STATEMENT OF
LAWRENCE A. BIRO
DIRECTOR, VA SOUTHEAST NETWORK (VISN 7)
VETERANS HEALTH ADMINISTRATION
DEPARTMENT OF VETERANS AFFAIRS
BEFORE THE
UNITED STATES SENATE
COMMITTEE ON VETERANS' AFFAIRS
AUGUST 28, 2007

Mr. Chairman, and Members of the Committee:
Thank you for allowing me to appear before you today to discuss the Active Duty Rehabilitation Unit at the Augusta VA Medical Center (VAMC), operated by the Augusta VA Medical Center in partnership with the U.S. Army Southeast Regional Medical Command (SERMC).  Veterans Integrated Service Network (VISN) 7 serves the broad tri-state region of Georgia, Alabama and South Carolina, home to 1.5 million veterans.
In October 2005, Secretary Nicholson presented the Augusta VAMC with the Olin "Tiger" Teague Award, the highest award recognized in VA.  Secretary James Nicholson remarked that "doctors, nurses, rehabilitation specialists and support staff, came together at the Augusta VAMC in what can only be described as a blessed partnership of caring, healing, and compassionate health care professionals."
I could not agree more, and it is a privilege to testify today on their behalf.
The Augusta VAMC and the Eisenhower Army Medical Center (AMC) have a long history of partnering to provide exemplary care to veterans and service members.  In October 1993, the Augusta VAMC and Eisenhower AMC began sharing operations under a Joint Venture for Shared Services (JVSS) agreement approved at the highest levels of VA and DoD.  This agreement allowed the facilities to share services with few restrictions.  The joint venture also streamlined the process for establishing local agreements to meet the urgent needs of both facilities.  VA and DoD created a joint neurosurgery program, and since that time, all neurosurgery services for veterans and service members are provided at Augusta VAMC with the help of Department of the Army neurosurgeons.
Over the past 15 years, VA and DoD have relied on the JVSS for a number of other business sharing and medical care agreements, including open heart surgery, imaging services (including mammography), gynecological/obstetric services, separation physical examinations, expansion of laboratory services, physical and occupational therapy, intensive care unit (ICU) beds, echocardiogram readings, and lodging for Eisenhower inpatient substance abuse programs, among others.
The 2003 National Defense Authorization Act (NDAA) expanded VA-DoD health care resource sharing and coordination projects by including coordinated management operations in budget and financial management systems, coordinated personnel staffing, and interlinked medical information technology systems.
Pursuant to this Act, the Augusta VAMC and Eisenhower AMC received funding for a national demonstration project in coordinated personnel staffing.  The project focused on hiring registered nurses (RNs) for critical care and was later expanded to include neurosurgery.  VA and DoD used approved funds from this project to hire two new neurosurgeons to continue the joint program.  This project is due to expire at the end of Fiscal Year 2007, and Augusta VAMC and Eisenhower AMC officials are discussing how best to continue the neurosurgery program.
In 2004, VA and DoD agreed to adopt a rate 10 percent below the CHAMPUS Maximum Allowance Charge for outpatient services provided by one Department to the other, in accordance with the 2003 NDAA.  VISN 7 and the SERMC established a blanket sharing agreement, which provided guidance to VA and DoD facilities on outpatient and inpatient care billing practices.  Inpatient rates of exchange were based upon the interagency exchange rate or locally agreed upon rates to ensure coverage of facility costs.  VA and DoD updated this agreement in FY07.
While all of these accomplishments are certainly noteworthy, our cooperation on treating the critical health care needs of military service personnel injured in Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF) is truly our "crown jewel."  In 2003, VISN 7 and SERMC partnered to create the Augusta VAMC Active Duty Rehabilitation Unit, which provides rehabilitative care, including both traumatic brain injury (TBI) and blast injuries, to Soldiers, Sailors, Airmen and Marines.
The Active Duty Rehabilitation Unit represents the best of VA and DoD medical care, and represents the fulfillment of our promise to veterans and service members.  Mr. Chairman, this concludes my prepared remarks.  I would like to request my written statement be submitted for the record, and I would be happy to answer any questions you may have.