trust fund in the U.S. Treasury
to be used after fiscal year 2004 for providing medical care
and conducting VA medical and prosthetic research.
On June 23, 1999, the full Committee approved the bill and
ordered it to be reported to the full House.
The Subcommittee on Health heard testimony at a hearing on
June 30, 1999, concerning cost estimates for H.R. 2116. The
principal witnesses were Mr. Paul N. Van de Water, Assistant
Director for Budget Analysis, Congressional Budget Office; and
Dr. Thomas L. Garthwaite, VA Deputy Under Secretary for Health.
Testimony indicated a discrepancy between the budget estimates
for long-term care from the Congressional Budget Office (CBO),
and from VA. VA's estimate, based on experience and trends in
long-term care, was between $115-$184 million during the first
year with offsets from co-payment collections, while CBO's
estimate of VA's resource requirements, more theoretical in
nature, was $1 billion per year.
Based on cost concerns, the extended care provision was
later changed from a required 50 percent service-connection to
a 70 percent service-connection. The emergency care provision
was changed in the compromise language to a two-year (rather
than 12 month) requirement for VA care prior to emergency
services being reimbursed by VA, but eligibility was extended
to veterans of any priority group who were enrolled in the VA
health care system. Conference language for H.R. 2116 did not
include the tobacco illness provision. The enhanced services
program was dropped in conference, but the idea was taken up by
VA in its ``Capital Assets Realignment for Enhanced Services''
(CARES) program.
As agreed by conferees, a new provision was added to the
Millennium Bill to authorize a voluntary separation incentive
program in which VA could offer up to 4,770 ``buyouts'' to
selected VA employees and various staff offices. The program
was intended to address VA's management needs but not to serve
as a means for VA to ``downsize'' its workforce. The Committee
closely observed VA's actions under this authority throughout
the second session of the 106th Congress to ensure that buyouts
were offered when these employment shifts were in VA's best
interest; to restructure health care programs to enhance the
quality of care for veterans; and to improve access to care for
aging veterans.
H.R. 2116, the Veterans Millennium Health Care and Benefits
Act, was signed into law on November 30, 1999 (See summary of
Public Law 106-117, p. 29).
Second Session
During the second session of the 106th Congress, VA
personnel issues and coordination of hospital benefits for
veterans became issues forming the backbone for legislative
development proposed by Members. Their ideas were incorporated
in H.R. 4759, the ``VA Health Care Personnel Act of 2000.'' VA
personnel issues were the focus of a hearing on recruitment,
retention, and compensation of the VA health care workforce on
April 12, 2000.
Testimony at the hearing documented that nurses were not
receiving locality pay increases that Congress had intended
with legislation enacted in 1990. For example, if a medical
center director decided that nurse locality pay increases were
cost-prohibitive, pay remained at pre-survey levels, and in a
few cases, pay rates were actually reduced. Also, the locality
system itself was flawed in that sometimes needed pay raises
were prevented from being approved.
With a large percentage of the VA dental workforce becoming
eligible for retirement or expected to retire in the next
several years, witnesses testified that renewed pay incentives
for VA's dental workforce would be necessary to keep many
dental services viable at medical centers. Legislation in 1991
had authorized VA to pay physicians and dentists supplementary
amounts of pay (above base pay rates) in exchange for their
agreements to work for additional specified terms. This special
pay authority was intended to give the agency flexibility to
respond to local labor market conditions. At the time in 1991,
recruitment and retention of dentists did not pose as
significant a problem for VA as it did for physicians and,
accordingly, the Act provided lesser amounts of special pay in
most categories for VA dentists than for VA physicians. Prior
to the hearing, Representative Bob Filner of California had
introduced legislation, H.R. 2660, which spurred the
Committee's interest and action in addressing inequities in
dental pay.
During the VA capital asset planning hearing on April 5,
2000, Representative Dave Weldon of Florida spoke of the
success of a pilot project in his Congressional district in
which veterans who were treated at the Viera Beach VA
Outpatient Clinic were hospitalized in local hospitals for
routine inpatient care, with VA coordinating their hospital
benefits. Veterans who were approved for this program did not
travel great distances to a VA medical center for these
hospital episodes. Mr. Weldon had proposed legislation, H.R.
4575, that would allow for several pilot programs throughout
the country to provide veterans enrolled in VA outpatient care,
but living distant from a VA medical center, to receive care at
local hospitals for general medical-surgical hospitalizations.
This provision was included in H.R. 4759 and then, later in the
session, with significant changes to clarify intent and limit
expenditures, in H.R. 5109. During negotiations with the
Senate, the pilot proposal was dropped from the language in S.
1402.
Many of the provisions of H.R. 4759 were subsequently
incorporated into a bipartisan bill, H.R. 5109, the Department
of Veterans Affairs Health Care Personnel Act of 2000, a bill
that was marked up by the Subcommittee on Health on September
7, 2000 and unanimously approved by the full Committee on
September 13, 2000.
Section 101 of H.R. 5109 would reform the local labor
market survey process and replace it with a discretionary
survey technique. The bill would provide more flexibility to VA
medical center directors to obtain the data needed to complete
necessary surveys and also restrict their authority to withhold
indicated rate increases. Directors would be prohibited from
reducing nurse pay. In addition, the House bill would also
guarantee VA nurses a national comparability increase
equivalent to the amount provided to other federal employees.
The bill also would require Veterans Health Administration
network directors to consult with nurses on questions of policy
affecting the work of VA nurses, and would provide for
registered nurses' required participation on medical center
committees considering clinical care, budget matters, or
resource allocation involving the care and treatment of veteran
patients. The Senate had no comparable provision in its
legislation, so these provisions became part of S.1402.
With respect to VA dentist pay levels, the compromise
agreement between the Houses included the House language in
which the Committees urge medical center directors to utilize
the full range of pay increases authorized, including increases
in the higher range, to optimize dentist recruitment and
retention efforts.
Under this legislation, the Under Secretary would be
required to designate physician assistants (PAs) to serve as
consultants to the Under Secretary to provide advice on all
matters related to employment and utilization of PAs in the
Department of Veterans Affairs.
Other major health provisions in S. 1402 included
construction authorization in Palo Alto, Beckley, Miami, and
Long Beach, authorizing a long-term care psychiatric facility
at the Murfreesboro VA Medical Center, and extending
authorization for a long-term care project at the Lebanon VA
Medical Center.
Real property matters in S. 1402 included changing the
enhanced-use lease Congressional notification period from 60
``legislative'' days to 90 ``calendar'' days. The bill
transfers parcels of land from Carl Vinson VA Medical Center to
the State of Georgia; from Allen Park VA Medical Center to Ford
Motor Land Development Corporation; from Miles City VA Medical
Center to Custer County, Montana; and from Fort Lyon VA Medical
Center to the State of Colorado; with conditions. The Miles
City and Fort Lyon matters were proposed in a Senate bill. This
language was adopted in the compromise agreement.
S. 1402, the Veterans Benefits and Health Care Improvement
Act of 2000, passed the Senate on October 12, 2000, passed the
House on October 17, 2000, and became Public Law 106-419.
Oversight Activities
First Session
The Subcommittee on Health held a hearing on February 24,
1999 to give the Department of Veterans Affairs an opportunity
to justify its budget request for VA medical care for FY 2000.
The principal VA witness appearing at this hearing was Dr.
Thomas L. Garthwaite, Deputy Under Secretary for Health. A
panel of national veterans organizations also presented their
views, including Mr. Dennis Cullinan, Executive Director,
Veterans of Foreign Wars; Ms. Jacqueline Garrick, Deputy
Director, National Veterans Affairs and Rehabilitation, The
American Legion; Mr. Richard Wannemacher, Jr., Associate
National Legislative Director, Disabled American Veterans; Mr.
Harley Thomas, Associate Legislative Director, Paralyzed
Veterans of America; Ms. Veronica A'zera, Legislative Director,
AMVETS; Mr. George C. Duggins, National President, Vietnam
Veterans of America; and Mr. Nick Bacon, Director, Arkansas
Department of Veterans Affairs.
Testimony was submitted for the record by Mr. Bobby L.
Harnage, Sr., National President, American Federation of
Government Employees. These individuals and organizations
offered testimony on the President's budget request for
veterans health care programs. A number of subcommittee Members
expressed concerns about the adequacy of the budget request to
maintain quality of care for an aging veteran population, given
the Administration's apparent objective of holding VA's medical
care spending to a fixed level in the face of obvious and
persistent financial difficulties, especially in the northern,
central and eastern parts of the national system. These
concerns were not assuaged as a result of this hearing, and the
Committee subsequently made strong recommendations to the
Budget and Appropriations Committees to significantly increase
the Veterans Benefits and Services allotment and Medical Care
appropriation, respectively, for the fiscal year 2000 period.
On March 10, 1999, the Subcommittee on Health held a
hearing on VHA capital asset management. This hearing was
motivated by the subcommittee's concerns about the state of
VA's infrastructure, 4,700 aging and increasingly unused
buildings. Appearing as GAO's lead witness was Mr. Stephen
Backhus, Director of Veterans' Affairs and Military Health Care
Issues. Also testifying at this hearing was Dr. Daniel H.
Winship, Dean of the Loyola University Chicago Stritch School
of Medicine and former VHA Associate Deputy Chief Medical
Director. Dr. Thomas Garthwaite, Deputy Under Secretary for
Health, appeared as the VA's lead witness.
GAO testified that VA could enhance veterans' health care
benefits if it reduced the level of resources spent on
underused, inefficient, and obsolete buildings and instead
reinvested these savings in providing health care more
efficiently in modern facilities at existing locations or in
new locations closer to where veterans live. GAO expressed
concern at VA's slow progress in addressing the need to deal
with its unneeded capital infrastructure. VA's witnesses
expressed agreement in principle with GAO's critique, but
asserted that VA's new approach was designed to address many of
these concerns and would render overall improvements in VA's
capital assets management practices (see Subcommittee on
Oversight and Investigations follow-up hearing, July 22, 1999,
p. 71).
As a result of the March 10, 1999 and July 22, 1999
hearings, the Committee included in Title II of its initial
1999 health care bill, H.R. 2116, a statutory system to
authorize VA to probe alternative uses and enhanced services to
veterans from proceeds realized by disposals through out-
leasing, sale or donation of unneeded VA capital facilities.
This statutory language was eventually dropped in conference
with the Senate, but some of its objectives were subsequently
realized in the previously discussed CARES initiative,
currently underway.
On April 21, 1999, the Subcommittee on Oversight and
Investigations and the Subcommittee on Health held a joint
hearing on suspension of medical research at the West Los
Angeles and Sepulveda VA medical facilities, and on the status
of informed consent and patient safety in VA medical research.
The principal witnesses were Dr. J. Thomas Puglisi, Director,
Division of Human Subject Protections, Office for Protection
from Research Risks, National Institutes of Health, Department
of Health and Human Services; Dr. Dean C. Norman, Acting Chief
of Staff, West Los Angeles VAMC; Dr. Stephen Pandol, Former
Director, Research and Development, West Los Angeles VAMC; Mr.
Kenneth Clark, Chief Network Officer and Former Director, West
Los Angeles VAMC; and Mr. Ronald Norby, Clinical Manager and
Deputy Network Director, VISN 22. Also testifying were the
Honorable Kenneth Kizer, VA Under Secretary for Health; Dr.
Eric M. Meslin, Executive Director, National Bioethics Advisory
Commission; Dr. Paul Appelbaum, Chair, Department of
Psychiatry, University of Massachusetts Medical School, and
Chair, American Psychiatric Association Ethics Appeals Board;
and Dr. Adil E. Shamoo, Professor, Department of Biochemical
and Molecular Biology, University of Maryland, Baltimore.
While VA in its testimony attempted to reassure the
subcommittees regarding its research program at West Los
Angeles, other witnesses did not provide a basis for the
subcommittees to be confident that human subject protections
throughout the VA were thorough and rigorous. Therefore, the
subcommittees subsequently requested GAO to conduct a
comprehensive review of VA's human subject research programs
(see Subcommittee on Oversight and Investigations follow-up
hearing, September 28, 2000, p. 79).
The Subcommittee on Health held a hearing on VA long-term
care on April 22, 1999 to examine VA actions in the wake of the
Report of the Federal Advisory Committee on VA long-term care.
The VA's lead witness was the Honorable Kenneth W. Kizer, Under
Secretary for Health. Other witnesses were Dr. John W. Rowe,
Chairman, Federal Advisory Committee on the Future of VA Long-
Term Care; Mr. Robert Shaw, President, National Association of
State Veterans Homes; Ms. Pamela Zingeser, Principal, Birch and
Davis Associates, Inc.; Ms. Kathleen Greve, Chief, VA State
Home Construction; Mr. Steve Watson, Administrator, Ocala
Harborside Healthcare Nursing Home, Ocala, Florida; and Mr.
Richard Jelinek, Senior Vice President, Managed Care Solutions.
The advisory committee concluded that VA needed to launch
more alternatives to the traditional approach of building and
staffing VA nursing home beds to meet the needs of an aging
veteran population. Among its recommendations were those to
encourage VA to expand and enhance adult day care, assisted
living, respite care and hospice care, and to rely more on
community-based programs rather than VA institutional programs
in attempting to meet these needs. VA testified that it was
making progress on some of these initiatives but needed
statutory clarification in order to proceed with some of the
recommendations of the advisory committee. The Committee
subsequently enacted expansions of a variety of VA long-term
care programs in Public Law 106-117, the Veterans Millennium
Health Care and Benefits Act of 1999.
On July 15, 1999, the Subcommittee on Health conducted a
hearing on VA's experience in implementing patient enrollment
under Publilc Law 104-262. The principal witnesses were Mr.
Stephen P. Backhus, Director, Veterans' Affairs and Military
Health Care Issues, GAO; and Dr. Thomas L. Garthwaite, VA
Acting Under Secretary for Health.
This hearing concentrated on the issue of ``Priority 7''
veterans--those whose incomes are higher than the means test
threshold and who must therefore agree to make co-payments to
VA as a condition of eligibility. The Committee was concerned
about the manner in which the VA Secretary had been managing
the policy of annual enrollments as it affected these Priority
7 veterans. The purpose of the hearing was to review whether VA
was implementing correctly the statutory policy. In addition,
the Committee focused on the level of funding available for VA
health care--principally whether the management of eligibility
policy and allocation of available resources were consistent
and rational.
On November 16, 1999, the Subcommittee on Health and
Subcommittee on Oversight and Investigations conducted a joint
hearing on the issue of the Department of Defense's use of the
substance pyridostigmine bromide (PB) as a pre-treatment to
protect against possible chemical nerve agent attacks in
250,000 U.S. military service members in the Persian Gulf War.
The witnesses included Dr. Beatrice Alexandra Golomb,
Consultant, RAND Center for Military Health Policy Research,
accompanied by Dr. C. Ross Anthony, Director; and Dr. Joseph S.
Cassells, Project Director, Institute of Medicine, National
Academy of Sciences. Other participants included the Honorable
Sue B. Bailey, Assistant Secretary of Defense for Health
Affairs; and Dr. Bernard D. Rostker, Special Assistant to the
Deputy Secretary of Defense for Gulf War Illnesses. The VA's
lead witness was Dr. Frances Murphy, Acting Deputy Under
Secretary for Health. Service organizations were represented by
Mr. Matthew L. Puglisi, Director of Veterans Affairs and
Rehabilitation, The American Legion; Mr. Paul Sullivan,
Executive Director, National Gulf War Resource Center; and
Persian Gulf veteran nurse, Denise Nichols, Vice-Chairman,
National Vietnam and Gulf War Veterans Coalition. The
testimonies of witnesses explored the use of PB in the war, the
possibility of toxic effects in human beings, and any potential
relationship of PB exposure to the maladies often referred to
as ``Gulf War illnesses.''
Second Session
The House Committee on Commerce Subcommittee on Health and
Environment and the Veterans' Affairs Subcommittee on Health
conducted a joint hearing on medical errors and improving the
quality of care on February 9, 2000. Witnesses included Dr.
Donald M. Berwick, President and CEO, Institute of Healthcare
Improvement, testifying for the Institute of Medicine; Mr.
Randall Bovbjerg, Principal Research Associate, The Urban
Institute; and Dr. Kenneth Kizer, President and Chief Executive
Officer, The National Quality Forum and former VA Under
Secretary for Health; Dr. Thomas Garthwaite, Deputy Under
Secretary for Health, VHA; Ms. Janet Heinrich, Associate
Director, Health Financing and Public Health Issues, GAO; Dr.
Audrey Nelson, Director of Patient Safety Center of Inquiry,
James A. Haley VAMC; Ms. Diane Cousins, Vice President,
Practitioner and Product Experience Division, United States
Pharmacopeia. Other witnesses included Mr. Daniel Perry,
Executive Director, Alliance for Aging Research, testifying on
behalf of the Foundation for Accountability; Dr. William
Golden, President, American Health Quality Association; Ms.
Mary Foley, President, American Nurses Association; Dr. Dennis
S. O'Leary, President, Joint Commission on Accreditation of
Healthcare Organizations; and Dr. Michael L. Lanberg, Senior
Vice President, Medical Affairs, Chief Medical Officer, Cedars-
Sinai Health System, testifying on behalf of the American
Hospital Association.
This hearing was the result of concerns expressed in a
landmark report by the Institute of Medicine of the National
Academy of Sciences. The report concluded that preventable
patient injuries from a wide range of medical mistakes were
jeopardizing patient safety across all facets of American
health care. IOM's report, however, noted VA's policies and
practices are designed to protect VA patient safety by using a
systems approach to reducing medical errors. The hearing
explored these issues in depth.
The Subcommittee on Benefits and Subcommittee on Health
conducted a joint hearing March 9, 2000 on homeless veterans
issues with Miss Heather French of Kentucky, Miss America 2000,
as keynote witness. Miss French was joined in testimony by a
number of VA officials, including clinicians working in various
aspects of veterans programs for the homeless, as well as
representatives from the veterans service organizations. Their
testimony indicated that VA's programs are effective in meeting
the needs of the homeless veterans VA actually serves, that a
significant number of veterans in the United States still
remain or will become homeless, and that VA is not reaching
these veterans with the level of resources available to these
programs.
On April 5, 2000, the subcommittee held a hearing on
capital asset planning in the VA health care system.
Representative Dave Weldon of Florida presented his proposal
for a pilot program for veterans health benefits coordination
of VA-enrolled veterans through other insurers, including
Medicare and indemnity insurers, in four VA community-based
clinic sites. Mr. Weldon subsequently introduced his
legislation on May 25, 2000, as H.R. 4575. The proposal
authorized program participants to use local community
hospitals for basic acute inpatient care. The subcommittee also
heard testimony from VA, GAO and veterans service
organizations. Two VA network directors testified on their
local plans for restructuring VA facilities within their
jurisdictions. Following the hearing, the Committee developed
legislation that would authorize the pilot program of
coordinating benefits envisioned by Dr. Weldon. This
legislation was incorporated in H.R. 5109 (see Legislative
Activities, pp. 51-52).
Recruitment, retention, and compensation of the VA health
care workforce were examined in a hearing on April 12, 2000 by
the Subcommittee on Health. Witnesses for this hearing were Mr.
Kenneth J. Clark, VA Chief Network Officer; Dr. John F. Burton,
Jr., National Association of VA Physicians and Dentists; Dr.
Robert M. Anderton, American Dental Association; Ms. Margaret
Kruckemeyer, President, Nurses Organization of Veterans
Affairs; and Mr. Bobby Harnage, Sr., President, American
Federation of Government Employees.
The subcommittee focused on the pay rates and systems for
VA nurses and dentists, especially their impact on recruitment,
retention and professional employee morale issues.
Subsequently, the full Committee incorporated measures to
reform VA nurse pay and to update VA dentist pay in its major
health care legislation for 2000, H.R. 5109 (see also p. 52).
The subcommittee's hearing on May 17, 2000 examined health
resource sharing between the Departments of Veterans Affairs
and Defense. Witnesses included Mr. Anthony J. Principi,
Chairman, Congressional Commission on Servicemembers and
Veterans Transition Assistance and former VA Deputy Secretary;
Mr. Stephen P. Backhus, Director, Veterans' Affairs and
Military Health Care Issues, GAO; Dr. Thomas L. Garthwaite, VA
Deputy Under Secretary for Health, Ms. Gwendolyn A. Brown,
Deputy Assistant Secretary of Defense, Health Budgets and
Financial Policy, and Lt. Gen. Paul K. Carlton, Jr., Surgeon
General, USAF.
From testimony given at this hearing, the subcommittee
concluded that while sharing has been a worthwhile effort on
the part of both Departments, a number of barriers have
prevented additional sharing and should be addressed (see also
Subcommittee on Oversight and Investigations hearing, May 25,
2000, on VA-DOD joint pharmaceutical procurement, p. 76).
Pharmaceutical procurement policy was also examined in a
subcommittee hearing on July 25, 2000 with Mr. William Flynn,
Director, Retirement and Insurance Programs, Office of
Personnel Management; the Honorable Edward A. Powell, VA
Assistant Secretary for Management; Mr. Richard A. Wannemacher,
Jr., Assistant National Legislative Director, Disabled American
Veterans; and Dr. Robert B. Betz, Executive Director, Health
Industry Group Purchasing Association; as the principal
witnesses.
The Office of Personnel Management and the VA were at the
time of the hearing in negotiation to jointly sponsor an
experiment in pharmaceutical procurements involving the use of
the Federal Supply Schedule (FSS) by a participating
organization of the Federal Employee Health Benefits Program.
The experiment was intended to test whether this method of
procurement through the FSS might offer a significant price
advantage to this initial group of federal employees, and
whether a price advantage could be gained by future expansion
to other health plans used by federal workforce and federal
retiree groups.
The subcommittee was concerned about the implications of
this initiative on the prices VA's pharmaceutical procurement
programs are able to obtain under current law. Several weeks
after the hearing, OPM announced that the pilot project had
been cancelled due to lack of cooperation by pharmaceutical
manufacturers.
The subcommittee's final hearing of the 106th Congress was
conducted on October 3, 2000 on the issue of chiropractic
services in the Department of Veterans Affairs. Testifying as
VA's principal witness was Dr. Frances M. Murphy, Acting Deputy
Under Secretary for Health. Other witnesses were Dr. Rick A.
McMichael, American Chiropractic Association; Dr. Michael S.
McLean, International Chiropractors Association, accompanied by
Mr. Ronald M. Hendrickson, Executive Director, International
Chiropractors Association; Dr. George Goodman, President, Logan
College of Chiropractic, and Immediate Past President,
Association of Chiropractic Colleges, accompanied by Dr. Reed
Phillips, President, Los Angeles College of Chiropractic and
Past President, Association of Chiropractic Colleges. The
principal witness for the Department of Defense was RADM
Michael L. Cowan, USN, Deputy Executive Director and Chief
Operating Officer, TRICARE Management Activity, Office of the
Assistant Secretary of Defense for Health Affairs.
Chiropractors had expressed concerns about their
perceptions of barriers to their profession's effective
utilization within the VA. Specifically, the professional
organizations advocated for an increased role in direct health
care delivery to veterans under the Department's care. VA
opposed involving chiropractors as primary care providers
within the VHA and instead relied upon policy VA published on
May 5, 2000.
Under this policy, Veterans Integrated Service Networks
(VISNs) or medical centers were required to establish local
policies consistent with the broader guidance of the national
directive which significantly limited chiropractors' scope of
practice. The chiropractic organizations testified in
opposition to VA's approach and requested Congress consider
legislation to create a more workable policy on the use of
chiropractors in VA health care. The subcommittee has informed
VA of its concerns about current policy and asked VA to re-
engage with chiropractic organizations in an effort to be more
accommodating to the interests of veterans in gaining access to
chiropractic care as a part of the VA health benefits package.
Subcommittee on Benefits
The Subcommittee on Benefits has jurisdiction over
veterans' matters affecting compensation, pension, insurance,
memorial affairs, education, training, vocational
rehabilitation, small business, employment and housing. In
addition to overseeing programs administered by the Veterans
Benefits Administration and the National Cemetery
Administration, the subcommittee has oversight of Arlington
National Cemetery under the jurisdiction of the U.S. Army, and
overseas cemeteries under the jurisdiction of the American
Battle Monuments Commission (see Oversight Plan for the 106th
Congress, p. 83).
Legislative Activities
First Session
On March 18, 1999, the full Committee marked up H.R. 70,
the Arlington National Cemetery Burial Eligibility Act. The
bill was favorably reported to the House (see House Report 106-
70), and passed by a vote of 428-2 on March 23, 1999.
On April 21, 1999, the subcommittee held a legislative
hearing on H.R. 1071, the Montgomery GI Bill Improvements Act
of 1999, and H.R. 1182, the Servicemembers Educational
Opportunity Act of 1999. Witnesses were the Honorable G.V.
