Sunday, March 09, 2014

Congress and Veterans

congress



Dona: Last Thursday, the House Veterans Affairs Committee and the Senate Veterans Affairs Committee held a hearing on veterans issues and C.I. covered it in that day's "Iraq Snapshot."  The day before, Wednesday, the two committees heard a presentation from the VFW and the week before, Tuesday, February 25, the two committees held a joint-hearing where they heard from Disabled American Vets which C.I. reported on in that day's snapshot.  Along with C.I. of The Common Ills and The Third Estate Sunday Review, we've got Ava of  The Third Estate Sunday Review, Kat of Kat's Korner (of The Common Ills), and Wally of The Daily Jot who were also at the hearings.  Wally, tell me something about rural veterans that came up in the hearings, if it did, because I've had many e-mails about that.

Wally:  Sure.  There are rural veterans all over the country.  In a small state that might seem less of an issue -- less of an issue, but still one -- but in larger states, it's a huge issue.  Alaska is a big state.  Senator Mark Begich is one of Alaska's representatives and he brought up the VA's partnership with the Indian Health Services and how it was working and this was important because, otherwise, you're looking at many veterans having to come to Anchorage for health care which might cost them as much as "$2,000 air fare."

Dona: The partnership is in just Alaska?

Wally: In 2010, the Department of Veterans Affairs and Indian Health Services agreed on terms to help serve the Alaskan community. I'm not aware of one in another state.  The reality is that some senators attend these hearings and some don't, some who do use their limited time to explore other issues and may or may not get to the issue of rural veterans.  Senator Jon Tester, of Montana, is an example of someone who will always address the issues around rural veterans if he's at the hearing.  Because you mentioned ahead of time that this was a topic you were getting e-mails about, I pulled a press release from Senator Tom Udall's office.  He is a Senator out of New Mexico and I went with him because he's not on the Committee and I don't think we mention him.  Let me back up there for just a second.  I'm from Florida, if anyone from my state on either House or Senate Committee does something of value, I will find a way to note it.  This is from a Valentine's Day press release:


More than 6 million veterans, including a third of all Iraq and Afghanistan veterans, live in rural communities. But as many as half of those veterans may be going without care from the VA. Rural veterans too often struggle to access quality care because it isn't available locally. For some, traveling to and from an appointment can take all day. Veterans who can't drive must rely on neighbors or volunteers to get to appointments, and many simply go without adequate care.

Dona: Okay, so 6 million are rural veterans and that's also one-third of veterans of today's wars.  Conner e-mailed a question, "How many veterans of today's wars need health care?"

C.I.: That's not an easy answer.  I can give you a government figure.  For Fiscal Year 2013 -- which ended September 30, 2013 -- the VA's figures show that 965,000 Iraq War and Afghanistan War veterans have utilized the VA or one of its designated care givers.  So you can say "965,000," but you should really say "at least 965,000" if the issue is "need health care" and not just "used VA health care."  There are many who are using civilian providers and doing so for a number of reasons which can include MST -- Military Sexual Trauma -- or PTS -- Post-Traumatic Stress.  Equally true, since we're talking about rural veterans, a number may see a civilian provider of some form if they are rural veterans due to issues with travel and scheduling an appointment.  Scheduling an appointment is a problem rural veterans have been expressing for some time, the problems with that.  So at least 965,000 have sought treatment.

Dona: Thank you.  Our e-mail address is thethirdestatesundayreview@yahoo.com.  Wally?

Wally:  Alright, let me quote Udall from the press release,  "I've met with veterans across New Mexico, some of whom have to drive four hours or more to get to a VA hospital. Many rural veterans are also frustrated with the lack of health care options and the frequent turnover among staff at their local clinics. Rural veterans of Iraq and Afghanistan suffering from TBI and PTSD also often don't have adequate access to mental health care in their communities."  With Senator Dean Heller of Nevada, Udall has introduced the Rural Veterans Improvement Act.  The press release identifies the bill's four issues as:

*Enhancing mental health care options by allowing the Department of Veterans Affairs (VA) to work with nonVA mental health providers in rural communities.

