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[109 Senate Hearings]
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S. Hrg. 109-564
LEGISLATIVE PRESENTATIONS OF THE NATIONAL ASSOCIATION OF STATE
DIRECTORS OF VETERANS AFFAIRS, THE AMVETS, THE AMERICAN EX-PRISONERS OF
WAR, AND THE VIETNAM VETERANS OF AMERICA
=======================================================================
HEARING
BEFORE THE
COMMITTEE ON VETERANS' AFFAIRS
UNITED STATES SENATE
ONE HUNDRED NINTH CONGRESS
SECOND SESSION
__________
MARCH 30, 2006
__________
Printed for the use of the Committee on Veterans' Affairs
Available via the World Wide Web: http://www.access.gpo.gov/congress/
senate
_____
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COMMITTEE ON VETERANS' AFFAIRS
Larry Craig, Idaho, Chairman
Arlen Specter, Pennsylvania Daniel K. Akaka, Ranking Member,
Kay Bailey Hutchison, Texas Hawaii
Lindsey O. Graham, South Carolina John D. Rockefeller IV, West
Richard Burr, North Carolina Virginia
John Ensign, Nevada James M. Jeffords, (I) Vermont
John Thune, South Dakota Patty Murray, Washington
Johnny Isakson, Georgia Barack Obama, Illinois
Ken Salazar, Colorado
Lupe Wissel, Majority Staff Director
D. Noelani Kalipi, Minority Staff Director
C O N T E N T S
----------
March 30, 2006
SENATORS
Page
Craig, Hon. Larry, Chairman, U.S. Senator from Idaho............. 1
Prepared statement........................................... 3
Akaka, Hon. Daniel K., U.S. Senator from Hawaii.................. 4
Prepared statement........................................... 5
Salazar, Hon. Ken, U.S. Senator from Colorado.................... 13
Prepared statement........................................... 13
Obama, Hon. Barack, U.S. Senator from Illinois................... 34
WITNESSES
Basker, George, President, National Association of State
Directors of Veterans Affairs.................................. 7
Prepared statement........................................... 9
Harvey, Gerald S., National Commander, American Ex-Prisoner of
War............................................................ 14
Prepared statement........................................... 16
Rowan, John, National President, Vietnam Veterans of America..... 17
Prepared statement........................................... 19
Kemp, Edward W., National Commander, AMVETS...................... 25
Prepared statement........................................... 26
APPENDIX
The VVA 2006 Legislative Agenda & Policy Initiatives brochure.... 43
LEGISLATIVE PRESENTATIONS OF THE NATIONAL ASSOCIATION OF STATE
DIRECTORS OF VETERANS AFFAIRS, THE AMVETS, THE AMERICAN EX-PRISONERS OF
WAR, AND THE VIETNAM VETERANS OF AMERICA
----------
THURSDAY, MARCH 30, 2006
U.S. Senate,
Committee on Veterans' Affairs,
Washington, DC.
The Committee met, pursuant to notice, at 10:00 a.m., in
room SD-106, Dirksen Senate Office Building, Hon. Larry E.
Craig (Chairman of the Committee) presiding.
Present: Senators Craig, Akaka, Salazar, and Obama.
OPENING STATEMENT OF HON. LARRY E. CRAIG,
U.S. SENATOR FROM IDAHO
Chairman Craig. Well, good morning, ladies and gentlemen
and fellow Americans. Welcome to the Committee on Veterans'
Affairs. The Committee will now be in order.
It is my pleasure to welcome all of you here today. I would
like to single out a person in your membership who is a
personal friend of mine that we have worked with over the years
who represents my home State all so well. I said hello to him a
few moments ago, Herb Kerchoff, National Director of the
Northwest Region, American Ex-Prisoners of War. Herb, thank
you.
Herb is from beautiful Couer d'Alene, Idaho. For those of
you who have not been there, this is a personal invitation from
Herb to visit him.
I wish to thank all of you for your fine service and that
service that you have rendered veterans in your respective
communities over the years. Your valuable contributions of
service to many of our veterans is greatly appreciated.
The past year has been an extremely gratifying one for me,
my first as Chairman of the Veterans' Affairs Committee here in
the Senate. I sincerely believe that this Committee and its
Members, while sometimes differing in approach, are all united
in one common mission: ensuring that our Nation's veterans,
particularly veterans wounded in the line of duty receive the
highest quality health care and benefits that they need. By any
measure, we have had a very busy and productive first session,
convening 23 hearings here in Washington, nine field hearings,
and four mark-ups.
More importantly, the committee-related activity has led to
several what I think are extremely important accomplishments. I
am going to single out one of those accomplishments in
particular that deserves special attention because some of you
were instrumental in securing its enactment. About a year ago,
I walked into my office to meet three veterans of Operation
Iraqi Freedom. One of them was missing a leg. Another was
missing both legs, and the third had lost his sight. They asked
that I sponsor legislation to create a new insurance benefit
for traumatic injuries such as theirs, but not for them, mind
you, but for their fellow compatriots and for future severely
wounded service Members, and here is the result that we can all
be proud of:
Earlier this month, VA has now paid out to almost 1,500
traumatically injured members from OIF and OEF. These are young
men and women with amputations, severe burns, total blindness,
total deafness, paralysis, and a host of other disabilities,
all of them sustained in defense of America. Going forward,
Wounded Warriors Insurance will fill the gap in financial help
that these heroes need and faced during their convalescence.
Thank you for helping us get that done.
Let me touch on what has consumed much of our attention of
late, the fiscal year 2007 VA budget. I believe this record
budget is extraordinary. The Senate-passed budget resolution
would provide VA health care systems a 12.4 percent increase in
direct appropriations. That would mean that since 2001, VA
health care budgets have increased by nearly 70 percent. At
these rates, the cost of VA medical care will double every 6
years. There is almost no other area of the Federal budget that
has experienced that kind of increase.
Yes, if what is demonstrated continues in a fiscal austere
climate, the President and us and you have a challenge to
sustain this level of spending--a top budget priority of this
President, a top budget priority of ours. That said, I am
concerned that at the present spending rates, VA budgets will
soon collide with spending demands in other areas of the
government. Although we may wish that VA funding exists in a
vacuum, you and I both know it does not and I am sure that
everyone here is aware that the President has proposed one way
for us to respond to some of these realities, by asking
Priority Seven and Eight veterans with no service-
related disabilities to contribute about $21 per month to
enroll in the VA health care system and to pay $15 for a 30-day
supply of medicine.
While these proposals did not survive in the budget
resolution, they reflect a fiscal reality of limited resources
that we must face someday. I personally find these proposals to
be reasonable, and while I know that many in your organizations
voiced concern and even opposed, I reiterate, my hope is that
VSOs and others will engage this Committee in serious and
candid discussion if not about the President's proposal, then
about other options.
It is our collective responsibility to sustain this
incredible VA health care system today and for future needs. If
we begin addressing these issues now, we can help ensure that
future veterans will not be faced with even bigger challenges
and more radical changes to meet those challenges. Personally,
I do not want to pass this issue on to the next guy or gal that
may chair this Committee. I want to pass on to tomorrow's
veterans what we have collectively created, a health care
system that provides quality care, that is accessible to those
who need it, but affordable to those who want it. I hope you
agree with my goals and are willing to work with me and my
colleagues on this effort.
Today, we have four distinguished members of the veterans
community testifying. They are George Basher, National
President, National Association of State Directors of Veterans
Affairs; Gerald S. Harvey, National Commander, American Ex-
Prisoners of War; John Rowan, National President, Vietnam
Veterans of America; and Edward Kemp, National Commander for
AMVETS.
[The prepared statement of Senator Craig follows:]
Prepared Statement of Hon. Larry E. Craig, U.S. Senator from Idaho
Good morning, ladies and gentlemen. The Committee on Veterans'
Affairs will now come to order. It is my pleasure to welcome all of you
here today. I'd like to single out a person of your membership from my
home State of Idaho who is in attendance:
Mr. Herb Kirchhoff, National Director of the Northwest Region,
American Ex-Prisoners of War. He is from Coeur D'Alene, Idaho. I wish
to thank all of you for the fine service you render the veterans in
your respective communities. Your valuable contributions of service to
many of our veterans is greatly appreciated.
The past year has been an extremely gratifying one for me . . . my
first as Chairman of the Veterans' Affairs Committee. I sincerely
believe that this Committee and its Members, while sometimes differing
in approach, are all united in one, common mission: ensuring that our
nation's veterans--particularly veterans wounded in the line of duty--
receive the highest quality of health care and benefits that they need.
By any measure, we have had a busy and productive first session,
convening twenty-three hearings here in Washington, nine field
hearings, and four markups. More importantly, committee-related
activity has led to several important accomplishments.
I am going to single out one accomplishment in particular that
deserves special attention because some of you were instrumental in
securing its enactment. About a year ago, I walked into my office to
meet with three veterans of Operation Iraqi Freedom: one was missing a
leg; another was missing two legs; and the third had lost his sight.
They asked that I sponsor legislation to create a new insurance benefit
for traumatic injuries such as theirs. Not for them, mind you. But for
their fellow compatriots, for future severely wounded service members.
And here is the result we can all be proud of: Earlier, this month,
VA had paid almost 1,500 traumatically injured service members from
OIF/OEF. These are young men and women with amputations, severe burns,
total blindness, total deafness, paralysis, and a host of other
disabilities . . . all of them sustained in defense of America. Going
forward, ``Wounded Warrior'' insurance will fill the ``gap'' in
financial help these heroes face during their convalescence.
Let me touch on what has consumed much of our attention of late . .
. the fiscal year 2007 VA budget. I believe this record budget is
extraordinary. The Senate passed budget resolution will provide VA's
health care system with 12.4 percent increase in direct appropriations.
That would mean that since 2001, VA's health budget has increased by
nearly 70 percent. At this rate the cost of VA medical care will double
every 6 years. Yes, it conclusively demonstrates that in this fiscally
austere climate, both the Senate and the President have chosen to make
veterans, once again, a top budget priority.
That said, I am concerned that at present spending rates, VA's
budget will soon collide with spending demands in other areas of
government. Although we may wish that VA funding existed in a vacuum,
it simply does not.
As I am sure everyone here is aware, the President had proposed one
way for us to respond to these fiscal realities . . . by asking
priority 7 and 8 veterans--with no service-related disabilities to
contribute about $21 per month to enroll in the VA health care system
and pay $15 for a 30-day supply of medicine. While these proposals did
not survive in the Budget Resolution they reflect a fiscal reality of
limited resources that we must face someday. I personally find these
proposals to be reasonable, and while I know that many in your
organizations voiced concern and even opposition I reiterate my hope
that the VSOs and others will engage this Committee in serious and
candid discussions . . . if not about the President's proposals, then
about other options. It is our collective responsibility to sustain
this incredible VA health care system into the future.
If we begin addressing these issues now, we can help ensure that
future veterans will not be faced with even bigger challenges and more
radical changes to meet those challenges. Personally, I do not want to
pass this issue on to the next guy. I want to pass on to tomorrow's
veterans what we have collectively created, a health care system that
provides quality care that is accessible to those who need it, but
affordable to those who want it. I hope you agree with my goals and are
willing to work with me and my colleagues in our efforts.
Today we have four distinguished members of the veteran community
testifying.
They are: Mr. George Basher, President, National Association of
State Directors of Veterans Affairs; Mr. Gerald S. Harvey, National
Commander, American Ex-Prisoners of War; Mr. John Rowan, National
President, Vietnam Veterans of America; and Mr. Edward W. Kemp,
National Commander, AMVETS.
Chairman Craig. Before I turn to our panelists this morning
and testifiers, let me turn to the Ranking Member, Senator
Danny Akaka of Hawaii. Danny and I work very closely together
on all of the issues that pertain to veterans.
Danny.
STATEMENT OF HON. DANIEL K. AKAKA,
U.S. SENATOR FROM HAWAII
Senator Akaka. Thank you very much, Mr. Chairman. It has
always been a pleasure for me to be part of this Committee and
to work with you.
Before I proceed with my statement, I just want to comment
on the news we received this week. My counterpart in the House,
Congressman Lane Evans, will be retiring at the end of this
year. Congressman Evans is a true champion for veterans and I
will greatly miss working with him. As a Vietnam-era Marine and
an unyielding advocate for veterans and their families, Mr.
Evans has done so much for our country's veterans. He is a true
patriot and we will all miss his great leadership. I look
forward to continuing to work with him this year and wish him
my warmest aloha for the future.
Mr. Chairman, it is certainly a pleasure to be here with
our veterans. I want to thank the commanders and national
presidents who are testifying here today, and my thanks go as
well to all veterans and their families who have made the
journey to the Nation's Capital to express their concerns. This
truly is the democracy in action.
Your organizations have a long and proud tradition of
public service, and your advocacy on behalf of veterans is
truly exemplary. This Committee relies heavily on your concerns
and agendas for the coming year.
I would like to share some of my concerns and priorities.
During this time last year, many of us here in Congress were
sounding the alarm that the VA budget was facing a crisis
situation. Many months later, the Administration acknowledged
this fact and Congress took action to provide emergency
funding. Chairman Craig kept his promise and was a driving
force behind that emergency funding.
When we started working together last year, we pledged to
work in a bipartisan manner, and we have done so. There are
times, however, when we agreed to disagree. We both agree that
veterans deserve to have the best health care, the best
services, and the best benefits, though we sometimes disagree
on how to pay for it. I want to be clear, however, that we have
the same goal and that is to ensure that VA is provided with
the resources to provide quality care and services to our
Nation's veterans. I remain dedicated to ensuring that VA has
the resources it needs to care for all veterans.
We must learn a lesson from last year's budget crisis and
do everything we can to ensure that veterans and their family
members have access to the health care and benefits they have
earned. VA's budget has increased for the past 6 years, as
mentioned by the Chairman, since 2001. It has increased by 70
percent, and this is as it should be.
The cost of caring for our veterans is in my opinion a cost
of war. If the Department of Defense's budget can grow
exponentially and we fund it yearly out of supplementals, it
makes sense that VA's budget needs to grow exponentially as
well. It is no secret that each service member that we so
readily fund out of DOD will eventually seek services from VA.
It follows, then, that if DOD's budget grows steadily, VA's
budget must grow steadily as well.
For me, it is a matter of priorities. We must stand by our
veterans and ensure that they receive the care and services
that they have earned through their service to our country and
we must ensure that we care for all veterans. We cannot fund
the VA system out of the pockets of the middle income veterans
as many of these men and women make as little as $27,000 a
year. Higher copayments and enrollment fees are not justified.
To date, over a quarter of a million veterans have been
excluded from VA health care. We must work to overturn this
Administration's decision and open the VA system up to those
who need it.
I also am concerned about the VA research program being
slated for a cut under this budget. Since its inception, the VA
research program has made landmark contributions to the welfare
of not only veterans, but the entire Nation. Illustrating the
unique importance of keeping it adequately funded with
thousands of military personnel engaged in conflict overseas,
it is vital that Congress invest in research that could have a
direct impact on their post-
deployment quality of life.
With regard to VBA budget, I am concerned whether or not
this budget provides an adequate level of staffing for
compensation claims rating. VA must be ready to adjudicate
claims in a timely and accurate manner. I believe that VA must
begin to hire additional staff now to handle the anticipated
influx of new claims from recently separated service members.
In closing, I would like again to thank the witnesses and
all who are here with us today. Your service, your dedication
to this Nation and its veterans is unquestionable. I look
forward to your presentation and working with you in the
future.
Thank you very much, Mr. Chairman.
