[Senate Hearing 109-516]
[From the U.S. Government Publishing Office]
S. Hrg. 109-516
THE LEGISLATIVE PRESENTATIONS OF THE FLEET RESERVE ASSOCIATION, THE AIR
FORCE SERGEANTS ASSOCIATION, THE RETIRED ENLISTED ASSOCIATION, THE GOLD
STAR WIVES OF AMERICA, INC., AND THE MILITARY OFFICERS ASSOCIATION OF
AMERICA
=======================================================================
HEARING
BEFORE THE
COMMITTEE ON VETERANS' AFFAIRS
UNITED STATES SENATE
ONE HUNDRED NINTH CONGRESS
SECOND SESSION
__________
MARCH 2, 2006
__________
Printed for the use of the Committee on Veterans' Affairs
Available via the World Wide Web: http://www.access.gpo.gov/congress/
senate
U.S. GOVERNMENT PRINTING OFFICE
28-132 PDF WASHINGTON : 2007
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Washington, DC 20402-0001
COMMITTEE ON VETERANS' AFFAIRS
.........................................................
Larry E. Craig, Idaho, Chairman
Arlen Specter, Pennsylvania Daniel K. Akaka, Hawaii, Ranking
Kay Bailey Hutchison, Texas Member
Lindsey O. Graham, South Carolina John D. Rockefeller IV, West
Richard Burr, North Carolina Virginia
John Ensign, Nevada James M. Jeffords, (I), Vermont
John Thune, South Dakota Patty Murray, Washington
Johnny Isakson, Georgia Barack Obama, Illinois
Ken Salazar, Colorado
Lupe Wissel, Majority Staff Director
D. Noelani Kalipi, Minority Staff Director
C O N T E N T S
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March 2, 2006
SENATORS
Page
Craig, Hon. Larry E., Chairman, U.S. Senator from Idaho.......... 1
Akaka, Hon. Daniel K., Ranking Member, U.S. Senator from Hawaii.. 3
Thune, Hon. John, U.S. Senator from South Dakota................. 51
WITNESSES
Barnes, Joseph L., National Executive Secretary, Fleet Reserve
Association; accompanied by Chris Slawinski, National Veteran
Service Officer, Fleet Reserve Association..................... 5
Prepared statement........................................... 7
Holleman, Deirdre Parke, National Legislative Director, the
Retired Enlisted Association................................... 13
Prepared statement........................................... 15
Brown, Morgan D., Manager, Military and Government Relations, Air
Force Sergeants Association.................................... 20
Prepared statement........................................... 22
Norton, Colonel Robert F. (Ret.), U.S. Army; Deputy Director,
Government Relations, Military Officers Association............ 30
Prepared statement........................................... 31
Lee, Rose Elizabeth, Chairman, Legislative Committee, Gold Star
Wives of America, Inc.; accompanied by Edith Smith, Member,
Legislative Committee, Gold Star Wives of America, Inc......... 39
Prepared statement........................................... 42
THE LEGISLATIVE PRESENTATIONS OF THE FLEET RESERVE ASSOCIATION, THE AIR
FORCE SERGEANTS ASSOCIATION, THE RETIRED ENLISTED ASSOCIATION, THE GOLD
STAR WIVES OF AMERICA, INC., AND THE MILITARY OFFICERS ASSOCIATION OF
AMERICA
----------
THURSDAY, MARCH 2, 2006
U.S. Senate,
Committee on Veterans' Affairs,
Washington, DC.
The Committee met, pursuant to notice, at 10:01 a.m., in
room 106, Dirksen Senate Office Building, Hon. Larry E. Craig,
Chairman of the Committee, presiding.
Present: Senators Craig, Thune, and Akaka.
OPENING STATEMENT OF HON. LARRY E. CRAIG, CHAIRMAN
U.S. SENATOR FROM IDAHO
Chairman Craig. Good morning, ladies and gentlemen. The
Committee on Veterans' Affairs will now come to order.
Good morning to all of our presenters. It is a great honor
to have you before the Committee and a pleasure to welcome each
of you to this second opportunity that we have had this week to
receive legislative presentations from our veterans and
military service organizations. We are looking forward to your
comments.
I would like to extend a very special welcome to the
organization members who have traveled here, and we have not
filled the room, but we know that all good intentions are out
there. My guess is we are probably competing a little bit. The
Secretary is on the other side of Capitol Hill at this time. So
the House and the Senate are competing for attention. That will
not stop us from focusing on your testimony and that which you
have to present to us.
You presenters are not merely important to us, but you will
help us shape what is going to be an awfully important year.
This is a unique opportunity for us to give our thanks for your
dedication and for all of the work on behalf of the veterans
and their families.
We have mutual goals, mutual responsibilities, and your
presentation in these hearings will help us tackle the
difficult task of appropriately handling a myriad of very
important issues in this session.
Before I turn it over to the panel, I would like to say a
few words about the Committee's activities last year and some
important challenges that we will undertake this year.
By any measure, this Committee had a busy and productive
first session, convening 23 hearings here in Washington, 9
field hearings, and 4 markups. Despite the depth and breadth of
these issues and the many challenges we encountered, we
accomplished many good things together: the enactment of
legislation to increase disability compensation and survivor
payments, to provide traumatic injury insurance protection to
seriously wounded servicemembers, to increase the maximum
amount of veterans' and servicemembers' life insurance
coverage, and to close the parole loophole that allowed certain
capital offenders to receive burial and funeral honors.
In addition, the Committee also worked to fill a gap in VA
health care funding which resulted in 6 consecutive years that
VA's health care system has outranked the private sector for
customer satisfaction.
We also approved legislation to improve housing and PTSD
and bereavement services, readjustment counseling, blindness
rehabilitation, and other enhancements to health care programs.
In the coming year, we will continue to work on issues of this
magnitude.
In your testimony, many of you have expressed interest in
improving upon the seamless transition from military
servicemember to civilian veteran. With the aid of pace-setting
electronic medical records and world-class health care, I
believe we have the necessary tools to make great strides. But
through the spring, the Committee's focus must be on the
President's fiscal year 2007 budget proposal. For the
Department of Veterans Affairs, this is important.
As I have stated at a hearing earlier this month and again
earlier this week, I believe this record budget request is
extraordinary and shows that in this fiscally austere climate,
the President has chosen to make veterans a top budget
priority.
That said, I am concerned that at present spending rates,
VA spending will double almost every 6 years and will soon
collide with spending demands in other areas of Government.
Although we may wish that veterans funding existed in a vacuum,
it simply does not. It is a reality of our budget processes
here, and we may face some important decisions about how to
deal with these realities sooner than we would like.
As I am sure everyone here is aware, the President has
proposed one way for us to respond to these fiscal realities by
asking Priority 7 and 8 veterans with no service-related
disabilities to contribute $21 a month to enroll in the VA
health care system and pay $15 for a 30-day supply of medicine.
Although I personally find these proposals to be reasonable, I
know some organizations have voiced strong opposition.
I will reiterate my hope that your organization and others
will engage this Committee in serious and candid discussion, if
not about the President's proposal, then about other options.
It is our collective responsibility and our collective
obligation to sustain the incredible VA health care system into
the future. If we begin addressing these issues now, we can
help ensure that future veterans will not be faced with even
bigger challenges and more radical changes to meet those
challenges.
Personally, I do not want to pass this issue on to the next
guy. I want to pass on to tomorrow's veteran what we have
collectively created, a health care system that provides
quality care, that is accessible to those who need it, but
affordable to those who want it.
I hope you would agree with me about the goals that we are
willing to work for, and if you will work with me, somehow we
can accomplish these rather difficult tasks.
Again, thank you all for joining us today. I think that the
next few years will be ones of progress and wisdom in handling
veterans' issues. I look forward to hearing your testimony and
to continuing a dialogue with your organizations about the
important issues concerning today's veterans.
In that spirit, let me extend a warm welcome to the members
of this panel. Joe Barnes is the national executive secretary
of the Fleet Reserve Association. We welcome Deirdre Parke
Holleman, the national legislative director for the Retired
Enlisted Association, and also retired Master Sergeant Morgan
Brown, the manager of Military and Government Relations of the
Air Force Sergeants Association. Representing the Military
Officers Association of America is the deputy director of
Government Relations, Colonel Robert Norton, United States
Army, retired. Finally, a warm welcome to Rose Lee, chairman of
the Legislative Committee of the Gold Star Wives of America.
Just this past year, Ms. Lee, you talked with us about the
challenges that survivors face in accessing necessary benefits
information, and we did something about it, and I intend to
hold a hearing later this year to further evaluate the VA
survivor benefits homepage. This is work in progress, and we
will stay with it until it is usable, easily accessed, and
understandable by all.
It is a pleasure to work with all of you and to continue
that work as we set our targets on the good and true service to
our country's veterans.
With that, let me turn to our Ranking Member Danny Akaka
for any opening statements he would like to make, and then we
will move on.
Edie, I guess I didn't say hello to you. Accompanying Rose
Lee, of course, is Edie Smith. Welcome.
STATEMENT OF DANIEL K. AKAKA, RANKING MEMBER,
U.S. SENATOR FROM HAWAII
Senator Akaka. Thank you, Mr. Chairman.
I want to add my welcome and greetings to all of you here.
As the Chairman pointed out, we have a full house of panelists.
We don't have any empty chairs at the table, and I am so glad
to see all of you here.
I want to thank you veterans for being here and
representing the service organizations. There are five of them
that you are representing here, and we are delighted to have
all of you here. I know some of you have made this journey to
our Nation's Capital, to express your concerns.
Your being here at this hearing is truly democracy in
action. Your organizations have a long and proud tradition, and
this Committee relies heavily on your concerns and agendas for
the coming year.
At this time, I would like to share some concerns that I
have. During this time last year--let's go back to that--many
of us here in Congress were sounding the alarm that the VA
budget was facing a crisis situation. Many months later, the
Administration acknowledged this fact, and Congress took
action, this Committee took action, to provide emergency
funding.
This year, I remain dedicated to ensuring that VA has the
resources it needs to care for all veterans.
We must learn a lesson from last year's budget crisis and
do everything we can to ensure that veterans and their family
members have access to health care and benefits they have
earned.
We cannot fund the VA system out of the pocket of middle-
income veterans, as many of these men and women make as little
as $26,902 a year. Higher copayments and enrollment fees are
not justified.
Caring for servicemembers when they return home, in
addition to veterans already in this system, must be considered
part of the continuing cost of war. To date, a quarter of a
million veterans have been excluded from VA health care. Over
700 veterans in Hawaii have knocked on the doors of VA for
care, only to be denied, and I am sure this has happened in
other States. We must work to overturn this Administration's
decision and open the VA system up to those who need it.
I also am concerned about the VA research program being
slated for a cut under this budget. Since its inception, the VA
research program has made landmark contributions to the welfare
of not only veterans, but the entire Nation, illustrating the
unique importance of keeping it adequately funded.
With thousands of military personnel engaged in conflict
overseas, it is vital that Congress invest in research that
could have a direct impact on their post-deployment quality of
life.
With regard to the VBA budget, I am concerned whether or
not this budget provides an adequate level of staffing for
compensation claims rating. Whatever the reason for the
increase in compensation claims, VA must be ready to adjudicate
claims in a timely and accurate manner.
I will continue to monitor VA's workload and rating output
because our veterans deserve nothing less than their claims
rated accurately and in a reasonable amount of time.
I will continue to oppose efforts to reduce veterans'
compensation, as we saw with the ill-fated PTSD review. Now the
Institute of Medicine and the Veterans' Disability Benefits
Commission are reviewing veterans' disability compensation. It
is my hope that these groups will recommend new ways for
Congress to improve benefits, not call for cuts in current
benefits. In this time of conflict abroad, a reduction in
benefits would send the wrong message to veterans,
servicemembers, and their families.
My last priority is near and dear to my heart. As a veteran
of World War II, I owe a great deal of where I am today to the
GI bill, educational benefits I used as a young man. With this
in mind, I will continue to look for ways to enhance and
modernize educational benefits to more adequately prepare
veterans for new challenges of our economy.
In closing, I would like, once again, to thank the
panelists for their testimony and all members of the
organizations here today. Your service and your dedication to
this Nation and its veterans is unquestionable.
I also want to apologize that I will not be able, Mr.
Chairman, to stay for the entire hearing this morning. My
presence is required at another committee.
I look forward to your presentation and working with you in
the future.
Thank you very much. Thank you, Mr. Chairman.
Chairman Craig. Danny, thank you very much, and we
certainly understand this is a busy time here on the Hill as we
are trying to hear all aspects of the budget and begin the
processes of an early portion of a session. So thank you for
being here, and thank you for those opening remarks.
Now, let us turn to our panelists. Joe Barnes, national
executive secretary, Fleet Reserve Association, and he is
accompanied by Chris Slawinski, a national veteran service
officer, Fleet Reserve Association.
Joe, please proceed.
STATEMENT OF JOSEPH L. BARNES, NATIONAL EXECUTIVE SECRETARY,
FLEET RESERVE ASSOCIATION; ACCOMPANIED BY CHRIS SLAWINSKI,
NATIONAL VETERAN SERVICE
OFFICER, FLEET RESERVE ASSOCIATION
Mr. Barnes. Mr. Chairman, Senator Akaka, thank you for the
opportunity to present FRA's recommendations on the fiscal year
2007 Department of Veterans Affairs budget.
As you noted, accompanying me today on my right is Chris
Slawinski, our national service officer.
FRA appreciates the increased funding in the fiscal year
2007 budget, particularly for VA health care, long-term care,
mental health, and other key accounts. This marks significant
progress over last year's budget request and follows emergency
supplemental appropriations that were necessary at the end of
the last fiscal year, and I would note we sincerely appreciate
your leadership in addressing this emergency funding shortage.
Our members are very concerned about the discovery of
inaccurate projections and faulty models used to prepare the
previous budgets and GAO findings about the methods used to
project management efficiency savings.
FRA is also concerned about the assumptions used to prepare
the budget which assumes congressional approval of a $250
enrollment fee and significantly higher prescription copays for
Priority 7 and 8 beneficiaries. This is not a new proposal, and
FRA strongly opposes the establishment of these increases.
VA health care funding must be adequate to meet the needs
of the growing number of veterans seeking services, many from
Operations Enduring Freedom and Iraqi Freedom, and the budget
must be based on realistic projections.
FRA believes that adequately funding health care and other
programs for veterans, their families and survivors, is part of
the cost of defending our Nation and ensuring our freedoms.
The VA suspended enrollments in Priority Group 8 in 2003,
and FRA urges the sufficient resources be authorized to allow
resumption of enrollment for all veterans.
FRA supports the authorization of Medicare reimbursements
as an alternative to the enrollment fee in higher pharmacy
copays. A significant number of veterans enrolled in the VA
health care system have paid into Medicare. Yet, the VA is not
authorized to receive reimbursements for providing services to
these veterans.
Injured combat veterans from Iraq and Afghanistan should be
immediately processed into the VA system. This is also
important for personnel retiring from military service with
service-connected disabilities. Electronic medical records,
plus expanded and improved coordination between DOD and VA,
will ensure the seamless transitions of these personnel.
FRA believes DVA's efforts in decreasing the backlog of
initial disability claims are commendable, but the backlog of
veterans waiting for decisions on their claims has grown
significantly. Increased staffing levels within the VBA claims
processing system would be a positive step toward reducing this
backlog.
FRA strongly supports adequate funding for medical and
prosthetic research and is concerned about the budget for these
programs and its reliance on partnering initiatives with other
institutions. Ensuring sufficient funds to maintain VA's world-
class research program is very important.
FRA supports the modernization of the MGIB to include much-
needed changes to Guard/Reserve benefits. The association
believes MGIB benefits should cover the average cost of a 4-
year public college or university education.
FRA also believes that Congress should restore and sustain
education benefits to members of the selected Reserve to 47
percent of basic benefits, as authorized when the MGIB was
established in 1984.
The Reserve MGIB should also be transferred from title 10
to title 38 to allow better accountability and improved
processing. There are thousands of senior enlisted personnel
who entered service during the Veterans Education Assistance
Program period, or VEAP era, from 1977 to 1985. They are
seeking an opportunity to sign up for the MGIB. Included in
this total are about 14,000 Navy personnel and nearly 5,000
Marines.
FRA urges authorization of an open enrollment period to
provide an opportunity for them to sign up for the MGIB. This
is a major issue within the career senior enlisted communities.
Finally, some additional priority concerns for our members,
these include full concurrent receipt of military retired pay
and VA disability for all disabled retirees, support for
shifting the effective paid-up date for SBP from 2008 to 2006
for participants who have paid premiums for 30 years and are 70
years of age, and last, FRA strongly supports needed reform of
the Uniformed Services Former Spouses' Protection Act.
Mr. Chairman, in closing, allow me to again express the
appreciation of the association for what all the Members of the
Veterans' Affairs Committee and the professional staff do for
our Nation's veterans. Our legislative team stands ready to
assist you and your staff at any time, and I stand ready to
answer any questions you may have.
Thank you.
[The prepared statement of Mr. Barnes follows:]
Prepared Statement of Joseph L. Barnes, National Executive Secretary,
Fleet Reserve Association
Mr. Chairman, and distinguished Members of the Committee, the
membership of the Fleet Reserve Association (FRA) appreciates this
opportunity to present the Association's fiscal year 2007 legislative
goals. On behalf of more than 110,000 shipmates, I extend sincere
gratitude for the concern, active interest and progress to date
generated by the Committee in protecting, improving, and enhancing
benefits that are truly deserved by our Nation's veterans. We look
forward to working with you to further enhance the quality of life for
over 25 million of our Nation's veterans, their families and survivors.
FRA was established in 1924 and its name is derived from the Navy's
program for personnel transferring to the Fleet Reserve or Fleet Marine
Corps Reserve after 20 or more years of active duty, but less than 30
years for retirement purposes. During the required period of service in
the Fleet Reserve, assigned personnel earn retainer pay and are subject
to recall by the Secretary of the Navy.
As a congressionally chartered association, FRA's mission is to act
as the premier ``watch dog'' organization in maintaining and improving
the quality of life for Sea Service personnel and their families. FRA
is a leading advocate on Capitol Hill for enlisted active duty,
Reserve, retired and veterans of the United States Navy, Marine Corps,
and Coast Guard.
the fiscal year 2007 dva budget
FRA appreciates the Administration's proposed record $80.6 billion
fiscal year 2007 budget, representing an $8.8 billion increase over the
DVA's 2006 budget. And the 11.3 percent increase for veterans' health
care, totaling $34.3 billion, is a step in the right direction toward
maintaining the highest quality care for our Nation's veterans.
However, the Association also questions the assumptions used to
determine these amounts, particularly in shifting part of the cost
burden on to veterans' shoulders.
FRA strongly opposes the plan to impose a $250 enrollment fee for
veterans in Priority Groups 7 and 8. The Administration's request also
includes a recommendation to nearly double prescription drug copayments
from $8 to $15, for a 30 day supply--a plan FRA also opposes.
According to DVA estimates, 200,000 veterans would be discouraged
from seeking VA health care, and more than a million veterans currently
enrolled in Priority Groups 7 and 8 would drop out of the system if
this fee structure were implemented. Beneficiaries in these Priority
Groups are veterans, and FRA adamantly opposes shifting costs to them.
Fortunately, the House Veterans Affairs Committee rejected the
proposed enrollment fees, and increased copays in its Budget Views and
Estimates. Instead, the Committee called for a $795.5 million increase
to the budget, the amount of revenue projected from the fees and
increased copays.
persistent shortfalls
This past year is perhaps the most unique ever in the debate over
the Department of Veterans' Affairs (DVA) budget. The Department
acknowledged that it did not have the resources necessary to meet the
growing demands being placed on its health care system due primarily to
Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF).
During the past year, DVA acknowledged that it was facing a
shortfall of approximately $1 billion for veterans' health care funding
for fiscal year 2005. During a subsequent hearing conducted by this
distinguished Committee, Under Secretary for Health, Jonathan Perlin,
MD, stated that because of flaws with its health care model, DVA would
be transferring approximately $1 billion from other health care
accounts in order to continue to meet the demand for care. During
subsequent hearings, Secretary of Veterans Affairs James Nicholson
explained that it would be necessary to transfer approximately $600
million from operations and non-recurring maintenance accounts, and
approximately $400 million from fiscal year 2006 funding.
FRA appreciates your leadership and the Committee's immediate
response to this situation by authorizing additional appropriations
totaling $1.2 billion to cover the shortfall.
However, despite these actions, DVA still faces the real
possibility that it will not receive adequate resources in future
budgets, and funds may not become available until after the start of
each fiscal year. These factors place enormous stress on the system and
will leave the DVA struggling to provide care that all veterans have
earned and deserve.
Assumed management efficiency savings also places a heavy burden on
the Department to cut corners and do more with less which may lead to
another shortfall and associated reductions to care for our Nation's
veterans.
Research by the Government Accounting Office (February 1, 2006) on
methodology used by DVA, found that unrealistic assumptions, estimate
errors, insufficient data, and inaccurate budget models resulted in the
2005 DVA budget shortfalls. Hopefully these issues were taken into
account in the preparation of the proposed fiscal year 2007 DVA budget.
discretionary versus mandatory funding
Currently only the Veterans Benefits Administration (VBA) portion
of the DVA budget is designated as mandatory spending, while the entire
Veterans Healthcare Administration (VHA) part of the DVA budget is
discretionary spending. Unfortunately the budgetary process has become
more and more politicized and continues to fail veterans who depend on
DVA for all or part of their healthcare.