*Building on the VA's transportation program to ensure more veterans living in rural areas have a way to get to doctors' appointments.
*Creating programs and incentives to attract and retain doctors and nurses to rural VA health care facilities.
*Requiring the VA to conduct a full assessment of its community-based outpatient clinics (CBOCs) to determine what improvements are needed and prioritize those projects.



Wally (Con't): The bill was introduced February 10th and its status is currently that it's been referred to the Senate Veterans Affairs Committee. Another veterans bill recently introduced was by Senator Tester and, from Kansas, Senator Pat Roberts.  Critical Access Hospitals currently have a rule that, within 96 hours of admission, their patients must either be discharged or transferred.   Their bill is called The Critical Access Hospital Relief Act.  This bill was introduced February 24th and its also still in Committee.  It's co-sponsors include Senators Tammy Baldwin, Al Franken, Susan Collins, Chuck Grassley, Deb Fischer, Mike Johanns, Amy Gkobuchar and Heidi Heitkamp.

Dona: Thank you, Wally.  Kat, can I get an overview from you?  Specifically, Wally's talking about proposed legislation and can you explain the hearings?

Kat:  Sure.  VSOs are Veterans Service Organizations.  C.I. and I were at the Veterans of Foreign Wars hearing last Wednesday -- Ava and Wally weren't able to make that one -- so I'll use that as an example.  As Wally pointed out, bills are referred to the Committee.  A veterans bill will be referred to the Committee -- if it's a House bill, to the House Committee, a Senate one to the Senate Committee.  The VFW provided testimony on Wednesday regarding the needs of veterans that they represent and how proposed bills could impact the veterans.  They basically, all the VSOs, argue to the two Committees about what will improve veterans' lives, what might harm them and which bills they have no opinion on.  And, yes, there are bills that VSOs will take no opinion on.


Dona: And I'm going to C.I.'s February 25th snapshot and Disabled Veterans of America's Joseph Johnston to ilustrate that:



Joseph Johnston: Members of these Committees, during last year's Veterans Day activities, I attended a ceremony commemorating the Traveling Vietnam Veterans Memorial Wall, a national tribute to Vietnam veterans who gave the ultimate sacrifice in that unpopular war, a war in which I and many members beside and behind me, in this historic room, served. When the ceremony ended and the crowd was dispersing, a woman from the audience approached me to say how grateful she and her husband were to DAV for our strong advocacy and unflagging efforts in helping to end the government shutdown mere days before VA ran out of funds to support the payment of disability compensation. She explained to me that she and her husband's only income due to his disability and her personal care giving of him is his monthly VA compensation. As the shutdown lingered day after day, she told me, with tears in her eyes, they had worried terribly that without that VA payment on November 1, they wouldn't be able to buy food, gas, or pay their rent. As National Commander of this tremendous organization, I was grateful to her for her kind words about DAV's effective advocacy, but it concerned me greatly that she and her husband were forced to go through such a terrible ordeal, given the sacrifice they had already made for this country. We should never again put a disabled veteran or his or her family in such a situation. This is why DAV's Operation: Keep the Promise intends to make advance appropriations for all VA funding accounts, including its mandatory disability payments to veterans, our highest legislative priority in 2014. Thousands of DAV members and supporters from all over this nation are sending social networking, email, and telephonic messages today to your offices and those of every Senator and House Member. Today, when you pick up and browse your Roll Call, POLITICO, National Journal Daily, or The Hill, you'll see our Operation: Keep the Promise message prominently displayed. DAV launched this one-day intense campaign because we are serious and dedicated to this goal, and I assure you this testimony will not be the last time you hear about this urgent need. This is not a partisan issue; not a Democratic or Republican issue; it’s a veteran issue, and as National Commander of DAV, I want all of you to join me and everyone else in this room, and our 1.4 million DAV and Auxiliary members, in making it your highest priority as well. If solving this particular problem for wounded, injured, and ill veterans is not a high priority for your Committees, Congress in general, and the Administration in this New Year, please tell me what is. Bills to make this a reality are pending in both Congressional chambers; DAV urges you to pass the Putting Veterans Funding First Act as a top priority for 2014.