[The prepared statement of Senator Akaka follows:]
Prepared Statement of Hon. Daniel K. Akaka, U.S. Senator from Hawaii
It is certainly a pleasure to be here today. I want to thank the
Commanders and National Presidents testifying today. My thanks go as
well to all the veterans and their families who have made the journey
to the Nation's capital to express their concerns. This is truly
democracy in action. Your organizations have a long and proud tradition
of public service and your advocacy on behalf of veterans is truly
exemplary. This Committee relies heavily on your concerns and agendas
for the coming year.
I would like to share some of my concerns and priorities. During
this time last year, many of us here in Congress were sounding the
alarm that the VA budget was facing a crisis situation. Many months
later, the Administration acknowledged this fact and Congress took
action to provide emergency funding. Chairman Craig kept his promise
and was a driving force behind the emergency funding. When we started
working together last year, we pledged to work in a bipartisan manner.
And we have done so.
There are times, however, when we agree to disagree. We both agree
that veterans deserve to have the best health care, services, and
benefits. Though, we sometimes disagree on how to pay for it. I want to
be clear, however, that we have the same goal and that is to ensure
that VA is provided with the resources to provide quality care and
services to our Nation's veterans.
I remain dedicated to ensuring that VA has the resources it needs
to care for all veterans. We must learn a lesson from last year's
budget crisis and do everything we can to ensure that veterans and
their family members have access to the health care and benefits they
have earned.
VA's budget has increased over the past 6 years. This is as it
should be. The cost of caring for our veterans is, in my opinion, a
cost of war. If the Department of Defense's budget can grow
exponentially, and be funded yearly out of supplementals, it only makes
sense that VA's budget needs to grow exponentially as well. It is no
secret that each servicemember that we so readily fund out of DOD will
eventually seek services from VA. It follows then, that if DOD's budget
grows steadily, VA's budget must grow steadily as well. For me, it is a
matter of priorities--we must stand by our veterans and ensure that
they receive the care and services that they have earned through their
service to our country. And we must ensure that we care for all
veterans.
We cannot fund the VA system out of the pockets of ``middle-
income'' veterans, as many of these men and women make as little as
$27,000 a year. Higher copayments and enrollment fees are not
justified. To date, over a quarter of a million veterans have been
excluded from VA health care. We must work to overturn this
Administration's decision and open the VA system up to those who need
it.
I also am concerned about the VA Research program being slated for
a cut under this budget. Since its inception, the VA research program
has made landmark contributions to the welfare of not only veterans,
but the entire Nation, illustrating the unique importance of keeping it
adequately funded. With thousands of military personnel engaged in
conflict overseas, it is vital that Congress invest in research that
could have a direct impact on their post-deployment quality of life.
With regard to the VBA budget, I am concerned whether or not this
budget provides an adequate level of staffing for compensation claims'
rating. VA must be ready to adjudicate claims in a timely and accurate
manner. I believe that VA must begin to hire additional staff now to
handle the anticipated influx of new claims from recently separated
servicemembers.
In closing, I would like once again to thank the witnesses and all
who are here with us today. Your service and dedication to this Nation
and its veterans is unquestionable. I look forward to your presentation
and working with you in the future.
Chairman Craig. Senator Akaka, thank you, and let me join
with the Senator in his expression and recognition of
Congressman Lane Evans and his retirement. He clearly has been
a dedicated public servant with veterans foremost in his mind
almost his entire service period here, and we have had the
opportunity to work with him. We will miss him in his
retirement.
Let me also add before we turn to our panelists, Senator
Akaka and I insisted last year with the budget difficulties we
had with the VA that they change their practices and their
habits and that they report to us on a quarterly basis of their
spend-down and their needs, and they are now doing that.
Yesterday before the Subcommittee of MILCON, which is MILCON
and Veterans Affairs that I serve on in Appropriations, we took
testimony from the Secretary. Not only did he refer to that
effort that Senator Akaka and I insisted upon, but they are now
reporting monthly to OMB, the Office of Management and Budget.
This is without question a new precedent for them. It will
help us shape and understand their needs much more clearly. It
will allow us to read trend lines of growth and demand or the
lack of demand. It will show all of those factors, and I think
that that is a very positive step, and Senator Akaka and I
insisted that that be a part of the way that we would deal with
VA and the only way we would deal with VA when it came to
budget matters, open, transparent, and timely reporting as to
their fiscal needs.
Now let us turn to all of you witnesses and, again, we
thank you so very much for being with us this morning. Let me
first turn to George Basher, President, National Association
for State Directors of Veterans Affairs.
George, welcome before the Committee.
STATEMENT OF GEORGE BASHER, PRESIDENT, NATIONAL ASSOCIATION OF
STATE DIRECTORS OF VETERANS AFFAIRS
Mr. Basher. Thank you, Mr. Chairman.
Mr. Chairman and distinguished Members of the Committee, as
President of the National Association of State Directors of
Veterans Affairs, I thank you for the opportunity to testify
and present the views of the State Directors of all 50 States,
our commonwealths and our territories. As the Nation's second
largest provider of services to veterans, spending over three
and a half billion dollars this year, State Government's role
continues to grow. We believe it is essential for Congress to
understand this role and ensure we have the resources to carry
out our responsibilities. We partner very closely with the
Federal Government in order to best serve our veterans, and as
partners, we are continuously striving to be more efficient in
delivering services to veterans.
We greatly appreciate the leadership of Chairman Craig and
Ranking Member Akaka and the entire membership of the Senate
Veterans' Affairs Committee for their past support of building
on the Administration's budget and hope that it continues.
Because of the war on terror, we are now serving a new
generation of veterans. They will need our help as they return
to civilian life, and we believe, therefore, that there will be
an increased demand for certain benefits and services, and the
overall level of health care funding proposed by the
Administration must meet that demand while continuing to serve
those veterans already under VA care.
The State Directors support the Capital Asset Realignment
for Enhanced Services, CARES, process, and we urge that the
capital funding required for implementation be included over a
reasonable period of time to enable these recommendations to be
realized. We recommend an in-depth examination of long-term
care of mental health services. The CARES Commission review did
not include long-term care of mental health services, but it
did recommend further study of both areas. To that end, we ask
again that a study be done to thoroughly examine veterans'
long-term care and continue the study currently being done in
mental health service needs to include gap analysis clearly
identifying where services are lacking.
The CARES report recognized State veteran homes as a
critical component of veteran long-term health care and a model
of cost efficient partnership between Federal and State
Governments. These State nursing care facilities and
domiciliaries bear over half the national long-term health care
workload for our infirm and aging veteran population. Forty-
eight States provide care for more than 27,500 veterans in 120
homes.
We urge you to continue to oppose proposals that jeopardize
the viability of our State veteran homes. State tax payers have
supported the State homes through their 35 percent share of
construction costs with an understanding that the Federal
Government will continue to make its contribution through per
diem payments.
Since 1977, State construction grant requests have
consistently exceeded congressional appropriations for the
program. According to the fiscal year 2006 priority list,
pending programs, there are 80 projects in Priority Group One
with State matching funds of $226 million for a Federal match
of $420 million. Any grant moratorium or lessening only
exacerbates an already underfunded program where the fiscal
year 2006 appropriation is only 85 million.
The success of VA's effort to meet the current and future
long-term care needs of veterans is contingent on resolving the
current mismatch between demand and available funding. We
recommend this issue be included in any long-term care study
undertaken.
We support increasing the per diem payment to one-half of
the national average annualized for cost in State veteran
homes. Current law allows VA to pay per diem up to one-half the
cost of care of a veteran in a State home; however, in the
first quarter of 2005, the VA per diem payment amounted to only
31 percent of the daily average cost of nursing home care. We
ask that the per diem for both programs be increased to one-
half the national average annualized cost of providing care.
We support Medicare subvention. We recommend veterans
medication purchase option be implemented for Priority Group 7
and 8 enrollees. Under the compensation and pension benefits
area, we support consideration of a greater role for State
Director Divisions of Veteran Affairs in the overall efforts to
manage and administer claims processing regardless of whether
the State uses State employees, veteran service organizations,
or county veteran service officers. As noted in the recent VA
Inspector General review of variances, veteran access to
competent claim assistance is still very much an action of
geography, and this organization stands ready to assist VA in
alleviating that condition.
We strongly support improving and providing a seamless
transition and help our returning service members' transition
back into civilian life and also support veterans preference
with regard to employment.
Mr. Chairman and distinguished Members of the Committee, we
respect the important work that you have done to improve and
support veterans who have answered the call to serve our
Nation. State Directors of Veterans' Affairs remain dedicated
to doing our part. We urge you to be mindful of the increasing
financial challenge that States face just as you address the
fiscal challenges at the Federal level. We are dedicated to our
partnership with the VA in the delivery of service and care to
our Nation's veterans.
This concludes my statement, and I am ready to answer any
questions you might have.
[The prepared statement of Mr. Basher follows:]
Prepared Statement of George Basher, President, National Association
of State Directors of Veterans Affairs
introduction
Mr. Chairman and distinguished Members of the Committee, as
President of the National Association of State Directors of Veterans
Affairs (NASDVA) I thank you for the opportunity to testify and present
the views of the State Directors of all 50 states, commonwealths, and
territories.
As the nation's second largest provider of services to Veterans,
State governments' role continues to grow. We believe it is essential
for Congress to understand this role and ensure we have the resources
to carry out our responsibilities. We partner very closely with the
Federal Government in order to best serve our veterans and as partners,
we are continuously striving to be more efficient in delivering
services to veterans.
We greatly appreciate the leadership of Chairman Craig and Ranking
Member Akaka and the entire Membership of the Senate VA Committee for
their past support of building upon the administration's budget and
hope that it continues. Because of the War on Terror, we are now
serving a new generation of veterans. They are going to need our help
as they return to civilian life. We believe, therefore, that there will
be an increased demand for certain benefits and services and the
overall level of health care funding proposed by the administration
must meet that demand while continuing to serve those veterans already
under VA care.
veterans health benefits and services
NASDVA supports the Capital Asset Realignment for Enhanced Services
(CARES) process.
Capital Asset Realignment for Enhanced Services (CARES): We were
generally pleased with the report and recommendations made in the final
plan. We also support the process for planning at the remaining 18
sites and the direction it will move VA as a national system. We urge
that capital funding required for implementation be included over a
reasonable period of time to enable these recommendations to be
realized.
NASDVA supports the opening of additional Community-Based
Outpatient Clinics (CBOCs). We would like to see the new priority CBOCs
deployed rapidly with appropriate VA Medical Center (VAMC) funding.
Community-Based Outpatient Clinics (CBOCs): Continued development
of CBOCs has greatly improved veterans' access to VA health care. We
continue to encourage rapid deployment of new priority clinics over the
next few years with the corresponding budget support to VAMCs. VA needs
to quickly develop these additional clinics, to include mental health
services. We encourage the investment of capital funding to support the
many projects recommended by CARES. We support VA contracting-out some
specialty care to private-sector facilities where access is difficult.
Likewise we would like to see this process continue in fiscal year
2007, with sufficient funding in the budget.
NASDVA recommends an in-depth examination of long-term care and
mental health services.
Long-Term Care and Mental Health Services in CARES Initiatives: The
CARES Commission review did not include long-term care or mental health
services, but did recommend further study of both areas. To that end,
we again ask that a study be done to thoroughly examine veterans' long-
term care and continue the study currently being done on mental health
care needs, to include gap analysis clearly identifying where services
are lacking. The CARES report recognized State Veterans Homes (SVHs) as
a critical component of veterans' long-term health care and a model of
cost-efficient partnership between Federal and State governments. These
State nursing care facilities and domiciliaries bear over half of the
national long-term health care workload for our infirm and aging
veteran population. Forty-eight (48) States provide care for more than
27,500 veterans in 120 SVHs. We urge you to continue to oppose
proposals that jeopardize the viability of our SVHs. State taxpayers
have supported the SVHs through its 35 percent share of construction
costs with an understanding that the Federal Government would continue
to make its contribution through per diem payments. The Federal
Government should continue to fulfill its important commitment to the
states and ultimately to the individual veterans in need of care.
NASDVA continues its strong support for the State Home Construction
Grant Program. The annual appropriation for this program should be
continued and increased. Based on the reduction in funding in fiscal
year 2006, we recommend that the amount in fiscal year 2007 be
increased to $115 million. Re-ranking of projects should be eliminated
once a project is established as Priority group 1 (state matching funds
are available).
Funding of the State Homes Construction Grant Program. Since 1977,
state construction grant requests have consistently exceeded
Congressional appropriations for the program. According to the fiscal
year 2006 Priority List of Pending State Home Construction Grant
Applications, there are 80 projects in Priority group 1 with state
matching funds of $226M for a Federal match of $420M. Any grant
moratorium only exacerbates an already under-funded program, where the
fiscal year 2006 appropriation was only $85M. This deficit in Federal
program support causes long delays in the establishment of long-term
care beds in areas where these services are badly needed by an aging
veteran population. We recommend rejection of any proposed moratorium
and an increase in funding.
The success of VA's efforts to meet the current and future long-
term care needs of veterans is contingent upon resolving the current
mismatch between demand and available funding. We recommend this issue
be included in any long-term care study undertaken.
Ranking of State Home Construction Projects. Priority groups for
construction or acquisition of SVHs are established in 38 CFR, Chapter
59.50. States that have applied and made matching funds available for
projects are ranked Priority group 1. Due to insufficient funding each
budget year, some Priority group 1 projects do not receive Federal
funding and are then subject to reprioritization the following budget
year. Since these projects have state funds committed, they should
maintain their ranking in Priority group 1 except for new projects that
are for ``life and safety'' issues.
NASDVA supports full reimbursement for care in SVHs for veterans
who have a 70 percent or more service-connected disability or who
require nursing home care because of a service-connected disability.
Full Reimbursement for Cost of Care for Qualifying Veterans in
SVHs: The November 1999 Millennium Act requires VA to provide nursing
home care to those veterans who have a 70 percent or more service-
connected disability or who require nursing home care because of a
service-connected disability. VA provides nursing home services through
three national programs: VA owned and operated nursing homes, SVHs
owned and operated by the state, and contract community nursing homes.
VA General Counsel interpretation of the law allows only contract
community facilities to be reimbursed for full cost of care. SVHs
merely receive per diem towards the cost of care, requiring the veteran
to make a co-payment. This is unfair to those veterans who are eligible
for full cost of care, but prefer to reside in a SVH.
NASDVA supports increasing per diem to provide one-half of the
national average annualized cost of care in a SVH.
Increase in Per Diem Payments to SVHs. Current law allows VA to pay
per diem up to one-half of the cost of care each day a veteran is in a
SVH. However, in 1QTR fiscal year 2005, VA per diem amounted to only 31
percent of the average daily cost of nursing home care ($185.56) and
only 25 percent of the average daily cost of domiciliary care ($119.94)
in a SVH. We ask that per diem for both programs be increased to one-
half of the national average annualized cost of providing care, as the
SVH program is the most cost effective nursing care alternative used by
VA.
NASDVA supports VA Medicare Subvention. We recommend a veterans'
medication purchase option be implemented for Priority group 7 and 8
enrollees who only seek medications. We request continued protection of
the Federal Supply Schedule for VA/DOD pharmaceuticals.
Medicare Subvention. We recommend that VA implement a Medicare
Subvention program similar to the unrealized ``VA Advantage'' Program.
Working with the Department of Health and Human Services, this program
will allow Priority group 8 veterans aged 65 and older to use their
Medicare benefits to obtain VA health care. VA would receive Medicare
payments to cover its costs. This is an HMO concept we have supported,
however, we are concerned about the delay in implementation of a pilot.
It was our understanding 2 years ago that this program would be
available to veterans within a few months. Another year has now passed
without implementation.
Optional Purchase of VA Medications. NASDVA requests Secretary
Nicholson consider a veterans' medication purchase option. Large
numbers of Priority group 7 and 8 enrollees are seeking prescription
drugs; they do not necessarily seek access to the VA health care
system. A medication only purchase program could separate this
population from the enrollee lists and reduce backlogs, assisting VA in
delivering services to the core constituency of service-connected
veterans. Such a plan would provide veterans an attractive alternative
to Medicare Part D funding for pharmaceuticals.
