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GOVERNMENT AFFAIRS
BY JOHN MITERKO, CHAIR, VVA GOVERNMENT AFFAIRS COMMITTEE,
WITH VVA GOVERNMENT AFFAIRS STAFF
When Rep. Chris Smith (R-N.J.) chaired the House Veterans’ Affairs
Committee, he cultivated a reputation as an advocate for
veterans. Deposed by House leadership two years ago in the
109th Congress because he fought so hard for funding for
veterans’ health care at his own political peril, he
left the committee. But he has not ceased serving veterans.
At
a hearing of the Senate Veterans’ Affairs Committee
on July 25, Smith was the lead witness to testify in favor
of the need to overhaul the funding mechanism for veterans’ health
care. “No one on earth has done more to protect and
preserve freedom, democracy, and fundamental human rights
than our veterans,” he intoned. “When the dust
settles, it is the veteran and his or her family who bear
the physical and emotional scars of war; for some it’s
the ultimate price.”
Smith painted what he called a “sobering
picture” of
the current direction veterans’ health care funding
is headed. “Notwithstanding a potentially huge
plus-up in the FY’08 VA Medical Appropriations, the
funding mechanism remains broken,” he said.
“Unless
we fix the funding process for VA health care, all efforts
to improve its delivery will continue to be impeded, and
worse, we risk new Walter Reed-like problems at VA facilities
in the future,” he told the committee. Smith argued
that the recent shortfalls in veterans’ health care
funding could only be fixed by “sufficient, timely,
and predictable funding. “It is astonishing to me that
since 1990, 16 of the 18 VA appropriations were late—on
two occasions five months late, once
seven months late. How can the Secretary, VISN directors,
and medical directors plan and execute delivery of medical
services under those adverse circumstances?”
Smith,
who chaired the House Veterans’ Affairs Committee from
2001 to 2004, pointed to the proposal of a previous advisory
board set up by President Bush to support his recommendation
that the system must be reformed.
Smith, who has introduced
legislation to create an independent, expert panel to determine
the level of funding required to meet projected demand with
accepted access standards, said that either of these suggestions
or perhaps a hybrid of both “would be a dramatic improvement
over the status quo.”
Smith noted that “no single
issue garnered more of the committee’s
attention than ensuring that the VA received the funds it required to provide
services veterans needed” during his tenure as chairman. Despite the bipartisan
nature of the committee, he said that the Congressional appropriations process
for veterans’ funding is where the process becomes flawed as it “replaces
sound data with other
agendas.
“With the devastating types of injuries being suffered
in the war today and the long-term care needs of so many
veterans on the rise, we must ensure that the VA continues
to provide world-class medicine far into the future,” Smith
said. “I urge you to move forward with recommendations
for a systematic reform of VA’s health care funding
system that provides sufficient, timely, and predictable
funding.”
SEEING THE LIGHT AT THE PENTAGON
Meanwhile, top brass at the Pentagon have acknowledged what
most of the rest of the veterans’ community have known
for a while now, that the military is unable to provide adequate
psychological care for troops, a situation made all the more
dire by the nature and extent of the fighting in Afghanistan
and Iraq. The problem is compounded because of insufficient
funding and prejudices toward mental illness.
“The military
health system lacks the fiscal resources and the fully trained
personnel to fulfill its mission to support psychological
health in peacetime or fulfill the enhanced requirements
imposed during times of conflict,” according
to “An Achievable Vision,” a report from the
Pentagon’s Task
Force on Mental Health.
Among the report’s findings:
- A stigma attached to mental
health problems among service members “remains
pervasive and often prevents service members from seeking
needed care.”
- “Existing processes for psychological
assessment are insufficient to overcome the stigma inherent
in seeking mental health services.”
- “Mental health
professionals are not sufficiently accessible to service
members.”
- “Leaders, family members, and medical
personnel are insufficiently trained in matters relating
to psychological health.”
- “Some Department of
Defense policies, including those related to command notification
or self-disclosure of psychological health issues, are
overly conservative.”
- “The number of active duty mental
health professionals is insufficient and likely to decrease
without substantial intervention.”