(Sonny) Montgomery; the Honorable G. Kim Wincup, Vice Chairman,
Commission on Servicemembers and Veterans Transition
Assistance; SFC Thomas R. Krech, Recruiter, USA; PO Laura D.
Johnson, Recruiter, USN; SSgt. Robert A. Austin, Field
Recruiter, USAF; Gunnery Sgt. Paul Jornet, Recruiter, USMC;
Electricians Mate Second Class Keisha R. Gill, Recruiter, USCG,
VADM Patricia A. Tracey, Deputy Assistant Secretary of Defense,
Military Personnel Policy; Maj. Gen. Evan Gaddis, Commanding
General, USA Recruiting Command; RADM Barbara E. McGann,
Commander, USN Recruiting Command; Brig. Gen. Peter U. Sutton,
Commander, USAF Recruiting Service; Maj. Gen. Gary L. Parks,
Commanding General, USMC Recruiting; and RADM Thomas J.
Barrett, Director of Reserve and Training, USCG. Mr. Joshua R.
Krebs, Manager, Legislative Affairs, Air Force Sergeants
Association; and Mr. Michael P. Cline, Executive Director,
Enlisted Association of the National Guard, submitted testimony
for the record.
Mr. Montgomery, Mr. Wincup, the military associations, and
service branch witnesses testified in support of H.R. 1071 and
H.R. 1186. The Deputy Assistant Secretary of Defense for
Military Policy testified that the Montgomery GI Bill has met
or exceeded the expectations of its sponsors and has been a
major contributor to the All-Volunteer Force.
On May 20, 1999, the subcommittee held a second legislative
hearing on H.R. 1071 and H.R. 1182. Witnesses included Ms. Nora
Egan, VA Deputy Under Secretary for Management, VBA; Dr. Steven
F. Kime, Chairman, Secretary of Veterans Affairs Advisory
Committee on Education; Ms. Judith Lee Ladd, President,
American School Counselor Association; Mr. David A. Guzman,
President, National Association of Veterans Program
Administrators; Mr. C. Donald Sweeney, Legislative Director,
National Association of State Approving Agencies; Mr. Sid
Daniels, Deputy Director, National Legislative Services,
Veterans of Foreign Wars; Mr. William F. Frasure, Deputy
Director, Government Relations, Vietnam Veterans of America;
Mr. Peter Gaytan, Legislative Director, AMVETS; Mr. Matthew L.
Puglisi, Assistant Director, National Veterans Affairs and
Rehabilitation Commission, The American Legion; Mr. Harley
Thomas, Associate Legislative Director, Paralyzed Veterans of
America; Mr. Larry D. Rhea, Deputy Director, Legislative
Affairs, Non Commissioned Officers Association; Mr. Charles L.
Calkins, National Executive Secretary, Fleet Reserve
Association; Mr. John J. Daly, Legislative Assistant, The
Retired Enlisted Association; Mr. Benjamin H. Butler, Associate
Legislative Counsel, National Association for Uniformed
Services; Mr. Joshua W. Krebs, Manager, Legislative Affairs,
Air Force Sergeants Association; Mr. Theodore Stroup, Vice
President, Association of the U.S. Army; and Mr. Robert F.
Norton, Deputy Director, Government Relations, The Retired
Officers Association. The higher education, military, and
veterans service organizations all supported H.R. 1071 and H.R.
1186. VA acknowledged the MGIB's role in military recruiting
and access to higher education, but said more study was needed
before it could formulate a position.
On June 10, 1999, the subcommittee held a legislative
hearing to receive testimony on the following bills: H.R. 605,
the Court of Appeals for Veterans Claims Act of 1999; H.R. 690,
a bill to add bronchiolo-alveolar carcinoma to the list of
diseases presumed to be service-connected for certain
radiation-exposed veterans; H.R. 708, a bill to provide for the
reinstatement of certain benefits administered by the Secretary
of Veterans Affairs for remarried surviving spouses upon
termination of their remarriage; H.R. 784, a bill to authorize
the payment of Dependency and Indemnity Compensation to the
surviving spouses of certain former prisoners of war; H.R.
1214, the Veterans' Claims Adjudication Improvement Act of
1999; and H.R. 1765, the Veterans' Compensation Cost-of-Living
Adjustment Act of 1999.
Representative Chris Smith of New Jersey testified in
support of his bill, H.R. 690, and Representative Michael
Bilirakis of Florida testified in support of H.R. 784, which he
sponsored. The Honorable Joseph Thompson represented VA and
opposed H.R. 690 and a portion of H.R. 605. The veterans
service organization witnesses testified in support of the
bills.
On June 16, 1999, the subcommittee held a legislative
hearing on H.R. 1247, the World War II Memorial Completion Act;
H.R. 1476, the National Cemetery Act of 1999; H.R. 1484, to
authorize appropriations for homeless veterans reintegration
projects under the Stewart B. McKinney Homeless Assistance Act;
H.R. 1603, the Selected Reserve Housing Loan Fairness Act of
1999; H.R. 1663, the National Medal of Honor Act; and H.R.
2040, the Veterans' Cemeteries Assessment Act of 1999. The
veterans service and military organizations essentially
supported these measures. VA testimony varied depending on the
bill or specific aspects of each bill.
On June 17, 1999, the subcommittee marked up a draft bill
of the Veterans' Benefits Improvement Act of 1999, which
included H.R. 605, H.R. 690, H.R. 708, H.R. 784, H.R. 1214,
H.R. 1247, H.R. 1476, provisions of H.R. 1484, H.R. 1765, and
H.R. 2040. The bill was reported favorably to the full
Committee by voice vote. On June 23, 1999, the bill, H.R. 2280,
was favorably reported to the House by the full Committee (see
House Report 106-202).
On October 28, 1999, the subcommittee held a hearing on
draft legislative concepts for a 21st Century Veterans'
Employment and Training bill, draft legislative concepts for
miscellaneous VA education programs, H.R. 364, the Veterans'
Employment and Training Bill of Rights Act of 1999, and H.R.
625, the Veterans' Education Benefits Equity Act of 1999.
Witnesses included Mr. Joseph Andry, Director, Veterans Service
Division, Ohio Bureau of Employment Services; Ms. Effie
Baldwin, Local Veterans Employment Representative, Arizona
Department of Economic Security; Mr. Dennis A. Beagle,
Executive Board Member, New York State Public Employees
Federation; Mr. Michael Blecker, Executive Director, Swords to
Plowshares, San Francisco, California; the Honorable Espiridion
Borrego, Assistant Secretary for Veterans' Employment and
Training, Department of Labor; Mr. Christopher J. Brennan, Dean
of Business and Workforce Development and Mr. George J.
Moriarity, Executive Director, The Career Place, Middlesex
Community College; Ms. Celia P. Dollarhide, Director, VA
Education Service; Mr. Ronald W. Drach, President, R. W. Drach
Consulting; Mr. Robert C. Gross, President, Interstate
Conference of Employment Security Agencies; Mr. John Hall,
Disabled Veterans Outreach Program Specialist, New York
Department of Labor; Mr. James H. Hartman, New York State
Director of Veterans' Employment and Training, DOL; Mr. James
B. Hubbard, Director, National Economic Commission, The
American Legion; Mr. James N. Magill, Director, National
Employment Policy, Veterans of Foreign Wars; Mr. Woodrow C.
McCutcheon, President, Association of Small Business
Development Centers; Representative Robert W. Ney of Ohio, Mr.
Larry D. Rhea, Director of Legislative Affairs, Non
Commissioned Officers Association; Mr. Philip Wilkerson, Deputy
Director, Veterans Affairs and Rehabilitation, The American
Legion; MG Thomas F. Sikora, USA, Ret., Vice President and
Division General Manager, Resource Consultants, Inc.; and Mr.
Anthony L. Baskerville, Deputy National Service Director for
Employment, Disabled American Veterans.
The purpose of this hearing was to obtain advice from
witnesses regarding the feasibility of various concepts to
revise policies governing the delivery of veterans employment
and training in each of the states. The Department of Labor
opposed most of the concepts while other witnesses supported
some concepts but not others.
Second Session
On March 23, 2000, the subcommittee held a hearing on H.R.
3193, the Duty to Assist Veterans Act of 1999. Representatives
from the Non Commissioned Officers Association, Vietnam
Veterans of America, Disabled American Veterans, The American
Legion, Paralyzed Veterans of America, and Veterans of Foreign
Wars all testified in support of the bill. All the veterans
service organization witnesses were opposed to the VA's
proposed rules in response to the decision in Morton v. West,
12 Vet. App. 477, remanded on other grounds F.3d , 2000 U.S.
App. LEXIS 22464 (Fed. Cir., August 17, 2000), which was the
impetus for the introduction of H.R. 3193. The Honorable Joseph
Thompson, Under Secretary for Benefits, testified on behalf of
the VA. The Department recommended the subcommittee defer
action on the bill until VA completed its ongoing rulemaking.
As the result of this hearing and subsequent meetings with
representatives from the veterans service organizations and VA
officials, H.R. 4864 was introduced and passed the House on
July 25, 2000.
On April 13, 2000, the subcommittee received testimony on
H.R. 1020, the Veterans' Hepatitis C Benefits Act of 1999; H.R.
3816, to provide that a stroke or heart attack suffered by a
member of a reserve component while performing inactive duty
for training shall be considered service-connected; H.R. 3998,
the Veterans' Special Monthly Compensation Gender Equity Act;
and H.R. 4131, the Veterans' Compensation Cost-of-Living Act of
2000. In addition, the subcommittee received testimony on the
VA's adjudication of hepatitis C claims.
Representative Vic Snyder of Arkansas testified in support
of his bill, H.R. 1020, and Representative Bart Stupak of
Missouri testified in support of H.R. 3816, which he sponsored.
Additional witnesses included Dr. Gary Roselle, Program
Director for Infectious Diseases at the VA Medical Center in
Cincinnati, Ohio; Mr. Keith Snyder, Mr. Michael Shallow, a
hepatitis C-positive disabled veteran; Ms. Linda Spoonster
Schwartz, Chair, VA Advisory Committee on Women Veterans; Ms.
Joy Ilem, Disabled American Veterans; Mr. Harley Thomas,
Paralyzed Veterans of America; Mr. Peter Gayton, AMVETS; Mr.
Richard Schneider, Non Commissioned Officers Association; Mr.
Sidney Daniels, Veterans of Foreign Wars; and Mr. Philip
Wilkerson, The American Legion. Ms. Nora Egan testified on
behalf of VHA.
Mr. Shallow and Mr. Snyder testified in support of making
hepatitis C a presumptive disease for purposes of VA disability
compensation and cited the problems VA is having in
adjudicating all claims. The veterans service organization
witnesses testified in support of all the bills on the hearing
agenda. VA supported H.R. 3816, H.R. 3998 and H.R. 4131, but
opposed H.R. 1020. VA testified that they were in the process
of proposing revisions to the rating schedule that would
provide a separate code for hepatitis C, and new, more
appropriate criteria for evaluating the condition.
On May 11, 2000, the full Committee marked up H.R. 4268,
the Veterans and Dependents Millennium Education Act. The bill
was favorably reported to the House (see House Report 106-628).
On May 23, 2000, the House passed S. 1402, as amended by H.R.
4268, by a vote of 417-0.
On July 12 and July 13, 2000, the subcommittee held
hearings on H.R. 4765, the 21st Century Veterans Employment and
Training Act. Witnesses included Miss Heather French, Miss
America 2000; the Honorable Anthony J. Principi, Chairman,
Congressional Commission on Servicemembers and Veterans
Transition Assistance; the Honorable Espiridion Borrego,
Assistant Secretary of Labor for Veterans' Employment and
Training; Mr. Alan Gibson, Disabled Veterans Outreach Program
Specialist (on extended disability leave from) Missouri
Division of Workforce Development, Department of Labor and
Industrial Relations, and President, Missouri State Council,
Vietnam Veterans of America; Mr. James Hartman, Director of
Veterans' Employment and Training, State of New York; Dr. Carol
A. Cowan, President, Middlesex Community College; Mr. Stephen
A. Horton, Manager, Employment Security Program Services,
Alabama Department of Industrial Relations; Mr. Mike Sheridan,
Former Executive Director, Texas Workforce Commission; Mr.
Donald E. Shasteen, Former Assistant Secretary of Labor for
Veterans' Employment and Training; Ms. Heather W. Whitley,
Director, Division of Employment and Training, Kansas
Department of Human Relations; Mr. William C. Plowden, Jr.,
Director for Veterans' Employment and Training, South Carolina;
Mr. Peter Gaytan, Legislative Director, AMVETS; Mr. Dennis A.
Beagle, Executive Board Member, New York State Employees
Federation; Mr. Robert F. Gross, President of ICESA; Maj. Gen.
Matthew P. Caulfield, USMC (Ret), CEO, MilitaryHub.com and
Chairman of the Board, Hire Quality, Inc. and Third Rail, Inc.;
Mr. Rick Weidman, Director, Government Relations, Vietnam
Veterans of America; Mr. Raymond G. Boland, Secretary,
Wisconsin Department of Veterans Affairs; Mr. James B. Hubbard,
Director, National Economic Commission, The American Legion;
Mr. Ronald W. Drach, President, R. W. Drach Consulting; Mr.
James N. Magill, Director, National Employment Policy, Veterans
of Foreign Wars; Mr. Geoff Hopkins, Associate Legislative
Director, Paralyzed Veterans of America; and Mr. John Lopez,
Chairman, Association of Service Disabled Veterans, accompanied
by Mr. Joseph Forney, Assistant Coordinator, Disabled Veterans
Enterprise Institute. Miss French and the Transition Commission
witness strongly endorsed this bill. The Department of Labor
largely opposed this legislation, arguing that it was
unnecessary. Other witnesses largely supported the legislation
with selected revisions for additional improvements.
On July 18, the subcommittee marked up H.R. 4850, the
Veterans Benefits Act of 2000 and H.R. 4864, the Veterans
Claims Assistance Act of 2000. Both bills were reported
favorably to the full Committee. On July 20, the full Committee
met and marked up H.R. 4850 and H.R. 4864. Each bill was
favorably reported to the House (see House Report 106-783 and
106-781, respectively). On July 25, H.R. 4850 unanimously
passed the House by voice vote; and H.R. 4864 passed the House
by a vote of 414-0.
Oversight Activities
First Session
On February 23, 1999, the full Committee held a hearing to
receive the Report of the Commission on Servicemembers and
Veterans Transition Assistance. The Honorable Anthony Principi,
Chairman of the Commission, testified on the Commission's
findings and its over 100 recommendations addressing 31
separate issues. The Honorable Bob Dole, who introduced the
Senate legislation that created the Commission on
Servicemembers and Veterans Transition Assistance, testified in
support of the Commission's efforts and urged the Congress to
move forward on making the kinds of improvements necessary for
servicemembers transitioning back into civilian life.
On February 24, 1999, the subcommittee held an oversight
hearing on the fiscal year 2000 budget for the Department of
Labor Veterans' Employment and Training Service (VETS). The
Honorable Espiridion Borrego, Assistant Secretary of Labor for
Veterans' Employment and Training, testified on behalf of the
Department of Labor. The veterans service organizations were
represented by Vietnam Veterans of America, The American
Legion, Veterans of Foreign Wars, AMVETS, and Non Commissioned
Officers Association. Mr. Borrego, in addition to presenting
VETS' budget, noted fiscal year 1998 accomplishments and
addressed some of the Department of Labor's current efforts,
pilots and initiatives. While the veterans service
organizations were supportive of the overall monetary funding
in the budget, they pointed out various areas where they saw a
funding shortfall, most notably in the Disabled Veteran
Outreach Program, the Local Veteran Employment Representative
program, and the Homeless Veteran Reintegration Program.
On March 25, 1999, the subcommittee held an oversight
hearing on the state of the Veterans Benefits Administration.
Witnesses included the Honorable Joseph Thompson, VA Under
Secretary for Benefits, Ms. Cynthia Bascetta, Associate
Director for Veterans Affairs and Military Health Care Issues,
GAO, and representatives of veterans service organizations. Mr.
Thompson testified that the Department has been working
aggressively to address the areas of major concern detailed in
prior hearings and meetings with all stakeholders. The six
areas VBA is developing are; (1) focusing on veterans, (2)
delivering exceptional service, (3) basing all areas on strong
core values, (4) forming productive partnerships with
stakeholders, (5) initiating change rather than responding to
it, and (6) developing ways to equip future staff to serve 21st
century veterans. Ms. Bascetta of GAO testified to the long-
standing challenges facing the VA in administering benefits,
but noted recent progress the Department has made in major
areas, including measurement of decision accuracy,
accountability for performance, and training for
decisionmakers. The veterans service organizations testified to
the challenges VBA faces, including a system of adjudication
that is process-oriented rather than results-oriented.
On September 9, 1999, the subcommittee conducted a hearing
on veterans' employment regarding civilian credentialing
requirements for military job skills. Witnesses included the
Honorable Espiridion Borrego, Assistant Secretary of Labor for
Veterans Employment and Training, Mr. Victor Vasquez, Jr.,
Deputy Assistant Secretary of Defense, Personnel Support,
Families and Education; Mr. Julius Williams, Jr., Director,
Vocational Rehabilitation and Counseling Service, VBA; Mr.
James Hubbard, The American Legion; the Honorable Ruby DeMesme,
Assistant Secretary of the Air Force, Manpower, Reserve
Affairs, Installations and Environment; RADM Fred Ames,
Assistant Commandant for Human Resources, USCG; BG Kathryn
Frost, The Adjutant General, USA; RADM David Brewer, III, Vice
Chief of Naval Education and Training, USN; Lt. Gen. Jack
Klimp, Deputy Chief of Staff for Manpower and Reserve Affairs,
USMC; Mr. Steve Halsey, The Coalition for Professional
Certification; Mr. Raymond Pryor, The Ohio Military Veteran
Licensing and Certification Project; Maj. Gen. (Ret.) Matthew
Caulfield, Hire Quality, Inc.; and Maj. Gen. (Ret.) Thomas
Sikora, Resource Consultants.
All the witnesses agreed that skilled servicemembers
leaving the military may miss out on the chance to quickly move
into good, high-paying, career-building jobs because they must
undergo lengthy and expensive retraining in order to meet
civilian licensure and certification requirements, often for
the same types of jobs they held in the military. Each of the
witnesses detailed what the service branches and private
sectors are doing to ensure that separating servicemembers have
the credentials necessary to transition into civilian
employment.
On October 26, 1999, the subcommittee held a hearing on
claims adjudication issues facing certain Persian Gulf War
veterans, specifically a past lack of consistency in claims
decisions, inadequate employee training, relatively poor
outreach and less than uniform development of evidence. The
veterans service organizations, including The American Legion,
Disabled American Veterans, National Gulf War Resource Center,
Veterans of Foreign Wars, and the Vietnam Veterans of America,
testified that VA has interpreted Public Law 103-446 in an
overly narrow manner, thus veterans suffering from undiagnosed
illnesses are significantly disadvantaged in terms of health
care and claims adjudication. Dr. Claudia Miller, Environmental
and Occupational Medicine, Department of Family Practice,
University of Texas Health Science Center, testified on what
has been done to understand why certain veterans are sick and
suggested an ``unmasking'' study in order to isolate what
exposures are producing symptoms. Dr. Victor Gordon, staff
physician at the VAMC in Manchester, New Hampshire, described
his experiences in treating Persian Gulf War veterans and
provided an explanation on how physicians attribute similar
signs and symptoms to a diagnosed condition. The Honorable
Joseph Thompson, VA Under Secretary for Benefits, represented
VBA. Mr. Thompson testified on the progress the VA has made in
processing Gulf War claims, identified the Department's
initiatives to aid in the processing of all claims, and
detailed the interaction and coordination efforts between the
VHA and the VBA in adjudicating Persian Gulf claims.
Second Session
On March 9, 2000, the subcommittee conducted a hearing on
the status of public and private sector initiatives to address
homeless veterans issues. Witnesses included Miss Heather
French, Miss America 2000; Dr. Fran Murphy, VHA; Ms. Estella
Morris, Program Manager, VA Comprehensive Homeless Center,
Little Rock, Arkansas; Ms. Henrietta Fishman, VISN 3; Mr. Fred
Karnas, Deputy Assistant Secretary for Special Needs Programs,
Department of Housing and Urban Development; the Honorable
Espiridion Borrego, Assistant Secretary of Labor for Veterans'
Employment and Training; Mr. Douglas Haywood, Western New York
Veterans Housing Coalition; Mr. Raymond Boland, Wisconsin
Department of Veterans Affairs; Mr Thomas Cantwell, U.S. Vets;
Ms. Chris Noel, Vetsville Cease Fire House, Inc.; Ms. Lynne
Heidel, Centre City Development Corporation; Mr. Harold
Schultz, Disabled American Veterans; Mr. Joseph Caouette,
Veterans of Foreign Wars; Mr. Richard Schneider, Non
Commissioned Officers Association; and Mr. Calvin Gross,
Vietnam Veterans of America.
The Administration witnesses testified about their wide
range of programs and services to address homeless veterans'
needs. The private sector witnesses detailed the programs and
services they offer, and the need for additional funds. Many
witnesses would like to see the Department of Housing and Urban
Development take more of an interest in, and provide additional
funding for, veteran-specific programs.
On March 14, 2000, the subcommittee held a joint oversight
hearing with the Committee on Small Business' Subcommittee on
Government Programs and Oversight on the implementation of
Public Law 106-50, the Veterans Entrepreneurship and Small
Business Development Act of 1999. Witnesses included Mr. Emil
Naschinski, The American Legion; Mr. Rick Weidman, Vietnam
Veterans of America; Mr. Geoffrey Hopkins, Paralyzed Veterans
of America; Mr. John Lopez, Association of Service Disabled
Veterans; Mr. Anthony Baskerville, Disabled American Veterans;
Mr. Joseph Forney, Disabled Veteran Business Enterprise
Network; Mr. Woodrow McCutchen, Association of Small Business
Development Centers; Mr. W. Kenneth Yancey, National SCORE
Office; and Mr. Darryl Dennis, U.S. Small Business
Administration. Mr. Dennis outlined SBA's progress in
implementing Public Law 106-50. Veterans organizations
expressed their displeasure with what they perceived as SBA's
recalcitrant implementation of the new law. The SBA disagreed,
arguing that ``by definition'', start up of new services takes
time, but it was completely committed to implementing the
program.
On September 27, 2000, the subcommittee held its second
hearing on licensing and credentialing of military job skills
for civilian employment. Witnesses included Mr. James Hubbard,
The American Legion; Mr. Peter Gaytan, AMVETS; Mr. Michael
Martin, National Organization for Competency Assurance; Maj.
Gen. Matthew Caufield, Hire Quality, Inc.; Mr. Steven Halsey,
The Coalition for Professional Certification; RADM Fred Ames,
USCG; Lt. Gen. Jack Klimp, USMC; RADM David Brewer III, USN;
Ms. Mary Lou Keener, Deputy Assistant Secretary for Manpower,
Reserve Affairs, Installations and Environment; USAF; BG
Kathryn Frost, USA; and the Honorable Espiridion Borrego,
Assistant Secretary of Labor for Veterans' Employment and
Training. The representatives of the service branches testified
to the efforts being made to train and certify active duty
servicemembers, along with joint service efforts. The hearing
built upon the testimony the subcommittee received on September
9, 1999.
Subcommittee on Oversight and Investigations
The Subcommittee on Oversight and Investigations reviews
the benefits and the health care services that the federal
government provides to eligible veterans and family members. It
also oversees the programs and operations of the Department of
Veterans Affairs, as well as those of other federal agencies
that pertain to veterans. In carrying out its responsibilities,
the subcommittee conducts hearings, site visits and
investigations nationwide. It also requests reports from the
General Accounting Office, the Congressional Research Service
and the VA's Office of the Inspector General. The subcommittee
does not have legislative jurisdiction so that its resources
can be solely dedicated to oversight activities (see Oversight
Plan for 106th Congress, p. 83).
Oversight Hearings
First Session
The subcommittee held a hearing on March 11, 1999, on
whistleblowing and retaliation in the VA. The principal
witnesses included the Honorable Elaine Kaplan, Special
Counsel, Office of Special Counsel; the Honorable Richard J.
Griffin, VA Inspector General; the Honorable Eugene A.
Brickhouse, VA Assistant Secretary for Human Resources and
Administration; and the Honorable Leigh Bradley, VA General
Counsel. Also testifying were Dr. Gordon D. Christensen, Dr.
Edward H. Adelstein, Dr. Earl Dick, Mr. Donald Bumgardner, Mr.
Kenneth Wilson, all VA employees, and Ms. Joan Pastor, a former
VA employee.
