The Official Voice of Vietnam Veterans of America, Inc. ®
An organization chartered by the U.S. Congress
October/November 2003
GOVERNMENT RELATIONSFictions from the 108th Congress
Or: "Fighting the Good Fight"BY H. AVERY TAYLOR, CHAIR, VVA GOVERNMENT AFFAIRS COMMITTEE,
WITH VVA GOVERNMENT RELATIONS STAFFFA lot has happened in Congress since VVA's National Convention that is relevant to veterans and their families. Unfortunately, not a lot of this is good.
VVA made a persuasive case that the medical operations of the VA are woefully underfunded. Had the mandates of Public Law 104-262, the Veterans Health Care Eligibility Reform Act of 1996, been followed, and had funding not been flat-lined in the mid-1990s, the debate in Congress would be over a level of funding $10 billion greater than what was proposed in the President's budget. ( See the White Paper on health-care funding on the VVA Web site, www.vva.org/legiss/white_paper.pdf)
That the system needs more money to care adequately for the veterans it is charged with serving is a point of agreement for all the veterans' service organizations. Intense lobbying throughout the spring led to the addition of $1.8 billion above the President's budget request in both the House and Senate budget committees. But the appropriations committees in the House did not see fit to endorse the wisdom of their colleagues. In the House, the $1.8 billion disappeared from the budget language, a casualty of pressure from the White House. The Senate Appropriations Committee was a bit more deceptive, adding only $250 million in appropriated dollars and an additional $1.3 billion in contingency emergency funding--meaning this sum can become real only if the President declares an emergency. Nobody is overjoyed at this compromise because no one believes that the President will declare an "emergency" and release this $1.3 billion.
Additional language in the Senate's appropriation bill authorized $183 million for the CARES process - and grants the Secretary of Veterans Affairs the discretion to take an additional $400 million for CARES from the VA's budget for medical operations.
As this issue went to press, Senators Bond, Mikulski, Byrd and others were attempting to insert the $1.3 billion into the Supplemental Appropriations Bill for Operation Iraqi Freedom. While this does not address the structural funding problem of veterans health care, VVA applauds these efforts.
CARES MARCHES ON
The idea behind CARES - Capital Asset Realignment for Enhanced Services - is a good one: Eliminate waste and dispose of antiquated, unusable buildings and other real estate to help free up resources that will enhance medical care for veterans.
The CARES Commission held hearings from mid-August through early October in each VISN to solicit oral and written testimony about its plans. Although VVA believes this data-driven process is elementally flawed, we've worked with local and regional VVA leaders to craft testimony about the impact that planned changes in their VISNs would have on service delivery. VVA will continue to work with the distinguished chair of the CARES Commission, the Honorable Everett Alvarez, and with VA officials to try to limit the damage this process - along with a desperate shortage of funds, is doing to the VA health care system.
"FIGHTING THE GOOD FIGHT"
In the wake of the vote in the House of Representatives that eliminated the $1.8 billion, the House Republican Conference published something called "Fighting the Good Fight." This document strained the truth. Perhaps its most egregious statement: "What Congress is unable to provide one year is placed on high priority for the following year." Really? This has not happened yet, and the VA health care system falls into further disrepair as resources do not match needs.
This document amounted to a thinly veiled defense of what VVA considers to be an indefensible position: Congress patting itself on its collective back with one hand while cutting funding that is barely adequate to begin with, with the other.
DISABLED VETERANS TAX
When it comes time to be counted, not with promises but with votes, many in Congress simply are not true to their word. H.R. 303, the bill introduced by Rep. Mike Bilirakis (R-Fla.) to eliminate what is, in effect, a 100 percent tax on the pensions of career military personnel who also receive VA disability benefits, has approximately 370 co-sponsors. Yet few of these co-sponsors on one side of the aisle have had the courage of their convictions, it seems.
Because full funding of this initiative is estimated to cost between $51 and $68 billion over ten years - an excessive estimate in our view - many in Congress are leery of endorsing what the Democrats and most VSOs are now calling the Disabled Veterans Tax. They cite their concern over the rapidly increasing deficit. This skirts the fundamental unfairness of the law as currently written.
Because this is an issue that won't quietly go away, some attempted to work what they called a compromise: Setting up a commission in January that would study the issue with a report due in six months or so, and herald this solution at a press conference. While some military associations saw this as progress, the VSOs weren't buying.
As this issue went to press, the congressional leadership and the White House came to what they consider a solution. We don't. Please check www.vva.org/PressReleases/2003/pr03-41.htm for an update.
