June 5, 2014

 

Chairman Sanders, Ranking Member Burr and distinguished members of the committee, on behalf of Commander Dan Dellinger and the 2.4 million members of The American Legion, we thank you and your colleagues for the work you do in support of our service members and veterans as well as their families.

 

Nationwide, The American Legion has over 2,900 accredited service officers to ensure veterans receive the benefits to which they are entitled at no cost to those veterans. Not only do we advocate for the 2.4 million members in our organization, but also the millions of veterans who do not hold membership; in short, we live by the motto “a veteran is a veteran” and is deserving of representation when seeking VA benefits. We recognize the necessity to adequately compensate veterans and veterans’ families for disabilities incurred during service to our nation. 

 

As a grassroots organization, The American Legion draws upon the strength of its membership to provide guidance on policies in the form of resolutions passed during annual national conventions or at meetings of the National Executive Committee. The will of the membership of the Legion is expressed through these resolutions, which support or oppose policy decisions on topics of concern, whether for veterans, the children and youth of America, a strong national defense, or the principles of Americanism. The support and positions of The American Legion on any legislation is derived from the guidance of these resolutions and the founding documents of our organization.

 

S. 1606 (Udall):

 

A bill to designate the community-based outpatient clinic of the Department of Veterans Affairs to be constructed at 3141 Centennial Boulevard, Colorado Springs, Colorado, as the "PFC Floyd K. Lindstrom Department of Veterans Affairs Clinic".

 

The American Legion has no position on this legislation.

 

S. 1637 (Manchin): United We Stand to Hire Veterans Act

 

To better connect current and former members of the Armed Forces with employment opportunities by consolidating duplicative Federal Government Internet websites into a single portal, to conserve resources by merging redundant and competing programs, and for other purposes.

 

The American Legion has historically supported legislation that would create a consolidated online portal for veterans and transitioning service members.  The American Legion has recognized for a long time the need for a single point of entry for veterans to gain access to employment benefits and resources.  There is redundancy in online platforms and confusion among the ranks of their users.  The government could reduce costs, redundancy and confusion by consolidating its online employment resources for veterans. 

 

The American Legion supports this bill. 

 

S. 1643 (Cardin): Veterans Advisory Committee on Education Improvement Act of 2013

 

To amend title 38, United States Code, to provide for a two-year extension of the Veterans' Advisory Committee on Education.

 

The Veterans’ Advisory Committee on Education (VACOE) is composed of members who are prominent leaders in veterans’ education and training. The American Legion has been a longtime member and can attest from organizational experience to the value of this advisory committee. It provides valuable insight and advice to the VA Secretary and Members of Congress. The American Legion believes there is a need to maintain this independent body in order to advise VA Congress, and other stakeholders on issues relating to veterans and higher education.  The American Legion is deeply committed to ensuring the GI Bill receives proper support and educational benefits are evaluated to determine where improvements may be made.[1].

 

The American Legion supports this bill.

 

S. 1662 (McConnell): Veterans Healthcare Improvement Act of 2013

 

To provide for the introduction of pay-for-performance compensation mechanisms into contracts of the Department of Veterans Affairs with community-based outpatient clinics for the provision of health care services, and for other purposes.

 

This bill Directs the Secretary of Veterans Affairs to submit to Congress a plan to introduce pay-for-performance mechanisms into contracts which compensate Department of Veterans Affairs (VA) contractors for the provision of veterans' health care services through community-based outpatient clinics (clinics), commence plan implementation within 60 days after submission, and report semiannually to Congress on the feasibility and advisability of utilizing such mechanisms in the provision of VA health care services by means in addition to such clinics.

 

The American Legion has no position on this bill.

                                                                                                                                                  

S. 1682 (Casey): Veterans Education Counseling Act of 2013

 

To amend title 38, United States Code, to make certain clarifications and improvements in the academic and vocational counseling programs administered by the Secretary of Veterans Affairs, and for other purposes.

