Hearing: Pending Health and Benefits Legislation






Hearing: Pending Health and Benefits Legislation

WASHINGTON, D.C.                                                                              October 30, 2013


On behalf of the men and women of the Veterans of Foreign Wars of the United States (VFW) and our Auxiliaries, I want to thank you for the opportunity to provide our testimony for the record regarding pending health and benefits legislation. 

S. 875, Department of Veterans Affairs Disease Reporting and Oversight Act of 2013

The VFW supports most provisions of this legislation which would require Veterans Integrated Service Networks (VISN) directors to report within 24 hours the presence at a Department of Veterans Affairs (VA) facility of any infectious disease that is on the list of nationally notifiable diseases published by the Council of State and Territorial Epidemiologists and the Centers of Disease Control and Prevention (CDC), or covered by a state law that requires the reporting of infectious diseases, to VA Central Office, the Director of CDC, and the state and county in which the facility is located.  For each individual who has contracted or is at risk of contracting a notifiable infectious disease at a VA facility, the VISN director would be required to notify the individual and the individual’s next of kin, the individual’s primary health care provider, the county in which the individual resides, and each employee of the VA facility.  The VISN director would then be required to confirm the receipt of each notification within 24 hours and develop and implement a plan of action to prevent the spread of the infectious disease within seven days and maintain a record of infectious disease reports for at least 10 years. 

Timely disease reporting is critical in detecting, controlling, and preventing the spread of communicable disease, and is a widely accepted norm of sound public health practice.  Since the laws which create disease reporting requirements are established by individual state legislatures, they do not apply to federal entities, including VA.  Although individual facilities may have disease reporting policies, the lack of statutory guidance across the department can lead to dangerous outcomes, as seen by the recent outbreak of Legionnaires ’ disease within the VA Pittsburgh Healthcare System (VAPHS) which resulted in the deaths of at least five veterans and the infection of as many as 16 others.  Subsequent reports by the Office of Inspector General (OIG) and CDC found that the failure by VAPHS to properly address the outbreak in a timely manner contributed greatly to the spread of the disease.  Had more stringent disease reporting protocols been in place, this terrible tragedy may have been averted.   The VFW strongly supports the provisions of this legislation which would strengthen VA standards in reacting to infectious disease outbreaks and mandate that VISNs report instances of notifiable infectious disease to federal, state, and local authorities.

The only provision of this legislation that the VFW does not support is the requirement that the Secretary suspend any VISN director who is found by OIG to have failed to comply with disease reporting requirements.  While we recognize the necessity for accountability, we feel that VA must be allowed to retain ultimate authority over how punishments are applied in each unique situation.  To allow the results of OIG reports to determine which employees are to be punished would essentially grant enforcement power to OIG, undermining the authority of the Secretary.  For this reason, we suggest that paragraph (2) of subsection (f) Enforcement and Disciplinary Action should be changed by striking “suspend” and adding “take disciplinary action up to and including the suspension of.”  Such a change would allow the VFW to offer its full support to this legislation. 

S. 1148, Veterans Benefits Claims Faster Filing Act

This legislation would require VA to provide public notification and notice of the average processing time to applicants submitting claims for benefits. The intent of this bill would be to show the benefits of filling fully developed, electronic claims. The issue that arises from this is that each claim that is filed under the methods described in Section 2, paragraph (c)(2) is unique to itself, and factors outside of the method used to file will have an impact on the length of time it will take to properly adjudicate the claim. Stating the average time to adjudicate a claim under a certain method will set an expectation for the veteran that may not be realistic, and it may put pressure on claims processors to adjudicate claims quickly, regardless of quality. Instead of stating the average time it takes to complete a claim using a particular method, it might be more accurate and realistic to state a claim that is filed using a particular method is completed, on average, so many days faster. This will help manage veterans’ expectations and remove arbitrary dates that put undue pressure on claims processors, leading to inaccurate decisions and increased appeals by veterans. Also, amendments are needed to improve the accuracy of Section 2, paragraph (b)(2) and Section 2, paragraph (c)(B). Paragraph (b)(2) would need to be amended to clarify the language that only original claims may qualify for the extra year of benefit payment. Paragraph (b)(2) would need to be amended to change “durable power of attorney” to “limited power of attorney.”


