Statement of
Edward R. Cruickshank, Col. U.S.A. (Ret)
Director, Office of Veterans Services
Before the
Senate Committee on Veterans' Affairs
Relating to State of VA Health Care in Hawaii

Chairman Craig, Senator Akaka and members of the Senate Committee on Veteans' Affairs, I am Edward Cruickshank, Director of the Office of Veterans Services, this office serves as the single office within the State Government responsible for the welfare of Veterans and their family members.  We act as a liaison between the Governor and veterans groups and organizations and serve as an intermediary between the Department of Veterans Affairs and Hawaii's veterans.  Based upon veteran's population estimates as of September 30, 2004, data from the Office of the Actuary, Department of Veterans Affairs, there are 107,310 veterans in Hawaii.  The majority or 72% live on Oahu, 13% reside on the island of Hawaii, 10% live on one of the three islands which comprise Maui County, and approximately 5% live on Kauai.  We are an island state located in the middle of the Pacific Ocean and Hawaii presents unique challenges for the Department of Veterans Affairs.

Before I discuss some of these challenges, I want to share with you comments that my staff and I hear about VA health care very frequently.  These comments speak to the excellence of VA care, how VA's staff treat our veterans with dignity and respect, and that the services rendered by the dedicated health care professionals is superior to the care they received on the mainland (that is the continental United States).  These comments are shared with us by local veterans as well as by veterans who visit Hawaii and have a need to interact with Spark M. Matsunaga Medical staff.  When you speak of an organization that supports our troops, the VA exemplifies that phrase by supporting our troops at home, when they return and after conclusion of their military service.  I am delighted with the services that VA offers to Hawaii's veterans, to include the health care, benefits, and services provided at the National Memorial Cemetery of the Pacific; locally known as the Punchbowl Cemetery.

As mentioned earlier Hawaii present challenges to the VA.  We are an island state with one large population center on Oahu and 30% of veterans living on the neighbor islands.  Presently many of our veterans are referred for surgical services to mainland VA medical centers.  For neighbor island veterans this can be very traumatic.  They are booked on flights, sent to a city on the mainland, find the VA facility, operated on and sent back to Hawaii.  We ask that:  those who reside on neighbor islands that have direct flights to the mainland be offered, at a minimum, return flights that do not require a stop in Honolulu but fly directly to their island of residence.  Individuals who are recovering from surgery are further inconvenienced by a delay in route because they were not booked on a direct flight.  This delay increases the time these individuals endure pain and discomfort.  Direct booking is available, we ask the VA to make this option a standard.

Another issue that affects Hawaii and Alaska involves changes that were made to 38 USC 1151, Benefits for persons disabled by treatment of vocational rehabilitation.  With the change the only facilities covered by the law are those over which the Secretary of Veterans Affairs has direct jurisdiction or Government Facilities contracted by the Secretary.  Tripler Army Medical Center and other medical facilities in Hawaii, such as Straub, Queens and St Francis do not qualify.  This means that in the unlikely event that a veteran is disabled or their death is caused by hospital care, medical or surgical treatment, or examination in any medical facility that VA refers the veteran to in Hawaii, he or she will not be covered under 38 USC 1151.  The definition as listed in 38 USC 1701 (3), of who is covered by the law should be changed so that veterans in Hawaii are afforded the same protection as veterans who receive VA medical care in VA facilities on the mainland.  Hawaii's veterans must have the same right of redress as veterans treated at mainland VA facilities.  They too must be able to apply for and be granted compensation for injuries and not forced to pursue legal action against the facility.  Only a modification of the law can address this issue.  We ask the committee to consider including VA referrals to medical facilities that provide surgical and medical treatment in Hawaii and Alaska under 38 USC 1701 (3).

Hawaii's neighbor islands must be offered the same level of medical care and services as veterans located on Oahu.  Presently neighbor island veterans wait long periods to be scheduled for specialty medical care.  With the use of Tel-a-medicine, this problem is being addressed, never the less, implementation has been slow.  Veterans have been known to wait several months before they see a specialist.  We can and must do better in supporting these veterans.  Additionally, VA should consider contracting dental care on the neighbor islands.  With rising airline fairs, contract dentist may save veterans time and the VA much needed dollars that can be reallocated to other needed medical services, such as orthopedic or mental health services.

As you are aware, Hawaii will be receiving thousands of its returning National Guardsmen and Reservist.  As Director of the Office of Veterans Services and a Vietnam combat veteran I want these returning military members to be able to access medical and benefit services in a timely manner.  We ask that VA Health and Benefits Administrations be adequately staffed to provide medical care and benefit services to all veterans who make Hawaii their home.  I know this involves dollars, however, as an organization that supports our veterans, we must acquire funds to complete the job.  We must take care of our veterans.  We must continue to support our troops, our veterans, and our citizens ? after all they are our most Patriotic Americans.

I thank the committee for this opportunity to speak on this matter and I will respond to any questions that you may have.