 

This bill would ensure that all GI Bill-eligible veterans applying for benefits are made aware of the free educational counseling available to them by the Department of Veterans Affairs (VA) before receiving their certificate of eligibility. In addition, this legislation also provides information on the other types of education benefits offered by the VA (i.e., Chapter 36: Vocational Rehabilitation & Education (VR&E).  This represents an overall improvement to veterans’ GI Bill benefits[2].

The American Legion supports this bill.

S. 1684 (Toomey): Servicemembers Transition Improvement Act of 2013

 

To require a pilot program on the provision of certain information to State veterans agencies to facilitate the transition of members of the Armed Forces from military service to civilian life.

 

The Department of Labor’s Veterans' Employment and Training Service (DOL-VETS) has been capturing information from the Transition Assistance Program (TAP) attendees and following up with phone calls and referrals to the American Job Centers once the service members have separated. The existing model works well to steer unemployed veterans to their local veterans’ representatives and enroll them into employment programs. This pilot program would bolster DOL-VETS’s capacity to find and provide employment services to veterans[3].

 

The American Legion supports this legislation.

 

S. 1717 (Kaine): SERVE Act of 2013

 

To amend title 38, United States Code, to improve oversight of educational assistance provided under laws administered by the Secretary of Veterans Affairs and the Secretary of Defense, and for other purposes.

This bill would increase the minimum standards that educational programs receiving GI Bill and Military Tuition Assistance funds must meet by requiring them to be “Title IV” eligible, under the Higher Education Act.

 

However well intended the legislation might be, the enactment of this legislation in its current form could have unforeseen consequences on veterans who seek to acquire some forms of certifications which are acquired outside of the traditional educational system, including programs such as pilots’ licenses and certain certifications in the medical field. The American Legion hopes to work with the Senator Kaine’s office to improve the language of the legislation to be more inclusive of these other options.

 

The American Legion does not support this legislation in its current form.

 

S. 1736 (Durbin): SERVe Act

 

To amend titles 5 and 38, United States Code, to clarify the veteran status of an individual based on the attendance of the individual at a preparatory school of a service academy, and for other purposes.

 

The American Legion has no position on this legislation.

 

S. 1740 (Landrieu): Department of Veterans Affairs Major Medical Facility Lease Authorization Act of 2013

 

To authorize Department of Veterans Affairs major medical facility leases, and for other purposes.

 

Over the last 20 years, The Department of Veteran Affairs (VA) has relied on Federal Acquisition Regulation (FAR) authority to lease nearly 600 Community Based Outreach Centers (CBOCs).  The wisdom and need for these centers is not in question or dispute.

 

The average facility goes through a comprehensive bid process whereby VA compiles their unique needs in a bid proposal, and offers competing construction contractors the chance to submit competitive applications in an attempt to meet the VA’s needs.  Included in the design/build requirements is a ceiling price that is commensurate with the average competitive price per square foot for similar commercial space, in that area.  Simply put – the VA enters into a leasing contract for these properties at the same competitive rate they would pay any other landlord for equal valued commercial property.  The advantage to VA in the case of these leases is that they get to have a facility custom tailored to our veterans needs.

 

Commercial property leasing is a common in the United States, and long-term leases are an industry standard.  Some of the reasons that leasing property might make more sense that owning property include;

  • Flexibility – As population demographics change, the lessee has the freedom to relocate to an area where they can best meet the needs of their client/customer/patients.
  • Cost – Leasing a facility minimizes the financial burden placed on the organization, and the cost of occupancy can be stretched over the course of 10, 15, or even as much as 20 years.
  • Risk – Construction cost overruns are more than common in the construction industry, they are almost a guarantee.  Design/build lease contracts help insulate the lessee from unexpected cost due to unforeseen issues, poor planning, loss-leader bidding, or underbidding.  Underbidding is a common problem in the competitive construction process as bidders seek to win large contracts by underbidding their competition, and then attempt to recover some of those lost revenues by adding on charges later that weren’t specifically named in the original bid, but are essential to the successful completion of the project.  In the industry, these are referred to as modifications, or “mods” for short.

