Chairman Moran, Ranking Member
Filner, and other distinguished members of the
subcommittee, Vietnam Veterans of America (VVA) is pleased to have this
opportunity to provide a statement for the record on H.R. 3253, the National
Medical Emergency Preparedness Act of 2001, and H.R. 3254, the Medical Education
for National Defense in the 21st Century Act. VVA will address each bill in
H.R. 3253 National Medical Emergency Preparedness Act of 2001
Since the war on terrorism began
last year, VVA has testified repeatedly on the need for the VA to be properly
prepared to meet the obligations of the VA’s “Fourth Mission,” and be prepared
to handle mass casualty contingencies, particularly those involving weapons of
mass destruction (WMD). Accordingly, in the broadest terms, we share this
committee’s view that VA must do more to address this critical “fourth mission”
problem area. However, H.R. 3253 as currently drafted is not the vehicle for
achieving our common goal.
Given the abundant evidence that
VVA and our fellow Veteran Service Organizations have presented to this
committee about the funding shortfalls in veterans health care, VVA was
surprised to find the following language in H.R. 3253:
`(e) FUNDING- (1) Amounts appropriated for the
activities of the centers shall be appropriated separately from amounts
appropriated for the Department for medical care.
`(2) There are authorized to be appropriated for
the centers under this section $20,000,000 for each of fiscal years 2002 through
`(3) In addition to funds appropriated for a
fiscal year pursuant to the authorization of appropriations in paragraph (2),
the Under Secretary for Health shall allocate to such centers from other
funds appropriated for that fiscal year generally for the Department of Veterans
Affairs medical care account and the Department of Veterans Affairs medical and
prosthetics research account such amounts as the Under Secretary for Health
determines appropriate to carry out the purposes of this section.
VVA believes that while this
proposal needs significant refinement, the most important point is that this
effort should be funded from the $24 billion that the Congress appropriated for
P.L. 107-38 the Homeland Defense in the Fall of 2001. Thus far VA has only asked
for $77 million from this fund and received far, less than this amount. Given
the overall downsizing of the VA medical system, and the fact that every VA
hospital in the country is reducing staff and services by at least 5 to 7% this
fiscal year (not even counting the $500 million to $700 million shortfall),
there is not even enough organizational capacity to take care of the veterans
whom the VA currently serves, much less possible military casualties returning
from overseas or civilian casualties at home. VVA respectfully urges the
Committee to work with other appropriate committees in the Congress as well as
the Executive branch to ensure that adequate funds are transferred from the
Homeland Security (P.L. 107-38) accounts to properly fund this effort and to
restore vitally needed organizational capacity in the VA health care system now
and in the future. VVA estimates this requires a minimum of $500 million over
the next two years.
Additionally, VVA finds the
following language in the bill equally problematic:
`(g) PEER REVIEW PANEL- (1) In order to provide
advice to assist the Secretary and the Under Secretary for Health to carry out
their responsibilities under this section, the Under Secretary shall establish a
peer review panel to assess the scientific and clinical merit of proposals that
are submitted to the Secretary for the designation of centers under this
`(2) The peer review panel shall include experts
in the fields of toxicological research, bio-hazards management education and
training, radiology, clinical care of patients exposed to such hazards, and
other persons as determined appropriate by the Secretary. Members of the panel
shall serve as consultants to the Department.
`(3) The panel shall review each proposal
submitted to the panel by the officials referred to in paragraph (1) and shall
submit to the Under Secretary for Health its views on the relative scientific
and clinical merit of each such proposal. The panel shall specifically determine
with respect to each such proposal whether that proposal is among those
proposals which have met the highest competitive standards of scientific and
`(4) The panel shall not be subject to the
Federal Advisory Committee Act (5 U.S.C. App.).
This language makes no provision for the inclusion of
veteran advocates on the proposed peer review panel, an omission VVA finds
extremely curious. VVA recommends that if this proposal advances, that VSO
representation is key to its success.
VVA also notes that there is no
language defining outcome measures included in the bill. The principles in both
the letter and the spirit of the Government Performance & Results Act (GPRA)
should be the guidelines followed in all programs. If the VA subsequently
asserts that it has trained a certain number of medical professionals at each
center to deal with WMD casualties, how will the committee know this is in fact
the case? What types of individual standardized proficiency tests will these
personnel be required to take on a regular basis? How will unit performance be
measured? How frequently will WMD exercises be held, and how will such exercises
be graded? What mechanisms will be established to ensure that individual and
unit proficiency and training shortfalls are successfully addressed? In short,
how will the Congress measure VA’s WMD defense efforts in the absence of clearly
defined outcome measures that are directly tied to managerial performance? VVA
respectfully urges the Committee to correct this omission in the proposal.
