Statement of
Major General Robert G. F. Lee
The Adjutant General of the State of Hawaii
Before the
Senate Committee on Veterans' Affairs
Relating to State of VA Health Care in Hawaii

 Chairman Akaka, Senator Craig and members of the Senate Committee on Veterans' Affairs, I am Major General Robert G. F. Lee, The Adjutant General for the State of Hawaii. 
 Within the State Department of Defense, there are five major divisions: the Hawaii Army and Air National Guard, State Civil Defense, Youth Challenge Academy, and the Office of Veterans' Services (OVS).  The Director of Office of Veterans Service is Mr. Mark Moses, a retired Marine major and a former state legislator.
 The Office of Veterans' Services is the single office in the State government responsible for the welfare of our veterans and their families.  OVS serves as the liaison between Governor Linda Lingle and the veterans groups and organizations.  They also act as an intermediary between the Department of Veterans Affairs and Hawaii's veterans.
 Veterans make up more that ten percent of Hawaii's total population.  The majority of them - about 72% - live on the island of Oahu.  About 13% reside on the island of Hawaii, 10% live on one of the three islands that comprise Maui County, and about 5% live on the island of Kauai.
 Within this large veteran population are many World War II veterans, many members of the famed 100th Battalion and the 442nd Regimental Combat Team.  Hawaii's overall numbers were declining because many veterans of this era, most in their 80s, are passing on in large numbers.
 But since September 11, 2001, mobilizations have involved nine of every ten Army National Guard and Reserve soldiers.  They served honorably in Iraq, Afghanistan and other locations; and have returned to Hawaii after their 12-15 month activations.  Air National Guard members have also deployed in support of Operations Iraqi Freedom and Enduring Freedom. Therefore, Hawaii's overall veteran population has increased.
 We must insure these new veterans return to their civilian lives in good health.  The Office of Veterans Services partners with the Veterans Administration here during the soldiers demobilization process.  This partnership works to insure no one or no benefit falls through the crack.
 The United States government has an obligation to our military members from enlistment, through their service years, to veterans' benefits and finally, death benefits.  We must insure that all veterans receive all entitled benefits now and in the years to come. 
 The National Guard Bureau recently issued a memorandum authorizing both the Army and Air National Guard to release medical records to the Department Veterans Affairs without the veteran's signature.  This new procedure speeds the Department of Veterans Affairs adjudication of veterans' claims and provides medical care to Guard members.
 I come to you with a few concerns. 
 My most important concern is the access to Veterans Administration services to all our veterans, especially, on our neighbor islands and our Pacific Islander veterans from Tinian, Rota and Saipan.  In July 2007, a VA clinic opened in American Samoa that supports our veterans there.  However, veterans from other Pacific islands must pay the high cost of airline and hotel accommodations to receive follow-on VA medical treatment.  In Hawaii, a similar situation occurs when neighbor island veterans must come in to Tripler Army Medical Center or the Matsunaga VA Hospital in Honolulu for treatment.  We must work to find a solution to this situation.
 My next concern deals with the certification of a disability by the Department of Veterans Affairs.  Often a service member is awarded a decoration recognizing the specific incident that is associated with an injury or disability.  However, when filing for a disability, the VA requires a complete recertification of the incident causing the injury or disability.  Approval and certification of this letter of determination is required prior to providing any services.
 My final concern is the recruitment and staffing of VA hospitals to the levels that they are authorized.  For example, the Post Deployment Health Reassessment Program (PDHRA) requires an initial appointment within 30 days of VA registration.  On average, the VA hospital schedules initial appointments as much as 90-120 days from the registration date.  Our local VA hospital staff has been doing their best to provide services, but needs a full staff to serve all our veterans.  They have stretched their limited health care provider resources to support veterans in the Pacific Basin.
 In closing, I want to thank the committee for their continuing support of our veterans.  Thank you for coming to Hawaii to conduct these hearings.
 Are there any questions?