[Senate Hearing 108-623]
[From the U.S. Government Publishing Office]
S. Hrg. 108-623
PENDING LEGISLATION
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HEARING
BEFORE THE
COMMITTEE ON VETERANS' AFFAIRS
UNITED STATES SENATE
ONE HUNDRED EIGHTH CONGRESS
FIRST SESSION
__________
JULY 29, 2003
__________
Printed for the use of the Committee on Veterans' Affairs
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senate
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COMMITTEE ON VETERANS' AFFAIRS
ARLEN SPECTER, Pennsylvania, Chairman
BEN NIGHTHORSE CAMPBELL, Colorado BOB GRAHAM, Florida
LARRY E. CRAIG, Idaho JOHN D. ROCKEFELLER IV, West
KAY BAILEY HUTCHISON, Texas Virginia
JIM BUNNING, Kentucky JAMES M. JEFFORDS, (I) Vermont
JOHN ENSIGN, Nevada DANIEL K. AKAKA, Hawaii
LINDSEY O. GRAHAM, South Carolina PATTY MURRAY, Washington
LISA MURKOWSKI, Alaska ZELL MILLER, Georgia
E. BENJAMIN NELSON, Nebraska
William F. Tuerk, Staff Director and Chief Counsel
Bryant Hall, Minority Staff Director and Chief Counsel
C O N T E N T S
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Date
SENATORS
Page
Specter, Hon. Arlen, U.S. Senator from Pennsylvania.............. 1
Murray, Hon. Patty, U.S. Senator from the State of Washington.... 2
Rockefeller, Hon. John D. IV, U.S. Senator from West Virginia,
prepared statement............................................. 30
WITNESSES
McClain, Tim S., General Counsel, U.S. Department of Veterans
Affairs; accompanied by Francis M. Murphy, M.D., Deputy Under
Secretary for Health Policy Coordination, Veterans Health
Administration................................................. 3
Biographic Summary........................................... 1
Prepared statement........................................... 5
Response to written question submitted by Hon. Patty Murray.. 28
Wiblemo, Cathleen C., Deputy Director for Health Care, Veterans
Affairs and Rehabilitation Commission, The American Legion..... 8
Prepared statement........................................... 9
Hayden, Paul A., Deputy Director, National Legislative Service,
Veterans of Foreign Wars....................................... 13
Prepared statement........................................... 13
Atizado, Adrian M., Associate National Legislative Director,
Disabled American Veterans..................................... 16
Prepared statement........................................... 17
Blake, Carl, Associate Legislative Director, Paralyzed Veterans
of America..................................................... 19
Prepared statement........................................... 20
Jones, Richard, National Legislative Director, AMVETS............ 22
Prepared statement........................................... 23
APPENDIX
Campbell, Hon. Ben Nighthorse, U.S. Senator from Colorado,
prepared statement............................................. 33
Miller, Hon. Zell, U.S. Senator from Georgia, prepared statement. 34
Harnage, Bobby, National President, American Federation of
Government Employees, prepared statement....................... 34
Nygaard, Jane, President, AFGE Local 3669 and Jay Price,
President, AFGE Local 1969, prepared statement................. 37
Hansen, Roy S., Adjutant, Disabled American Veterans, Department
of Minnesota, prepared statement............................... 38
Schneider, Richard C., National Director, Veterans and State
Affairs, Non-Commissioned Officers Association of the United
States, prepared statement..................................... 38
Cullinan, Dennis, Director, National Legislative Service,
Veterans of Foreign Wars, prepared statement................... 38
Van Bergen, Steve, State Commander, Department of Minnesota,
Veterans' of Foreign Wars...................................... 39
Corey, Thomas H., National President, Vietnam Veterans of
America, prepared statement.................................... 39
Rochelle, Frederick, Former President, St. Paul Chapter, Vietnam
Veterans of America, prepared statement........................ 39
PENDING LEGISLATION
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TUESDAY, JULY 29, 2003
U.S. Senate,
Committee on Veterans' Affairs,
Washington, DC.
The committee met, pursuant to notice, at 2:10 p.m., in
room SR-418, Russell Senate Office Building, Hon. Arlen Specter
(chairman of the committee) presiding.
Present: Senators Specter, Rockefeller, and Murray.
OPENING STATEMENT OF HON. ARLEN SPECTER,
U.S. SENATOR FROM PENNSYLVANIA
Chairman Specter. Our lead witness today is Mr. Tim
McClain, confirmed by the Senate as general counsel for the
Department of Veterans Affairs on April 6th. Mr. McClain has a
very extensive resume, which we will put in the record.
[The resume of Mr. McClain follows:]
biographic summary of tim s. mcclain, esq.
Tim S. McClain was born in Johnstown, Pennsylvania on June 10,
1948. He earned a Bachelor of Science degree from the United States
Naval Academy in 1970 and served as a Surface Warfare Officer for his
first 5 years of commissioned service. During tours in the Western
Pacific, Mr. McClain was awarded the Navy Commendation Medal with
Combat ``V'' for duty in Vietnam. In 1975 Mr. McClain was selected to
participate in the Navy's Law Education Program. He attended California
Western School of Law in San Diego, California received his Juris
Doctor degree in 1978, and began service in the Navy Judge Advocate
General's Corps. He is a member of the State Bar of California.
Mr. McClain served as a military defense counsel, Head Claims
Officer, and Head Legal Assistance Officer while stationed at Navy
Legal Service Office, San Diego. In 1981 he served as Staff Judge
Advocate for the Commanding Officer, Naval Air Station Miramar. In 1983
he was assigned as department head and instructor at the Naval Justice
School, Newport, Rhode Island.
Mr. McClain attended training as a trial advocacy instructor and
was instrumental in starting trial advocacy programs in the Navy
patterned after the programs developed by the National Institute for
Trial Advocacy (NITA). Mr. McClain was awarded the Meritorious Service
Medal for his leadership at the Navy's law school. In 1986 Mr. McClain
was assigned as a General Court-Martial Military Judge at Navy-Marine
Trial Judiciary, Southwest and presided over hundreds of courts-
martial. He received his second Meritorious Service Medal upon his
retirement from the military in 1990.
Mr. McClain entered the private practice of law and joined a
litigation law firm in San Diego, California. He specialized in
defending professional negligence cases, especially medical and legal
malpractice cases. Mr. McClain later joined an international management
consulting firm and was assigned to work with mid-level managers of
several Fortune 500 companies in implementing process and productivity
improvements. Within 2 years he was a Director of Operations and
supervising multiple projects. In 1999 Mr. McClain joined a small law
partnership in La Jolla, California. He specialized in military
administrative law, medical licensing matters, civil litigation and
government administrative hearings.
Mr. McClain is married to the former Lynn Hollyfield of Virginia.
Mrs. McClain earned a bachelor's degree in Education from James Madison
University and a Master's Degree in Counseling from Providence College.
They have two sons, Scott age 27, and Brendan age 24, who reside in
California.
Chairman Specter. We are expecting to vote shortly, so we
are going to have to stay on schedule with the 3-minute
allocation, and I would ask all of the witnesses to focus on
that, and when the red light goes on to terminate within the
sentence. Mr. McClain, we start with you.
Senator Murray. Mr. Chairman, would it be possible to make
an opening statement?
Chairman Specter. Of course, Senator Murray.
OPENING STATEMENT OF HON. PATTY MURRAY, U.S. SENATOR FROM THE
STATE OF WASHINGTON
Senator Murray. Thank you, and I am sorry to interrupt, Mr.
McClain, but it is a statement I really did want to get on the
record.
I want to thank you for convening the committee today, and
welcome all of the panelists, but this afternoon I did want to
focus this committee's attention on some late-breaking
developments that are threatening many of the 700,000 veterans
in Washington State.
Under the CARES Initiative, the Department of Veterans
Affairs asked its regional offices to study the health care
needs of local veterans and to develop a plan to meet those
needs, and the local experts in my region, which are
Washington, Oregon, Idaho and Alaska, submitted their plans
several months ago. It showed that enrollment is growing
dramatically and that there are significant gaps in areas like
primary care and specialty care.
The VA sat on the report for several months and then last
week, just 8 days before the release of their national report,
the VA called the leaders in my region with some pretty
shocking news and said they did not like the recommendations in
the report. VA headquarters then ordered our regional leaders
to include a new and troubling recommendation to close three VA
facilities in Washington State, including American Lake in
Tacoma and VA facilities in Walla Walla and Vancouver.
This directive to regional VA leaders came last Wednesday
in a phone call from the Secretary of Veterans Affairs, and the
next day I sent a letter to Secretary Principi objecting to the
VA's interference with this regional market plan and expressed
my strong opposition to closing these three Washington State
facilities.
Frankly, I am pretty outraged at this proposal, and I find
it particularly appalling that it came just 8 days before the
deadline for the VA's national plan. We just had 8 days to
respond to a plan that is going to impact thousands of
Washington State veterans. This directive essentially ensures
that the VA will include the closure option for the three
Washington facilities in its national plan, and that is just
unacceptable.
Veterans in Washington State deserve more from the VA than
just 8 days' notice that their facilities are in jeopardy, and
we should not forget that there is a Federal law on the books
since 1987 that prohibits changing the mission of the Veterans
Administration Medical Center in Walla Walla.
These last-minute suggested closures are going to hurt
veterans in all three areas of my State. In the Puget Sound, it
means that homeless veterans, veterans with mental health
problems and veterans with spinal and brain injuries will lose
an important facility at American Lake, which today cares for
more than 46,000 veterans annually. Closure would cause demand
on the Seattle VA to skyrocket and cause further delays in care
which we already have beyond belief right now.
In Vancouver, instead of the creative community-based
partnerships proposed, the VA is potentially shutting this
facility in the fastest-growing area of metropolitan Portland.
In Walla Walla, veterans may lose a facility that was
shifting to long-term care and some contracting out of other
services. At the Walla Wall VA Medical Center, it is also one
of the largest employers in that community and serves a
population of approximately 69,000. Closure of the Walla Walla
facility would leave area veterans 180 miles from the next
center, Spokane, their VA Medical Center there.
Mr. Chairman, Washington State veterans are having a
terrible time getting the care they need, and instead of
improving services, the VA is now exploring closing three
critical facilities, and to me that is really unacceptable, and
I am going to continue to speak up for the veterans that I
represent. They certainly deserve better treatment than they
are getting from this administration right now. So I want to
raise those concerns today with Mr. McClain because I fear that
the CARES process is really losing its legitimacy and that this
committee needs to increase its oversight.
We have to ensure that the CARES, and the work of the
Department, and the Commission are transparent and accessible
to veterans. The VA's stealth effort to potentially close these
facilities in Washington State, despite the regional
recommendations that were given to them, is a sign that the
CARES process is a growing problem for the VA and for Congress.
I am a co-sponsor of Senator Graham's legislation to allow
for congressional review of the CARES recommendation. His bill
will bring needed congressional input, I think, back into the
CARES process.
Mr. Chairman, our veterans deserve better than they are
getting in Washington State, and I am going to hold this
administration responsible for the way it has been treating the
veterans that I represent.
Thank you very much.
Chairman Specter. Thank you very much, Senator Murray.
Mr. McClain.
OPENING STATEMENT OF TIM S. McCLAIN, GENERAL COUNSEL, U.S.
DEPARTMENT OF VETERANS AFFAIRS; ACCOMPANIED BY FRANCES M.
MURPHY, M.D., DEPUTY UNDER SECRETARY FOR HEALTH POLICY
COORDINATION, VETERANS HEALTH ADMINISTRATION
Mr. McClain. Good afternoon, Mr. Chairman, members of the
committee. Thank you very much for inviting us here this
afternoon. I am accompanied this afternoon by Dr. Frances
Murphy, our Deputy Under Secretary for Health Policy
Coordination.
We are also pleased to be here with the representatives
from the various veterans' service organizations to address
these very important issues.
I will briefly discuss the measures that you are
considering, but my prepared statement has more in-depth
statements, and I ask that it be made a part of the record.
Chairman Specter. It will be made a part of the record in
full.
Mr. McClain. Before discussing the specific legislation
before you, I want to mention that VA has recently transmitted
to Congress an important draft bill to greatly improve our
ability to recruit and retain the highest-quality physicians
and dentists to treat the Nation's veterans. The bill would
completely revise the physician and dentist pay system to allow
us to adjust compensation according to market levels. It also
contains provisions to enhance our ability to recruit and
retain nurses. We desire to work with you and the committee on
this very important legislation and urge passage as quickly as
possible.
Mr. Chairman, I will focus my comments on your bill, S.
1156, the omnibus health care bill. The bill contains various
provisions, including provisions to extend for 5 years the
long-term care provisions of the Millennium Act, and to reduce,
from 70 percent to 50 percent the threshold for mandatory
eligibility for VA nursing home care.
We are concerned with this particular provision, since we
estimate it would cost almost $2.5 billion over 5 years, and it
has not been planned for in the current budget process. The
provision could have serious unintended consequences, including
slowing the rate of growth of non-institutional long-term care
services and reducing the availability of services for non-
mandatory categories of veterans because of competing
priorities for limited resources.
We also believe cost-free care in State homes should be
included in the options available to those severely disabled
service-connected veterans. State home care should be made
available to these veterans without any out-of-pocket costs. We
would like to work with the committee to develop the necessary
legislation.
S. 1156 would also authorize two construction projects. We
support those projects, in concept, and will consider them in
future budget preparations. However, we would urge that you
also include authorization for other projects included in the
President's budget, including a health care facility in Las
Vegas. The latter is needed because VA just recently, on July
1st, vacated an outpatient clinic in Las Vegas due to
structural inadequacies.
Finally, S. 1156 would broaden the authority of the
Veterans Benefit Administration to contract with outside
entities for disability examinations in connection with the
adjudication claims for veterans' benefits. Current law allows
such contracting at no more than 10 regional offices on a pilot
basis. Your bill would remove the 10-office limitation.
Sir, I see that my time is up, and I would be glad to
answer any questions the committee has.
[The prepared statement of Mr. McClain follows:]
Prepared Statement of Hon. Tim S. McClain, General Counsel,
Department of Veterans Affairs
Good afternoon Mr. Chairman and Members of the Committee.
I am pleased to be here to present the Administration's views on
six bills that pertain primarily to the veterans' health care system.
S. 1156
Mr. Chairman, I will begin by addressing S. 1156, your omnibus
health-care bill. It includes provisions pertaining to long-term health
care in VA, personnel matters, authorization for construction of two
major medical facilities, and permanent authorization of the Veterans
Benefits Administration to obtain disability examinations on a contract
basis.
LONG-TERM CARE PROVISIONS
In 1999, the Congress made significant changes in our long-term
care programs through enactment of what we commonly refer to as ``The
Millennium Act.'' Among other things, that law directed that VA
``shall'' furnish nursing home care to any veteran needing such care
for a service-connected disability and to any veteran with a service-
connected disability rated at least 70 percent. It also directed that
VA include various non-institutional extended care services in the
medical benefits package. At the time of enactment, the impact both
provisions would have on VA was uncertain, and Congress chose to limit
their applicability to the 4-year period ending December 31st of this
year. Section 101 of your bill would extend the provisions for an
additional 5 years through December 31, 2008. That section would also
extend the requirement that we furnish needed nursing home care to all
veterans with service-connected disabilities rated 50 or 60 percent.
The Department's view is that it would be premature at this time to
extend the two Millennium Act provisions for 5 years. As you know, we
provided the Congress with a report on implementation of the Millennium
Act in March. We are continuing to gather information and will provide
the Congress with an additional report later this year. That report,
and other actuarial analyses, will provide data that will aid VHA
leaders and Congressional policymakers in determining appropriate
longer-term directions for development of VA long-term care services.
Accordingly, we recommend only a 1-year extension at this time.
