BY JOHN MITERKO, CHAIR,
GOVERNMENT AFFAIRS COMMITTEE,
WITH GOVERNMENT AFFAIRS STAFF
“The annual exercise of debating the merits of the
President’s proposed budget is flawed,” said
John Rowan, National President of Vietnam Veterans of America,
in prepared testimony before the Senate Committee on Veterans’ Affairs. “Medical
center directors should not have to be held in limbo as Congress
reworks and adjusts this budget and perhaps misses, yet again,
the start of the next federal fiscal year.
servants can be more effective, more efficient, and better
managers of the public trust if they can properly plan for
the funding they need to carry out their mission of caring
for their patients. We hope that this can be avoided this
year, and ask that you seriously consider an immediate alternative
to the broken system we currently have.”
as “inadequate” the FY’09
request for $2.34 billion more than the FY’08 appropriation.
This “does not quite keep pace with medical inflation” and “will
not allow VA to continue the needed pace of enhancing its
health care and mental health care services for returning
veterans, restore needed long-term care programs for aging
veterans, or allow working-class veterans to return to their
health care system.” To accommodate these goals, Rowan
said, VVA recommends an increase of $5.24 billion.
amount, $1.3 billion should be dedicated to restoring the
access of so-called Priority 8 veterans who were “temporarily” barred
from entering the system five years ago.
The House Veterans’ Affairs
Committee is committed to an increase of $4.6 billion.
condemned the proposed budget for again attempting to tax “higher
income” veterans with an annual
fee for signing into the VA health care system and for almost
doubling the co-payment for prescription pharmaceuticals. “This
is further evidence,” Rowan said, “of the attempt
to rid the system of as many ‘higher income’ veterans
as possible. We trust that you will see the folly in this
and will reject outright any attempt to enact these measures
into the law of the land.”
If you are the head of a
household that earns more than $28,000 a year, you are considered
by the VA to be “higher
Rowan voiced skepticism that the President’s
budget will provide resources “to virtually eliminate
the patient waiting list by the end of 2009.” He voiced
concern that the budget will provide adequate resources “to
deal with the flood of troops and veterans returning to our
shores with a range of mental health issues.” And he
dismissed the claim that “one of VA’s highest
priorities will be to continue an aggressive research program
to improve the lives of veterans returning from Iraq and
“It is our understanding,” Rowan
data collecting on the maladies and diseases of returning
troops is not happening. It’s almost as if our government
does not want to know about these ailments so that it won’t
be burdened with Dependency Indemnity Compensation payments.”
Last November, VVA sponsored a parade in Washington, D.C.,
to commemorate the 25th anniversary of The Wall. One component
of the parade consisted of informational tents on issues,
most of them health-related, of concern to veterans. Shortly
after the parade ended, two young women and their father,
a Vietnam veteran, visited VVA’s Agent Orange Awareness
exhibit. There they spoke with a VVA employee from our Veterans
The father suffered from both diabetes
type II and prostate cancer. Both girls were born with spina
bifida. Neither father nor daughters were aware that they
were eligible for VA benefits because of presumptive service
connection for exposure to Agent Orange. We ask: How many
other families like this are out there?
Part of the problem
exists because VA honchos are not committed to effective
outreach. After all, the more veterans and their families
know about what is available to them—what
the veteran has earned by virtue of his or her service in
uniform—the more claims the VA will have to rate, and
the more money it will have to pay out.
To help remedy this,
we recommend S. 1314, introduced by Sens. Russ Feingold (D-Wisc.)
and Richard Burr (R-N.C.). The Veterans Outreach Improvement
Act would help the VA achieve real outreach: “reaching
out in a systematic manner to provide proactively information,
services, and benefits counseling to veterans, and to the
spouses, children, and parents of veterans who may be eligible
to receive benefits under the laws administered by the Secretary
of Veterans Affairs, to ensure that such individuals are
fully informed about, and assisted in applying for, any benefits
and programs under such laws.”
If enacted, S. 1314 would
mandate that the VA Secretary establish a separate account
for the funding of the outreach activities of his department,
and to establish a separate sub-account for funding the outreach
activities for the Veterans Health Administration, the Veterans
Benefits Administration, and the National Cemetery Administration.
Such a provision would establish and maintain procedures
for ensuring the effective coordination of outreach activities
of the various facets within the VA—and with state
Passage of such a measure surely is needed.
