Last week General Schellhase made a
trip to Washington D.C. to discuss several Kerrville VA Hospital issues with
our Congressmen. Meetings were with Senator Phil Gramm, Representative Lamar
Smith and Mr. Dave Davis, Legislative Aid to Senator Kay Bailey Hutchison.
In general, all meetings were of a
positive nature. Specific issues discussed were as follows:
Support for H.R. 3193
- This bill is the issue of “well grounded” rule
regarding Veterans having to prove their own claim without VA assistance.
Representative Smith assured me he would co-sponsor this bill. Both Senators
said they would support a Senate version, when introduced, if not different
from H.R. 3193.
GAO Reports - It was pointed out to all our congressmen that the last 5
GAO Reports to Congress have highlighted the 25-30,000 empty beds in the VA
system. The reports state that Veterans do not use the system but the reports
never state why, other than there are fewer Veterans. We contend, the empty
beds are due to the system and not the need. When only Priority A Veterans
are allowed to use the system, the use drops off. All assured me they would
direct GAO to address this specific point in their next report to Congress
which should be in April 2000.
H.R. 2116 - It should be noted that all Texas Congressmen voted for this bill - know as the “Veterans’ Millennium Health Care and Benefits Act”. This bill was signed into law by the President last year and presents a couple of problems in it for the Kerrville VA Hospital.
First, the bill set a date of
September 30, 1998 as the date at which level of service should be restored
to. In that much of our hospital was closed by this date, we need a date of
Therefore, we need to work to get
this date amended in the law.
Second, the bill is so written that Texas is excluded from participation in the State Veterans Home funding. This directly effects Kerrville in our work with the Texas Land Commissioner in working to renovate the 5th and 6th floors for a Texas Veterans Home.
Senator Gramm and Mr. Davis felt an
amendment to the date was possible and that there may be a way to get these
renovation funds and would work with Mr. John Snead of the Texas Land
Commissioners office to that end. Mr. Davis said the Mr. Snead had plans to be
in Washington next week to discuss this very matter.
Representative Smith was aware of
these problems with 2116, but Texas did not have enough votes to get the
wording changed. He will look into what can be done on both issues.
Mr. Davis said
Senator Hutchison was aware of the issue and had co-signed a letter with Senator
Gramm to Senator Specter, Chairman, Senate Veterans’ Affairs Committee
requesting an amendment to fix the Texas Veterans Home problem. He seemed quite
sure that Senator Hutchison would work with Senator Gramm to get the needed
Service provided by STVHCS
- Current condition of services were discussed
regarding: management in general, waiting time at hospital, waiting time to get
appointment, overcrowded conditions, number of trips to hospital for different
illnesses, transportation problems, etc.
We also discussed the improvements at
Kerrville - The new PA (Physicians Assistance) added to staff, the eye contract
with Dr. Priour, the hearing clinic with audio booths from Frank Tejeda Clinic,
the assignment of a doctor from the “Blue Team” to the new Gastro Intestinal
Shop and the co-operative effort for the Texas Veterans Home.
Budget 2001 - As you all know from our web site, we asked you to write your
Congressmen in support of the IBVSO proposal of $21.061 billion. This proposal
does not have Congressional support at this time. We have our work cut out for
In general, all Congressmen felt the
President will recommend a budget of about $1.0 billion over last years
recommendation. Senator Gramm felt the Senate will add another billion to the
figure. That will put the VA Health Care budget at about $19.3 billion, about
the same as 2000. However, according to Senator Gramm the $900 million roll
over from 2000 into 2001 will probably be taken into consideration in the
manipulations of figures. Which means the Veterans again take a big cut.
STATEMENT OF KENNETH W. KIZER
Undersecretary of Health VA Before the committee on Veteran's Affairs 29 Jan 1999
Discussion on the report of the commission on Service Members and Veterans Transaction Assistance
which has not been released.
"A over-arching implicit theme is the desire to implicit the two health care systems to work more closely
together. Recommendations to combine congressional appropriations and oversight for DOD and VA
health care systems, as well as budget review at OMB, are included as well as a recommendation for a
joint policy staff serving both DOD and VA and a recommendation for a common information technology
STATEMENT OF TOGO D. WEST, JR.