We are also concerned about extending so-called ``mandatory''
nursing home eligibility to all veterans with service-connected
disabilities rated at least 50 percent. We estimate that the change
from 70 percent to 50 percent would cost $2.5 billion over 5 years and
has not been planned for in the budget process. As a result, the
provision could have serious unintended consequences including slowing
the rate of growth of non-institutional long-term care services and
reducing the availability of services for non-mandatory categories of
veterans because of competing priorities for limited resources. We
recommend that the Committee defer any such change in law until further
data about VA's experience under the Millennium Act are available to
better inform its decision. We also believe State homes should be
included in the options available to these severely disabled service-
connected veterans. State-home care should be made available to these
veterans without out-of-pocket cost. We would like to work with the
Committee to develop the necessary legislation.
Section 102 of your bill would amend existing law to clarify that
we have authority to provide veterans with nursing home care and adult
day health care in private community nursing homes and other facilities
using agreements for reimbursement similar to those used under the
Medicare Program. That approach would differ from our current practice
of providing such care only through actual contracts with the nursing
homes or providers of adult day health care. To implement the
authority, the Department would have to promulgate regulations to
establish a program to directly reimburse the community facilities on
behalf of veterans for the care furnished. The regulations would
include all of the parameters for the program, including amounts VA
would pay for various types of care, and the standards that facilities
would have to meet to receive VA reimbursement. In many respects, the
parameters for the program could mirror those now used in the Medicare
Program. We do not object to section 102 as an alternative approach to
assist us in meeting the needs of veterans for nursing home care and
adult day health care in non-Department facilities.
CONSTRUCTION AUTHORIZATION
Section 201 of the bill would authorize construction of a long-term
care facility in Lebanon, Pennsylvania, in an amount not exceeding
$14,500,000 and a long-term care facility in Beckley, West Virginia, in
an amount not to exceed $20,000,000. We would point out that the cost
for the project in Beckley is now estimated to be $20,800,000. We
generally support these projects in concept and we will be considering
them in the context of future budget preparations.
Mr. Chairman, the President's fiscal year 2004 budget included a
request for authorization for a major construction project at Chicago
(West Side), Illinois for a new inpatient tower; outpatient clinic
leases in Boston, Massachusetts and Pensacola, Florida; and a lease for
the Health Administration Center in Denver, Colorado. In addition we
requested an authorization for an outpatient lease in Charlotte, North
Carolina that received an appropriation in fiscal year 2002. We ask
that you act favorably on those requests, as well as those seismic
projects that were listed in the President's fiscal year 2003 budget.
The facilities at Palo Alto, San Francisco, and West Los Angeles remain
as a critical risk to the safety of patients and staff in the case of
seismic events and those projects remain a high priority for the
Department. We are confident that the CARES studies will validate the
continued need for these major facilities. In addition, we request
authorization for a health care facility in Las Vegas to replace the
existing clinic that we were required to vacate on July 1st because of
structural inadequacies in the building. It is important that the
Department be provided this authorization so we will be able to move
forward next year.
PERSONNEL PROVISIONS
S. 1156 also contains four separate sections that address personnel
matters. The first provision, section 301, would amend existing law to
add a significant number of mission-critical, scarce, skilled health
care positions, such as dietitians, medical technologists, and medical
records administrators/specialists to the current list of Title 38
hybrid positions. We support the goals of increased flexibility in
staffing these positions because of today's fierce competition for
qualified candidates (particularly those who possess skills acquired in
primary care settings), market-wide shortages in these health care
occupations, and VA's aging health care work force. We are currently
considering a similar proposal to increase flexibility in staffing
these positions, and the Office of Personnel Management recently issued
interim final regulations greatly expanding availability of direct hire
authority for critical need or shortage situations. We are examining
whether or not we need legislation given these brand new regulations,
and will work with Congress to reconcile if we do.
In the past, we have not been able to quickly and efficiently
recruit candidates. Our inability to consistently make timely job
offers is a chief reason why the Department is experiencing hiring
difficulties. These difficulties can adversely affect access to care
for many of our veterans. Second, the delays cause many qualified
candidates to forego consideration of VA employment. With multiple job
opportunities in hand, they turn to the private sector where the hiring
process is more responsive.
Section 302 of the bill would amend the law establishing the
Veterans Canteen Service (VCS) to permit persons employed by VCS to be
considered for competitive service appointments in the Department in
the same manner that Department employees in the competitive service
are considered for transfers to competitive service positions.
Currently, VCS Management Program employees may be appointed to
positions in the competitive service under an interchange agreement
between the Department and the Office of Personnel Management (OPM).
Section 302 would authorize a similar interchange agreement for non-
managerial VCS employees. It would authorize all VCS employees to
transfer into a competitive service position. Time served in the
Canteen Service would count toward the 3-year service requirement for
career civil service status.
The Administration does not support section 302 because it believes
that establishing eligibility for the non-competitive conversions of
VCS hourly employees into competitive service positions would provide
an unfair advantage over excepted service employees from other
Departments and agencies seeking appointment to competitive service
positions at VA.
Section 303 of the bill would retroactively apply recently
legislated changes to the method of computing retirement annuities for
certain VA health-care personnel who are already retired. The
Department of Veterans Affairs Health Care Programs Enhancement Act of
2001 prospectively changed the way part-time service performed before
April 7, 1986, by certain VA health-care personnel is credited for
annuity purposes. Section 303 would extend this change to individuals
who retired before the effective date of enactment. Traditionally,
retirement benefit changes have been applicable only to individuals
retiring after enactment of the change. This change would recreate a
very expensive precedent for governmentwide application of the
principle of retroactivity in retirement cases involving part-time
service. Consequently, the Administration strongly opposes this
provision, as it would impact retirement fund outlays and have a PAYGO
cost not contemplated in the President's Budget.
Section 304 of S. 1156 would broaden the authority of the Veterans
Benefits Administration to contract with outside entities for
disability examinations in connection with the adjudication of claims
for veterans' benefits. Current law allows VBA to do so at no more than
10 regional offices on a pilot basis. Section 304 would remove the 10-
office limitation. The pilot has been a success, however, there are
funding issues and we do not yet have cleared views and estimates on
this provision. We will supply them when they are available.
S. 613
S. 613, the Veterans' New Fitzsimons Health Care Facilities Act of
2003, would authorize us to carry out major medical facility projects
at the former Fitzsimons Army Medical Center in Aurora, Colorado. The
bill would provide us with flexibility in selecting the projects by
providing that they may include acute, sub-acute, primary, and long-
term care services. It would limit project costs to an amount not to
exceed $300,000,000 if a combination of direct construction and capital
leasing is selected and no more than $30,000,000 per year in capital
leasing costs if a leasing option is selected. In addition, the bill
places certain limitations on the fiscal years from which appropriated
funds can come.
Mr. Chairman, we support the intent of this provision of S. 1613.
We have been involved in evaluating and planning for a facility for the
Fitzsimons site and there is a potential for a joint venture with DOD
to provide health care to both veterans and DOD beneficiaries. Many
issues still remain including the availability of land, but VA would be
able to provide the report to Congress within 120 days as required if
the bill is enacted.
I also note that Section 3 of S. 613 would require the secretaries
of Veterans Affairs and Air Force to undertake such joint activities as
they deem appropriate to address the health care needs of veterans and
active duty Air Force members. We have no objection to this provision.
S. 1213
S. 1213, a bill entitled the ``Filipino Veterans' Benefits Act of
2003,'' is the Administration's bill that you introduced on our behalf.
I want to express my sincere appreciation to you for introducing the
measure. As you know, section 2 of the bill would extend health care
benefits to Filipino veterans residing legally in the United States who
served in the Commonwealth Army and new Philippine Scouts. I urge that
you act on the bill as expeditiously as possible so we can meet the
needs of these very deserving Filipino veterans.
S. 615, S. 1289 AND S. 1144
S. 615 would designate the outpatient clinic located in Horsham,
Pennsylvania, as the ``Victor J. Saracini Department of Veterans
Affairs Outpatient Clinic''. S. 1289 would designate the Minneapolis VA
Medical Center as the Paul Wellstone Department of Veterans Affairs
Medical Center. S. 1144 would designate the facility in Chicago now
known as the West Side VA Medical Center as the ``Jesse Brown
Department of Veterans Affairs Medical Center''. While we ordinarily
defer to the views of Congress on the naming of Federal properties, in
the case of former Senator Wellstone and former Secretary Jesse Brown
we make an exception. Enactment of S. 1144 and S. 1289 would be an
altogether fitting tribute to these two truly courageous and steadfast
advocates for America's veterans.
S. 1283
S. 1283 would impose new Congressional notice-and-wait requirements
on VA before we could take any action to implement our Capital Asset
Realignment for Enhances Services (CARES) decisions. The bill would
prohibit VA from taking a proposed action for 60 days following
submission of advance written notice of the action to Congress, or
before 30 days during a continuous session of Congress.
Mr. Chairman, we must object to enactment of this bill. As drafted,
the bill is overly broad, unnecessary, and would significantly impede
our completion of the CARES process. By stating that VA must provide
prior notice of ``any action,`` apparently including even minor
actions, the measure would effectively prevent completing the CARES
process in anything like a timely manner. I can assure you we will
provide Congress and this Committee with our CARES plan well in advance
of undertaking significant actions to implement it. Congress will have
considerable lead-time to consider our proposed actions before they are
undertaken.
I would also point out that we are already subject to various
existing notice-and-wait requirements that serve the same purpose as
that intended by this legislation. We currently provide such advance
notice under section 510 of Title 38 whenever we undertake a
significant reorganization of any office or facility. Congress must
also approve in advance any significant construction project, and we
provide Congress with advance notice of any proposed enhanced-use
leases. The additional requirements this bill would impose are
therefore unnecessary.
THE ADMINISTRATION'S PHYSICIANS AND DENTISTS PAY BILL
Finally Mr. Chairman, on July 18th, we delivered to the President
of the Senate and the Speaker of the House of Representatives the
Administration's draft bill ``to simplify and improve pay provisions
for physicians and dentists, to authorize alternate work schedules and
executive pay for nurses.'' This very important bill will greatly
improve VA's ability to recruit and retain the highest quality
physicians and dentists to treat the Nation's veterans. It would
completely revise the VA physician and dentist pay system to allow VA
to adjust compensation according to market levels. The draft bill would
also reduce the potential for conflicts of interest at the Department's
affiliated facilities by prohibiting senior clinician managers at the
Chief of Staff level and above from receiving any compensation from the
medical schools affiliated with their respective facilities. Finally,
the bill would enhance the Department's ability to recruit and retain
nurses by permitting the use of alternate work schedules and by
authorizing special pay for VA nurse executives.
This bill is critical to the Department's ability to recruit and
retain the highly skilled medical professionals we need to care for our
veterans. I offer to work with you and the Committee to get this very
important legislation passed as expeditiously as possible.
That concludes my prepared statement. I would be pleased to answer
any questions you may have.
Chairman Specter. Thank you very much, Mr. McClain. We will
be observing the time, and I know that everybody will submit
statements or has submitted statements which detail the
positions to the extent anyone wishes to take them, as to all
of the legislation on the agenda.
Our next witness will be Ms. Cathleen Wiblemo, the deputy
director for Health Care, Veterans Affairs and Rehabilitation
Commission of The American Legion. Thank you for joining us,
and we look forward to your testimony.
STATEMENT OF CATHLEEN C. WIBLEMO, DEPUTY DIRECTOR FOR HEALTH
CARE, VETERANS AFFAIRS AND REHABILITATION COMMISSION, THE
AMERICAN LEGION
Ms. Wiblemo. Thank you, Mr. Chairman. It is an honor to be
here to present the views of the American Legion on these
important pieces of legislation before us today. For the sake
of brevity, I will limit my comments and highlight only the
bills of major importance to the American Legion.
S. 1156, the Department of Veterans Affairs Long-Term Care
and Personnel Authorities Enhancement Act of 2003. Although the
American Legion supports the provision within this bill to
require VA to provide long-term care for those veterans rated
50-percent disabled and higher, it is critical that VA meet the
long-term care needs of those veterans currently provided for
in Title 38, those that are 70 percent and higher.
On S. 1213, Filipino Veterans' Benefit Act of 2003, the
American Legion has long advocated for the recognition of the
selfless contributions of these brave men and women in World
War II. The American Legion fully supports this bill.
With regard to S. 613, the Veterans New Fitzsimons Health
Care Facilities Act of 2003, the American Legion is again
pleased to support this legislation. The VA Medical Center in
Denver is operating out of a 50-year-old building with lead
paint issues, among other system shortfalls. Piecemealing
renovation is not an option.
On S. 1283, this legislation would require advance
notification of Congress regarding any action proposed to be
taken by the Secretary regarding the Capital Asset Realignment
for Enhancement Services, also known as CARES Initiative.
The American Legion believes that the implementation of
CARES will not be a seamless transition. There will be
questions of funding, reevaluations of initiatives as the years
pass, and more than likely changes will have to be made. This
initiative promises to impact millions of veterans and disrupt
at least for some time their medical services.
The American Legion continues to support CARES. However, we
have voiced our concerns regarding the process, the
implementation phase, and strategic planning into the future.
The American Legion will continue to monitor the CARES process
and believe it may indeed require additional congressional
oversight to ensure its effective implementation.
Thank you, again, for this opportunity, and we look forward
to working with you and this committee on these important
issues. I will be happy to answer any questions.
[The prepared statement of Ms. Wiblemo follows:]
Prepared Statement of Cathleen C. Wiblemo, Deputy Director for Health
Care, Veterans Affairs and Rehabilitation Commission, The American
Legion
Mr. Chairman and Members of the Committee: Thank you for the
opportunity to present The American Legion's views on S. 613, the
Veterans' New Fitzsimons Health Care Facilities Act of 2003; S. 1156,
the Department of Veterans Affairs Long-Term Care and Personnel
Authorities Enhancement Act of 2003; S. 1213, the Filipino Veterans'
Benefits Act of 2003 and S. 1283 a bill requiring advance notice of
actions under VA's Capital Asset Realignment for Enhanced Services.
In the wake of the ongoing Medicare Prescription Drug Benefit
debate, it is important for Congress to focus on the nation's Senior
Citizens and equally important to include military veterans in that
forum. While America struggles to provide comprehensive health care
services for all of its citizens, Congress cannot shirk its duty to
provide those services to the men and women who have served this Nation
in its armed services.
S. 1156, DEPARTMENT OF VETERANS AFFAIRS LONG-TERM CARE AND PERSONNEL
AUTHORITIES ENHANCEMENT ACT OF 2003
This legislation provides for certain improvements and enhancements
to VA's Long-Term Care program.
Section 101 amends Title 38, USC, section 1701(a) (10) to extend
authorization for non-institutional long-term care services, as part of
VA ``medical services,'' from December 31, 2003 to December 31, 2008.
This bill amends section 1710A to require VA to provide nursing home
care to those veterans rated 50 percent or more disabled for a service
connected disability through December 31, 2008. Section 102 of the bill
would provide VA with enhanced agreement authority to utilize non-VA
nursing home facilities in furnishing eligible veterans' nursing home
or adult day health care.
The American Legion consistently advocates the need to improve VA's
ability to meet the increasing demand for long-term care. We strongly
supported the enactment of P.L. 106-117, the ``Veterans' Millennium
Health Care and Benefits Act'', which included a number of provisions
that were intended to ensure veterans rated 70 percent or more disabled
for a service-connected disability would be provided long-term care
through VA. The American Legion is disappointed in VA's inability to
meet its current mandate to provide care for veterans rated 70 percent
disabled or higher. While The American Legion supports the provision
within this bill to require VA to provide long-term care for those
veterans rated 50 percent disabled and higher, it is imperative that VA
meet the long-term care needs of those veterans currently provided for
in Title 38, USC.
Section 201 would authorize specific major medical construction
projects in Lebanon, Pennsylvania and Beckley, West Virginia. The
American Legion is supportive of these initiatives. They will help
bring much needed improvement in the medical care and services provided
by these facilities.