FRA concurs with, and endorses recommendations that the Committee
on the Budget convert the veterans' health care account from
discretionary to mandatory spending. FRA understands the jurisdictional
and other challenges associated with this issue and believes that
veterans' health care is as important as other Federal benefits funded
in this manner. Regardless of the method used, the Association supports
any efforts to help ensure full funding for VA Healthcare to ensure
care for all beneficiaries.
veterans health administration
VA-DOD Collaboration
The Departments of Defense (DOD) and Veterans Affairs have made
great progress in sharing information and resources, but much more is
needed, particularly with regard to access standards, to truly provide
a ``seamless transition'' from military service to veteran status.
This came to light during the January 2006 meeting of the Veterans
Disability Benefits Commission (VDBC). Commissioners heard testimony of
the real life stories from combat injured personnel returning from the
front lines. The most compelling story came from Sarah Wade, wife of
retired U.S. Army Sergeant Edward Wade who suffered a traumatic brain
injury. He had his right arm amputated above the elbow, broke his right
foot and suffered shrapnel wounds. While still in a coma, Wade was
medically ``retired'' and shifted to the DVA. In her presentation to
the Commission, Mrs. Wade reflected how her husband was pushed back and
forth between the two departments to receive proper care.
Unfortunately, this is not unique and there are other examples of
personnel encountering challenges in moving from the military to DVA.
Some OEF/OIE combat-injured servicemembers are being discharged or
medically retired and transferred to VA without adequate consideration
of family needs for adjustment counseling and seamless follow-up
services.
The Final Report of the ``President's Task Force (PTF) to Improve
Health Care Delivery for Our Nation's Veterans'' (June 2003) addressed
these and other issues that would smooth the transition of
servicemembers to veterans' status and speed the development of their
claims.
FRA urges the Committee to review these recommendations, and due to
the ongoing war on terror and the heightened importance of sharing
services between departments, recommends hearings to review progress in
implementing major PTF recommendations. This may also be beneficial to
establishing outcome measures after assessing CARES, BRAC actions and
other DOD Military Treatment Facilities initiatives.
Waiting Times
FRA is encouraged by the goal of DVA to schedule 93.7 percent of
all appointments within 30 days of a patient's desired date. The
Association welcomes a detailed clarification on waiting times for
appointments for veterans rated less than 50 percent service connected
either on their first visit or those veterans who are already in the
VHA system. FRA believes that a 30-day maximum wait is reasonable for
routine care and will require that VA Medical Center directors monitor
all appointments and make any necessary changes in a timelier manner.
DVA Medicare Subvention
In 2003, then DVA Secretary Principi suspended enrollment in
Priority Group 8. According to Congressional estimates, more than
260,000 veterans who do not have illnesses or injuries incurred during
military service and earn more than the average wage in their community
have been prevented from enrolling. Although termed ``temporary'' at
the time, it appears that this suspension will continue with no end in
sight. FRA urges sufficient funding be authorized and appropriated to
allow resumption of the enrollment process for all veterans.
As previously stated, FRA opposes the imposition of a ``user's
fee'' and an increase in copayments for prescriptions. A much better
alternative would be the full and immediate implementation of DVA
Medicare Subvention. The funds recovered from the Department of Health
and Human Services (HHS) and specifically the Centers for Medicare and
Medicaid Services (CMS), for health care provided to those eligible
veterans, would go a long way in ensuring adequate health care for more
veterans. But it would be incumbent that Congress mandate any funds
recovered from CMS be provided to the VA and not put in the General
Fund. It is puzzling to our members why this program has not been given
serious consideration and enacted long ago.
VA+Choice
In 2003, DVA also announced that a VA+Choice program would be
established for veterans unable to enroll in the VA Health Care System.
Subsequently, DVA's Health Services Research and Development Service
conducted a study in 2005 to investigate the potential of developing a
program now known as ``VA Advantage'' and how it would impact veterans'
care to VA beneficiaries.
FRA urges Congress to closely examine the report from this study
before ``VA Advantage'' is fully implemented. There are numerous
problems with Medicare+Choice programs in the country and it is
becoming more difficult for Medicare-eligible beneficiaries to locate
plans and doctors willing to accept new Medicare insured patients.
Nursing Homes, Long-Term Care, and Other Health Care Programs
The Veterans Millennium Health Care Act, Public Law 106-117,
Section 101, made great strides in providing long-term care for our
veterans. However, this program is only authorized for a 4-year period,
and only for veterans who need care for a service-connected disability,
and/or those with service-connected disability ratings of 70 percent or
more. This program should be extended, and expanded to include veterans
with service-connected disability ratings of 50 percent or more.
World War II and Korean veterans are in their late 60's and older,
as are some Viet Nam veterans, and many require a greater level of
long-term care. No one can argue that as veterans age, more and more of
them will become dependent upon the VA to provide the necessary care in
nursing homes, domiciles, state home facilities, and its underused
hospital beds. The Nation can ill afford to wait for out-year funds
before it expands nursing or long-term care.
Congress and the Administration must ensure sufficient funding for
the construction of new facilities and renovation of existing hospitals
outlined by the CARES plan. Funding intended for implementation of
CARES initiatives should not be diverted to other projects and CARES-
based construction should be allowed to proceed as planned.
In implementing the CARES plan, DVA must ensure that mental health
services and long-term care are made part of the full continuum of care
for veterans. FRA commends DVA for moving forward on implementing the
national strategic plan for mental health services, and progress on
this plan should be incorporated into DVA's reporting to Congress on
its capacities to care for veterans.
Medical and Prosthetic Research
DVA is widely recognized for its effective research program and FRA
continues to strongly support adequate funding for medical research and
for the needs of the disabled veteran. The value of both programs
within the veterans' community cannot be overstated. Noteworthy is the
fact that the fiscal year 2007 proposed DVA Budget for Medical and
Prosthetic Research shows a slight 1 percent increase ($17.3 million)
in one of the most successful aspects of all VA Medical Programs. Even
the DVA CARES Commission recommends the improvement and expansion of VA
Medical Research Facilities.
veterans benefits administration
Total Force Montgomery GI Bill
The Montgomery GI Bill is important and aids in the recruitment and
retention of high-quality individuals for service in the active and
Reserve forces; assists in the readjustment of service men and women to
civilian life after they complete military service; extends the
benefits of higher education (and training) to service men and women
who may not be able to afford higher education; and enhances the Nation
by providing a better educated and productive workforce.
Double-digit education inflation is dramatically diminishing the
value of MGIB. Despite recent increases, benefits fall well short of
the actual cost of education at a 4-year public college or university.
In addition, thousands of career servicemembers who entered service
during the Veterans Education Assistance Program (VEAP) era, but
declined to enroll in that program (in many cases, on the advice of
government education officials) have been denied a MGIB enrollment
opportunity.
Unfortunately, not all of MGIB objectives are being achieved,
particularly for mobilized members of the National Guard and Reserve
forces. Specific concerns include:
Delayed implementation of MGIB benefits for mobilized
Reservists authorized under Chapter 1607 of Title 10 USC. Few
educational benefits claims have been processed for the more than
500,000 personnel who have served on active duty under contingency
operation orders since 9/11/01.
Mobilized Reservists lack of a readjustment benefit. They
must leave behind remaining MGIB benefits upon separation unless the
separation is for disability.
During the early years of the MGIB, benefits earned by
Guard and Reserve members amounted to 47 cents to the dollar compared
to active duty MGIB participants. Since 9/11/01, the ratio has dropped
to 29 cents to the dollar.
Reserve MGIB programs are under Title 10, whereas basic
MGIB benefits for active duty servicemembers are codified under Title
38. There are major challenges in coordinating the oversight and
management of MGIB programs. Outmoded information management and
information technology is part of this.
The Nation's active duty, Guard and Reserve forces are effectively
being integrated under the Total Force concept, and educational
benefits under the Montgomery GI Bill should be re-structured
accordingly.
FRA, along with its partners in The Military Coalition, the
American Legion, the Veterans Independent Budget for fiscal year 2007,
and major higher education associations, support enactment of a ``Total
Force Montgomery GI Bill'' for the 21st century. The integration of
active and Reserve force MGIB programs under Title 38 is very important
and will provide equity of benefits for service performed, enable
improved administration, and facilitate accomplishment of statutory
purposes intended by Congress for the MGIB.
Disability Compensation Claims Processing
DVA can promptly deliver benefits to entitled veterans only if it
can process and adjudicate claims in a timely and accurate fashion.
Given the critical importance of disability benefits, DVA has a
paramount responsibility to maintain an effective delivery system,
taking decisive and appropriate action to correct any deficiencies as
soon as they become evident. However, DVA has neither maintained the
necessary capacity to match and meet its claims workload nor corrected
systemic deficiencies that compound the problem of inadequate capacity.
Rather than making headway and overcoming the chronic claims
backlog and consequent protracted delays in claims disposition, DVA has
lost ground on the problem, with the backlog of pending claims growing
substantially larger.
FRA believes DVA's efforts in decreasing the backlog of initial
disability claims are commendable but the backlog has swelled,
increasing the lists of veterans waiting for decisions on their claims.
FRA commends the Chairman for his statements at the December 8, 2005
hearing on VBA claim processing and agrees that ``the increase in
disability claims can be directly related to the increase in U.S.
military operations abroad. Doing more with less is not a strategy of
success.'' An increase in staffing levels within the VBA claims
processing system is essential to moving forward to reduce this
backlog.
Separation Pay
Under current law, servicemembers released from active duty who
fail to qualify for veterans' disability payments, and are not accepted
by the National Guard or Reserve, never have to repay any portion of
separation pay. However, if qualified for either, it's time for
payback. FRA has difficulty understanding why the individual willing to
further serve the Nation in uniform, or is awarded service-connected
disability compensation, should have to repay the Federal Government
for that privilege.
FRA is opposed to the repayment requirement and recommends the
repeal of, or the necessary technical language revision, to amend the
applicable provisions in Chapters 51 and 53, 38 USC, to terminate the
requirement to repay the subject benefits. (Also requires an amendment
to 1704(h)(2), 10 USC.)
Court-Ordered Division of Veterans Compensation
The intent of service-connected disability compensation is to
financially assist a veteran whose disability may restrict his or her
physical or mental capacity to earn a greater income from employment.
FRA believes this payment is that of the veteran and should not be a
concern in the states' Civil Courts. If a Civil Court finds the veteran
must contribute financially to the support of his or her family, let
the court set the amount allowing the veteran to choose the method of
contribution. FRA has no problem with child support payments coming
from any source. However VA disability should be exempt from
garnishment for alimony. If the veteran chooses to make payments from
the VA compensation award, then so be it. The Federal Government should
not be involved in enforcing collections ordered by the states. Let the
states bear the costs of their own decisions. FRA recommends the
adoption of stronger language offsetting the provisions in 42 USC, now
permitting Federal enforcement of state court-ordered divisions of
veterans' compensation payments.
national cemetery administration
Cemetery Systems
The National Cemetery Administration (NCA) has undergone many
changes since its inception in 1862. Currently, the administration
maintains almost 2.5 million gravesites at 124 national cemeteries in
39 states, the District of Columbia, and Puerto Rico.
VA estimates that about 24.4 million veterans are alive today. They
include veterans from World War I, World War II, the Korean War, the
Vietnam War, the Gulf War, and the global war on terrorism, as well as
peacetime veterans. Nearly 688,000 veteran deaths are estimated to
occur in 2006 and it is expected that one in every six of these
veterans will request burial in a national cemetery.
FRA is grateful to Congress for funding new cemetery sites and
urges authorization of funding for new cemeteries in Bakersfield,
California, Birmingham, Alabama, Columbia/Greenville, South Carolina,
Jacksonville, Florida, Southeastern Pennsylvania, and Sarasota,
Florida. The NCA needs initial funding for these cemeteries in order to
meet the expected demand over the next several decades. The NCA is
doing much to meet resource challenges and the demand for burial spaces
for aging veterans. With additional resources, the NCA will hopefully
be able to meet the demand. FRA urges increased funding, which is
fenced for the purchase of land, preparation, construction and
operation of new cemeteries, the maintenance of existing cemeteries,
and the expansion of grants to States to construct and operate their
own cemeteries.
As part of the Veterans Education and Benefits Act of 2001, the
government is to provide grave markers for veterans whenever requested,
even if there is another marker on the grave. However, as written, the
law only applies to burials after December 27, 2001. FRA believes the
grave-marker rule should be amended to include the thousands of
families denied grave markers in the past decade.
other recommendations for consideration
Concurrent Receipt
FRA continues its advocacy for full concurrent receipt of military
retired pay and veterans' service-connected disability payments as
envisioned in H.R. 303, introduced by Representative Michael Bilirakis
of Florida.
The fiscal year 2006 Defense Authorization Act reduced the phase in
period for disabled military retirees deemed ``individual
unemployable'' (IU) from 2014 to 2009, and FRA appreciates this
progress. However, our members are extremely disappointed and perplexed
that such undeserved discrimination will be allowed to continue for
three more years.
FRA urges the Committee to end the disability offset to retired pay
immediately for otherwise-qualifying members rated as ``individual
unemployable'' by the DVA.
Progress has been made in recent years to expand Combat-Related
Special Compensation (CRSC) to all retirees with combat-related
disabilities and authorize concurrent receipt of retired pay and
veterans' disability compensation for retirees with disabilities of at
least 50 percent.
While the concurrent receipt provisions enacted by Congress benefit
tens of thousands disabled retirees, an equal number are still excluded
from the same principle that eliminates the disability offset for those
with 50 percent or higher disabilities. The fiscal challenge
notwithstanding, eliminating the disability offset for those with
disabilities of 50 percent is just as valid for those with 40 percent
and below, and FRA urges the Committee to be sensitive to the thousands
of disabled retirees who are excluded from current provisions.
As a priority, FRA asks the Committee to consider those who had
their careers cut short solely because they became disabled by combat
or combat-related events, and were forced into medical retirement
before they could complete their careers.
Under current law, a member who is shot in the finger and retires
at 20 years of service with a 10-percent combat-related disability is
rightly protected against having that disability compensation from his
or her earned retired pay. But a member, who is shot through the spine,
becomes a quadriplegic and is forced to retire with 19 years and 11
months of service, suffers full deduction of VA disability compensation
from his or her retired pay. This is grossly unfair.
For chapter 61 (disability) retirees who have more than 20 years of
service, the government recognizes that part of that retired pay is
earned by service, and part of it is extra compensation for the
service-incurred disability. The added amount for disability is still
subject to offset by any VA disability compensation, but the service-
earned portion (at 2.5 percent of pay times years of service) is
protected against such offset.
FRA believes strongly that a member who is forced to retire short
of 20 years of service because of a combat disability must be
``vested'' in the service-earned share of retired pay at the same 2.5
percent per year of service rate as members with 20+ years of service,
as envisioned in H.R 1366, also introduced by House Representative
Michael Bilirakis of Florida. This would avoid the ``all or nothing''
inequity of the current 20-year threshold, while recognizing that
retired pay for those with few years of service is almost all for
disability rather than for service and therefore still subject to the
VA offset.
Veterans Disability Benefits Commission
FRA understands that many in Congress are looking to the Veterans
Disability Benefits Commission (VDBC) for recommendations on this and
other issues, and we fully expect the Commission will validate the
principle that a military retiree should not forfeit any portion of
earned retired pay simply because he or she also had the misfortune of
incurring a service-connected disability.
But FRA is concerned that the recent extension of the Commission's
work can only delay an equitable outcome further. In the meantime, FRA
believes action is needed on the critical areas which we believe there
should be little question as to their propriety.
Uniformed Former Spouses Protection Act (USFSPA)
The USFSPA was enacted over 20 years ago; the result of
Congressional maneuvering that denied the opposition an opportunity to
express its position in open public hearings. With one exception, only
private and public entities favoring the proposal were permitted to
testify before the Senate Manpower and Personnel Subcommittee. Since
then, Congress has made 23 amendments to the Act: eighteen benefiting
former spouses. All but two of the amendments were adopted without
public hearings, discussions, or debate. Since adoption, opponents of
the USFSPA or many of its existing inequitable provisions have had
opportunities to voice their concern to a Congressional panel. The last
hearing, in 1999, was conducted by the House Veterans Affairs Committee
and not the Armed Services Committee that has the oversight authority
for amending the USFSPA.
One of the major problems with the USFSPA, of its few provisions
protecting the rights of the servicemember, none are enforceable by the
Department of Justice or DOD. If a State court violates the right of
the servicemember under the provisions of USFSPA, the Solicitor General
will make no move to reverse the error. Why? Because the Act fails to
have the enforceable language required for Justice or the Defense
Department to react. The only recourse is for the servicemember to
appeal to the court, which in many cases gives that court jurisdiction
over the member. Another infraction is committed by some State courts
awarding a percentage of veterans' compensation to ex-spouses, a clear
violation of U.S. law, yet, the Federal Government does nothing to stop
this transgression.
FRA believes Congress needs to take a hard look at the USFSPA with
a sense of purpose to amend the language therein so that the Federal
Government is required to protect its servicemembers against State
courts that ignore provisions of the Act. More so, a few of the other
provisions weigh heavily in favor of former spouses. For example, when
a divorce is granted and the former spouse is awarded a percentage of
the servicemember's retired pay, this should be based on the member's
pay grade at the time of the divorce and not at a higher grade that may
be held upon retirement. The former spouse has done nothing to assist
or enhance the member's advancements subsequent to the divorce;
therefore, the former spouse should not be entitled to a percentage of
the retirement pay earned as a result of service after the decree is
awarded. Additionally, Congress should review other provisions
considered inequitable or inconsistent with former spouses' laws
affecting other Federal employees with an eye toward amending the Act.
Survivor Benefit Plan
FRA appreciates recent enhancements to the military's Survivor
Benefit Plan (SBP) to increase benefits for survivors over several
years. Unfortunately, there is another inequity to the program that is
a major concern for our membership.
FRA strongly supports an amendment to the program to accelerate
from 2008 to 2006 the time the military retiree will be a paid-up
participant after paying premiums for 30 years and is at least 70 years
of age. This is an equity issue for participants who've paid premiums
since the program was established in 1972.
conclusion
Mr. Chairman, in closing, allow me to again express the sincere
appreciation of the Association's membership for all that you and the
Members of the Veterans Affairs Committee do for our Nation's veterans.
Our Legislative Team stands ready to meet with you, other Members
of the Committees or their staffs at any time, to work together to
improve benefits and entitlements for all veterans.
Chairman Craig. Joe, thank you very much for that very
thoughtful testimony.
Now let's turn to Deirdre Parke Holleman. I think I misused
that last name a little bit when I introduced you.
Ms. Parke Holleman. That is fine.
Chairman Craig. National legislative director, the Retired
Enlisted Association. Welcome.
STATEMENT OF DEIRDRE PARKE HOLLEMAN, NATIONAL
LEGISLATIVE DIRECTOR, THE RETIRED ENLISTED ASSOCIATION
Ms. Parke Holleman. Thank you. Good morning, Mr. Chairman.
May I ask that our full written testimony be made part of
the record?
Chairman Craig. Thank you for asking. It certainly will be.
All of your full written statements and any accompanying
material will be a part of the official record.
Ms. Parke Holleman. Thank you.
Mr. Chairman, it is always an honor for TREA to speak on
the issues and concerns facing today's and tomorrow's veterans
and their families.
As we all know, this is a crucial time for our country. We
are waging a war on terror, both at home and abroad. There are
additional servicemembers deployed in numerous hot spots
throughout the world, and the veterans who have protected us
throughout history, in both hot and cold wars, are getting
older and in more need of their Nation's help.
TREA is a nationwide organization whose members have served
a career in the enlisted ranks or of our military or are doing
so at this time. The services and benefits, that they are the
provenance of the Department of Veterans Affairs and this
Committee, are crucial for them to be able to live the life in
their retirement years that they have so justly earned. TREA is
grateful to everyone who has worked to create these benefits
and to make sure that they are implemented in an efficient and
fair way.
We should start with the statement that TREA was pleased
and relieved at the realistic figure that the Administration
put in its budgetary request for VA health care this year. It
is a far more sensible and workable amount than what had
previously been requested and what you had to repair.
We are also pleased that the President exempted the VA from
the across-the-board cuts that most of the Federal Government
is dealing with. During this time of increased medical needs,
it is clear that returning veterans need more focus, not less,
on the VA health care system.
Of course, we do not agree with all of the Administration
proposals for the last several years. TREA, as well as other
organizations, has been firmly opposed to the proposed
imposition of a $250 enrollment fee for those veterans
presently enrolled in Category 7 and 8, and we are opposed to
it again this year.
This proposal is unwise and unfair for several reasons.
First of all, this was not what these veterans were promised
when they enrolled at the urging of the VA.
Second, the veterans in 7 and 8 do not have priority to be
seen or access standards for care. Therefore, they are the
equivalent of ``Space A,'' space available. There is no
guarantee of care. However, everyone in this large room knows
that if you start charging a yearly fee, the beneficiaries will
predictably and rightly demand the care that they are paying
for. Rather than lessening the work requirements of the VA, it
will most likely increase them.
The VA predicts that 325,000 beneficiaries will leave
Categories 7 and 8 in the coming fiscal year. We presume that
number is based on the expectation that many present enrollees
will drop out rather than pay the yearly fee, but that is not
an appropriate way to lessen one's caseload, and we believe the
ones who remain will be predictably more demanding. So it is
not even an effective way.
Additionally, the VA states in their proposal that they
expect to collect $3 billion, more or less, in third-party
insurance claims, OHI. We are doubtful that they will be able
to reach that heady goal. In the past, they have had trouble.