Presentation to House Committee on Veteran Affairs 11 Feb 1999
VII. Conclusion (quote)
"Mr. Chairman, veterans from all periods of services should be satisfied that this budget is a budget that
protects their interest and lives up to the nations commitment to them."
TESTIMONY OF GEORGE
National President Vietnam Veteran of America 24 Feb 1999
The ordinary processes of the Congress
in the making of a budget will not be such as to allow for the adding of the 2.5
billion it will take just to preserve the delivery of existing health care. In the "business as usual" scenario, it is unlikely that much
more than 300 to 500 million will be added to the administrations inadequate request for health care, inasmuch as the budget
process is played as a zero sum game, and any money not requested by the President, must come from somewhere else.
Mr. Chairman, Vietnam Vets of America urges that you join with Chairman Walsh of the Subcommittee on Appropriation ,as
well as the Chairman of your respective subcommittees ,and your distinguished colleagues on both sides of the isle to find a way
to fund the VHA ,at a level of at least $20 billion. Take the unprecedented step of sending the entire VA budget back to the
administration to come back with a more reasonable submission in a very short time.
TESTIMONY OF HARLEY L. THOMAS
Associate Legislative Director Paralyzed Veterans of America 24 Feb 1999
Under Secretary for Health (Kizer) in his 8 Feb 1999 memo to Secretary West announced his intentions
to begin massive cut backs in staffing and resources now to prepare for even larger cuts imposed by the
disastrously 2000 budget. So called, "strategic planning initiatives", such as program adjustments, facility
integration, bed reductions, consolidations and mission changes, are basically designed to change and
downgrade the VA health care system as we know it today.
Today President Clinton's office of Management Budget in one overt stroke is, calling for and presiding
over, the demise of the VA health through intentional budget strangulation. OMB's crafty design is clear,
to so weaken VA health in one bold stroke that it potentially becomes impossible to revive it.
Based on Independent Budgets projection is to close the equivalent of 26 VA hospitals, a reduction of
8,000 health care staff and reduce the mission of scores of other facilities.
Obviously, VA already has its plan as Dr. Kizer wrote in Feb 8th memo - the plan to "right size" the VA
system. Rather than keeping this plan a secret, we believe the veterans of this nation and the Congress
have a right to see it.
1) How many hospital beds are going to be shut down?
2) How many doctors, nurses and health care providers are going to be fired?
3) Above all, which hospitals are going to close?
4) Where are these closures going to take place? In what areas of the country?
5) In what states?
6) In whose congressional district?
Apart from the impact on veterans, we suppose the White House and OMB, obviously think it makes
sense to close VA hospitals and shut down health care for veterans right in the middle of the year 2000
election campaigns. Last year Dr. Kizer said he wanted VA to be able to admit all veterans to the VA
health care system, That is not going to take place now. We want to see the plan showing just who is
going to get into a VA hospital and who is going to be turned away at the door. All these plans exist. We,
as consumers of VA health care have a right to see them now to prepare our members for the dangers to
their health and well being coming down the road."
522 Rolling Green Drive Kerrville TX 78028
Tel. 830-896-6323 FAX 830-896-6268May 3, 1999
To the Editor:
There's great irony, and not a little hypocrisy, in the fact that the same Administration which calls piously for the nation to support our troops in the Yugoslav campaign is turning its back on those who already have served their country.
Dozens of Veterans Administration hospitals are being closed or downsized into nursing homes, and thousands of doctors and nurses are being retired or fired
The Secretary of Veterans Affairs refused to appear before Sen. Arlen Specter and his Veterans Affairs Committee to explain reductions in veterans' healthcare. Secretary Togo West is quoted (by The Washington Post) as saying that he answers only to the President and does not have to explain his actions and policies to Congress.
At the local level, VA employees say that it's common knowledge that the WNte House has told its Office of Management and Budget to starve the VA by slashing its funds, or, at best, keep funding at current levels even though costs are rising by 10 to 12 percent annually. The resultant downsizing forces veterans onto Medicaid and Medicare roles -- if they qualify.
Senate staffers tell veterans groups that it will take $3 billion a year just to get the VA back where it was in the rffid-1990s. With Congress ordering pay raises for all federal employees -- including those in the VA -- and with Washington telling the VA to begin treating veterans who suffer from hepatitis C, hospital administrators say that there simply isn't enough money to do their job. They admit that they're cannibalizing smaller hospitals in order to keep larger facilities running -- and they say further that if the budget-squeeze continues, the big hospitals will be downsized as well.
