[House Report 107-804]
[From the U.S. Government Publishing Office]
Union Calendar No. 505
107th Congress, 2d Session - - - - - - - - - - House Report 107-804
ACTIVITIES REPORT
of the
COMMITTEE ON VETERANS' AFFAIRS
HOUSE OF REPRESENTATIVES
ONE HUNDRED SEVENTH CONGRESS
__________
first session
Convened January 3, 2001
Adjourned December 20, 2001
second session
Convened January 23, 2002
Adjourned November 22, 2002
January 2, 2003--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
For Sale by the Superintendent of Documents, U.S. Government Printing Office
Internet: bookstore.gpr.gov Phone: toll free (866) 512-1800; (202) 512�091800
Fax: (202) 512�092250 Mail: Stop SSOP, Washington, DC 20402�090001
COMMITTEE ON VETERANS' AFFAIRS
CHRISTOPHER H. SMITH, New Jersey, Chairman
BOB STUMP, Arizona LANE EVANS, Illinois
MICHAEL BILIRAKIS, Florida BOB FILNER, California
FLOYD SPENCE, South Carolina \3\ LUIS V. GUTIERREZ, Illinois
TERRY EVERETT, Alabama CORRINE BROWN, Florida
STEVE BUYER, Indiana COLLIN C. PETERSON, Minnesota \1\
JACK QUINN, New York JULIA CARSON, Indiana
CLIFF STEARNS, Florida SILVESTRE REYES, Texas
JERRY MORAN, Kansas VIC SNYDER, Arkansas
J.D. HAYWORTH, Arizona \2\ CIRO D. RODRIGUEZ, Texas
HOWARD P. (BUCK) McKEON, California STEPHEN F. LYNCH, Massachusetts
JIM GIBBONS, Nevada \4\
MICHAEL K. SIMPSON, Idaho RONNIE SHOWS, Mississippi
RICHARD H. BAKER, Louisiana SHELLEY BERKLEY, Nevada
ROB SIMMONS, Connecticut BARON P. HILL, Indiana
ANDER CRENSHAW, Florida TOM UDALL, New Mexico
HENRY E. BROWN, Jr., South Carolina SUSAN A. DAVIS, California \4\
JEFF MILLER, Florida \5\
JOHN BOOZMAN, Arkansas \6\
Patrick E. Ryan, Chief Counsel and Staff Director
-------------
\1\ April 26, 2001--Rep. Collin C. Peterson resigned from the
Committee to serve on the Permanent Select Committee on Intelligence.
\2\ June 20, 2001--Rep. J.D. Hayworth resigned from the Committee
to serve on the Committee on Resources.
\3\ August 16, 2001--Rep. Floyd Spence died.
\4\ November 7, 2001--Rep. Stephen F. Lynch and Rep. Susan A. Davis
were appointed to the Committee.
\5\ November 8, 2001--Rep. Jeff Miller was appointed to the
Committee.
\6\ December 4, 2001--Rep. John Boozman was appointed to the
Committee.
(ii)
?
__________
SUBCOMMITTEE ON HEALTH
JERRY MORAN, Kansas, Chairman
CLIFF STEARNS, Florida, BOB FILNER, California
HOWARD P. (BUCK) McKEON, California RONNIE SHOWS, Mississippi
JIM GIBBONS, Nevada SHELLEY BERKLEY, Nevada
MICHAEL K. SIMPSON, Idaho CIRO D. RODRIGUEZ, Texas
RICHARD H. BAKER, Louisiana LUIS V. GUTIERREZ, Illinois
ROB SIMMONS, Connecticut VIC SNYDER, Arkansas
ANDER CRENSHAW, Florida STEPHEN F. LYNCH, Massachusetts
HENRY E. BROWN, Jr., South Carolina
JEFF MILLER, Florida
JOHN BOOZMAN, Arkansas
__________
SUBCOMMITTEE ON BENEFITS
MICHAEL K. SIMPSON, Idaho, Chairman
JACK QUINN, New York SILVESTRE REYES, Texas
ANDER CRENSHAW, Florida CORRINE BROWN, Florida
CHRISTOPHER H. SMITH, New Jersey LANE EVANS, Illinois
JEFF MILLER, Florida SUSAN A. DAVIS, California
__________
SUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS
STEVE BUYER, Indiana, Chairman
BOB STUMP, Arizona JULIA CARSON, Indiana
MICHAEL BILIRAKIS, Florida BARON P. HILL, Indiana
TERRY EVERETT, Alabama TOM UDALL, New Mexico
(iii)
?
Committee Staff
Patrick E. Ryan, Chief Counsel and Staff Director
Charles M. Durishin, Democratic Staff Director
Kingston E. Smith, Deputy Chief Counsel
Arthur K. Wu, Deputy Staff Director/Staff Director, Subcommittee on
Oversight and Investigations
John M. Bradley, Staff Director, Subcommittee on Health
Geoffrey K. Collver, Democratic Counsel, Subcommittee on Benefits
Veronica Crowe, Professional Staff Member, Subcommittee on Oversight
and Investigations
Peter A. Dickinson, Communications Director
Bernadine N. Dotson, Office Manager
Susan C. Edgerton, Democratic Staff Director, Subcommittee on Health
Darryl W. Kehrer, Staff Director, Subcommittee on Benefits
Sarah Keller-Likins, Democratic Executive Assistant, Subcommittee on
Health
Elizabeth A. Kilker, Democratic Executive Assistant, Subcommittee on
Benefits
Steven R. Kirkland, Director of Information Systems
Summer L. Larson, Staff Assistant, Legislative
Ruth J. Mahnken, Democratic Professional Staff Member, Subcommittee on
Oversight and Investigations
Mary Ellen Mc Carthy, Democratic Staff Director, Subcommittee on
Benefits
Mary Stevens McDermott, Administrative and Financial Assistant/Chief
Clerk
Jonathan M. McKay, Staff Assistant, Subcommittee on Oversight and
Investigations
Paige E. McManus, Professional Staff Member, Subcommittee on Benefits
Jeanne M. McNally, Legislative Coordinator
Thomas A. O'Donnell, Democratic Professional Staff Member
Devon E. Seibert, Staff Assistant, Subcommittee on Benefits
Leonard A. Sistek, Jr., Democratic Staff Director, Subcommittee on
Oversight and Investigations
Tanya J. Skypeck, Staff Assistant, Front Office
Deborah A. Smith, Democratic Administrative Assistant/Executive
Assistant, Subcommittee on Oversight and Investigations
Jeremiah B. Tan, Printing Clerk
Stacy H. Zelenski, Research Assistant, Subcommittee on Health
(v)
LETTER OF SUBMITTAL
----------
House of Representatives,
Committee on Veterans' Affairs,
Washington, DC, January 2, 2003
Hon. Jeff Trandahl,
Clerk, House of Representatives,
Washington, D.C.
Dear Mr. Trandahl:
In accordance with Clause 1(d) of Rule XI of the Rules of
the House of Representatives, I submit herewith the report of
the Committee on Veterans' Affairs setting forth its activities
in reviewing and studying the application, administration, and
execution of those laws, the subject matter of which is within
the jurisdiction of our committee.
Christopher H. Smith,
Chairman
FOREWORD
----------
With renewed emphasis on security following the heinous
terrorist attacks of September 11th, the role of America's
servicemen and women has returned to the spotlight. In the
107th Congress, this led to a renewed focus upon the debts and
obligations our Nation owes to military veterans.
The House Committee on Veterans' Affairs took historic
steps in the 107th Congress to ensure that 25 million living
veterans, including 16 million war veterans, and their
survivors are receiving the benefits and services they have
earned through their service. Over the past two years, the
Committee has worked to expand the scope and improve the
efficiency of veterans' benefits and services.
Specifically, the Committee focused upon:
Providing comprehensive and timely health care to
all eligible veterans;
Properly compensating disabled veterans and their
survivors;
Strengthening and expanding veterans' education
and vocational training programs;
Ending the scourge of homelessness among our
veterans;
Reforming veterans' job training and placement
programs;
Investing in medical research to benefit veterans
and homeland security; and
Ensuring that future veterans' health is properly
protected while on active duty.
The Committee pursued these goals through three primary
activities: the budget and appropriations process; amending
existing statutes and enacting new legislation; and
investigating and overseeing the operation of the Department of
Veterans Affairs and other federal veterans' programs.
Budget for Veterans Programs.--At the start of the 107th
Congress, the Committee conducted a complete review of the
budgetary requirements of the Department of Veterans Affairs
(VA) and developed a series of recommendations for funding
increases in a number of vital program areas. The most critical
need for increased discretionary funding was the VA medical
care account. From 1995 to 2000, the number of unique patients
in the VA health care system rose dramatically from
approximately two million to four million veterans. This rapid
influx of new patients--in part due to the opening of hundreds
of new outpatient clinics across the country, as well as VA's
generous prescription drug benefits--had produced an enormous
strain on VA's ability to provide both timely and comprehensive
medical care.
For fiscal year 2002, the Administration requested a $1.1
billion increase in VA medical care in order to meet the
growing demand. After conducting a series of hearing in January
and February, and receiving testimony from both VA and veterans
service organizations, the Committee recommended an increase of
$2.1 billion for VA medical care for fiscal year 2002.
Overall, the Committee recommended $53.5 billion for the
Department of Veterans Affairs for fiscal year 2002, which
provided an increase of $2.1 billion over fiscal year 2001 for
discretionary programs and $300 million in budget authority to
fund an increase in the Montgomery GI Bill (MGIB).
Among the specific components of the Committee's budget
recommendation was an additional $141 million for programs
serving the chronically mentally ill; $88 million for programs
for veterans in need of long-term care; $75 million to hire
staff to reduce the time it takes to see a VA physician; $100
million to cover increased pharmacy costs; $68 million for
higher emergency care costs, $23 million to restore spinal-cord
injury treatment capacity; $30 million for enhancing programs
serving homeless veterans; and $30 million for medical and
prosthetic research to enable the VA to maintain its research
into diseases that affect the veteran population and attract a
new generation of researchers.
Congress ultimately adopted a budget that increased VA's
health care spending authority by $1.7 billion, and fully
accommodated the proposed increases for the Montgomery GI Bill.
The Committee recommended that Congress enhance VA's budget
request for fiscal year 2003 with $1.1 billion more than the
President requested in order to sustain VA health care for
increased enrollment of Priority 7 veterans, those who have no
service-connected disability and whose incomes are above
poverty levels. The House agreed with the Committee's
recommendation, rather than with an Administration proposal for
a new $1,500 deductible for Priority 7 veterans.
The Committee also recommended a funding increase of $150
million above the Administration's proposal to meet statutory
obligations for new programs approved by Congress and enacted
into law during the past few years, including long-term care
for older veterans and immediate assistance to homeless
veterans. Further, the Committee recommended an additional $200
million to strengthen the VA's security preparedness and role
in homeland security.
Congress ultimately agreed with the Committee's
recommendation to fund Priority 7 health care and an overall
increase in VA health care funding of $2.6 billion.
Legislation.--Improvement of the Montgomery GI Bill, with
the goal of increasing both its utility and utilization rates,
was a top legislative priority of the Committee in the 107th
Congress. With spiraling higher education and specialized
training costs eroding the value of the MGIB benefit, the
Committee proposed a three-year plan to increase the benefit.
The Committee's proposed MGIB increase become the
centerpiece of a comprehensive veterans' benefits law, Public
Law 107-103, the Veterans Education and Benefits Expansion Act
of 2001. This legislation authorized more than $3.1 billion
over five years to expand and increase educational, housing,
burial and disability benefits. Signed by President Bush on
December 27, 2001, Public Law 107-103 provided increases in the
MGIB college education benefit that will by October 1, 2003,
have boosted current benefit levels 46 percent, from $672 to
$985 per month for veterans enlisted for three or more years.
Over a two year period, Public Law 107-103 will have increased
the total MGIB educational benefit for qualified veterans from
$24,192 to $35,460. It also increased monthly benefits for
veterans with two-year enlistments by 56 percent over two
years, from $546 to $800 per month, and increased monthly
Survivors' and Dependents' Educational Assistance program
payments from $608 to $670 per month for full-time, $456 to
$503 per month for three-quarter-time, and $304 to $345 per
month for half-time studies.
Other provisions of Public Law 107-103:
Allow veterans enrolled in academically-
intensive, short-term, high-cost programs, such as certified
network engineering, to ``accelerate'' their MGIB benefits by
receiving up to 60 percent of their total benefit upfront when
they first enroll in the course;
Restore lost MGIB benefits for reservists and
National Guard members called up to active duty;
Increase VA guaranteed home loans from a maximum
mortgage of $203,000 to $240,000;
Increase Specially Adapted Housing grants for
severely disabled veterans from $43,000 to $48,000;
Increase the Automobile and Adaptive Equipment
grant for severely disabled veterans;
Increase burial and funeral expense benefits by
25 percent and doubles burial plot allowances;
Make type II Diabetes a service-connected
condition for Vietnam veterans exposed to Agent Orange; and
Add undiagnosed conditions, such as fibromyalgia,
chronic fatigue syndrome and chronic multi-symptom illnesses to
list of service-connected conditions for Gulf War veterans.
A second major initiative of the Committee was to address
the persistent problem of homelessness among veterans. The
Department of Veterans Affairs estimates that there are at
least 275,000 homeless veterans on the streets of America every
night. In order to drastically reduce these numbers, provide
services to those who remain homeless and prevent at-risk
veterans from becoming homeless, the Committee approved an
historic new law that established a national goal of ending
chronic homelessness among veterans within a decade.
Public Law 107-95, the Homeless Veterans Comprehensive
Assistance Act of 2001, authorized almost $1 billion to aid
homeless veterans and prevent at-risk veterans from becoming
homeless. As enacted on December 21, 2001, Public Law 107-95:
Authorizes 2,000 additional section 8 HUD low-
income housing vouchers for homeless veterans;
Authorizes 10 new Domiciliaries for Homeless
Veterans programs;
Authorizes $285 million for the Homeless Grant
and Per Diem Program;
Authorizes $250 million for the Department of
Labor's Homeless Veterans Reintegration Program (HVRP);
Requires VA to provide technical assistance to
nonprofit community-based organizations seeking federal funding
for homeless programs;
Requires the VA to provide mental health programs
wherever primary care is provided; and
Earmarks $10 million for medical care for
homeless veterans with special needs, including older veterans,
women and substance abusers.
The Committee also produced Public Law 107-14, the
Veterans' Survivor Benefits Improvements Act of 2001, which
added $100 million in new health care benefits for surviving
spouses of veterans, and extends life insurance coverage to
spouses and children of servicemembers. Public Law 107-14
expanded CHAMPVA to surviving spouses of veterans who die of a
service-connected disability; expanded Servicemembers' Group
Life Insurance (SGLI) to include spouses and children of
servicemembers; provided $100,000 coverage for spouses and
$10,000 coverage for children; and made retroactive to October
1, 2000 the increase to $250,000 for the maximum SGLI benefit
for servicemembers dying in the line of duty.
Another major new law initiated by the Committee is Public
Law 107-135, the Department of Veterans Affairs Health Care
Programs Enhancement Act of 2001. This legislation increases
health programs for veterans by $1.4 billion. Specifically, it:
Lowers out-of-pocket hospitalization expenses for
lower income veterans by 80 percent to compensate for regional
differences in the cost-of-living;
Requires the VA to establish chiropractic care
programs nationwide;
Authorizes service dog programs for paralyzed and
other severely disabled veterans;
Requires the VA to maintain specialized medical
programs--such as for mental illness, spinal cord injuries and
prosthetics--in each of the VA's 21 regional networks; and
Creates new incentive and recruitment programs to
attract and retain VA nurses.
Following the attacks of September 11th and the subsequent
anthrax attacks, the Committee reviewed the role of the
Department of Veterans Affairs in emergency preparedness. After
holding public hearings, the Committee reported legislation
that eventually became Public Law 107-287, the Department of
Veterans Affairs Emergency Preparedness Act of 2002. Public Law
107-287 expands the Department of Veterans Affairs' ability to
respond to injuries and illnesses caused by biological,
chemical, radiological, and explosive weapons. It increases the
VA's role in homeland security, creating new research centers
to counter biological, chemical, and radiological terrorism.
The law:
Authorizes the Department of Veterans Affairs to
establish four National Medical Emergency Preparedness Centers
at VA medical centers to conduct bio-medical research on, and
develop health care responses for, chemical, biological,
radiological, and explosive weapons;
Authorizes $100 million over five years to fund
the new centers;
Requires the new centers to provide education,
training, and advice to VA and community health care
professionals on how to respond to chemical, biological, and
radiological emergencies;
Requires the new centers to provide rapid
response laboratory assistance to local health care and law
enforcement authorities in the event of a terrorist threat or
other national emergency;
Requires the Secretaries of VA and Defense to
carry out a joint program to develop model education and
training programs on the medical responses to the consequences
of terrorist activities, and disseminate these programs to
students of health professions, graduate medical education
trainees, and active health practitioners; and
Authorizes the Secretary to furnish health care
during major disasters and medical emergencies to non-veterans,
and to collect reimbursement for providing such services.
The Committee also addressed the challenges of employment
and job training for veterans, approving Public Law 107-288,
the Jobs for Veterans Act. This new law will reform veterans'
job training and placement programs in the Department of Labor
through a new system of incentives and accountability that:
Provides veterans and spouses of certain veterans
priority for the receipt of employment, training, and placement
services in federal job training programs;
Requires Federal contractors to take affirmative
action to employ and advance qualified veterans;
Authorizes a new program of financial performance
incentive awards to States to encourage the improvement and
modernization of employment, training and placement services
for veterans;
Changes the funding formulas for veterans' jobs
grants to States to reward States that perform well;
Requires poor performing States to implement
corrective action plans and provides technical assistance
grants to these States;
Establishes a system to measure the performance
of veterans jobs programs in States;
Requires each State to have minimum staffing
levels for Director for Veterans' Employment and Training
(DVET), Disabled Veterans Outreach Program Specialist (DVOPS),
and Local Veterans Employment Representatives (LVERs);
Establishes the President's National Hire
Veterans Committee to furnish information to employers on the
advantages afforded employers by hiring veterans; and
Requires a Comptroller General study on
effectiveness of implementation of these provisions not later
than six months after the conclusion of the program year that
begins during fiscal year 2004.
Oversight.--The Committee continued to play an aggressive
role overseeing the Department of Veterans Affairs, holding
hearings and using other congressional powers to ensure that VA
faithfully carries out its statutory mandates in conformity
with Congressional intent. During the 107th Congress, oversight
hearings were held to examine the Department's information
technology programs, VA research corporations, Medical Care
Collection Fund (MCCF), claims processing programs, the
Veterans Equitable Resource Allocation (VERA) formula,
Transition Assistance Programs (TAP), and women veterans'
programs.
The Committee also examined new revelations about Operation
SHAD and Project 112, secret chemical and biological warfare
experiments conducted by the Department of Defense during the
1960s with American servicemen. In addition, the Committee
pressed the VA to quickly implement the new laws approved
during the 107th Congress, particularly Public Law 107-95, the
Homeless Veterans Comprehensive Assistance Act of 2001. The
Committee also pushed VA to fulfill its obligations for long-
term care to veterans as contained in Public Law 106-117, the
Veterans Millennium Health Care and Benefits Act.
The success of the Committee in the 107th Congress would
not have been possible without the support and participation of
Members and staff from both sides of the aisle. The Committee's
Ranking Minority Member was the Honorable Lane Evans of
Illinois, and I want to thank him for his commitment to working
in a bipartisan manner, putting the interests of veterans
first. I want to thank the Subcommittee Chairmen and Ranking
Members for their hard work on behalf of veterans: the
Honorable Mike Simpson, Chairman, and the Honorable Silvestre
Reyes, Ranking Member, of the Subcommittee on Benefits; the
Honorable Jerry Moran, Chairman, and the Honorable Bob Filner,
Ranking Member, of the Subcommittee on Health; and the
Honorable Steve Buyer, Chairman, and the Honorable Julia
Carson, Ranking Member, of the Subcommittee on Oversight and
Investigations. I also want to thank the Honorable J.D.
Hayworth, who served as Chairman of the Benefits Subcommittee
at the beginning of the 107th Congress, as well as the
Honorable Mike Bilirakis, who served as Vice Chairman of the
full Committee throughout the 107th Congress.
This impressive legislative record achieved on behalf of
veterans would not have been possible without the cooperation
and contributions of the Senate Veterans' Affairs Committee,
and I wish to thank the Honorable John D. Rockefeller and the
Honorable Arlen Specter, who served as Chairman and Ranking
Member during parts of the 107th Congress, as well as their
professional staffs.
I want to thank the entire House Committee on Veterans'
Affairs staff, from both the majority and minority sides, for
all of the hard work, dedication, expertise and commitment they
have given to assist the Members of the Committee in fulfilling
our responsibilities.
Further, I want to thank the Honorable Bob Stump, Chairman
Emeritus of the Committee, who retires after serving in the
House of Representatives for 26 years, including six years as
Chairman of this Committee.
The Committee notes with sadness the passing of one of its
most distinguished members, the Honorable Floyd Spence, who
served on the Committee from 1991 until his death on August 16,
2001. Born and raised in South Carolina, Floyd Spence served
his country as a member of the United States Naval Reserve for
more than 40 years, including active duty service during the
Korean War. A Member of the House of Representatives for more
than 30 years, Floyd Spence was a leader on national security
issues and a strong supporter of our Nation's veterans. He also
served for six years as Chairman of the Committee on Armed
Services.
Finally, the Committee also notes with sadness the passing
of former Secretary of Veterans Affairs Jesse Brown, who served
as Secretary from 1993 through 1997. A decorated Marine Corps
veteran who was wounded in Vietnam in 1965, Jesse Brown spent
his professional career with the Disabled American Veterans,
serving as its executive director from 1989 to 1993, until his
confirmation as Secretary in 1993. He was recognized as a
tireless and effective advocate on behalf of veterans.
The 107th Congress faced grave new challenges and
responsibilities in order to enhance the security of our
Nation. As has always been the case when America's security is
in jeopardy, America's servicemen and women stepped forward.
The Committee on Veterans' Affairs also stepped forward to
ensure that the soldiers, sailors, airmen, and marines--who
will become our future veterans--receive the benefits and
services they deserve. Working together, in a bipartisan and
bicameral fashion, with our professional staffs and with the
advice and support of veterans service organizations, the
Committee on Veterans' Affairs achieved remarkable results in
the 107th Congress. For the men and women who have served, are
serving, and will serve in defense of our Nation, nothing less
would suffice.
Christopher H. Smith,
Chairman
C O N T E N T S
----------
Page
Jurisdiction of the House Committee on Veterans' Affairs......... 1
Veterans programs:Activities under jurisdiction of the
committee as administered by: deg.
Department of Veterans Affairs............................... 2
Veterans Health Administration........................... 2
Medical care......................................... 3
Medical and prosthetic research...................... 4
Veterans Benefits Administration......................... 4
Compensation and pension............................. 5
Insurance............................................ 5
Education............................................ 5
Home loan assistance................................. 5
National Cemetery Administration......................... 6
Department of Labor.......................................... 7
American Battle Monuments Commission......................... 7
Arlington National Cemetery.................................. 8
Legislation enacted into law:
Public Law 107-11............................................ 9
Public Law 107-14............................................ 9
Public Law 107-94............................................ 10
Public Law 107-95............................................ 11
Public Law 107-103........................................... 12
Public Law 107-135........................................... 18
Public Law 107-183........................................... 20
Public Law 107-184........................................... 20
Public Law 107--247.......................................... 20
Public Law 107--287.......................................... 21
Public Law 107--288.......................................... 22
Public Law 107--330.......................................... 26
Activities of the Committee...................................... 29
Activities of the subcommittees:
Subcommittee on Health....................................... 41
Subcommittee on Benefits..................................... 59
Subcommittee on Oversight and Investigations................. 70
Summary of action by the Committee on Veterans' Affairs.......... 78
Hearings and Executive Sessions.................................. 79
Committee web site............................................... 84
Oversight Plan for 107th Congress................................ 85
Subcommittee on Health....................................... 85
Subcommittee on Benefits..................................... 88
Subcommittee on Oversight and Investigations................. 89
Report on the budget proposed for fiscal year 2002............... 92
Report on the budget proposed for fiscal year 2003............... 112
Messages from the President and other Executive Branch
communications................................................. 129
Statistical data--war veterans and dependents.................... 140
Union Calendar No. 505
107th Congress Report
HOUSE OF REPRESENTATIVES
2d Session 107-804
======================================================================
ACTIVITIES OF THE COMMITTEE ON VETERANS' AFFAIRS FOR THE 107TH CONGRESS
_______
January 2, 2003--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Smith of New Jersey, for the Committee on Veterans' Affairs,
pursuant to Clause 1(d) of Rule XI, submitted the following
R E P O R T
Jurisdiction
Rule X of the Rules of the House of Representatives
establishes the standing committees of the House and their
jurisdiction. Under that rule, all bills, resolutions, and
other matters relating to the subjects within the jurisdiction
of any standing committee shall be referred to such committee.
Clause 1(r) of Rule X establishes the jurisdiction of the
Committee on Veterans' Affairs as follows:
(1) Veterans' measures generally.
(2) Cemeteries of the United States in which veterans
of any war or conflict are or may be buried, whether in
the United States or abroad (except cemeteries
administered by the Secretary of the Interior).
(3) Compensation, vocational rehabilitation, and
education of veterans.
(4) Life insurance issued by the Government on
account of service in the Armed Forces.
(5) Pensions of all wars of the United States,
general and special.
(6) Readjustment of servicemen to civil life.
(7) Soldiers' and sailors' civil relief.
(8)Veterans' hospitals, medical care, and treatment
of veterans.
The Committee on Veterans' Affairs was established January
2, 1947, as a part of the Legislative Reorganization Act of
1946 (60 Stat. 812), and was vested with jurisdiction formerly
exercised by the Committee on World War Veterans' Legislation,
Invalid Pensions, and Pensions. Jurisdiction over veterans'
cemeteries administered by the Department of Defense was
transferred from the Committee on Interior and Insular Affairs
on October 20, 1967, by H. Res. 241, 90th Congress. The
Committee during the 107th Congress had 31 members, 17 in the
majority and 14 in the minority.
VETERANS PROGRAMS
Department of Veterans Affairs
President Herbert Hoover issued an executive order on July
21, 1930, creating the Veterans Administration. At that time,
the Veterans Administration had 54 hospitals and 31,600
employees to serve 4.7 million veterans. President Ronald
Reagan signed legislation on October 25, 1988, creating the
Department of Veterans Affairs (VA), which assumed
responsibility from the Veterans Administration for the mission
of providing federal benefits to veterans and their dependents.
VA carries out its missions nationwide in three
administrations. The Veterans Health Administration (VHA) is
responsible for veterans' health care programs. The Veterans
Benefits Administration (VBA) is responsible for compensation,
pension, vocational rehabilitation, education assistance, home
loan guaranty and insurance programs. The National Cemetery
Administration (NCA) is responsible for the operation of 120
national cemeteries. The Board of Veterans' Appeals (BVA)
provides final decisions for the Secretary on appeals of
veterans benefits claims.
As of September 30, 2002, VA had 222,985 employees. Among
all the departments and agencies of the federal government,
only the Department of Defense has a larger work force. Of the
total number of VA employees, the Veterans Health
Administration has 200,700, the Veterans Benefits
Administration has 13,454, the National Cemetery Administration
has 1,492, and the Veterans Canteen Service has 3,178. The
remaining 4,161 employees are in staff offices including those
of the Inspector General, and acquisition and material
management. VA is a leading employer of veterans with about
26.2 percent of VA's employees being veterans. Since the
formation of the Department, the Secretaries of Veterans
Affairs have been: Honorable Edward J. Derwinski, 1989-1992;
Honorable Jesse Brown, 1993-1997; Honorable Togo D. West, Jr.,
1998-2000; and the current Secretary, Honorable Anthony J.
Principi.
The veteran population was approximately 25.6 million on
September 30, 2002. About 76 of every 100 veterans served
during defined periods of armed hostilities. Altogether,
approximately 70 million veterans, dependents and survivors of
deceased veterans--nearly one-fourth of the nation's
population--are potentially eligible for VA benefits and
services.
VETERANS HEALTH ADMINISTRATION
VA's largest and most visible component is the Veterans
Health Administration (VHA). It has 163 hospitals, with at
least one in each of the 48 contiguous states, Puerto Rico, and
the District of Columbia, and with small VA inpatient bed
complements in Alaska and Hawaii at military treatment
facilities. VHA is divided into 21 Veterans Integrated Service
Networks (VISNs) that provide its basic management structure.
VHA is headed by the Under Secretary for Health, who is
appointed by the President for a four-year term.
In addition to its 163 hospitals, VA operates 743
community-based outpatient clinics, 137 nursing homes and 43
domiciliary homes.
Medical Care
In 2001, with about 22,000 average operating acute hospital
beds VA treated 642,217 inpatients, 87,232 veterans in nursing
home care units or in community nursing facilities at VA
expense, and 23,205 veterans in home care and other community-
based health programs sponsored by VA. The Department's
outpatient clinics registered over 43 million visits by
veterans in 2001. Altogether, 3.89 million veterans received
care under VA auspices in 2001.
Across the nation, VA is currently affiliated with 107
medical schools, 55 dental schools, and over 1,000 other
schools offering students allied and associated education
degrees or certificates in 40 health profession disciplines.
More than one-half of all practicing physicians in the United
States received at least part of their clinical educational
experiences in the VA health care system. In 2001,
approximately 81,000 health care professionals received
training in VA medical centers. The Department is the largest
employer of registered nurses in the United States, with 36,721
nurses on its rolls as of September 30, 2002.
In 1979, VA through its Readjustment Counseling Service
began operating community-based Outreach Centers (``Vet
Centers'') to provide readjustment counseling to Vietnam-era
veterans. Following the Gulf War, Congress extended eligibility
for Vet Center services to Gulf War veterans and to veterans
who served during other periods of U.S. armed forces
deployments subsequent to Viet Nam, including military
deployments in Lebanon, Grenada, Panama, Somalia, Bosnia and
Kosovo. Public Law 104-262, the Eligibility Reform Act of 1996,
expanded eligibility for readjustment counseling to combat
veterans of conflicts prior to Viet Nam. VA's 206 Vet Centers
accommodated over 900,000 visits in fiscal year 2002.
The Department conducts a variety of specialized programs
including compensated work therapy to provide disabled veterans
with job skills, training and rehabilitative residencies. Often
these programs assist homeless veterans. Both substance-use
disorder rehabilitation and PTSD outreach programs continue to
expand.
VA provides a unique range of services for homeless
veterans including outreach, case management, clinical care,
residential treatment and rehabilitation, care for serious
mental illnesses and substance-use disorder, and supported
housing. VA funding for specialized care for homeless seriously
mentally ill veterans increased by 44 percent between 1996 and
2001.
In operating its health care facilities, the Department
benefits from the contributions of time and energy of more than
111,000 volunteers from all walks of life. Many veterans
themselves and family members of veterans volunteer through
VA's Voluntary Service. Volunteers donate more than 13 million
hours of service each year to bring companionship, faith, hope
and comfort to hospitalized veterans and to the millions of
veterans who visit VA outpatient clinics.
Medical and Prosthetic Research
The Department conducts medical and prosthetic research
programs that focus on the special needs of veterans but that
have made important contributions to virtually every area of
medicine and health. VA's current areas of emphasis include
research into aging, chronic diseases, mental illnesses,
substance-use disorders, sensory losses, trauma-related
illnesses, rehabilitation, and health systems and services.
The Department's medical researchers have played key roles
in innovating and improving artificial limbs, curing
tuberculosis, and developing the cardiac pacemaker, the
computerized tomographic scanner and magnetic resonance imager.
The first kidney transplant in the United States was performed
at a VA medical center. VA researchers pioneered the first
successful drug treatments for high blood pressure and
schizophrenia. A VA researcher created a sensation in the
prosthetics field with introduction of the ``Seattle Foot,'' a
device that gives below-the-knee amputees an adaptive ability
to walk, run and even jump, greatly improving the quality of
life of tens of thousands of veterans and non-veterans alike.
VA contributions to medical knowledge have won VA scientists
many prestigious awards, including six Lasker Awards and three
Nobel Prizes.
VA researchers conducted the largest prevalence study ever
of amyotrophic lateral sclerosis (Lou Gehrig's disease).
Focusing on 2.8 million Persian Gulf War era veterans,
researchers discovered that deployed veterans had almost twice
the risk of acquiring this rare, fatal disease. Two other
studies tested the effectiveness of treatments for fatigue,
muscle and joint pain, and memory and thinking problems
reported by some Persian Gulf War veterans. The researchers
found that exercise and/or cognitive behavior therapy can
improve the quality of life for veterans suffering from these
health problems.
VA scientists and colleagues have identified a synthetic
compound that reverses bone loss in mice without affecting the
reproductive system, unlike conventional hormone replacement
therapy. The finding may lead to new treatments to prevent
osteoporosis for millions of women and men and lead to safer
alternatives to hormone treatments. Other advances by VA
scientists include the development of an oral drug to treat
smallpox, a significant discovery that may have important
implications for the war on terrorism; the discovery that
Hepatitis G helps the immune system fight HIV infection; and
the identification of an appetite-stimulating hormone.
VETERANS BENEFITS ADMINISTRATION
The Veterans Benefits Administration (VBA) is responsible
for administering and delivering benefits and services to
eligible veterans and certain survivors and dependents. VBA
operates 58 regional offices throughout the United States,
Puerto Rico, and the Republic of the Philippines. The regional
offices have been realigned into nine Service Delivery
Networks, which set goals, monitor performance, and share
responsibility for mission accomplishment within their
geographic area. VBA programs include disability compensation
and pension, education, life insurance, home loan guaranty, and
vocational rehabilitation and counseling. VBA is headed by the
Under Secretary for Benefits, who is appointed by the President
for a four-year term.
Compensation and Pension
More than 2.4 million veterans receive disability
compensation or pension payments from the VA. Some 313,540
individual widows, children and parents of deceased veterans
are paid survivor compensation or death pension benefits. VA
disability and death compensation and pension payments amounted
to more than $21 billion for fiscal year 2002.
Insurance
VA operates the seventh largest insurance program in the
United States. VA administers six life insurance programs under
which two million policies with a value of $20 billion remained
in force at the end of fiscal year 2002. In addition, VA
supervises the Servicemembers' Group Life Insurance and
Veterans' Group Life Insurance programs, which provide some
$728 billion in insurance coverage to approximately 2.8 million
members of the uniformed services and veterans, plus 3.1
million spouses and children. The 2002 GI life insurance
dividend will return almost $625 million to more than 1.8
million policyholders.
Education
Since 1944, when the first GI Bill became law, more than 20
million beneficiaries have participated in GI Bill education
and training programs. This includes 7.8 million World War II
veterans, 2.3 million Korean War veterans, 8.2 million post-
Korean and Vietnam era veterans, and active duty personnel.
Proportionally, Vietnam era veterans were the greatest
participants in GI Bill training. Approximately 76 percent of
those eligible took training, compared with 50.5 percent for
World War II veterans and 48.4 percent for Korean era veterans.
The All-Volunteer Force Educational Assistance Program provides
benefits for veterans, service personnel, and members of the
Selected Reserve who train under the Montgomery GI Bill (MGIB).
Approximately 56 percent of veterans eligible for the MGIB used
it through fiscal year 2001. Over 20,000 more claimants
received education benefits during fiscal year 2001 than during
fiscal year 2000. Almost 70 percent of the 421,000
beneficiaries who used VA education benefits during fiscal year
2001 qualified under the provisions of the MGIB. Reservists
accounted for nearly 20 percent of education benefit
recipients, and the Survivors' and Dependents' Educational
Assistance program for certain eligible dependents of veterans
accounted for almost 11 percent of recipients.
Home Loan Assistance
More than 16.8 million veterans and their dependents have
benefited from VA's loan guaranty program. From this program's
establishment as part of the original GI Bill in 1944 through
the end of fiscal year 2002, VA home loan guaranties totaled
more than $740 billion. In fiscal year 2002, VA guaranteed
317,000 loans valued at $40 billion. Since 1948, VA has
assisted 35,000 disabled veterans with grants for specially
adapted housing totaling more than $537 million.
NATIONAL CEMETERY ADMINISTRATION
VA assumed responsibility for the National Cemetery
Administration (NCA) in 1973. As of July 31, 2002, NCA
maintains almost 2.5 million gravesites at 120 national
cemeteries in 39 states and Puerto Rico. Of these, 61 have
available, unassigned gravesites for the burial of both
casketed and cremated remains; 26 will only accept cremated
remains and the remains of family members for interment in the
same gravesite as a previously deceased family member; and 33
are closed to new interments, but may accommodate family
members in the same gravesite as a previously deceased family
member. NCA also oversees 33 soldiers' lots, monument sites and
confederate cemeteries.
During the period of 1997 to 2000, VA opened five new
national cemeteries: Tahoma National Cemetery in the Seattle/
Tacoma, Washington area; Saratoga National Cemetery, near
Albany, New York; Abraham Lincoln National Cemetery near
Chicago, Illinois; Dallas-Ft. Worth National Cemetery to serve
veterans in north and central Texas; and Ohio Western Reserve
National Cemetery, near Cleveland, Ohio. The opening of five
new national cemeteries within four years is unprecedented
since the Civil War.
VA is continuing to actively pursue the development of new
cemeteries in those metropolitan areas that are presently not
served by a national cemetery: Atlanta, Georgia; Detroit,
Michigan; Fort Sill, Oklahoma; Miami, Florida; Pittsburgh,
Pennsylvania; and Sacramento, California. Interments in
national cemeteries are expected to increase from 82,700 in
fiscal year 2000 to more than 117,000 in 2008.
Since July 30, 1973, total acreage in NCA has increased
from 4,260 acres to 13,850 acres in fiscal year 2001. The
number of occupied graves maintained is projected to increase
from 2,380,500 in fiscal year 2000 to over 2,998,100 in 2008.
In fiscal year 2001, VA provided over 304,000 headstones and
markers to mark the graves of veterans buried in private, state
veterans, military/post, and national cemeteries. VA has
provided 7.7 million headstones and markers since 1973.
The Department of Veterans Affairs State Cemetery Grants
Program was established in 1978 to complement VA's National
Cemetery Administration. The program assists states in
providing gravesites for veterans in those areas where VA's
national cemeteries cannot fully satisfy their burial needs.
Grants may be used only for the purpose of establishing,
expanding, or improving veterans cemeteries that are owned and
operated by a state or U.S. territory.
During fiscal year 2002, the VA state grants program
awarded 14 new grants and five grant increases for a total of
$40.8 million. Since the program became active in 1980, it has
awarded 58 grants for the initial establishment of new state
cemeteries and 66 new grants for cemetery expansion or
improvements for a total of $148 million in grants. As of
November 1, 2002, 30 states and territories have been awarded
grants. There are 51 open state veterans cemeteries in 28
states and Guam, and 37 pending grant applications.
Department of Labor
VETERANS' EMPLOYMENT AND TRAINING
Congress has determined that our nation has a
responsibility to meet the employment and job training needs of
veterans. To accomplish those goals, the Veterans' Employment
and Training Service (VETS) of the Department of Labor provides
job services for veterans through grants to state employment
service agencies.
Chapter 41 of title 38, United States Code, governs the
administration of veterans' employment and training throughout
the states. This chapter pre-dates the Government Performance
and Results Act, the Workforce Investment Act of 1998, and
self-service through America's Job Bank and America's Talent
Bank, for example. On November 7, 2002, Congress amended this
chapter with the Jobs for Veterans Act, Public Law 107-288.
This law redesigns the veterans' employment and training
service delivery system based on four broad themes: results,
incentives, accountability, and flexibility. The Committee
believes that the Jobs for Veterans Act should help many more
veterans find good jobs, ensure fairness to states in grants,
give states greater flexibility to manage, and reward states
that do well, while making states accountable for results.
American Battle Monuments Commission
The American Battle Monuments Commission (ABMC), created by
an Act of Congress in 1923, is a federal agency responsible for
the construction and permanent maintenance of military
cemeteries and memorials on foreign soil, as well as certain
memorials in the United States. Its principal functions are to
commemorate, through the erection and maintenance of suitable
memorial shrines, the sacrifices and achievements of the
American armed forces where they have served since April 6,
1917; to design, construct, operate, and maintain permanent
American military burial grounds and memorials in foreign
countries; to control the design and construction on foreign
soil of U.S. military monuments and markers by other U.S.
citizens and organizations, both public and private; and to
encourage U.S. governmental agencies and private individuals
and organizations to maintain adequately the monuments and
markers erected by them on foreign soils.
In performance of these functions, ABMC administers,
operates and maintains 24 permanent American military cemetery
memorials and 22 monuments, memorials, markers and separate
chapels in fourteen foreign countries, the Commonwealth of the
Northern Mariana Islands, Gibraltar, and three memorials in the
United States. When directed by Congress, ABMC develops and
erects national military monuments in the United States, such
as the Korean War Veterans Memorial and the World War II
Memorial, which the Committee is pleased to note is expected to
be dedicated on Memorial Day, May 29, 2004. ABMC also provides
information and assistance, on request, to relatives and
friends of the war dead interred or commemorated at its
facilities.
Interred in the cemeteries are 124,918 U.S. war dead--750
from the Mexican War, 30,922 from World War I, and 93,246 from
World War II. Additionally, 6,010 American veterans and others
are interred in the Mexico City and Corozal cemeteries. The
Mexico City cemetery and those of the World Wars are closed to
future burials except for the remains of U.S. war dead yet to
be found in the battle areas of World Wars I and II. In
addition to burials at the cemeteries overseas, 94,132 U.S.
servicemembers of the World Wars, Korea, and Vietnam are
commemorated individually by name on the Tablets of the Missing
at cemetery memorials and at three memorials on U.S. soil.
Arlington National Cemetery
Arlington Mansion and 200 acres of ground immediately
surrounding it were designated as a military cemetery on June
15, 1864, by Secretary of War Edwin M. Stanton. With more than
260,000 people buried, Arlington National Cemetery has the
second-largest number of people buried of any national cemetery
in the United States. The cemetery conducts approximately 6,300
burials each year. In addition to in-ground burial, the
cemetery has a large columbarium for cremated remains. Four
courts are currently in use, each with 5,000 niches. Arlington
is the site of many non-funeral ceremonies, and approximately
3,000 such ceremonies are conducted each year. Arlington is
expected to continue to provide burials through the year 2060
with its recently approved capital investment plan.
More than four million people visit the cemetery annually,
many coming to pay final respects at graveside services, of
which nearly 125 are conducted each week. Veterans from all the
Nation's wars are buried in the cemetery, from the American
Revolution through the Persian Gulf War, Somalia and
Afghanistan. Also, more than 3,800 former slaves are buried
there. The Tomb of the Unknowns and the grave of President John
F. Kennedy are among the most visited sites at the cemetery.
Arlington National Cemetery is administered by the Department
of the Army.
LEGISLATION ENACTED INTO LAW
------
Public Law 107-11
Expediting Construction of the World War II Memorial
(H.R. 1696)
Removed additional delays in the construction of the World
War II Memorial.
May 28, 2002: Signed by the President, Public Law 107-11.
------
Public Law 107-14
Veterans' Survivor Benefits Improvements Act of 2001
(H.R. 801, AS AMENDED)
Title: To amend title 38, United States Code, to expand
eligibility for CHAMPVA, to provide for family coverage and
retroactive expansion of the increase in maximum benefits under
Servicemembers' Group Life Insurance, to make technical
amendments, and for other purposes.
Summary: H.R. 801, as amended:
1. LExpands health insurance under CHAMPVA for survivors of
veterans who die of a service-connected disability. CHAMPVA
beneficiaries who are Medicare-eligible would receive coverage
similar to the ``TRICARE for Life'' enhancements that Public
Law 106-398 provided for Department of Defense beneficiaries.
Future Medicare-eligible CHAMPVA beneficiaries would be
required to obtain Medicare Part B coverage as a pre-condition
to eligibility for this new benefit; coverage would be
automatic for CHAMPVA beneficiaries who are eligible for
Medicare on the date of enactment.
2. LExpands the Servicemembers' Group Life Insurance (SGLI)
program to include spouses and children. Spousal coverage could
not exceed $100,000; child coverage could not exceed $10,000.
Upon termination of SGLI, the spouse's policy could be
converted to a private life insurance policy.
3. LMakes the effective date of an increase from $200,000
to $250,000 in the maximum SGLI benefit provided for in Public
Law 106-419 retroactive to October 1, 2000, for a servicemember
who died in the performance of duty and had the maximum amount
of insurance in force.
4. LFor purposes of VA's outreach program, defines an
eligible dependent as the spouse, surviving spouse, child or
dependent parent of a servicemember/veteran. It would also
require VA to make eligible dependents aware of VA's services
through media and veterans publications.
Effective date: Date of enactment except the following
sections
Sec. 4: The first day of the first month that begins more
than 120 days after date of enactment.
Sec. 5: October 1, 2000, with respect to any member of the
uniformed services who died in the performance of
duty.
Sec. 7(a)(1): Shall take effect as if enacted on November
1, 2000.
Sec. 7(b): Shall take effect as if enacted on November 1,
2000.
Sec. 7(c): Shall take effect as if included in the
enactment of sec. 105 of the Veterans Benefits and
Health Care Improvement Act of 2000 (Public Law
106-419; 114 Stat. 1828).
Sec. 7(d): May 1, 2001.
Sec. 7(e): Shall take effect as if enacted on November 1,
2000.
Cost: The Congressional Budget Office estimates that H.R.
801, as amended, would make the survivors of certain veterans
eligible for medical insurance, and extend coverage under
Servicemembers' Group Life Insurance (SGLI). Neither measure
would affect pay-as-you-go scoring.
Legislative history:
Mar. 21, 2001: H.R. 801 ordered reported favorably amended by the
Committee on Veterans' Affairs.
Mar. 26, 2001: H.R. 801 reported amended by the Committee on
Veterans' Affairs. H. Rept. 107-27.
Mar. 27, 2001: Passed the House amended under suspension by vote of
417-0 (Roll No. 63).
Mar. 28, 2001: Referred to the Senate Committee on Veterans'
Affairs.
May 24, 2001: Senate Committee on Veterans' Affairs discharged by
unanimous consent.
May 24, 2001: Passed the Senate with an amendment and an amendment
to the title by unanimous consent.
May 24, 2001: House agreed to the Senate amendments under
suspension by voice vote.
June 5, 2001: Signed by the President, Public Law 107-14.
------
Public Law 107-94
Veterans' Compensation Rate Amendments of 2001
(H.R. 2540, AS AMENDED)
Summary: H.R. 2540, as amended, would:
Provide, effective December 1, 2001, a cost-of-living
adjustment to the rates of disability compensation for veterans
with service-connected disabilities and to the rates of
dependency and indemnity compensation for survivors of certain
service-connected disabled veterans. The percentage amount is
equal to the increase for benefits provided under the Social
Security Act (2.6 percent).
Legislative history:
July 24, 2001: H.R. 2540 reported amended by the Committee on
Veterans' Affairs. H. Rept. 107-156.
July 31, 2001: Passed the House amended under suspension by vote of
422-0 (Roll No. 301).
July 31, 2001: Referred to the Senate Committee on Veterans'
Affairs.
Nov. 15, 2001: Senate Committee on Veterans' Affairs discharged by
unanimous consent.
Nov. 15, 2001: Passed the Senate with an amendment and an amendment
to the Title by unanimous consent.
Dec. 11, 2001: House agreed to Senate amendments under suspension
by voice vote.
Dec. 21, 2001: Signed by the President, Public Law 107-94.
------
Public Law 107-95
Homeless Veterans Comprehensive Assistance Act of 2001
(H.R. 2716, AS AMENDED)
Title: An Act to amend title 38, United States Code, to
revise, improve, and consolidate provisions of law providing
benefits and services for homeless veterans.
Summary: H.R. 2716, as amended, will:
1. LProvide that this bill may be cited as the ``Homeless
Veterans Comprehensive Assistance Act of 2001''.
2. LEstablish a national goal to end chronic homelessness
among veterans and encourage all governmental and private
agencies to work together to achieve this goal.
