April 2001/May 2001
Undersecretary Garthwaite To Leave The VA
By Philip Litteer, Chair, Government Affairs Committee, And Rick
Weidman, Director of Government Relations
Dr. Thomas Garthwaite, the Undersecretary for Health, will be leaving
the VA as soon as his successor is selected and confirmed by the Senate.
Dr. Garthwaite has served America’s veterans with distinction in many
roles, from physician to VA Medical Center Director, Deputy
Undersecretary, and Undersecretary. He has been a leader who has listened
to the concerns of the veterans community and has moved to correct
problems and implement good suggestions. Dr. Garthwaite has been a good
friend to VVA and will be missed at the VA.
"Perhaps chief among Dr. Garthwaite’s many accomplishments was
his bold conceptualization of the Veterans Health Initiative (VHI) and his
strong and intrepid support for full implementation of this effort,"
said VVA President George C. Duggins. The field testing of the
computerized version of taking a complete military history on every
veteran who uses the VA starts this month and is due to be completed in
each VA medical facility by the end of May 2002.
VVA has fully supported Dr. Garthwaite in this effort. Dr. Artie
Shelton, entrusted with the military history portion of the VHI, met with
VVA’s Veterans Affairs Committee and national officers on April 20 to
further secure VVA input on how to take and use military histories in the
VA clinicians who demonstrate competence in the unique health care
problems of veterans will receive extra pay. VVA believes that this
effort, when fully implemented, will have a profound influence in helping
the VA health care system focus on the true needs of veterans--to make the
VA a veterans health care system and not just a general health care system
The Director of the VA National Center for Women Veterans, Joan Furey,
and the Director of the VA National Center for Minority Veterans, Willie
Hensley, will be leaving their posts May 15. Furey and Hensley have done
much to establish their centers as useful advocacy and research resources
that help insure that veterans benefits and services are fully available
to all veterans, regardless of gender, race, or ethnic background. VVA
salutes Furey--who served as a surgical nurse in Vietnam and is a
long-time VVA member and an effective advocate for women veterans--and
Hensley for jobs well done in the formative years of these new
institutions. The VA Secretary has said these posts will be filled soon.
VVA’S LEGISLATIVE AGENDA
On March 22, VVA President George C. Duggins presented the 2001
Legislative and Policy Agenda for Vietnam Veterans of America before a
joint hearing of the House and the Senate Committees on Veterans’
Affairs. Duggins was accompanied by Vice President Thomas H. Corey, Chair
of the VVA National Task Force on Veterans Health Care Linda Schwartz,
Executive Director Ed Croucher, and VVA Director of Government Affairs
In that testimony, President Duggins stressed the need for adequate
resources for the VA accompanied by significant accountability for the use
of those resources. He stressed the need for additional research on Agent
Orange and overall health effects of service in Southeast Asia--the
He called upon Congress to pass HR5132, The Comprehensive Hepatitis C
Treatment Act of 2001, sponsored by Rep. Rodney Frelinghuysen (R-N.J.),
which would insure proper outreach, testing, patient education, treatment,
and follow-up services for veterans with hepatitis C. Duggins also called
for presumptive service-connected status for veterans with hepatitis C who
meet certain criteria, as well as presumptive service connection for
diabetes Type II in veterans exposed to Agent Orange and other toxins. He
also issued a strong and passionate call for enactment and proper funding
for concurrent-receipt legislation in the 107th Congress.
Duggins called for significant increases in the Montgomery GI Bill
educational benefits for veterans to at least $1,000 per month. Due to
bipartisan cooperation, the increase of the Montgomery GI Bill to $1,100
per month by 2004 has since passed the House of Representatives.
Duggins called on Congress and President Bush to work together for the
fullest possible effective implementation of Public Law 106-50, the
Veterans Entrepreneurship and Small Business Act of 1999, which has yet to
be implemented properly. He also stressed the need for significant reforms
to improve performance of the Veterans Employment and Training Service at
the Labor Department, which is designed to help veterans--especially
disabled veterans--obtain and sustain decent jobs.