S. 1155, Rural Veterans Mental Health Care Improvement Act

The VFW supports this legislation which contains several provisions that improve the quality of mental health services for rural veterans.  By providing advance appropriations for VA Information Technology (IT) Systems account, this legislation would ensure that VA care is delivered without any disruption to the replacement of medical equipment or the functioning of information systems.  The VFW supports this provision, strongly believing that all VA accounts should receive advance appropriations. 

This legislation would also include licensed mental health counselors, and marriage and family therapists for participation in the VA Health Professionals Trainee Program, which is used as qualifying training to hire mental health care providers to work within VA. The VFW is hopeful that the recently signed Patient-Centered Community Care (PCCC) contracts will provide the needed specialty health care providers in these rural and remote locations. The VFW recommends waiting for full implementation of PCCC and evaluating remaining gaps in care before expanding the eligibility for participation in the VA Health Professionals Trainee Program. Any program expansion must not reduce the quality of care that is delivered.

The VFW also supports the provision of this legislation which would strengthen the language in current law providing mental health services to family members of Post-9/11 veterans.  Finally, this legislation requires VA to submit a report to Congress describing any factors which are impeding the expansion of telehealth services.  The VFW believes that telehealth has great potential to improve access to VA programs and services for rural veterans, and any barriers to its expansion must be identified and overcome.

S. 1165, Access to Appropriate Immunizations for Veterans Act of 2013

The VFW strongly supports this legislation which contains two important health-related enhancements for veterans.  The bill would ensure that veterans receive the full complement of immunizations on the recommended adult immunization schedule established by the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP).  It would also mandate that VA develop and implement quality measures and metrics to ensure that veterans receiving VA medical services receive each immunization at the proper time according to the ACIP. 

As many as 70,000 American adults die each year in from vaccine-preventable diseases.  In 2008, the CDC estimated that the number of deaths among adults that could be prevented by vaccination is greater than the number of deaths caused by breast cancer, colorectal cancer or prostate cancer combined.  The VFW believes the evidence is clear that vaccination is one of the safest, most cost effective ways to prevent disease and death from infectious diseases. 

Efforts to quantify and track vaccine utilizations in the past have clearly shown that prioritizing increased utilization and effectiveness of vaccination inoculations, in tandem with rigorous performance measures, generate monumental savings while improving patient health.  When VA adopted performance measures for influenza and pneumococcal, significant improvement in vaccine utilization rates resulted – from 27 percent to 77 percent and 26 percent to 80 percent, respectively.  Expanding performance measures to the entire list of VA and CDC recommended adult vaccinations would undoubtedly promote timely and appropriate vaccinations, while placing a greater emphasis on preventable care for veterans.

S. 1211, a bill to amend title 38, United States Code, to prohibit the use of the phrases GI Bill and Post-9/11 GI Bill to give a false impression of approval or endorsement by the Department of Veterans Affairs.

In 2011, the VFW signed on to a letter to the White House calling on VA to trademark the phrase “GI Bill.” Through the VFW’s advocacy, this recommendation was included in Executive Order No. 13607, which improved consumer resources for student veterans. The VFW agrees in principle with Senator Boxer on this legislation, which seeks to ensure that veterans cannot be duped by bad actors in higher education by misrepresenting themselves as a VA-associated entity or a GI Bill-sanctioned institution or informational tool. However, we believe that this legislation is unnecessary since VA successfully trademarked GI Bill in 2012.


S. 1216, Improving Job Opportunities for Veterans Act of 2013

The VFW supports Senator Bennett’s legislation to modify VA’s on-the-job training (OJT) program in a manner that will encourage more companies to participate by lowering the out-of-pocket cost to the employer during the training program. College is not for everyone, which is why the VFW has long supported OJT as an option for GI Bill-eligible veterans. OJT programs offer veterans an opportunity to acquire critical skills that prepare them to compete in the civilian workforce when they do not wish to pursue a college degree program. Sadly, OJT is vastly underutilized and some companies believe that they do not have enough incentive to participate, because of potential costs to the company. The VFW encourages the Senate to pass this legislation, which when coupled with an awareness campaign on VA OJT could significantly improve real world training opportunities for veterans.


S. 1262, Veterans Conservation Corps Act of 2013

The VFW has long supported the concept of the Veterans’ Conservation Corps. In 2010, the VFW supported the concept as part of a broader veterans’ employment initiative before this committee and last year we expressed our support for stand-alone legislation, which is why we are proud to support Senator Nelson once again. We believe that a conservation corps will offer unique opportunities to veterans who do not participate in other federal training programs to work preserving national parks, monuments and other infrastructure projects.