3. LProvide a ``Sense of the Congress'' regarding the
needs of homeless veterans and the responsibility of federal
agencies in meeting those needs.
4. LConsolidate and improve laws relating to homeless
veterans into a new chapter of title 38, United States Code.
Include provisions to increase per diem payments up to the rate
paid to state home domiciliaries by community providers,
authorize appropriations for the Homeless Veterans'
Reintegration Program, coordinate outreach services among
agencies dealing with homeless individuals, and undertake an
outreach demonstration program within VA. Other provisions
authorize establishment of a grant program for homeless
veterans with special needs, limited dental care for veterans
using VA homeless programs, technical assistance to nonprofit
community based groups, and establish in law an Advisory
Committee on Homeless Veterans.
5. LEstablish evaluation centers for programs that serve
homeless populations and require annual program assessments to
be submitted to Congress.
6. LRequire a study of outcome effectiveness of grant
program for homeless veterans with special needs.
7. LRequire VA to develop a plan to provide veterans
access to mental health services, including substance abuse
treatment; and expand the comprehensive homeless services
program.
8. LRequire disabled veterans' outreach program
specialists and local veterans' employment representatives to
coordinate employment services with entities receiving
financial assistance under homeless veterans' reintegration
programs.
9. LEstablish priorities for homeless programs when VA
considers disposing of real property or entering into enhanced-
use lease arrangements.
10. LRequire an annual meeting of the Interagency Council
on Homeless.
11. LIncrease set-aside rental assistance vouchers for HUD
VA-Supported Housing Program.
Effective date: Date of Enactment.
Legislative history:
Oct. 10, 2001: H.R. 2716 ordered reported favorably with an
amendment in the nature of a substitute by the Committee on
Veterans' Affairs.
Oct. 16, 2001: H.R. 2716 reported amended by the Committee on
Veterans' Affairs. H. Rept. 107-241, Part I.
Oct. 16, 2001: House Committee on Financial Services discharged by
unanimous consent.
Oct. 16, 2001: Passed the House amended under suspension by voice
vote.
Oct. 17, 2001: Received in the Senate. Placed on Senate Legislative
Calendar under General Orders. Calendar No. 201.
Dec. 6, 2001: Passed the Senate with an amendment by unanimous
consent.
Dec. 11, 2001: House agreed to the Senate amendment under
suspension by voice vote.
Dec. 21, 2001: Signed by the President, Public Law 107-95.
------
Public Law 107-103
Veterans Education and Benefits Expansion Act of 2001
(H.R. 1291, AS AMENDED)
Title: An Act to amend title 38, United States Code, to
modify and improve authorities relating to education benefits,
compensation and pension benefits, housing benefits, burial
benefits, and vocational rehabilitation benefits for veterans,
to modify certain authorities relating to the United States
Court of Appeals for Veterans Claims, and for other purposes.
Summary: H.R. 1291, as amended, will:
Title I - Educational Assistance Provisions
1. LIncrease the amount of educational benefits under the
Montgomery GI Bill (MGIB) for an approved program of education
on a full-time basis from the current monthly rate of $672 for
an obligated period of active duty of three or more years to
$800 effective January 1, 2002; $900 effective October 1, 2002;
and $985 effective October 1, 2003.
2. LIncrease the amount of educational benefits under the
MGIB for an approved program of education on a full-time basis
from the current monthly rate of $546 for an obligated period
of active duty of two years to $650 effective January 1, 2002;
$732 effective October 1, 2002; and $800 effective October 1,
2003.
3. LSuspend the statutory annual adjustment in MGIB rates
based on the Consumer Price Index for fiscal years 2003 and
2004.
4. LIncrease the rates of Survivors' and Dependents'
Educational Assistance from $608 to $670 for full-time, $456 to
$503 for three-quarter-time, and $304 to $345 for half-time
studies.
5. LRestore educational assistance entitlement to
participants in VA-administered programs who have received
benefits for the pursuing courses they were unable to complete
because they were called to active duty or, in the case of
active-duty servicemembers, were relocated and/or assigned
duties that prevented them from completing their courses.
6. LExtend, in the case of a member of a Reserve component
who was called to active duty, the period during which the
person may use VA educational benefits by a period equal to the
length of their active service plus 4 months for chapters 31
and 35; and further provide that the Reservist is not to be
considered to have been separated from the Selected Reserve for
education purposes by reason of their active-duty service.
7. LAllow an accelerated payment of MGIB benefits of up to
60 percent for short-term, high cost training courses that lead
to employment in a high technology industry.
8. LAllow a Vietnam-era veteran to convert from Vietnam-
era GI Bill benefits to MGIB benefits if the veteran had
eligibility for the Vietnam-era GI Bill benefits as of December
31, 1989, was not on active duty on October 19, 1984, and
served three continuous years in the Armed Forces after July 2,
1985.
9. LIncrease from $2,000 to $3,400 the maximum allowable
annual award that an SROTC participant may receive and still be
eligible for benefits under MGIB.
10. LExpand for five years VA's work-study program for
veterans to include working in state veterans homes, VA
national cemeteries and state veterans cemeteries, and helping
State Approving Agencies with outreach efforts.
11. LReinstate a 10-year delimiting period in which spouses
may, upon first becoming eligible, use Dependents Educational
Assistance (DEA) benefits. Spouses made eligible for DEA under
more than one of the eligibility criteria would have two
delimiting periods in which to use their DEA benefits, without
an increase in the total 45-month entitlement period.
12. LInclude certain private technology entities (primarily
businesses) in the definition of educational institution so
that veterans enrolled in technical courses can qualify for VA
educational assistance benefits.
13. LPermit veterans to use VA educational assistance
benefits for a certificate program offered by an accredited
institution of higher learning by way of independent study.
Title II - Compensation and Pension Provisions
1. LRepeal the 30-year presumptive period for respiratory
cancers associated with exposure to herbicide agents. Direct
the Secretary to enter into contract with the National Academy
of Sciences to determine whether an upper time limit on
manifestations of respiratory cancers can be supported and
authorizes the Secretary to provide a time limit if warranted
by such studies. Protect the grant of service connection for
veterans provided benefits under this section.
2. LAdd Diabetes Mellitus (Type 2) to the list of diseases
presumed to be service-connected in Vietnam veterans exposed to
herbicide agents.
3. LPresume that veterans who served in the Republic of
Vietnam during the time when herbicides were used were exposed
to herbicides.
4. LExtend the authority to presumed service-connection
for additional diseases to September 30, 2012.
5. LDirect VA to contract with National Academy of Science
(NAS) for continued review of scientific evidence on effects of
dioxin or herbicide exposure for 10 more years (five reports),
and extend the authority of the Secretary to presume service
connection for additional diseases based on future NAS reports
for 10 more years.
6. LExpand, effective March 1, 2002, the definition of
illnesses presumed service-connected for Gulf War veterans to
include a medically unexplained chronic multisymptom illness
such as chronic fatigue syndrome, fibromyalgia and irritable
bowel syndrome defined by a cluster of signs or symptoms. Signs
or symptoms that may be a manifestation of undiagnosed illness
or a chronic multisymptom illness would include fatigue,
unexplained rashes or other dermatological signs or symptoms,
headache, muscle pain, joint pain, neurological signs or
symptoms, neuropsychological signs or symptoms, signs or
symptoms involving the respiratory system (upper or lower),
sleep disturbances, gastrointestinal signs or symptoms,
cardiovascular signs or symptoms, abnormal weight loss, and/or
menstrual disorders.
7. LInclude a technical correction substituting a date
certain of October 1, 2010, for ``10 years after the last day
of the fiscal year in which the National Academy of Sciences
(NAS) submits the first report'' as written under current law
in section 1603(j) of the Persian Gulf War Veterans Act of
1998. Require the Secretary to contract with the NAS for five
additional biennial reports on Gulf War health issues. Clarify
that the authority of the Secretary to determine that a disease
warrants presumptive service-connection based on these NAS
reports continues until September 30, 2011.
8. LAuthorize the Secretary of Veterans Affairs to protect
the grant of service connection of a Persian Gulf War veteran
who participates in a Department of Veterans Affairs-sponsored
medical research project. In the case of a Gulf War veteran
being compensated for an undiagnosed illness, current law may
not protect the individual's service-connected grant if, as a
result of participating in a medical research study, the
condition is diagnosed.
9. LRepeal the limitation on assets for payment of
benefits to incompetent institutionalized veterans. Current law
prohibits payment of compensation and pension benefits to an
incompetent veteran with no dependents and assets exceeding
five times the 100 percent compensation rate, if the veteran is
being provided institutional health care by the government.
10. LExtend, in the computation of the monthly payments of
compensation and Dependency and Indemnity Compensation (DIC)
the requirement of rounding down the benefit paid to the next
lower whole dollar amount from fiscal year 2002 to fiscal year
2011.
11. LExpand the definition of permanent and total
disability for veterans applying for nonservice-connected
pension to include: (1) a patient in a nursing home for long-
term care because of disability, (2) a person disabled, as
determined by the Commissioner of Social Security for purposes
of benefits administered by the Commissioner, (3) a person
unemployable, as a result of disability reasonably certain to
continue throughout the life of the person, and (4) a person
suffering from any disability which is sufficient to render it
impossible for the average person to follow a substantially
gainful occupation, but only if it is reasonably certain that
such disability will continue throughout the life of the person
or otherwise justifying a determination of permanent and total
disability.
12. LProvide a non-service-connected pension to low-income
wartime veterans aged 65 and older without requiring a
determination of disability.
Title III - Transition and Outreach Provisions
1. LProvide VA the authority to operate transition
assistance offices overseas so as to furnish ``one-stop''
assistance to servicemembers in such areas prior to their
separation from military service.
2. LExtend the time that preseparation counseling is
available to servicemembers separating from service to as early
as 12 months before discharge, and 24 months prior to discharge
for military retirees.
3. LImprove education and training outreach services by
requiring each State Approving Agency to conduct outreach
programs and provide services to eligible veterans and
dependents for state and federal veterans' education and
training benefits.
4. LRequire VA to provide to the veteran or eligible
dependent general information concerning VA benefits and
services whenever that person first applies for any benefit.
Title IV - Housing Matters
1. LIncrease the home loan guaranty from $50,750 to
$60,000.
2. LExtend to December 31, 2005, VA's direct home loan
program for Native American veterans living on trust lands, and
eliminate the requirement for VA to have a separate memorandum
of understanding (MOU) with tribal authorities if another
federal agency has an MOU which substantially complies with
VA's requirement.
3. LModify the requirement for loan assumption language in
home loan documents.
4. LIncrease the grant for specially adapted housing for
severely disabled veterans from $43,000 to $48,000, and
increase the amount for less severely disabled veterans from
$8,250 to $9,250.
5. LExtend to September 30, 2009, the authority for housing
loan guaranties for members of the Selected Reserve; extend
VA's loan asset sale authority through December 31, 2011;
extend the VA's home loan fee authorities through October 1,
2011; extend the effectiveness of the procedures applicable to
liquidation sales on defaulted home loans guaranteed by the VA
through October 1, 2011.
Title V - Other Matters
1. LIncrease the burial and funeral expense benefit for a
service-connected veteran from $1,500 to $2,000, and increase
the burial plot allowance from $150 to $300.
2. LCreate a five-year program requiring the Secretary to
furnish a bronze marker to those families that request a
government marker for the marked grave of a veteran at a
private cemetery. The Secretary is required to furnish the
marker directly to the cemetery and the family is required to
place the marker on the veteran's gravesite. Not later then
February 1, 2006, the Secretary shall submit to the Committees
on Veterans' Affairs of the Senate and the House of
Representatives a report on the use of this five-year
authority.
3. LIncrease the automobile and adaptive equipment grant
for severely disabled veterans from $8,000 to $9,000.
4. LExtend to September 30, 2011, the limitation of VA
pension to $90 per month for certain veterans receiving
Medicaid-covered nursing home care.
5. LProhibit payment of veterans' benefits to fugitive
felons.
6. LLimit payment of compensation for veterans remaining
incarcerated for felonies since October 7, 1980. In 1980,
Congress enacted legislation to reduce compensation to
incarcerated veterans to the equivalent of the rate of
compensation paid for a 10 percent disability (or, if they only
receive ten percent, to the equivalent dollar amount of 5
percent). Veterans who were already incarcerated in 1980 were
not covered by this change in law.
7. LEliminate the requirement for veterans to furnish the
Secretary of Veterans Affairs with a copy of the notice of
appeal filed with the U.S. Court of Appeals for Veterans
Claims.
8. LIncrease the fiscal year limitation on the number of
veterans in programs of independent living services and
assistance from 500 to 2,500.
9. LTechnical and clerical amendments.
Title VI - United States Court of Appeals for Veterans Claims
1. LAllow two additional judges to be appointed, to allow
transition as the original judges retire, and temporarily
expand the membership of the U.S. Court of Appeals for Veterans
Claims from seven to nine until August 2005.
2. LRepeal the requirement that a judge provide written
notice regarding acceptance of reappointment, as a precondition
to retirement from the U.S. Court of Appeals for Veterans
Claims.
3. LEliminate the post-November 17, 1988, Notice of
Disagreement as a prerequisite to jurisdiction at the U.S.
Court of Appeals for Veterans Claims.
4. LAllow the U.S. Court of Appeals for Veterans Claims to
impose registration fees on persons participating in Court-
sponsored activities, including judicial conferences.
5. LProvide the U.S. Court of Appeals for Veterans Claims
with the authority to use practice and registration fees for
the purposes of disciplinary matters, and for defraying the
expenses of judicial conferences and other activities to
support and foster bench and bar relationships, veterans law or
the work of the Court.
6. LProvide the U.S. Court of Appeals for Veterans Claims
with the authority to proscribe administrative practices which
are consistent with those exercised by federal courts of
general jurisdiction.
Effective date: Date of enactment except the following
sections:
Sec. 101(a)(1)(A): January 1, 2002
Sec. 101(a)(1)(B): October 1, 2002
Sec. 101(a)(1)(C): October 1, 2003
Sec. 101(a)(2)(A): January 1, 2002
Sec. 101(a)(2)(B): October 1, 2002
Sec. 101(a)(2)(C): October 1, 2003
Sec. 102: January 1, 2002
Sec. 103: September 11, 2001
Sec. 104: October 1, 2002 with respect to enrollments in
courses or programs of education or training
beginning on or after that date
Sec. 106: Shall apply with respect to educational
assistance allowances paid for months beginning
after the date of enactment of this Act
Sec. 108: Applies to determinations made on or after date
of enactment
Sec. 110: Shall apply to enrollments in courses occurring
on or after date of enactment of this Act
Sec. 111: Shall apply to enrollments in courses occurring
on or after date of enactment of this Act
Sec. 201(a): January 1, 2002
Sec. 202: March 1, 2002
Sec. 203: VA medical research projects commenced before,
on, or after date on enactment
Sec. 206: September 17, 2001
Sec. 207: September 17, 2001
Sec. 501(a): September 11, 2001
Sec. 501(b): December 1, 2001
Sec. 502: Shall apply to individuals dying on or after date
of enactment
Sec. 505: Shall apply with respect to the payment of
compensation for months beginning on or after the
end of the 90-day period beginning on the date of
enactment
Sec. 506: Shall apply to the months beginning 90 days after
date of enactment
Sec. 508: September 30, 2001
Sec. 603: Shall apply to appeals filed on or after date of
enactment or filed before date of enactment for
which the decision is not final as of date of
enactment
Legislative history:
June 19, 2001: Passed the House under suspension by vote of 416-0,
1 Present (Roll No. 166).
June 20, 2001: Referred to the Senate Committee on Veterans'
Affairs.
Dec. 7, 2001: Senate Committee on Veterans' Affairs discharged by
unanimous consent.
Dec. 7, 2001: Senate struck all after the enacting clause and
substituted the language of S. 1088 amended.
Dec. 7, 2001: Passed the Senate in lieu of S. 1088 with an
amendment by unanimous consent.
Dec. 11, 2001: House agreed to Senate amendments with an amendment
pursuant to H. Res. 310. (Note: Consists of certain
provisions from H.R. 801, H.R. 2540, H.R. 3240, and S.
1088. Also, H. Res. 310 agreed to by the House under
suspension by voice vote.)
Dec. 13, 2001: Senate agreed to House amendment to Senate
amendments by unanimous consent.
Dec. 27, 2001: Signed by the President, Public Law 107-103.
------
Public Law 107-135
Department of Veterans Affairs Health Care Programs Enhancement Act of
2001
(H.R. 3447)
Title: To amend title 38, United States Code, to enhance
the authority of the Secretary of Veterans Affairs to recruit
and retain qualified nurses for the Veterans Health
Administration, to provide an additional basis for establishing
the inability of veterans to defray expenses of necessary
medical care, to enhance certain health care programs of the
Department of Veterans Affairs, and for other purposes.
Mr. Smith of New Jersey (for himself, Mr. Evans, Mr. Moran
of Kansas, and Mr. Filner) introduced H.R. 3447 on December 11,
2001.
Summary: H.R. 3447 will:
1. LEnhance eligibility and benefits for the Employee
Incentive Scholarship and Education Debt Reduction Programs by
enabling VA nurses to pursue advanced degrees while continuing
to care for veterans, in order to improve recruitment and
retention of nurses within the VA health care system.
2. LMandate that VA provide Saturday premium pay to title
5/title 38 hybrid employees. Such hybrid-authority employees
include licensed vocational nurses, pharmacists, certified or
registered respiratory therapists, physical therapists, and
occupational therapists.
3. LRequire VA to develop a nationwide policy on staffing
standards to ensure that veterans are provided with safe and
high quality care, taking into consideration the numbers and
skill mix required of staff in specific health care settings.
Require a report on the use of mandatory overtime by licensed
nursing staff and nursing assistants in each VA health care
facility; include in report a description of the amount of
mandatory overtime used by facilities.
4. LChange reporting responsibility of the Director of the
Nursing Service to report to the Under Secretary for Health.
5. LRecompute annuities for part-time service performed by
certain health care professionals before April 7, 1986.
6. LEstablish a 12-member National Commission on VA
Nursing that would assess legislative and organizational policy
changes to enhance the recruitment and retention of nurses by
the Department and the future of the nursing profession within
the Department, and recommend legislative and organizational
policy changes to enhance the recruitment and retention of
nursing personnel in the Department.
7. LAuthorize service dogs to be provided by VA to a
veteran suffering from spinal cord injuries or dysfunction,
other diseases causing physical immobility, hearing loss or
other types of disabilities susceptible to improvement or
enhanced functioning in activities of daily living through
employment of a service dog.
8. LModify VA's system of determining nonservice-connected
veterans' ``ability to pay'' for VA health care services by
introducing (as an upper income bound contrasted with current
income limits) the ``Low Income Housing Limits'' employed by
the Department of Housing and Urban Development (HUD), used by
HUD to determine family income thresholds for housing
assistance. This index is adjusted for all Standard
Metropolitan Statistical Areas (SMSAs), and is updated
periodically by HUD to reflect economic changes within the
SMSAs. Would retain current-law means test national income
threshold, but reduce co-payments by 80 percent for near-poor
veterans who require acute VA hospital inpatient care.
9. LStrengthen the mandate for VA to maintain capacity in
specialized medical programs for veterans by requiring VA and
each of its Veterans Integrated Service Networks to maintain
the national capacity in certain specialized health care
programs for veterans (those with serious mental illness,
including substance use disorders, and spinal cord, brain
injured and blinded veterans; veterans who need prosthetics and
sensory aids); and extend capacity reporting requirement for 3
years.
10. LEstablish a program of chiropractic services in each
Veterans Integrated Service Network and require VA to provide
training and educational materials on chiropractic services to
VA health care providers. Authorize VA to employ chiropractors
as federal employees and obtain chiropractic services through
contracts; create a VA advisory committee on chiropractic
health care.
11. LRequire the Office of Research Compliance and
Assurance, which conducts oversight and compliance reviews of
VA research and development, be funded by the Medical Care
appropriation, rather than the Medical and Prosthetic Research
appropriation.
12. LAuthorize $28,300,000 for major medical facility
construction project at the Miami, Florida VA Medical Center.
13. LRequire Secretary of Veterans Affairs to assess all
special telephone services made available to veterans, such as
``help lines'' and ``hotlines.'' Assessment would include
geographical coverage, availability, utilization,
effectiveness, management, coordination, staffing, cost, and a
survey of veterans to measure effectiveness of these telephone
services and future needs. A report to Congress would be
required within 1 year of enactment.
4. LExtend expiring authorities for VA to collect proceeds
from veterans' health insurance policies for care provided for
non-service connected care.
15. LProvide authority for Secretary to study, and then if
determined feasible, obtain personal emergency-notification and
response systems for service-disabled veterans.
16. LExtend VA's authority to provide health care for those
who served in the Persian Gulf until December 31, 2002.
Effective date: Date of Enactment.
Cost: The Congressional Budget Offices estimates that two
provisions of H.R. 3447 would increase direct spending by $1
million in 2002, $8 million over the 2002-2006 period, and $24
million over the 2002-2011 period.
Legislative history:
Dec. 11, 2001: Passed the House under suspension by voice vote.
Dec. 12, 2002: Received in the Senate.
Dec. 20, 2001: Passed the Senate by unanimous consent.
Jan. 23, 2002: Signed by the President, Public Law 107-135.
------
Public Law 107-183
Naming the Bob Hope Veterans Chapel
(H.R. 4592)
Designated the Chapel located in the National Cemetery in
Los Angeles, California, as the ``Bob Hope Veterans Chapel''.
May 29, 2002: Signed by the President, Public Law 107-183.
------
Public Law 107-184
Naming the Robert J. Dole VA Medical and Regional Office Center
(H.R. 4608)
Named the VA Medical and Regional Office Center in Wichita,
Kansas, the ``Robert J. Dole Department of Veterans Affairs
Medical and Regional Office Center''.
May 29, 2002: Signed by the President, Public Law 107-184.
------
Public Law 107-247
Veterans' Compensation Cost-of-Living Adjustment Act of 2002
(H.R. 4085, AS AMENDED)
Title: An Act to increase, effective as of December 1,
2002, the rates of compensation for veterans with service-
connected disabilities and the rates of dependency and
indemnity compensation for the survivors of certain disabled
veterans.
H.R. 4085, as amended, will:
Provide, effective December 1, 2002, a cost-of-living
adjustment to the rates of disability compensation for veterans
with service-connected disabilities and to the rates of
dependency and indemnity compensation for survivors of certain
service-connected disabled veterans; the percentage amount
would be equal to the increase for benefits provided under the
Social Security Act (1.4 percent), which is calculated based
upon changes in the Consumer Price Index.
Effective date: Date of enactment except the following
sections:
Sec. 2: December 1, 2002.
Legislative history:
May 9, 2002: H.R. 4085 ordered reported amended favorably by the
Committee on Veterans' Affairs.
May 16, 2002: H.R. 4085 reported amended by the Committee on
Veterans' Affairs. H. Rept. 107-472.
May 20, 2002: Considered under suspension of the rules. At the
conclusion of debate, the Yeas and Nays were demanded and
ordered. Pursuant to the provisions of clause 8, rule XX,
the Chair announced that further proceedings on the motion
would be postponed.
May 21, 2002: Considered as unfinished business. On motion to
suspend the rules and pass the bill, as amended, agreed to
by the Yeas and Nays: 410-0 (Roll No. 185).
May 22, 2002: Referred to the Senate Committee on Veterans'
Affairs.
Sep. 26, 2002: Passed the Senate with an amendment and an amendment
to the Title by unanimous consent.
Oct. 7, 2002: House agreed to the Senate amendments under
suspension by voice vote.
Oct. 23, 2002: Signed by the President, Public Law 107-247.
------
Public Law 107-287
Department of Veterans Affairs Emergency Preparedness Act of 2002
(H.R. 3253, AS AMENDED)
Title: To amend title 38, United States Code, to enhance
emergency preparedness of the Department of Veterans Affairs,
and for other purposes.
Summary: H.R. 3253, as amended, will:
1. LDirect the Department of Veterans Affairs to establish
four National Medical Emergency Preparedness Centers at VA
medical centers to: conduct bio-medical research on, and
develop health care responses for, chemical, biological,
radiological, incendiary or other explosive weapons that
threaten the public health and safety; provide related
education, training, and advice to VA and community health care
professionals either through the National Disaster Medical
System or interagency agreements; and, provide rapid response
laboratory, epidemiological, medical or other assistance to
Federal, State or local health care and law enforcement
authorities in the event of a national disaster or emergency,
or as necessary to protect the public safety and prevent
biological, chemical or radiological threats.
2. LRequire the centers to coordinate with health
professions and public health schools in bio-terrorism related
education and training of health care professionals.
3. LAuthorize $100 million over 5 years to fund the new
centers and allow each center to seek additional research funds
from public and private sources.
4. LRequire the Secretary to select the sites for each
center competitively based upon certain qualifying criteria and
ensuring the centers are geographically dispersed throughout
the United States.
5. LRequire the Secretaries of VA and Defense to carry out
a joint program to develop and disseminate a series of model
education and training programs on the medical responses to the
consequences of terrorist activities.
6. LRequire the Secretary of VA to disseminate training
programs and research findings to health professions students,
graduate medical education trainees, and active health
practitioners in coordination with other Federal departments
and agencies.
7. LAuthorize a new assistant secretary in the Department
of Veterans Affairs. This assistant secretary will coordinate
Department-wide operations, preparedness, security and law
enforcement functions.
8. LAuthorize an increase in the number of deputy
assistant secretaries from 18 to 19.
9. LAuthorize VA to furnish hospital care and medical
services to individuals responding to, involved in, or
otherwise affected by a major disaster or emergency, including
members of the Armed Forces on active duty.
10. LAuthorize VA to negotiate with other Federal entities
to collect the cost of providing care or services and retain
such collections in the event of a major disaster or emergency.
Effective date: Date of enactment
Cost: The Congressional Budget Office estimates the cost of
H.R. 3253, as amended, to be $12 million in 2003 and $87
million over the 2003-2007 period, assuming appropriation of
the authorized amounts. Because the bill does not affect direct
spending or receipts, pay-as-you-go procedures do not apply.
Legislative history:
May 9, 2002: H.R. 3253 ordered reported amended favorably by the
Committee on Veterans' Affairs.
May 16, 2002: H.R. 3253 reported amended by the Committee on
Veterans' Affairs. H. Rept. 107-471.
May 20, 2002: Considered under suspension of the rules. At the
conclusion of debate, the Yeas and Nays were demanded and
ordered. Pursuant to the provisions of clause 8, rule XX,
the Chair announced that further proceedings on the motion
would be postponed.
May 21, 2002: Considered as unfinished business. On motion to
suspend the rules and pass the bill, as amended, agreed to
by the voice vote.
May 21, 2002: Referred to the Senate Committee on Veterans'
Affairs.
August 1, 2002: Senate Committee on Veterans' Affairs discharged by
unanimous consent.
August 1, 2002: Passed the Senate with an amendment and an
amendment to the Title by unanimous consent.
Sep. 17, 2002: House agreed to Senate amendments with an amendment
pursuant to H. Res. 526.
Sep. 18, 2002: Message on House action received in Senate and at
desk: House amendment to Senate amendments.
Oct. 15, 2002: Senate concurred in House amendments with an
amendment by unanimous consent.
Oct. 16, 2002: The Majority Leader asked unanimous consent that the
House agree to the Senate amendment to the House amendment
to the Senate amendments.
Oct. 16, 2002: On motion that the House agree to the Senate
amendment to the House amendment to the Senate amendments.
Agreed to without objection.
Nov. 7, 2002: Signed by the President, Public Law 107-287.
------
Public Law 107-288
Jobs For Veterans Act
(H.R. 4015, AS AMENDED)
Title: To amend title 38, United States Code, to revise and
improve employment, training, and placement services furnished
to veterans, and for other purposes.
Summary: H.R. 4015, as amended, will:
1. LProvide priority of service to veterans and spouses of
certain veterans for the receipt of employment, training, and
placement services in any job training program directly funded,
in whole or in part, by the Department of Labor,
notwithstanding any other provision of law.
2. LProvide, with respect to Federal contracts and
subcontracts in the amount of $100,000 or more, that the
contractor and any subcontractor take affirmative action to
employ and advance qualified veterans in employment, including
immediately listing employment openings for such contracts
through the appropriate employment delivery system.
3. LReplace the Veterans Readjustment Appointment
authority and its 10-year eligibility period with a Veterans
Recruitment Appointment authority and an unlimited eligibility
period. This provision also makes certain eligibility changes.
4. LRequire the Secretary to carry out a program of
financial and non-financial performance incentive awards to be
administered by the States to encourage the improvement and
modernization of employment, training and placement services
for veterans.
5. LMake the position of Deputy Assistant Secretary for
Veterans' Employment and Training (DASVET) a federal civil
service position; the individual appointed to this position
will be required to have at least five years of Federal civil
service employment in a management position or a comparable
position in the Armed Forces preceding appointment as DASVET.
6. LInclude, among the conditions for receipt of funding
by States, a requirement that a State submit an application for
a grant or contract describing the plan by which the State is
to furnish employment, training, and placement services.
7. LRevise the methods by which the Secretary furnishes
funds to a State. Require the Secretary to make funds available
for a fiscal year to each State in proportion to the number of
veterans seeking employment using such criteria as the
Secretary may establish in regulation, including civilian labor
force and unemployment data. The proportion of funding will
reflect the ratio of the total number of veterans seeking
employment in the State to the total number of veterans seeking
employment in all States.
8. LRequire that the Secretary phase in the funding
described by paragraph seven over a three fiscal year period
that begins on October 1, 2002.
9. LAuthorize the Secretary to establish minimum funding
levels and ``hold-harmless'' criteria in administering funding
to the States.
10. LRequire the Secretary to establish in regulations a
uniform national threshold entered-employment rate for a
program year by which determinations of deficiency in program
performance may be made. The Secretary will be required to take
into account the applicable annual unemployment data for the
State and consider other factors, such as prevailing economic
conditions, that affect performance of individuals providing
employment, training, and placement services in the State.
11. LRequire that when a State has an entered-employment
rate that the Secretary determines was deficient for the
preceding year, the State must develop and implement a
corrective action plan that is submitted to and approved by the
Secretary.
12. LRequire the Secretary to establish a technical
assistance program to assist States that have or may have a
deficient entered-employment rate.
13. LGive the Secretary authority to determine the duties
of the Regional Administrator for Veterans' Employment and
Training.
14. LRequire the Assistant Secretary of Labor for Veterans'
Employment and Training to establish and implement a
comprehensive accountability system to measure the performance
of delivery systems in a State. Require such standards and
measures to be (1) consistent with State performance measures
applicable under section 136(b) of the Workforce Investment Act
of 1998, and (2) appropriately weighted to provide special
consideration for placement of veterans who require intensive
services, or who enroll in readjustment counseling services
furnished by the Department of Veterans Affairs.
15. LRequire the Secretary to assign to each State a
representative of the Veterans' Employment and Training Service
(VETS) to serve as the Director for Veterans' Employment and
Training (DVET) and full-time Federal clerical or other support
personnel to each Director; authorize the Secretary to assign
other supervisory personnel as the Secretary determines
appropriate.
16. LRequire, subject to approval by the Secretary, that
States employ a sufficient number of full or part-time Disabled
Veterans Outreach Program Specialist (DVOPS) to carry out
intensive services to meet the employment needs of special
disabled veterans, other disabled veterans and other eligible
veterans. Require to the maximum extent practicable that such
employees be qualified veterans, with preference given to
qualified disabled veterans.
17. LRequire, subject to approval by the Secretary, that a
State employ such full and part-time Local Veterans Employment
Representatives (LVERs) as the State determines appropriate and
efficient to carry out employment, training and placement
services. (To the maximum extent practicable, such employees
would be qualified veterans or eligible persons.)
18. LAllow the Secretary to gain performance credit,
through the States, for assisting servicemembers in transition
to civilian careers.
19. LRequire the Secretary, within 18 months of enactment,
to enhance the delivery of services by providing ``one-stop''
services and assistance to covered persons electronically by
the Internet and by other electronic means.
20. LClarify the authority of the National Veterans'
Employment and Training Services Institute (NVETSI) to enter
into contracts or agreements with departments or agencies of
the United States or of a State, or with other organizations,
to carry out training in providing veterans' employment,
training, and placement services. Require that each annual
budget submission include a separate listing of the funding
requested for NVETSI.
21. LAuthorize $3 million to be appropriated to the
Secretary of Labor from the employment security administration
account in the Unemployment Trust Fund for each of fiscal years
2003 through 2005 to establish within the Department of Labor
the President's National Hire Veterans Committee. The Committee
would furnish information to employers on the training and
skills of veterans and disabled veterans, and on the advantages
afforded employers by hiring veterans.
22. LRequire a Comptroller General study on effectiveness
of implementation of provisions in this title not later than
six months after the conclusion of the program year that begins
during fiscal year 2004.
Effective date: Date of enactment except the following
sections:
Sec. 2(b): The amendments made by this section are
summarized in paragraph two above, and would apply
with respect to contracts entered into on or after
the first day of the first month that begins 12
months after the date of the enactment of this Act.
Sec 2(c): The amendments made by this section are
summarized in paragraph three above, and shall
apply to qualified covered veterans without regard
to any limitation relating to the date of the
veteran's last discharge or release from active
duty that may have otherwise applied under section
4214(b)(3) as in effect on the date before the date
of enactment of this Act.
Sec 4(a): The amendments made by this subsection are
summarized in paragraph five above, and shall take
effect on the date of enactment of this Act, and
apply for program and fiscal years under chapter 41
of title 38, United States Code, beginning on or
after such date.
Sec 4(b): The amendment made by this section are summarized
in paragraphs six and seven above, and shall take
affect on the date of enactment of this Act, and
apply to budget submissions for fiscal year 2004
and each subsequent fiscal year.
Sec. 5(d): The amendments made by paragraph (1) are
summarized in paragraphs 10 and 11 above, and shall
apply to reports for program years beginning on or
after July 1, 2003.
Legislative history:
May 9, 2002: H.R. 4015 ordered reported amended favorably by the
Committee on Veterans' Affairs.
May 20, 2002: H.R. 4015 reported amended favorably by the Committee
on Veterans' Affairs. H. Rept. 107-476.
May 20, 2002: Considered under suspension of the rules. At the
conclusion of debate, the Yeas and Nays were demanded and
ordered. Pursuant to the provisions of clause 8, rule XX,
the Chair announced that further proceedings on the motion
would be postponed.
May 21, 2002: Considered as unfinished business. On motion to
suspend the rules and pass the bill, as amended, agreed to
by the Yeas and Nays: 409-0 (Roll No. 184).
May 22, 2002: Referred to the Senate Committee on Veterans'
Affairs.
Oct. 15, 2002: Senate Committee on Veterans' Affairs discharged by
unanimous consent.
Oct. 15, 2002: Passed the Senate with an amendment by unanimous
consent.
Oct. 16, 2002: The Majority Leader asked unanimous consent that the
House agree to the Senate amendment.
Oct. 16, 2002: On motion that the House agree to the Senate
amendment. Agreed to without objection.
Nov. 7, 2002: Signed by the President, Public Law 107-288.
------
Public Law 107-330
Veterans Benefits Act of 2002
(S. 2237, AS AMENDED)
Title: An Act to amend title 38, United States Code, to
improve authorities of the Department of Veterans Affairs
relating to veterans' compensation, dependency and indemnity
compensation, and pension benefits, education benefits, housing
benefits, memorial affairs benefits, life insurance benefits,
and certain other benefits for veterans, to improve the
administration of benefits for veterans, to make improvements
in procedures relating to judicial review of veterans' claims
for benefits, and for other purposes.
Summary: S. 2237, as amended, would:
Title I - Compensation and Benefits Enhancements
1. LProvide that a surviving spouse, upon remarriage at age
55 or older, would retain eligibility for the Civilian Health
and Medical Program of the Department of Veterans Affairs
(CHAMPVA).
2. LProvide that women veterans who have suffered the
anatomical loss of 25 percent or more tissue from a single
breast or both breasts in combination (including loss by
mastectomy or partial mastectomy) or received radiation
treatment of breast tissue may be eligible for special monthly
compensation.
3. LAllow VA to consider partial non-service-connected
hearing loss in one ear when rating disability for veterans
with service-connected hearing loss, rated at 10 percent or
more, in the other ear.
4. LAuthorize VA to contract with the National Academy of
Sciences to review and assess hearing loss related to military
service.
Title II - Memorial Affairs
1. LProhibit the issuance of Presidential Memorial
Certificates, flags, and memorial headstones or grave markers
to veterans convicted or fleeing from prosecution of a State or
Federal capital crime.
2. LEliminate the requirement that the Secretary of
Veterans Affairs or the Secretary of the Army be notified of a
finding by the Attorney General or the appropriate State
official, in cases of persons who are found to have committed
capital crimes but who avoided conviction of the crime through
flight or death preceding prosecution.
3. LProvide that the Secretary of Veterans Affairs shall
furnish a government marker to those families who request one
for the marked grave of a veteran buried at a private cemetery,
who died on or after September 11, 2001 (Public Law 107-103
applied to veterans who died on or after December 27, 2001).
4. LAuthorize the Secretary of the Army to place in
Arlington National Cemetery a new memorial marker honoring
veterans who fought in the Battle of the Bulge during World War
II.
Title III - Other Matters
1. LIncrease funding for State approving agencies to $14
million in fiscal year 2003, $18 million in fiscal year 2004,
$18 million in fiscal year 2005, $19 million in fiscal year
2006, and $19 million in fiscal year 2007.
2. LAllow veterans over the age of 70 to continue coverage
under Veterans' Mortgage Life Insurance.
3. LAuthorize VA to guaranty hybrid adjustable rate
mortgages for a period of two years.
4. LIncrease the Medal of Honor special pension from $600
to $1,000 per month, beginning October 1, 2003. The pension
amount would be adjusted annually to maintain the value of the
pension in the face of the rising cost of living. The recipient
would receive a one-time, lump-sum payment in the amount of
special pension the recipient would have received between the
date of the act of valor and the date that the recipient's
pension actually commenced.
5. LProvide coverage under the provisions of the Soldiers'
and Sailors Civil Relief Act of 1940 to members of the National
Guard who are called to active service for more than 30
consecutive days under section 502(f) of title 32, United
States Code, to respond to a national emergency.
6. LExtend the authority of the Internal Revenue Service
(IRS) to furnish income information to VA from IRS records so
that VA might determine eligibility for VA needs-based pension,
parents dependency and indemnity compensation, and priority for
VA health-care services to September 30, 2008.
7. LIncrease the loan fee for assumptions for fiscal year
2003 from 0.50 percent to 1.0 percent.
Title IV - Judicial Matters
8. LMake jurisdictional and scope of review changes for the
Court of Appeals for Veterans Claims and for the Court of
Appeals for the Federal Circuit, and authorize payment of
reasonable fees under the Equal Access to Justice Act to
certain non-attorney practitioners before the Court.
Effective date: Date of enactment except the following
sections:
Sec. 101(b): 50 percent effective June 1, 2003
100 percent effective December 2007
Sec. 203: September 11, 2001
Sec. 301: October 1, 2002
Sec. 304(a) and (b): September 1, 2003
Sec. 308(c): December 28, 2001
Sec. 308(e): November 1, 2000
Legislative history:
April 24, 2002: Referred to the Senate Committee on Veterans'
Affairs.
June 6, 2002: Senate Committee on Veterans' Affairs. Ordered to be
reported with an amendment in the nature of a substitute
favorably.
August 1, 2002: Reported to the Senate with an amendment in the
nature of a substitute and an amendment to the Title, with
written report number 107-234.
Sep. 26, 2002: Passed the Senate with an amendment and an amendment
to the Title by unanimous consent.
Sep. 30, 2002: Received in the House.
Nov. 15, 2002: The Majority Leader asked unanimous consent that the
House agree with amendments to the Senate bill. Agreed to
without objection. (Note: Consists of certain provisions
from H.R. 2561, H.R. 3423, H.R. 4085, H.R. 4940, and H.R.
5055.)
Nov. 18, 2002: Senate concurred in the House amendments to the
Senate bill by unanimous consent.
Dec. 6, 2002: Signed by the President, Public Law 107-330.
ACTIVITIES OF THE COMMITTEE
LEGISLATIVE ACTIVITIES
First Session
Hearing on H.R. 811, Veterans' Hospital Emergency Repair Act
On March 13, 2001, the Committee held a hearing on H.R.
811, the Veterans Hospital Emergency Repair Act. The Committee
received testimony from three panels of witnesses, including
the major veterans' organizations and two panels of witnesses
representing the Department of Veterans Affairs (VA). Witnesses
representing the veterans service organizations were: Mr.
Dennis Cullinan, Director, National Legislative Service, the
Veterans of Foreign Wars; Mr. Thomas Davies, A.I.A., Paralyzed
Veterans of America; Ms. Joy Ilem, Assistant National
Legislative Director, Disabled American Veterans; Mr. James
Fischl, Director, National Veterans Affairs and Rehabilitation
Commission, the American Legion; and Mr. Richard Jones,
National Legislative Director, AMVETS (American Veterans of
WWII, Korea and Vietnam).
The two VA panels were led by Honorable Thomas L.
Garthwaite, M.D., Under Secretary for Health, Veterans Health
Administration (VHA), accompanied by Dr. Frances M. Murphy,
Deputy Under Secretary for Health, VHA; Mr. D. Mark Catlett,
Acting Assistant Secretary for Management, Office of Financial
Management; and Mr. Charles Yarbrough, VHA Chief Facilities
Management Officer. VA's second panel consisted of VHA Veterans
Integrated Service Network (VISN) Directors, including Mr.
Lawrence A. Biro, Director, VISN 4 (Pennsylvania-Delaware); Dr.
Jeannette Chirico-Post, Director, VISN 1 (New England); Mr.
Kenneth Clark, Director, VISN 22 (Southern California-Nevada);
Ms. Patricia A. Crosetti, Director, VISN 15 (Missouri-Kansas);
Mr. James J. Farsetta, Director, VISN 3 (New Jersey-New York
City and lower Hudson Valley); and Robert L. Wiebe, M.D.,
Director, VISN 21(Northern California-Nevada).
H.R. 811 would have provided the Secretary of Veterans
Affairs a major medical facility construction authority for
fiscal years 2002 and 2003 for projects that cost less than $25
million each. Up to two projects could exceed this limitation
if the purpose was for urgent seismic correction. The bill
would have authorized $250 million in appropriations in fiscal
year 2002 and $300 million in fiscal year 2003.
This bill was introduced because the Committee identified
the need for Congress to address problems of substandard and
unsafe patient care infrastructure in some VA medical
facilities. Many older VA hospitals are deteriorating because
VA is encountering increasing difficulty in obtaining funding
to update, modernize and renovate patient care facilities for
veterans in need of care.
For the past two years, VA has engaged in an effort to
determine whether present VA health-care facility
infrastructures are meeting veterans' needs in the most
appropriate manner. This process, called ``Capital Assets
Realignment for Enhanced Services'' (CARES), may not achieve
its intended goals for at least several years. In the interim,
the Committee was concerned that a number of VA hospitals need
additional maintenance, repair and improvements to address
immediate dangers and hazards, promote patient and staff
safety, and maintain a reasonable standard of care for the
veterans.
After the introduction of this bill, VA provided the
Committee with a list of immediate construction needs in VA
medical centers that would be appropriate according to its
provisions, as follows:
----------------------------------------------------------------------------------------------------------------
Location Purpose Cost
----------------------------------------------------------------------------------------------------------------
Atlanta............................. Patient Wards Modernization................. $12.9 million
Cleveland........................... Special Emphasis Renovation................. $19.6 million
Miami............................... Energy Center Replacement................... $24.9 million
San Diego........................... Seismic Corrections......................... $35.6 million
VISN 6.............................. Special Emphasis Renovation................. $17.1 million
Augusta............................. Spinal Cord Injury Modernization............ $10.6 million
Boston.............................. Clinical Inpatient Improvements............. $25 million
Cleveland........................... Ambulatory Surgery Consolidation............ $19.9 million
Dallas.............................. Mental Health Improvements.................. $27.6 million
Palo Alto........................... Seismic Corrections......................... $26.6 million
Philadelphia........................ Research Renovation......................... $21.8 million
Pittsburgh.......................... Ambulatory Care Addition.................... $28.2 million
San Francisco....................... Seismic Corrections......................... $29.4 million
Syracuse............................ Clinical Expansion/MRI Addition............. $4.7 million
Tampa............................... Ambulatory Care Addition.................... $12 million
Washington.......................... Outpatient Clinic Expansion................. $20.8 million
West Haven.......................... Nursing Units Renovation.................... $14.3 million
Los Angeles......................... Seismic Corrections......................... $26.6 million
----------------------------------------------------------------------------------------------------------------
The Committee believes that numerous additional meritorious
projects could have been identified and approved under the
authority H.R. 811 would have provided.
Markup of H.R. 811
On March 21, 2001, the Committee met to markup H.R. 811,
the Veterans Hospital Emergency Repair Act. The bill was
approved unanimously by the Committee, which ordered the bill
reported favorably, as amended, to the House (see House Report
107-28). The House passed the bill by voice vote on March 27,
2001. However, the Senate did not act on it.
Hearing on H.R. 2716, the Homeless Veterans Assistance Act of
2001, and H.R. 936, the Heather French Henry Homeless Veterans
Assistance Act
On September 20, 2001, the Committee on Veterans' Affairs
held a hearing on homelessness among veterans, and received
testimony on H.R. 2716, the ``Homeless Veterans Assistance Act
of 2001'', introduced by the Committee's Chairman, Honorable
Christopher H. Smith, and other Members on August 2, 2001, and
another measure, H.R. 936, the ``Heather French Henry Homeless
Veterans Assistance Act of 2001'', introduced by the
Committee's Ranking Member, Honorable Lane Evans, and other
Members on March 8, 2001.
Those testifying at the hearing included: Dr. Frances M.
Murphy, Deputy Under Secretary for Health, VHA; Mr. Peter H.
Dougherty, Director, VA Homeless Veterans Program; Honorable
Roy A. Bernardi, Assistant Secretary for Community Planning &
Development, Department of Housing and Urban Development (HUD);
Mr. John B. Garrity, Director, Office of Special Needs
Assistance, HUD; Mrs. Heather French Henry, Miss America 2000;
Mr. John Kuhn, Chief, VA New Jersey Homeless Services; Ms.
Angela Gipson; Mr. Stuart Collick; Mr. Walter McConnell; Mr.
Carl Blake, Associate Legislative Director, Paralyzed Veterans
of America; Mr. Brian E. Lawrence, Associate National
Legislative Director, Disabled American Veterans; Ms.
Jacqueline Garrick, Deputy Director, Health Care, National
Veterans Affairs & Rehabilitation Commission, The American
Legion; Ms. Linda Boone, Executive Director, National Coalition
for Homeless Veterans; Mr. Theodore R. Jones, Chief Steward,
Local 1647, American Federation of Government Employees, AFL-
CIO; Mr. Len Selfon, Director, Veterans Benefits, Vietnam
Veterans of America; and Mr. Richard Schneider, Director,
State/Veterans Affairs, Non-Commissioned Officers Association.
The main objective of H.R. 2716 was to address homelessness
among the veteran population, innovative approaches at
prevention, expansion of current programs, and applications of
greater accountability for federally-funded programs. This bill
consolidated and improved laws relating to homeless veterans
into a new chapter 20 of title 38, United States Code.
In addition, this bill established priorities for homeless
programs when VA considers disposing of real property or
entering into enhanced-use lease arrangements, and set aside
rental assistance vouchers for The Department of Housing and
Urban Development's VA-Supported Housing Program.
H.R. 936 worked toward the goal of ending homelessness
within veterans in a decade. It increased per diem payments for
the care of homeless veterans by authorizing rates equal to
that of state home domiciliaries. Other provisions of the bill
authorized the establishment of a grant program for homeless
veterans with special needs, dental care for veterans using VA
homeless programs, technical assistance to nonprofit community
based groups, and an Advisory Committee on Homeless Veterans.
Each of the witnesses expressed strong overall support for
the bills.
