ARMED FORCES NEWS
VA TO FILL SOME NON-VA PRESCRIPTIONS
August 1, 2003

 

Some veterans waiting to see Department of Veterans Affairs physicians for the first time may be eligible to receive medications from VA mail-out pharmacies that were prescribed by private doctors. To qualify, veterans must: have enrolled in VA health care before July 25, 2003; requested their first primary care appointment with VA before July 25, 2003; and be waiting more than 30 days for their first appointment with a primary care physician on Sept. 22, 2003. The first prescriptions will be filled on September 22. The period between announcement of the program (July 24) and filling the first prescriptions (Sept. 22) is necessary to allow VA to and contact eligible veterans and set up the system. The policy is a short-term measure to assist veterans who were enrolled and waiting for the appointment before July 25. It will not apply to veterans who were put on the waiting list after July 24. 

ARMED FORCES NEWS
LEGION: "FORGET PORK, FUND VETERANS"
August 1, 2003

 

"Instead of lumping VA health care in with flying Elvis impersonators and statues for mythological gods, let's put it where it belongs: on the same mandatory-funding stage as Social Security and Medicare," says American Legion commander Ronald F. Conley. He was referring to a list of funding examples which he compares against the need for VA health care. Mandatory funding, he asserts, will reduce the backlog of "hundreds of thousands of veterans" who are waiting to see doctors, and reinstate "tens of thousands" who have been denied access. The problem, he explains, is that more than 164,000 veterans who are in the recently created Priority Group 8 have been prohibited from entering the system "because they are not poor enough and because they lack a service-connected disability rating." This decision, according to Conley, means the Veterans Health Care Eligibility Reform Act of 1996 is now unraveling. 

MY SAN ANTONIO
Military 
VETERANS HOSPITAL IN WACO ON LIST OF HEALTH
FACILITIES TARGETED FOR CLOSURE

By Suzanne Gamboa 
Associated Press 

Web Posted : 08/05/2003 12:00 AM 

 

WASHINGTON — The Department of Veterans Affairs announced a plan Monday to close seven VA hospitals — one of them in Waco — while opening others and retargeting its health care services.
The plan includes major mission changes at 13 facilities, Veterans Affairs spokeswoman Karen Fedele said.

In addition to Waco, the VA wants to close hospitals in Canandaigua, N.Y.; Pittsburgh; Lexington, Ky.; Brecksville, Ohio; Gulfport, Miss.; and Livermore, Calif.

The proposal would open new hospitals in Las Vegas and in Orlando, Fla.; add centers for the blind in Biloxi, Miss., and Long Beach, Calif.; and place new spinal cord injury centers in Denver; Minneapolis; Syracuse or Albany, N.Y.; and Little Rock, Ark.

The proposals are part of a VA restructuring begun last year to shift the agency's focus to outpatient care, place services where they are needed most and save money by eliminating underused facilities.

"This is probably the most comprehensive assessment of VA infrastructure since World War II," VA Secretary Anthony Principi said.

A 15-member commission, appointed by Principi, will consider the proposed changes.

The secretary must accept or reject the plan as a whole. His decision is expected by the end of the year.

"I'm not trying to save money," Principi said. "I'm trying to transform an infrastructure that has been built or acquired over the past 50 years." 

 


ARMED FORCES NEWS
ENROLLMENT FEE KILLED FOR VA PRIORITY 8s
August 8, 2003

 

The house has rejected an administration proposal for the Veterans Administration to charge a $250 annual enrollment fee for veterans in Priority Group 8. The proposal also would have more than doubled prescription copays for Priority 8 veterans, from $7 to $15. Although the VA suspended new enrollments in Priority 8 earlier this year, veterans already enrolled continue to be eligible for treatment, and would have incurred the new payments. Priority 8s are veterans with no service-connected disabilities who have higher incomes than geographically determined means test levels.

ARMED FORCES NEWS
VA PROPOSES MAJOR FACILITY CHANGES
August 8, 2003

 

The Department of Veterans Affairs has forwarded a plan to an independent CARES (Capital Asset Realignment for Enhanced Services) commission which aims to eliminate outdated or underused VA medical facilities and to continue shifting its focus to outpatient care. Under the plan, seven VA hospitals would be closed, two new ones would be opened, and the system would add 48 new clinics. Closings would be at Gulfport, Miss.; Lexington, Ky.; Waco, Texas; Pittsburg; Canandaigua, N.Y.; Brecksville, Ohio; and Livermore, Calif. New facilities would be hospitals in Las Vegas and Orlando,Fla.; centers for the blind in Biloxi, Miss., and Long Beach, Calif.; and spinal cord injury centers in Denver, Minneapolis, Syracuse or Albany, N.Y., and Little Rock, Ark. The CARES Commission is scheduled to evaluate the plan and send final recommendations to the VA secretary for review by November 30, 2003.
 