Veterans were hit disproportionately hard by the recent recession, and the latest employment figures for the Bureau of Labor Statistics indicate that Iraq and Afghanistan-era veterans still struggle at finding employment when compared to their civilian peers. The conservation corps is just one more step to help veterans get back to work and acquire the kinds of skills that will make them competitive in the job market. This model succeeded for past generations of veterans and we believe it could succeed again.


S. 1281, Veterans and Servicemembers Employment and Housing Rights Act of 2013

The VFW supports Senator Blumenthal’s legislation that will ensure veterans are offered decisive legal protection against discrimination when seeking employment or housing. At a time when so few Americans choose to serve in the military, some veterans may face discrimination as a result of either their perceived future military obligations or negative stereotypes associated with military service. This bill seeks to align veterans’ status with other protected groups who have faced discrimination in the workplace or in acquiring housing. Veterans should not be shut out of quality careers or denied a lease because of their current or past military service. This legislation seeks to ensure that it never happens again.

S.1295, a bill to amend title 38, to require the Secretary of VA to provide veterans with notice, when veterans electronically file claims for benefits under laws administered by the Secretary, that relevant services may be available from veterans service organizations.

The VFW supports the intent of this legislation, which would codify much of what VA is currently doing to make veterans aware of the services veterans service organizations (VSO) can provide when filing claims for disabilities. Currently, on VA’s “benefits description” page of its website, there is a link to search from a list of VSOs that can provide assistance. There is similar information found once veterans log on to eBenefits. The only additional measure this legislation provides is direct notification to veterans when they begin the application process. The VFW would support an added step, in the form of a pop-up, which would direct the applicant to the claims assistance information page VA already has established when applying for benefits online. 

S.1399, Servicemember Student Loan Affordability Act

The VFW fully supports Senator Durbin’s bill which extends SCRA protections to servicemembers seeking to refinance or consolidate pre-service federal or private student loans.  Currently, service members who secured student loans prior to military service and choose to participate in the Federal Public Service Loan Forgiveness program (PSLF) lose the six percent loan rate cap afforded to them by SCRA.  This legislation corrects this loophole and extends the option of PSLF to service members without forcing them to lose their six percent loan rate cap.  Additionally, this legislation protects service members seeking to refinance student loans through debt consolidation from losing their six percent loan rate caps.  As student debt is on the rise, now second only to mortgages, programs such as (PSLF) and debt consolidation are both practical and effective ways to manage student loan debt.


S. 1411, Rural Veterans Health Care Improvement Act of 2013

VA will be reporting its findings of rural health care gaps through its Strategic Plan Refresh for Fiscal Years 2012 through 2014 VA Office of Rural Health. This legislation would define some of the data points VA must report and use to determine their performance and accountability goals. These data collection points would include recruitment and retention of health care providers, timeliness and quality of care by VHA, and through contract and fee-based care, and the implementation and expansion of telemedicine. VA would also be required to describe its procedures for assessing each rural Department facility.

It is apparent that a wide gap exists between rural veterans and their urban counterparts in the ability to access their earned VA health benefits.  With 41 percent of all VA enrollees residing in rural areas, the VFW believes that this access gap must be closed, but the situation is not without significant challenges. While roughly 25 percent of the U.S. population lives in rural areas, only 10 percent of physicians practice in those communities. This highlights the need for VA to proactively recruit and retain physicians in rural facilities. Of highly rural veterans, 64 percent must travel more than four hours to receive specialty care, emphasizing the need for VA to continue to expand telehealth services. By addressing these and other issues, the VFW believes that this legislation represents a positive step towards solving the unique problems faced by rural veterans.

S. 1471, Alicia Dawn Koehl Respect for National Cemeteries Act

This act would codify the authority of the Secretaries of Veterans Affairs and Defense to reconsider prior decisions of interments in national cemeteries. Title 38, U.S.C. outlines crimes that disqualify veterans from interment in national cemeteries, but there are no provisions for the removal of a veteran who was laid to rest in a national cemetery prior to the discovery that he or she had committed a disqualifying crime. This legislation also calls for the disinterment of a specific veteran who committed murder, and then turned the gun on himself, ending his life. He was buried in a national veterans cemetery six days later. The circumstances of this case made it very difficult for VA to discover the murder that would have precluded this veteran from interment.