Section 301 would expand the list of positions within the Veterans
Health Administration (VHA) that are considered necessary for the
medical care of veterans in Title 38, USC, Section 7401, to include a
variety of specialists and other health care professionals. It would
also authorize additional pay for these individuals. The American
Legion has no objection to this proposal, since it will enable VHA to
recruit and retain essential medical care personnel necessary to
provide high quality medical care.
Section 302 amends Title 38, USC, Section 7802 to provide that
employees of the VA Canteen Service may be considered for appointment
to Department positions in the same manner as Department employees are
considered for transfer to such positions.
Section 303 establishes effective dates for computation of the
annuity for part-time service performed by certain health care
professionals, who retired after April 7, 1986, as provided by P.L.
107-135. The American Legion has no objection to this amendment.
Section 304 provides VA with permanent authority to use contract
physicians to conduct disability examinations. P.L. 104-275 authorized
VA to conduct a pilot program of contract disability examinations.
Beginning in 1997, VA established an initial 5-year contract with QTC,
a medical group analysis firm who conducted Compensation and Pension
(C&P) disability examinations at 13 sites around the nation. The
contract was renewed late last year. The American Legion believes that
the contract exam program has proven itself to be an important adjunct
to the traditional C&P exams performed at VA medical centers. QTC, up
to this point, has been the only company engaged in this type of
service for VA. With permanent authority, VA will have the flexibility
to explore and expand the use of such contract providers and part of
the overall effort to improve both the quality and timeliness of
veterans' claims processing. The American Legion supports making VA's
authority to establish such contracts permanent.
S. 1213, FILIPINO VETERANS' BENEFITS ACT OF 2003
This legislation provides long-needed improvements in certain
benefits for former members of the Philippine Commonwealth Army and New
Philippine Scouts, who are residing in the United States and are U.S.
citizens or legal aliens. It authorizes VA to provide these veterans
with hospital care, nursing home care, and medical services. It also
equalizes rates of payment of VA disability compensation and dependency
and indemnity compensation as well as providing entitlement to VA
burial benefits, including burial in a National Cemetery, to those
former New Philippine Scouts who reside in the United States. It also
authorizes the continued operation of the VA Regional Office in Manila
until 2008.
Mr. Chairman, The American Legion urges Congress to recognize the
selfless contributions of these brave men during World War II and
redress the longstanding inequity in the benefits provided these
veterans. The American Legion fully supports this bill.
S. 613 VETERANS' NEW FITZSIMONS HEALTH CARE FACILITIES ACT OF 2003
This legislation authorizes the VA Secretary, under 38 USC, Section
8104, to carry out major medical facility projects at the site of the
former Fitzsimons Army Medical Center. Projects, selected by the
Secretary, may include inpatient and outpatient facilities providing
acute, sub-acute, primary and long-term patient care services. Project
costs shall not exceed $300 million, if a combination of direct
construction by VA, and capital leasing is selected or no more than $30
million per year, if capital leasing alone is selected.
The American Legion supports the relocation of the Denver Veterans
Affairs Medical Center (VAMC) to Fitzsimons. The Fitzsimons
Redevelopment Authority has begun converting the site of the former
Army medical center to a Bio-Science Park, with the anchor tenant to be
the University of Colorado Health Science Center (UCHSC). UCHSC has
begun implementing its long-range plan to relocate its existing
facilities, including its hospital to Fitzsimons. The Denver VAMC has
had a longstanding, synergistic relationship with UCHSC and a move to
Fitzsimons would facilitate sharing, unite the Eastern Colorado Health
Care System with the university, and ultimately improve the timeliness
and quality of health care provided to the enrolled veterans of the
Denver area.
The core space of the current VAMC is 50 years old and undersized
for its mission. Its support systems are inadequate for modern health
care and it is reaching a non-recovery condition. A state-of-the-art
facility would create flexible space and facilitate patient treatment
in a modern day health care setting. The American Legion is pleased to
support this legislation.
While the legislation we have discussed are solid efforts to
address the challenges facing the Veterans Health Administration and
its mission to provide health care services, they do not go far enough.
Until health care funding is provided in a consistent and timely
manner, VA cannot grow to meet the future demands nor adapt to the
changing face of the veterans' community. The demand and funding
mismatch must be resolved in order to enhance health care delivery for
the nation's veterans. The American Legion supports mandatory funding
for VA's medical care.
s. 1283, advance notification of congress regarding any action proposed
to be taken by the secretary of veterans affairs regarding the capital
ASSET REALIGNMENT INITIATIVE
The veterans' health care delivery system was designed when
inpatient care was the primary focus, long inpatient stays were common
and access was open to any veteran in need of care. As demand for
services increased, budgetary constraints forced Congress and VA to
take steps to restrict access to health care with the enactment of
complex rules and regulations to limit both care and services.
Throughout the 1990's to the present, efforts have been made in the
public and private sectors to control the cost of health care delivery
through efficiencies and cost cutting. VA has changed from a hospital-
based health care system into an integrated health care delivery
network. In 1996, landmark legislation opened enrollment to all
veterans within existing appropriations.
In 1999, a Government Accounting Office (GAO) report found that VA
spent approximately $1 million a day on unused or underutilized space.
GAO recommended, and VA agreed, that these funds could be better spent
on improving the delivery of services and treating more veterans at
more locations. In response to the GAO report, VA developed a process
to provide the right care, at the right place, in the right setting.
The Capital Asset Realignment for Enhanced Services (CARES) was
initiated in October 2000. The pilot program was completed in Veterans
integrated Services Network (VISN) 12 in June 2001 with the Secretary
announcing the final decision in February 2002. The remaining 20 VISN's
were to be assessed in Phase II that began in June 2002.
During the pilot program in VISN12, stakeholders played no major
role in the planning process. As a major stakeholder, The American
Legion wants to ensure objectivity and inclusion of veterans'
perspectives in the outcomes of CARES Phase II. To that end, The
American Legion National Commander, Ronald F. Conley, authorized the
creation of the Veterans Affairs Facility Advisory Committee on CARES
(VAFACC). The committee's charge was to review the VISN market plans,
planning initiatives and VA Facility Assessment Reports relating to the
CARES process, keeping in mind VISN's were tasked to cut 10 percent of
their vacant space by 2004 and 30 percent by 2005.
The committee raised the following concerns:
Funding.--Clearly, billions of dollars in discretionary
appropriations will be needed to accomplish the new construction and
approved renovations. CARES is an ongoing process, and incremental
changes are anticipated. With the proposed consolidations and
transferring of services, it is imperative that no veteran experience
any delays in access to the delivery of quality health care, and
patient safety must not diminish. No VA medical facilities should be
closed, sold, transferred or downsized until the proposed movement of
services is complete and veterans are being treated in the new
locations.
Veteran's Population.--There is some concern that the projected
veterans' population is underestimated. Indeed, it might be
underestimated based on the war on terrorism. Certainly with regard to
long-term care, mental health, domiciliary and other specialized care
populations, the CARES process has yet to incorporate projections.
Long-Term Care.--A spent close to $3.3 billion on long-term care in
fiscal year (FY) 2002. With the enactment of the Millennium Health Care
Act, demand will most likely increase due to the aging of the veteran
population over the next decade. VA estimates that the number of
veterans most in need of long-term care, those veterans 85 and older,
will more than double to about 1.3 million in 2012. Yet, even with
these numbers, veterans long-term care needs and projected growing
demand are not included in Phase II of the CARES process.
Mental Health.--Due to several factors concerning the initial
projections, the National CARES Planning Office (NCPO) and several
other experts are reviewing the mental health inpatient and outpatient
projections. Because of the questionable decline of demand in several
markets, networks were instructed to plan for increase in mental-health
services only. Stakeholders were very concerned about the mental-health
projections and expressed dissatisfaction with the model.
Unutilized Space.--According to VA's office of Facilities
Management (OFM), VA facility assets include 5,300 buildings; 150
million square feet of owned and leased space; 23,000 acres of land;
and a total replacement value estimated at 38.3 billion. OFM assessed
and graded 3,150 buildings for a total of 135 million square feet with
correction costs estimated at $4.5 billion. More development is needed
by the VISN's to more effectively utilize this unused space instead of
just selling or demolishing these buildings. Once the buildings are
gone, there will be no way of getting them back. Before any unutilized
space is sold, transferred, destroyed or otherwise disposed of, the
CARES process must consider alternative uses of that space to include:
services for homeless veterans, long-term care and the expansion of
existing services.
Contracting Care.--Throughout the VA health-care system,
contracting out of care is prevalent. While contracting may be
necessary in some circumstances, the wholesale use of this health care
delivery tool should be used with caution. Contracting out of care was
extensive in the VISN proposals. Some VISN's made the blanket statement
that care would be contracted out to meet excess demand in 2012 and
2022. Considering that extensive research and cost analysis that will
have to be done concerning available resources (if they are available)
within each community, The American Legion does not believe that is
much of a plan.
Enhanced Use Lease Agreements.--Through the use of EU leases, VA
can receive cash or ``in-kind'' consideration (such as facilities,
services, goods, or equipment). Several of the VISN's proposed
enhanced-use lease agreements with the public and private sectors. VA
should continue to seek opportunities in the area of enhanced use
leasing. It can certainly have a positive impact on service delivery to
veterans and local communities.
VA/DoD Sharing.--There are many opportunities for sharing between
VA and the Department of Defense (DoD). Both VA and DoD benefit from
these agreements, and every effort should be made by the VISN's to
pursue this avenue in order to save money through cost avoidance, in
particular pharmaceuticals, supplies and maintenance services.
The American Legion intends to remain an active partner with VA
during this critical process of realigning the agency's capital assets
to better serve American's veterans. Recent developments in the CARES
process serve to reinforce our concerns outlined in this testimony. The
Undersecretary for Health sent back the market plans to 15 VISN's and
20 facilities with instructions to develop other options and look at
further consolidating inpatient services in many of the facilities.
Additionally, the CARES Commission hearings, after being postponed for
60 days are due to start August 12, 2003. These hearings concern the
National Cares Plan, which no one has seen yet, and won't until at
least August 1, 2003. That gives no lead time for stakeholders to study
the plan before written statements are due for the initial hearings.
The delays have given rise to many questions and concerns on the part
of the stakeholders. We will continue to be vigilant in monitoring the
progress in CARES. Indeed, the CARES process may require congressional
oversight given the above concerns.
I thank you again for your commitment to veterans and look forward
to working with you and the Committee on these important issues.
Chairman Specter. Thank you very much, Ms. Wiblemo.
We will now turn to Mr. Paul Hayden, National Legislative
Service of the Veterans of Foreign Wars. Thank you for joining
us, Mr. Hayden. The floor is yours.
STATEMENT OF PAUL A. HAYDEN, DEPUTY DIRECTOR, NATIONAL
LEGISLATIVE SERVICE, VETERANS OF FOREIGN WARS
Mr. Hayden. Thank you much, Mr. Chairman, members of the
committee.
On behalf of the 2.6 million men and women of the Veterans
of Foreign Wars of the United States and our Ladies Auxiliary,
I would like to thank you for allowing our organization to
testify at today's hearing.
Four of the bills under consideration today represent
attempts to improve the delivery of health care to our Nation's
veterans, while three honor and recognize individuals for their
important contributions to their fellow veterans and the
Nation.
We are pleased to support them all, and I would offer the
following comments.
First, the VFW strongly endorses S. 615, S. 1144, and S.
1289.
Second, shifting to those bills that will improve veterans'
health care delivery, we would offer our support for S. 613
that would authorize the construction or lease of a new medical
facility at the site of the former Fitzsimons Medical Center.
This hospital would be constructed and operated in conjunction
with the University of Colorado that would also maintain
facilities at the former base.
As for the implementation, we would caution the veterans
must remain a priority at this facility.
Further, the VFA is a strong supporter of improving and
expanding VA's statutory authority to provide long-term care
services to our Nation's veterans. Therefore, we believe that
S. 1156, to improve and enhance the provision of long-term
health care provided for veterans by the VA is a positive step
in the right direction.
Turning to S. 1213, the Filipino Veterans' Benefits Act,
our comments are limited to Section 2 of this legislation,
which would provide access to VA health care for certain
Filipino veterans currently residing in the United States. We
believe that providing these Commonwealth Army veterans and
Filipino scouts with access to the hospital, nursing home care
and medical services, consistent with a veteran of the U.S.
Armed Forces, is the proper thing to do.
Finally, the VFA backs S. 1283 that would require advance
notification of Congress of actions to be taken under VA's
Capital Asset Realignment for Enhanced Services program.
With Phase II of the CARES process moving so rapidly, we
appreciate the opportunity that this oversight would provide in
order to ensure that what VA is proposing, under the CARES
program, is truly consistent with enhancing services to this
Nation's veterans.
Mr. Chairman, this concludes my testimony. I will be happy
to answer any questions that you or members of the committee
may have.
[The prepared statement of Mr. Hayden follows:]
Prepared Statement of Paul A. Hayden, Deputy Director,
National Legislative Service, Veterans of Foreign War
Mr. Chairman and Members of the Committee: On behalf of the 2.6
million men and women of the Veterans of Foreign Wars of the United
States (VFW) and our Ladies Auxiliary, I would like to thank you for
allowing our organization to testify at today's hearing. The bills
under consideration during today's hearing represent a wide range of
issues but have one thing in common: the VA health care system. Four of
the bills represent attempts to improve the delivery of health care to
our nation's veterans and three honor and recognize individuals for
their important contributions to their fellow veterans.
S. 613, VETERANS' NEW FITZSIMONS HEALTH CARE FACILITIES ACT OF 2003
This legislation would authorize the construction or lease of a new
medical facility at the site of the former Fitzsimons Medical Center.
This hospital would be constructed and operated in conjunction with the
University of Colorado that would also maintain facilities at the
former base. The VFW supports this legislation, but we do have several
concerns with the implementation.
We must be assured that veterans will remain a priority at this
facility. We have raised questions about the governing board of the
complex and must receive assurances that VA will be properly
represented on the board and that VA retains enough independent control
to ensure that veterans remain a priority. VA must be able to adapt to
any changes in the veteran population, in technology, and in health
care and business practices to remain able to effectively treat
veterans. Without proper control and representation, the partnership
may compromise this ability.
Recent statements by VA Under Secretary for Health Robert Roswell
and Representative Bob Beauprez of Colorado at the June 11, 2003,
hearing of the House Committee on Veterans' Affairs indicate that
agreements can be reached to ensure that the partnership and governance
are not a hindrance. We must make certain that these agreements do, in
fact, result in quality health care and an ensured priority for
Colorado's veterans.
S. 615, TO NAME THE DEPARTMENT OF VETERANS AFFAIRS OUTPATIENT CLINIC IN
HORSHAM, PENNSYLVANIA, AS THE ``VICTOR J. SARACINI DEPARTMENT OF
VETERANS AFFAIRS OUTPATIENT CLINIC''
The VFW supports this legislation that would name the VA outpatient
clinic in Horsham, Pennsylvania, after Victor J. Saracini. Captain
Saracini retired from the Naval Reserve after having served on active
duty in the U.S. Navy. Captain Saracini was the pilot of United
Airlines Flight 175, which was one of the four airplanes hijacked by
terrorists on September 11, 2001. His flight was crashed into the south
tower of the World Trade Center, killing all on board.
In light of the terribly tragic events of that day and Captain
Saracini's distinguished career in service to this country, it is
fitting that we would honor his memory by renaming this clinic. It is
the least we can do to recognize the ultimate sacrifice he and his
family have made.
S. 1144, TO NAME THE HEALTH CARE FACILITY OF THE DEPARTMENT OF VETERANS
AFFAIRS LOCATED AT 820 SOUTH DAMEN AVENUE IN CHICAGO, ILLINOIS, AS THE
``JESSE BROWN DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER''
The VFW is pleased to support this legislation, which would name
the Westside VA Medical Center after the late Jesse Brown. Our
organization is honored to have called him a member, and we hold him in
the highest esteem for his lifetime of service to this country and its
veterans.
