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An organization chartered by the U.S. Congress

June/July 2002

Roswell Sworn In As Undersecretary For Health


On May 9, Dr. Robert Roswell was officially sworn in as VA Undersecretary for Health in a ceremony at the VA Central Office.  Dr. Roswell served most recently as VISN 8 director, which includes Florida, Puerto Rico, and part of southern Georgia. VVA knows Dr. Roswell from many past contacts and believes he will be an excellent leader, and that we will have an excellent working relationship with him.


VVA maintains that Congress and the Bush administration must add not less than $1.6 billion to the existing administration request, with a target VHA budget of $25.5 billion. As we continue to hear on virtually a daily basis about clinic closures and staff cuts at VA facilities nationwide, VVA=s leadership uses every opportunity to drive the message home.  VVA National President Tom Corey led the way when he met with seven Senators in May, explaining why the VA medical system needs more funds and that Congress needs to do much more to insure accountability of how senior managers spend the funds they do have.

During the week of May 13, Missouri State Council President Alan Gibson, accompanied by VVA Government Relations staff, paid a series of courtesy calls on the entire Missouri congressional delegation. At each stop, the VVA team emphasized the need for additional funding and additional accountability within the VA system. Democratic Rep. William Lacy Clay spent nearly an hour with the VVA team discussing the state of the VA budget and related issues.  

VVA=s Missouri and national leadership will be following up with each office to insure maximum support for increased VHA funding and accountability in the FY02 supplemental and the FY03 budget. The previous week, West Virginia State President Charlie Mitchem joined VVA national staff in visiting members of his congressional delegation. Follow up on this effort is also underway. A similar effort with the Maryland leadership is now underway. 

This move to get intensive involvement of state and local leadership is essential if we are to secure the appropriated dollars needed to fund veterans health care properly.  


Proving once again the adage that some bad ideas just won=t go away, the House included language in the FY2003 National Defense Authorization Act (HR 4546) that would place at risk an already overloaded VA healthcare system. Section 723 of the proposal contains extremely disturbing DoD/VA healthcare sharing provisions:

"(3)(A) The guidelines established under paragraph (1) shall authorize the heads of individual Department of Defense and Department of Veterans Affairs medical facilities and service regions to enter into health care resources coordination and sharing agreements.

(B) Under any such agreement, an individual who is a primary beneficiary of one Department may be provided health care, as provided in the agreement, at a facility or in the service region of the other Department that is a party to the sharing agreement." 

VVA=s leadership firmly believes that this would be a prescription for chaos in the military and veteran health care systems. 

The legislation as written would guarantee the creation of a bewildering kaleidoscope of differing access standards and resource allocations that would ill serve beneficiaries. It also likely would lead to VA patients being routinely displaced from care to accommodate DoD personnel or their dependents. We now have many years of unhappy experience with differing levels of care and effort across the VISN system. This language in the House version of the NDAA, if enacted into law, would insure a further devolution of the quality and continuity of health care for both DoD and VA beneficiaries.

In communicating with House Veterans= Affairs Committee majority staff on this subject, VVA reiterated its view that the ongoing decline in VA capacity, particularly in the specialized services, makes any potential health care delivery sharing totally impractical. VVA also pointed out that active-duty personnel are highly unlikely to avail themselves of VA=s PTSD counseling services for fear that using such services would create a medical paper trail that would compromise the service member=s ability to remain on active duty.  

VVA is working with Senate staff to kill this portion of the NDAA. VVA believes that Congress would be well served by waiting until the Presidential Task Force to Improve Health Care for our Nation=s Veterans has issued its final report next March before attempting to legislate greater DoD/VA healthcare sharing. The PTF may offer some well-informed recommendations that would be preferable to the DoD/VA sharing language currently in the House FY03 NDAA legislation. 


On May 17, the Associated Press reported that the Pentagon was about to resume use of the controversial anthrax vaccine--this time giving the shots to those only at ``highest risk== and classifying the shots secret so that ``would-be attackers would not know which troops are protected.== In VVA=s view, this is another tragic example of the non-thinking that characterizes the Pentagon=s NBC defense establishment. VVA is totally opposed to the classification of any portion of a servicemember=s military medical record. 

VVA suggests the top leadership--including the Secretary of Defense and all military and civilian personnel located at the Pentagon--should be vaccinated first, and then the rest of the troops. As the anthrax attack on the Senate proved, those in key places in Washington are at highest risk. If the vaccine is good enough for troops in the field, then it is good enough for top brass and civilian officials. Leadership by example should be the rule. 

As last fall=s anthrax letter attacks amply demonstrated, all of us--civilian and soldier alike--are vulnerable to even low-level threats. VVA believes that America=s armed forces and civilians are best protected by 1) real-time NBC detection and decontamination capabilities, and 2) medically sound post-exposure antibiotic treatment regimens such as were employed after the anthrax letter attacks last fall. VVA will continue to urge the Defense Department, the services, and the Congress to craft biomedical defense policies that are minimally invasive and truly user friendly. 


As most veterans know, nerve agent exposure can be fatal within minutes unless appropriate medications are administered immediately. In this scenario, two days may as well be two years. 

This VHA directive confirms what VVA has feared and publicly articulated since September 11: citizens will die needlessly in the aftermath of a WMD incident unless VA receives adequate resources now. The VA has been allocated a tiny fraction (less than $80 million) of last year=s post-9/11 multi-billion-dollar emergency appropriation for homeland defense. VVA estimates that VA needs not less than $250 million in emergency preparedness funds this fiscal year alone, along with an annual line item of not less than $300 million for WMD-related staffing, training, and pharmaceutical stockpiling. VVA will continue to press vigorously for adequate funding for VA WMD preparedness initiatives.

Even more importantly, the VA does not have the organizational capacity in the way of doctors, nurses, and allied health care staff to be able to meet the vital needs of the veterans they serve now, much less successfully handle a large attack. Congress must provide at least $25.5 billion to the Veterans Health Administration for FY 2003 for there even to be a reasonable chance to be able to meet the responsibilities set forth under the fourth mission of VA. 


The Bush Administration still has not tried to take effective action to see that Public Law 106-50, the Veterans Entrepreneurship & Small Business Act of 1999, is fully implemented.  VVA is surprised that this administration would not make the Executive Branch obey the law that benefits both the government and service-disabled veterans in small business, particularly in this time of war.   

In close coordination with our partners in the Task Force for Veterans Entrepreneurship, VVA is working closely with Congress, particularly Sens. John F. Kerry (D-Mass.) and Christopher "Kit" S. Bond (R-Mo.), as well as with leaders of both the Small Business Committee and the Veterans Affairs Committee in the House of Representatives to seek implementation and compliance with the law.  This may well necessitate further changes in the law, including shifts in money away from the SBA to entities that want to obey the law and are competent enough to make the law a reality for disabled-veteran business owners.


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