Already, veterans complain of increasingly long lines and of having to wait weeks or months when they're referred to specialists.
More than a century ago, Rudyard Kipling attacked Britain's habit of turning its collective back on its soldiers -- its Tommies -- between wars:
. . . it's Tommy this, and Tommy that, and 'Tommy, how's your soul?'
But it's 'Thin red line of heroes' when the drums begin to roll.
. . it's Tommy this, and Tommy that, and 'Tommy, fall behind'
But it's 'Please to walk in front, sir' when there's trouble in the wind.
it's Tommy this, and Tommy that, and 'Chuck him out , the brute!'
But it's 'Savior of his country' when the guns begin to shoot."
That was then; this is now. We have GIs rather than Tommies, and sad to say, we don't have a Kipling. But welching on our national commitment to those who risked their lives for this country is as reprehensible now as it was in Kipling's day, and as obscene on this side of the Atlantic as it was in Victorian England.
by: Lieutenant General Murphy Chesney, USAF Retired MC
Meeting with Dr. Chong
I HAVE SOME CONCERNS ABOUT THE IDEAS THAT WERE PRESENTED AT THE MEETING
YESTERDAY. BECAUSE I PROVIDE MENTAL HEALTH CARE FOR THE KERRVILLE
VETERANS AND HAVE SOME INSIGHT INTO THEIR THINKING,
I WOULD LIKE TO SHARE WITH DR. CHONG WHAT I BELIEVE WOULD DEFUSE
SOME OF THE ANGER/RESENTMENTS TO WHICH HE IS RESPONDING.
FIRST OF ALL, THE WWII AND KOREAN VETERANS ARE MORE ORGANIZED. ARTICULATE.
AND FINANCIALLY ABLE TO PROMOTE THEIR INTERESTS. THUS. IT IS THIS
GROUP'S CONCERNS THAT NEED TO BE ADDRESSED POLITICALLY.
RESUMING CATARACT. AS SUGGESTED YESTERDAY. AND PERHAPS OTHER SURGERIES AT KD WOULD BE PLEASING TO THEM. HOUSING DRUG ADDICTS/ALCOHOLICS WILL IS VIEWED AS A WASTE OF MONEY TO THEM; THAT IN THEIR OPINIONS* IS NOT A HEALTH PROBLEM ASSOCIATED WITH THEIR AGE GROUP.
BY THE COMMUNITY, THAT WOULD BE VIEWED AS BRINGING IN "RIFF-RAFF" OR
SOME OF THE SERVICES THEY HAVE EXPRESSED A DESIRE FOR ARE A POW MEDICAL
CLINIC, WHICH WAS HELD HERE PREVIOUSLY, SUPPORT FOR POW WIVES. AND A CARDIOLOGY CLINIC* THEY HAVE ALSO TALKED ABOUT NEEDING A CARDIOLOGIST FOR OUTPATIENT APPOINTMENTS HERE. I UNDERSTAND THAT WE ARE TRYING TO GENERATE REVENUE. HOWEVER, TO VETERANS, OFFERING CARE TO NON-VETERANS IS TAKEN AS AN AFFRONT: "THEY ARE CUTTING OUR SERVICES BUT THEY WILL SEE SOMEONE WHO'S NEVER BEEN IN THE MILITARY." THIS GENERATES EXTREME ANGER AND UPSET SINCE THEY PERCEIVE THIS AS DISCOUNTING THEIR SERVICE TO THEIR COUNTRY-WE DON'T COUNT." THIS IS JUST A VERY SENSITIVE ISSUE FOR THEM.
I WOULD LIKE FOR SOMEONE TO ASK THE VETERANS WHAT SERVICES THEY CONSIDER MOST NEEDED HERE AT KD. WE CAN GO TO GREAT LENGTHS TO PROVIDE ADDITIONAL SERVICES BUT IF WE DON'T PROVIDE THE ONES THEY ARE EXPECTING/DESIRING, THE VETERANS WILL STILL NOT BE SATISFIED AND THE POLITICIANS WILL CONTINUE TO QUESTION THE SERVICES. SO RATHER THAN WASTE TIME. MONEY, AND EFFORT.
