SVAC Bill Hearing
May 09, 2013
RAYMOND C. KELLEY, DIRECTOR
NATIONAL LEGISLATIVE SERVICE
VETERANS OF FOREIGN WARS OF THE UNITED STATES
FOR THE RECORD
COMMITTEE ON VETERANS’ AFFAIRS
UNITED STATES SENATE
WITH RESPECT TO
S. 49, S. 62, S. 131, S. 229, S. 287, S. 325, S. 412, S. 422, S. 455, S,
522, S. 529, S. 543,
S. 633, S. 800, S. 825, S. 832, S. 845, S.
851, S. 852, AND DRAFT LEGISLATION
WASHINGTON, D.C. MAY 9, 2013
49, Veterans Health Equity Act of 2013
VA routinely assesses veterans’ health
care access needs through its Strategic Capital Investment Plan (SCIP). SCIP
prioritizes all levels of construction projects based on a scoring system,
placing those with the highest score at the top of the list. This model of
evaluation and resource allocation allows for equitable and consistent
distribution of capital funding. However, for SCIP to fully be realized,
sufficient funding must accompany the plan.
The requirement in S. 49 mandating VA to
maintain a full-service medical center in each of the 48 contiguous states
could cause funding for a higher priority construction project to be redirected.
The VFW does encourage VA to reevaluate New Hampshire, to ensure at any gaps in
service are identified and prioritized by SCIP.
62, Check the Box for Homeless Veterans Act of 2013
The VFW appreciates the spirit of this
legislation, but has some reservations about the possible negative unintended
consequences of creating non-traditional funding sources for important VA
programs. This bill would give taxpayers
the option of donating to a new Homeless Veterans Assistance Fund, which would
be established through the U.S. Treasury, by checking a box on their annual tax
returns. That money would then be made
available to VA, the Department of Labor, and the Department of Housing and
Urban Development, for the purposes of supporting programs that serve homeless
veterans. It also provides for
oversight of the Homeless Veterans Assistance Fund by requiring that the
secretaries of the aforementioned departments submit detailed expenditure plans
prior to using the funds, and that the use of the funds for the prior and
upcoming years must be described in the President’s annual budget submission.
Although the VFW commends the intent of
this legislation which is designed to support the administration’s goal of
ending homelessness by 2015, we are concerned that the establishment of the
Homeless Veterans Assistance Fund may create the rationale for future
reductions in traditional funding for homeless veterans’ programs. VA has made
marked and consistent progress toward that goal over the past several years
through adequate funding for effective initiatives such as Supportive Services
for Veterans Families, the Grant Per Diem Program, the Homeless Veterans
Reintegration Program, and HUD-VASH vouchers.
The VFW feels that now is not the time to experiment with alternative
funding sources for these critical services.
We must continue to pay for these programs with congressionally appropriated
dollars in order to ensure that they receive consistent and reliable funding
Women Veterans and Other Health Care Improvements Act of 2013
A decade of war has put service members
at risk for experiencing reproductive and urinary tract issues due to the lack
of pre-deployment health information, and the use of improvised explosive
devices (IED) leaving many more susceptible to blast injuries including trauma
to the reproductive areas. DOD has
reported that from 2003 to 2011at least 2,000 service members have suffered
from reproductive and/or urinary tract trauma.
Providing reproductive services that
meet the complex needs of our severely wounded veterans is critical in helping
many move forward with their lives and aspirations. Dreams of having a family
often are at the top of the list. Currently, VA offers some fertility services,
but they often do not meet the needs of those severely injured with more
complex reproductive needs (In-vitro fertilization or IVF is excluded from VA
medical benefits package under 38CFR 17.38 (c) (2)).