ARMED FORCES NEWS
VFW TARGETS VA FUNDING, CONCURRENT RECEIPT
August 8, 2003

 

Dennis Cullinan of the Veterans of Foreign Wars has outlined two legislative issues for VFW members to discuss with lawmakers during the summer congressional recess. First, the VA/HUD Appropriations bill is some $2 billion less than what a budget resolution called for. As a result, asserted Cullinan, more than 200,000 veterans will undergo rationed health care by being forced to wait over six months for appointments, and more than a million more will be turned away. He urged veterans to ask their legislators how this would affect service members fighting the war on terrorism. Second, he said to tell legislators that they expect their full support for concurrent receipt. Ask them to sign on to the discharge petition, and thank them if they have done so as well as to support HR-303 and S-392, the Retired Pay Restoration Act, that would provide full concurrent receipt for all disabled military retirees, he said. 
 

ARMED FORCES NEWS
MOAA SLAMS TRICARE ACCESS PROBLEMS
August 15, 2003


The General Accounting Office has released a report on the Tricare program that recommends that the Defense Department improve its oversight of Tricare Prime. DoD responded that new Tricare managed care contracts beginning next year would fill the blanks. The Military Officers Association of America says that is not enough. MOAA expressed disappointment that the report does not address MOAA's concerns that low reimbursements and administrative hassles are keeping doctors from accepting Tricare patients. MOAA also is concerned that Congress might direct a follow-on study of access to Tricare Standard providers, and "another year will have been wasted and military families will be no better off." The association says that DoD and the Tricare Management Authority must begin to address Tricare Prime and Standard access problems now. See the report at http://www.gao.gov/new.items/d03928.pdf.
 

WACO VA HOSPITAL'S CLOSE PROTESTED
SAN ANTONIO EXPRESS NEWS ~ ROGER CROTEAU
August 17, 2003


CRAWFORD — A caravan of about a thousand people — veterans and their supporters — rolled through town Saturday morning as part of a protest against the proposed closing of the Waco Veterans Affairs Hospital. 
About 60 local residents, many waving flags, turned out at Crawford's main intersection to offer support to the protesters.

The caravan, led by hundreds of motorcycle riders, took about 20 minutes to pass. However, the route came no closer than eight miles from President Bush's Prairie Chapel Ranch, so it was unlikely the president saw them.

The protesters gathered at the Waco School District football stadium parking lot for a rally before driving the 22 miles to Crawford.

"A nation that can afford this year to give a $230,000 tax break to someone sitting at home making $1 million in dividend income is one that can afford to take care of its veterans," said U.S. Rep. Chet Edwards, D-Waco.

Veterans of Foreign Wars State Commander Ron Hornsby told the stadium crowd that the VA commissioner looking at closing hospitals could harm veterans all across the country, not just in Waco.

"We can never repay the veterans — we hear those words a lot," Hornsby said. "At times like this, those words become very hollow, very meaningless." 

Many protesters carried signs chastising Bush for the proposal to close the Waco hospital.

As the caravan rolled through downtown Crawford, resident Gina Plemons cheered it on. Crawford has drawn several protests since Bush established his "Western White House" here, but this was the first such group Plemons said she was glad to see.

"It's a good cause," she said. "Crawford is behind them. I'm sure President Bush is, too. The veterans gave us our liberty and our freedom. Just because they are old and need medical care, we can't abandon them."

Last year the Capital Asset Realignment for Enhanced Services Commission began studying the nation's system of health services for military veterans. The independent commission, often compared with those that recommended military base closures, has recommended seven VA hospitals across the country, including the one in Waco, for closure.

The Waco VA hospital has 250 beds, mostly for pyschiatric inpatients, and 17,000 vets used the facility on an outpatient basis last year. It opened in 1932 and has almost 800 employees.

If it closes, most of the veterans who go to the Waco hospital instead would be sent to a VA hospital in Temple, about 30 miles away. A final decision on the closures is expected by the end of the year.