They have not been very successful in collecting private
insurance claims, but if this is a serious goal for them, these
beneficiaries in Categories 7 and 8 should be the main source
of such insurance. These veterans cannot depend on the VA for
all their health care and so are much more likely to have plans
that the VA may look to for collections.
Numerous people, both in this Committee and at the VA,
believe that veterans choose to enroll in the Categories 7 and
8 to get the drug benefit. If that is correct, the new Medicare
Part D benefit, once it settles down, should cause a drop in
enrolled veterans looking to obtain service. The new drug plan
will have several advantages for them. They can use their
civilian doctor scripts. They can have them filled near their
homes, et cetera. If we are correct, the concerns about the
cost of Categories 7 and 8 should subside without unfair and
unpopular steps being taken.
TREA is also firmly against the Administration's proposal
to raise the pharmacy copays to $15 for a 30-day prescripton
for 7s and 8s. This year, the VA raised its copay from $7 to
$8, and I assure you, it caused great consternation in many of
our members. These veterans are not being petty or cheap. They
are on fixed incomes, and many have many daily medications.
TREA assures you that practically doubling the copay would
be disastrous to many of our members, and we hope you will
oppose that proposal.
These proposals, as well as the draconian proposed
increases in enrollment fees and deductibles in TRICARE Prime
and TRICARE Standard on the DOD side are meant, we believe, not
primarily to raise money, but rather to disabuse veterans and
military retirees from using the benefits that they have earned
and deserve due to their brave and dedicated service. This is
not the way to try and save money, and we hope and expect that
Congress will also find it unacceptable.
The VA, as you well know, is tasked not only to care for
those who have borne the battle, but also widows and orphans.
TREA was very pleased and grateful that Congress increased the
top amount of SGLI to $400,000 as well as increasing the death
gratuity to $100,000. Thank you so much for these improvements.
As you well know, TREA and all the members of the Coalition
Alliance have also worked hard last year to try and end the
SBP/DIC offset. Of course, we are well aware that is not your
Committee of jurisdiction, but we also know of your focus and
concern for military widows and that many of you are also on
the Armed Services Committee. Therefore, we urge all of you to
convince your colleagues that this is the time to finally
correct this unfair situation.
Although we know it is a great task, TREA also hopes that
this Committee will take on more work. It is crucial to look
toward improving and modernizing the Montgomery GI bill. As
stated by Mr. Barnes, the split between title 10 and title 38
makes the coordination and improvements of the bill that you
have done much harder to accomplish, and we hope that joining
them together, this bill will no longer be the stepchild in the
title 10 for Guard and Reserve, but rather be in its proper
place here.
There are more suggestions in our written testimony, and we
would be grateful if you would consider them all. We all share
a love and admiration for our servicemembers, our veterans, our
military retirees and their families and survivors. Because
they have served and dared, we can live in freedom and argue
public policy.
TREA is grateful for all the efforts and time the Members
of this Committee and their staff has dedicated to making the
VA the best that it can be. We believe that adoption of our
suggestions would make its service even more effective.
We thank you for your time and attention. I would be
honored to try and answer any questions you may have, Mr.
Chairman.
[The prepared statement of Ms. Parke Holleman follows:]
Prepared Statement of Deirdre Parke Holleman, National Legislative
Director, the Retired Enlisted Association
disclosure of federal grants or contracts
The Retired Enlisted Association does not currently receive, nor
has it received during the current fiscal year or either of the two
previous years any Federal money for grants or contracts. All the
Association's activities and services are accomplished completely free
of any Federal funding.
Mr. Chairman, Senator Akaka and Members of the Committee: It is
always an honor for The Retired Enlisted Association to testify about
the needs and concerns of America's veterans and their families and
survivors.
The Retired Enlisted Association is a Veterans Service Organization
founded over 40 years ago to represent the needs and points of view of
enlisted men and women who have dedicated their careers to serving in
all the branches of the United States Armed Services active duty,
National Guard and Reserves, as well as the members who are doing so
today.
Today there are hundreds of thousands of enlisted men and women
serving in war zones and dangerous locations throughout the world.
While they protect our freedom, we all embrace the duty to make sure
that when they return they will find all the care and benefits they
need and were promised. This includes health care and education and
much more. The Nation also has a sacred duty to provide for the
survivors of those who will not be coming back. We also have a duty
never to forget those who protected us in past years and conflicts and
to make sure that they are properly cared for and treated. It is an
honor for TREA to be a part of the noble work that Congress, the VA and
our brother and sister organizations do to make sure that these goals
are reached.
va health care
As always when appearing before you our first concern is to make
sure that first rate and adequately funded healthcare is available for
our Veterans. Last year was a shambles that no one wishes to occur
again. We are happy and relieved that the Department has requested
$80.6 billion for its budget for fiscal year 2007. This includes $34.3
billion for Health care. This is a reasonable and rational number and
TREA is pleased. However there are calculations and proposed income
sources that we are opposed to or do not believe will materialize.
Additionally, there are some programs that we are still concerned will
not be adequately funded. The GAO report requested by Congress, ``VA
Health Care: Preliminary Findings on the Department of Veterans Affairs
Health Care Budget Formulation for Fiscal Years 2005 and 2006'' GAO-06-
43OR February 2, 2006, indicated that the ``VA's internal process for
formulating the medical programs funding requests were informed by, but
not driven by projected demand.'' We hope that this Committee will
carefully oversee the funding levels needed for several crucial
programs that are likely to see large increases in needs of services.
These include the 2 year qualification for healthcare that all
returning veterans from Iraq and Afghanistan are entitled to have at
the VA as well as the need to increase the number and size of the
``politrauma centers'' dealing with the large numbers of severely and
multiple injured veterans who are returning home and looking to the VA
for hope in their future lives. There are presently 4 of these centers
but we may very well need more as the War on Terror continues. There is
also likely to be a substantial increase in the necessity of mental
health services (both outpatient and in patient) for Veterans returning
from the War. And for older Veterans there will be growing need for
nursing home care. TREA is concerned that the budgetary calculations
have not been sufficiently increased. We hope this Committee will again
exercise its oversight function to make sure as the next year goes on
that sufficient funds have been requested and will be obtained. It is
critical that the VA's healthcare service is fully funded. And that
that this full funding is predictable so the VA can truly make sensible
long term plans rather than living from year to year's budget with no
ability to predict the next several year's finances.
We are also deeply concerned that a segment of the VA's increased
health care budget, once again, rests in part on an expectation on
proposed increases in enrollment fees and prescription drug copayments.
In the past year the Department raised the copay for drugs from $7 to
$8. This may not sound like a great deal at first glance but that is
when you are looking at 1 prescription. Many veterans are not taking 1
medication a day but 10 or 15. Even a small increase in the copay can
have a harsh affect on a veteran on a fixed income. But the proposed
budget calls for a copay of $15. This almost doubles the present copay.
This proposal could be truly financially crippling to many TREA members
and we are strongly opposed to it.
TREA is also firmly opposed to the proposal of a $250 enrollment
fee. Categories 7 and 8 members would be required to pay the proposed
enrollment fees while they would have no guarantee that they will be
served. While those Veterans who are 50 percent or more disabled or are
being treated for the service connected disability get priority others
are inevitably pushed to the back of the line. Veterans in Categories 7
and 8 have no guarantee that they will be seen at all. Additionally
those that are 50 percent disabled or are being treated for their
service connected disability have an access standard. They will be seen
at the VA within 30 days for their primary care appointment or the VA
will arrange for outside care. But again Category 7 an 8 Veterans have
no such guarantee. They will be seen when an appointment becomes
available. So these men and women who served our Country so well are
not overwhelming the system; they are simply waiting for an appointment
to become available. It is a space available system for them now. But
we all know well that if the government starts charging a yearly fee
for their status there will be a much greater push for the VA to
provide guaranteed service. And there is no reason to believe at this
time that it is a service they will be able to provide. Rather than
lessening the pressure on the VA due to its waiting lists, this
proposal will in all likelihood increase the pressure and discontent.
This proposal has been made for the last several years and each time
Congress has refused to implement it. We hope that you will once again
take that wise path.
The VA's proposed budget also includes an expected increase of 3rd
party insurance collections (OHI). The Department of Veterans Affairs
predicts that they will collect $3 billion this year. While we can hope
that this is true none who has watched the VA try to collect civil
insurance claims in the past has a great deal of faith that they will
be successful.
TREA indeed doubts that the VA will be able to reach their goal.
However it is obvious that the VA enrollees who are most likely to have
other health insurance are those who are enrolled in Categories 7 and
8. These are the people who cannot completely rely on the VA for their
everyday care and will therefore have insurance plans. These are the
people that the VA could look to for the 3rd party collections. TREA
knows that the VA, and indeed, some members of this Committee have been
worried that the VA would be overwhelmed by elderly Veterans looking
for a pharmacy benefit. The VA predicts that membership in Categories 7
and 8 will decline by 235,000 this coming year. Clearly they hope that
the proposed enrollment fee and increased copayments will force many to
leave. But that is unnecessary. For those 7 and 8 enrollees who are on
Medicare a new drug benefit has been put into effect since the last
time TREA testified. While the standup of Medicare Part D has been a
bit rocky that group of Veterans now have a plan that is not limited to
the VA formulary. They can use it for prescriptions that their civilian
doctor has written and they can use it at their local pharmacy or many
mail order programs. So this previous concern should no longer be as
worrisome.
TREA have argued for years that the VA should be able to collect
from Medicare for non service connected treatments provided to Veterans
who are enrolled in and pay premiums for Medicare Part B. This would
put the Department of Veteran Affairs in the same position that Indian
Health Care Service is in under Title 25 Section 1645. The CBO has
indicated that about half of all enrolled veterans are also enrolled in
Medicare. This would be a large and fair income flow to VA health care.
Obviously, this proposal would not be under your Committee's
jurisdiction but it is an idea that should be considered.
TREA urges this Committee to exercise your oversight to make sure
that VA's crucial healthcare programs continue to be adequately funded
throughout the budgetary year.
TREA urges Congress to reject the proposed increases in drug copays
and the proposed $250 yearly user fee for Categories 7 and 8 enrollees.
TREA urges the Committee Members to support legislation to allow
the VA to become a Medicare provider.
improvements in the montgomery gi bill (mgib)
One of the most important benefits that this Nation provides to its
Veterans is the Montgomery GI Bill (MGIB) for both its active duty and
its National Guard and Reserve members. It serves as a crucial
recruiting tool and as a way for patriotic, disciplined and intelligent
men and women to move up in the civilian world. However, with all its
virtues the MGIB has structural flaws that should be changed. The
Active Duty MGIB is sensibly under Title 38, Veterans Benefits and
under this Committee's authority. However, Selected Reserve Programs
are still under Title 10, the Armed Forces Code. Your many improvements
to the Montgomery GI Bill have not been reflected in the Selected
Reserve Program. With the massive call ups of the Guard and Reserve and
the future outlook that this will not change, it's time to properly
coordinate the two programs. TREA feels strongly that it is time, for
the long term good of the program that the SR MGIB should be placed
under Title 38 and the jurisdiction of this Committee. Needed
modifications and improvements could then be made in tandem in both
programs. These include increasing the monetary benefit (as you have
for the Active Duty plan) and allowing Guard and Reserve members to be
allowed to continue using their benefits after they leave the Guard and
Reserves. Since 9/11 the role the Guard and Reserve plays in our
National Defense has changed dramatically. Additionally, with the
increased pace of call ups and our increasing reliance on the Guard and
Reserve (a reliance that TREA doubts will change in the foreseeable
future) the benefit itself should be readjusted and increased. With
your focus on the whole program this is the Committee with both the
focus and the expertise necessary to properly coordinate the two
programs.
When looking at the Active Duty program TREA, along with our fellow
members of the Partnership for Veterans Education, has called for the
Montgomery GI Bill to cover the average costs of a 4-year education at
a State University. When hundreds of thousand of members of the
military are stationed throughout the world fighting the War on Terror
this would show our gratitude as a Nation and would make a huge
improvements in these servicemembers' lives when they return home. It
would also be a wonderful recruitment tool at this difficult time. The
original GI Bill after World War II transformed the Nation. This change
would also improve the future for the entire Nation, not just the
servicemembers and their families who it will directly help. We also
urge this Committee to broaden the types of education programs that can
be paid for by the MGIB. This is a new world--this is a new world where
a great deal of critical higher education is presented in non-four year
degree programs. These changes would reflect the changes in America's
changing Education System.
TREA urges this Committee to attempt to move the SR Montgomery GI
Bill under its jurisdiction in Title 38.
TREA urges that the SR MGIB benefit be readjusted to both reflect
the improvements in the Active Duty MGIB program and to reflect the
added duties and burdens that are being placed on the Reserve
Components.
TREA urges this Committee to move toward having the Active Duty
Montgomery GI Bill cover the costs of a four (4) year Public University
education.
va claims backlog
This is a perennial concern and worry. With all the best efforts
and motives in the world the VA disability claims backlog has not
improved. According to the Department of Veteran Affairs submission in
2005 it took 167 days to process a claim as compared to 166 days in
2004. In 2005 the number of filed claims increased to 788,298 up from
771,115 in the year before the VA states that they are expecting a 3
percent increase in filings to 811,947 (with an additional approximate
100,000 cases resulting from the new outreach program created in the
fiscal year 06 Appropriation Act). This means that the average case is
taking almost half a year. Furthermore as the cases become more
complicated from injuries returning from Iraq and Afghanistan the
delays may grow even larger. This is just too long. Desperate people
are anxiously waiting so they can know how they can move on with their
lives. TREA is sure that all Members of this Committee are extremely
concerned about this continuing back log. Hopefully, correcting this
problem will remain a top priority of the VA.
TREA urges the Committee to closely monitor the Department of
Veterans Affairs on their efforts to increase both the speed and the
accuracy of their claim decisions.
capital asset realignment for enhanced services (cares)
While there certainly has not been as much public discussion about
CARES as there has been about BRAC this year, this program is still
proceeding apace. And it is still a major concern for TREA. We
certainly agree with the stated goal of CARES to modernize the VA plant
and make their operations more efficient. However we are still greatly
concerned that the needs analysis for CARES did not take into account
the VA's future Mental Health and Long term health care (nursing home
care) requirements. The Department of Veteran Affairs is obligated to
provide nursing home care for Veterans with a 70 percent or over
disability rating or for those Veterans who require Nursing Home care
due to their service connected disability. We are all aware of the
Nation's demographics and the growing number of citizens that will need
Nursing Home care. There is no reason to believe that the Veterans
population will require less such care than the general population. So
when planning for CARES this important and predictably growing duty of
the VA should have been analyzed. The CARES needs analysis also failed
to consider mental health needs. If anything, 4 years of War has made
this omission more serious than it was before the War. Of course it is
a treatment goal of mental health practitioners to have as much care be
conducted outpatient as possible. However there are times when
inpatient treatment is clearly necessary. When dealing with Post
Traumatic Stress Disorder (PDSD) and other war related conditions there
is no institution that has more experience and skill than the VA. And
there is no place where Veterans would feel more at home. Before the VA
takes irreversible steps they should make sure that these future needs
are factored into the calculation.
During this dramatic time of War and returning Veterans, it seems
unwise to dramatically destabilize the plant structure. And it is
certainly unwise to do so based on a plan that did not take into
account two of the VA's important and growing missions.
TREA urges that no additional steps in the CARES process occurs
until a full study on the future needs of the VA for both long term
health care and mental health facilities are studied and incorporated
into any future plans.
military retirees and the va
This Committee knows well that all Military Retirees are Veterans.
The combination of their military retiree benefits and their Veterans
benefits make it possible for them to achieve the quality of life they
deserve in their retirement years. They have served their Nation for at
least 20 years. Many of these Military Retirees are daily patients in
the VA Health Care system. It is already true that 30 percent of all
enrollees in Categories 1-3 (Service Connected Disabilities) are
Military Retirees. They have been found to have been wounded, injured
or developed illnesses and conditions while serving their Country. But
many other retirees have also lived the hard and wearing life of a
career servicemember. But this health care needs that are caused by
this life have not been acknowledged by the VA. They deserve and need
to be able to get the expert care for their service connected
conditions from the VA while receiving normal healthcare near their
homes through DOD's healthcare programs. They deserve to be seen as a
special category of patients. To place retirees in Category 3 would
acknowledge the lifetime of service they have provided to the military
and their special medical needs.
TREA urges Congress to place military retirees into Category 3 of
the VA Health Care System.
dod-va collaboration/seamless transition
Another goal for all of us who are concerned with the well being of
America's Veterans is to create a seamless transition between the
status of a member of the military to that of a Veteran. This is
another area where this Committee's oversight function is critical. We
need to know whether the much praised VA electronic health record
program will be able to speak to DOD's new ALHTA electronic health
record program. We need to know when both Departments will be able to
create an electronic health care record that all TRICARE and VA health
care patients can carry with them wherever they are throughout the
world for their entire lives. We need to know when will DOD and the VA
be able to stand up throughout the country on a single separation exam?
This would be a boon to the Veteran, and both the VA and DOD. Years
have gone by and only partial implementation has occurred. Now is the
time Congress should insist that the Government improve the hand off
from DOD to the VA for the future.
TREA hopes your Committee will continue to monitor the progress in
this crucial area.
survivors benefits
Everyday in this time of our War on Terror wives, husbands and
children are becoming survivors. We are presently in the exact
situation that President Lincoln faced at when he gave the Nation's its
call: With malice toward none; with charity for all; with firmness in
the right, as God gives us to see the right, let us strive to finish
the work we are in; to bind up the nation's wounds, to care for him
that has borne the battle, his widow and orphan . . .'' from his
glorious Second Inaugural address. TREA is very grateful to all of
Congress, and especially this Committee for last year's significant
improvements in the SGLI coverage. When combined with the new $100,000
death gratuity passed last year, the families of those ``who gave their
full measure of devotion'' for this Nation will be able to try to
restart their lives without the extreme and immediate financial
difficulties that they had to deal with in the past.
In the first half of the 109th session of Congress TREA along with
many of our other Veterans Service and Military Service Organizations
worked very hard to end the Survivor Benefit Plan Dependency and
Indemnity Compensation Program (SBP/DIC) Offset. (The program often
referred to as the widow's concurrent receipt.) And we intend to work
just as hard again this year. We are well aware that the VA pays the
full DIC amount to the surviving widow and thus any change to this
program will have to go through the Committee on Armed Services. But
this Committee has always shown great interest in Veterans' survivors
and we hope that you can work with your colleagues to pass Senator Bill
Nelson's S. 185 and finally end this unfair practice.
S. 185 would also move up the paid up provisions for SBP (Another
subject under the jurisdiction of the Armed Service Committee). This
would help elderly couples who have paid into SBP for at least 30 years
and whose servicemember is at least 70 years old.
Both provisions would help survivors who have served our Nation
faithfully but have not been touched by recent improvements this
Congress has enacted.
Additionally we hope that you will all support the concept in the
House encompassed in Representative Michael Bilirakis's H.R. 1462 and
allow survivors to retain DIC if they remarry at the age of 55 or
older. At this time the age for retention of DIC is 57. However the age
to retain CHAMPVA upon remarriage is the normal Federal program age of
55. The difference is because the two benefits were reinstated in
different years and during different Congressional negotiations. There
are no policy reasons for this awkward and unequal distinction and we
hope that this year it can finally be corrected.
TREA urges Congress to finally end the SBP/DIC dollar for dollar
offset and urges this Committee to support S185 and allow surviving
spouses to retain their DIC if they remarry after reaching the age of
55.
conclusion
The members of TREA are grateful for the opportunity to speak about
the needs and concerns of our members and the needs of all American
Veterans, their families and survivors. Veterans and their families
need and deserve all the benefits and services--healthcare, education
and others--that the VA provides and that you oversee. During this
critical time for our Nation it is crucial that the VA has the money
and expertise that is necessary to accomplish its duty. TREA is sure
that this dedicated Committee will strive to make sure that our
veterans, whether young or old, and their families are provided that
they receive the quality care and benefits services that we owe them
for the dedicated service they have given to their Country.
Chairman Craig. Thank you very much, Deirdre.
Now let's turn to Morgan Brown, manager, Military and
Government Relations, Air Force Sergeants Association.
STATEMENT OF MORGAN D. BROWN, MANAGER, MILITARY AND GOVERNMENT
RELATIONS, AIR FORCE SERGEANTS
ASSOCIATION
Mr. Brown. Good morning, Mr. Chairman, and thank you again
for the opportunity to appear before this Committee.
I am honored to represent the leadership of the Air Force
Sergeants Association and its 130,000 members as you work on
legislation for this coming fiscal year.
I would like to begin by letting you know that we sincerely
appreciate your leadership to overcome last year's health care
funding shortfalls and in particular increases in SGLI
coverage. On behalf of the Air Force enlisted community, we
thank you.
Having listened to my colleagues and having spoken with
others who will appear before you, we, too, are concerned about
some of your primary focus items such as VA health care
funding, seamless transition efforts, and the accelerated
adjudication of the claims process. I have covered these and
other items in my full written statement, and therefore, this
morning, I will restrict my comments strictly to educational
benefits, primarily the Montgomery GI bill because of its
importance to the well-being of noncommissioned members.
As a member of the Partnership for Veterans Education, AFSA
supports a restructuring of the Montgomery GI bill, which
Congress intended to support military recruitment, as well as
transition. As such, we urge this Committee's support for
educational enhancements. This includes increasing the amount
of the benefit to cover the actual cost of a 4-year education
at a public institution and indexing future increases to
prevent further reduction of the benefit.