Naming the Medical Center after Jesse Brown is a fitting tribute to
a man who dedicated his life to serving veterans. As VA Secretary, he
placed emphasis on serving veterans and seeing that VA met their needs.
He was a true advocate and friend to our nation's disabled veterans.
Throughout his entire career he repeatedly demonstrated strong
leadership. From his military service in the Marine Corps during
Vietnam to his role as Executive Director of the Disabled American
Veterans, and later as VA Secretary, he set a course and inspired
everyone to follow him.
With his passing the Nation lost one of its strongest and most
tireless veterans' advocates. As such, we feel that it is entirely
appropriate that we make this small gesture to help foster remembrance
of this remarkable man and to inspire the kinds of genuine leadership
and advocacy that were his hallmarks.
S. 1156, TO AMEND TITLE 38, UNITED STATES CODE, TO IMPROVE AND ENHANCE
THE PROVISION OF LONG-TERM HEALTH CARE FOR VETERANS BY THE DEPARTMENT
OF VETERANS AFFAIRS, TO ENHANCE AND IMPROVE AUTHORITIES RELATING TO THE
ADMINISTRATION OF PERSONNEL OF THE DEPARTMENT OF VETERANS AFFAIRS, AND
FOR OTHER PURPOSES
The VFW is a strong supporter of improving and expanding VA's
statutory authority to provide long-term care services to our nation's
veterans. VFW Resolution 605, which was approved by the voting
delegates to our National Convention, calls on Congress to ``mandate
and provide funding for the provision of nursing home care for all
veterans.'' Although this legislation does not completely fulfill the
intent of this resolution, we do strongly support it, as it is a
positive step in the right direction and an acknowledgement that
Congress understands the seriousness and importance of the issues
surrounding long-term care for veterans.
Title I of this legislation would extend VA's statutory authority
to provide nursing home and non-institutional care through the end of
2008. It is set to expire at the end of this year. Further, it would
lower the disability threshold for receiving nursing home care from the
current 70 percent service connected, down to 50 percent service
connected. We feel that VA has a responsibility to provide for the full
continuum of health care for all veterans and that this legislation
moves us closer toward that goal.
Title I also includes provisions to enhance the delivery of non-
institutional care by allowing VA to contract out for care in
accordance with section 1866 of the Social Security Act. While we are
opposed to VA shifting its statutory obligations, we certainly support
expanding more non-institutional solutions to long-term health care. We
would caution, however, that VA should ensure that any contracted care
is at the same level and quality as VA care. With that in mind, the VFW
believes that these non-institutional programs must be expanded and
made available nationwide in order to ensure equitable access for
eligible veterans.
Title II authorizes the construction of two long-term care
facilities: one in Lebanon, Pennsylvania, the other in Beckley, West
Virginia. As we support expanding access to long-term care for our
veterans, we would support the construction of these facilities. They
would be of great benefit to Pennsylvania's and West Virginia's veteran
population.
With respect to the personnel provisions contained in Title III, I
would point out that the VFW supports any legislation that will improve
the access, timeliness, and quality of care to our nation's veterans.
S. 1213, FILIPINO VETERANS' BENEFITS ACT
Our comments are limited to section two of this legislation, which
would provide access to VA health care for certain Filipino veterans
currently residing in the U.S. The VFW supports this provision.
We believe that providing these Commonwealth Army veterans and
Philippine Scouts with access to the hospital, nursing home care, and
medical services consistent with a veteran of the U.S. Armed Forces is
the proper thing to do. These brave veterans fought alongside our
service members during World War II and were a great asset to our
struggle against the empire of Japan.
These veterans and their families made the same types of sacrifices
for the benefit of freedom that our young men and their families did.
Extending the same health care benefits to those who currently reside
in the U.S., particularly as their population ages, is fair and just.
S. 1283, TO REQUIRE ADVANCE NOTIFICATION OF CONGRESS REGARDING ANY
ACTION PROPOSED TO BE TAKEN BY THE SECRETARY OF VETERANS AFFAIRS IN THE
IMPLEMENTATION OF THE CAPITAL ASSET REALIGNMENT FOR ENHANCED SERVICES
INITIATIVE OF THE DEPARTMENT OF VETERANS AFFAIRS, AND FOR OTHER
PURPOSES
The VFW backs this legislation that would require advance
notification of Congress of actions to be taken under VA's Capital
Asset Realignment for Enhanced Services (CARES) program.
With Phase II of the CARES process moving so rapidly we appreciate
the opportunity that this oversight would provide in order to ensure
that what VA is proposing under the CARES program is truly consistent
with enhancing services to this nation's veterans.
We would caution, however, that Congress not allow this role to
turn political or forestall real progress as we have witnessed with the
Base Realignment and Closure (BRAC) program.
S. 1289, TO THE NAME THE VA MEDICAL CENTER IN MINNEAPOLIS, MINNESOTA
AFTER PAUL WELLSTONE
We would like to offer our strong support for S. 1289, legislation
that would rename the VA Medical Center in Minneapolis, MN after the
late Paul Wellstone, former Senator and tireless advocate for America's
veterans.
Paul Wellstone constantly and consistency crusaded and championed
for the many issues that were of vital interest to our veteran
population. He was tenacious in his efforts to assure passage of
legislation that would provide for those veterans suffering from
radiation exposure, Gulf War illness and those in need of VA health
care.
He took great efforts to ensure that veterans received the proper
care and treatment they earned through their service in defense of this
country. Naming this VA Medical Center is a fitting tribute to the long
legacy he left behind after his tragic accident.
Mr. Chairman, this concludes my testimony. I will be happy to
answer any questions that you or the members of this committee may
have.
Chairman Specter. Thank you very much, Mr. Hayden.
We now turn to Mr. Adrian Atizado, Associate National
Legislative Director for the Disabled American Veterans.
Thank you for joining us. We look forward to your
testimony.
STATEMENT OF ADRIAN M. ATIZADO, ASSOCIATE NATIONAL LEGISLATIVE
DIRECTOR, DISABLED AMERICAN VETERANS
Mr. Atizado. Thank you, Mr. Chairman, members of the
committee. I thank all of you for the opportunity to present
the views of the Disabled American Veterans on seven bills
under consideration in today's hearing.
The first measure under consideration, S. 613, would
authorize the Secretary to carry out a construction project at
former Fitzsimons Army Medical Center in Aurora, Colorado. DAV
does not have a resolution in support of this measure.
Therefore, we do not object to favorable consideration of S.
613 by this committee. However, we would oppose any proposal to
establish a fully integrated facility with joint governance and
management.
S. 1156, the Department of Veterans Affairs Long-Term Care
and Personnel Authorities Enhancement Act of 2003 would extend
through 2008 VA's authority to provide enrolled veterans access
to alternative outpatient-based long-term care services.
In addition, this measure would lower, from 70 to 50
percent, the threshold level of service-connected disability
that would qualify a veteran has high priority for
institutionalized care if needed. DAV has a resolution that
allows us to fully support the aforementioned provisions of
this bill.
Section 2 of S. 1213 of the Filipino Veterans' Benefits Act
of 2003 would authorize hospital and nursing home care and
medical services to certain Filipino veterans. DAV does not
have a resolution in support of this bill. However, we do not
object to its favorable consideration by the committee, as long
as sufficient funding to cover the costs of the authorized
health care is provided.
S. 1283 would require advance notification of Congress
regarding any proposed action and implementation of VA's CARES
Initiative. We do believe VA should provide all relevant
information and implementation plans to Congress and veterans
service organizations prior to taking any action proposed under
the CARES Initiative.
S. 1289 is a bill to name VA Medical Center in Minneapolis,
Minnesota, as Paul Wellstone Department of Veterans Affairs
Medical Center, along with S. 1144, the renaming of the VA
Medical Center Westside in Chicago, Illinois, after the late
Secretary for Veterans Affairs, Jesse Brown. We are proud to
support both measures, including the last eight S. 615 renaming
measure as well.
This concludes my statement, Mr. Chairman, and I would be
happy to answer any questions you may have.
[The prepared statement of Mr. Atizado follows:]
Prepared Statement of Adrian M. Atizado, Associate National Legislative
Director, Disabled American Veterans
Mr. Chairman and Members of the Committee: Thank you for the
opportunity to present the views of the Disabled American Veterans
(DAV) on the seven bills under consideration in today's hearing. The
DAV appreciates the Committee's interest in improving benefits and
services for our nation's sick and disabled veterans. The measures
under consideration today include:
S. 613, a bill to authorize a construction project at the
former Fitzsimons Army Medical Center, in Aurora, Colorado.
S. 615, a bill relating to the naming of a VA outpatient
clinic in Horsham, Pennsylvania.
S. 1144, a bill relating to the naming of a VA medical
center in Chicago, Illinois.
S. 1153, the ``Veterans Prescription Drugs Assistance
Act.''
S. 1156, the ``Department of Veterans Affairs Long-Term
Care and Personnel Authorities Enhancement Act of 2003.''
S. 1213, Section 2, a section of a bill relating to
eligibility of Filipino veterans for health care in the United States.
S. 1283, a bill to require VA to provide advance
notification to Congress of its intent to implement Capital Assets
Realignment For Enhanced Services initiatives.
S. 1289, a bill relating to the naming of the VA medical
center in Minneapolis, Minnesota.
S. 613
Section 2 of S. 613 authorizes the Secretary of the Department of
Veterans Affairs (VA) to carry out major medical facility projects at
the site of the former Fitzsimons Army Medical Center in Aurora,
Colorado, and may include inpatient and outpatient facilities to
provide acute, sub-acute, primary, and long-term care services. Using
funds appropriated for fiscal year 2004 through 2007 costing no more
than $300 million for direct construction, capital leasing, or a
combination of both, and $30 million for each fiscal year for capital
leasing alone; the bill would also require the Secretary to report his
actions to Congress on the options selected pursuant to this section.
Section 3 of the bill, requires the VA Secretary and the Secretary of
the Air Force to undertake joint activities, as they consider
appropriate, to address the health care needs of veterans and members
of the Air Force on active duty.
DAV does not have a resolution in support of this measure; however,
we do support maintaining the integrity of a viable and independent VA
health care delivery system to provide health care to our nation's sick
and disabled veterans. We do not object to favorable consideration of
S. 613 by the Committee.
Clearly, there are many options to consider when implementing a
major medical facility project as proposed in S. 613. We remain
cognizant of the complex health care, policy, legal, and financial
issues involved in a proposed relocation to the Fitzsimons campus
including the identity of the veterans health care system, priorities
within the VA's capital asset program, and the budget required to
support the proposed relocation. In this instance, we believe that
whatever option is chosen, VA should maintain a separate identity with
direct line authority in all areas involving care of veteran patients.
This will allow VA to fulfill its primary health care mission to serve
the needs of America's veterans by providing primary and specialized
care, and related medical and social support services. We would oppose
any proposal to establish a fully integrated inpatient facility with
joint governance and management.
We do, however, support maintaining strong relationships with
medical affiliates. In addition to their value in developing the
nation's health care workforce, the affiliations bring first-rate
health care providers to the service of America's veterans. The
opportunity to teach attracts the best practitioners from academic
medicine along with state-of-the-art medical science to VA. Veterans
get excellent care, society gets well-trained doctors and nurses, and
the taxpayer pays a fraction of the market value for the expertise the
academic affiliates bring to VA.
S. 615
S. 615 would name the VA outpatient clinic in Horsham,
Pennsylvania, as the Victor J. Saracini Department of Veterans Affairs
Outpatient Clinic in honor of the distinguished veteran and United
Airlines pilot whose plane was hijacked by terrorists and flown into
the World Trade Center on September 11, 2001. DAV does not object to
favorable consideration of this measure by the Committee.
S. 1144
S. 1144 would rename the West Side VA Medical Center in Chicago,
Illinois, after the late Secretary ``for'' Veterans Affairs, the
Honorable Jesse Brown.
Jesse Brown, a combat-disabled Marine Corps veteran of the Vietnam
War, was a fiery advocate for the rights of all veterans, especially
those disabled in service to their country. During his nearly 5 years
as Secretary of Veterans Affairs in the cabinet of President William J.
Clinton, Mr. Brown earned the love and respect of his fellow veterans
across the United States. Enactment of S. 1144 would be a fitting
tribute to Jesse Brown, a man many see as one of the 20th century's
greatest champions of America's veterans. Therefore, we are pleased to
support this bill.
THE DEPARTMENT OF VETERANS AFFAIRS LONG-TERM CARE AND PERSONNEL
AUTHORITIES ENHANCEMENT ACT OF 2003 (S. 1156)
Title I of the Department of Veterans Affairs Long-Term Care and
Personnel Authorities Enhancement Act of 2003, S. 1156, would extend
through 2008 VA's authority to provide enrolled veterans access to
alternative outpatient-based long-term care services such as adult day
health care, home health aide assistance, non-institutional respite
care, and home-based primary care. In addition, this measure would
lower from 70 percent to 50 percent, the threshold level of service-
connected disability that would qualify a veteran as high priority for
institutionalized care if needed. Currently, highest priority access to
inpatient long-term care services is only granted to veterans who are
70 percent or more disabled, unless such care is needed for the
treatment of a service-connected disability. Title I of the measure
would also make technical changes to VA authority to contract for
nursing home care and allow a greater number of smaller community-based
providers to contract with VA.
DAV fully supports the aforementioned provisions in Title I of S.
1156. DAV Resolution Number 154 specifically supports a comprehensive
program of extended care services for veterans and a higher priority of
access to inpatient long-term care by extending such services to
veterans rated 50 percent service connected or higher.
Title II of the bill would authorize major construction for long-
term care facilities in Beckley, West Virginia, and Lebanon,
Pennsylvania, to accommodate a substantial elderly veteran population
in those locations who are in need of long-term care programs. We have
no objections to these provisions in the bill.
Title III of the bill would convert several clinical staff
professional positions, such as clinical social workers, psychologists,
medical technicians, and pharmacists into ``hybrid Title 38'' status
and permit VA increased hiring and promotion flexibility, and
compensation at special, locally based pay scales. We have no position
on this section of the bill.
THE FILIPINO VETERANS' BENEFITS ACT OF 2003 (S. 1213, SECTION 2)
S. 1213, Section 2, of the Filipino Veterans' Benefits Act of 2003
would authorize hospital and nursing home care and medical services to
certain Filipino veterans. DAV does not have a resolution in support of
this bill; however, we do not object to its favorable consideration by
the Committee as long as sufficient funding to cover the cost of the
authorized health care is provided.
S. 1283
S. 1283 would require advance notification of Congress regarding
any action proposed to be taken by the Secretary of Veterans Affairs in
the implementation of the VA's Capital Asset Realignment for Enhanced
Services (CARES) initiative.
We believe VA should provide all relevant information and
implementation plans to Congress and veterans service organizations
prior to taking any action proposed under the CARES initiative. Given
the potential impact of CARES on health care delivery to our nation's
sick and disabled veterans, the complexity of the CARES process, and
the voluminous planning initiatives that have been submitted for each
Network, it is appropriate for VA to keep Congress and all concerned
with VA health care well informed about final implementation plans for
the CARES initiatives. Therefore, we have no objection to favorable
consideration of this measure by the Committee.
S. 1289
S. 1289 would rename the VA medical center in Minneapolis,
Minnesota, as the Paul Wellstone Department of Veterans Affairs Medical
Center. Senator Wellstone was a true advocate for America's veterans.
He never wavered in his commitment to improving the lives of sick and
disabled veterans and championed many issues that were of the utmost
importance to our veteran population.
Enactment of S. 1289 would be an appropriate way to honor Paul
Wellstone's outstanding commitment to veterans and would be an
excellent tribute to his memory. Therefore, we have no objection to
favorable consideration of this bill by the Committee. In closing, DAV
sincerely appreciates the Committee for holding this hearing and for
its interest in improving benefits and services for our nation's
veterans. The DAV deeply values the advocacy this Committee has always
demonstrated on behalf of America's service-connected disabled veterans
and their families.
Thank you for the opportunity to present our views on these
important measures.