COULDN'T WE ASSESS THE VETERANS TO ACTUALLY ASCERTAIN WHAT SERVICE, OR FEW SERVICES, THEY MOST WANT INITIATED OR RESTORED AT KD?
THANK YOU FOR READING THIS.,
DEBBIE BAILEY, RNCS
Vote Tally for the Wellstone Amendment No. 1747 follows:
Voted Yea: 36 Mbs
|Voted Nay: 63 Mbs
Ted Stevens (R-AK)
Frank Murkowski (R-AK)
Richard Shelby (R-AL)
Jeff Sessions (R-AL)
Blanche Lambert Lincoln (D-AR)
Jon Kyl (R-AZ)
Dianne Feinstein (D-CA)
Wayne Allard (R-CO)
William Roth (R-DE)
Bob Graham (D-FL)
Connie Mack (R-FL)
Paul Coverdell (R-GA)
Daniel Inouye (D-HI)
Larry Craig (R-ID)
Michael Crapo (R-ID)
Peter Fitzgerald (R-IL)
Richard Lugar (R-IN)
Evan Bayh (D-IN)
Sam Brownback (R-KS)
Pat Roberts (R-KS)
Mitch McConnell (R-KY)
Jim Bunning (R-KY)
John Breaux (D-LA)
Mary Landrieu (D-LA)
Paul Sarbanes (D-MD)
Barbara Mikulski (D-MD)
Carl Levin (D-MI)
Spencer Abraham (R-MI)
Rod Grams (R-MN)
Christopher Bond (R-MO)
John Ashcroft (R-MO)
Thad Cochran (R-MS)
Trent Lott (R-MS)
Conrad Burns (R-MT)
|Jesse Helms (R-NC)
John Edwards (D-NC)
Chuck Hagel (R-NE)
Judd Gregg (R-NH)
Frank Lautenberg (D-NJ)
Robert Torricelli (D-NJ)
Pete Domenici (R-NM)
Richard Bryan (D-NV)
Daniel Patrick Moynihan (D-NY)
Mike DeWine (R-OH)
George Voinovich (R-OH)
Don Nickles (R-OK)
James Inhofe (R-OK)
John Chafee (R-RI)
Strom Thurmond (R-SC)
Ernest Hollings (D-SC)
Fred Thompson (R-TN)
Bill Frist (R-TN)
Phil Gramm (R-TX)
Kay Bailey Hutchison (R-TX)
Orrin Hatch (R-UT)
Robert Bennett (R-UT)
John Warner (R-VA)
Slade Gorton (R-WA)
Herbert Kohl (D-WI)
Russ Feingold (D-WI)
Robert Byrd (D-WV)
Craig Thomas (R-WY)
Michael Enzi (R-W)
Not Voting: 1 Mbs
John McCain (R-AZ)
Senator Patty Murray of Washington
intends, in the near future, to introduce a bill in the Senate that would amend
title 38, United States Code, to clarify and improve veterans’ claims and
appellate procedures. Among other things, this bill, if enacted into law, would
clarify that the Department of Veterans Affairs (VA) has a duty to assist
veterans in developing all facts pertinent to their claims, without any
preliminary burden upon the veteran to first supply evidence that the claim is
The courts have misinterpreted the law as requiring veterans, without government assistance, to produce enough evidence to prove their claims are well grounded before VA has any duty to assist them in gathering evidence to substantiate their claims. This defeats the duty to assist because it means that a veteran is not entitled to government assistance in obtaining evidence until he or she has first obtained evidence on his or her own. If the veteran is able to obtain the necessary evidence from government and private sources without VA assistance, he or she then needs no assistance from VA. If the veteran is unable to obtain the necessary evidence alone, the claim is denied as not well grounded. This misinterpretation of law by the courts has unduly and unnecessarily burdened veterans and immensely complicated the claims process for both veterans and VA.
The bill also includes several other provisions that are beneficial to veterans. The DAV views this as one of the most important bills for veterans to be introduced in the 106th Congress.
We therefore request that you contact your Senators and urge them to cosponsor this bill, entitled "Veterans Claims and Appeals Procedures Clarification and Improvement Act of 1999."