The White House press office declined comment on the issue Saturday.
 

GULF WEB 
SICK U.S. GULF WAR VETS
SUE COMPANIES, BANKS

August 19, 2003

NEW YORK (Reuters) - Veterans of the 1991 Gulf War filed suit on Tuesday against banks and corporations they say helped former Iraqi leader Saddam Hussein build chemical weapons that poisoned them and caused birth defects in their children. 
The suit, filed in Brooklyn federal court, seeks class action status on behalf of some 100,000 veterans suffering from illnesses including memory loss, deterioration of the central nervous system and chronic fatigue. 


The case seeks unspecified damages and a court order forcing the defendants to pay for medical monitoring of the veterans and their children. Among accusations in the suit is a charge that the defendants violated international laws barring the use of chemical weapons. 


The plaintiffs say that they were exposed to sarin nerve gas, mustard gas and other chemical agents manufactured and obtained by Saddam Hussein's government. They said they were exposed to the chemicals when U.S. and allied forces blew up hundreds of Iraqi ammunition dumps. 


Defendants include 11 companies that supplied chemicals and equipment to Iraq and 33 banks that helped finance the transactions. Most of the defendants are based overseas but do business in New York. 


Some lawyers involved in the case filed a 1994 suit in Texas on behalf of Gulf War veterans injured by chemical agents. Plaintiffs' lawyers said the Brooklyn case includes defendants whose identities were recently revealed in Iraqi disclosures made to United Nations weapons inspectors. 

Historic Veterans Hospital in Texas among Several Targeted for Closure 
by John Flores 
August 21, 2003

The Department of Veterans Affairs announced a plan to close seven VA hospitals throughout the nation in an August 4 press conference in Washington, D.C. Veterans Affairs spokeswoman Karen Fedele said the hospitals considered for closure are located in Canandaigua, N.Y.; Pittsburgh, Pa. (Highland Drive); Lexington, Ky. (Leestown); Brecksville, Ohio; Gulfport, Miss.; Livermore, Calif.; and Waco, Texas. Fedele said the VA will also open facilities in other regions while restructuring vital services in an effort to eliminate unused space while bringing services closer to where veterans live. But most veterans are voicing outrage, calling the plan a cost-cutting measure that comes at exactly the wrong time.

Historic VA hospital in Waco, Texas

"It's another slap in the face to veterans. We're still at war in the Middle East and Afghanistan, and who knows where else our troops will be sent," said Carl Flores, a retired aerospace engineer who was an artillery officer at Fort Hood in the waning days of the Korean War. Flores, 72, a rancher who lives north of Waco, says he may need health care in the coming years. "There are many veterans, a lot of them past retirement age, who need these services here and now. The Waco VA Center is now being considered for phasing out, but it serves almost 20,000 veterans in this region of Texas. This hospital has been here since the 1930s, and is an anchor in the regional VA system. To close it would be to arbitrarily throw away a wonderful, historically profound mission."

In Texas, 407,000 of the state's 1.7 million veterans are enrolled in the VA's health care system. The Waco VA hospital is also part of the Central Texas Veterans Health Care System, one of the largest VA medical consortiums in the United States, with about 2,700 staff members and a budget of nearly $250 million. Two years ago it had almost 600,000 outpatient visits.

Officials say the proposal will undergo a review process first, and if approved may not be implemented for several years. Even so, Central Texans -- many of them veterans and some in wheelchairs -- are protesting. Recently, hundreds of local residents gathered at the front entrance to the Waco VA Hospital to protest.

U.S. Rep. Chet Edwards, D.-Waco, was among those leading the procession that marched in front of the VA hospital's main administrative building. He said showing support for the hospital was the only way to keep it from being shut down. "I'm convinced that if Central Texans don't speak out loudly and clearly now, the administration will make a decision to shut the Waco VA Hospital sometime late this year," said Edwards. 

Even some VA employees, like nurse Doris Tucker, shouted their support for the hospital. "I'm here for everyone: the community, the workers, and the veterans," said Tucker, a VA employee for 26 years. "It's just not right. We have a large clientele. They deserve this place. And by God, we're going to go down fighting." 

Katherine Turner, whose husband is a VA employee, said the VA is not making any sense. The Waco facility could house hundreds more patients, she said. "I think the big question is, why there are only 200-something beds filled? They've got the demand and could fill them right now," she said. 

