Area VA facilities expect to dodge closure

By Bonnie Pfister and Cindy Tumiel
Express-News Staff Writers

Web Posted : 06/07/2002 12:00 AM

South Texas veterans likely will retain access to subsidized medical care as the U.S. Department of Veterans Affairs reorganizes its health system based on national need, VA officials said Thursday.

"We've had no indication that anything is going to be closed, changed or realigned," said D. Creager Brown, spokesman for South Texas Veterans Health Care System. "One of the big reasons is because we have virtually no duplication of services in the South Texas area."

The South Texas system includes San Antonio's Audie Murphy Veterans Memorial Hospital and Frank M. Tejeda VA Outpatient Clinic, Kerrville Veterans Hospital, and primary-care clinics in Corpus Christi, Victoria, McAllen and Laredo.

There are about 300,000 veterans in the region, but just 56,000 enrolled in the VA health care system, Brown said. Of the roughly 400,000 patient visits systemwide in fiscal year 2001, about 225,000 were at San Antonio facilities.

If anything, observers say that an objective evaluation of national demographics and demand for VA services in predominantly Hispanic South Texas should bring increased care.

Proportionate to their population, more Mexican Americans served in World War II than any other identifiable ethnic group, scholars of Hispanics in the military say.

Additionally, population growth is up in Sun Belt states like Texas, and down in some northern cities. The Lower Rio Grande Valley alone was home to 143,000 elderly retirees from 2000-2001.

Last year 1,100 Winter Texans availed themselves of services in McAllen, said Roger Roehl, the health system's administrative director.

The VA provides subsidized services in South Texas through its four primary care clinics, and by contracting with non-VA facilities in Brownsville, San Benito and Edinburg, Roehl said.

The McAllen facility also provides general surgery, radiology, physical therapy, orthopedics, podiatry and psychiatric services.

The system is considering collaboration with the new University of Texas Health Science Center's regional facility in Harlingen.

Still, about 40 Valley veterans take VA-funded vans to San Antonio every week to access special services only available at Audie Murphy.

Free vans also travel twice a week from Laredo, where Webb County Veterans Service Officer Jesus Cantu says service should be more comprehensive.

"It's not unusual for aged veterans to have a loss of hearing. But to get a hearing aid, we've got to go all the way to San Antonio," Cantu said.

San Antonio is also the only option for those needing to follow up on prostate cancer biopsies or to treat serious stomach ailments, Cantu said.

He was hopeful that the VA might consider contracting for specialty services with Laredo hospitals or the UTHSC facility that is scheduled to open in coming months.

"It would be a big plus. If they have anything serious, they need to get on a van, go to San Antonio, wait for an appointment, then come all the way back," he said.

The VA's move away from hospitalization toward outpatient care and primary care clinics follows a similar initiative in South Texas in the late 1990s.

"Every attempt is made to bring health care closer to the veteran and to make it as convenient as possible for them to use our services," said Jose R. Coronado, director of the South Texas Veterans Health Care System.

In 1999, Hill Country veterans successfully battled the elimination of inpatient care and other service reductions at the Kerrville VA Hospital. Today the facility has 25 beds for acute care and 154 beds for long-term care, officials said.

"Our main hospital building is 100 percent occupied," said Walter Schelhase, a retired Army general who is president of the Hill Country Veterans Council.

Schelhase said he feels relatively secure about the Kerrville hospital's future based on comments by Veterans Affairs Secretary Anthony Principi during a tour there last year.

"He said, 'This hospital will not close,'" Schelhase recalled. "But I guess they could come to Kerrville tomorrow and say, 'Close that hospital' if the budget so dictated."

Express-News Staff Writers Zeke MacCormack and John Tedesco contributed to this report.



