Field Report: VFW Leaders On Hand for Hearing to Discuss Orlando VA Hospital

This week the House Veterans Affairs Committee hosted a field hearing at the University of Central Florida to discuss the lack of progress on a new VA Medical Center in Orlando.

VFW Past Department Commander David Harris was on hand to hear witnesses from the VA Office of Construction and Facilities Management, and hospital contractor Brasfield and Gorrie, testify on persistent delays in the project.

Harris described the hearing as a “circular firing squad” between the project’s architects, construction management, and the VA project manager, who all blamed each other for the project delays.

Construction on the new facility started in October 2008 and was scheduled for delivery this October; however, numerous change orders to the contract, design issues, and other delays have pushed the opening to late 2013 at the earliest, and possibly into 2014.

“My single interest is the expeditious completion of this facility for the veterans of Central Florida who have been waiting over a decade for this medical center,” said Veterans Affairs Committee Chairman Jeff Miller, R-Fla. “It is clear from today’s hearing both VA and the contractor still have quite a long way to go to come together and figure out how to work together, which is what needs to happen. But I am cautiously hopeful that will become the goal moving forward, as it should have been all along.”

Despite the finger-pointing, both VA and Brasfield and Gorrie officials promised to continue working toward consensus on how to move the project toward completion of the new medical hub for central Florida’s veterans.

Local VFW officials will continue to monitor progress on the new VA medical center, holding public officials accountable for its completion.

To view an archived webcast of the hearing and to read the prepared statements of each witness, click here.

Members of both the House and Senate are in their home districts throughout the month of August, tending to constituent affairs. VFW advocates are once again taking this opportunity to meet directly with their elected leaders on veterans’ issues, and we are looking to share those stories on this blog.

To submit your Field Reports for consideration on the VFW’s Capitol Hill blog, simply fill out our online form here, or send photos and stories directly to vfwac@vfw.org. Information for this story was provided by VFW National Legislative Committee member Lee Kichen.

Post Reports That Pentagon Fudged TRICARE Numbers

The Washington Post reported this week that the Department of Defense has requested nearly $3 billion over the last three years be moved from funds dedicated to TRICARE into weapons programs and other accounts unrelated to healthcare, despite assurances from Pentagon officials that healthcare costs were "eating the U.S. military alive."

According to a report on the FY2013 Defense Appropriations Act provided by the Senate Appropriations Subcommittee on Defense, the Pentagon reprogrammed $1.36 billion dollars from TRICARE in fiscal year 2011, $772 million in fiscal year 2010, and requested an additional $708 million to reprogram from this year's budget.

This reprogramming has been happening at a time that the VFW has worked tirelessly to prevent the Pentagon from arbitrarily raising TRICARE copayments, adding and expanding fees, and tying increases to medical inflation; while retiree health costs are rising at an average rate of 2.6 percent.

"The VFW is adamant that the Pentagon must not be allowed to pull this bait-and-switch on Congress and TRICARE beneficiaries," said VFW Executive Director Bob Wallace. "Instead, the Pentagon must improve its budget and management controls so Congress can have an accurate view of the fiscal situation within TRICARE and the entire Military Health System before shifting responsibility to those who choose to wear the uniform to pay for their own health care."

Your VFW has been one of the few veterans' organizations in Washington fighting to prevent any increases in military health care premiums, encouraging Washington bureaucrats to do the hard work of generating a more cost-effective military, without jeopardizing the welfare of military families and breaking faith with military retirees.

VFW advocacy efforts earlier this year successfully fought off TRICARE fee increases, and in light of this recent report, the VFW intends only to ratchet up the pressure.

To make your voice heard on TRICARE fees, click here, and check back regularly with this blog for updates.

To read the full Senate report, click here. Details on health care reprogramming can be found on p. 228. 

House Moves Series of VFW-Supported Legislation

This week, each of the House Veterans Affairs subcommittees moved more than a dozen bills to the full committee for consideration, many of which the VFW has vocally supported in recent testimony.

House VA Subcommittee on Disability Assistance and Memorial Affairs: 

On Wednesday afternoon, the House VA Subcommittee on Disability Assistance and Memorial Affairs marked up and passed three bills, H.R. 5735, H.R. 5881, and H.R. 5880.

H.R. 5735, which the VFW helped to draft, was amended to not only commission a "Place of Remembrance" for unclaimed remains of American service members, but it will also clarify that burial proceedings at National Cemetery Administration facilities must reflect the wishes of the grieving family and that veterans convicted as Tier Three sex offenders or who receive life imprisonment will be excluded from burial in national cemeteries.