U.S. Army retiree Bill Mahon, a Vietnam veteran, chairman of the McLennan County Veterans Association, and a rally organizer, said: "This is our hospital, it's not the government's. We paid for it, not only in money but in our blood, and paid for it with our lives. We're not asking for anything we haven't earned. We want what was promised us and what was earned." 

Many at the protest rally questioned what would happen if hundreds more troops are injured in Iraq and elsewhere. "When they come back and we shut down all the beds in America, where are they going to go? This is a service paid for by the Americans and the veterans themselves," said Fredna White, who is retired from the Waco VA after 27 years there.

The Waco Hospital handles outpatients, but also houses patients requiring long-term psychiatric care, blind patients who are part of a rehab program, and veterans hospitalized for post-traumatic stress disorders and related problems. There are almost 800 people on the hospital's payroll, one of the largest employers in the city, and the closing would shut down 250 beds.

The proposal is the outgrowth of a 1999 General Accounting Office study finding that the VA was spending $1 million a day on unneeded or unused facilities. That study led to CARES, short for "Capital Asset Realignment for Enhanced Services," an initiative to study the VA infrastructure and identify ways to provide care in the future. 

The Waco VA Hospital, also known as the Veterans Affairs Medical Center (VAMC), is a cluster of 24 structures on a 500-acre campus that opened for business on May 8, 1932 five miles south of Waco. The architectural style of the buildings is Spanish Revival and Colonial Revival. Its initial capacity was 308 patients. The facility was expanded once in 1939 to include bed space for 1,151 patients, and then again during World War II; its capacity was 2,040 by 1945. Waco was one of the first Veterans Administration facilities to have an approved residency program, and in the 1940s was the only one in the state devoted entirely to the treatment of mental illnesses. It served as a teaching center for professional education in neuropsychiatry, clinical psychology, and psychiatric nursing. 

The opening of other VA hospitals in the state took some pressure off of the Waco facility. By 1972, the center was able to reduce its available bed space to 1,184. In 1990, the medical center had 684 hospital beds and 160 nursing home beds; 340 additional beds were out of service because of construction projects. 

The hospital's medical programs included a day treatment center, a mental hygiene clinic, rehabilitation for alcoholics and the blind, and a community residential-care program. The center also had the state's only inpatient post-traumatic stress unit. In the 1990s, the hospital renovated two medical buildings, an admissions and canteen area, and built a new plant to air-condition the entire facility. The center was proposed as a national historic site in 1991.

The VA is seeking public comment through November on the recommended changes. VA Secretary Anthony Principi is expected to make a final decision in December. 

JOHN FLORES served four years active duty at the Coast Guard search-rescue station in New Orleans. He is author of When the River Dreams, a biography of Marine Sgt. Alfredo Gonzalez. Awarded a personal citation from Marine Commandant Charles Krulak in 1998 for series of stories detailing Sgt. Gonzalez's life, he is at work on a book about PT 109.
 


ARMED FORCES NEWS
GENERALS SEEK CONCURRENT RECEIPT EQUITY
August 22, 2003
 

Fifty-two retired Army and Air Force general officers representing 1500 years of service to the nation have signed a letter to President Bush asking him to support congressional legislation for concurrent receipt. The letter says that last year the 107th Congress passed legislation "with overwhelming majorities in both houses" for concurrent receipt, but killed it because of White House opposition over costs, and substituted Combat Related Special Compensation. The writers state that CRSCcovers less than five percent of disabled military retirees. With a similar situation this year, the generals wrote, "We urge you as Commander-in-Chief to speak for the thousands of disabled GIs who faithfully served their country for an entire career, were disabled in service to their country and now find their retired pay taxed at a rate of 100 percent of their disability compensation." 

Update on Concurrent Receipt Letter
Currently, most military retirees forfeit one dollar of retired pay for every dollar of disability compensation awarded by the Veterans Affairs department. Congressional legislation to correct this inequity by authorizing "concurrent receipt" has been stalled in Congress by threats of a presidential veto because of costs. The sponsor of the letter from the retired general officers, retired Army Lieutenant General Billy M. Thomas stated, "It is really sad that our troops are giving it all they have in Iraq and doing a wonderful job, yet the President and his advisers would take the retired pay away from those who are disabled in Iraq should they make it to retirement." 
 

