HVAC Healthcare Sub-Committee Hearing
April 16, 2012
SHANE BARKER, SENIOR LEGISLATIVE
NATIONAL LEGISLATIVE SERVICE
VETERANS OF FOREIGN WARS OF THE UNITED
COMMITTEE ON VETERANS’ AFFAIRS
UNITED STATES HOUSE OF REPRESENTATIVES
WITH RESPECT TO
H.R. 1460, H.R. 3016, H.R. 3245, H.R. 3279,
H.R. 3337, H.R. 3723
and H.R. 4079
WASHINGTON, DC April
Madam Chairwoman and Members of this committee,
on behalf of the more than 2 million members of the Veterans of Foreign Wars of
the United States (VFW) and our Auxiliaries, the VFW would like to thank this
committee for the opportunity to present its views on the following bills:
1460, to provide for automatic enrollment of veterans returning from combat
zones into the VA medical system:
The VFW supports the concept of H.R.
1460, legislation that would automatically enroll service members who have
deployed to Iraq or Afghanistan for health services in the Department of
Veterans Affairs (VA). For years now, our nation has provided 5 years of
no-cost health care for separating service members through VA, but they must
first go through the enrollment process.
This generous provision has been critically important to many veterans,
and the enrollment numbers are high.
However, for a variety of reasons, many veterans have not enrolled for
VA care. We believe that this automatic
enrollment could positively affect those individuals, and tip the scale in
favor of them receiving the VA health care they have earned.
H.R. 1460 will take the assistance we
provide one step further by having VA initiate enrollment into the system on
behalf of the combat veterans of our current conflicts, and taking the cumbersome
work of enrolling off their shoulders while preserving their choice through a
process to opt-out. Returning warriors
have serious and pressing concerns they must address without delay when they
return from combat – employment endeavors, rekindling relationships with family
and friends, and coping with the emotional burden of their war
experiences. The least we can do is
remove burdens to begin receiving care from the VA so they can more quickly
begin to address those important needs.
However, the VFW is concerned that it
would create a paradigm in which the injuries and illnesses veterans who do not
deploy incur are not given similar priority as those who deploy but do not
experience any adverse health effects immediately attributable to their
military service. While it does not
incentivize current conflict veterans who have deployed to hostile regions to
avail themselves to VA care, it could prove to be polarizing, and send the
message to non-deployed veterans that they do not qualify for VA health care.
The VFW would support this legislation
if it were amended to include enrolling all separating service members into
VHA. This would allow service members
who were injured or became ill during service, but who did not deploy, the same
accessibility as those who have deployed.
Also, Congress would need to ensure VA has the resources to properly
3016, to direct the Secretary of Defense and the Secretary of Veterans Affairs
to jointly operate the Federal Recovery Coordination Program:
The VFW supports H.R. 3016. In our view, the most important aspect of
this legislation is the length it goes to keep the Federal Recovery
Coordination program (FRC) a top priority of the Secretaries of Defense and
Veterans’ Affairs. By mandating the
administration of this program must stay in the respective offices of each
secretary, we can have more peace of mind that the wounded, ill and injured
warriors the program was created to serve will receive the high-level attention
they deserve. Administration of the FRC
program has been shuffled around more than once since it was created in 2007,
and we believe this legislation will end that by mandating in law that it be
housed where it belongs – at the very top.
This committee must also conduct continued oversight over this program
as practicable to ensure that the letter and spirit of this law – and the
critical importance of the FRC program – are embraced within DOD and VA. The men and women who go to war and come
back with life-threatening injuries deserve no less, and we give our full
support to this legislation.
3245, the Efficient Service for Veterans Act:
The VFW supports H.R. 3245. This
legislation requires collaboration between the DOD and VA to ensure that VA’s
Vet Centers have access to the two data repositories that house a service
member’s DD-214. Granting Vet Centers
access to these databases means that they can independently verify a veteran’s
eligibility for services without the veteran needing to provide a paper copy of
the DD-214. This instant access to
service records will remove an unnecessary and often time-consuming hurdle to
care for veterans needing peer support or mental health counseling from other
veterans. At a time when so many of our
veterans are in need of these kinds of counseling options, we should make this
change without delay and continue to look for ways we can expedite and
3279, to amend title 38, United States Code, to clarify that caregivers for
veterans with serious illnesses are eligible for assistance and support
services provided by the Secretary of Veterans Affairs:
The VFW strongly supports H.R.
3279. The Caregivers and Veterans
Omnibus Health Services Act of 2010, commonly known as the Caregiver Bill or P.L.
111-163, provided long-overdue financial
and medical support for family members or other designated individuals who are
willing to be trained to provide high-quality in-home health care for severely
injured veterans of the conflicts in Iraq and Afghanistan. The Department of Defense provides similar
support to family members of members of the armed forces who are
catastrophically disabled, and includes disability caused by illnesses in their
eligibility requirements. Because the
law does not currently provide VA caregiver support to those who are seriously
disabled because of an illness, the potential exists for military members and
their families to lose a critical benefit as they transition out of the
military into VA care.
The caregiver benefit must be
seamless. It is simply too important for
the physical health and general well-being of the men and women who are
catastrophically disabled in service to preclude those who have suffered from a
debilitating illness from receiving this benefit.
3337, the Open Burn Pit Registry Act of 2011:
The VFW supports H.R. 3337. Open-air burn pits were used extensively in
Iraq and Afghanistan to incinerate everything from medical supplies to
automobiles, with possible hidden and grave health reactions on the military
personnel exposed to them. VA, DOD, and
other partners in the civilian sector are working to give us the tools
necessary to properly diagnose and treat the conditions associated with
open-air burn pits and other environmental exposures. However, much work remains to be done, and
any delay means less than optimal treatment options now.