The task force calls
for changing “policies to reflect current knowledge
about psychological health, making “psychological assessment
procedures an effective, efficient, and normal part of military
life,” and ensuring
that the military health network’s provisions “fulfill
beneficiaries’ mental
health needs.”
According to that report, soldiers who
were deployed more than six months or multiple times were
more likely to screen positive for a mental health issue.
ONE
OF MANY
As a result of the media attention and public firestorm over
conditions that erupted this spring at Walter Reed Army Medical
Center, the President, acting decisively, appointed task
forces and commissions to investigate what went wrong and
what needs to be done to right the health care system.
Much
of the media that jumped on the story after initial revelations
by two reporters for The Washington Post managed to confuse
military hospitals with VA medical centers. But all the attention
and outrage helped crystallize the gaps in service that undermine
health care at both VA and military facilities.
The findings
and recommendations of the task forces and commissions, particularly
the commission headed by former Senator Bob Dole, a veteran
of World War II, and former Health and Human Services Secretary
Donna Shalala, now the president of the University of Miami,
generated much interest in the public and the press. Many
of the recommendations are sensible and can be implemented
at no cost or minimum cost.
But to really assist veterans,
and particularly combat-wounded veterans and active-duty
troops, the military services and the VA have got to forego
their turf wars. The bottom line, that caring for our war-wounded
is part of the continuing cost of the national defense, is
basic: If the soldier or sailor or Marine or airman or Coast
Guardsman is not afforded all the assistance (s)he needs
to transition from active duty to veteran status, if the
continuum of non-clinical case management breaks down somewhere
along the chain, then all of the recommendations and new
ways of doing business, all of the good will and sincere
offers of assistance will be for naught. Both DoD and VA
officials need to be held strictly accountable for implementing
these recommendations, and bonuses withheld until all are
actually accomplished. That will certainly focus the attention
of all concerned on the tasks at hand that are most pressing.
AID
FOR WOUNDED WARRIORS
H.R. 1538, the Dignified Treatment of Wounded Warriors Act,
which passed the Senate on July 25, addresses veterans’ issues
and concerns in a variety of arenas. In regard to mental
heath, the bill authorizes $50 million to improve the diagnosis,
treatment, and rehabilitation of service members with traumatic
brain injury (TBI) and Post-traumatic Stress Disorder (PTSD).
The legislation also establishes TBI and PTSD centers of
excellence to conduct research and develop “best
practices” for addressing these combat-related disorders.
The
bill creates a new evaluation system for disability rating
and increases severance pay for service members whose disability
is rated 30 percent or less.
This legislation contains a provision that would allow the
enrollment of Priority 8 veterans, e.g., veterans who do
not have a disability related to their military service and
whose annual incomes exceed $27,790. Passage of the bill
by both the Senate and the House would rescind a January
2003 regulation that prohibited their enrollment.
Opposing
this Democratic initiative, Larry Craig (R-Idaho), as of
this writing still the Ranking Member of the SVAC, said, “If
we open the door, the reality is that they will come.” He
estimated that as many as 17 million additional veterans
would be eligible to use VA medical services, although Sen.
Daniel Akaka (D-Hawaii), the committee chairman, said that
only 1.5 million veterans would likely enter the system as
a result of the change. VVA continues to strongly advocate
re-opening the VA health care system to all veterans, each
of whom earned that right by virtue of military service.
A
suicide-prevention bill (S. 479), also approved by the committee,
would require the VA secretary to conduct an outreach effort
aimed at Iraq and Afghanistan veterans and their families,
and to mount a campaign to discuss mental-health problems
among veterans. It would require the VA to make mental-health
care available around the clock. Perhaps anticipating Congressional
action, the VA announced a 24/7 suicide hotline. The House
passed a similar bill (H.R. 327) in March.
The omnibus benefits
bill (S.1315) would also provide expanded life insurance
benefits for veterans and treat Filipino World War II veterans
as U.S. veterans by paying them service-connected compensation
benefits at the full rate for veterans living outside the
United States.