Markup of H.R. 2716
On October 4, 2001, the Subcommittee on Health met and
unanimously favorably reported H.R. 2716, as amended, to the
full Committee. A number of the concepts of H.R. 936 were
included in H.R. 2716. On October 10, 2001, the full Committee
met and ordered H.R. 2716 reported favorably, as amended, to
the House by unanimous voice vote (see House Report 107-241,
Part I). On October 16, 2001, the House passed H.R. 2716, as
amended, by voice vote. On December 6, 2001, the Senate passed
the bill with an amendment by unanimous consent. Five days
later the House agreed by voice vote to accept the Senate
amendment, which was subsequently enacted into Public Law 107-
95, the Homeless Veterans Comprehensive Assistance Act of 2001,
on December 21, 2001 (see p. 11 for summary).
Hearing on H.R. 3423, to Enact into Law Eligibility of Certain
Veterans and Their Dependents for Burial in Arlington National
Cemetery
On December 13, 2001, the Committee held a hearing on H.R.
3423, which would have extended in-ground burial eligibility in
Arlington National Cemetery to members or former members of a
reserve component of the Armed Forces and their dependents, who
at the time of death were under 60 years of age and but for
age, would have been eligible for military retired pay under
title 10, United States Code. H.R. 3423 would also have
extended such eligibility to members of a reserve component of
the Armed Forces who die in the line of duty while on active
duty for training or inactive duty training, and their
dependents. Further, the bill would have authorized the
Secretary of the Army to construct and place a memorial at
Arlington National Cemetery honoring the victims of the acts of
terrorism perpetrated against the United States on September
11, 2001. Over the years, Congress has extended various
veterans' benefits to members of the reserve components (the
Reserve and National Guard) that were previously available only
to veterans who had served on active duty. Reservists play an
essential role in the total force concept of today's military;
the reserve components are responsible for providing many
critical skills and mission capabilities.
Mr. John Metzler, Superintendent, Arlington National
Cemetery, testified on behalf of the Administration.
Representatives of the veterans service organizations included
Mr. Bob Manhan, Veterans of Foreign Wars; Mr. Steven Garrett,
The Retired Enlisted Association; Mr. Richard Schneider, Non
Commissioned Officers Association; Mr. Bob Norton, The Retired
Officers Association; and Mr. Patrick Eddington, Vietnam
Veterans of America.
The Administration did not support codification of burial
eligibility criteria. The Administration disapproved expansion
of the burial eligibility because of current space limitations
at the cemetery and the possible denial of in ground burial to
other eligible veterans. The veterans service and military
organizations strongly supported the bill.
On December 13, 2001, the full Committee met and ordered
H.R. 3423 reported favorably, as amended, to the House by
unanimous voice vote (see House Report 107-346). On December
20, 2001, the House passed H.R. 3423, as amended, by voice
vote. However, the Senate did not act on the bill.
Second Session
Hearing on H.R. 4939, the Veterans Medicare Payment Act of 2002
On June 13, 2002, Chairman Smith introduced H.R. 4939, the
Veterans Medicare Payment Act of 2002, which would have amended
title 18 of the Social Security Act to provide for a transfer
of the Part B (Supplementary Medical Insurance) premium payment
from the Federal Supplementary Medical Insurance Trust Fund to
the Department of Veterans Affairs for outpatient care
furnished to Medicare-eligible veterans by the Department.
The bill would have allowed VA to begin receiving an annual
sum of money in 2003, equal to the Medicare Part B premium paid
by each veteran enrolled in Medicare Part B and also receiving
outpatient care from VA during that year. For 2002, the monthly
Medicare Part B premium was approximately $54 and would have
resulted in annual payments of approximately $650 for each
covered veteran. The bill would have allowed covered veterans
to choose both VA and non-VA health care providers to meet
their outpatient care needs.
The Committee held a legislative hearing on H.R. 4939, the
Veterans Medicare Payment Act of 2002, on July 13, 2002. The
principal witnesses were Honorable Robert H. Roswell, M.D.,
Under Secretary for Health, VHA, accompanied by Dr. Frances M.
Murphy, Acting Deputy Under Secretary for Health and Policy
Coordination, VHA, and Mr. Tim S. McClain, VA General Counsel;
Mr. Tom Grissom, Director, Center for Medicare Management at
the Centers for Medicare and Medicaid, Department of Health and
Human Services (HHS); Mr. Carl Blake, Associate Legislative
Director, Paralyzed Veterans of America; Mr. Paul A. Hayden,
Deputy Director, National Legislative Service, Veterans of
Foreign Wars; Mr. Steve Robertson, Director, National
Legislative Commission, The American Legion; Mr. Rick Weidman,
Director, Government Relations, Vietnam Veterans of America;
and Ms. Joy J. Ilem, Assistant National Legislative Director,
Disabled American Veterans.
Dr. Roswell testified that, although VA strongly supported
the concept of coordinating federal health care benefits to
enhance beneficiary care and maximize the use of federal funds,
the Administration was concerned that this transfer of federal
funds would significantly increase mandatory spending with no
identified offset; and that the additional income would likely
be offset against the appropriations, thus resulting in zero
net gain in additional resources for VA medical care. VA
pointed out the existence of the presidential task force
examining the coordination of health care delivery issues
between VA and the Department of Defense.
Mr. Tom Grissom, Director of the Center for Medicare
Management at the Centers for Medicare and Medicaid, HHS,
agreed in his testimony that beneficiaries eligible for both
Medicare and veterans health care benefits should enjoy a wide
range of choices and improved service, provided that any
changes to the Medicare program did not harm the financial
integrity of the Medicare Trust Funds.
In a second panel, testimony from five veterans service
organizations offered support for the intent of the bill and
suggested additional considerations regarding such issues as
service-disabled veterans, specialized care, TRICARE for Life-
compatible authority and mandatory funding for VA health care.
OVERSIGHT ACTIVITIES
First Session
Hearing on Proposed Fiscal Year 2002 Budgets for Veterans
Programs
On March 6, 2001, the Committee held a hearing on the
fiscal year 2002 budgets for veterans programs. The principal
witness for VA was Honorable Anthony J. Principi, Secretary of
Veterans Affairs. Representatives testifying on behalf of the
Independent Budget group were: Mr. Harley Thomas, Health Policy
Analyst, Paralyzed Veterans of America; Mr. David W. Gorman,
Executive Director, Disabled American Veterans; Mr. Howie
DeWolf, National Service Director, AMVETS; Mr. Frederico
Juarbe, Jr., Director, National Veterans Service, Veterans of
Foreign Wars. Also testifying were: Mr. James R. Fischl,
Veterans Affairs & Rehabilitation Commission, The American
Legion; Mr. Richard Weidman, Director, Government Relations,
Vietnam Veterans of America; and Mr. Mark Olanoff on behalf of
National Military Veterans Alliance.
The Administration submitted a broad budget outline without
detailing specific program funding levels. The President
requested over $51 billion for veterans' benefits and services,
with $28.1 billion for entitlement programs and $23.4 billion
for discretionary programs. This proposed budget amounted to a
discretionary funding increase of $1 billion or 4.5 percent
more than the fiscal year 2001 funding level.
The veteran service organization representatives presenting
the Independent Budget testified that the President's budget
was not adequate and at least a $1.3 billion increase in
discretionary funding was necessary to maintain the status quo.
In order to realize VA's stated goals for improving medical
care, the Independent Budget asked for an increase of at least
$2.7 billion.
The Committee recommended a fiscal year 2002 budget calling
for a $2.1 billion increase in discretionary spending for VA.
The Committee recommended increases of more than $1.525 billion
for VA medical care, including $141 million for mental health
programs, $100 million for higher pharmacy costs, $88 million
for long-term care, $75 million for staff to reduce waiting
times, $68 million for emergency care, $30 million for homeless
programs, $23 million for spinal cord injury programs a $1
billion inflationary adjustment.
The Committee also recommended a $130 million increase for
VBA, including $49.8 million for 830 full time employees to
help reduce a large claims backlog. In addition to the
recommended discretionary spending increases, the Committee
recommended $300 million in additional direct spending for
education and other benefits increases (see p. 92, Report on
the Budget Proposed for Fiscal Year 2002).
Hearing on VA's Ability to Respond to DOD Contingencies and
National Emergencies
On October 15, 2001, the Committee held a hearing to
examine VA's role in responding to Department of Defense
contingencies and national emergencies. Witnesses included: Ms.
Cynthia A. Bascetta, Director, Veterans' Health and Benefits
Issues, GAO; Honorable Anthony J. Principi, Secretary of
Veterans Affairs; Honorable Claude A. Allen, Deputy Secretary
of Health and Human Services; Dr. Sue Bailey, former Assistant
Secretary of Defense for Health Affairs; Mr. Kenneth S.
Kasprisin, Associate Director of the Readiness, Response and
Recovery Division, Federal Emergency Management Agency; Mr.
James Krueger, Executive Vice President for Chapter Services
Network, the American Red Cross; Ms. Annie W. Everett, Acting
Regional Administrator for the National Capitol Region, U.S.
General Services Administration; and Honorable David S. C. Chu,
Under Secretary of Defense for Personnel and Readiness.
Public Law 97-174, the ``Veterans' Administration and
Department of Defense Health Resource Sharing and Emergency
Operations Act,'' (section 8111A of title 38, United States
Code) states that VA is the principal medical care backup for
military health care ``during and immediately following a
period of war, or a period of national emergency declared by
the President or the Congress that involves the use of Armed
Forces in armed conflict.''
Under the VA/DOD Contingency Hospital System, DOD may use
available VA hospital beds for treatment of casualties. The Act
also provided for the establishment of a national database to
collect information about bed availability within VA to support
DOD needs. The terrorist attacks of September 11th necessitated
assessment of VA capabilities to provide health care to
casualties that could result from either military operations or
national emergencies.
The Committee examined a number of issues concerning VA's
statutory role, and whether its role should be enhanced. The
hearing also reviewed what impact the President's call up of
the Reserve Components would have on VA medical personnel and
its ability to provide patient care. Secretary Principi
provided a detailed account of the actions taken by VA in the
aftermath of the attacks, as well as VA's state of readiness to
respond to future events. The Committee also heard from a
number of federal agencies that work with VA in the Federal
Response Plan and the National Disaster Medical System. The
Committee questioned these agencies on both the effectiveness
of the assistance received from VA, and the potential for VA to
provide support in additional areas. VA and the agencies
present agreed that further cooperation would enhance the
Nation's ability to respond to future terrorist attacks.
Finally, the Committee requested assurance from Secretary
Principi that the VA clinical and research laboratories
authorized to receive and store potential biological agents,
chemical agents, radiological agents with potential use in
weapons of mass destruction were adequately secure, and that
individuals with access to those materials were of known
reliability. Secretary Principi responded with an investigation
of VA laboratories by the Office of the Inspector General (IG)
and subsequently addressed the IG's findings.
Hearing to Receive the Report of the VA Claims Processing Task
Force
On November 6, 2001, the Committee held a hearing to
receive the report of the VA Claims Processing Task Force.
Admiral Daniel Cooper (USN, Ret.), Chairman of the Task Force,
testified on behalf of the Task Force.
The Task Force was created by the Secretary of Veterans
Affairs in April 2001 to find ways to make adjudicating
applications for veterans benefits faster, easier, and more
accurate. The 10-person task force examined issues affecting
disability claims adjudication, including medical examinations,
information technology, and efforts to reduce the backlog and
increase the accuracy of decisions. The Task Force delivered
their final report to the Secretary on October 3, 2001.
Admiral Cooper outlined the Task Force's mission,
methodology, and recommendations. The Task Force made 34
recommendations: 20 short-term recommendations possible to
implement within six months, and 14 medium-term
recommendations. The recommendations of the Task Force fell
within the following general categories: freeing up direct
labor hours; eliminating the backlog; improving claims
timeliness; improving accountability; streamlining the
organization, management and process of adjudicating claims;
streamlining operations; improving the quality of decisions;
improving and streamlining compensation and pension medical
examinations; examining appeals and remands; and examining the
training procedures at the regional office level.
Second Session
Hearing on Proposed Fiscal Year 2003 Budgets for Veterans
Programs
On February 13, 2002, the Committee held a hearing on
proposed fiscal year 2003 budgets for veterans programs. The
principal witnesses for the government were Honorable Anthony
J. Principi, Secretary of Veterans Affairs, and Honorable
Frederico Juarbe, Jr., Assistant Secretary for Veterans'
Training and Employment, Department of Labor. Representatives
testifying on behalf of the Independent Budget group were: Mr.
Bob Jones, Executive Director, AMVETS, Mr. Richard B. Fuller,
National Legislative Director, Paralyzed Veterans of America,
Mr. Rick Surratt, Deputy National Legislative Director,
Disabled American Veterans, Mr. Dennis Cullinan, Director,
National Legislative Service, Veterans of Foreign Wars, and Mr.
Richard Jones, National Legislative Director, AMVETS. Also
testifying were Mr. James R. Fischl, Director, National
Veterans Affairs & Rehabilitation Commission, The American
Legion, and Mr. Rick Weidman, Director, Government Relations,
Vietnam Veterans of America.
On behalf of the Administration, Honorable Anthony J.
Principi presented a budget proposal of $58 billion for
veterans' benefits and services--$30.1 billion for entitlement
programs and $27.9 billion for discretionary programs. This
represented an increase of $6.1 billion over the 2002 enacted
level, with VA's discretionary funding receiving a $3.1 billion
increase over the 2002 level, including medical care
collections. Secretary Principi presented the budget as ``. . .
the largest increase ever proposed for veterans' discretionary
programs.'' Excluding certain new activities, VA's budget for
discretionary programs reflected an increase of $1.9 billion,
or 7.8 percent over the previous year's funding level.
VA's budget proposal included a ``demand initiative'' of
$1.8 billion in funding for new veterans expected to seek VA
health care in fiscal year 2003; $396 million to address health
care inflation for fiscal year 2003, and $317 million in
savings to be achieved through management improvements. The
budget request also included a legislative proposal that
Congress impose an annual health care deductible of $1,500 for
Priority 7 veterans.
For fiscal year 2003, the Independent Budget recommended a
medical care appropriation of $24.468 billion, representing an
increase of $3.1 billion over fiscal year 2002. This proposed
increase assumed no new initiatives or workload increases. The
veterans service organization representatives testifying on
behalf of the Independent Budget estimated the veterans budget
for fiscal year 2002 was inadequate by $1.5 billion. To address
this shortfall, and to provide for the current services
requirements of VA, the Independent Budget recommended a $3.1
billion increase.
The Committee recommended increasing spending on veterans'
health care by $3.2 billion to a level of $24.5 billion in the
fiscal year 2003 budget. The Committee proposed that VA health
care funding be increased more than $1.8 billion above the
Administration's budget request for fiscal year 2003, an
increase in health care and other discretionary spending of
more than $3.6 billion over fiscal year 2002 appropriations,
including almost $1 billion requested by the Administration to
cover increased payroll costs and medical inflation. In
addition, the major recommendations of the Committee for
increases above the budget proposal from the Administration
were: $1.1 billion to meet increased demand by Priority 7
veterans for health care; $300 million to make up a budget
shortfall from fiscal year 2002; $194 million for hospital
construction and renovation; $150 million for health care
enhancements, including long term care and services for
homeless veterans; and $200 million for emergency preparedness,
including medical backup for DOD and bio-terrorism response
(see p. 112, Report on the Budget Proposed for Fiscal Year
2003).
Hearing on Recommendations to Revise VA System of Health Care
Resource Allocation
On April 30, 2002, the Committee held a field hearing in
Trenton, New Jersey, on the status of recent recommendations to
revise the system VA uses to make resource allocations to its
health care facilities. The principal witnesses were Honorable
Robert H. Roswell, M.D., Under Secretary for Health, VHA; Mr.
Michael Slachta, Jr., VA Assistant Inspector General for
Auditing, accompanied by Mr. Stephen L. Gaskell, Director,
Office of Audit Central Office Operations Division; Ms. Cynthia
A. Bascetta, Director, Healthcare-Veterans' Health and Benefits
Issues, U.S. General Accounting Office (GAO), accompanied by
Dr. James C. Musselwhite, Assistant Director, Healthcare, GAO;
Mr. Michael H. Wysong, New Jersey Legislative Director,
Veterans of Foreign Wars, accompanied by Mr. Donald E.
Marshall, Jr., State Commander, Veterans of Foreign Wars; Mr.
Vincent S. Bevilacqua, Department Service Officer, Department
of New Jersey, The American Legion; Mr. Paul J. Tobin,
Associate Executive Director of Benefit Services, Eastern
Paralyzed Veterans Association; Mr. Daniel T. Flynn, Commander,
Department of New Jersey, Disabled American Veterans; and Mr.
Robert Maras, National Board of Directors, Vietnam Veterans of
America.
The Veterans Equitable Resource Allocation (VERA) formula
pursuant to Public Law 104-204 apportions federal funding for
veterans' health care to the 21 Veterans Integrated Service
Networks (VISNs) in the United States. This hearing focused on
GAO and VA Inspector General reports calling for significant
changes to the VERA formula.
First implemented in April 1997, the goal of the VERA
formula was to better align VA's limited health care resources
with the changing workloads at VA facilities across the
country. According to the GAO and the VA Inspector General
witnesses, however, their reports pointed out important
weaknesses with the current VERA formula.
The hearing testimony emphasized the dramatic increase in
demand by veterans for health care at VA. Prescription drug
costs have risen dramatically in the past several years, while
retirement income levels have remained fairly static. These
combined trends have generated demand for VA-provided
prescription drugs. At the same time, millions of veterans
continue to use VA as their primary care provider because of
the quality medical services available at increasingly
convenient locations.
VA agreed at the conclusion of the hearing to consider the
issues presented and to make appropriate modifications in the
fiscal year 2003 VERA cycle wherever possible.
Hearing on Department of Veterans Affairs Homeless Veterans
Programs
On September 12, 2002, the Committee held a hearing to
assess the implementation of Public Law 107-95, the Homeless
Veterans Comprehensive Assistance Act of 2001, (see p. 11 for
summary) and other matters dealing with assistance to homeless
veterans. This Act was signed into law on December 21, 2001,
and amended title 38, United States Code, by revising,
improving and consolidating provisions of law that provide
benefits and services to homeless veterans into a new Chapter
20.
The principal witnesses were Honorable Anthony J. Principi,
Secretary of Veterans Affairs, accompanied by Mr. Peter H.
Dougherty, Director, VA Homeless Veterans Programs, Office of
Public and Intergovernmental Affairs, Ms. M. Gay Koerber,
Associate Chief Consultant, Health Care for Homeless Veterans,
VHA, and Ms. Diane Fuller, Assistant Director, Veterans
Services Staff, Compensation and Pension Service, VBA; Mr.
Raymond Boland, Secretary, Wisconsin Department of Veterans'
Affairs; Mr. G. Allan Kingston, President/CEO, Century Housing
Corporation, Los Angeles, California; Mr. Robert Van Keuren,
Chairman, Advisory Committee on Homeless Veterans; Ms. Linda
Boone, Executive Director, National Coalition for Homeless
Veterans; Mr. Richard C. Schneider, Director, State/Veterans
Affairs, Non Commissioned Officers Association; Mr. Philip
Mangano, Executive Director, Interagency Council on
Homelessness; Mr. John Kuhn, Chief, New Jersey Homeless
Services, Department of Veterans Affairs; Mr. Carroll Thomas,
Chief Executive Officer of Middlesex County's Economic
Opportunity Corporation; Mr. Scott Gaines, Veteran, United
States Navy; Ms. Winter Otis, Veteran, United States Army; and.
Mr. Jerome McCoy, Veteran, United States Marine Corps. The
Committee also received statements for the record from Mr.
Richard Jones, National Legislative Director, AMVETS, and Ms.
Sandra A. Miller, Chair, Vietnam Veterans of America.
Public Law 107-95 improved the accountability of the three
federal departments most directly involved in homeless
assistance to veterans: VA, and the Departments of Labor (DOL),
and Housing and Urban Development (HUD). It provided $1 billion
in new authorities over the next five years, including:
increases in VA's grant and per diem program; new funds for the
Homeless Veterans Reintegration Program (HVRP) at DOL;
demonstration projects that deal with the most seriously
mentally ill homeless veterans; approaches for homeless
veterans with special needs, such as terminal illness, female
veterans with dependent children, veterans who are frail and
elderly; projects that focus on jailed or imprisoned veterans;
a supported-housing voucher program administered jointly by VA
and HUD; and technical assistance grants to community-based
provider organizations.
With the Homeless Veterans Comprehensive Assistance Act of
2001, Congress identified ending chronic homelessness among
veterans within a decade as a national goal. Honorable Anthony
J. Principi cautioned that, while the authorities provided in
this legislation will greatly assist in the effort to meet this
goal, it will also take significant resources to implement many
of the programs, which must be weighed against other VA health
care priorities. Secretary Principi elaborated on the progress
VA has made in the past nine months with a number of the
provisions included in Public Law 107-95, such as the creation,
charter and appointment of the Federal Advisory Committee on
Homelessness; revitalization of the Interagency Council on
Homelessness with HUD; partnerships with HUD, HHS, the
Departments of Justice, DOL, and Agriculture and the Internal
Revenue Service have been established on a variety of matters
to improve veterans' access to homeless prevention and related
services.
The Secretary testified that since authorized in 1992, the
Homeless Providers Grant and Per Diem Program has obligated $63
million to help develop 5,700 transitional housing beds and 17
independent service centers, and purchase 128 vans. These
projects are in 45 States and the District of Columbia. An
additional 1,200 beds in existing community-based programs for
the homeless have also received funding from VA.
Secretary Principi provided additional testimony on the
status of such provisions as outreach services to address the
needs of veterans at risk for homelessness (those being
released from institutions after inpatient psychiatric care,
substance abuse treatment, or imprisonment). These services
were being explored collaboratively between VA, DOJ, and DOL.
VA has established 35 Domiciliary Care for Homeless Veterans
(DCMV) programs with a total of 1,873 beds over the past 15
years, according to the Secretary.
In addition, HUD funded three rounds of Section 8 vouchers
of almost 600 vouchers each (a total of 1,753) for the HUD-VASH
(VA Supported Housing) program. The Secretary reported that a
rigorous experimental, three-year follow-up study found that
HUD-VASH veterans had 25 percent more nights housed than
veterans receiving standard VA care and had 36 percent fewer
nights of homelessness. Three years after entering the program,
80 percent of these veterans remained independently housed
through the program. Despite the demonstrated effectiveness and
existing authority for the program already existed, the
Committee was disappointed to learn that no additional
resources had been designated to issue new vouchers.
The slow forward movement in the Loan Guaranty for
Multifamily Housing for Homeless Veterans program is another
area of concern to the Committee. Secretary Principi pledged to
implement this program on a pilot basis, in three to five
locations, beginning in fiscal year 2004.
A major contribution to this hearing was the testimony of
three formerly homeless veterans, Mr. Scott Gaines, Ms. Winter
Otis, and Mr. Jerome McCoy, whose lives were positively
impacted by the programs authorized in Public Law 107-95.
Hearing to Review the Department of Veterans Affairs Report on
Veterans Burial Needs
On October 16, 2002, the Committee held a hearing on the
current and future burial needs of America's veterans.
Witnesses included: Dr. William Moore, Vice President for
Infrastructure Management, Logistics Management Institute; Mr.
Ronald Lind, Program Director, Organizational Improvement,
Logistics Management Institute; Mr. Donald Prettol, Research
Fellow, Logistics Management Institute; Mr. Vincent Barile, VA
Deputy Under Secretary for Memorial Affairs; Mr. Daniel Tucker,
Director, Office of Finance and Planning, NCA; and Mr. Richard
Jones, National Legislative Director, AMVETS, on behalf of the
Independent Budget.
Congress originally passed legislation in July of 1862
authorizing the President to purchase ``cemetery grounds to be
used as national cemeteries for soldiers who shall have died in
the service of the country.'' NCA had an operating budget of
$121 million for fiscal year 2002 with approximately 1,460 full
time employees. NCA provided more than 83,000 internments
annually. This figure represents an eight percent increase over
the number of burials in the previous year.
At the hearing, the Logistics Management Institute (LMI)
witnesses presented the Committee with a summary of its report,
``Study on Improvements to Veterans Cemeteries.'' The report
was mandated by section 613 of Public Law 106-117, the
Millennium Health Care and Benefits Act of 1999.
Two major issues concerning future burial needs were raised
at the hearing. The first issue was the appropriateness of the
75-mile area of service radius set by VA. The second was VA's
decision to build only three of 31 new cemeteries LMI
recommends will be needed by 2020. LMI examined the existing
conditions of each cemetery and recommended a set of standards
that NCA can use throughout its system. The standards of
appearance fell into two categories, maintenance and burial
operations. The standards were for headstones, turf and other
groundcover, horticulture, facilities, floral tributes,
neatness, personnel and security. LMI's overall assessment
identified the need for 928 projects totaling more than $279
million. There was a general consensus among Committee members
and witnesses that a set of national standards for cemetery
appearance should be established.
The State Cemetery Grants Program (SCGP) was also
discussed. The SCGP works with NCA to establish gravesites for
veterans where NCA cannot meet the burial needs of veterans.
The SCGP was established in 1978 to complement NCA. The program
assists states in providing gravesites for veterans in those
areas where VA's national cemeteries cannot meet the burial
needs of our veterans. VA has authority to provide up to 100
percent of the planning, design, and construction of an
approved new cemetery. In response to questioning, LMI stated
that it made no assumptions of additional state cemeteries
concerning its construction recommendations.
ACTIVITIES OF THE SUBCOMMITTEES
Subcommittee on Health
The Subcommittee on Health has legislative and oversight
jurisdiction over the Department of Veterans Affairs' health
care programs and the VA's health care delivery system (see p.
85 for Oversight Plan for 107th Congress).
LEGISLATIVE ACTIVITIES
First Session
Hearing on H.R. 2792, the Disabled Veterans Service Dog and
Health Care Improvement Act of 2001 and Related Legislative
Matters
On August 2, 2001, the Honorable Jerry Moran, Chairman of
the Subcommittee on Health, introduced H.R. 2792, the Disabled
Veterans Service Dog and Health Care Improvement Act of 2001.
The bill authorized VA to provide service dogs to disabled
veterans suffering from spinal cord injuries or dysfunction,
other diseases causing physical immobility, hearing loss or
other types of severe disabilities susceptible to improvement
or enhanced functioning in activities of daily living through
employment of a service dog. Also, the bill required a veteran
to be enrolled in VA care as a prerequisite to eligibility for
a service dog. The measure clarified that service dogs be
provided to veterans in accordance with existing priorities for
VA health care enrollment. H.R. 2792 strengthened the mandate
for VA to maintain capacity in specialized medical programs for
veterans by requiring each Veterans Integrated Service Network
(VISN) to maintain a proportional share of national capacity in
certain specialized health care programs. Those programs deal
with serious mental illness, including: substance use
disorders, opioid substitution programs; programs for ``dual
diagnosis'' patients; spinal cord, brain injured and blinded
veterans rehabilitation programs; and prosthetics and sensory
aids programs.
Further, the bill established a new chiropractic services
program in the Department, beginning with 30 medical centers,
with nationwide implementation over a five-year period. It
authorized chiropractors to be appointed as VA employees or
their services acquired through contract, and created an
advisory committee on chiropractic health care. It authorized
chiropractors to function as VA primary care providers, and
provided for a national director of chiropractic service
appointed with the same authority as other service directors in
the Department's headquarters.
On September 6, 2001, the Subcommittee held a legislative
hearing on H.R. 2792; and also on H.R. 1136, a bill to require
VA pharmacies to dispense medications to veterans for
prescriptions written by private practitioners; H.R. 1435, a
bill to award grants to provide for a national toll-free
hotline to provide information and assistance to veterans; and
H.R. 936, the Heather French Henry Homeless Veterans Assistance
Act.
The hearing witnesses were: Representative Lois Capps of
California; Representative Dave Weldon of Florida;
Representative Roger Wicker of Mississippi; Honorable Anthony
J. Principi, Secretary of Veterans Affairs; Dr. Frances Murphy,
Deputy Under Secretary for Health, Veterans Health
Administration (VHA); Mr. Richard Fuller, National Legislative
Director, Paralyzed Veterans of America; Ms. Joy Ilem,
Assistant National Legislative Director, Disabled American
Veterans; Mr. Thomas H. Miller, Executive Director, Blinded
Veterans Association; Ms. Jacqueline Garrick, Deputy Director,
American Legion; Mr. Richard Jones, National Legislative
Director, AMVETS; and, Ms. Beth Barkley, Vice President, A
Rinty for Kids, Inc., accompanied by several service dogs.
Witnesses supported a number of the proposals in the bills
before the Subcommittee; nevertheless, the Secretary expressed
concerns and reservations about a proposal in H.R. 2792 that
would authorize a VA-community coordination pilot demonstration
project. Also, the Secretary expressed concerns over the cost
of the bill relative to other priorities for Veterans Health
Administration.
Representative Weldon defended the VA-community
coordination proposal, which had its genesis in a single-site
demonstration in his Congressional district. Representative
Wicker urged the Subcommittee to give further consideration to
the concept of VA providing a prescription drug service to
veterans who are cared for in their communities by licensed
physicians and other caregivers licensed by state law to
prescribe drugs. Representative Capps recommended her concept
in H.R. 1435 of a toll-free hotline telephone service for
veterans in need of VA interventions, as a means to improve
coordination across VA programs, to stem homelessness, and
employed as a performance improvement tool for the Department.
Veterans organization witnesses generally supported many of
the provisions in H.R. 2792. However, most veteran service
organizations expressed significant concerns about the
coordinated-care demonstration pilot, in addition to concerns
about providing a prescription-only service, as presented in
H.R. 1136.
Subcommittee Markup of H.R. 2792
On October 4, 2001, the Subcommittee on Health met and
unanimously favorably reported H.R. 2792, as amended, to the
full Committee. The bill, as amended, incorporated a number of
proposals considered by the Subcommittee during the hearing on
September 6, 2001. On October 10, 2001, the full Committee met
and by voice vote ordered H.R. 2792, as amended, reported
favorably to the House (see House Report 107-242). On October
23, 2001, the House approved H.R. 2792, as amended.
Subsequently, the Chairman of the Senate Veterans' Affairs
Committee introduced S. 1188, a bill with a number of measures
identical to the House bill.
The House and Senate Committees on Veterans' Affairs
developed consensus legislation on these bills, subsequently
introduced on December 11, 2001, by the Chairman and Ranking
Member of the House Committee as a new bill, H.R. 3447, the
Department of Veterans Affairs Health Care Programs Enhancement
Act of 2001. The House passed H.R. 3447 on December 11, 2001
and the Senate passed it on December 20, 2001. The bill was
signed by the President on January 23, 2002, and became Public
Law 107-135 (see p. 18 for summary).
Second Session
Hearing on H.R. 3253, National Medical Emergency Preparedness
Act of 2001 and H.R. 3254, Medical Education for National
Defense in the 21st Century Act
On April 10, 2002, the Subcommittee on Health held a
hearing to consider the following bills: H.R. 3253, National
Medical Emergency Preparedness Act of 2001; and H.R. 3254, the
Medical Education for National Defense in the 21st Century Act.
The hearing witnesses were: Honorable Leo S. Mackay, Jr.,
Ph.D., Deputy Secretary of Veterans Affairs, accompanied by
Honorable Robert H. Roswell, M.D., Under Secretary for Health,
VHA, and Dr. Kristi Koenig, Director, Emergency Management
Strategic Healthcare Group, VHA; Dr. Kevin Yeskey, Director,
Bio-Terrorism Preparedness and Response Program, Centers for
Disease Control and Prevention, Department of Health and Human
Services; Dr. Deborah E. Powell, Executive Dean, University of
Kansas School of Medicine; and Dr. Stephen F. Wintermeyer,
Associate Professor of Clinical Medicine, Indiana University
School of Medicine.
Also, the Subcommittee received testimony from
representatives of veterans service organizations, including:
Ms. Joy J. Ilem, Assistant National Legislative Director,
Disabled American Veterans; Mr. Richard Jones, National
Legislative Director, AMVETS; Mr. Thomas H. Corey, National
President, Vietnam Veterans of America; Mr. James R. Fischl,
Director, National Veterans Affairs and Rehabilitation
Commission, The American Legion; Mr. Richard B. Fuller,
National Legislative Director, Paralyzed Veterans of America;
and Mr. Paul A. Hayden, Deputy Director, National Legislative
Service, Veterans of Foreign Wars.
As part of the response to the September 11th terrorist
attacks on the Nation, H.R. 3253 provided for at least four
geographically separated National Medical Emergency
Preparedness Centers. Each center would study remedies for the
health consequences that arise from human exposure to chemical,
biological, and nuclear substances that may be used as weapons
of mass destruction. The bill authorized $100 million over five
years to fund the new centers.
In addition to its medical care mission to care for
millions of veterans, the veteran's health care system is the
nation's largest provider of graduate medical education and is
a major contributor to biomedical and other scientific
research. Because of its widely dispersed, integrated health
care system, the Committee believes VA should be appropriately
utilized as a medical asset in responding to national, regional
and local emergencies. The VA has long been an integral part of
the Federal Response Plan, and an important local resource in
helping communities cope with natural disasters of recent
years. VA should be prepared to conduct research and develop
detection, diagnosis, prevention and treatment methods for
responding to emergencies, and should serve as a clearinghouse
to disseminate related information to other public and private
health care providers.
H.R. 3254, the Medical Education for National Defense in
the 21st Century Act, introduced Representative Steve Buyer of
Indiana on November 8, 2001, gave VA the responsibility to
establish a program to develop and disseminate model education
and training programs for medical responses to terrorist
activities. VA's national infrastructure, which allows
affiliations with over 107 medical schools and other schools of
the health professions, is ideal for preparing medical
professionals to be more knowledgeable and medically competent
in the treatment of casualties from terrorist attacks.
Testifying for the Department, Deputy Secretary Mackay
acknowledged that VA has the infrastructure and expertise to be
a vital and integral link in the nation's Homeland Security
efforts, with VA facilities in virtually every community across
the United States. VA has a robust research program and is
already actively engaged in numerous projects in the areas of
bio-terrorism and medical emergency preparedness. However, the
Deputy Secretary raised two major concerns with the proposed
legislation. The first concern centered on the President's
Homeland Security policy, which was pending at that time. The
Department asked the Committee to ensure that the provisions of
H.R. 3253 and H.R. 3254 were consistent with the comprehensive
federal plan for homeland security.
The second concern the Deputy Secretary presented in his
testimony focused on the inadequacy of the Department's budget
to implement an unfunded mandate of this scope. Deputy
Secretary Mackay testified that carrying out the proposed
activities of H.R. 3253 and H.R. 3254 without dedicated funding
could unacceptably diminish VA's ability to provide health care
and services to veterans and their families. This particular
concern was shared by Members of the Subcommittee and witnesses
alike.
Dr. Kevin Yeskey, testifying for the Centers for Disease
Control and Prevention (CDC), provided an overview of CDC's
activities to improve the nation's capability to prepare for
and respond to a bio-terrorist event, and asserted CDC's
commitment to working with other federal agencies and partners,
as well as state and local public health departments to ensure
the health and medical care of our citizens.
Dean Powell was extremely supportive of efforts to
strengthen the partnerships between the VA medical centers and
its affiliated health professional schools. These historical
partnerships are well-established and uniquely suited to meet
the challenges confronting the nation. Dean Powell pledged that
the University of Kansas would play whatever role was necessary
to assure the success of these initiatives. Dr. Wintermeyer, a
veteran with experience as a patient, medical student and
physician with VA, also supported the initiatives of H.R. 3253
and H.R. 3254, but emphasized the need to support VA with new
resources so that other valuable VA programs would not be
jeopardized or compromised.
In their statements for the record, the veterans service
organizations were largely supportive of both measures, but
stressed similar funding concerns and requested that these
operations receive earmarked appropriations.
Hearing on the Major Medical Facilities Construction
Authorization bill
On April 24, 2002, the Subcommittee on Health received
testimony on H.R. 4514, Veterans' Major Medical Facilities
Construction Act of 2002, and issues related to the
Department's major medical facilities construction policies and
planning. The hearing witnesses were: Mr. D. Mark Catlett, VA
Principal Deputy Assistant Secretary for Management;
accompanied by Mr. Robert L. Neary, Associate Chief Facilities
Management Officer, VHA, Mr. Gary Rossio, Chief Executive
Officer, VA San Diego Health Care System, and Mr. Alex Spector,
Director, Alaska VA Health Care System and Regional Office;
Colonel David D. Gilbreath, Commander, Elmendorf Air Force Base
Hospital; Mr. Antonio Laracuente, Chairman, National
Association of Veterans' Research and Education Foundations, on
behalf of Friends of VA Medical Care and Health Research
(FOVA); and Dr. Donald E. Wilson, Vice President for Medical
Affairs and Dean, University of Maryland School of Medicine.
The Subcommittee also received testimony from: Mr. Brian E.
Lawrence, Associate National Legislative Director, Disabled
American Veterans; Mr. Robert L. Jones, Executive Director,
AMVETS; Mr. Thomas H. Corey, National President, Vietnam
Veterans of America; Mr. Paul A. Hayden, Deputy Director,
National Legislative Service, Veterans of Foreign Wars; Mr.
Delatorro L. McNeal, Executive Director, Paralyzed Veterans of
America; and Mr. James R. Fischl, Director, National Veterans
Affairs and Rehabilitation Commission, The American Legion.
H.R. 4514 was a bill to authorize the Secretary of Veterans
Affairs to carry out construction projects for the purpose of
improving, renovating, and updating patient care facilities at
Department medical centers. The bill particularly addressed
seismic risks at a number of VA facilities and provided for
other capital improvements. Facilities that would have received
seismic upgrades and corrections, or seismic bracing and
anchorage of non-structural items included VA medical
facilities in Palo Alto, San Francisco, West Los Angeles, Long
Beach, and San Diego, California.
Another important project included in the bill was
replacement of the outdated mechanical and electrical systems
installed at the VA Medical Center in Cleveland, Ohio, in 1961.
They were installed in 1961 and are in dire need of attention.
An Anchorage, Alaska project also included in the bill would
have been construction of a consolidated Veterans Affairs-Air
Force health care and benefits facility to help address growing
workload and demands, and provide space for additional
personnel.
The bill also provided for a number of important
improvements for the VA Medical Center in West Haven,
Connecticut, including essential renovations to inpatient wards
to correct patient privacy inadequacies; consolidation of
support services; correction of deficiencies in air quality,
and compliance with Americans with Disabilities Act (ADA)
accessibility. The bill included a construction project for the
VA medical facility in Tampa, Florida, relocating three Spinal
Cord Injury (SCI) inpatient wards and ancillary support
functions to the new SCI building dedicated in February 2002.
The Department expressed specific support for four projects
proposed in the President's fiscal year 2003 budget submission.
The Department asserted that the four projects (seismic
corrections in two buildings in Palo Alto, one in San
Francisco, and one in West Los Angeles, California) would not
be affected by the ongoing Capital Asset Realignment for
Enhanced Services (CARES) initiative. These four major medical
construction projects were included among those identified in
H.R. 4514. The Committee was assured that as VA completes its
CARES initiative, identifies options to improve the health care
system and provides better access, infrastructure modifications
will lead to numerous construction project proposals for future
authorization and funding.
Veterans service organizations agreed that H.R. 4514 was
beneficial legislation for the Department and for veterans. In
their statements, each organization stated its appreciation of
the Committee's focus on renovating buildings in order to
create structurally sound and safe facilities for patients.
However, the Veterans of Foreign Wars agreed with VA's
testimony that the bill should be modified to allow the
Secretary to retain discretion in selecting minor construction
projects.
Markup of H.R. 3253 and H.R. 4514
On May 1, 2002, the Subcommittee on Health met to markup
H.R. 3253, the National Medical Emergency Preparedness Act of
2002, and H.R. 4514, the Veterans' Major Medical Facilities
Construction Act of 2002. The bills were unanimously favorably
reported by the Subcommittee, as amended, to the full
Committee. Amendments to H.R. 3253 included incorporation of
H.R. 3254, the Medical Education for National Defense in the
21st Century Act, and H.R. 4559, the Department of Veterans
Affairs Reorganization Act of 2002, introduced by Chairman
Smith, on April 24, 2002, at VA's request. Also, an amendment
to H.R. 4514 added an authorization for a capital lease for a
Charlotte, North Carolina, outpatient clinic relocation.
On May 9, 2002, the full Committee met and ordered H.R.
3253, as amended, and H.R. 4514, as amended, reported favorably
to the House by unanimous voice vote (see House Report 107-471
and House Report 107-473, respectively). The House passed H.R.
3253 on May 20, 2002, and H.R. 4514 on May 21, 2002.
The Chairman of the Senate Veterans' Affairs Committee
introduced a bill similar to H.R. 3253 on July 31, 2002.
Subsequently, the Senate passed H.R. 3253 with an amendment
containing the text of S. 2132. The two houses agreed on a
compromise measure. On September 17, 2002, the House passed H.
Res. 526, returning H.R. 3253 to the Senate. The Senate, on
October 16, 2002, passed H.R. 3253, with a further amendment.
On October 16, the House concurred in the amendment of the
Senate to the bill. The President approved H.R. 3253 as Public
Law 107-287 on November 7, 2002 (see p. 21 for summary).
However, the Senate did not act on H.R. 4514.
Hearing on H.R. 3645, Veterans Health Care Items Procurement
Reform and Improvement Act of 2002
On June 26, 2002, the Subcommittee on Health held a
legislative hearing to consider H.R. 3645, the Veterans Health
Care Items Procurement Reform and Improvement Act of 2002,
introduced by the Honorable Lane Evans, Ranking Member of the
Committee. This bill was intended to establish improved
procurement practices by requiring the purchase of health-care
and medical supply items by any element of the Department of
Veterans Affairs to be made through the use of a Federal Supply
Schedule (FSS) contract or a national contract that would meet
specified requirements, including the presence of pre-award and
post-award audit clauses, and a price reduction clause. The
bill would have allowed under limited circumstances the use of
other types of contracts. The bill also would have limited
emergency procurements of health-care items to quantities
necessary to respond to a particular emergency.
The hearing also considered certain management activities
of the Department of Veterans Affairs with respect to
procurement policies and practices. The Secretary of Veterans
Affairs commissioned a task force in 2001 to review and
evaluate VA's various procurement programs. The task force
report contained over 60 recommendations, and a number of
provisions of H.R. 3645 related to them. The bill also
contained a provision directing the Secretary to establish
annual goals for Department medical centers for the purchase of
health-care items using FSS and national contracts.
Hearing witnesses included: Mr. Mark Catlett, VA Principal
Deputy Assistant Secretary for Management, accompanied by Mr.
Gary Krump, VA Deputy Assistant Secretary for Acquisition and
Materiel Management, and Ms. Phillipa Anderson, VA Assistant
General Counsel; Ms. Cynthia A. Bascetta, Director, Health
Care-Veterans' Health and Benefits Issues, GAO; Mr. John S.
Bilobran, VA Deputy Assistant Inspector General for Auditing,
accompanied by Ms. Maureen T. Regan, Counselor to the VA
Inspector General. Written statements for the record were
received from Mr. Terry Baker, Executive Director of Veterans
Aimed Toward Awareness, Allied Health for Veterans Care; Mr.
David Gorman, Executive Director, Disabled American Veterans;
Mr. James B. King, Executive Director, AMVETS; Mr. Paul A.
Hayden, Deputy Director, National Legislative Service, Veterans
of Foreign Wars; Mr. John F. Sommer, Jr., Executive Director,
The American Legion; Mr. Richard B. Fuller, National
Legislative Director, Paralyzed Veterans of America; Mr.
Richard Weidman, Director of Government Relations, Vietnam
Veterans of America; and Mr. Thomas H. Miller, Executive
Director, Blinded Veterans Association.
Mr. Catlett reported that VA would not support the
enactment of H.R. 3645. The objections to the provisions of the
bill were that it was too restrictive and inflexible, and that
it limited the Secretary's existing authority to remedy the
problems already identified by the Department's procurement
task force. Mr. Catlett maintained that VA could accomplish the
Department's procurement goals by implementing the
recommendations of its procurement task force through the
establishment and implementation of Department policy.
Ms. Bascetta and Mr. Bilobran testified that additional
savings were achievable and necessary to conducting VA's
multimillion dollar contracting and procurement activities. Mr.
Bilobran cited specific examples that demonstrated multiple
opportunities for improvement and reform within the VA system.
Both GAO and the OIG supported enactment of H.R. 3645.
The veterans service organizations were in general support
of the intent of H.R. 3645, but raised a number of concerns
about the impact of the bill on VA's specialized medical
programs.
Markup of H.R. 3645
The Subcommittee on Health met on July 12, 2002, and
unanimously favorably reported H.R. 3645, as amended, to the
full Committee.
On July 16, 2002, the full Committee met and ordered H.R.
3645, as amended, reported favorably to the House by voice vote
(see House Report 107-600). The amended bill incorporated
provisions to authorize hospital and nursing home care, and
medical services to certain Filipino World War II veterans of
the Philippines Commonwealth Army and former Philippines ``New
Scouts'' who now permanently and legally reside in the United
States; to expand the eligibility for outpatient dental care
for all former prisoners of war; to strengthen auditing and
reporting requirements for VA research and education
corporations established at VA medical centers; to authorize
the Department of Defense to participate in VA's Revolving
Supply Fund for the purchase of health-care items; and to name
the VA outpatient clinic in New London, Connecticut, for the
late John J. McGuirk, a World War II veteran.
On July 22, 2002, the House passed H.R. 3645 under
suspension of the rules and the bill was referred to the
Senate. However, the Senate did not act on H.R. 3645.
OVERSIGHT ACTIVITIES
First Session
Hearing on the State of the VA Health Care System
On April 3, 2001, the Subcommittee held an oversight
hearing concerning the current state of the VA health care
system. The hearing witnesses included: Honorable Thomas L.
Garthwaite, M.D., Under Secretary for Health, VHA; Dr. Frances
M. Murphy, Deputy Under Secretary for Health, VHA; Dr. John G.
Clarkson, Senior Vice President Medical Affairs and Dean,
University of Miami School of Medicine, Miami, FL; Dr. George
Thibault, Chairman, VA Special Medical Advisory Group, Vice
President and Chairman of Clinical Affairs, Partners Health
Care, Inc.; Mr. James R. Fischl, Director, National Veterans
Affairs and Rehabilitation Commission, The American Legion; Mr.
Paul A. Hayden, Associate Director, National Legislative
Service, Veterans of Foreign Wars; Ms. Joy J. Ilem, Assistant
National Legislative Director, Disabled American Veterans; Mr.
John Bollinger, Deputy Executive Director, Paralyzed Veterans
of America; Mr. Richard Jones, National Legislative Director,
AMVETS; Mr. Bobby J. Harnage, Sr., National President, American
Federation of Government Employees; Ms. Ellen M Pitts, R.N.,
President, VA Medical Center, Brockton, MA, Local R1-187,
National Association of Government Employees; and Ms. Elaine
Gerace, R.N., Divisional President, VA Medical Center,
Syracuse, NY, Local 200B, Service Employees International
Union.
This was the Subcommittee's first hearing since the new
Administration had taken office, with the new Under Secretary
for Health, Dr. Thomas Garthwaite. The Subcommittee itself had
a new Chairman, the Honorable Jerry Moran of Kansas, and a new
Ranking Member, the Honorable Bob Filner of California.
The VA health care system has been transformed over the
past five years. It has restructured Central Office and field
operations, delegated substantial management authority to
regional officials, activated hundreds of new primary care
clinics, and opened enrollment to VA care to nearly two million
new veterans. Congress has played a leading role in this
transformation. Congress passed key legislation approving the
basic design of reform in 1995, the simplified health care
eligibility in Public Law 104-262, and enacted a variety of
program reforms in Public Laws 106-117 and 106-419. Congress
also increased funding for veterans' health care by $3 billion
in fiscal years 2000 and 2001, and provided an increase of $1
billion for veterans' health care in fiscal year 2002.
However, the VA health care system continues to face
significant challenges. Many veterans are concerned whether
their health care needs will be met in their later years, and
if so, how; waiting times for care often exceed the VA's 30-day
standard; another VA nursing personnel shortage looms; VA
capabilities in some specialized programs may be declining; and
VA appears to be losing capacity in critical areas such as
long-term care and mental health.