H.R. 5881, the Access to Veterans Benefits Improvement Act, was amended to reflect the wishes of the VFW to ensure that only properly vetted employees, such as VA employees, tracking officers, county service officers and VSO service officers, with proper need to access a veteran's claim information can have access to sensitive VA database information.

H.R. 5880, the Veterans Disability Examination Access Improvement Act, was passed without amendments. VFW vocally supported this bill in testimony before the subcommittee earlier this month.

To read VFW's full testimony on each of these bills, click here.

House VA Subcommittee on Oversight and Investigations: 

On Wednesday morning, the House VA Subcommittee on Oversight and Investigation marked up and passed three bills, H.R. 3730, H.R. 4481, and H.R. 5948.

H.R. 3740, the Veterans Data Breach Timely Notification Act, was amended and passed to require VA to notify the VA secretary of any data breach within 10 days, then notify the affected veteran within the next 10 days, finally notifying the public within the subsequent 10 days.

H.R. 5948, the Veterans Fiduciary Reform Act of 2012, was amended in the form of a substitute and passed to add further protections and oversight on VA fiduciaries to protect veterans. The amendment initiates harsher penalties to organizations and businesses that seek to scam or take advantage of VA beneficiaries or their fiduciaries.

H.R. 4481, the Veterans Affairs Employee Accountability Act, which would prohibit VA employees who violate federal acquisition laws from receiving bonuses, also passed the committee.

The subcommittee hosted a hearing on each of these bills earlier this month. To view a full list of witnesses and to read their prepared remarks, click here.

House VA Subcommittee on Economic Opportunity: 

On Thursday morning, the House VA Subcommittee on Economic Opportunity marked up and passed five bills, H.R. 4057, H.R. 4115, H.R. 4740, H.R. 3524, and H.R. 5747.

The VFW was paying close attention to H.R. 4057, the Improving Transparency of Education Opportunities for Veterans Act of 2012; a bill which VFW legislative staff worked diligently to introduce. The bill was amended to include specific disclosures VA would have to make to potential student-veterans as part of pre-enrollment counseling available to G.I. Bill recipients. The VFW has been the leading voice in Washington advocating for improved student-veteran consumer information and consumer protections, which is why the VFW has pushed for this bill and similar bills in the Senate.

H.R. 3524, the Disabled Veterans Employment Protection Act, was amended to allow disabled veterans not covered under the Family Medical Leave Act an additional four weeks of leave from work in a calendar year for treatment of service-connected injuries. The subcommittee originally proposed 12 weeks of additional leave, but was concerned that employers would balk at the prospect of hiring veterans with such a strong provision.

During testimony earlier this spring, the VFW pointed out that VA must adapt its treatment options to allow service-connected disabled veterans to schedule care around reasonable work schedules. The VFW contends that it is not fair to the veteran or to his or her employer if VA can only schedule appointments during the work day.

H.R. 4115, the HIRE at HOME Act, which the VFW helped to craft, passed favorably, along with H.R. 4740, the Fairness for Military Homeowners Act, and H.R. 5747, the Military Family Home Protection Act.

The VFW testified on each of these bills within the last few months. To read our testimony on H.R. 4057 and H.R. 3524, click here. To read our testimony on H.R. 4115, H.R. 4740 and H.R. 5747, click here. 

House VA Subcommittee on Health:

On Friday morning, the House VA Subcommittee on Health marked up and passed two bills, H.R. 3337 and H.R. 4079.

The VFW has been a vocal advocate for H.R. 3337, the Open Burn Pit Registry Act, helping to introduce the bill late last year, and even helping to introduce a companion bill in the Senate, with the help of the burn pit exposure advocacy group Burn Pits 360. The bill easily passed the subcommittee.

H.R. 4079, the Safe Housing for Homeless Veterans Act, was also amended and passed the subcommittee, ensuring housing for homeless veterans meets safe living standards.

The VFW testified on each of these bills in April. To read VFW's full testimony, click here.

The VFW will continue to track each of these bills as they move through committee, possibly to be included in another veterans' benefits omnibus package later this fall. Check back regularly for updates.