The subcommittee examined the VA's policies and protections
for its employees who have claimed or been granted
whistleblower status, as well as for employees who had filed
various types of complaints or claims against the Department. A
GAO survey of whistleblower protection in the VA found that VA
health care employees were not confident that the Department
would provide effective protection to those who report
wrongdoing or expose waste, fraud and mismanagement. VA
officials could not identify an instance when the Department
protected a whistleblower. Moreover, VA officials could not
identify VA managers or supervisors held accountable for
retaliation without external pressure. In response, VA has
undertaken education and training of managers, supervisors and
employees, and has reaffirmed its policy of protecting
whistleblowers. The subcommittee requested the OIG identify all
senior managers that have had allegations of waste, fraud and
mismanagement sustained against them. The OIG has not yet
completed work on its response.
On March 25, 1999, the subcommittee held an oversight
hearing on the Department of Veterans Affairs management of the
Federal Employees Compensation Act. Principal witnesses
included Mr. Shelby Hallmark, Deputy Director, Office of
Workers' Compensation Programs, Department of Labor; and the
Honorable Richard J. Griffin, VA Inspector General.
Representing the VA were Mr. Ronald E. Cowles, Deputy Assistant
Secretary for Human Resources Management; Dr. Frances M.
Murphy, Chief Consultant, Occupational and Environmental
Health, Strategic Health Group; Mr. John Hancock, Director,
Occupational Health and Safety Staff, Office of Administration;
Mr. Frederick Malphurs, Director, VISN 2; and Mr. Smith
Jenkins, Jr., Director, VISN 22.
A December 21, 1999 audit report from the Office of
Inspector General found that VA is still at significant risk
for fraud, abuse and unnecessary costs related to its Workers'
Compensation Program (WCP). The OIG concluded that VA could
reduce program fraud and abuse with more effective review and
oversight of WCP claims. OIG estimated VA annually pays $17.8
million in unverified compensation claims payments. Based on
these findings, the OIG projected total savings of
approximately $250 million. The OIG concluded that management
of the WCP needs to be improved.
VA officials stated that 1994, the Department has
implemented programs and practices to reduce workers'
compensation costs. Among these initiatives is ``Workers'
Compensation Management Information Systems'' developed in
cooperation with the Department of Labor. This system provides
current information to case managers from VA facilities as well
as from DOL. In addition, VA is working to prevent injuries and
illnesses by enhancing hazard identification and mishap
prevention; promoting research into injury and illness
causation; and seeking more effective methods to provide
employee safety and health education opportunities.
However, DOL asserted that VA's continued lack of
timeliness in submitting claims exposes VA to potential
overpayments and undetected fraudulent claims. DOL also
emphasized the need for increased case management of workers'
compensation claims.
The subcommittee held a hearing on VA's Year 2000 (Y2K)
readiness on April 15, 1999. Principal witnesses included Mr.
Joel C. Willemssen, Director, Civil Agencies Information
Systems, Accounting and Information Management Division, GAO;
Mr. Michael Slachta, Jr., VA Deputy Assistant Inspector General
For Auditing; the Honorable Hershel Gober, VA Deputy Secretary;
Mr. Harold F. Gracey, Jr., VA Acting Assistant Secretary for
Information and Technology; Mr. William K. Hubbard, Acting
Deputy Commissioner for Policy, Food and Drug Administration
(FDA); and Ms. Judy Bello, Executive Vice President for Policy
and Strategic Affairs, Pharmaceutical Research and
Manufacturers of America, accompanied by Mr. Del Persinger,
Vice President, Finance and Operations.
GAO testified that VA continued to make progress in its Y2K
readiness initiatives, but that key actions remained to be
performed. VBA and VHA had not completed testing all mission
critical systems. VHA had not completed assessments of its
facility systems to ensure uninterrupted health care. Neither
VA nor FDA had implemented GAO's prior recommendation to review
the test results for biomedical equipment used in critical care
or life support environments.
In response to VA and FDA's inability to identify to the
subcommittee non-compliant biomedical equipment, both agencies
partnered in developing a single data clearinghouse for
biomedical equipment and its Y2K compliance status. FDA was
prompted to launch much more aggressive initiatives to
encourage and monitor biomedical equipment manufacturers' Y2K
compliance. Pharmaceutical Research and Manufacturer of America
urged its members to comply and respond to GAO's survey
regarding Y2K plans and contingency plans.
The subcommittee held a joint hearing with the Subcommittee
on Health on the suspension of medical research at West Los
Angeles and Sepulveda VA medical facilities and on informed
consent and patient safety in VA medical research on April 21,
1999. Principal witnesses included Dr. Thomas Puglisi,
Director, Division of Human Subject Protections, Office for
Protection from Research Risks, National Institutes of Health,
Department of Health and Human Services; Mr. Dean C. Norman,
Acting Chief of Staff, West Los Angeles VAMC; Dr. Stephen
Pandol, Former Director, Research and Development, West Los
Angeles VAMC, Mr. Kenneth Clark, VHA Chief Network Officer and
Former Director, West Los Angeles VAMC; the Honorable Kenneth
W. Kizer, VA Under Secretary for Health, Dr. John R. Feussner,
VHA Chief Research and Development Officer; Dr. Eric M. Meslin,
Executive Director, National Bioethics Advisory Commission; Dr.
Paul Appelbaum, Chair, Department of Psychiatry at University
of Massachusetts Medical School, and Chair, American
Psychiatric Association Ethics Appeals Board; and Dr. Adil E.
Shamoo, Professor, Department of Biochemical and Molecular
Biology, University of Maryland, Baltimore.
The subcommittee heard testimony on the unprecedented
suspension of all human and animal subject medical research at
the West Los Angeles and Sepulveda VA medical facilities. It
also examined informed consent issues. VA officials
acknowledged many sustained allegations of research
irregularities and failure to correct deficiencies of informed
consent procedures. These deficiencies did not meet regulatory
standards identified by the Department of Health and Human
Services and were not corrected over a six-year period. There
also were numerous deficiencies in the Institutional Review
Board's operating procedures and record-keeping practices. The
subcommittee concluded that the VA had failed in its obligation
to provide adequate levels of protections to veterans
volunteering for VA medical research. In response to this
hearing, VA announced the creation of an Office for Research
Compliance and Assurance to provide external accreditation of
VA research programs. The subcommittee requested GAO to conduct
an independent audit to determine if the serious deficiencies
demonstrated by the West Los Angeles VAMC were systemic in VA's
research programs.
On May 20, 1999, the subcommittee held an oversight hearing
on maintenance and space planning at Arlington National
Cemetery and the National Cemetery Administration. Witnesses
included Representative Helen Chenoweth of Idaho; Mr. Philip
Wilkerson, Deputy Director, Veterans Affairs and
Rehabilitation, The American Legion; Ms. Joy J. Ilem, Associate
National Legislative Director, Disabled American Veterans; Mr.
Rick Weidman, Director, Government Relations, Vietnam Veterans
of America; Col. Robert F. Norton, USA (Ret.), Deputy Director,
Government Relations, The Retired Officers Association; Mr.
Larry D. Rhea, Deputy Director, Legislative Affairs, Non
Commissioned Officers Association; Mr. Ray Boland, Secretary,
Wisconsin Department of Veterans Affairs; Mr. Charles F. Smith,
Assistant Secretary, North Carolina Division of Veterans
Affairs, Mr. Eli Panee, Program Manager; Lt. Col. Robin L.
Higgins, USMC (Ret.), Executive Director, Florida Department of
Veterans Affairs; Mr. Brian E. Burke, Principal Deputy
Assistant Secretary of the Army (Civil Works), Department of
the Army, Mr. John C. Metzler, Superintendent, Arlington
National Cemetery (ANC); Mr. Roger R. Rapp, Acting Under
Secretary, VA National Cemetery Administration (NCA); and Mr.
Vincent L. Barile, NCA Director, Office of Operations Support.
The purpose of the hearing was to examine the maintenance
of national cemeteries, including Arlington National Cemetery,
and VA's strategic planning for future cemetery needs,
including construction of new cemeteries. The average age of
the veteran population is rising and World War II veterans are
dying at a rate of over 1,000 per day. Yet, despite the
demographic trend for the next decade, the VA seemed to have no
plans for new cemetery construction. The VA testified that it
would ``continue to evaluate the potential establishment of new
national cemeteries.''
The hearing established that both national cemeteries and
Arlington National Cemetery have a large backlog of deferred
maintenance projects, even though all cemeteries are being
maintained as much as current resources permit. Currently, many
cemeteries have maintenance needs such as dirty and tilting
headstones, crumbling walkways and deteriorating cemetery
buildings.
The hearing also identified burial and space needs and
secured additional funding for cemetery maintenance and
construction. The hearing resulted in approximately $3 million
in additional funding for maintenance projects in the Arlington
National Cemetery budget. In addition, the 1999 Veterans
Millenium Health Care and Benefits Act, Public Law 106-117,
directed the VA Secretary to use the advance planning fund for
costs required to begin pre-construction planning for six new
cemetery sites in the geographic areas most in need of a
national cemetery. The Act further required the Secretary to
contract for a study assessing one-time repairs required at
each national cemetery.
The subcommittee held a hearing on the effectiveness of
federal homeless veterans programs on June 24, 1999. Witnesses
included Ms. Cynthia A. Bascetta, Associate Director for
Veterans Affairs and Military Health Care Issues, GAO; Ms.
Linda Boone, Executive Director, National Coalition For
Homeless Veterans; Mr. Thomas R. Cantwell, Jr., President,
Westside Residence Hall; Col. Charles Williams, USA (Ret.),
Executive Director, Maryland Center For Veterans Education &
Training, Inc.; Ms. Toni Reinis, Executive Director, New
Directions, Inc., accompanied by John Keaveney, Chief Operating
Officer, New Directions, Inc., Dr. Lorin Linder, Program
Director, New Directions, Inc.; Mr. Roosevelt Thompson, Jr.,
Account Associate, Xerox Business Services, Xerox Corporation,
accompanied by Ms. Michele Cahn, Manager of External Affairs,
Mr. Charles A. James, Jr., Manager, Business Development
Private Sector, Xerox Business Services; the Honorable
Espiridion A. Borrego, Assistant Secretary of Labor for
Veterans' Employment and Training; Mr. Fred Karnas, Deputy
Assistant Secretary For Special Needs Assistance Programs,
Department of Housing and Urban and Development; Mr. Peter H.
Dougherty, Director, VA Homeless Programs Office, accompanied
by Dr. Robert Rosenheck, Director, VA Northeast Program
Evaluation Center; Mr. Emil W. Naschinski, Assistant Director,
National Economic Commission, The American Legion; Ms. Valerie
Callaway, Employment Specialist, Veterans of Foreign Wars; and
Mr. Rick Weidman, Director of Government Relations, Vietnam
Veterans of America.
The subcommittee heard testimony from GAO, several
community-based homeless programs, and a former homeless
veteran who had successfully reentered mainstream society. The
subcommittee also heard from the Department of Housing and
Urban Development, VA and several veterans service
organizations. Homelessness among veterans continues to be a
serious and complex problem with no easy solutions. The
estimated number of homeless veterans has been estimated to be
close to a quarter-million. The 1994 count was validated last
year by findings of the Urban Institute (Contractor for the
Inter-Agency Council) which found 824,000 people homeless in
any week (annual total is higher). Of this figure, 24 percent
or 202,000 are veterans. In fiscal year 1997, VA obligated
approximately $84 million to homeless veterans programs. The
entire federal government spent approximately $1.2 billion on
homeless programs. GAO testified that while the VA has
developed partnerships with other federal departments, state
and local agencies, and community-based organizations, it has
little information about the long-term effectiveness of its
homeless programs. GAO recommended VA conduct a series of
program evaluations to clarify the effectiveness of VA's
homeless programs and identify best practices and ways to
improve those programs. GAO concluded that VA's methodological
shortcomings in obtaining information on outcomes prevents it
from making clear conclusions about program effectiveness. GAO
recommended that VA conduct further research on program
effectiveness in order to direct VA's limited resources and
improve its homeless programs. Witnesses from veterans service
organizations and hands-on providers testified favorably
regarding the effectiveness of VA and DOL grant programs for
homeless veterans through community-based organizations.
The subcommittee held a hearing on July 22, 1999 on VA's
Capital Assets Realignment Plan for enhancing services to
veterans. Principal witnesses included Mr. Stephen P. Backhus,
Director, Veterans' Affairs and Military Health Care Issues,
GAO; Mr. D. Mark Catlett, VA Deputy Assistant Secretary for
Budget; and Mr. Kenneth Clark, VHA Chief Network Officer.
VA's capital assets plan addresses how and when the
Department is going to restructure its vast health care system.
GAO testified that VA's hospital utilization has dropped from
49,000 to 21,000 patients in the last ten years. It also stated
that the veteran population will decline by 36 percent, or nine
million people, over the next 20 years. VA's progress in light
of these dramatic changes in demographics and medical practices
has been limited. Its planning lacks uniformed guidelines and
criteria needed to conduct fair and equitable decisions. VA has
not prioritized its assessments in order to maximize the return
on investment. GAO concluded that VA could be spending $1
million or more a day to operate and maintain unneeded
buildings. The subcommittee will continue to conduct oversight
on this subject.
On July 29, 1999, the subcommittee held an oversight
hearing on the effectiveness and strategic planning of
Veterans' Employment and Training Service Program (VETS) at the
Department of Labor. The purpose of this hearing was to give
VETS an opportunity to respond to the recent Congressional
Transition Commission's report and to articulate its vision for
the new century. Witnesses included Ms. Carlotta C. Joyner,
Director of Operations, Health, Education, and Human Services
Division, GAO; the Honorable Espiridion A. Borrego, Assistant
Secretary of Labor for Veterans' Employment and Training; Mr.
Ronald W. Drach, Former Commissioner, Commission On Service
Members And Veterans Transition Assistance; Mr. James B.
Hubbard, Director, National Economics Commission, The American
Legion; Mr. Anthony L. Baskerville, Deputy National Service
Director For Employment, Disabled American Veterans; Mr. James
N. Magill, Director, National Employment Policy, Veterans of
Foreign Wars; Mr. Calvin Gross, Chair of Employment Training
And Business Opportunities Committee, Director of Government
Relations, Vietnam Veterans of America;
The General Accounting Office testified that VETS' May 1999
revised strategic plan and its fiscal year 2000 performance
plan ``lack vision and clarity and do not clearly identify what
the program is to achieve and the direction the agency intends
to take.''
The Transition Commission concluded that based upon data
provided by VETS, only two percent of veterans go to state
employment services when looking for a job. The Commission also
concluded that only 12 percent of those veterans who registered
with state employment services obtained permanent employment.
Furthermore, nine states were able to meet VETS performance
standards while placing fewer than ten percent of registered
veterans. The Commission found this overall performance to be
an inadequate return on annual program costs of $183 million,
and bluntly called this employment and training program ``a
failed and expensive system with exorbitant overhead.''
Subcommittee Chairman Terry Everett recommended to Chairman
Jack Quinn of the Subcommittee on Benefits, which has
legislative jurisdiction over these matters, that he consider
giving VETS a time certain to greatly improve its performance
and planning along the lines of the Transition Commissions
suggestions. If it does not show improvement and produce a
satisfactory roadmap to the future after this period, Chairman
Everett stated that the program should be drastically
overhauled.
The subcommittee held a hearing on September 23, 1999 on
VA's financial management in the areas of reducing fraud and on
increasing third-party collections. Principal witnesses
included the Honorable Richard J. Griffin, VA Inspector
General; Mr. Stephen P. Backhus, Director, Veterans' Affairs
and Military Health Care Issues, GAO; and the Honorable Edward
A. Powell, Jr., VA Assistant Secretary for Financial
Management; and Mr. D. Mark Catlett, VA Deputy Assistant
Secretary for Budget.
The subcommittee examined two recent cases involving VA
employees from two separate VBA regional offices who stole over
$1.2 million of veterans' compensation funds. The IG conducted
a vulnerability assessment of VBA's regional office operations
and management and identified 18 areas of vulnerability in six
general internal control categories. These vulnerabilities
diminished quality control and facilitated the ability to
commit system-wide fraud in VBA. Recent Office of the Inspector
General (OIG) audits in areas of improper payments identified
opportunities for the Department to save millions of dollars.
Senior VA officials acknowledged that fraud was successful
because VA's own internal controls were either lacking,
circumvented, or not followed.
GAO testified that VA's third-party medical care
collections are woefully inefficient, that they have declined
over three consecutive years, and that they likely will
continue declining. GAO verified the audits conducted by OIG,
Price Waterhouse Coopers and the American Association of
Retired Persons that concluded VA's billing process was
``unacceptably inaccurate.'' Bill coding had been shown to be
up to 90 percent inaccurate, compounding the poor third-party
collection process.
VA has acknowledged and is addressing the deficiencies and
lack of management identified by OIG and GAO. The subcommittee
should continue to conduct oversight on these issues.
On September 30, 1999, the subcommittee held an oversight
hearing on EEO Complaint Resolution in the Department of
Veterans Affairs. The purpose of the hearing was to examine how
the VA has implemented Public Law 105-114, the ``Veterans
Benefits Act of 1997,'' with respect to the EEO Complaint
Resolution System. Witnesses included Ms. Kathleen Dyer,
Principal, Ms. Elaine Brenner, Associate, and Ms. Jan Bayer,
Associate, Booz Allen & Hamilton Inc.; Mr. Carlton Hadden,
Acting Director, EEOC Office of Federal Operations, U.S. Equal
Employment Opportunity Commission; the Honorable Eugene A.
Brickhouse, VA Assistant Secretary for Human Resources and
Administration; Ms. Ventris C. Gibson, VA Deputy Assistant
Secretary for Resolution Management; Mr. Charles R. DeLobe,
Director, VA Office of Employment Discrimination Complaint
Adjudication.
The bill and the Public Law established within the VA the
Office of Resolution Management (ORM) and the Office of
Employment Discrimination Complaint Adjudication (OEDCA) which
operate independently from field facilities and headquarters'
offices. Each of the new organizations is headed by a director
who is solely responsible for all complaints of unlawful
employment discrimination and any associated complaints of
reprisal.
ORM and OEDCA have been in operation for more than a year.
The hearing examined VA's efforts to restore confidence in the
system that is supposed to resolve employment discrimination
complaints and hold transgressors accountable.
This subcommittee previously had heard concerns relating to
problems with the system for resolving employment
discrimination complaints. It was the perception of too many
men and women of the VA that senior managers within the
Department were not held accountable for their actions and too
often did not take the EEO process seriously.
Under the Act, VA was required to hire an independent
contractor to conduct an assessment of its programs for
improving the EEO environment and its approach to processing
EEO-related complaints. VA hired Booz Allen & Hamilton, Inc. to
conduct this assessment. Their testimony concluded that, based
on their overall assessment, the complaint resolution system at
VA had made ``notable strides in certain areas, such as working
towards achieving its mission, providing initial training for
ORM staff, and establishing administrative procedures to guide
the program.''
One year is not long enough to conclude that VA has
corrected all the problems of the past. Employees still appear
to quite concerned about reprisal from supervisors and managers
if they file complaints. The subcommittee will continue to
monitor the progress of these two new offices with respect to
timeliness of complaint resolution and confidence and trust
among VA employees.
The subcommittee held its fifth hearing on VA's Y2K
readiness on October 28, 1999. Principal witnesses included Mr.
Joel C. Willemssen, Director, Civil Agencies Information
Systems, GAO; Mr. William K. Hubbard, Senior Associate
Commissioner for Policy, Planning and Legislation, Food and
Drug Administration; the Honorable Hershel W. Gober, Deputy
Secretary of Veterans Affairs; and Mr. Harold F. Gracey, Jr.,
VA Principal Deputy Assistant Secretary for Information
Technology.
The subcommittee examined VA's readiness to provide
uninterrupted benefits delivery in compensation and pension
checks, safe medical care and adequate pharmaceutical supplies.
It also examined the testing, verification and confirmation of
VA's contingency plans. GAO testified that VA continued to make
progress in addressing the Y2K problem. It also noted that VBA
had only tested its contingency and business continuity plan at
ten percent of its 58 regional offices. GAO determined that FDA
had made progress in making compliance information on
biomedical equipment available to users through its Federal Y2K
Biomedical Equipment web site. Prompted by this subcommittee,
FDA decided to conduct surveys to determine the Y2K readiness
of pharmaceutical, biological, and consumable medical product
manufacturers. The subcommittee acknowledged the tremendous
effort put forth by the VA and FDA and encouraged them to
continue their testing and verification efforts up to the eve
of the new millennium.
On March 16, 2000, the subcommittee held an oversight
hearing on the VA's Home Loan Guaranty Program. The purpose of
this hearing was to review the management and efficiency of the
home loan program. Principal witnesses included Representative
Gary Ackerman of New York; Mr. Michael Slachta Jr., VA
Assistant Inspector General for Auditing; Mr. Keith Pedigo,
Director, Loan Guaranty Service, VBA; Mr. James B. Hubbard,
Director, National Economic Commission, The American Legion;
Mr. Peter S. Gayton, National Legislative Director, AMVETS; Mr.
Benjamin H. Butler, Associate Legislative Counsel, National
Association for Uniformed Services.
The program generally appears to be operating to the
benefit of the veteran and the taxpayer. The VA home loan
guaranty program clearly remains popular with veterans and
active duty members of our military services. It provides a
valuable benefit for them and their families.
However, some questions were raised by the testimony of the
VA Inspector General's Office regarding the effective and
aggressive oversight of lending institutions and contractors by
the VA. The OIG witness stated there are material internal
control weaknesses that impede timely completion of financial
statements and reduce effectiveness of safeguards over program
resources. The OIG witness further stated that VBA has
represented that organization and system changes were underway
to address the internal control weaknesses and all corrective
actions should be completed by the end of fiscal year 2000.
The loan guaranty service is increasingly utilizing
commercial mortgage lending practices and delegating functions
to lenders, so its own oversight and accountability practices
must continue to be strengthened. The subcommittee requested
that the VA report back to it when, as outlined by OIG, all
corrective actions have been taken. The report should include
an explanation and detailed description of all actions taken to
remedy the material internal control weaknesses found by OIG.
Also, VA is to report to the subcommittee regarding the results
of the A-76 study on contracting out property management.
Finally, the subcommittee is expecting a report from VA on the
situation involving the contract for servicing on direct loans.
The subcommittee held a hearing on VA's information
technology (IT) programs on May 11, 2000. Principal witnesses
included Mr. Joel C. Willemssen, Director, Civil Agencies
Information Systems, GAO; the Honorable Richard J. Griffin, VA
Inspector General; Mr. Harold F. Gracey, Jr., VA Principal
Deputy Assistant Secretary for Information Technology; Mr. Dan
L. Marsh, Associate Chief Information Officer for
Implementation and Training, VHA; Ms. K. Adair Martinez, Chief
Information Officer, VBA; Mr. Charles R. DeCoste, Director,
Data Management Office, VBA; and Mr. Vincent L. Barile,
Director of Operations Support, National Cemetery
Administration.
The focus of the subcommittee's first hearing on VA's $1.2
billion IT program for fiscal year 2000 was on three specific
projects: the Master Veteran Record (MVR), VBA's computer
modernization programs (VETSNET), and VHA's Decision Support
System (DSS). The delay in integrating the MVR with VBA's
compensation and pension service line has resulted in a loss of
significant savings in reduced overpayments. Two of VBA's ten-
year major modernization projects missed many significant
milestones and currently had no expected completion dates. A $3
million education redesign project was finally terminated
without any deliverable product. VHA has spent more than $267
million on its DSS system. Utilization of DSS in budget
formulation, resource allocation, and collecting health
outcomes has been very limited. The VA IG testified that its
audits this year continue to demonstrate widespread system
security control weaknesses. The IG reiterated that these
weaknesses were reported in 1997, 1998 and 1999 financial
statements and made recommendations for the Department to
implement a comprehensive security program.
The subcommittee requested the Department submit a plan
within 60 days for an integrated systems architecture that
includes specific completion milestones. The subcommittee held
an IT hearing in the Fall to assess the Department's progress
and determine which material weaknesses had been corrected.
On May 18, 2000, the subcommittee held an oversight hearing
on disability claims processing at the Department of Veterans
Affairs. The hearing was intended to set a base line for the VA
disability claims system as it has performed over the past
decade. Principal witnesses included Representative Bill
McCollum of Florida; Mr. Eugene R. Birge; Mr. Johnny Nixon; Mr.
Michael G. Sullivan, VA Deputy Inspector General; Ms. Cynthia
Bascetta, Associate Director, Veterans' Affairs and Military
Health Care Issues, GAO; the Honorable Joseph Thompson, VA
Under Secretary for Benefits; Mr. Robert Epley, Director,
Compensation and Pension Service, VBA; Mr. Rick Surratt, Deputy
National Legislative Director, Disabled American Veterans; Mr.