This last provision sparked charges by the
Ranking Member of the House Veterans’ Affairs
Committee, Steve Buyer (R-Ind.), that, to pay for this “pork,” the
VA would have to take monies that would otherwise be dedicated
to the care of indigent and disabled veterans. Although spurious,
this charge sparked confusion and concern in the veterans’ community.
In fact, the poor interpretation of the law passed several
years ago would mean that veterans who are 60 percent disabled
at age 60 would receive larger payments from VA than 100
percent disabled veterans, which is simply not equitable.
MORE
$$ FOR HEALTH CARE
As this issue of The VVA Veteran was going to press, the
Senate was still debating the $109.2 billion Military Construction/Veterans
Affairs spending bill, which would add $3.6 billion for veterans’ health
care over and above the Administration’s
budget request for FY ‘08.
(Ever the good and loyal
acolyte of the President, VA Secretary Nicholson, who had
announced his resignation during the VVA convention in July,
effective no later than the first of October, argued that
the President’s budget request
would give the VA all the funding it needed. In fact, VVA
believes that the additional $3.6 billion above the President’s
requested amount is very much needed, and is too conservative,
if anything.)
Despite early threats of a presidential veto
because the spending measure passed in the House (H.R. 2642)
would provide almost $4 billion more than the President requested,
the White House Office of Management and Budget (OMB) stopped
short of threatening to veto the bill. According to Congressional
Quarterly, the OMB did state strong opposition to a provision
pushed by Sen. Dianne Feinstein (D-Calif.) that would prohibit
the commercial use of land at the 388-acre VA medical center
site in Los Angeles.
“The provision circumvents the
VA’s Capital Asset Realignment for
Enhanced Services [CARES] process, which the department uses
to determine where and when to build VA facilities,” CQ
wrote. “Feinstein’s concerns
came after the VA leased some of the land for commercial
use to private companies, including the Fox Entertainment
Group and Enterprise Rental Car, and her provision would
not allow similar developments to take place at the site
in the future.”
That provision, according to the OMB
statement, estimated that the provision “would
eliminate more than $4 billion of revenue,” which OMB
suggested “would
be used to improve facilities around the country for our
nation’s veterans.”
The VA has not officially determined how it plans to use
the Los Angeles site. It issued a report in August outlining
four possible plans for the tract, citing a “need to
maximize the reuse potential of surplus buildings and land” as
a main consideration for future planning. It planned a September
6 public hearing to discuss the proposed plans with Los Angeles
residents.
VVA continues to strongly support Senator Feinstein’s
position in this matter. Furthermore, VVA has repeatedly
pointed out the deep and fundamental flaws of the formula
used by the VA in CARES, but the VA continues to use this
civilian formula instead of one that would be more appropriate
to our nation’s
military veterans, given all of the injuries and illnesses
that afflict veterans by virtue of their military service,
which far exceeds a middle class, non-veteran population
formula.
I-T BREAKDOWN, AGAIN
How could this be, after soon-to-be-former VA Secretary Nicholson
promised his department would set the “gold standard” for
IT security?
More than a quarter of the computer equipment
at the Veterans Affairs Medical Center in Washington could
not be found by investigators, according to a recent report
by the Government Accountability Office (GAO).
Three other
VA facilities showed slightly better results but still could
not locate between 6 and 11 percent of their equipment, including
computers, hard drives, monitors, and other devices. In all,
the four facilities audited by the GAO reported more than
2,400 missing items originally worth $6.4 million.
Aside from
decrying potentially wasted tax dollars, lawmakers said the
report raises fresh questions about the security of the agency’s
information, including sensitive medical records and Social
Security numbers.
For the audit, the GAO sampled equipment
inventories at medical centers in Washington, San Diego,
Indianapolis, and at VA headquarters offices.
Auditors said
much of the equipment that could be found was not where inventory
records said it should be. Equipment often was moved or set
aside for discard without documentation. As a result, it
was difficult or impossible to determine what had happened
to the missing equipment, the report said.
Equipment slated
for disposal—some containing sensitive records—often
sat unprotected in storage rooms for months or years, the
report said. “Essentially
no one was accountable for IT equipment,” it concludes.