May 31

The Department of Veterans Affairs is contacting participants in military tests involving biological and chemical warfare materials during the 1960s about medical care and benefits to which they may be entitled. Initial notifications went to 622 of some 4,300 veterans identified so far as participants in Project SHAD (Shipboard Hazard and Defense). The SHAD tests were conducted to determine the effectiveness of shipboard detection and protective measures against chemical and biological threats and to determine the potential risk to American forces. Medically significant information from twelve tests has been declassified and released to the VA: Autumn Gold, Copper Head, Shady Grove, Eager Belle (phases I and II), and Scarlet Sage, Fearless Johnny, Flower Drum (phases I and II), DTC Test 68-50, DTC Test 69-32, and Purple Sage. Additional letters will be sent as more test reports are declassified. Veterans concerned should call 1-800-749-8387 or e-mail shad.


June 7, 2002

Last month, Defense Department spokesman Dr. Michael Kilpatrick briefed Gulf War veteran leaders about the Khamisiyah chemical warfare agent exposure plume, and during the briefing he said that DoD's effort to explain the possibilities of exposure to sarin and cyclosarin was non-scientific. Subsequently, Steve Robinson, Executive Director of the National Gulf War Resource Center, wrote the Department of Veterans Affairs, declaring that "Gulf War veteran leaders are stunned to hear his comments because they represent a reversal in DoD policy." Robinson added that "the benefit of the doubt should be in favor of the veteran when the veteran seeks health care or compensation benefits for medical conditions associated with chemical warfare agent exposure." Therefore, the only fair and reasonable solution for ill Gulf War veterans is for VA to affirm the presumption that every deployed Gulf War veteran was exposed to chemical weapons, he asserted.

June 13, 2002

Military retirees generally must forfeit one dollar in retired pay for every dollar of VA disability compensation they receive. However, signs are that Congress will pass legislation to eliminate that inequity over a five year period for retirees with disability ratings of 60 percent or higher. The VA estimates that perhaps 80,000 would be in line for a pay hike, from a minimum of $790 a month for 60 percent disabled to a minimum of $2163 a month for 100 percent disabled. In addition, as many as 118,000 retirees now drawing VA compensation might file for a review of disabilities with hopes of moving into the 60 percent or higher brackets. In addition, some 700,000 new claims could be expected within five years, said a VA official.


June 18, 2002

Gulf War Medical Research Library 

The Departments of Defense, Health and Human Services, and Veterans Affairs have joined together to create this centralized reference library of government-sponsored Gulf War-related medical research. This library was developed to help service members, veterans, families, and the public learn about research efforts into health concerns related to service during the Gulf War. 

This web site reflects the federal government's desire to make the results of government-sponsored research available to as many people as possible. Additionally, this web site will provide scientists and others in the medical field the ability to learn about achievements and initiatives in Gulf War-related medical research. 
This service is brought to you by the Department of Defense, Department of Health and Human Services, and Department of Veterans Affairs in cooperation with the Deployment Health Support Directorate. 
The appearance of external hyperlinks does not constitute endorsement by the Deployment Health Support Directorate of the linked web sites, or the information, products or services contained therein. 

This service is brought to you by the Department of Defense, Department of Health and Human Services, and Department of Veterans Affairs in cooperation with the Deployment Health Support Directorate.

The appearance of external hyperlinks does not constitute endorsement by the Deployment Health Support Directorate of the linked web sites, or the information, products or services contained therein.

Please read this privacy and security notice.

Medsearch was last updated on June 18, 2002 

June 20, 2002
Defense Bill Veto Threat Riles Disabled Veterans

Renewed threats of a presidential veto of legislation that would allow disabled military retirees to receive both disability and retirement benefits perpetuates a gross injustice against America's disabled veterans.

At issue is the Senate's Defense Department authorization bill which has prompted renewed veto threats from the White House Office of Management and Budget. One of the provisions the White House finds strongly objectionable would repeal a century-old prohibition against the concurrent receipt of military longevity retired pay from the Department of Defense and disability compensation from the Department of Veterans Affairs.

"It is fundamentally wrong that military retirees must forfeit a dollar of their longevity retired pay for every dollar they receive in veterans' disability compensation," said George H. Steese, Jr., National Commander of the Disabled American Veterans.

In a June 18 meeting with President Bush, National Commander Steese voiced the DAV's strong support for concurrent receipt.

