The Official Voice of Vietnam Veterans of America, Inc. ®
An organization chartered by the U.S. Congress
March/April 2006
GOVERNMENT RELATIONSDespite the Spin The VA Budget Is Short Again
A GOVERNMENT RELATIONS DEPARTMENT STAFF REPORT“Veterans have long memories,” VVA National President John Rowan said in presenting the organization’s legislative agenda before Chairman Steve Buyer (R-Ind.) and the other members of the House Committee on Veterans’ Affairs on February 16. “We remember why we served, what we saw, what we did when we donned the uniform to answer our country’s call. We remember our comrades, those who died and most of the rest who were forever changed by their service.”
We also remember last July, Rowan said, when Congress and the administration “were embarrassed by the revelation that the Department of Veterans Affairs was $800 million in the hole to meet 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.”
Rowan noted that Congress closed this budget gap by adding $1.5 billion to the VA’s FY’05 operating budget and an additional $1.2 billion in emergency funds for the current fiscal year. This, even with a reported $1.1 billion carryover in the VA’s budget, “will still not be enough for the VA to maintain its current level of care,” he said.Despite the seeming increase in VA health care funding as proposed by the administration, Rowan said, “Again this year we believe the administration’s budget request, despite the spin, is short by at least $4.2 billion, which would open enrollment into the VA’s health care system to Priority 8 veterans who were ‘temporarily’ restricted from enrolling 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.
“We’ve said this before, and we’ll say this again,” Rowan continued. “Had the VA’s health care budget not been flat-lined for four 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 has been proposed for FY 2007.”
The reality is that the proposed budget just simply is not enough money, even to take care of those already in the system. Along with the other veterans’ service organizations, VVA will expend countless hours and energy fighting for funding that is sufficient to meet the needs of America’s veterans. More than 260,000 veterans who applied to receive health care at VA facilities in fiscal year 2005 were turned away because of the administration’s cost-cutting decision to limit veterans’ access to VA hospitals, clinics, and medications, Rep. Evans noted.Since January 17, 2003, the administration has barred access to VA care to new Priority 8 veterans—those who do not receive monetary compensation from VA for service-connected disabilities and whose incomes are above a national and geographic income threshold. In 2005, the national income means threshold for a single veteran was $25,842.
“This is one battle we should not have to wage,” Rowan said. “Instead, we should be working together to fashion a formula to fund 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.
“VVA believes, in concert with The Partnership for Veterans Health Care Budget Reform, that a fair funding formula can be arrived at,” Rowan continued, “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.”
Some legislators, from the GOP as well as the minority, are hearing the arguments and endorsing them.South Dakota Republican Sen. John Thune and his Democratic colleague, Tim Johnson, have asked the Senate Veterans’ Affairs Committee to look at new ways of paying for veterans’ health care, including providing guaranteed funding similar to how the government pays for Medicare, according to the Navy Times. In a joint letter to the Veterans’ Affairs Committee, Johnson and Thune asked the committee to examine “how we can ensure” the VA has enough money.
“As you know, the discretionary funding has become a cause for concern among many of our nation’s veterans,” the letter says. “This concern is due to the uncertainty that arises each year as to whether funding will be adequate to serve the health care needs of our veterans, and has been aggravated by the unexpected budget shortfall in VA funding last year.
“While we understand mandatory funding may be controversial as a solution, we believe it deserves equal consideration along with any other proposals that may have merit. It is becoming abundantly clear that there is a growing consensus that the current funding model for veterans’ health care is inadequate and a permanent solution needs to be found.”
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,” Rowan told the House Veterans’ Affairs Committee. “The VA projects this situation will get worse, yet requests funding for only 130 new employees for all of the VBA for FY 2007. Congress needs to insure that the new platoon of adjudicators is properly trained, supervised, and—along with their supervisors and managers—held accountable for their work.
“Congress must demand an explanation from the VA as to why it takes upwards of two and a half years to adjudicate cases. Congress must demand that the VA not only develop but put into practice a real strategy for unclogging the system.” Rowan suggested that the VA 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,” he said. “There should be no reason why his claim can’t be adjudicated in sixty to ninety days.”