The VFW supports this legislation, but believes it falls short in preventing future non-qualifying interments from taking place. Current protocol requires the surviving family member to fax qualifying paperwork - DD214 and death certificate - to the National Cemetery Administration (NCA). Upon receipt of these documents, NCA calls the family member and asks 16 questions. These questions range from location of death and burial needs to cemetery choice and marital status. Nowhere in the questioning does NCA ask a question regarding criminal activity. The requesting family member should be required to fill out a form that asks the current 16 questions and an additional question regarding federal or state capital crimes. Knowing this information will assist NCA in investigating disqualifying crimes, prior to the veteran’s interment.


S. 1540, a bill to amend title 38, United States Code, to include contracts and grants for residential care for veterans in the exception to the requirement that the Federal Government recover a portion of the value of certain projects.

The VFW supports this legislation which would allow state veterans homes that receive residential care contracts or grants from VA to also contract with VA under the Health Care for Homeless Veterans (HCHV) supported housing program.  Since state veterans homes receive VA funding for other programs, the recapture clause of section 8136 of title 38 prohibits them from receiving HCHV funds. Only those state veterans homes that also run outpatient VA clinics are currently exempted from the recapture clause.  This means that many state veterans homes with empty beds are unable to offer them to homeless veterans in their communities.  Similarly exempting them from the recapture clause would solve this problem.

The Secretary’s ambitious five year plan to end homelessness among veterans includes six strategic pillars. The sixth pillar is community partnerships, which certainly must include state veterans homes.  The VFW strongly supports the Secretary’s five year plan and believes that state veterans homes should be utilized to the fullest extent possible to ensure its success.  As long as there are homeless veterans who need them, beds in state veterans homes should not remain empty simply due to the unintended consequences of a federal regulation.

S. 1558, Veterans Outreach Enhancement Act of 2013

The purpose of this legislation is to enact a five-year program designed to increase awareness and access to federal, state and local veterans programs for service members and veterans. In doing so, VA could enter into agreements with federal and state agencies, as well as provide technical assistance and award grants for projects that build awareness and increase usage of programs and services available to veterans. The VFW supports this legislation.


S. 1573, a bill to provide payments of temporary compensation to surviving spouses of veterans upon the death of the veteran.

This legislation would provide six months of temporary payments of Dependency and Indemnity Compensation (DIC) or Pension for surviving spouses of veterans if, at the time of death of the veteran, the veteran was in receipt of or entitled to receive certain kinds of service-connected disability compensation or pension.

The VFW supports the intent of these provisions as a stop-gap measure for surviving spouses during their time of greatest need. However, as the bill is written, the benefit would be paid regardless of whether or not the surviving spouse ever submits a claim for the benefit. The VFW recommends that at minimum a certificate of death must be provided to VA by the surviving spouse, to act as an informal claim before temporary payments begin. This will protect the integrity of the program, but allow payments to be made while the claim is developed and approved.

A Draft Bill to amend title 38, United States Code, to provide replacement automobiles for certain disabled veterans and members of the Armed Forces, and for other purposes.

The VFW supports this legislation which would allow VA to replace a vehicle provided to a veteran under the Automobile Grant Program twice, with the aggregate amount of the original and replacement vehicles not to exceed the maximum amount allowable under the program.  Further, it increases the maximum amount from $18,900 to $30,000 and authorizes VA to replace vehicles provided under the program that are destroyed by natural disasters or other circumstances in which the veteran is found to be not at fault.

Currently, the VA automobile grant is a one-time benefit.  Veterans may use the grant only once in their lifetimes, regardless of whether they purchased a vehicle for less than the full amount allowable under the law, or if that amount is ever increased.  The VFW believes that eligible veterans should be able to receive additional grants if the grant amount for the initial vehicle was less than the maximum.  This legislation achieves that goal, providing greater spending flexibility for eligible veterans and ensuring that they are able to make full use of the benefit.

VA automobile grants are provided only to the most severely disabled veterans who may require vehicles with specific accommodations.  The original intent of the grant when it was established in 1946 in the amount of $1,600 was to cover 100 percent of the cost of a new vehicle.  According to the Department of Transportation, the average costs of a modified vehicle today range from $40,000 to $65,000 new and $21,000 to $35,000 used.  Although the current automobile grant amount of $18,900 is useful to veterans as a means of cost abatement, it does not come close to covering the full purchase price.  Clearly the grant has not been sufficiently increased over time, relative to inflation.  Increasing the amount to $30,000 would represent a big step towards ensuring that severely disabled veterans are able to afford the specialized vehicles they need.