House Veterans Affairs Committee Questions VA on Mental Health Care Delivery

On Tuesday, the VFW was on hand as the House Veterans’ Affairs Committee held a hearing to discuss the findings of a recent VA Office of Inspector General report, highlighting serious concerns with access to mental health care within the VA system. At the request of Committee Chairman Jeff Miller, R-Fla., VA Secretary Eric Shinseki testified alongside Dr. Robert A. Petzel, VA undersecretary for health, and other distinguished members of the VA team.

To view an archived webcast of the hearing, click here. To view a full list of witnesses and to read their prepared remarks, click here.

The panelists defended VA efforts and practices against the recent damaging OIG report which found, among other things, that the measurements used by VA to calculate wait times for mental health appointments lack accuracy and reliability. The report explicitly said that the measurements offered “no real value” and should be replaced. OIG also found that nearly half of veterans seeking a mental health episode of care waited approximately 50 days -- a figure in stark contrast to the 14-day standard VA has regularly promoted.

Much of the hearing focused on VA’s recent announcement that the agency would hire 1,900 new mental health staff -- 1,600 clinicians and 300 support staff -- to help overcome shortfalls across the country that currently prevent veterans from receiving timely care.

Unfortunately, The VFW believes many questions remain unanswered. VA does not yet have a true staffing model to ensure the mental health contingent within VA is right-sized or properly distributed across the system. Because of that, many committee members and other witnesses questioned the effectiveness of VA’s response, and whether or not 1,900 is the optimal number of new hires. Questions of how VA would pay for the additional staff were also raised, and VA’s response that they would be taking the money out of the dollars allocated to the VISNs did not seem to satisfy many on the committee.

Shinseki admitted that VA had much to do to resolve this problem, and made clear his belief that the problem could get worse in coming years as the conflicts in Iraq and Afghanistan draw to a close and more service members seek VA care. Dr. Petzel offered that VA needed to do more fee-basis mental health authorizations, and more mental health contracting with private providers, especially in rural areas. VA also discussed a new and ongoing peer counselor program in which VA is currently training 400 veterans to become peer counselors. Tele-mental health and the future deployment of an integrated electronic health record were also mentioned as facets of VA’s plan to address the need to provide more mental health treatment for our veterans.

In the midst of all these efforts, committee members and veterans’ advocates did not seem satisfied. As your voice on Capitol Hill, your VFW will continue to keep VA’s feet to the fire to improve the delivery of mental health care for our veterans. Check back regularly for updates.

Watch Live: Senate Hosts Hearing on Vets' Mental Health Care

UPDATE: The archived webcast from yesterday's hearing is now available on the Senate VA Committee's Web site. To view a full list of witnesses, read their prepared remarks, and view the archived webcast, click here. 

This morning the Senate Veterans Affairs Committee will host a hearing to evaluate the ease-of-access for veterans seeking mental health care at VA facilities. The hearing comes in the wake of an alarming report from the VA's Office of the Inspector General, indicating that VA may have misled Congress and the veterans' community on how it ensured prompt access to care for veterans seeking treatment for mental health conditions.

Your VFW will be on hand when the hearing is scheduled to commence at 9:30 a.m. in Senate Dirksen Office Building room 138. To view a live webcast of the hearing on the committee's home page, click here.

VA policy dictates that veterans who seek treatment for mental health must be seen with 14 days of requesting treatment. However, the report, which can be read here, claims that VA misrepresented how it tracked whether or not veterans received treatment in a timely manner, many times only starting the 14-day clock from the earliest date on which a veteran physically entered a VA facility for treatment.

For example, if a veteran were to contact VA on April 1 to seek treatment, VA could offer an appointment date on April 16. If the veteran accepted the April 16 appointment and was actually treated in a VA clinic on April 16, VA would report that the veteran waited zero days for his or her treatment, as opposed to the actual 15-day waiting period.

As a result, OIG determined that VA's reports on wait times and treatments were neither accurate nor reliable, and called on the VA Undersecretary of Health to revise policies to clarify how patient scheduling and treatment should be tracked and identify staffing shortfalls that may impede timely treatment.

Senate VA Committee Chairman Patty Murray, D-Wash.,  and Ranking Member Richard Burr, R-S.C., called for the IG report. The results come less than a week after VA pledged to hire an additional 1,900 mental health care personnel to include marriage and family therapists and licensed professional mental health counselors.

VFW leaders were disturbed at the report that VA may have misled the public and the veterans’ community on how it delivers mental health care. Your VFW will continue to keep its finger on the pulse of this critical issue, putting pressure on VA officials and leaders in Congress to take decisive action. Check back regularly for updates.