VA BUDGET: BACK TO SQUARE ONE
After months of work by VVA leaders, staff, and members who contacted
their congressional representatives, we are back where we started: the
President’s inadequate request. Many people on the Hill, including House
Veterans’ Affairs Committee Chairman Chris Smith (R-N.J.), Reps. Lane
Evans (D-Ill.), Bob Filner (D-Calif.), J.D. Haworth (R-Ariz.), and House
Budget Committee Chairman Jim Nussle (R-Iowa), did their best to advocate
on our behalf for a decent budget. They found funds for a $2.4 billion
increase from FY 2001 to FY2002. This budget passed the House of
Representatives in April.
Similarly the Senate, led by Sens. Arlen Specter (R-Pa.), Jay
Rockefeller (D-W.Va.), Paul Wellstone (D-Minn.), and Tim Johnson (D-S.Dak.),
worked to craft a budget for veterans in the Senate that contained a
marked increase over the House version and was a drastic improvement over
the administration’s request.
On May 9 the House passed a budget and tax plan that stripped away all
the hard work and thoughtful effort that would have made this a good
budget for the VA and for veterans. The vote was 221-207. A list of
members’ votes is on our website at www.vva.org in the "Legislative
Issues" section. While providing tax cuts that the President and
others maintain are needed, this plan returns to the original
administration request, which will not even begin to keep up with
inflation, much less meet the many pressing needs that developed in Fiscal
Years 1997 through 1999 when the VA was flat-lined.
On May 10, the Senate followed suit and passed the same stripped-down
version of resources for veterans with the same set of tax cuts.
PRESS ON FOR PROPER FUNDING
While VVA and the entire veterans community are disappointed and
astonished by this turn of events--which clearly came from a top-level
deal struck by the President with the congressional leadership--we will
continue to press the Appropriations Committees to seek proper resources.
It is now more important than ever that VVA members let their Senators
and Representatives know what this lack of proper funding is doing to
erode the extent and the quality of care for veterans--particularly
service-disabled veterans. Call, write, e-mail, or visit today.
On April 19, the Institute of Medicine (IOM) of the National Academy of
Sciences issued the results of the biennial assessment of the scientific
literature on associations between diseases and exposure to toxins such as
Agent Orange that were in Vietnam during the war. The IOM found
"limited and suggestive" evidence of an association between
dioxin exposure of the parent and Acute Myoardial Leukemia (AML) in
The IOM review panel also strengthened their previous findings
regarding an association between respiratory diseases, prostate cancer,
and toxic exposure. The IOM also reaffirmed all previous findings of
evidence of associations made since the enactment of the Agent Orange Act
of 1991. Vietnam Veterans of America is grateful to the scientists who
participated in the panel during the many months of this exhaustive
When asked by VVA if the lack of scientific studies hampered their
work, the chairman and a panel member at the briefing of veterans service
organizations the day before the public release of the review replied they
had enough general scientific literature per se, but that the lack
of epidemiological studies of Vietnam veterans and their children was a
significant barrier to doing their job correctly.
The IOM review is just that: It is an intensive review of scientific
studies done by others. The IOM does not perform original research. Nor
can the IOM review that which is not there. Other than the flawed Ranch
Hand Study, the U.S. Government is not funding any such research, despite
the fact that the Agent Orange Act of 1991 authorizes and mandates such
IN-COUNTRY EFFECT RESEARCH NEEDED
VVA continues to press to find ways to promote research on the
in-country effect of service in the Vietnam theater of operations. Mere
service in a particular war zone at a certain time may cause a much larger
occurrence of a variety of health problems than occur in populations that
did not serve in the war zone. The health problems Vietnam veterans and
their families continue to experience may be due to exposure to toxins
such as Agent Orange and other hazardous conditions in Southeast Asia.