Geoff Hopkins, Associate Legislative Director, Paralyzed
Veterans of America; Mr. Jeff Dolezal, Director, Field
Services, Paralyzed Veterans of America; Mr. Paul Ivas,
Associate Director of Field Services, Paralyzed Veterans of
America; and Mr. Ron Abrams, Deputy Director, National Veterans
Legal Services Program.
There are serious problems with the VA disability claims
process. For the past decade, data has shown that the
disability compensation adjudication process has experienced
large claims backlogs, high error rates, and poor timeliness.
In addition, some of VA's reported performance data is false or
misleading, particularly for fiscal year 1997.
Disability claims adjudication is an overly complex process
that gives many veterans terrible service. In 1999, at least
770 veterans died before their claims were decided.
The VA outlined what it is doing to improve. But, if past
performance is any indication, the VA will continue to fail
unless it makes more fundamental improvements, both in process
and management. Otherwise, any gains will be marginal and
temporary.
The subcommittee held a hearing on joint procurement of
pharmaceuticals by VA and DOD on May 25, 2000. Principal
witnesses included the Honorable G. Kim Wincup, Vice Chairman,
Congressional Commission on Servicemembers and Veterans
Transition Assistance; Mr. Steve P. Backhus, Director,
Veterans' Affairs and Military Health Care Issues, GAO; Mr.
Robert J. Lieberman, Assistant Inspector General for Auditing,
DOD; Mr. Gary J. Krump, VA Deputy Assistant Secretary for
Acquisitions and Materiel Management; Mr. John Ogden, Chief
Consultant, Pharmacy Benefits Management Group, VHA; BG Daniel
Mongeon, USA, Commander, Defense Supply Center, DOD, and Capt.
Charles Hostettler, USN, Director, DOD Pharmacy Programs,
TRICARE Management Activity.
The GAO, DOD IG, and the Transition Commission testimony
all agreed that increased VA/DOD joint medical purchasing could
yield considerable savings. GAO estimated that the savings
could amount to $1.5 billion over five years. It further
recommended that DOD consider utilizing VA's mail-order
pharmacy for its 25 million prescription refills that would
result in annual savings of about $45 million. The subcommittee
requested both Departments report within 90 days on the
feasibility of a pilot demonstration project. The subcommittee
also introduced H. Con. Res. 413. This Sense of the Congress
encouraged VA and DOD to increase their joint procurement of
medical items, including prescription drugs.
The subcommittee held a field hearing on quality of care,
patient and employee safety, and management effectiveness at
the Marion VA Medical Center on June 1, 2000, at Marion,
Indiana. Full Committee Chairman Bob Stump chaired the hearing,
which was requested by Representative Steve Buyer of Indiana.
Principal witnesses included Mr. Alanson Schweitzer, VA
Assistant Inspector General for Healthcare Inspections; Dr.
Michel Calache, Marion VAMC Staff Physician; Mr. Bill Overbey,
President, Local 1020, American Federation of Government
Employees; Mr. Steven Stewart, Marion VAMC employee; Mr. John
Hickey, Director of Rehabilitation, Indiana Department, The
American Legion; Mr. William Caywood, Commander, Indiana
Department, Disabled American Veterans; Mr. William Hahn, Past
5th District Commander, Veterans of Foreign Wars; Ms. Linda
Belton, Director, VISN 11, VHA, accompanied by Dr. Michael
Murphy, Director, Northern Indiana Health Care System, VHA; and
Dr. Allen Mellow, Director, VA Network Mental Health Service
Line.
VA employees, union officials, and VA and OIG officials
testified about understaffing, patient and employee safety,
lack of communication between employees and management, and
lack of proactive management from senior leadership. The OIG
Combined Assessment Program Review (CAPR) identified sixteen
areas of vulnerability that included the management of long-
term care, pharmaceutical control violations, patient and
employee safety issues, and lack of assignment of
accountability and responsibilities for these deficiencies. VA
officials testified that the majority of the issues had been
corrected or would be corrected when the new long-term care
facility opened in the fall of 2000.
After a series of post-hearing meetings with Mr. Buyer,
subcommittee staff and VA officials highlighting the funding
shortfalls, low employee morale, and patient and employee
safety issues, VA approved $6.5 million in supplemental funding
to address those issues.
On June 8, 2000, the subcommittee held an oversight hearing
on women veterans issues. The purpose of this hearing was to
review the changing needs of women veterans. The number of
women serving in our military has been steadily increasing and
women now comprise 15 percent of active duty military service
members. Witnesses included Dr. Linda Schwartz, Chair, VA
Advisory Board on Women Veterans; Ms. Jacqueline Garrick,
Deputy Director, Healthcare, National Veterans Affairs and
Rehabilitation Commission, The American Legion; Ms. Joy J.
Ilem, Associate National Legislative Director, Disabled
American Veterans; Ms. Marsha Tansey Four, Chair, Women
Veterans Committee, Vietnam Veterans of America; Ms. Joan
Furey, Director, VA Center for Women Veterans, Ms. Carole
Turner, Director, Women Veterans Health Program, VHA; and Mr.
Robert Epley, Director, Compensation and Pension Service, VBA.
The hearing documented VA's attention to the needs of women
veterans in both benefits and health care services. However,
the pace of improvement could reasonably be expected to be
faster. Some medical centers have lagged behind the majority of
providers within the VA medical system in providing more
adequate services to women veterans. Congress expects VA to
provide directly or by contract the same level of services for
women veterans that it does for male veterans.
On July 27, 2000, the subcommittee held a hearing on
patient safety and quality management in VA. Principal
witnesses included the Honorable Richard J. Griffin, VA
Inspector General; Ms. Cynthia Bascetta, Associate Director,
Veterans Affairs and Military Health Care, GAO; Ms. Linda
Connell, Director, Aviation Safety Reporting System, NASA Ames
Research Center; Dr. James Bagian, Director, National Center
for Patient Safety, VHA, Dr. Jonathan Perlin, Chief Quality and
Performance Officer, VHA; and Ms. Helen Cornish, Director,
Lexington, KY, VAMC. Because votes on the House floor precluded
the subcommittee from hearing the oral testimony of the
witnesses, Chairman Terry Everett ordered that all written
statements of the witnesses be submitted for the record.
The subcommittee called this hearing after receiving
disturbing reports of many avoidable patient deaths and other
adverse medical events. Also, the subcommittee was aware of a
1999 report by the Institute of Medicine (IOM) which estimated
that 44,000 to 98,000 American deaths occurred as a result of
medical errors. The subcommittee requested the GAO to determine
the status of VA's initiatives to detect and prevent adverse
events and to identify the obstacles and challenges VA would
face in order to establish a major change in the organizational
culture for safety. GAO testified that VA has developed a
number of initiatives that will aid the Department in
developing a culture for safety. GAO stated that VA leadership
must make patient safety a priority that clearly establishes
responsibilities and communicates the importance of patient
safety to every VA employee. GAO also stated that VA had yet to
establish outcome measures that would determine the
effectiveness of its patient safety initiatives.
VA has not defined or identified an implementation plan
detailing timelines and milestones of accomplishments or
measurable improvement outcomes. Subcommittee continuing
oversight on VA research programs has been a factor in a number
of initiatives in VA's patient safety program. VA established
the National Center for Patient Safety to lead and integrate
the Department's patient safety efforts. VA also established an
independent Office of Research Compliance and Assurance (ORCA).
The subcommittee held the second hearing on VA's
information technology programs on September 21, 2000.
Witnesses included Mr. Joel C. Willemssen, Director, Civil
Agencies Information Systems, GAO; Mr. Michael Slachta, Jr., VA
Assistant Inspector General for Auditing; Dr. Howard H. Green,
retired VA employee; and Mr. Robert P. Bubniak, VA Acting
Principal Deputy Assistant Secretary for Information
Technology.
This hearing focused on continuing weaknesses previously
identified in previous hearings of this subcommittee. GAO
testified on the status of VA's efforts to: improve its process
for selecting, controlling and evaluating IT investments; fill
the Chief Information Officer position; develop an overall
strategy for reengineering its business processes; complete a
department-wide integrated systems architecture; track its IT
expenditures; implement the Veterans Health Administration's
Decision Support System and the Veterans Benefits
Administrations compensation and pension replacement project;
and improve the Department's computer security.
GAO and OIG testified on the extremely serious department-
wide information security weaknesses. GAO stated that it had
reported on VA's computer security weaknesses as early as
September 1998. This report identified weaknesses that could
place critical VA operations such as financial management,
health care delivery, and benefits payments at risk for
inadvertent or deliberate misuse, fraud, improper disclosure,
or destruction, which could possibly occur without detection.
OIG's testimony reiterated that a number of significant control
weaknesses existed that made VBA systems vulnerable to
unauthorized access and misuse. OIG identified the high
vulnerability in the computer systems as early as 1997.
GAO was critical of the Department's plan not to develop a
department-wide business process reengineering strategy. VA had
yet to develop an integrated IT architecture as required by the
Clinger-Cohen Act. VA lacked a uniform mechanism for tracking
IT expenditures as required by its own VA Directive 6000. VHA
has spent a quarter-billion dollars on its Decision Support
System (DSS), yet utilization remains low. Of 140 VA medical
centers, 59 were not using DSS in any capacity.
The subcommittee concluded that while VA has made some
improvements, VA's IT programs have been chaotic due to weak
leadership and management. VA's improvement of its serious
computer security weaknesses will take sustained leadership and
commitment to develop and implement a comprehensive security
management program.
On September 27, 2000, the subcommittee held a second
oversight hearing on the effectiveness and strategic planning
of Veterans' Employment and Training Service (VETS) at the
Department of Labor. The purpose of this hearing was to follow-
up this subcommittee's hearing in July 1999. Witnesses included
Dr. Sigurd R. Nilsen, Associate Director, Education, Workforce,
and Income Security Issues, GAO; Mr. Kenneth McGill, Associate
Commissioner, Employment Support Program, Social Security
Administration; Mr. Rick Weidman, Director, Government
Relations, Vietnam Veterans of America; Mr. Anthony Eiland,
Special Assistant for Veterans Employment, Veterans of Foreign
Wars; Mr. Theodore Daywalt, President and CEO, VetJobs.com; Dr.
George Boggs, President, American Association of Community
Colleges; Mr. Raymond Boland, Secretary, Wisconsin Department
of Veterans Affairs; and the Honorable Espiridion A. Borrego,
Assistant Secretary of Labor for Veterans' Employment and
Training.
GAO testified that VETS has made ``some'' progress and
improvements with regard to its strategic and performance
plans. The subcommittee expected greater progress since VETS
hired an outside contractor to write these plans. However, the
subcommittee is skeptical about a plan that, in GAO's opinion,
lacks a vision for the future. Further, the VETS plan has not
articulated how it will integrate with the Workforce Investment
Act that Congress passed two years ago.
The other witnesses provided the subcommittee with
suggestions for improvements in VETS and testified about new
approaches being used in employment services as the result of
dramatic changes over the past decade.
On September 28, 2000, the subcommittee held a follow-up
hearing on how the VA had improved its protection of human
subjects in VA medical research since the suspension of all
medical research at West Los Angeles VA medical facilities in
May 1999. Principal witnesses included Dr. Greg E. Koski,
Director, Office of Human Research Protections, Office of the
Secretary, Department of Health and Human Services; Mr. Victor
S. Rezendes, Assistant Comptroller General, GAO; the Honorable
Thomas L. Garthwaite, VA Under Secretary for Health; Dr. John
R. Feussner, Chief Research and Development Officer, VHA; Dr.
John H. Mather, Chief Officer, Office of Research Compliance
and Assurance, VHA; and Dr. James P. Bagian, Director, National
Center for Patient Safety, VHA.
This hearing was a result of the subcommittee's inquiry
whether the widespread abuse and disregard of required patient
protections that led to the suspension of all medical research
at West Los Angeles VAMC was an anomaly in VA's vast research
programs. The subcommittee requested the GAO review VA's
research programs system-wide to determine if the violation of
patients' protections was a systemic issue. GAO testified that
the VA exhibited a disturbing pattern of non-compliance across
the medical centers that were reviewed. GAO further stated,
``The cumulative weight of the evidence indicated failures to
consistently safeguard the rights and welfare of research
subjects.''
GAO identified three specific weaknesses that compromised
VA's ability to protect human subjects: (1) lack of adequate
guidance to medical centers about human subject protections.
(2) insufficient monitoring of local protections; (3)
inadequate attention to ensure those funds needed for human
subject protection activities are allocated and available for
those purposes. GAO concluded that while VA has begun to
address these issues, progress has been slow. The subcommittee
recommends another follow-up hearing in the 107th Congress.
Other Oversight Activities
The Government Performance and Results Act of 1993 (Results
Act) requires federal agencies to implement strategic planning,
prepare annual performance plans that set performance measures
and targets, and report annually on actual performance. VA
began preparing an annual performance plan two years before it
was first required by the Results Act. The first VA Strategic
Plan under the Results Act was published in September 1997.
During the 106th Congress, VA continued Results Act
implementation. VA has improved development of performance
measurements and targets, integration of strategic planning,
budget formulation and program outcomes. VA is attempting to
address the Department's strategic direction from a unified
departmental perspective.
A revised VA Strategic Plan was published in September
2000. Since publication of the first VA Strategic Plan in 1997,
VA has developed new strategic goals and objectives that are
more outcome-oriented and veteran-focused. The fiscal year 1999
Performance Report, the first required under the Results Act,
was published at the end of March 2000. The Performance Report
was rated the third best among the 24 agencies with chief
financial officers.
VA has made progress in aligning the Strategic Plan, Annual
Performance Plan, budget, and Annual Performance Report. VA has
also continued joint consultation with its major stakeholder
groups. In order to achieve the consultation requirement of the
Results Act more efficiently in a single forum, VA implemented
a series of one-day ``Four Corners'' planning and consultation
meetings with its stakeholders. VA leadership, House and Senate
Veterans' Affairs Committee staff, and representatives of the
Office of Management and Budget and veterans service
organizations engaged in dialogue on issues impacting the
Department's strategic direction. Five such meetings were held
to discuss the strategic plan, scenario-based planning for the
future, and a number of important policy issues, including
discussion of VA's health care enrollment policy. The final
draft of the FY 2001-2006 VA Strategic Plan was reviewed at a
Four Corners meeting in August 2000. Several comments received
from stakeholders resulted in improvements to the quality of
the document that was submitted to the Administration and
Congress on September 29, 2000.
Over the past two years, VA completed its first formal
program evaluation, which addressed the Montgomery GI Bill
(MGIB) for active duty personnel and veterans; MGIB for
selected reserves; and Survivors' and Dependents' education. In
addition, VA initiated comprehensive evaluations of VA's
Cardiac Care Program and Survivors Benefits Programs that
include the Dependency Indemnity Compensation (DIC) and
Insurance Programs. Planning has begun on evaluations of the
Pension and Parent's DIC Programs and the Prosthetics and
Sensory Aids Program. A key element of planning for each
evaluation has been consultation with Congressional staff,
veterans service organizations and other stakeholders in
developing a consensus on the priorities and focus for each
program evaluation. The consultations have included review of
the contract Statement of Work and research questions prior to
contract award. A multi-year schedule for program evaluations
has been developed that includes evaluations of programs in
most business lines during the period covered by the strategic
plan. Better organizational and individual accountability for
program results would provide improved services to veterans and
greater return on investment for taxpayers. The subcommittee
recommends continued oversight of VA's Results Act compliance
and implementation.
Finally, the chairman of the subcommittee requested GAO
studies on VA travel expenditures, VA health care food service
operations, and VA laundry services. In brief, GAO found in VA
TRAVEL: Better Budgeting and Stronger Controls Needed, GAO/GGD-
99-137 (August 1999), that VA did not report to Congress that
since 1993 it had spent $61 million in travel funds on items
other than travel. GAO also found that some senior officials
had approved their own travel. VA agreed to more carefully
monitor travel authorizations and delegated travel authority,
but asserted that travel funding reprogramming was not a major
program activity and that reporting was not required. The
subcommittee believes the practice of reprogramming substantial
amounts of funding without reporting to Congress is undesirable
and that continued monitoring of these expenditures is
warranted.
GAO found in VA LAUNDRY SERVICE: Consolidations and
Competitive Sourcing Could Save Millions, GAO/01-61 (November
2000), that VA has the opportunity to reduce costs by closing
13 of its 67 laundries serving VA health care facilities and
moving their workloads to other, underused laundries. According
to GAO, these consolidations would reduce operating costs by $2
million or more annually, and would also allow about $9 million
in one-time savings. GAO also recommended VA explore greater
use of competitive sourcing. VA concurred with GAO's
recommendations. However, the American Federation of Government
Employees opposed the recommendations because of concerns that
wages of some VA workers could be reduced, or that jobs could
be eliminated. During its review, GAO also conducted a special
investigation of contractor practices at the Albany, NY, VA
Medical Center. At Albany, GAO found inadequate management and
oversight of the laundry contractor may have resulted in
inflated contract costs for VA. The improper practices have
been corrected.
In a second report related to VA hospital support services,
VA HEALTH CARE: Expanding Food Service Initiatives Could Save
Millions, GAO/01-64 (November 2000), GAO found that VA could
save an estimated $79 million annually--about one-quarter of
its inpatient food service expenditures--by consolidating food
production, shifting to Veterans Canteen Service workers, or
contracting with private sector food service organizations. VA
concurred in principle or concurred fully with GAO's
recommendations. However, the American Federation of Government
employees disagreed with the recommendations and expressed a
number of concerns regarding them. The subcommittee believes
that review of VA hospital support services should continue.
COMMITTEE WEB SITE
The VA Committee's web site, http://veterans.house.gov, is
a source of information on Committee activity and a gateway to
veterans' resources. Activity on the site grew from
approximately 18,000 visits during the early months of the
105th Congress to a high of 113,939 visits in September 2000
during the 106th Congress. The site contains over 5,000 files,
with new files being added weekly. The site was also named
``One of the Best Web Sites in Congress'' by the Congressional
Management Foundation (CMF) on May 3, 1999.
The site's Home Page has a table of contents, highlights of
current issues, and a Committee News Section, which has digital
photographs of recent hearings. The site includes a search
engine and a Tour of the Site with a web index and links to
other House sites. The site also consists of nine other
categories of information: The Chairman's Welcome, About the
Committee, Communications, Hearings, Issues, Legislation,
Veterans' Information, Veterans in Congress and the Democrat's
Home Page.
For the 106th Congress, the site includes the text and
summaries of all veterans legislation that was enacted and the
witness statements or text of all VA Committee and subcommittee
hearings. Whenever possible, witness statements for each
hearing are posted on the site within two hours after the
hearing is concluded. On its own pages and with its links to
other web sites, including the Department of Veterans Affairs,
the VA Committee's web site features information for veterans
that is both easy to access and the most comprehensive ever
available.
OVERSIGHT PLAN FOR 106th CONGRESS
In accordance with clause 2(d)(1) of Rule X of the House of
Representatives, the Committee on Veterans' Affairs has adopted
by resolution of February 3, 1999, its oversight plan for the
106th Congress.
This oversight plan is directed at those matters most in
need of oversight within the next two years. The Committee is
cognizant of the requirement that it conduct oversight on all
significant laws, programs, or agencies within its jurisdiction
at least every ten years. To ensure coordination and
cooperation with the other House committees having jurisdiction
over the same or related laws affecting veterans, the Committee
will consult as necessary with the Committee on Armed Services,
the Committee on Education and the Workforce, and the Committee
on Government Reform.
Oversight will be accomplished through Committee and
subcommittee hearings, field and site visits by members and
staff, and meetings and correspondence with interested parties.
Methods of oversight will include existing and requested
reports, studies, estimates, investigations and audits by the
Congressional Research Service, the Congressional Budget
Office, the General Accounting Office, and the Offices of the
Inspectors General of the Departments of Veterans Affairs and
Labor.
The Committee will seek the views of veterans' service
organizations, military associations, other interest groups and
private citizens. The Committee also welcomes communications
from any individuals and organizations desiring to bring
matters to its attention. A series of joint hearings is
scheduled with the Senate Committee on Veterans' Affairs at
which veterans' service organizations and military associations
will present to the committees their national resolutions and
agendas for veterans.
While this oversight plan describes the foreseeable areas
in which the Committee expects to conduct oversight during the
106th Congress, the Committee and its subcommittees will
undertake additional oversight activities as the need arises.
Because the Committee generally conducts oversight through its
subcommittees, the plan is organized by subcommittee.
Subcommittee on Health
Veterans Health Administration (VHA) Budget. The operation
of the VA health care system, the largest integrated health
care provider in the country, represents the most visible
expression of the nation's commitment to America's veterans.
With a medical care budget exceeding $17 billion, VA provides
care to some three million veterans annually. Through focused
analyses and hearings, VHA spending choices will undergo
careful scrutiny. Winter 1999 and Winter 2000.
Capital Asset Planning. The VA health care system
encompasses an extensive facility infrastructure including
thousands of buildings, some over 100 years old. Its extensive
and complex infrastructure requires substantial maintenance and
repair. Its need for major and minor construction and
renovation has outstripped available funding. The subcommittee
will examine the adequacy of VA's capital asset planning and
the manner in which the Department establishes its construction
priorities and associated funding plans. Winter 1999.
Hospital Consolidation and Missions Changes. Sweeping
changes in health care delivery practice and hospital
utilization have led hospitals in the private and public
sectors to close beds and in some instances to cease operating.
The VA health care system has closed thousands of operating
beds and reduced its hospital workforce while increasing its
ambulatory care capacity. As a decentralized system, the VA has
employed different strategies across the country to improve
operating efficiency. While hospital ``merger'' has been a
widely used strategy, there exists no apparent national
strategy to align infrastructure with patient need. In this
seeming vacuum, a few networks have initiated more far-reaching
steps, to include major medical center mission changes which
range from ceasing to provide inpatient surgery programs to
ceasing to provide acute hospital care directly. The
subcommittee will review management ``solutions'' and the need
for a national policy and appropriate realignment mechanisms.
Spring 1999 and Spring 2000.
Eligibility Reform Implementation. Congress enacted an
``eligibility reform'' law (Public Law 104-262) to eliminate
statutory barriers in VA to providing veterans needed
ambulatory care. In expanding access to medical care, the law
called for the establishment of an enrollment system to ensure
that veterans with a high priority to care would be afforded
treatment. The law left VA with discretion as to the categories
of veterans to be served and the specific benefits to be
furnished. The subcommittee will review the VA's decisions in
implementing that law. Spring and Summer 1999.
Resource Allocation. VA has implemented, and subsequently
refined, a methodology for distributing funds so as to provide
veterans similar access to care regardless of the region in
which they live. The subcommittee will continue to review the
extent to which the methodology meets its stated objectives.
Summer 1999 and Spring 2000.
Quality Management. ``Quality of Care'' has long been
invoked as central to VA's obligation and commitment to
veterans' care. Medicine, however, has yet to develop and
refine reliable, comprehensive indicators for assessing the
quality of care-delivery. While VA has long had organizational
structures, process requirements, and policies in place
designed to assure good quality care, quality management
remains an ongoing challenge for any institution. The
subcommittee will continue to review the record of compliance
with such policies, and the risk that budget-driven decision-
making could compromise quality management efforts. Summer 1999
and Summer 2000.
VA Role in Long-term Care. The VA, in response to
longstanding concerns about the manner in which it would meet
the needs of aging veterans, established an advisory committee
on long-term care. That committee's report calls on VA to
maintain, invigorate and reengineer VA-provided long-term care
while expanding noninstitutional community-based care services.
Through focused analysis and a hearing, the subcommittee will
review the status of VA's nursing home and long-term care
programs, and will study the advisory committee's findings and
recommendations, as well as the many important questions its
report raises. The subcommittee will also review the state home
program, the role that program can play in meeting veterans'
long-term care needs, and the need for any legislative changes
to the program. Spring 1999 and Summer 2000.
VA Specialized Medical Programs. Public Law 104-262
requires VA to maintain its capacity to provide for the
specialized needs of disabled veterans through such clinical
programs as post-traumatic stress disorder care, prosthetics,
and spinal cord injury care and rehabilitation. As a follow-up
to the subcommittee's oversight into VA's adherence to this
provision, Congress in Public Law 105-368 required VA to
institute performance requirements for network directors to
ensure compliance with the specialized program capacity law.
The subcommittee will carry out further oversight regarding
these programs, VA's establishment of such performance
requirements, and their impact. Fall 1999 and Fall 2000.
VA Pharmaceutical Procurement and Management. With growing
drug utilization in the VA, increasing numbers of VA patients,
and high-cost breakthrough drugs coming to market, the
Department's pharmaceutical spending is estimated to increase
to $2 billion this fiscal year. As such, pharmaceuticals
represent VA's largest single cost item other than personnel.