Testifying on behalf of VA, Dr. Garthwaite acknowledged
that the VA health care system had undergone a dramatic
transformation since 1995, moving from an inpatient model to an
outpatient model with more than 350 additional sites of care.
Primary care providers and teams were now coordinating quality
health care for more than 500,000 additional veterans with
25,000 fewer employees than six years ago-and at a cost per
patient of 24 percent less than VA expended in 1996.
Information technology, biotechnology, health care financing,
and public accountability were cited as leading the changing
trends in the health care industry at large. Challenges that VA
still faced included managing health care information more
effectively, improving care coordination and communications
with its patients, eliminating variability in care and changing
its infrastructure to meet current and future needs.
Dr. Carlson testified on behalf of the Association of
American Medical Colleges (AAMC), an organization with 107
medical schools affiliated with VA medical centers, and more
than 30,000 medical residents and 22,000 medical students that
rotate through VA hospitals and clinics to receive a portion of
their medical training. He addressed some of the challenges
that the affiliated partnerships have undergone in the
restructuring of VA's health care system into 22 Veterans
Integrated Service Networks (VISNs). As the national health
care environment evolves and changes are necessary at VA, Dr.
Carlson stressed that it is essential that VA's academic
affiliations be afforded consideration in the ongoing decision-
making processes.
Additional panels praised improvements in the quality of
care being provided to veterans, but focused primarily on the
damaging consequences of insufficient funding for VA's health
care system. They stated that inadequate budgets have
contributed to a deteriorating infrastructure, staffing
shortages, increased waiting times, (especially for specialty
care), and inadequate access to care. Concerns were voiced
about the aging veteran population and its growing health care
needs, particularly for specialty and long-term care services.
At the time of the hearing many of the provisions of Public Law
106-117, the Veterans' Millennium Health Care and Benefits Act,
though enacted in November 1999, had not yet been implemented
by VA.
Hearing on Mental Health, Substance-Use Disorders, and
Homelessness
On June 20, 2001, the Subcommittee on Health held a hearing
on mental health, substance use disorders, homelessness in the
veteran population, and the Department's policies in dealing
with these challenges. Hearing witnesses included: Honorable
Thomas Garthwaite, M.D., Under Secretary for Health, VHA; Mr.
Peter H. Dougherty, Director, Homeless Veterans Programs, VA
Office of Public and Intergovernmental Affairs; Dr. Paul
Errera, Connecticut VA Health System (former Director, Mental
Health and Behavioral Sciences, VHA); Dr. Laurent S. Lehmann,
Chief Consultant, Mental Health and Behavioral Sciences
Services, VHA; Dr. Miklos Losonczy, New Jersey VA Health
System, and Co-chair, VA Advisory Committee on Serious Mental
Illness; Dr. Richard McCormick, Ohio VA Health System, and Co-
chair, VA Advisory Committee on Serious Mental Illness; Dr.
Bruce Rounsaville, Connecticut VA Health System, and Professor
of Psychiatry, Yale University; Ms. Linda Boone, Executive
Director, National Coalition for Homeless Veterans; Dennis
Culhane, Ph.D., Associate Professor, University of
Pennsylvania; Fred Frese, Ph.D., Chair, Veterans Committee,
National Alliance for the Mentally Ill; Mr. Ralph Ibson, Vice
President for Government Affairs, National Mental Health
Association; Mr. Richard Fuller, National Legislative Director,
Paralyzed Veterans of America; Ms. Joy Ilem, Assistant National
Legislative Director, Disabled American Veterans; Ms. Linda
Schwartz, Associate Research Scientist, Yale University School
of Nursing; and Mr. Richard Weidman, Executive Director,
Government Relations, Vietnam Veterans of America.
The testimony clearly showed that problems and challenges
exist today in VA's mental health programs, including steep
reductions in hospital inpatient beds. Changes VHA has
initiated in mental health programs for veterans may have gone
too far in recent years, especially the substantial reductions
of VA residential programs in drug rehabilitation. The hearing
testimony confirmed that several of VA's networks are
contracting for residential drug rehabilitation, while in eight
major US cities VA offers little, if any, substance-abuse
residential care. This is inconsistent with the capacity
mandate in the law.
Also, during this hearing the Subcommittee learned that
VA's homeless assistance programs need more authority, better
coordination and improved outreach, along with a greater
commitment of resources and more creative strategies, if VA is
to effectively address the problem of homeless veterans.
Findings from this hearing led Chairman Smith, Mr. Evans,
Mr. Moran, Mr. Filner, and others to fashion a compromise bill,
H.R. 2716, on homeless assistance to strengthen VA's programs
and promote creative applications of methods to begin to stem
this unacceptable problem (see p. 11 for summary).
Hearing on Rural Health Care
On September 24, 2001, the Subcommittee on Health held a
field hearing in Wichita, Kansas, on veterans' rural health
care issues. Hearing witnesses included: Mr. James R. Franklin,
Vietnam veteran, Liberal, Kansas; Mr. Olen Mitchell, WWII
veteran, Hutchinson, Kansas; Mr. Scott Ratzlaff, Desert Storm
veteran, Colby, Kansas; Ms. Tamina Fromme, Vietnam veteran,
Dodge City, Kansas; Mr. Kent Hill, Director, VA Medical and
Regional Office Center, Wichita, Kansas; Dr. L.S. Raju, VA
Community Based Outpatient Clinic, Liberal, Kansas; Ms. Leann
Zimmerman, Nurse Practitioner, VA Community Based Outpatient
Clinic, Hays, Kansas; Dr. Peter Almenoff, Director, VA
Heartland Network (VISN 15), Kansas City, Missouri.
The hearing featured testimony and demonstrations on how VA
uses new telemedicine technology to bring better diagnostic and
therapeutic care to veterans. The use of telemedicine in VA
community based clinics (CBOCs) is an innovative way for
veterans to gain access to specialists without traveling to
large urban areas. These kinds of technologies can help ensure
that rural veterans have effective access to VA's health care
resources.
The Subcommittee also received a report on the work of the
Kansas Persian Gulf War Veterans Health Initiative, a program
monitoring over 7,500 Kansas veterans of the Persian Gulf War.
In addition to providing information on health resources and
federal benefits, the Initiative completed a baseline study of
the health of Kansas Persian Gulf veterans, and reported on its
plans for a second study focusing on neurological problems.
This program was established in 1997 by the Kansas State
Legislature and functions under the Kansas Commission on
Veterans' Affairs.
Second Session
Hearings to Consider Issues of Operational and Medical
Readiness in the Active Duty Force and Their Relationships to
the Health Status of the Veteran Population
On January 24, 2002, the Subcommittee held a hearing on
operational and medical readiness in the active duty force.
This was the first of two related hearings to examine troop
deployments to the Persian Gulf War to see if the lessons
learned regarding military personnel health issues have aided
the Departments of Defense and Veterans Affairs in avoiding
similar problems in current deployments.
The principal witnesses were Honorable Warren B. Rudman,
former U.S. Senator from New Hampshire and former Chairman,
Presidential Advisory Board on Persian Gulf War Illnesses;
Honorable Donald S. Riegle, former U.S. Senator from Michigan
and former Chairman, Senate Committee on Banking; Dr. Frances
Murphy, Deputy Under Secretary for Health, VHA, accompanied by
Dr. Susan Mather, Chief Public Health and Environmental
Hazards, VHA, and Dr. Craig K. Hyams, Chief Consultant,
Occupational and Environmental Health, VHA; Ms. Ellen P.
Embrey, Deputy Assistant Secretary of Defense for Force Health
Protection & Health Affairs, accompanied by Dr. Michael E.
Kilpatrick, DOD Director of Deployment Health Support;
Honorable James Holsinger, M.D., former VA Under Secretary for
Health; Honorable Enrique Mendez, M.D., former Assistant
Secretary of Defense for Health Affairs; Honorable Sue Bailey,
D.O., Former Assistant Secretary of Defense for Health Affairs;
Dr. Ronald R. Blanck, former Army Surgeon General; Dr. Garth
Nicolson, President, Institute for Molecular Medicine; Mr.
Steve Robertson, Executive Director, National Gulf War Resource
Center, Inc.; Mr. Patrick G. Eddington, Associate Director of
Government Relations, Vietnam Veterans of America; and Mr. Paul
Hayden, Associate Director of Legislation, Veterans of Foreign
Wars.
The testimony was from officials involved in the Gulf War,
from officials who conducted reviews and investigations, and
from officials in this Administration with the responsibility
to keep U.S. troops healthy. The Subcommittee examined whether
baseline physical evaluations, electronic patient records,
troop monitoring systems, vaccine protocols, coordination of
operational preparedness, and medical readiness are integrated
in the actions of the Departments in prosecuting the war on
terrorism.
The Subcommittee learned that baseline troop health
assessments in prior deployments were not systematic;
information on troop movements was scant or classified;
determination of exposure to biohazards was problematic;
vaccines were administered haphazardly; vaccine records were
unclear, and physical assessments of troops were not
comprehensive. A second hearing to further examine these issues
further was scheduled for the following month.
On February 27, 2002, the Subcommittee held the second
hearing to consider issues of operational and medical readiness
in the active duty force and their relationships to the health
status of the veteran population. The principal witnesses were
Ms. Cynthia Bascetta, Director, Veterans' Health & Benefits
Issues, GAO, accompanied by Ms. Ann Calvaresi-Barr, Assistant
Director; Ms. Ellen Embrey, Deputy Assistant Secretary of
Defense for Force Health Protection & Health Affairs,
accompanied by Ronald A. Maul, M.D., Colonel, U.S. Army,
Command Surgeon, Central Command; Dr. Frances Murphy, Acting
Under Secretary for Health, VHA, accompanied by Dr. Kenneth C.
Hyams, Chief Consultant, Occupational and Environmental Health,
VHA.
The hearing investigated the continuing challenges in DOD
and VA with respect to so-called ``force protection'' and
``medical readiness'' policies, and how post-deployment health
care and other service-related needs of post-deployment
veterans should be met. The Subcommittee believes protecting
active duty military members by establishing proper baseline
health data is essential before they become veterans. These
hearings helped to emphasize the need for both Departments to
share their resources.
Joint Hearing with House Armed Services Committee, Subcommittee
on Military Personnel. Hearing on Health Care Sharing by the
Department of Defense and the Department of Veterans Affairs
On March 7, 2002, the Subcommittee held a joint hearing
with the House Armed Services Subcommittee on Military
Personnel, on Department of Defense/Department of Veterans
Affairs health resources sharing. Those testifying at the
hearing included: the Honorable Christopher H. Smith, Chairman,
Committee on Veterans' Affairs; Honorable Leo S. Mackay, Jr.,
Deputy Secretary, Department of Veterans Affairs; Honorable
David S.C. Chu, Under Secretary of Defense (Personnel and
Readiness); Honorable Nancy Dorn, Deputy Director, Office of
Management and Budget; Dr. Gail R. Wilensky, Co-Chair,
President's Task Force To Improve Health Care Delivery For Our
Nation's Veterans; Mr. Robert Washington, Director, Membership
Services, Fleet Reserve Association, and Co-Chair, The Military
Coalition Health Care Committee; Ms. Deirdre Parke Holleman,
Co-Chair, Health Care Committee, National Military Veterans
Alliance; Mr. Steve Robertson, Director, Legislative Affairs,
The American Legion; Mr. Harley Thomas, Health Policy Analyst,
Paralyzed Veterans of America; Ms. Joy J. Ilem, Assistant
National Legislative Director, Disabled American Veterans; and
Mr. Dennis Cullinan, Director of Legislative Services, Veterans
of Foreign Wars.
Public Law 97-174, the Veterans Administration and
Department of Defense Health Resources Sharing and Emergency
Operations Act, May 4, 1982, provides broad authority to VA and
DOD for health resource sharing. VA/DOD sharing began with a
flurry of activity in early 1980's, with hundreds of agreements
executed between military and VA hospitals, but over the years,
sharing has waned. The purpose of this hearing was to examine
reasons for the decline in sharing, and to explore legislative
improvements that would renew sharing in the Departments.
Prior to the hearing, the Committee staff made a number of
visits last year to military and VA facilities, and made a
staff report to the Committee (Department of Veterans Affairs
and Department of Defense Health Resources Sharing, House
Committee Print No. 4, February 25, 2002). The report was
provided to the Subcommittee Members.
Chairman Smith, testifying in the first panel, urged the
Subcommittees to aggressively seek to increase resource sharing
between the VA and DOD health care systems. His testimony
reviewed his bill, H.R. 2667, introduced July 27, 2001, to
require improved coordination and sharing of health care
resources between the Departments by authorizing new
initiatives, promoting new incentives and establishing new
demonstration projects.
Secretary Chu assured the Committees that he and Dr. MacKay
share a common vision of quality health care for the men and
women serving our country, their families, and those that have
served in the past. The cooperative efforts of DOD and VA are,
according to Secretary Chu, focused on a proactive partnership
that meets the missions of both agencies while benefiting the
service member, veteran and taxpayer with new initiatives and
increased efficiency. Dr. Wilensky testified that the
President's task force is seeking to improve the delivery of
health care to our nation's veterans by formulating
recommendations to institutionalize VA-DOD sharing so that the
men and women who rely on health care from VA and DOD receive
treatment through a process that is seamless and transparent.
The military and veterans service organizations were
generally supportive of an increased effort to improve DOD/VA
coordination. However, they stressed that these activities must
at a minimum enhance or maintain access to health care,
quality, safety, and services offered to each category of
beneficiaries without negatively impacting any beneficiary
group. Congress subsequently enacted many of the concepts of
H.R. 2667 in title VII, subtitle C of Public Law 107-314, the
Bob Stump National Defense Authorization Act of Fiscal Year
2003.
Hearing on the Health Care of Filipino World War II Veterans
within the Department of Veterans Affairs
On June 13, 2002, the Subcommittee on Health held a hearing
to consider the provision of health care to certain Filipino
World War II veterans by the Department of Veterans Affairs.
Witnesses who appeared before the Subcommittee included His
Excellency Albert Del Rosario, Ambassador to the United States,
Embassy of the Philippines; Honorable Anthony J. Principi,
Secretary of Veterans Affairs, accompanied by Mr. John H.
Thompson, VA Deputy General Counsel; Representative Benjamin
Gilman of New York; Representative Randy ``Duke'' Cunningham of
California; Representative Dana Rohrabacher of California;
Representative Patsy T. Mink of Hawaii; Representative Juanita
Millender-McDonald of California; Representative Robert A.
Underwood from the Territory of Guam; Mr. Lou Diamond Phillips,
actor and Filipino veterans activist, Los Angeles, California;
Mr. Fritz Friedman, Chair, Assembly for Justice, Los Angeles,
California; Mr. Resty Supnet, President, Filipino World War II
Veterans Foundation of San Diego County, accompanied by Mr.
Romy Monteyro; Mr. Patrick Ganio, President, American Coalition
for Filipino Veterans; Ms. Susan Espiritu Maquindang, Executive
Director, Filipino-American Service Group; Ms. Lourdes Santos
Tancinco, President, San Francisco Veterans Equity Center; Ms.
Joy Ilem, Assistant National Legislative Director, Disabled
American Veterans; Mr. Richard Weidman, Director of Government
Relations, Vietnam Veterans of America; and Mr. James Fischl,
Director of National Veterans Affairs and Rehabilitation
Commission, The American Legion. Written testimonies were
received from Senator Barbara Boxer of California;
Representative Barbara Lee of California; Representative Nancy
Pelosi of California; Representative Maxine Waters of
California; General Tagumpay Nanadiego, Former Special
Presidential Representative, Embassy of the Philippines; Ms.
Wendy Lawrence, Associate Director, National Legislative
Service, Veterans of Foreign Wars; and Mr. Richard Jones,
National Legislative Director, AMVETS.
This hearing focused on H.R. 4904, the ``Health Care for
Filipino Veterans Act,'' introduced by the Honorable Bob
Filner, Ranking Member of the Subcommittee on Health, to
improve benefits for certain Filipino veterans of World War II
who reside in the United States and for their surviving
spouses. For many years, efforts have been made to extend the
same health care and compensation benefits that American
veterans receive to Filipino veterans of World War II. This
legislation would have provided limited benefits to certain
Filipino veterans.
Secretary Principi testified that President Bush and
President Arroyo of the Philippines, in commemorating the 50th
anniversary of the signing of the U.S. Philippine Mutual
Defense Treaty, reaffirmed the alliance of the United States
and the Philippines as vital to both nations. Their meeting,
according to the Secretary, heralded a new era of comprehensive
cooperation and friendship between the United States and the
Philippines. President Bush also agreed to review the services
and benefits that the United States provides for Filipino
veterans. Secretary Principi announced that the President
anticipated making an equipment grant of $500,000 to the
Republic of the Philippines to assist in providing medical care
and treatment for Commonwealth Army veterans and new Philippine
Scouts. The Secretary's testimony was generally favorable to
the provision of some benefits to Filipino veterans.
Representatives Benjamin Gilman, Randy ``Duke'' Cunningham,
Dana Rohrabacher, Patsy T. Mink, Juanita Millender-McDonald,
and Robert A. Underwood each provided support for the enactment
of this legislation. Mr. Phillips and Mr. Friedman added their
personal accounts and support to the provision of benefits for
Filipino veterans.
The final paned of witnesses included Filipino veterans who
would be affected by the provisions of H.R. 4904. They
unanimously supported the measure.
Field Hearing to Investigate Conditions at Kansas City Veterans
Medical Center
On June 17, 2002, the Subcommittee held an oversight
hearing entitled ``Patient Care at the Kansas City Veterans'
Affairs Medical Center: Investigating Infestations and
Management Practices,'' at the Kansas City VA Medical Center,
4801 Linwood Boulevard, Kansas City, Missouri. Those testifying
at the hearing included: Mr. Michael Slachta, VA Assistant
Inspector General for Auditing,; Dr. Stephen Klotz, Professor
of Medicine, University of Arizona, Section of Infectious
Diseases, and Staff Physician, Southern Arizona VA Health Care
System, VA Medical Center, Tucson, AZ, accompanied by Ms. Teola
Tillman, Former Infection Control Nurse, VA Medical Center,
Kansas City, MO; Mr. Hugh Doran, Former Director, VA Medical
Center, Kansas City, MO; Mr. Bryan Baldwin, President, Local
Union 2663, American Federation of Government Employees, VA
Medical Center, Kansas City, MO; Ms. Linda McEwen, President,
Union Local 910, American Federation of Government Employees,
VA Medical Center, Kansas City, MO; Ms. Sherie Grewe, Patient
Advocate, VA Medical Center, Kansas City, MO; Honorable Robert
H. Roswell, Under Secretary for Health, Veterans Health
Administration, Department of Veterans Affairs; and Mr. Kent
Hill, Director, VA Medical Center, Kansas City, MO.
The Subcommittee on Health held this field hearing at the
Kansas City VAMC to review an on-going VA Inspector General's
investigation on the cleanliness of the medical center. This
hearing was prompted by the March 2002 publication of an
article in the Archives of Internal Medicine, ``Nasal Myiasis
in an Intensive Care Unit Linked to Hospital-Wide Mouse
Infestation.'' This article contained a hypothesis of a link
between mice within the medical center, an infestation of
flies, and subsequently the discovery of nasal myiasis in two
medical intensive care unit patients. The article reviewed a
variety of actions taken to remedy these problems. However, it
appeared as though management did not sufficiently act to
eliminate them.
Also, it was suggested that the medical center had
insufficient funds, leaving the staff with few options to
eradicate the pest infestation, and ultimately, to ensure high
quality care to patients. The Secretary of Veterans Affairs
acted swiftly to make changes at the medical center as well as
at the network level. The Secretary initiated two
investigations in response to VA's realization that some of
these conditions existed for years prior to publication of the
article and reassigned management pending the outcome of these
two investigations.
Upon the completion of these investigations, reports were
made available to the Subcommittee, and the hearing was
scheduled to review these reports and to take testimony from
current and past personnel from the medical center, as well as
the author of the article on the infestation. Members of
Congress present at the field hearing included Subcommittee
Chairman Jerry Moran, Ranking Democratic Subcommittee Chairman
Bob Filner, Rep. John Boozman of the Subcommittee, and Rep.
Karen McCarthy of Missouri, who attended the hearing.
Hearing on VA's Current Programs for Women Veterans
On October 2, 2002, the Subcommittee held an oversight
hearing on VA's current programs for women veterans. The
principal witnesses were Representative Heather Wilson of New
Mexico; Honorable Robert H. Roswell, Under Secretary for
Health, VHA, accompanied by Dr. Susan Mather, Chief Officer,
Public Health and Environmental Hazards; Dr. Irene Trowell-
Harris, Director, Center for Women Veterans; Ms. Marsha Four,
RN, Chair, VA Advisory Committee on Women Veterans; Ms. Joy J.
Ilem, Disabled American Veterans and Former Member, VA Advisory
Committee on Women Veterans; Dr. Linda Schwartz, Former Chair,
VA Advisory Committee on Women Veterans and Former Chair of
School of Nursing, Yale University; Ms. Carole Turner,
Director, Women Veterans Health Programs, Veterans Health
Administration; Ms. Toni Lawrie, Coordinator, Women Veterans
Clinic, VA Medical Center, Bay Pines, Florida; and Dr. Margaret
Seaver, Director, Women's Veterans Health Care Program, VA
Boston Health Care System.
The Subcommittee held this oversight hearing to address
concerns about the level and types of accommodations for
privacy, facilities and specialized programs that VA provides
for female patients, and the Department's responsiveness to
recommendations on women's health issues from its Women's
Advisory Committee and the Department's Center for Women
Veterans.
The Subcommittee noted that until recent years VA was
largely a men's medical program. As more women join the
military services and take on new responsibilities in military
occupations, more women are entering the veteran population and
thus turning to the VA for care and services. The purpose of
the hearing was to review VA's progress in making women
veterans full participants in its health care programs.
Specifically, the Subcommittee examined whether women veterans
are offered sufficient services for both primary and
specialized health care, counseling for sexual trauma, mental
health services, and secure bed and privacy accommodations.
Witnesses testifying for the Department asserted VA is
making significant progress in renovating facilities for female
patient privacy and moving to ensure VA facilities have the
expertise and technology for the particular needs of women
patients. For example, VA testified that in 2000, 152,094 women
veterans were seen as outpatients and 12,955 as inpatients. In
2001, these numbers rose to 166,108 outpatients and 13,640
inpatients. In 2001, 14,790 Pap smears were completed in VA
clinics and 17,209 screening mammograms were accomplished, as
well as 21,268 diagnostic mammograms.
VA asserted it intended to assure that women veterans gain
equal access to high-quality care, while admitting that in the
past, some VA facilities had tended to ignore women because
they simply could not provide comprehensive, holistic care for
women veterans. In addition to providing more specific
services, VA stated it was using tools such as clinical
guidelines, performance measures, quality improvement
mechanisms, patient safety monitoring, and female veteran-
relevant research to change its culture.
VA's Women's Center Director provided testimony on the
history of the Advisory Committee on Women Veterans, and
highlighted its 2002 report recommendations, including: the
creation or modification of services to provide specifically
for the needs of women; staffing levels for women veterans
coordinators (WVC) positions; permanent removal of eligibility
restrictions for sexual trauma counseling; the monitoring and
analysis of services recently introduced by VA, such as
obstetrical care and pilot programs for women veterans who are
homeless, to ensure that services would meet potential
increases in demand; the development and distribution of
guidelines for case management of women veterans who are
homeless based on the analysis of successful pilot projects; an
emphasis on the need for research to determine the success of
health and benefit programs in meeting the needs of women
veterans, including women veterans subgroups such as Blacks,
Hispanics, Asians, and Native Americans, as VA conducts
strategic planning to design future care and services; and the
need for research to assess the impact of the increasing number
of women in the military and their changing military roles on
the design and delivery of VA services. The rising proportion
of minority women heightens the need for meaningful data
regarding women veterans of all racial/ethnic groups.
Witnesses representing the VA Women's Health Programs
testified that improvements have been made in VA's approach to
caring for women veterans. They testified that Women Veterans
Coordinators provide essential services as advocates, case
managers, and specialized resources for female patients. They
asserted that establishment of dedicated women's clinics and
women's centers in VA health care facilities contributes to
research-based knowledge on women veterans' health and mental
health, promotes better treatment of military sexual trauma,
provides a basis for coordinated care for complex medical and
mental health problems, and improves quality of life for
patients with post traumatic stress disorder and its co-
morbidities. Also, they testified that women-focused programs
provide improved patient compliance with preventive health
measures such as pap smears and mammograms. However, these
witnesses also agreed with the Subcommittee concern that
fragmentation of care for women is still a major challenge in
VA health care. A recent national survey by the Department
indicated that many gender specific services were often
contracted out to community medical providers or academic
affiliates. The Subcommittee agreed with witnesses that to
overcome this difficulty, VA women's health programs need to
have adequate staffing for better case coordination.
Hearing on Project SHAD, Regarding Secret Chemical and
Biological Tests Conducted on American Servicemembers
On October 9, 2002, the Subcommittee held a hearing on
Project 112 and Operation Shipboard Hazard and Defense (SHAD).
The principal witnesses were Honorable William Winkenwerder,
Jr., M.D., M.B.A., Assistant Secretary of Defense for Health
Affairs, accompanied by Dr. Michael E. Kilpatrick, Director of
Deployment Health Support, Dr. Anna Johnson-Winegar, Deputy
Assistant to the Secretary of Defense, Chemical and Biological
Defense; and Dr. Jonathan B. Perlin, Deputy Under Secretary for
Health, VHA, accompanied by Mr. Robert J. Epley, Associate
Deputy Under Secretary for Policy and Program Management, VBA.
The oversight hearing addressed Cold War chemical, nuclear,
and biological tests at sea and over land during Project 112
and Operation SHAD. The principal focus of this hearing was the
Department of Defense's public announcement of the results of
their declassification review to examine health effects of 31
tests from Project 112 and Operation SHAD. In addition, the
Subcommittee reviewed VA's role in contacting veterans who may
have participated in these tests, and determining the health
status of these veterans.
This project began during the 1960's and originally
involved 109 planned tests to identify U.S. warship
vulnerability to chemical, nuclear, and biological attacks, and
to develop methods to defend against them. It was a component
of a larger DOD effort called Project 112. In late 2000, based
on a VA request, DOD began to review and declassify information
concerning the exact agents used and other details of these
tests, including identities of U.S. ships and other military
units that were involved. In addition, DOD began working with
the VA to identify individual veterans who participated in
these tests and to determine whether any veterans suffered
negative health consequences because of these tests.
The Assistant Secretary of Defense for Health Affairs,
Honorable William Winkenwerder, Jr., testified that DOD is
absolutely committed to an uncompromising and thorough
investigation of all chemical and biological warfare tests
planned and performed by the Deseret Test Center between 1962
and 1973. To date, DOD's search has revealed significant
information about the Deseret Test Center experiments. The
Center planned 134 tests between 1962 and 1973. DOD has
verified that 46 tests were conducted, while 62 tests were
cancelled. The status of 26 remaining tests is still in
question. The majority (24 of these 26 tests) were designed to
take place in 1970-1974, during a period in which plans were
being made to close the Deseret Test Center.
Secretary Winkenwerder assured the Subcommittee at this
hearing that DOD is continuing to declassify the remaining
Project 112 and Operation SHAD data as quickly as possible. He
also revealed that the military services are still using
simulations during operational testing and training. He stated
that DOD's objective is to ensure that concerns like those
surrounding the Deseret Test Center tests do not arise in the
future.
Testifying on behalf of VA, Dr. Perlin discussed the
outreach efforts VA had undertaken to contact the 5,000
veterans who have been identified as Project 112 participants.
VA efforts also include educational programs for VA health care
providers and health care services that VA has implemented for
these veterans. VA was asked to assume an aggressive follow-up
with these veterans to ensure that all are afforded an
opportunity to review their medical histories with VA health-
care providers.
Subcommittee on Benefits
The Subcommittee on Benefits has jurisdiction over
veterans' programs for compensation, pension, insurance,
memorial affairs, education, training, vocational
rehabilitation, small business, employment, and housing. In
addition to overseeing programs administered by the Veterans
Benefits Administration and the National Cemetery
Administration, the Subcommittee has oversight of Arlington
National Cemetery, and overseas cemeteries of the American
Battle Monuments Commission. The Subcommittee also oversees
veterans' programs administered by the U.S. Department of
Labor, the Small Business Administration, the National Veterans
Business Development Corporation, and the U. S. Office of
Personnel Management, as well as certain servicemember programs
administered by the Department of Defense (see p. 88, Oversight
Plan for 107th Congress).
LEGISLATIVE ACTIVITIES
First Session
Hearing on H.R. 801, the Veterans' Opportunities Act of 2001,
and VA's Implementation of Veterans' Transitional Housing
Assistance
On March 15, 2001, the Subcommittee on Benefits held a
hearing on H.R. 801, the Veterans' Opportunities Act of 2001.
H.R. 801 contained a number of provisions affecting a range of
veterans' programs, including burial benefits, readjustment
benefits, the Servicemembers' Group Life Insurance program, and
expanded outreach efforts by the Department of Veterans
Affairs. The Subcommittee also requested from VA status
information on its implementation of section 601 of Public Law
105-368, which the President signed on November 11, 1998. This
section authorized the establishment of a new $100 million
program of loan guarantees for developers of transitional
housing for homeless veterans. Twenty-seven months later, the
program was not operational.
Witnesses at the hearing included Honorable Anthony
Principi, Secretary of Veterans Affairs; Honorable Joseph
Thompson, Under Secretary for Benefits, VBA; Representative
Bill Pascrell, Jr. of New Jersey; Representative Michael Doyle
of Pennsylvania; Mr. Patrick Sutliff, University of Phoenix;
Mr. Jack Lunsford, Maricopa (AZ) Community College; Ms. Faith
Stellitano, National Association of Veterans Program
Administrators; Ms. Rose Lee, Washington Representative and
Past Chairman, Gold Star Wives of America; Mr. Sidney Daniels,
Deputy Legislative Director, Veterans of Foreign Wars; Ms. Joy
Ilem, Associate National Legislative Director, Disabled
American Veterans; Mr. Blake Ortner, Associate Legislative
Director, Paralyzed Veterans of America; and Mr. Peter Gaytan,
Assistant Director, National Legislative Commission, The
American Legion.
Also, Representative Jo Ann Davis of Virginia testified on
her bill, H.R. 1015, to make the maximum amount of
Servicemembers' Group Life Insurance (SGLI) retroactive to
November 1, 2000 (Public Law 106-419, signed into law on
November 1, 2000, increased SGLI to $250,000 effective on the
first day of the first month that began more than 120 days
after date of enactment). Senator John Warner of Virginia
testified in support of this retroactive payment.
The veterans service organizations largely supported H.R.
801, but were concerned that the benefits programs needed
continuing increases to keep pace with the rising cost of
living. VA supported most of the provisions incorporated in
H.R. 801. With regard to the implementation of Public Law 105-
368, Secretary Principi announced that the Office of Management
and Budget had recently cleared the transitional assistance
housing program to make 100-percent loan guarantees, and that
while the program was established in 1998, VA did not receive
funding until fiscal year 2000. Secretary Principi testified
further that the process of implementing Public Law 105-368 was
slow because there was no model for this type of federal loan
guaranty program.
Full Committee Markup of H.R. 801
On March 21, 2001, the full Committee met and marked up
H.R. 801. The bill was favorably reported, as amended, to the
House (see House Report 107-27). On March 27, the House passed
H.R. 801, as amended, by a vote of 417-0. After being amended
by the Senate, the bill became Public Law 107-14 on June 5,
2001 (see p. 9 for summary).
Hearings on H.R. 1291, 21st Century Montgomery GI Bill
Enhancement Act
On May 24, 2001, the Subcommittee on Benefits held the
first of two hearings on H.R. 1291, the 21st Century Montgomery
GI Bill Enhancement Act. The bill would have increased the
amount of educational benefits under the Montgomery GI Bill
(MGIB) for an approved program of education on a full-time
basis from a monthly rate of $650 for an obligated period of
active duty of three or more years to: $800 effective October
1, 2001; $950 effective October 1, 2002; and $1,100 effective
October 1, 2003. H.R. 1291 would also have increased the amount
of educational benefits under the MGIB for an approved program
of education on a full-time basis from the current monthly rate
of $528 for an obligated period of active duty of less than
three years to: $650 effective October 1, 2001; $772 effective
October 1, 2002; and $894 effective October 1, 2003.
Testifying in support of the bill was Representative
Charles ``Chip'' Pickering of Mississippi. Mr. G. Kim Wincup,
Vice Chairman, testified on behalf of the Congressional
Commission on Servicemembers and Veterans Transition
Assistance. General Charles Boyd (USAF, Ret), Executive
Director, and Admiral Harry D. Train, II (USN, Ret) testified
on behalf of the United States Commission on National Security/
21st Century. Vice Admiral Patricia Tracey, Assistant Secretary
of Defense for Personnel testified on behalf of the
Administration. The personnel chiefs of the five service
branches, Lieutenant General Timothy Maude, U.S. Army; Vice
Admiral Norbert Ryan, U.S. Navy; Lieutenant General Garry L.
Parks, U.S. Marine Corps; Lieutenant General Donald Peterson,
United States Air Force; and Rear Admiral R. Dennis Sirois,
U.S. Coast Guard, appeared before the Subcommittee to answer
questions. Each of the personnel chiefs testified that the MGIB
served as their best recruiting incentive. The veterans service
organizations (VSO) were represented by Mr. Sidney Daniels,
Deputy Legislative Director, Veterans of Foreign Wars; Mr. Bob
Norton, Deputy Director of Government Relations, The Retired
Officers Association; Mr. Mark H. Olanoff, Legislative
Director, The Retired Enlisted Association; Mr. John Vitikacs,
Deputy Director for the National Economic Commission, The
American Legion; and Mr. Richard Weidman, Director of
Government Relations, Vietnam Veterans of America. Mr. Richard
Jones, AMVETS, submitted testimony for the record. Each VSO
supported the bill.
On June 7, 2001, the Subcommittee on Benefits conducted the
second hearing on H.R. 1291, and also took testimony on the
General Accounting Office's report, Veterans' Employment and
Training Service (VETS), Proposed Performance Measurement
System Improved, But Further Changes Needed (GAO-01-580).
Testifying in support of H.R. 1291 were Representative John
D. Dingell of Michigan and Representative Ronnie Shows of
Mississippi. Representative Jim Saxton of New Jersey testified
on behalf of the Joint Economic Committee. Honorable Anthony
Principi, Secretary of Veterans Affairs, testified on behalf of
the Administration, accompanied by Honorable Joseph Thompson,
Under Secretary for Benefits, VBA, and Mr. Chris Yoder,
Counselor to the Secretary. The Higher Education Community was
represented by Ms. Kathleen Little, Executive Director of
Financial Aid Services, The College Board; Dr. Constantine W.
``Deno'' Curris, President, American Association of State
Colleges and Universities; Dr. David Warren, President,
National Association of Independent Colleges and Universities;
Dr. Horace W. Fleming, President, University of Mississippi;
and Mr. David Guzman, President, National Association of
Veteran Program Administrators. Testifying on behalf of GAO was
Dr. Sigurd Nilsen, GAO Director of Education, Workforce, and
Income Security Issues. Testifying on behalf of the Department
of Labor was the Honorable Chris Spear, Assistant Secretary of
Labor for Policy, accompanied by Mr. Stanley Seidel, Acting
Assistant Secretary for VETS. Submitting statements for the
record were the Air Force Sergeants Association; Honorable Don
Sundquist, Governor of Tennessee; Mr. C. Donald Sweeney,
National Association of State Approving Agencies; Ms. Kimberlee
D. Vockel, Director of Legislative Affairs, Non Commissioned
Officers Association; Mr. Thomas J. McKee, Air Force
Association; and Mr. Brian E. Lawrence, Associate National
Legislative Director, Disabled American Veterans.
H.R. 1291 had over 100 cosponsors and was supported by all
who testified before the Subcommittee. Many Members agreed with
the Chairman that the increases proposed in H.R. 1291
represented a first step toward the ultimate goal to have MGIB
pay tuition, fees, and a monthly subsistence allowance.
The GAO report examined performance measures that VETS had
proposed for employment and training services through the
public labor exchange. GAO found that VETS' proposed
performance measures improved performance over the current
system but certain aspects of the new measures raised concerns
that VETS should address, especially with respect to measuring
``results,'' not ``process.'' The Department of Labor
representatives testified that they agreed with most of the
conclusions of the GAOs report. However, VETS had concerns
about GAO recommendations to allow half-time Disabled Veterans'
Outreach Specialists (DVOP) staff positions and to combine DVOP
and Local Veterans' Employment Representatives (LVER) grants
into a single staffing grant.
Hearing on H.R. 862, H.R. 1406, H.R. 1435, H.R. 1746, H.R.
1929, H.R. 2359 and H.R. 2361
On July 10, 2001, the Subcommittee on Benefits held a
legislative hearing on the following bills: H.R. 862, to add
Type 2 diabetes to the list of diseases presumed to be service-
connected for veterans exposed to certain herbicide agents;
H.R. 1406, the Gulf War Undiagnosed Illness Act of 2001, which
addressed Persian Gulf War illness issues; H.R. 1435, the
Veterans' Emergency Telephone Service Act of 2001, and H.R.
1746, to establish a single ``1-800'' telephone number for
veterans benefits counseling, both of which addressed providing
veterans a toll-free number they could call to access full
veterans benefits information; H.R. 1929, the Native American
Veterans Home Loan Act of 2001, which extended and improved the
Native American home loan pilot project; H.R. 2359, which made
program changes to the National Service Life Insurance and U.S.
Government Life Insurance programs; and H.R. 2361, the
Veterans' Compensation Cost-of-Living Act of 2001.
Representative Tom Udall of New Mexico testified in support
of his bill, H.R. 1929, Representative Richard Baker of
Louisiana testified in support of his bill, H.R. 1746, and
Representative Donald Manzullo of Illinois testified in support
of his bill, H.R. 612. Representative Lois Capps of California
submitted a statement for the record in support of her bill,
H.R. 1435. Honorable Joseph Thompson, Under Secretary for
Benefits, VBA, testified on behalf of VA. Dr. John Feussner,
Chief Research and Development Officer, VHA, accompanied Mr.
Thompson. Representing the veterans service organizations were:
Mr. Joseph Violante, National Legislative Director, Disabled
American Veterans; Mr. James Fischl, Director of Veterans'
Affairs and Rehabilitation Commission, The American Legion; Mr.
Sidney Daniels, Deputy Director of National Legislative
Service, Veterans of Foreign Wars; Mr. David Tucker, Senior
Legislative Director, Paralyzed Veterans of America; Mr.
Richard Jones, National Legislative Director, AMVETS; and
Leonard Selfon, Esq., Director of Veterans Benefits Programs,
Vietnam Veterans of America.
VA and veterans service organization witnesses generally
supported the bills under consideration with the following
exceptions: VA did not support the addition of certain
conditions to the list of service-connected diseases for
Persian Gulf War veterans contained in the bill because it
believed the descriptions of the conditions were vague and
would result in uncertainty regarding proper implementation.
Also, most of the witnesses, including the VA representative,
opposed H.R. 1435 and H.R. 1746 as not necessary in light of
the improvements VA had made to its toll-free phone service.
Subcommittee Markup of H.R. 862, H.R. 1406, H.R. 1435, H.R.
1746, H.R. 2359 and H.R. 2361
On July 12, 2001, the Subcommittee marked up a draft bill
incorporating provisions from H.R. 862, H.R. 1406, H.R. 1435,
H.R. 1746, H.R. 2359, and H.R. 2361. The bill was reported
favorably to the full Committee by voice vote. On July 19, the
full Committee met and marked up H.R. 2540, as amended, the
Veterans Benefits Act of 2001 (see House Report 107-156). On
July 31, the House passed H.R. 2540, as amended, by a vote of
422-0. After being amended by the Senate, the bill was enacted
as Public Law 107-94 containing only the cost-of-living
allowance provisions (see p. 10 for summary).
Second Session
Hearing on H.R. 1108, H.R. 2095, H.R. 2222, and H.R. 3731
On April 11, 2002, the Subcommittee held a hearing on H.R.
1108, to provide that remarriage of the surviving spouse of a
veteran after age 55 would not result in termination of
dependency and indemnity compensation; H.R. 2095, the Reservist
VA Home Loan Fairness Act of 2001, to provide for uniformity in
fees charged to qualifying members of the Selected Reserve and
active duty veterans for home loans guaranteed by the Secretary
of Veterans Affairs; H.R. 2222, the Veterans Life Insurance
Improvement Act of 2001, to increase benefit amounts for VA
insurance programs; and H.R. 3731, to increase amounts
available to State approving agencies in light of their
additional statutory responsibilities with respect to licensing
and credentialing and employer outreach duties.
Witnesses included Honorable Daniel Cooper, Under Secretary
of Benefits, VBA, accompanied by Mr. Robert Epley, Associate
Deputy Under Secretary for Policy and Program Management, VBA;
Mr. Michael Walcoff, Associate Deputy Under Secretary (West),
VBA; and Mr. John Thompson, VA Deputy General Counsel. The
veterans service organizations were represented by Ms. Erin
Harting, Legislative Analyst, The Enlisted Association of the
National Guard; Mr. Carl Blake, Associate Legislative Director,
Paralyzed Veterans of America; Mr. Sidney Daniels, Assistant
Director, Benefits Policy, Veterans of Foreign Wars; Mr. Brian
Lawrence, Associate National Legislative Director, Disabled
American Veterans; Ms. Aseneth Blackwell, President, Gold Star
Wives of America; Mr. Jim Fischl, Director of Veterans' Affairs
and Rehabilitation Commission, The American Legion; Mr. Richard
Jones, National Legislative Director, AMVETS; and Mr. Rick
Weidman, Director of Government Relations, Vietnam Veterans of
America. Representative Michael Bilirakis of Florida testified
in support of his bill, H.R. 1108, pointing out that many
federal annuities are accorded to surviving spouses who remarry
at older ages. Representative Bob Filner of California
testified in support of his bill, H.R. 2222.
There was consensus among the witnesses in support of the
provisions contained in the four bills before the Subcommittee.
Hearing on H.R. 4015, Jobs for Veterans Act
On April 18, 2002, the Subcommittee held a legislative
hearing on H.R. 4015, the Jobs for Veterans Act. H.R. 4015 was
intended to enhance veterans' job training programs at the
Department of Labor's Veterans' Employment and Training Service
(VETS), and provide greater accountability, flexibility, and
incentives for state Job Service programs to secure jobs,
especially for disabled and other hard-to-place veterans. The
bill provided priority of service to veterans in any job-
training program funded in whole or in part by the Department
of Labor. The bill also required the Assistant Secretary of
Labor for VETS to establish and implement a comprehensive
performance accountability system to measure the performance of
veterans' employment and training and public labor exchange
systems.
Witnesses included Honorable Frederico Juarbe, Jr.,
Assistant Secretary for Veterans' Employment and Training
Service, U.S. Department of Labor (DOL), who testified on
behalf of the Department and was accompanied by Mr. Charles S.
Chiccolella, Deputy Assistant Secretary for Veterans'
Employment and Training Service; Mr. Stanley Seidel, VETS
Director, Office of Operations and Programs; Mr. Ronald
Bachman, VETS Director of Strategic Planning; and Mr. Ronald
Drach, VETS Special Assistant for Strategic Planning and
Legislative Matters. Representing state workforce entities were
Mr. Rex Hall, Chairman, Veterans' Advisory Committee, National
Association of State Workforce Agencies; Mr. Rodger Madsen,
Director, Idaho Department of Labor; Mr. T.P. O'Mahoney,
Commissioner Representing Labor, Texas Workforce Commission;
and Mr. Ken Mayfield, President-Elect, National Association of
Counties. Employment and Labor Associations and Unions were
represented by Mr. Bruce Wyngaard, Operations Director, Ohio
Civil Service Employees Association, AFSCME Local 11; Mr.
Dennis Beagle, New York State Public Employees Federation; and
Mr. Wesley Poriotis, Chief Executive Officer, Wesley, Brown &
Bartle Company, Inc.
The veterans service organizations were represented by Mr.
James N. Magill, Director, National Employment Policy, Veterans
of Foreign Wars; Mr. Steve Robertson, Legislative Director, The
American Legion; Mr. Carl Blake, Associate Legislative
Director, Paralyzed Veterans of America; Mr. Rick Weidman,
Director of Government Relations, Vietnam Veterans of America;
and Mr. Richard Jones, National Legislative Director, AMVETS.
Submitting statements for the record were the Workforce New
Jersey; the Disabled American Veterans; Mr. Raymond Boland,
Legislative Director, National Association of State Directors
of Veterans Affairs; Mr. John K. Lopez, Chairman, Association
for Service Disabled Veterans; and Captain Thomas M. Hale, USN
(Ret.), Senior Vice President, Resource Consultants, Inc.
All witnesses supported H.R. 4015. The Department of Labor
representative supported many of the provisions of the bill and
suggested some revisions including a 3-year implementation
period and a ``hold harmless'' provision for the DVOP-LVER
funding formula.
Subcommittee Markup of H.R. 4085 and H.R. 4015
On May 2, 2002, the Subcommittee on Benefits marked up H.R.
4085 and H.R. 4015, with amendments. Both bills were reported
favorably to the full Committee. On May 9, the full Committee
met and marked up H.R. 4085 and H.R. 4015. Each bill was
reported favorably, as amended, to the House (see House Report
107-472 and House Report 107-476, respectively). On May 21, the
House passed H.R. 4085, as amended, by a vote of 410-0; the
House passed H.R. 4015, as amended, by a vote of 409-0. H.R.
4085 ultimately became Public Law 107-247 on October 23, 2002,
and H.R. 4015 ultimately became Public Law 107-288 on November
7, 2002 (see p. 20 and p. 22 for summaries).
Hearing on H.R. 3173, H.R. 3735, H.R. 3771, and H.R. 4042, and
Draft Bills: the Arlington National Cemetery Burial Eligibility
Act; and Legislation Providing Dependency and Indemnity
Compensation to the Surviving Spouse of a Veteran with a
Totally Disabling Service-Connected Cold-Weather Injury
On June 11, 2002, the Subcommittee on Benefits held a
legislative hearing on H.R. 3173, the Servicemembers and
Military Families Financial Protection Act of 2001, to increase
the maximum monthly lease protection under the Soldiers' and
Sailors' Civil Relief Act as well as coverage under the
Servicemembers' Group Life Insurance and Veterans' Group Life
Insurance programs; H.R. 3735, the Department of Veterans
Affairs Overpayment Administration Improvement Act of 2002, to
authorize the Secretary to waive veterans' overpayments in
certain instances and extend the application period for waiver
recovery; H.R. 3771, to exclude from income for pension
purposes certain monetary benefits paid to disabled veterans by
states; H.R. 4042, the Veterans Home Loan Prepayment Protection
Act of 2002, to prohibit additional daily interest charges
following prepayment of VA housing loans; and two draft bills,
the Arlington National Cemetery Burial Eligibility Act, to
codify burial eligibility requirements for interment at
Arlington, and legislation to provide dependency and indemnity
compensation to the surviving spouse of a veteran with a
totally disabling service-connected cold weather injury.
Representative Luis Gutierrez of Illinois testified in
support of his bill, H.R. 3173. Honorable Daniel Cooper, Under
Secretary for Benefits, testified for the Veterans Benefits
Administration (VBA). Mr. Cooper was accompanied by Mr. Robert
Epley, Associate Under Secretary for Policy and Program
Management, VBA, Mr. John Thompson, VA Deputy General Counsel,
and Mr. Thomas Lastowka, Director, VA Regional Office and
Insurance Center. Additional witnesses included Mr. Craig
Duehring, Acting Assistant Secretary of Defense (Reserve
Affairs), Department of Defense; Mr. Thurman Higginbotham,
Deputy Superintendent, Arlington National Cemetery; Mr. Brian
Lawrence, Associate National Legislative Director, Disabled
American Veterans; Mr. Carl Blake, Associate Legislative
Director, Paralyzed Veterans of America; Mr. Patrick Eddington,
Associate Director of Government Relations, Vietnam Veterans of
America; Mr. Richard Jones, National Legislative Director,
AMVETS; Mr. Thomas Miller, Executive/Legislative Director,
Blinded Veterans Association; Mr. James Fischl, Director,
National Veterans' Affairs and Rehabilitation Commission, The
American Legion; Mr. Sidney Daniels, Assistant Director for
Veterans Benefits Policy, Veterans of Foreign Wars; and Mr.