"It is unconscionable that the White House would perpetuate this gross injustice against those men and women who dedicated more than 20 years of their lives in the armed forces and who were disabled as a result of their service to our nation," said Commander Steese. "What message does this send to the brave men and women who today are serving this nation in the war against global terrorism?"

As approved by the Senate, the defense bill would authorize concurrent receipt of longevity retired pay and disability compensation for military retirees eligible for non-disability retirement.

The House version of the defense bill, which earlier drew a veto threat from the White House, also would authorize concurrent receipt of VA disability compensation and military retirement pay.

"The men and women who have dedicated their lives to serving our nation and became disabled as a result of their service deserve to be treated fairly," said Commander Steese. "They are counting on Congress and the White House for justice."

The nearly 1.3 million-member Disabled American Veterans, a non-profit organization founded in 1920 and chartered by the U.S. Congress in 1932, represents this nation's disabled veterans. It is dedicated to a single purpose: building better lives for our nation's disabled veterans and their families. For more information, visit the organization's Web site

You can access the updated version of the alert and letter to the President by clicking here.

June 22, 2002

Maj. Gen. Leonard M. Randolph Jr. of Tricare Management Activity has published communication guidelines for patients. Highlights: Listen to your body and write a diary of symptoms before an appointment. Do not be embarrassed about describing symptoms. Bring a written list of allergies, medications and supplements, along with written questions and concerns. Don't believe everything you read on the Internet, but do bring in relevant articles from any source. Take the time needed to heal and stay healthy. And keep the healing plan simple by asking questions during the appointment and requesting a telephone consultation or a follow-up appointment if you have further questions or concerns.



TO: National Officers
National Service Officer Supervisors
Department Commanders and Adjutants
Benefits Protection Team Leaders
National Interim Legislative Committee
Hospital Service Coordinators
State Directors of Veterans Affairs
DAV CAN Members
Action E-List Members
DAVA National Adjutant

FROM: David W. Gorman, Executive Director, Washington Headquarters
June 26, 2002 

Due to perennially inadequate health care budgets, the Department of Veterans Affairs (VA) health care system can no longer meet the needs of our nation’s service-connected disabled veterans and other enrolled veterans. National Commander George H. Steese, National Adjutant Arthur H. Wilson, and I met with President George W. Bush on June 18, 2002, to discuss the growing VA health care crisis and the inability of our nation’s service-connected disabled veterans to receive health care in a timely manner.

We shared our concern about the current funding shortfall for VA health care with President Bush and urged him to consider a proposal to make VA health care funding mandatory to ensure the viability of the VA health care system for current and future sick and disabled veterans. Detailed information about our proposal is enclosed.

Please feel free to share this information with your local DAV chapters and local veterans. We appreciate your continued support.

Executive Director, Washington Headquarters



Veterans News 

VA takes aim at backlog of claims 

(Based on an article by Laurie Kellman of the Associated Press) 

The Department of Veterans Affairs has doubled the number of claims it decides each month and reduced a mountainous backlog of benefit requests dating back years, Secretary Anthony J. Principi said. That backlog generated widespread concern on Capitol Hill and among veterans groups as it ballooned during the 1990s. But it has been cut from 600,000 to 394,000 claims in recent months. 

“We decided to really declare war on that backlog and took some rather bold steps to address it,” Principi said in an interview. “We’re really getting this backlog under control, and we did it through sheer focus and discipline, performance measurements and production goals.” 

VA claims managers now resolve about 70,000 claims a month, more than double last year’s monthly rate of 29,000, he said. In addition, the department has established a “tiger team” of managers in Cleveland. It ruled on claims for about 28,000 veterans over the age of 70 who had waited more than a year for an answer, he said. 

Veterans hailed Principi’s commitment to the issue but said it remains to be seen whether the agency is properly deciding claims. 

“We have seen the figures where VA has been increasing their production. I believe Secretary Principi is seriously concerned about the state of the VA backlog and the adjudication process,” said Joe Violante, national legislative director for Disabled American Veterans. “Our concern, however, is that while they are increasing their production, if they are not getting them right the first time they are no better off than if they weren’t processing those cases,” he said. 