Accordingly, the subcommittee will review issues associated
with pharmaceutical procurement and benefits management. This
will include the role of VA's pharmacy benefit in VA health
care utilization, VA's drug formulary, opportunities for joint
procurement with the Department of Defense, and VA's
vulnerability to further price increases through efforts to
expand access to the Federal Supply Schedule. Summer 1999 and
Summer 2000.
Infectious Disease Programs. By virtue of its size and the
number of at-risk patients who rely on VA medical care
services, the VA has become an important source of care for
some of the major infectious disease problems affecting the
nation, including AIDS and tuberculosis. Based on prevalence
studies at selected VA medical centers, Department officials
have cited Hepatitis C as also having particular importance for
the VA health care system. The subcommittee will assess what is
known about the incidence and prevalence of this disease among
VA patients, likely medical consequences, the Department's
response, research efforts underway on this disease, and
emerging treatments. Fall 1999.
Effectiveness of VA Health Care Delivery for Persian Gulf
Veterans. In response to statute, VA is conducting two
important clinical trials to determine effective health care
treatments for the symptoms many Persian Gulf veterans have
manifested that appear to be similar to chronic fatigue
syndrome or fibromyalgia which occur in the general population.
The first is assessing the benefits of antibiotic therapy; the
second will determine the beneficial effects of exercise and
cognitive behavioral therapy for this population. The
subcommittee will review the results of these trials and ensure
VA continues to identify effective strategies for improving
health care delivery to Persian Gulf veterans. Summer 2000.
Contracting for Medical Services. With VA's downsizing of
its hospital bed capacity and ongoing efforts to establish new
points of health care access, the system has increased its
reliance on contracting as a means of service-delivery. The
subcommittee will review the extent of such contracting, the
extent to which such arrangements employ good business
practices and sound quality controls, and the impact of
contracting-out care. Summer 2000.
Status of VA/DoD Sharing of Health Resources. Although
provisions of law specifically encourage coordination and
sharing of health care resources between VA and DoD health care
facilities, there appear to be opportunities for greater
collaboration, including those identified by the Report of the
Congressional Commission on Servicemembers and Veterans
Transition Assistance. The subcommittee will review the extent
of VA/DoD sharing, opportunities for further expansion, and
factors that have encouraged or impeded such initiatives.
Summer 1999.
VA Research Program. The VA research program complements
the Department's medical care mission. As a national research
program aimed at improving the medical care and health of
veterans, the program supports medical research, outcomes and
health systems research, and prosthetics research and
development. The subcommittee will review the program's
contributions and goals, examine the appropriateness and
balance among its component elements, assess the effectiveness
of its peer review and patient safety mechanisms, and review
the role of VA research corporations to enhance the program.
Summer 2000.
Subcommittee on Benefits
Veterans Benefits Administration Services to Veterans. The
Veterans Benefits Administration (VBA) administers programs for
compensation and pension, vocational rehabilitation, education
and training, home loan, survivors, and life insurance. About 3
million veterans and dependents actively use these programs
annually. Funding for such programs and administration
comprises over one-half of VA's total budget. Myriad challenges
exist with respect to poor quality of claims decisions, a
declining workforce, a declining workforce skill level, and an
outdated benefits delivery process. A hearing will examine
progress in addressing such challenges. Winter 1999 and Winter
2000.
Veterans Employment: Military Occupational Specialties
Requiring Civilian Licensing, Certification or Apprenticeship.
The civilian employment sector increasingly relies on various
forms of credentialing to regulate entry into an occupation and
to promote accountability for performance and public safety.
More than one-third of enlisted military separatees work in
military occupations that have civilian equivalents with
credentialing requirements. A hearing will examine the role of
the Departments of Veterans Affairs, Labor, and Defense in
helping separating servicemembers and veterans meet
credentialing requirements. Spring 1999.
Veterans' Claims Adjudication Commission and National
Academy of Public Administration Reports. The Commission's
December 1996 and the Academy's April 1997 reports to Congress
made recommendations for improving veterans' benefits claims
processing. A hearing will review VA's implementation of
Commission and Academy recommendations through testimony from
VA, veterans' service organizations, and other interested
parties. Summer 1999.
Veterans' Appeals of Benefit Claims. The Board of Veterans'
Appeals is the first forum for a veteran to appeal a VA
decision on a claim for benefits. Although the Board is making
demonstrable progress in its productivity, major issues still
exist with respect to applying U.S. Court of Appeals for
Veterans Claims precedents, current law, and VA regulations in
appellate decisions. In addition, on average VA regional
offices require 558 days to act on BVA-remanded cases. The
subcommittee will review Board and regional office appellate
operations, as informed by Government Performance and Results
Act principles and customer service standards. Fall 1999.
Memorial Affairs. VA's department-wide strategic plan
covers only a 5-year period--through the year 2003. The
National Cemetery Administration (NCA) projects annual
interments will increase over 40 percent between 1995 and 2010,
and VA has not clearly articulated how it will meet the demand
for burials through 2010. The subcommittee will review NCA
plans to ensure that the Department is well prepared to meet
the increasing workload which will result from the declining
veteran population. Summer 1999.
Veterans Entrepreneurship Opportunities. Veterans should be
accorded a full opportunity to participate in the economic
system that their service sustains. The November 1998 report of
the SBA Veterans' Affairs Task Force for Entrepreneurship and
the Congressional Commission on Servicemembers and Veterans
Transition Assistance each made numerous recommendations for
improvements in both SBA and VA services to current and
prospective veteran small business owners. The subcommittee
will review SBA and VA implementations of Task Force and
Commission recommendations. Spring 2000.
Long-Term Residuals of Mustard Gas and Lewisite Exposure.
During World War II, the U.S. government used 60,000 U.S.
servicemen as human subjects in secret tests to develop better
methods of protecting U.S. forces against the use of mustard
gas by our adversaries. Some testing was conducted in full-body
gas chambers and focused on the development of protective
clothing, which could prevent or lessen the severe blistering
effects of mustard agents and Lewisite (an arsenic-containing
agent). The subcommittee will examine implementation of
Department of Defense and VA policy to identify such
individuals. It will further examine implementation of VA
policy to assess their health status and award them disability
compensation for long-term residuals on VA's presumptive list.
Summer 2000.
Ionizing Radiation. VA provides medical treatment and
compensation benefits to veterans suffering from exposure to
ionizing radiation. The subcommittee plans to review the
problems facing this category of veterans. Summer 2000.
Persian Gulf War Veterans Benefits. In the 105th Congress,
two public laws identified plans to determine conditions and
diseases that should be presumed service-connected for purposes
of compensation. Some provisions of the two laws are
contradictory and the bills have been referred to the
Department of Justice for resolution. The subcommittee will
monitor the Department of Justice guidance to the VA, the VA's
external study into conditions for which service-connected
compensation for veterans may be warranted, and how VA
addresses other matters described in these laws. Winter 2000.
Commission on Servicemembers and Veterans Transition
Assistance. In January 1999, the Commission released its
findings and recommendations on the adequacy and effectiveness
of benefits and programs for servicemembers and veterans in
their transition and adjustment to civilian life. The
Commission's review of benefits and services is the most
comprehensive since the Omar Bradley Commission in 1955. A
hearing will review implementation of Commission
recommendations by the Departments of Veterans Affairs, Labor,
and Defense, Small Business Administration, Office of Personnel
Management, and state approving agencies. Summer 2000.
Air Force Health Study (Ranch Hand). The study is a 20-year
prospective epidemiological study of veterans of Operation
Ranch Hand, the unit responsible for the aerial spraying of
Agent Orange and other herbicides in Vietnam from 1961 to 1971.
Study investigators report their progress and results annually
to Congress and results are further reviewed and summarized bi-
annually by the National Academy of Sciences. Congress has used
previous study findings as a basis to provide compensation for
spina bifida in children of Vietnam veterans. A hearing will
review the study's annual submission and results to date, as
presented by AFHS epidemiologists. Fall 1999.
``Roadmap to Excellence''. This May 1998 document is the
Veterans Benefits Administration's plan for reforming itself,
so as to regain its focus and accomplish its mission. The plan
expresses VBA's commitment to important changes in its
organizational structure, workflow, job design, and
relationship with veterans and their representatives. The
subcommittee will determine VBA's progress, as measured against
VBA's published activities and milestones. Summer 2000.
Subcommittee on Oversight and Investigations
Facilities Management. The VA health care system, with its
172 hospitals, 439 outpatient clinics, 131 nursing homes and 40
domiciliaries, operates a multitude of support services for its
facilities and the veterans they serve. The subcommittee will
examine how efficiently and effectively the VA provides
services, including the following areas: food service,
institutional laundries, staff housing, biomedical equipment
repair, engineering, energy savings performance contracting,
janitorial services, waste management, fire protection,
security and training. Summer 2000.
Medical Resources Contracts. The Veterans Health
Administration (VHA) is authorized under Public Law 104-262 to
non-competitively contract with affiliated medical schools for
medical services such as radiological imaging, laboratory
services, nursing support services, scarce medical specialty
care, medical examinations and consultations. The subcommittee
will review the Department's efforts to ensure that such
contracts follow recently adopted pricing guidelines. Summer
1999.
Realignment of the VA Health Care System. The subcommittee
in conjunction with the Subcommittee on Health will review VA's
long-term strategy to reorganize and restructure its health
care delivery system. The subcommittee will also examine
opportunities for the Departments of Defense and VA to partner
in delivering health care to the men and women who serve or
have served in uniform. Spring 2000.
Patient Safety. The VA health care system continues to
operate without a centralized or regional reporting system to
track ``sentinel'' events in patient care. Reports of patient
deaths and serious lapses in quality health care delivery raise
concerns about the adequacy of quality assurance and quality
management programs to correct, reduce or prevent potentially
serious incidents. The subcommittee will continue its review of
the investigation and forensic laboratory work of the Federal
Bureau of Investigation concerning the 1992 veteran deaths that
occurred at the Harry S Truman VA Medical Center, Columbia, MO.
The subcommittee will also review VHA's practices regarding
autopsies. Winter 1999.
Information Technology. VA's information technology
programs will spend over $1 billion on software, hardware and
contractor support in 1999. The subcommittee will review VA's
information technology programs and VA's progress in its
computer-based Decision Support System and Master Veteran
Record, VETSNET, Year 2000 preparations and other computer
modernization. Summer 1999.
Whistleblowing in the VA. The subcommittee will examine the
VA's policies and protections for employees who have claimed or
been granted whistleblower status as well as for employees who
have filed various types of complaints or claims against the
Department. The subcommittee will investigate allegations of
retaliation and violations of confidentiality by the
Department. Winter 1999.
Central Alabama Veterans Health Care System and
Accountability within VHA. The subcommittee will continue to
follow-up the Department's actions to implement corrections and
hold responsible officials accountable regarding the VA Office
of Inspector General's findings of serious health care
deficiencies, mismanagement, misconduct and prohibited
personnel practices in the Central Alabama Veterans Health Care
System. The subcommittee will also review accountability of
management within VHA generally. The subcommittee will continue
to monitor the integration of the Montgomery and Tuskegee VA
Medical Centers, and VA medical facility mergers nationwide.
Spring 1999 and Fall 1999.
Office of Resolution Management. The subcommittee will
examine the effectiveness of the VA's EEO complaint resolution
system administered by the newly established Office of
Resolution Management. The subcommittee will review the new
system for timeliness, fairness, integrity, trust and
independence from VA management in handling claims and appeals.
Spring 1999 and Spring 2000.
Civilian Health and Medical Programs of the Department of
Veterans Affairs. There are approximately 80,000 beneficiaries
of the CHAMPVA program who generate over 800,000 medical
claims. Current annual program expenditures are in excess of
$93 million and claims total $85.1 million. The subcommittee
will review the effectiveness of program management controls
for duplicate claims payments, eligibility verification, and
recovery of fraudulent claims payments. Spring 1999.
Office of Inspector General. The subcommittee will review
the five-year strategic plan of the Office of the Inspector
General (OIG). The review will include organizational
structure, staffing, investigative protocols, responsiveness to
congressional inquiries and management of hotline inquiries.
Summer 1999.
Procurement Management. The subcommittee will review VA's
overall procurement process. The review will include:
efficiencies of the National Acquisition Center; initiatives in
electronic commerce; centralized acquisitions; pharmaceutical,
medical and surgical supply procurement; performance based
contracting; and other acquisition streamlining. Further, the
subcommittee will review instances of vendor overcharges and
contractor fraud, and departmental measures instituted to deter
future incidents. The subcommittee will also review the backlog
of capital medical equipment and VA's acquisition strategy for
reducing the backlog. Winter 2000.
Medical Care Collections Fund. VA collects over $500
million per year from third party insurers for medical care
provided to veterans with health care insurance. The
subcommittee will review the efficiency and effectiveness of
the VA's collection process. The review will focus on
collection procedures, cost of collections and the adequacy of
billing rates based on the quantity and cost of care provided
to veterans. Spring 1999.
Workers Compensation Claims by VA Employees. In 1995, a
pilot program was initiated by OIG and VHA to identify VA
employees who were fraudulently receiving workers compensation
benefits. Because of the success of the pilot program, OIG and
VHA expanded their investigative and audit efforts. The
subcommittee will review the incidence of such fraudulent
claims at VA as well as the efforts to detect and deter their
occurrence. Spring 1999.
Inappropriate Benefits Payments. Based on results of OIG
audits, the Veterans Benefits Administration should develop and
implement effective methods to identify inappropriate
compensation and pension benefit payments. For example, VBA
should improve procedures for offsetting disability
compensation payments to active military reservists. The
subcommittee will review VBA's efforts to implement procedures
to timely identify deceased beneficiaries and terminate their
compensation and pension benefits in order to reduce
overpayments. Spring 1999.
Government Performance and Results Act. The Government
Performance and Results Act (Results Act) requires federal
agencies to report performance outcomes annually to Congress.
VA has numerous automated data collection systems in order to
report the Results Act's objectives. Prior OIG audits have
found unreliable data in VA's financial and management systems.
The subcommittee will continue its oversight of the VA's
compliance with the Results Act, including program evaluations,
performance plans and strategic planning department-wide. Fall
1999 and Fall 2000.
Veterans' Vocational Rehabilitation Benefits and
Employment. Subcommittee oversight activity will include review
of the following programs: Transition Assistance Programs,
Disabled Transition Assistance Programs, vocational
rehabilitation programs at VA and veterans' employment and
training programs at the Department of Labor. The extent of
coordination among these programs will be part of the oversight
review. Pertinent recommendations of the Commission on
Servicemembers and Veterans Transition Assistance will be
considered. Spring 2000.
VBA Business Process Reengineering. Subcommittee oversight
will include review of VBA's business process reengineering
efforts for improving claims and appeals processing, and
quality management. Government Performance and Results Act
requirements, and recommendations of both the National Academy
on Public Administration Analysis of Claims Processing and the
Veterans' Claims Adjudication Commission will be considered.
Winter 2000.
Arlington National Cemetery Burial Waivers. The
subcommittee will complete the investigation of burial waivers
for Ambassador M. Larry Lawrence and Dr. C. Everett Koop which
were begun in the previous Congress, and will examine
administrative and eligibility issues regarding the cemetery.
Spring 1999.
Case Narratives on Persian Gulf War Veterans. The
Department of Defense Office of the Special Assistant on Gulf
War Illnesses (OSAGWI) has developed a series of case
narratives to ascertain the likelihood of certain biochemical
and environmental exposures in the Persian Gulf. In only one of
the many cases reviewed has the office deemed an exposure
``likely.'' The subcommittee will continue to review the
standards and protocols OSAGWI has implemented for these case
narratives to ensure that the process is thorough and fair to
veterans who may have been exposed to hazardous materials
during their service in Southwest Asia. Summer 1999.
Departmental Travel and Videoconferencing. The subcommittee
will review the VA's travel requests and expenditures for
recent budget cycles, including whether the VA has adequate
internal controls for approval of official travel. The
subcommittee will also examine the VA's use of
videoconferencing for hearings, conferencing and training.
Winter 1999 and Fall 1999.
REPORT TO THE COMMITTEE ON THE BUDGET FROM THE COMMITTEE ON VETERANS'
AFFAIRS ON THE BUDGET PROPOSED FOR FISCAL YEAR 2000, WITH ADDITIONAL
AND DISSENTING VIEWS, SUBMITTED ON MARCH 15, 1999
BACKGROUND AND COMMITTEE RECOMMENDATIONS
Department of Veterans Affairs
VETERANS HEALTH ADMINISTRATION
Medical Care
In the last four years, the VA health care system has
undergone an extraordinary transformation, to include
1. Lreductions in the number of hospital beds (down 52
percent, or some 27,200 beds since September 1994) and a 31.7
percent decline in hospital admissions;
2. Lan accompanying increase of 9 million ambulatory care
visits in the last four years; and
3. La reduction in the medical care workforce since 1994 of
some 19,000.
As though unaware of the extraordinary savings VA has
already wrung from its health care system, the architects of
the President's budget propose that VA somehow continue to care
for an increasing number of patients, take on costly new
initiatives, and meet an acknowledged funding shortfall of more
than $1 billion through more savings. VA concedes that there is
no plan to achieve management efficiencies and savings, and
defers to its network directors to identify and execute them.
Those directors, in both testimony before our Subcommittee on
Health at a February 24, 1999 hearing and telephone surveys,
have candidly stated that this budget plan would require them
to close needed programs and even hospitals, forego opening new
clinics, and make additional cuts which would deny veterans
access to care and delay care for others. While some modest
additional savings may yet be realized, no responsible VA
official has identified a means to achieve savings of the
magnitude proposed without having a marked adverse impact on
patient care.
In capsule, this budget, which proposes to meet veterans'
medical care needs at the FY 1999 level of $17.3 billion:
seeks no funds for the projected $870 million in
uncontrollable cost increases (including pay raises, inflation
and State home payments) identified in the President's budget;
proposes no new funds for a new medical
obligation of major proportion--a nationwide hepatitis C
problem, which is acknowledged to be more prevalent among VA
patients than among the population at large--recognized in the
President's budget;
proposes, without seeking any new funds,
expansion of several health-care priorities; and
``plugs'' the huge resultant shortfall with a
staffing reduction of at least 6,949 full time positions.
Looking below the surface, this budget would have a more
severe impact than the Administration's submission suggests,
because its projections mask the depth of the shortfall VA
would face. For example, the Administration budget fails to
take account of:
VA pharmaceutical costs--already nearly $2
billion--escalating at a considerably higher rate (more than 10
percent annually) than the 4 percent inflation factor built
into the budget. (At the Committee's budget hearing, for
example, VA's Under Secretary for Health acknowledged that
``the pharmaceutical budget increases are disproportionate to
other elements of our budget''. Network directors cited cost
increases ranging from 10-15 percent despite tight
pharmaceutical benefits management and implementation of a
national drug formulary.) Drug costs may thus be $110 to $200
million higher than provided for under the budget.
VA's prosthetics costs, now about $500 million/
year, have been increasing at a rate of approximately 18
percent/year; yet the budget provides only about 4 percent for
inflation. Prosthetics costs, projected to continue at double-
digit growth, are likely to be understated by some $50 million.
VA's failure, despite the incentive of retaining
these monies, to meet its recent medical collections' goals.
With FY 1998 collections more than $139 million short, current
year collections running behind target, and an FY 2000 goal
$124 million higher than this year's, VA could realistically
fall as much as $124 million short of projected revenues.
The projection that VA would have to reduce
``only'' 6949 FTE to realize $1.1 billion in savings fails to
acknowledge that VA's ``30-20-10 plan'' (achieving a 30 percent
reduction in unit costs and 20 percent increase in patients
served and increasing non-appropriated revenues to 10 percent),
which is the basis for this budget reduction, has broken down.
As a recently retired network director testified, it would take
a reduction of 20,000 employees to yield $1 billion savings.
As VA medical administrators contemplate this very
troubling budget, they must confront a unique patient
population. It ranges from a growing population of aging
veterans with complex medical needs to a large number of
homeless patients. But VA also faces what the House Committee
on Government Reform and Oversight recently characterized as a
``silent epidemic''. Chairman Burton, in an October report,
described hepatitis C (HCV), as posing a ``daunting challenge
to public health'':
Chronic infection can linger without symptoms for more
than 20 years, then produce profound health
consequences, including liver failure and cancer. There
is no preventive vaccine or universally effective
treatment. Up to 10,000 will die this year from the
disease. That number could triple in the next two
decades, according to the Centers for Disease Control
and Prevention. HCV has now spread to an estimated 4
million Americans. (H. Rept. 105-820)
The budget does recognize a need for, and proposes, a
national program to screen and treat VA patients at risk for
hepatitis C. It projects spending on this program of an
additional $136 million in FY 2000. These are new cost, yet the
budget fails to request any funds to support such an effort. An
additional concern is that the cost could be greater than
projected. A combination of drugs has recently been shown to
have some efficacy in treating the disease. While the cost of
such drug therapy is known--in excess of $1000/patient/month--
there is limited data from which to estimate the prevalence of
infection among veterans. Veterans who rely on VA for health
care are expected to be at greater risk of hepatitis C than the
rest of the U.S. population because of exposure to major risk
factors for this infection, including blood transfusion prior
to 1992 and a history of intravenous and other drug abuse. (The
best evidence is from San Francisco where the rate of hepatitis
C among VA patients is more than 10 times that of the U.S.
adult population. The rate in San Francisco is likely to be
higher than in VA settings overall because of the high
prevalence of risk factors in the San Francisco area.) It is
reasonable and conservative to assume that rates in San
Francisco are twice as high as rates in other metropolitan
settings. On this basis, it can be estimated that approximately
8.9 percent of VA users nationwide are infected with hepatitis
C. The President's budget estimates a prevalence of hepatitis C
in the VA user population at 5.5 percent, an estimate which
seems low, given the high levels of risk factors for the
disease among VA patients. On the basis of assumptions made in
the budget, the Committee estimates costs for hepatitis C
screening and treatment in FY 2000 of $236 million, $122
million above the projected spending level for FY 1999. Based
on these estimates, the budget projection, which calls for an
additional $136 million for FY 2000, would appear to be a
reasonable estimate of VA's needs for this program. The
Committee is concerned, however, that VA may be overestimating
the scope of the screening effort for this fiscal year. If
medical centers are slow in starting up this effort, the
numbers screened in FY 2000 may be larger than anticipated and
the costs closer to the full $236 million, resulting in a still
larger shortfall.
In essence, without even reaching the merits of the new
initiatives proposed in the budget, it is apparent that VA
would require an additional $1.1 billion just to maintain the
services it is now providing. It is also clear to this
Committee, in the face of what VA is now not providing, that
shrinking VA's budget still further would have severe,
irreversible repercussions. By way of illustration, this
Committee has long questioned VA's planning for the needs of
aging veterans. According to the June 1998 independent advisory
committee report, ``VA Long Term Care at the Crossroads'', the
number of veterans needing long-term care services is predicted
to grow by 13 percent over the next five years. The report
confirms this Committee's finding that in many areas to meet
budget needs VA long-term care services have been downsized and
the mission has been changed from long-term care to
rehabilitation. The Committee's budget hearings made it clear
that the FY 2000 budget would force still more network
directors to make cuts of that kind. For VA to be shrinking
nursing home care programs and reducing funding for other long
term care programs at the very time that its population is
aging is extraordinarily troubling. Such a shift in VA's long
term care mission certainly also has implications beyond the VA
medical care budget, and would be felt by Medicaid, Medicare,
and State home programs, for example.
Administration-proposed legislation--.The Administration's
budget again recommends that Congress enact legislation to
authorize ``a new smoking-cessation program for any honorably
discharged veteran who began smoking in the military.'' The
budget submission advises that, once this program is
authorized, the Administration would submit a budget amendment
requesting $56 million for this activity.
This proposal is as ill-conceived as its predecessor last
year. Notwithstanding this budget's huge funding shortfall,
this recommendation calls for substantial new spending on a
benefit, which as proposed, must be provided through contracts.
It ignores authority under current law under which VA is
already providing such services as part of the care furnished
VA patients.
The Administration also requests legislation to expand VA's
very limited authority to cover emergency services furnished in
community hospitals when VA emergency facilities are
unavailable. As discussed above, however, it is troubling in
the face of a budget shortfall in excess of $1 billion that the
Administration would recommend an expansion in this or any
other area, without providing needed funding to support it.
The Administration's emergency care proposal also suffers
from the lack of a coherent rationale. In advocating for a
Patient Bill of Rights, the Administration has argued for
legislation which would require any health plan to guarantee
its participants emergency care coverage. In proposing that
Congress provide emergency care coverage for veterans, however,
the Administration would not cover many of those veterans most
in need of such a guarantee. Certainly, legislation proposing
to cover all veterans' emergency care needs would relieve third
parties of contractual or other obligations. Many veterans, for
example, do not use VA care exclusively and, through insurance
or Medicare coverage, for example, have and use other
alternatives. The Committee believes, however, that uninsured
veterans who have a high priority to VA care (``category A''
veterans) who have relied on VA as their primary health-care
provider should not incur extraordinary costs in medical
emergencies where a VA facility is not reasonably accessible.
