TESTIMONY
of

Richard ?Rick? Jones
AMVETS National Legislative Director

before the

Committee on Veterans' Affairs
U.S. Senate

on

?Veterans Health Care Improvements Act of 2005?; ?Mental Health Capacity Enhancement Act of 2005?; ?Neighbor Islands Veterans Health Care Improvements Act?; S.481, a bill to extend combat veterans' post-discharge 2-year period of eligibility for VA health care to 5 years; S.614, the ?Veterans Prescription Drugs Assistance Act?; S. 716, the ?Vet Center Enhancement Act of 2005?; ?Sheltering All Veterans Everywhere Act?; a bill to require VA to publish a strategic plan for long term care; a bill to establish a grant program to provide transportation for rural veterans; ?Blinded Veterans Continuum of Care Act of 2005

Thursday, June 9, 2005
Committee Hearing Room,
412 Russell Office Building
United States Senate

Chairman Craig, Ranking Member Akaka, and members of the Committee:

Thank you for the opportunity to present testimony to the Veterans' Affairs Committee on legislation subject to this hearing devoted to healthcare related matters.  My name is Richard Jones, AMVETS National Legislative Director. 

AMVETS is pleased to present our views the ten bills before the Committee: the Chairman's proposed legislation called the ?Veterans Health Care Improvements Act of 2005?; Ranking Member Akaka's four proposals, the ?Mental Health Capacity Enhancement Act of 2005?, the ?Neighbor Islands Veterans Health Care Improvements Act?, and S. 481, a bill to extend combat veterans' post-discharge 2-year period of eligibility for VA health care to 5 years, and S.716, the ?Vet Center Enhancement Act of 2005?; Senator Specter's bill, S. 614, the ?Veterans Prescription Drugs Assistance Act?; Senator Obama's bill the ?Sheltering All Veterans Everywhere Act?; and Senator Salazar's bills to require VA to publish a strategic plan for long term care; to establish a grant program to provide transportation for rural veterans; and the ?Blinded Veterans Continuum of Care Act of 2005?.
 
Mr. Chairman, AMVETS has been a leader since 1944 in helping to preserve the freedoms secured by America's Armed Forces.  Today, our organization continues its proud tradition, providing not only support for veterans and the active military in procuring their earned entitlements but also an array of community services that enhance the quality of life for this nation's citizens.

Throughout our sixty-one year history, our focus and indeed our passion have been to represent the interests of veterans as their advocates.  In this regard, this Committee and our organization share a common purpose ? we support veterans in their efforts to receive the benefits that a grateful nation intended them to have in recognition of their dedicated service to our country. 

As a nation, we owe veterans an enormous debt of gratitude ? for their service, their patriotism, and their sacrifices.  The benefits to which they are legally entitled are not the product of some social welfare program, as some might argue.  Rather they are yet another cost of freedom that unfortunately is too often forgotten. 

As a national veterans service organization, chartered by Congress, AMVETS is committed to assisting veterans in their times of need.  For example, during the past eighteen years, we, together with DAV, PVA, and VFW, have co-authored a document titled The Independent Budget in which we identify the funding requirements necessary to support the Department of Veterans Affairs.

We believe that America's promises made to veterans for their military service need to be recognized and honored as our forebears intended.  We believe that veteran's benefits should be provided in a timely and compassionate manner.  We believe that to do less dishonors those whose service in defense of this nation provides a central underpinning for the prosperity and freedoms we all enjoy.

We appreciate the opportunity you provide to testify on pending legislation to enhance, update, and strengthen veterans legislation.

S. 614, the Veterans Prescription Drugs Assistance Act

Mr. Chairman, AMVETS supports the goal of this legislation.  As introduced, the legislation would allow Medicare-eligible veterans to obtain prescription drugs from the Department of Veterans Affairs at the significantly discounted cost that VA, as a high-volume purchaser of prescriptions medications, is able to secure in the marketplace.

S.614 would provide a partial remedy to the situation faced by older Priority 8s ?banned? from the VA healthcare system under the 2003 decree that halted their access to medical care. Under this legislation, a veteran who has been diagnosed and prescribed medication by a non-VA healthcare provider could have a prescription filled by VA at a steeply reduced price.

As the Committee knows, the Department of Veterans Affairs Secretary has banned healthcare access to an estimated 495,000 veterans who could have enrolled for care prior to January 17, 2003, when former Veterans Affairs Secretary Anthony Principi closed off their healthcare benefits and denied them access to VA medical care.

These so-called high-income veterans or ?Priority 8s? remain eligible for VA care, but neither Congress nor the administration has supported the funding necessary to ensure adequate resources for their care.