Daniel Borinsky, attorney-at-law, Esquire Settlement Services.
The Administration witnesses opposed the bills before the
subcommittee; the veterans service organization and other
witnesses supported all the bills.
Subcommittee Markup of H.R. 4940 and H.R. 5055
On July 9, 2002, the Subcommittee on Benefits met and
marked up H.R. 4940 and H.R. 5055. Both bills were ordered
reported favorably to the full Committee. On July 16, the full
Committee met and marked up H.R. 4940 and H.R. 5055. H.R. 4940
was favorably reported to the House by a vote of 22-3 (see
House Report 107-588). H.R. 5055 was also favorably reported to
the House (see House Report 107-589). On July 22, the House
passed H.R. 4940 and H.R. 5055 by the House by voice vote.
However, the Senate did not act on H.R. 4940. H.R. 5055
ultimately became part of Public Law 107-330 on December 6,
2002 (see p. 26 for summary).
Hearings on H.R. 5111, the Servicemembers' Civil Relief Act,
and H.R. 4017, the Soldiers' and Sailors' Civil Relief Equity
Act
On July 24 and July 25, 2002, the Subcommittee on Benefits
held hearings on H.R. 5111, the Servicemembers' Civil Relief
Act, and H.R. 4017, the Soldiers' and Sailors' Civil Relief
Equity Act. H.R. 5111 was a restatement and clarification of
the Soldiers' and Sailors' Civil Relief Act of 1940. H.R. 4017
added coverage under Soldiers' and Sailors' Civil Relief Act
for those National Guard members called up under title 32,
United States Code, for 30 days or more.
On July 24, the witnesses included Mr. Craig Duehring,
Acting Assistant Secretary of Defense (Reserve Affairs); Ms.
Judy Wilson, Deputy Director, Government Relations, the
Enlisted Association of the National Guard; Mr. Bob Manhan,
Assistant Director, National Legislative Service, Veterans of
Foreign Wars; Mr. Richard Jones, National Legislative Director,
AMVETS; and Ms. Joyce Wessel Raezer, Director, Government
Relations, the National Military Family Association, Inc.
On July 25, the witnesses were Robert Hirshon, Esq.,
President, American Bar Association; Eugene R. Fidell, Esq.,
Feldeman, Tucker, Leifer, Fidell & Bank, LLP; Mr. James Murphy,
Chairman, Mortgage Bankers Association of America; Henry R.
Desmarais, MD, M.P.A., Senior Vice President, Health Insurance
Association of America; Ms. Kimberlee D. Vockel, Director of
Legislative Affairs, Non Commissioned Officers Association; Mr.
William B. Loper, Director of Government Affairs, Association
of the United States Army; and Mr. James P. Tierney, Deputy
Director of Legislative Programs, National Guard Association of
the United States.
The Administration supported both bills in concept while
opposing some specific provisions. Other witnesses also
generally supported the bills in concept with suggestions for
substantive or technical improvements.
OVERSIGHT ACTIVITIES
First Session
Hearing on the General Accounting Office's Report: ``Veterans'
Employment and Training Service Flexibility and Accountability
Needed to Improve Service to Veterans''
On October 30, 2001, the Subcommittee on Benefits held a
hearing on the GAO report: ``Veterans' Employment and Training
Service: Flexibility and Accountability Needed to Improve
Service to Veterans'' (GAO-01-928), and the VA's implementation
of the Vocational Training and Rehabilitation program. The GAO
report was requested by Representative Steve Buyer of Indiana,
Chairman of the Oversight and Investigations Subcommittee.
Witnesses included Mr. Julius Williams, VA Director of
Rehabilitation, accompanied by Ms. Gloria M. Young, Vocational
Rehabilitation and Counseling Officer; Mr. Charles S.
Ciccollela, Deputy Assistant Secretary of Labor for VETS,
accompanied by Mr. Stanley Seidel, Director, Office of
Operations and Programs; Dr. Sigurd Nilsen, GAO; Mr. Rex Hall,
Chairman, Veterans Affairs Committee, National Association of
State Workforce Agencies; Mr. Roger Madsen, Director, Idaho
Department of Labor; Mr. Terrence P. O'Mahoney, Commissioner
Representing Labor, Texas Workforce Commission; Mr. Steve
Robertson, Legislative Director, The American Legion; Mr. James
N. Magill, Director of Employment Policy, Veterans of Foreign
Wars; and Mr. Rick Weidman, Director of Government Relations,
Vietnam Veterans of America.
This report was the seventh GAO has issued on VETS programs
since 1997. GAO testified on the numerous improvements needed
in the VETS delivery system, including collecting outcome data,
such as information on veterans' wages and job retention, and a
more effective performance management system in the states. The
testimony of veterans service organizations largely supported
GAO's recommendations. VA's witness testified on initiatives
and measures employed in the vocational rehabilitation program,
including job placement. Findings from this hearing helped in
formulating H.R. 4015, which used many of the recommendations
from the GAO reports.
Second Session
Staff Site Visit to National Personnel Records Center, St.
Louis, Missouri
On January 24, 2002, majority and minority staff members of
the Subcommittee on Benefits made a site visit to the National
Personnel Records Center (NPRC) in St. Louis, Missouri. NPRC,
part of the National Archives and Records Administration, is
responsible for maintaining the official military personnel
records of discharged members of the Armed Forces.
Approximately 80 million military records are stored and filed
at NPRC.
NPRC is faced with a large backlog of requests for
veterans' records. The Veterans Benefits Administration (VBA)
has indicated that waiting for service documentation from NPRC
can be a significant obstacle in processing a veteran's claim
in a timely manner. Subcommittee staff made this site visit in
order to evaluate the problems confronting NPRC and to consider
how Congress could alleviate the backlogs at both NPRC and VBA.
Staff Site Visit to VA Regional Office, Cleveland, Ohio
On April 1, 2002, majority and minority staff members of
the Subcommittee on Benefits made a site visit to the VA
Regional Office in Cleveland, Ohio, to view operations of the
``Tiger Team.'' Secretary Principi established this initiative
to expedite the processing of claims of older veterans. In
November 2001, VA began an 18-month ``Tiger Team'' effort to
resolve 81,000 of the oldest compensation and pension claims.
This team is comprised of claims experts, and though located at
the Cleveland RO, operates independently of it. The team is
concentrating on processing older claims throughout the system,
with top priority accorded claims from veterans over age 70
that have been pending for a year or more.
Field Hearing on VA Claims Processing
On April 26, 2002, the Subcommittee on Benefits held a
field hearing at Ft. Bliss, a U.S. Army base in El Paso, Texas,
on VA claims processing. Representatives in attendance included
Subcommittee Chairman Mike Simpson of Idaho, Subcommittee
Ranking Member Silvestre Reyes of Texas, and full Committee
Ranking Member Lane Evans of Illinois. Witnesses from the El
Paso veterans community included Mr. John McKinney, Mr. Ron
Holmes, Ms. Jane Franks, and Mrs. Mary Ann Stewart. Ms. Barbara
Cook testified on behalf of Local 2571, American Federation of
Government Employees. Ms. Cynthia Bascetta, Director for Health
Care--Veterans' Health and Benefits Issues, represented GAO and
was accompanied by Ms. Irene Chu, Mr. Martin Scire, and Mr.
Greg Whitney. Mr. Robert Epley, Associate Deputy Under
Secretary for Policy and Program Management, represented VBA
and was accompanied by Mr. Michael Walcoff. Mr. Carl Lowe,
Director, Waco VA Regional Office, also testified. The
veterans' representatives expressed their frustration with an
overburdened claims system, and the VA detailed its efforts to
reduce the backlog while retaining quality of claims decisions.
Hearing on Status of VA Implementation of Claims Processing
Task Force Recommendations, and Potential for Greater VA/
Veterans Service Organization Partnership
On June 6, 2002, the Subcommittee on Benefits held an
oversight hearing on the status of VA's implementation of the
VA Claims Processing Task Force's recommendations, and the
potential for a greater VA/veterans service organization (VSO)
partnership. Witnesses included: Honorable Daniel Cooper, Under
Secretary for Benefits, VBA, accompanied by Mr. Robert Epley,
Associate Deputy Under Secretary for Policy and Program
Management, Mr. E. Dane Clark, Board of Veterans' Appeals, Ms.
Laura Miller, Assistant Deputy Under Secretary for Health, Mr.
John H. Thompson, VA Deputy General Counsel, and Mr. Jack Ross,
Director, Cleveland VA Regional Office; Mr. George Hunt,
President, National Association of County Veterans Service
Officers, accompanied by Mr. Michael Murphy, First Vice
President, and Mr. Ronald Melendez, Treasurer/Chief Financial
Officer; Mr. Raymond Boland, President, National Association of
State Directors of Veterans Affairs; Mr. Carl Blake, Associate
Legislative Director, Paralyzed Veterans of America; Mr. John
McNeil, Deputy Director, National Veterans Service, Veterans of
Foreign Wars; Mr. Brian Lawrence, Associate National
Legislative Director, Disabled American Veterans; Mr. James
Fischl, Director, National Veterans Affairs and Rehabilitation
Commission, The American Legion; Mr. John Lopez, Chairman,
Association of Service Disabled Veterans; Leonard Selfon, Esq.,
Director, Veterans Benefits Program, Vietnam Veterans of
America; and Mr. Howard DeWolf, National Service Director,
AMVETS.
Several veterans service organizations, particularly the
National Association of County Veterans Service Officers, the
Paralyzed Veterans of America, and the Veterans of Foreign Wars
expressed their vision for submitting fully-developed, ready-
to-rate disability compensation claims; the VA supported a
stronger VA/VSO ``partnership,'' and described its initiatives
for partnership.
Hearing on the Transition Assistance Program and the Disabled
Transition Assistance Program
On July 18, 2002, the Subcommittee on Benefits held a
hearing on the Transition Assistance Program (TAP) and the
Disabled Transition Assistance Program (DTAP). With an
estimated 1.1 million servicemen and women transitioning to
civilian life over the next five years, the progress and
effectiveness of federal programs to help them find jobs is an
important issue for the Committee. As required by law, the
Army, Navy, Air Force, Marine Corps, Coast Guard provide pre-
separation counseling not later than 180 days prior to
separation, and as early as 12 months prior to separation for
servicemembers serving one term and 24 months prior to
separation for retirees. Among the items discussed were earned
educational and home loan benefits, disability compensation and
health care benefits, job search and placement information, and
financial planning.
The witnesses included Ms. Cynthia Bascetta, GAO,
accompanied by Ms. Sheila Drake; Mr. John M. Molino, Deputy
Assistant Secretary of Defense for Military, Community and
Family Policy; Mr. John McLaurin, Deputy Assistant Secretary
for Human Resources, U.S. Army; Ms. Anita Blair, Deputy
Assistant Secretary for Personnel Programs, U.S. Navy; Ms.
Kelly Craven, Deputy Assistant Secretary for Force Management
Integration, U.S. Air Force; Rear Admiral Joyce Johnson,
Director, Directorate of Health and Safety, U.S. Coast Guard;
Mr. Robert Epley, Associate Deputy Under Secretary for Policy
and Program Management, VBA; and Honorable Frederico Juarbe,
Jr., Assistant Secretary of Labor for Veterans' Employment and
Training Service.
Each service branch and the Department of Defense testified
that a Department of Labor presence on U.S. military bases
abroad would help transitioning servicemembers, many of whom
cannot communicate with employers in the states and territories
during the business day due to time-zone differences. All
witnesses, Chairman Simpson, and Ranking Member Reyes expressed
support for DOL stationing personnel at major military bases
overseas to assist transitioning servicemembers in finding
jobs; DOL agreed to expeditiously explore this possibility.
Witnesses at the hearing reiterated that one of the
hallmarks of a successful transition is sustained, quality
employment. They confirmed that the reliability, initiative and
leadership qualities servicemembers possess are valuable to
civilian employers, and that hiring former servicemembers is a
good business decision.
Subcommittee on Oversight and Investigations
The Subcommittee on Oversight and Investigation is charged
with oversight of all matters within the jurisdiction of the
Committee on Veterans' Affairs. Primary focuses include:
combating government waste, fraud, and abuse; improving Federal
accountability; and assuring Federal compliance with law
through oversight and investigation. The Subcommittee also
strives to protect the rights of veterans and their family
members. In order to carry out its responsibilities, the
Subcommittee conducts hearings, site visits and investigations
nationwide, and commissions reports from the General Accounting
Office, the Congressional Research Service, and the VA's Office
of the Inspector General. (See p. 89, Oversight Plan for 107th
Congress).
OVERSIGHT HEARINGS
First Session
Hearing on VA Information Technology
On April 4, 2001, the Subcommittee on Oversight and
Investigations held a hearing on the Department of Veterans
Affairs' information technology programs. Witnesses included:
Honorable Anthony J. Principi, Secretary of Veterans Affairs;
Honorable Thomas L. Garthwaite, Under Secretary for Health,
VHA; Honorable Joseph Thompson, Under Secretary for Benefits,
VBA; the Honorable Roger H. Rapp, VA Under Secretary for
Memorial Affairs; Mr. Karl Ware, Executive Vice-President of
Operations, BioNetrix Systems Corporation; Mr. Ken Brandt,
Managing Director, Tiger Testing; Mr. Scott C. Sherman,
Director of Advanced Technology Architectures, EMC2
Corporation; Dr. David McClure, Director of Information
Technology Management Issues, GAO; Ms. Valerie C. Melvin,
Assistant Director for Accounting and Information Management
Issues, GAO; Honorable Richard J. Griffin, VA Inspector
General; and Mr. Michael Slachta, VA Assistant Inspector
General for Audit. The House Majority Leader, Honorable Richard
Armey, also provided a statement for the record.
In this second follow-up hearing (previous hearings on May
11, 2000, and September 21, 2000, 106th Congress), the
Subcommittee heard testimony concerning computer security, VA's
efforts to develop an integrated, department-wide enterprise
architecture, VHA's Decision Support System (DSS), and VBA's
VETSNET compensation and pension system. VA testified that it
had not defined its system-wide architecture. It also gave a
progress report on the DSS program.
VA has been upgrading its IT infrastructure for the last
decade. The IT budget for 2001 was $1.4 billion and for 2002
was $1.1 billion. It has received approximately one billion
dollars a year for the past decade.
The hearing concluded with the Chairman stating that at
planned follow-up hearings, VA should anticipate the following
questions being asked: (1) when will the integrated enterprise
architecture plan be delivered to Congress; (2) when will VA's
level of IT security be at adequate levels to protect the
privacy of veterans; (3) when will VETSNET be required to pass
the independent audit referenced in VA's testimony; and (4)
when will DSS be fully implemented and standardization audits
be in place?
Field Hearing on Quality of Care and Management Issues
On September 5, 2001, the Subcommittee held a field hearing
at the Indiana War Memorial in Indianapolis, on quality of care
and management issues in Indiana, and the management and
delivery of benefits by the VA Regional Office for Benefits in
Indianapolis. Witnesses included: Honorable Anthony J.
Principi, Secretary of Veterans Affairs; Honorable Richard
Griffin, VA Inspector General; Mr. Alanson Schweitzer, VA
Assistant Inspector General for Healthcare Inspections; Mr.
William DeProspero, Director, Chicago Operations Division, VA
Office of Inspector General; Mr. Paul Curtice, Veteran Service
Officer, Morgan County Indiana Veterans Office; Mr. Randy
Fairchild, Veteran Service Officer, Tippecanoe County Indiana
Veterans Office; Mr. William D. Jackson, Director, Indiana
State Department of Veterans Affairs; Mr. Jay Kendall, Veteran
Service Officer, Miami County Indiana Veterans Office; Mr. John
Michalski, Commander, The American Legion of Indiana; Ms. Linda
Belton, Director of VHA Veterans Integrated Service Network 11;
Michael W. Murphy, Ph.D., Director VA Northern Indiana Health
Care System; Mr. Robert H. Sabin, Director, Richard L.
Roudebush VA Medical Center; Mr. Jeffrey M. Alger, Director, VA
Regional Office for Benefits, Indianapolis; Mr. Frederick G.
Bitner, President, AFGE Local 610; Ms. Teri James, RN,
President, AFGE Local 609; and Mr. William Overbey, President,
AFGE Local 1020.
Secretary Principi testified that one of his highest
priorities was to reduce the 650,000 claims backlog that was
largely inherited from the previous administration. He also
outlined VA's goals, based on his five-part vision (health
care, benefits, medical research, national cemeteries, and VA's
business practices). The Secretary discussed his Tiger Team
initiative, the Claims Processing Task Force headed by Admiral
(ret.) Daniel Cooper, and the Acquisition Reform Task Force,
which were designed to achieve his goals for the VA in the 21st
century.
The Inspector General provided an overview of the Combined
Assessment Program Review dated May 31, 2000, and cited several
areas that required improvement at Roudebush Medical Center,
including the need to strengthen its informed consent
procedures used for surgical and human research projects. The
Inspector General also identified three systemic concerns:
reconciliation of government purchase cards; inventory control
problems with some of the more expensive drugs; and destruction
of expired drugs.
The Subcommittee addresses several management issues at the
Marion VA facility. VA witnesses were questioned about the cost
benefit and justification of possible bed closures at the
Marion VA. Also, they were questioned about the justification
for building and dedicating a new Psychiatric facility at the
Marion VA, if it were to be used at only a fraction of design
capacity.
Several veterans' service officers and union
representatives testified about issues affecting Indiana
veterans and the VA. These issues include union disagreements
with VA management, lengthy waiting times for veterans to get
appointments and staffing shortages at the VA facilities in the
state.
Hearing on VA's Medical Care Collection Fund
On September 20, 2001, the Subcommittee held a hearing
which examined a number of issues that have confronted VA in
its efforts to improve its third party collections under the
Medical Care Collection Fund (MCCF). Witnesses included: Mr.
Steven P. Backhus, Director of Health Care--VA and Military
Health Issues, GAO; Honorable Richard J. Griffin, VA Inspector
General; Mr. James E. Woys, President and Chief Operating
Officer, Health Net Federal Services; Mr. Edward Gaskell,
President, AdvanceMed Corporation; Honorable Thomas L.
Garthwaite, M.D., Under Secretary for Health, VHA; and Ms.
Karen Sagar; MCCF Director, Martinsburg VA Medical Center.
In 1997, Congress gave VA authority to retain third party
collections it recovered, instead of returning the funds to the
U. S. Treasury. This was done at the request of VA as a part of
its five year plan to obtain ten percent of its funding from
third party collections and other revenue sources. VA had not
been able to meet this goal and acknowledged that for fiscal
year 2002 revenues from alternative sources would only reach
four percent.
The Inspector General shared information gathered from his
Combined Assessment Program Reviews that were conducted from
January 1, 1999 to August 15, 2001, as well as the most recent
MCCF findings. GAO testified that the VA reversed its decline
in third-party collections mainly due to its implementation of
the ``reasonable charges'' billing system. However, the GAO
representative suggested that the system's longstanding
problems still existed. The Subcommittee also heard testimony
from individuals in the private sector about what is necessary
to maximize collections, and why information collection is
important. VA provided its overview of the progress it had made
in collections. VA also presented the Price Waterhouse report
it commissioned that identified actions in 24 major areas that
should be taken to improve revenue operations.
Hearing on the Need to Develop Education and Training Programs
on the Medical Responses to the Consequences of Terrorist
Activities
On November 14, 2001, the Subcommittee on Oversight and
Investigations held a hearing to review the capabilities of the
Nation's medical community to diagnose and treat casualties
resulting from biological, chemical, and radiological
incidents. Witnesses included: Representative John Cooksey of
Louisiana; Representative Dave Weldon of Florida; John Eisold,
M.D., Attending Physician to Congress; Susan Matcha, M.D., Mid-
Atlantic Permanente Medical Group; Carlos Omenaca, M.D., Miami
Heart Center; Frances Murphy, M.D., Deputy Undersecretary for
Health, VHA; Susan Mather, M.D., Chief Officer, Public Health
and Environmental Hazards, VHA; Mr. Kenneth Misrach, Director,
VA New Jersey Health Care System; Val Hemming, M.D., Dean, F.
Edward Hebert School of Medicine, Uniformed Services University
of the Health Sciences (USUHS); J. Edward Hill, M.D., Chairman-
Elect of the Board of Trustees, American Medical Association;
Jordan J. Cohen, M.D., President, American Association of
Medical Colleges; Martin J. Blaser, M.D., Professor and
Chairman, Department of Medicine, New York University School of
Medicine. The Subcommittee heard testimony about the roles of
VA and DOD in educating the nation's medical students and
current health care professionals to diagnose and treat
casualties resulting from an unconventional attack.
The merits of H.R. 3254, the Medical Education for National
Defense Act of the 21st Century, introduced by Subcommittee
Chairman Buyer, were also discussed. DOD testified that the
USUHS curriculum prepares its physicians to deal with
biological, chemical, and chemical terrorism. USUHS is the only
medical school in the Nation that has this training as part of
its core curriculum. The VA representative testified that VA's
infrastructure, which consists of 171 medical centers, 800
clinics, satellite broadcast capabilities and a preexisting
affiliation with 107 medical schools, would enable current and
future medical professionals in this country to become
knowledgeable and medically competent in the treatment of such
exposures.
Dr. Matcha and Dr. Omenaca, who treated anthrax victims in
Washington, DC, and Florida respectively, testified that their
medical training left much to be desired when responding to an
anthrax attack. Dr. Eisold shared with the Subcommittee the
steps he took to safeguard individuals potentially exposed to
anthrax on Capitol Hill. Dr. Hill and Dr. Cohen testified that
the civilian medical community would be receptive to
information and training programs offered by VA and DOD and
that this information would enhance the medical schools'
curricula. The substance of H.R. 3254 became part of Public Law
107-287 (see p. 21 for summary).
Second Session
Hearing on VA Information Technology with Review of Integrated
Systems Architecture, VETSNET, DSS, Information Security, and
the Government Computer-Based Patient Record Program
On March 13, 2002, the Subcommittee on Oversight and
Investigations held a third follow-up hearing on VA's
continuing efforts to improve and secure its information
technology system. Witnesses included: Honorable John A. Gauss,
VA Assistant Secretary for Information and Technology; Mr.
Bruce A. Brody, VA Associate Deputy Assistant Secretary for
Cyber Security; Mr. Gary Christopherson, VHA CIO; Ms. K. Adair
Martinez, VBA CIO; Mr. William Campbell, VA Deputy Assistant
Secretary for Finance; Dr. Leon Kappelman, Director,
Information Systems Research Center at the University of North
Texas; Dr. David McClure, Director, Information Technology
Management Issues, GAO; Ms. Valerie C. Melvin, Assistant
Director, Accounting and Information Management Issues, GAO;
Honorable Richard J. Griffin, VA Inspector General; and Mr.
Steven Gaskell, Director, VA Inspector General Central Office
Operations.
The purpose of the hearing was to learn what progress had
been made with VA's IT architecture plan, VHA's VETSNET claims
processing program, VHA's Decision Support Systems, the
Government Computer-Based Patient Record Program, and computer
security.
The Clinger-Cohen Act of 1996 requires that agencies on a
government-wide basis develop an enterprise architecture. VA
had disparate systems with multiple data centers, technologies,
CIOs, networks and vendor products, which often resulted in
duplication or incompatibility. A ``One-VA'' integrated
enterprise architecture would eliminate many of these problems
and reduce operating costs. This would allow more
interoperability between VBA, VHA, and NCA.
In this hearing, the Subcommittee examined VA's progress on
the implementation of the ``One-VA'' integrated enterprise
architecture plan; progress on the development of the VETSNET
compensation and pension delivery system; the implementation of
the Government Computer Based Records system; VA's continuing
efforts to improve the strength of its network and information
security; and VHA's Decision Support System. The Subcommittee
questioned the newly appointed Department CIO about his plans
for these systems and his ability to take control of the
Department's IT programs, despite lacking a direct line of
authority over the CIOs of VHA, VBA and NCA. Dr. Gauss stated
that he would evaluate all legacy systems and would then make
appropriate recommendations. Regarding the direct line of
authority over the administration CIOs, Dr. Gauss stated that
he would not be opposed to receiving such authority, but he did
not feel such action was necessary for him to achieve his
objectives. Other witnesses discussed the need for the CIO's
increased line and budgetary authority to strengthen management
and to affect the required changes to achieve ``One-VA.''
The VA's new head of computer security, Bruce Brody,
outlined VA's ongoing efforts to strengthen its IT systems
against infiltration, with the highest priority being to
protect the system against external attack.
Joint Hearing on Nonprofit Research Corporations and
Educational Foundations Affiliated with Specific Veterans
Health Administration facilities
On May 16, 2002, the Subcommittee on Oversight and
Investigations and the Subcommittee on Health held a joint
hearing on VA research and research corporations and
educational foundations. Witnesses included: Mr. Michael
Slachta Jr., VA Assistant Inspector General for Audit; Mr. John
Bilobran, VA Deputy Assistant Inspector General for Audit; Dr.
John Mather, Chief Officer, Office of Research Compliance and
Assurance, VHA; Honorable Robert H. Roswell, M.D., VA Under
Secretary for Health; Honorable Tim S. McClain, VA General
Counsel; Dr. John R. Feussner, Chief Research and Development
Officer, VHA; Dr. Mindy Aisen, Director of Rehabilitation
Research and Development, VHA; Mr. Antonio Laracuente,
Chairman, National Association of Veterans' Research and
Education Foundations (NAVREF); Dr. Franklin Zieve, President,
McGuire Research Institute, Inc.; Mr. Kenneth Hickman,
Executive Director, Brentwood Biomedical Research Institute;
and Dr. Wendy Baldwin, Deputy Director for Extramural Research,
National Institutes of Health (NIH).
The hearing focused on several issues, including: a follow-
up on a Subcommittee hearing held in April 1999 on the
suspension of medical research at the West Los Angeles and
Sepulveda VA medical facilities; the status of VA's research
accreditation program; a review of the management and
effectiveness of VA research and education foundations; and an
examination of intellectual property rights concerning VA's
inventions and discoveries.
The Subcommittees received testimony on VA's protection for
human subject research programs, as well as testimony on
nonprofit research corporations and educational foundations
affiliated with VA. The Inspector General testified on VHA's
lack of knowledge concerning specific aspects and details of
the 85 active research corporations. Dr. Mather testified that
VA made significant improvements in its efforts to ensure the
effectiveness of its human research protection program, but
that many problems still exist. The VA representatives
acknowledged that it had to improve its oversight of the
corporations, but stressed the progress made in the protection
of human subjects in medical trials. The NAVREF representatives
testified that the individual research corporations were vital
VA research programs.
The Subcommittee questioned VA about its initiative to
attain intellectual property rights to the many medical
breakthroughs with which it has been associated. VA provided a
brief overview of this new program, and was informed to expect
a Subcommittee hearing on this issue. The Subcommittee also
questioned NIH on its policy of not including full funding to
include indirect costs for research conducted at VA facilities.
NIH provides these costs to most other organizations, including
foreign research entities. NIH and VA agreed to enter into
discussion concerning this topic.
Hearing on VA Medical Research Programs
On September 19, 2002, the Subcommittee on Oversight and
Investigations held a hearing on VA research activities.
Witnesses included: Mr. Benjamin Wu, Deputy Under Secretary for
Technology, U.S. Department of Commerce; Mr. Michael Slachta
Jr., VA Assistant Inspector General for Audit; Ms. Cynthia
Bascetta, Director of Veterans' Health and Benefits Issues,
GAO; Honorable Robert H. Roswell, M.D., Under Secretary for
Health, VHA; Dr. John Mather, Chief Officer, Office of Research
Compliance and Assurance (ORCA), VHA; Mindy Aisen, M.D.,
Director of Rehabilitation Research and Development, VHA; James
Burris, M.D., Acting Chief Research and Development Officer,
VHA; Mr. John Bradley, Director of Finance, Office of Research
and Development, VHA; Mr. Antonio Laracuente, Chairman,
National Association of Veterans' Research and Education
Foundations (NAVREF); and Wendy Baldwin, M.D., Deputy Director
for Extramural Research, National Institutes of Health (NIH).
The hearing provided the Subcommittee with an update on
several issues: VA's efforts in securing intellectual property
rights for its medical discoveries and inventions; VA's Human
Research Protection Accreditation Program; management and
effectiveness of VA research and education foundations; and
NIH/VA indirect cost for administration of research grants.
Witnesses from VA and Commerce testified concerning the
effectiveness of VA's technology transfer initiatives and how
they compared to those of other government agencies. It was
agreed that VA's efforts in this area were generally consistent
with those of other government agencies and appeared to be
headed in a positive direction. ORCA testified that it was
close to completing a comprehensive report on human subject
protections. The need to strengthen the reporting and
accountability standards of VA's 85 research and educational
foundations was discussed. NAVREF provided the Subcommittee
with an update of its ongoing efforts to ensure the financial
activities of the corporations comply with the letter and
spirit of the law.
The Subcommittee readdressed the NIH research funding
issues raised in the May 2002 hearing. Dr. Roswell indicated
the lack of NIH funding for indirect research costs could
impact veterans' healthcare. Other witnesses testified that VA
research included the types of research covered by an existing
statute that requires payments to VA when payments for a
similar purpose are made to other organizations. Before 1989,
NIH paid VA for indirect costs for research. A subsequent NIH
policy eliminated payment for indirect costs requiring VA to
cover indirect costs for NIH funded research at VA facilities.
The meeting between VA and NIH, promised at the May 2002
hearing, occurred only two weeks prior to this hearing.
Finally, the Subcommittee questioned both the Department of
Commerce and VA on the topic of intellectual property rights.
The Subcommittee highlighted VA's past missed opportunities to
obtain credit and royalties for its involvement in medical
discoveries, but also applauded VA's recent actions to obtain
them.
Hearing on VA Information Technology
On September 26, 2002, the Subcommittee on Oversight and
Investigations held a fourth follow-up hearing on VA's
continuing efforts to improve and secure its information
technology (IT) system. Witnesses included: Honorable John A.
Gauss, VA Assistant Secretary for Information and Technology;
Mr. Bruce A. Brody, VA Associate Deputy Assistant Secretary for
Cyber Security; Dr. Franklin A. Perry, VA Chief Technology
Officer; Mr. Joel C. Willemssen, Managing Director for
Information Technology Issues, GAO; Ms. Valerie C. Melvin,
Assistant Director for Accounting and Information Management
Issues, GAO; Honorable Richard J. Griffin, VA Inspector
General; and Mr. Michael Slachta Jr., VA Assistant Inspector
General for Audit.
The Subcommittee reviewed the progress on several programs,
including the VETSNET compensation and pension delivery system.
Dr. Gauss assured the Subcommittee that this six-year-old
program would be fully deployed by April 2004. The
implementation of the Government Computer Based Records system,
recently renamed the Federal Health Information Exchange
(FHIE), was also explored. VA and DOD's Memorandum of
Understanding dated May 3, 2002, stated that VA will take the
lead on FHIE's execution and completion. The review of VA's
continuing efforts to improve the strength of its network and
information security showed significant improvement, but also
identified continuing weaknesses.
The Secretary's decision to realign the Department's IT
personnel under the direct authority of the Department CIO was
also discussed by Dr. Gauss in his testimony. The Subcommittee
examined what effect this would have on VA's IT administrative
structure. For a number of years, GAO recommended that VA
realign its IT program and place it under the direct control of
the Departmental CIO. Previously, each administration within VA
(VHA, VBA, and NCA) had respective CIO's who reported to their
respective Under Secretaries. The Department CIO could only
advise the Under Secretary concerning actions that should be
taken.
The Secretary's reorganization was hailed by the
Subcommittee as an important step for VA. The Subcommittee
pledged its support to the Department in its efforts to
implement the integrated enterprise architecture plan and the
consolidation of authority in its CIO position.
SUMMARY OF VETERANS' AFFAIRS COMMITTEE ACTION
BILLS AND RESOLUTIONS REFERRED AND HEARINGS / EXECUTIVE SESSIONS CONDUCTED
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Congress
-------------------------------------------------------------------------------------------------------------------------------------------------------
89th 90th 91st 92d 93d 94th 95th 96th 97th 98th 99th 100th 101st 102d 103d 104th 105th 106th 107th
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Bills and resolutions referred.......... 791 685 740 693 839 719 709 339 273 229 198 147 194 215 174 128 134 146 194
Hearing sessions........................ 71 46 43 37 44 58 72 84 89 71 76 44 72 67 71 39 56 66 58
Meetings and mark-up sessions........... 32 13 27 21 16 30 26 19 18 16 20 16 26 20 23 19 18 13 14
Bills reported.......................... 47 \3\ 19 34 26 \4\ 14 23 32 11 16 15 17 14 33 21 25 15 15 10 14
Bills in House.......................... \1\ 4 4 1 4 1 ...... 1 1 1 3 3 1 4 3 11 ...... ...... 1 ......
Pending in Senate committees............ \2\ 12 3 9 7 2 \5\ 9 17 3 6 6 8 9 23 7 11 10 1 1 10
Bills on Senate Calendar or in Senate... 1 ...... ...... ...... ...... ...... 1 1 1 ...... 1 3 1 3 3 ...... ...... 1 ......
Recommitted............................. ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ......
Bills vetoed............................ ...... ...... ...... 2 1 ...... ...... 1 ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ......
Bills passed over veto.................. ...... ...... ...... ...... 1 ...... ...... 1 ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ......
Laws enacted............................ 30 15 24 15 15 15 13 6 8 8 6 4 8 24 15 6 6 11 12
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ and \2\ One bill in a Senate committee had purpose accomplished administratively; 5 other were enacted as sections of another bill; and portions of 1 bill left in the House were enacted as
part of another bill.
\3\ Includes S.J. Res. 197 making technical correction to law, which was brought to House floor for immediate consideration and passage by unanimous consent.
\4\ The difference in number of bills reported (14) and laws enacted (15) is due to the fact that S. 3705 did not go to the House Committee. However, the subject matter was included in H.R.
12628.
\5\ Includes H.R. 9576 subject matter of which was contained in S. 969, passed in lieu.
HEARINGS AND EXECUTIVE SESSIONS
(All hearings and executive sessions of the Committee are
held in the Committee hearing room, Room 334, Cannon House
Office Building unless otherwise designated.)
February 14, 2001. OPEN. 11:00 a.m. Full Committee.
Meeting. Organizational and Oversight Plan.
February 28, 2001. OPEN. 10:00 a.m. House and
Senatej1 deg. Veterans' Affairs Committees. Joint
Hearing. Room 345 Cannon HOB. The legislative priorities of the
Veterans of Foreign Wars.
March 1, 2001. OPEN. 9:30 a.m. House and
Senatej2 deg. Veterans' Affairs Committees. Joint
Hearing. Room 345 Cannon HOB. The legislative priorities of The
Retired Enlisted Association, Gold Star Wives, Fleet Reserve
Association and Air Force Sergeants Association.
March 6, 2001. OPEN. 1:00 p.m. Full Committee. Hearing.
Department of Veterans Affairs Budget Request for Fiscal Year
2002. (Serial No. 107-1)h1 deg.
March 7, 2001. OPEN. 12:45 p.m. Full Committee. Meeting.
Approve the Committee's Views and Estimates of the
Administration's Fiscal Year 2002 Budget.
March 8, 2001. OPEN. 9:30 a.m. House and
Senatej3 deg. Veterans' Affairs Committees. Joint
Hearing. Room 345 Cannon HOB. The legislative priorities of the
Blinded Veterans Association, Non Commissioned Officers
Association, Military Order of the Purple Heart, Jewish War
Veterans and Paralyzed Veterans of America.
March 13, 2001. OPEN. 1:30 p.m. Full Committee. Hearing.
H.R. 811, Veterans' Hospital Emergency Repair Act. (Serial No.
107-2)h2 deg.
March 14, 2001. OPEN. 10:00 a.m. House and
Senatej4 deg. Veterans' Affairs Committees. Joint
Hearing. Room 345 Cannon HOB. The legislative priorities of the
Disabled Veterans of America.
March 15, 2001. OPEN. 9:00 a.m. Subcommittee on Benefits.
Hearing. H.R. 801, the Veterans' Opportunities Act of 2001, and
VA's Implementation of Veterans' Transitional Housing
Assistance. (Serial No. 107-3)h3 deg.
March 21, 2001. OPEN. 10:00 a.m. Full Committee. Markup.
H.R. 801 and H.R. 811.m1 deg.
March 22, 2001. OPEN. 10:00 a.m. House and
Senatej5 deg. Veterans' Affairs Committees. Joint
Hearing. Room 345 Cannon HOB. The legislative priorities of the
American Ex-Prisoners of War, Vietnam Veterans of America, The
Retired Officers Association, National Association of State
Directors of Veterans Affairs and AMVETS.
April 3, 2001. OPEN. 2:00 p.m. Subcommittee on Health.
Hearing. The State of the VA Health Care System. (Serial
No.107-4)h4 deg.
April 4, 2001. OPEN. 10:00 a.m. Subcommittee on Oversight
and Investigations. Hearing. Hearing III on Information
Technology. (Serial No. 107-5)h5 deg.
May 24, 2001. OPEN. 10:00 a.m. Subcommittee on Benefits.
Hearing. H.R. 1291, 21st Century Montgomery GI Bill Enhancement
Act. (Serial No. 107-6)h6 deg.
June 7, 2001. OPEN. 11:30 a.m. Subcommittee on Benefits.
Hearing. H.R. 1291, 21st Century Montgomery GI Bill Enhancement
Act. (Serial No. 107-6)h7 deg.
June 20, 2001. OPEN. 2:00 p.m. Subcommittee on Health.
Hearing. Mental Health, Substance-Use Disorders, and
Homelessness. (Serial No. 107-7)h8 deg.
July 10, 2001. OPEN. 10:00 a.m. Subcommittee on Benefits.
Hearing. Legislative Hearing on H.R. 862, H.R. 1406, H.R. 1435,
H.R.1746, H.R. 1929, H.R. 2359 and H.R. 2361. (Serial No. 107-
8)h9 deg.
July 12, 2001. OPEN. 10:30 a.m. Subcommittee on Benefits.
Markup. Pending Legislation.m2 deg.
July 19, 2001. OPEN. 9:00 a.m. Full Committee. Markup. H.R.
2540.m3 deg.
September 5, 2001. OPEN. 10:00 a.m. Indianapolis, Indiana.
Subcommittee on Oversight and Investigations. Hearing. Field
Hearing on Quality of Care and Management Issues. (Serial No.
107-9)h10 deg.
September 6, 2001. OPEN. 2:00 p.m. Subcommittee on Health.
Hearing. H.R. 2792, the Disabled Veterans Service Dog and
Health Care Improvement Act of 2001 and Related Legislative
Matters. (Serial No. 107-10)h11 deg.
September 20, 2001. OPEN. 10:00 a.m. Subcommittee on
Oversight and Investigations. Hearing. VA's Medical Care
Collection Fund. (Serial No. 107-11)h12 deg.
September 20, 2001. OPEN. 1:30 p.m. Full Committee.
Hearing. H.R. 2716, the Homeless Veterans Assistance Act of
2001, and H.R. 936, the Heather French Henry Homeless Veterans
Assistance Act. (Serial No. 107-12)h13 deg.
September 24, 2001. OPEN. 9:00 a.m. Veterans Affairs
Medical Center, Wichita, Kansas. Subcommittee on Health.
Hearing. Rural Health Care. (Serial No. 107-
13)h14 deg.
October 4, 2001. OPEN. 2:00 p.m. Subcommittee on Health.
Markup. H.R. 2716 and H.R. 2792.m4 deg.
October 10, 2001. OPEN. 10:00 a.m. Full Committee. Markup.
H.R. 2716 and H.R. 2792.m5 deg.
October 15, 2001. OPEN. 2:00 p.m. Full Committee. Hearing.
VA's Ability to Respond to DOD Contingencies and National
Emergencies. (Serial No. 107-14)h15 deg.
October 30, 2001. OPEN. 9:00 a.m. Subcommittee on Benefits.
Hearing. General Accounting Office's report: ``Veterans'
Employment and Training Service Flexibility and Accountability
Needed to Improve Service to Veterans.'' (Serial No. 107-
15)h16 deg.
November 6, 2001. OPEN. 2:00 p.m. Full Committee. Hearing.
To Receive the Report VA Claims Processing Task Force (Cooper
Report). (Serial No. 107-16)h17 deg.
November 14, 2001. OPEN. 10:00 a.m. Subcommittee on
Oversight and Investigations. Hearing. The Need to Develop
Education and Training Programs on the Medical Responses to the
Consequences of Terrorist Activities.h18 deg.
December 13, 2001. OPEN. 10:00 a.m. Full Committee.
Hearing. H.R. 3423, to amend Title 38, United States Code, To
Enact into Law Eligibility of Certain Veterans and Their
Dependents for Burial in Arlington National
Cemetery.h19 deg.
December 13, 2001. OPEN. 2:00 p.m. Full Committee. Markup.
H.R. 3423.m6 deg.
January 24, 2002. OPEN. 9:00 a.m. Subcommittee on Health.
Hearing. To Consider Issues of Operational and Medical
Readiness in the Active Duty Force and Their Relationships to
the Health Status of the Veteran Population.h20 deg.
February 13, 2002. OPEN. 10:00 a.m. Full Committee.
Hearing. Department of Veterans Affairs Budget Request for
Fiscal Year 2003.h21 deg.
February 27, 2002. OPEN. 9:30 a.m. House and
Senatej6 deg. Veterans' Affairs Committees. Joint
Hearing. Room 345 Cannon HOB. The Legislative Priorities of the
Disabled American Veterans.
February 27, 2002. OPEN. 12.00 p.m. House and
Senatej7 deg. Veterans' Affairs Committees. Joint
Hearing. Room 345 Cannon HOB. The Legislative Priorities of the
Veterans of Foreign Wars.
February 27, 2002. OPEN. 2:00 p.m. Subcommittee on Health.
Hearing. Hearing to Consider Issues of Operational and Medical
Readiness in Active Duty Force and Their Relationships to the
Health Status of the Veteran Population.h22 deg.
March 7, 2002. OPEN. 10:00 a.m. House and
Senatej8 deg. Veterans' Affairs Committees. Joint
Hearing. Room 345 Cannon NOB. The legislative priorities of the
Paralyzed Veterans of America, Jewish War Veterans, Blinded
Veterans Association, Non Commissioned Officers Association,
Military Order of the Purple Heart.
March 7, 2002. OPEN. 10:00 a.m. Subcommittee on Health and
Committee on Armed Services, Subcommittee on Military
Personnel. Joint Hearing. 2118 Rayburn HOB. Health Care Sharing
by the Department of Defense and the Department of Veterans
Affairs. (H.A.S.C. 107-39)h23 deg.
March 13, 2002. OPEN. 10:00 a.m. Subcommittee on Oversight
and Investigations. Hearing. Hearing on VA's Information
Technology Initiatives.h24 deg.
March 14, 2002. OPEN. 10:00 a.m. House and
Senatej9 deg. Veterans' Affairs Committees. Joint
Hearing. Room 345 Cannon HOB. The legislative priorities of
Gold Star Wives, Fleet Reserve Association, the Air Force
Sergeants Association, and The Retired Enlisted Association.
March 20, 2002. OPEN. 2:00 p.m. House and
Senatej10 deg. Veterans' Affairs Committee. Joint
Hearing. Room 345 Cannon HOB. The legislative priorities of
American Ex-Prisoners of War, Vietnam Veterans of America, The
Retired Officers Association, National Association of State
Director of Veterans Affairs and AMVETS.
April 10, 2002. OPEN. 3:00 p.m. Subcommittee on Health.
Hearing. Hearing on H.R. 3253, National Medical Emergency
Preparedness Act of 2001; and H.R. 3254, Medical Education for
National Defense in the 21st Century Act.h25 deg.
April 11, 2002. OPEN. 9:00 a.m. Subcommittee on Benefits.
Hearing. Hearing on H.R. 1108, Allow Payment of Dependency and
Indemnity Compensation to Surviving Spouses Who Marry After Age
55; H.R. 2095, Reservist VA Home Loan Fairness Act of 2001;
H.R. 2222, Veterans Life Insurance Improvement Act of 2001; and
H.R. 3731, Increase Funding For State Approving
Agencies.h26 deg.
April 18, 2002. OPEN. 9:00 a.m. Subcommittee on Benefits.
Hearing. Hearing on H.R. 4015, Jobs for Veterans
Act.h27 deg.
April 24, 2002. OPEN. 3:00 p.m. Subcommittee on Health.
Hearing. Hearing on the Major Medical Facilities Construction
Authorization bill.h28 deg.
April 26, 2002. OPEN. 1:00 p.m. El Paso, Texas.
Subcommittee on Benefits. Hearing. Field Hearing on VA Claims
Processing.h29 deg.
April 30, 2002. OPEN. 10:00 a.m. George Washington
Ballroom, War Memorial Building, Trenton, New Jersey. Full
Committee. Hearing. Field Hearing on Recommendations to Revise
VA System for Healthcare Resource Allocation.h30 deg.
May 1, 2002. OPEN. 1:30 p.m. Subcommittee on Health.
Markup. H.R. 3253, H.R. 4514 and H.R. 4608.m7 deg.
May 2, 2002. OPEN. 10:00 a.m. Subcommittee on Benefits.
Markup. Pending legislation.m8 deg.
May 9, 2002. OPEN. 10:00 a.m. Full Committee. Markup.
H.R.4015, H.R. 4085, H.R. 4514, H.R. 3253 and H.R.
4608.m9 deg.
May 16, 2002. OPEN. 10:00 a.m. Subcommittee on Health and
Subcommittee on Oversight and Investigations. Joint Hearing.
Nonprofit Research Corporations and Educational Foundations
Affiliated with Specific Veterans Health Administration
Facilities.h31 deg.
June 6, 2002. OPEN. 10:00 a.m. Subcommittee on Benefits.
Hearing. Hearing on the Status of the Department of Veterans
Affairs' Implementation of the VA Claims Processing Task
Force's Recommendations, and the Potential for a Greater VA/
Veterans Service Organization ``Partnership.''h32 deg.
June 11, 2002. OPEN. 10:00 a.m. Subcommittee on Benefits.
Hearing. Hearing on H.R. 3173, the Servicemembers and Military
Families Financial Protection Act of 2001; H.R. 3735, the
Department of Veterans Affairs Overpayment Administration
Improvement Act of 2002; H.R. 3771, to Exclude Monetary
Benefits Paid to Veterans by States and Municipalities from
consideration as income for purposes of pension benefits; and
H.R. 4042, the Veterans Home Loan Prepayment Protection Act of
2002. Two Draft Bill were also considered: the Arlington
National Cemetery Burial Eligibility Act, and Legislation
Providing Dependency and Indemnity Compensation to the
Surviving Spouse of a Veteran with a Totally Disabling Service-
Connected Cold-Weather Injury.h33 deg.
June 13, 2002. OPEN. 3:00 p.m. Subcommittee on Health.
Hearing. Hearing on the Health Care of Filipino World War II
Veterans within the Department of Veterans
Affairs.h34 deg.
June 17, 2002. OPEN. 9:00 a.m. Veterans Affairs Medical
Center, Kansas City, Missouri. Subcommittee on Health. Hearing.
Field Hearing to Investigate Conditions at Kansas City Veterans
Medical Center.h35 deg.
June 26, 2002. OPEN. 9:30 a.m. Subcommittee on Health.
Hearing. Hearing on H.R. 3645, Veterans Health-Care Items
Procurement Reform and Improvement Act of
2002.h36 deg.
July 9, 2002. OPEN. 1:00 p.m. Subcommittee on Benefits.
Markup. H.R. 4940 and H.R. 5055.m10 deg.
July 10, 2002. OPEN. 2:00 p.m. Subcommittee on Health.
Markup. H.R. 3645.m11 deg.
July 16, 2002. OPEN. 9:30 a.m. Full Committee. Markup.
H.R.4940, H.R. 5055 and H.R. 3645, as amended.m12 deg.