As the Congress moves forward on legislation to provide
certain minimum safeguards for those in health plans (to
include a right to emergency care), it must certainly ensure no
less for veterans. Accordingly the Committee would propose to
take up legislation under which VA would cover reasonable costs
of catastrophic care furnished in a medical emergency. Such
legislation would provide VA with appropriate control
mechanisms to contain costs including authority to ensure
adequate utilization review. The Committee estimates that
enactment of such legislation would entail costs of $500
million in fiscal year 2000.
Additional Legislation: The ``Veterans' Millenium Plan''
While recognizing the huge deficiencies of the FY 2000
medical care budget, the Committee believes there is a need for
legislation to help set the future of VA health care on a
sounder footing and to better position VA for future year
budgets. Such legislation should include a framework for better
matching VA's infrastructure with veterans' needs, improving
access to and the quality of VA care, and calling on veterans
to bear a reasonable part of the cost of nonservice-connected
long term care, for example.
While this plan has several elements, the Committee
strongly believes that its component parts--including a
substantial increase in medical care appropriations for fiscal
year 2000--are interdependent, both to achieve the goal of
improved care and to win the support needed for enactment.
The major themes of such legislation would include the
following:
providing greater access to needed care through
facility realignment;
preservation of long-term care programs, and
providing for enhanced revenues.
1. Improved access through facility realignment
Historically, VA hospitals were not consistently sited near
veteran population centers. Today, occupancy rates at numbers
of VA hospitals are substantially below levels needed for
efficient operation and optimal quality of care. Maintaining
highly inefficient hospitals, which were designed and
constructed decades ago to standards no longer deemed
acceptable or, in some cases, functional, substantially
diminishes the availability of funds needed to strengthen care-
delivery in facilities which should be retained.
While the private sector has seen widespread closure of
community hospitals, VA's first hospital closure in many years
came about not through the persuasiveness of health planners,
but as a result of an earthquake threat. The lessons of that
experience are telling, however. The closure of the Martinez,
California VA Medical Center and decision not to build a
replacement hospital--but instead to establish a full-service
ambulatory clinic--are widely recognized as having resulted in
improved access to care for many veterans. Subsequent
decisions, rejecting proposed construction of hospitals in
California and Florida, and relying instead on multi-site
contracts for hospital care and new outpatient care sites,
provide important case studies. These experiences and
subsequent mission changes at other VA hospitals suggest a
framework for better matching underutilized, inefficient
infrastructure with veterans' needs.
Building on these experiences and VA system needs, the
Committee, as one facet of its ``Millenium'' legislative plan,
intends to develop legislation which would:
require VA, pursuant to network-based strategic
plans, to establish ``enhanced service programs'' at
appropriate locations;
provide that an ``enhanced service program''
would include
(1) establishing in the affected service area
a state-of-the-art outpatient clinic (and/or
expanded long-term care capacity),
(2) contracting in accordance with specific
legislation for needed hospital care (with
ongoing VA case-management), and
(3) preferential re-employment assistance for
dislocated VA employees in any area where VA
ceases to provide direct hospital care under
the terms of the bill;
provide criteria for hospitals that might be
considered for selection as ``enhanced service program'' sites;
require that VA develop a plan (that takes
account of veterans' and other interested parties' views) for
each site which must improve accessibility and service-quality
and which ensures that all savings remain in the network; and
require that such plans could not be put into
effect until Congress has had a period of time to review them.
While acknowledging the need to better align VA's capital
assets to needed missions, the Committee notes that the
downsizing which has taken place in the past four years under a
decentralized decisionmaking process may in some instances have
gone too far. For example, as the aging veteran population has
grown, budget-cutting goals have led to closure of long-term
care programs in certain areas. While savings from the closure
of psychiatric beds in some networks have funded new primary
care clinics, intensive outpatient programs have not
universally replaced the diminished hospital care capacity.
With the recognition that pressures to ``increase workload''
may overtake statutory obligations to meet often costly patient
needs, the Committee will also develop legislation to provide
better oversight of significant program closures or downsizing
before they are implemented. Such legislation would require VA
to develop and submit to Congress detailed business plans
associated with any proposed closure of a major health care
services (such as the proposed closure of a hospital's surgical
service), and to defer implementation for a prescribed review
period.
As envisioned, facility realignment should substantially
improve veterans' access to care. At the same time, the
Committee recognizes that provisions of law governing
eligibility still limit some veterans' access. Congress in 1996
enacted legislation, the ``Veterans Health Care Eligibility
Reform Act of 1996'', which revised the patchwork of laws
governing eligibility for VA medical care. Given its experience
under that law, the Committee proposes to make further remedial
changes to that ``eligibility reform''. Specifically, the
Committee will develop legislation to provide express medical
care eligibility for veterans who have been injured in combat
(Purple Heart recipients). While their combat-incurred injuries
are by definition service-incurred, some of these veterans have
never sought compensation and could face lengthy delays in
receiving needed care because their residual disability has
never been formally adjudicated.
The Committee will also seek to elevate the priority of
veterans who have retired from military service. A retiree who
is not service-connected disabled, has no other ``special''
eligibility status for VA care, and who has income in excess of
VA's statutory ``means'' test, has generally had limited access
to VA medical services. With the closure or downsizing of many
military medical facilities, many retirees have also been
deprived of access to promised care in military treatment
facilities. While Government-sponsored care is available to
them through the TRICARE program, many retirees reasonably
question why they cannot receive care through the VA health
care system. The Committee intends to pursue legislation to
provide retirees such an option. Since provision of care to
retirees is primarily a Department of Defense responsibility,
the Committee believes such legislation should provide for that
Department to reimburse VA. This legislation would also include
appropriate safeguards to ensure that this proposed new
treatment mission would not diminish or compromise VA's
obligation to veterans already entitled to priority under law.
2. Preservation of VA long-term care programs
The Department of Veterans Affairs has long recognized the
aging of America's World War II and Korean War veterans as a
major challenge. Aging veterans' access to acute-care services
has expanded significantly since the publication in 1984 of a
VA needs-assessment entitled ``Caring for the Older Veteran''.
In contrast, many veterans who have enjoyed markedly improved
access to ambulatory or hospital care have been at relative
risk with respect to needed nursing home care or alternatives
to institutional care.
VA's capacity to furnish needed long-term care has actually
shrunk in some areas as officials, identifying such programs as
``discretionary'', have closed beds or changed the mission of
some nursing homes from long-term care to rehabilitation. The
Committee is deeply concerned that VA network or facility
directors have dismantled critically needed programs on the
basis that nursing home care is costly or that Congress has
somehow invited VA officials to exercise ``discretion'' to
provide or not provide such care.
The Committee proposes to address long-term care issues by:
making it clear that nursing home care is not a
``discretionary'' program, and is clearly part of the VA's
health care mission;
requiring that VA provide ongoing nursing home
care in the case of a veteran (1) in need of such care for a
service-connected disability or (2) who is 100-percent service-
connected;
providing, for purposes of access to VA nursing
homes for care of nonservice-connected conditions, priority for
specialized patient populations (such as patients with
geropsychiatric disorders and Alzheimers' disease), patients
for whom there are no other suitable placement options, and
patients in need of rehabilitation; and
. requiring VA to augment provision of community-
based long-term care services such as adult day health and
home-based care (subject to maintaining current level of
program effort) through the establishment of a revolving fund
in the Treasury for deposit of certain new revenues
3. Enhanced revenues
Through its long years of service to America's veterans,
the VA health care system has found support primarily as a
system dedicated to the care and rehabilitation of veterans
with service-incurred disabilities and as a ``safety net'' for
other veterans who lack medical insurance or other health care
options. Consistent with this mission, Congress has provided
for VA to furnish cost-free care to both veterans needing
treatment for service-connected disabilities and to low-income
veterans. While current law sets broadly applicable copayment
requirements on outpatient prescriptions and requires higher-
income veterans to bear part of the cost of their care, there
is an inherent inconsistency in these policies. This
Committee's recommendation for increased medical care
appropriations and its companion effort to establish a
legislative foundation for better meeting veterans' health care
needs makes it appropriate that it re-evaluate current policy
on cost-sharing. Considerations of equity support such a re-
evaluation.
For example, under current law, largely arbitrary
circumstances often dictate whether similarly situated veterans
will receive entirely cost-free VA nursing home care or bear
very substantial costs of care--either in a State veterans
nursing home or indirectly through a required spend-down of
assets to qualify for Medicaid. All but three States operate
State veterans' nursing homes, and in all but one State
veterans are required to make payments toward the cost of their
care, up to a prescribed maximum and subject to ability to pay.
The severe reductions anticipated under the fiscal year
2000 budget raise the prospect that many nonservice-connected
veterans who now enjoy free or nearly cost-free VA care could
lose access to VA services entirely. In that regard, recent
news accounts highlight that those with other health-care
options will, for example, face managed care-plan prescription
copayments of $5 for generic drugs, $15 to $20 for a brand-name
drug on a plan's formulary, and up to $40 for a brand-name non-
formulary drug (Wall Street Journal, January 12, 1999). Current
law limits VA to charging a $2 copayment for each 30-day supply
of medications furnished on an outpatient basis for treatment
of a nonservice-connected disability. (Veterans who are 50
percent or greater service-connected disabled and veterans with
very limited income are exempt from this requirement.) Also in
marked contrast to other health plans, VA is providing large
numbers of veterans hearing aids, eyeglasses, and other devices
under a liberal VA interpretation of eligibility law.
Individuals seeking such services under other health plans
would often incur out-of-pocket payments under copayment or
deductible provisions, or be denied the service altogether. Yet
most nonservice-connected veterans, receiving a benefit never
before available in the VA, bear no part of its cost.
In the context of the multi-faceted legislative plan
discussed above, the Committee will develop legislation on
cost-sharing which would:
remove the inherent inequity in current law by
requiring VA to establish a copayment policy applicable to any
episode of nursing home care for a nonservice-connected
condition. Such policy would be based on a copayment
methodology derived from requirements used by States for
veterans' nursing home care (to include ability to pay and
protection of the spouse of a veteran from financial hardship).
A similar requirement would be established for extended periods
of home health care;
provide that copayments applicable to long-term
care would be for deposit into a revolving fund to be used
exclusively to expand long-term care programming; and
authorize the Secretary to establish reasonable
copayment increases on prescription drugs and reasonable
copayments on hearing aids and similar items (subject to the
exemption policy reflected in section 1722A of title 38, United
States Code). For veterans with higher incomes, the Secretary
could seek to recover substantially higher copayments for such
items.
Medical Research
The proposed $316 million budget for medical and prosthetic
research reflects a well-balanced strategy to continue broad-
based programs to expand understanding of disease and
disability. The budget targets research areas of particular
importance to veterans. While recognizing that this budget
falls short of maintaining the level of research staffing for
the current fiscal year, the Committee does not propose to
increase this appropriation, given the extraordinary shortfall
in medical care funding.
Major Medical Construction
As the Veterans Health Administration continues to evolve
from a hospital-based network to an integrated health care
system which provides services through a broad spectrum of
delivery mechanisms, VA is necessarily reviewing the missions
of many of its facilities. In some instances hospitals have
taken on more focused missions, and even ceased to provide
hospital care. At the same time, many of VA's major tertiary
care facilities have only grown in the complexity of the
services they provide.
VA's infrastructure is vast and has an estimated
replacement cost of over $34 billion. It is an aging
infrastructure, with more than 40 percent of its building over
50 years old, an age industry would consider obsolete. Although
many of its patient care facilities have undergone some
renovation work over the years, few were designed and
constructed to accommodate current medical practice patterns.
While VA has made significant strides in establishing
community-based outpatient clinics and shifting care from
inpatient beds to outpatient services, VA will undoubtedly
continue to need to operate hospitals, and, in many cases, VA
must bring those facilities into compliance with patient care
and safety needs. There continues to be an important role,
accordingly, for major medical construction.
VA has not had great success, however, in articulating
where such construction should take place and how to establish
priorities among competing construction needs. The Committee is
disappointed with the fruits of its efforts to require the
Department to employ systemwide strategic planning in answering
those questions. To illustrate, the Committee has learned that
seven of the 18 major construction projects identified by the
Department (in its Strategic Planning Report in response to
section 204 of Public Law 104-262) as its FY 1999 highest
priority major medical construction projects were dropped from
that list based on network re-evaluations. One must question
the nature of this planning process when more than one-third of
VA's top priorities last year are deemed ``rejects'' today. In
that regard, it is perplexing--given the problem of medical
centers which were not designed with significant ambulatory
practice in mind--that a proposed construction project for the
Washington, D.C. VA Medical Center, which was identified as a
priority in the FY 1999 Strategic Plan, and which was
authorized by Congress last year, was not proposed for funding
this year (and, in fact, is among the projects which was
dropped from the priority list).
There is no question but that there is an extensive need
for major medical construction in VA. Given uncertainty,
however, regarding VA's own assessment of where construction
should take place, and lack of a basis to understand its
priority-setting, the Committee approaches the identification
of needed major medical construction projects with great
caution. Testimony by VA's Under Secretary for Health citing a
need for additional hospital mission changes highlights the
importance of such a cautious approach.
Most of the unfunded construction projects recommended by
this Committee last year and authorized by the Congress appear
still to be needed. Accordingly, with an eye to meeting those
construction needs as an initial priority, the Committee
recommends a funding level of $140 million, a $66 million
increase above the Administration's proposal.
Minor Construction
The minor construction account funds a broad range of
construction work on projects costing less than $4 million,
ranging from inpatient and outpatient renovations and
improvements to upgrading electrical, ventilation, and heating
and cooling systems. Operating in facilities which are often
many decades old, VA requires the flexibility provided by this
account to correct safety and code deficiencies, replace
utility systems, improve ambulatory care space, and address
other such physical plant needs.
The Committee is concerned, however, that minor
construction funds are being committed to projects without any
apparent connection to strategic plans. Accordingly, the
Committee envisions further oversight on this area to ensure
prudent allocation of the $175 million requested for this
important account.
State Home Construction
This program provides funding for up to 65 percent of the
cost of construction or needed renovation to help assure that
States can assist in meeting veterans' needs for nursing home
and other long term care. The states have been reliable
partners in this effort, and many have appropriated monies in
advance to establish priority for grant funding. (States which
have already made their share of funds available for a needed
project have the highest priority for grant assistance.)
With VA medical centers having reduced long-term care
nursing home beds, the State Veterans Home Program has become
even more critical to meeting the needs of aging veterans.
Increasingly, VA nursing home beds are available only to
veterans in need of short-term rehabilitation. It is most
troubling, accordingly, that this budget would more than cut in
half, to $40 million, appropriations for a program
substantially dedicated to long-term nursing home care. Such a
cut would leave without funding support in FY 2000 more than
$75 million in pending ``priority #1'' projects, those for
which the States have already put up the required funding.
The Committee awaits with interest the results of a
consultant management study on this program, and believes its
findings and recommendations will be helpful in its review of
proposals for revising the rules governing prioritization for
funding of grant applications. The Committee's interest in
considering such legislation should in no way, however, suggest
a diminution in commitment to this program. Accordingly, the
Committee proposes an appropriation of $90 million for fiscal
year 2000.
Medical Administration and Miscellaneous Operating Expenses (MAMOE)
The MAMOE budget funds the headquarters' operations of the
largest health care system in the country. Over the years, an
ever-shrinking MAMOE budget has reduced the size of VA's
headquarters' staff. Congress, however, has not reduced its
expectations of VA. It looks to VA's headquarters not simply to
set policy, but to manage and oversee the VA health care
system. Last year, based on concerns regarding headquarters'
lack of sufficient oversight of the quality of VA care,
Congress increased the MAMOE budget. The proposed MAMOE budget
of $61.2 million for FY 2000 will permit VA to meet the
expectations set by Congress last year.
VETERANS BENEFITS ADMINISTRATION
General Operating Expenses
The General Operating Expenses account funds full time
employee equivalents (FTEE) and operating expenses for both the
Veterans Benefits Administration (VBA) and VA's Central Office
(headquarters). VBA administers a broad range of non-medical
benefits to veterans, their dependents, and survivors through
60 regional offices or medical and regional office centers.
These programs include compensation and pension, education,
vocational rehabilitation, insurance, and loan guaranty (home
loans). VBA is also responsible for processing applications for
these programs. Headquarters includes the Secretary's staff and
other VA support staff, and is located in Washington, DC.
The Department proposes to increase overall VBA staffing by
creating 164 new FTEE in fiscal year 2000. Such positions would
be used for adjudicating disability compensation and pension
claims.
The Committee supports this proposed increase in FTEE
because VBA's backlog of claims waiting to be processed is
again increasing, approaching 454,000 claims. The situation is
simply this: the funnel into which all the work is being poured
is too small. The adverse effects of the overflow are a decline
in the quality of work and employee moral. The Administration
and Congress must recognize that benefit programs cannot be
delivered effectively without sufficiently well-trained staff.
To illustrate the Committee's concern about the quality of
work being affected by the FTEE levels, in January, 1998, VA
completed the first Systematic Technical Accuracy Review
(STAR). This review of a national sample of original
compensation claims found that 36 percent of the claims
contained at least one serious error. In that group of claims,
errors averaged over four per claim. Clearly, this error rate
is substantially higher than VA had ever admitted or recognized
and the VA Committee highly commends VBA for its candor and
willingness to finally document what most stakeholders have
been saying for years.
Benefit Program Operations
Compensation and Pension Service (C&P).--The ability of VA
to provide timely and quality benefits delivery is heavily
dependent on a combination of proper staffing levels, effective
implementation of computer modernization initiatives, training
and retention incentives, and inter-departmental cooperation
between the various VA agencies and military service
departments. Over the past decade the number of trained
personnel in the adjudication division has declined by
approximately 40 percent. The Committee commends the Department
for continuing to reverse this trend--with the 140 FTEE
increase it proposed for adjudication services in fiscal year
1999--and a net additional 440 FTEE for such purposes for FY
2000. The 440 FTEE increase is derived from two sources: (1)
164 new FTEE mentioned above, and (2) 276 derived largely from
a redistribution of resources from general support staff, and
the education, housing, and insurance programs. These
additional employees are critical as VBA faces the loss of
numerous highly experienced claims decisionmakers due to
retirement. Further, with VA's Inspector General reporting
average processing times of 150.6 days for an original
compensation claim and 145.6 days for a reopened compensation
claim, the Committee supports the 440 FTEE increase in the C&P
Service proposed in fiscal year 2000. The Committee recommends
an additional $5 million to be used for quality assurance and
staff training and development purposes.
Vocational Rehabilitation and Counseling Program
(VR&C)--.The goal of the Vocational Rehabilitation and
Counseling Program is employment of disabled veterans and
certain dependents. To accomplish that goal, VR&C is authorized
to furnish all services and assistance necessary to enable
service-connected disabled veterans to become employable,
obtain and maintain suitable employment, or to achieve maximum
independence in daily living. Additionally, VR&C is authorized
to provide educational and vocational counseling services to
eligible active-duty members, veterans, and dependents. Last
year, about 9,000 veterans were rehabilitated, and VA projects
a slight decline in program participants from 53,004 in FY 1998
to 50,726 in FY 2000. Vocational rehabilitation specialists
currently carry an average caseload of 300 participants, and
the small decline in overall participation will not appreciably
affect the average.
The General Accounting Office issued reports in 1984, 1992,
and 1996 citing significant program management problems, such
as a failure to focus on employment, an inability to identify
program costs, high drop-out rates, poor case management and an
almost blanket use of college degree programs for
rehabilitation. VA's Inspector General in 1988, VA's VR&C
Design Team in 1996, and the Congressional Commission on
Servicemembers and Veterans Transition Assistance in 1999
confirmed such findings, especially with respect to a proper
focus on long-term suitable employment for program
participants. The Committee applauds VBA initiatives to (1)
reduce the average number of days for veterans to enter
suitable employment from 103 days in FY 1996 to 75 days in FY
2000, (2) improve the percentage of participants who exit the
program and are successfully rehabilitated from 42 percent in
FY 1999 to at least 55 percent for the years beyond FY 2000,
and (3) develop and implement a joint training program with the
Department of Labor's Veterans' Employment and Training
Service. The Committee is supportive of the budget request of
969 FTEE for the Vocational Rehabilitation and Counseling
Service. The Committee notes this request includes the
establishment of the newly-created position of Employment
Services Specialist in each of VBA's nine Service Delivery
Networks. These are new positions that will be used to help
place service-disabled veterans in long-term, suitable
employment and will be funded through existing resources.
Education Service.--VA's Education Service is responsible
for several programs, most notably the Montgomery GI Bill
(MGIB), which provides earned education assistance benefits to
411,000 veterans, active duty, and National Guard and Reserve
personnel, as well as programs for survivors of veterans who
are 100 percent disabled, died of a service-connected
disability or were killed on active duty.
The Committee notes that today's veteran is different from
veteran-populations under previous GI Bills. For example, it
has been estimated that 10-20 percent of the uniformed military
population during the Vietnam era was married. Today, 68
percent of all separating soldiers and almost 40 percent of
those eligible for Montgomery GI Bill benefits upon separation
are married. Usage is lower for married veterans than for
single veterans.
The Committee commends VA for an initial savings of 19 FTEE
generated in large part by electronic data interchange
technology initiatives such as electronic claims folders,
electronic certification and verification of monthly
enrollment, and school-generated electronic awards. The
Committee encourages continued development of such initiatives
for program management purposes.
NATIONAL CEMETERY ADMINISTRATION
The National Cemetery Administration (NCA) (known as the
National Cemetery System from 1973 to 1998) provides national
shrines honoring those who served in uniform and should be
maintained as places of high honor, dignity and respect.
Currently, 149 cemeteries and soldiers' lots located in 41
states, the District of Columbia and Puerto Rico comprise the
NCA. Since establishment of the NCA in 1862, approximately 2.6
million veterans have been interred in national cemeteries and
approximately 6.7 million headstones and markers have been
furnished.
For fiscal year 2000, the Administration is proposing an
increase of $4.89 million to fund NCA. This includes funds for
23 additional FTEE to accommodate increased workloads
throughout the system as well as to support operations and
activation requirements at the Abraham Lincoln, Dallas/Fort
Worth and Saratoga National Cemeteries, and the new national
cemetery in the Cleveland, Ohio, area. The Committee is in full
support of the Administration's request for an additional $4.89
million, including 21 FTEE, for the National Cemetery
Administration.
Between fiscal years 1995 and 2010, the veteran population
will decrease by six million (23 percent). Consequently, NCA
faces an increasing workload because many of the remaining 6.3
million veterans of the World War II generation will seek
burial in a national cemetery. The NCA's workload per FTEE will
continue to grow in all areas of operations. For example, the
total number of gravesites and acreage maintained will increase
every year. The number of headstone and memorial certificates
delivered will also increase. In fiscal year 1998, VA interred
76,718 veterans and family members. In fiscal year 2000, VA
expects to inter 80,300 individuals and by the year 2004, the
number of interments is projected to increase to 98,700. VA
also expects to process 342,000 grave marker applications in
fiscal year 2000. Similarly, the number of gravesites
maintained is estimated to exceed 2.3 million in fiscal year
2000. NCA must have both human and material resources to
accommodate these increases.
National Cemetery System Operating Account
The Committee is pleased that VA is proposing to increase
funding by $1.2 million for maintenance and repair, grounds
maintenance and related supplies. These funds are vital to
preserving the appearance of the cemeteries.
The National Cemetery Administration maintains
approximately 400 buildings and 100 miles of roads. To help
with that maintenance, VA has an inventory of more than 8,000
pieces of equipment with an estimated value of $23 million,
approximately $7.2 million of which is past due for
replacement. The Committee supports the Administration's
proposal of $2.2 million to replace equipment and reduce the
backlog of obsolete units by $400,000.
Cemetery Construction
VA's construction needs for new and existing cemeteries are
addressed through Major and Minor Construction appropriations.
NCA has focused construction planning on creating new
cemeteries in areas of the country with the greatest unserved
veteran population, extending the life of existing cemeteries
through gravesite development and repairing and maintaining the
infrastructure of the system. The Committee notes (1) there are
no funds requested for additional new cemeteries beyond the
four scheduled to open through 2000, and (2) VA requests only
$500,000 in Advance Planning Funds for cemetery construction.
