VIETNAM VETERANS OF AMERICA
Deputy Director for Policy and Government Affairs
House Committee on Veterans Affairs Subcommittee on Health
Veterans’ Health Bills
(HR 1197, 2770, 1293, 1302, 1335, 1546, 2734, & 2738
Plus three Draft Bills)
June 18, 2009
Good morning, Chairman Michaud, Ranking Member Brown, and other members of this distinguished Subcommittee. We appreciate your giving Vietnam Veterans of America (VVA) the opportunity to testify today on legislation that relates to improving the health care of veterans and issues involving their caregivers. And on behalf of the members and families of VVA, we thank you for the stellar work this Subcommittee has been doing.
We would like first to comment on H.R. 1197, the “Medal of Honor Health Care Equity Act of 2009.” VVA supports enactment of this bill unequivocally. We would like to offer a bit of commentary as to why.
Americans are hungry for heroes. We confer this status on people who lead their sports teams to championships to the adoration of their fans: guys who can throw for fifty touchdowns or run for two thousand yards in a season; guys who can rocket baseballs into the stands fifty times a season; guys who score thirty points a game; guys who drive race cars really fast. We tend, too, to overuse this term when we honor men and women in uniform.
In reality, all who serve are not heroes. Yes, they don the uniform and, during times of war or conflict, put themselves in harm’s way. Some are killed. Others are wounded, some grievously. Mostly, though, they are men and women doing the jobs for which they’ve been trained (and oftentimes doing jobs for which they haven’t been trained).
While this gesture – dubbing them heroes – may be understandable, and even commendable, it in some ways diminishes what a hero really is: one who puts his (and as more women serve in the military, her) life in danger, and sometimes loses it, attempting to protect or save the lives of his comrades.
We have heroes – true heroes – who have met this standard. Their heroism, their selfless acts of valor and bravery in the chaos of combat, has been acknowledged with the awarding of the Medal of Honor. Others who have committed heroic acts have been honored with the Silver Star, the Navy Cross, the Distinguished Service Cross.
These heroes are deserving of our enduring appreciation and honor. This is what, in one small way, H.R. 1197 seeks to do. To accord all of these men, and women, who obtain their health care from VA facilities higher priority status is warranted. We are willing to bet, however, that most will not take advantage of this. Humble as most tend to be, they will not flaunt a medal to “get to the head of the line.” They will stand in line, with the rest of their comrades, awaiting their turn.
H.R. 2770, the “Veterans Nonprofit Research and Education Corporations Enhancement Act of 2009.” This bill, introduced by Chairman Filner and Ranking Member Buyer in what we wish was a permanent display of bipartisanship, seeks to modify and update provisions of law relating to nonprofit research and education corporations by facilitating the conduct of research, education or both at more than one VA medical center. If enacted, this bill should help facilitate research projects, the fruits of which can help not only veterans and their families but so many others as well.
VVA supports passage of H.R. 2770.
H.R. 1293, introduced by Mr. Buyer and designated the “Disabled Veterans Home Improvement and Structural Alteration Grant Increase Act of 2009,” in effect acknowledges the realities of inflation by increasing the amount available to disabled veterans for improvements and structural alterations furnished as part of home health services.
VVA supports the enactment of H.R. 1293.
As physician assistants have come to play increasingly important roles in the Veterans Health Administration, it seems to us a logical if somewhat belated effort with H.R. 1302 to establish the position of Director of Physician Assistant Services under the Under Secretary of Veterans Affairs for Health. As stipulated in this bill, the director, who would be a qualified physician assistant, “shall be responsible to and report directly to the Under Secretary for Health on all matters relating to the education and training, employment, appropriate utilization, and optimal participation of physician assistants within the programs and initiatives of the Administration.” The last three persons to occupy the position of Undersecretary of Health have refused to accord Physician Assistants, most of whom are veterans, equal prestige and respect with Nurse Practitioners (most of whom are not veterans). The reasons are puzzling, and to say the aforementioned individuals and their functionaries have been less than honest in discussing this issue with Congress, veterans’ service organizations, and organized labor would be an understatement.
Whomever President Obama ultimately selects as the next Undersecretary of Health must be an individual who will be open, transparent, respectful of the clear will of the Congress (as in the case of the status of Physician Assistants within the Veterans Health Administration), and above all truthful and honest. It is frankly shameful that this bill needs to be enacted to get the VHA to act decently, honestly, and as common sense would dictate, but this is the case.
VVA applauds Congressman Hare for having introduced this legislation, thanks him for his leadership on this and so many other issues, and supports its enactment without reservation.
It is a stark reality that as the military is able to save more and more troops who have received catastrophic wounds or injuries on the battlefield, more and more veterans will survive who are catastrophically disabled. H.R. 1335, introduced by Mrs. Halvorson, would prohibit the Secretary of Veterans Affairs from collecting certain co-payments and other fees for hospital or nursing home care from these veterans.
This bill is right-minded and forward-thinking. As such, VVA endorses for enactment H.R. 1335.
While we are not thrilled about creating yet another committee to focus on yet another facet of combat injury, H.R. 1546, the “Caring for Veterans with Traumatic Brain Injury Act of 2009,” would meet a growing and highly visible need if enacted. As TBI has become the “signature wound” of the fighting in Iraq and increasingly in Afghanistan, it has garnered a great deal of attention in the media as well as in the medical and veterans’ communities. Millions of dollars have been appropriated to learn more about it. Is this money being spent wisely and well? Which treatment modalities are working? Which aren’t? What ought to be the role of community-based organizations in caring for veterans with such wounds?