Currently, the Montgomery GI bill does not keep up with the
inflation that affects educational programs. According to the
college board reports, in order to cover the cost of books,
tuition, and fees at an average State college or university for
a commuter student, the program should be worth about $1,700
per month. It is now worth $1,034 per month.
The fix is to increase the value of the benefit and then
tie the value of this important program to the college board's
reports annual cost assessment to reflect educational
inflationary increases and base it on a nonresident commuter
student.
Many of the rules relating to the application of the GI
bill discourage its use. For instance, young servicemembers are
given a one-time irrevocable decision to enroll in the
Montgomery GI bill at basic military training. They are
automatically enrolled unless they identify themselves to the
TIs or the DIs and say they don't want the program. At this
point in their careers, they are making the least pay, and to a
young enlisted recruit that has a family and other financial
obligations, expecting them to give $100 out of an $1,100
monthly paycheck seems unreasonable.
Other young recruits turn down enrollment because they just
joined the military, deciding to forego education for the time
being, and, of course, many of them later regret that decision
and tell us they would enroll if given the opportunity.
However, the program, as currently administered, does not offer
a second chance, not even at a penalty for late enrollment.
Basic training is a tumultuous time. Young recruits leave
the familiar and secure environment they are accustomed to and
are thrust into an intense fast-paced environment as designed
to ensure they can physically and mentally withstand the rigors
of military service.
Considering all the demands of basic training, is it really
necessary to have these young recruits make this important
decision during basic training? Keep in mind, it takes 2 years
of active-duty service to be able to use the basic entitlement.
Why do we ask them to make this decision in a matter of a day
or two?
Our recommendation would be to move the decision out of
basic training and allow new recruits the ability to enroll in
the Montgomery GI bill at any point during their first 18
months of service. Additionally, once enrolled, allow them to
have the $1,200 payroll deduction spread out over a period of
18 months. This change alone would greatly improve the program
without significant additional obligation of funds.
The primary purpose of the Montgomery GI bill is to help
servicemembers readjust to civilian life after their separation
from military service, and therefore, I would be remiss if I
also didn't mention those currently serving that turned down
the old Veterans Educational Assistance Program, otherwise
known as VEAP.
VEAP was the educational program in place from 1977 to July
1985. It was poorly counseled and a relatively inadequate
program. Thousands of military members chose not to enroll in
VEAP, and many were even advised not to enroll in VEAP because
a better program was coming along, the current Montgomery GI
bill. Unfortunately, when that happened, they were not allowed
to enroll into that program.
Several years ago, Congress afforded VEAP participants two
enrollment opportunities, but VEAP decliners were not included.
Today, less than 50,000 servicemembers in all branches,
primarily noncommissioned members, are getting ready to end
their military careers without that transitional education
benefit. Fairness alone would suggest they deserve a similar
opportunity to enroll in the GI bill.
In closing, I ask this Committee to seriously consider
these items mentioned in my testimony, and again, adjusting the
initial participation decisionmaking point and extending the
payroll deduction period would have no or minimal additional
obligation to the American taxpayer. However, both changes
would be a large step toward making the Montgomery GI bill a
more user friendly, sincere, and equitable benefit for the
noncommissioned men and women serving today.
Chairman Craig, on behalf of the association and
noncommissioned members for whom you work so very hard, I thank
you again for the opportunity to present our views, and I too
am ready to respond to any questions you may have.
[The prepared statement of Mr. Brown follows:]
Prepared Statement of Morgan D. Brown, Manager, Military and Government
Relations, Air Force Sergeants Association
Mr. Chairman and distinguished Committee Members, on behalf of the
130,000 members of the Air Force Sergeants Association, thank you for
this opportunity to offer the views of our members on the fiscal year
2007 priorities of the Department of Veterans Affairs. This hearing
will address issues critical to those serving and who have served our
Nation. AFSA represents active duty, Guard, Reserve, retired, and
veteran enlisted Air Force members and their families. Your continuing
effort toward improving the quality of their lives has made a real
difference, and our members are grateful. In this statement, I will
list several specific goals that we hope this committee will pursue for
fiscal year 2007 on behalf of current and past enlisted members and
their families. The content of this statement reflects the views of our
members as they have communicated them to us. As always, we are
prepared to present more details and to discuss these issues with your
staffs.
How a nation fulfills its obligation to those who serve reflects
its greatness. How we treat them also influences our ability to recruit
future servicemembers since a significant percentage of those wearing
the uniform today were once members of military families. They watched
to see how their moms and dads were treated as they put their lives on
the line for America. And that trend continues. People observe how the
servicemember is taken care of during service and after they have
served. Simply speaking, if we want to keep good people in the
military, it is important that our country live up to the commitments
made to our veterans--the role models for today's and tomorrow's force.
It is important that this committee view America's veterans as a
vital national resource rather than as a financial burden. As you
deliberate on the needs of America's veterans, this association is
gratified to play a role in the process and will work to support your
decisions as they best serve this Nation's veterans. We believe this
Nation's response for service should be based on certain principles. We
urge this committee to consider the following principles as an
underlying foundation for making decisions affecting this Nation's
veterans.
guiding principles
1. Veterans Have Earned a Solid Transition Back Into Society. This
country owes its veterans dignified, transitional, and recovery
assistance. This help should be provided simply because they served in
the most lethal of professions.
2. Most Veterans Are Lower-Paid Enlisted Members. Enlisted veterans
served with lower pay, generally re-entered the civilian populace with
non-transferable military skills, probably had relatively little
civilian education, and most likely served in skills that are less
marketable. We should factor in the unique circumstances of enlisted
veterans, especially in the area of transitional education; i.e., the
Montgomery G.I. Bill.
3. Decisions on Veterans' Funding Primarily Should be Based on
Merit. Funding for military veterans must, of course, be based on
fiscal reality and prudence. However, Congress and, in turn, the VA
must never make determinations simply because ``the money is just not
there'' or because there are now ``too many'' veterans. Funding for
veterans' programs should be viewed as a national obligation--``must
pay'' situation.
4. Remember That Reservists Are Full-Fledged Veterans. In Iraq,
Afghanistan, and around the world, reserve component members are
valiantly serving, ready to sacrifice their lives if necessary. Record
numbers have been called up to support operations since September 11,
2001. By spring of this year, nearly half of U.S. forces serving in
Iraq will be guardsmen and reservists. Without question, enlisted
guardsmen and reservists are full-time players as part of the ``Total
Force.'' Differences between reserve component members and the full-
time force, in terms of VA programs or availability of services, need
to be critically examined.
5. The VA Must Openly Assume the Responsibility for Treatment of
the Maladies of War. We are grateful for VA decisions in recent years
that show a greater willingness to judge in favor of the servicemember.
The VA focus on health care conditions caused by battle should be on
presumption and correction, not on initial refutation, delay, and
denial. It is important that the decision to send troops into harm's
way also involves an absolute commitment to care for any healthcare
condition that may have resulted from that service. Many veterans call
and write to this association about our government's denial, waffling,
then reluctant recognition of illnesses caused by conditions during
past conflicts. We applaud past decisions of this committee toward
reinforcing a commitment to unconditional care after service, and
encourage the committee to do the same in the future.
This statement will focus on three main areas: education, health
care, and general issues that we hope you will consider as you
deliberate the fiscal year 2007 VA budget and policies.
education programs
Frankly speaking, this is an enlisted, non commissioned officer
issue. Unlike commissioned officers, few enlisted members enter the
service with a college degree. Relatively few of them are able to
achieve one while in the service.
Prior to 9/11 this committee did a good job of increasing the value
of the Montgomery G.I. Bill (MGIB), but very little has been done
since. There's no escaping the fact that college costs are rising and
last year the average public school tuition rates jumped 10.5 percent.
As the gap between the cost of an education and value of the MGIB
widens, the significance of the benefit becomes less apparent. Without
an overhaul to reinvigorate the MGIB, this benefit will lose its
effectiveness when it comes to recruiting this Nation's finest young
men and women into service. As a member of the Military Coalition and
Partnership for Veterans' Education, we strongly recommend you
transform the program to something similar to the post-WW II G.I. Bill.
We ask this committee to work toward funding a program that pays for
books, tuition, and fees, and that the benefit be annually indexed to
reflect the actual costs of education, especially for enlisted members.
When young enlisted men and women opt for military service, they
should know that this ``company'' will provide them with a no-cost,
complete education, as do numerous companies in the private industry.
But our government does not do this in the way that it should. It gives
them a one-time chance to enroll in the MGIB during basic training. It
charges them $1,200 to enroll at a time when they can least afford it.
It limits the use of the benefit to a designated monthly amount which
prevents its use for all educational expenses as needed, or in amounts
to support accelerated programs, or courses with lab requirements, or
advanced programs; and it imposes a benefit-termination clock that
starts ticking when the servicemember separates from military duty.
Each of these provisions suggests the government's lack of sincerity
toward providing a user-friendly benefit that may be fully used to
benefit the servicemember and this Nation. Remember, enlisted initially
make about half that a new commissioned officer makes. Enlisted members
who actually need the MGIB, must proportionally agree to pay twice the
portion of their initial pay as commissary officers do. This is just
plain unfair.
Despite the extremely commendable, fairly recent value increases in
the MGIB (which, in October 2005 increased to $1,034 per month for 36
months), more needs to be done. If this Nation is going to have an
effective, beneficial military educational benefit program, it should
mirror the comprehensive ones provided by civilian industry. Recent
studies show that the average costs for colleges and universities are
approximately $1,770 per month--a figure that reflects the cost of
books, tuition, and fees at the average college or university for a
commuter student (based on the annual ``College Board'' report). That
means that despite the recent increases in the MGIB, it will only cover
about 58 percent of the average cost of a 4-year public college or
university for academic year 2005-2006. As educational costs rise and
if Congress does not increase funding, the value of the MGIB will
continue to deteriorate. Without automatic indexing for inflation, MGIB
purchasing power continues to erode, thereby negating the previous hard
work of this committee. We ask that you look toward further increases
in the MGIB program by legally indexing the MGIB benefit to annual
increases in ``educational'' inflation.
We are aware of recent interest among some Members of Congress to
``renovate'' the MGIB. Specific characteristics that a new
comprehensive benefit should include are as follows:
Provide an MGIB Enrollment Opportunity for All Currently Serving
Enlisted Members Who Declined Enrollment in the Old Veterans
Educational Assistance Program (VEAP). We are mindful that VEAP was
intended to be a transitional benefit which enabled departing
servicemembers to secure necessary skills as they transition back into
the civilian workforce. It's only in more recent years that the MGIB
has evolved into a recruiting incentive. That being the case, and
without question, one of the greatest needs cited by our members is to
provide a second chance for those who turned down their initial
opportunity to enroll in the Veterans Educational Assistance Program
(VEAP). VEAP was the program in place for those who were serving
immediately prior to the July 1985 initiation of the Montgomery G.I.
Bill. VEAP was a far less beneficial program than the MGIB.
Hundreds of thousands of military members chose not to enroll in
the VEAP program. Many were advised not to enroll in VEAP because a
better program was coming along. Unfortunately, when the MGIB program
began, those who turned down the VEAP program were not allowed to
enroll in the MGIB program. So many turned down their one-time
opportunity (during the 1980's) to enroll in the VEAP program that
approximately 50,000 military members who declined VEAP enrollment are
still serving.
Approximately 15,000 still-serving commissioned officers turned
down VEAP; by definition they already have at least bachelor's degrees
when they enter service--most have graduate and higher degrees by the
time they reach retirement. For that reason, and considering funding
challenges, AFSA would contend that the MGIB enrollment opportunity
should be limited to still-serving enlisted (noncommissioned) members
who turned down the old VEAP program.
Rep. Dave Camp has introduced H.R. 269 which would provide an MGIB
enrollment opportunity to the estimated less than 50,000 currently
serving who turned down the old VEAP program--including commissioned
officers. In evaluating this same legislation in the 108th Congress,
CBO scored this bill at $173 million over 10 years (figure based on the
96,000 plus eligible active duty personnel at that time) Taking into
consideration that the number of eligibles is now halved, estimated
costs of implementation would now be in the range of $86 million.
However, if we limit the enrollment opportunity to enlisted members
only, it will reduce the number by more approximately one-fourth and,
therefore, the cost by 25 percent. The projected scoring would then be
reduced to somewhere in the neighborhood of 65 million over 10 years if
limited to enlisted members only.
Time is running out for Congress to provide these deserving
individuals an MGIB enrollment opportunity; unfortunately many have
already retired. As of July 1, 2005, all actively serving members who
enlisted in this era were eligible to retire. We urge these committees
to act quickly before it is too late to at least provide a transitional
education assignment to the remaining VEAP-era enlisted members.
Remember these citizens served a full career of dedicated service and
sacrifice fighting this Nation's wars and preserving the peace.
Provide a Second Chance for Those Currently Serving Enlisted
Members Who Declined Enrollment in the MGIB. Since the end of the VEAP
program, tens of thousands more have declined enrollment in the MGIB.
Most enlisted members did so because they were (and still are) given
only a one-time, irrevocable enrollment opportunity at basic military
training when many simply could not afford to give up $100 per month
for the first 12 months of their career. While this may not apply to
all accessions, it certainly applies to enlisted members.
In fact, in the Air Force alone, there are now over 25,000 on duty
who came in during the MGIB era but who declined to enroll in the MGIB.
Hundreds of noncommissioned members tell us that they want a second
chance to get into the MGIB, now that they can afford to do so. This is
particularly a serious problem among enlisted members--those who
generally enter military service without a college degree and with
prospects of relatively little income. As we said earlier, thanks to
the fine work of these committees, the MGIB value has been
significantly increased in recent years. Although more work needs to be
done, the benefit is now a comparatively ``lucrative'' benefit--a far
cry from that which most VEAP and MGIB non-enrollees turned down. For
that reason alone, fairness would dictate an enrollment opportunity for
any military member not currently enrolled in the MGIB. They have made
freedom possible during their service; now let's say ``Thank You'' to
them! H.R. 3195 by Rep. Peter Visclosky specifically calls for an
enrollment opportunity for these deserving individuals.
Eliminate the $1,200 MGIB Enrollment Fee. The Montgomery GI Bill is
the one of the only company-provided educational programs in America
that requires a student to pay $1,200 (by payroll deduction during the
first 12 months of military service) in order to establish eligibility.
This $1,200 DOD payroll cost-avoidance method amounts to little more
than a tax penalty on a benefit that must be paid before it is
received.
Sadly, this fee causes many young noncommissioned servicemembers to
decline enrollment simply because they are given a one-time,
irrevocable decision when they are making the least pay and under the
pressure of initial training. Those who decline enrollment--many due to
financial necessity--do not have a second chance to enroll in the
program. This is probably the biggest complaint we get from the lowest-
ranking airmen. They feel that, in a sense, it is a ``dirty trick'' to
offer such an important program only when it is clearly a financial
burden for enlisted members to enroll in the program. After all,
because of lower pay, enlisted members must sacrifice a significantly
higher percentage of their income (in relation to new commissioned
officers) in order to be eligible for the program. Further, it sends a
very poor message to those who enter service expecting a world-class
educational benefit.
We would imagine that a good case could be made to show that
eliminating the fee will not be as expensive as estimated since the
administration of the fee (tracking and collection) most likely costs
nearly as much as, if not more than, the fee itself. To our knowledge,
this has never been explored, and we encourage these committees to
investigate this matter further. S. 43, by Sen. Chuck Hagel, and its
companion bill, H.R. 786, by Rep. Lee Terry, would eliminate the $1,200
user fee for those serving during the period of Executive Order 13235.
Both bills would also give a second MGIB enrollment opportunity for
those serving during this period. AFSA maintains that both elimination
of the $1,200 payroll reduction and a second MGIB enrollment
opportunity should be permanently provided for enlisted servicemembers.
Allow Enlisted Military Members to Enroll in the MGIB Later During
Their Careers. As I explained above, the one-time enrollment
opportunity at Basic Training is a problem. Of course, abolishing the
$1,200 fee would eliminate the non-enrollment problem while
simultaneously reintroducing some honesty into the recruitment promises
made concerning educational benefits. This would alleviate the need for
young recruits to make a monumental financial decision under the
pressure of Basic Military Training when they are making very little
money. Another option would be to allow them to enroll at any time
during their first or subsequent enlistments. In the 108th Congress,
H.R. 3041, which was introduced by House Veterans Affairs Committee
Vice Chairman Congressman Michael Bilirakis, would have allowed
individuals to make an election to participate in the MGIB at any time
during the first 2 years of service. AFSA would strongly encourage the
committee to incorporate this legislation as they look to revamp the
benefit.
Extend or Eliminate the Ten-Year Benefit Loss Clock. Once an MGIB
enrollee separates or retires, they have 10 years to use their benefit
or they lose any unused portion. Transitioning from a military career
to civilian life requires a period of readjustment and satisfying
survival needs--especially for enlisted members. These include
relocation, job and house hunting, and family arrangements, just to
name a few. For many, using their ``earned'' educational benefit (for
which they paid $1,200), must be delayed a few years--or their
education must be pursued piecemeal (e.g., a class at a time) due to
conflicting work and family obligations. However, the benefit self-
destruct clock is ticking as the government prepares to take the
benefit away. We urge you to extend that 10-year clock to 20 years, or
repeal the ``benefit-loss'' provision altogether. The benefit program
has been earned, the Federal computer program that tracks the MGIB
usage is not earmarked to go away, and extending the 10-year benefit
loss clock would have negligible cost implications.
Provide ``Portability'' (Transferability) of MGIB to Family
Members. ``Critical skills'' portability for family members was signed
into law in the fiscal year 2002 NDAA. To date, this powerful retention
incentive has gone largely unused as only a very small percentage of
personnel were ever provided this opportunity. Part of the problem is
the service secretaries get to determine just what ``critical'' means.
For example, in the Air Force, less than 500 personnel in a dozen
career fields were provided this opportunity despite the fact that over
60 career fields were considered critical enough to require Selective
Reenlistment Bonuses. The vast majority of MGIB enrollees, many of whom
have been told their jobs are ``critical,'' find it unfair that they
have not also been afforded this opportunity. As an issue of fairness,
we urge that the portability feature be extended to all MGIB enrollees.
Portability would be an important career incentive for the vast
majority of military members and, if we are wise, a good retention tool
across the board. For enlisted members, in particular, it could mean
the ability to offer greater educational opportunities to their
children. A career-promoting alternative would be to offer the option
to transfer (at least a portion of) the benefit to family members once
the individual has served 12 to 15 years. This would make the option
available in time to help send their kids to college, and it would
serve as an incentive to stay in the service. Please work to extend the
``portability'' option across the board to all military enrollees
(enlisted ones in particular).
medical care
The health care system administered by the Veterans Administration
impacts, in one way or another, all of those who served. As reported,
the Administration's fiscal year 2007 budget proposal provides an 8
percent or $2.65 billion increase in discretionary funding for VA
health care, which gives Congress a much better starting point in the
appropriations process than in previous years. AFSA, like most military
and veterans associations remain concerned that the requested levels of
funding and the calculations utilized to arrive at these figures may
not reflect the true needs of this department. We recommend the
committee scrutinize the Administrations proposals closely so as to
avoid previous It is critical that those fighting wars today receive
care when needed, while at the same time, full funding is provided to
cover past veterans. Recent practice is that in order to keep funding
down we progressively redefine the categories of eligibility to exclude
a portion of currently eligible veterans.
Once again the Administration is proposing to increase prescription
copayments and create an annual ``enrollment fee'' of $250 for almost
two million Category 7 and 8 veterans who do not have service-connected
disabilities. The copayment would jump 88 percent--from $8 to $15--per
30-day supply, per prescription. AFSA feels these two proposals are
unacceptable and urges Congress to reject it in similar fashion to last
year's proposed $250 ``enrollment fee.'' Our feeling is that such an
enrollment fee should only be applied prospectively. Current veterans
should not be charged a fee for access which earlier Congresses
determined was not appropriate. One would have to wonder what the next
Congress is going to add or eliminate as the policies relative to
veterans health care change based on the changing economy and personal
preferences and interpretations. Upon what can veterans depend when it
comes to national provision of benefits and services?
The fiscal year 2007 VA Budget should be sufficient to provide full
health care and program needs for those who are currently defined as
eligible for care. Funding should not be based on additional
redefinitions of who is eligible and on a proposed institution of
additional copayments and enrollment usage fees.
I wish to briefly touch on some issues that have been reflected in
the many letters and phone calls that AFSA has received from the field.
As a general rule, we tend to hear most loudly (and frequently) from
those who are not happy with the adjudication of their claims or the
treatment they have received. I am not going to go into isolated
problems, because anecdotal information is just that. Rather, I want to
briefly touch on some specific health-related situations/conditions
that we feel need to be addressed.
Work Toward Mandatory Funding and Program Permanence. This
association believes that the parameters of who will be served, what
care will be provided, the facilities needed, and the full funding to
accomplish those missions should be stabilized as mandatory
obligations. If that were so, and Congress did not have to go through
redefinition drills as economic philosophies change, the strength of
the economy fluctuates, and the numbers of veterans increases or
decreases--these committees and this Nation would not have to re-debate
obligations and funding each year. We believe that these important
programs should be beyond debate and should fall under mandatory rather
than discretionary spending.
Policy Consistency Needed. The pervading feeling among veterans is
that the Administration's approach to providing adequate service to an
ever-growing number of veterans is to shrink the number of patients by
excluding increasing classes of veterans. These veterans who are being
excluded were expressly included in earlier congressional legislation.