 

In 2005, The Congressional Budget Office (CBO) published an Economic and Budget Issue Brief titled “Third-party Financing of Federal Projects”.  It is this brief that CBO now uses as the basis for their opinion to score future CBOCs by claiming that the total expenditure of a long-term lease be charged against the federal budget in the first year of the contract, as if the federal government were to purchase the property and supporting land outright.  In addition, CBO further states that a subsequent lease of 20 years would not be scored in the same way, but would instead be scored only for the years worth of financial commitment the government would need to draw from the treasury, year-by-year stretching the impact over the life of the lease, instead of in the first year, as in the case of a new lease.  According to CBO “We would treat renewal of the lease after the construction note is paid off as a straight lease.  There would be no direct spending”[4].

 

According to the report “if agencies do not initially record the full cost of governmental activities, the budget understates the size of the federal government and its obligations at the time when those obligations are made”[5].  The American Legion fails to see the difference between an initial lease, and a subsequent lease.

 

The 2005 CBO brief assumes that long term leases that are built-to-suit sufficiently satisfy the financed debt that the contractor invested in the project, and therefore the contract should be viewed a being more costly to taxpayers; “In many instances of third-party financing, a project is created as a stand-alone entity, sustained by the cash flows generated by its assets”[6].  Based on our understanding of the brief, CBO disagrees with this business model, and leaves us, the reader, with the impression that the contractor, financier, and landlord are all somehow unjustly enriched, and that the government will predominantly pay more for these types of contracts than they would have, had they either purchased the property outright, or leased an existing property through a commercial leasing agent.  Based on The American Legions research, we find little to no evidence to support this claim.

 

CBO further warns that the government could be liable for the total cost of a lease, even in the case of an early termination.  In the 20 year history of the CBOC leasing program, The American legion understands that there has only been one case where a lease was prematurely terminated, and that the government did not suffer liability as a result of that early termination.

 

The American Legion recognizes that The Congressional Budget Office is in place to provide cost estimates through assumptions and methodologies, and that the opinion of the analyst is not politically motivated.  We also recognize that the recommendations of CBO are provided to congress for inclusion in the overall evaluation process, and are specifically not intended as policy recommendations.  As such, The American legion calls on congress to consider the government's cost to own, operate, and maintain facilities after their economic life has outlived its competitive usefulness. Healthcare treatment has advanced more in the past 20-years than any other time in our history. It will advance at the same rate over the next 20-years. The American Legion is concerned that the VA will be saddled with an inventory of antiquated facilities, leaving veterans with substandard care, reduced access to care, and outdated technology. The lease model provides VA with an exit strategy for inefficient facilities. If they own the properties, the exit strategy is less clear and possibly more expensive. 

 

While The American legion accepts that the analyst’s opinion is not politically motivated, we question the whether the opinion, in this case, is based on sound and reasonable business practices.  As an example, CBO states “Third-party transactions are generally structured in such a way as to try to justify recording investment costs in the federal budget over the life of a project instead of in full when the investment is made—as would be the case with normal appropriations. Treating investment costs as an annual operating expense may make it easier to get projects funded by eliminating the need for substantial up-front appropriations. However, such budgetary treatment is at odds with established principles of federal budgeting, which require agencies to record the costs of government investments when they are made.”  Accounting for obligations is different than accounting for investments.  The leases discussed here are not burdens placed on the federal treasury in a single year, rather a series of investments committed to over the course of a long term contract.  The American Legion disagrees with CBO’s opinion that first term leases place a disproportionate obligation on the budget in the first year, as opposed to subsequent leases, and is able to find no statistical or empirical data to support this claim.