July 16, 2002. OPEN. 11:00 a.m. Full Committee. Hearing.
Hearing on H.R. 4939, the Veterans Medicare Payment Act of
2002.h37 deg.
July 18, 2002. OPEN. 10:00 a.m. Subcommittee on Benefits.
Hearing. Hearing on the Transition Assistance Program and the
Disabled Transition Assistance Program.h38 deg.
July 24, 2002. OPEN. 10:00 a.m. Subcommittee on Benefits.
Hearing. Hearing on H.R. 5111, the Servicemembers' Civil Relief
Act and H.R. 4017, the Soldiers' and Sailors' Civil Relief
Equity Act.h39 deg.
July 25, 2002. OPEN. 10:00 a.m. Subcommittee on Benefits.
Hearing. Continuation of hearing on H.R. 5111 and
H.R.4017.h40 deg.
September 10, 2002. OPEN. 10:00 a.m. House and
Senatej11 deg. Veterans' Affairs Committees. Joint
Hearing. Room 345 Cannon HOB. The legislative priorities of The
American Legion.
September 12, 2002. OPEN. 1:30 p.m. Full Committee.
Hearing. Hearing on the Department of Veterans Affairs Homeless
Veterans Programs.h41 deg.
September 19, 2002. OPEN. 11:00 a.m. Subcommittee on
Oversight and Investigations. Hearing. Hearing on the
Department of Veterans Affairs Medical Research
Programs.h42 deg.
September 26, 2002. OPEN. 10:00 a.m. Subcommittee on
Oversight and Investigations. Hearing. Hearing on the
Department of Veterans Affairs Information Technology (IT)
Program.h43 deg.
October 2, 2002. OPEN. 9:30 a.m. Subcommittee on Health.
Hearing. Hearing on VA's current Programs for Women
Veterans.h44 deg.
October 9, 2002. OPEN. 10:45 a.m. Subcommittee on Health.
Hearing. Hearing on Project SHAD, regarding Secret Chemical and
Biological Tests conducted on American
Servicemembers.45 deg.
October 16, 2002. OPEN. 1:00 p.m. Full Committee. Hearing.
Hearing to review the Department of Veterans Affairs Report on
the National Cemetery System.46 deg.
COMMITTEE WEB SITE
WWW.VETERANS.HOUSE.GOV
The Committee on Veterans' Affairs maintains a
comprehensive web site that provides up-to-date information on
the activities of the Committee, records of Committee hearings,
press releases, legislation, official documents and other
reference materials of interest to veterans. The web site also
provides links to other web sites pertaining to veterans,
veterans service organizations, Congress, the Department of
Veterans Affairs, and other agencies and organizations of
interest to veterans, or involved in veterans policy issues.
In the first session of the 107th Congress, the Committee
reviewed, redesigned and redeveloped the Committee web site in
order to apply the latest technologies and techniques for the
benefit of the web site's users. In redesigning the web site,
the Committee's goal was to create a web site that provided
complete and timely information; delivered that information in
a simple and accessible manner; and provided enhanced value for
our target audience of veterans, Congress, and other public and
private agencies involved in determining policy on veterans'
issues.
Using a professional web site consultant, the Committee
developed a new design that placed the most recent and
important information directly on the front page in a
straightforward and uncluttered format. In addition, the menu
structure was reorganized in order to provide quicker access to
the activities and work products of the Committee. The new web
site also contained new search tools to access the information
contained within the Committee's web site as well as
legislative information available from the Library of Congress.
OVERSIGHT PLAN FOR 107th CONGRESS
In accordance with clause 2(d)(1) of Rule X of the House of
Representatives, the Committee on Veterans' Affairs has adopted
by resolution of February 14, 2001, its oversight plan for the
107th Congress.
This oversight plan is directed at those matters most in
need of oversight within the next two years. The Committee is
cognizant of the requirement that it conduct oversight on all
significant laws, programs, or agencies within its jurisdiction
at least every ten years. To ensure coordination and
cooperation with the other House committees having jurisdiction
over the same or related laws affecting veterans, the Committee
will consult as necessary with the Committee on Armed Services,
the Committee on Education and the Workforce, and the Committee
on Government Reform.
Oversight will be accomplished through committee and
subcommittee hearings, field and site visits by Members and
staff, and meetings and correspondence with interested parties.
Methods of oversight will include existing and requested
reports, studies, estimates, investigations and audits by the
Congressional Research Service, the Congressional Budget
Office, the General Accounting Office, and the Offices of the
Inspectors General of the Departments of Veterans Affairs and
Labor.
The Committee will seek the views of veterans' service
organizations, military associations, other interest groups and
private citizens. The Committee also welcomes communications
from any individuals and organizations desiring to bring
matters to its attention. A series of joint hearings is
scheduled with the Senate Committee on Veterans Affairs at
which veterans' service organizations and military associations
will present to the committees their national resolutions and
agendas for veterans.
While this oversight plan describes the foreseeable areas
in which the Committee expects to conduct oversight during the
107th Congress, the Committee and its subcommittees will
undertake additional oversight activities as the need arises.
Because the Committee generally conducts oversight through its
subcommittees, the plan is organized by subcommittee.
Subcommittee on Health
Veterans Equitable Resource Allocation (VERA) System. The
Veterans Health Administration (VHA) adopted this system of
allocating funds to its field health activities in April 1997,
but this year the Under Secretary for Health approved special
dispensations of more than $220 million from a national reserve
for contingencies to restore some under-funded networks. The
Subcommittee will review the operation and effectiveness of
VERA.
Maintaining Capacity of Programs for Special Disabilities
and Long-Term Care. Public Law 104-262, the Veterans' Health
Care Eligibility Reform Act of 1996, requires VA to maintain
specialized capacities to care for veterans. By law, VA
provides a report to Congress each year to indicate the stasis
of these capacities. The next report, in April, adds capacity
for VA's long-term care programs. The Subcommittee intends to
carefully monitor and evaluate VA's capacities to meet high-
priority, specialized needs of veterans.
Hepatitis C (HCV) Programs. The VA health care system
reports that it is currently treating 70,000 veterans who have
tested positive for HCV. The Subcommittee will examine VA's
response to the growing incidence of HCV infection among the
population treated by VA and the consequential rise in demand
for treatment. We will assess VA's research approach to
exploring the etiology of HCV; VA's use of clinical therapies;
and methods by which VA allocates and monitors HCV funding.
Mental Health and Substance-Use Disorder Programs. Reported
reductions in capacity in VA programs to care for the most
seriously mentally ill veterans, especially those with
psychoses and with substance-use disorders, are of particular
concern. The Subcommittee will explore the state of VA's mental
health programs and the effectiveness of chronic mental illness
treatment programs in VA's institutional, contract, community-
based, case-management and aftercare programs.
Rural Health Care Matters. The Committee is concerned about
the health of veterans who live in rural and remote regions,
particularly whether they have adequate access to VA health
care and services. The emergence of VA telemedicine holds
promise to extend VA services beyond major VA medical centers.
The Subcommittee will examine the role of telemedicine in VA's
efforts in rural care. Also, VA has promoted improved access
through its community-based clinics, primary care outlets now
numbering in the hundreds. The Subcommittee will explore these
clinics' geographic distribution to determine if VA has
adequately responded to rural veterans' needs, including
exploration of the availability of mental health services in
VA's outreach efforts in rural areas.
Women Veterans' Programs. An Advisory Committee on Women
Veterans was established in 1983 under Public Law 98-160 to
assess the health care, outreach, and benefits needs of women
and make recommendations to the Secretary of Veterans Affairs
and Congress. VA medical centers have been mandated to
designate women veterans' coordinators, in addition to
providing specialized services and outreach. A recent report to
the Under Secretary for Health identified the lack of privacy
and gender-specific accommodations for women in VA facilities.
The Subcommittee will continue to review VA policies and
programs for women veterans.
Follow-up on Millennium Act. Public Law 106-117, the
Veterans Millennium Health Care and Benefits Act, was the most
significant health care legislation Congress has enacted for
veterans in a number of years. The Subcommittee will pay close
attention to the steps VA must take to comply fully with its
mandates. The Subcommittee is especially concerned about the
implementation of new copayment policy and its impact on poor
and disabled veterans. Therefore, the Subcommittee will review
VA's copayment plan.
Follow-up on Recent Personnel Legislation. Congress passed
significant changes in VA practitioner pay systems and methods
during the 106th Congress in Public Law 106-419, the Veterans
Health Care Personnel and Benefits Act of 2000. The
Subcommittee will examine VA's implementation of these changes.
Scarce Medical Specialty Contracting. The Subcommittee is
concerned about the services of various medical specialties
obtained through government contracts. Some of these contracts
are very expensive. The Subcommittee will explore VA's options
in obtaining such services in a cost-effective manner,
including consideration of title 38 employment authority rather
than contract arrangements.
VA and DOD Health Resources Sharing. Authorized under
Public Law 97-174, the VA-DOD health resources sharing program
has been in existence for nearly twenty years. Yet, oversight
by the Subcommittees on Health and Oversight and Investigations
has revealed that barriers to sharing still exist in the
organizational cultures of VA and DOD. The GAO reported to the
Committee that VA and DOD efforts to consolidate procurement of
drugs and biologicals could save the federal government
hundreds of millions of dollars. Also, the Congressional
Commission on Servicemembers and Veterans Transition Assistance
made a number of recommendations in 1999 for increased sharing
in these federal health programs. The Subcommittee intends to
continue its oversight of VA-DOD resource sharing to encourage
more effective use of funding for veterans and military health
care.
VA Nonprofit Research Corporations. Public Law 100-322
authorized the establishment of nonprofit research corporations
at VA medical centers to advance their research mission. VA is
required to report to Congress on an annual basis the
activities of these corporations. The Subcommittees on Health
and on Oversight and Investigations will conduct joint
oversight of them to ensure that they are effective and that
their operations are consistent with Congressional intent.
Status of VA Medical Research. VA medical research in
collaborative affiliations with the Nation's schools of
medicine has been remarkably successful in curing human disease
and advancing biomedicine. The Subcommittees on Health and on
Oversight and Investigations have monitored VA research for a
number of years and have recently observed some lapses in
human-subject protections, inadequate management systems and
other problems. VA has made a commitment to improve its
performance. The Subcommittee will continue to review the
progress in carrying out this major mission of the Department.
Adequacy of CHAMPVA Benefits. In Public Law 106-398, the
Floyd Spence Armed Forces Reauthorization Act of 2000, Congress
enacted a sweeping reform of military health care programs.
However, the Civilian Health and Medical Program-Veterans
Affairs (CHAMPVA) continues to offer health care benefits to
eligible family members of veterans under the previous CHAMPUS/
TRICARE criteria, with significant limitations and considerable
cost-sharing. The Subcommittee will consider the adequacy of
this benefit for CHAMPVA beneficiaries compared to the
restructured military health care programs.
Infrastructure Maintenance in VA Health Care. The VA health
care system capital asset planning process, known as Capital
Assets Restructuring for Enhanced Services (CARES), will
consume several years of effort. In the meantime, the
Subcommittee is concerned about the medical facilities that
CARES may not address. Many need maintenance, repair and
upgrading. The Subcommittee will review these needs.
Waiting Times for Outpatient Care. The Committee's chairman
and ranking member during the 106th Congress requested a series
of reports from the General Accounting Office on the amount of
time veterans must wait until they receive an appointment for
routine or specialty care in VA outpatient clinics. GAO has
questioned the value of some of the initiatives for which VA
requested funding in fiscal year 2001 and also raised concerns
about data used to assess waiting times in VA. The Subcommittee
will continue to evaluate factors that exacerbate waiting times
and the efficacy of strategies underway to reduce waiting times
in VA.
Subcommittee on Benefits
Accuracy and Timeliness of Claims Decisions. VA provides
over $20 billion a year in disability compensation and pension
benefits to more than 2.5 million veterans and survivors.
Public Law 106-117 required the VA to implement a quality
assurance program for programs administered by the Veterans
Benefits Administration. Reports by the General Accounting
Office and VA's Inspector General have analyzed longstanding
problems with the timeliness of claims adjudication. A hearing
will examine issues of quality and timeliness in the claims
adjudication process, to include veterans' appeals of VA claims
decisions.
Claims Adjudication Commission Recommendations. The 1996
report of the Veterans' Claims Adjudication Commission
recommended that VA and veterans service organizations
establish a formal claims processing partnership group, develop
case management practices and consider a lump sum payment of
these benefits. A hearing will examine VA's progress in
partnership initiatives and case management, and explore the
issue of lump sum payments of disability compensation benefits.
Long-Term Issues in Claims Processing. The Veterans
Benefits Administration has developed a number of initiatives
designed to improve the processing of claims. These include
computerized training programs, rating board adjudication
revisions, telephone improvements and revised notices. In
addition, the Veterans Claims Assistance Act, Public Law 106-
475, mandates a number of changes in claims processing. A
hearing will review these issues.
Persian Gulf War Veterans. The Institute of Medicine of the
National Academy of Sciences and the RAND National Defense
Research Institute have released reports concerning the health
of Gulf War veterans. The Subcommittee will conduct a joint
hearing with the Subcommittee on Health to review these and
other research findings.
Veterans Entrepreneurship Opportunities. Veterans should be
accorded a full opportunity to participate in the economic
system that their service sustains. In conjunction with the
House Small Business Committee, the Subcommittee on Benefits
will conduct its second oversight hearing on the Small Business
Administration and federal government-wide implementation of
the Public Law 106-50, the Veterans Entrepreneurship and Small
Business Development Act of 1999. A hearing will focus efforts
on the business development and technical, financial, and
procurement assistance aspects of the law.
Military Occupational Specialties Requiring Civilian
Licensing, Certification or Apprenticeship. The civilian
employment sector increasingly relies on various forms of
credentialing and licensing to regulate entry into an
occupation or profession. The Subcommittee on Benefits held two
hearings on this issue in the 106th Congress. A hearing will
continue to examine the role of the Departments of Veterans
Affairs, Labor, and Defense in helping separating
servicemembers and veterans meet credentialing requirements.
National Personnel Records Center (NPRC). NPRC, located in
St. Louis, MO, is the records center for all military service
documents. Understaffing and minimal technological equipment
appear to contribute to a growing backlog of requests for
information, thus delaying the processing of veterans' claims.
Following an onsite visit by VA Committee Members and staff, a
hearing will address what efforts are needed to improve the
processing of requests for medical and separation information.
National Cemetery Administration (NCA). Public Law 106-117
required VA to determine those geographic areas most in need of
a new national cemetery. Following receipt by Congress of the
report, a hearing will examine the areas NCA deems most in need
of a national cemetery.
Burial Benefits. Public Law 106-117 required VA to enter
into a contract to independently examine the adequacy and
effectiveness of the current burial benefits administered by
VA. Currently, there is no provision in title 38, United States
Code, requiring the Secretary of Veterans Affairs to conduct
periodic assessments of the burial benefits program. A hearing
to receive the report and review the recommendations will
inform the Committee how the program could better serve the
burial needs of veterans and their families.
Subcommittee on Oversight
Inappropriate Benefits Payments. VA Office of Inspector
General (OIG) audits indicate that the Veterans Benefits
Administration (VBA) should develop and implement effective
methods to identify inappropriate compensation and pension
payments. Additionally, coordination between VA, the Defense
Manpower Data Center, and local National Guard and Reserve
units continues to be problematical in achieving accurate and
timely payments under the Selected Reserve provisions of the
Montgomery GI Bill. The Subcommittee will review VBA's efforts
to implement procedures to timely identify deceased
beneficiaries and terminate their compensation and pension
benefits in order to reduce overpayments. Further, the
Subcommittee will examine coordination issues associated with
selected reserve educational assistance payments under the
MGIB.
VBA Internal Fraud Controls. VA OIG criminal investigations
have exposed several instances where VBA employees established
fraudulent disability compensation claims and stole more than a
million dollars of government funds. The OIG is currently
investigating more than a hundred similar fraud cases within
VBA. As a part of continuing oversight, the Subcommittee has
requested VBA study internal control and security measures used
by private sector companies. The Subcommittee will monitor
VBA's efforts to improve internal controls and security.
Disability Claims Processing. VA has outlined what it is
doing to improve processing of veterans disability claims, but
GAO has stated concerns that VA's existing plans may not be
adequate. The Subcommittee has requested that VBA gather
information from private sector companies regarding information
technology and best practices to streamline processing of
claims. In conjunction with the Subcommittee on Benefits, the
Subcommittee will continue review of VBA implementation of
plans to improve timeliness and accuracy of veterans claims
processing.
Veterans Employment and Training Service (VETS). The
Subcommittee will continue its oversight of this Department of
Labor program. In prior testimony, GAO stated that VETS lacks a
clear vision for the future and has no strategy to conform its
operations to the Workforce Investment Act. GAO is performing a
detailed study of VETS and will submit a report to Congress in
September 2001. This report will be the subject of an oversight
hearing. The Subcommittee will determine what progress VETS has
made in improving its service to veterans.
Veterans Preference. Veterans who are disabled or who
served during certain periods have preference in federal jobs.
The U.S. Government should be a model employer of veterans. The
Subcommittee will examine the federal observance and
enforcement of veterans preference.
Benefits Delivery at Discharge. To improve the transition
of servicemembers to civilian life, VA has stepped up its
outreach and services to active duty servicemembers before they
are discharged. Subcommittee oversight of benefits delivery at
discharge will include the extent to which DOD provides VA
timely notice of medical discharges. The Subcommittee will also
examine the timeliness of entry by veterans into VA's
vocational rehabilitation program and the VA's coordination
with VETS for job placement.
Faith-Based and Other Nonprofit Programs for Homeless
Veterans. The Subcommittee will continue to examine the success
rates of faith-based and other nonprofit homeless programs, as
well as the development of performance measures for homeless
veterans programs. The Subcommittee will further examine
whether such faith-based and other nonprofit programs are
awarded federal grants on an equitable basis.
Federal Employees' Compensation Program in VA. The
Subcommittee will follow-up its previous oversight hearing
during the 106th Congress. The Subcommittee will examine the
manner in which workers' compensation claims of VA employees
are processed as compared with other public and private sector
organizations.
Information Technology. VA's information technology
programs will spend over $1.4 billion in fiscal year 2001. The
Subcommittee will continue to review the role of VA's Chief
Information Officer and VA's Capital Investment Board in the
procurement and management of its IT programs. The Subcommittee
will also review VA's progress in IT programs, including:
developing a VA-wide data architecture, improving computer
security, utilizing VHA's Decision Support System, processing
claims with the VETSNET project, and developing the government
computerized patient record.
Patient Safety. The VA health care system has established
an adverse medical event incident reporting system in response
to the Institute of Medicine's report last year on medical
errors and continuing reports of serious lapses in the delivery
of quality health care in the VA. The Subcommittee will
continue to monitor and review VA's progress in identifying,
reporting and correcting adverse medical events.
Capital Asset Realignment for Enhanced Services (CARES).
The Subcommittee in conjunction with the Subcommittee on Health
will continue to review VA's long-term strategy and current
efforts to modernize the VA health care delivery system's vast
infrastructure. The Subcommittees will examine opportunities
for DOD and VA to participate in joint delivery of health care
to the men and women who serve or have served in uniform and
their family members. The Subcommittee will also examine the
VA's plans for addressing the future use of many VA buildings
that are functionally obsolete, but have historic significance.
Civilian Health and Medical Programs of the Department of
Veterans Affairs (CHAMPVA). In fiscal year 2000, there were
approximately 101,500 beneficiaries of the CHAMPVA program who
generated over 1.6 million medical claims. Annual program
expenditures were in excess of $13.4 million and claims
totaling $122.9 million. In conjunction with the Subcommittee
on Health, the Subcommittee will review of effectiveness and
current requirements of this program.
Medical Care Collections Fund. In fiscal year 2000, VHA
carried forward $1.3 billion in the Medical Care Collections
Fund, two-year obligations and equipment funds. Yet individual
facilities and several of its health care networks experienced
funding shortfalls. The Subcommittee will review VHA's
utilization of health care funding, including over multiple
fiscal years.
VA Medical Research. Subcommittee hearings in the 106th
Congress revealed violations of federally established
procedures for the protection of human subjects in VA medical
research. The Subcommittee will review how VA has corrected
these violations, particularly regarding informed consent and
Institutional Review Board procedures.
VA Nonprofit Medical Research Corporations. Funds not
appropriated to the Department of Veterans Affairs may be
received and administered by a nonprofit corporation at any VA
medical center. The Subcommittee will review the accountability
of funds expended by such corporations on approved VA research.
REPORT TO THE COMMITTEE ON THE BUDGET FROM THE COMMITTEE ON VETERANS'
AFFAIRS, SUBMITTED PURSUANT TO SECTION 301 OF THE CONGRESSIONAL BUDGET
ACT OF 1974, ON THE BUDGET PROPOSED FOR FISCAL YEAR 2002, MARCH 13,
2001
Background and Committee Recommendations
In a number of areas summarized below, the Members of the
Committee are convinced more must be done and can be done in a
responsible, accountable manner to reaffirm our Nation's
commitment to veterans. The Committee strongly recommends the
addition of funding needed to improve areas affecting the
delivery of services, particularly to service-connected and
low-income veterans.
Department of Veterans Affairs
VETERANS HEALTH ADMINISTRATION
Medical Care
Inflation.--Health care inflation in the United States was
reported to be 4.3 percent in 2000, and some experts predict
higher rates this year. This is about 1 percent above the
general inflation rate in the U.S. economy. Inflation poses
significant challenges to the Department of Veterans Affairs.
One reflection of this, for example, is that the increase in
insurance and managed care premiums paid by enrollees of the
Federal Employee Health Benefits Program averaged nearly 10
percent from 2000 to 2001. This ``corporate'' inflation alone
represents almost $40 million in outlays. VA health care
employees deserve a significant pay raise in 2002. The
comparability rate increase for all federal employees is
expected to be 3.5 percent. If so, VA's contribution to
employees' pay raises would be about $425 million. Also, energy
costs are expected to significantly inflate costs in energy-
intensive industries and businesses this year. VA Medical
Centers, employing 180,000 staff and caring for 3.9 million
veterans in over 600 sites, are significant consumers of
federally procured energy in gas, oil, electricity, steam,
nuclear materials, etc. Unquestionably these costs will rise,
but will not produce higher productivity or efficiency in VA's
``business'' of providing quality care to the Nation's
veterans.
A simple inflation rate of 4.3 percent in VA health care
would mean, conservatively, that about $900 million of any
increase in funding VA health care from fiscal year 2000 would
be consumed simply by the general erosion of purchasing power
it will experience from a variety of external forces. The
Committee believes that the budget approved by Congress must
overcome inflationary pressures beyond the inflation rate
itself, in order to assure that veterans' earned rights to VA
health care will not be undermined by external factors over
which the VA Secretary has virtually no control. Therefore, the
Committee recommends for the VA health care account $1 billion
over the fiscal year 2001 appropriated level for uncontrollable
cost increases.
Millennium Act Implementation.--In 1999, Congress enacted
the Veterans Millennium Health and Benefits Act (Public Law
106-117). This legislation authorized the Secretary of Veterans
Affairs to reimburse veterans costs of non-VA emergency care
provided they are enrolled in the Veterans Health
Administration and lack health insurance. When fully
implemented, VA estimates this provision will cost between
$400-$500 million annually. Since the law's effective date (May
2000), VA Headquarters has collected claims for reimbursement
from its medical centers totaling $21 million. As more veterans
learn they may be eligible for this new benefit, the Committee
expects the number of claims to grow.
A number of additional provisions in the Millennium Act
still require implementation. VA and the Administration are
still developing and reviewing regulations that will clarify
the broad guidance Headquarters has already provided to medical
centers about implementation of the bill. Until regulations are
completed, however, the Committee expects that full
implementation will lag. Assuming that regulations become
available early in fiscal year 2002, the Committee expects VA
will begin a gradual implementation of its non-VA emergency
care reimbursement program as well as other major provisions of
the bill. The Committee recommends that an additional $68
million be provided for Millennium Act implementation in fiscal
year 2002.
Mental Health Programs for Disabled Veterans.--Over the
past five years, the Department has conducted a managed shift
of resources and programs away from institutional mental health
care. The Committee supported this reallocation (see House
Committee Print No. 5, 106th Congress, First Session, March 16,
1999). However, it was understood at the time that sufficient
resources would be preserved to provide an appropriate level of
care for VA's chronically mentally ill patients. VA designed
new community-based intensive case management programs. In
fact, these plans only partially materialized while VA shifted
critical resources away from mental health.
The VA Advisory Committee on Seriously Mentally Ill
Veterans estimates the diversion of funds may be as much as
$600 million. VA dramatically expanded its primary care
clinics, referred to as ``Community Based Outpatient Clinics''
(CBOCs). While the Committee certainly supports the primary
care clinics, VA also should at least partially restore lost
support for these mentally ill veterans, an especially
vulnerable group. The budget requested could not do this. To
release these veterans to the community and then provide
occasional clinic visits in a primary care setting is not
optimal care for the severely mentally ill. The VA Program
Evaluation Resource Center maintains a registry of veterans
suffering with psychosis and bipolar disorder that contains
200,000 individuals. These veterans cannot be sustained
medically without intensive attention, and because of the
nature of their illnesses, most cannot speak for themselves. To
this end, the Committee recommends a number of adjustments to
redress their unmet needs in the following areas:
1. Mental health intensive case management teams
The Committee understands that VA presently operates
about 50 intensive case management teams assigned to
intensive aftercare of VA patients with serious and
chronic mental illness. Some of these teams that
already had a minimal staffing complement have recently
suffered reductions in staff. A fully functioning
team's annual average direct cost (primarily in
staffing) is approximately $400,000. If VA were to
deploy 30 additional teams during the 2002 budget year
and restore resources to those existing teams that have
been reduced, these 80 fully functioning Mental Health
Intensive Care Management teams could, for an estimated
cost of $40 million, provide vulnerable veterans better
follow-up care and improved coordination of community
based services, including foster care, sponsorship,
lifestyle and medication monitoring, employment and
training options; and a higher quality of life.
2. Mental health in community primary care
The Department operates approximately 350 community
based outpatient clinics, distributed nationwide. When
VA made the decision to provide better access to
community-based primary care, it did not sufficiently
provide for mental health needs in these clinics.
Approximately 40 percent of these facilities offer
dedicated mental health services but the remaining 200
sites do not. The addition of qualified mental health
staff to support effective professional services in
these settings, given the depletion of mental health
resources in VA medical centers, is a way to ensure
that mental health care becomes more accessible and
convenient. A clinic with an average workload may
require a part-time mental health practitioner, a full-
time social worker, and a part-time clerk. Adding a
small cadre of mental health professionals in each of
the approximately 200 locations, according to their
need, would provide a more complete service in VA
community-based clinics. A $40 million enhancement to
mental health capacity would also give VA better
options to treat/provide care to not only the de-
institutionalized chronically mentally ill, but also
veterans with acute mental health needs who may not
otherwise receive adequate care.
3. Substance-use disorder programs
VA currently cares for 130,000 veterans with this
troubling and life-long disorder. Over the past decade,
VA shifted its drug treatment programs from residential
care to ambulatory-based programs. VA has acknowledged
in its report required by Public Law 104-262 on special
program capacities that capacity in the substance-use
disorder programs is declining. The Committee believes
these programs should be restored, along with
enhancements in VA's opioid-substitution programs using
Methadone and newer substitutes. These activities are
insufficiently available in VA facilities and, in some
metropolitan areas, do not provide enough care to meet
the veteran population's needs. The Committee believes
that the reduction in resources combined with the
inadequate availability of these clinics could be
addressed with $40 million in additional funds.
4. Increased psycho-pharmaceutical costs
In the past 10 years, a number of new
antidepressants, anti-psychotics and other
pharmacological treatments in mental health have
emerged that cause inflationary spikes in VA's overall
pharmaceutical budget. Currently, 17 percent of VA's
total pharmacy budget is spent on psychotropic drugs;
nevertheless, the Serious Mental Illness Treatment,
Research and Evaluation Center has reported widespread
variability in the use of some of the most effective
drug therapies, particularly atypical drugs such as
Clozapine for the management of schizophrenia. The
Committee believes that additional funding of $20
million should be dedicated to these agents to ensure
that VA makes available to veterans the latest
therapeutic agents.
5. Evaluation in mental health programs
The Department evaluates and monitors its mental
health programs in three small analytic centers, the
Northeast Program Evaluation Center, located at the VA
Medical Center, West Haven, Connecticut, the Program
Evaluation Resource Center at the Palo Alto VA Medical
Center in Palo Alto, California, and the Serious Mental
Illness Treatment Research and Evaluation Center at the
VA Medical Center in Ann Arbor, Michigan. Each of these
research-oriented activities has aided the Department,
the VA Advisory Committee on Seriously Mentally Ill
Veterans, mental health advocates and the Congress in
assessing the effectiveness of VA's mental health,
substance-use disorder and homelessness programs. The
Committee recommends a small but crucial additional
allowance of $1 million be provided to these centers
for continuation of their vital work in evaluating and
reporting on VA's mental health mission.
VA Long-Term Care and Diseases of Aging
Demand for Services.--The Veterans Millennium Health Care
and Benefits Act of 1999 clarified and expanded VA's mission to
maintain specialized capacity to care for aging veterans. The
Committee in crafting the Millennium legislation challenged VA
to reposition itself to meet the needs of the World War II
veteran generation, now averaging 80 years of age. Many of
these veterans suffer from a multiplicity of age-related
problems and diseases. Of particular note and concern to the
Committee are Alzheimer's Disease, other dementias and other
brain disorders. About 600,000 veterans are estimated to be
suffering from brain diseases, most of who live at home with
family caregivers. Indeed the Department is attempting to
address some of their specialized needs, but the Committee
noted that the shift to primary care has had an erosive effect
on VA's distinguished mental health programs. This decline also
detracts from VA's ability to mount and sustain programs to
deal with veterans' problems associated with advanced age.
While VA reports it is operating some small-scale delivery
models and pilot programs to meet these challenges in geriatric
care, the Committee believes VA's efforts to date only begin to
address the potential demand for services. Specific
recommendations are as follows:
1. Dementia special care (inpatient) units
At the Bedford, Massachusetts VA Medical Center, VA
operates a Geriatric Research, Education and Clinical
Center (GRECC), one of 21 such centers of excellence in
geriatrics. The Bedford Center has developed an
innovative approach to caring for veterans with
Alzheimer's Disease and other dementias that should be
exported to other VA medical centers. The Committee
recommends $55 million for advancing the concept
developed at the Bedford center to all VA networks to
place VA health care in the forefront of treatment for
persons with Alzheimer's Disease and other brain
disorders. Also, placing one such unit in each of VA's
22 networks of care provides a more equitable
distribution of public resources of a specialized
program that all veterans should be afforded.
2. Dementia and end-of-life care in home-based and VA
nursing home care
VA sponsors home-based primary care programs in about
75 sites. Also the Department operates 131 VA nursing
home care units. The Committee believes many of these
programs are unable to fully address needs for dementia
or end-of-life care because of resource constraints.
Whether under care at home or in VA's nursing homes,
veterans with Alzheimer's Disease and other forms of
dementia require specialized services. VA has
identified an approach that adds a focused complement
of these services to its HBPC/NHCU programs. The
Committee supports VA's ``rapid cycle improvement'' in
this area and encourages its implementation. An initial
increment toward this goal can be attained with a
modest funding increase for HBPC programs of $17
million ($3.5 million in HBPC; $13.5 million in NHCU).
3. Psycho-geriatric evaluation and treatment
Nine VA medical centers currently operate ``Unified
Psycho-geriatric Biopsychosocial Evaluation and
Treatment'' or ``UPBEAT'' programs. These programs test
the hypothesis that intensive psychosocial intervention
in cases of hospitalized elderly veterans with
depression, anxiety or substance-use disorders can
reduce the number of days veterans require
hospitalization. The model is proving successful, and
VA is poised to expand the application with additional
resources. Operational UPBEAT programs are cost
effective and result in better care for veterans.
Adding 15 additional sites in VA medical centers will
give more veterans access to these programs at
reasonable cost of $6 million.
4. Dementia caregiver respite program
The majority of veterans with Alzheimer's Disease and
other dementias receive their care at home from family
caregivers. Given their responsibility for providing
around-the-clock care, these caregivers need periodic
relief from their care duties. VA has a small, ongoing
program of respite care. A substantial expansion is
essential, but is not addressed in current agency
plans. The Committee proposes an expansion of VA's
caregiver training program accompanied by provision of
a period of respite care to allow veterans' caregivers
relief from their duties for 2-4 weeks each year. This
expansion would allow VA to provide such care in 12
additional locations, at a total estimated cost of $10
million.
Unacceptable Waiting Times for Outpatient Care.--The
extraordinary growth of demand for care is resulting in
thousands of veterans being denied access to care in VA
facilities. Once VA accepts veterans for enrollment, it must
ensure that it has adequate resources to provide reasonable
access to the full range of services that it has committed to
offer enrolled veterans. VA has described access in terms of
geographic proximity, reasonable patient costs, and the ability
to meet a reasonable (community) timeliness standard. While VA
has accomplished its goal for geographic access and veterans'
copayments are reasonable, its progress in accomplishing, and
even its ability to assess timeliness is problematic. (See
Veterans Health Care: VA Needs Better Data on Extent and Causes
of Waiting Times, May 20, 2000, GAO/HEHS-00-90.)
At the VA Chicago Medical Center, veterans wait up to 214
days to be seen in the gastroenterology clinic. This delay is
attributed to higher demand from veterans suffering from
hepatitis C. In New Jersey's Brick and Ft. Dix VA community-
based clinics, veterans are required to wait to be seen by a VA
practitioner from 6 to 11 months for an initial, non-urgent
appointment. The Department created high expectations within
the veteran population, many members of whom had never used VA
health care before, as it expanded services away from VA
medical centers to communities for improved access and
convenience nearer veterans' homes. Veterans had a reasonable
expectation to be able to use these services routinely once
these clinics were fully functioning, as well as to begin, or
continue, using VA medical centers when appropriate. As of
today, however, their access to care in many cases is being
rationed by strict resource limitations.
The Committee believes that Congress should take the lead
and respond now to these veterans' needs. Therefore, the VA
Committee recommends additional funds in the amount of $75
million be provided in the fiscal year 2002 budget to
supplement VA's allocation of resources to both VA medical
centers and their community-based outpatient clinics. The new
funds will support the employment of 1,000-1,500 new Veterans
Health Administration staff, to increase practitioner presence
in VA's 350 community-based clinics and supplement ambulatory
care staff in VA centers. The Committee believes this is a
modest method to address a very challenging situation in VA
health care.
Rising Pharmaceutical Costs.--The VA expects to expend
about $2.7 billion this year on pharmaceuticals. VA's budget
for prescription drugs has doubled over the past 5 years and,
at the current rate of growth, will exceed $4 billion in only
3-4 more years. Higher VA drug costs at the present time are
not due to inflation; pharmaceutical cost increases as an
element in overall health care inflation are abating. VA's
higher costs stem from utilization and the advent of new drugs.
As of December 31, 2000, the Veterans Health Administration
reports that 4.7 million veterans are enrolled in VA health
care, and nearly 3.9 million are expected to be active
consumers of VA health care services this year. If the higher
enrollment is overlaid on the phenomenon of veterans' aging,
about which so much has already been reported, along with new
pharmaceutical therapies being made available, it becomes clear
that VA's success in reaching more veterans to meet more of
their health care needs is going to produce extraordinary
pressure on VA's pharmaceutical budget. The Committee is
particularly concerned about veterans' access to the apparently
uneven availability of drug treatment for Hepatitis C and
psychotropic agents (see below). The Committee believes that,
beyond funding VA adequately to cover its inflationary
challenges so that VA will be able to meet the growing disease
burden among the veterans treated in VA facilities, Congress
should provide supplemental funding to assist VA providers in
ensuring that adequate pharmaceutical resources are made
available to support their professional prescribing. Therefore,
the Committee recommends an additional $100 million above
normal inflation for fiscal year 2002 to ensure that VA
resources are sufficient to meet these pharmaceutical demands.
Specialized Programs-Restoration of Spinal Cord Injury Care
The Veterans Health Care Eligibility Reform Act of 1996
requires VA to maintain the capacity of specialized programs
for certain disabled veterans, including those with spinal cord
injury or dysfunction. VA has identified beds, full-time
employees, dollars, and patients treated as measures that best
depict VA's maintenance of capacity for this program. VA now
acknowledges a 65 percent reduction in its specialized bed
capacity for veterans with spinal cord injury or dysfunction.
The Committee is very concerned about this unacceptable
reduction in services for one of VA's most physically
challenged patient populations.
To restore and enhance care in this area, VA developed a
plan in concert with Paralyzed Veterans of America. VA's Under
Secretary for Health issued a formal directive to establish a
minimal level of staffing and staffed beds at each of 23
medical centers with a spinal cord injury center and also
issued a memorandum to managers to identify the resources
necessary to restore staff to a minimum level of capacity. VA
agrees that there are more than 200 staff vacancies in its SCI
program. Most of these vacant positions are nurses, but
therapists, psychologists and physicians are also in short
supply. While the plan fulfills needs for long-term care, the
Committee's proposal only restores acute care capacity.
Paralyzed Veterans of America estimates restoring only acute
care capacity will require $23 million. The Committee supports
$23 million to fund this restoration of capacity.
Homelessness among Veterans
The Committee remains dedicated to addressing homelessness
in the veteran population. The Committee is encouraged by
recent data showing that, since 1987, there seems to be a
perceptible, if small, reduction in homelessness among
veterans, estimated to be 8.5 percent. Nevertheless, according
to VA's most recent estimates, about a quarter-million veterans
are still homeless in this country at some point each year.
Over the past 15 years, the Committee has developed
legislation that authorized, expanded and extended VA's
programs addressing homelessness. Among these are in-house
homeless domiciliary expansion, a grant and per diem program
for community providers, and the so-called ``Health Care for
Homeless Vets'' initiative. VA also funds several smaller
programs in mental health and coordinates with other Federal
agencies (principally the Departments of Housing and Urban
Development, and Labor) to address veterans' homelessness. The
Committee recommends $30 million additional funding for these
programs, including funds to increase the grant and per diem
program and enhance existing and add new VA Domiciliary Care
for Homeless Veterans programs during fiscal year 2002.
Medical and Prosthetics Research
The Department carries out an extensive array of research
as a complement to its health-professions affiliations. While
these programs are specifically targeted to the needs of
veterans, VA research discoveries help define new medical
standards of care that benefit all Americans. Among the major
emphases of the program are research into aging, chronic
diseases, mental illnesses, substance-use disorders, sensory
losses, and trauma-related illnesses. VA's research programs
are internationally recognized and have made important
contributions in virtually every area of medicine and health
for veterans and the general public. These contributions to
medical knowledge have won VA scientists many prestigious
awards, including six Lasker Awards and three Nobel Prizes in
Medicine.
Advances by VA researchers in the past two years include
findings from several major clinical trials of significant
potential value and relevance. These include research in
cancer, heart disease, anemia and kidney failure. Important new
VA studies are underway now in post-traumatic stress disorder
in women veterans; amyotrophic lateral sclerosis (``Lou
Gehrig's Disease''), fatigue, muscle and joint pain, and memory
and cognitive problems among Persian Gulf War veterans; and the
development of a vaccine for shingles.
The Committee supports an increase in the research account
of $30 million. We believe this additional funding is needed in
VA's research programs to keep pace with external funding
developments in the U.S. biomedical research field. We note the
President's State of the Union address confirmed the national
goal to double the research funding of the National Institutes
of Health. Additional funding of $30 million in VA biomedical
research in fiscal year 2002 would cover inflation and permit a
small program expansion.
Medical Administration and Miscellaneous Operating Expenses
The Medical Administration account supports the employment
of 535 Central Office staff and officials to oversee and manage
the multiplicity of programs that deliver health care to
America's veterans.
The Committee is concerned that the Medical Administration
and Miscellaneous Operating Expenses (MAMOE) account may not
provide a sufficient resource base to ensure high-quality
patient care services while VA simultaneously continues to
restructure its health care delivery system. In particular, the
Committee has pressed VA to improve its methods of assuring
accountability, beginning with the Under Secretary for Health,
and extending to the Administration's 22 network directors, who
operate in a highly decentralized management environment. MAMOE
requires additional staff and resources to properly carry out
the responsibilities of supervising, managing, and accounting
for the diverse and far-flung health care system.
A modest increase of $5 million in this MAMOE account would
provide the VA Central Office a funded staff of 589 in fiscal
year 2002 to better manage its essential health care programs.
Medical Facility Construction
Urgently Needed Projects.--VA is now undertaking an
initiative to identify the most effective and efficient use of
its infrastructure in care delivery to veterans. The VA uses
the acronym ``CARES'' (for Capital Assets Realignment for
Enhanced Services) to describe this initiative. The Committee
held a number of hearings during the 106th Congress dealing
with VA's capital assets. VA hospitals were primarily built or
converted after World War II to rehabilitate and care for
wounded, sick and traumatized soldiers, sailors, airmen and
marines. The Committee agrees with the principle that VA should
seek the most effective use of its facilities and modernize, or
declare as excess, buildings based on the health care needs of
veterans.
In the wake of its wars, the nation faced the daunting task
of dealing with hundreds of thousands of wounded and maimed
veterans. The care VA provided to the most seriously injured of
these veterans often concluded years, rather than days or even
months after a patient's initial admission. VA has now changed
its approach to care from that of being an institutional
provider of rehabilitation and restorative care to that of
largely being a primary care provider often serving and older
population. The capital infrastructure built for its previous
approach does not easily lend itself to its new delivery model.
Even though VA's CARES process is ongoing, the Committee
believes that VA's most pressing capital infrastructure needs
must to be addressed. In recent years, VA has proposed few
construction projects, and, awaiting the outcome of the CARES
process, Congress appropriated little funding for this purpose
the last four years.
Outside consultants and VA's own reports show a growing
need and rising backlog of major and minor projects. For
example, a 1998 Price Waterhouse report suggested VA, in
proportion to the value of its $35 billion infrastructure,
should be investing in the range of $700 million to $1.4
billion annually on replacement and modernization projects. A
second consultant report disclosed dozens of VA patient care
buildings at the highest level of risk for earthquake damage or
even collapse. Indeed, a 6.8 tremor on February 28, 2001,
damaged two of VA's patient care buildings at the American Lake
VA Medical Center cited by this consultant. Another report
revealed $57 million in needed projects to protect women's
privacy in VA health facilities.
The Committee believes that, regardless of the course the
CARES process identifies for VA's infrastructure, continuing
maintenance on the system is essential to keep it viable and
safe. To this end, on March 1, 2001, the Chairman and a number
of other Committee Members introduced H.R. 811, the Veterans'
Hospitals Emergency Repair Act, to authorize the Secretary to
select small to medium-sized projects to maintain and improve
VA facilities while CARES proceeds. The bill would authorize
$250 million in capital projects in fiscal year 2002, subject
to the Secretary's site selection based on specific criteria in
the legislation. The Committee believes that these funds are
critically needed and recommends $250 million be provided for
this interim program for fiscal year 2002.
Major Construction Projects.--Since fiscal year 1996, under
the authority of section 8104 of title 38, United States Code,
Congress has authorized nearly $1 billion for 41 major medical
facility projects. However, due to lack of specific
appropriation, only 28 of these projects were completed.
Authorizations for these projects for this year alone total
over $100 million, but no appropriations were provided. The
Committee believes that funding should be provided for
Congressionally authorized major medical facility projects.
Therefore the Committee recommends that $112 million be
provided to fund at least some of these previously approved
facilities.
Minor Construction Projects.--For many of the reasons we
stated above with respect to the delegated-projects proposal
the Chairman and colleagues recently introduced, the Committee
believes that VA needs to increase its investment in the minor
construction program. VA hospitals, nursing homes and other
health care facilities are deteriorating, and not enough is
being done about it. Therefore, the Committee recommends that
the minor projects account--an activity that funds hundreds of
very inexpensive yet critical maintenance and repair needs--be
provided $200 million in fiscal year 2002 to address some of
the large backlog presently awaiting funding.
State Home Grants Programs
The Department has not approved requests totaling $245
million for new construction and renovation grants for state
veterans homes and other facilities. A new round of requests
under this program will soon be solicited for fiscal year 2002.
This program is the only one of three available types of
institutional long-term care that is expanding to meet the
needs of the aging veteran population. Moreover, states commit
to pay 35 percent of the construction costs for these
facilities and to bear most of the cost of care that exceeds
amounts contributed by the VA (current daily VA reimbursements
are $51 for nursing home care and $22 for domiciliary care for
each veteran).
Congress revised the state home program in Public Law 106-
117 to provide a higher priority for renovation needs in
existing state homes. Until enactment of P.L. 106-117, these
longstanding projects were given a lower priority for funding
than grants for constructing new beds. Given the recent changes
in law and the growing backlog of unfunded projects, the
Committee proposes additional funding of $35 million to support
a more adequate VA response to this ever-growing demand for
long-term care facilities.
VETERANS BENEFITS ADMINISTRATION
General Operating Expenses
The General Operating Expenses account funds full-time
employee equivalents (FTEE) and operating expenses for both the
Veterans Benefits Administration (VBA) and VA's Central Office
(headquarters). VBA administers a broad range of non-medical
benefits to veterans, their dependents, and survivors through
58 regional offices. These programs include compensation and
pension, education, vocational rehabilitation, insurance, and
loan guaranty (home loans). VBA is also responsible for
processing applications for these programs. Headquarters
includes the Secretary's staff and other VA support staff, and
is located in Washington, DC.
The Committee supports a funding increase of $49.8 million
for 830 additional FTEE for compensation and pension claims
adjudication. VBA has a backlog of more than 459,000 claims
waiting to be processed. During the three-month period of
November 24, 2000 to February 23, 2001, the backlog of pending
claims increased by 130,294, from 329,278 to 459,572. This is
an average weekly increase of more than 10,000 pending claims.
Adverse effects of the increasing backlog are a decline in the
quality of work, veteran satisfaction and employee morale.
Approximately one-third of claims decisions have some type of
error, most of which are administrative in nature. However, 4.2
percent of errors do involve grant/denial or rating issues. The
percent of cases remanded from the Board of Veterans' Appeals
has declined from 45 percent in 1997 to about 29 percent today,
thus reducing the number of claims that must be reworked by the
regional offices. However, there has been an increase from 16
percent to 26 percent in the number of claims denied by the
regional offices that have been allowed by the Board. In fiscal
year 2000, only 41 percent of the decisions appealed from
regional offices were upheld by the Board of Veterans' Appeals.
The Committee commends the Department for numerous
initiatives including:
Pre-Discharge compensation examinations and
ratings (including overseas);
Case management;
Decision Review Officer program;
Establishment of nine Service Delivery Networks;
Systematic Technical Accuracy Review program;
Data integrity initiatives;
Electronic claims filing including online benefit
applications;
Development of paperless claims folders known as
``Highway One;''
Reader-focused writing; and
The ``Balanced Scorecard.''
Despite these numerous initiatives by VBA, it still takes
205 days to adjudicate an original compensation claim. It is
important to understand the customer base in VA's $21 billion
per year compensation and pension program. According to the
1996 report of the Veterans' Claims Adjudication Commission, if
VA stopped receiving first-time disability claims in 1995 for a
period of 20 years, and repeat claims activity remained
consistent with current levels over that time, in the year 2015
VA would still have 72 percent of the 1995 workload--without
taking a single new claim. The majority of VA claims for
disability compensation are on the lower end of the rating
schedule. Claims rated below 30 percent generate a large number
of the reopened claims and appeals. The VBA Annual Benefits
Report for Fiscal Year 1998 notes that most disabilities are
rated at 30 percent or less, including 94 percent of the 95,000
veterans added to VA compensation rolls in fiscal year 1998.
The VBA Annual Benefits Report for Fiscal Year 1999 found that
57 percent of disability compensation payments are less than
$200 monthly.
