Legislative Issues

STATEMENT

VIETNAM VETERANS OF AMERICA

SUBMITTED BY

RICHARD WEIDMAN
DIRECTOR, GOVERNMENT RELATIONS
VIETNAM VETERANS OF AMERICA

BEFORE THE

HOUSE COMMITTEE ON VETERANS= AFFAIRS

REGARDING

DEPARTMENT OF VETERANS AFFAIRS BUDGET REQUEST FOR FISCAL YEAR 2002

MARCH 6, 2001

Mr. Chairman, on behalf of Vietnam Veterans of America (VVA), I thank you and your distinguished colleagues for the opportunity to present our views in regard to the President’s proposed FY 2002 budget for the United States Department of Veterans Affairs (VA).

While we appreciate President Bush speaking with emphasis about the Nation’s responsibility toward veterans, a one billion dollar increase in discretionary spending at VA is just not an acceptable increase. VVA is very concerned about what this grossly inadequate proposal, which does not even keep pace with medical inflation in the veterans health care system, will have on vitally needed services to veterans. In addition, VVA is equally concerned about the inadequate accountability whether the resources made available by the Congress are utilized for maximum positive impact, and whether VHA is actually spending funds in the manner directed by the Congress.

The rate of medical inflation in the United States varies from about 8% to 12% (+) per year. The reported $800 million dollar increase for the Veterans Health Administration (VHA) from FY 2001 to FY 2002 is approximately a 4% increase. In other words the Administration’s proposal for VHA is less than half of the conservative estimate of what VHA needs in order to not have their ability to serve veterans properly to be further eroded. Put simply the Congress can and must do better than this.

Vietnam Veterans of America does enthusiastically endorse the Independent Veteran Service Organization (IBVSO) budget. At least $ 1.7 Billion in additional funds over the FY 2001 level is needed in the VHA just to keep up with inflation. This level of funding for VHA does not address the need to restore the organizational capacity needed to serve veterans properly that resulted from the virtually “flat lined” appropriations of FY 1996, FY 1997, and FY 1998.

The so-called specialized care services at VHA (e.g., spinal cord injury treatment, blind & visually impaired services, post traumatic stress disorder treatment (PTSD) programs and services, etc.) have all been dramatically eroded in the past five years. When the Veterans Eligibility Reform Act was enacted in 1996, Congress mandated that the level of resources and capacity to deliver the specialized services, which is really the heart of the VHA mission, be maintained at least at the FY1996 level of effort. That has not happened. Rather, such services have been diminished and truncated due to both lack of resources and a poor job of emphasis on these programs by key managers at the Veterans Health Administration at the local health care delivery level, the Veterans Integrated Services Network (VISN) level, and at the national level.

One example of this diminishment of services is to the Seriously & Chronically Mentally Ill (SCMI) patients, which includes PTSD treatment. The funding for SCMI has dropped dramatically below the funding provided in FY 1996, never mind adjustment for inflation. At least five VISNs have no inpatient or resident treatment for chronic, acute PTSD. Substance Abuse treatment programs have disappeared or been dramatically cut. Yet VA maintains that they are in compliance with the capacity requirements of the 1996 law. The General Accounting Office (GAO) has determined that the management information systems and documentation of where it spends resources (much less the outcomes for the veteran) are woefully inadequate or non-existent. VVA believes that even without adequate systems it is clear that VA is not in compliance with the 1996 law, and needs to move to restore needed capacity, particularly in the specialized services.

Therefore, VVA recommends that an average of $1 Billion per year be dedicated to restoration of vitally capacity in VHA. This would probably be $600 million the first year, $ 1 Billion the second year, and $1.4 Billion the third year that would become part of VHA “baseline” funding. The overwhelming majority of these funds (i.e., 75% to 90%) should go to the specialized services, with the balance going in to staffing needs in acute care areas such as hepatitis c.

It is our belief at this point that centralized control of funding is required in the “specialized services” and some other key areas. The VA has been trusting the decentralized process of allocating all control of funds to the Directors of the Veterans Integrated Services Networks (VISNs) for the past five years has resulted in dramatic reductions in specialized services, including prosthetics. After the flood of complaints of denial of service from veterans who needed prosthetics to Congress, and the resulting seeming inability of VHA central management to win cooperation of the VISN Directors, it was determined that the only way to ensure that veterans could get proper prosthetics services, no matter where they lived in the United States, was to centralize the funding. That effort has proven to be a success.

VVA believes that the same centralized control of funding, along with adequate control being centralized, is necessary for all specialized services and other key areas, such as outreach, testing, and treatment of hepatitis C. This requirement for centralized control can be removed once the VHA has actually developed a sensible and workable computerized management information system, and has proven that there is a working system for holding VISN directors and other managers truly accountable for results and performance of the right measures.

The fact is that while VHA has done a great deal to address hepatitis c, there still has not been the kind of outreach, testing, treatment, and case management program needed in the face of the apparent magnitude of this problem. Nor has there generally been proper moves to acquire new staff at the medical center level needed to deal with the large number of veterans (more than 70,000) who have tested positive for the hepatitis c virus, even with only sporadic testing and virtually no outreach. Congress appropriated $350 million to deal with this problem, but VHA cannot account for where these funds went. The same could be said about any of the specialized services.