Protection of VA Pharmaceutical Costs. NASDVA requests continued
protection of the Federal Supply Schedule 'FSS) for VA/DOD
pharmaceuticals. While we support the goal of reduced drug prices for
all Americans, we are concerned that if the FSS prices were extended to
Medicare recipients or other entities, it would result in increased
prices for VA/DOD, diverting millions of dollars from health care
funding for veterans.
NASDVA supports continued efforts to reach out to veterans. This
should be a partnership between VA and the State Departments of
Veterans Affairs (SDVAs).
Outreach to Veterans. While growth has occurred in VA health care
due to improved access to CBOCs, many areas of the country are still
short-changed due to geography and/or due to veterans' lack of
information and awareness of their benefits. VA and SDVAs must reduce
this inequity by reaching out to veterans regarding their rights and
entitlements. NASDVA supports implementation of a grant program that
would allow VA to partner with the SDVAs to perform outreach at the
local level. There is no excuse for veterans not receiving benefits to
which they're entitled simply because they are unaware of those
benefits.
compensation and pension benefits
NASDVA supports considerations of a greater role for SDVAs in the
overall effort to manage and administer claims processing, regardless
of whether the state uses state employees, Veterans Service
Organizations 'VSOs), and /or County Veterans Service Officers 'CVSOs).
Restructured Claims Management. Recent studies regarding claims
processing have all noted that VA needs to make better use of the
assets of the State government and VSOs to assist in claim processing.
One example is the October 2001 Claim Processing Task Force Report to
the Secretary, which stated:
``The full partnership and cooperation of VBA and Veterans
Service Organizations 'VSOs) are vital elements in assuring
timely service to the veteran. A well-developed network of VSOs
and State Departments of Veteran's Affairs (SDVAs) should be
encouraged to cooperatively enhance the delivery of services to
veterans. Service organizations can help improve service to
beneficiaries and increase veteran satisfaction by providing
assistance in gathering evidence for the development of a well
documented and ``ready-to-rate'' claim, helping deter frivolous
claims, and by providing timely information on claim status.''
Additionally, as noted in the recent VA Inspector General's Review
of State Variances in VA Compensation Payments, veteran access to
competent claim assistance is still very much an accident of geography.
Effective advocacy for veterans from initiation of a claim to a VA
decision can improve sufficiency and timeliness of claims. Numerous
studies indicate ``well-developed'' claims produce better outcomes for
veterans in a shorter time and at a lower cost to VA.
The SDVAs, nationally chartered VSOs, and county veteran service
officers have the capacity and capability to assist VA. NASDVA can be
an effective partner with VA to establish and achieve higher
performance standards in claims preparation. SDVAs could assume a role
in more effective and comprehensive training programs and certification
of service officers to ensure competence and technical proficiency in
claims preparation. We can support VA in its ``duty to assist'' without
diminishing our role as the veterans' advocate.
For all the reports and testimony to the contrary, VBA has not been
very successful in making effective use of the state/county/VSO system
of service officers and counselors. Under the current system of claims
processing, the interface between VBA and those who represent veterans
is clumsy and poorly integrated. We recommend VBA explore methods of
integrating its existing and future applications and its business
process with those state, county, and VSO personnel supporting claim
processing. We further recommend the establishment and enforcement of
uniform training programs and performance measures for all personnel
involved in the preparation of veteran claims.
NASDVA strongly supports passage of legislation to eliminate the
time-phased concurrent receipt of military retirement pay and service-
connected disability compensation.
We appreciate the fiscal year 2005 Defense Authorization Act
authorizing full concurrent receipt of retired pay and disability
compensation for retirees with 100 percent VA disability ratings. We
are disheartened, however, by the DoD decision to exclude the 30,000
retirees currently rated as ``unemployable'' and receiving disability
compensation at the 100 percent rate. This decision should be based on
fairness, not budgetary constraints.
NASDVA strongly supports passage of legislation to eliminate the
time-phased concurrent receipt of military retirement pay and service-
connected disability compensation. These are both earned entitlements
and should apply to all retired veterans, regardless of their level of
disability.
burial and memorial benefits
NASDVA recommends and increase in the plot allowance for all
veterans to $1000 per interment. We strongly support an increase in
funding for the State Cemetery Grant Program. A new Federal/State
national Cemetery Administration 'NCA) grant program could be
established to support state costs.
Increase in Burial Plot Allowance. The average operational cost of
interment in a state veterans' cemetery is $2000. This adds to the
fiscal burden of many SDVAs. The current burial plot allowance of $300
per qualified interment provides 15 percent of the average cost of
interment. NASDVA recommends the Plot Allowance be increased to $1000
in order to offset operational costs. The increase should also apply to
the plot allowance for veterans' interment in private cemeteries.
Increased Funding for State Veterans Cemetery Grant Program (SCGP).
The State Veterans Cemetery Grant Program (SCGP) has greatly expanded
the SDVAs' ability to provide gravesites for veterans and their
eligible family members in those areas where national cemeteries cannot
fully satisfy burial needs, particularly in rural and remote areas of
the country. The existing State Cemetery Grant Program has allowed the
number of state cemeteries to grow by nearly 40 percent over the past 5
years with a corresponding increase in interments. Currently there are
some 40 project pre-applications pending totaling $160M. We ask that
SCGP funding be increased to $50M.
Establishment of a State Veterans Cemetery Operations Grant
Program. SDVAs are provided construction grants for veterans'
cemeteries and a limited burial plot allowance as discussed above to
partially offset the cost of interment. Operational costs for both
state and national veterans' cemeteries continue to rise. However, once
a state establishes a state veterans' cemetery there is no further
source of Federal funding to defer operational costs. NASDVA recommends
the establishment of a Federal grant program to assist state veterans'
cemeteries with operational costs.
homelessness among veterans
NASDVA supports efforts to diminish the national disgrace of
homelessness among veterans. SDVAs would prefer an active role in
allocating and distributing per diem funds for homeless veterans to
non-profit organizations, ensuring greater coordination, fiscal
accountability, and local oversight of the services provided.
Homeless Providers Grant and Per Diem Program: VA grants greatly
assist states in reducing homelessness among veterans and we urge an
increase in per diem 'currently $27.44) to ensure appropriate support
services at transition facilities. Additionally, NASDVA recommends VA
partner with SDVAs in the process of allocating and distributing per
diem funds to non-profit organizations. This would create an
appropriate level of accountability and collaboration between non-
profit agencies and SDVAs, ensuring funding is used to provide care to
veterans in the program in a most effective manner.
seamless transition and jobs
NASDVA strongly supports improving upon and providing ``Seamless
Transition'' to help our service members' transition into civilian
life.
We support the expansion of the Transition Assistance Program
'TAP). Efforts need to be made to maximize the integration of services
provided by the DoD, VA and State and Local Governments. It must be
recognized that no single agency can adequately meet the transition
needs of our returning service members.
NASDVA strongly supports Veterans' preference with regard to
employment.
We support full implementation of existing programs and laws with
regard to veterans' preference to ensure our returning veterans have
every opportunity available in their transition into civilian life. We
also support incentives to businesses that hire veterans.
conclusion
Mr. Chairman and distinguished Members of the Committee, we respect
the important work that you have done to improve support to veterans
who have answered the call to serve our nation. NASDVA remains
dedicated to doing our part, but we urge you to be mindful of the
increasing financial challenge that states face, just as you address
the fiscal challenge at the Federal level. We are dedicated to our
partnership with the VA in the delivery of services and care to our
Nations Veterans.
This concludes my statement and I am ready to answer any questions
you may have.
Chairman Craig. George, thank you very much for that
statement, and to all of our panelists, your full written
statements will be a part of the record.
Before I turn to you, Gerald, let me recognize one of our
colleagues that has joined us for any opening comments he would
like to make, Senator Ken Salazar of the State of Colorado.
Ken.
STATEMENT OF HON. KEN SALAZAR, U.S. SENATOR FROM COLORADO
Senator Salazar. Thank you very much, Chairman Craig and
Senator Akaka, for holding today's hearing. I want to thank the
members of the National Association of State Directors of
Veterans Affairs, the AMVETS, the American Ex-Prisoners of War,
and the Vietnam Veterans of America for coming here today. Your
presence here today and your testimony will ensure that we here
at the United States Senate do the very best that we can to
fulfill our Nation's promise to the veterans of America.
I have a longer statement, Mr. Chairman, and I will submit
that for the record, but again, I just want to welcome all of
you and say thank you for being here to provide your testimony
today.
[The prepared statement of Senator Salazar follows:]
Prepared Statement of Hon. Ken Salazar, U.S. Senator from Colorado
Thank you, Chairman Craig and Senator Akaka for holding today's
hearing. As a relatively new Member of this Committee, I have found
these hearings incredibly helpful as I further my understanding of the
issues that are uniquely important to our veterans.
With that in mind, I want to thank the members of the National
Association of State Directors of Veterans Affairs, the AMVETS, the
American Ex-Prisoners of War, and the Vietnam Veterans of America for
coming here today to talk about the legislative issues that are so
important to them--and to us as Members of this Committee. We certainly
value what you have to say; we are here to represent you by doing
everything we can to ensure that you receive the best support our
nation can provide.
We've now had several hearings on this year's budget proposal for
the Department of Veterans' Affairs, and we've had an opportunity to
evaluate the budget from the varied perspectives of a diverse range of
our nation's prominent veterans' groups. Yet at each of these hearings,
we seem to be hearing the same thing--that while the 2007 budget
proposal for Veterans' Affairs is better than last year, it remains
deficient in a number of critical respects.
For example, this Administration wants to generate revenue and
decrease costs by establishing enrollment fees and doubling
prescription drug co-payments for Priority 7 and 8 veterans. As I've
said before, this is an unacceptable solution. While I certainly
understand the need to focus our services on those veterans who need
the most help, we cannot turn our backs on the promises we have made to
provide all our veterans with the high-quality healthcare they deserve.
For that reason, I oppose these enrollment fees and co-pay increases.
Another troubling aspect of this budget proposal is the revelation
that, beyond fiscal year 2008, it projects drastic cuts in VA funding.
Whether or not this is an accurate reflection of the intentions of this
Administration, the fact remains: deep budget cuts for veterans'
services and cynical budget shell games are equally unacceptable. We
need to provide for our veterans each and every year. We also need to
be honest about the challenges we face when it comes to future deficits
and their potential impact on the quality of healthcare services we can
provide.
In my view, the way to solve this problem is to provide mandatory
funding for VA healthcare. I have co-sponsored legislation that would
make this goal a reality, and I will continue to push for mandatory
funding for VA because I believe it is the best way to provide for the
ever-growing needs of our veterans.
In addition, there are a number of benefits issues that must be
addressed immediately. We need to end the disability tax on veterans
and allow full concurrent receipt immediately. And we must support our
military survivors by allowing them to receive compensation in the
event that their spouse passes away due to service-related causes--
compensation that does not interfere with the survivors' insurance
their spouse paid into while he or she was alive.
Finally, I'd like to express a general concern about our national
veterans' policies. Specifically, I am concerned that these policies
fail to meet the needs of a particularly vulnerable veterans'
population--veterans living in rural communities. In my home state of
Colorado, some veterans have to travel hundreds of miles to receive
treatment from VA facilities. We need to be aware of the challenges our
rural veterans face, and we need to make sure the Federal agencies
responsible for assisting them are adequately equipped to meet their
needs. That's why I recently introduced legislation with Senator Thune
and several other Members of this Committee to ensure the VA is
sufficiently targeting its efforts toward rural veterans.
As we continue to face these and other challenges, I want to again
thank Chairman Craig and Senator Akaka for all they do as leaders of
this Committee. I also want to thank you, our veterans, for your
continued diligence in working to help us serve you better.
Thank you.
Chairman Craig. Ken, thank you very much.
Now let us turn to Gerald Harvey, National Commander,
American Ex-Prisoners of War.
Gerald, welcome before the Committee.
STATEMENT OF GERALD S. HARVEY, NATIONAL COMMANDER, AMERICAN EX-
PRISONERS OF WAR
Mr. Harvey. Chairman Craig, Ranking Member Akaka,
distinguished Members of the Senate Veterans' Affairs
Committee, and guests. I welcome the opportunity to speak on
behalf of American Ex-Prisoners of War. We are deeply grateful
for all that Congress and the VA have done for prisoners of war
over the last 30 years.
As you know, prior to that, POWs were an invisible part of
this Nation's veterans. It has been incorrectly stated that we
preferred it this way out of shame over being captured. This is
not true. We are proud to have lost our liberty while defending
the rights of all Americans to be free. We were so happy to be
free, we simply wanted to enjoy that freedom at home with our
families. As a result, we made few requests upon our government
at that time.
Public awareness about the plight of aging POWs in general
was reawakened by the plight of Americans held for months and
years by North Vietnam. Max Cleland--then VA Administrator and
later Senator from Georgia, took the lead in correcting our
country's failure to remember POWs from earlier wars, including
World War II. For the first time, the identities of those
captured, re-patriated, and currently alive were obtained from
original military records. VA then immediately took steps to
identify all POWs receiving health care or disability benefits.
Congress too responded promptly and directed VA to conduct a
review of all policies and procedures related to POWs. In a
very real sense, POWs were changed to a high-priority group
within VA and Congress.
Over the past 30 years, many presumptives were established
to simplify the process by which POWs could obtain needed
disability benefits and medical care. The ongoing research
conducted on POWs by the National Academy of Science provided
the basis for these congressional and VA actions.
At present, most of the long-term health problems
associated with brutal and inhumane conditions of captivity
have been identified and are presumptive. We urge Congress to
act on the several remaining medical conditions identified in
current legislation. The first of these, chronic liver disease,
is simply a clarification of a current presumptive, cirrhosis
of the liver. The National Academy of Science has stated in
writing that this more accurately reflects their finding.
Cirrhosis is simply the final stages of chronic liver disease.
The second is diabetes. It has already been established for
Vietnam Veterans exposed to certain chemicals and other
factors, POWs were also exposed to adverse factors while in
captivity that are related to diabetes.
Third, osteoporosis, this is directly related to the
absence of the calcium needed to maintain bone structure, a
common situation for POWs. This condition becomes apparent
after a bone break. Adjudicators typically already decide these
claims for POWs. Making it a presumptive simplifies the process
for adjudicators and POWs alike.
H.R. 1598, introduced by Representative Michael Bilirakis,
and S. 1271, introduced by Senator Patty Murray cover these
presumptives. We call to your attention that there is virtually
no increased cost to any of these proposed presumptives. Costs
are more than offset by rapidly diminishing numbers of POWs
already on the disability rolls or favorably acted on by VA
adjudicators by a longer process of evaluation.
Earlier this month, Senator Harry Reid introduced A. 2385,
known as the Combat-Related Special Compensation Act.
Representative Michael Bilirakis, a long-time advocate of
concurrent receipt legislation, previously introduced the
companion bill, H.R. 1366, in the House. It is currently before
the Armed Services Committee. This legislation will amend some
parts of the Combat-Related Special Compensation Act, Chapter
61 of the Defense Authorization Act, to an earlier effective
date of January 1, 2006. With a concurrent effective date of
2014 and their advanced age, it is a statistical possibility
World War II military retirees will not live to receive this
deserved compensation.
Representative Bob Filner introduced H.R. 2363 to provide
for the Purple Heart to be awarded to prisoners of war who die
in captivity. We ask the Committee to give their full support
to these bills.
In closing, I want to again express our deep appreciation
for identifying POWs as a high priority and worthy segment of
the veteran population. We are also grateful for VA's ongoing
efforts to identify every POW and for them to be processed for
VA benefits by adjudicators specially trained to handle POW
claims.