 

At the time this report was written, the CBOC lease program was still fairly new.  CBO used only colloquial data to support their assumptions, which in-turn supported their conclusions.  After 20 years of facility leasing, The American Legion can find no accusations of overspending based on the CBOC facilities leasing program, nor has CBO offered any evidence that the CBOC leasing program has cost the American taxpayer a dime more than should have been spent.

 

The American Legion has actually learned that the opposite is true, that the CBOC leasing program is less expensive than purchasing, and as an added advantage the VA budget is not overextended, which allows them the freedom to open 10 to 20 times the amount of clinics to serve veterans than they would be able to if they had made the decision to purchase the same facilities.

 

The American Legion supports the aims of this legislation, to provide for the authorization of 27 CBOCs in critical need of funding.  Especially now, at the height of access problems for veterans who struggle to receive their health care within the VA system, we cannot fall short and impede the ability of the CBOCs to deliver care to veterans[7]

 

The American Legion supports this bill

 

S. 1751 (Heller):

 

A bill to improve authorities for performance of medical disabilities examinations by contract physicians for benefits under laws administered by the Secretary of Veterans Affairs, and for other purposes.

 

The American Legion recognizes the need, especially in light of the deeply backlogged Veterans Benefits Administration (VBA) claims process, to supplement VA Compensation and Pension (C&P) examinations with examinations conducted by outside contractors.  These contract C&P exams can help bridge the gap in service and help veterans receive more timely access to adjudication for benefits. 

 

The American Legion has conducted extensive Regional Office Action Review (ROAR) visits to Regional Offices (ROs) across the country over the past fifteen years and during that time has evaluated the contract exams in addition to regular VA C&P exams.  During that period, The American Legion has observed the following criteria should be met for contracted C&P exams to ensure veterans are receiving the proper exams[8]:

 

·         VA should develop and ensure all non-VA contract providers complete military culture awareness and evidence based treatment training to ensure veterans receive exams that understand the unique situations of military life

·         VA provide exam providers with full access to VA’s computer patient record system (CPRS) to ensure the contract provider can review the veteran’s full history

·         VA develops a national tracking system to ensure national or local purchased care contracts do no lapse

 

The American Legion supports this bill based on the acceptance of recommendations TAL has discussed with Senator Heller’s staff.

 

S. 1755 (Toomey): Dignified Interment of Our Veterans Act of 2013

 

To require the Secretary of Veterans Affairs to conduct a study on matters relating to the claiming and interring of unclaimed remains of veterans, and for other purposes.

 

This legislation aims to address the sad state of affairs that has led to unclaimed veterans remains languishing nationwide at funeral homes.  Up until now, the sole means for dignified burial for these forgotten heroes has been private groups, such as the Missing in America Project (MIAP)[9], a non-profit organization launched nationwide in 2007 that has been supported by The American Legion in their efforts to bring honor to all of America’s fallen.

 

This legislation would enable VA support of this mission, directing VA to:

 

(1)    Conduct a study on matters relating to the identification, claiming, and interring of unclaimed remains of veterans; including

a.       Estimating the number of unclaimed remains

b.      Assessing the effectiveness of procedures of the VA for claiming and interring unclaimed remains of veterans

c.       Assessing state and local laws that affect the ability of VA to indentify, claim and inter these remains

d.      Recommend appropriate legislative action

All of America’s veterans deserve to be remembered for eternity with dignity and honor.

 

The American Legion supports this legislation.

 

S. 1863 (Brown):

 

A bill to establish in the Department of Veterans Affairs a continuing medical education program for licensed medical professionals to increase knowledge and recognition of medical conditions common to veterans and family members of veterans, and for other purposes.

 

This legislation establishes continuing medical education perform a task that is one of the hallmarks of what makes VA health care important to veterans – increase knowledge of medical conditions common to veterans and family members of veterans.  The American Legion has stated the VA health care system is important because it understands the unique needs of veterans.  This educational program will only increase that understanding, and research and education that increases understanding of veteran-centric conditions is essential to a proper VA healthcare system[10].  The bill would also help with outreach to veterans and their families and increase transparency, always an important goal when dealing with veteran health care.