The bottom line is that VVA recommends at least $ 2.3 Billion be appropriated to VHA over the FY 2001 level, with special tight controls over at least $ 600 million of these funds to ensure that these funds are utilized as intended by the Congress (i.e., restoration of vitally needed organizational capacity, mostly in specialized services).

In regard to the Veterans Benefits Administration (VBA) we recommend at least $80 million increase, with the proviso that increased attention be paid to the hiring and proper training of new adjudicators, ensuring that these new personnel are attuned to knowledgeably, accurately, and equitably adjudicate veterans claims in a timely manner, with presumption in favor of approving a substantiated claim. To bring in new personnel and training them in a mind set of looking for reasons to deny a claim, as opposed to working to assist the veteran by identifying evidence to support the claim, is not acceptable, as we believe is occurring in some stations.

Furthermore, the VBA needs to take significant meaningful steps toward holding their staff, but particularly the supervisors and managers, a great deal more accountable for the accuracy and quality of their work. As of now, the predominant measurement emphasis is on volume of processed veteran claims, irrespective of how well or accurately the decision on that claim is determined. Because veterans know this, the number of appeals and remands by the Court of Veterans Appeals and the Board of Veterans Appeals back to the Regional Office of the Veterans Benefits is very high.

The reason why the number of appeals is so high is that individual veterans have lost any confidence in the system, and therefore appeal everything. The number of remands and Regional Office decisions eventually overturned would indicate that the veterans are correct to have little faith in the fairness and accuracy of decisions in many Regional Offices. Moreover, the high remand rate on appeal is directly responsible for increasing the pending claims backlog at the Regional Offices. Returned claims are afforded expedited consideration, pushing new claims that have been languishing in piles even further down the docket.

If we are ever going to eliminate the unacceptable backlog of claims, then the focus has to be on doing it right the first time. A few years ago the Ford Motor Company almost went out of business because the emphasis on the production line was solely on speed and volume, and not on quality. Once Ford changed the corporate culture to one of focusing on getting it right the first time, production costs went down, and the Ford Motor Company survived and earned the trust of the American people as a quality project.

The same sort or improvement in performance and results can also happen at the VA if the Congress moves to assist Secretary Principi in this task. While at least $80 million more is required for VBA, VVA is equally concerned about performance and results. Vietnam Veterans of America (VVA) is very concerned about effective use the money that is being spent toward accomplishing the objectives set by the Congress and the Secretary.

The National Cemetery Administration needs a significant increase to keep pace with inflation, or at least $10 to $12 million. The Office of the Inspector General appropriation should be significantly increased, at the same time that the Congress assist them in refocusing the way they carry out their mission. Too much time is being spent on recurring reviews that result in few changes or improvements of services to veterans.

Mr. Chairman, Vietnam Veterans of America (VVA) urges you and your distinguished colleagues to push hard for a significant increase to the inadequate request for the FY 2002 VA appropriation from the Administration. VVA also urges that you push hard for some of the safeguards to ensure accountability for actual performance and results in all areas of the VA, including greater accountability placed on key managers.

Vietnam Veterans of America (VVA) strenuously objects to the proposal to transfer $235 million from the Veterans Health Administration (VHA) to the Department of Defense (DoD) to help pay for the recently expanded Tri Care benefits. This is an outrageous suggestion, and we urge the Congress to reject it out of hand. The Defense side of the budget has plenty of room under the cap to pay for these benefits that retirees have earned by virtue of longevity retirement. General Motors does not ask Medicare to pay part of the retiree benefits paid to their workers who retirees, nor should a resource rich DoD ask an under funded VA to pay their bills.

VVA also strongly urges you and the Committee to move forward with a series of oversight hearings this year focusing on what VA said they were going to do with both the money appropriated for FY 1999 and FY 2000. Since the Congress gave them significantly more funds than VA said they needed to accomplish the goals set forth in their submittal, the central theme question should be on what are the results and actual performance.

Mr. Chairman, Vietnam Veterans of America thanks you for this opportunity to share our views on the budget for FY 2002 for the Veterans Administration. We stand ready to actively support you and your colleagues on this committee in every way we can to achieve proper funding for vitally needed services and treatment of veterans, and to ensure that those funds are spent most effectively as possible.

Richard Weidman serves as Director of Government Relations on the National staff of Vietnam Veterans of America (VVA). He served as a medic with Company C, 23^rd, Med, Americal Division, located in 1 Corps of Vietnam in 1969.

Mr. Weidman was part of the staff of VVA from 1979 to 1987, serving variously as Membership Services Director, Agency Liaison, and Director of Government Relations. He left VVA to serve in the Administration of Governor Mario M. Cuomo (NY) as Director of Veterans Employment & Training for the New York State Department of Labor.

He has served as Consultant on Legislative Affairs to the National Coalition for Homeless Veterans, and served at various times on the VA Readjustment Advisory Committee, the Secretary of Labor’s Advisory Committee on Veterans Employment & Training, the President’s Committee on Employment of Persons with Disabilities, Advisory Committee on Veterans’ Entrepreneurship at the Small Business Administration, and numerous other advocacy posts in veterans affairs.

Mr. Weidman was an instructor and administrator at Johnson State College (Vermont) in 1970s, where he was also active in community and veterans affairs. He attended Colgate University, B.A., (1967), and did graduate study at the University of Vermont.

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.