The Committee recommends adding $3.6 million in major
construction planning funds, i.e. planning and site
acquisition, to create national cemeteries in Atlanta, Georgia
and Detroit, Michigan. Atlanta and Detroit appear on VA's list
of the ten areas of the country having the greatest need for a
national cemetery in light of veterans' burial needs, which
will peak in fiscal year 2008. Prudent planning is essential
as: (1) at the end of fiscal year 1998, of the 115 existing
national cemeteries, only 57 contained available, unassigned
gravesites for the burial of both casketed and cremated
remains, and (2) by the year 2004, only 55 VA national
cemeteries will be open for both casketed and cremated remains.
The Administration's fiscal year 2000 proposal contains a
$11.9 million major construction project for gravesite and
columbarium development at the Leavenworth National Cemetery.
The Committee fully supports this proposal.
Minor construction projects, which are those costing less
than $3 million, total $18.9 million for fiscal year 2000, and
the Committee supports that request.
State Cemetery Grants Program
The State Cemetery Grants Program provides grants to assist
the states in establishing, expanding, and improving state-
owned veterans cemeteries. Increasing the availability of state
veterans' cemeteries is one way to serve veterans who do not
reside near a national cemetery. State cemeteries augment--but
do not supplant in any way--VA's national cemetery program. The
Veterans Benefits Improvements Act of 1998 made the State
Cemetery Grants Program more attractive to the States by
increasing the maximum Federal share of the costs of equipment
from 50 percent to 100 percent, and by making initial equipment
costs eligible for grant funding. The States remain responsible
for providing the land and for paying all costs related to the
operation and maintenance of the state cemeteries, including
the costs for subsequent equipment purchases.
The State Cemetery Grants Program is funded at $11 million
for fiscal year 2000. Since its establishment in 1980, VA has
made grants of $56.4 million through fiscal year 1998. Nearly
100 grants have been awarded to 25 states, Saipan and Guam
since the program's inception. For fiscal year 2000, NCA has
budgeted $11 million for the State Cemetery Grants Program. In
light of veterans' burial needs projected to peak in FY 2008,
the Committee recommends an additional $4 million for the State
Cemetery Grants program to help address such needs.
Arlington National Cemetery
Arlington National Cemetery is the nation's premier
resting-place for veterans. The cemetery is currently the final
resting-place for over 250,000 remains. In fiscal year 2000,
Arlington Cemetery officials estimate they will add about 5,900
remains to that total, and conduct 2,800 non-funeral
ceremonies.
The Administration's request is $33,000 above the fiscal
year 1999 appropriation. The Committee does not support that
request and recommends an additional $500,000 to support
operations and maintenance at Arlington National Cemetery. The
Committee also recommends an additional $1.75 million to(a)
design and construct a vehicle storage garage building at
Arlington's facilities maintenance complex, (b) initiate a
study relating to repairs needed at (1) the interior of the
reception building at the Memorial Amphitheater, and (2) the
Robert F. Kennedy gravesite.
Board of Veterans' Appeals (BVA)
More than 80 percent of the Board's decisions concern
contested disability compensation claims. Prior to fiscal year
1992, BVA response time--the number of days it would take BVA
to render decisions on all pending certified appeals at the
processing rate of the immediately preceding on-year time
frame--rarely exceeded 150 days. However, as the impact of the
Court of Appeals for Veterans Claims decisions began to take
effect, BVA's response time climbed steadily from 139 days in
FY 1991 to a peak of 781 days at the end of fiscal year 1994.
By the end of fiscal year 1998, the Board reduced its response
time to less than 200 days (197 days) for the first time in
seven years.
A review of BVA data over the past three fiscal years
provides a snapshot of the demonstrable progress BVA has made
toward meeting the production levels needed to reduce the
backlog of appeals pending. For example, the Board reduced the
fiscal year 1996 backlog of over 60,000 appeals to under 35,000
as a result of additional resources provided over fiscal years
1997 and 1998, as well as several management initiatives. In
fiscal year 1997, the BVA made over 43,000 decisions, an
increase of 10,000 over the previous year. Regrettably,
however, 42 percent of those decisions were remands to the
regional offices, another example of the quality problems that
continue to plague the regional offices. In FY 1998, BVA issued
38,886 decisions. This total represents a 10.3 percent decrease
from FY 1997, when the Board issued 43,347 decisions. The
decrease is primarily a result of (1) a higher percentage of
final, non-remand decisions (56.7 percent) than was issued the
previous year (53.3 percent), and (2) a heightened emphasis on
decisional quality.
The Committee commends the Board on its recent integration
into a single appeals tracking system of the formerly separate
systems used by VBA and the Board. This joint system, Veterans'
Appeals Control and Locator System, allows the Department to
(1) monitor and process appeals in a more efficient manner, and
(2) analyze appellate workload trends and appeals processing
performance. The Committee also commends BVA's ongoing
initiative to increase electronic exchange of information with
VBA and thus improve date currency and decrease administrative
handling.
The Committee supports the Administration's request of
$41.5 million for the Board.
Inspector General
The VA's fiscal year 2000 request for a $7.2 million
increase in budget authority for the Office of the Inspector
General (OIG) is fully justified by the office's workload and
scope of activities. The requested increase includes $4.7
million to contract out the audit of VA's consolidated
financial statement, and $2.5 million for current services.
While the contract would free audit staff to address other
audit issues, the budget request would not provide any funding
for additional staff needed for essential investigation and
inspection work. Despite the budget request's apparent
misstatement that the funding would support an increase of 12
in ``average employment,'' OIG employment for fiscal year 2000
would actually remain at about the fiscal year 1999 level of
360 authorized full time employees, well below the statutory
floor of 417 set by 38 U.S.C. section 312.
Therefore, the Committee recommends providing the OIG with
increases for fiscal year 2000 of $4.7 million for contracting
out audit of the consolidated financial statement, $2.5 million
for maintaining current services, and $3.5 million for 35
additional employees. The Committee believes 10 of the
additional employees should be assigned to the IG Hotline,
which is seriously understaffed and is referring many cases
back to VA rather than to the OIG. This damages VA employee
confidence in the Hotline by making assurances of
confidentiality problematical. The remaining additional
employees should be assigned to criminal investigations and
health care inspections.
U.S. Court of Appeals for Veterans Claims
The Veterans' Judicial Review Act, Public Law 100-687,
established the U.S. Court of Veterans Appeals as an executive
branch court (later renamed as the U.S. Court of Appeals for
Veterans Claims.) The Court is empowered to review decisions of
the Board of Veterans' Appeals and may affirm, vacate, reverse
or remand such decisions as appropriate. The Court has the
authority to decide all relevant questions of law, to interpret
constitutional, statutory, and regulatory provisions, and to
determine the meaning or applicability of the terms of an
action by the Secretary of Veterans Affairs. The Court also has
the authority to compel actions of the Secretary that are found
to have been unlawfully withheld or unreasonably delayed. The
Committee supports the Court's budget request of $11.4 million.
Department of Labor
VETERANS' EMPLOYMENT AND TRAINING SERVICE
Congress has determined that our nation has a
responsibility to meet the employment and training needs of
veterans. To accomplish those goals, the Assistant Secretary of
Labor for Veterans' Employment and Training (ASVET) is
authorized to implement training and employment programs for
veterans. The ASVET also acts as the principal advisor to the
Secretary of Labor with respect to the formulation and
implementation of all departmental policies and procedures that
affect veterans.
The Committee is aware of the significant changes in the
national labor exchange system. States are changing the way
they deliver employment services and adopting new service
delivery models ranging from devolving state programs to the
county level to privatizing some or all employment functions
and instituting one-stop employment centers under the Workforce
Investment Act of 1998.
Since the Veterans' Employment and Training Service and its
state-based Disabled Veterans Outreach Program Specialist and
Local Veterans Employment Representative system depends upon
the state employment services, VETS must adopt new strategies
to deliver employment services to veterans. Aggressive
recommendations for doing so are made in the January 14, 1999,
report of the Congressional Commission on Servicemembers and
Veterans Transition Assistance. By statute, the Secretary of
Labor has until about April 19, 1999, to comment to the House
and Senate Committees on Veterans' Affairs on the Commission's
findings and recommendations.
Such Commission findings include: (1) fewer than two
percent of veterans go to the Employment Service (ES) when
looking for a job and ES data show that only 12 percent of the
veterans who do go to the ES get permanent jobs following their
visit, and (2) according to DOL's 1997 Annual Report, nine
states met DOL performance standards while placing fewer than
10 percent of veteran registrants in jobs. Conversely, the
Department of Labor states that during program year 1997 that
it helped into jobs 26.5 percent of veterans registering for
services.
Commission recommendations include: (1) Congress should
reengineer veterans' employment services to meet the new
reality of a highly automated, integrated, and customer-focused
environment; (2) Congress should replace the DVOP and LVER
programs with (a) a new Veterans Case Manager program to
provide job-seeking skills, job development, and referral
services to disabled veterans, veterans facing employment
barriers, and recently separated veterans, and (b) a new
Veterans Employment Facilitator program to facilitate
Transition Assistance Program (TAP) workshops and market
veterans' employment to local employers; and (3) DOL should
award grants for veterans employment and training services
competitively on a state-by-state basis so that the most cost-
effective organizations can provide the services.
The Committee wishes to note it has consistently supported
the LVER program since Congress established it in 1944 as part
of the original G.I. Bill of Rights. The Committee has also
supported the DVOP program, including codifying it in 1980. In
addition, with the 1988 enactment of Public Law 100-323, the
Committee supported a statutory funding formula for both LVERs
and DVOPs. Moreover, in its annual budget views and estimates,
the Committee has consistently recommended full funding for
DVOPs and LVERs, although such full funding has not occurred
since 1989. However, in light of recent findings and
recommendations of the Congressional Commission on
Servicemembers and Veterans Transition Assistance, the
Committee believes it should focus its efforts on reengineering
the delivery of Veterans' Employment and Training Services
rather than recommending additional resources for the current
program.
Disabled Veterans' Outreach Program
Under section 4103A, title 38, United States Code, the
Secretary of Labor is required annually to make available
sufficient funds for use in each state to support the
appointment of one DVOP specialist per 6,900 veterans of the
Vietnam era, veterans who entered active duty as a member of
the armed forces after May 7, 1975, or service-disabled
veterans. For fiscal year 1999, this formula results in 2,119
DVOPs. The Administration's budget provides funds to support
1,431 DVOP positions, 688 below the Congressionally-mandated
level. The Committee supports this request.
Congress established the Disabled Veterans Outreach Program
(DVOP) to provide intensive employment and training services to
service-connected disabled veterans and other veterans in need
of job search and placement assistance. DVOPs serve as workshop
facilitators for the Transition Assistance Program (TAP), a 3-
day program that provides transition counseling, job-search
training and information, placement assistance and other
information and services to servicemembers who are within 180
days of separation from active duty. DVOPs also develop job and
job-training opportunities for veterans through contacts with
employers. Additionally, DVOPs provide assistance to community-
based organizations and grantees who provide services to
veterans under other federal and federally-funded employment
and training programs, such as the Job Training Partnership Act
and the Stewart McKinney Act.
Local Veterans' Employment Representatives
Section 4104(a)(1), title 38, United States Code, mandates
that the Secretary of Labor make available funding to support
the appointment of at least 1,600 full-time LVERs and the
states' administrative expenses associated with the appointment
of that number of LVERs. The Administration's budget provides
funds to support 1,306 LVER positions. The Committee supports
this request.
Congress established the LVER program to functionally
supervise the provision of job counseling, testing, job
development, referral and placement to veterans in local
employment services offices. LVERs participate in TAP workshops
and maintain regular contact with community leaders, employers,
labor unions, training programs and veterans service
organizations in order to keep them advised of eligible
veterans available for employment and training. LVERs also
provide labor exchange information to veterans, and promote and
monitor participation of veterans in federally funded
employment and training programs. Finally, LVERs monitor the
listing of jobs by federal contractors and subsequent referrals
of qualified veterans to these employment openings, refer
eligible veterans to training, supportive services, and
educational opportunities, and assist, through automated data
processing, in securing and maintaining current information
regarding available employment and training opportunities.
DOL also manages the Homeless Veterans Reintegration
Program (HVRP). The program is designed to provide support
services to local agencies targeting homeless veterans with
employment assistance. For the past three years, the President
and the Appropriations Committee have failed to support funding
for the program, while the law creating this program authorizes
$10 million per year. This year the President has proposed $5
million for HVRP. The Committee notes that the funding for HVRP
veterans' employment and training initiatives has failed to
keep pace with the funding for other agencies that provide
transitional housing and supportive services. For example,
Congress has increased funding for HUD (homeless) programs from
$72 million in FY 1988 to $823 million in FY 1998, and also
increased health care and substance abuse programs administered
by the Department of Veterans Affairs from $13 million to $76
million during the same time period. The Committee recommends
funding for HVRP at the authorized level of $10 million to
increase employment services to homeless veterans.
The Committee notes that 458 DVOPs and 431 LVERs do not
have personal computers or access to the Internet or America's
Job Bank/Talent Bank. The employment search needs of many job-
ready veterans can be met primarily through their personal
access to the Internet. Nevertheless, many veterans do not have
personal access to such electronic job listings and must visit
a local Employment Service office for help. The Committee
recommends the addition of $1.75 million to outfit DVOPs
($911,000) and LVERs ($840,000) with Internet/AJP access at
their workstation or their outstation location.
National Veterans' Employment and Training Services Institute
The National Veterans' Employment and Training Services
Institute (NVETSI) is operated under contract by the University
of Colorado at Denver and provides basic and advanced
instruction in veterans employment programs and services.
Because this is the only source of formal training for federal
and state employees for veterans employment programs, NVETSI is
vital to the success of those programs. The President has
recommended $2 million for fiscal year 2000 to train 1,500
veteran service providers. Of the current 2,700 DVOP and LVER
staff, 2,400 have not attended the new Labor Employment
Specialist training to provide core competencies to veteran
service provider staff. An additional $1 million would train
2,800 veteran service providers. The Committee recommends
funding NVETSI at $3 million for FY 2000.
Proposed Legislation
Cost of Living Adjustment (COLA).--The Committee supports a
cost-of-living adjustment (COLA) for compensation and
dependency and indemnity compensation equal to the COLA
calculation for Social Security recipients.
The Committee will not take action on the Department's
proposed legislation to pay Filipino veterans and survivors
full disability compensation. Prior to the Committee's July 22,
1998, oversight hearing on existing veterans' benefits for
Filipinos, the Committee sent a series of questions to the
Department. Because the Department will be affected by any
change to existing law, the Committee requested that, among
other things, VA address how it would prevent Filipino veterans
not actually residing in the U.S. from using post office boxes
or fictitious residences in order to qualify for compensation.
History has shown a very real potential for fraud. To date, the
Department has not provided the Committee with a plan for
implementing the Administration's proposed legislation.
Additional Legislative Items Which the VA Committee May Report with
Direct Spending Implications
Montgomery GI Bill.--The Committee recommends a $200
million addition to the President's request for improvements to
veterans' education benefits. This will provide improvements in
the basic education benefit.
The cost of education has increased over 7 percent per year
since the inception of the Montgomery GI Bill in 1985. Today, a
veteran with two years of honorable military service receives a
maximum of $4,752 for a nine-month school year from the
Montgomery GI Bill (MGIB). But the average annual cost in 1996
for tuition, room and board, fees, books and transportation at
a public institution was $10,759, a total increase of 109
percent since 1987. For private schools, the annual cost is now
$20,003, an increase of 84 percent since 1987. As a result, the
Montgomery GI Bill falls short by $6,007 annually for a public
school and $15,251 for a private school. The Committee notes
that participation in the MGIB lags behind the Vietnam-era GI
Bill. Through FY 1997, some 13 years after the 1984 enactment
of the MGIB, 48.7 percent of eligible beneficiaries used the
MGIB. Vietnam-era GI Bill usage for the first ten years (June
1966 to June 1976) was 63.6 percent.
The Committee notes the recent Congressional Commission on
Servicemembers and Veterans Transition Assistance found that
most college-bound youth and their families see a tour of
military service as a detour from their college plans, not as a
way to achieve that goal. Not surprisingly, each of the
military services except the Marine Corps is experiencing
recruiting problems in various ways. Each of the Joint Chiefs
of Staff believes a rejuvenated Montgomery GI Bill would help
recruitment, as evidenced by their testimony before the Senate
Armed Services Committee on September 29, 1998.
Minor Revisions Requiring Direct Spending Authority.--The
Committee recommends $10 million for minor changes to the
dependency and indemnity program and other limited revisions in
the compensation program.
National Shrine Initiatives
The Committee recommends $1 million for a one-time
assessment, by an independent contractor, of the basic
maintenance repairs needed at individual VA national cemeteries
to ensure a proper and respectful setting. Such a step would
serve as the first component of an on-going assessment of (1)
how to make a reasonable number of VA national cemeteries more
of the design/quality/stature of the American Battle Monuments
Commission, and (2) the number of VA national cemeteries needed
beyond 2010.
Homeless Veterans Reintegration Program
The Committee recommends a five year authorization for this
program at $10 million per year, beginning in fiscal year 2000.
Such reauthorization would make the program more permanent.
HOUSE COMMITTEE ON VETERANS' AFFAIRS
March 11, 1999
[In Thousand U.S. Dollars]
--------------------------------------------------------------------------------------------------------------------------------------------------------
FY 1999 Enacted FTE President's 2000 Budget
-------------------------- Request 99/'00 Budget Committee Administration/
-------------------------- Comparison Recommendation Congressional
Amount FTE Amount FTE Comparison
--------------------------------------------------------------------------------------------------------------------------------------------------------
Benefits Programs
Compensation and Pensions...................... $21,857,058 ........ $21,568,364 ........ $(-\288,694) $21,568,364 0
Proposed COLA (2.4%) eff. 12/1/99.............. .............. ........ 293,300 ........ (+293,300) 303,300 $(+10,000)
Readjustment Benefits.......................... 1,175,000 ........ 1,469,000 ........ (+294,000) 1,469,000 0
Proposed Legislation........................... .............. ........ .............. ........ ............... 200,000 (+200,000)
Veterans Insurance and Indemnities............. 46,450 ........ 28,670 ........ (-\17,780) 28,670 0
Veterans Housing Benefit Program Fund.......... 746,503 ........ 282,342 ........ (-\464,161) 282,342 0
Veterans Housing Benefit Program Fund, Current. 159,121 ........ 156,958 ........ (-\2,163) 156,958 0
Native American Veterans Housing Program....... 515 ........ 520 ........ (+5) 520 0
Guaranteed Trans. Housing Loans; Homeless .............. ........ 9,600 ........ (+9,600) 9,600 0
Veterans......................................
Education Loan Program......................... 207 ........ 215 ........ (+8) 215 0
Vocational Rehabilitation Program.............. 455 ........ 472 ........ (+17) 472 0
------------------------------------------------------------------------------------------------------
Total Benefits Program........................... 23,985,309 ........ 23,809,441 ........ (-\175,868) 24,019,441 (+210,000)
======================================================================================================
Medical Programs
Medical Care................................... 17,278,580 184,800 17,306,000 174,420 (+27,420) 18,499,000 (+1,193,000)
Proposed Legislation........................... .............. ........ .............. ........ ............... 500,000 (+500,000)
Transfer from Med. Care Collections Fund....... 625,000 ........ 749,141 ........ (+124,141) 625,000 (-\124,141)
------------------------------------------------------------------------------------------------------
Subtotal Medical Care............................ 17,903,580 ........ 18,055,141 ........ (+151,561) 19,624,000 (+1,569,859)
Medical and Prosthetic Research................ 316,000 3,036 316,000 2,838 0 316,000 0
MAMOE.......................................... 63,000 540 61,200 573 (-\1,800) 61,200 0
------------------------------------------------------------------------------------------------------
Total Medical Programs........................... 18,282,580 188,376 18,432,341 177,831 (+149,761) 20,001,200 (+1,569,859)
======================================================================================================
Construction Programs
Construction, Major............................ 142,300 50 60,140 50 (-\82,160) 126,140 (+66,000)
Construction, Minor............................ 175,000 ........ 175,000 80 0 175,000 0
Parking Revolving Fund......................... .............. ........ .............. ........ ............... ............... ...............
Grants State Extended Care Facilities.......... 90,000 ........ 40,000 ........ (-\50,000) 90,000 (+50,000)
Grants State Veterans Cemeteries............... 10,000 ........ 11,000 ........ (+1,000) 15,000 (+4,000)
------------------------------------------------------------------------------------------------------
Total Construction Programs...................... 417,300 130 286,140 130 (-\131,160) 406,140 (+120,000)
======================================================================================================
General Operation Expenses and Misc.
GOE-VBA........................................ 654,809 11,273 706,353 11,437 (+51,544) 711,353 (+5,000)
GOE-General Administration..................... 228,392 2,490 206,000 2,601 (-\22,392) 206,000 0
General Operating Expenses..................... 883,201 13,763 912,353 14,039 (+29,152) 917,353 0
National Cemeteries System..................... 91,916 1,369 97,000 1,406 (+5,048) 98,000 (+1,000)
Inspector General.............................. 35,970 374 43,200 374 (+7,230) 47,900 (+4,700)
------------------------------------------------------------------------------------------------------
Total GOE and MISC............................... 1,011,087 15,506 1,052,553 15,819 (+41,570) 1,063,253 (+10,700)
======================================================================================================
Total Appropriation.............................. $43,696,276 204,012 $43,580,475 193,780 $(-\115,801) $45,490,034 $(+1,909,559)
======================================================================================================
--------------------------------------------------------------------------------------------------------------------------------------------------------
ADDITIONAL AND DISSENTING VIEWS AND ESTIMATES
On March 11, 1999, the House Committee on Veterans' Affairs
met to recommend views and estimates on the Department of
Veterans Affairs fiscal year 2000 budget. On a party-line vote
to move the previous question, the Ranking Democrat, the
Honorable Lane Evans, was denied the opportunity to offer a
Democratic alternative to the Chairman's proposal.
In the simplest terms, the Administration and the Committee
majority have failed to recommend sufficient resources for
fiscal year 2000 for the Department of Veterans Affairs (VA)
and the Veterans Employment and Training Service (VETS) of the
Department of Labor (DOL). Neither of these proposed budgets
would provide the funding required to meet our national
obligation to America's veterans. It is our view that, if we as
a nation are to fulfill our commitment to this group of special
and unique citizens, the Administration's FY 2000 budget
request for VA and VETS must be increased by $3.196 billion. In
contrast, the Committee majority recommends an increase of only
$1.9 billion.
Although the Administration would require the VA to provide
an increased level of benefits and services, its budget
proposal does not include the resources needed for VA to
fulfill the goals set for it. Similarly, although the Committee
has recommended a funding level significantly above that
provided by the Administration, the Majority proposal also
assumes the VA can successfully fulfill its added
responsibilities without providing the necessary resources.
We are concerned that, although the Committee majority has
acknowledged that the resources proposed by the Administration
for VA for next fiscal year are inadequate, they have
underestimated the magnitude of the budget shortfall. We are
also concerned that the majority appears to have embraced the
Administration's overconfident assertion that increased VA
management efficiencies will somehow provide the additional
monies required to reduce and eliminate the funding shortfall.
As the Committee has pointed out in past years, the
decision to deny needed resources and claim that unreliable
management efficiencies will generate the required funding is
disingenuous, at best. Some, in fact, have described this
approach to budgeting as cynical. The truth is that although
carefully selected and implemented efficiencies can generate
needed funding, these efficiencies simply cannot provide
savings of the magnitude necessary to fund the initiatives
proposed by the Administration and acknowledged by the
Majority. Additionally, to the degree that management
efficiencies do produce savings, there are not enough of those
dollars to address existing problems, such as unacceptably long
waits for health care, much less restore reductions in programs
which have already occurred, provide the needed expansion of
current programs and fund new initiatives.
It should also be pointed out that management efficiencies
are too often achieved by slashing staff and closing beds. The
obvious result is that veterans must either wait longer and
longer for medical care or choose another health care provider.
An example of this inevitable result was illustrated in a
recent edition of the Miles City (MT) Star. The article
described a local veteran who, as a result of untimely VA care,
was forced to obtain private care and a stiff bill even though
his 50 percent service-connected disability should have ensured
him access to VA care. The Salisbury (NC) Post recently
described the plight of a veteran who for months unsuccessfully
sought an appointment with a VA doctor because of pain in his
foot. Finally giving up in frustration, the veteran was found
to have an inoperable tumor by non-VA doctors. This is not the
quality of care our grateful nation has promised to provide our
veterans.
We are also concerned that the majority budget, unlike the
Democratic budget proposal, does not specifically include
needed increases in funding for VA long-term care initiatives
or mental health programs. Funding these two proposals is
imperative if we are sincerely committed to meeting veterans'
needs. Long-term care is virtually disappearing from the VA
health care system as many facilities begin to ration this care
because of budget constraints. Most facilities are now limiting
what they continue to refer to as ``nursing home'' care to
restorative care, rehabilitative care, and care for terminal
illness. Lifetime placement is almost a thing of the past. Many
of VA's medical centers are even discharging veterans with
Alzheimer's disease.