Both DOD and VA have areas where they
could improve their support to those suffering from an environmental
exposure. In addition to working to
treat these conditions, the Veteran Benefits Administration must continue to
improve their ability to account for their effects when evaluating claims, and
DOD could make a greater effort.
Unfortunately, their lack of responsiveness to repeated requests for
information from Congressman Akin in relation to this bill has made it
difficult to ascertain what, if any, measures they have taken. We lament DOD’s unwillingness to provide the
requested information, and hope they will soon respond to that request. We would also very much like to see DOD reach
out to veterans and military service organizations to forge a more productive
working relationship on this important issue.
The VFW believes that this registry is
essential to allow service members the peace of mind of going on record with VA
at the earliest possible time to say they were exposed, and to assist VA in
knowing how to best deploy advances in medicine and technology as they become
available to treat the serious conditions associated with burn pit exposure. We know that the physical effects of
environmental exposures can go unnoticed for decades, and it can be
extraordinarily difficult to establish causation to military service that has
long since passed. This legislation is a
positive step forward, and we ask the committee to pass this measure without
3723, the Enhanced Veteran Healthcare Experience Act of 2011:
The VFW does not support H.R. 3723. While
we do not support the legislation, we understand the impetus for it and agree
that improvements to the current Fee-Basis system of referring veterans to a
private-sector provider are long overdue.
The program has many areas where improvements would provide more return
on investment for the government and would improve the quality of care for
veterans. Currently, coordination of
care between VA and the private provider is virtually non-existent. As a result of limited controls and
processes, VA does not have the ability to evaluate the quality of care
provided, or integrate the associated private-sector medical records into
existing medical history records the VA maintains for that veteran. VA also has little reach into the offices of
doctors caring for veterans through the Fee-Basis paradigm to ensure the services
being billed were actually performed. VA
has no ability to guarantee or measure distance or timeliness standards, and
veterans get no assistance from VA in finding doctors or assistance making
appointments once a doctor is found.
Clearly, there is much to be desired, especially when taking into
account that the VA paid out more than $4 billion in health care claims in FY
Nevertheless, the VFW cannot support
this legislation at the present time.
The bill would mandate the Secretary to enter into contracts with
network providers in order to provide a nationwide network of service providers
to improve the non-VA care, thereby addressing many of the issues identified
above. However, the VFW is concerned
that the legislation would result in VA moving veterans outside of the VA system
precipitously. Instead of working to
improve processes and make the VA system more efficient and increase
throughput, VA would have the obligation to move veterans into the non-VA care
program when timeliness or distance standards are not met.
Complicating matters is the reality
that the only way to make such a program cost-effective is to actively manage
the volume of referrals into the program.
Network providers would find it necessary to give care providers
reasonable expectations of patient access and volume to negotiate a favorable
rate for services being contracted.
The VFW would also call into question
the ability for contracts entered into under this paradigm to be successful
without first seeing how VA executes the implementation of the Patient Aligned
Care Team (PACT) model of patient-centric care within the VA. The proponents of this legislation
pre-suppose that the PACT care coordinator would act as a conduit to a care
coordinator employed by the network provider.
However, we see no evidence to suggest that the PACT model will
routinely and successfully coordinate the care provided internally at VA
without this layer of complexity added to the equation. The VFW believes that the PACT model must be
a success. Therefore, we should ensure that it is refined to smooth out the
rough edges before taking this step.
At the same time, VA is moving forward,
if slowly, with their own efforts to implement the Patient Centered Community
Care (PCCC) program that would establish contracts to provide a limited
portfolio of services that would be more fully coordinated with VA. Publicly available data suggests that this
portfolio is limited to medical and surgical services, but excludes dialysis,
mental health, and primary care. While
it is certainly true that we believe any successful program to coordinate
non-VA care would include these services, we firmly believe VA must get this
right. It is imperative that these
issues be resolved, and we believe that VA’s initiative must be given a chance
to be executed and evaluated before fundamental and controversial changes, such
that this bill would precipitate, are allowed to move forward.
Our veterans deserve access to timely
and high quality health care that is fully integrated and responsive to their needs. To achieve this, we strongly encourage the
committee to expeditiously conduct due diligence on the Fee-Basis program to
have a better understanding of this and other potential options before
initiating further legislative changes to this program.
H.R. 4079, the Safe Housing for
Homeless Veterans Act:
supports H.R. 4079. We believe this legislation will ensure that homeless veterans are living in housing that is
deemed safe and in compliance with codes required by county and state laws. Currently,
VA is required to check housing certificates before awarding grants for housing
services provided to homeless veterans. However, a thorough check of fire and
safety requirements, as well as structural conditions of the building, are
H.R. 4079 would require certification
that the building has met all necessary code specifications before a grant
would be awarded. It also gives priority in awarding grants to those seeking
assistance for any project that would make improvements to a building in cases
where plans exist to provide housing and services for homeless veterans.
The VFW believes that there is no
greater need than providing a safe and secure environment for our homeless
veterans and their families. This legislation will protect the most
vulnerable by making certain that the housing provided fills that need until
they can return to independent community living.
Madam Chairwoman, this concludes my
statement. I would be happy to answer
any questions that you or the members of the Committee may have.
Information Required by Rule XI2(g)(4) of the House of Representatives
Pursuant to Rule XI2(g)(4) of the House
of Representatives, VFW has not received any federal grants in Fiscal Year
2012, nor has it received any federal grants in the two previous Fiscal Years.
BACK TO NEWS >