THE RETIRED ENLISTED ASSOCIATION
THE HOUSE APPROPRIATIONS COMMITTEE
SUBCOMMITTEE ON VETERANS AFFAIRS, HOUSING AND URBAN DEVELOPMENT AND INDEPENDENT AGENCIES APPROPRIATIONS
FISCAL YEAR 2001 DEPARTMENT OF VETERANS AFFAIRS APPROPRIATIONS
UNITED STATES HOUSE OF REPRESENTATIVES
JOHN J. DALY
DEPUTY LEGISLATIVE DIRECTOR
DISCLOSURE OF FEDERAL GRANTS OR CONTRACTS
The Retired Enlisted Association does not currently receive, has not received during the current fiscal year or either of the two previous years any federal money for grants or contracts. All of the Associations activities and services are accomplished completely free of any federal building.
Biography of John J. Daly
Deputy Legislative Director
The Retired Enlisted Association
John Daly, a native of Woodbury Heights, New Jersey, first came to Washington, DC in the fall 1994 as an intern in the United States Department of Commerce. Following the earning of a Bachelors Degree in International Relations from St. Josephs University in Philadelphia, in May of 1996, Daly returned to Washington, DC as an intern in the White House, serving in the Office of Vice President Al Gore. After completion of the internship program, Daly became the Staff Assistant at American Defense International, Inc., a Washington, DC based government relations and business development firm.
In December of 1997 Daly joined the staff in the Legislative Affairs Office of The Retired Enlisted Association as the Legislative Correspondent. He presently serves as TREAs Deputy Legislative Director.
John, and his wife Kerry, reside in Alexandria, Virginia with their son John.
Chairman Walsh, Ranking Member Mollohan, distinguished Subcommittee members, on behalf of the 110,000 members and auxiliary of The Retired Enlisted Association (TREA), TREA National President Fred Athans and TREA National Auxiliary President Kay Claman, I would like to extend our sincerest appreciation for having the opportunity to come before you today and express the views of TREA regarding appropriations for the Department of Veterans Affairs for Fiscal Year 2001.
I would first like to express our appreciation for the support the members of this subcommittee, and the entire Congress, gave to our efforts last year to increase the VAs budget by $1.7 billion. This additional funding will directly help veterans receive they care they deserve at VA facilities.
HEALTH CARE FUNDING
TREA was very pleased with the proposal put forth this year by the Administration for the budget of the Department of Veterans Affairs. We are hopeful that Congress will approve an appropriation matching, if not increasing, the Presidents request for fiscal year 2001. As the nations veterans population ages and requires more frequent health care needs, at an ever increasing cost, it is imperative that the VA has the necessary resources to meet the increasing demand.
One of the most pressing issues for Veterans Service Organizations today is the implementation of VA Subvention. The time has come to allow the Department of Veterans Affairs to bill Medicare when the VA treats Medicare patients. This particular program can accomplish two goals: one, the VA would benefit by billing Medicare for care it may have to provide to veterans regardless of whether or not the VA would be compensated. Two, it greatly improves veterans access to health care. Presently, many older veterans are severely limited in their health care options. In particular, military retirees over the age of 65 are forced out of the TRICARE system. These retirees were the ones who were promised free life-time health care if they served twenty or more years in the military. We were not told that legislation passed in 1956 and 1966 effectively eliminated that benefit. In fact, recruits up until 1993 were being told of the promise of free medical care in return for a military career. Allowing those veterans to receive their health care at the VA will greatly expand the number of facilities a military retiree could turn to for care, thereby greatly improving the health care benefit offered to those who have served this nation. TREA realizes that the Medicare Subvention program also falls under the jurisdiction of the Senate Finance Committee and House Ways and Means Committee, however, we would certainly appreciate the support of all the members of the this Subcommittee in this process. This issue has gone on long enough. In the past, we have had support in the House, but not in the Senate, and vice versa. While political posturing continues, veterans suffer without access to quality health care. We have been informed that the Senate is ready to act on legislation, therefore, I ask you today to urge your colleagues on the Health Subcommittee of the Ways and Means Committee to finally address this issue.
HEALTH CARE FACILITIES
Often, veterans and their representatives in Washington, DC are told that that scarce dollars are hard to come by when it comes to funding important improvements to veterans benefits. However, TREA believes that one of the solutions to a continual lack of financial resources may be under the control of the VA already.
