Mr. Chairman and other distinguished Members of this Committee, on behalf of the membership of Vietnam Veterans of America (VVA), I am pleased to submit our views with respect to the President’s budget proposal for FY’06 as it pertains to the funding of programs of relevance and concern to veterans and their families. VVA thanks you for the opportunity to provide this statement, and for considering our thoughts in this important matter.

This Administration has trumpeted the increases in funding for the operations of the Department of Veterans Affairs in the past four years. It is true that in President Bush’s first term, appropriations for veterans’ affairs have increased by more than 40 percent. Some of those increases were in mandatory funding, some were in increased collections from veterans and third-party payments. But there have been substantial increases in funds for medical care. Yet these increases have failed to keep pace not only with medical inflation, but also with the increased demand for services by veterans statutorily eligible for care and treatment by the VA. The per capita funding for a veteran at VA has lagged far behind even the increases provided to Medicare recipients, which is so inadequate that providers continue to drop out of that system.

In fairness to the President, he inherited an inadequate budget base, due to the flat line funding of veterans’ health care during his predecessor’s second term. It appears that another few years of flat line medical budget proposals are in our future yet again. Certainly Undersecretary of Defense David Chu’s public statement portends this attitude, especially in light of the fact that neither the President nor anyone else in the administration moved to neither rebuke Mr. Chu for his remarks nor to distance themselves from his remarks demeaning and slandering those who have served our nation honorably and well in military service. It appears that this unfortunate and disgraceful pattern of second-term neglect and irresponsibility is about to repeat itself.

We see the writing on the wall in the President’s budget proposal for FY 2006. The “enhanced restraint” touted by the Office of Management and Budget (OMB) bodes ill for veterans. This restraint eliminates, on paper, more than one million veterans from the VA health care system. Men and women who are categorized as Priority 7 and 8 veterans, who have no service-connected disabilities but whose economic fortunes are tottering or who do have service-connected disabilities but are rated as 0 percent compensable at the present time.

It is an affront to term these men and women “higher income” veterans. Most make less than $40,000 per year; most have no health insurance. Otherwise they would likely not seek help from the VA health care system. VVA points out that these are also the men and women who account for some 40 percent of the third-party reimbursement to VA coffers. The marginal cost of including these veterans in the system actually may produce more income than they cost the system, as they tend to be less sick when they seek help from VA. Most importantly, they are men and women who have served our country honorably and are statutorily eligible for care and treatment. Yet they are being denied that earned entitlement by the conscious starving of the system for resources.

This “enhanced restraint” also will make it difficult if not impossible to well serve all disabled veterans who depend on the VA system as their primary health care provider. Let is be clearly said: “enhanced restraint” means budget cuts.

We have seen this coming for a while, in VA’s long-term strategic planning documents and, most recently in, a February 7^th press release from the Department of Veterans Affairs that attempted to put a rosy spin on the $70.8 billion budget request for that agency’s operations. No fewer than five times is it noted that the department “will be able to care for those veterans who count on VA the most.” This makes a presumption that the veterans who will be pushed out of the system have other options for health care. Many do not. Therefore, they will do without medical care until they get so sick that they lose their jobs, and become destitute and therefore eligible for care. For those who are service-connected disabled, but excluded for the moment, they will be denied medical care until such time as their service-connected condition worsens to the point that they become service-disabled compensable. This does a distinct disservice to veterans. It also means that when, after much delay and worsening of their medical condition, these veterans are granted medical care from VA to which they were statutorily eligible, their need for clinical resources will likely be greater and therefore more expensive than it would have been if they had been granted access to VA health care at an earlier point.

This is not only wrong, but it is fiscally foolish in the medium and long run. It is also a blatant attempt to circumvent the law and the will of the American people to care for veterans.

We challenge the new Secretary of Veterans Affairs, the bureaucrats at the Office of Management and Budget (OMB) who are in large measure responsible for this document, and all concerned to cite anywhere in statute where it says that the VA will only serve a “core constituency” of “veterans who count on VA the most.” Indeed, if it is the will of the people to narrow the parameters of eligibility for VA services, then one would hope you will be open, honest, and forthright in this matter and move to amend the law. But do not penalize veterans in a backdoor machination.

VVA has said this before and we’ll say it again: The cost of caring for those who have borne the battle, and their widow and their orphans – this quote adorns the side of the VA headquarters on Vermont Avenue – is part of the cost of the national defense. It is up to you, the members of Congress who must agree on what programs and services are to take precedence in funding, to consider this – and honor this – as you deliberate the administration’s budget proposal. Caring for veterans is not a Democratic cause. It is not a Republican effort. It is an American issue, one that cuts across all party affiliations.