In other words, rather than funding for increased needs, the VA's
allowable clientele definition is changed by adding an increasing
number of ``Priority'' groups, raising copays, and charging fees for
use. The VA's ``temporary'' moratorium on Priority Group 8 enrollment
has now assumed a ``permanent'' status.
Seek Proactive Cost-Saving Approaches. Provisions in the fiscal
year 2005 budget proposal allowed the VA to pay for emergency room care
at non-VA facilities. This proactive approach prevented delays in
treating life-threatening conditions, thereby saving the lives of
veterans who do not reside in close proximity to a VA medical facility.
Periodically the VA has agreed to a change in policy and filled
prescriptions written by non-VA providers under very specific
circumstances. These are excellent examples of how the VA can enhance
the care provided to veterans at a modest cost through using new
approaches!
Support VA Subvention. With more than 40 percent of veterans
eligible for Medicare, VA-Medicare subvention is a very promising
venture, and AFSA offers support for this effort. Under this plan,
Medicare would reimburse the VA for care the VA provides to non-
disabled Medicare-eligible veterans at VA medical facilities. This
funding method would, no doubt, enhance some older veterans' access to
VA health care. The VA has an infra-structural network to handle this,
and we anticipate the effort would be successful. This is an
opportunity to ensure that those who served are not lumped in with all
those who have not, and would, no doubt, save taxpayer dollars by
potentially reducing an overlap in spending by Medicare and the VA for
the same services.
Support Judicious VA-DOD Sharing Arrangements. We believe the
enlisted force would be pleased with judicious use of VA-DOD sharing
arrangements involving network inclusion in the DOD health care
program, especially when it includes consolidating physicals at the
time of separation. This decision alone represents a good, common sense
approach that should eliminate problems of inconsistency, saves time,
and takes care of veterans in a timelier manner. In that sense, such
initiatives will actually save funding dollars. AFSA supports testing
such program but recommends that the committee closely monitor the
collaboration process to ensure these sharing projects actually improve
access and quality of care for eligible beneficiaries. DOD beneficiary
participation in VA facilities must never endanger the scope or
availability of care for traditional VA patients, nor should any VA-DOD
sharing arrangement jeopardize access and/or treatment of DOD health
services beneficiaries. VA and DOD each have a lengthy and
comprehensive history of agreeing to work on such projects but have yet
to follow-through on most of them. A memorandum of understanding to
renew their commitment to joint ventures was recently signed by the two
departments. With this committees urging, perhaps this latest effort
won't go by the wayside as past ``restarts.''
Support State Veterans Homes. One hundred and thirty-three state-
run veterans' homes, serve about 30,000 former servicemembers. These
homes are a good Federal investment since the states provide funding
for two-thirds of total operating costs. Funding reductions in this
area could be devastating and would force the closure of several
facilities. We urge the committees to take a close look at the required
level of support to protect these important national assets. We urge
these committees to provide full funding for state veterans homes--
building on levels established in the past with inflation factored in.
If changes are to be made in the future, they should be announced for
future implementation and should be applied prospectively without
harming those who have come to depend on these facilities.
Care for Women Veterans. We applaud the actions of these committees
in recent years to directly address the issue of the unique health
challenges faced by women veterans. Between 1990 and 2000, the women
veteran population increased by 33.3 percent from 1.2 million to 1.6
million, and women now represent approximately 7 percent of the total
veteran population. By the year 2010, the VA estimates that women
veterans will comprise well over 10 percent of the veteran population.
Currently women make up 15 percent of the active duty force and
approximately 23 percent of the Reserve force. Many of these female
veterans have served in more recent years. Tens of thousands of female
troops have been serving, or have already returned from service in Iraq
and Afghanistan. As the number of women veterans increases, the VA must
be funded to increasingly provide the resources and legal authority to
care for female-specific healthcare needs.
general issues
Speedier Claims Processing and Improved Accuracy. For many veterans
association with the VA begins with the claims process. Two years ago,
the Veterans Benefit Administration announced they had reached a steady
state of 250,000 claims in progress but recent numbers reflect a number
three times that. Not mentioned in the Administrations fiscal year 2007
budget plan was how this agency intends to address a claims backlog
that currently exceeds more than 800,000 cases!
The key to sustained improvements in claims processing rests
primarily on adequate funding to attract and retain a high-quality
workforce of claims workers who are supported by full investment in
information management and technology. This agency is facing a mass
exodus of experience once the baby-boomer generation retires from
Federal service over the next 5 years. It's becoming more and more
apparent that this particular section of the agency needs additional
funding consideration verses funding reductions to overcome this
growing backlog. Additionally, proper training impacts the quality and
consistency of claims decisions. An infusion of funding specifically
for this purpose could save the agency millions, if not more as errors
in processing claims and the subsequent appeals they generate are
reduced. Much of the past success of this agency can be directly
attributed to the funding and support of this committee. The time to
take a closer look is long overdue.
``Seamless,'' Transferable Medical Records. The record numbers of
veterans being generated by the wars in Afghanistan and Iraq underscore
the importance of accelerating DOD and VA plans to seamlessly transfer
medical information and records between the two Federal departments. A
lifetime DOD-VA service medical record could help veterans obtain
early, accurate, and fair VA disability ratings, save the Department of
Veterans Affairs funding, and facilitate pre- and post-deployment
research that could advance standards of care. Additional savings would
be realized by preventing the ``doubling'' of diagnostic testing which
currently occurs when VA runs similar testing (MRIs/X-rays, etc) to
validate DOD findings. Common sense and cross flow of information
between the DOD and VA systems could save taxpayers a great deal of
money. With thousands of servicemembers retiring each year, this amount
could easily total several billion dollars. Accepting service connected
diagnosis's made by DOD providers and their accompanying documentation
would help resolve another problem that plagues VA by freeing up
thousands of doctors and specialists thereby reducing the wait list
times for specialized care. According to recent VA statistics about
50,000 veterans can presently be expected to wait more than 6 months
for care its increases in demand and expected changes in the intensity
of service delivery.
At an Oversight and Investigations Subcommittee hearing in November
2003, it was pointed out that the technology already exists to
accomplish the goal of a seamless record. We urge this committee to
assume an oversight role and facilitate implementation of this
important document as quickly as possible.
Legitimate, Sincere Veterans' Preference. In recent years, Congress
has taken steps toward making ``Veterans' Preference'' a reality. We
have seen commendable moves in this Administration involving the VA and
the Department of Labor to enhance the job preferences available to
veterans. We continue to urge these committees to support any
improvement that will put ``teeth'' into such programs so that those
who have served have a ``leg up'' when transitioning back into the
civilian workforce.
Support of Survivors. AFSA commends this committee for previous
legislation which allowed retention of DIC, burial entitlements, and VA
home loan eligibility for surviving spouses who remarry after age 57.
However, we strongly recommend the age 57 DIC remarriage provision be
reduced to age 55 to make it consistent with all other Federal survivor
benefit programs. H.R. 1462 introduced by Rep. Bilirakis would make
this important change in law. We also endorse the view that surviving
spouses with military Survivor Benefit Plan (SBP) annuities should be
able to concurrently receive earned SBP benefits and DIC payments
related to their sponsor's service-connected death. We regret that the
109th Congress felt it was unable to address this issue as it finalized
the fiscal year 2006 National Defense Authorization Act.
Protect VA Disability Compensation. Despite being clearly stated in
law, veterans' disability compensation has become easy prey for former
spouses and lawyers seeking money. This, despite the fact the law
states that veterans' benefits ``shall not be liable to attachment,
levy, or seizure by or under any legal or equitable process, whatever,
either before or after receipt by the beneficiary.'' Additional
legislation is needed to enforce the probation against court-orders or
state legislation that would award VA disability dollars to third
parties in divorce settlements.
Provide a Written Guarantee. Many veterans are frustrated and
disappointed because existing programs they thought they could depend
on have been altered or eliminated due to changing budget philosophies.
That creates a perception among servicemembers and veterans that the
covenant between the Nation and the military member is one-sided, with
the military member/veteran always honoring his/her obligation, and
hoping that the government does not change the law or the benefits upon
which they depend. We urge this committee to support a guarantee in
writing of benefits to which veterans are legally entitled by virtue of
their service. This would demonstrate that the government is prepared
to be honest and consistent with its obligation to its servicemembers.
Veterans Disability Benefits Commission. AFSA remains concerned
about the intent of the Veterans Disability Benefits Commission set up
as part of recent years' concurrent receipt legislation. We are
encouraged that various military and veterans' associations and
individual veterans have had the opportunity to provide input into the
panel's deliberations and hope that trend continues. Congress recently
granted the panel an extension that carries its reporting date into the
latter part of 2007. Until then, and understanding the budgetary
constraints faced by this committee, we simply ask that the following
items be included in deliberations on the impact of future decisions as
they will apply to current veterans.
Obviously, budgetary parameters/limitations must be set by sound
fiscal decisions. However, one dynamic of changing the definition of
those who are to be served by the Department of Veterans Affairs in the
future is that these decisions can have a life-altering affect on
current veterans and their families. Many have already made decisions
to purchase housing near a VA facility and have made other financial
and life-altering decisions based on earlier decisions and philosophies
of governmental decisionmakers.
Whereas this committee has made ``access'' decisions in the past
(as to who would be eligible for full access to VA programs) based on
the urging of veterans groups, the voters, their fellow Members of
Congress, or simply fiscal restraints, the ultimate decisions was made
by Congress. As such, once the congressional decisions are signed into
law, it is understandable that veterans would have a reasonable
expectation that the VA programs available today will be available on
the same terms in the future. Accordingly, these veterans make/made
life-affecting decisions based on their faith and trust in the United
States government.
It is also understandable that significantly redefining the system,
adding user fees, significantly increasing costs for certain categories
of veterans who are already using the system, etc., lead to further
mistrust, frustration, and in some cases significant financial
hardship. In that sense, this association urges that future funding
decisions and the implementation of the decisions of the blue ribbon
panel be applied prospectively. That is, current veterans should not be
significantly affected by the periodic and aperiodic changing decisions
of governmental bodies; citizens ought to be able to depend on standing
governmental decisions.
As the government changes its decisions from Congress to Congress,
because the economy changes or there are now too many veterans, we
would hope that the members of the applicable committees will consider
the impact on current veterans and set timetables or effective dates
for future applications of its decisions. For that reason, we cannot
endorse annual user fees and significantly increased pharmaceutical
costs for certain categories of veterans--except prospectively. That
is, these congressional decisions should most properly apply to new
veterans entering the system. While this may seem unfair to new
veterans, we believe that is the way the law generally and properly has
been applied for changes to the military retirement system and other
major benefit reductions--the changed laws were applied in such a way
that they would not negatively affect the financial and family security
of those to which the current law applies.
Mr. Chairman, in conclusion, I want to thank you again for this
opportunity to express the views of our members on these important
issues as you consider the fiscal year 2007 budget. We realize that
those charged as caretakers of the taxpayers' money must budget wisely
and make decisions based on many factors. As tax dollars dwindle, the
degree of difficulty deciding what can be addressed, and what cannot,
grows significantly. However, AFSA contends that it is of paramount
importance for a nation to provide quality health care and top-notch
benefits in exchange for the devotion, sacrifice, and service of
military members, particularly while the Nation remains at war. So too,
must those making the decisions take into consideration the decisions
of the past, the trust of those who are impacted, and the negative
consequences upon those who have based their trust in our government.
We sincerely believe that the work done by this committee is among the
most important on the Hill. On behalf of all AFSA members, we
appreciate your efforts and, as always, are ready to support you in
matters of mutual concern.
Chairman Craig. Morgan, thank you very much, and I
appreciate your focusing on the Montgomery GI bill. You make
some very solid proposals. Thank you.
Now, let me turn to Colonel Robert Norton who is retired,
and currently the deputy director of Government Relations,
Military Officers Association of America.
Robert.
STATEMENT OF COLONEL ROBERT F. NORTON (RET.), U.S. ARMY; DEPUTY
DIRECTOR, GOVERNMENT RELATIONS, MILITARY OFFICERS ASSOCIATION
Mr. Norton. Thank you, Mr. Chairman. Good morning.
I am pleased to have this opportunity to appear before you
today on behalf of the 360,000 members of the Military Officers
Association.
At the beginning, Mr. Chairman, I want to echo, as my
colleagues did, our great appreciation to you, to Senator
Akaka, and to the Committee for setting a new standard for
engaging veterans' issues in this Committee. We greatly
appreciate it. We also want to thank you for the work that the
Senate in particular did last year on the traumatic injury
insurance rider to SGLI and on raising SGLI coverage levels.
These are very important benefits to our wounded servicemembers
and their families, and it is a great show of the support of
Congress to these great young Americans.
MOAA is pleased to see a significant increase in the
medical services budget in the VA for fiscal year 2007. This is
an important first step in matching resources to the rising
demand for care.
We continue to support the President's task force
recommendation that the VA health care system should be fully
funded either by mandatory means or by any other means that
will accomplish that objective.
MOAA is opposed to the $250 user tax for certain enrolled
veterans. Instead, to avoid another VA medical budget
shortfall, we recommend a $795 million increase to the VA
health care budget.
Less than 1 percent of the American population is fighting
to protect the Nation in the War on Terror, and those who have
served should not have to pay for their access to VA care.
MOAA recommends that the Committee and Congress continue to
press VA and the Department of Defense to speed up seamless
transition initiatives.
When Army Captain Mark Giammatteo returned home from Iraq
with serious wounds to his right leg, he underwent 30 surgeries
at Walter Reed. On convalescent leave, he had problems with his
surgery and attempted to check into the local VA facility.
There, he was turned away. VA officials said they couldn't
treat him because he was on active duty. Captain Giammatteo's
story illustrates the personal dimension of the importance of
getting seamless transition right, and our statement goes into
greater detail on the recommendations we feel need to be
pressed in terms of seamless transition.
Advances in medical treatment and casualty management have
raised the survival rates for our wounded warriors to
unprecedented levels, what the medical folks call the ``golden
hour.'' MOAA leadership has seen firsthand the need for
polytrauma center upgrade and expansion. The need is not
adequately addressed, however, in the budget request. MOAA
strongly urges the Committee to restore the proposed $627
million cut in VA health care construction and to increase
medical research funding to $460 million.
Turning now to benefits, MOAA strongly recommends the
Committee endorse needed increases in full-time-equivalent
positions, training, and technology upgrades, so that the long
and costly delays in processing disability claims can be fixed.
I want to thank you, Mr. Chairman and Senator Akaka and the
Committee, for holding a hearing on the 2nd of February
concerning the 15 percent unemployment rate among young
veterans. MOAA believes that stronger transition assistance
programs are an important tool to help attack this problem, and
we recommend that the Committee support expanding and tailoring
TAP services for all of our veterans, including the Guard and
Reserve.
Another issue related to potential veteran unemployment is
the Montgomery GI bill. National Guard and Reserve servicemen
and women who have been mobilized earn Montgomery GI bill
benefits during their active-duty service under chapter 1607 of
title 10. However, when they complete their Reserve contracts,
they forfeit those benefits, and they don't get an opportunity
to use them to gain the skills and education they need to be
competitive in the workforce and to avoid unemployment.
Let me illustrate. According to the Defense Department,
there are 579 citizen soldiers from Idaho currently on active
duty from units in Boise, Gowen Field, Lewiston, and Pocatello.
These great young Americans are serving in the War on Terror,
defending the rest of us. They earn Montgomery GI bill benefits
which range from about $15,000 to $29,600, depending on the
length of their call-up. When they return home to Lewiston and
Pocatello and someday complete their service commitment, they
must forfeit every penny of those benefits unless they stay in
the Guard and Reserve. That is not right, Mr. Chairman, and it
must be fixed.
Along with my colleagues, we recommend that the Montgomery
GI bill be restructured so that a basic principle is
underwritten, namely that service in the Armed Forces should be
matched by appropriate benefits, including the Montgomery GI
bill. So we also recommend that the title 10 Reserve programs
be transferred to Title 38 and that a readjustment benefit be
authorized for men and women who serve on active duty from the
Guard and Reserve, so that they can take their benefits with
them when they complete their service, avoid unemployment, and
enable this great Nation of ours to be competitive in the
marketplace.
Thank you again, Mr. Chairman, for this opportunity to
testify, and I look forward to your questions.
[The prepared statement of Mr. Norton follows:]
Prepared Statement of Colonel Robert F. Norton (Ret.), U.S. Army;
Deputy Director, Government Relations, Military Officers Association
Mr. Chairman and distinguished Members of the Committee, on behalf
of the 360,000 members of the Military Officers Association of America
(MOAA), I am honored to have this opportunity to present the
Association's legislative agenda for veterans health care and benefits
programs.
MOAA does not receive any grants or contracts from the Federal
Government.
veterans health care
Health Funding Overview
MOAA is grateful to Congress for addressing a woefully inadequate
VA health care budget for the past (fiscal year 2005) and current
fiscal year, fiscal year 2006. Since 9/11, we have been particularly
concerned that VA demand projections have not properly accounted for
the increased number of veterans from the Iraq and Afghanistan
conflicts (OIF/OEF). In accordance with VA's 2-year ``open door''
policy, more than 525,000 Guard and Reserve veterans are now eligible
for VA care, in addition to the active duty veteran population. VA data
show that greater numbers of active duty veterans than Guard/Reserve
veterans are enrolled in the VA, but Guard-Reserve usage is higher. The
GAO recently confirmed that the VA's demand model is inadequate for
estimating projected costs for the VA health care system.
MOAA fully supports reforming the VA's enrollment projection model
used to justify the VA health care budget and strongly endorses the
President's Task Force recommendation that the VA health care system
should be fully funded by mandatory spending or by some other means
that will ensure the full-funding objective is met.
The fiscal year 2007 VA Medical Care Budget includes $31.5 billion
in discretionary appropriations and $2.8 billion in increased
collections for a total of $34.3 billion for VA medical care. The
budget request recognizes the need to provide timely care to those who
have served the Nation in uniform and is in range of the budget
estimate set forth in the Veterans Independent Budget for fiscal year
2007, which MOAA endorses. Included in the spending plan is an
estimated $795 million in collections that would come directly out of
veterans' pockets, not the Federal treasury.
MOAA recommends that Congress provide $33 billion for veterans'
health care, an increase of $4.2 billion over the fiscal year 2006
appropriation, and approximately $1.5 billion over the administration's
fiscal year 2007 budget request, without collections.
Usage Fees and Drug Copays
MOAA is surprised and disappointed to note that after twice being
rejected by Congress, the Administration is again seeking enactment of
a $250 usage fee for 2.3 million Priority Group 7 & 8 enrolled
veterans.
The Administration is also reviving its proposal to increase
pharmacy copayments from $8 to $15 for these veterans. The fees would
generate revenue of $251 million in fiscal year 2007.
What's wrong with this picture? First, under the VA's 2-year open
door policy for OIF / veterans, many thousands of veterans are
completing their ``trial'' enrollment and, if they have not been
determined to have a service-connected disability, are being assigned
to PG-7 or 8 depending on income levels. We must ask if it is right
that a Nation that sent these veterans into harm's way in the War on
Terror should now charge them a fee for their VA care? Second, the
proposals fail to consider the lost revenue from PG 7 and 8 veterans
who may have other health insurance (OHI).
Third, attempts to correlate the fees with TRICARE Prime fees are
fallacious: the VA is not a health insurance system with managed care
standards. TRICARE Prime is a managed care (HMO) component of the
military health system. TRICARE Prime fees are optional for those who
choose this coverage over TRICARE Standard. Participants pay modest
annual fees in order to obtain assured access to TRICARE providers
under established access standards. The fees the Administration seeks
bring no reciprocal benefit in terms of access to care in a timely
manner. Their only purpose is to depress demand and save money by
driving veterans away.
MOAA is opposed to VA usage fees and higher drug copays. During
this long and difficult war on terror, Congress would send the wrong
signal to the Nation's warriors and future veterans by endorsing usage
fees for VA health care.
Medical and Prosthetic Research
The budget request shows a $17 million increase in the research
budget above the 2006 level. Additionally, the VA indicates that OIF/
OEF research is a high priority and special research is being done
concerning PTSD, traumatic brain injury, prostheses and injuries
associated with blast injuries. However, we are concerned that the $17M
increase appears to be due only to funds from other Federal and non-
Federal resources that may or may not actually be available.
MOAA strongly urges Congress to ensure a funding level of $460
million for medical research--including traumatic brain injury, spinal
cord injury, prosthetic devices, and burn therapies.
Polytrauma Centers Funding
Advances in medical treatment and casualty management during the
``golden hour'' have raised the survival rates for our wounded warriors
to unprecedented levels. But, unfortunately, the injuries often are
much more severe and may involve multiple systems intervention and
rehabilitation in highly advanced polytrauma centers. The VA has four
such polytrauma centers throughout the United States and the DOD is
planning to establish three more. Senior MOAA leaders have been
privileged to visit some of these facilities. We have seen first hand
the need for facility modification and expansion in order to keep up
with demand and enable the most efficient use of modern technology. But
the need is not adequately addressed in the budget request, which
proposes a $627 million cut in minor and major construction dollars.
MOAA strongly urges the Committee to reverse the $627 million cut
in construction allocations and restore construction funding required
for needed upgrades to VA polytrauma centers and for other critical
construction needs.
Seamless Transition Road Map
MOAA appreciates the leadership of the Committee in keeping up the
pressure on the VA and DOD to accelerate accomplishment of ``seamless
transition'' policies, procedures, and supporting objectives for our
Nation's service men and women and their families.