Left to their own devices, VA managers will continue to do
ONE UP AND AT ’EM
The new Secretary of Veterans Affairs, General James Peake,
M.D., has one year to make his mark on the VA. VVA National
President John Rowan and Rick Weidman, executive director
for policy and government affairs, have met with Dr. Peake
and have been favorably impressed.
The big questions are:
Can he light a fire under a torpid bureaucracy? Will he
be the true veterans’ advocate
that his predecessor was not? Will he think out of the box
and try alternate ways of funding both the VA’s health
care system and benefits administration?
All this remains
to be seen. We wish him well and will work with him to achieve
mutually acceptable goals.
Shortly after Dr. Peake took occupancy
of his office on the tenth floor at 810 Vermont Avenue, one
of his top aides left. Adm. Dan Cooper, who had headed the
Veterans Benefits Administration for the past six years,
left under a cloudburst. It seems that the admiral’s
public statements hyping religion were not embraced outside
the administration. He was also criticized for the continuing
backlog in processing benefits claims.
Of the new secretary,
President Bush has said, “Dr.
Peake takes office at a critical moment in the history of
this department. Our nation is at war—and many new
veterans are leaving the battlefield and entering the VA
system. This system provides our veterans with the finest
care—but sometimes the bureaucracy can be difficult.
To address these problems, our administration, along with
the Secretary’s leadership, is implementing recommendations
of the Dole-Shalala Commission on Wounded Warriors.
other words, we’re not going to tolerate
bureaucratic delays. We want the very best for our veterans….
Our nation has no higher calling than to provide for those
who have borne the cost of battle—and we will honor
KUDOS FOR MANSFIELD
Deputy Secretary of Veterans Affairs Gordon H. Mansfield,
a life member of VVA, was named the first recipient of the
Robert Dole National Award for Service on Jan. 28 during
the annual conference of the Military Health System, which
provides health care for the Department of Defense.
Mansfield has devoted much of his adult life to serving this
nation and its veterans,” said Secretary
Peake. “Making him the first recipient of this honor
sets the bar high for those who follow.”
a combat-wounded Vietnam veteran and a long-time official
with the Paralyzed Veterans of America, has been the second
ranking officer in the VA since January 2004. The award was
established in Sen. Dole’s name to recognize
veterans who continue to serve the nation through public
“I cannot think of anyone who has done more
[than Sen. Dole] for the military and veterans health care
said. “As a patient and as a proponent in Congress,
he did everything he could to improve the care we provide
for our active-duty personnel, our veterans, and their families.”
TO ME, SAYS DoD
Finally moving quickly, the Department of Defense announced
a further step in its ability to share electronic health
information with the Department of Veterans Affairs.
development allows each agency to view the other’s
clinical encounters, medical procedures, and lists of medical
problems on shared patients, according to a DoD news release.
is the third enhancement announced this year to the ability
of DoD and VA to exchange information. In October, the VA
was provided access to DoD in-theater clinical data. In July,
pharmacy, allergy, microbiology, chemistry/hematology data,
and radiology reports were made available.
Data standardization remains a significant hurdle to the
ultimate goal of VA-DoD electronic medical record interoperability.
To achieve interoperability, both agencies must standardize
how data are defined, structured, and communicated and agree
on interagency code sets for such domains as pharmacy, allergy,
chemistry, and radiology.
Most of these elements have not
yet been standardized.
But the two departments, under the
watchful eyes of Congress, insist that they are committed
to making incremental improvements, allowing more records
to follow patients as they move from the military to the
veterans health care system.
28.5 CENTS A MILE
More than a million eligible veterans should be seeing their
mileage reimbursement more than double for travel to VA medical
The 2008 appropriations act provided funding for
the VA to increase the beneficiary travel mileage reimbursement
rate from 11 cents per mile to 28.5 cents per mile. The
increase went into effect Feb. 1.
After little more than a
month on the job, Secretary Peake used his authority to establish
the first increase in the mileage reimbursement in 30 years,
fulfilling a pledge he made during his Senate confirmation
While increasing the payment, the VA, as mandated
by law, also equally increased the deductible amounts applied
to certain mileage reimbursements. The new deductibles are
$7.77 for a one-way trip, $15.54 for a round trip, with a
maximum of $46.62 per calendar month. However, these deductibles
can be waived if they cause a financial hardship to the veteran.