The VFW thanks Senator Murray for taking
the lead on this issue and supports Sections 2 and 3 which will provide
fertility counseling and treatment to include assisted reproductive technology,
like IVF, to a spouse or surrogate of a severely wounded, ill or injured
veteran who has an infertility condition which was incurred in the line of duty
or while on active duty. The patient must be enrolled in VHA and, in the case
of a spouse or surrogate of a veteran not enrolled, VA would coordinate
fertility and counseling for them. VA is not required to find or certify a
surrogate, or connect the veteran with a surrogate, or provide maternity care
for the spouse or surrogate, which will negate any legal issue that may arise
during the process.
The legislation also calls on VA to
conduct collaborative research with DOD and Health and Human Services (National
Institutes of Health) to address the long-term reproductive health care needs
of veterans with service-connected reproductive injuries. We believe that this
research is critical in addressing and treating the unique infertility issues
of veterans with combat injuries now and in to the future.
The VFW also supports section 9 which
improves access to services for women veterans through VA’s Women Veterans Call
Center. With an increasing number of female veterans entering the health care
arena, VA must take every opportunity to reach out and provide assistance and
guidance, as well as referrals to community resources for services not offered
We are also pleased to see provisions in
sections 10 and 11 of the bill that would expand the child care pilot program
for veterans seeking readjustment counseling at Vet Centers, and also increase
the number of counseling retreat locations which help to ease newly separated
female veterans back into civilian life. The VFW supported the original
language established in P.L. 111-163, and is happy to see these programs
229, Corporal Michael J. Crescenz Act of 2013
The National VFW does not take positions
on the designation of federal property. We do encourage our state and local VFW
members to be involved in these designations to ensure community buy-in.
287, a bill to amend title 38, United States Code, to expand the definition of
homeless veteran for purposes of benefits under the laws administered by the
Secretary of Veterans Affairs, and for other purposes.
The VFW is pleased to support S.287,
legislation that would clarify the definition of “homeless,” thereby aligning
it with the McKinney-Vento Act to include those displaced by domestic violence.
No veteran should ever be homeless, and
expanding the definition to include those veterans who are fleeing situations
of domestic abuse is the right thing to do.
By making this change, we support this population of veterans and help
them to have the courage and means to leave their abusive and sometimes
life-threatening situation. This bill
will also ensure they receive access to the benefits VA already provides
thousands of homeless veterans.
We believe this legislation will
significantly improve the lives of those who become homeless as a result of difficult circumstances
outside of their control, and help them on their way to beginning a new chapter
in their lives. We urge the Committee to
pass this bill quickly.
325, a bill to amend title 38, United States Code, to increase the maximum age
for children eligible for medical care under the CHAMPVA program, and for other
The VFW strongly supports this
legislation to extend the age limit for coverage of veterans’ dependents
through the Civilian Health and Medical Program of the Department of Veterans
Affairs (CHAMPVA) to the level set by the Patient Protection and Affordable
The health care reform legislation,
passed in early 2010, allowed families with private health insurance coverage
to keep their children on their plans until age 26. Left out of that change was TRICARE and
CHAMPVA recipients. Thanks to
responsible leaders in Congress, TRICARE coverage has been guaranteed to this
age group. Unfortunately, CHAMPVA
beneficiaries have not been afforded the same privileges. This program, which was established in 1973
and has more than 330,000 unique beneficiaries comprised of dependents and
survivors of certain veterans, should in no instance ever receive less than the
national standard. This legislation
would provide equity to CHAMPVA beneficiaries and rectify this outstanding
412, Keep Our Commitment to Veterans Act
The VFW supports S. 412. Congress must
authorize the funding of the FY2013-FY2014 major medical leases. Without this
funding, twelve VA facilities across the United States may not be able to properly
serve their communities. For example,
the Errera Community Care Center (ECCC), a leading center of innovation
providing psychological rehabilitation, homeless reintegration, substance abuse
counseling, and employment services to over 4,700 veterans in the greater West
Haven, Connecticut area must relocate to a larger facility in order to remain
effective. The facility that currently
houses the ECCC is so insufficient to meet the demand for services that
veterans’ group therapy sessions are conducted in hallways, and two to three
staff members share a single desk. In
order to ensure that the momentum that has recently been achieved in solving
the complex problems many veterans face is maintained, community centers like
the ECCC must be provided with adequate facilities.