What is seamless transition? In its 2003 report, the President's
Task Force on DOD-VA health care collaboration outlined the following
objectives:
Single separation physical: ``The Departments [of Defense
and Veterans Affairs] should implement by fiscal year 2005 a mandatory
single separation physical as a prerequisite of promptly completing the
military separation process.''
Electronic Medical records: ``VA and DOD should develop
and deploy by fiscal year 2005 electronic medical records that are
interoperable, bi-directional, and standards based.''
Privacy: ``The Administration should direct the Department
of Health and Human Services (HHS) to declare the two Departments to be
a single health care system for the purposes of implementing HIPAA
regulations.''
Occupational and Hazard Exposure Data: ``VA and DOD should
expand their collaboration in order to identify, collect, and maintain
the specific data needed by both Departments to recognize, treat, and
prevent illness and injury resulting from occupational exposures and
hazards experienced while serving in the Armed Forces; and to conduct
epidemiological studies to understand the consequences of such
events.''
Joint Health Surveillance and Reporting: ``The Departments
[of Defense and Veterans Affairs] should: (1) add an ex officio member
from VA to the Armed Forces Epidemiological Board and to the DOD Safety
and Occupational Health Committee; (2) implement continuous health
surveillance and research programs to identify the long-term health
consequences of military service in high-risk occupations, settings, or
events; and (3) jointly issue and annual report on Force Health
Protection, and make it available to the public.''
The record of accomplishment on these goals is mixed, though there
is some progress. We offer the following observations on policy,
procedures, and technologies supporting seamless transition objectives:
Transparency in oversight and policy coordination. MOAA
commends Congress for enacting legislation that established a formal
coordination process between the Departments of Defense and Veterans
Affairs. The DOD-VA Joint Executive Council (JEC) and its subordinate
Benefits Executive Council (BEC) and Health Care Executive Council
(HEC) have the potential to spearhead greater progress on seamless
transition initiatives.
MOAA recommends greater transparency and oversight of the DOD-VA
Joint Executive Council activities.
Electronic Medical Records. The VA has fielded a standard-
setting electronic medical records system for its hospital facilities
and outpatient clinic networks. Known as VISTA, the VA system has
received high marks in the medical community and is being adopted by a
growing number of civilian provider networks. DOD is now fielding a
military electronic medical records system called AHLTA. AHLTA is
expected to be on line this year. The question, however, is whether
VISTA and AHLTA can ``talk to each other.''
MOAA continues to strongly urge accelerated development of bi-
directional, interoperable standards-based electronic medical records
between DOD and the VA.
Medical Evaluation Board (MEB)/Physical Evaluation Board
(PEB).
MEBs are conducted to determine suitability for continued service
following an injury, wound, or illness. MEBs follow a ``period of
observation'' or ``time to heal'' for ill or injured service men and
women. MEBs average 121 days, but can vary considerably depending on
the medical condition and healing process. For example, Army MEBs
currently take 67 days to complete. The PEB is charged with making
personnel decisions based on the input from the MEB. DOD requires a PEB
in peacetime to be completed within 40 days following an MEB. The
average PEB completion time since OIF and OEF is 87-280 days. Taken
together, the convalescence, MEB and PEB processes appear to average
between nine and fifteen and a half months for Army soldiers.
MOAA has recommended that the Veterans Disability Benefits
Commission evaluate MEB-PEB policy and procedures to ensure fair
treatment among the Services including members of the Guard and
Reserve.
Single Separation Physical. MOAA remains concerned about
known gaps in implementing a single separation physical. Some time ago,
DOD and VA announced an agreement on a single separation physical
protocol. Yet, at key medical treatment facilities like the Walter Reed
Army Medical Center and the National Naval Medical Center neither
facility has implemented a single, systematic process for a separation
physical under a joint DOD-VA protocol. That being the case at the Army
and Navy's premier medical facilities, it's unlikely that a single
separation physical has been implemented elsewhere.
MOAA continues to urges support for accelerated development of a
single separation physical.
Seriously Wounded Transition Program. DOD and VA have made
commendable progress in coordinating services for injured and ill
servicemembers. DOD has established a joint center to oversee care and
services for injured and ill OIF and OEF servicemembers. The VA has
assigned caseworkers to major military medical facilities that are
providing care and rehabilitation services to severely injured or ill
troops. Last year, the GAO recommended improving information sharing
between DOD and VA on seriously injured service men and women
(Vocational Rehabilitation; More VA and DOD Collaboration Needed to
Expedite Services for Seriously Injured Service Members (January 2005).
MOAA recommends continued emphasis on improving the coordination of
care and information sharing between DOD-VA for seriously wounded
servicemembers.
Expansion of Mental Health Services
Recent studies project that 1 out of 6 servicemembers returning
from Iraq and Afghanistan will need care for PTSD and other mental
health conditions. The budget request increases funding for mental
health services from $2.8 billion to $3.2 billion. We are pleased that
the VHA Mental Health Strategic Plan Workgroup is developing a 5-year
strategic plan to eliminate deficiencies and gaps in the availability
and adequacy of mental health services.
Retired Military Veterans Access to Earned DOD-VA Health Care Benefits
Veterans who complete a full career in the Armed Forces earn
lifetime entitlement to health care benefits in the Department of
Defense TRICARE system, and eligibility for VA health care services.
About one out of eight enrolled veterans is a dual-
eligible veteran.
One out of ten users (``unique patients'') of VA care is a
dual-eligible veteran.
Enrollment of military retired veterans has increased by a
little over one-third since June 2000 when VA began tracking the data
(600,870 retired veteran enrollees to 970,549 as of Sept. 2005).
[GRAPHIC] [TIFF OMITTED] 28132.001
The more severe a disability, the more likely it is that a veteran
would seek VA care:
77 percent of dual-eligibles with disabilities rated at 50
percent or greater (PG-1) used VA care last year.
54 percent of dual-eligibles with disabilities rated 40-50
percent (PG-2) used VA care last year down.
44 percent of dual-eligibles with disabilities rated 10-30
percent (PG-3) used VA care last year down.
By contrast, only 26 percent of PG-8 retired veterans used
VA care last year down from 29 percent in 2004.
In 2005, 53 percent of enrolled military retired veterans used VA
health care in some way.
Because many enrolled retired veterans have serious disabilities,
it is imperative that they have assured access to the VA's spectrum of
health care services including its well-regarded specialty care
capabilities.
As we have noted in past testimony, military retired veterans often
prefer to obtain their routine health care locally from the TRICARE
network, but are willing to travel some distance to have access to VA
specialty care services.
MOAA appreciates Congress' continued support in opposing ``forced
choice'' proposals that would compel dual-eligible veterans to
relinquish access to earned DOD or VA health care services.
Capital Assets for Enhanced Services (CARES)
MOAA and other military and veterans organizations have noted that
the CARES planning process does not include planning for mental health
services and long-term care. MOAA continues to urge inclusion of mental
health care and long term care services in ongoing facilities decisions
resulting from the CARES process.
veterans benefits
Overview. The 2007 VA Budget Request includes $42.1 billion for
entitlement costs associated with benefits administered by the Veterans
Benefits Administration (VBA). The total includes an additional $4
billion for disability compensation for veterans and their survivors
for disabilities or diseases incurred or aggravated in military
service.
Disability Claims: Quality and Process Improvements Needed
The workload and complexity of VA disability claims continues to
increase. The VA projects over 900,000 claims this year. The estimate
includes almost 100,000 claims from ``special outreach'' programs
mandated by Congress last year. Disability claims processing time rose
to 167 days on average in 2005. The VA's performance goal for claims
processing is 100 days. In addition to increased workload, a continuing
challenge is replacing retiring claims workers with highly trained
individuals and providing them with the tools, policies and procedures
to improve the quality and timeliness of production. The VA ``tiger
team'' model, which is used to adjudicate claims of WWII and other
older veterans, should be used throughout the system. Additional
investment in training, full time positions, and technology also will
be needed to reach sustainable quality and timeliness goals.
MOAA continues to urge additional claims-workers, technology
upgrades, and training to reach and sustain the VA's original strategic
performance goal of 100 days on average per VA claim.
Seamless Transition--TAP/DTAP Programs and Related Issues. MOAA
appreciates that this Committee held a hearing on 2 February 2006 to
examine the issue of rising unemployment among veterans recently
separated from military service. The rate of unemployment among
veterans aged 20-24 is 15 percent, almost double that for non-veterans
(8 percent unemployment). Since 2001 the active Armed Forces have
separated an average of 200,000 service men and women each year. In
addition, the call-up of more than 525,000 Guard and Reserve service
men and women since 9/11 has increased the demand on transition
assistance programs (TAP). MOAA believes there is a link between strong
military TAP programs and the goal of reducing unemployment among young
veterans.
A GAO report issued last year stated that TAP resources have been
``flat since fiscal year 1995'' and that DOD's budget has not taken
into account the needs of separating veterans from the National Guard
and Reserve.
MOAA recommends that the Committee support policy and funding
initiatives to:
Enable TAP services to be delivered in local communities
for separating Guard and Reserve veterans.
Expand VA outreach to provide ``benefits delivery at
discharge'' services in local settings convenient to de-mobilizing
Guard and Reserve veterans.
MOAA urges the Committee to support seamless transition initiatives
that underwrite TAP/DTAP programs in order to reduce the potential of
unemployment and homelessness among veterans of the war on terror.
Total Force Montgomery GI Bill
Congress intended that the all-volunteer force Montgomery GI Bill
would support DOD recruitment and retention programs, enable a smoother
readjustment to civilian life, and enhance the Nation's
competitiveness.
But these goals are not being fully realized especially for
mobilized members of the National Guard and Reserve forces. Ongoing
challenges include:
Delayed implementation of MGIB benefits for mobilized
reservists authorized under Chapter 1607 of Title 10 USC. Only a
handful of educational benefits claims have been processed--and these,
manually--for the more than 525,000 Guard and Reserve troops who have
served on active duty under contingency operation orders since 9/11.
Lack of a readjustment benefit for mobilized reservists.
After serving the Nation on active duty in the war on terror and
successfully completing a Guard or reserve service commitment,
reservists are not authorized any readjustment benefit. They must leave
behind remaining MGIB benefits upon separation unless the separation is
for disability.
Benefit disparities. For the first 15 years of the MGIB,
benefits earned by individuals who initially joined the Guard or
Reserve paid 47 cents to the dollar for active duty MGIB participants.
Since 9/11, however, the ratio has dropped to 29 cents to the dollar.
Administrative difficulties. DOD and VA officials report
enormous challenges in de-conflicting and coordinating the oversight
and management of MGIB programs. Policy and procedural challenges are
compounded by outmoded information management and information
technology support for the MGIB.
The Total Force MGIB for the 21st Century
The Total Force MGIB has two broad concepts. First, all active duty
and reserve MGIB programs would be organized under Title 38. (The
responsibility for cash bonuses, MGIB ``kickers'', and other
enlistment/re-enlistment incentives would remain with the Department of
Defense under Title 10). Second, MGIB benefit levels would be
structured according to the level of military service performed.
The Total Force MGIB would restructure MGIB benefit rates as
follows:
Tier one--Chapter 30, Title 38--no change. Individuals who
enter the active Armed Forces would earn MGIB entitlement unless they
decline enrollment.
Tier two--Chapter 1606, Title 10: MGIB benefits for
initial entry into the Guard or Reserve. Chapter 1606 would transfer to
Title 38. No other change is envisioned at this time. In the future,
the Committee should consider adjusting benefit rates in proportion to
the active duty program. Historically, Selected Reserve benefits have
been 47-48 percent of active duty benefits.
Tier three--Chapter 1607, Title 10, amended--MGIB benefits
for mobilized members of the Guard / Reserve on ``contingency
operation'' orders. Chapter 1607 would transfer to Title 38 and be
amended. Mobilized servicemembers would receive 1 month of ``tier one''
benefits (currently, $1034 per month) for each month of activation
after 90 days active duty, up to a maximum of 36 months for multiple
call-ups.
A servicemember would have up to 10 years to use remaining
entitlement under Tier One or Tier Three programs upon separation or
retirement. A Selected Reservist could use remaining Second Tier MGIB
benefits only while continuing to serve satisfactorily in the Selected
Reserve. Reservists who qualify for a reserve retirement or are
separated/retired for disability would have 10 years following
separation to use all earned MGIB benefits. In accordance with current
law, in cases of multiple benefit eligibility, only one benefit may be
used at one time, and total usage eligibility extends to no more than
48 months.
MOAA strongly supports enactment of a ``Total Force Montgomery GI
Bill''.
other educational benefits issues
Benchmarking MGIB Rates to the Average Cost of Education.
Department of Education data for the 2005-2006 academic year show the
MGIB reimbursement rate for full-time study covers 61 percent of the
cost at the average public 4-year college or university. MOAA
recommends the Committee increase MGIB benefit rates to keep pace with
the average cost of education at a 4-year public college or university.
Enrollment Option for Career Servicemembers who Declined ``VEAP''.
Approximately 50,000 career servicemembers who continue to serve on
active duty declined to enroll in the precursor to the MGIB known as
``VEAP'', the Post-Vietnam Era Veterans Education Assistance Program
(Chapter 32, Title 38). Many declined VEAP on the advice of military
counselors. They were told that they would do better to invest the VEAP
enrollment fee of $2700 and wait to enroll in the coming Montgomery GI
Bill. MOAA supports enactment of H.R. 269.
Transferability of Benefits. About two-thirds of today's force is
married. Many reenlistment decisions are based on family needs. MOAA
supports enactment of legislation to permit a servicemember to transfer
up to one-half of remaining MGIB-AD entitlement to immediate family
members in exchange for a career commitment (e.g., those who commit to
serve at least 14 years normally will later complete 20 or more years
service).
MGIB Eligibility for Certain Officers. Under current law, officers
commissioned from a Service Academy or Senior ROTC scholarship program
are ineligible for the MGIB. Most officers today are required to obtain
advanced degrees for future assignments and promotion competitiveness.
But Service tuition assistance programs are limited to a discrete
number of designated specialties. MOAA recommends the Committee
consider establishment of MGIB entitlement for officers commissioned
from a Service Academy or Senior ROTC Scholarship program in exchange
for extension of their active duty service commitment.
Uniformed Services Employment and Reemployment Rights Act (USERRA)
MOAA is grateful to Congress for enacting legislation that requires
the posting of USERRA rights and responsibilities in the workplace.
We are also grateful for Veterans Affairs Committees' past support
in urging that the Department of Labor issue implementing regulations
and guidance for the USERRA. The new USERRA rule explains the law using
a ``question and answer'' format that is clear and understandable.
Other adjustments to the USERRA are still needed, however. It is
our understanding that mobilized reservists are treated as ``severed
employees'' with respect to their employer-based retirement plans such
as 401k or 403b programs. Consequently, they are not authorized to
contribute to retirement plans during the period of activation.
Although employers must match any 401k contributions that would have
been made during the absence upon the return to the workplace, the
reservist is prohibited from making personal contributions during the
period of lengthy active duty. MOAA recommends the Committee endorse a
change to the USERRA that would permit optional contributions to
reservists' 401k plans during a call-up.
Servicemembers Civil Relief Act (SCRA)
MOAA has heard from active duty service families regarding tax
problems that arise from changing duty stations. States of residence
often treat military spouses differently than their sponsors with
respect to the tax code and on matters such as the joint registration
of vehicles at the new duty station. MOAA supports a review of these
type issues with the goal of providing fair tax treatment of military
families who are compelled to make frequent relocations.
Arlington National Cemetery Interment Rules
On multiple occasions since 1998 the House of Representatives by
unanimous or near-unanimous vote favorably reported legislation that
would codify the rules governing interment in our Nation's most
hallowed ground for its military heroes. In addition, this Committee
has previously endorsed legislation that would authorize burial in ANC
for reservists on inactive duty and for retired reservists eligible to
retire but not yet 60 years of age.
The most recent House-passed legislation would authorize an in-
ground burial to:
Members of the Armed Forces who die on active duty.
Retired members of the Armed Forces, including Reservists
who served on active duty.
Former members of the Armed Forces who have been awarded
the Medal of Honor. Distinguished Service Cross, Air Force Cross, or
Navy Cross, Distinguished Service Medal, Silver Star, or Purple Heart.
Former prisoners of war.
Members of the National Guard/Reserve who served on active
duty and are eligible for retirement, but who have not yet retired.
Members of the National Guard/Reserve who die in the
performance of inactive duty training.
The President or any former President.
The spouse, surviving spouse, minor child and at the
discretion of the Superintendent of Arlington, unmarried adult children
of the above categories.
MOAA understands that many Members of the Senate support
codification of these rules, but also want to maintain longstanding
tradition and practice of considering certain exceptions in the case of
individuals who have made extraordinary contributions to the Nation.
MOAA continues to recommend codification of the rules governing
interment in Arlington National Cemetery.
Presumption of Service Connection for Hepatitis-C Infection
Medical research has established that there is a significantly
higher rate of Hepatitis-C (HCV) infection among veterans than in the
general population.
Before development of a reliable HCV screening test in the early
1990s, many thousands of servicemembers were exposed to HCV through
air-gun inoculations, surgery, other medical procedures, and
battlefield exposure. Accordingly, it is reasonable to presume service-
connection for servicemembers exposed to the HCV virus prior to
development of definitive screening tools.
MOAA recommends legislation adding presumption of service
connection for Hepatitis-C in servicemembers determined to have been
exposed to this disease prior to development of definitive screening
protocols in 1992.
Survivors Issues
MOAA is extremely grateful to the Committee and Congress for
passage of legislation last year to raise Servicemembers' Group Life
Insurance (SGLI) to $400K, enact a Traumatic Injury Insurance rider to
SGLI, and affirm the ``24-7'' principle for service-connected
disabilities.
SBP-DIC Offset. MOAA was extremely disappointed that House and
Senate conferees failed to make at least some progress in the fiscal
year 2006 Defense Authorization Act to ease the unfair law that reduces
military Survivor Benefit Plan (SBP) annuities by the amount of any
survivor benefits payable from the VA Dependency and Indemnity
Compensation (DIC) program.
Under current law, the surviving spouse of a retired member who
dies of a service-connected cause is entitled to DIC from the
Department of Veterans Affairs. If the military retiree was also
enrolled in SBP, the surviving spouse's SBP benefits are reduced by the
amount of DIC (about $1,000 per month). A pro-rated share of SBP
premiums is refunded to the widow upon the member's death in a lump
sum, but with no interest. The offset also affects all survivors of
members who are killed on active duty. There are approximately 60,000
military widows/widowers affected by the DIC offset.
MOAA believes SBP and DIC payments are paid for different reasons.
SBP is purchased by the retiree and is intended to provide a portion of
retired pay to the survivor. DIC is a special indemnity compensation
paid to the survivor when a member's service causes premature death. In
such cases, the VA indemnity compensation should be added to the SBP
the retiree paid for, not substituted for it. It's also noteworthy as a
matter of equity that surviving spouses of Federal civilian retirees
who are disabled veterans and die of military-service-connected causes
can receive DIC without losing any of their purchased Federal civilian
SBP benefits.
In the case of members killed on active duty, a surviving spouse
with children can avoid the dollar-for-dollar offset only by assigning
SBP to the children. But that forces the spouse to give up any SBP
claim after the children attain their majority--leaving the spouse with
only a $1,000 monthly annuity from the VA.
MOAA notes that most large city fire departments continue 100
percent of pay for survivors of firefighters killed in the line of
duty, in addition to far larger lump sum payments than military
members' survivors receive. Military members whose service costs them
their lives deserve fairer compensation for their surviving spouses.
MOAA strongly supports legislation to repeal the SBP-DIC offset
introduced by Sen. Nelson (D-FL) (S. 185).
Retain DIC on Remarriage at Age 55. Legislation was enacted in 2003
to allow eligible military survivors to retain Dependency and Indemnity
Compensation (DIC) upon remarriage after age 57. At the time,
Congressional staff advised that age-57 was selected only because there
were insufficient funds to authorize age-55 retention of DIC upon
remarriage. MOAA's goal remains age 55 retention of DIC upon remarriage
in order to bring this benefit in line with rules for the military SBP
program and all other Federal survivor benefit programs.
conclusion
The Military Officers Association of America greatly appreciates
the opportunity to present the Association's legislative priorities on
veterans' health care and benefits issues for the second session of the
109th Congress.
Chairman Craig. Well, thank you very much.
Now let's turn to Rose Lee, chairman, Legislative
Committee, Gold Star Wives of America. She is accompanied by
Edith Smith, member, Legislative Committee, Gold Star Wives.
Please proceed, Rose.
STATEMENT OF ROSE ELIZABETH LEE, CHAIRMAN, LEGISLATIVE
COMMITTEE, GOLD STAR WIVES OF AMERICA, INC.;
ACCOMPANIED BY EDITH SMITH, MEMBER, LEGISLATIVE COMMITTEE, GOLD
STAR WIVES OF AMERICA, INC.
Ms. Lee. Yes. Thank you very much, Mr. Chairman. Good
morning to you, and thank you for the opportunity to testify
before you today on behalf of Gold Star Wives.
In the audience, by the way, are a few Gold Star Wives
members, I must add.
Gold Star Wives was founded in 1945 and is a
Congressionally chartered service organization comprised of
surviving spouses of military servicemembers. We are the widows
of those who died while on active duty or as a result of a
service-connected disability.
I will present to you the collective goals of the Gold Star
Wives with the hope that they will alert you to certain
discrepancies and inefficiencies that you may be able to
alleviate in your deliberations this year.