 

The American Legion supports this legislation.

 

S. 1892 (Collins):

 

A bill to direct the Secretary of Veterans Affairs to establish a registry of certain veterans who were stationed at or underwent training at Canadian Forces Base Gagetown, New Brunswick, Canada, and for other purposes.

The Gagetown Military Camp was the largest military training facility in Canada from its opening in 1956 to the opening of Canadian Forces Base Suffield in 1971.  As a large training base, US forces worked in conjunction with our Canadian allies, and service personnel were sent to Gagetown for training.  Gagetown is recognized as a site when the chemical defoliant Agent Orange was used, potentially from the mid-50’s to the 1980’s. 

The American Legion strongly supports ensuring veterans receive the benefits they deserve when exposed to environmental hazards, from Agent Orange to radiation, from Alabama to North Carolina, to Vietnam and to Canada[11].  The veterans who served at this base while exposed to Agent Orange deserve to be tracked by registry and are entitled to benefits as befitting their exposure to Agent Orange or other environmental hazards.

The American Legion supports this legislation.

S. 1985/S. 2095 (Moran): Veterans Health Care Access Received Closer to Home Act of 2014

 

To reauthorize and modify the pilot program of the Department of Veterans Affairs under which the Secretary of Veterans Affairs provides health services to veterans through qualifying non-Department of Veterans Affairs health care providers, and for other purposes.

 

This bill would amends the Veterans' Mental Health and Other Care Improvements Act of 2008 to reauthorize a VA pilot program of contract care authority within specified Veterans Integrated Service Networks for the health care needs of veterans in highly rural areas. The program in question, Access Received Closer to Home (ARCH) aimed at improving health services for rural veterans in five pilot sites: Northern Maine; Farmville, VA; Pratt, KS; Flagstaff, AZ; and Billings, MT.  VA paid a negotiated contract rate for the veterans care provided they met the following criteria:

 

  • Already enrolled for VA health care at the program start,
  • Live more than 60 minutes driving time from the nearest VA health care facility providing primary care services, or
  • Live more than 120 minutes time distance from the nearest VA health care facility providing acute hospital care, or
  • Live more than 240 minutes driving time from the nearest VA health care facility providing tertiary care.

 

The new legislation requires:

 

(1)    That medical appointments for veterans, under the pilot program, occur during the 30-day period beginning on the date that is 15 days after the appointment is requested, and

(2)    That the Secretary of Veterans Affairs ensures that eligible veterans are informed of the program.

 

The American Legion has, for over a decade, maintained a System Worth Saving Task Force dedicated to evaluating the VA health care system and aspects of its operation.  The 2012 System Worth Saving report[12] focused specifically on the challenges of delivering health care to veterans in rural areas.  The report found the care was successful, although VA sometimes struggled to get the word out to veterans about the availability of the program and in some cases, participation suffered.  Because rural veterans struggle with access to care, measures such as Project ARCH, which can increase that access, are critical and should be implemented and promoted to ensure veterans get the word about improved access.  Specifically, in some locations, The American Legion found Project ARCH to be highly successful in increasing access. 

 

The American Legion strongly supports improved access to quality primary and specialty health care services using all available means for veterans living in rural and highly rural areas[13].

 

The American Legion supports this bill.

 

 

S. 1987 (Feinstein):

 

A bill to authorize the Secretary of Veterans Affairs to enter into enhanced-use leases for certain buildings of the Department of Veterans Affairs at the West Los Angeles Medical Center, California, and for other purposes.

 

This bill authorizes the Secretary of Veterans Affairs to enter into an enhanced-use lease agreement (EULA) for buildings 205 and 208 of the West Los Angeles Medical Center in California.  The EULA would provide for long-term, therapeutic housing for homeless veterans who require assisted living or other, similar, forms of care. 