Another dimension of the current system as designed by
Congress is the percentage of veterans who file for claims and
are already receiving VA compensation. Such ``reopened'' claims
outnumber original claims almost 3 to 1. The Congressional
Veterans' Claims Adjudication Commission found that veterans
already in receipt of compensation file 69 percent of reopened
claims and 67 percent of appeals. Veterans may reopen a claim
because a service-connected condition has worsened or they have
obtained new and material evidence concerning a decision or
evaluation on a previously adjudicated claim. A recent survey
by the Veterans Benefits Administration found that the average
age of a veteran filing an original claim is 34, the average
life expectancy is 77, and the average number of claims
expected in a lifetime is 17.9. The average age of veterans
receiving service-connected compensation benefits is 59 with 26
percent of service-connected veterans between the ages of 50
and 59. The medical conditions most frequently service-
connected involve orthopedic conditions and hearing loss,
conditions which can be expected to worsen as veterans age.
Thus, it should be anticipated that VBA would see an increase
in veterans reopening their claims as their service-connected
conditions worsen during the aging process.
Veterans rarely file for only one disability. With respect
to new claims, in fiscal year 1999, the average number of
disabilities filed per claim was 4.72. The average number of
service-connected disabilities granted to Gulf War veterans is
more than 80 percent greater than for World War II veterans.
From 1979 to 1999, the number of disabilities for which VA pays
service-connected benefits increased from 3.0 million to 5.7
million, while the number of veterans receiving service-
connected compensation increased from 2.1 million to 2.3
million. Gulf War and peacetime veterans file for and receive
compensation at a higher rate than Vietnam, Korea, and World
War II veterans.
Benefit Program Operations
Compensation & Pension Service (C&P).--The ability of VA to
furnish timely and quality benefits delivery is heavily
dependent on a combination of proper staffing levels, effective
implementation of computer modernization initiatives, training
and retention incentives, and inter-departmental cooperation
between various VA organizations and the military service
branches. Over the decade of the 1990's, the number of trained
personnel in the adjudication division declined by
approximately 40 percent.
According to the President's Blueprint for New Beginnings,
the budget fully implements new legislation that strengthens
VA's ``duty to assist'' veterans in preparing their claims and
a regulation that adds Type 2 diabetes to the list of
presumptive conditions that are associated with exposure to
herbicides. The President's budget asserts that it fully funds
the VBA additional workload for this initiative and assumes
that VBA will develop a vision for future benefits delivery
that incorporates and harnesses paperless technology. Part of
this effort to modernize will be for VBA to complete the
consolidation of aging data centers into its state of the art
facility in Austin, Texas.
However, with respect to anticipated workload under ``duty
to assist'' requirements, the Committee understands that for
the current fiscal year VA will need to rework about 98,000
claims previously denied under the Morton v. West decision, 12
Vet. App. 477 (1999), review the current inventory of 342,000
claims for compliance with duty to assist requirements and take
corrective actions, and perform expanded development on 87,000
new claims. VBA expects to receive 105,000 new claims for
service connection of Vietnam veterans who have been diagnosed
with Type 2 diabetes. VA's average age of pending claims is
expected to climb to 241 days by the beginning of fiscal year
2002 from VA's target of 119 days.
VA must have additional personnel to make up for past
reductions in claims adjudicators, to meet increased workload
demands, to provide essential training for current and new
personnel, to ensure quality, and to achieve and maintain
satisfactory timeless in claims processing. Approximately 40
percent of VBA's workforce is in training status.
If VA's claims' adjudication system does not have quality,
it does not serve veterans. To improve quality, VA should
devote more resources to training. To deliver training on a
system-wide basis, VA will need to add 200 FTEE in fiscal year
2002. To meet the projected workload demands, VA should add 170
new adjudicators. To handle its appellate workload in regional
offices, VA needs 200 additional Decision Review Officers, a
concept recommended by the Veterans' Claims Adjudication
Commission. Regional offices that have implemented the DRO
program have seen a significant decline in the number of claims
that are appealed to the Board of Veterans' Appeals.
VA also would benefit from staff to conduct quality reviews
of the work of each of its claims adjudicators to assess
performance, impose accountability, and remedy deficiencies on
an individual level. Through its Systematic Individual
Performance Assessment initiative, VA intends to review 100
decisions from each adjudicator per year. VA would need about
260 new employees in fiscal year 2002 to accomplish this task.
In summary, for the above initiatives, the Committee
recommends a total of 830 FTEE at a cost of $49.8 million.
Also, the Committee expects a continuing adverse affect in
services in the absence of an urgently needed supplemental
appropriation for fiscal year 2001 of about $26.6 million (347
FTEE) for compensation and pension claims processing. Absent
funding of a supplemental appropriation for fiscal year 2001,
the Committee anticipates that additional funding will be
needed in fiscal year 2002.
Vocational Rehabilitation and Employment Program (VR&E).--
The goal of the Vocational Rehabilitation and Employment
program is employment of disabled veterans and eligible
dependents. To accomplish that goal, VR&E is authorized to
furnish all services and assistance necessary to enable
service-connected disabled veterans to become employable,
obtain and maintain suitable employment, or to achieve maximum
independence in daily living. Additionally, VR&E is authorized
to provide educational and vocational counseling services to
eligible active-duty members, veterans and dependents.
VR&E was recently renamed to reflect a newfound emphasis on
employment--the program's ultimate goal. The Committee has been
pleased with recent VBA initiatives to promote better case
management and lifecycle completion times and success rates.
The Committee is also pleased thus far with VR&E's progress
with implementing Employment Service Specialist positions into
existing service delivery schemes. Further, the Committee
commends the VR&E program for its strategic document ``The
Business Case Continues.''
The Committee remains concerned, however, with VR&E's
relying too heavily on private contractors to fulfill various
phases of the VR&E program lifecycle. Further, participant
dropout rates and the quality of post-program employment are
still troubling to the Committee. Therefore, the Committee
recommends a $2 million increase above the fiscal year 2001
funding level.
Educational Assistance Programs.--VA's Education Service
administers the All-Volunteer Force Educational Assistance
Program (Montgomery GI Bill, chapter 30), the Post-Vietnam era
Veterans' Educational Assistance Program (chapter 32), the
Vietnam era Veterans' Educational Assistance Program (chapter
34), the Survivors' and Dependents' Educational Assistance
Program (chapter 35), and numerous other activities, including
overseeing the role of State Approving Agencies and
coordination with the Department of Defense on the Selected
Reserve aspect of the Montgomery GI Bill. Public Law 106-398
and Public Law 106-419 expand opportunities for increased usage
of the educational assistance programs administered by VA.
Several provisions will provide significant workload challenges
for VA.
First, the Floyd D. Spence National Defense Authorization
Act for Fiscal Year 2001 (P.L. 106-398) gives members of the
Armed Forces an opportunity to receive increased payment for
off-duty education and training. In most cases, the service
branches can pay up to 75 percent of the tuition or expenses
for off-duty education. Under the new law, the military
services can pay up to 100 percent of tuition and expenses
charged by the school. If the service branch pays less than 100
percent, a servicemember eligible for the MGIB can elect to
receive MGIB benefits for all or part of the remaining
expenses. VA administers this program, though most of the costs
are borne by the service branch. VA anticipates about 161,000
new claimants in this program in fiscal year 2001 and 214,000
additional claimants in fiscal year 2002. In fiscal year 2002,
if the military services maintain a 75 percent Tuition
Assistance reimbursement policy and all servicemembers seek
payment of the balance from VA, VA's workload could double,
thus requiring 151 additional FTEE for 340,000 additional
claims annually.
Second, the Veterans Benefits and Health Care Improvement
Act for 2000 (Public Law 106-419) allows payments for licensing
and certification tests under the chapter 30, 32, and 35
programs. These tests are needed to enter, maintain, or advance
into employment in a civilian vocation or profession. The
eligible veteran or family member receives reimbursement for
the fee charged for the test, or $2,000, whichever is less. VA
estimates 100,000 veterans will apply for such benefits in
fiscal year 2002 and will need 65 additional FTEE for this
purpose.
Third, Public Law 106-419 also creates an opportunity for
some 139,000 active duty servicemembers who have zero dollars
in their Post-Vietnam Era Veterans' Educational Assistance
Program (VEAP) account or have dollars in their account and did
not act on a previous opportunity to convert to the Montgomery
GI Bill to do so. These servicemembers can become eligible for
MGIB if they 1) make an irrevocable election to receive MGIB,
2) were VEAP participants on or before October 9, 1996,
continuously served on active duty from October 9, 1996 through
April 1, 2000, and 3) make a payment of $2,700. VA estimates
13,000 individuals will convert to MGIB in fiscal year 2002
requiring 8 FTEE.
Last, the Committee notes degradation in education claims
processing due to the transfer of all education inquiries
(about three million calls annually) from 58 regional offices
to four regional processing offices without additional FTEE,
and the transfer of about 50 FTEE in fiscal year 1999 and 45
FTEE in fiscal year 2000 to the Compensation and Pension
Program. Not surprisingly, the four regional processing offices
currently have a pending workload of about 90,000 education
claims for which veteran-students are awaiting payment, far
exceeding acceptable levels set by VBA. While the Committee
appreciates the need to furnish more FTEE to the compensation
program, the 95 FTEE transferred from education claims
processing to Compensation and Pension processing represents a
significant percentage of the approximately 800 FTEE used to
process education claims. The Committee recommends 95
additional FTEE for education claims processing to fill this
void.
In summary, the Committee recommends an additional 329 FTEE
at a cost of $13.16 million for education claims processing.
Further, the Committee notes a demonstrable adverse affect in
services in the absence of an urgently needed supplemental
appropriation for fiscal year 2001 of about $2.5 million (60
FTEE) for education claims processing.
State Cemetery Grants Program.--The State Cemetery Grants
Program provides grants to assist the states in establishing,
expanding, and improving state-owned veterans cemeteries.
Increasing the availability of state veterans' cemeteries is
one way to serve veterans who do not reside near a national
cemetery. State cemeteries augment--but do not supplant in any
way--VA's national cemetery program. VA has awarded 106 grants
totaling more than $87 million to establish, expand, or improve
49 veterans cemeteries in 26 states plus Guam and Saipan.
Forty-three cemeteries in 22 states and Guam are now
operational. The Committee recommends an increase from $25
million in fiscal year 2001 to $30 million in fiscal year 2002.
NATIONAL CEMETERY ADMINISTRATION
The National Cemetery Administration (NCA) provides
national shrines honoring those who served in uniform and
should be maintained as places of high honor, dignity and
respect. Currently, NCA maintains more than 2.3 million
gravesites in 119 national cemeteries in 39 states (including
Puerto Rico), as well as 33 soldier's lots and monument sites.
The Committee recommends a $25 million increase over fiscal
year 2001 funding for the beautification, upkeep, maintenance
and repair of the national cemetery system.
Since 1973, when NCA was established, annual interments in
national cemeteries have more than doubled from 36,400 to more
than 82,700. NCA provided more than 327,000 headstones and
markers in fiscal year 2000 compared to 190,000 headstones and
markers in 1973.
It is estimated that 574,000 veterans died in 2000, and
veterans' deaths are expected to peak at 620,000 in 2008. To
meet the increasing workload, section 611 of Public Law 106-117
directed the Secretary of Veterans Affairs to establish six
additional national cemeteries in those areas the Secretary
deems to be most in need.
In response to the growing demand for burials in national
cemeteries, section 613 of Public Law 106-117 required the
Secretary to conduct an independent study on improvements to
veterans' cemeteries. The study will include an assessment of
the one-time repairs required at each national cemetery under
the jurisdiction of the NCA to ensure a dignified and
respectful setting appropriate to such cemetery, and shall
identify: 1) the number of national cemeteries necessary to
ensure 90 percent of America's veterans reside within 75 miles
of a national or State cemetery, 2) the number and percentage
of veterans in each State who would reside within 75 miles of
an open national or State cemetery, 3) an estimate of the
expected construction costs and the future costs of staffing,
equipping, and operating the projected national cemeteries in
1) and 2) above. In addition to projecting cemetery needs at 5-
year intervals beginning in 2005 and ending in 2020, the report
will take into account cemeteries which will close to new
burials and the age distribution of local veterans' populations
during the reporting periods.
BOARD OF VETERANS' APPEALS
In fiscal year 2000, the Board of Veterans' Appeals (BVA)
issued 34,028 decisions. Of those, 91 percent (30,966) involved
compensation for service-connected disability. These include
not only claims for service connection, but also claims for
increased ratings and earlier effective dates.
The average response time for fiscal year 2000 was 220
days, down dramatically from 595 days in fiscal year 1996. At
the end of fiscal year 2000, there were 20,521 cases pending
before the Board, down from a high of 60,120 at the end of
fiscal year 1996. BVA requires adequate funding and staffing to
continue these recent improvements. The Board continues to
remand a large percentage of claims to the originating regional
office and has seen an increase in the number of claims allowed
by the Board after denial at the regional office level,
indicating a need for more staff and better training at the
local office level.
INSPECTOR GENERAL
The Inspector General is charged with ensuring that VA
programs are managed efficiently and effectively and are free
of fraud, waste and abuse. OIG has implemented a Combined
Assessment Program (CAP) that provides on-site reviews of VA
health care facilities on a cyclical basis. The CAP program is
a unique joint OIG effort involving its Audit, Healthcare,
Inspections and Investigations sections. The fiscal year 2002
appropriation for the OIG will support an expected 28 CAP
reviews. At this pace, six years would be required to conduct a
CAP review of each VA health care facility-year. An interval of
six years between comprehensive CAP reviews is not in the best
interest of veterans and not acceptable.
Accordingly, the Committee supports an appropriation
increase for the OIG sufficient to support an additional 55
FTEE in each of the next two fiscal years. These manageable
incremental increases of 55 additional FTEE in 2002 and 2003
would expand the number of CAP reviews to 56 in 2002 (43 VHA
and 13 VBA) and to 76 reviews annually beginning in 2003 (57
VHA and 19 VBA).
The Committee further notes Congress established a
statutory staffing floor of 417 FTEE for OIG in P.L. 100-527.
Section 312 of title 38, United States Code, requires the
budget transmitted to Congress for each fiscal year to be
sufficient to support this statutory floor. This requirement
has not been met since 1993. Current OIG staffing supported by
appropriations is 369 FTEE. An additional 24 FTEE are supported
by reimbursements received for Department contract review
activities.
Increased staffing for the Office of the Inspector General
is a prudent use of resources. Over the past three years, the
monetary benefits of OIG activities have reportedly exceeded
$1.7 billion, providing an average return on investment of 15
to 1. More importantly, an adequately staffed OIG will save
more veterans' lives, improve the quality of health care
provided, foster better access to health care, increase VA
security against fraud and theft, and result in improved
overall management.
The Committee recommends an appropriation of $56.5 million
for the Office of the Inspector General (OIG) for fiscal year
2002. The recommended fiscal year 2002 OIG appropriation
represents an increase of $8.1 million compared to the fiscal
year 2001 OIG appropriation.
Department of Labor
VETERANS' EMPLOYMENT AND TRAINING SERVICE
Congress has determined that our nation has a
responsibility to meet the employment and training needs of
veterans. To accomplish those goals, the Assistant Secretary of
Labor for Veterans' Employment and Training (ASVET) is
authorized to implement training and employment programs for
veterans. The ASVET also acts as the principal advisor to the
Secretary of Labor with respect to the formulation and
implementation of all departmental policies and procedures that
affect veterans.
The Committee is aware of the significant changes in the
national labor exchange system that are not a part of the
delivery system for veterans' employment and training services
as reflected in chapter 41 of title 38, United States Code.
First, the states are changing the way they deliver
employment services and adopting new service delivery models
ranging from devolving state programs to the county level to
privatizing some or all employment functions and instituting
one-stop employment centers under the Workforce Investment Act
of 1998.
Second, the current version of chapter 41 predates
requirements of the Government Performance and Results Act
focusing on outcomes.
Third, there is insufficient reward for states that help
veterans get jobs in an exemplary manner.
The Committee remains concerned about accountability and
incentives for performance in the current delivery system as
designed by Congress in chapter 41. Dedicated Local Veterans
Employment Representatives and Disabled Veterans Outreach
Program specialists are engaging and resourceful individuals.
The Committee expects to consider legislation to position them
to deliver services effectively in the 21st century.
Proposed Legislation
The President's budget submission contains a number of
mandatory proposals to reduce spending in various programs
through Omnibus Budget Reconciliation Act extenders. The
Committee does not plan to consider these proposals.
Legislation the Committee May Report with Direct Spending Implications
Montgomery GI Bill.--The Committee recommends a three-step
approach, all of which ties in with revitalizing our military.
The first step was an improvement in the Montgomery GI Bill-
Active Duty basic benefit from $552 to $650 per month with the
enactment of Public Law 106-419 last November 1, 2000. The
second or interim step will be an increase in the basic MGIB
benefit in consecutive fiscal years to $800 per month on
October 1, 2001, to $950 per month on October 1, 2002, to
$1,100 per month on October 1, 2003, incurring a cost of about
$300 million the first year and $3 billion over five years. The
third and ultimate step would implement the Servicemembers and
Veterans Transition Assistance Commission recommendation for an
MGIB that pays tuition, fees, and a monthly subsistence
allowance, thus allowing veterans to pursue enrollment in any
educational institution in America limited only by their
aspirations, abilities and initiative. Against the current
baseline, this measure would cost about $1.3 billion in year
one, and $2.6 billion over five years. The third step could be
enacted in the 107th Congress if the Administration were to
propose it.
The Committee cites recent data from Trends in College
Pricing furnished by the College Board, and concludes that the
monthly basic MGIB benefit would need to be $1,025 per month
for a veteran student to be able to pay the average tuition and
expenses as a commuter student at a four-year public college
for academic year 1999-2000. Over four years, the numbers are
even more alarming, as reported by the College Board. The
College Board's most recent statistics reflect average annual
tuition and fees for attending a four-year public college is
$9,229 for commuter students and $11,338 for students who live
on campus. Four-year private institutions cost $21,704 and
$24,946 respectively. With the current basic MGIB benefit of
$5,850, however, a veteran is expected to pay for tuition,
fees, and room and board over the academic year. The disparity
between these ever-increasing costs and a veteran's ability to
pay for them seems clear.
The MGIB now provides $650 monthly stipends over four
years; the total benefit payable is $23,300. The Committee also
notes the April 21, 1999, testimony of Vice Admiral P.A.
Tracey, then-Deputy Assistant Secretary of Defense, Military
Personnel Policy: ``Since its inception, the value of the MGIB,
when adjusted for inflation, has grown by only 24 percent,
while college costs have risen by 49 percent.''
Veterans Opportunities Act of 2001.--The Committee
recommends about $60 million per year for improvements to
programs of educational assistance, outreach to separating
servicemembers, veterans and dependents, to increase burial
benefits, to provide for family coverage under Servicemembers'
Group Life Insurance, and for other purposes.
Pilot Project for Interim Assistance to Homeless
Veterans.--Currently, processing of claims for compensation and
pension programs takes months. The Committee notes that
Representative Lane Evans plans to introduce legislation
authorizing a three-year pilot program to provide three months
of transitional assistance to 600 homeless veterans who are
being released from institutions. The assistance may be
extended for an additional six months if the veteran is
awaiting a regional office decision on a claim for compensation
or pension benefits. Since any transitional assistance paid
would be offset from a retroactive award of compensation or
pension benefits, Mr. Evans advises the Committee that the cost
of this pilot program would be approximately $2 million over
three years.
Homeless Veterans' Reintegration Programs (HVRP).--In
section 901 of Public Law 106-117, the Committee authorized
appropriations to the Department of Labor to carry out Homeless
Veterans' Reintegration Projects at $10 million in fiscal year
2000, $15 million in fiscal year 2001, $20 million in fiscal
year 2002, and $20 million in fiscal year 2003. The Committee
notes that Representative Evans plans to introduce legislation
extending HVRP and authorizing expenditures of $50 million a
year in fiscal years 2002 through 2006.
Comparison of President's Proposed Budget, Independent Budget and VA Committee Recommendations for the Department of Veterans Affairs
(Budget Authority in millions)
--------------------------------------------------------------------------------------------------------------------------------------------------------
FY 2002 Admin. VA VA
FY 2000 FY 2001 Admin. Request Indep. IB +/- FY Committee Committee +/
Enacted Enacted Request +/- 2001 Budget (IB) 2001 Recom. - 2001
--------------------------------------------------------------------------------------------------------------------------------------------------------
Medical Care (including receipts)........................ $19,534 $20,890 ......... ........ 1 $22,869 +$1,979 2 $22,415 +$1,525
Research................................................. 321 351 ......... ........ 395 +44 381 +30
Construction............................................. 225 237 ......... ........ 811 +583 562 +325
State Nursing Home and Cemetery Grants................... 115 125 ......... ........ 130 +5 155 +30
Veterans Benefits Administration......................... 858 985 ......... ........ 1,071 +86 1,115 +130
National Cemetery Administration......................... 97 110 ......... ........ 119 +9 135 +25
Other Discretionary...................................... 317 336 ......... ........ 467 +98 371 +35
----------------------------------------------------------------------------------------------
Total VA Discretionary Including $608 million in MCCF 21,467 23,033 24,033 +1,000 1 25,832 +2,799 25,134 +2,101
Receipts 1..............................................
----------------------------------------------------------------------------------------------
VA Mandatory Spending.................................... 23,397 24,586 28,100 +3,514 ... ... 28,400 +3,814
==============================================================================================
--------------------------------------------------------------------------------------------------------------------------------------------------------
1 The Independent Budget (IB) advocates that all funding for medical care be provided through appropriations. Therefore the IB Medical Care and Total VA
Discretionary amounts do not include MCCF receipts.
2 The VA Committee Recommendation assumes that the one-time change to the law regarding ``Millennium Bill'' receipts contained in the VA's appropriation
bill (P.L. 106-377) will not be extended past fiscal year 2001. Thus, individual facility budgets will be augmented to the extent VA actually
implements this collection authority.
REPORT TO THE COMMITTEE ON THE BUDGET FROM THE COMMITTEE ON VETERANS'
AFFAIRS, SUBMITTED PURSUANT TO SECTION 301 OF THE CONGRESSIONAL BUDGET
ACT OF 1974, ON THE BUDGET PROPOSED FOR FISCAL YEAR 2003
Background and Committee Recommendations
The Committee on Veterans' Affairs has carefully analyzed
the Department of Veterans Affairs Fiscal Year 2003 Budget
Submission.\1\ The Members of the Committee believe that
substantially increased funding for veterans' healthcare will
be necessary in order to fulfill Congressional mandates. New
challenges and new veterans lead to the inescapable conclusion
that we must provide the funding needed now by veterans who are
filling VA's outpatient clinics in unprecedented numbers.
---------------------------------------------------------------------------
\1\ 2003 Administration Request is calculated without proposed
accrual funding for federal retiree costs.
---------------------------------------------------------------------------
Department of Veterans Affairs
VETERANS HEALTH ADMINISTRATION (VHA)
Rising Demand for VA Healthcare.--The Department of
Veterans Affairs (VA) operates the largest and most extensive
system of healthcare services in the United States. Since 1996,
it has reformed its delivery system, emphasizing primary and
managed care, and expanded points of service. It has also
launched a formal enrollment system for veterans who seek VA
care, and attracted over six million veterans to enroll in the
VA healthcare system. The VA system has the world's most
advanced patient safety program and provides a superior quality
of care.
Nevertheless, VA healthcare struggles today, because
appropriated funding is not keeping pace with growth in
enrollment and the increased demands for service. Further, much
of VA's physical infrastructure is old, crumbling and in
immediate need of hundreds of millions of dollars in repairs,
restorations and upgrades. In 2001, serious damage to several
buildings demonstrated VA's seismic vulnerability at its
American Lake facility in the State of Washington. So far,
repairs at that facility have been completed only on a
patchwork basis. VA has dozens of other buildings in earthquake
zones at serious risk of seismic catastrophe.
Many veterans enrolled in the VA healthcare system report
difficulties in obtaining timely appointments for care and
services. Some clinics, such as one in Rockford, Illinois,
report waiting times in excess of one year for routine
appointments. In discussions with VHA officials, Committee
staff has been informed that funds are short in every network
and every region, and that any gains made in the reallocation
of resources to balance funding across the nation have been
overwhelmed by new demands.
The Secretary of Veterans Affairs, Honorable Anthony J.
Principi, on February 13, 2002, presented the VA's budget
request for fiscal year 2003 to the Committee on Veterans'
Affairs. In his testimony, the Secretary observed: ``Perhaps
we're the victim of our own success in many ways, but the VA
has seen extraordinary growth in our workload since open
enrollment came about in the mid-1990s; 30 percent overall
growth in workload in the number of veterans who are coming to
us for care, that's grown from 2.4 million to 3.4 million; and
in addition in Category 7, so [it's a] 500 percent increase
since 1996.''
``Demand Initiative''.--The budget proposal the Secretary
presented includes a ``Demand Initiative'' request of $1.8
billion in funding for new veterans expected to seek VA
healthcare in fiscal year 2003. The Department's budget
proposal also states an intention to implement management
improvements that would achieve $317 million in savings for
fiscal year 2003.
The Committee agrees with the Department that healthcare
demands from newly enrolled veterans should be accounted for
and funded in the budget, and the Committee commends the
Secretary for this forthright approach. However, the Committee
is skeptical of the VA's ability to quickly implement and
annualize management improvements. Therefore, the Committee
accepts the premise that $217 million in savings can be
achieved in fiscal year 2003.
Legislative Proposal for $1,500 Deductible.--In 1996,
Congress reformed veterans' healthcare eligibility with Public
Law 104-262, mandating VA care for service-connected and low-
income veterans, and permitting care for nonservice-connected,
higher income veterans on a resource available basis. VA
established a seven-tier healthcare priority system for
veterans. VA's treatment focus shifted to primary care, and VA
began a rapid expansion of access points. Today VA has over 800
community clinics that provide primary care and serve as the
referral system for its 172 medical centers.
The budget request for fiscal year 2003 includes a proposal
that Congress impose an annual healthcare deductible of $1,500
for Priority 7 veterans. This group consists of nonservice-
connected and noncompensable zero percent service-connected
veterans who are enrolled in VA healthcare. Priority 7 veterans
have incomes above VA's means test threshold ($24,304 for a
single veteran and $29,168 for a veteran with one dependent),
and must make copayments set by the Secretary as a condition of
eligibility.
The budget request reports rapid growth in Priority 7
enrollment, with nearly 1.9 million veterans enrolled now,
about 33 percent of total enrollees. It projects enrollment by
Priority 7 veterans will increase to 42 percent of all VA
enrollees by 2010. For fiscal year 2003, VA's budget projects
that it would need an additional $1.1 billion above the budget
request level to meet projected demand for healthcare by
Priority 7 veterans. According to VA, the proposed deductible
of $1,500 would produce $260 million in additional revenue for
fiscal year 2003, reduce projected enrollment by 121,000
veterans, discourage utilization by hundreds of thousands of
additional veterans, and thus save VA $885 million. The
estimated total savings to VA would be $1.1 billion.
In his testimony before the Committee on February 13, 2002,
the Secretary stated that each Priority 7 veteran's healthcare
is expected to cost approximately $1,800 annually, but VA chose
$1,500 as the deductible amount proposed, without further
explanation. The proposal is inconsistent with a new policy the
President approved in Public Law 107-135 on January 23, 2002,
to lower by 80 percent VA's existing deductible for inpatient
hospitalization for certain veterans. Thus, if Congress
approves VA's proposal to impose a new $1,500 deductible, it
would reverse a course set in law only a short time ago. It
would also reverse a policy adopted by the VA in December of
2001 to reduce the required copayment for routine outpatient
visits.
In making this proposal, the Department does not appear to
have considered the effect on its existing collections system.
VA depends on collections from veterans and their private
insurers for a significant and growing portion of its revenues
to support care. Under current law, VA charges copayments for
inpatient, outpatient, nursing home and other extended care, as
well as for prescription drugs for all Priority 7 veterans. The
copayment requirement for prescription drugs also applies to
those veterans whose incomes exceed the current VA nonservice-
connected pension rate, approximately $9,000 per year under
current law. In Public Law 106-117, Congress authorized the
Secretary to review the copayments policy and implement a more
rational system. VA recently changed a number of these
policies.
Even if Congress were to quickly enact and the President
were to sign this proposed legislation, it is doubtful that VA
could administratively implement the deductible policy until
late in fiscal year 2003, if at all. VA would need at least
several months to issue implementing regulations, including
opportunity for public comment. VA would also need to establish
a method to account for each veteran's deduction status in an
annual accounting cycle. The deductible amount would be
directly chargeable to a veteran only if the veteran were
uninsured. Collections from insurers are complicated and often
significantly delayed from the time VA sends bills. Further, VA
collects only a small fraction of billed charges in its
existing Medical Care Collection Fund programs. Implementing a
new individual deductible would only add to the administrative
difficulties. The Committee believes the new deductible would
have at best a small effect on funds or workload in fiscal year
2003. The Committee recommends Congress reject this proposal
and instead enhance VA's budget request with the additional
appropriated funding needed to sustain VA Priority 7 workload
during fiscal year 2003.
Inflation.--Medical inflation for 2001 in the United States
was reported to be 4.6 percent overall. In the coming year,
inflationary increases will occur for the Department in health
insurance and managed care premiums for its more than 200,000
employees, transportation and energy costs, maintenance on
thousands of buildings, and particularly in higher cost for
prescription drugs for nearly six million enrolled veterans.
Prescription drug cost inflation in this country is of
special concern, because it has risen from 3.6 percent in 2000
to 6.2 percent in 2001, according to the commercial
publication, ``Health Inflation News,'' December 31, 2001. The
Bureau of Labor Statistics estimates 2001 inflation of
pharmaceuticals and medical supplies at 5.99 percent. The
proposed budget predicts VA pharmaceutical cost increases of
8.58 percent above the Administration's projected medical
inflation rate of 3.9 percent. Inflation in U.S. hospital
inpatient care rose from 5.6 percent in 2000 to a current 6.9
percent. The terrorist attacks of September 11, 2001 will also
contribute to health inflation due to unplanned increased
utilization of both public and private healthcare resources.
The Committee supports VA's request in the budget for $396
million to address healthcare inflation in fiscal year 2003.
Implementation of New Veterans Healthcare Authorities.--The
full cost of implementing new laws was not taken into account
in the Department's budget submission. The Homeless Veterans
Comprehensive Assistance Act of 2001, Public Law 107-95,
requires VA to significantly expand programs and services for
homeless veterans in conformance with the legislation's stated
goal of ending chronic homelessness in the veteran population
within 10 years. VA included in its budget request only $8
million for additional programs for homeless veterans. The
Department of Veterans Affairs Health Care Programs Enhancement
Act of 2001, Public Law 107-135, expands existing health
programs, creates new ones, and enhances accountability of VA
in maintaining certain VA healthcare services to disabled
veterans. In total, the Committee believes that these
legislative measures will require $100 million in
implementation costs for fiscal year 2003.
Over the past year, the Committee has observed long-term
care bed reductions in VA facilities. VA's position is that it
cannot afford to maintain the beds required by law, and VA has
even suggested Congress change the law to permit VA to
``credit'' its capacity maintenance requirement with beds in
the state home system and in the private sector. The Committee
rejects such an approach, and insists that VA observe the
requirement to maintain a share of the responsibility to care
for old and ill veterans in its own beds, rather than sending
these patients outside the VA. To partially restore some of the
capacity that VA has reduced in the past several years since
Congress imposed these capacity restrictions, the Committee
recommends an additional $51 million for fiscal year 2003. This
is in addition to the $121 million requested by VA as part of
its healthcare demand initiative.
Emergency Preparedness.--A number of initiatives have been
launched in Federal agencies to deal with both the immediate
and longer term needs of addressing terrorist threats to the
Nation's security and safety. The Department of Veterans
Affairs should play a role in this effort because it operates
the only nationwide civilian healthcare system. The funding
requested in the 2003 budget for this function, $55 million,
would be insufficient for this very complicated and expensive
task. Therefore, the Committee recommends an increase of $200
million in this account for a total allotment of $255 million
for fiscal year 2003.
Major Medical Facility Construction.--Last year the House
passed H.R. 811, the Veterans Hospital Emergency Repair Act,
and the House Committee on Appropriations provided $300 million
for its implementation in fiscal year 2002. However, the Senate
did not act on the bill and the House-Senate conference on VA
appropriations did not include the proposed funding. A number
of urgent infrastructure projects remain without funding in the
Department. In its budget request, the Department proposes only
$94 million for major medical facility construction to fund
four VA seismic projects in the San Francisco and Los Angeles
areas of California. Each of these projects has been proposed
before as top VA priorities, and has been authorized previously
by Congress.
The Committee's views on VA healthcare infrastructure needs
have not changed since last year. Immediate needs must be met.
Congress should commit funding and provide authority to enable
the Secretary of Veterans Affairs to complete at least half of
the top twenty infrastructure projects identified by the
Secretary in the annual report required by law. Funding these
projects is essential to helping VA maintain a safe and decent
healthcare system for veterans. The Committee recommends VA's
request be supplemented with an additional $191 million for
major medical facility construction funding, including funding
for the San Diego, California, seismic corrections project, a
total of $285 million for fiscal year 2003. The Committee also
recommends VA be provided with $250 million in fiscal year 2003
for minor construction.
Medical and Prosthetic Research.--After discounting amounts
included for accrual of retiree costs, the Department's budget
proposes $394 million for VA's medical and prosthetic research
activity in fiscal year 2003. The Committee fully supports this
request.
VETERANS BENEFITS ADMINISTRATION
General Operating Expenses.--The General Operating Expense
account funds full-time employee equivalents (FTEE) and
operating expenses for both the Veterans Benefits
Administration (VBA) and VA's Central Office (headquarters).
VBA administers a broad range of non-medical benefits for
veterans, their dependents, and survivors through 57 regional
offices. These programs include compensation and pension,
education, vocational rehabilitation, insurance, and loan
guaranty (home loans). Headquarters employees include the
Secretary's staff and other VA administrative staff located in
Washington, DC.
From October 1, 2001 through March 1, 2002, the pending
backlog of claims for benefits has increased each week by an
average of 3,025 claims, in large part due to VA having to
apply new duty-to-assist standards and review almost 350,000
claims. In light of the increased workload and recent
legislative changes, including a repeal of the 30-year time
limitation for respiratory cancers and the addition of Type 2
diabetes to the presumptive list for Vietnam veterans, the
Committee supports the Administration's funding increase for
106 additional FTEE for development of Virtual VA (a paperless
claims prototype), additional quality reviews of claims
adjudication decisions, and redesign of the compensation and
pension medical evaluation system.
VA has reported a significant improvement in the quality of
its claims decisions in the last few years. According to VA's
Departmental Performance Plan, overall rating accuracy
(including procedural and substantive errors) in fiscal year
2001 was 78 percent, a considerable improvement from the 59
percent accuracy rate reported in fiscal year 2000. According
to the Secretary in testimony before the Committee on February
13, 2002, the accuracy rating today is 88 percent. Nationally,
accuracy for authorization work reportedly improved from 51
percent in fiscal year 2000 to 62 percent in fiscal year 2001.
In addition, the reported accuracy for fiduciary work improved
from 60 percent in fiscal year 2000 to 68 percent in 2001. For
fiscal year 2002, VBA has revised its rating accuracy criteria;
only ``clear and unmistakable errors'' and errors which are
expected to result in a remand on appeal will be counted in
determining the accuracy rate.
VBA's 57 regional offices process about 24 million pieces
of mail and answer about nine million phone calls annually in
administering the veterans' benefits system. The average VA
rating specialist will make about three-quarters of a billion
dollars in ratings decisions through the awards he or she
authorizes over a 20-year period. The Committee supports the
Administration's request which provides an additional 106 FTEE
to provide increased quality review of the larger compensation
and pension workload associated with recently enacted
legislation and regulations and to support several VBA
initiatives to improve claims processing.
The Committee recommends that the General Operating
Expenses account be increased by an additional $5 million for
fiscal year 2003 to provide 78 additional FTEE as human
resource staff for regional offices. Regional offices currently
lack adequate on-site experienced human resource personnel to
provide assistance and advice to management on personnel-
related issues. These include employee relations, equal
opportunity complaints, accommodation for workers with
disabilities, personnel actions, labor-management issues, local
community relations, retirement planning, and other human
resource activities involving face-to-face interactions. With
employee retirements expected to increase and regional offices
consequently employing a large percentage of trainees, the need
for additional local human resource personnel has become
apparent.
This additional funding will provide one GS-12 Personnel
Management Specialist, one GS-11 Personnel Management
Specialist and one GS-5 or 6 Clerical support staff for each of
the 20 largest regional offices. The remaining personnel (six
GS-12, five GS-11, personnel specialists and five GS-5
clerical) would be available to VBA for allocation to regional
offices where additional staff is warranted due to the size of
the office, special personnel problems exist, or for other
compelling reasons. With this addition of human resources staff
to regional offices, regional office management will be able to
devote more time to analyzing and managing claims processing
activities, providing appropriate counseling to employees in
training status and those transitioning to retirement,
improving labor management relations and improving community
relations. These human resources staff positions are intended
to supplement and not replace personnel who are currently
performing human resource liaison activities at regional
offices.
Compensation and Pension Service (C&P).--The ability of VA
to achieve timely and quality benefits delivery is heavily
dependent on a combination of an adequate number of properly
trained staff, effective business process reengineering and
computer modernization initiatives, training and retention
incentives, inter-departmental cooperation between VA and both
the Department of Defense and the National Personnel Records
Center, and assistance from veterans service organizations.
In 1993, when Congress was contemplating legislation that
created the Veterans' Claims Adjudication Commission, the
pending claims workload was 570,000; when the VA Claims
Processing Task Force issued its report in October 2001, the
pending claims workload was 533,000. As of March 1, 2002, VBA
had 599,121 claims pending at VA regional offices. The increase
is due in large part to VA complying with new duty-to-assist
standards for 244,000 pending claims, as well as the
readjudication of 98,000 claims that had been previously denied
under former duty-to-assist standards established by the U.S.
Court of Appeals for Veterans Claims. VA also received a much
larger than expected influx of claims for diabetes related to
service in Vietnam. Additional statutory and regulatory
presumptions for service connection of disabilities of atomic
veterans and Vietnam veterans are expected to increase the
pending caseload further.
During fiscal year 2001, rating decisions required an
average of 181 days to process, up from 173 days during fiscal
year 2000. The Secretary of Veterans Affairs has publicly
announced a goal of 100 days to process rating-related claims
by the summer of 2003. The Committee applauds the
Administration for putting a high priority on improving
timeliness, but is concerned that in an effort to improve
timeliness so dramatically in the stated timeframe, training
and supervision of new employees and the quality of VA claims
processing may be adversely affected. Some VA regional offices
indicate that training staff, decision review officers,
supervisory and management employees have been devoting
significant amounts of time to claims adjudication activities.
Through the first five months of fiscal year 2002, VA
reports completing 294,000 rating-related actions and has an
expected completion rate of 800,000 claims for the fiscal year.
This would represent a substantial increase compared to the
482,000 rating-related claims processed in 2001. Although
``output'' has increased, the backlog has continued to grow. In
light of increases in production, the Committee is puzzled by
the continued growth in the backlog. The Committee supports
initiatives aimed at improving the processing of veterans' and
dependents' claims and the continued emphasis on claims
accuracy. However, the Committee encourages the Department to
strive for a proper balance in the direct labor hours devoted
to new employee training and supervision and to appellate
matters as well.
According to the VBA Annual Benefits Report for Fiscal Year
2000, among the disabilities most frequently service-connected
for veterans who began receiving compensation in fiscal year
2000 are those involving musculoskeletal conditions (42
percent) and impairment of auditory acuity (10.8 percent). VBA
should anticipate that as the veteran population ages, these
types of service-connected conditions will worsen and veterans
will reopen their claims. At the beginning of fiscal year 2001,
the 50 to 59-year old age group had the most veterans receiving
service-connected compensation and also received the highest
average dollar amount of compensation.
During fiscal year 2000, 83,159 veterans began receiving
disability benefits, 46 percent of whom received a combined
disability evaluation of 30 percent or higher. The Committee
notes 81.8 percent of approximately 265,000 disabilities among
the 83,000 veterans who began receiving compensation during
fiscal year 2000 were zero or ten percent disabilities. Gulf
War veterans have an average of 3.26 disabilities per veteran,
while World War II veterans have an average of 1.82
disabilities per veteran.
For the combined degrees of disability at the beginning of
fiscal year 2001, distribution of all service-connected
disability ratings was:
\7.4 percent of veterans (170,307) rated at 100
percent;
\5.1 percent of veterans (118,638) rated at 50
percent;
\13.4 percent of veterans (308,893) rated at 30
percent;
\36.3 percent of veterans (838,886) rated at 10
percent.
VA adjudicators work with over 1,000 pages of regulations,
700 different disability codes and 113 presumptive conditions.
They must also comply with hundreds of precedential decisions
of the U.S. Court of Appeals for Veterans Claims as well as
decisions by the U.S. Court of Appeals for the Federal Circuit
and opinions of VA's General Counsel. It takes three years to
train a rating veterans' service representative. During the
1990's, the number of fully trained personnel in the
adjudication division declined by approximately 40 percent.
Although additional staffing was authorized during the past
two fiscal years, many regional offices currently have between
25 percent and 66 percent of their employees in training
status. One-third of the VBA staff is expected to retire within
the next five years. However, if veterans service organizations
and state and county veterans affairs departments would fully
develop ready-to-rate claims, the effect would be about the
same as adding 3,000 additional staff to help develop claims.
According to testimony by the former Under Secretary for
Benefits, Joseph Thompson, before the Subcommittee on Benefits,
this could result in speedier decisions and greater acceptance
of the VA's initial decision.
The Committee commends the creation of the VA Claims
Processing Task Force and the Departments' rapid implementation
of several Task Force recommendations with respect to workload
and productivity, accountability, organizational structure, and
information technology. Among the noteworthy initiatives are:
\Creation of a ``Tiger Team'' at the Cleveland
Regional Office responsible for resolving about 81,000 of the
oldest claims for disability compensation and wartime pensions
of veterans aged 70 and older;
\Consolidating all existing pension maintenance
program operations at three pension maintenance centers;
\Creation of six specialized teams to manage the
claims process, with pilot operations at four sites;
\Organizational realignment of Board of Veterans'
Appeals processing;
\Extension of the timeframe for routine follow-up
compensation and pension exams;
\A plan for reorganization of compensation and
pension regulations, as well as the operational manual; and
\A centralized training model for an integrated
program of compensation and pension technical training.
As of January 2002, of the 34 Task Force recommendations,
comprising 66 action items, VA has completed six action items,
16 action items are to be completed within six months, and 29
action items are to be completed within six to 12 months.
VA continues to make improvements to its disability and
education claims processing programs, as well as expand
outreach to servicemembers, veterans, and eligible dependents.
Improving the timeliness and quality of the claims process is
appropriately a top priority. The Committee supports funding of
$1.271 billion for General Operating Expenses, including the
additional 106 FTEE recommended by the Administration's budget
and an additional 78 FTEE for human resources activities at the
20 largest regional offices.
Vocational Rehabilitation and Employment Program (VR&E).--
The goal of the Vocational Rehabilitation and Employment
program is the employment of disabled veterans and eligible
dependents. To accomplish that goal, VR&E is authorized to
furnish all services and assistance necessary to enable
service-connected disabled veterans to become employable,
obtain and maintain suitable employment, or to achieve maximum
independence in daily living. Additionally, VR&E is authorized
to provide educational and vocational counseling services to
eligible active-duty members, veterans and dependents.
In 2000, VR&E assumed its current name to reflect an
emphasis on employment as the program's ultimate goal. The
Committee has been pleased with recent VBA initiatives to
promote better case management, lifecycle completion times and
success rates. The Committee also notes VR&E's continued
progress in implementing Employment Service Specialist
positions into existing service delivery schemes.
The VA reports improved job placement rates in its VR&E
program. In fiscal year 2001, 53 percent of rehabilitated
disabled veterans acquired suitable employment. During the
first five months of fiscal year 2002, 67 percent did so. The
Committee supports the Administration's request of 1,205 FTEE
in the Vocational Rehabilitation and Employment program, an
increase of 27 FTEE over fiscal year 2002.
Educational Assistance Programs.--VA's Education Service
administers the All-Volunteer Force Educational Assistance
Program (Montgomery GI Bill, chapter 30 of title 38, United
States Code), the Post-Vietnam-era Veterans' Educational
Assistance Program (chapter 32), the Vietnam-era Veterans'
Educational Assistance Program (chapter 34), the Survivors' and
Dependents' Educational Assistance Program (chapter 35), and
numerous other activities, including overseeing the role of
State Approving Agencies and coordination with the Department
of Defense on the Selected Reserve program of the Montgomery GI
Bill (MGIB).
The Veterans Education and Benefits Expansion Act of 2001,
Public Law 107-103, increased the basic benefit under the MGIB
program for an obligated period of active duty of three years
or more from $672 to $800 effective January 1, 2002, $900
effective October 1, 2002, and $985 effective October 1, 2003.
The Act also included improvements to Survivors' and
Dependents' Education Benefits, Internet-based education, high
technology education and courses offered through the private
sector, certain Vietnam-era veterans' education benefits, and
other areas. The improved benefit levels will likely contribute
to continuing workload challenges for VA. For fiscal year 2003,
VA estimates 325,815 veterans and servicemembers will
participate in the MGIB chapter 30 program alone.
The Committee notes that about six weeks prior to the 2001
fall semester, VA had a pending workload of about 90,000
education claims at VA's four regional processing offices. VA
addressed the fall education workload by hiring additional
staff, authorizing overtime, and streamlining certain claims
processing measures. Nevertheless, the average time to process
an original education claim increased from 36 days in fiscal
year 2000 to 50 days in fiscal year 2001. Further, the
``blocked call'' rate increased from 39 percent in 2000 to 45
percent in 2001, an unacceptable level when compared with the
three percent blocked call rate in other VBA activities. The
increase appears to be attributable in some part to a greater
than expected number of calls received by the four regional
processing offices assuming responsibility for administering a
nationwide toll-free GI Bill telephone inquiry line. VA expects
to improve the blocked call rate by enhancing VA's education
service web site to provide electronic alternatives to
telephone services and by increasing the number of seasonal
employees for peak usage periods.
The Committee notes timeliness in VA education claims
processing reached a five-year low in fiscal year 2001--in
large part due to transferring 50 FTEE in fiscal year 1999 and
45 FTEE in fiscal year 2000 to the Compensation and Pension
program and the transfer of all educational inquiries (about
three million calls annually) from 57 regional offices to four
regional processing offices without additional FTEE. The
Committee disfavors such transfers of personnel, as they tend
to create dysfunction in one program in order to improve
another.
VBA has implemented a prototype, The Expert Education
System (TEES), that is able to process selected enrollment
information for MGIB claimants for whom data has been submitted
electronically from their educational institution. The
Administration has requested $6.3 million for TEES. The
Committee recommends $16 million to enhance TEES automation, an
increase of $9.7 million compared to the Administration's
request. Based on testimony before the Committee and
projections contained in the Independent Budget, $16 million is
needed in order for the automated data exchange between VA and
schools to be maximized. The Committee expects there will be
fewer delays and greater accuracy for veterans receiving
education benefits once this system is completely implemented.
One-VA Telephone Access Initiative.--The Virtual
Information Center (VIC) forms a single telecommunications
network among several regional offices. VIC technology also
allows VBA to answer calls at any place and at any time without
complex call routing reconfigurations and with fewer FTEE. Also
included in this initiative is support for upgrading the
National Automated Response System to allow improved call flow
design, increased Interactive Voice Response and customer
survey functionality. The Committee supports the fiscal year
2003 budget request of $10.8 million for this project.
Vendee Loans.--When a purchaser agrees to buy a foreclosed
VA home, VA often offers to finance the sale by establishing a
vendee loan to encourage the prompt sale of the home. Vendee
loans are made at market interest rates and often require a
down payment. Borrowers are charged a 2.25 percent funding fee
that is paid in cash.
The Committee views vendee loans as an important tool to
obtain a higher return on property sales, which reduce the
overall cost of program operations. VA makes, and subsequently
sells, $800 million to $1.2 billion in such loans each fiscal
year. There is an ample body of empirical data indicating that
offering vendee financing results in higher returns on taxpayer
investment in VA's loan guaranty program. In March 2000, Booz,
Allen, and Hamilton, Inc. independently analyzed the cost
effectiveness of vendee loan financing. Their report indicated
a savings to the Government of $16 million in fiscal year 1999
due to vendee financing.
