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March/April 2007

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VA Budget Proposal
Still Shorts Veterans


“We recognize that the budget recommendation VVA is making this year—an increase of $6.9 billion over the expected fiscal year 2007 appropriation for veterans’ health care—is extraordinary,” VVA President John Rowan said in testimony before the House Committee on Veterans’ Affairs Feb. 8.

“But with troops in the field, years of under-funding of health care organizational capacity, renovation of an archaic and dilapidated infrastructure, updating capital equipment, continued underestimation of usage by veterans, particularly returnees from Iraq and Afghanistan, and several cohorts of war veterans reaching ages of peak health care utilization, these are extraordinary times,” Rowan said. “It’s past time to meet these needs.

“The $2 billion increase the administration has requested for medical care may almost keep pace with medical inflation,” Rowan said in testimony submitted for the record. “But it will not allow VA to enhance its health care or mental health care services for returning veterans, restore diminished staff in key disciplines, restore needed long-term care programs for aging veterans, or allow working-class veterans to return to their health care system.

“VVA’s recommendation does accommodate these goals, in addition to restoring eligibility to veterans exposed to Agent Orange for the care of their related conditions,” Rowan said.

Rowan cited the imperative for the VA to have the resources necessary “to bolster the mental health programs that should be readily available to serve our young veterans from Iraq and Afghanistan.” The Department of Defense estimates that as many as 17 percent of those serving in Iraq “will have issues requiring them to seek post-deployment mental health services,” Rowan said, “and recent studies have shown that four out of five of the veterans who may need post-deployment care are not properly referred to such care.”

In the benefits realm, Rowan said, there is the need for additional vocational rehabilitation specialists to work with returning service members who are disabled to help them find and succeed in meaningful work at a living wage, as well as well-trained and properly supervised adjudicators, or raters, if the Veterans Benefits Administration is to have any realistic hope of cutting into the backlog of cases awaiting adjudication. There simply must be much more real accountability demanded from VA.

Rowan later echoed his remarks before the Senate Veterans’ Affairs Committee.

Among the first acts of the new Democratic leadership when power passed to them after 12 years of GOP control of Congress was to reinstate the joint hearings process in which veterans and military service organizations appear before the Veterans’ Affairs Committees of both houses.

Joint hearings have traditionally been held in the spring, after the President submits his budget request to Congress. The hearings are generally tied to the veterans’ service organizations national meetings in Washington, D.C.

“I am proud of [the] decision to reinstate the joint hearings,” said Rep. Bob Filner (D- Calif.), the new chair of the House Veterans’ Affairs Committee. “These forums provide veterans and military families an opportunity to voice their concerns and provide guidance to the government for whom they fought and sacrificed so much. I look forward to working with the veterans’ community, the administration, and my colleagues in the House and Senate to provide our troops, veterans, and military families the benefits and health care they have earned and deserve.”

Filner began his tenure in fine fashion, joining VVA’s officers and Board of Directors at breakfast during the BOD meeting in January in Silver Spring. Addressing those assembled at the Crowne Plaza Hotel, Filner said: “You all have educated me” about the needs of veterans and their families.

After calling the situation faced by homeless veterans “a moral disgrace for our nation,” Filner promised to focus attention on mental illness among veterans. And on the lingering legacy of Agent Orange. And on the need to provide more benefits for members of the National Guard who have seen increasing recent call-ups.

Filner promised to make sure sufficient funding is provided for veterans’ health care each year. He promised, too, to work in a bipartisan manner and to run the committee “as a problem-solving group of people” using, as much as is practicable, a roundtable format for hearings. The first hearing, he said, would be on how to reduce the disability claims backlog that just never seems to get smaller.
VVA expects to work closely with the new chair on issues of vital interest to veterans and their families.

Over on the Senate side, “DoD/VA Collaboration and Cooperation to Meet the Needs of Returning Service Members” was the focus at the initial oversight hearing of the Veterans’ Affairs Committee. It was a session not without a bit of drama.
Gordon Mansfield was seven minutes into his upbeat opening remarks when Sen. Jay Rockefeller of West Virginia interrupted the VA deputy secretary.

“If I can be bold and slightly unkind, this is like every other presentation made by any government agency that I’ve ever heard in 23 years here,” an obviously annoyed Rockefeller said.

“You’re telling us all the good things that are happening. Whether they are or not, you’re telling them to us. If you listened to us at all, we weren’t interested in that. We were interested in what’s happening to suicides, to mental health, to PTSD, to speediness of cure and care. You are simply not addressing them.”

Rockefeller called Mansfield’s statement a farce that was “totally unresponsive to the committee”—and to veterans. The packed hearing room on the fourth floor of the Russell Senate Office Building was stunned.

In his remarks, David S. C. Chu, Under Secretary of Defense for Personnel and Readiness, the only other witness to testify, said he had been misunderstood, or misinterpreted, or misquoted by the Wall Street Journal when he told a reporter that the burdensome costs of caring for veterans was affecting the ability of the nation to defend itself. Chu praised Mansfield and waxed poetic about his department’s transition-assistance program.