I want to thank the Members of this Committee and the staff
for your continued support of programs that directly support
the well-being of our servicemembers' widows and their
families.
Too often, we feel that survivors, widows, and orphans, if
you will, are overlooked. They shouldn't be. A couple of years
ago, I took this snapshot of the VA's mission statement that is
on the wall of the VA building. It is Lincoln's statement, and
it reads: ``To care for him who shall have borne the battle and
for his widow and his orphan.''
Last month, I attended the VA's budget briefing, and at
this briefing, I was glad to hear them say that they had
convinced OMB and got the budget increase requested for 2007.
What bothered me is that nowhere in this briefing handout
did the words ``survivors'' or ``widows'' and ``orphans''
appear. We seem to get lost in the shuffle. We hope that these
oversights will be corrected and we are not forgotten.
If there is one message I could leave with you today, it is
that there is never enough good communication. The casualty
assistance calls officers have a difficult mission in a
difficult time, but they don't always know about the benefits
and entitlements managed by the VA or the DOD.
Gold Star Wives sponsors a chatroom for new widows
following 9/11. New widows joined this chatroom and asked
questions about benefits. Our widows do need our help.
We need to examine the coordinating process between
agencies more closely and work hard to prevent these widows and
their children from encountering gaps in identifying benefits.
The VA and DOD have cohosted meetings that focus on
improving outreach to surviving family members. Thanks to you,
Mr. Chairman, VA has created a survivors Web site that offers
communications channels for all service widows and widowers. We
participate in this outreach and applaud these efforts.
However, often widows still do not even know where to turn
simply to identify their benefits.
Periodically, by the way, thanks to your chief of staff,
Ms. Lupe Wissel, I sent e-mails to the chatroom to remind them
of the survivor Web site. I also frequently provide them with
contact information on the Military Services Headquarters
Casualty Assistance offices. However, to enhance these efforts,
Gold Star Wives asks your serious consideration of creating an
oversight office for survivors across the VA and DOD to assure
improved delivery of benefit information and benefits to
survivors.
Despite valiant efforts over the past year, the dollar-for-
dollar offset of survivor benefit plans--that is the SBP--
annuity payments from the VA's DIC was not eliminated.
To illustrate the bad publicity that this issue is getting,
the New York Times op-ed published an article by Attorney Dan
Shea on February 13, 2006, just last month, in which he wrote:
``My brother LTC Kevin Shea was killed by a rocket attack in
Falluja on September 14, 2004.'' Dan Shea went on to describe
the problem which prevents his brother's wife to receive both
SBP and DIC without offset. We do recognize you must act with
your colleagues on the Committee on Armed Services on this
issue. We thank Senator Bill Nelson for introducing S. 185 to
eliminate the offset and encourage Congress to provide this
real relief for our military surviving spouses.
Current law provides for remarriage at age 57 to retain VA
benefits. For those who remarried before the law was enacted,
there was a 1-year period to apply for reinstatement. Lowering
the age to 55 would bring this benefit in line with rules for
SBP and other Federal survivors programs and open up the
reinstatement period with renewed outreach efforts to make
survivors aware of their eligibility.
There are inequities for the child survivor that needs
immediate attention. The additional monthly $250 child DIC
payment per family only applies to survivors of deaths after
January 1, 2005. This should be made retroactive to October 7,
2001. It makes no sense that the survivors of those who died
first should be prohibited from accessing a benefit given to
survivors of those who died later in the same war.
The program evaluation of benefit study recommended that
surviving spouses with dependent children receive the $250 for
5 years instead of 2 years that this has currently provided,
and that amount should be indexed for inflation to avoid a
devaluation of the benefit.
Unfortunately, those recommendations were ignored. The $250
child DIC is the only DIC benefit that doesn't receive the
cost-of-living adjustment. We request that the Committee work
on this until it is given the rightful COLA.
CHAMPVA currently does not carry with it a dental plan. In
order to increase beneficiaries' access to dental care at a
reasonable cost, Gold Star Wives seek the widows and all
CHAMPVA beneficiaries the ability to purchase a volunteer
dental insurance plan similar to the TRICARE program for
military service retirees' dental care. Gold Star Wives
recommend Congress fix this and provide a dental plan for
CHAMPVA beneficiaries.
We request Congress to review how the DIC rate is
established, which is currently a flat rate of $1,033. The SBP
is calculated at 55 percent of retired pay, as if the member
had retired for total disability on the date of death. We
recommend that the DIC be calculated in a similar manner at 55
percent of the disabled veteran's 100 percent disability
compensation. We recognize that there are complexities in this,
depending on rank of the deceased and on date of death, but we
do believe this would help alleviate growing financial
difficulties of widows from wars prior to this conflict who are
receiving only DIC.
In conclusion, we do not want our widows to be forgotten,
whether they are experiencing their losses in the global war on
terror or over the past 5 years, or whether they are members of
the so-called ``greatest generation'' and experienced their
loss many years ago during World War II.
I thank this Committee for using this hearing as one more
avenue of awareness and education and for giving me an
opportunity to share my thoughts and the goals of Gold Star
Wives.
We will be happy to work with the Committee on any of these
initiatives.
Thank you.
[The prepared statement of Ms. Lee follows:]
Prepared Statement of Rose Elizabeth Lee, Chair, Legislative Committee,
Gold Star Wives of America, Inc.
Mr. Chairman, Senator Akaka and Members of the Senate Veterans'
Affairs Committee, I would like to thank you for the opportunity to
testify before you today on behalf of all Gold Star Wives regarding the
importance of addressing critical services for America's military
widows and their children.
My name is Rose Lee. I am a widow and I am here before you as the
Chair of the Gold Star Wives (GSW) Committee on Legislation. I am also
currently President of the Potomac Area Chapter. In the past, I have
held the positions of National President and Chair, Board of Directors
for GSW. For many years now I have been working to achieve the overall
goals of the Gold Star Wives, and more specifically to assist our
young, new widows, one by one, wind their way through the maze that
lies before them with first notification of the death of their loved
one.
The Gold Star Wives of America, Inc. was founded in 1945 and is a
Congressionally chartered service organization comprised of surviving
spouses of military servicemembers who died while on active duty or as
a result of a service-connected disability. We could begin with no
better advocate than Mrs. Eleanor Roosevelt, newly widowed, who helped
make GSW a truly national organization. Mrs. Roosevelt was an original
signer of our Certificate of Incorporation as a member of the Board of
Directors. Many of our current membership of over 10,000 are the widows
of servicemembers who were killed in combat during World War II, the
Korean War, the Vietnam War and the more recent wars including the one
we are currently in, the Global War on Terrorism (GWOT).
In my testimony I will respond to your request for our legislative
views on the past year, an assessment of the present, and a look ahead
into 2008. In doing so, I will present to you the collective goals of
the Gold Star Wives with the hopes that they will alert you to certain
discrepancies and inefficiencies that you may be able to alleviate in
your deliberations this year.
I do want to thank the Members of this Committee and the staff for
your continued support of programs that directly support the well-being
of our servicemembers' widows and their families. It is imperative that
the difficulty of the sacrifice of our husbands' lives should not be
compounded by lack of information, confusing information and sometimes
even erroneous information that prevent our widows from accessing the
assistance she needs to begin the rest of her life without that core
person who had been her most critical support.
Too often, we feel that survivors--widows and orphans if you will--
are overlooked, though they shouldn't be. A couple of years ago, I took
a snapshot of the VA's Mission Statement that's on the VA building--its
Lincoln's statement: ``To care for him who shall have borne the battle
and for his widow, and his orphan.'' Last month, I attended the VA's
budget briefing. I was glad to hear them say, that they convinced OMB
and got the budget increase requested for 2007. What bothered me is
that nowhere in the briefing handout did the words ``survivors or
widows and orphans'' appear. We seem to get lost in the shuffle--we
hope that these oversights will be corrected and we are not forgotten.
the challenge
We are unmistakably in a time of war. Warriors are dying and
leaving behind young families. If there is one message I could leave
you with today it is that there is never enough good communication. The
Casualty Assistance Calls Officers (CACOs) have a difficult mission in
a difficult time. They act to assist survivors from the death
notification to assistance with coordinating funeral arrangements to
applying for benefits and entitlements. They do a valiant job but CACOs
are not trained to be the subject matter expert for the benefits and
entitlements managed by the VA or the DOD.
Our widows need our help. We need to identify and reach out to
them. In addition, we must coordinate with our counterparts in other
agencies to ensure that the message given is thorough and consistent as
they transition to their lives made forever different by the loss of a
loved one.
Gold Star Wives sponsors a chat room for new widows following 9/11.
New widows join this chat room and ask questions about benefits. One
recent example concerns a remarried widow with two children. She was
told by her assigned Casualty Assistance Officer that upon her
remarriage, her children are no longer covered by the Survivor Benefit
Plan (SBP), but she couldn't understand why and asked that question in
the chat room. I sent her question to Mr. Brad Snyder, Armed Forces
Services Corporation and to Mr. Mark Ward, Department of Defense (DOD).
Mr. Snyder and Mr. Ward both agreed that the remarried widow's children
are indeed eligible for SBP. They instructed her to contact the
Headquarters Casualty Assistance Office to get her records corrected
and have her two children receive the SBP until age 22 if in college.
This is an example of wrong information provided by the assigned CAO.
Just imagine if she didn't question the reason why, her children would
not have received their rightful SBP benefit throughout their childhood
years.
We need to examine the coordination process between agencies more
closely and work hard to prevent these widows and their children from
encountering gaps in identifying benefits.
government initiatives
The Departments of Veterans Affairs (VA) and Defense (DOD),
including the Military Services, have several on-going programs which
merit attention as critical facets in serving widows in this most
difficult time of their lives. These organizations together have
cohosted meetings that focus on improving outreach to surviving family
members. VA in collaboration with DOD and the Social Security
Administration has created a Survivors Web Site that offers
communication channels for all services widows and widowers who are
entitled to and need to continue their daily living. Often widows do
not even know where to turn simply to identify their benefits. We
participate in this outreach and applaud these efforts. To enhance
these efforts, GSW asks your serious consideration of creating an
oversight office for survivors across the VA and DOD to assure improved
delivery of benefit information and benefits to survivors.
bridging the gaps
Getting the right information to the right people at the right time
is important. Getting the right benefit is important as well. There are
gaps in the benefit for survivors that we have called for corrective
action on over time. Most will not be new to you. It is time to act.
1. Despite valiant efforts over the past year, the dollar for
dollar offset of Survivor Benefit Plan (SBP) annuity payments by
benefits from the VA's Dependency and Indemnity Compensation program
was NOT eliminated. The SBP was meant to provide income protection for
survivors. This income is not protected when the DIC benefit offsets
the SBP income to which a survivor is entitled, sometimes eliminating
the entire SBP. To illustrate the bad publicity that this issue is
getting, the NY Times Op Ed published an article by Attorney Dan Shea
on February 13, 2006 in which he wrote: ``My brother LTC Kevin Shea was
killed by a rocket attack in Falluja on Sept. 14, 2004. He knew the
risks when he joined the Marine Corps in 1989. But he also thought that
if anything ever happened to him, the United States government would
take care of his wife Amy and his two children. Sadly, that's not the
case.'' Dan Shea went on to describe the problem which prevents his
brother's wife to receive both SBP and DIC without offset. We recognize
you must act with your colleagues on the Committee on Armed Services on
this issue. We thank Senator Bill Nelson for introducing S. 185 and
encourage Congress to provide this real relief for our military
surviving spouses now.
2. The law currently allows for surviving spouses who remarry after
age 57 to retain their VA DIC survivor benefit. For those who remarried
before that law was enacted, there was a 1-year period to apply for
reinstatement. Communication in the form of outreach was lacking during
the retroactive period. We recommend that two equitable changes to the
law are made:
a. allow survivors to retain DIC on remarriage at age 55 in order
to bring this benefit in line with rules for SBP and other Federal
survivor programs; and
b. open up the reinstatement period with renewed outreach efforts
to make survivors aware of their eligibility.
3. There are inequities among several payments for the child
survivor that need immediate attention. The SBP child option applies
now only to survivors of deaths after November 24, 2003. We seek this
benefit to be linked to October 7, 2001, the beginning of the Global
War on Terror as are other survivor benefits. Similarly, the additional
monthly $250 child DIC payment per family only applies to survivors of
deaths after January 1, 2005. This too should be linked to October 7,
2001. It makes no sense that the survivors of those who died ``first''
should be prohibited from accessing a benefit given to survivors of
those who died later in the same war. There's another grievous
oversight concerning the $250 child DIC. The program evaluation of
benefits study recommended that surviving spouses with dependent
children receive the $250 for FIVE years instead of TWO years this is
currently provided and that amount should be indexed for inflation, to
avoid a devaluation of the benefit. Unfortunately, those
recommendations were ignored. I want to note that the $250 child DIC is
the only DIC benefit that doesn't receive the Cost of Living Adjustment
(COLA). However, we wish to thank those of you who tried to include a
COLA in legislation for the $250 child DIC.
4. CHAMPVA, the Civilian Health and Medical Program of the
Department of Veterans' Affairs, currently does not carry with it a
dental plan. In order to increase beneficiaries' access to dental care
at a reasonable cost, GSW seeks for widows and all CHAMPVA
beneficiaries the ability to purchase a voluntary dental insurance
plan. We are in agreement that the model of the TRICARE program for
military service retirees for dental care in which the payment of
premiums or services is completely funded by the enrollee is an
acceptable model. Beneficiaries are simply looking for affordable
dental care, which can be accomplished through a group plan. Allowing
for assignment of VA benefits to cover the cost of dental insurance
premiums would be an additional benefit to ease the payment process.
This would require a modification to Title 38, Chapter 53.
5. We would like to begin the process of reviewing how the DIC rate
is established, which is currently a flat rate of $1,033. The SBP is
calculated at 55 percent of retired pay, as if the member had retired
for total disability on the date of death. We recommend that the DIC be
calculated in a similar manner at 55 percent of the disabled veterans
100 percent disability compensation amount. We recognize there are
complexities in this depending on rank of the deceased and on date of
death, but we do believe this would help alleviate growing financial
difficulties of widows from wars prior to this conflict who are
receiving only DIC. We would welcome the opportunity to work with the
committee in determining how to implement these changes, which will
provide more equitable compensation to our survivors.
Finally, there are three other issues that we want to bring to your
attention:
1. Widows whose husband died in VA hospitals due to wrongful VA
hospital care receive only DIC without any other VA benefits (Title 38
USC 1151). We urge the Committee to support the measures necessary to
allow these widows to be entitled to the CHAMPVA benefit also. These
wrongful deaths are not much different than those killed by friendly
fire.
2. We recommend that the Committee ensure that medical benefits be
provided fairly and equitably include surviving spouses and eligible
children (i.e., seek legislation to remove Part B penalties and
interest for late enrollment and promote a feasibility study to convert
VA facilities to Long Term Care facilities which would welcome widows/
widowers).
3. Education benefits for surviving spouses who are on active duty
should be able to use the education benefit derived from her deceased
husband while still serving on active duty. Currently, the active duty
widow must resign from the military in order to use the derived
educational benefit. GSWs urge this Committee to review and change this
law.
conclusion
In conclusion, we do not want our widows to be forgotten whether
they are experiencing their losses in the Global War on Terror over the
past 5 years or whether they are members of the so-called Greatest
Generation and experienced their loss many years ago during World War
II. Whenever the ultimate sacrifice is given, there is family left
behind. In the same way we have asked some to give their lives, we have
also asked some to continue their lives with a chasm so large it is
difficult to transgress. Let us show the spirit of this Nation by not
forgetting these widows, whose numbers grow daily.
I thank this Committee for using this hearing as one more avenue of
awareness and education and for giving me an opportunity to share my
thoughts and the goals of the Gold Star Wives. We will be happy to work
with the committee on any of these initiatives. Thank you.
Chairman Craig. Rose, thank you very much, and again, to
all of you, thank you very much for your time here and your
testimony.
Before I run by a couple of questions--and I will offer
some of them in kind of a generic way that you may all wish to
respond to--it is fresh in my mind that you, Rose, had
mentioned, if you will, the charge of the VA.
I just finished a book in which Lincoln at that time in his
life and on through to his assassination--well, I should say
the book dealt with just that period. It is called ``Manhunt.''
I recommend it to all of you. It is a very good book, but what
is coincidentally unique, that speech in which that statement
is embodied was his second inaugural speech delivered on March
4, 1865. Today is March 2, so on Saturday, 141 years ago--I
think, if my math is correct--and from that point forward, we
have used that thought to remind ourselves of our
responsibility as a Nation, appropriately so and I think
necessary. I ran right into it again as I started this book,
because that is about when the book starts, during that period
from the second inaugural speech on to the collapse of the
confederate capital in Richmond and then on down the road to
his assassination and the 12 days in the effort to capture John
Wilkes Booth. I highly recommend it, a good book to read,
fascinating history.
My question to all of you, because you have all spoken to
it, as have I, is the challenge we have in front of us today--
and it is not going to go away, it is going to continually
increase--is if we do not use the President's proposal or VA's
proposal and find no alternative source of revenue--and you
have said it--we are looking at approximately for this budget
about a $795 million shortfall. I don't believe any VSO today
has come out in favor of this proposal, and I understand that,
and I understand the tough choices that are involved in here.
So my challenge to you is, if not this, then what? I am not
going to put this Congress through another emergency funding
device and just stack it onto the deficit. I don't think that
is responsible for anyone, including the VA.
The Chairman of the Budget Committee and I have had some
talks with implementation already. He is very frustrated by
this, as is Senator Hutchison, the Chair of the Appropriating
Committee, because the Budget Committee is just beginning to
sit down to put all of this together and to make the 302(b)
allocations which must adhere to the budget framework.
It is a tremendous challenge for all of us. There is no
question about it. As I mentioned, we are looking at a VA
budget that is nearly doubling now every 6 years. Good health
and all of that says that.
I chair a VA Committee in which we will look at our first
$100 billion budget in a relatively short time. We are almost
on the threshold of that now, looking at the multiplier of just
what is in the President's budget of about 11.3 percent as it
relates to health care.
Visit with me, and I mean it just that way. Visit with me
about what we do. Back when we reformed this program in the
1990s, almost every organization out there said, ``No. The 7s
and 8s certainly can afford to pay something to gain access.''
It was reasonable. It was appropriate.
Now, back in 1996 and 1997, we all know that VA health care
was maybe not the health care of first choice for a lot of
veterans it is today. We have improved it dramatically. We all
know that. It has been written up and recognized nationwide as
one of the top health care providers in the Nation today.
Obviously, that sends a signal out to all, here is a program
that you can qualify for if you are a veteran.
For those that are not disabled, for those that are not
service-connected, I understand the minimum income level. Maybe
that is an adjustable proposition, but I would find it very
difficult for someone out there who meets all of the
qualifications, who has health care now--90-some percent of
those in the 7s and 8s have health care now, access to
insurance all of that--for $21 a month, to deny what they have
got, to come to what they can get.
I am not sure that is good policy if we don't recognize all
of the capability of our health care delivery system and the
private and the public and work to resolve that because the
true commitment we have, in my opinion, is truly to the
disabled and the needy, and that has to have a priority in it
that we just simply cannot deny.
You have all described--and I have been there. I have seen
it. I am spending time with these young men and women coming
out of Iraq and Afghanistan, and they are unique, unique in
spirit, but also unique in injury because of our phenomenal
capabilities in the field today and our immediate response to
delivering that.
I flew out of Baghdad to Landstuhl, Germany, and I was
walking through the hospital corridors, and the director of the
hospital said to me, ``Those who we will treat this evening
have not yet been injured,'' and I am in Germany, not Iraq. I
found that statement that has stuck in my mind--because never
have we applied that capability before, but we are today, and
there they are, out at Bethesda and Walter Reed and other
places across the country. They are surviving, and they are
going to be, in time, productive citizens in most instances.
Some will not be, and we have phenomenal obligations to them.
Well, I have gone on long enough. Visit with me, if you
would. I cannot, in a fiscally responsible way, turn my back on
the need to look for alternative revenue measures in the
totality of the VA budget.
Deirdre.
Ms. Parke Holleman. Mr. Chairman, Mr. Barnes did--I wasn't
here when the changes--the creation of 7s and 8s, occurred. I
was here, however, when there was a large push to have Medicare
subvention----
Chairman Craig. Yes.
Ms. Parke Holleman [continuing].--both on the DOD and the
VA side, and it sort of frittered away.
As Mr. Barnes said, these are people who have paid into
Medicare. The Medicare budget is getting--and I know it is
perhaps undiplomatic--a break on the cost there with what is
being covered by the VA. A subvention of VA, subvention of
Medicare to the VA budget, I think would go a long way, since
so many of the 7s and 8s are over 65 at this point, to paying
for that. I know that would be a huge war because people
protect their own budgets. I do understand the difficulties,
Lord knows, in dealing with this, but I do think that would be
an appropriate thing.
And I did say, as you said, with the 90 percent of these
folk having OHI, having other health care, they will be the
people who do have the health care. A greater effectiveness in
collecting from the private sector for the care, that is being
provided, just as they would collect from another hospital. It
would be totally appropriate.
I would add something that has nothing to do with it. I
haven't gone to read ``Manhunt'' yet, but I understand Harrison
Ford bought it to star in it. So, presumably, we will all see
it pretty soon.
Mr. Barnes. Mr. Chairman.
Chairman Craig. I think you are right. I don't think he is
going to be John Wilkes Booth, though.
Ms. Parke Holleman. No.
Chairman Craig. Yes, Joe.