Putting Veterans Funding First Act?  Here for S. 932 and here for HR 813.

Ranking Member Mike Michaud:  I want to thank you for your work of advocating in the passage and enactment of HR 813, the Putting Veterans Funding First Act.  We have seen how well advanced appropriation has worked for VA's medical care.  It is time that the rest of VA's discretionary budget  be treated the same way.  We owe it to America's veterans to provide certain and stable VA budget funding.


Dona:  That may be the only time we get to note that hearing.  Right now, let's go back to the VFW hearing, did they have anything on rural veterans that they raised to the two Committees?

Kat: Yes.  For example, telehealth.  That's kind of weird because we've been attending the hearings since before this was really accepted and there's been an ocean of change.

Ava: Because VA's realized they're not just going to farm that off on the rural veterans and offer nothing else.

Kat: That's true.  In the early days, there were notions that the VA would just 'treat' rural veterans via computer hook ups.  Today, telehealth is a tool that rural veterans can use.  The VFW, on Wednesday, advocated for more resources to go into the program.  Let me quote a moment from the testimony of VFW's William Thien:


While the VFW recognizes the limitations of broadband and mobile infrastructure in many rural araes, we strongly believe VA must continue to be the leader in developing practical telehealth options that will benefit veterans and the larger medical community.  Today, many CBOCs are linked to larger VA facilities and their medical experts through teleconferencing, allowing for consultations and diagnostic testing.  These services must continue to be expanded.  Telehealth also allows for veterans to receive care while at home for mental health follow-ups, diabetes maintenance, post-surgical updates and many other services. 


Dona: About the hearings, a regular reader, Alex, e-mailed to ask why there wasn't coverage of these hearings from everyone and not just C.I.  Kat, you want to field that?

Kat: If Senator Richard Burr is at the hearing and has something to offer, I'll report on that.  Otherwise, I basically just do an overview.  These are hearings from VSOs and there's far less back and forth.  C.I. noted last week, offered praise on this, that these joint-hearings have included questions from the Committee members.  We don't get that in the past.  In the past, a VSO leader sits there reading from his or her testimony and they finish and that's the end of the hearing.  Senator Patty Murray, when she was Chair, would usually ask a question or two.  But that was really it.  As C.I.'s pointed out, that has changed with this round of hearings and that's a good thing.

Dona: Ava, you agree?

Ava: Yes.  We go to NYC for the UN whenever it's time for the Security-Council to get the report on Iraq.  And I don't mind.  My father lives there, it's a good visit.  But as, C.I. has pointed out, we end up sitting through the Secretary-General's Special Envoy, who's flown in from Iraq for this hearing, reading a written report out loud for close to 25 minutes.  Then someone from the Iraqi government reads a rebuttal for about 20 minutes.  And that's it.  There are no questions asked, nothing apparently needs to be clarified or examined further. It's like when stupid ass Nancy Pelosi was still House Majority Leader.  We went to a  subcommittee hearing on a very important issue -- rape and assault in the military.  Witnesses flew in for that, veterans flew in to observe that hearing.  It was one of the most packed hearings.  No press was present but you had veterans who cared about this issue and wanted to be present.  And what happened was, those present to testify were told their prepared remarks would go into the record and then that was it.  Why?  Because the queen of plastic surgery Nancy Pelosi had decided everyone needed to hear from the President of Mexico.  Nancy Pelosi didn't value the struggles of the veterans.  She didn't give a damn that people had flown in to talk to Congress about being assaulted and raped.  It was more important for Nancy to bring Congress to a halt so she could play footsie with the president of Mexico.  She really needs to retire.  And, yes, she is supposed to be represent me in Congress, but no she does not.  I felt sorry for the Subcommittee Chair, John Hall, who was apologizing to everyone present but that didn't change the fact that we didn't get the hearing.  It didn't change the fact that witnesses and observers had a made a point to be there first thing in the morning for a hearing that didn't take place.  And, bringing back to the topic of your question, these VSO hearings really are worthless if you're not going to ask questions.  Sometimes, the questions can clarify something or it can add to the value by bringing up a need or caution that no one's thought of.