VVA feels that efforts to
confront WMD contingencies must be part of a larger overall effort, spearheaded
by the Department of Health and Human Services, to establish national training
and education standards and procedures for dealing with WMD events. VA does not
exist in a public health vacuum; its approach to WMD defense must be directly
connected to the larger overall public effort to address this issue. VVA urges
the committee to work with other committees in the House that deal with civilian
public health issues to develop a unified approach to this problem.
H.R. 3254 Medical Education for National Defense in the 21st
Last fall’s anthrax letter
attacks forcefully demonstrated how disruptive (and deadly) such unconventional
attacks could be on a vulnerable public health system. VVA agrees with this
committee that public health professionals generally should become far more
acquainted with WMD-related health threats than is currently the case. In fact,
VVA strongly believes that VA should also be engaged in a major effort to
educate the private sector medical providers in the importance of discovering if
their patients are veterans and, if so, taking a complete military history for
use in diagnosis and treatment. Perhaps what is needed is a comprehensive
approach to the problem, one that must include the Department of Health and
Human Services (HHS) as the lead agency and executive agent for any such
program, but of course include VA and the Department of Defense as cooperating
and participating agencies.
HHS, university medical centers,
and private medical centers must play the lead role in formulating America’s
public health response to WMD contingencies. VA and DoD can and should be
partners in this effort, but in a supporting role. Thus, HHS and the larger
public health policy community should come together to develop the kinds of WMD-related
curricula, training, and exercise programs necessary for properly equipping the
United States to deal with domestic WMD contingencies. VVA would suggest that
the President direct the creation of a national WMD medical preparedness center
within HHS. VA, DoD, and the relevant state agencies would all be full partners
in this new center, which would focus on all aspects of domestic WMD medical
preparedness and response: education, individual and unit training, and
Further, research into the
effects of WMD agents should be led by the National Institutes of Health, and
should include an emphasis on the health effects of sublethal exposures to WMD
agents. VVA believes that this area of research remains significantly
under-funded and inadequately explored. We hope this committee will work with
its sister committees in the House with jurisdiction over HHS to develop the
kind of comprehensive approach we have outlined here today.
this concludes our statement. Please accept our thanks for the opportunity to
share our views with you and the committee on this very important topic.
VETERANS OF AMERICA
April 10, 2002
Veterans of America (VVA) is a national non-profit veterans membership
organization registered as a 501(c)(19) with the Internal Revenue Service. VVA
is also appropriately registered with the Secretary of the Senate and the Clerk
of the House of Representatives in compliance with the Lobbying Disclosure Act
VVA is not
currently in receipt of any federal grant or contract, other than the routine
allocation of office space and associated resources in VA Regional Offices for
outreach and direct services through its Veterans Benefits Program (Service
Representatives). This is also true of the previous two fiscal years.
Director of Government Relations
Vietnam Veterans of America
(301) 585-4000, extension 127
currently serves a National President of Vietnam Veterans of America, the
nation’s only congressionally chartered organization devoted to serving the
needs of Vietnam-era veterans and their families.
A native of
Detroit, Corey was drafted into the U.S. Army and sent to Vietnam in May 1967.
He served as a squad leader with the 1st Air Cavalry Division. While
engaged in an assault against enemy positions in January 31, 1968, he received
an enemy round in the neck which hit his spinal cord and left him quadriplegic.
He was medically retired in May 1968.
After an extended
period of hospitalization, Corey returned to his family in Detroit where he
spent much of his time in and out of the local VA hospital. He relocated to
West Palm Beach, Florida, in 1972, where he is involved in community affairs and
serves on many advisory boards. He has received awards for speaking out for
veterans and disabled persons rights.
Corey was the
first recipient of the Vietnam Veterans of America’s Commendation Medal, VVA’s
highest award for service to veterans, their families, and the community.
He has served as
a member of the board of directors and President of the Paralyzed Veterans
Association of Florida. He also serves on advisory boards at the VA Medical
Center in West Palm Beach, the VA Research Foundation of the Palm Beaches, and
VISN 8 Management Assistance Council.
Corey was the
founding President of VVA Palm Beach County Chapter 25, in 1981. In 1991 the
chapter was named the Thomas H. Corey Chapter at its tenth anniversary
celebration. In 1985, he was elected to a two-year term as a VVA national board
member. In 1987, he was elected VVA National Secretary and was re-elected in
1989, 1991, 1993, and 1995 to that position. In 1997, he was elected VVA’s
currently resides in West Palm Beach. He has a 19-year-old son, Brian.
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