It is apparent to us that the need for long-term care for
an aging veterans' population is limitless. While we cannot
afford to provide ``everything to everybody'', neither can we
ignore the problem while growing numbers of veterans are
compelled to turn to Medicare or Medicaid to meet these needs.
Unfortunately, this rationing is happening at a time when World
War II veterans are reaching the age when their reliance on
long-term care is at a peak.
VA's Federal Advisory Committee on Long-term Care has
recommended that VA double or triple its investment in home and
community based extended care. The President's Budget
recommended that VA commit $106 million to begin to achieve
this goal, but did not provide the funding to do so.
Additionally, the Majority budget does not expressly address
the growing need for long-term care for veterans. In contrast,
our proposal would support a $165 million initiative to allow
VA to restore some nursing home care in its own programs, state
homes, and the community.
The Democratic budget includes $100 million in additional
funding to bolster the faltering continuum of care available
for chronically mentally ill veterans. The evidence that these
programs are being seriously compromised, at least partially
because of budget constraints, is substantial. The Northeast
Program Evaluation Center (or NEPEC) says that the resources
devoted to mental health programs are decreasing as a share of
the budget. This is a clear indication that VA has trimmed all
the ``fat'' and is beginning to cut into the bone. As a result,
VA's mental health programs are being more adversely affected
than other treatment programs. As in the private sector, which
once had managed care but now has managed spending, VA is
choosing to treat the ``visible wounds'' of our veterans over
the psychic ones.
The decreasing share of the budget provided for mental
health is reflected in cutbacks in mental health workloads. If
plans for 2000 are implemented, VA will have eliminated \2/3\
of its psychiatric census and almost \1/2\ of its psychiatric
inpatients treated since fiscal year 1995. In addition,
psychiatric beds have dropped from 16,392 in 1996 to 10,285 in
1998, a 37 percent decrease.
Ambulatory mental health care is also feeling the pinch.
Outpatient visits for post-traumatic stress disorder (PTSD)
dropped between 1995 and 1997. VA also closed specialized
outpatient PTSD and specialized inpatient and residential PTSD
programs. Between FY 96 and FY 97, VA also decreased both the
number of veterans treated in the Health Care for Homeless
Veterans program and the number of visits per veteran treated.
Between FY 93 and FY 97, the homeless veterans VA treated were
less likely to have either serious psychiatric disorders or a
substance abuse disorder, indicating VA may be selecting easier
cases over the most chronically ill. VA is closing these
programs despite evidence of their effectiveness. The NEPEC has
documented improvements in alcohol and drug problems, mental
illness and social or vocational problems. Despite
Congressional protection and demonstrated effectiveness, VA
appears to be withdrawing its support of these programs,
leading us to conclude the cause is inadequate funding. To
ensure that VA can maintain effective programs for the
chronically mentally ill, the Democratic budget recommends
adding $100 million to restore these types of needed and
effective programs. Neither the Administration budget nor the
Majority proposal recommends the funding needed to strengthen
these programs.
The Democratic budget proposal will support a higher level
of care for aging veterans and veterans with chronic mental
illness. Evidence of program erosion in both of these areas is
rampant and we must give VA the resources to halt and reverse
it.
As shown in the documents that follow, the Democratic
budget also included increased funding levels for the
Montgomery GI Bill, employment programs, burial benefits, VA
staffing, and other important veterans' benefits and services.
The Democratic members of the House Committee on Veterans
Affairs carefully considered the needs of the veteran community
and our national commitment to these special men and women. The
budget we recommended was realistic, reasonable, responsible
and appropriate. We are disappointed that the Republican
majority refused us the opportunity to even discuss this
proposal on behalf of the veterans of America.
We listened closely to the testimony of the veterans'
service organizations over the past few weeks and we heard a
strong sense of urgency and frustration that we have never
heard before. America's veterans are telling us they have done
more than their fair share--and now they expect us to be their
advocates. They are telling us to speak up--to speak up and
remind our colleagues that America is safe and free only
because of the generations of men and women who willingly
endured the hardships and sacrifices required to preserve our
liberty. They are telling us to speak up and remind our
colleagues that no act of citizenship is worthier of our
respect than the willingness to serve in America's Armed Forces
and to protect and defend our ideals.
In summary, the Democratic budget proposal is similar in
magnitude to that recommended in the Independent Budget and
would add $3.196 billion to the Administration proposal. The
Democratic budget would increase health care spending by $2.17
billion over the Administration request and $474 million over
the Chairman's recommendation. Our proposal would increase GI
Bill funding by $881 million over the Administration and $681
million over the Chairman's proposal. The Democratic
alternative would provide an additional $61.45 million in
benefits over the Administration and $50.45 million over the
Chairman. Finally, the Democratic proposal would provide $79.9
million more than the Administration for veterans' employment
services and VA general operating expenses. This is an increase
of $66.9 million over the Chairman's proposal. We deeply regret
the Majority's refusal to allow full consideration of the
Democratic budget proposal for fiscal year 2000. Unfortunately,
it is America's veterans who have served and sacrificed to
defend democracy who, ironically, will suffer as a result of
this subversion of the democratic process.
Representative
Lane Evans
Representative
Bob Filner
Representative
Luis Gutierrez
Representative
Corrine Brown
[Attachments follow:]
LETTER TO THE COMMITTEE ON THE BUDGET FROM THE COMMITTEE ON VETERANS'
AFFAIRS ON THE VETERANS' BUDGET PROPOSED FOR FISCAL YEAR 2001
----------
House of Representatives,
Committee on Veterans' Affairs,
Washington, DC, February 25, 2000.
Hon. John R. Kasich,
Chairman, Committee on the Budget,
U.S. House of Representatives, Washington, DC.
Dear Mr. Chairman: We are writing in response to the Budget
Committee's request that we provide our views by February 25,
2000, on the budget for fiscal year 2001 for programs in the
jurisdiction of the VA Committee. Although the veteran
population is declining, an unexpected record number of
veterans are drawing disability compensation and using the VA's
health care system. The National Cemetery System is predictably
experiencing an increase in requests for burial services, a
trend that will probably continue through the end of this
decade.
In light of this increasing utilization of our Nation's
services for veterans, there are two principles which guide our
recommendations to your Committee. The first is that the
general increase in productivity associated with the improved
performance of businesses in the United States must be
continuously examined for lessons that can be applied to the
provision of veterans benefits and services. As stewards of
this Nation's significant commitment to serve veterans, we can
do no less. The second is that we must recognize when programs
are not performing as intended, and make the necessary changes
to assure that results meet Congress's and the American
people's expectations. In the area of veterans health care and
education, this means investing resources to provide better
access to safer health care, and making sure that the Nation's
most successful veterans readjustment program, the GI Bill,
serves its intended purpose.
Medical Care.--The Administration's budget identifies a
need for some $1.4 billion in additional medical care funds for
fiscal year 2001. Absent a good understanding of the VA health
care system, one could question the rationale for this major
increase in VA medical care funding on top of a record $1.7
billion increase for this fiscal year. This is particularly so
if one were only to examine current General Accounting Office
(GAO) recommendations for closing VA hospitals.
However, this is a responsible budget which sets VA on a
sound course. It sustains a trend of increased reliance on non-
hospital services and projects an ability to serve 3.9 million
veterans, almost one million more veterans than were served in
1996. It specifically recognizes and plans for new costs to
expand long-term care services to veterans residing outside of
nursing homes and provide payments for emergency care for
eligible veterans who have no other health coverage. At the
same time, the budget also includes $10 million in funding for
independent market-based studies recommended by GAO to enable
VA to develop plans for potential hospital mission changes
(savings from which would not be realized in FY 2001). This
budget also recognizes the ongoing needs which led Congress to
increase VA medical care funding last year: increasing numbers
of patients and associated delays in providing timely care,
greater-than-inflationary increases in the costs of
pharmaceuticals veterans need, required pay increases for VA
employees, and anticipated costs of treating Hepatitis C. While
providing needed funding for new requirements and unavoidable
costs of operations, VA projects that it will continue to
realize efficiencies in many areas of operation as well as in
national procurement policies.
This is a complex budget, elements of which may exceed or
fall short of projections. A significant new cost facing the
Department results from enactment of legislation recommended by
the Department to assist uninsured veterans who are in need of
emergency care. Another new cost results from the overdue
expansion of alternatives to nursing home care for older
veterans. While estimating these new costs is necessarily
imprecise, this budget's projections are in line with the VA
Committee's estimates. It is important to recognize that many
of the initiatives that the Department plans to undertake
require substantial further policy development. The
Department's emergency care authority, for example, requires
the establishment of both a major regulatory framework and new
administrative apparatus. With little progress to date in
implementing these authorities, VA may not actually incur in
full the costs projected for this type of care in FY 2001. On
the other hand, continued growth in patient workload could
contribute to both a greater increase in pharmaceutical costs
than the 15 percent increase budgeted and to continued delays
in providing timely care. Although workload is a key factor, it
bears noting that policy changes in other governmental programs
could substantially alter this budget's projections.
Legislation expanding access to pharmaceuticals under the
Medicare program or improving DoD's TRICARE program for
military retirees, for example, would likely result in many
veterans substantially diminishing their use of VA services, or
foregoing VA services entirely.
The Administration has unwisely included as part of the
medical care budget a proposal that Congress amend the Veterans
Millennium Health Care and Benefits Act, Public Law 106-117
(the Act), to redirect new receipts to the Treasury. The VA
Committee rejects this proposal. While the Administration is
requesting a record level of funding for VA medical care, it
also recommends requiring the deposit in the Treasury of the
first $350 million in collections authorized under the
Millennium Act. The Administration's receipts target for FY
2001 must also be questioned. The Committee had anticipated
that the Act's costs would ultimately be partially offset by
new receipts. But more than half of the $350 million receipts
target identified in the budget depend on Department of Defense
reimbursements for care furnished to higher-income, TRICARE-
eligible military retirees under section 113 of the Act. The
Act, however, provides for a phased implementation of section
113, tied to the renegotiation of existing TRICARE contracts.
With the first such contract renegotiation and award not
occurring before the summer of 2001, there is no plausible
scenario under which VA could receive any significant
reimbursements for care in the coming fiscal year, let alone
the projected $180 million.
In sum, while untested assumptions and projections in this
budget could heighten the challenge of meeting VA's goal of
providing timely care to all veterans who seek it, a $1.4
billion increase in medical care appropriations should meet
VA's core requirements.
Medical Research.--While recognizing the need to increase
medical care funding in FY 2001, the Administration budget
proposes to freeze VA medical research funding. Given inflation
and required salary increases, flat funding is like a 10
percent cut. The decision not to provide an increase in this
account is in striking contrast to this Administration's call
for ``a bold course of strategic growth'' for science and
technology, and its proposed 6 percent increase for National
Institutes of Health funding and 17 percent increase in
National Science Foundation funding.
The Department acknowledges the importance of a strong
research program to maintaining its medical care program. In
the interests of maintaining a strong medical and research
program, the VA Committee recommends the appropriation of an
additional $25 million (an 8 percent increase) for VA medical
research. Of that amount, $11 million is needed to prevent
erosion of VA's current level of research activity. Another $3
million is requested to support new centers of excellence to
investigate new treatments for Parkinson's Disease, and the
remainder to further VA's important work on patient safety and
other high priority areas.
Construction.--There are differing views regarding VA's
need for additional construction funds, but the most clear-cut
instance of underfunding is in the State Veterans home
construction grant program for which the Administration
proposes only $60 million--an unwise $30 million reduction from
the enacted level for fiscal year 2000. In proposing this
reduction, the Administration's budget does not reflect the
enactment of legislation last year (in the Millennium Act)
which requires VA to fund a list of long-pending projects and
to revise the priorities for the award of new grants. The
proposed reduction in funding would defer for still another
year up to $17 million in Congressionally approved projects,
and another $70 million in applications submitted by states
which have already appropriated the state's 35 percent share of
funding. In light of the large backlog of pending projects, the
VA Committee recommends that this account be increased by $80
million to $140 million.
The VA Committee is aware that the Department, through its
own planning and review processes, has identified a number of
major construction projects which were not included in the
Administration's budget. The VA Committee notes the
Department's plan to conduct market-based assessments of its
capital asset needs, and ventures no view at this time as to
the merits or relative merits of VA's pending projects. The VA
Committee does intend to hold hearings early this year to
review the Department's construction priorities and capital
asset plans.
Montgomery GI Bill (MGIB) and Other Educational Assistance
Programs.--The recruiting success of the All-Volunteer Force
and the MGIB educational assistance program are inextricably
linked. Even though total Department of Defense recruiting
requirements declined by 33 percent between 1989 and 1998, the
Army, Navy, Air Force and Coast Guard are experiencing serious
recruiting challenges. ``Money for college'' ranks as the major
reason young men and women give for enlisting. However, many
youth do not enlist because financial aid abounds for those who
do not serve in the military. In addition, the purchasing power
of the MGIB basic benefit has eroded dramatically for veterans
who wish to use it as a transition tool. Figures furnished by
the College Board show that in academic year 1998-1999 the MGIB
covered only 54 percent of tuition and expenses for a commuter
student at a four-year public college. Further, the VA
Committee notes that Survivors' and Dependents' Educational
Assistance benefits provided to the surviving spouse and
dependent children of an individual who dies either on active
duty or due to a service-connected cause similarly have not
kept pace with college costs. Current benefits cover only 49
percent of the cost of a four-year public college education.
The VA Committee will also consider a number of recommendations
to make VA education programs more accessible to veterans. In
light of the pressing need to improve the MGIB, the Committee
recommends that the Budget Committee provide $125 million in
each of fiscal years 2001 and 2002 to fund a basic benefit
increase and other improvements.
Veterans Benefits Administration.--The Department is
proposing a 13 percent increase in funding for the Veterans
Benefits Administration (VBA). Factors compelling this
recommended increase include a high incidence of errors in
decisions on disability claims (32 percent national error rate
in ``core rating work'' in 1999) and increases in the average
time it takes to process an original compensation claim (from
161 days in 1995 to 205 days in 1999). A number of training and
office automation initiatives would be funded with this
proposed higher level of funding, some of which are long
overdue. Additional personnel will be added to the VA's
``Compensation and Pension'' activity to permit more intensive
training of personnel and to address claims backlogs. However,
even this increased level of resources will probably not have a
significant effect on results because of: 1) the increasing
complexity in the body of law governing disability claims; 2)
the projected loss of highly experienced decisionmakers; and,
3) an increased propensity of separating servicemembers to file
disability claims, many of which involve multiple claimed
disabilities.
The VA Committee has supported the Department's proactive
initiatives to redirect FTEE from non-compensation and pension
(C&P) programs into C&P claims adjudication in light of claims
``backlogs.'' In FY 2000 and 2001, VA will have redirected 45
FTEE from administration of the MGIB and various other
education programs to C&P claims adjudication. The VA Committee
recommends caution in further transfers of FTEE from the
education program at a time when average days to complete
original education claims continues to increase. Further,
without benefit of additional FTEE, VA's four regional
processing offices have assumed responsibility from the 57
regional offices for administering a nationwide, toll-free
education programs telephone service.
Veterans Employment.--With respect to the Veterans'
Employment and Training Service of the U.S. Department of
Labor, the VA Committee's hearings have found that the current
Local Veterans Employment Representative/Disabled Veterans
Outreach Program contains no incentives to reward success or
penalize failure. Individual states that place small
percentages of veterans in jobs year after year receive grant
funds in the same manner as states that consistently place
larger percentages. The VA Committee expects to examine a
number of possible initiatives including: (a) an allocation
system that would require states to compete among themselves
for available dollars based on performance; (b) an incentive
system that would authorize up to $10 million annually for
exemplary performance; and, (c) consistent with the Vice
President's initiative to reduce Federal monopolies, provide
the Secretary of Labor explicit authority to compete veterans'
employment and training services in states that do not
demonstrably improve services within two years.
A summary table of the VA Committee's recommendations
follows.
Sincerely,
Bob Stump, Lane Evans,
Chairman Ranking Democratic Member
Enclosure.
Comparison of President's Proposed Budget, Independent Budget and VA
Committee Recommendations for the Department of Veterans Affairs
(Budget Authority in millions)
Additional Views On The Department of Veterans Affairs Budget For FY
2001 of Honorable Bob Filner
On February 17, 2000, the House Committee on Veterans'
Affairs met to conduct a hearing on the Department of Veterans
Affairs fiscal year 2001 budget. I am pleased that the
Administration's budget for the year 2001 recognizes that the
men and women who have served in uniform deserve an adequate
budget for the Department of Veterans Affairs (VA).
The $1.4 billion increase in the health care budget will
assure our aging and disabled veterans who need medical care,
especially long term care, emergency care and specialized
services that their needs are a high priority. I join my
colleagues and the authors of the Independent Budget in
objecting to the proposal that $350 million of new resources
for medical care authorized by the Veterans Millenium Health
Care and Benefits Act be deposited to the Treasury. Funds
collected from veterans for the provision of veterans' health
care should be used to enhance the health care provided to
veterans and not as a substitute for appropriated dollars.
I wish to emphasize my continuing concern that VA is not
adequately meeting the benefit and health care needs of those
veterans who served in the Gulf War and who now suffer from
various diagnosed and undiagnosed disabilities. It has been
almost ten years since the men and women of our Armed Services
were sent to the Gulf. The veterans of the Gulf War are sick
with illnesses whose causes and cures remain a mystery. We must
not relax our efforts to fund necessary and appropriate
research. I join the authors of the Independent Budget in
supporting an increase in funding for VA medical research and
specifically request that the medical research budget be
increased by $65 million as recommended in the Independent
Budget and that at least $30 million of that increase be
directed to research involving the health of Gulf War veterans.
As our veteran population ages, the need for long-term care
increases. One means of providing access to such care is
through the funding of State Veterans Homes, such as we have in
California. I am opposed to the proposed decrease in funding
for State Homes and urge the Budget Committee to increase
funding for this important program as recommended by the Full
House Committee on Veterans Affairs.
I am also pleased that this Administration has recognized
what Members of Congress have known for years. Additional
personnel are needed if VA is to promptly and accurately
adjudicate claims for compensation and pension benefits. This
budget will help to provide a well-trained corps of
adjudicators to replace those who are nearing retirement age.
Necessary improvements to the claims adjudication system will
not achieve instant results. I want to emphasize that the
continued loss of experienced adjudicators over the past seven
years, together with an increased workload in the number of
issues which must be decided in each claim, have led to serious
problems of quality and timeliness. The increased staffing in
this budget is essential to stem the tide of deterioration in
claims processing.
As a former college professor, I recognize the value of a
quality education for our Nation's veterans. I am disappointed
that no increase for the G.I. Bill is provided in the
Administration's budget. Currently, the G.I. Bill provides far
less than is needed to obtain an education at a public
institution. I support raising the basic education benefit.
As we honor our veterans during their lives, so must we
honor their remembrance in death. The Administration's increase
in funding for the National Cemetery System will improve the
appearance of our cemeteries by a long-overdue and much needed
renovation of grounds, gravesites and grave-markers. I urge the
Budget Committee to fund the National Cemetery Administration
and the State Cemetery Grants at the levels recommended by the
Committee.
Representative Bob Filner
STATISTICAL DATA--WAR VETERANS AND DEPENDENTS
(As of October 2000)
American Revolution (1775-1783)
Total Servicemembers.............................................217,000
Battle Deaths......................................................4,435
Non-mortal Woundings...............................................6,188
Last Veteran, Daniel F. Bakeman, died April 5, 1869,................ 109
Last Widow, Catherine S. Damon, died November, 11, 1906,..........age 92
Last Dependent, Phoebe M. Palmeter, died April 25, 1911,..........age 90
War of 1812 (1812-1815)
Total Servicemembers.............................................286,730
Battle Deaths......................................................2,260
Non-mortal Woundings...............................................4,505
Last Veteran, Hiram Cronk, died May 13, 1905,....................age 105
Last Widow, Carolina King, died June 28, 1936,...............age unknown
Last Dependent, Esther A.H. Morgan, died March 12, 1946,..........age 89
Indian Wars (approx. 1817-1898)
Total Servicemembers........................................1
106,000
Battle Deaths.................................................1
1,000
Last Veteran, Fredrak Fraske, died June 18,1973,.................age 101
Mexican War (1846-1848)
Total Servicemembers..............................................78,718
Battle Deaths......................................................1,733
Other Deaths in Service...........................................11,550
Non-mortal Woundings...............................................4,152
Last Veteran, Owen Thomas Edgar, died September 3, 1929,..........age 98
Last Widow, Lena James Theobald, died June 20 1963,...............age 89
Last Dependent, Jesse G. Bivens, died November 1, 1962,...........age 94
Civil War (1861-1865)
Total Servicemembers (Union)...................................2,213,363
Battle Deaths (Union)............................................140,414
Other Deaths in Service (Union)..................................224,097
Non-mortal Woundings (Union).....................................281,881
Total Servicemembers (Confederate).............................1,050,000
Battle Deaths (Confederate).......................................74,524
Other Deaths in Service (Confederate)........................2
59,297
Non-mortal Woundings (Confederate)...............................Unknown
Last Union Veteran, Albert Woolson, died August 2, 1956,.........age 109
Last Confederate Veteran, John Salling, died March 16,1958,......age 112
Spanish-American War (1898-1902)
Total Servicemembers (Worldwide).................................306,760
Battle Deaths........................................................385
Other Deaths in Service............................................2,061
Non-mortal Woundings...............................................1,662
Last Veteran, Nathan E. Cook, died September 10, 1992,...........age 106
World War I (1917-1918)
Total Servicemembers (Worldwide)...............................4,734,991
Battle Deaths.....................................................53,402
Other Deaths in Service...........................................63,114
Non-mortal Woundings.............................................204,002
Living Veterans....................................................2,416
World War II (1940-1945)
Total Servicemembers (Worldwide)..............................16,112,566
Battle Deaths....................................................291,557
Other Deaths in Service..........................................113,842
Non-mortal Woundings.............................................671,846
Living Veterans................................................5,559,489
Korean Conflict (1950-1953)
Total Servicemembers (worldwide)...............................5,720,000
Battle Deaths.....................................................33,686
Other Deaths (In theater)..........................................2,830
Other Deaths in Service...........................................17,730
Non-mortal Woundings.............................................103,284
Living veterans................................................3,945,801
Vietnam Era (1964-1975)
Total Servicemembers (Worldwide)...............................9,200,000
Battle Deaths.....................................................47,410
Other Deaths (In Theater).........................................10,788
Other Deaths in Service......................................est. 32,000
Non-mortal Woundings.............................................153,303
Living Veterans................................................8,055,023
Gulf War (1990-1991)
Total Servicemembers (Worldwide)...............................2,322,332
Battle Deaths........................................................148
Other Deaths (In Theater)............................................235
Other Deaths in Service..............................................914
Non-mortal Woundings.................................................467
Living Veterans...........................................1
1,753,530
America's Wars Total
Military Service During War...................................42,303,460
Battle Deaths....................................................650,954
Other Deaths in Service (In Theater)..............................13,853
Other Deaths in Service (Non-Theater)............................524,605
Non-mortal Woundings...........................................1,431,290
Living War Veterans......................................1
19,316,259
Living Ex-Servicemembers.................................1
24,411,562
Veterans and Dependents on the Compensation and Pension Rolls
(As of October 2000)
----------------------------------------------------------------------------------------------------------------
SURVIVING
VETERANS CHILDREN PARENTS SPOUSES
----------------------------------------------------------------------------------------------------------------
Civil War................................................... ........... 13 ........... 1
Indian Wars................................................. ........... 1 ........... 1
Spanish-American War........................................ ........... 264 ........... 438
Mexican Border.............................................. 12 25 ........... 206
World War I................................................. 219 6,068 1 29,195
World War II................................................ 679,426 18,981 1,639 278,851
Korean Conflict............................................. 255,430 4,127 1,675 64,512
Vietnam Era................................................. 847,326 13,713 6,448 112,746
Gulf War.................................................... 322,621 8,078 347 5,875
TOTAL WARTIME............................................... 2,105,034 51,270 10,110 491,825
----------------------------------------------------------------------------------------------------------------
NOTE: Figures on the number of living veterans are projected from the final 1990 Census data and include only
veterans living in the U.S. and Puerto Rico. Periods of service used in Census data may differ slightly from
those of DOD. Although Gulf War figures are shown for the peak 1990-1991 period, the Gulf War period has not
yet been officially terminated.
Source: Department of Defense, unless otherwise indicated.
``Other Deaths in Service'' is the number of servicemembers who died while on active duty, other than those
attributable to combat, regardless of the location or cause of death.
\1\ VA estimate
\2\ An estimated additional 26,000 to 31,000 died in Union prisons.