Dona: Such as in Thursday's hearing.  C.I., you slid me this quote, "The first thing they can do is trash the seamless transition, it's not getting anywhere." The seamless transition refers to the record that is supposedly going to follow a service member from the day he or she is inducted on through all their service and then into the VA as they become a veteran.  It will be one electronic record.  So Thursday, someone opposed it?

C.I.: Correct.  It was Vietnam Veterans of America. John Rowan speaking in response to a question from Senator John Boozman.  Rowan's opposed to it and he stated:

And right now we got the DoD planning to spend $28 billion for a computer system nobody needs.  They can go across the street to their friends in the VA and, instead of feeding all of their contractors that are in the DoD, get VISTA from the VA upgraded a little bit because it does need a little bit of that -- we know that -- and take it.  Why does everybody have to have their own damn computer system? And this is not alone.  I used to work for the Controller of the City of New York.  And I watched the same thing happen in city agencies.  I watched the New York Police Department flush a hundred million dollars down the drain on a stupid system they never used.  There's your answer.  28 billion dollars, wipe it out, get rid of that system, take VISTA add maybe 5 10 million to upgrade it, whatever, billion, it takes.  Upgrade it.  Then there's no -- there's no 'seamless' anything.  It's the same system and they simply walk their records from one side of the street to the other.  And we're done.

C.I. (Con't): At which point everyone not on the Committee began applauding Rowan's statements.

Dona: Okay.  Well I thought a seamless record was a good thing.

C.I.: It might be.  It might not be.  This was supposed to have been implemented during Barack's first term as President.  Secretary of the VA Eric Shinseki dragged his feet and refused to do so.  As this became more of an embarrassment, Barack finally sat down with Shinseki and Secretary of Defense Chuck Hagel to get an agreement on the system that would be used.  But 'seamless record'?  They have that now.  It's not very seamless but they have it.  It's more of a paper record.  This would be an electronic record and the hope there is that, by being electronic, it will be less likely for records to get lost.  Is it needed?  Some say yes, some say no.  Rowan says no.  I was surprised by the thunderous applause.  That means a lot of people agree with him.  This may be a tech issue or a generational one.  Younger veterans seem to feel that an electronic record is needed.  This may be due to the VA making them prove various conditions.  Which does happen.  They're asked to jump through hoops on claims.  But it may also include a technological comfort or a technological bias that older generations don't have.

Dona: What's your position on this?

C.I.: If the conversation is going to be restarted on whether or not this is necessary -- a conversation which seriously began in 2006 -- it needs to happen immediately because a lot of money's already been spent under the assumption or belief that this is necessary.


Dona: Ava, you wanted to talk briefly about something.

Ava: We're hoping to write a piece this edition on a topic.  In case we don't, I don't want to hear another damn word from a whiner about how, two weeks ago, a really important veterans didn't get passed because of those mean old Republicans.  In real time, I took that seriously.  I no longer do.  Last week, we saw an important bill that would have protected those who serve get shot down by Republicans and Democrats.  And I'm not seeing any letters to the editor there.  So spare me your partisan bulls**t because it's not just that I don't care, it's that I don't believe you.

Dona: And Ava's referring to last week's trashing of Senator Kirstin Gillibrand's efforts to bring accountability in the armed services with regards to assaults and rapes.  Kat, you wanted to note something from Thursday's hearing.

Kat:  The Military Officers Association of America's Robert F. Norton raised an issue which he said was in that morning's papers.  I hadn't read the papers before the hearing.  But he was talking about the fact that "a number of service members had gotten pink slips while deployed in Afghanistan" and marveling over that -- as we all should.  You're in a combat zone, risking your life and you get a pink slip?  As he noted, this left them "worrying about that they're not going to have a military career when they get back."

Dona: What was his answer?

Kat: He argued that the Defense Department should be offering some sort of incentive program to encourage people to leave as opposed to firing people.

Dona: Alright, thank you.  This is a rush transcript and it's a recurring feature.  Our e-mail address is thethirdestatesundayreviw@yahoo.com.




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