National Commander Michael E. Dobmeier, in letters
to President Clinton, House Majority Whip Tom DeLay (R-Tex.), and every member
of the U.S. House of Representatives, said that a proposed 1.4 percent reduction
in the fiscal year 2000 Department of Veterans Affairs (VA) health care budget
would threaten the health and lives of the nation's 2.3 million disabled
veterans. Commander Dobmeier called on President Clinton to exercise his
leadership to stop the effort to cut veterans health care funding. "This
proposed across-the-board spending reduction flies in the face of the needs of
our veterans and ignores the intent of Congress and the Administration which
approved a $1.7 billion increase in veterans health care funding," Commander
Dobmeier said in his letter to Rep. DeLay. "The $1.7 billion increase is less
than required to fulfill our nation's promise to adequately care for veterans.
This is especially true since most of the $1.7 billion increase essentially will
be delayed until fiscal year 2001. Any further reductions will catastrophically
affect veterans health care and breach the promises made to our men and women
who served this nation so honorably." The DAV and others had clearly identified
the need for an additional $3 billion in fiscal year 2000 funding for VA health
care in order to continue the same level of services to America's sick and
disabled veterans. Commander Dobmeier said that a statement by Congressman DeLay
alleging $480 million in mismanagement and waste in VA health care does not make
the case for additional funding reductions. "If such fraud and waste exist, I
urge that the VA identify such cases and eliminate them," he said. "If the VA can't, then Congress is required to act. But reducing VA funding and then searching for cost savings is not an effective mechanism to ensure that veterans receive adequate health care." Commander Dobmeier urged President Clinton to exercise his leadership in defeating "this movement toward fiscal irresponsibility which would adversely affect the health and lives of fellow veterans. Our nation is based on the premise of liberty, which has been bought and paid for with the lives and limbs of millions of American men and women." The Disabled American Veterans, a non-profit organization founded in 1920 and chartered by the U.S. Congress in 1932, represents 2.3 million disabled veterans. It is dedicated to one, single purpose: building better lives for our nation's disabled veterans and their families
1. Reduce the share of patients reporting
coordination of care problems in the outpatient setting to 14% by FY 2001 and
12% by FY 2005.
2. By 2005, 100% of funded research projects will be relevant to VA's healthcare mission in designated research areas.
3. Increase the number of nique patients treated in the healthcare system by 20% by FY 2002. Reach 18% by FY 2001.
4. Increase the scores on the Chronic Disease Care Index to 91% by FY 2001 and 95% by FY 2005.
5. Increase the scores on the Prevention Index to 83% by FY 2001and 90% by FY 2005.
6. Expand to 659 by FY 2003 the number of Community Based Outpatient Clinics (CBOC) at which veterans and eligible dependents can receive outpatient care. Achieve 635 by FY 2001.
7. Increase all alternative revenues to 6.4% in FY 2001 and 7.6% in FY 2005 including medical recoveries, Medicare, and other sharing revenue as a percentage of the Medical Care operating budget. (FY 1997 baseline: $5,458). Achieve 24% by FY 2001.
8.Increase the percent of customers rating VA healthcare as very good or excellent to 68% in FY 2001 and 72% in FY 2005 (inpatient and outpatitent)
9. Reduce the average cost per patient by 30% in FY 2002. (FY 1997 baseline: $5,458). Achieve 24% by FY 2001.
10. Increase percentage of spinal cord injury respondents to the National Customer Feedback Center (NCFC) who rate their care as very good or excellent to 58% by FY 2001 and 62% by FY 2005.
11. Increase the percentage of veterans who acquired Independent living arrangements at discharge from a Domicilary Care for Homeless Veterans (DCHV) Program or a community-based contract residential care program to 56% by FY 2004. (FY 1997 baseline = 8,502)
12. By FY 2001, treatment will be provided for patients who are Hepatitis C for whom treatment is medically appropriate and desired. A baseline of data will be developed in FY 2000.
13. Implement primary care by increasing the percentage of patients who know there is one provider or team in charge of their care to 84% in FY 2001 and 89% in FY 2005.
14. By FY 2001, see 72% of all patients with scheduled appointments at VA healthcare facilities within 20 minutes of their appointments. By FY 2005, see 80% of all paients within 20 minutes.