Currently, veterans are eligible to receive prescription medications from the VA only if a VA physician prescribes the medication.  While insisting that a VA doctor see the patient may not seem like too great an imposition, many veterans waiting for a doctor's appointment are waiting solely to have a prescription written at VA, so it can be filled.

It is commonly noted that the majority of the Priority 8s have entered the system to gain access to the VA prescription drug program.  For these veterans, once they are under the care of a VA physician, they can see dramatically reduced prescription drug costs versus the private sector.  The current VA prescription cost for enrolled patients is $7.00 per prescription for a 30-day supply. 

VA dispenses over 100 million prescriptions yearly to its nearly 5 million patients, and with this volume, VA can negotiate very favorable drug prices.  Figures from the National Association of Chain Drug Stores claim that for 2001, VA cost per prescription was almost half the cost found in the private sector.  With the ever increasing cost of prescriptions, it is little wonder Priority 8 veterans have availed themselves of this benefit after Congress allowed them access to the VA system.

It is important to understand that AMVETS remains deeply disappointed in the continuing ban of Priority 8 veterans, which began on January 17, 2003.  In past years, this Committee and its members have fought for adequate funding for VA, yet VA has not been adequately resourced.

It is also important to never forget who these so-called Priority 8 veterans are.  These are brave Americans who answered our nation's military call, and with fortune and God's grace they have returned from service whole and able to continue their lives without disabling injury or illness. 

In today's war on terrorism, the Priority 8 veteran may be one of the soldiers, sailors, airmen or marines who stand a post or walk a patrol in Iraq or elsewhere across the globe, replacing a fellow soldier who was injured or who gave his life in defense of freedom and our way of life.

These patriots serve, voluntarily, and the members of AMVETS believe each of them has earned access to the VA healthcare system following their military service, as statute provides. For a moment in our history they held in their hands the defense of our nation and its cherished freedoms.  These men and women did not fail us in our nation's time of need, and we should not fail them.  It is the least our nation can do for those on whom America depends to defend her liberty.

S.716, the ?Vet Center Enhancement Act of 2005?

Introduced by Ranking Member Akaka, S.716 would enhance care and services provided through Vet Centers.  The bill recognizes the need to augment these centers especially at a time when there are an increasing number of troops returning from Operation Enduring freedom and Operation Iraqi Freedom. The legislation would also increase authorized funding for Vet Centers to $180 million from $93 million to help returning service members and surviving family members through a smoother readjustment period.  AMVETS supports this legislation.

S.481, a bill to extend combat veterans post-discharge 2-year period of eligibility for VA health care to 5 years

Introduced by Ranking Member Akaka, S.481 would extend policies and procedures for providing free health care services and nursing home care to combat veterans for a period of 5 years beginning on the date of separation from active military service. Under current coverage, recently separated service members, including National Guard and reserve personnel, are eligible for health care for 2-years. The benefit covers all illnesses and injuries except those clearly unrelated to military service such as the common cold and injuries from accidents that occurred after discharge. Dental services are also no included. Unlike other veterans there is no burden to prove they have low-income to qualify for VA health care.  This is an important change.  In past conflict, veterans have reported medical problems that have been hard to explain or difficult to diagnose.  Providing an extended period of eligibility, common medical problems may be better diagnosed and care more properly applied in a timely manner. AMVETS supports this legislation.

S. _____, a bill to require VA to publish a strategic plan for long term care

Senator Salazar proposes legislation to direct VA to develop and publish a strategic plan for long term care.  The bill recognizes that long-term care was not included in VA's Capital Asset Realignment for Enhanced Service (CARES) process and is therefore lacking in appropriate consideration.  AMVETS supports restructuring the VA system through the CARES process, but it must be done with a sharp eye for the future and with sound facilities and operations planning.  With the number of veterans over the age of 85 years old and older expected to nearly double over the next decade to 1.3 million from 870,000, AMVETS supports this legislation.

S. _____, a bill to establish a grant program to provide transportation for rural veterans

Senator Salazar proposes legislation to establish a grant program managed through VA to provide critically needed transportation services to veterans in rural remote areas. But there probably are hardly any States in the Union with the exception of maybe Rhode Island or Connecticut or someplace like that where we do not have at least some veterans who are somewhat isolated from VA hospitals and are having to go great lengths to get their medical care. Provision of a grant program would offer a degree of opportunity to veterans who live in these areas to access the health care benefits to which they are entitled through honorable military service.  AMVETS supports this legislation.