Draft Bill, Veterans Health Care Eligibility Expansion and Enhancement Act of 2013

This legislation calls for extraordinary changes to the Veterans Health Administration by providing for the largest enrollment eligibility expansion in over a decade. The VFW supports the intent of this legislation, however, we would like to offer certain caveats and recommend several changes before we are able to offer our full endorsement.

Section 3 would greatly expand VA patient enrollment by extending eligibility to veterans with non-compensable service-connected disabilities rated as zero percent disabling and those without service-connected disabilities who are not currently able to enroll, so long as they do not have access to health insurance, except through a health exchange established by the Patient Protection and Affordable Care Act.

The VFW supports the spirit of this section, as it would provide an increased number of honorably discharged veterans with access to quality health care who may not otherwise have that opportunity.  We are concerned, however, that a large influx of new enrollees could overcrowd the system, exacerbating already unacceptably long wait times.  In order to prevent this, VA would presumably need to expand its capacity by hiring additional employees and constructing or leasing new facilities.  This would require either a significant funding increase, or the redirection of funding from other areas of the VA budget, which the VFW could never support.  With no discernible offset, we feel that there is some cause for trepidation.  As a result, we must state that the VFW would only support the eligibility expansion called for in section 3 if VA is provided the additional funding necessary to carry it out, and without compromising current quality or access standards, or in any way diminishing the programs and services provided to those already enrolled. It is important that the care provided to veterans who are service connected or have finical need is not disrupted or diminished in any way. Also, with rapid expansion a plan must be put in place to account for the capacity issues that will arise. The VFW looks forward to working with the Committee on solving these issues.

Section 4 would further extend the period of eligibility for health care benefits for combat veterans of certain periods of hostilities and war.  Eligibility for Iraq and Afghanistan veterans would be extended from five to ten years following separation from service, and eligibility for veterans of post-Gulf War hostilities prior to January 28, 2003 would be extended until January 28, 2018.  The VFW fully supports this section.

Section 6 would simplify the method VA uses to determine which veterans qualify for enrollment as members of low income families.  Currently, each county has its own geographically based income threshold.  This section would mandate that the highest income threshold among the counties of each state become the income threshold of the entire state.  This would qualify many veterans for enrolment who are currently ineligible but whose income level is relatively close to the geographic means test threshold.  The VFW supports this eligibility expansion, but only if VA is provided with adequate funding to ensure that access or services are not diminished for current enrollees.    

Draft Bill, Enhanced Dental Care for Veterans Act of 2013

This legislation contains several provisions relating to non-service-connected dental services, most of which the VFW supports.

Section 2 would authorize VA to provide restorative non-service-connected dental services, including necessary dental appliances, to certain veterans.  Currently, VA may provide those services to any veteran receiving hospital care or nursing home care in a VA facility if the non-service-connected dental condition is associated with or aggravating a disability for which the veteran is receiving hospital care, or if VA determines that a dental emergency is present during hospitalization.  This legislation would allow VA to also furnish dental services to restore functionality that has been lost as the result of any services or treatment received while under hospital or nursing home care.  The VFW supports this common sense fix.

Section 3 would establish a three-year pilot program at no less than 16 locations to provide dental services to any veteran commensurate with the dental services furnished to 100 percent service-connected veterans.  VA would be authorized to enter into contracts as necessary and copayments would be collected.  The amount expended on each veteran per year would be capped at $1,000 or a greater amount, as determined by VA.

VA is already set to roll out a three year pilot program to offer affordable dental insurance to all enrolled veterans and CHAMPVA beneficiaries known as the VA Dental Insurance Program (VADIP).  Created by the Caregivers and Omnibus Health Services Act of 2010, VADIP will offer a wide array of dental plans to those veterans and eligible dependents through the Delta Dental and MetLife insurance companies at reduced rates, with care available nationwide and monthly premiums starting as low as $8.65.  While the VFW is not fundamentally opposed to the program model offered by section 3, we are supportive of VADIP and believe that it should function for the duration it has been authorized and evaluated for effectiveness and veteran satisfaction before another program which offers duplicative services, as outlined by this section, is piloted.