Thank you.
[The prepared statement of Mr. Harvey follows:]
Prepared Statement of Gerald S. Harvey, National Commander,
American Ex-Prisoners of War
Chairman Craig, Ranking Member Akaka, Distinguished Members of the
Senate Veterans Affairs Committee and Guests: I welcome the opportunity
to again speak on behalf of American Ex-Prisoners of War (POWs). We are
deeply grateful for all that Congress and VA have done for POWs over
the last 30 years. As you know, prior to that, POWs were an invisible
part of this nation's veterans. It has been incorrectly stated we
preferred it ``this way'' out of shame over being captured. This is not
true, we are proud to have lost our liberty while defending the right
of all Americans to be free. We were so happy to be free we simply
wanted to again enjoy that freedom with our homes and families. As a
result, we made few requests upon our government at that time.
Public awareness about the plight of aging POWs in general was re-
awakened by the plight of the Americans held for months and years by
North Vietnam. Max Cleland, then VA Administrator and, later, Senator
from Georgia--took the lead in correcting our country's failure to
remember POWs from earlier wars, including WWII. For the first time,
Total Captured, Repatriated, and Currently Alive were obtained from
original military records.
VA then immediately took steps to identify all POWs receiving
health care or disability benefits. Congress, too, responded promptly
and directed VA to conduct a review of all policies and procedures
relevant to POWs and established a POW Advisory Committee to review and
advise VA and Congress on matters related to POWs. In a very real
sense, POWs were changed to a high priority group within VA and
Congress.
Over the past 30 years many presumptives were established to
simplify the process by which POWs could obtain needed disability
benefits and medical care. The ongoing research conducted on POWs by
the National Academy of Sciences provided the basis for these
Congressional and VA actions. At present most of the long term health
problems causally associated with the brutal and inhumane conditions of
captivity have been identified and made presumptive.
We urge Congress to act on the several remaining medical conditions
identified in current legislation. The first of these, ``chronic liver
disease'' is simply a clarification of a current presumptive--
``cirrhosis of the liver''. The National Academy of Sciences has stated
in writing, this more accurately reflects their findings--cirrhosis is
simply the final stage of chronic liver disease.
The second is diabetes. It has already been established for Vietnam
veterans exposed to certain chemicals and other factors. POWs were
similarly exposed to adverse factors while in captivity that are
causally related to diabetes.
Third, osteoporosis. This is directly related to the absence of the
calcium needed to maintain bone structure, a common situation for POWs.
This condition becomes apparent after a bone break. Adjudicators
typically already decide these claims for POWs. Making it a presumptive
simplifies the process for adjudicators and POWs alike.
H.R. 1598 introduced by Rep. Michael Bilirakis and S. 1271
introduced by Senator Patty Murray cover these presumptives. We call to
your attention that there is virtually no increased cost to any of
these proposed presumptives. Costs are more than off-set by rapidly
diminishing numbers of POWs already on the disability rolls or
favorably acted on by VA adjudicators via a longer process of
evaluation.
Senator Harry Reid introduced S. 2385 earlier this month known as
the Combat Related Special Compensation Act. Rep. Michael Bilirakis, a
long time advocate of concurrent receipt legislation, previously
introduced the companion bill H.R. 1366 in the House. It is currently
before the Armed Services Committee. This legislation will amend some
parts of The Combat Related Special Compensation Act chapter 61 of the
Defense Authorization Act to an earlier effective date of January 1,
2006. With the current effective date of 2014 and their current
advanced age it is a statistical probability WWII military retirees
will not live to receive this deserved compensation. Rep. Bob Filner
introduced H.R. 2369 to provide for the Purple Heart to be awarded to
prisoners of war who die in captivity. We ask the Committee to give
their full support to these bills.
In closing, I want to again express our deep appreciation for
identifying POWs as a high priority and worthy segment of the veterans
population. We are also gratified for VA's ongoing efforts to identify
every POW and be processed for applicable VA benefits by adjudicators
specially trained to handle POW claims.
Note: '1) AXPOW receives no grants or funds from the Federal
Government; '2) My curriculum vitae is that of service as a member and
officer of AXPOW.
Chairman Craig. Gerald, thank you. Thank you very much,
Gerald.
Now let us turn to John Rowan, National President of
Vietnam Veterans of America. John, welcome again before the
Committee. Good to see you.
STATEMENT OF JOHN ROWAN, NATIONAL PRESIDENT, VIETNAM VETERANS
OF AMERICA
Mr. Rowan. Thank you, Chairman Craig. Thank you, Member
Akaka.
Chairman Craig. Is your microphone on, John?
Mr. Rowan. Now, it is.
Chairman Craig. There you go. Thank you.
Mr. Rowan. I thought it was automatic. I was watching
everything else.
Anyway, starting again, thank you, Senator Craig, Chairman
of the Committee, and Ranking Member Akaka and Senator Salazar
for allowing us to testify here this morning. I am appreciative
to be able to join my distinguished colleagues, and hearing
their words, we support what they said before and I am sure
what the gentleman from the AMVETS will say as well and, of
course, the veterans that are here joining us this morning and
their families and friends.
Our testimony this year, our legislative agenda this year,
was a little bit different. We really focused on three
overarching issues, basically funding, which you had mentioned
earlier, accountability, and outreach, and while we appreciate
the increases that have been coming down the VA budget over the
last several years, we believe it has only been a start to
recoup from the losses we had suffered in the late nineties
over several years of flat-line budgets.
We also believe, quite honestly, that we predicate all of
our discussions on what we believe is the looming health crisis
and benefit crisis in the VA. Obviously the VA was not ready
for a new war and all of the new men and women coming home from
Iraq and Afghanistan and elsewhere around the world. More
importantly, they weren't ready for the Vietnam Veterans. They
weren't ready for our agent orange-related service-connected
disabilities that are now showing up as we get into our fifties
and early sixties. All of the diseases that are now
presumptive, diabetes, prostate cancer, lung cancer, all of the
many cancers are ravaging the Vietnam Veterans.
Everybody talks, of course, because of the age of the World
War II Veterans and how quickly they are dying off. We are
dying off at a faster rate than any veterans previously ever
recorded in the history of this country because of agent
orange. ``The Veteran'', which is our national newspaper, every
month comes out with hundreds of names of our own members, just
our members, who are dying every month, and if you look at the
ages and you look at the results and why, it is cancer, heart
attack, cancer, cancer, diabetic-related problems, cancer, on
and on.
This is creating a health crisis, I believe, in the VA
because they are not ready for us. The reason why they are not
ready for us is because they never finished the National
Vietnam Veterans Longitudinal Study that should have been
finished 3 years ago that was mandated by Congress, which the
VA has totally disobeyed. They disobeyed your order to do this
study to find out what has been happening with Vietnam Veterans
over time. The Australians did their study and they showed what
happened, and they have been dealing with their veterans, but
we haven't been dealing with ours.
We think that our issues, our health care issues, are
putting a substantial burden on the VA and will continue to do
so over the next several years. What is really concerning to us
is they are not doing outreach to these Vietnam Veterans. Many
veterans don't belong to VSOs, don't belong to the VA and,
therefore, don't understand when they get that prostate cancer,
it has something to do with where they were 35 years earlier.
It is not just the fiscal issue. It is a health care issue.
We need to tell Vietnam Veterans in particular that they need
to go to their doctors, whether they are VA or private, and get
annual exams, detailed exams for all of the myriad of things
that we unfortunately suffer from, and while the budget may be
a problem and we understand the fiscal realities of life--
everybody has to go home and write a checkbook every month--the
problem is this is the continuing cost of national defense, as
Senator Akaka said earlier.
Like it or not, this is just a bill that was left over from
Vietnam from 35 years ago. We may have left there in 1975 in
the last helicopters off the roof of the embassy, but that bill
is still being paid every day by Vietnam Veterans, and we need
to make sure that the VA has the resources to cover that bill
not only on the health care side, but on the benefit side. In a
weird perverse way, the Vietnam Veterans are affecting that
too. The Vietnam Veterans are retiring from the VA in droves.
They are reaching retirement age. They came to work for the VA
and they are sitting there as adjudicators or senior
adjudicators or appeals officers, and all of those people in
the VA are going to march out the door over the next several
years because they reached retirement age and they are not
being backfilled with newer veterans. We hope they do. We need
to do a lot more of that, and they are not prepared for that
either.
So all of those cases, while we understand fiscal
realities, as we said, this is a cost. We didn't ask for it. It
is a cost that has to be bourne by this country because they
sent us off to war and just as they are sending the new
veterans off to war, and while I focused mainly on the Vietnam
Veterans issues, I would not relieve our colleagues who are
following us in any way either. We still don't know what is
going on with the Persian Gulf War Veterans. They still have
all these unknown ailments. We are starting to find out more
science about what happened to them. We don't know what the
health effects are of the Marines who stood next to those
burning oil wells for month after month. We don't know what is
happening to the new veterans.
We see from our service representatives, which I have been
one for the last several years, people coming into our system
that we see who have been injured. The most visible ones are
sitting in Walter Reed in Bethesda, but there are thousands
more that get hurt from not just IADs, but from accidents,
vehicle mishaps, helicopter crashes, all kinds of things, and
many of them are being taken off the field for disease, but we
have no idea what that is about. So we are looking to see all
of those things, and unfortunately it is going to cost money,
and money is the issue. I am sorry. They are just going to have
to bear the burden.
Thank you for your listening to us and listening to my
colleagues. Thank you.
[The prepared statement of Mr. Rowan follows:]
Prepared Statement of John Rowan, National President, Vietnam Veterans
of America
Good morning Chairman Craig, Senator Akaka, and other distinguished
Members of this Committee. It is my privilege this morning to present
to you the thoughts and views of Vietnam Veterans of America 'VVA) on
the funding priorities and issues of significance for veterans and our
families.
It has been said many times, only half-jokingly, that Americans
have the shortest attention span of all mammals. What makes headlines
today most of us forget about 6 months from now. Remember Chandra Levy?
Veterans, though, have long memories. We remember why we served,
what we saw, what we did when we donned the uniform to serve our
country. We remember our comrades, those who died and most of the rest
who were forever changed by having donned the uniform.
We also remember last July, when Congress and the Administration
were embarrassed by the revelation that the Department of Veterans
Affairs was $800 million in the hole in meeting its health care
obligations. After a flurry of meetings and a spate of publicity,
Congress moved quickly, if belatedly, to do the right thing for
veterans, even as this shortfall grew by several hundred million
dollars as the VA suddenly ``discovered'' it was treating 103,000 OEF
and OIF veterans rather than 26,000. Some 144,000 of our newest
veterans are now being treated at VA facilities.
To your credit, and for this we thank you, you closed this budget
gap by adding $1.5 billion to the VA's FY 2005 operating budget. And
you added another $1.2 billion in ``emergency funds'' for the current
fiscal year which, we fear will still not be enough for the VA to
maintain its current level of care, even with a reported $1.1 billion
carryover in the VA's budget. You cited, correctly, some of the
problems inherent in how the VA predicts the usage and attendant costs
of its health care operations. While we are hardly omniscient, VVA's
budget projections and those of the Independent Budget were right on
the money, again.
fy 2007 budget
This year, we believe the Administration's budget request, despite
the hype, is short by at least $4.2 billion, $1.9 billion of which
would open enrollment to Priority 8 veterans who were ``temporarily''
restricted from enrolling in the VA's health care system in January
2003. If the ban on statutorily eligible Priority 8s continues, VVA
believes the budget for health care is still short by some $2.3
billion.
The real effect of this shortfall is felt in the VISNs, in the VA
medical centers, where the real work--patient care--is done. Next time
you are back home, next time you visit one of the VA medical centers in
your state, ask around how they're doing with the current budget
constraints. We think you'll be surprised by what you learn.
VVA believes that the budget for veterans' health care should not
be capped by the need to control the deficit--a need that is
exacerbated by tax cuts that benefit the wealthiest among us--but by
the needs of the eligible veterans who choose to utilize the VA for
their health care.
We've said this before and we'll say this again: Had the VA's
health care budget not been flat-lined for 4 years just as eligibility
reform was opening the system to hundreds of thousands of deserving
veterans, we would be discussing a budget $8- to $10-billion greater
than it has been, than what is proposed for FY 2007.
This year, yet again, we dispute the numbers in the
Administration's budget request. It is not enough money, even to
properly take care of those already in the system. Along with the other
veterans' service organizations, VVA will expend countless hours and
considerable energy arguing about and fighting for funding that is
sufficient to meet the needs of the veterans the VA serves.
This is one battle we should not have to wage. Instead, we should
be working together to fashion a formula for funding the VA's health
care operations. We challenge Congress here and now: Form a bipartisan
group to meet, study the issues and options, hold hearings, and
recommend legislation that would fundamentally change the way in which
veterans health care is funded to ensure adequate funding for veterans'
health care.
VVA believes, in concert with other eight VSOs that comprise The
Partnership for Veterans Health Care Budget Reform, that a fair funding
formula can be arrived at, one that won't bust the budget, one that
recognizes our nation's obligations to veterans and is indexed to
medical inflation and the per capita use of the VA health care system.
adjudication backlog
What sometimes gets lost in the debate over sufficient funding for
veterans' health care is the continuing backlog in the adjudication of
claims at the Veterans Benefits Administration. More than 525,000 cases
have been in various stages of adjudication for far too long now. The
VA projects this situation will get worse, yet only requests funding
for 130 new employees for all of the VBA for fiscal year 2007. Congress
needs to ensure that the new platoon of adjudicators is properly
trained, supervised, and, along with their supervisors and managers,
held accountable for their work.
We believe that Congress must demand an explanation from the VA as
to why it takes upwards of 2\1/2\ years to adjudicate cases. Congress
must demand that the VA not only develop but put into practice a real
strategy for unclogging the system. 'The VA might try to triage cases,
akin to what military medical personnel do as casualties are brought in
from the field of battle.) There's no reason why a veteran who has all
of his paperwork in order in making a claim for, say, tinnitus must
wait a year or more. There should be no reason why his claim can't be
adjudicated in 60 to 90 days.
greater accountability
We do not make the argument, however, that budget reform is an end
in and of itself. It is, rather, a means to an end. It must be
accomplished hand-in-hand with real changes in how VA senior managers
and middle managers perform. Give ``attaboys'' and bonuses to those who
have earned them; give warnings and sanctions to those who have not
done their jobs well. Please do not get us wrong: The overwhelming
number of those who work at the VA are dedicated to helping veterans,
and we applaud the efforts they make every day. But better management--
and training--is needed if efficiencies are to be increased.
expanded outreach
According to the U.S. Bureau of the Census, there are more than 25
million veterans in the United States today. Only around one-fifth of
them have any real interaction with the Department of Veterans Affairs.
However, many of them, particularly in-country Vietnam veterans, are
eligible for compensation for several maladies incurred during their
military service--and far too many remain unaware of the benefits to
which their service entitles them.
These are not just veterans who have been having difficulties
coping with life. As an example, in speaking with one Navy veteran, we
learned that he had served in-country in Vietnam. When he mentioned
that he had suffered with prostate cancer, we asked if he knew that
this was service-connected compensable, presumptive to exposure to
Agent Orange. This was news to him. And he is a lawyer with the IRS
here in Washington, D.C.
VVA believes that the VA has an obligation to reach out to all
veterans to ensure to the maximum extent possible that they know what
benefits they have earned, and they know how to access these benefits.
This is starting to happen as VA personnel are assigned to the bases
where active-duty personnel transition to civilian life and veteran
status. This, however, is hardly enough.