S. _____, the ?Blinded Veterans Continuum of Care Act of 2005?

Senator Salazar's proposed legislation would provide critical enhancements to the care provided blinded veterans.  The bill would establish Blind Rehabilitation Outpatient Specialists positions at medical centers with Visual Impairment Service Teams (VISTs) with a full-time coordinator or with more than 150 currently enrolled legally blind veterans.  Blind Rehabilitation Outpatient Specialists play an important role in helping blinded veterans with a number of living skills.  In many cases, these blinded individuals achieve successful careers despite their blindness.  Clearly however, many sensory disabled veterans have not had the same opportunities afforded them or the same veterans assistance programs. Accordingly, this legislation would pursue its goals of enhancing these types of services which combined with research, rehabilitation and re-employment can make a critical difference in the lives of blinded veterans.  AMVETS supports this legislation.

S. _____, the ?Neighbor Islands Veterans Health Care Improvements Act of 2005?

Senator Akaka's legislation would establish vet centers and clinics on certain islands of Hawaii.  The bill would also provide staffing enhancements to assist in adjustment counseling and related mental health services for veterans. It also would establish a mental health center in Hilo for the provision of mental health care and treatment. In addition, it authorizes construction of a mental health center at Tripler Army medical center.  The facilities in Hawaii are superb and AMVETS supports this legislation.

S. _____, the ?Mental Health Care Capacity Enhancement Act of 2005?

The proposed legislation of Senator Akaka would take a number of steps to strengthen and improve VA capacity to provide mental health care and treatment.  The bill would establish patient-staff ratios and foster collaborative approaches for primary and mental health care providers. The bill would also require VA to have onsite, contract, or tele-mental health services available at not less than 90 percent of Community-Based Outpatient Clinics. In addition the bill would establish a joint VA-DoD workgroup on mental health tasked to study how to recognize signs of and to deal with mental health disorders.  Under the bill, the workgroup would also consider collaborative approaches to improve the transition of servicemembers to veterans status, care, and treatment.  AMVETS supports the goal of improving mental health treatments and ensuring the availability of care at outpatient clinics and throughout the VA healthcare system.

S. 1180, ?Sheltering All Veterans Everywhere Act?

Senator Obama has introduced S.1180, the Sheltering All Veterans Everywhere Act, to reauthorize the Homeless Providers Grant and Per Diem (GPD) program, the Homeless Veterans Reintegration Program (HVRP), and the Grant Program for Homeless Veterans with Special Needs.  The GPD and HVRP programs sunset in 2006 and VA homeless programs expire later this year.  The bill also calls for VA to study the interrelationship between military sexual trauma and homelessness and effective service models for addressing trauma among homeless veterans.  AMVETS goal is to bring a continuity of commitment to getting homeless veterans back on their feet and into the mainstream of our communities.  AMVETS clearly recognizes that progress is being made, and our members support this legislation, to defeat homelessness and help veterans.

S. _____, the ?Veterans Health Care Improvements Act of 2005?

It is critical that service men and women who have sacrificed for their country in the Armed Services be taken care of upon their return to home and community.  To abandon our responsibilities would bring dishonor and send a message that the contributions of our servicemembers are not fully appreciated. 

Our First President George Washington warned us to be careful about honoring our veterans, ?The willingness with which our young people are likely to serve in any war, no matter how justified, shall be directly proportional to how they perceive the Veterans of earlier wars were treated and appreciated by their nation.?

The ?Veterans Health Care Improvements Act of 2005,? introduced by Chairman Craig, would undertake a number of changes in veterans healthcare.  Section 2 of this legislation completes the exemption from hospice co-payments as enacted last year.  It eliminates co-payment for veterans using outpatient hospice care as well as previously enacted co-payment for institutional hospice care. AMVETS supports this section of the bill. Amvets also supports the elimination of co-payments for former POWs.  However, we oppose the elimination of VA requirement for maintaining a certain nursing home bed level, also contained in this section.  AMVETS supports improvements in the reimbursement of expenses for veterans using emergency room facilities, and we support as well Section 5 designed to care for newborn children of women veterans.  It is also appropriate to enhance payer provisions for health care furnished to certain children of Vietnam veterans for Spina Bifida and associated disabilities.  Section 7 authorizes appropriations for the homeless providers grant and per diem program. This is an important and competitive program. And AMVETS is pleased to support this authorization.  AMVETS also supports the sections dealing with improvements in tele-health, marriage therapists, and mental health services. AMVETS also supports the bill's authorization of additional VA personal to expand National Guard outreach programs. The upward spiral of Guard deployment over the recent past dictates action to improve understanding of benefits available to those who serve in our National Guard.

This concludes AMVETS testimony.  Again, thank you for the opportunity to testify on these important bills, and thank you as well for your continued support of America's veterans.