 

The American Legion is deeply committed to ensuring the scourge of veteran homelessness is ended.  By resolution The American Legion supports a publically transparent, Enhanced-Use Leasing program[14] and believes strongly the uses must conform to priority services that meet the needs of the veterans’ community[15].  This program would serve homeless veterans, a critical need within the veterans’ community.

 

The American Legion supports this legislation.

 

S. 1993 (Warren): Veterans Care Financial Protection Act of 2014

 

To protect individuals who are eligible for increased pension under laws administered by the Secretary of Veterans Affairs on the basis of need of regular aid and attendance from dishonest, predatory, or otherwise unlawful practices, and for other purposes.

 

This bill calls for the development and implementation of standards to protect individuals and their families eligible for increased pension under VA’s rules for non-service-connected pension.  The American Legion is supportive of protecting these very vulnerable veterans, often subject to predatory lenders and unscrupulous individuals who manipulate their financial situation to the detriment of the veteran and their families and to the gain of the predatory financial institutions. 

 

The situation is often complicated by the desire to make sure the regulations enacted to protect veterans do not hurt veterans or their surviving spouses from seeking these benefits, usually at a time of great financial risk.

 

The bill calls upon VA to work on implementation of standards with the heads of other federal agencies and states, and The American Legion would recommend including Veteran Service Organization stakeholders in the decision making process.  VSOs have critical information about protecting veterans that would be informative to the process.

 

The American Legion encourages this legislation, but wants to ensure any implemented standards would prevent veterans and their families from receiving a monetary benefit they would have to repay if determined to be unqualified at a later date, and to ensure no portion of the safeguards would harm veterans or their families[16].

 

The American Legion supports this legislation.

 

S. 1999 (Graham): SCRA Rights Protection Act of 2014

 

To amend the Servicemembers Civil Relief Act to require the consent of parties to contracts for the use of arbitration to resolve controversies arising under the contracts and subject to provisions of such Act and to preserve the rights of servicemembers to bring class actions under such Act, and for other purposes.

 

This bill would improve the protections afforded to active duty service members, and deployed reservists under the Servicemembers Civil Relief Act. 

 

This bill would require the consent of all parties in a contract in order to use the arbitration system currently in place. It also provides service members the option to bring class-action suits against those who violate their rights as defined by SCRA. The American Legion strongly believes that the enactment of this bill would be extremely beneficial[17] because it has been increasingly difficult for servicemembers to enforce their SCRA rights due to expanding use of forced arbitration clauses hidden in the fine print of many contracts. These clauses prevent veterans from using the court system and instead funnel SCRA claims into an arbitration system set up by those who are violating the law.

 

The American Legion supports this bill.

  

S. 2009 (Udall): Rural Veterans Improvement Act of 2014

 

To improve the provision of health care by the Department of Veterans Affairs to veterans in rural and highly rural areas, and for other purposes.

 

Veterans should not be penalized on where they choose to live.  Veterans residing in rural areas of the country have traditionally been underserved in regards to their health care due to lack of access to quality health care.  This can be attributed to several factors such as: lack of insurance, lack of knowledge of what VA benefits are available to them, and an inadequate number of health care specialty providers that are available in rural communities that can successfully treat their complex illnesses and injuries.

 

The Caregivers and Veterans Omnibus Health Services Act of 2010, encourages improved mental health services to veterans residing in rural areas.  The Vet Centers provide a broad range of mental health services ranging from mental health therapy, family counseling, and readjustment counseling.  The American Legion has supported that the Vet Centers be expanded in geographic locations that veteran can maximize the offered services.  

 

As a result of growing veterans living in rural communities the VA created the Office of Rural Health (ORH) in 2007 in order to better serve rural veterans. The ORH main mission is to improve access and quality of care for all veterans through collaborations and partnerships.  The ORH has accomplished this through their community-based outpatient centers and through their non-VA partnerships through Project ARCH (Access Received Closer to Home) which allowed the VA to increase services for rural veterans.