A preliminary, informal estimate by the Congressional
Budget Office shows a projected loss of $745 million over 10
years if VA were to eliminate vendee loans, largely due to a
lower purchase price on such foreclosed VA-financed homes. The
Committee believes the vendee loan program is based on sound
business principles and produces cost-effective results. The
Committee opposes the President's budget proposal to eliminate
the vendee loan program administratively in fiscal year 2003.
State Cemetery Grants Program.--The State Cemetery Grants
Program provides grants to assist states in establishing,
expanding, and improving state-owned veterans' cemeteries. The
State Cemetery Grants Program is not a replacement of VA's
national cemetery program, but is one way of increasing the
availability of state veterans' cemeteries to serve veterans
who do not reside near an open national cemetery. Since the
program became active in 1980, the State Cemetery Grants
Program has awarded more than $108 million in grants: 53 grants
for the initial establishment of new state cemeteries and 56
new grants for expansion or improvements. There are 48 open
state veterans cemeteries in 25 states and Guam, and 37 pending
grant applications.
With the implementation of the Veterans Program Enhancement
Act of 1998, interest in the State Cemetery Grants Program has
accelerated. Public Law 105-368 increased the federal
government's share of the cost for establishing, expanding or
improving a state veterans' cemetery from 50 percent to 100
percent. The Committee supports the Administration's requested
increase from $25 million to $32 million in fiscal year 2003.
NATIONAL CEMETERY ADMINISTRATION
Currently, the National Cemetery Administration (NCA)
maintains more than 2.4 million gravesites in 120 national
cemeteries, as well as 33 soldier's lots and monument sites.
These national shrines honoring those who served in uniform
should be maintained as places of high honor, dignity and
respect. Since 1973, when NCA was established, annual
interments in national cemeteries have more than doubled from
36,400 to 84,822 in fiscal year 2001. Last year, VA provided an
estimated 304,000 headstones and markers compared to 190,000
headstones in markers in 1973. VA estimates that 663,000
veterans died in fiscal year 2001, 89,000 more than the number
who died in fiscal year 2000.
Veterans' deaths are expected to peak in 2006. In order to
meet the demand for burial space, section 611 of Public Law
106-117 directed the Secretary of Veterans Affairs to establish
six additional national cemeteries in those areas the Secretary
deems to be more in need. The Committee supports the fiscal
year 2003 budget request of $23 million for development of a
cemetery in southern Florida and $16 million for development of
a cemetery in Pittsburgh. The fiscal year 2002 budget request
included $28 million for the Phase I development of a cemetery
in Atlanta, Georgia. On November 2, 2001, the first section
completed at the Ft. Sill, Oklahoma, national cemetery was
dedicated, and interments are being conducted. VA expects to
report in May 2002 to Congress on the status of these new
cemeteries, as well as those in Detroit, Michigan, and
Sacramento, California.
Congress has been active in ensuring that the final resting
place of our veterans is befitting their service to the nation.
Section 613 of Public Law 106-117 also directed the Secretary
of Veterans Affairs to enter into a contract to assess the
standards of appearance of active national cemeteries, and the
feasibility of making standards of appearance of closed
national cemeteries commensurate with standards of appearance
of the finest cemeteries in the world. The Standards of
Appearance Report is expected to be released in March 2002. The
Committee supports the Administration's request for $133
million in fiscal year 2003--a $17 million increase over last
year--as well as an additional 59 FTEE.
BOARD OF VETERANS' APPEALS
In fiscal year 2001, the Board of Veterans' Appeals (BVA)
issued 31,557 decisions. Of those, 91 percent (28,698) involved
the compensation program. The cases include claims for service-
connection, increased ratings, dependency and indemnity
compensation, and earlier effective dates. About two percent
(579 cases) involved more than one program. Almost 50 percent
of the claims appealed were remanded to regional offices. The
Board allowed another 22 percent of the claims appealed. Only
26 percent of the appeals were denied.
There was substantial difference in performance among
regional offices. Appeals from the Manila, Fargo, St. Paul, and
Milwaukee regional offices were reversed or remanded much less
frequently than the national average. Appeals from Columbia,
Wilmington, Montgomery, and Newark regional offices were
reversed or remanded in a high percentage of cases. The
Committee is concerned about the significant differences in
reversal and remand rates among regional offices.
For fiscal year 2003, BVA projects that it will take an
average of 520 days to process an appeal. At the end of fiscal
year 2001, 7,731 cases were pending before the Board, down
substantially from 20,521 cases at the end of fiscal year 2000.
The Committee recognizes that as a result of Public Law
106-475, which requires VA to assist a claimant in obtaining
evidence, a significant number of claims were remanded to
regional offices by the Board. In an effort to assist with the
increased caseload at the regional offices and reduce the
number of remanded appeals, in 2002 VA issued a regulation
allowing BVA to obtain and clarify evidence rather than remand
the appeal to the originating regional office. By reducing the
number of appeals remanded, BVA may be able to shorten both
appeal processing times and reduce the number of claims
awaiting decisions at regional offices.
The Committee supports the Administration's request of
$51.2 million and 451 FTEE for BVA. The Committee notes that
this request will reduce the number of FTEE for BVA
decisionmakers by 34 from the 2002 original budget estimate and
by 14 from the 2002 current estimate. While the BVA workload
has decreased during the current fiscal year, the Committee
cautions that as the effect of the duty-to-assist legislation
decreases and the number of claims decided by regional offices
increases, BVA staffing may prove to be insufficient. It will
not improve claims processing for veterans if the regional
office pending workload is decreased and VA pending workload
increases. The Committee intends to carefully monitor these
outcomes.
OFFICE OF INSPECTOR GENERAL
The VA Office of the Inspector General (OIG) exists to
ensure veterans programs are managed efficiently and
effectively, and are free of fraud, waste and abuse. OIG
reports that the monetary benefits of their activities usually
provide a return on investment of 30 to 1. In 1999, OIG
reestablished cyclical audits under a Combined Assessment
Program (CAP) that provides on-site reviews of VHA and VBA
facilities as a joint effort of OIG's Audit, Healthcare,
Inspections and Investigations sections. These audits were
severely curtailed in 1993 because of staffing reductions, and
were finally ended in 1995. Current OIG staffing levels will
allow a CAP review of each VA healthcare facility every six
years. A six-year interval between audits is not in the best
interest of veterans or taxpayers.
The Committee notes Congress established a statutory OIG
staffing floor of 417 FTEE in Public Law 100-527. Section 312
of title 38, United States Code, requires the budget
transmitted to Congress for each fiscal year to be sufficient
to support this statutory floor. This requirement has not been
met since 1993. Current OIG staffing supported by
appropriations is 405 FTEE. An additional 24 FTEE are supported
by reimbursements received for Department contract review
activities.
In December 2001, Public Law 107-103 tasked the OIG to
identify fugitive felons who are disqualified from receiving VA
compensation and pension benefits. The OIG estimates that the
annual amount of the benefits could be as high as $104 million.
The OIG estimates that it will require 37 FTEE to fully
implement this new legislative requirement.
Increased OIG staffing is a prudent use of resources.
Accordingly, the Committee supports an appropriated funding
increase of $10.1 million for 92 additional FTEE in fiscal year
2003. This increase would allow OIG to comply with the new
legislative requirements of the fugitive felon program without
impairing its current operations, reduce its CAP review cycle
to four years, and bring OIG into compliance with the staffing
floor. An adequately staffed OIG would improve quality and
access for veterans' healthcare, increase VA security against
fraud and theft, and result in improved overall management. The
Committee therefore recommends overall funding of $69.1 million
for OIG for fiscal year 2003, which would support 497 FTEE.
Department of Labor
VETERANS' EMPLOYMENT AND TRAINING SERVICE (VETS)
Congress has determined that our nation has a
responsibility to meet the employment and training needs of
veterans. To accomplish those goals, the Veterans' Employment
and Training Service (VETS) of the Department of Labor provides
job services for veterans through grants to state employment
services.
The Committee is aware of significant changes in the
national labor exchange system that are not a part of the
delivery system for veterans' employment and training services
under chapter 41 of title 38, United States Code. States are
changing the way they deliver employment services and adopting
new service delivery models. These range from devolving state
programs to the county level, competing some or all employment
functions, instituting one-stop employment centers under the
Workforce Investment Act of 1998, and using Internet-based job
placement services under America's Job Bank and America's
Talent Bank. Also, the current version of chapter 41 predates
requirements of the Government Performance and Results Act to
focus on performance measurement and outcomes.
The Committee finds the performance of the VETS program to
be unsatisfactory. The General Accounting Office (GAO) reports
that seven out of ten veterans that visit state employment
security agencies do not get jobs. The Committee expects to
consider legislation to promote effective job service delivery
for veterans in the 21st century. Fundamental objectives of
such legislation would be to help veterans get jobs, ensure
fairness to states in grants, give states greater flexibility
to manage, reward states that do well, and allow all states an
equal chance to excel.
Between 1997 and 2001, GAO issued seven reports on
veterans' employment and training services identifying serious
deficiencies in VETS planning and performance. The President's
fiscal year 2003 budget submission would transfer to VA three
grant programs: (1) the Local Veterans Employment
Representatives (LVER), (2) the Disabled Veterans Outreach
Program (DVOP), and (3) the Homeless Veterans Reintegration
Program (HVRP). In addition, the Transition Assistance Program,
which provides job training, employment assistance, and other
transitional services to separating servicemembers, would also
be transferred to VA. The Office of Management and Budget,
VETS, and VA have working groups focusing on various
administrative, financial, and legislative implications of the
proposed transfer. The total transfer of funding to VA would be
$197 million. The transfer also includes shifting 199 VETS
employees (state directors and assistant directors and their
staffs) to VA. In the absence of a detailed plan and a
legislative proposal to accomplish this transfer, the Committee
reserves judgment on a transfer of VETS to VA.
Therefore, the Committee recommends $214 million for VETS
in fiscal year 2003, including $81,615,000 for DVOP services,
$77,253,000 for LVER services, $27,776,000 for administration,
$3 million for the National Veterans' Training Institute, $50
million for HVRP, and $7,550,000 for the Veterans Workforce
Investment Program.
Legislation the Committee May Report With Direct Spending Implications
State Approving Agencies (SAA).--The Committee recommends
legislation to increase funding available to State Approving
Agencies (SAAs) from $14 million to $18 million in fiscal year
2003, and to increase such funding by three percent in each of
fiscal year 2004 and fiscal year 2005. SAAs approve colleges
and employers for veterans' training under VA education
programs. The Committee's legislation reflects the SAA's new
duties in occupational licensing and credentialing, and
veteran, servicemember and employer outreach in each state. The
Committee notes from fiscal years 1989 to 1994, SAA funding was
capped at $12 million with no annual increases. From fiscal
years 1995 to 2000, such funding was capped at $13 million.
However, for fiscal years 2001 and 2002, Congress furnished
SAAs a temporary increase in funds from $13 million to $14
million. In the absence of legislation, SAA funding for fiscal
year 2003 reverts to $13 million, the fiscal year 1995 funding
level.
Dependency and Indemnity Compensation for Surviving Spouses
Who Remarry after Age 55.--Dependency and Indemnity
Compensation (DIC) provides a partial substitute for the
economic loss suffered by the survivors upon the service-
connected death of a veteran. For a survivor to be eligible,
the veteran must have died during military service, from a
service-connected disability, or have had a service-connected
disability that was rated 100 percent for a certain period of
time before dying from a nonservice-connected condition. DIC
terminates upon the remarriage of a surviving spouse, although
benefits may be restored in the event that the subsequent
remarriage ends in death or divorce. Civil Service, Central
Intelligence Agency and Social Security survivorship programs
allow surviving spouses to remarry at older ages and retain
their survivor benefits. The Committee will consider
legislation to allow a surviving spouse who remarries after age
55 to retain DIC benefits. The Congressional Budget Office
(CBO) informally estimated the additional cost of this
eligibility change to be $107 million in the first year, $1.4
billion over five years, and $3 billion over 10 years.
Uniform Home Loan Fees for Active Duty and Reservists.--
Currently, certain home loan fees paid by members of the
Selected Reserves are 0.75 percent higher than the fees paid by
active duty personnel. Given the significant contribution to
military activities currently performed by reservists and the
relatively low default rate of their loans, the higher fees are
not justified. CBO estimated the cost of this eligibility
change to be $7 million per year.
Mortgage Insurance for Severely Disabled Veterans.--
Severely disabled veterans who have received grants for
specially adapted housing from VA qualify for Veterans'
Mortgage Life Insurance (VMLI) at a maximum amount of $90,000.
The insurance is terminated when the veteran reaches age 70.
The Committee may consider legislation to increase the amount
of VMLI to $200,000 and to continue insurance after age 70. CBO
estimated the increase to $200,000 in the amount of insurance
would cost $2 million the first year and $11 million over five
years. CBO estimated that the cost of continuing VMLI after age
70 would be negligible the first year and $3 million over five
years.
ADDITIONAL VIEWS AND ESTIMATES
March 11, 2002.
Hon. Christopher H. Smith,
Chairman, Committee on Veterans' Affairs,
House of Representatives, Washington, DC.
Dear Mr. Chairman: Thank you for the opportunity to review
the recommendations which you and Congressman Evans plan to
submit to the Committee on the Budget with respect to the
budget for veterans' programs for fiscal year 2003.
Following are additional views and estimates which I wish
to propose:
$30 million for FY 2003 to provide VA health care for all
non-service connected Filipino World War II veterans residing
in the United States, using the same eligibility criteria as
are used for U.S. veterans.
$.5 million for FY 2003 to expand access at the VA
Outpatient Clinic in Manila for both service-connected and non-
service-connected Filipino World War II veterans residing in
the Philippines (to provide full health care, including
service-connected and non-service-connected disabilities).
I appreciate your consideration of these additional budget
items.
Sincerely,
Bob Filner,
Member of Congress
Comparison of President's Proposed Budget, Independent Budget and VA Committee Recommendations for the Department of Veterans Affairs
(Budget Authority in millions)
--------------------------------------------------------------------------------------------------------------------------------------------------------
FY 2003 Admin. VA
FY 2002 Administration Request +/- Independent IB +/- FY VA Committee Committee +/
Estimate Request\1\ 2002 Budget (IB) 2002 Recommendation\2\ - 2002
--------------------------------------------------------------------------------------------------------------------------------------------------------
Medical Care (excluding receipts).................... $21,331 $22,744 +$1,413 $24,468 +$3,137 $24,534 +$3,203
MCCF and HSIF receipts............................... 1,031 1,449 +418 No estimate ... 1,189 +158
provided
Research............................................. 371 394 +23 460 +66 394 +23
Construction, Major.................................. 183 194 +11 401 +218 385 +202
Construction, Minor.................................. 211 211 ... 400 +189 250 +39
State Nursing Home and Cemetery Grants............... 125 132 +7 142 +17 142 +17
General Operating Expenses (excludes credit reform).. 1,199 1,256 +57 1,264 +66 1,271 +72
National Cemetery Administration..................... 121 133 +12 138 +17 133 +12
Other Discretionary (includes credit reform)......... 288 293 +5 No estimate ... 300 +12
provided
--------------------------------------------------------------------------------------------------
Total VA Discretionary (Excluding MCCF and HSIF 23,829 25,357 +1,528 .............. ......... 27,407 +3,578
Receipts)...........................................
--------------------------------------------------------------------------------------------------
VA Mandatory Spending................................ 26,997 30,123 +3,126 No estimate ... 30,234 +3,237
provided
==================================================================================================
--------------------------------------------------------------------------------------------------------------------------------------------------------
1 2003 Administration Request is calculated without proposed accrual funding for federal retiree costs.
2 VA Committee Recommendation does not assume enactment of Administration's proposed $1,500 deductible for veteran healthcare users, transfer of VETS
from Labor to VA, or increased accrual funding for federal retiree costs.
MESSAGES FROM THE PRESIDENT AND EXECUTIVE COMMUNICATIONS
------
presidential messages
Feb. 13, 2002:
Communication from the President of the United States,
transmitting the Administration's 2002 National Drug Control
Strategy, pursuant to 21 U.S.C. 1705.
------
executive communications
Jan. 20, 2001:
Letter from the Director, Office of Regulations Management,
Veterans Benefits Administration, Department of Veterans
Affairs, transmitting the Department's final rule--New Criteria
for Approving Courses for VA Educational Assistance Programs
(RIN: 2900-AI67) Received December 21, 2000, pursuant to 5
U.S.C. 801(a)(1)(A).
Jan. 31, 2001:
Letter from the the Director, National Legislative
Commission, The American Legion, transmitting the proceedings
of the 82nd National Convention of the American Legion, held in
Milwaukee, Wisconsin from September 5, 6, and 7, 2000 as well
as a report on the Organization's activities for the year
preceding the Convention, pursuant to 36 U.S.C. 49.
Feb. 26, 2001:
Letter from the Secretary, Department of Veterans Affairs,
transmitting a letter regarding the status of a joint report to
Congress on the implementation of that portion of the Health
Resources Sharing and Emergency Operations Act (38 U.S.C.
8111(f)) dealing with sharing of health care resources between
the Department of Veterans Affairs and the Department of
Defense.
Mar. 12, 2001:
Letter from the Director, Office of Regulations Management,
Board of Veterans' Appeals, Department of Veterans Affairs,
transmitting the Department's final rule--Appeals Regulations:
Tide for Members of the Board of Veterans' Appeals--Rescission
(RIN: 2900-AK61) Received March 6, 2001, pursuant to 5 U.S.C.
801(a)(1)(A).
Mar. 12, 2001:
Letter from the Director, Office of Regulations Management,
Veterans Benefits Administration, Department of Veterans
Affairs, transmitting the Department's final rule--Revised
Criteria for Monetary Allowance for an Individual Born with
Spina Bifida Whose Biological Father or Mother Is a Vietnam
Veteran (RIN: 2900-AJ51) Received March 6, 2001, pursuant to 5
U.S.C. 801(a)(1)(A).
Apr. 3, 2001:
Letter from the Director, Office of Regulations Management,
Veterans Benefits Administration, Department of Veterans
Affairs, transmitting the Department's final rule--Claims Based
on the Effects of Tobacco Products (RIN: 2900-AJ59) Received
April 3, 2001, pursuant to 5 U.S.C. 801(a)(1)(A).
Apr. 3, 2001:
Letter from the Director, Office of Regulations Management,
Veterans Benefits Administration, Department of Veterans
Affairs, transmitting the Department's final rule--Signature by
Mark (RIN: 2900-AK07) Received April 3, 2001, pursuant to 5
U.S.C. 801(a)(1)(A).
Apr. 27, 2001:
Letter from the Secretary, Department of Veterans Affairs,
transmitting a report on cases recommended for equitable
relief, pursuant to 38 U.S.C. 503(c).
May 7, 2001:
Letter from the Director, Office of Regulations Management,
Veterans Benefits Administration, Department of Veterans
Affairs, transmitting the Department's final rule--
Certification of Evidence for Proof of Service (RIN: 2900-AJ55)
Received April 18, 2001, pursuant to 5 U.S.C. 801(a)(1)(A).
May 10, 2001:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Review of Benefit Claims Decisions (RIN: 2900-AJ99)
Received May 2, 2001, pursuant to 5 U.S.C. 801(a)(1)(A).
May 14, 2001:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Disease Associated With Exposure to Certain
Herbicide Agents: Type 2 Diabetes (RIN: 2900-AK63) Received May
4, 2001, pursuant to 5 U.S.C. 801(a)(1)(A).
May 14, 2001:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Reasonable Charges for Medical Care or Services
(RIN: 2900-AK73) Received May 2, 2001, pursuant to 5 U.S.C.
801(a)(1)(A).
May 17, 2001:
Letter from the Director, Office of Regulations Management,
Veterans Benefits Administration, Department of Veterans
Affairs, transmitting the Department's final rule--U.S. Flags
for Burials of Certain Members of the Selected Reserve (RIN:
2900-AK56) Received May 15, 2000, pursuant to 5 U.S.C.
801(a)(1)(A).
June 5, 2001:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Schedule for Rating Disabilities: Disabilities of
the Liver (RIN: 2900-AK12) Received May 25, 2001, pursuant to 5
U.S.C. 801(a)(1)(A).
June 14, 2001:
Letter from the the Adjutant General, the Veterans of
Foreign Wars of the U.S., transmitting proceedings of the 101st
National Convention of the Veterans of Foreign Wars of the
United States, held in Milwaukee, Wisconsin, August 20-25,
2000, pursuant to 36 U.S.C. 118 and 44 U.S.C. 1332.
June 18, 2001:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Delegation of Authority-Portfolio Loan Servicing
Contractor (RIN: 2900-AK72) Received June 14, 2001, pursuant to
5 U.S.C. 801(a)(1)(A).
June 25, 2001:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Veterans Education: Increased Allowances for the
Educational Assistance Test Program (RIN: 2900-AK41) Received
June 13, 2001, pursuant to 5 U.S.C. 801(a)(1)(A).
June 25, 2001:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Increase in Rates Payable Under the Montgomery GI
Bill--Active Duty and Survivors' and Dependents' Educational
Assistance (RIN: 2900-AK44) Received June 13, 2001, pursuant to
5 U.S.C. 801(a)(1)(A).
June 27, 2001:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Grants to States for Construction and Acquisition
of State Home Facilities (RIN. 2900-AJ43) Received June 22,
2001, pursuant to 5 U.S.C. 801(a)(1)(A).
July 10, 2001:
Letter from the General Counsel, Department of Defense,
transmitting a draft of proposed legislation to authorize
appropriations for fiscal year 2002 for military activities of
the Department of Defense, to prescribe military personnel
strengths for fiscal year 2001, and for other purposes.
July 12, 2001:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Payment or Reimbursement for Emergency Treatment
Furnished at Non-VA Facilities (RIN: 2900-AK08) Received July
9, 2001, pursuant to 5 U.S.C. 801(a)(1)(A).
July 12, 2001:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Board of Veterans' Appeals: Rules of Practice--
Effect of Procedural Defects in Motions for Revision of
Decisions on the Grounds of Clear and Unmistakable Error (RIN:
2900-AK74) Received July 9, 2001, pursuant to 5 U.S.C.
801(a)(1)(A).
July 23, 2001:
Letter from the Director, Office of Regulations Management,
Board of Veterans' Appeals, Department of Veterans Affairs,
transmitting the Department's final rule--Board of Veterans'
Appeals: Rules of Practice--Notification of Representatives in
Connection with Motions for Revision of Decisions on Grounds of
Clear and Unmistakable Error (RIN: 2900-AJ75) Received July 16,
2001, pursuant to 5 U.S.C. 801(a)(1)(A).
July 25, 2001:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Rules of Practice: Medical Opinions from the
Veterans Health Administration (RIN: 2900-AK52) Received July
18, 2001, pursuant to 5 U.S.C. 801(a)(1)(A).
July 27, 2001:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--End of the Service Members Occupational Conversion
and Training Program (RIN: 2900-AK45) Received July 24, 2001,
pursuant to 5 U.S.C. 801(a)(1)(A).
Aug. 1, 2001:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Montgomery GI Bill--Active Duty (RIN: 2900-AK06)
Received July 27, 2001, pursuant to 5 U.S.C. 801(a)(1)(A).
Sept. 5, 2001:
Letter from the Secretary, Department of Veterans Affairs,
transmitting a draft of proposed legislation entitled,
``Veterans' Benefits Act of 2001''.
Sept. 14, 2001:
Letter from the Deputy Secretary, Department of Defense,
transmitting a report on Outreach to Gulf War Veterans Calendar
Years 1999 and 2000.
Sept. 20, 2001:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Certification for Eligibility for Adaptive
Equipment for Automobiles or Other Conveyances (RIN: 2900-AK96)
Received August 23, 2001, pursuant to 5 U.S.C. 801(a)(1)(A).
Sept. 20, 2001:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Veterans Benefits Administration Nomenclature
Changes (RIN: 2900-AK46) Received August 21, 2001, pursuant to
5 U.S.C. 801(a)(1)(A).
Oct. 3, 2001:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Duty to Assist (RIN: 2900-AK69) Received September
4, 2001, pursuant to 5 U.S.C. 801(a)(1)(A).
Oct. 5, 2001:
Letter from the Director, Office of Regulations Management,
Veterans Benefits Administration, Department of Veterans
Affairs, transmitting the Department's final rule--Veterans'
Benefits and Health Care Improvement Act of 2000 (RIN: 2900-
AK68) Received September 19, 2001, pursuant to 5 U.S.C.
801(a)(1)(A).
Oct. 12, 2001:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Board of Veterans' Appeals: Rules of Practice--
Subpoenas for Filing Substantive Appeal (RIN: 2900-AK54)
Received October 1, 2001, pursuant to 5 U.S.C. 801(a)(1)(A).
Oct. 12, 2001:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Board of Veterans' Appeals: Rules of Practice--
Subpoenas (RIN: 2900-AJ58) Received September 26, 2001,
pursuant to 5 U.S.C. 801(a)(1)(A).
Nov. 1, 2001:
Letter from the Secretaries, Departments of Defense and
Veterans Affairs, transmitting a report on the implementation
of the health resources sharing portion of the ``Department of
Veterans Affairs and Department of Defense Health Resources
Sharing and Emergency Operations Act'' for Fiscal Year 2000,
pursuant to 38 U.S.C. 8111(f).
Nov. 6, 2001:
Letter from the the Executive Secretary, the Disabled
American Veterans, transmitting the 2001 National Convention
Proceedings of the Disabled American Veterans, pursuant to 36
U.S.C. 90i and 44 U.S.C. 1332.
Nov. 30, 2001:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
``Major'' final rule--Copayments for Medications (RIN: 2900-
AK85) Received November 30, 2001, pursuant to 5 U.S.C.
801(a)(1)(A).
Dec. 6, 2001:
Letter from the Director, Office of Regulations Management,
Veterans Benefits Administration, Department of Veterans
Affairs, transmitting the Department's final rule--Written and
Oral Information or Statements Affecting Entitlement to
Benefits (RIN: 2900-AK25) Received November 30, 2001, pursuant
to 5 U.S.C. 801(a)(1)(A).
Dec. 6, 2001:
Letter from the Director, Office of Regulations Management,
Veterans Benefits Administration, Department of Veterans
Affairs, transmitting the Department's final rule--Written and
Oral Information or Statements Affecting Entitlement to
Benefits (RIN: 2900-AK25) Received November 27, 2001, pursuant
to 5 U.S.C. 801(a)(1)(A).
Dec. 6, 2001:
Letter from the Director, Office of Regulations Management,
Veterans Benefits Administration, Department of Veterans
Affairs, transmitting the Department's final rule--Extension of
the Presumptive Period for Compensation for Gulf War Veterans'
Undiagnosed Illnesses (RIN: 2900-AK98) Received November 27,
2001, pursuant to 5 U.S.C. 801(a)(1)(A).
Dec. 6, 2001:
Letter from the Director, Office of Regulations Management,
Veterans Benefits Administration, Department of Veterans
Affairs, transmitting the Department's final rule--Extension of
the Presumptive Period for Compensation for Gulf War Veterans'
Undiagnosed Illnesses (RIN: 2900-AK98) Received November 30,
2001, pursuant to 5 U.S.C. 801(a)(1)(A).
Dec. 11, 2001:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Board of Veterans' Appeals: Rules of Practice--
Notice of Appeal in Simultaneously Contested Claim (RIN: 2900-
AJ73) Received November 30, 2001, pursuant to 5 U.S.C.
801(a)(1)(A).
Dec. 11, 2001:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Provision of Hospital and Outpatient Care to
Veterans'--Enrollment Decision Level; Copayments for Inpatient
Hospital Care and Outpatient Medical Care (RIN: 2900-AK50)
Received November 30, 2001, pursuant to 5 U.S.C. 801(a)(1)(A).
Jan. 23, 2002:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Per Diem for Adult Day Health Care of Veterans in
State Homes (RIN: 2900-AJ74) Received January 4, 2002, pursuant
to 5 U.S.C. 801(a)(1)(A).
Jan. 23, 2002:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Filipino Veterans' Benefits Improvements (RIN:
2900-AK65) Received January 4, 2002, pursuant to 5 U.S.C.
801(a)(1)(A).
Jan. 23, 2002:
Letter from the Secretary, Department of Veterans Affairs,
transmitting a draft bill to enhance veterans' programs and the
ability of the Department of Veterans Affairs to administer
them.
Jan. 23, 2002:
Letter from the the Director, National Legislative
Commission, The American Legion, transmitting the proceedings
of the 83rd annual National Convention of the American Legion,
held in San Antonio, Texas from August 28, 29, and 30, 2001 as
well as report on the Organization's activities for the year
preceding the Convention, pursuant to 36 U.S.C. 49.
Feb. 4, 2002:
Letter from the Director, Department of Veterans Affairs,
transmitting the Department's final rule--Compensated Work
Therapy/Transitional Residences Program (RIN: 2900-AK01)
Received January 28, 2002, pursuant to 5 U.S.C. 801(a)(1)(A).
Feb. 4, 2002:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Board of Veterans' Appeals: Obtaining Evidence and
Curing Procedural Defects Without Remanding (RIN: 2900-AK91)
Received January 17, 2002, pursuant to 5 U.S.C. 801(a)(1)(A).
Feb. 4, 2002:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Civilian Health and Medical Program of the
Department of Veterans Affairs (CHAMPVA) (RIN: 2900-AK89)
Received January 28, 2002, pursuant to 5 U.S.C. 801(a)(1)(A).
Feb. 5, 2002:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Diseases Specific to Radiation-Exposed Veterans
(RIN: 2900-AK64) Received January 23, 2002, pursuant to 5
U.S.C. 801(a)(1)(A).
Feb. 14, 2002:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Claims Based on Exposure to Ionizing Radiation
(RIN: 2900-AK87) Received February 12, 2002, pursuant to 5
U.S.C. 801(a)(1)(A).
Feb. 27, 2002:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Special Monthly Compensation for Women Veterans Who
Lose a Breast as a Result of a Service-Connected Disability
(RIN: 2900-AK66) Received February 13, 2002, pursuant to 5
U.S.C. 801(a)(1)(A).
Mar. 4, 2002:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Loan Guaranty: Advertising and Solicitation
Requirements (RIN: 2900-AJ86) Received February 28, 2002,
pursuant to 5 U.S.C. 801(a)(1)(A).
Mar. 13, 2002:
Letter from the Director, Office of Regulations Management,
Department of Veterans Affairs, transmitting the Department's
final rule--Exclusion from Countable Income of Expenses Paid
for Veteran's Last Illness Subsequent to Veteran's Death but
Prior to Date of Death Pension Entitlement (RIN. 2900-AK84)
Received February 28, 2002, pursuant to 5 U.S.C. 801(a)(1)(A).
Apr. 9, 2002:
Letter from the Acting Director, Office of Regulatory Law,
Department of Veterans Affairs, transmitting the Department's
final rule--Information Collection Needed in VA's Flight-
Training Programs (RIN: 2900-AJ23) Received March 18, 2002,
pursuant to 5 U.S.C. 801(a)(1)(A).
Apr. 16, 2002:
Letter from the Acting Director, Office of Regulatory Law,
Department of Veterans Affairs, transmitting the Department's
final rule--Board of Veterans' Appeals Rules of Practice: Claim
for Death Benefits by Survivor (RIN: 2900-AL11) Received April
5, 2002, pursuant to 5 U.S.C. 801(a)(1)(A).
Apr. 23, 2002:
Letter from the Acting, Director Office of Regulatory Law,
Department of Veterans Affairs, transmitting the Department's
final rule--Board of Veterans' Appeals Title Change (RIN: 2900-
AL15) Received April 4, 2002, pursuant to 5 U.S.C.
801(a)(1)(A).
Apr. 25, 2002:
Letter from the Secretary, Department of Veterans Affairs,
transmitting a draft bill, ``To amend Title 38, United States
Code, to establish a new Assistant Secretary to perform
operations, preparedness, security, and law enforcement
functions, and for other purposes''.
May 1, 2002:
Letter from the General Counsel, Department of Defense,
transmitting the Department's proposed legislation entitled the
``National Defense Authorization Act for Fiscal Year 2003''.
May 1, 2002:
Letter from the General Counsel, Department of Defense,
transmitting the Department's proposed legislation relating to
the housing of civilian teachers at Guantanamo Bay, and
expansion of our dependent summer school program, and
clarification of authority relating to United Nations' efforts
to inspect and monitor Iraqi weapons systems.
May 8, 2002:
Letter from the Acting Director Office of Regulatory Law,
Department of Veterans Affairs, transmitting the Department's
final rule--Policy Regarding Participation in National
Practitioner Data Bank (RIN: 2900-AJ76) Received April 22,
2002, pursuant to 5 U.S.C. 801(a)(1)(A).
May 10, 2002:
Letter from the Secretary, Department of Veterans Affairs,
transmitting a draft bill entitled, ``Veterans' Benefits
Improvement Act of 2002''.
May 22, 2002:
Letter from the Acting Director, Office of Regulatory Law,
Department of Veterans Affairs, transmitting the Department's
final rule--Copayments for Inpatient Hospital Care and
Outpatient Medical Care (RIN: 2900-AK50) Received May 2, 2002,
pursuant to 5 U.S.C. 801(a)(1)(A).
May 23, 2002:
Letter from the Deputy Assistant Secretary, VETS,
Department of Labor, transmitting the Department's final rule--
Annual Report from Federal Contractors (RIN: 1293-AA07)
Received May 10, 2002, pursuant to 5 U.S.C. 801(a)(1)(A).
June 6, 2002:
Letter from the Secretaries, Department of Veterans Affairs
and Department of Defense, transmitting a report for fiscal
year 2001 regarding the implementation of the health resources
sharing portion of the Department of Veterans Affairs and
Department of Defense Health Resources Sharing and Emergency
Operations
June 6, 2002:
Letter from the Assistant Secretary for Congressional and
Legislative Affairs, Department of Veterans Affairs,
transmitting the Fiscal Year 2002 Veterans Equitable Resource
Allocation (VERA).
June 13, 2002:
Letter from the Acting Director, Office of Regulatory Law,
Department of Veterans Affairs, transmitting the Department's
final rule--Increased Allowances for the Educational Assistance
Test Program (RIN: 2900-AL02) Received May 13, 2002, pursuant
to 5 U.S.C. 801(a)(1)(A).
June 13, 2002:
Letter from the Secretary, Department of Veterans Affairs,
transmitting a draft bill entitled, ``Veterans' Employment,
Business Opportunity, and Training Act of 2002''.
June 20, 2002:
Letter from the Acting Director, Office of Regulatory Law,
Department of Veterans Affairs, transmitting the Department's
final rule--Board of Veterans' Appeals: Rules of Practice-
Attorney Fee Matters (RIN: 2900-Al98) Received May 21, 2002,
pursuant to 5 U.S.C. 801(a)(1)(A).
June 25, 2002:
Letter from the Acting Director, Office of Regulatory Law,
Department of Veterans Affairs, transmitting the Department's
final rule--Medical Benefits Package; Copayments for Extended
Care Services (RIN: 2900-AK32) Received June 7, 2002, pursuant
to 5 U.S.C. 801(a)(1)(A).
July 11, 2002:
Letter from the Acting Director, Office of Regulatory Law,
Veterans Health Administration, Department of Veterans Affairs,
transmitting the Department's final rule--Filipino Veterans
Eligible for Hospital Care, Nursing Home Care, and Medical
Services (RIN: 2900-AL18) Received June 20, 2002, pursuant to 5
U.S.C. 801(a)(1)(A).
July 26, 2002:
Letter from the Acting Director, Office of Regulatory Law,
Department of Veterans Affairs, transmitting the Department's
final rule--Ankylosis and limitation of motion of digits of the
hands (RIN: 2900-AI44) Received July 24, 2002, pursuant to 5
U.S.C. 801(a)(1)(A).
July 26, 2002:
Letter from the Acting Director, Office of Regulatory Law,
Department of Veterans Affairs, transmitting the Department's
final rule--Adjudication; Fiduciary Activities--Nomenclature
Changes (RIN: 2900-AL10) Received July 16, 2002, pursuant to 5
U.S.C. 801(a)(1)(A).
July 26, 2002:
Letter from the Acting Director, Office of Regulatory Law,
Department of Veterans Affairs, transmitting the Department's
final rule--VA Acquisition Regulation: Construction and
Architect-Engineer Contracts (RIN. 2900-AJ56) Received July 25,
2002, pursuant to 5 U.S.C. 801(a)(1)(A).
July 26, 2002:
Letter from the Deputy Secretary, Department of Defense,
transmitting a report on Outreach to Gulf War Veterans Calendar
Year 2001.
Sept. 4, 2002:
Letter from the Secretary, Department of Veterans Affairs,
transmitting a report covering those cases in which equitable
relief was granted in calendar year 2001, pursuant to 38 U.S.C.
210(c)(3)(B).
Sept. 4, 2002:
Letter from the Deputy General Counsel, Veterans Benefits
Administration, Department of Veterans Affairs, transmitting
the Department's final rule--Duty Periods; Inactive Duty for
Training (RIN: 2900-AL21) Received July 30, 2002, pursuant to 5
U.S.C. 801(a)(1)(A).
Sept. 4, 2002:
Letter from the Deputy General Counsel, Veterans Benefits
Administration, Department of Veterans Affairs, transmitting
the Department's final rule--Monetary Allowances for Certain
Children of Vietnam Veterans; Identification of Covered Birth
Defects (RIN: 2900-AK67) Received July 30, 2002, pursuant to 5
U.S.C. 801(a)(1)(A).
Sept. 4, 2002:
Letter from the Deputy General Counsel, Department of
Veterans Affairs, transmitting the Department's final rule--
Board of Veterans' Appeals: Rules of Practice-Attorney Fee
Matters; Notice of Disagreement Requirement (RIN: 2900-AL25)
Received July 30, 2002, pursuant to 5 U.S.C. 801(a)(1)(A).
Sept. 4, 2002:
Letter from the Acting Director, Office of Regulatory Law,
Veterans Benefits Administration, Department of Veterans
Affairs, transmitting the Department's final rule--Schedule for
Rating Disabilities; Intervertebral Disc Syndrome (RIN: 2900-
AI22) Received August 23, 2002, pursuant to 5 U.S.C.
801(a)(1)(A).
Sept. 4, 2002:
Letter from the Acting Director, Office of Regulatory Law,
Regional Office and Insurance Center, Department of Veterans
Affairs, transmitting the Department's final rule--National
Service Life Insurance (RIN: 2900-AK43) Received August 23,
2002, pursuant to 5 U.S.C. 801(a)(1)(A).
Sept. 4, 2002:
Letter from the Deputy General Counsel, Department of
Veterans Affairs, transmitting the Department's final rule--
Schedule for rating disabilities The Skin (RIN: 2900-AF00)
Received July 30, 2002, pursuant to 5 U.S.C. 801(a)(1)(A).
Sept. 9, 2002:
Letter from the Acting Director, Office of Regulatory Law,
Insurance Center, Department of Veterans Affairs, transmitting
the Department's final rule--Accelerated Benefits Option for
Servicemembers' Group Life Insurance and Veterans' Group Life
Insurance (RIN: 2900-AJ80) Received August 13, 2002, pursuant
to 5 U.S.C. 801(a)(1)(A).
Sept. 19, 2002:
Letter from the Acting Director, Office of Regulatory Law,
Department of Veterans Affairs, transmitting the Department's
final rule--Priorities for Outpatient Medical Services and
Inpatient Hospital Care (RIN: 2900-AL39) Received September 17,
2002, pursuant to 5 U.S.C. 801(a)(1)(A).
Sept. 30, 2002:
Letter from the Acting Director, Office of Regulatory Law,
Department of Veterans Affairs, transmitting the Department's
final rule--Recoupment of Severance Pay from VA Compensation
(RIN: 2900-AK95) Received September 25, 2002, pursuant to 5
U.S.C. 801(a)(1)(A).
Oct. 8, 2002:
Letter from the Acting Director, Office of Regulatory Law,
Department of Veterans Affairs, transmitting the Department's
final rule--Loan Guaranty: Net Value and Pre-Foreclosure Debt
Waivers (RIN: 2900-AG20) Received October 7, 2002, pursuant to
5 U.S.C. 801(a)(1)(A).
Oct. 8, 2002:
Letter from the Acting Director, Office of Regulatory Law,
Department of Veterans Affairs, transmitting the Department's
final rule--Prohibition of Interment or Memorialization in
National Cemeteries and Certain State Cemeteries Due to
Commission of Capital Crimes (RIN: 2900-AJ77) Received October
7, 2002, pursuant to 5 U.S.C. 801(a)(1)(A).
Oct. 9, 2002:
Letter from the Acting Director, Office of Regulatory Law,
Department of Veterans Affairs, transmitting the Department's
final rule--Enrollment--Provision of Hospital and Outpatient
Care to Veterans (RIN: 2900-AK38) Received October 7, 2002,
pursuant to 5 U.S.C. 801(a)(1)(A).
Oct. 31, 2002:
Letter from the Acting Director, Office of Regulatory Law,
Department of Veterans Affairs, transmitting the Department's
final rule--Evidence for Accrued Benefits (RIN: 2900-AH42)
Received October 25, 2002, pursuant to 5 U.S.C. 801(a)(1)(A).
Nov. 7, 2002:
Letter from the Acting Director, Office of Regulatory Law,
Department of Veterans Affairs, transmitting the Department's
final rule--Civilian Health and Mental Program of the
Department of Veterans Affairs (CHAMPVA) (RIN: 2900-AK89)
Received November 1, 2002, pursuant to 5 U.S.C. 801(a)(1)(A).
Nov. 8, 2002:
Letter from the Acting Director, Office of Regulatory Law,
Department of Veterans Affairs, transmitting the Department's
final rule--Service Connection by Presumption of Aggravation of
a Chronic Preexisting Disease (RIN: 2900-AL20) Received
November 4, 2002, pursuant to 5 U.S.C. 801(a)(1)(A).
Nov. 13, 2002:
Letter from the Director, Office of Personnel Management,
transmitting the Office's Fiscal Year 2001 annual report on
Veteran's Employment in the Federal Government, pursuant to 38
U.S.C. 4214(e)(1).
STATISTICAL DATA--WAR VETERANS AND DEPENDENTS
(As of October 2002)
American Revolution (1775-1783)
Total Servicemembers.............................................217,000
Battle Deaths......................................................4,435
Non-mortal Woundings...............................................6,188
Last Veteran, Daniel F. Bakeman, died April 5, 1869,................ 109
Last Widow, Catherine S. Damon, died November, 11, 1906,..........age 92
Last Dependent, Phoebe M. Palmeter, died April 25, 1911,..........age 90
War of 1812 (1812-1815)
Total Servicemembers.............................................286,730
Battle Deaths......................................................2,260
Non-mortal Woundings...............................................4,505
Last Veteran, Hiram Cronk, died May 13, 1905,....................age 105
Last Widow, Carolina King, died June 28, 1936,...............age unknown
Last Dependent, Esther A.H. Morgan, died March 12, 1946,..........age 89
Indian Wars (approx. 1817-1898)
Total Servicemembers........................................1
106,000
Battle Deaths.................................................1
1,000
Last Veteran, Fredrak Fraske, died June 18, 1973,................age 101
Mexican War (1846-1848)
Total Servicemembers..............................................78,718
Battle Deaths......................................................1,733
Other Deaths in Service...........................................11,550
Non-mortal Woundings...............................................4,152
Last Veteran, Owen Thomas Edgar, died September 3, 1929,..........age 98
Last Widow, Lena James Theobald, died June 20 1963,...............age 89
Last Dependent, Jesse G. Bivens, died November 1, 1962,...........age 94
Civil War (1861-1865)
Total Servicemembers (Union)...................................2,213,363
Battle Deaths (Union)............................................140,414
Other Deaths in Service (Union)..................................224,097
Non-mortal Woundings (Union).....................................281,881
Total Servicemembers (Confederate).............................1,050,000
Battle Deaths (Confederate).......................................74,524
Other Deaths in Service (Confederate)........................2
59,297
Non-mortal Woundings (Confederate)...............................Unknown
Last Union Veteran, Albert Woolson, died August 2, 1956,.........age 109
Last Confederate Veteran, John Salling, died March 16, 1958,.....age 112
Spanish-American War (1898-1902)
Total Servicemembers (Worldwide).................................306,760
Battle Deaths........................................................385
Other Deaths in Service............................................2,061
Non-mortal Woundings...............................................1,662
Last Veteran, Nathan E. Cook, died September 10, 1992,...........age 106
World War I (1917-1918)
Total Servicemembers (Worldwide)...............................4,734,991
Battle Deaths.....................................................53,402
Other Deaths in Service...........................................63,114
Non-mortal Woundings.............................................204,002
Living Veterans.......................................1 Less
than 500
World War II (1940-1945)
Total Servicemembers (Worldwide)..............................16,112,566
Battle Deaths....................................................291,557
Other Deaths in Service..........................................113,842
Non-mortal Woundings.............................................671,846
Living Veterans...........................................1
4,750,000
Korean Conflict (1950-1953)
Total Servicemembers (worldwide)...............................5,720,000
Battle Deaths.....................................................33,686
Other Deaths (In theater)..........................................2,830
Other Deaths in Service...........................................17,730
Non-mortal Woundings.............................................103,284
Living veterans...........................................1
3,724,000
Vietnam Era (1964-1975)
Total Servicemembers (Worldwide)...............................9,200,000
Deployed to Southeast Asia.....................................3,100,000
Battle Deaths.....................................................47,410
Other Deaths (In Theater).........................................10,788
Other Deaths in Service......................................est. 32,000
Non-mortal Woundings.............................................153,303
Living Veterans...........................................1
8,274,000
Gulf War (1990-1991)
Total Servicemembers (Worldwide)...............................2,322,332
Deployed to Gulf...............................................1,136,658
Battle Deaths........................................................147
Other Deaths (In Theater)............................................235
Other Deaths in Service..............................................914
Non-mortal Woundings.................................................467
Living Veterans................................................1,852,000
America's Wars Total
Military Service During War...................................42,348,460
Battle Deaths....................................................650,954
Other Deaths in Service (In Theater)..............................13,853
Other Deaths in Service (Non-Theater)............................229,661
Non-mortal Woundings...........................................1,431,290
Living War Veterans......................................3
17,537,500
Living Ex-Servicemembers.................................1
25,625,000
------
Veterans and Dependents on the Compensation and Pension Rolls
(As of August 2002)
----------------------------------------------------------------------------------------------------------------
SURVIVING
VETERANS CHILDREN PARENTS SPOUSES
----------------------------------------------------------------------------------------------------------------
Civil War................................................... ........... 7 ........... 1
Indian Wars................................................. ........... 1 ........... ...........
Spanish-American War........................................ ........... 203 ........... 273
Mexican Border.............................................. 5 23 ........... 149
World War I................................................. 59 5,290 1 18,615
World War II................................................ 585,891 17,870 884 260,593
Korean Conflict............................................. 242,994 3,848 1,085 62,645
Vietnam Era................................................. 915,537 12,055 5,219 122,727
Gulf War.................................................... 416,536 9,127 364 7,460
TOTAL WARTIME............................................... 2,161,022 48,424 7,553 472,463
----------------------------------------------------------------------------------------------------------------
Source: Department of Defense, unless otherwise indicated.
Living veterans estimates are based on Census 2000 figures. Sum of veterans shown for each war period does not
equal total number of war veterans, as approximately 1,063,000 veterans served in more than one conflict. They
are shown for each period in which they served, but are counted only once in total war veterans figure.
Periods of service used in Census data may differ slightly from those of DOD. For compensation and pension
purposes, the Gulf War period has not yet been terminated and includes those discharged from 1991 to date. The
living Gulf War veterans estimate is for the peak 1990-1991 period only.
``Other Deaths in Service'' is the number of servicemembers who died while on active duty, other than those
attributable to combat, regardless of the location or cause of death.
\1\ VA estimate as of September 30, 2002.
\2\ Does not include 26,000 to 31,000 who died in Union prisons.
\3\ Approximately 1,063,000 veterans served in more than one conflict. They are counted in each period, but only
once in total.