“It is a different relationship today than it was six years ago, and I think the reason for that difference is commitment: commitment by the administration, commitment by the two cabinet secretaries, commitment by the individuals up and down the line in the two agencies that are responsible for our military personnel and the veterans of the United States,” Chu said.

Sen. Patty Murray (D-Wash.), in her remarks, did not let up. “We don’t need a hearing to discover if we have a seamless transition. I know we don’t. And we don’t need this hearing to find out if the Pentagon and the VA are working together or not. I don’t think they are.

“We do need to use this hearing to find out from our witnesses what they are doing about it and how they are going to fix it. And I can tell you one thing: The veterans I talked to don’t really care about Washington, D.C., talk. They care about the reality they see in my state and across the nation: whether they can get a job, whether they can get health care, whether they get the benefits they need.

“If we do want to make progress, I think we have to understand how we got here, so we can change course. How did we get to a point where, four years into this war, we have a two-year backlog for VA benefits, mental health care that’s inaccessible, and long lines to see a VA doctor? We better understand how we got here so that we do not make the same mistakes moving forward.”

Murray was unflinching in her summation of the administration’s failures. “The first problem,” she said, “is that the Bush administration did a miserable job planning for the aftermath of the war. The failures we’ve seen in the planning on the military side are mirrored by failures of planning on the VA side.

“We all know the VA has some of the best employees in the world, and we’re very proud of the work they do. But for too long, we’ve had a VA leadership that has not done an adequate job planning for the many veterans this war is creating, and the VA is still woefully behind in its projections. Last year, the VA planned to see 110,000 veterans from Iraq and Afghanistan; it ended up seeing more than 185,000.

“The second problem is, the Bush administration has never made a commitment to fund veterans’ health care as an essential part of the cost of war. This war is being paid for by supplementals, but those supplementals do not include funding for veterans health care. [This] has gone up, but it’s still not tied to the real needs.”
Mirroring VVA’s “Leave No Veteran Behind” button, Murray said: “We need to get the VA and the White House to match the funding for what the real needs are so that our veterans are not left behind.

“And the third problem is that we have not been able to get straight answers or real numbers out of the VA. The Government Accountability Office has found in report after report that VA has misled Congress, concealed funding problems, and based its projections on inaccurate models. That has to change, because our veterans are paying the price.

“With all due respect to our witnesses, other officials from your agencies have assured us that everything was fine when it certainly was not. I was assured many times that the VA had the funding it needed, only to learn later that the VA had a $3 billion shortfall and the agency had falsified budget savings over many years.”
Sen. Bernie Sanders of Vermont also lambasted the VA. “If we go to war, I think what we have to understand is that the cost of war does not stop the day that the war ends,” he said. “The cost of war stops when the last veteran stops needing benefits and the help that they should receive as a result of their service to this country.

“Let’s be very blunt about it,” Sanders said. “We had a major problem in the VA before the Iraq war began. Before the Iraq war began, in my state and all over this country, there were very long waiting lists to get into the VA system. Now, how could that be? How could people who put their lives on the line defending this country have to wait month after month after month to get the health care that they need?

“How could it happen that the Bush administration, in order to save money, would throw hundreds of thousands of Category 8 veterans off of VA entirely, so that a 90-year-old veteran who calls my office and served in World War II can’t get into the VA because he is ‘too wealthy,’ earning more than $27,000 a year?
“This,” Sanders intoned, “is a national disgrace.”

If this seems to be a venting ground for disgruntled Democrats, readers ought to know that, in addition to Sen. Akaka, six of his Democratic colleagues—Rockefeller, Murray, Sherrod Brown, Jim Webb, and Barack Obama—attended the hearing. On the other side of the aisle, only Larry Craig of Idaho, now ranking member of the committee, bothered to show up.

Although the leadership in the House and Senate has determined that the only way to manage the budget is to operate the FY’07 appropriations by continuing resolution, veterans’ health care will not suffer—if the legislators enact and if the president signs into law legislation that will boost funding by some $3.6 billion in the current fiscal year. Because this is the first budget initiated by the Democrats, HVAC chairman Bob Filner said it was particularly important to do the right thing for veterans.

“They are to be applauded for making good on their word to the VSOs,” said VVA President John Rowan. “Despite the constraints on domestic and discretionary spending, veterans will not be unduly penalized because of what had been an impasse over spending levels for veterans affairs.”

VVA has long supported the rights of veterans to be represented in the claims process. Sen. Larry Craig (R-Idaho) made it happen as chair of the Senate Committee on Veterans’ Affairs during the 109th Congress.

Almost immediately after the President signed this landmark legislation, there were grumblings. Many VSOs are opposed, fearing that having the option to hire lawyers will steer veterans seeking representation away from their services and into unnecessary and costly arrangements.

First, in the particular vernacular of the Pentagon, MIAs were renamed DUSTWUNs in the current GWOT, the acronym for Global War on Terrorism. No longer is a GI missing in action; rather he is a DUSTWUN, which stands for “Duty Status Whereabouts Unknown.”