Chairman Specter. Thank you. Thank you very much, Mr.
Atizado.
We now turn to Mr. William Blake, Associate Legislative
Director of the Paralyzed Veterans of America.
Thank you for being with us today, Mr. Blake. The floor is
yours.
STATEMENT OF CARL BLAKE, ASSOCIATE LEGISLATIVE DIRECTOR,
PARALYZED VETERANS OF AMERICA
Mr. Blake. Thank you, Mr. Chairman, members of the
committee. PVA would like to thank you for the opportunity to
testify today on the proposed legislation.
PVA has concerns regarding S. 613, the Veterans New
Fitzsimons Health Care Facilities Act of 2003. We stand
committed to finding workable solutions for the delivery of
veterans' health care in the Denver area, and we would work
tirelessly toward this end. We also believe that a new Spinal
Cord Injury Center is needed in the Denver area and that this
center should move forward, along with any decisions,
concerning Fitzsimons. PVA stands ready to work with this
committee to ensure that veterans in Colorado are accorded the
very best VA health care.
PVA generally concedes to the wishes of our local chapters,
as well as the members of other veterans' service organizations
and the congressional delegations on issues involving naming VA
facilities. We, as the national office of PVA, support in
concept S. 615, as well as S. 1144, which would rename the
Westside VA Medical Center after the late Secretary of Veterans
Affairs, Jesse Brown.
PVA supports the long-term care provisions of S. 1156. We
are particularly pleased with the provisions that would extend
through 2008 the authorities that now require the VA to provide
to veterans enrolled in the VHA long-term care services, such
as adult day health care, home health aid assistance, non-
institutional respite care and home-based primary care.
PVA also appreciates the provision that would allow the VA
to now provide nursing home care to veterans who suffer from a
service-connected disability rated at 50 percent or greater.
PVA supports S. 1283. We believe that it is fair and
reasonable for Members of Congress to have a stake in the CARES
process and comment on the decisions that the VA intends to
make with regards to the future of VA facilities.
PVA would like to commend Senator Graham for introducing S.
1289, a bill that would name the Minneapolis VA Medical Center
after the late Senator Paul Wellstone. Senator Wellstone was a
tireless advocate for all veterans. I must reiterate, though,
we defer to all of our local chapters, as well as other VSO's
and State congressional delegations on these issues involving
naming VA facilities. Again, we, as the national office,
support in concept S. 1289.
I would like to thank you for the opportunity to testify
today, and I would be happy to answer any questions that you
might have.
[The prepared statement of Mr. Blake follows:]
Prepared Statement of Carl Blake, Associate Legislative Director,
Paralyzed Veterans of America
Chairman Specter, Ranking Member Graham, members of the Committee,
PVA would like to thank you for the opportunity to testify today
concerning the proposed legislation. PVA is pleased to present our
views on the important issues that you have addressed with this
legislation.
S. 613, THE ``VETERANS' NEW FITZSIMONS HEALTH CARE FACILITIES ACT OF
2003''
PVA has concerns regarding S. 613, the ``Veterans' New Fitzsimmons
Health Care Facilities Act of 2003.'' PVA stands committed to finding
workable solutions for the delivery of veterans' health care in the
Denver area, and we have worked tirelessly toward this end.
PVA understands that constructing a new, freestanding VA medical
center at the Fitzsimmons site is no longer feasible due to space
limitations at the site and cost concerns. We are adamantly opposed to
any option that would essentially integrate Denver VA medical center
patients into the patient population of the University of Colorado
Hospital. We are open to the many collaborative opportunities between
the two entities, but integrating veteran patients in this manner would
fundamentally change the way VA provides care.
We believe that an option involving the VA leasing within a new
facility could be a viable one, as long as many essential elements are
included within such a plan. These elements would include governance
issues ensuring that VA leadership has direct line authority and
accountability for veterans' health care, ensuring dedicated space and
a distinct VA presence, ensuring that facility staff remain Federal
(VA) medical center employees, and finally, ensuring that current VA
procedures and policies for the provision of appropriate
pharmaceuticals, supplies and prosthetics be maintained. We believe
that these issues must be resolved before blanket authority is provided
to proceed.
We also believe that a new spinal cord injury (SCI) center is
needed in the Denver area, and that this center should move forward
along with any decisions concerning Fitzsimmons. The CARES process has
identified the Denver area as one in critical need of an SCI center.
Any new SCI center must be operated as all current centers are, with
dedicated services and staff. The development of a new SCI center must
follow the requirements of the Memorandum of Understanding between VA
and PVA allowing for architectural review, must operate in compliance
with all existing VA policies and procedures, and must continue the
relationship between VA and PVA allowing for site visits of SCI center
facilities.
PVA stands ready to work with this Committee to ensure that
veterans in Colorado are accorded the very best VA health care.
S. 615
PVA generally concedes to the wishes of our local chapters, as well
as other local veterans' service organization members and State
Congressional delegations on issues involving naming VA facilities. We,
as the National Office of PVA, support, in concept, S. 615.
S. 615 is a bill that would name the Department of Veterans Affairs
outpatient clinic in Horsham, Pennsylvania, as the ``Victor J. Saracini
Department of Veterans Affairs Outpatient Clinic.'' Having served his
military career in the United States Navy and Naval Reserve, Mr.
Saracini understood what it meant to serve and sacrifice for this great
country. This honor would be a fitting tribute to a dedicated
individual whose life was taken by terrorists on September 11, 2001.
S. 1144
Again, noting our deferral to our local chapters and others, we
also support, in concept, S. 1144, a bill that would rename the
Westside Department of Veterans Affairs (VA) Medical Center after the
late Secretary of the VA, the Honorable Jesse Brown. Secretary Brown
was a leading advocate for veterans across the Nation during his term.
His efforts to ensure proper benefits and health care for all veterans,
to include service-disabled veterans and veterans suffering from
exposures to Agent Orange or Post-Traumatic Stress Disorder (PTSD), are
a reason why the VA health care system is second to none in the United
States. Allowing the Westside VA Medical Center to bear his name would
be a fitting tribute to a man who cared so deeply for sick and disabled
veterans for his entire professional career. Once again, I would like
to reiterate that PVA generally defers decisions of naming of VA
facilities to the local PVA chapter and the State Congressional
delegation.
S. 1156, THE ``DEPARTMENT OF VETERANS AFFAIRS LONG-TERM CARE AND
PERSONNEL AUTHORITIES ENHANCEMENT ACT OF 2003''
PVA supports the long-term care provisions of S. 1156, the
``Department of Veterans Affairs Long-Term Care and Personnel
Authorities Act of 2003.'' We are particularly pleased with the
provision that extends through 2008 the authorities that now require
the VA to provide to veterans enrolled in the Veterans Health
Administration (VHA) long-term care services, such as Adult Day Health
Care, Home Health Aide assistance, Non-Institutional Respite Care, and
Home-based Primary Care.
P.L. 106-117, the ``Veterans Millennium Health Care and Benefits
Act'' authorized eligibility for a wide range of services, alternatives
to inpatient nursing home care, for all enrolled veterans. For many
veterans and non-veterans with catastrophic disabilities, alternatives
to being confined in nursing homes can be a true blessing. With the
proper case management, home- and community-based care can provide a
more humane and often less costly alternative to inpatient long-term
care. PVA welcomed this provision when it was enacted. However, VA has
begun to implement this program, not as an alternative to inpatient
long-term care, but as an offset to required inpatient nursing home
capacity levels. Worse, VA has been reducing inpatient levels saying
that home and community programs would pick up that slack of that
demand, and then failing to implement the alternative programs at
required levels.
Long-term care is a serious problem that PVA has focused on for
many years. Unlike an elderly veteran who suffers a debilitating stroke
and requires nursing home care, a young, high level quadriplegic on a
ventilator could be facing decades of extended care services. Where,
and how, that person receives that care is always a difficult decision.
Fortunately, VA has established the specialized services in VA SCI
centers that can be found nowhere else in the United States. VA nursing
homes can provide a level of care for such a complex patient, with the
appropriate training and monitoring of VA care givers, which can never
be purchased or found in the private sector. Also, at stake are the
wishes of the veteran patient and his or her family. Careful
determination needs to be made whether this person can be cared for
properly at home, or closer to home. In that sense, assessments need to
be made as to the consequence of the veteran's well-being and the
veteran's family's well-being. The entire array of VA long-term care
services must be put into play, including respite care, home- and
community-based care for this individual. But above all, VA needs to
ensure that the veteran is receiving the appropriate care, by
appropriately trained individuals, in the most appropriate setting.
PVA also appreciates the provision that would allow the VA to now
provide nursing home care to veterans who suffer from a service-
connected disability rated at 50 percent or greater. Currently, the VA
can only provide these services to veterans with a service-connected
disability rated 70 percent or greater.
S. 1213, THE ``FILIPINO VETERANS' BENEFITS ACT OF 2003''
PVA strongly supports S. 1213, the ``Filipino Veterans' Benefits
Act of 2003.'' This legislation would extend health care benefits to
certain Filipino veterans residing legally in the United States. It
would also eliminate statutory payment rates that allow Filipino
veterans and their survivors who live in the United States to be paid
less than other veterans and their survivors who live in the United
States. PVA supports the provision of health care and nursing home care
outlined in Section 2 of this bill.
Section 3 of the draft bill addresses a basic issue of fairness and
equality for payments of compensation and dependency and indemnity
compensation (DIC). Currently, Filipino veterans receive compensation
payments at the rate of $0.50 for every dollar that other veterans
receive. PVA supports Section 3. PVA also supports the extension of the
operation of a regional office in the Philippines provided for in
Section 4 and the offering of national cemetery burial to New
Philippine Scouts provided for in Section 5.
S. 1283
PVA supports S. 1283. We believe that it is fair and reasonable for
Members of Congress to have a stake in the CARES process and comment on
the decisions that the VA intends to make with regards to the future of
VA facilities. This will allow the members of the Senate and the House
of Representatives to evaluate and understand the decisions that the VA
is making that will affect the veterans that they represent.
S. 1289
PVA would like to commend Senator Graham for introducing S. 1289.
This bill would name the Minneapolis VA Medical Center after the late
Senator Paul Wellstone. Senator Wellstone was a tireless advocate for
all veterans. He worked very hard to ensure that the men and women who
served this country received the medical care and benefits that they
rightly deserve. PVA believes this would be a fitting memorial to
Senator Wellstone's advocacy on behalf of all veterans. Like the other
two naming measures before us today, we support, in concept, this
proposal. However, I must reiterate that we defer to our local
chapters, as well as other local veterans' service organization members
and State Congressional delegations on issues involving naming VA
facilities. We, as the National Office of PVA, support, in concept, S.
1289.
Thank you for the opportunity to testify today. I would be happy to
answer any questions that you might have.
Chairman Specter. Thank you very much, Mr. Blake.
Our final witness on this panel is Rick Jones, the National
Legislative Director for AMVETS.
The floor is yours, Mr. Jones.
STATEMENT OF RICHARD JONES, NATIONAL LEGISLATIVE DIRECTOR,
AMVETS
Mr. Jones. Chairman Specter, Senator Rockefeller, Senator
Murray, thank you for the opportunity to allow AMVETS to
testify at this hearing.
S. 613, Senator Campbell's bill, AMVETS fully supports. We
believe this bill will allow Denver VA to serve an increasing
veterans population, appropriations willing, and replace a
venerable, but aging facility.
Senate bill 615 would rename a clinic, the Victor J.
Saracini Clinic. We support that legislation. Mr. Saracini was
a Navy veteran, a pilot who was on the unfortunate flight that
was brutally smashed on that disturbing day into the Towers of
New York. We support the legislation to honor Mr. Saracini, and
we hope that we will inspire others in his memory.
Senate bill 1144, Jesse Brown Medical Center. We support
this provision to name the Chicago facility after Jesse Brown.
Jesse Brown was a man with a distinguished career. He is a man
who dedicated his life and service to the honor of veterans,
and we think this is a wonderful honor. We support this
legislation.
Senate bill 1156 would provide for long-term care
amendments and changes, modifying that to allow 50-percent
disabled veterans access to in-hospital care. We believe this
presents the VA with an opportunity to be more flexible. We
believe there are studies that do say that this could be done
without additional exorbitant costs to VA, and we believe that
it is in the right venue and helps veterans. We would hope that
you would consider this bill as soon as possible.
With regard to Senate bill 1213, the Filipino Veterans'
Benefit Act, AMVETS is certainly mindful of the brave and
historic contributions made by Filipino nationals during World
War II. Their actions, as part of the allied effort, are
legendary. Measured in these terms, we believe Filipino
veterans of World War II certainly deserve our grateful
appreciation for the heroic contributions they made during the
war effort. In a fiscally unconstrained environment, AMVETS
would most assuredly support allowing these individuals access
to appropriate veterans' benefits.
However, while we would certainly prefer a fiscal climate,
where both interests of similarly situated Filipino benefits
and American veterans could be satisfactorily accommodated, we
find it difficult at this time to see a positive effect on our
veterans by extending benefits to Filipino veterans at this
time.
With regard to Senate bill 1283, this bill would require a
congressional notification of the CARES process. We believe the
decisions made under CARES will have a broad effect on millions
of veterans, and while VA is providing an opportunity for
everyone to participate in their hearings and give their voice,
we believe a brief review of final decisions is appropriate.
We would mention and encourage all Senators to support an
appropriation that equals the budget proposal that was agreed
to earlier in the year. With regard to this legislation on
CARES, we would recognize action taken in the House last
Friday, which would severely restrict appropriations to VA.
There may be unanticipated consequences of that regarding
closure of hospitals, medical centers and clinics. We believe
the CARES process in this legislation would help others
understand what might occur.
With regard to Senate bill 12----
Chairman Specter. Would you please sum up, Mr. Jones.
Mr. Jones. I am terribly sorry. I looked, and I wondered
why the clock was going the wrong direction. I am sorry, sir.
Chairman Specter. Go ahead. Sum up.
Mr. Jones. I would only sum up with regard to Senator
Wellstone's bill. We support that. We look for another
champion. Senator Wellstone stood strongly for veterans
continually. We look for someone to stand for veterans and help
restore the honor due American veterans.
[The prepared statement of Mr. Jones follows:]
Prepared Statement of Richard Jones, National Legislative Director,
AMVETS
Chairman Specter, Ranking Member Graham, and members of the
Committee:
Thank you for the opportunity to present testimony to the Veterans'
Affairs Committee on the six bills subject to this legislative hearing.
AMVETS is pleased to present our views regarding S. 613, Veterans' New
Fitzsimons Health Care Facilities Act of 2003; S. 615, Victor Saracini
Outpatient Clinic; S. 1144, Jesse Brown Medical Center; S. 1156, the
Department of Veterans Affairs Long-Term Care and Personnel Authorities
Enhancement Act of 2003; and S. 1213, Filipino Veterans' Benefits Act
of 2003; S. 1283, providing CARES notice; and S. 1289, to name the
Minneapolis VAMC after Senator Paul Wellstone.
Mr. Chairman, AMVETS has been a leader since 1944 in helping to
preserve the freedoms secured by America's Armed Forces. Today, our
organization continues its proud tradition, providing, not only support
for veterans and the active military in procuring their earned
entitlements, but also an array of community services that enhance the
quality of life for this nation's citizens.
s. 613, veterans' new fitzsimons health care facilities act of 2003
Senator Campbell's bill, S. 613, would move the Denver VA center
from its current location to the former Fitzsimons Army Medical Center.
The move would coincide with a move to the Fitzsimons site by the
University of Colorado's Health Sciences Center. This relocation is
warranted to maintain the close working relationship between the Denver
VA and the University. It will also allow the Denver VA to serve an
increasing veterans population, appropriations willing, and replace a
venerable, but aging, facility. AMVETS fully supports this bill and the
wise use of Federal resources it employs.