However, the passage of this Act does
not solve the long-term problem of funding VA major medical leases under the
Congressional Budget Office’s new lease evaluation. While S. 412 is a good
first step, Congress must take action to ensure that these annually
appropriated leases are not continually delayed.
422, Chiropractic Care Available to All Veterans Act of 2013
The VFW supports this legislation which
would establish chiropractic care services at all VA medical centers by the end
of 2016. In accordance with P.L. 107-35,
chiropractic care is currently offered at 47 of the 152 VA medical centers
nationwide, with at least one facility being in each VISN. This bill would initiate a gradual expansion
of chiropractic care services, requiring that they be made available at no
fewer than 75 medical centers by December 31, 2014, and all medical centers by
December 31, 2016.
It is well known that service members
who deploy to combat and participate in military training are subject to
extraordinary physical demands, often resulting in the premature onset of
painful spine and joint conditions. The
2010 VA analysis of health care utilization among OIF and OEF veterans listed
“diseases of musculoskeletal system/connective system” as the number one
condition for which Iraq and Afghanistan veterans sought VA care. Chiropractic care can often be a successful
alternative to drugs or invasive procedures for treating musculoskeletal
disorders, while also offering suggestions for lifestyle modifications which
promote overall wellness. The VFW
believes that chiropractic care is a valuable option and should be made available
to veterans at all VA medical centers.
455, a bill to amend title 38, United States Code, to authorize the Secretary
of Veterans Affairs to transport individuals to and from facilities of the
Department of Veterans Affairs in connection with rehabilitation, counseling,
examination, treatment, and care, and for other purposes.
The VFW supports this legislation to
permanently authorize the Veterans Transportation Service (VTS). This program, commissioned by the VHA Office
of Rural Health in 2010, has greatly improved access to care for rural and
seriously disabled veterans by allowing VA facilities to establish and
coordinate networks of local transportation providers including VSOs, community
and commercial transportation providers, and government transportation
services. The VTS serves an innovative
supplement to the existing beneficiary travel programs of mileage
reimbursement, which does nothing to assist in the coordination of
transportation for those who need it, and special mode travel, for which few
veterans medically qualify.
The VTS program suffered a major setback
in 2012 when it was temporarily suspended following a determination by the VA
Office of General counsel that VA lacked the statutory authority to provide the
new benefits. Congress wisely passed a
one-year authorization of the program in January 2013, but a long-term fix is
The VFW believes that unnecessary
hardships associated with accessing VA health care should be eliminated at
every opportunity. This legislation
would guarantee the continuation and future expansion of VTS, which plays a
critical role in minimizing the challenges many veterans face in traveling to
their appointments due to physical disabilities or great distances.
522, Wounded Warrior Workforce Enhancement Act
The VFW does not support this
legislation which would require the VA to award grants to eligible educational
institutions that establish or expand existing master’s degree programs in
orthotics and prosthetics. The bill
would also create a grant to be awarded to an institution that establishes a
private Center of Excellence in Orthotic and Prosthetic Education. Although the VFW recognizes the importance of
promoting the development of high quality prosthetic staff and services, we
feel that this bill takes the wrong approach.
Since it mandates no service requirement for the students who would
benefit from the funding provided by the grants, VA does not stand to reap any
direct benefit from their enhanced training.
Additionally, the VFW questions whether veterans would be better served
by a Center of Excellence in this field within the VA, as opposed to one that
is privately operated.
529, a bill to amend title 38, United States Code, to modify the commencement
date of the period of service at Camp Lejeune, North Carolina, for eligibility
for hospital care and medical services with exposure to contaminated water, and
for other purposes.