Line of Duty Service Connection
At the meeting in Rep. Bilirakis' office, the issue of who ought to be eligible reared its head. This led to a brief discussion of the definition of "line of duty" service connection. In a seeming attempt to restrict eligibility, proposed language in the House version of the Defense Authorization Act for Fiscal Year 2003 would limit service-connected disability compensation to those veterans whose diseases or injuries were sustained while actually performing their military job. Specifically, the proposal would limit payment of compensation for disabilities that are the "direct result of the performance of duty."
This language, should it be enacted into law, would be an unprecedented and unconscionable breach of America's covenant to care for those who have borne the battle. Delayed onset of disabilities incurred as a consequence of military service is responsible for thousands of inappropriately denied claims for compensation, even under current law. Should the proposed standard become law, it will likely prove impossible for tens of thousands of deserving veterans who may have become ill or injured during their active-duty service, regardless of whether such illness or injury is the proximate result of the performance of their official duties or under a superior's lawful direct order. For instance, no claims would be allowed for sexual traumas, Agent Orange and other toxic exposures, or other maladies and diseases that originated in military service.
How anyone can claim to support our troops and advance such a proposal is beyond our comprehension. VVA testified as such in a hearing of the Senate Appropriations Committee on September 23.
SHADES OF SHAD?
Another potentially scary note was sounded in the House by the Committee on Energy and Commerce, which is pushing legislation - the Project Bioshield Act of 2003 - that would reduce the military's obligation to inform soldiers about the health risks of unlicensed biological defense drugs and vaccines they might be required to receive in an emergency.
Under the proposed changes to the law, according to a report from the Global Security Newswire, the President could waive the requirement to notify troops that they may refuse a drug, although they must be informed of a drug's unapproved status and potential side effects.
On another note, the House incorporated the essence of a bill introduced in June by Rep. Ciro Rodriquez (D-Tex.) that would authorize the Secretary of Veterans Affairs to provide veterans who participated in certain chemical and biological warfare testing - Project 112/SHAD - with health care for illness without a requirement of proof of service-connection.
If enacted into law, a veteran who participated in a test conducted by the Department of Defense's Deseret Test Center as part of a program for chemical and biological warfare testing from 1962 through 1973 will be eligible to receive hospital care, medical services, and nursing home care for any illness, notwithstanding any insufficient medical evidence to conclude that such illness was attributable to such testing.
The DoD has identified some 5,800 veterans who participated, most of them unwittingly, in these tests. VVA's Project 112/SHAD Task Force will be revving up to see if the tests already acknowledged by DoD are all that were conducted or if they represent only the tip of the iceberg. Stay tuned.
HEPATITIS C AND HOMELESS VETERANS
The July issue of Social Psychiatry and Psychiatric Epidemiology featured an article on the "Prevalence of Hepatitis C Virus Infection in a Sample of Homeless Veterans." The study measured the prevalence of hepatitis C infection in some 418 homeless veterans treated in a domiciliary care program in Massachusetts over a five-year period.
The overall rate of infection was 44.02 percent, a rate more than ten times higher than the national rate for men aged 20-59 and more than twice as high as other VA patient samples. Adjusting for age, significant risk factors in the sample included a history of substance abuse and service during the Vietnam Era.
"Public systems of care, including the VA, should expect increasing costs of care related to HCV infection as prevalent cases develop serious medical sequelae of HCV infection," the authors of the study concluded.
New Members of the Team
Philadelphia native Eddie Gleason, a service-disabled Air Force veteran, and Tim Redmon, a veteran of the Navy, have joined the Government Relations staff.
Gleason, who signed on in September as Associate Director of Government Relations, brings passion and dedication to the operation. Prior to joining VVA, he was Director of Government Relations for the Personal Communications Industry Association. In that position, he represented the telecommunications industry before legislators, regulators, public policy forums, and local communities. Formerly, he served as a Government Affairs Specialist with MCI at its headquarters in Washington, D.C., where his responsibilities included analyzing new and proposed federal, state, and local legislation and regulations.
Redmon has had extensive experience in the health care industry, having worked for more than two decades for a variety of health-care associations. Most recently, he was Director of Home Health Care Regulatory Affairs and Long-Term Care Pharmacy Services for the National Community Pharmacists Association. Previously he served in senior positions with the National Home Infusion Association, the National Association of Medical Equipment Suppliers, the American Hospital Association, and the American Optometric Association.
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