And now, with the fighting in Iraq officially lasting longer than the American participation in World War II, the deep thinkers in the Pentagon are refiguring the way in which casualty totals are given.

In Vietnam, two sets of books were kept on those who died: For every four to five KIAs—Killed In Action—there was one casualty who died in-country from accident or illness. Was this an honest attempt to tell the truth about American losses, or was it a blatant attempt to minimize the numbers of those who died in the war? And what of this newest reconfiguration by the Pentagon?

What moved the bureaucrats in the Pentagon to change definitions in mid-war? As Grady reported: “Concern about public perceptions of the wounded increased last month after Linda Bilmes, a Harvard professor, published an opinion article in The Los Angeles Times mentioning 50,508 ‘nonmortal woundings’ in Iraq and Afghanistan. That number,” Grady wrote, came from a web page posted by public affairs employees at the VA.

“But officials from both agencies said that figure had been posted by mistake,” Grady continued, “lumping combat and noncombat injuries as well as illnesses and labeling them all ‘woundings’ instead of casualties.

“‘If public affairs people at the VA misunderstood,’” she quoted Michael Kilpatrick, deputy director of force health protection and readiness at DoD, “‘we thought the public would misunderstand it, too.’”

What the public cannot help but understand is that “shock and awe” has long since given way to a protracted guerrilla war in which improvised explosive devices (IEDs) are the face and stamp of the insurgents. And revised nomenclature cannot hide the human costs of this war.

The bottom line is: Whether a GI is wounded in a firefight or injured driving a Humvee, in Iraq or stateside, the true cost of war cannot be hidden. During the Civil War, and during the First World War, more American soldiers died of disease and unsanitary conditions than were felled by enemy ordnance.

On Tuesday, February 20, the surgeon general of the Army, Lt. Gen. Kevin C. Kiley, M.D., was one of four presenters to DoD’s Health Care Task Force. In his PowerPoint presentation, Gen. Kiley spoke with vigor and with confidence about his mission and areas of emphasis. He employed slides of charts and graphs galore. He indicated great pride in the advances being made in military medical care.

Conspicuously absent from his presentation, however, was any mention about the disheartening and indeed scandalous conditions at the “crown jewel” of the military’s health care institutions: Walter Reed Army Medical Center in Washington, D.C.

Indeed, as a series that week in The Washington Post illuminated appalling conditions faced by recuperating war fighters—that’s the new jargon at the Pentagon for soldier, sailor, marine, flier, et al.— and their families on the WRAMC campus, the Army’s top doc said nary a word about it in his prepared remarks.

Thankfully, the glare of publicity is having a salutary effect. Brass at Walter Reed are falling all over themselves to repair the damage—not only to the buildings and living quarters, but to the reputation of this stalwart institution.

A few years back, in the first year of the fighting in Iraq, Steve Robinson, then executive director of the National Gulf War Resource Center, represented VVA in exposing similarly deplorable conditions at Fort Stewart, Georgia. What has been happening at WRAMC is simply more of the same. The conditions exposed by journalists Dana Priest and Anne Hull should have come as no shock to anyone, particularly those in charge of Army medical operations.

Hence, those claiming no knowledge of what they should have known about does not ring true. For these conditions to have festered as long as they did, with little or nothing done to correct them until the glare of publicity got rather too bright, is scandalous. The real questions should be: What did Gen. Kiley and Gen. George Weightman, commanding officer at Walter Reed, know and when did they know it? And why did it take stories in the media to stimulate corrective action?

We can recall in the late ’60s and early ’70s when a series of reports uncovered deplorable conditions at VA medical centers. It was these reports that galvanized the Veterans Administration to address the problem. Too bad DoD didn’t learn the VA’s lesson.

The VA Vet Center program, which provides readjustment counseling and outreach services to veterans, is expanding into 23 new communities across the nation in the next two years.

New Vet Centers will be located in Montgomery, Alabama; Fayetteville, Arkansas; Modesto, California; Grand Junction, Colorado; Orlando, Fort Myers, and Gainesville, Florida; Macon, Georgia; Manhattan, Kansas; Baton Rouge, Louisiana; Cape Cod, Massachusetts; Saginaw and Iron Mountain, Michigan; Berlin, New Hampshire; Las Cruces, New Mexico; Binghamton, Middletown, Nassau County, and Watertown, New York; Toledo, Ohio; Du Bois, Pennsylvania; Killeen, Texas; and Everett, Washington.

During 2007, the VA plans to open new facilities in Grand Junction, Orlando, Cape Cod, Iron Mountain, Berlin, and Watertown. The other new centers are scheduled to open in 2008. Currently, VA maintains 209 Vet Centers in all 50 states, the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands.

VVA has long been a proponent of the Vet Center program. Our only concern is this: Will the new, and the old, Vet Centers be adequately funded? Will they have counselors who are in tune to family and bereavement issues? We maintain that the Vet Center program needs 300 additional, permanent professional staff members skilled in bereavement, mental health, and family counseling.

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