S. 615, A BILL TO NAME THE VA OUTPATIENT CLINIC IN HORSHAM,
PENNSYLVANIA, AS THE ``VICTOR J. SARACINI DEPARTMENT OF VETERANS
AFFAIRS OUTPATIENT CLINIC''
S. 615, introduced by Senator Santorum, would name VA outpatient
clinic in Horsham, Pennsylvania, as the ``Victor J. Saracini Department
of Veterans Affairs Outpatient Clinic''. Victor J. Saracini, a Navy
veteran and father of three, was a captain with United Airlines who
unfortunately died on September 11, 2001, when his hijacked Boeing 767
was crashed into the World Trade Center's South Tower by al-Qaeda
terrorists. Boeing pilot Saracini and his passengers were some of the
first casualties in the war against terrorists and the countries that
support them. We will not forget when those towers fell and the
sacrifice of all those Americans who died on that disturbing day. We
support this legislation to honor Mr. Saracini and inspire others in
his memory.
S. 1144, JESSE BROWN MEDICAL CENTER
S. 1144, introduced by Senator Durbin, would name the VA health
care facility located at 820 South Damen Avenue in Chicago, Illinois,
as the ``Jesse Brown Department of Veterans Affairs Medical Center''.
Those of us in the veterans community are well aware of the service and
career of the late Secretary Brown. He served our Nation as a marine
and suffered a disabling wound in Vietnam. After his service in Vietnam
and rehabilitation of his wounds, Secretary Brown began a long and
admired career as executive director of the Disabled American Veterans.
From 1993-1997, Secretary Brown headed VA and worked hard against
strong odds to assure that the services of VA helped meet the nation's
obligations to America's veterans. AMVETS supports this legislation to
honor a man who dedicated his life and career to the service of our
Nation and its veterans.
S. 1156, DEPARTMENT OF VETERANS AFFAIRS LONG-TERM CARE AND PERSONNEL
AUTHORITIES ENHANCEMENT ACT OF 2003
One of the most critical missions of the VA system is the service
offered to those in need of long-term care. For these critically
injured and disabled veterans, VA provides the most competent and
scientifically advanced care available. Under current law, veterans
with service-connected disabilities rated 50 percent or greater have
highest priority access to care if it is provided by an outpatient
clinic or hospital.
To be eligible for inpatient based long-term care, a service-
connected disabled veteran must be rated 70 percent or greater. This
disparity in access was brought about by enactment of Public Law 106-
117, the Veterans Millennium Health Care and Benefits Act. The 70
percent rating threshold on inpatient long-term care contained in
Public Law 106-117 sought to ensure VA long-term care facilities did
not become overwhelmed and that levels of care could be maintained.
However, evidence since enactment of Public Law 106-117 shows us
that service-connected disabled veterans rated 50 percent to 70 percent
can be accommodated without undo burdens placed on the system. AMVETS
supports the Chairman's bill, S. 1156, and its lowering of the
eligibility rating from 70 percent to 50 percent for inpatient-based
long-term care. We are also in support of changes to the hiring process
for clinical professionals for the VA system that mirror those used in
hiring physicians and nurses. The psychologists, pharmacists, and
social workers that attend to our veterans are integral to their care
and well-being. The hiring changes sought by the bill will allow VA to
hire these professionals in a timely, flexible manner and seek the best
qualified candidates available.
S. 1213, FILIPINO VETERANS' BENEFITS ACT OF 2003
Mr. Chairman, AMVETS is certainly mindful of the brave and historic
contributions made by Filipino nationals during World War II. Their
actions as part of the allied effort are legendary. Measured in these
terms, we believe Filipino veterans of World War II certainly deserve
our grateful appreciation for their heroic contributions they made
during the war effort, regardless of where they may reside. And, in a
fiscally unconstrained environment, AMVETS would most assuredly support
allowing these individuals access to appropriate veterans benefits.
However, despite the efforts of the Chairman and this Committee, VA
funding has been chronically deficient for far too long. With this in
mind, AMVETS must offer its opposition to S. 1213, the Filipino
Veterans' Benefits Act of 2003, introduced by the Chairman at the
request of Secretary Principi. By the Secretary's own figures, this
bill would cost VA an additional $16.2 million for Fiscal Year 2004 and
total in excess of $130 million over the next decade. These are
expenditures VA can little afford to make.
AMVETS certainly values the contributions and sacrifices made by
our Filipino comrades in arms during World War II, yet we believe the
interests of American veterans must continue to come first. We would
certainly prefer a fiscal climate where both the interests of similarly
situated Filipino beneficiaries and American veterans could be
satisfactorily accommodated. However, it is difficult to see a positive
effect on our veterans by extending benefits to Filipino veterans, at
this time.
S. 1283, A BILL TO REQUIRE CONGRESSIONAL NOTIFICATION ON ANY VA ACTION
TO IMPLEMENT THE CAPITAL ASSET REALIGNMENT FOR ENHANCED SERVICES
S. 1283 would direct the Secretary to submit CARES recommendations
to Congress for a 60-day review period. The bill would provide Congress
with a more intimate role in the decision process regarding possible
reductions, closures, and related decisions that would have an impact
on delivery of health care to our nation's veterans. The members of
AMVETS support giving our elected Members of Congress a higher degree
of review in the CARES process than is currently contemplated. AMVETS
supports the goals of the CARES process, namely to reduce VA
expenditures on the maintenance of obsolete or unused facilities and
better apply those resources to support improvements in VA health care
and provide for future services to those who wore our country's
military uniform. The decisions made under CARES will have a broad
affect on millions of veterans and, while VA is providing an
opportunity for our voice to be heard, we believe a brief review of
final decisions is appropriate.
S. 1289, A BILL TO NAME THE DEPARTMENT OF VETERANS AFFAIRS MEDICAL
CENTER IN MINNEAPOLIS, MINNESOTA, AFTER PAUL WELLSTONE
S. 1289 would provide a fitting honor to former Senator Paul
Wellstone, a dedicated legislator who continually fought to recommit
our country to its sacred responsibility to care for the men and women
who serve in the military. Senator Wellstone understood that our Nation
has a moral obligation to those brave men and women who commit
themselves to defend the cause of freedom. As AMVETS National Commander
W.G. ``Bill'' Kilgore said following the loss of Senator Wellstone,
``His unwavering support year after year of adequate funding
for veterans health care, in particular, was something we could
always count on. Similarly, he championed the cause of homeless
veterans to ensure that they were not forgotten and that their
needs were addressed by the Nation they served. Though not a
veteran himself, he brought energy and commitment to issues
important to veterans and their families. He was a fighter and
leading voice and, if ever there was a true friend of America's
veterans, Senator Wellstone was it.''
AMVETS fully supports this bill.
This concludes our testimony. Again, thank you for the opportunity
to testify on this important legislation, and thank you, as well, for
your continued support of America's veterans.
Chairman Specter. Thank you very much, Mr. Jones.
Mr. Jones. Thank you, sir.
Chairman Specter. We are going to have 3-minute rounds. As
I say, we are anticipating votes here soon.
Let's begin with the issue of Senate bill 1156. That bill
would lower the threshold rate from 70- to 50-percent of
service-connected disability for purposes of creating
eligibility for mandated inpatient long term care by VA. How
significant do you consider that bill to be, starting with you,
Ms. Wiblemo?
Ms. Wiblemo. Well, I think it is very significant, and we
fully support that.
Chairman Specter. Mr. Hayden, do you think that would be
especially helpful for the veterans?
Mr. Hayden. I do, sir. The VFW actually has a resolution,
605, which was approved by our voting delegates to our national
convention last year, that calls on Congress to mandate and
provide funding for the provision of nursing home care for all
veterans, not just 50 percent.
Chairman Specter. How significant do you consider that
provision, Mr. Atizado?
Mr. Atizado. Well, it is significant enough as well with my
colleague here that our members passed a resolution last year
requesting that it be extended, long-term care be extended well
below 70-percent service connected, especially in a climate
where long-term care is a rather expensive service line to
provide. We look to VA to champion that cause, especially for
those who have served this Nation and lost so much.
Chairman Specter. Mr. Jones, what do you think about that
reduction in disability percentage threshold?
Mr. Jones. We believe the chairman is on the right path,
and that is the correct direction to go, and we believe that
this could be accommodated by VA, without of course
overwhelming cost.
Chairman Specter. Do you dissent, Mr. Blake?
Mr. Blake. No, sir, I do not. Mr. Chairman, we would
certainly support this provision.
Chairman Specter. Mr. McClain, a couple of questions for
you. I want to ask them before my time runs up.
There has been an estimate by VA that S. 1153 would cost
$500 million a year. I would like you to respond to how the VA
arrived at that figure.
The other question that I want to put in before I get a red
light here is by using a hybrid Title 5, Title 38 hiring
system, VA would be able to avoid many processes for hiring set
out by the Office of Personnel Management.
While that sounds good, would those procedures preclude
favoritism and other abuses?
I still have 1 second left. You may proceed.
[Laughter.]
Mr. McClain. Thank you, Senator.
Our estimate as to the cost of reducing the service-
connected percentage from 70 percent to 50 percent was based on
actuarial models that the VHA Actuary and Economic Office
produced. We will be glad to provide more detail for the record
and also a briefing for your staff if you desire.
Regarding the Title 38-Title 5 hybrid issue, we already
have the Title 38 hybrid personnel hiring authority in place.
This would extend the authority to cover some additional
medical specialties. The idea behind the entire system is to be
able to hire qualified people at a very competitive salary rate
much quicker than we could under Title 5.
We discovered that, especially in the scarce medical
specialties, we were losing people to the civilian sector
because we were not able to offer them a position within what
they considered to be a reasonable period of time, and they
were accepting employment with civilian employers.
We found that the Title 38 hybrid system allows us to
respond much more quickly and allow us to make a competitive
offer to these scarce medical specialists and bring them on
board at VA.
Chairman Specter. Senator Murray.
Senator Murray. Thank you, Mr. Chairman.
Mr. McClain, you heard my opening statement. Last week in a
phone call, the VA gave direction to the VISN 21 leadership in
my State to include closure of three VA facilities, American
Lake, Walla Walla and Vancouver. Can you explain to this
committee why headquarters is demanding a significantly redrawn
plan for Washington State and VISN 21?
Mr. McClain. Senator, I am sorry I cannot. I am not
specifically aware of this event that you are talking about. We
did receive your correspondence, dated July 24th, essentially
laying out the same parameters. Obviously, we have not had a
chance yet to respond to this, but we will respond specifically
to your----
Senator Murray. Can you tell me the timing on that?
Mr. McClain. As to when you will receive it?
Senator Murray. When we will get a response because my
understanding is, from your under secretary who was in my
office yesterday, that they will have their plan forwarded by
the end of this week or early next week. We had 8 days to
respond to the fact that you were closing or potentially
closing three facilities.
Mr. McClain. Once again, I cannot address that in
particular. I am familiar with the CARES process, which you
have referenced in your correspondence, and part of the CARES
process is that there is no firm national plan at this point.
In other words, there are a lot of recommendations that need to
be vetted nationally across-the-board.
The next step I believe is for the Secretary to provide a
draft national plan to the CARES Commission to hold hearings,
and the hearings will be held. They will be public, and there
will be plenty of opportunity for everyone, including in the
State of Washington, to have input into the draft plan before
it becomes final.
Senator Murray. Well, the VISN 21 did give their plan. I
think the Department has had it since April, and what it sounds
like to all of us is that they did not like that response
because it did show the increased need for care in my State and
with our veterans population. It looked like, after months of
reviewing it, the VA decided to rewrite the rules to get a
response that they wanted, rather than listening to what the
VISN 20 recommendations were in my State, and then gave them 8
days to say how they would rewrite their plan to close three
facilities.
Mr. McClain. I understand your point. Unfortunately, I
cannot talk specifically to those allegations, but we will
respond.
Senator Murray. Well, let me just tell you that American
Lake, which is Tacoma, provides significant care. It has
primary care, a women's health clinic, a 76-bed nursing home
unit, a substance abuse treatment program, a 60-bed homeless
domiciliary and a post-traumatic stress treatment program,
numerous programs that they put there.
The VISN report says that they will see a 33-percent
increase in enrolled veterans in the Western Washington market
that is served by American Lake and the Seattle Medical Center.
So I do not understand how this now, they sent that to you and
what you all send back is we did not like your report. We want
you to close this facility.
I do not understand how that responds to the needs of our
veterans. I know that people from the VA, obviously, Leo McKay,
your deputy secretary said, and I will read you his quote,
``We will work with veterans, VA employees, university
affiliates and local and national elected officials to ensure
everyone's concerns are heard as we enhance the quality of
veterans' health care.''
Well, this does not sound to me like they are working with
anybody.
Mr. McClain. Well, once again, I cannot address the
specific question you have laid out in your correspondence, but
there is still a lot of work to be done both by the VA, and by
the public and the veterans' service organizations in reviewing
the draft plan, which will be sent to the CARES Commission in
the near future.
Senator Murray. Well, Mr. McClain, I know you knew I was
going to ask these questions today. So I find it kind of
astounding that we do not hear any responses. Your office did
call to ask what I was going to ask about. So I know you know I
was going to ask about this.
I will tell you that the veterans in my State are up in
arms over this. Mr. Chairman, they worked very hard to put
their recommendations forward, and then to be given 8 days'
notice that they have to change their whole plan, and to change
the whole VISN to close three facilities is just an amazing
turn of events, and I am very upset about this, and I would
like to work with the committee to continue to work with this.
Chairman Specter. Well, Senator Murray, you articulate a
real issue, and we will be looking forward to responses from
the Veterans Administration, Mr. McClain.
Mr. McClain. Yes, sir.
Response to Written Question Submitted by Hon. Patty Murray to
Tim McClain, General Counsel, Department of Veterans Affairs
Question. Can you explain to this committee why headquarters is
demanding a significantly redrawn plan for Washington State and VISN
20?
Response. The Under Secretary for Health requested changes to the
market plans as a result of reviews conducted during preparation of the
draft National CARES Plan. This review was an integral part of the
design of the CARES process to ensure that the plan was truly national
in scope and not simply a compilation of the individual VISN market
plans. Rather than undercutting the CARES process, this review and the
proposed changes to the market plans were an effort to ensure that
national, system-wide issues are adequately addressed.
When the Under Secretary reviewed the results of the market plans,
he concluded that there were opportunities to realign campuses to
improve the quality, access, and resource use by examining
opportunities to move these campuses from inpatient to outpatient
operations, i.e. by converting from 24-hour, 7-days/week to 8-hours, 5-
days/week operations. He asked the VISN's to determine how this could
be accomplished at selected sites with the provision that there would
be no loss of services to veterans.
The realignments focused on moving long-term care sites to sites
with an acute care presence because this would also improve access to
diagnostic and therapeutic services for the long-term care population.
In addition, the current physical environment in many sites, such as
Walla Walla and White City, would require significant capital
investment in older buildings. It would be more expensive to renovate
such buildings than it would be to build a new Nursing Home, for
example. Many patients served by long-term care facilities are often
more dispersed geographically than those served by acute care
facilities, and where contracting is combined with relocation of beds
to other VAMC's, access may be improved.
With respect to the Vancouver campus, we believe we have an
opportunity to put the campus to better use. It appears to be
underutilized for inpatient care services, and we may have an
opportunity to improve access to outpatient services at another
location.
The only changes in the VISN 20 market plan involved the three
facilities indicated in the realignment analysis mentioned above.
Chairman Specter. We have just been notified the vote is in
process. We have 10 minutes remaining.
Senator Rockefeller.
Senator Rockefeller. I will try to stick to 3 minutes, Mr.
Chairman. You have got 3 minutes on there.
First of all, I have to say that I am pleased, under 1156,
and incidentally, Mr. McClain and Dr. Murphy, do not mess with
Patty. You will end up in trouble. She is an appropriator.
I am very pleased at both the Beckley and the Lebanon,
Pennsylvania, VA Medical Centers both are on the VA's list of
priority medical construction projects, and I am very happy
about that. But my question for you is this, and I think it is
an impossible one for you to answer, and I am trying to make it
appear that it is impossible for you to answer.