We commend to you legislation--S. 1342--introduced by Mr. Feingold
that would require the Secretary of Veterans Affairs to establish a
separate account for the funding of the outreach activities of his
department--and a sub-account for the funding of the outreach
activities of each element within the department. This legislation
would assist states in carrying out programs that offer a high
probability of improving outreach and assistance to veterans--and to
their spouses, children, and parents who may be eligible to receive
veterans' benefits. We urge Members of this Committee to seriously
consider holding hearings on this bill.
This morning, rather than offer a laundry list of issues and
priorities, VVA is focusing on specific issues that demand our best
efforts to achieve and warrant your attention and support.
fee-basis health care
Approximately 60 percent of OEF/OIF service members, particularly
in the National Guard and the Reserves, come from rural areas. Despite
the VA's network of clinics, too many of these returnees and other
veterans do not live near a VA clinic or medical center. They are at a
distinct disadvantage in accessing VA health care. When the VA cannot
provide the highest quality care, within a reasonable distance or
travel time from a veteran's home, the VA has a duty to provide care
via a fee-basis provider of choice for service-disabled veterans. VA
personnel who deal with these veterans must be aware of their duty in
this regard.
This most assuredly does not mean that the VA should begin to
dismantle its network of healthcare facilities and outsource, or
privatize, VA services, as some might encourage. It does mean that
Congress must ensure that every effort is made so that veterans--
particularly our newest veterans--receive timely care from providers.
military history
The Veterans Health Administration 'VHA) must become a true
``veterans health care system'' instead of a general health care system
that happens to be for veterans. Without taking a complete military
history of its patients, this is just not possible. We cannot state
emphatically enough the need for VA clinicians to take a complete
military history as a matter of course for all veterans currently in or
entering the VA health care system. This must be part of the automated
patient treatment record, so that it can be keyed to training, be the
basis of clinical reminders based on the veterans' military record, and
focus the general mindset of all clinicians at VA toward being a true
``veterans health care system.''
What is true for VA clinicians is true as well for private
clinicians. A medical professional who knows a patient is a veteran,
and knows a patient's military history, should have a better idea about
what that patient may have been exposed to, what emotional trauma were
faced that will have ongoing physical and/or mental repercussions.
military sexual trauma
It has become clear in the last decade that sexual harassment and
sexual abuse are far more rampant than what had been acknowledged by
the military. Reported instances of sexual harassment and abuse
represent only the tip of the proverbial iceberg. While we are
gladdened that both the Departments of Defense and Veterans Affairs
seem now to be taking this seriously, even acknowledging sexual trauma
as a crime in the Defense Authorization Act of 2005, there is still a
long road to travel to change the current atmosphere that conditions
victims of sexual abuse to not report this abuse to authorities. We
urge Congress to call for a review of the penalties for military sexual
trauma under the Uniform Code of Military Justice to determine if the
penalties are commensurate with the offenses, and to act to ensure
uniform enforcement in all branches of the military.
VVA also shall seek, via legislation or regulation, to re-authorize
the biennial report of the Advisory Committee on Women Veterans, to be
submitted to the Secretary of Veterans Affairs for response and then to
Members of Congress; and we shall seek as well legislation to provide
contract care, for up to 14 days post-delivery, for infants born to
women veterans who receive delivery benefits through the VA.
va research
Perhaps the coalition of Friends of VA Medical Care and Health
Research endorsing a $48 million increase in appropriations for medical
and prosthetics research--and $45 million for facilities improvements--
did not reach the right ears yet. It should be clear to all, however,
that the $13 million ``hit'' the VA research budget will take if the
Administration's proposal is approved is unconscionable, particularly
in a time of war. Research may not reap immediate benefits, but
research is critical in finding answers to the unique medical problems
of veterans, and treatments that ease pain and save lives. The VA
research program results in discoveries that advance the fields of
mental and physical rehabilitation, increase research on blast injuries
and burns, study means to improve the quality of health care delivery,
and continue investigation on addressing chronic diseases and their
complications.
VVA urges a significant increase, not any decrease, in funding VA
research. VVA also calls for a separate line item of $25 million in
Research & Development funds to fund the National Vietnam Veterans
Longitudinal Study 'NVVLS), with report language compelling the rapid
resumption and early completion of this vital study. (ee further
explication below.)
agent orange
Far too many in-country Vietnam veterans are afflicted with
serious, life-threatening diseases at a relatively young age, diseases
that we believe are borne of exposure to Agent Orange and other
herbicides, defoliants, and desiccants during their tour of duty in the
jungles and rice paddies of Southeast Asia. Congress must provide the
funds for study by reputable scientists into the long-term health
effects of dioxin, the culprit element in Agent Orange. Some of this
research must focus on the intergenerational effects of exposure on the
children--and on future generations--of Vietnam veterans.
Even though VVA agrees that funds should no longer be expended on
the flawed Air Force Ranch Hand Study, we fully intend to work to
ensure that the data gleaned from this study, as well as the tissue
samples, are properly stored and accessible for legitimate scientific
study.
lung cancer and veterans
As the VA acknowledged in 1994, there is mounting evidence of a
``positive association'' between exposure to herbicides--like Agent
Orange--and the subsequent development of respiratory cancers.
Additionally, a series of studies over the past 20 years has linked
military service to higher smoking rates and smoking-related diseases
and deaths. Because lung cancer is usually not diagnosed until late
stage, making treatment costly and not very effective--the mortality
rate for lung cancer is 85 percent--VVA urges Congress to mandate that
the VA institute an early detection and screening program for all
veterans--and especially Vietnam veterans--at high risk for this lethal
cancer.
project 112/shad
VVA has been and will continue to work diligently to ensure the
passage of The Veterans' Right to Know Commission Act 'H.R. 4259). This
legislation, introduced by Reps. Mike Thompson 'D-California) and Denny
Rehberg 'R-Montana), would empower an independent commission to delve
into the history and non-disclosure of information to American service
members who participated in the testing of chemical and biological
substances as part of the Project 112/SHAD program.
This bill is about achieving justice for those Americans whose
health may have been compromised by toxic elements to which they were
exposed. Most were exposed unwittingly. The VA acknowledges that at
least 70,000 service members may have been exposed in tests that go
back to the end of World War II. Those still living, and the survivors
of those no longer with us, should be provided with the information
they need to resolve questions about their health, and to make claims
for service-connected disabilities derived from their participation in
these tests.
Additionally, the legislation entitling a veteran who was in one of
the Project 112/SHAD tests to medical services at the VA must be
reauthorized and extended; and we extend our thanks to Senator
Brownback for his leadership in this realm. VVA strongly recommends
that the VA be required to issue a national protocol for these
physicals based on the agents, simulants, tracers, and decontaminants
to which 112/SHAD veterans were potentially exposed.
ptsd and substance abuse
VVA believes that the National Vietnam Veterans Longitudinal Study
'NVVLS), a follow-up to a study done some 20 years ago, must be
funded--and the VA compelled to immediately re-initiate this
statutorily mandated study and bring it to an early and proper
conclusion. The NVVLS represents the last best chance we have of
understanding the scope of the health of Vietnam veterans. Line-item
funding for this study and strong explicit report language are needed
to compel the VA to fulfill its responsibility to comply with the
mandate set by Congress in Public Law 106-419, The Veterans' Benefits
and Health Care Improvement Act of 2000.
Just as important, Congress must take the necessary steps to ensure
that the organizational capacity and funding of the VA's mental health
programs for the diagnosis and treatment of the neuro-psychiatric
wounds of war are restored to at least the level of effort that existed
in FY 1996. So many veterans of the fighting in Afghanistan and Iraq
are returning home haunted by their experiences. We do a disservice to
them if we do not provide the necessary mental health services that
they require.
As all of us are aware, PTSD has been a hot topic of late. The
108th Congress authorized and funded the Veterans' Disability Benefits
Commission to research and make recommendations as to how service-
connected disability compensation is adjudicated, if the manner in
which the VA adjudicates claims is in accord with the intent and will
of Congress. The very existence of this commission, combined with the
VA's ill-advised--and now revoked--decision to conduct a retrospective
review of some 72,000 cases in which veterans were granted 100 percent
disability compensation for PTSD, has left many veterans fearing that
their benefits will somehow be reduced or taken away.
The VA is obliged to use as a guidepost for the diagnosis of PTSD
the mental health standards set forth in the current edition of the
Diagnostic and Statistical Manual of the American Psychiatric
Association. VVA believes strongly that if VA adjudicators are properly
trained and supervised, if they follow the VA's own ``Best Practices''
manual, the hubbub surrounding the variation in awards for PTSD would
be silenced. The VA specifically and firmly refuses to utilize its own
``Best Practices'' for PTSD adjudication. Now, 4 years after the
completion of the manual, and having refused to use it to train
clinical or adjudication staff, or to issue a directive on its use--or
to even distribute a copy of the manual--the VA is awaiting the results
of a study by the Institute of Medicine to let VA officials know if how
they adjudicate PTSD claims is the ``gold standard'' or if they need to
do things differently. We have been monitoring this closely, and we
will continue to monitor it to ensure that veterans whose lives have
never been quite the same since they came home from a war--from a
jungle or desert or rice paddy or metropolis--are protected from any
undue or hasty changes in the rules.
employment, training, and business opportunities
VVA will continue to work to ensure that all provisions of
executive orders, public laws, and legislation pertaining to the
employment, training, and business opportunities for all veterans, and
especially for service-disabled veterans, be enforced. State, local,
and Federal agencies that work diligently to meet the spirit and intent
of these provisions should be rewarded; any attempts to weaken the
provisions should receive appropriate sanctions.
For the Secretary of Labor to continue to implement the Jobs for
Veterans Act as it has been is astonishing. A recent Government
Accountability Office report is far too kind to the Department of
Labor, which has made no progress in the past 3 years to put in place a
system to gather information to learn if the Jobs for Veterans Act is
actually working and meeting the intent of Congress. In fact, the DOL
has done nothing of consequence to implement ``priority of service''
for veterans, particularly disabled veterans and returning service
members.
In fact, there is no real national strategy to assist returning
veterans, including National Guard and Reservists, who are unemployed
or under-employed--and some 15 percent of our newest veterans have yet
to find gainful employment. Similarly, there is no effective mechanism
in place for enforcing veterans' preference, and we have an
Administration that appeals a case against a disabled veteran who had
finally won his case before the Merit System Protection Board pursuant
to The Veterans Employment Opportunities Act of 1998.
It is imperative that re-education and work skills upgrades,
including self-employment, be made a priority by those agencies of
government that provide these services, especially considering the
battalions of seriously and permanently disabled veterans returning
from Afghanistan and Iraq.
Additionally, VVA implores Congress to begin an investigation into
the disparities of the Compensated Work Therapy programs in the
Veterans Health Administration, which we believe is just not doing the
job they were created to do, of creating a bridge to permanent
employment.
homeless veterans
It is a national scandal that so many men--and, increasingly,
women--who have served our nation now do not have a roof over their
head, a place to call home. Although there are many reasons that have
caused them to become homeless, they deserve our best efforts to help
them salvage their lives.
Public Law 107-95, The Homeless Veterans Assistance Act of 2000,
must be sufficiently funded and its provisions fully implemented--
including the maximum appropriations stipulated in a variety of
homeless assistance programs. Furthermore, we believe that
congressional action is necessary to readdress what has emerged as a
difficulty: VA Homeless Grant and Per Diem funding must be considered a
payment rather than a reimbursement for expenses, an important change
that will enable the community-based organizations that deliver the
majority of these services to operate effectively and to require that
the Department of Housing and Urban Development comply with section 12
of P.L. 107-95 authorizing 500, additional HUD/VASH vouchers in fiscal
year 2003, fiscal year 2004, fiscal year 2005 and fiscal year 2006. HUD
acknowledges in a letter of December 5, that these funds have not been
appropriated and that housing needs of homeless American is one of the
top priorities, of the department, if this is so, then why are they
leaving about 2,000 homeless veterans' without the most vial resources
they need a safe and secure place to live by not asking Congress to
appropriate these vouchers.
compensation and pension
To promote uniform claims decisions, current policy must be changed
to permit VA staff and VSO service representatives to collaborate in
developing uniform training materials, programs, and competency-based
re-certification exams.
VVA also seeks to secure a pension for Gold Star parents, many of
whom are in dire financial straits and have lost the son or daughter
who might have been able to assist them in their old age.
For currently deployed or soon-to-be deployed troops, VVA believes
that greater financial protections are warranted for their security and
the security of their loved ones. For the survivors of those who die in
military service, we seek a permanent prohibition of offsets of
Survivor's Benefit Plan and Dependency & Indemnity Compensation.
Finally, a change in the law is necessary to permit service members
wounded in combat and placed on temporary disability status to be
considered as remaining on active duty for the purpose of computing
leave and retirement benefits.
a new generation of veterans
The force readiness plan being developed by the Pentagon at the
behest of Congress must include a full medical examination, to include
a blood draw and a psychosocial history by a qualified clinician, for
all troops prior to their deployment overseas and upon their
redeployment.
Because our newest veterans appear to be suffering the
psychological stresses and disorders in far greater numbers than even
we of the Vietnam generation, it is imperative that a system of acute
stress counseling and PTSD counseling be emplaced, a system funded by
DoD and delivered by VA personnel and private practitioners. This
counseling must be made available to Reservists and members of the
National Guard and their families in addition to active-duty troops.
pow/mia
The fullest possible accounting of the fate of American service
members who had been Prisoners of War or who had been declared Missing
in Action has long been a keynote of Vietnam Veterans of America. To
further VVA's long-standing efforts in this regard, we urge Congress to
appropriate additional funds to put more teams on the ground to conduct
searches for remains in Vietnam, Laos, and Cambodia.
VVA also urges that all documents relevant to the status of POW/
MIAs be declassified and released to the public; and we ask Congress to
pass a resolution urging the government of Vietnam to provide all
relevant wartime records and to continue to repatriate the remains of
American service members that have been recovered.
Finally, we seek funding for a public awareness program to inform
all the families of those still listed as POW/MIA of the need to
provide DNA family reference samples for potential identification of
recovered remains.
To lose a son or daughter, father or sister or mother or brother is
difficult enough for families to deal with. To not know the fate of
their loved ones places these families in emotional limbo. We must do
all that we can to bring closure to them. And to all of us.
Attach please find as an addendum the VVA 2006 Legislative Agenda &
Policy Initiatives brochure.\1\
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\1\ The VVA 2006 Legislative Agenda & Policy Initiatives brochure
can be found in the Appendix section on page 43.
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Thank You.
To conclude, the members and their families of Vietnam Veterans of
America, and the Associates of Vietnam Veterans of America, thank all
of you in Congress who have served our nation, and those of you who
continue to serve veterans and their families as Members of this
Committee. I will be more happy to answer any question you may have.
Chairman Craig. John, thank you very much for that
testimony for the record.
Now let me turn to Ed Kemp, National Commander, AMVETS.
Welcome before the Committee.
STATEMENT OF EDWARD W. KEMP, NATIONAL COMMANDER, AMVETS
Mr. Kemp. Thank you, sir.
Mr. Chairman, Members of the Committee, this distinguished
Committee has a fine tradition of working in a bipartisan
manner and is a real example of how members of opposing parties
and opposing views can work together to reach a common goal. I
thank you for your support of veterans.
We are here today to speak about issues that are near and
dear to us, but most importantly, we are here to let the Senate
know that we mean business when we say veterans deserve the
benefits they were promised when they put on the uniform.
AMVETS is concerned about future veterans' benefits, so we are
doing something about this.
This October, AMVETS is holding a national symposium for
needs of young veterans in Chicago. The symposium's goal is to
draw attention to the challenges of modernizing VA benefits
specifically for younger veterans.
Just before Veterans Day this November, we will publish an
action plan that will define and prioritize the steps needed to
bring VA into the 21st century. We ask for your support in this
endeavor. The need for this forum could not be more timely,
given that we have a new generation of brave Americans deployed
around the world. VA has seen more and more younger veterans, a
lot of them from OEF and OIF.