15. Increase education time and other learning experience time to a minimum of 2% of total work time or 40 hours per year for 70% of all permanent full-time employees by FY 2005.
Please consider this proposal carefully, and indicate your agreement, disagreement, or any suggestions you may have by E-mail. (Click on the "E-Mail" above or below to bring up a ready-to-post letter)
Thank you for your feedback, it's important to us all !
Joseph A. Violante, National
Legislative Director Concerning
COSPONSORSHIP OF H.R. 3193
SUBJECT: LEGISLATIVE ALERT-E-MAIL MESSAGES TO HOUSE MEMBERS
DATE: November 4, 1999
On our legislative advocacy program, accessible from our Internet web site, we currently have a prepared E-mail message for House members requesting their cosponsorship and support of H.R. 3193. This is a bill Congressman Lane Evans (D-Ill.) introduced. It will amend the law to correct the problems resulting from the courts' misinterpretation of the rule on "well-grounded" claims and duty to assist. E-mail messages and letters need not be sent to the following House members because they have already cosponsored H.R. 3193: Bob Filner (D-Calif.), Mike Doyle (D-Pa.), Ciro Rodrigues (D-Tex.), Ronnie Shows (D-Miss.), Julia Carson (D-Ind.), Shelly Berkley (D-Nev.), Neil Abercrombie (D-Hawaii), and Tim Holden (D-Pa.). However, you are encouraged to send thank-you letters to these
members of Congress from your state.
Because H.R. 3193 is an extremely important bill, we ask that all National Service Officers and support staff, DAV departments, chapters, and members send this message to their members of Congress. For those on the Internet, access the service through the DAV home page at www.dav.org and select the "Legislation Action" button. Then, select "Write to Congress."
JOSEPH A. VIOLANTE
National Legislative Director
HILL COUNTRY VETERANS COUNCIL
1700 Sidney Baker, Suite 100
Kerrville, Texas 78028
Ph 830-896-1157 Fax 830-896-1175
22 December 1999
Mr. Stephen P. Backhus, Director
Veterans' Affairs & Military Health Care Issues
Department of Veterans Affairs
810 Vermont Avenue, N.W.
Washington, DC 20420
Dear Mr. Backhus:
I have recently had the opportunity to read your testimony before the GAO last July. I found it
very interesting that your study over the past 5 years was based on: 1) location visits, 2) visits to
VHA headquarters, 3) discussions with officials, 4) reports by inspectors generals, and 5) private
Where were the visits with the millions of Veterans being served by the VA? Also your report
included nothing about why the utilization of our hospitals is on a decline. Your report failed to
disclose that when VA changes the rules as to who can receive treatment at a VA facility the
utilization goes up or down depending upon the rule being changed.
As an example, in 1992 as a Priority Group 7, I was entitled to medical care at our local VA
hospital. In 1998, because of the so called budget constrains, I was no longer eligible for care. In
Oct 1999 the rules were again changed so that I could receive care and so could my wife. So
utilization is totally dependent up the rules at the time.
It would have appeared to me that GAO and Congress should be told how the rules effect the
utilization. If utilization is the basis for changes, consolidations, closures, etc., you should
determine why the under utilization occurs.
Granted, many or our facilities are old, run down, poorly maintained and poorly staffed. Is there
any possibility that these conditions account for the poor utilization? I think yes.
I would suggest for your next GAO report: I ) an in-depth survey of Veterans - those using the
VA facilities and those not using them - to report a Veterans view on what health care he or she
needs, 2) a complete review of utilization and why. Starting with the assumption the Veterans
are out there (25 - 30 million of us), so why don't they use our facilities?
Our figures show ( as do most Veterans organizations) that the number of Veterans in this
country will continue to grow until about 2005 - 2008, not decrease. The reason being Veterans are living longer and new ones continue to enter the system. After 2008 there will be a decline
that will continue thru the year 2020 at which time there will be a leveling off of total Veteran
count. The year 2020 is totally predicated on the fact the US has no additional major conflicts.
However, until 2005 - 2008 we should not be worried about saving 1 1/2 - 2 % per year, but providing those dedicated Veterans what was promised - quality health care.
Your report also failed to disclose the millions the VA spends on research and teaching in
conjunction with universities. Sure some is needed, but not at the expense of adequate health
care for our Veterans.
Hill Country Veterans Council
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