VVA has in the past, and does today, Mr. Chairman, call for action for much greater accountability from all elements of the VA. From Veterans Health Administration (VHA) there must be much greater accountability for clinical outcomes, overall management of resources, and securing the best possible use of the taxpayer dollars to secure the best possible health care for our nation’s veterans. That means greater scrutiny of all contracts, of part time physicians, of so-called “enhanced use” lease deals that may be in fact be “sweetheart” deals, a hard look at bonuses at every level, and comprehensive and close scrutiny of high ranking doctors, nurses, and other clinicians who see few or no patients at the same time that it is difficult to secure enough coverage for inpatient wards.

We hope that you will work with us on this vital issue of accountability, as well as the effort to ensure that VHA moves more quickly toward truly becoming a “veterans health care system” and not one that is all too often general health care that happens to be for veterans. To VVA, that means that a complete military history must be taken and used for each veteran in the VHA system, to get the most complete diagnosis and medical treatment plan possible.

VVA also hope to work closely with you to achieve more proper observance of veterans preference in hiring by all parts of VA, and ensuring that VA exceeds the goal set in law, and re-emphasized by President Bush in Executive Order 13-360 to exceed securing at least 3% of all goods and services from service-disabled veteran-owned businesses. Part of real accountability is holding VA managers strictly accountable in regard to these two federal laws, which affect the economic well being of veterans.

VVA has certain very specific concerns about the budget request for FY’06. We outline them for you now.

Our main concern revolves around the effects of this flat-line budget. The effect on a system already operating on the margin of safety in medical and acute care units will now be strained all the more by the “hard freeze” on hiring already implemented at most VA medical centers. Specialized services, such as prosthetics, spinal cord injury, and mental health will be strained to the point of delays or denials of service.
If passed, this budget will eventuate in a decrease of 1,110,416 veterans from the VA health care system. It says so on page 2-16 of the medical programs budget submission. This is not right. This usurps the covenant between the American people and those who in uniform defended the Constitution.
The $250 “user fee,” if passed, will force the exodus of veterans who cannot afford this fee. The VA estimates that some 213,000 currently enrolled veterans will opt not to pay this fee to the detriment of their health nor will they opt not to pay the increased drug co-payment of $15 as proposed by the administration. Congress rejected these misguided proposals last year. We hope you will do the same this time around.
The budget cites an anticipated savings of some $590 million in unnamed “management efficiencies.” Does this mean laying off half of the staff at VA’s headquarters? Deferring yet more needed preventive maintenance and capital improvements? More important, what exactly will this mean as it trickles down to individual VA medical centers? We fear that this will lead to longer waits to be seen by primary care physicians and by specialists, and a general degradation of the system.
At the same time, the proposed budget does not take into account long-term care. Nor does it consider the short-term or long-term needs of a new generation fighting today in hotspots around the globe. Many of these men and women are returning to our shores with grievous, maiming injuries that will take years of treatment and rehabilitation.
With regard to long-term care facilities, an increasing need will be met by decreasing resources. The $312 million slash in funding for nursing homes (including care for veterans in state extended care facilities) will result, according to top VA officials, in some 5,000 fewer beds in the VA system. This will impact the states, and on the families of veterans who urgently need this care. What will they do?
There are no additional resources provided for the VA Readjustment Counseling Service, or vet center program. This is the most studied program of the VA, and every study, by GAO and others, have found that this is the most cost-effective, cost-efficient program operated by the VA. An investment of $17 million in the vet centers would by one full-time family counselor skilled in grief counseling and PTSD counseling in each of the 206 centers, as well as an additional 40 staff to augment the staff at centers near clusters of the returning veteran population to be able to meet their needs. Vet Centers help keep veterans employed, and help keep their families together. This $17 million would disappear into the rest of VHA without a trace, whereas by setting aside this amount for an increase in the vet centers budget will have an immediate, measurable, and very visible impact.
The budget proposal flat-lines funding for medical research, which we believe is a mistake. The National Institutes for Health received a significant increase yet once again, despite the fact that it does not fund even one veteran-specific grant. Are veterans less worthy, or their health care needs not worth studying? It is only through research that we gain knowledge that we then turn into practical applications of immediate benefit to improve care for veterans, especially as to conditions that may have originated in military service. Of course, these discoveries not only accrue to veterans but to all of us. The VA can be justifiably proud of the fruits of its research over the past half-century; one researcher was awarded a Nobel Prize for her research. This cannot continue without proper funding.
When the endorsement of the CARES program by former Secretary Principi was announced, we were assured, in a presentation at the Longworth House Office Building, that this initiative would be funded to the tune of $1 billion a year over the next five years. This was guaranteed. Now we see funding of $750 million. This might be the silver lining in an otherwise grim budget: The VA is forced to rework what we see as a flawed formula on which the CARES model is based. Most veterans are not middle class. They present at VAMCs with far greater frequency than do most middle-class health consumers, a salient fact not taken into account by CARES. Currently CARES still does not take into account long-term care, nor does it take into account returning veterans who are disabled, wounded, and ill from the war raging in Iraq, Afghanistan, and elsewhere in the world.