Principi said he did not have exact figures, but added that most of the processed claims approve benefits for the veterans requesting them. 

“It’s a case study that things can, in fact, turn around – not only in private-sector corporations but in government bureaucracy as well,” said Principi, a U.S. Naval Academy graduate and Vietnam War veteran. 

The VA, the second-largest government agency with 220,000 people, has been besieged with caseload problems. Last year, Congress blasted the department for training problems that resulted in inaccurate decisions on 4 of every 10 claims for veterans’ disability payments. 

Newly confirmed by the Senate last year, Principi told Congress and the General Accounting Office, its investigative branch, that fixing those problems would be one of his top priorities. He implemented GAO recommendations to set up a system to track the outcome of video conferencing and other state-of-the-art training methods. 

Looking forward, Principi said he has set up “triage” teams in various regions – Texas, Florida, Washington, for example – to handle massive amounts of claims and prevent future backlogs. 

He said the department is not favoring speed over accuracy. “It’s not that we’re just rushing these decisions and forgetting about the quality aspect of it,” Principi said. “We’ve focused on both time lines and quality.” 

Restructuring the VA claims processing 

The Department of Veterans Affairs has created a pilot program with the goal of reforming its claims processing system. The new program calls for a reorganization at the front lines. The goal is to create specialized teams, who will review the benefits claims for veterans and their spouses and who will refine the day-to-day duties and procedures. 

The test pilot calls for an initial, specialized team to perform “triage” on all of the incoming mail, pulling the claims that can be processed within a 2-3 day period. The team will then distribute the more complex claims to the offices of the other specialized teams, who work with particular types of claims, such as appeals, degree of disability/time in service, or customer service issues. 

This pilot program has been started in four regional offices and will be instituted to the rest of the 57 regions as soon as all potential bugs have been worked out. 

VA launches inventory of cemetery memorials 

– Volunteers Sought – 

The VA began the first comprehensive inventory of an estimated 300 memorials at about 100 national cemeteries to coincide with National Historic Preservation Week, May 12-18, 2002. 

VA is looking for volunteers through September to gather historical information and detailed descriptions of the memorials. Individual headstones and post-1960 text tablets are excluded from the inventory project, which will last through the year. 

VA has a great number of cemetery memorials, large and small, beginning with those installed after the Civil War. Historic cemetery memorials include inscribed stone blocks, bronze tablets affixed to boulders, sundials, sarcophagi, obelisks, columns and the ubiquitous soldier standing atop a granite pedestal. 

Contemporary memorials are typically a standardized 18” x 24” bronze plaque. Some, however, are substantial buildings, such as the Medal of Honor Memorial (1999) at California’s Riverside National Cemetery and the Pennsylvania Veterans’ Memorial (2001) at Indiantown Gap National Cemetery in Annville, PA. The project will also offer essential information to support VA’s goal of maintaining its cemeteries as the best in the world, an objective VA calls its “national shrine commitment.” 

VA is recruiting volunteers from diverse sources, including Civil War organizations, scout groups, veterans’ service organizations and VA employees. Volunteers will be given a cemetery map, survey form, instructions and film to take photographs of each memorial, and are encouraged to conduct some local historical research as part of the project. 

The solicitation is based on the model developed by Save Outdoor Sculpture (SOS!), a Washington, DC-based, non-profit organization that uses volunteers to survey public outdoor sculpture nationwide. Information gathered through the SOS! program is publicly accessible through an on-line database managed by the Smithsonian American Art Museum (SAAM), called SIRIS As part of its educational program, VA will make its findings available to SOS! and SAAM. 

VA manages 120 national cemeteries as well as 33 government, soldiers’ and confederate lots in non-federal cemeteries throughout 41 states, the District of Columbia and Puerto Rico. More information about the project and how to volunteer is found at under “What’s New.” Interested individuals or organizations can also email or write to: 

Sara Amy Leach, Historian 
Department of Veterans Affairs 
National Cemetery Administration 
810 Vermont Ave., NW (402B4) 
Washington, DC 20420 

VA Cemetery Advisory Committee 

The Department of Veterans Affairs has created a 12-person committee that will oversee its 120 national cemeteries. The function of the advisory committee, formally the Advisory Committee on Cemeteries and memorials, is to oversee the grants that support the state veterans cemeteries, the creation of additional cemeteries, the VA burial benefits and the maintenance of the veterans’ cemeteries. 