VA
officials did not dispute the findings, but said they were
making “progress.” Since
the three-month audit was completed, officials said they
had located much of the missing equipment or had verified
that it was sent to surplus.
Robert Howard, VA’s Assistant
Secretary for Information and Technology, said he did not
believe the agency has enough manpower to keep up with the
problem.
The VA has been under intense scrutiny in the past year over
the quality of its care for veterans and a series of information
technology blunders.
Last year, the VA lost data on 26.5 million
veterans when computer equipment was reportedly stolen in
Maryland. In January, a VA hospital in Birmingham, Ala.,
lost sensitive data on more than 1.5 million people when
a hard drive went missing. A recent internal review of that
incident found that the medical center repeatedly failed
to follow policies and regulations to protect information,
including storing the hard drive.
FEDERAL AGENCIES FAIL TO
MEET CONTRACTING GOAL FOR VETERANS
According to an article in WashingtonBusiness.com, contracting
data for the fiscal year that ended last September 30 show
that agencies have sent more contracting dollars to service-disabled
veteran-owned small businesses than in past years, but they’re
still falling short of the mark, an SBA official told a House
subcommittee at a hearing on July 12.
Agencies have a long way to go in spending 3 percent of
their contracting dollars with service-disabled, veteran-owned
small businesses. Last year, only two agencies—the
Small Business Administration and the Department of Veterans
Affairs—met
the mark. Most agencies lag well behind, officials told the
House Veterans’ Affairs
Committee’s Economic Opportunity Subcommittee.
Rep.
Stephanie Herseth Sandlin (D-S.D.), who chairs the subcommittee,
requested a list of agencies with the lowest percentages.
The SBA’s Bill Elmore said
a soon-to-come electronic scorecard rating agencies may be
effective in urging them to meet the 3 percent goal. The
scorecard will list the details of contracting dollars in
real time.
Veteran small-business owners—and the Veterans’ Entrepreneurship
Task Force, which VVA’s Al Gibson and Rick Weidman
were instrumental in founding—are eagerly awaiting
the scorecard. It is inexcusable that the SBA is still sitting
on this and other key data pertaining to veteran-owned and
service-disabled veteran-owned small businesses. The bright
promise a year ago of SBA getting a new leader in Administrator
Steve Preston dims as the SBA continues to fail to meet its
responsibilities to veteran small-business owners under the
law and as directed by Executive Order 13-360.
Paul Dennett,
administrator of Office of Federal Procurement Policy, said
contracts to small businesses owned and controlled by service-disabled
veterans increased to $1.9 billion, up from $1.2 billion
in 2004. However, that is far short of 3 percent the law
and President Bush’s executive order
call for, by about $10 billion in FY 2006.
WE REGRET
THE OUTBURST, SECRETARY MANSFIELD
The only sour note at the smooth-running national convention
in Springfield, Illinois, was sounded by a New York VVA member
who interrupted the remarks of VA Deputy Secretary Gordon
Mansfield.
The comments, writes Robert Parsons of VVA Chapter
295 in Indianapolis, “were
disrespectful, embarrassing, and totally inappropriate.”
“The
delegate’s views and the belligerent manner in which
they were presented did not represent the opinions of myself
or any other veterans that I spoke with, and certainly did
not reflect the standards of civilized behavior that the
vast majority of delegates tried to maintain throughout the
convention.
“We as a body owe this official, who is
a Vietnam veteran himself and took the time and effort to
come and speak to us, a sincere and official apology. This
will hopefully communicate that we are not all disrespectful,
boorish, and crude, and that we do not condone this type of conduct.
“This
official apology should appear prominently in The VVA Veteran.”
So
here it is. Deputy Secretary Mansfield, please accept our
sincere apology for this rude behavior that is so out of
character as to how VVA does business, and not characteristic
of how our leaders and staff at every level conduct ourselves.
We are strong advocates on the keys issues for veterans and
their families, but we are respectful of all persons whom
we encounter.
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2008, Vietnam Veterans of America. All Rights Reserved. 8605 Cameron
Street, Silver Spring, MD 20910