Mr. Chairman, as you are aware there are more than 250,000 homeless veterans sleeping on the streets or in shelters every night. While we appreciate the slight increase in the VA FY06 budget for homeless programs, VVA believes that the VA Health Care for Homeless Veterans funds, which includes the Homeless Grant and Per Diem Program, needs to be a separate line item in the budget. For these veterans, who once served our nation with pride, we simply must do more and we must do better.

In regard to the Veterans Benefits Administration, (VBA), VVA is concerned that the structural shortfall of resources in funding is not addressed in this budget. As you are aware, $125 million had to transferred from medical care services this year just to keep a minimum number of staff, particularly compensation and pension adjudicators, on the job and working in order not to fall even further behind in the time it takes to get a fair and accurate decision on a veteran’s claim. We are also concerned that there does not appear to be any significant enhancement in the number of veteran benefits counselors to assist returning OIF/OEF veterans who may need their assistance, nor does there appear to be any major outreach campaign to reach returning veterans, as well as returning members of the National Guard and Reserves.

Many member of this committee are familiar with a quote from the father of our country, George Washington: “The willingness with which our young people are likely to serve in any war, no matter how justified, shall be directly proportional as to how they perceive the veterans of earlier wars were treated and appreciated by their nation.” As you discuss and debate this budget, think about this, and those in uniform in Iraq and Afghanistan.

Mr. Chairman, Vietnam Veterans of America thanks you and your distinguished colleagues for considering our views on this issue of vital importance to veterans of every generation.

VIETNAM VETERANS OF AMERICA
Funding Statement
February 16, 2005

The national organization Vietnam Veterans of America (VVA) is a non-profit veterans membership organization registered as a 501(c)(19) with the Internal Revenue Service. VVA is also appropriately registered with the Secretary of the Senate and the Clerk of the House of Representatives in compliance with the Lobbying Disclosure Act of 1995.

VVA is not currently in receipt of any federal grant or contract, other than the routine allocation of office space and associated resources in VA Regional Offices for outreach and direct services through its Veterans Benefits Program (Service Representatives). This is also true of the previous two fiscal years.

For Further Information, Contact:
Director of Government Relations
Vietnam Veterans of America.
(301) 585-4000 ext. 127

Thomas H. Corey

Tom Corey serves as President of Vietnam Veterans of America, the nation’s only congressionally chartered organization exclusively serving the needs of Vietnam-era veterans and their families.

A native of Detroit, Corey entered the U.S. Army and was sent to Vietnam in May 1967 where he served as a squad leader with the 1^st Air Cavalry Division. While engaged in an assault against enemy positions on January 31, 1968, he received an enemy round in the neck, which hit his spinal cord and left him paralyzed and a quadriplegic. He was medically retired in May 1968. Corey is a decorated combat veteran.

After an extended hospitalization, Corey returned to his family in Detroit where he spent his time in and out of the local VA hospital. He relocated to West Palm Beach, Florida, in 1972, where he is involved in community affairs and serves on many advisory boards, including those at the VA Medical Centers in Miami and West Palm Beach, the VA Research Foundation of Palm Beaches, and the VSIN 8 Management Assistance Council. He has received numerous awards for speaking out on veterans’ and disabled persons’ rights.

Corey has returned to Vietnam numerous times regarding our POW/MIAs and Agent Orange issues with successful results.

Corey was the first recipient of the Vietnam Veterans of America’s Commendation Medal, VVA’s highest award for service to veterans, their families, and the community.

Corey was the founding President of VVA Palm Beach County Chapter 25 in 1981. In 1991, the chapter was named the Thomas H. Corey Chapter at its tenth anniversary celebration. In 1985, he was elected to VVA’s National Board of Directors. In 1987, he was elected VVA’s national Secretary and was re-elected in 1989, 1991, 1993, and 1995 to that position. In 1997, he was elected VVA’s national Vice President through 1999; in 2001 he was elected VVA President and was re-elected in 2003.

Corey is a member of the Paralyzed Veterans of America, Military Order of the Purple Heart Association, Disabled American Veterans, American Legion, Veterans of Foreign War, 1st Cavalry Association, and the National Association of Uniformed Services.

Tom Corey resides in West Palm Beach, Florida. He has a son Brian, and a daughter, Trang.

Statement

For the Record

of

Vietnam Veterans of America

Thomas H. Corey
National President

Thomas H. Corey

Statement For the Record of Vietnam Veterans of America

Thomas H. Corey National President

Thomas H. Corey

Statement

For the Record

of

Vietnam Veterans of America

Thomas H. Corey
National President