DAILY BRIEFING
August 29, 2003 

Senators brace for Veterans health care battle
By Sydney J. Freedberg Jr., National Journal 

 

As Congress returns from its summer recess, senators should brace themselves for flak from veterans groups’ irate over 2004 funding for veterans’ health care. Senators have a chance to get their House counterparts out of a jam, or to fall right in with them.

Back in April, in the budget resolution that outlines spending levels, the Senate persuaded the House to agree to add a whopping $1.8 billion to the president’s request for the perennially strapped Veterans Affairs health system. The amount would have brought the VA budget to the level recommended by leading veterans’ groups in their “Veterans’ Independent Budget” analysis. But the budget resolution paid for this increase with a promise to cut other unspecified domestic programs later.

“There was no real, solid money behind it,” said John Scofield, spokesman for the House Appropriations Committee. “Unlike the budget resolution, we have to deal with reality.” Even Rep. Robert Simmons, R-Conn., chairman of the Veterans’ Affairs Subcommittee on Health, said that appropriators “were essentially required to fund 10 pounds of program in a 5-pound bag.” So the appropriations bill to set actual spending levels simply left out the extra $1.8 billion. Over the bitter opposition of Simmons and others, the House stuck with President Bush’s requested sum.

But the House left out something else the president had asked for: authority to double co-payments and impose a $250 annual fee on veterans earning more than $24,000 a year. These measures would have raised revenues and reduced costs, chiefly by discouraging an estimated 1.2 million veterans from seeking VA care. By omitting these unpopular provisions, administration officials say, the House has left them $800 million in the hole.

In July, Veterans’ Affairs Committee Chairman Chris Smith, R-N.J., tried to raise a bipartisan revolt against his own party’s appropriations bill to get more money for veterans’ health. But his uprising failed. House GOP leaders, backing the president, introduced a procedural measure (a rule) that would have effectively barred any amendments designed to add back the $1.8 billion. Democrats opposed the procedural measure. All but six Republicans voted for it, even those who wanted more VA money, because the vote came down to a leadership test of party loyalty. (Smith himself did not cast a vote on the rule; Simmons voted against it.) Then when the full appropriations bill came up, 59 Republicans, including 21 of 33 freshmen, voted against it to register their disapproval of the VA shortfall. All but 50 Democrats supported the bill, seeing opposition as moot at that point, because the rule prevented adding more money. With veterans’ advocates divided, both the rule and the bill passed the full House.

So now everyone is unhappy. The administration wants its fees and co-pays back. Republican House members with lots of veterans in their districts feel that their leadership hyped up expectations only to dash them, leaving members to face the backlash at home. Veterans’ groups, most of which conveniently hold their national conventions in August, have mobilized their members to storm the Hill.

And now the whole mess is in the Senate’s hands. “The House dumped this dead bird in our laps,” said one Senate staffer. “We’re sure as hell going to do better.”

But by how much? The top Democrat on the Senate Appropriations’ subcommittee for veterans, Maryland’s Barbara Mikulski, has publicly pledged to restore the full $1.8 billion. However, it’s ultimately up to Republican Chairman Christopher “Kit” Bond of Missouri to make the math work out, and money is tight. There are only two practical options. Either the subcommittee must cut the grab bag of other popular programs in its jurisdiction—including NASA, the National Science Foundation, and housing programs for the poor. Or, 60 senators must vote to set aside budgeting rules and get the money by increasing an already record deficit—something Republican leaders are struggling to prevent.

Even splitting the difference will be hard. Just making up for those unpopular fees and co-pays that no one wants to let the VA levy would require $800 million on top of the president’s request. A $900 million compromise in the Senate was rumored, said Rep. Rick Renzi, R-Ariz., one of the House members who rebelled against the appropriations bill, but “now I’m hearing that they may be at our number”—no increase over the president’s request—“which is unjust.”

The politics of veterans’ needs will put real pressure on the Senate to beat the House’s number, and on the House to compromise. The VA bill, however, could easily get lost in what is becoming an annual financial train wreck, with VA funding tucked into a massive omnibus spending billed passed in a hasty shamble long after the budget deadline of October 1.

If that’s the outcome, veterans’ groups have ire enough for both Republicans and Democrats. Said Ron Conley, outgoing national commander of the nearly 3 million-member American Legion, “I’m angry at both of ’em.” The Senate’s task is to try to defuse that anger.

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