Establishment of a Committee on Care of Veterans with TBI does make sense and we commend Congressmen McNerney and Boozman for introducing it. However, such a committee should be comprised not only of VA employees “with expertise in the care of veterans with” TBI. It should integrate outside experts with perhaps differing expertise who might offer other and perhaps better ideas, along with representatives of veteran consumers and their families, who should be appointed by the Secretary of Veterans Affairs. Further, VVA recommends that we ensure that the operations of this committee are transparent, and that all deliberations and notes of this committee be open for public scrutiny.
As a general comment, the secrecy of the last eight years, and the unwarranted arrogance that has taken hold in the culture of the VA, particularly within the VHA, needs to be reversed and transparency, full public disclosure, consultation with veterans and veterans’ advocacy groups, and meaningful measures of accountability must be written into all areas. Frankly, it will take the Congress working closely in a bi-partisan manner with the new leadership team to undo the considerable damage that has been done, and to begin to resurrect significant gains and progress that could have been achieved in so many areas.
With these caveats, VVA endorses H.R. 1546.
H.R. 2734, the “Health Care for Family Caregivers Act of 2009,” would provide medical care to family members of disabled veterans who serve as caregivers to such veterans. As noted above, more and more troops who survive catastrophic wounds face life with extraordinary needs for medical services and home care. Home care is provided by a parent, or a spouse, in some cases a child, in others some other family relation, significant other, or other companion. To make life easier for these individuals, Mr. Perriello’s bill would inure such caregivers from “deductibles, premiums, co-payments, cost sharing, or other fees for medical care provided to such caregiver.”
Even though a family member will take on the burden of caring for these veterans out of love and familial obligation, H.R. 2734 would provide a small measure of assistance to them. As such, VVA endorses this bill.
H.R. 2738, introduced by Congressman Teague, would also assist family caregivers accompanying veterans to medical treatment facilities, in this case by paying for “lodging and subsistence” as well as “expenses of travel” to and from such facilities.
As this seems eminently fair, VVA supports enactment of this bill.
Two of the three Draft Bills relate to family caregivers. The Bill that would direct the Secretary of Veterans Affairs to conduct annual surveys of such caregivers makes eminently good sense. If properly conducted with well-thought-out questionnaires, it can help provide the VA with information that will better help caregivers assist the veterans for whom they are caring.
The Bill that would “provide support services for family caregivers” contains some important and viable clauses. One potentially valuable clause is (b)(2), which would provide caregivers with an Internet-based service containing “a directory of services available at the county level; message boards and other tools that provide family caregivers with the ability to interact with each other and disabled veterans for the purpose of fostering peer support and creating support networks; and comprehensive information explaining health-related topics and issues relevant to the needs of disabled veterans and family caregivers.”
We do not, however, agree that to accomplish this, the VA must “contract with a private entity.” This ought to be done in-house, by folks with the necessary expertise and technical savvy. To do so will eliminate an unnecessary layer of bureaucracy, and a potentially costly one at that.
Similarly, in the “Information and Outreach” clause, which would direct the Secretary to mount what is in effect a multi-faceted media campaign, ought to be done in-house. However, we would advocate that such a campaign be coordinated with other VA healthcare outreach efforts. In this realm, we have advocated a major effort by the VA to use various media and methods to communicate with veterans and their families about health conditions that may have derived from their service while in the military and the care and other benefits to which veterans are entitled to by virtue of their service. In the past, the VA’s attempts at outreach have been, to be generous, an embarrassment. The VA needs budget lines for its outreach activities, which must go a lot further than booklets and brochures in kiosks in VA healthcare facilities, and in-house media productions that are rarely, if ever, actually viewed by patients at these facilities.
We also would encourage this Subcommittee to meld the bills relating to family caregivers into a single “Disabled Veterans Family Caregivers Support Act of 2009.”
It is our understanding that the Draft Bill that would direct the VA Secretary “to provide, without expiration, hospital care, medical services, and nursing home care for certain Vietnam-era veterans exposed to herbicide and veterans of the Persian Gulf War” would codify in statute what the VA already is doing. The bill would basically grant permanent authorization for the VA to provide this care for herbicide-exposed Vietnam-era veterans and Gulf War-era veterans who have insufficient medical evidence to establish a service-connected disability by placing them in Priority Group 6.
VVA will support this legislation.
Mr. Chairman, we again thank you for the opportunity to present our thoughts before this Subcommittee, and we welcome the opportunity to respond to any questions you might have.
Bernard Edelman, a son of Brooklyn, New York, is deputy director for policy and government affairs for Vietnam Veterans of America (VVA). He previously served as director of the New York City Mayor’s Office of Veterans’ Affairs under Ed Koch and was director of content development for veteransadvantage.com.
He is the editor of the much acclaimed Dear America: Letters Home from Vietnam, was associate producer of the Emmy- and Peabody Award-winning film based on his book, and co-producer of the Academy Award-nominated documentary short, “Memorial: Letters from American Soldiers.” He also authored the oral history Centenarians: The Story of the 20th Century by the Americans Who Lived It.
Edelman served in the U.S. Army from 1969 through 1971, spending most of 1970 in Vietnam as a broadcast specialist/correspondent.
VIETNAM VETERANS OF AMERICA
June 18, 2009
Vietnam Veterans of America is a non-profit national 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 of 1995.
VVA is not currently in receipt of any Federal grant or contract, other than routine allocation of office space and associated resources in VA Regional Offices and the Board of Veterans Appeals for outreach and direct services through its Veterans Benefits Program (service representatives). This is also true of the previous two fiscal years.
For further information, please contact:
Executive Director of Policy and Government Affairs
Vietnam Veterans of America
(301) 585-4000, extension 127