The Veterans Millennium Health Care Benefits Act in
November 1999 required VA, and we worked hard to get this done,
the first time since Medicaid, to provide non-institutional
long-term care to all enrolled veterans who need it. It became
law. We are now reauthorizing that.
A GAO report released in May confirmed my suspicions that
these services are not being provided consistently throughout
VA, and as a matter of fact, they are not even being provided
consistently within my State of West Virginia. Now, if there is
anything, people, nobody escapes in life, it is the need for
long-term care. Nobody escapes that, unless they are hit by an
automobile. I mean, nobody gets out.
So I understand that the VA is taking action to increase
access to non-institutional long-term care service and to make
access even more available across networks and facilities, and
I am glad about that.
My question for you is this: If we expand the eligibility
for VA nursing home care to include those veterans who have 50-
percent service-connected disability or higher--and I favor
that--what effect do you think this is going to have on your
ability to provide both that? I ask both Dr. Murphy and Mr.
McClain to provide both long-term care and nursing home. I do
not think you have the budget to do it.
How are you going to do this?
Mr. McClain. First of all, I would certainly agree with
you, Senator, that that is a question that I am probably not
going to be able to answer. We believe that--of course, we are
speculating--but we are trying to determine how this reduction
from 70 percent to 50 percent service connected is going to
have an impact. We think, first of all, as Senator Specter
said, that it is going to cost us money, which you have just
brought up. We also think that it may impact the speed with
which we are trying to implement long-term care, extended care
services----
Senator Rockefeller. Do you remember how long that took to
get the rules and regulations going?
Mr. McClain. Yes, sir. Yes, sir, it took quite a while.
Senator Rockefeller. So I would just go on record, knowing
I do not have any time here, that I am very, very concerned
about this. Non-institutional long-term care is sacred for
veterans. So are nursing homes. We under fund veterans' health
care, your request and us. We are all at fault, and they are
both necessary, and I have a feeling you are going to do more
on nursing home than you are on non-institutional care, and
that is what I fear. I just want to make that clear.
Thank you, Mr. Chairman.
Do you want to answer, Dr. Murphy?
Dr. Murphy. I would like to comment.
We agree with you, Senator, that it is important to balance
the availability of non-institutional and institutional long-
term care and within available resources, we will do our best
to do that. VA will not under fund the non-institutional care
in favor of institutional care.
Senator Rockefeller. Thank you.
Prepared Statement of Hon. John D. Rockefeller IV, U.S. Senator from
West Virginia
Thank you, Mr. Chairman, for scheduling this Committee hearing
today giving us an opportunity to discuss some critically important
issues concerning VA health care.
Last week, many of us watched as Army Private First Class Jessica
Lynch returned home to West Virginia. Jessica was flown home from the
Walter Reed Army Medical Center, where for several months she had been
receiving treatment and rehabilitation for injuries she received during
an ambush in southern Iraq on March 23. The Nation and the world were
waiting to see her again, and to hear from her for the first time since
her rescue from a hospital in Nasiriyah. It was a proud day, indeed.
Jessica, and all the young men and women serving today in Iraq, and
on active duty around the world, remind us of why the Department of
Veterans exists, and they are also a gentle reminder of the important
work we do here on the Senate Committee on Veterans' Affairs.
I believe that what we have accomplished over the years in this
Committee has been some of the most important work done in the United
States Senate. And I look forward to the important work that lies
ahead.
Today, among other topics, we will be discussing crucial
legislation relating to VA health care. And while all of the bills on
the agenda are important, 1'd like to use my opening statement to say
just a few words about two specific issues--the CARES initiative and
long-term care for veterans.
I am pleased to be a cosponsor of Senator Graham's bill that would
require VA to give Congress a 60-day period for review of the CARES
recommendations before any action can be taken by the Secretary of the
Department of Veterans Affairs.
While I understand the importance of the concept of CARES, it is
critical that we don't go too far with this initiative. For no matter
how well the VA health care system provides preventative care for
veterans, there remains a certainty. Because of the enormous increase
in enrolled veterans, the ages of the majority of our veterans today,
and the very nature of the diseases and injuries seen at our VA medical
centers, we will continue to need hospital beds and specialty care
close to where our veterans live. Of particular concern in this process
is how VA accounts for the tremendous demand in both long-term care and
mental health care.
On the subject of long-term care for veterans, I know that I don't
have to remind anyone here that this has been, and remains, a priority
for me. The extension of the long-term care services mandated by the
Millennium Health Care Bill, both non-institutional and nursing home
care, is critically important to veterans and their families in every
State in this Nation. In March of this year, I introduced S. 836 that
would extend these long-term care initiatives, so I am glad to see this
provision included in S. 1156.
Unless the provisions of the current law are extended, veterans'
long-term care is in jeopardy, and that is just unacceptable. I am not
happy that it took VA 2-years after the mandate to issue a directive to
the medical centers about the non-institutional home care package
available to all enrolled veterans, and that delay has left little time
to effectively review the success of the program or to make appropriate
adjustments.
I look forward to hearing more about the provision to expand the
eligibility for VA nursing home care from 70 percent service-connected
veterans to 50 percent. Many of our aging veterans are suffering from
strokes or debilitating diseases, such as Alzheimer's or Parkinson's.
Some have very limited resources and depend upon VA. And in spite of
the critically important non-institutional long-term care services
available to all enrolled veterans, a number of spouses are still
unable to keep their loved ones at home because the demand for care is
so great.
While I wish VA could provide nursing home care to all enrolled
veterans--just as they are suppose to be doing with the non-
institutional long-term care services--and while I support expanding VA
nursing home care to include service-connected veterans rated above 50
percent, it would be imperative that VA receive the resources to be
able to do both. Otherwise, we could be adding a benefit at the expense
of another.
Recently, I ran across a copy of a House Committee on Veterans'
Affairs Subcommittee hearing held in my State of West Virginia in the
spring of 1984--almost 20 years ago--and almost a year before I came to
the Senate. The Subcommittee Chairman then, Bob Edgar from the State of
Pennsylvania, said at that hearing, and I quote:
``One of the important purposes of our field hearings is to
learn how the medical center directors are planning for the
significant increase in demand for health care caused by the
aging veteran population. This rapidly aging population not
only places a heavy demand on the VA for nursing home care, but
also hospital care resulting from acute episodes of chronic
illness. We must cope with the present demand. However, we must
also be prepared to accommodate the future demand.''
Today, 20 years later, the same is true. Today's hearing gives us
an opportunity to again address these vital concerns, and make every
effort to make sure we are prepared--both today and tomorrow. Thank
you.
Chairman Specter. Thank you very much, Senator
Rockefeller.
Well, thank you all very much for coming, ladies and
gentlemen. We are always under time constraints. We regret that
time is so limited. It may be worth repeating, in less than 3
minutes, the sequence of events at the memorial service for
Ambassador Walter Annenberg which was recently held in
Philadelphia, and the speakers included President Ford, and
Secretary of State Colin Powell, Arlen Specter and others. We
were all limited to 3 minutes.
So thank you all very much.
[Whereupon, at 4:44 p.m., the committee was adjourned.]
A P P E N D I X
----------
Prepared Statement of Hon. Ben Nighthorse Campbell,
U.S. Senator From Colorado
Mr. Chairman, thank you for holding this hearing on proposed
legislation relating to VA health care benefits and construction
projects.
And, I thank you for this opportunity to talk with you about my
legislation, S. 613, the Veterans' Fitzsimons Health Care Facilities
Act, which authorizes the VA to move its Denver medical facilities to
the former Fitzsimons Army base in Aurora.
I want to say right in the beginning, that I realize that moving
the VA hospital to the Fitzsimons campus will cost a lot of money. I
understand, too, that you, Mr. Chairman, have a project in Lebanon that
you have been wanting to fund for some time, and that you, Bob, have
projects in your State that need attention.
But, every now and then an opportunity arises that should not be
passed up . . . one that will not only save money, but one--which if
passed up--will cost more in the future. The VA relocation to
Fitzsimons is that kind of project.
WHAT YOUR BILL DOES
My bill would authorize the Secretary of Veterans Affairs to
construct, lease or modify major medical facilities at the site of the
former Fitzsimons Army Medical Center.
Specifically, it would authorize $300 million for direct
construction, or a combination of direct construction and capital
leasing, or $30 million a year for capital leasing alone.
And it would give the Secretary of Veterans Affairs the authority
to choose how best to proceed with this project. This authority would
prevent funds for this project from being taken from patient care.
It also instructs the Secretary to work with the Department of
Defense in planning a joint Federal project that would serve the health
care needs of active duty Air Force and the VA.
HISTORY OF THE PROJECT
Mr. Chairman, since the end of WWII the Denver Veterans Medical
Center, and the University of Colorado Health Sciences Center and the
University of Colorado Hospital have been partners at the University's
campus in Denver. This partnership has included the sharing of faculty,
medical residents and staff, and access to equipment.
The University of Colorado Health Sciences Center has already moved
its facilities from its overcrowded location near downtown Denver to
the Fitzsimons site, a decommissioned Army base, which is eight miles
away. This leaves the VA Medical facilities in the downtown area
without the advantages of the shared facilities.
At the new 217 acre campus, an outpatient and cancer pavilion, an
eye institute, and a Native American Health Sciences building have
already been completed. Research towers are being built and Children's
Hospital in Denver has agreed to relocate to the complex. On the site,
too, is a State Veterans' Nursing Home.
THE PLAN
As I understand, the relocation plans would have the VA build its
own ambulatory care center. This new Federal tower would be located
next to the University of Colorado Hospital. The VAMC would share
expensive facilities and services such as operating rooms, recovery
beds, imaging and radiology, labs and other specialized services with
the University of Colorado Hospital. And, if the DOD decides to be part
of the project, it would share part of the building and use beds in
this new Federal tower.
REASONS TO MOVE
Mr. Chairman, the need to move is pressing. The present VA hospital
was built in the 1950's. While still able to provide service, the core
facilities are approaching the end of their useful lives and many of
the patient care units have fallen horribly out of date.
The cost of maintaining the current VA hospital to satisfy
accreditation levels until 2020 has been estimated to be $233 million,
and estimates to rebuild the facility in 2020 are $377 million, in
today's dollars. The estimated cost to relocate the VA Hospital to
Fitzsimons is $300 million. And, the cost to the VA could be as much as
10 percent less with the DOD deciding to be part of the project.
Studies indicate that co-location with the University on a state-
of-the-art medical campus would be a cost effective way to give
veterans the highest quality of care.
Veterans who have highly specialized needs would have easy access
to the best diagnostic and treatment programs in the nation.
A move to the new location would also provide a tremendous
opportunity to showcase a nationwide model of cooperation between the
University, the Department of Veterans Affairs and the Department of
Defense.
SUPPORT FOR THE PROJECT
This project has the support of more than 45 local, State and
national Veterans' Service Organizations, the entire Colorado
delegation, the United Veteran's Committee of Colorado which represents
42 VSO's, and the University of Colorado. Also, the Government
Employees Local 2241 has expressed its approval for this proposal.
Recently, I have had conversations with Secretary Principi and
contact with Dr. Robert Roswell's office and understand that they think
now is the time to consider the relocation.
CLOSING
Mr. Chairman, we owe it to our veterans to give them the most up-
to-date, comprehensive and cost-efficient medical care available.
I believe the relocation of the Denver Veterans Medical Center to
the former Fitzsimons site offers us a unique opportunity to provide
the highest quality medical care for our veterans.
I look forward to working with this committee in passing S. 613 and
bringing this project to completion.
Thank you, Mr. Chairman.
__________
Prepared Statement of Hon. Zell Miller, U.S. Senator From Georgia
Good afternoon. I want to thank the Chair and Ranking Member for
having this hearing to address health care related legislation.
At a time when over 150,000 service members are deployed in Iraq,
it is important for Congress to address the circumstances and concerns
of our soldiers. As we all know, when the Active Duty and Reservists
return from fighting in Iraq, they may need the services offered by the
VA. It is vitally important that when these soldiers return, they
receive the services they have earned.
Even though I understand the VA's budget dilemma, limiting the
commitment to our veterans comes at great expense. It is my hope that
Congress and the Administration can continue to work together to find
solutions that adequately address VA's health care budget concerns,
without greatly limiting necessary services to our veterans.
We have the best military in the world. It is essential for us to
do everything we can to help these men and women when they return from
combat or separate from the Service. Many of these bills will ensure
that veterans are fairly compensated for putting their lives on the
line to protect the Nation's freedom.
I thank the Chair.
__________
Prepared Statement of Bobby Harnage, National President,
American Federation of Government Employees
Dear Chairman Specter and Ranking Member Graham: On behalf of the
American Federation of Government Employees (AFGE), AFLCIO, and the
600,000 Federal and DC government employees we represent, we wish to
raise our concerns regarding S. 1156, S. 613 and S. 1283, which will be
considered by the Senate Veterans Affairs Committee.
S. 1156--VETERANS CANTEEN SERVICE EMPLOYEES
We greatly appreciate that Chairman Specter included in S. 1156 a
provision to address the inequity in the Veterans Service Canteen
(VCS), whereby managers but not rank-and-file employees are able to
transfer to competitive service positions within the Department of
Veterans' Affairs (VA).
VCS employees who are non-supervisors work in food service and
sales clerk positions at the VA. According to OPM, working full-time
these employees earn an average salary of $18.192 (before taxes), after
an average of 8 years of service. VSC employees are Federal employees
appointed under 38 U.S.C-7802, which is a merit-based system.
Appointments for V5C employees, however, are only subject to the
provisions of Title 5 with respect to veterans' preference, workers'
compensation, and retirement. VCS employees are paid through non-
appropriated funds. Because VCS employees are appointed without regard
to Title 5 competitive civil service rules these workers are not
considered in the Federal civil competitive service. As a result, rank-
and-file VSC workers are prohibited from applying for VA food service
positions, nursing assistant positions or any jobs at the VA as an
internal competitive service candidate.
Even after 8 years of service at the VA, a VSC employee cannot
transfer to another job at the VA without first going through a civil
service competition, as if he or she had never been a Federal employee.
This is wrong and unfair.
VSC supervisors and managers are also appointed under the same
statutory authority (38 U.S.C. 7802) but they can easily transfer into
other Federal jobs as if they were originally appointed under Title 5
competitive service. The Office of Personnel Management (OPM) has
approved a personnel interchange agreement for VSC managers only. The
VA has repeatedly requested approval of a similar interchange agreement
for VSC hourly employees but OPM has rejected these requests.
AFGE supports Section 302 of S. 1156 to allow VCS employees to
transfer into competitive service jobs more easily. We believe this
will provide upward mobility for dedicated employees and could help VA
recruit needed nursing assistant staff.
In the 10th Congress the Senate Veterans Affairs Committee approved
legislation (S. 2043) which contained an identical provision, but the
Senate did not have an opportunity to vote on the legislation prior to
the end of the 107th Congress. We appreciate the bipartisan support
this provision has received and ask that the Senate Veterans Affairs
Committee continue to support the provision concerning canteen workers.
S. 1156--CONVERSION OF TITLE 5 HEALTH CARE WORKERS TO
TITLE 38-TITLE 5 HYBRID STATUS
We understand that Section 301 of S. 1156, which authorizes the
Secretary of the VA to convert possibly all Title 5 positions in the VA
to Title 38-Title 5 status, is intended to assist the VA in recruiting
and retaining needed staff. We have long advocated that the VA is
understaffed and look forward to working with the Committee on a number
of approaches to ensure that the VA maintains safe and adequate
staffing levels which are needed to ensure veterans with timely access
to health care.
We have a number of concerns with the conversion of staff to hybrid
status as currently drafted in Section 301.