I just got back from a trip to Iraq. When I talked to the
troops, not one single soldier had a negative thing to say
about their mission. Our soldiers are there to do a job and are
confident that they will win and restore order, but they need
assurance that VA is there for them. No serviceman in harm's
way should ever question the Nation's commitment to veterans,
but as things now stand, veterans are continuing to suffer
because the system they depend on has been routinely
underfunded.
Members of the Senate, you are provided with a benefit that
you earned representing the people. I would imagine that you
would never vote for any bill that would underfund those
benefits. We ask that you do the same for veterans.
VA budget for fiscal year 2007 still falls short, and like
most years, funding may be late or delayed. We feel the best
way to ensure stable and dependable funding of VA is to make it
mandatory. That way, there is never a question of how much or
when funds will be in place. Our Nation's veterans deserve
nothing less.
Mr. Chairman, you said you would want to begin a serious
dialogue on how to best develop sustainable and long-term VA
budgets. We are here to help you attain that mission. We
appreciate your leadership and look forward to working with you
on this.
Another issue that needs our immediate attention is the
growing backlog of claims. Many claims processors are retiring
and being replaced with less experienced ones. This type of job
requires months of training and years of experience to fully
understand the system. VBA needs to hire and train additional
full-time employees, not cut them, but you can only do so if
the Senate does its part. We need your help in getting the
funds.
AMVETS supports legislation that awards a military service
medal to Cold War veterans. We were disappointed that the
service metal was not passed last year. We encourage you to
pass it this year.
AMVETS will not waiver on its efforts to protect the flag
from being dishonored. We believe our children and
grandchildren should be raised patriots full of respect for the
flag and the constitutional values it represents. Senate
Majority Leader Frisk promised us that the flag amendment would
come before the Senate in June. We urge you to stand up and
support our veterans on this important bill.
AMVETS also wants the fullest possible accounting of our
missing service personnel. We ask for your support in funding
and identifying the remains.
One last point concerns the Joint Session Committee on
Veterans' Affairs. AMVETS feels that the tradition of the Joint
Session should continue. We encourage you to talk to your
counterpart in the House and ask him to re-instate the Joint
Session.
I would like to invite everyone here to attend our
reception tonight at 5:30 in room 369 in the Rayburn House
Office Building.
This concludes my testimony, and I thank you for allowing
me to testify and for your support of veterans.
[The prepared statement of Mr. Kemp follows:]
Prepared Statement of Edward W. Kemp, National Commander, AMVETS
Chairman Craig, Ranking Member Akaka and Members of the Senate
Veterans' Affairs Committee. I am Edward W. Kemp, national commander of
AMVETS, and it is my honor to present to you our legislative agenda for
2006. On behalf of AMVETS, the AMVETS Ladies Auxiliary, the Sons of
AMVETS and our other subsidiary organizations, thank you for giving us
this opportunity.
I am from the great state of Iowa and proudly joined AMVETS in
1982. For more than 60 years, this organization has taken to heart the
doctrine of service set forth by its founders. In so doing, we endeavor
to provide our fellow veterans with the type of support they truly
deserve. This outreach effort takes many forms, from the professional
advice of our service officers, to our legislative efforts on Capitol
Hill, to the work done by our hospital volunteers. Other AMVETS members
involve themselves in a wide range of initiatives aimed at contributing
to the quality of life in their local communities. These two areas--
veterans service and community service--drive our commitment to make a
difference in the lives of others.
Before presenting our agenda for this year, I'd like to speak for a
moment about an ambitious project we are working on, and kindly ask for
your support. AMVETS is hosting a National Symposium For the Needs of
Young Veterans this October in Chicago, Illinois. The Symposium--the
first of its kind--is designed to draw attention to the critical
challenge of modernizing the VA benefits system. We will bring together
a diverse array of veterans and speakers to examine what changes are
needed to make the system more responsive to veterans. The Symposium
will publish an action plan that will define, describe and prioritize
the steps needed to provide a modern benefits program and an effective
delivery system. I am very pleased that General Tommy Franks has agreed
to keynote the Symposium. Given his distinguished career of military
service and recent experiences in Iraq and Afghanistan, General Franks
is ideally suited to talk about the need to ensure our nation keeps its
promise to those who serve.
We are well underway, but I ask for your help in making the
Symposium a successful endeavor. I'd also like to thank our co-chairs,
former VA Secretary Anthony Principi and AMVETS Past National Commander
Bill Boettcher for keeping our agenda on a straight and true course.
Mr. Chairman, the timing of this important forum could not be more
relevant, given that we have a new generation of brave Americans once
again deployed around the world, answering the nation's call to arms.
Our soldiers are doing everything right, everything that we ask of them
and much more. Our country fights, not for land or fortune, but for
freedom. In past conflicts, America has fought to secure liberty,
abolish slavery, and crush communism. Our cause today is equally just.
We are fighting to conquer those evil forces who would rule by fear
and, in the process, are helping to spread freedom and democracy around
the world.
In mid-February, I had the unique opportunity to go to Iraq with my
colleagues in the veterans community. It is an experience I will never
forget. I met and talked with U.S. and British generals, Iraqi officers
and dozens of front-line soldiers. The most amazing part of my trip was
not one soldier had a negative thing to say about being there. Despite
all we hear and read in the news, our soldiers are there to do a job,
and are confident they will win and restore order. I am extremely proud
of them. Without a doubt they are the most dedicated, courageous and
passionate troops in the world, and I want each of them to know that I
appreciate all they do to protect the freedoms I enjoy as an American.
God bless them all.
Almost half of the military servicemen and women returning from
operations overseas will need healthcare services for the physical and
psychological traumas of war that may never heal. Seventeen percent of
them, in fact, have been diagnosed with post-traumatic stress disorder.
I encourage you to go and visit these injured soldiers. Talk with them
and listen to what they have to say. You will leave with a renewed
perspective of your obligations to veterans.
We are spending $6.8 billion a month for operations in Afghanistan
and Iraq, yet trying to nickel and dime veterans' health care here at
home. This year alone, the President is expected to request an
additional $92.2 billion for the war. We certainly support additional
monies to support our troops, but I can't understand why there is never
enough to fully fund VA. If Congress can find nearly a hundred billion
more for these operations, I believe it should be able to come up with
enough money to totally care for those charged with carrying them out.
As things now stand, our veterans are continuing to suffer because
the system they depend on has been routinely underfunded and is now ill
equipped to handle the large influx of those waiting and wanting to use
its services. I ask you to take a look at what the real needs are.
These are real people with real needs. They should not be subject to
political accounting games or petty disputes.
As Members of the United States Senate, you are provided with
certain benefits--paid for at taxpayer expense--that you earn as
representatives of the people. I would imagine that you would never
vote for any proposal or initiative that would underfund or undermine
the integrity of that delivery system. We ask that you do the same for
veterans.
For 20 years, AMVETS--together with the Disabled American Veterans,
the Paralyzed Veterans of America, and the Veterans of Foreign Wars--
have co-authored The Independent Budget, our blueprint for building the
kind of programs veterans deserve. Indeed, we are proud that more than
60 veteran, military and medical service organizations endorse these
recommendations. We believe it is a balanced and responsible analysis
of VA's funding requirements. In years past, however, budget requests
fell woefully short of our recommendations, and we all know about last
year's funding shortfall. If that crisis didn't do anything else, at
least it validated The Independent Budget recommendations. The IB was
right on target, and I ask that you follow our recommendations this
fiscal year. We were right then, and we are right now.
Looking at the administration's VA request for fiscal year 2007, I
must say it is much better than last year's pitiful recommended
increase of $110 million. This year, thanks in large measure to the
leadership and commitment of this Committee, VA fared better. The
request, however, still falls short.
We recommend Congress provide $32.4 billion to fund VA medical
care, approximately $1 billion over the President's request, without
collections. We ask that you recognize that the VA healthcare system
can only provide quality health care if it receives adequate and timely
funding.
As the Senate moves forward in the budget process, we ask that you
not divert precious monies already scheduled for VA medical centers,
construction projects and other purposes. We understand the total
devastation in Louisiana and Mississippi, and we fully support the
rebuilding and reconstruction efforts there. But we do not support re-
routing funds that have already been approved for VA projects. This
policy is taking a step backwards. Fund the emergency with emergency
funds, not VA monies.
As you understand, Mr. Chairman, it is very difficult to manage
programs as complex as those within VA based solely on current fiscal-
year appropriations. It is our hope that we can work with you and the
Committee to create a process that brings increased consistency to VA's
budgetary requirements by recognizing the need for a more efficient
fiscal plan. Frankly, the current system of funding veterans' health
care is broken. It doesn't work. AMVETS will continue to pursue
legislation with eight VSO partners for assured, or mandatory, funding
of VA's healthcare system.
Under the current process, VA health care competes with other non-
veterans priorities for adequate appropriations. Over the years, this
process has proven to be unsatisfactory in adequately providing for the
needs of enrolled veterans. Shifting to a mandatory funding system will
provide a stable and timely system of funding for VA. Mr. Chairman, we
understand your position on this issue, but we ask that you begin a
serious dialogue to explore alternative ways to fund VA. Compromise is
the cornerstone of this democracy, and we are certainly willing to work
with you to find a way to make VA funding more stable.
While assured funding remains our core legislative goal and
objective, there are several other areas we believe the Committee needs
to address this year. Let me briefly discuss them.
AMVETS believes increasing TRICARE premiums and deductibles will
have a negative impact on military retirees. While we understand that
health care costs are on the rise, DoD health care programs are part of
the on-going cost of war. Our Nation's military retirees have given so
much to this country. They deserve fair treatment.
No veteran leaving military service should fall through the
bureaucratic cracks. AMVETS believes DoD and VA have no greater
responsibility than to properly care for returning soldiers and provide
as many tools as possible to assist them in settling back into civilian
life. For some war wounded and their families, navigating between these
systems is pure frustration. In order to provide a seamless transition,
AMVETS recommends that veterans' basic service information, as
contained in the DD-214, be made available electronically--and we ask
that you explore ways to make this possible.
I do not think we realize how fortunate we are as a nation to have
a highly skilled veteran population able to lend its talents to the
workforce. Veterans have the skills that make them assets in a variety
of occupations. Leadership, integrity, and teamwork--all of which the
military teaches--are universal qualities for every industry.
While the Senate has done a good job in reauthorizing training,
education and job programs, I encourage you to take a look at the
Transition Assistance Program 'TAP) and other related programs to
ensure all our returning troops get the assistance they need. DoD
discharges approximately 25,000 service members annually. Recently
separated service personnel are likely to seek immediate employment or
continue their formal vocational education. But they need to know all
that's available to them.
The Department of Defense estimates that 68 percent of separating
service members attend the full TAP seminars, but only 35 percent of
the Reserve Components attend. Countless numbers of National Guard and
Reserve troops return from the war only to encounter difficulties with
their Federal and civilian employers at home. AMVETS encourages you to
explore ways to make TAP participation mandatory for active duty
military as well as for those in the Guard and Reserves.
While speaking about returning troops, we ask that you continue to
adequately fund the Department of Labor's Disabled Veterans' Outreach
Program 'DVOP) and the Local Veterans' Employment Representatives
'LVER) Program. Through the implementation of these programs, DOL-VETS
assists, not only veterans, but also helps reservists and Guard members
in securing employment and protecting their re-employment rights and
benefits.
Furthermore, AMVETS asks you to closely monitor legislative
attempts to consolidate and block grant the DVOP and LVER programs. We
firmly believe that this type of veteran-oriented program should remain
separate and distinct to ensure that these brave men and women are
given the assistance their country owes them for their military
service. It would be a grave error to downgrade employment services
that specifically help troops returning to the country they fought to
defend.
For decades, DVOPs and LVERs have been the foundation of employment
services for veterans. We believe it is important that states continue
to be required to hire veterans for these positions. One example of
just how important it is for veterans to advocate for veterans exists
within our own organization.
The AMVETS Department of Ohio developed and fully operates a
501'c)'3) career center designed to assist veterans in their career
needs. The AMVETS Career Center provides a range of services to help
veterans find employment in a substantial career, or assists them in
refreshing and/or upgrading their skills. The Center, for instance, can
help a veteran learn more about computers, business math, business
grammar, business management, word processing or database management.
It provides these services to veterans who are homeless, unemployed or
underemployed; to those who want to prepare for a new career or better
job; and to recently separated veterans making the transition to the
civilian workforce. The center also provides services to non-veterans
from the community for a small fee of $50.00. There is no cost to the
veteran.
Regarding claims, AMVETS is very concerned about the growing
backlog that leaves many veterans without due compensation. Veterans
Benefits Administration 'VBA) budgets have routinely come up short and
can't stretch to cover the needs. Many claims processors are retiring
and being replaced by those less experienced who require years of
training. This is no ordinary job. It requires months of training and
years of experience to fully understand and navigate the system. If VBA
is going to reduce the claims backlog to zero, VBA needs to hire and
train additional fulltime employees. But it can only do this if the
Senate does its part. We need your help to get the funds.
AMVETS supports legislation that would award a military service
medal to members of the Armed Forces who served honorably during the
Cold War Era. We are disappointed that the Cold War Service Medal did
not survive the House-Senate conference on the fiscal year 2006
National Defense Authorization Act. Presidents going back to Truman
have recognized the significance of the Cold War. By creating the Cold
War Victory Medal, this nation would certainly demonstrate its great
respect and appreciation for the men and women who carried the burden
of this policy.
For veterans, though, one issue transcends all others. It involves
the desecration of the United States flag. AMVETS will not waiver in
its efforts to protect the flag from being dishonored. As a member of
the Citizens Flag Alliance, we continue to strongly support a
constitutional amendment to protect our most sacred symbol. But the
flag is much more than a piece of cloth that drapes the coffins of
those who died so others might live; that covers the bodies of first-
responders who gave their lives in the line of duty; and that flies at
half mast in recognition of honorable Americans. Indeed, the flag
stands for all that is good about our country and the values on which
it was founded.
All 50 state legislatures have passed resolutions asking Congress
to submit the flag amendment for ratification. More than 80 percent of
the American people support such an amendment. If someone desecrated
the Halls of Congress, the Lincoln Memorial, or any other of our
national monuments, lawful action would be taken against the offenders.
We ask nothing less for our flag. We now ask you, our Senators, to
stand up and be counted and bring the flag protection bill to the
Senate floor as soon as possible.
Additionally, as the Committee is aware, there is a growing need
for long-term care in VA. Veterans 85 years and older, who are in most
need of these services, are expected to total 1.3 million over the next
decade. With the sharp increase in the projected number of elderly
veterans, AMVETS believes that VA's extended care services are
indispensable to its overall mission in providing veteran health care.
We urge you to explore the challenge ahead for providing long-term
assistance to veterans. And we seek action that will provide enrolled
veterans with affordable access to a continuum of extended care
services that include nursing home care and domiciliary care, as well
as home and community-based extended care services. This way we can
assure improved healthcare delivery and enhance the measure of care for
elderly veteran patients.
I would be remiss if I did not mention and acknowledge the fine
work VA nurses provide to wounded veterans. VA nurses care for more
than 5 million American veterans nationwide. The Veterans Healthy
Administration 'VHA) has the largest nursing workforce in the country
with nearly 59,000 registered nurses, licensed practical nurses, and
other nursing personnel. But VA staffing levels are so precarious that
even the loss of a single nurse can result in a critical staffing
shortage. Veterans are much more comfortable receiving treatment from
nurses who understand their service; who speak the same language; and
who know what they went through. AMVETS encourages this Committee and
VA to actively address the factors known to affect recruitment and
retention of VA nurses.