Section 4 would require VA to carry out a program of education to promote veterans’ dental health.  This would be achieved by distributing literature at VA facilities, publishing information on the VA website, and conducting small and large group presentations.  The VFW supports this section.

Section 5 would require VA to establish a mechanism by which private sector providers would be able to share information on dental care furnished under VADIP with VA for the inclusion of that information in the veteran’s electronic health record.  This information would only be shared at the election of the veteran and VA would be authorized to extend VADIP an additional two years, if the Secretary determines it is necessary to assess the information sharing mechanism.  The VFW supports this section, strongly believing that VA must be responsible for ensuring proper coordination and continuity of care for all non-VA services provided under any Department program.

Draft Bill, Mental Health Support for Veteran Families and Caregivers Act of 2013

The VFW supports this legislation which would establish an education program and peer support program for family members and caregivers of veterans with mental health disorders.  To carry out these programs, VA would contract with non-profit entities with experience in mental health education.  The education program would consist of instruction on types of mental health disorders, techniques for handling crisis situations, coping with stress, and additional services.  Those who graduate from the education program may be selected to act as peer support coordinators, who would then lead group meetings with other family members and caregivers to assist them with matters related to coping with mental health disorders in veterans.  These programs would initially be offered at 30 VA facilities, and the Secretary would be required to report on the feasibility and advisability of continuing and expanding the program after one year. 

Mental health disorders among veterans often affect family members, placing great strain on family relationships and ultimately exacerbating the veteran’s condition.  If properly trained, however, family members can have a positive impact on the veteran’s recovery.  The VFW supports promoting family engagement as an important part of mental health treatment.

Draft Bill, Medical Foster Homes Act of 2013

The VFW supports the intent of this legislation which will allow VA to cover the costs associated with the care of eligible veterans who require a protracted period of nursing home care and desire to live in medical foster homes.  VA currently has the authority to reimburse institutional care facilities such as nursing homes for long-term domiciliary care, but veterans who choose to live in medical foster homes must do so at their own expense.  Granting VA the authority to reimburse medical foster homes would provide veterans with an additional residency choice, potentially improving the quality of life for those who would prefer to live in a family style setting rather than an institutional one.  The VFW recommends, however, that this be achieved by amending section 1720 of title 38, United States Code, rather than instructing the Secretary on how to carry out section 17.73 of title 38, Code of Federal Regulations.  We feel that codifying this new benefit would reduce any chance of bureaucratic misinterpretation and ensure that it is not arbitrarily eliminated or diminished in the future.

Furthermore, the VFW strongly believes that all non-VA services should be provided in conjunction with proper care coordination.  VA Handbook 1141.02, Medical Foster Home Procedures, establishes the policies and standards of VA care coordination for veterans who choose to live in medical foster home settings.  It requires an interdisciplinary VA Home Care Team to provide the veteran with primary care, regularly communicate with the foster home caregiver, and monitor the care provided by the foster home with frequent unannounced visits.  The VFW feels that these requirements will continue to be instrumental in ensuring adequate care coordination for veterans who chose to participate in a fully-funded medical foster care program.  VA Handbook 1411.02 is scheduled for recertification in 2014, and the VFW recommends that the care coordination policies outlined in that document be made permanent by adding them to the language of this legislation.

Draft Bill, SCRA Enhancement and Improvement Act of 2013

The VFW supports Chairman Sanders and Senator Rockefeller in their efforts to improve the Servicemembers Civil Relief Act (SCRA).  SCRA exists to offer a wide range of protections to individuals entering active duty, as well as service members activated from the Reserve Component.  SCRA ensures service members are able to fully devote their attention to duty and seeks to assuage additional stress often placed on family members of those in service.  We believe many of the provisions found in this bill offer substantial improvements to SCRA‘s current framework as they provide much-needed expansions to the bill’s depth, reach, and enforcement.  For example, the VFW fully supports offering an additional year of SCRA protection to ensure transitioning service members can organize their affairs, and we also support policies that will ensure service members cannot be denied credit because of their military service.

The VFW applauds Chairman Sanders and Senator Rockefeller for each taking the issue of protecting service members and their families very seriously. We are pleased that this bill offers unique solutions to improve the many current issues related to SCRA.  However, we have several questions about the provisions in this draft of the legislation related to service members’ business properties and loans on which service members serve as the guarantor or co-signer. We look forward to discussing these issues with the committee and developing a quality bill that protects the financial and legal interests of our service members.