The VFW supports this legislation which
would adjust the date for VA health care eligibility associated with exposure
to contaminated water at Camp Lejeune, North Carolina from January 1, 1957 to
August 1, 1953 or an earlier date specified by the Secretary in consultation
with the Agency for Toxic Substances and Disease Registry, due to recent
findings by the ATSDR that the drinking water at that installation was
contaminated as early as 1953.
543, VISN Reorganization Act of 2013
The VFW does not support the enactment
of S. 543. The intent of this bill has merit. VA should assess the VISN
structure for improved efficiency and possible VISN realignment. VA has taken
steps to improve efficiency and is studying the impacts of VISN realignment.
Congress should continue oversight of this process to ensure veterans are
receiving the highest level of care in the most effective and efficient manner.
633, a bill to amend title 38, United States Code, to provide for coverage
under the beneficiary travel program of the Department of Veterans Affairs of
certain disabled veterans for travel in connection with certain special
disabilities rehabilitation, and for other purposes.
The VFW supports this legislation which
would extend beneficiary travel benefits to veterans with certain severe
non-service connected disabilities who travel to receive care provided through
a VA special disabilities rehabilitation program. Veterans who are catastrophically disabled
due to spinal cord injuries, visual impairments, and multiple amputations often
require in-patient care in order to achieve full rehabilitation. Not all VA facilities, however, offer the
specialized programs of care needed to properly treat these severe
disabilities, and many veterans are forced to travel great distances to receive
the care they need. Those not eligible
for travel reimbursement must do so at great personal cost and, as a result,
may be forced to forego essential primary or preventative care for financial
reasons. This legislation would
alleviate that hardship for this small but vulnerable population of veterans.
800, Treto Garza Far South Texas Veterans Inpatient Care Act of 2013
The VFW does not hold an opinion
regarding this legislation. The bill calls for the expansion of the Harlingen
VA Outpatient Clinic to a full-service, inpatient care facility. The VFW would
suggest that VA assess South Texas’ access and utilization gaps to ensure that
veterans in that region are receiving a full continuum of care without the
burden of excessive travel, and if there are gaps, prioritize the need and have
it added to Strategic Capital Investment Plan.
825, Homeless Veterans Prevention Act of 2013
The VFW supports most provisions of this
legislation which expands and reauthorizes a number of programs aimed at
addressing the unacceptable problem of homelessness among veterans. It also keeps families together by allowing
VA to house the children of veterans in transitional housing, while also
improving the security of those facilities.
The VFW firmly believes that no veteran who has honorably served this
nation should have to suffer the indignity of living on the streets. We praise
the great progress that has been made in reducing veterans’ homelessness in
recent years as a direct result of coordinated efforts across multiple
government agencies to provide transitional housing, rapid re-housing, and
employment programs for veterans in need.
The extension and adequate funding provided by this bill for these and
other programs are vital to achieving the Secretary’s goal of eradicating
homelessness among veterans by 2015.
The VFW generally supports Section 8 of
the bill which would allow the Secretary to “enter into partnerships with
public or private entities” to fund a portion of certain legal services for homeless
veterans. While we recognize that legal
problems are often a significant barrier to homeless reintegration and must be
addressed, we are concerned that there may be some for-profit legal entities
that would view this program as an opportunity to exploit the availability of
government resources in exchange for poor or inadequate services. For this reason, we suggest that the language
in this section be changed to allow VA to only enter into partnerships with
public or non-profit private legal entities that provide services to homeless
832, Improving the Lives of Children with Spina Bifida Act of 2013
Current law (Chapter 18, title 38,
United States Code) defines the services provided to children of Vietnam
veterans and certain Korea service veterans born with spina bifida to include
comprehensive health care, but some veterans have reported that they have had
difficulty accessing these benefits for their severely handicapped children.