Section 301 specifically lists 19 new occupations to covert into
hybrid status but the provision gives the VA Secretary carte blanche to
convert virtually all Title 5 employees into hybrid Title 38-Title 5
status. Section 301 authorizes the Secretary to designate other
positions as necessary to the medical care of veterans into the Title
38-Title 5 hybrid status. AFGE is concerned that could be viewed as a
broad mandate for the Secretary to move every position in the Veterans
Health Administration out of Title 5 and into Title 5-Title 38 status.
AFGE opposes giving the Secretary such broad unilateral discretion to
change the legal rights of such a broad group of employees.
We urge the Committee to consider the possible unintended and
adverse consequences of converting any employee from Title 5 to Title
38-Title 5 hybrid status.
1. Loss of Collective Bargaining and Union Representation
Current Title 5 employees who work in the VA and are represented by
AFGE have negotiated procedures for promotions to make sure that
promotional opportunities are posted and decisions are made fairly,
under equitably procedures and based solely on job-related criteria.
Employees can grieve when such negotiated equitable and merit-based
procedures and requirements are violated. Should Section 301 of S. 1156
be adopted by the Committee as currently drafted all employees who are
converted to hybrid status will lose these negotiated rights.
Many current hybrid employees and Register Nurses have repeatedly
voiced concerns with the arbitrariness, subjectivity and inconsistency
in their promotion process, which is totally at VA's unilateral
discretion to establish and change. We see no reason to take this
flawed system as the model for thousands of VA employees who currently
can negotiate a fairer, more objective process.
We fail to see how it is in the interests of VA's ability to retain
and recruit employees to erode the ability of professionals to
participate in setting the procedures for merit-based promotions.
AFGE stands ready to work with the Committee to ensure that this
unintended and adverse consequence of converting thousands of employees
to hybrid status is corrected
2. Potential Erosion of Pay
Under 38 USC 7451, the Secretary has the authority to place all
hybrid occupations into the pay system for VA's Registered Nurses.
Specifically, 38 USC 7451(a) (2) defined positions covered under the VA
RN pay system as ``(A) registered nurse and (8) positions referred to
in paragraphs (1) and (3) of section 7401 as the Secretary may
determine.'' Section 7401 (3) is the section listing occupations which
are considered to be Title 38-Title 5 hybrids and that S. 1156 expands
to explicitly include 18 new occupations and to implicitly include all
occupations employed at VA Medical facilities. Therefore, the Secretary
has discretion to put hybrids in to a nurse pay system and out of the
Title 5 pay system, know as the General Schedule (GS).
Although the Secretary has not exercised this authority with
current hybrids, and may not intend to use this authority, the VA
Secretary has the right to unilaterally place the thousands of Title
38-Title 5 hybrid employees into the nurse locality pay system if this
legislation is enacted as drafted. Employees under the nurse locality
pay system are only entitled to the GS nationwide pay raise not the GS
locality pay increase. VA Medical Directors have absolute discretion to
grant or deny the GS locality pay raise. VA Medical Directors have
frequently denied employees under this pay system the GS locality pay
raise. It is also not clear whether hybrid employee placed under the VA
RN pay system would continue to be eligible for annual step increases.
AFGE stands ready to work with the Committee to ensure that
employees under the hybrid system are not at risk of having their pay
eroded.
3. Veterans' preference
Veterans' preference requirements and ``merit'' requirements apply
to the Title 38-Title 5 hybrid system and the Title 5 competitive
service system. However, because the hybrid system permits VA
management maximum flexibility in hiring there are little or no checks
against management's avoidance of hiring veterans' preference eligible
candidates. AFGE urges greater accountability under the hybrid hiring
system to ensure that all qualified candidates are given a fair chance
and that veterans' preference is continued in hiring. We look forward
to working with the Committee to ensure that the broad discretion VA is
given for hiring under hybrid status is not abused.
4. Summary
Because of the significant adverse consequences of converting
thousands of employees from Title 5 personnel rules to Title 38-Title 5
personnel rules AFGE must oppose Section 301 of S. 1156. We stand ready
to work with the Committee to correct these serious, albeit unintended,
problems with the Title 38-Title 5 hybrid system.
S. 613
S. 613 authorizes the Secretary to carry out major medical facility
projects at the former Fitzsimons Army Medical Center in Aurora,
Colorado. Projects to be carried out at the site will be selected by
the Secretary and may include inpatient and outpatient facilities
providing acute, sub-acute, primary, and long-term care services. The
Secretary has two options: One is direct construction by the VA through
a combination of direct construction and capital leasing. The other
option is through capital leasing alone. AFGE is steadfastly opposed to
the blanket authorization in S. 613.
AFGE Local 2241 represents health care workers at the Denver
facility. We are concerned that this authorization will enable the VA
to privatize the work of many employees, including employees with
veterans' preference, with no real enhancement in services for
veterans.
AFGE is adamantly opposed to any option that would essentially
integrate Denver VA medical center patients into the patient population
of the University of Colorado Hospital. Integrating these two entities
by allowing VA to lease part of the facility would fundamentally change
the way VA provides care.
Absent from S. 613 are key elements to ensure collaboration
benefits veterans AFGE is opposed to S. 613 because it leaves silent
governance issues ensuring that VA leadership has direct line authority
and accountability for veterans' health care, ensuring dedicated space
and a distinct VA presence, ensuring that facility staff remain Federal
(VA) medical center employees, ensuring that current VA procedures and
policies for the provision of appropriate pharmaceuticals, supplies and
prosthetics be maintained, and ensuring that no VA staff lose their
jobs as a result of the integration. We believe that these issues must
be resolved and explicit in the legislation before any authority is
provided to proceed.
S. 1283
S. 1283 gives Congress an oversight role over the VA's Capital
Asset Realignment for Enhanced Services (CARES) planning initiative, a
process that will likely eliminate beds and close facilities. The
legislation allows Congress 60 days to review any actions proposed by
the Secretary of Veterans Affairs under the CARES process. AFGE
believes this legislation is an important first start in ensuring that
Congress has a real say in VA capacity to provide veterans with needed
care and services, including long-term care and treatment for substance
abuse and mental illness.
AFGE remains concerned that notice and 60-day reviews may not be
adequate, given the scope of changes being proposed by the VA and the
problems encountered in VA's phase I of CARES.
It is our understanding that the total cost of the ``enhanced
services'' component of the CARES proposals is at least $5.8 billion.
Given the Administration's repeated failure to request adequate funds
for veterans' health care, we are concerned that these enhancements
will not be fully funded. Without funding for ``enhanced services''
they become empty promises after the VA has already closed beds and
facilities, reduced staff and diminished existing programs and
services. In addition to enacting the notice and review requirements of
S. 1283, AFGE urges the Committee to consider adding legislation
language to prohibit the VA from reducing any facility from 24-hour
care to 8-hour care, or not staffing for or eliminating acute care,
spinal cord injury, long-term care, psychiatric care, or substance
abuse beds at any facility until funds have been authorized and
appropriated for ``enhanced services'' under the CARES proposals. In
short, the CARES reductions and elimination in beds and staff cannot
occur until the VA and Congress show veterans the money for
enhancements.
Chairman Specter and Ranking Member Graham, thank you for bearing
in mind AFGE's concerns and views as you consider S. 1156, S. 613 and
S. 1283. If you or your staff would like to discuss our concerns and
views please contact Linda Bennett, in AFGE's Legislative Department,
at (202) 639-6456.
__________
Prepared Statement of Jane Nygaard, President, AFGE Local 3669
and Jay Price, President, AFGE Local 1969
Dear Chairman Specter and Ranking Member Graham: We are writing you
today in support of S. 1282, which would allow us to name the
Minneapolis VA Medical Center after the late Senator Paul Wellstone. As
you know for many years Senator Paul Wellstone was a very active member
of the Senate Veterans Affairs Committee and a strong advocate for
veterans and the workers who cared for them.
Senator Wellstone was passionate in advocacy for veterans. He
listened to veterans, regularly visited our medical facility and was a
voice for veterans in the Senate. He was a champion of the Independent
Budget, was relentless and compassionate of the needs of vulnerable
veterans--the homeless, the mentally ill, the frail and elderly. He
sought vindication for veterans who had been exposed to radiation.
Senator Wellstone's strength as an advocate lay in his humility to
listen to veterans and his unwavering belief that our Nation would not
and could not forget the men and women who fought for our freedoms. He
truly cared for all veterans and they cared for him.
I was with him when he received the National Endorsement from the
Veterans of Foreign War. Did he deserve it? Absolutely!! He said it was
one of the highlights of his career. Let us never forget his true
character, someone who stood up for his convictions and supported the
causes of those less fortunate. He was a man of his word, and he acted
on it. Every day our members honor veterans by tending to their
physical and emotional wounds from war. We, who work at the Minneapolis
VAMC, think it is a fitting and just tribute to name our facility after
a passionate and compassionate veterans' advocate, the late Senator
Paul Wellstone.
__________
Prepared Statement of Roy S. Hansen, Adjutant, Disabled American
Veterans, Department of Minnesota
Dear Senator Graham: Thank you for sponsoring the Senate Bill on
naming the Minneapolis VA Medical Center in Honor of Senator Paul
Wellstone, the Best Friend those of us in the Disabled American
Veterans ever had.
As you know we adopted a resolution to that effect at our State
Convention in May.
Our members, at least 80-90 percent belong to other veterans
organizations such as the American Legion, Veterans of Foreign Wars,
Vietnam Veterans groups and while not speaking for them, I can say we
are representative of the 420,000 Veterans in Minnesota when I say to
you, we all owe Senator Paul Wellstone our gratitude.
Thank you so much.
Prepared Statement of Richard C. Schneider, National Director, Veterans
and State Affairs, Non-Commissioned Officers Association of the United
States of America
Dear Senator Graham: The Non-Commissioned Officers Association of
the United States of America (NCOA) fully supports the proposed
legislation contained in Senate 1289 to rename the existing Minneapolis
VAMC after the late Senator Paul Wellstone of Minnesota. NCOA greatly
appreciates your leadership in this matter.
The membership of NCOA held former Senator Wellstone in great
esteem for legislation he championed in the U.S. Senate on behalf of
Active Duty Military Personnel; Guard, Reserve, all American veterans,
and the families of each group. His efforts and clarity of message on
behalf of America's homeless veterans were monumental contributions to
the passage of a law to end veteran homelessness in a decade.
This Association conveyed its premier Legislative Vanguard Award to
Senator Wellstone just prior to his untimely death in 2002. The
Legislative Vanguard Award is the highest award that NCOA may present
for legislative achievement on behalf of its membership.
The proposed designation of the Minneapolis VAMC as the Paul
Wellstone Memorial Veterans Hospital honors an individual whose
national legislative achievements championed military and veteran
entitlements widely recognized and of direct benefit to all who serve
or have served.
__________
Prepared Statement of Dennis Cullinan, Director, National Legislative
Service, Veterans of Foreign Wars
Dear Senator Graham: On behalf of the 2.6 million men and women of
the Veterans of Foreign Wars of the United States (VFW) and our Ladies
Auxiliary, I would like to offer our strong support for S. 1283,
legislation that would rename the VA Medical Center in Minneapolis,
Minnesota, after the late Paul Wellstone, former Senator and tireless
advocate for America's veterans.
Paul Wellstone constantly and consistency crusaded and championed
for the many issues that were of vital interest to our veteran
population. He was tenacious in his efforts to assure passage of
legislation that would provide for those veterans suffering from
radiation exposure, Gulf War illness, and those in need of VA health
care.
He took great efforts to ensure that veterans received the proper
care and treatment they earned. Through their service in defense of
this country. Naming this VA Medical Center is a fitting tribute to the
long legacy he left behind after his tragic accident.
We thank you for introducing this legislation, and we look forward
to working with you to ensure its success.
Prepared Statement of Steve Van Bergen, State Commander, Department of
Minnesota, Veterans of Foreign Wars
Dear Senator Graham: We wish to inform you that on Saturday, July
19th in Spring Lake Park, MN the State VFW Council of Administration
took action on a request by our National VFW Legislative Office to
indicate our support for your legislation to name the VA Medical Center
in Minneapolis the ``Paul Wellstone Department of Veterans Affairs
Medical Center''.
The VFW Council rollcall vote was unanimous in support of your
legislation as well as from our Ladies Auxiliary.
Thank you for your concern.
__________
Prepared Statement of Thomas H. Corey, National President,
Vietnam Veterans of America
Dear Senator Graham: On behalf of the membership of Vietnam
Veterans of America (VV A), I express our full support of S. 1289
renaming the Department of Veterans Affairs Medical Center in
Minneapolis, MN after Senator Paul Wellstone.
Senator Graham, in 2001 Wellstone led the fight for passage of
Public Law 107-95, the Homeless Veterans Comprehensive Assistance Act
of 2001, which he sponsored. The bill was stalled in Congress and
Senator Wellstone held his ground and did not agree to any Senate
conferences or bills until this legislation was passed in the Senate.
He succeeded in his efforts and the first comprehensive legislation to
assist homeless veterans was passed and signed by the President.
``Paul Wellstone was one of the most thoughtful and vocal advocates
for veterans' affairs'', his leadership, skill, and impassioned pleas
for justice for America's veterans will stand as a testament to his
devotion to our country and those who defend it.
``If not for Senator Wellstone's tenacious leadership and dogged
determination, the veterans exposed to ionizing radiation would never
have gotten any redress. Senator Wellstone was one who supported
veterans when it was tough and spent political capital to assist
securing justice for veterans.''
VVA would like to thank you for introducing this legislation and
any support that you may need in securing passage of this important
bill, please feel free to contact Rick Weidman, Director of Government
Relations at (301) 585-4000 ext. 127.
__________
Prepared Statement of Frederick Rochelle, Former President,
St. Paul Chapter, Vietnam Veterans of America
Mr. Chairman, Mr. Ranking Member, and Members of the Committee.
Thank you for giving me the opportunity to offer testimony about my
strong and enthusiastic support in favor of S. 1289, a bill to name the
Department of Veterans Affairs Medical Center in Minneapolis,
Minnesota, after Paul Wellstone.
As a veteran of both the Air Force and the Army and as a past
President of the St. Paul Chapter of the Vietnam Veterans of America, I
followed with great interest, Senator Wellstone's legislative efforts
on behalf of veterans in Minnesota and around the nation. Though not a
veteran himself, Senator Wellstone demonstrated an unparalleled
commitment to secure veterans' benefits and even expand them to often-
overlooked populations, such as homeless and disabled vets.
Beyond his efforts in Washington, Senator Wellstone was an active
member among the veterans community in Minnesota. He often visited the
Minneapolis VA Medical Center to speak with vets and determine how the
health care system was functioning. For his efforts and involvement,
Senator Wellstone was awarded numerous distinctions from various
veterans service organizations, including: the 1995 Legislator of the
Year Award from the Vietnam Veterans of America; the 1995 Patriot Award
from the Paralyzed Veterans of America; the Congressional Leadership
Award from the Forgotten 216th; the 1997 Distinguished Citizen Award
from the Minnesota Veterans of Foreign Wars; the 2002 Distinguished
Science Award from the Disabled American Veterans; the 2002 Legislative
Leadership Award from the National Coalition for Homeless Veterans; and
the Vanguard Award for Legislative Achievement by the Non-Commissioned
Officers Association.
I note that the Disabled American Veterans of Minnesota has already
passed a resolution supporting the renaming of the Minneapolis
facility.
On a personal note, I will always remember Paul as the man who
wanted to right the wrongs that have been placed upon veterans and many
other groups of people. In Committee and on the floor of the Senate, he
spoke with passion and conviction to make changes for who he called
``the forgotten ones.'' He always stayed the course without regard to
the political ramifications.
Senator Wellstone, through his tenure, held many group and one-on-
one meetings with myself and many other of my fellow veterans to hear
our pleas, and if it was the right thing to do, he fought with all he
had to right the wrongs. He was honored in life by the above referenced
veterans' groups because of what he did. Let us recognize this great
man by renaming in his honor the Minneapolis VA Medical Center, a place
Paul held dear to his heart.
I urge the Members of this Committee to support and pass this
legislation. Thank you.