We also want the fullest possible accounting of our missing service
personnel and ask for your support in finding and identifying their
remains. This is important. It is a duty we owe the families of those
still missing--and an endeavor that honors the value of an American's
service to the nation.
AMVETS understands many Gulf War and younger veterans are reporting
illnesses stemming from weapons containing depleted uranium 'DU). This
material can remain in the human body for decades, if not life, causing
cancers and other unknown illnesses. AMVETS encourages Congress to pass
H.R. 4183 and H.R. 4184, which would locate, assist, and compensate
veterans affected by exposure to DU, and help them file a claim.
Lastly, just as we care for veterans when they are alive, we must
not forget them when they die. We need to ensure that our national
cemeteries remain dignified and respectful settings for honoring
deceased veterans. We are encouraged that the administration earmarked
$28 million for the National Shrine Commitment, and we are thankful for
the recommended increases above that figure. The National Cemetery
Administration 'NCA) has done a tremendous job of improving the
character and condition of our nation's cemeteries, but we have a long
way to go to get us where we need to be. AMVETS also feels it is time
to review a series of burial benefits that seriously eroded in value
over time. With a few modest adjustments, these benefits will make a
more meaningful contribution to the burial costs for our veterans.
Our commitment to make a difference in the lives of others, though,
doesn't stop there. Since its inception in the 1950s, for example, the
AMVETS National Scholarship Program has awarded more than $2 million in
scholarships to graduating high school students. And for the past 17
years, AMVETS has sponsored a youth leadership program in cooperation
with Freedoms Foundation at Valley Forge, Pennsylvania, that has served
more than 700 youth to date. At VA, AMVETS is proud to serve on the
National Advisory Committee of Veterans Affairs Voluntary Service
Program. Last year, more than 3,000 AMVETS, Ladies Auxiliary and Sons
volunteers tallied over 200,000 hours of voluntary service at 146 VA
Medical Centers. In addition, some 10,000 AMVETS from across the
country invested more than 700,000 hours in helping veterans and
providing an array of community services to enhance the quality of life
for our nation's citizens. I am pleased to report that based on The
Independent Sector statistics, AMVETS provided in excess of $23 million
in voluntary service to the local community.
One last point I'll mention, Mr. Chairman, concerns the Joint
Session of the Committees on Veterans' Affairs. First, we thank you for
extending us the opportunity to appear before you today and we thank
the Members of the House who are present here. We feel, however, that
the long-standing tradition of the Joint Session should continue. We
believe it is a more efficient and valuable way of presenting our
agenda to Congress. A Joint Session provides you the opportunity to
address the many constituents who are present from your respective
States, and it provides AMVETS members with the opportunity to see
their elected officials respond to issues important to them. We
encourage you to talk with your counterpart in the House and ask him to
reconsider his decision. Great decisions and challenges await us in the
months ahead. The membership of AMVETS looks forward to working with
you to establish a clear policy of national recognition for those who
serve. We have much to do, but we are encouraged in knowing that our
work will help the heroes who have borne the battle and lived to tell
about it.
This concludes my testimony. Again, thank you for extending me the
opportunity to appear before you today, and thank you for your support
of veterans. I hope all of you will be able to join us tonight for our
annual congressional reception and Silver Helmet presentation to The
Honorable Bob Filner of California, to be held in room B-369 of the
Rayburn House Office Building from 5:30 to 7:00 p.m.
Thank you.
Chairman Craig. Ed, thank you very much for that testimony.
I am going to ask a series of questions. I may direct it at
any one of you, but if others feel they can add to it or have
something to say specific to that question, please do so. Many
of you have expressed your concerns about VA claim processing,
and I think we all have that concern about its timeliness and
its responsiveness.
George, you mentioned in your testimony that State
Veterans' Affairs Departments can give help in VA claims
processing. Could you please explain what types of help could
be forthcoming and what efforts might be provided at the level
that you are responsible for?
Mr. Basher. Yes, sir. When the claim is processed,
initially most claims are filed, and if you look at the
Inspector General's report that came out last summer, claims
that veterans file that are not represented by any service
organization, State organization, or county organization, the
average annual award totaled something around $3,200 a year.
Any representation for a veteran filing a claim resulted in an
annual award of $10,500 a year. So there is a terrific spread
in the level of benefits received whether or not you are
represented.
The front end of the claim process, essentially the
outreach, the development of the claim, the gathering of the
story, and the evidentiary documents is all part and parcel of
what State organizations, service organizations, and county
service officers provide. Submitting that claim package in an
organized logical manner to the VA and then letting them make
the determination of service connection and a subsequent award
seems to me to be a logical division of work, but under the
current regulations and current process, essentially VA picks
up that pile of paper that we have submitted, starts all over
again gathering the same evidence, developing the same story,
and then coming to the same conclusion again, which is to my
mind a very inefficient process.
There are 4,000 people working in State and local
government who are accredited to do benefits claims or support
people who are accredited. VBA has got about 8,500 people
processing benefit claims nationwide. So it seems to me to be
sensible to leverage those State and local government employees
with the Federal employees to make it a seamless process that
expedites the whole deal instead of some places doing the work
twice.
Yes, John.
Mr. Rowan. Yes, Mr. Chairman. One of the other problems,
quite frankly, is the antiquated structure that the VA
processing is. It is still all paper, pen and paper. It's
amazing the counterbalance between the VBA and the VHA. Here
you have got on the health care side this wonderful computer
system where I can walk into any VA hospital in the country and
they can punch up my records and tell me exactly what my health
care looks like, whereas the VBA can't do anything like that.
I went through a training for virtual reality of VA, a
Virtual VA that they have been talking about proposing over a
year and a half ago that has not even been close to seeing the
light of day. They have got to get away from that paper and put
it back into a scan system. Before I retired, I worked for the
controller of the city of New York and I worked in contracts
administration. I was able to read 1,500-page contracts in
about 2 minutes using a scan system, a computer system, and a
data base that I could pull up, and I can't see why the VA
can't do the same. I understand it is a capital expense to try
to get that system up and running, but the cost savings over
time and, more importantly, the savings to the veteran of
anguish of waiting for the return on their claim is worth
whatever money it takes up front.
Chairman Craig. As all of you currently know, a veteran is
not permitted to hire an attorney to assist in filing claims
for VA benefits. A recent editorial in the Washington Post
posed this question: If American soldiers are mature and
responsible enough to choose to risk their lives for their
country, shouldn't they be considered competent to hire an
attorney where necessary? How would you answer that question?
Would any of you like to respond to that?
John.
Mr. Rowan. I will leap into the breach. Quite frankly, Mr.
Chairman, lawyers are nice, but unless the lawyer is trained in
the veterans' benefits field, frankly all of the people that
work for all of the people sitting at this table and all of the
people in the other VSOs and the county agencies and everybody
else, they may not have gone to law school, but their knowledge
of the system is better than any lawyer that I know of. That is
the issue that needs to be done. Those people are really good
at what they do.
I think George's point is well taken.
Chairman Craig. John, I was just going to say I am sure
your comments were not taken as anti-lawyer, not that I am one,
because I am not, but please comment about what George has
talked about, because that is a level of expertise that if it
is being relatively ignored at this moment doesn't seem to make
a lot of sense.
Mr. Rowan. I don't think it is so much ignored. I mean,
George has a better viewpoint of that than I do, but the
problem is, again, the structural system that the VA works in,
and I guess it is a legal mandate that they have to verify
everything that is handed to them, and I understand that, but I
think if we had a better way of flowing the information in, if
the Veterans Service Officers were able to utilize computers
today to be able to do the work that they were doing, and I am
sure George, I know--I happen to come from New York where
George is, and I know his system and his people can utilize
computers quite well. They could have all of that data and
everything entered into a system that could be easily accessed
by an adjudicator inside the VA if it was able to be
electronically filed.
We do it for taxes. We do it for everything under the sun.
Federal procurement, I know is all done that way because,
again, I used to be a procurement person. If we can do that
with $10 billion worth of contracts, we can do it with the VA
system of filing claims.
Chairman Craig. Thank you. My time is up.
Let me turn to Senator Akaka. We have been joined by
Senator Obama. Danny, I have got to step out and meet with
folks. I will be back. Why don't you finish your round and turn
it over to the Senator, if you would.
Thank you.
Senator Akaka. Thank you, Mr. Chairman.
Mr. Rowan, I want you to know that I really appreciate your
candid comments about what we need to focus on to help Vietnam
veterans and all veterans. You raise an excellent point
regarding staffing for VBA. I have been working to address this
issue for several years now as a Member of the Homeland
Security and Governmental Affairs Committee where I serve as
Ranking Member on the Oversight of Government Management
Subcommittee with Senator Voinovich.
You can be assured that I will continue to address this
matter, and I want to say that if you have further comments
regarding this matter, I welcome them.
Yes, George.
Mr. Basher. Senator, with respect to the staffing levels at
VBA, when they have retirements, it is not necessarily you are
hiring to backfill those jobs. It is a three-tiered process,
basically. Your senior people who leave tend to be the rating
specialists who have the most knowledge and the most expertise
and the most demand on them, and when they retire, those
positions are backfilled by service reps who typically do
development and the mid-level work, and when they get promoted,
they are then backfilled by people who are doing triage and
mail room work and phone unit work and essentially entry-level
jobs.
So when VA has to fill a gap due to retirement, they are
actually training in three different tiers simultaneously and
essentially taking the best people they have left in the unit
to train at all three levels. So it really is a difficult
process and it should be done on a continuing basis, not just
when, oh, my god; we have got a crisis and we have got to fill
it today. If you hired them today, it will still take 3 to 5
years to get them up to speed.
Senator Akaka. Well, Mr. Basher, we are talking about a
growing problem in our Nation, and that is replacing people
with other good personnel, and it is something that this
Committee, that I mentioned that I am on, is really looking at
and throughout our system, Federal system, we really have to do
something about this, and all together, all of us, have to join
in on trying to take care of this problem.
Commander Kemp, while I still have some time, in your
testimony, you address the large numbers of returning veterans
who are suffering from readjustment issues or more debilitating
PTSD. Unfortunately, we know that in some cases, service
members are reticent to seek help for mental health care
because of the stigma, the stigma attached to mental illness.
Do you or any of you other witnesses have insight on what can
be done to encourage service members and veterans to seek
mental health care?
Mr. Kemp. Yes, sir. AMVETS, we have in place right now for
the National Garden and State personnel coming back, we have a
pre-deployment briefing and a post-deployment, and that is to
get them into the system so they are in the system. We also
have outreach to the family so that they can start to recognize
some of these issues that come up prior to it getting to be an
emergency, and that is what AMVETS is doing for the veterans
coming back.
Senator Akaka. Mr. Rowan.
Mr. Rowan. If I might add, I heard during our meetings with
the various elected officials over the last few years that
there was some talk about extending the 2-year free VA to 5
years. We believe that is an important issue because we know
from the history, unfortunately, from Vietnam Vets, the first 5
years were very crucial when it came to PTSD to determine
whether or not somebody committed suicide. Most of the suicides
involved with the Vietnam Veterans, which were usually PTSD-
related, occurred within the first 5 years of their coming
home, and we all know--everybody that has been in the service--
it takes you a couple of years to debrief, basically, and come
back into the civilian world and just try to understand what it
is you need to deal with in your life.
So if they are in the system, and that gets to the Category
8 and 7 issue to some extent, if they are in the system, they
will get the information they need to come back into the system
and to get the health care and help that they need when they
need it.
Senator Akaka. I just want to mention that I authored the
legislation which would extend the 2-year period to 5 years,
and I am so glad to hear what you just mentioned. We are
finding that PTSD help really is needed within the period when
they return and become veterans, at least the first 5 years. So
I am glad to hear you mention it, and I will continue to work
to enact this bill.
My time has expired, Mr. Chairman.
Chairman Craig. Senator, thank you very much.
Now let me turn to Senator Obama. Welcome.
STATEMENT OF HON. BARACK OBAMA,
U.S. SENATOR FROM ILLINOIS
Senator Obama. Thank you very much, Mr. Chairman, and
thanks to not just the panelists, but to all the veterans in
the room for your outstanding service to our country. We
greatly appreciate it.
You know, I have been so impressed by the work that the
VSOs have done to make sure that veterans are being properly
served at every level of government. I particularly appreciate
the work that you have done, helping to cut through VA red tape
when it comes to issues like the claims processing. Some of you
are aware that in Illinois, we have had some problems with
respect to disability payments, speed of claims being turned
around. There has been a sense that many have been
shortchanged, and so I just am grateful to all of you for the
outstanding work that you have done.
I just have a couple of questions because several of my
questions have already been answered. The first one--and
anybody can take a stab at it--Mr. Rowan, if you want to start
off, the VBA has been very active in assistance to homeless
vets, many of whom served in Vietnam. We know that a lot of the
problems that homeless vets face have a mental health component
as well as a lack of job training and access to jobs. I
understand that some community-based organizations serving
homeless veterans are doing excellent work in integrated
housing assistance with job training and mental health
assistance and treatment. I am wondering if you could just talk
a little bit about some of the programs that you have seen that
have been most successful and how we can expand on those
programs and scale up to meet the enormous need.
Mr. Rowan. Yes, Senator. It is good to see you.
When we first got involved with homeless veterans, and I
was involved in this very early on in 1983 when, frankly, the
controller of the city of New York did a study of homelessness
and found all these veterans in the system and couldn't believe
it. We kind of differed from some of the homeless advocates. It
wasn't just about housing. We, frankly, believed that it was
about getting services, and you are correct. Many of them were
PTSD people, people with problems, addiction issues which are
often, again, related to PTSD amongst the Vietnam Veterans, and
we have seen that, unfortunately, in the more recent veterans
as well.
So it wasn't just housing them. You had to treat them with
social services, rehabilitation programs, detox programs if
necessary. One of the problems we have seen in the VA is the
alcohol and substance abuse programs that disappeared when the
budget got cut. The first thing the VISN directors cut was all
the alcohol and substance abuse services. Bad move. It is what
created the homeless group in the first place.
We see that today still and we see the high unemployment
amongst the new veterans, which is very disturbing to us. It,
again, reminds me of a flashback to the seventies when we had
trouble with the Vietnam Veterans' high unemployment rate.
The key is services associated with housing, and we know
that there are many transitional services programs that are run
across the countries. Many of my chapters are involved with
that. We have a Vietnam Veterans Assistance Fund that is our
foundation. We have houses in Connecticut that we have been
operating in association with the VA up there and the State of
Connecticut Veterans Agency, again a transitional housing
program. The idea is bring them in, bring them off the streets,
because that is the first step.
We actually give them a lot of tough love though. One of
the nice things about having veterans help veterans is we have
the ability to say to somebody sitting across the table,
``Yeah, you are a veteran, you deserve help, but that is not
enough of a reason, you have got to get your own help, you have
got to be willing to help yourself,'' and we were able to work
with many of them and get them off the streets, and we believe
over the years we have been very successful, but who is going
to provide the programs.
We believe, first of all, that HUD needs to provide a lot
more Section 8 housing programs. We need to provide a lot more
per diem payment programs for the housing programs that are out
there, and for all of those programs, again not just the
housing, but to provide them with the services they need. Hook
them up with the VA rehab centers. Get the VA to start to re-
establish the inpatient PTSD programs that they wiped out years
ago. There are only a few of them left scattered around the
country now with only 30-day inpatient programs. Ten-day detox
programs are almost all gone. Everything is outpatient. Well,
it doesn't always work that way, especially when you have
homeless veterans. The transitional housing facilities that the
VA does operate are very successful, and I have seen several of
them up close and personal because I work with a lot of the
veterans that have gone through them.