The continually increasing number of Community Based Outpatient Clinics (CBOC) has greatly increased veterans access to health care. These new, or renovated, facilities are helping veterans by "going to the veterans" as opposed to veterans having to travel sometimes hundreds of miles to the nearest VA Medical Center. The General Accounting Office reported in December 1995 that 11% of veterans live within 5 miles of a VA hospital and 17% of veterans live within 5 miles of an outpatient clinic. Further studies show that for every 1,000 veterans who live within 5 miles of a hospital, 34 use that facility for acute or surgical care, while for every 1,000 veterans within 5 miles of an outpatient clinic, 131 use that facility (VA Health Care, How Distance From VA Facilities Affects Veterans Use of VA Services). We have a wonderful opportunity to use modern science to expand the number of veterans who can easily, and therefore be more likely, to receive care from the VA. The implementation of these clinics is a positive development in achieving the VAs mission. I would urge this committee to fully fund the VAs request for outpatient clinics this year and in future years.
While the CBOC program is an example of a successful facilities development program being carried out by the Department of Veterans Affairs, there are other concerns relating to the facilities run by the VA. The GAO reports that the VA is spending $1 million a day on unneeded facilities (General Accounting Office, VA Health Care, Challenges Facing VA in Developing an Asset Realignment Process). This, simply, means less money can be directed to veterans health care. The time has come to analyze the infrastructure that was created in the post-World War II era as well as the demographics as to where our veterans are living today. Today, the VA directs funding to specific regions based on the number of patients being treated in that region. However, this does not address the number of unused hospital beds or empty buildings currently being maintained by the VA. This step must be taken so some of the $365 million being spent annually can be directed towards health care, not facilities maintenance. Further, the General Accounting Office (GAO) reports that by closing on VA hospital in an area with several facilities, the VA can redirect $200 million over ten years from facilities to health care while still providing veterans in that region with quality health care (GAO, VA Health Care, Closing a Chicago Hospital Would Save Millions and Enhance Access to Services).
2000 is the second year in a row in which the Secretary of Veterans Affairs has announced that all veterans who desire can be enrolled in the VA for health care. This is significant because it means that a large number of non-service connected veterans, whos income is above the means test, are now guaranteed health care through the VA. This has dramatically increased the number of potential patients at VA facilities. The unfortunate consequence of this decision is that service-connected disabled veterans are having difficult in receiving health care due to lack of space. While the category system may exist in name, it does not in practice. We have been greatly disturbed by calls we have received from disabled veterans, rated above 50%, placing them in Category 1, being told that there were no primary care teams to enroll them into because Category 7 veterans had flooded the system. Further, we have heard of a veteran rated 100% disabled having to wait three months for a particular medical appointment. While TREA appreciates the efforts of Congress for enacting eligibility reform, and the Secretary of Veterans Affairs for finding the necessary funding to allow Category 7 veterans to enroll, we are concerned that this increase in customers has shifted the focus away from disabled veterans seeking care for their service connected disabilities.
We have urged both members of Congress and representatives of the Department of Veterans Affairs to address the concerns rising from increased enrollment. While TREA does have concerns, our support for the overall enrollment policy has not waivered and we are hopefully that this subcommittee will appropriate the necessary resources to continue enrollment for all categories.
For more then 50 years, veterans of the Armed Forces of the United States have been rewarded for their honorable service with education opportunities. From World War II through today, an educational benefit has existed which was designed to make me good soldiers even better citizens. Unfortunately, the benefit provided to members of the services today does not adequately meet their educational needs. Based on the recommendations of the Commission on Servicemembers and Veterans Transition Assistance, along with the obvious data reflecting the increase in college tuition and fees, the time has come to enhance the Montgomery GI Bill (MGIB).
Today, the MGIB is paying just over half of the average tuition and fees of a public, four year college education for a non-resident student. Mr. Chairman, we have two choices, either increase the benefit, or tell new recruits that the MGIB pays for half of their education. TREA is proud to have joined with an unprecedented organization of representatives from higher education and the veterans community to push for a minimum standard of what the educational benefit must be. That minimum, to be determined annually, will be based on the average cost of a four year degree at a public college for a non-resident student. At a minimum, this is what we owe our veterans for this will provide them with the education they were promised.
I cannot stress enough the urgency of this issue and would urge the members of this subcommittee to act to put the necessary funding levels into the budget to make this new GI Bill a reality.
Mr. Chairman, for the past several years, TREA has had the opportunity to go before your colleagues on the House and Senate Veterans Affairs Committees and outline our view as to what programs should be implemented or modified in order to improve veterans benefits. We also have had the fortune to come before this subcommittee and urge funding for those initiatives. This year, we are fortunate that, unlike last year, we are dealing with a realistic budget proposal. However, there still are concerns, particularly regarding veterans education benefits. Billions of dollars have been proposed for educational program over the past seven years, none have addressed veterans educational benefits.
In closing Mr. Chairman, I would like to thank you and the other members of this subcommittee for providing The Retired Enlisted Association with an opportunity to testify. I would be pleased to answer any questions at this time.