ICYMI: VFW Testifies on Veterans Health Bills

In Case You Missed It:  On Monday night, VFW Legislative Associate Shane Barker appeared before the House Veterans Affairs Health Subcommittee to discuss pending legislation to improve veterans’ health care. To view an archived webcast of the hearing, click here.

In his remarks, which can be read here, Barker expressed VFW’s support for bills that would create accountability within Department of Defense and VA for the Federal Recovery Coordination, or FRC, program (H.R. 3016); improve access to VA and DoD informational databases for Vet Centers (H.R. 3245); ensure caregivers for service members suffering severe illnesses also have access to VA caregiver program benefits (H.R. 3279); codify safety standards for homeless veterans’ transitional housing (H.R. 4079); and establish a burn pit registry for Iraq and Afghanistan veterans possibly exposed to toxins from open-air burn pits overseas (H.R. 3337).

Barker expressed VFW’s support for the concept behind one bill, H.R. 1460, which would automatically enroll service members deployed to Iraq and Afghanistan with VA healthcare. However, Barker said that the VFW was concerned that veterans who do not deploy to Iraq and Afghanistan, but suffer service-connected injuries, would not be given the same priority for VA health care as their deployed counterparts. The VFW asked for the bill to be amended to include mandatory enrollment for non-deployed service members that satisfy the VA’s enrollment requirements.

The VFW opposed H.R. 3723, a bill that would overhaul VA’s fee basis system by insisting that VA enter into contracts with private health care providers. The VFW is concerned that VA could not successfully execute the types of contracts necessary to properly anticipate and successfully deliver the kinds of acute care needed by veterans that must utilize the fee-basis system. Barker also went on to say that the VFW was concerned that new business practices could encourage veterans to leave the VA health network entirely, threatening the viability of the VA health care system. The VFW suggested that VA instead focus on implementation of the Patient Aligned Care Team, or PACT, model and the Patient Centered Community Care, or PCCC, program to improve care delivery for current beneficiaries and veterans who need to utilize fee-basis care.

To view a full list of witnesses from Monday’s hearing and to read their prepared remarks on each of the bills, click here.

Your VFW will continue to work closely with the subcommittee as these bills move through Congress, ensuring all of our concerns are addressed before a subcommittee mark-up. To voice your opinion on these bills directly to your representatives in Congress, click on the VFW Action Corps page here, and as always, check back regularly with this blog for updates.

VFW Joins VA Nurses for Legislative Roundtable

On Friday VFW joined the Nurses Organization of Veterans Affairs, or NOVA, for their annual legislative roundtable at the Washington, D.C., office of the Disabled American Veterans, or DAV.

VFW Action Corps Manager Teresa Morris, who recently served on the NOVA foundation board, joined representatives from both the House and Senate Veterans Affairs committees, the American Nurses Association, Association of Veterans Affairs Nurse Anesthetists, National Association of Veterans Research and Education Foundations, and veterans advocates from the American Legion, DAV, Paralyzed Veterans of America and the Vietnam Veterans of America to discuss NOVA’s legislative priority goals for 2012.

The afternoon’s discussion centered around the fiscal year 2013 VA budget and the potential shortfalls in construction and research funding – particularly funding and availability of proper laboratory space. In addition to budget considerations, NOVA provided a handout of their legislative agenda for 2012 and discussed many areas of concern for nurses within the VA system, such as investment in proper IT infrastructure and programs to recruit and retain quality staff.

Morris discussed VFW’s role within the Independent Budget for VA, focusing on how inadequate funding for VA construction and infrastructure improvement could negatively affect veterans who rely on VA health care. The VFW testified on the VA’s budget proposal before the House Veterans Affairs Committee last week, expressing the same concerns.

Morris also focused on broader veterans’ health care issues outlined in the VFW’s 2012 Legislative Priority Goals including mental health, invisible wounds like post-traumatic stress disorder and traumatic brain injury, and proper training for all who serve in a patient care role to identify signs and symptoms related to these conditions.

House and Senate representatives talked about their committees’ priorities for the second session of the 112th Congress, stressing proper oversight of VA mental health programs and efficiencies within the department.

Next Wednesday, the VFW will appear before the Senate Veterans Affairs Committee to once again discuss the FY2013 VA budget, continuing to advocate for proper VA funding and voicing similar concerns over proper infrastructure funding. As the 2013 budget process moves forward, check back regularly with this blog for updates.