It can be done, but it is going to take some direction of
resources, and if we do this short term, and this is one of the
things with the PTSD issue--if I could take just a second, the
reason why we have 100 percent PTSD Vietnam veterans today is
because we didn't treat them 35 years ago, and we are going to
have 100 percent Iraq PTSD cases 20 years from now if we don't
treat them today, and it is very simple. Take care of them now.
The vet center program needs to be expanded into rural areas
where all of these guards and reservists are coming from. We
need to bring the Iraq and Afghanistan Veterans into that
system as peer counselors like they did with the Vietnam
Veterans program. We remember when the VA hated that program
and wanted to bring it inside, and we said, ``no, keep it on
the streets where it belongs.'' It was very successful, still
is to this day, and we think it is the only way we are going to
succeed with the newer veterans.
The one thing about them I would say, at least they know
what PTSD is. We didn't. They are still not quite sure what to
do about it, and I do agree with your earlier statements that
there is still a stigma attached with mental health issues and
PTSD that, unfortunately, keeps them from getting the care that
they need.
Senator Obama. Mr. Chairman, I know that a couple of the
panelists just wanted to respond. Would that be okay?
Chairman Craig. Sure.
Senator Obama. Mr. Basher and Mr. Kemp, please feel free to
chime in.
Mr. Basher. As a member of the Secretary's Advisory
Committee on Homeless Veterans, and we are actually meeting up
in Baltimore today and tomorrow, one of the issues that
revolves around homelessness is the fact that a lot of the
services are provided by community-based organizations and a
lot of the support they get is a very fragmented package. You
have got the Department of Labor providing homeless veteran re-
integration program money. You have got the Department of
Veterans' Affairs providing grant per diem money. Both programs
operate under very different premises and very different sets
of rules, but those CBOs are required to learn both sets and
become facile with that, and none of this actually provides
what the Committee is now concluding is an important element of
this, and that is permanent support of housing for veterans.
VA specifically doesn't provide any of it. HVAP is going
away from that, and HUD is now looking at providing only
housing, but they don't want to talk about any veteran-specific
programs.
Senator Obama. Mr. Kemp.
Mr. Kemp. Senator, as you know, we are having a symposium
for the young veterans' needs in Chicago this October. So far,
we have identified we have 60 work groups to look at different
issues that are facing the veterans, and I would invite each
and every one of you to participate so that we can come down
and have a true veterans' issues forum. The veterans will be
giving us the issues and trying to find the answers so that we
can best serve them.
It is not funding. It is being more effective and
efficient.
Senator Obama. Thank you, Mr. Chairman.
Chairman Craig. Thank you.
I have got a couple more questions, and then if any others
do, we will certainly continue. We thank you again for your
patience and your responses.
John, the next question I am going to ask is not intended
to put you on the spot. You are a very nimble fellow. So I
doubt that I could do that. But I think it is important that
the record show a little bit of time and place and history in
relation to where we were and where we are. At a hearing on
eligibility reform before the Senate Veterans Committee 10
years ago, in unified testimony, VSOs testified regarding how
eligibility reform could be accomplished so that it would be
cost neutral. That was the argument of that time. Your
organization suggested some veterans could contribute insurance
and copay dollars to VA and that high-income non-service-
connected Vietnam Veterans could bring substantial new funding
streams to VA in order to sustain care for service-
connected and indigent veterans, expand access to cost
effective primary and preventive care, and reduce VA reliance
on federally-appropriate rated dollars.
Doesn't the President's budget at a 9.6 increase in direct
appropriations and additional revenue generated through fees
proposals on lower priority veterans strike the kind of balance
that your organization espoused 10 years ago?
Mr. Rowan. Not exactly.
Chairman Craig. Okay. Please explain.
Mr. Rowan. I am not as much of a budget expert as I would
like to be and, frankly, we are working on another revised
white paper that we will present to the Congress reviewing all
the budgetary aspects. One of the problems with the whole
Category 8 thing is this whole idea of those bringing health
care into the system, their own insurance and the problem the
VA seems to have with dealing with that and making that work. I
guess the issue would become those wealthier veterans who don't
have insurance and would have to somehow pay some copayments,
and I think we could talk about that as well.
Again, I am not against sitting down and talking about
working on a whole development of how we fund the VA and
especially about the needs of the VA, and we call on Congress
to set up a bipartisan, bi-house committee to exactly do that.
We have done that for welfare reform. We have done it for
Medicare reform. We have done it for all kinds of things.
Perhaps it is time for you and your colleagues across the
street to sit down and both parties hammer out a bipartisan
proposal with the input of the Veterans Service Organization to
exactly how we can look at reasonably funding the VA.
One of the disturbing things to me, however, is this idea
of going after the sevens. The sevens are the zeros, the zero-
service connected. The example of those people is one I had not
too long ago as a client of mine. He came in with lung cancer.
As a service-
connected Vietnam Veteran, he got 100 disability immediately
for his lung cancer. He went into chemotherapy. He went into
all kinds of extensive treatment programs. Thank God, they
cured him or put him in remission. I hate to even use the word
``cured'', but they put him into remission.
Immediately, he drops to zero, rightfully so, no cancer, no
compensation, no problem; however his private health insurance,
which he had, would not cover the super-MRI that he needed on
an annual basis to make sure that his cancer wasn't coming
back. The VA did, and thankfully he is in the system, but if he
had been kicked out as a seven, he would not be in the system
and would be in serious, serious harm.
We need to re-evaluate all of those nuances that go on with
those sevens and, again, as I pointed out, with even the
eights. Frankly, 4 years ago, I wasn't in the system until they
came up with the presumption on diabetes. I had been a diabetic
from 1994, but they wouldn't give it to me in my claim until
2003, I think it was. I am a 90-percent rated disabled veteran
today because, unfortunately, I have got neuropathy and a few
other things, as has many Vietnam Veterans. I am in the system.
I am a category one. You can't touch me, but unfortunately
there are many people----
Chairman Craig. I am not hunting for you.
Mr. Rowan. But unfortunately there are many who if they
were eights, unfortunately if they got information, might in
fact turn into ones, twos, threes, and fours, and that is what
we are concerned about, again, as we point out with this
outreach effort.
So, Senator, I think everybody in this room would be more
than happy to sit down with you and your colleagues to hammer
out a way to make sure that the veterans' health care got
funded as long as it is understood exactly what that means when
we talk about our health care needs, not our desires, our
needs, and that is all we are looking for. I actually had
somebody tell me all you are looking for is new members and
more money, and it really got me annoyed. We are not.
Chairman Craig. That is a responsible and a legitimate
request. Thank you.
Does anyone else wish to comment?
George?
Mr. Basher. Sir, one of the problems I think we have with
this whole issue is we tend to look at it as a VA issue, and if
you look at it as a national health care issue, you have to
design a VA system that is big enough to handle the 25 million
veterans we have got in this country and you have to design a
Medicare system that is a certain size, and you have to design
a Medicaid system that is a certain size, and you have a
private insurance program that covers a certain number of
people. A lot of the people we are talking about are dual and
triple eligibles. So in my mind, one or more of those systems
is too big if we are truly trying to design the most efficient
and effective way to do this.
I think maybe what is also needed here is to have a
responsible conversation about the global issues of health care
and where VA fits into that. As you are well aware, medicare is
the one place--you can't spend your medicare dollars with a VA
hospital, and to me, that makes no sense. Congress took a whack
at solving that a number of years ago with VA Advantage, and
the thing just disappeared in a morass of conflicting
regulations, and people gave up. I think we should take another
stab at that.
Chairman Craig. Good suggestion.
Gerald, you had a comment? Please.
Mr. Harvey. One of the things that we need to remember is
that anybody who has been to war, no matter when or whose side
he is on, suffers from post-traumatic stress, no matter what
you call it. It is built in. So when we first come back, we are
young. We say don't talk to us about it. We want to forget all
of that, and of course that is the biggest mistake we did, not
talk about it, not work through it, not come out of it.
So some way or other, we need to think through a system so
when these men come back to get out of the service, they get
into the system right then so that you can say, ``When you
start seeing these signals, come back; you are already in the
system, and it is going to happen to you; you don't think so,
but it is.''
Chairman Craig. Well, those are very valuable suggestions,
yes.
Well, I appreciate this dialogue beyond the questions
because it is a very important dialogue to have, and one of my
frustrations, and it is a frustration that is spread nationwide
at this moment, when we look at Federal spending as a whole,
whether it be entitled or discretionary, and of course some are
advocates that all VA spending become entitled, and of course
there is a reality out there that I and Danny have to deal
with, and that is that Social Security, Medicare, and Medicaid,
entitled definitions, without substantial adjustments over the
next decade and a half will consume the entire Federal budget
based on demographics and current movement in the system of
aging Americans by the year 2028 or 2030, depending on the
robustness of our economy, literally consume all of the budget,
and that includes your budget, defense budget, all budgets.
Those are very important issues that Congress has not just yet
decided to deal with, although liberal and conservative
economists and demographics and all of that argue the same
argument. So it is all there and we understand it. So there is
a reality check we have to deal with.
Today, those who have made a career of the military who
have been in multiple theaters of war, the professional
soldier, if you will, who retired out who has TRICARE are being
asked to pay substantially more in their premiums. Obviously,
they are concerned. They will pay some more. The question is
how much more, and yet in sevens and eights, in all fairness,
who may have spent 4 years in the service alone might never
have seen a theater of war and may well have seen a theater of
war, we are asking a little bit.
It is very important we get to a dialogue of balance and of
fairness, because I want veterans to have access to the health
care system. There is no question about that. That is not a
question in my mind. The question is eligibility,
affordability, and a concern about, as Danny has expressed,
making sure that we extend out time and look for and try to
deal with those coming out of our current theaters, because I
agree with you, Gerald. I think anyone who has been there who
spends time there and leaves the streets of America for the
streets of Baghdad or Kabul is going to experience some form of
adjustment to some degree, depending on his or her experience
or association with that particular environment. I don't think
there is any doubt about that, and how we deal with that or how
we cause them or help them to deal with it in the long term is
going to be tremendously more beneficial to them, their
families, and to society as a whole.
So, gentlemen, thank you all very, very much.
Danny, do you have any additional questions?
Senator Akaka. I do, Senator.
Chairman Craig. Please proceed.
Senator Akaka. Thank you, Mr. Chairman. You certainly made
an eloquent statement there.
I just want to add this, George, that what you mentioned is
so important. We have talked about what we call seamless
movements from active duty to the veteran status. We need to
work on this. I feel sometimes that VA or the VSOs need to deal
with this by taking all those recently separated
servicemembers. We need to reach out to those people that are
afraid to come forward for help.
Director Basher, as you well know, each State has its own
unique populations and culture, and when I say culture, I feel
each war has had its culture. The rural area is its culture.
The urban area is its culture. So the culture makes a huge
difference in how we deal with those problems.
My question to you is what are the State directors doing to
cater their outreach efforts to reach certain cultures where
coming forward to seek treatment is frowned upon and what role
do you play in crafting VA's outreach efforts in particular
States?
Mr. Basher. Thank you for the question, Senator. One of the
things that everybody I think is aware of is that when people
are returning from the theater now and being demobilized or
separating from service, they are getting transition assistance
programs and they are getting--everybody is meeting the planes
at the tarmac and everybody is having the welcome home
celebration, and what we found is that most veterans--and my
fellow Vietnam Vet John and I remember what it was like when we
came home--paying attention to all that benefit stuff was
something that we didn't even hear when you were telling us,
and it takes more than one time to deliver the message.
So what we are trying to do is push awareness of veterans
and veteran issues and returning veteran issues down to State
and local level, because these are going to occur over time.
One letter from me or from my Governor or from the Secretary of
the VA is another piece of junk mail in that veteran's mailbox,
but a continued presence--veterans are real messy. They are not
going to show up in the community-based clinic or in the VA
hospital when they finally have an issue. They are going to
come in to the community mental health clinic, the local
hospital, the police station with whatever that issue is, and
what State directors are doing is trying to engage State and
county governments to when they get clients at intake, whether
that is a prisoner, a client, a patient, or whatever you want
to call it, the first question you ask them is: Were you ever
in the military?, and make those local and State institutions
aware of what the issues are surrounding military people.
If the answer is yes, we refer them back to some of our
counselors, to the local county veteran service agency, or to
the VA, and let us screen them at that point for the
appropriate level of treatment and get them referred to the
appropriate system, and whether that is done at the local level
in Manhattan or Harlem or the Oneida Reservation up in northern
New York, it is being delivered by local folks who understand
the local culture and in most cases probably know the people
who are affected.
So that is something that we are working very, very hard
at, is to make that connection push out all the way across the
State and local level of government.
Senator Akaka. John.
Mr. Rowan. If I might add real quick, one of the problems
we have had is the VA has built a wall around itself and said
we don't want anybody coming in anymore, stay away. They don't
do any outreach whatsoever, none, and it is left,
unfortunately, to the States and the VSOs and everybody else to
try to do that, and they are doing their best efforts, but the
VA needs to take some more generic national kind of outreach,
an E.R. program, if you will, to try to explain some of these
situations.
One of the things my organization is working on, we are
trying to develop a proposal to go out to the private sector,
to the medical community, to tell the doctors and nurses and
health care people out there, Ask that person across the table,
man or woman, because there are a lot of women today, are you a
veteran, did you serve somewhere, and if they answer the first
question yes, then you have got to go up to the next laundry
list, Were you in a combat theater, etc., etc., to elicit those
responses to enable them to do better health care. In 30 years
in a private HMO, nobody ever asked me the question are you a
veteran, ever, despite the fact of what I ended up with all my
disabilities.
So it is a real problem, and actually I was meeting with
Congressman Buyer yesterday, and he came up with a really good
issue, and I am going to run with it. That is to go to the
medical schools who teach all these doctors who often also
associated with VA hospitals, to teach them about veterans'
medical care, what it means when you are a veteran as compared
to a private citizen, and I think we can work wonders over the
long term of dealing with that kind of program.
Senator Akaka. Thank you. Thank you very much. This has
been valuable for me and for the Committee, and I really thank
you for your testimony, and my time has expired.
Thank you very much, Mr. Chairman.
Chairman Craig. Danny, thank you.
I have offered up to the challenge and, John, you have
responded appropriately, and other VSOs are doing the same. I
have not yet, nor have we collectively, decided how to shape an
evaluation of and a method by which we bring forth proposals as
it relates to the reality of VA funding and its
appropriateness.
I look at the current trend lines, and it is obvious that
probably during my tenure of this Committee, I will preside
over the first $100 billion budget for the VA, a phenomenal
amount of money. I am not disputing its need, not in any sense
of the word. What I am doing is placing it up against other
realities as it relates to overall funding of government and
our needs, and some of the questions, some of the proposals
that you just mentioned, George, are perfect examples of an
effort to look at this again to see if medicare subvention and
all those kinds of things fit, because back then, the reason it
didn't work was because there were too many people who didn't
want it to work, because the Medicare folks versus the VA and
versus veterans didn't really see that as appropriate because
it might be an offset and therefore it would discontinue
certain funding lines, and all of that game gets played when we
start breaking across these budgetary walls and lines that we
may necessarily have to do if we are interested in delivering
the kind of health care that is necessary and funding it
appropriately.
We have a good thing going. We have a quality health care
system, and we have invested heavily in it, and that is
appropriate and the question is how does it serve now and how
does it serve in the future in a way that I think encompasses
all of the needs that Danny and I are concerned about and that
you have expressed. So I would suggest, but I don't have to
worry about you doing it, that you stay tuned because we are
going to look at this. I think we have to as a Congress and as
a country to be responsible to America's veteran in a way that
is appropriate and acceptable.
Gentlemen, thank you all for your testimony today. The
record will remain open for any additional comment for a period
of up to 5 days, and we thank you all very much for being here.
The Committee will stand adjourned.
[Whereupon, at 11:25 a.m., the Committee was adjourned.]
A P P E N D I X
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