The new members on the Cemetery Advisory Committee are: Percy Butler, Nancy T. Norton, Leo P. Burke, Robert L. Cardensas, Roland F. Cinciarelli, George R. Cramer, Cooper T. Holt, Mylio S. Kraja, Joseph J. Martory, Robert G. Moorehead, Margaret Murphy Peterson, and Benedict J. Spardo. 

VA begins Phase II of CARES Process 

The Department of Veterans Affairs is beginning Phase II of its national initiative to ensure its health care system meets the needs of veterans today and in the future. This initiative is part of VA’s health care planning process called CARES (Capital Asset Realignment for Enhanced Services). 

The first phase of the CARES process was conducted in the Chicago area, Wisconsin and the Upper Peninsula of Michigan, and was completed in February 2002. Phase II will include the rest of the VA health care system and is scheduled to be completed within two years. 

“VA’s goal is to direct our resources where they are most needed, and at the same time provide the best care possible to more veterans at more locations,” said Deputy Secretary of Veterans Affairs Dr. Leo S. Mackay. Jr. “We will work with veterans, VA employees, university affiliates and local and national elected officials to ensure everyone’s concerns are heard as we enhance the quality of veterans health care.” 

VA launched CARES to bring its aging health care system into the 21st century. VA’s health care system was designed and built decades ago when inpatient care was the primary focus, with long admissions for diagnosis and treatment. With changes in geographic concentrations of veterans and new methods of medical treatment, VA’s medical system was not providing care as efficiently as possible and medical services were not always easily accessible to some veterans. 

“VA health care is changing now, and for the better,” said Mackay. “We’ve gone from mostly an inpatient setting where we treat illness in its latter stages to a system focused on disease prevention, early detection, health promotion and easier access. VA’s infrastructure, designed a half century or more ago, must be evaluated and updated to meet the needs of veterans today and in the future. That’s what CARES will do.” 

To coordinate VA’s 1,300 sites of care, representing the largest health care system in the country, VA’s medical system is divided into 21 regional networks called VISNs (Veterans Integrated Service Networks). VISN 12 (Chicago, Wisconsin and Upper Michigan) comprised the pilot study; Phase II of CARES will include the remaining 20 VISNs. 

During the next 18 months, the networks will collect data and facility information for planning initiatives that will provide the best care for veterans today and in the future. Throughout the process, veterans, academic affiliates, unions and employees will be briefed. Stakeholder opinions will be solicited and will be an important part of the decision process, as will be the preservation of special services, such as those provided our paralyzed veterans. 

Once completed, an independent commission selected by the Secretary of VA will evaluate the draft National CARES Plan. Members of the commission, who will be chosen in the fall of 2002, will include individuals with special knowledge or interest relating to VA health care, as well as representatives from stakeholders’ groups. 

As part of the commission’s evaluation of each VISN’s plans, hearings will be held with, and comments accepted from, local stakeholders. Only after careful evaluation of these comments will the commission then forward its recommendations to the Secretary. The Secretary will make his final CARES announcement in September 2003. 

Phase II of CARES will be headed up by Frederick L. Malphurs, who was the VISN 2 Network director for the upstate New York (Albany, Buffalo, Bath, Canandaigua and Syracuse VA medical centers) since October 1995. Since joining VA in 1969, Malphurs has been assigned to nine VA medical centers. 

Malphurs will work with an independent actuarial contractor and VA staff to project veteran populations, determine what kind of health care veterans need and where it is best to provide that care. This data will be available to networks within two months. 

“Health care is no longer about bricks and mortar. Twenty-first-century health care is about access to local care, early detection and prevention, efficient use of new technologies and home health care,” said Mackay. “CARES is about 21st-century health care.” 