This bill will help remedy some of these
issues by requiring VA to carry out a pilot program in rural areas, and report
to Congress on services they are providing to children under the law. The legislation is of little or no cost to VA
and will allow Congress an inside view of specifics within the program to
include statistics on what types of services and how many are being provided.
The VFW believes that this is an
appropriate use of Congressional oversight and the findings will provide
insights into the program, specifically answering questions as to whether VA is
doing everything within the law to provide care and services to this most
vulnerable population. The VFW encourages Congress to enact this legislation so
those in need of care and services can access what is rightfully and legally
theirs - we owe them nothing less.
845, a bill to amend title 38, United States Code, to improve the Department of
Veterans Affairs Health Professionals Assistance Program, and for other
The VFW supports this legislation which
removes the $60,000 cap on the total amount payable under the Education Debt
Reduction Program (EDRP) and extends the expiration date of the Health
Professionals Education Assistance Program from December 31, 2014 to December
31, 2019. VA must be given the tools to
recruit and retain high quality medical professionals in order to guarantee the
continued delivery of the highest level of care. By providing targeted education debt
repayment incentives to physicians in specific fields based on VA need in
exchange for service obligations, these programs play a vital role in properly
meeting VA staffing needs.
851, Caregivers Expansion and Improvement Act of 2013
The VFW strongly supports this
legislation which would extend current caregiver benefits to those who care for
veterans who were severely injured prior to September 11, 2001. We believe that severely wounded veterans of
all conflicts have made incredible sacrifices, and that all family members who
care for them are equally deserving of recognition and support.
The VFW applauded the passage of the Caregivers and Veterans Omnibus Health
Services Act of 2010 which provided a monthly stipend, respite care, mental
and medical health care, and the necessary training and certifications required
for caregivers of severely disabled Post 9/11 veterans, but have consistently
maintained that eligibility should be expanded to include veterans of all eras.
By striking “on or after September 11,
2001” from 38 USC Section 1720G(a)(2)(B), this bill would accomplish that
852, Veterans’ Health Promotion Act of 2013
This legislation would create a new complementary
and alternative medicine (CAM) program within VA in order to promote the
overall health and well-being of veterans.
Although the VFW feels that CAM and wellness programs have the potential
to play a significant role in VA health care, we would like to offer several
suggestions which we feel would strengthen this bill.
S. 852 would establish at least one
Center of Innovation for CAM in each of the 21 VISNs for health research,
education, and clinical activities in each VISN, while simultaneously
establishing a three year pilot program to assess the feasibility of CAM
centers in VA medical facilities. The VFW
feels that it would be more appropriate to conduct the pilot program and
analyze its results before mandating the establishment of CAM Centers of
Innovation across VA. Additionally, we
are concerned that some VISNs may not currently have a medical center suitable
to be designated a center of excellence.
The bill also establishes two pilot
programs intended to address the issue of obesity. The first would subsidize fitness center
memberships for veterans who are determined to be overweight or obese by VA
physicians. The VFW suggests that
veterans who participate in such programs should be required to report for
regular examinations to ensure that fitness programs are being executed
effectively and benefits are being achieved.
The second pilot program would establish fitness centers at VA
facilities which would be made available to any veteran enrolled in the VA
health care system. Recognizing that
space and resources are scarce, the VFW recommends that the use of such fitness
centers be reserved for those veterans deemed overweight or obese by a VA
physician. With these changes, we
believe that these programs would enhance the overall wellness of the veterans’
community, while allowing VA to most effectively experience the associated
long-term cost savings.
Bill, Veterans Affairs Research Transparency Act of 2013
The VFW has no position on this
legislation which would establish a new website to make VA research data
available to the public, and require the Veterans Affairs-Department of Defense
Joint Executive Committee to submit recommendations on the establishment of a
data –sharing program between VA and DOD in order to better facilitate
research. Although we see the value of the
public dissemination of information and greater cooperation between VA and DOD
with regards to data-sharing, we are unable to comment on whether the mandates
of this bill would achieve those objectives most effectively.
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