The only way to find out if an in-country effect can be demonstrated is
by large-scale epidemiological studies that compare the overall health of
veterans who served in Southeast Asia with two control groups--era
veterans and those the same age who did not serve in the military.
The VA has yet to fund additional epidemiological research on Vietnam
veterans in regard to the health consequences of service in Vietnam on
those who fought the war, even though it was mandated to do so by the
Comprehensive Agent Orange Act of 1991. The National Institute of
Environmental Health Sciences was appropriated funds for this purpose in
each of the last three years, but no studies were funded. It is time for
concerted action to insure that vitally needed studies are begun now, both
in the United States and in Vietnam, and that we get the answers we need
before all Vietnam veterans are dead.
Led by Vice President Tom Corey, VVA leaders and staff met Vietnam’s
Ambassador to the United States to seek his increased advocacy and support
for reaching an agreement between Vietnam and our government on joint
research in Vietnam on the effects of toxins used in the war. The results
of such a study would help veterans and families on both sides of that
conflict. Corey and Linda Schwartz, VVA’s Special Adviser on Veterans
Health Care, also met with Reps. Lane Evans, Marcy Kaptur (D-Ohio), and
key staff from Sen. Tom Daschles’ (D-S.Dak.) office to secure their help
to urge that such an agreement be reached and work begin by September. VVA
will continue to pursue all such work that will demonstrate the health
effects of exposure to toxins such as Agent Orange and other exposures on
the battlefield in Vietnam.
The value of such research in Vietnam, as well as its feasibility, was
highlighted by the publication of a study of dioxin contamination found in
men and women living near Bien Hoa, Vietnam. This study was conducted by
VVA member Arnold Shecter of the University of Texas at Houston Medical
School and Vietnamese scientist Le Cao Dai.
IN-COUNTRY EFFECT REVISITED
Former Secretary of Veterans Affairs Togo West dismissed VVA’s formal
petition on the in-country effect as a presumptively service connected
condition that was filed on the 25th anniversary of the end of
the Vietnam War, April 28, 2000. In that letter, VVA President Duggins
offered to work with the VA to design relevant studies. It now has come to
VVA’s attention that the VA convened a Vietnam In-Country Effect Working
Group on September 14-15. The attendees were all employees of the VA or
the Department of Health and Human Services.
The report of that group, obtained by VVA, says "the most
important step for evaluating Vietnam veterans health in the future may be
to reopen some of the major longitudinal studies on this population."
AROUND THE WALL
VVA testified before the National Capital Memorial Commission on April
26. In that testimony, VVA strongly and emphatically stressed the vital
need for an educational center in Constitution Gardens near the Vietnam
Veterans Memorial. VVA believes that such a center is too important to be
controlled by one organization and should be run by a consortium of
The chair of the commission then wrote to members of Congress saying
that VVA opposed an educational center, despite our clear and unequivocal
support for such a project. (The Commission is opposed to the project.)
VVA is now attempting to set the record straight on Capitol Hill, and we
are seeking a correction and apology from the commission.
At that same meeting, VVA also strongly supported the placement of the
Vietnam In Memory plaque, dedicated to the memory of those who have died
since the end of the Vietnam War of occurrences, health conditions, or
exposures that were incurred on the battlefield.
In testimony before the VA, HUD Subcommittee of the House
Appropriations Committee, the General Accounting Office stated that
differences in budgetary amounts made available by Congress for testing
and treatment of hepatitis C is not adequately explained by the VA. The
basic problem is that Congress has appropriated $340 million for the
current fiscal year, yet the VAMC directors are being told that there is
no money for additional vitally needed staff or other resources. From VVA’s
point of view, this means that the funds are not reaching the veterans who
need the assistance most. There must be a change in the mechanism of
getting the resources where they are needed when they are needed.
This confusion and lack of accountability means that HR 5132, The
Comprehensive Hepatitis C Health Care Act of 2001, is needed now more than
ever. Insure that your Member of Congress is a cosponsor of this
vitally needed legislation.