Moreover, the VFW believes that more understanding on SCRA is needed, which is why we recommend a possible stand-alone hearing on SCRA in the coming year. Make no mistake, SCRA is substantially beneficial to service members, but we constantly hear stories of how many still fall through the cracks. The VFW asks the committee to take an in-depth look at the financial and legal needs of our service members, solicit feedback from all relevant stakeholders, and develop comprehensive legislation that seeks to address many of the persistent shortfalls we often find in SCRA. We look forward to working with the committee to develop a comprehensive reform package that meets the needs of today’s service members by protecting their financial and legal interests.


Draft Bill, Survivors of Military Sexual Assault and Domestic Abuse Act of 2013

The VFW does not support section 2 of this legislation which would authorize VA to provide counseling services to active duty service members for the treatment of psychological trauma associated with military sexual assault without obtaining referrals from their military primary care providers.  While we recognize the need to support victims of military sexual assault in every reasonable way possible, we firmly believe that any counseling or treatment should be provided at Department of Defense facilities in order to ensure proper coordination of care and appropriate chain-of-command involvement.   Commanders are ultimately responsible for the health and well-being of their subordinates, and it is vitally important that they are aware of the mental health status of the members of their units.  Furthermore, they should be informed of any criminal activity which may have taken place under their commands, so that they may take appropriate action under the Uniform Code of Military Justice.

The VFW does support section 3 which would require VA to establish a screening mechanism to detect whether a veteran has been the victim of domestic abuse.  In recent years, VA has been making an effort to adapt to the needs of veterans who are the victims of abuse – specifically women veterans.  Domestic abuse is a particularly prevalent problem among this population, and detection is necessary to ensure they receive the proper counseling and care.

The VFW also supports section 4 which would require VA to submit reports on the treatment and prevalence of military sexual trauma and domestic abuse.  The data collected will be used to improve services for the victims of these physically and psychologically devastating crimes.

Draft Bill to amend title 38, United States Code, to expand eligibility for reimbursement for emergency medical treatment to certain veterans that were unable to receive care from the Department of Veterans Affairs in the 24-month period preceding the furnishing of such emergency treatment.

The VFW supports this legislation which would authorize VA to reimburse veterans for emergent non-VA care who do not meet the requirement of having been seen at a VA facility in the preceding 24 months, simply because long wait times for initial patient examinations have prevented them from doing so.  The strict 24-month requirement is especially problematic for current era veterans, many of whom have never had the opportunity to be seen at VA facilities due to long appointment wait times, despite their timely, good faith efforts to make appointments following separation.  Should they experience medical emergencies during that waiting period, VA is required to deny their claims for reimbursement, unnecessarily leaving them with large medical bills through no fault of their own. VA is aware of the problem and has requested the authority to make an exception to the 24-month requirement for veterans who find themselves in this situation.  The VFW supports this request, strongly believing that under no circumstances should long appointment wait times prevent a veteran from seeking emergent, possible life-saving care at a non-VA facility, or expose that veteran to financial hardship as a result of doing so. 

Draft Bill to amend title 38, United States Code, to require recipients of per diem payments from the Secretary of Veterans Affairs for the provision of services for homeless for homeless veterans to comply with codes relevant to operations and level of care provided, and for other purposes.

The VFW supports this legislation which would require facilities that house homeless veterans to meet the standards of the most recently published version of the Life Safety Code of the National Fire Protection Association, as well as all relevant local building codes before receiving per diem payments under the VA Homeless Providers Grant Per Diem Program.  Additionally, recipients would be inspected on an annual basis to ensure that compliance with those codes is maintained.  Current per diem recipients would have two years from the time of enactment to be certified in compliance with relevant codes before payments are terminated, giving them ample time to make any necessary improvements. 

Currently, VA is required to check housing certificates before awarding grants for housing services provided to homeless veterans.  However, thorough checks of fire and safety requirements, as well as structural conditions of the building, are often overlooked.  The VFW believes that VA funded transitional housing must be safe, secure, and sanitary.  This legislation would ensure that those standards are met, providing homeless veterans with the best chances of successful community reintegration.

Mr. Chairman, this concludes my testimony. I would be happy to take any questions you or any member of the Committee may have for the record.