Mr. Barnes. Mr. Chairman, I appreciate the challenge here
as do our members. A couple of observations about the
perception of priorities with regard to the entire budget
process. With regard to funding veterans' programs, our members
question this in a time of incredible amounts of money being
allocated for earmarks in the appropriations process. They look
at this from outside--obviously, we are very involved in this
process--and bring their concerns forward, but their perception
is about the priorities--and this is very much the case on the
active-duty side with regard to TRICARE--and the proposed fees
that are being--and were referenced by, I believe, Deirdre in
her presentation. This is something that we are looking at very
closely and we are very concerned about with regard to TRICARE,
the amount of the GDP that is being allocated for Defense and,
by association, Veterans Affairs is lower proportionately than
it has been historically, particularly during times of war.
There is discussion that if TRICARE--if retirees pay a fee
for TRICARE Prime, which they do now, 230/460, which is related
to the fee proposals on the DOD side, that by association the
Priority 7s and 8s should also pay a fee, and I understand the
rationale for that.
However, there is a significant difference with regard to
access standards. Military retirees in TRICARE by paying that
fee have access, guaranteed access, to care. Whereas, if these
fees were authorized and implemented in the Department of
Veterans Affairs, these veterans would go on a long waiting
list, and there is a significant difference with regard to the
TRICARE fees.
I will echo again may comments about Medicare subvention.
Our membership is perplexed that this is not being looked at or
that it is not possible. It is an issue that was addressed in
the Presidential Task Force, which I am sure you are familiar
with. I draw attention, perhaps renewed attention, to the
recommendations that are there with regard to seamless
transition, working smarter with the Department of Veterans
Affairs health care program and DOD.
There are authorizations, programs that have been
authorized since I believe the early 1980s that have been
really slow to be implemented. There are opportunities for cost
savings, but I appreciate your concern and the challenge here,
as do our membership. Hopefully, that sheds a little
perspective from our members.
Chairman Craig. Surely.
Mr. Brown. Thank you again, Mr. Chairman, for I guess the
additional opportunity to speak.
First and foremost, ditto on the comments of my two
colleagues here, and since you suggested looking within the
entire VA budget for potential funding resources, I would like
to take a moment first to begin with my own personal situation
because I am a disabled veteran.
You hear the VA, and I know the Administration routinely
used the word as it relates to the VA, ``management
efficiencies,'' improving management efficiencies. I would
suggest that the Committee take a hard look at either policy or
legislation to induce a change in behavior in the way that VA
applies some of their management principles.
As in my own situation, I retired from the military. I was
facing the possibility of actually a third medical evaluation
board. I have severe damage to my spine, relatively minor
spinal cord injury and a lot of damage to my joints. So,
essentially, I guess you could say my practical use toward the
active-duty service--I was deemed used up and they suggested I
retire.
At my retirement physical, I went through an MRI. I had to
go back to see the neurologist. I saw the neurosurgeon. I saw
the orthopedic surgeon, the rheumatologist. I was poked and
prodded by just about every specialist that you could possibly
think of. They did an outstanding job for me in preparing my
package and sent me on my way, and in turn, I turned that
information over to the VA.
About 6 months after I retired, the VA turned around and
called me in, did another MRI, sent me to the same specialist
and whatnot, presumably to establish service connection,
despite the fact my medical records are actually about that
thick and my condition is very well documented for about the
past 14 years.
My point here is this is a VA policy that they do this, and
as part of the seamless transition process, if we could just
get the VA to rely on the diagnosis and the establishment of
service connection made by the DOD, we are not talking millions
here. We are talking probably billions could be saved by that,
by that change in focus alone.
The second one is when I was called up to the VA, I came
home. It was like 8, 9 at night, and I had a message on my
answering machine at home saying this is a reminder about your
appointment tomorrow. Nobody sent me a letter. Nobody called
me.
When I called the VA that following morning, come to find
out, I had had an appointment the day prior that they failed to
notify me, and I am told that this is a routine process in
talking to a lot of our members. There are lots of instances
where patients are scheduled for appointments. I am assuming
the doctor is sitting there waiting. Yet, they haven't notified
the patient to make sure that they are there.
Likewise, depending on the situation, when the VA calls you
to the facility to do like an evaluation or a CMP exam, they
are required to reimburse the individual, and in my case, I was
called to the VA facility up here on Irving Street one time--I
wasn't even aware of the reimbursement part--and the doctors
weren't there. They had canceled the appointment, but they are
still required to reimburse me. So there again, a change in
those two policies would save some additional money.
The last one would be in regard to the Priority Group 7 and
8 folks, the ones that are currently in the system right now.
VA at one time I know had a policy where if you were waiting
for an appointment over 30 days, then you could have a
prescription written by a civilian provider. They would fill
that prescription. I might suggest that maybe we need to look
at lowering that time frame because the reality of it is a lot
of them are not going to be seen within 30 days, and even if
they are, it is at the 29th day just to meet the bare minimum.
If that is the only thing that they are going to use the VA
for, why would we bring them in and have them come and see a
doctor for an issue that we already know that they are required
to receive medication for?
Again, Mr. Chairman, that is just three thoughts, and
hopefully, that will help.
Chairman Craig. I appreciate that.
Mr. Norton. If I could just add a couple of brief comments,
Mr. Chairman, I would like to second what my colleagues have
said about VA Medicare subvention.
As you probably know, a couple of years ago, the VA
conducted an internal study of veterans enrolled in Priority 7
and 8 who are Medicare-eligible. They found in this study that
in order to access VA health care, they have to go through the
procedures, the tests, the screenings, blood tests and so forth
in order to get access to prescriptions.
At the same time, they are using Medicare on the outside
and obtaining those services. So the reality is that in many
cases for Medicare-eligible veterans enrolled in 7 and 8, the
Government is paying twice for the same services. The VA
demonstrated this in its internal study.
The second point I would make is that I believe in this
room a couple of years ago, your predecessor, Senator Specter,
said that at the time--and I believe the Senate ultimately
passed a VA Medicare subvention test. What Senator Specter said
at the time--and I remember it so clearly--was that he hoped
that a test would demonstrate the potential of a win-win-win
situation, a win for veterans certainly, the pre-eminent
objective, a win for the Government overall, and a win for the
VA health care system.
So, if overall VA Medicare subvention is beyond the realm
of the possible right now, certainly the idea of a test in 10
facilities, which has already once passed the Senate and it has
passed the House on a number of occasions, but never in both
chambers in the same session, we believe that would be a way to
get at this issue.
Finally, I would reinforce the point that Morgan Brown made
about cost efficiencies and cost savings. As you well know, the
GAO just came out with a report fairly criticizing the VA for a
lot of smoke and mirrors about how it calculates cost savings
and cost efficiencies. I think all of us here feel that there
is a lot of lack of credibility in terms of the VA numbers. We
would hope that the Committee would frankly get on top of the
VA to be rigorous in terms of finding out where are the real
numbers here, and what are we really talking about in terms of
the actual cost of operating the system. Then from there,
debate can begin about how we can go forward to cost out this
situation and meet the very critical challenge that you so
articulately laid out for us.
Chairman Craig. Thank you.
Yes, Rose, please.
Ms. Lee. Mr. Chairman, I want to tell you a little bit
about something that I experienced quite a number of years ago.
I was at a VA budget hearing in the early 1990s, and I was
there just listening. All of a sudden, I heard that a
particular benefit for widows was being eliminated. The reason
it was being eliminated was because it has the least number of
people affected and they were going to save money by just
wiping out that one benefit on these widows. I think that is
really unfair.
In fact, as I talk with many of our widows, they agree with
me. They say, ``Because we are the smallest group that is in
this budget, why shouldn't they keep it instead?'' That is what
I think we should do. When there is anything that has to be
cut, they shouldn't have to cut the widows.
Chairman Craig. I am not disagreeing with you at all, Rose.
Ms. Lee. Thank you.
Chairman Craig. Deirdre.
Ms. Parke Holleman. I just can't contain myself. I was the
care-giver where Morgan is entering his phase of dealing with
disability. My husband and these ladies' husbands were 100-
percent disabled, and we were their care-givers. That means
managing their care and paying the bills and all that.
So my passion and real concern is those that are coming
back that are young and returning from this war, in 29 months
they will be Medicare-eligible, and then the financial
incentive for the VA and the military treatment facility to
treat the most expensive, the catastrophically ill, is not
there. It is real easy to do this subtlely by--just
appointments are difficult. These cases need more time and
energy and skill, and so my husband, 100 percent disabled,
never was able to access care in a VA.
They did provide him with a battery-powered scooter with
very little difficulty at all, but his access to care even got
down to being when he refused to use the wheelchair where we
could go to local doctor for cold and things where he could
walk into the office, you know, with some ease.
So I don't pretend to know what your answer is, but I am
aware, since I belong to a couple of these associations, that
most of their membership is older, and I am really concerned
that we are not even telling our young people, while the
attitude is we don't worry about it, you are here at X-military
facility, and we are really going to take care of you.
I would also like to point out there is supplemental
insurance, to the best of my knowledge. While the supplemental
insurance policies for Medicare are required at age 65 without
pre-existing conditions that you can enroll, there is no law
for those under 65 to be included in supplemental insurance
without pre-existing conditions. So some of them maybe can
speak more to that, but I just didn't want to see the
youngsters left out.
Chairman Craig. Well, thank you for those thoughtful
comments. You all know the system very well, and many of you
have been in it or accessed it. I think those are extremely
valuable comments as we work our way through this.
Let me recognize one of my colleagues that has joined us,
Senator John Thune.
John, do you have any opening comments you would like to
make or questions you would like to ask of this group?
STATEMENT OF HON. JOHN THUNE,
U.S. SENATOR FROM SOUTH DAKOTA
Senator Thune. Thank you, Mr. Chairman, and let me express
my appreciation to you for holding this hearing to give our
veterans service organizations an opportunity to weigh in on
their legislative priorities before the Senate for this year
and also to welcome the leaders of those service organizations
and express my deepest appreciation to you for your very
distinguished service to our country.
As I have noted before, budgets are indicative of where a
nation places its priorities, and clearly, veterans funding is
a high priority for this Committee, for the Congress. I think
in this budget request, it is one of the few areas of the
budget that has been proposed to receive a generous increase in
funding.
I know there are organizations who have testified that it
is still not sufficient to the need. Certainly, as we work
through the budget and appropriations process up here, we will
be listening closely to the input that we receive from your
organizations and look forward to working through that process.
Again, I want to just say thank you for your testimony
today and for the record that you help us build in giving us
some insights about what you believe are the highest needs.
I have a couple of questions actually. Maybe I will submit
one for the record because I can't probably get them all
answered right now, but I do have one in particular I would
like to raise with all of you because it is something that we
hear about.
One of the problems that veterans have expressed to me is
the laborious process of having to reconcile their military
records with their VA medical records, and these are some cases
for veterans who are affected by illnesses or injuries several
years after their service, being able to prove that their
injury is, in fact, service-connected. And I see it evidently
that some of you had mentioned that in your testimony, and I
guess what I would like to know is what steps need to be taken
to make sure that the Department of Veterans Affairs and the
Department of Defense can have seamless access to the
servicemembers' records, and how would you suggest that we
alter the President's budget to combat that problem. Also, a
follow-up question to that, do you think that the Independent
Budget fairly addresses that issue?
Mr. Barnes. If I may.
Chairman Craig. Joe.
Senator Thune. Go ahead.
Mr. Norton. Thank you, Senator. I think it is a very
important question.
From our perspective, the objective that you talk about, I
think, can be achieved by the development of what we call a
single separation physical, a common platform for capturing
information on servicemembers while they are on active duty.
We believe that a separation physical can and should be
designed that would address both VA protocols, as well as
essential military medical management requirements.
It is really amazing that when these young men and women
come home, many of them wounded, they arrive at Walter Reed and
Bethesda. There is no common physical even between Walter Reed
and Bethesda, and as a result, problems accrue years later.
That accrual really comes home in terms of the growing
complexity of the VA disability system.
So there are tremendous long-term benefits about getting
seamless transition right up front. We think this is a major
priority, especially during this time of war, and coupled with
the development of a single separation physical, we believe
more needs to be done to deliver benefits at discharge, the BDD
program, Benefits Delivery at Discharge.
There are about 137 military separation transfer points
throughout the world where VA people are located and where
servicemembers can apply and actually get their rating before
they even separate. Getting this right up front, not only is
good for servicemembers and veterans, but potentially
downstream, it saves the Government a lot of money because you
have the clear evidentiary documentation for what ailments
occurred to them while they served their country.
So your leadership on this and that of the Committee would
be extremely important in pressing DOD and VA to get together
and get this thing done for the benefit of our serving men and
women.
Mr. Barnes. Senator, I would just add to Colonel Norton's
comments that on the DOD side, there is a project called the
ALTA project which addresses this. We have been tracking this
very, very closely. This was briefed at the recent TRICARE
conference, and I would, as I said, echo his comments.
The administrative challenge between the two Departments,
while on the face of it, looks like that would be fairly
simple, it is very, very complex. We appreciate your attention
to that and encourage resourcing and questioning the respective
Departments as opportunities allow as to how to enhance that.
I can tell you firsthand from some of our members and some
of the stories we hear--I think we have an example in our
statement about individuals coming back from the war and what
they have encountered--and I know that has been documented not
just here, but in various, local newspapers, local members that
have gone to serve and have come back, and they have had
significant problems, as have, in the case if they expired,
their widows with regard to benefits.
Senator Thune. Thank you all very much. I appreciate your
answers and again your testimony, and we look forward to
working with all of you to make sure that we are doing the
appropriate things and the right things to ensure that our
veterans get all the benefits, receive all the benefits that
they deserve.
Certainly, this Committee is intensely interested, as I
think the Chairman demonstrated last year as we went through
the budget process, in making sure that the VA is appropriately
funded to meet the need that is out there. So thank you very
much for your testimony.
Mr. Chairman, I yield back.
Chairman Craig. John, thank you very much.
Let me ask this. Several of you have mentioned this, and I
think you did, Colonel, the Montgomery GI bill and the
character of how we are using the Guard and Reserve today and
the change there that is upon us.
As was mentioned, 500 folks from Idaho, at one time a year
ago this time, we had the second largest contingency of Guard
and Reserve on a per-capita basis of any State in the United
States in Iraq out of Idaho--and Afghanistan. There is no
question, the character of how we look at the Guard may well be
changing.
Vice Chief Cody, General Cody, is talking about a
substantial realignment of forces in relation to that. I had
lunch with him recently, and he is saying that at a minimum of
every 6 years, Guard and Reserve will go active. Of course,
that is a significant change from our historic perception of
the Guard and Reserve and our reflection of them within policy.
So you are right to ask the question and to challenge us to
review that in relation to the commitment and what the
Montgomery bill does for them because it is a phenomenal asset.
Now that they have served--and, in this instance, they were
active. The 116th from Idaho was active for a period of, I
think, 13 months and, of course, served in a foreign theater.
They qualify, and yet you are right it extinguishes. That
particular benefit does. I am going to be taking a look at
that, to spread that out over what the new policy is, see how
it fits, see what the realities of that are. It is an expensive
item, but it is also a tremendously valuable asset, these young
men and women who might find themselves finally at that point
in their lives when they want to look at higher education for
helping them out.
Let me ask this question of you. I think I know what the
answer is. I was amazed at an editorial published in The
Washington Post last month which posed this question, and this
is in relation to the current law that a veteran is not
permitted to hire an attorney to assist in filing a claim for
VA benefits.
The quote was: ``If American soldiers are mature and
responsible enough to choose to risk their lives for their
country, shouldn't they be considered competent enough to hire
a lawyer?'' Does anyone want to react to that rather astute
observation on the part of The Washington Post?
Ms. Parke Holleman. Well, as a lawyer, I always think we
are of use.
I think it would help a great deal of the repetitive nature
of the filings that we have. So many people are not going to a
veterans service offices. Some of the large groups have
wonderful veterans services offices who, I am unhappy to
concede, I am sure do it just as well as we do.
However, the huge percentage are representing themselves.
They are going pro se, and they don't plead right. The aid is
not, you know, the help, as good as it may be when the VA is
not successful. So there are filings after filings after
filings, and when you are talking about the backlog and an
efficient professional filing of an appeal might help
enormously not just for that person, the strain, it is hard for
lawyers to remember how exhausting a lawsuit or filings or
waiting for something to happen are to people. It upsets them
enormously. So the pending matter is not just difficult to the
VA, but it is difficult to the individual.
Certainly, that was a long time ago. I don't find any logic
to it except history anymore that has barred that. I would
think it would be a fine idea.
Chairman Craig. Any disagreement with that statement?
All right. Let me ask one last question because several of
you have broached it, and probably what I am going to ask you
to do is keep your eyes on it, and we will watch it and monitor
it and see where we can nudge it along and insist that it get
better from the physicals you talk about, the development of
medical records. What I am talking about is the issue of smooth
transition or seamless transition from servicemembers to
veterans' status.
I agree with those of you who have spoken to it. The
Committee shares your goals for this seamless transition. It
sounds awfully good, but the test is how it works obviously and
the smoothness with which it works and hopefully the efficiency
that it produces and the ability to connect together medical
records and all of those things electronically.
I know that work is underway on that. We are going to watch
it and monitor it very closely. As reports come in to all of
you, let us know about them, because we are going to stay on
top of it. This is a modern sophisticated world out there, and
if we can't get it right just simply because that isn't the way
it was done in the past, shame on us.
Talking about the issue is one thing. Doing it is another,
and monitoring it and staying on top of it and maybe causing
DOD and VA to think out of the box is at best a challenge, but
certainly one that we can tackle.
Anyway, beyond what you have said, any other
recommendations in that particular area?
Yes, Rose.
Ms. Lee. Mr. Chairman, there are three issues that I didn't
cover in my oral statement, but some of it I think overlaps.
Well, it all concerns bucks, money.
Chairman Craig. Sure.
Ms. Lee. May I just list them off, please? We have a couple
of widows that have been contacting me for quite sometime now,
widows whose husbands die in a VA hospital, and their deaths
were malpractice deaths. So they are given DIC, but no other VA
benefit.
The widows who have contacted me are requesting at least
CHAMPVA as a benefit, in addition to just the DIC, and to us,
we think it is similar to a wrongful death, killed by friendly
fire. That is how we look at it.
Then the other issue would be, we recommend that the
Committee ensure that medical benefits be provided fairly and
equitably, and that would include surviving spouses and
eligible children. In other words, to seek legislation to
remove Part B penalties and interest for late enrollment, and
promote a feasibility study to convert VA facilities to long-
term care facilities, which would welcome widows and widowers.
The third one--and this is becoming very common from our
experience on the chatroom--we have young widows who are on
active duty themselves, and they are having difficulty with the
education benefit. They are not able to use their derived
education--derived from their deceased military husband's
education benefit while they are on active duty. They have to
resign from the military service in order to use it, and these
young ladies are also feeling this is terribly unfair. So that
is another big issue that has come up, and it is really
becoming quite common to have young widows who are still on
active duty. There are other problems in that area, but this is
one that has come to our attention over the past several
months.
Chairman Craig. Thank you.
Ms. Lee. Yes, sir.
Chairman Craig. We will take a look at that.
Ms. Lee. Thank you.
Mr. Barnes. Mr. Chairman.
Chairman Craig. Yes, Joe.
Mr. Barnes. If I could just respond and reiterate a point I
was attempting to make in my oral statement. The final report
of the Presidential Task Force to Improve Health Care Delivery
for our Nation's Veterans, I believe that was June 2003. It has
a number of recommendations in there.
Chairman Craig. Yes.
Mr. Barnes. Something that has not been brought up is where
we are heading with the CARES initiative, BRAC actions, and
DOD's re-basing initiatives, which are really significant and
have major impact on personnel and many of the issues we are
talking about today. So I just wanted to make that point.
Chairman Craig. Yes. The point is well made. We have plenty
of work to get done in this Committee. That is very true.
Yes, Morgan.
Mr. Brown. Yes. I would just say, Mr. Chairman, if you
don't mind, I will swing back to the seamless transition issue
real quick.
Chairman Craig. All right. Please do.
Mr. Brown. I honestly believe you really hit the nail on
the head as far as the Committee is going to need to, I guess
you could say, exercise a very deliberate oversight between the
DOD and the VA on this.
The first time I heard about the seamless medical record or
the medical record that would track me and my care in DOD, and
then in turn be used by the VA, was 25 years ago when it went
through the processing station at Lackland. Admittedly, at this
time, I am not even sure we had computers in the military back
then, but as the GAO indicated in a fairly recent study within
the past couple of years, the technology exists. The potential
for savings is tremendous, and I would certainly hope that the
Committee will do everything in its power to make sure that
that happens, as I am sure we will.
Chairman Craig. Thank you.
Well, to all of you again, thank you very much. I don't
even have to ask you to stay tuned. I know you will as we work
our way through these issues. We are a phone call away or a few
steps down a hallway, but as all develops, please work with us
to see where we get. As I say, we are looking at some of the
challenges we will tackle this year beyond the budget. We will
spend the next month probably resolving the budget issues
before we get on with some of these oversight issues, but we
will certainly stay very active and tackle them. There is a
great deal of work to be done out there.
Mr. Barnes. Thank you.
Ms. Parke Holleman. Thank you, Mr. Chairman.
Ms. Lee. Thank you.
Mr. Brown. Thank you, Mr. Chairman.
Mr. Norton. Thank you.
Chairman Craig. Thank you all very much. The Committee will
stand adjourned.
[Whereupon, at 11:30 a.m., the Committee was adjourned.]