GREATER ACCOUNTABILITY & OUTREACHReforming how the VA health care budget is funded is only a means to an end. This “must be accomplished hand-in-hand with real changes in how VA senior managers and middle managers perform,” Rowan said. “Give ‘attaboys’ and bonuses to those who have earned them; give warnings and sanctions to those who have not done their jobs well.”
Noting that only one-fifth of all veterans have any interaction with the Department of Veterans Affairs, Rowan said that although many, particularly in-country Vietnam veterans, are eligible for compensation for several maladies incurred during their military service, 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. In speaking with one Navy veteran, we learned that he had served in Vietnam. When he mentioned that he had suffered from 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 insure to the maximum extent possible that they know what benefits they have earned, and they know how to access these benefits,” Rowan added. “This is starting to happen as VA personnel are assigned to the bases where active-duty personnel transition to civilian life. This, however, is hardly enough.”
He cited S. 1342, introduced by Sen. Russ Feingold (D-Wisc.), which would require the Secretary of Veterans Affairs to establish a separate account for the funding of the outreach activities of the department and a sub-account for the funding of the outreach activities of each element within the department. This legislation would help states carry 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 introduce and hold hearings on companion legislation,” Rowan said.
THE TIME FOR NVVLS IS NOW
VVA believes that the National Vietnam Veterans Longitudinal Study (NVVLS), a follow-up to a study done some twenty years ago, must be funded. In his testimony before the House Veterans’ Affairs Committee, Rowan urged Congress to compel the VA “to immediately reinitiate 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,” Rowan said. “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.
”The funds for this study, Rowan said, should be a separate line item of $25 million in Research and Development funds.
SENSIBLE SOLUTION
Southern New Jersey’s 95,000 veterans will be able to get federally funded medical care at Kessler Memorial Hospital under a new partnership between the hospital and the Department of Veterans Affairs. Previously, area veterans had to travel to Philadelphia or Wilmington, Delaware, for hospital care.
Rep. Frank LoBiondo (R-N.J.) announced the agreement. In 2003, together with Rep. Chris Smith (R-N.J.), LoBiondo sponsored legislation that required the VA to develop a plan to address veterans’ health-care needs in southern New Jersey. Washington, he said, did not see the necessity of hospital services in the southern part of the state.
LoBiondo persevered, aided by Smith, and by Reps. Jim Saxton (R-N.J.) and Rob Andrews (D-N.J.). Under the agreement, the VA will reimburse Kessler for various services the hospital will provide to veterans, including inpatient stays, emergency care and stabilization, some gastroenterology procedures, dermatology, podiatry, and physical therapy.
HEALTH ASSESSMENT FOR SOLDIERS
In January, Secretary of the Army Francis Harvey and Army Chief of Staff Gen. Peter Schoomaker authorized a new health screening program, “Post Deployment Health Reassessment (PDHRA),” which is designed to address deployment-related physical and mental health needs of soldiers three to six months after returning from deployment. After nine months of pilot programs, the Army is now implementing the program, which is one component of the Defense Department’s ongoing efforts to safeguard the health of military personnel returning from deployment, including Active, Reserve, and National Guard.
Dubbing this program “unprecedented,” officials noted it will address the deployment- related physical and mental health needs of soldiers. Research has shown that deployment health concerns often evolve over time. Commanders, therefore, must facilitate and encourage returning soldiers to visit health care providers to insure that all their deployment-related health concerns are addressed as soon as possible.
Army Surgeon General, Lt. Gen. Kevin Kiley explained the health reassessment this way: “When our units return from operations around the world, their equipment is rechecked and reset. We see this health screening as an expansion of the process that looks at resetting the fighting force, and maintaining the wellness and health of soldiers.”
VVA, which criticized DoD for failing to conduct proper pre- and post-deployment physicals to troops bound for combat in Afghanistan and Iraq, applauds this initiative.
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