Health agreements reached with VA 

Pentagon Under Secretary of Defense for Personnel and Readiness David S. C. Chu reached agreements with Deputy Secretary of Veterans Affairs Leo MacKay on a single financial reimbursement methodology between the agencies and on a commitment to conduct joint strategic planning. The reimbursement methodology decision will result in the pursuit of a single regionally adjusted discounted rate structure for DoD-VA medical-sharing agreements. Currently, multiple methodologies are used to set reimbursement rates by the many health facilities of VA and DoD leading to complex and difficult to administer billing and collection processes. Plans call for initial implementation of this rate structure for ambulatory care services during the first quarter of FY03. Implementation for inpatient care, both facility and the professional fee components are targeted to begin in the third quarter of FY03. 

Federal Benefits for Veterans and Dependents Handbook 

Most of the nation’s 25 million veterans qualify for some kind of VA benefit. These benefits range from health care to burial to home loans. The Federal Benefits for Veterans and Dependents Handbook not only lists and describes the various benefits offered by the Department of Veterans Affairs, but has the rates for certain federal payments and includes the various contact information, such as phone numbers, internet addresses and VA facility locations. 

The handbook costs $5.00 for U.S. addresses and $6.25 for overseas shipping. You can call (866) 512-1800 (toll free) or write to: Government Printing Office at Superintendent of Documents, P.O. Box 371954, Pittsburgh, PA 15250-7954 (stock #051-000-00225-3) or download a free copy from the VA’s web site at


June 28, 2002

The fiscal 2003 National Defense Authorization Act is likely to overturn the requirement that military retirees -- the only group of federal or civilian retirees so affected -- must forfeit one dollar of retired pay for each dollar of disability compensation they are awarded by the Department of Veterans Affairs. The House's version of the act would phase out the forfeiture over five years forveterans disabled 60 percent or higher. The Senate's version would simply toss it out completely, and allow all disabled veterans to receive disability payments along with their earned retirement income. But senior Administration officials have advised President Bush to veto either version. 

Veterans' organizations vehemently oppose the forcing military retirees to forfeit their retired pay in exchange for VA disability compensation. In addition, 82 senators and 395 House members are cosponsors of legislation to repeal the 100-year-old law. Nevertheless, on June 19 the Office of Management and Budget said that for reasons of "fiscal discipline" the President's senior advisors would recommend that he veto the entire fiscal 2003 National Defense Authorization Act if it contained either of the concurrent receipt plans. The written statement asserted that the action "is contrary to the long-standing principle that no one should be able to receive concurrent retirement benefits and disability benefits based upon the same service." It added, "All federal compensation systems aim for an equitable percentage of income replacement in the case of either work-related injury or retirement."


A threat to veto the fiscal 2003 National Defense Authorization Act if it authorizes concurrent receipt of military retirement pay and VA disability compensation (previous items) has enraged leaders of many veterans' organizations. Examples:

American Legion Commander Richard J. Santos: "A military career is filled with hardships, family separations, personal sacrifices, and all too often being placed in harm's way. Denying a military retiree an earned benefit -- his or her military retirement pay -- is unconscionable. Today, in Afghanistan, career officers and noncommissioned officers risk losing their retirement pay if they are wounded or seriously injured, which is absurd."

Veterans of Foreign Wars Commander-in-Chief James N. Goldsmith: "This threat is a callous and irrational assault against rectifying a longstanding injustice endured by those in uniform who have devoted their lives to protecting the nation. No other category of federal employees, to include Congress and the executive branch, is required to relinquish a portion of their earned retirement pay simply because they are also receiving VA disability compensation. It is inconceivable to us that the president would perpetuate such an injustice for the sake of achieving a balanced budget." 

Disabled American Veterans: "It is unconscionable that President Bush appears to care so little about retired members of the armed forces who were disabled as a result of their service to our nation," said DAV commander George H. Steese, Jr. "We must put an end to this long-standing injustice against some of America's most deserving disabled veterans."

The Retired Enlisted Association: "Every veteran, every retiree -- every American -- should be outraged at a policy that discriminates against those who have put th
emselves in harm's way for their country," said TREA National President Vincent B. Niski.