 

Veterans’ barriers in receiving quality mental health treatments and care include distance to larger VA medical centers that are equipped with providing the care.  The distance that a veteran lives from a VA medical center can deter them from receiving needed mental health care.  Veterans who live in rural communities who do not have access to public transportation as compared to veterans living in urban areas will have more challenges in receiving their health care. 

 

According to the VA Office of Rural Health there are 3.1 million rural Veterans that are enrolled in the VA system. This represents 36 percent of the total enrolled Veteran population based on the 2010 US Census. Men and women Veterans from geographically rural areas make up a disproportionate share of service members and comprise approximately one-third of the enrolled Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) Veterans; many of whom are returning to their rural communities.

 

In the 2012, System Worth Saving Report on Rural Healthcare stated that the VA’s national travel times for FY 2010 were as follows:  Seventy-seven percent of all veterans enrolled in VA live within 30 minutes of the health care provider; 96.5 percent live within 60 minutes to a primary care provider; 79 percent live within 90 minutes to acute care; 89.3 percent live within 120 minutes to a acute care facility, and 92.4 percent of all veterans enrolled live within 240 minutes to a tertiary care facility[18].

 

The medical centers located in rural America have other challenges besides access they also have recruiting and retention of primary care and specialty care providers, telecommunication difficulties, and difficultly with transportation.  Some clinicians want to stay in urban centers because of the increased research opportunities and quality of life.  Rural areas have difficulty employing the newer technologies that urban areas offer, and transportation can be difficult due to area transportation and weather.   In order to successfully treat the veteran without having them go travel several hours to a VA medical center telehealth services need to be made more available to them as well as for their families.

 

The American Legion supports this bill.

 

S. 2013 (Rubio): Department of Veterans Affairs Management Accountability Act of 2014

 

To amend title 38, United States Code, to provide for the removal of Senior Executive Service employees of the Department of Veterans Affairs for performance, and for other purposes.

 

Long before the recent scandal in the Veterans Health Administration (VHA) facilities in Phoenix, The American Legion was speaking out about growing concerns about problems in the management culture of VA as a whole.  Whether it was within the Veterans Benefits Administration (VBA) where veterans’ claims often are rushed through a process more concerned with raw numbers driving executive bonuses, or preventable patient deaths in the health care system in Pittsburgh, PA; Augusta, GA; Columbia, SC; or other locations, the concern was the same.  There seemed to be little accountability for failure within VA.  Where backlogs in claims escalated along with high error rates, executives took home bonuses.  When patients died in Pittsburgh, not only was the executive in charge not fired for poor handling of the situation, he took home a $63,000 bonus.  Top VA officials insisted they did not have the authority to remove the leadership in the responsible positions.  This legislation provides that authority.

 

Executives and leaders in VA need to know veterans will not tolerate failures, preventable patient deaths, spiraling claims backlogs, and other mismanagement.  The new leadership at the Department of Veterans Affairs needs the tools to weed out mismanagement.  Private sector employees and leaders know their jobs hinge on their ability to successfully accomplish their mission, VA must apply the same standards.

 

The American Legion urges Congress to enact legislation to provide the Secretary of Veterans Affairs with the authority to properly enforce accountability[19], through firing or reassignment, to help bring trust back to the veterans’ community.

 

The American Legion supports this legislation.

 

S. 2014 (Durbin): GI Education Benefit Fairness Act of 2014

 

To amend title 38, United States Code, to provide for clarification regarding the children to whom entitlement to educational assistance may be transferred under Post-9/11 Educational Assistance, and for other purposes.

 

Currently, the Department of Defense and the Department of Veterans Affairs utilize different definitions of “eligible dependent” for the purposes of transferring earned educational benefits. This law will simply align the definition of an “eligible dependent” at the Departments of Defense and Veteran Affairs to ensure wards and foster children qualify for the usage of transferred education benefit, as well as offer a recourse and retroactive payment to those whose benefits were revoked due to the original discrepancy.  This represents an overall improvement of GI Bill benefits[20].

 

The American Legion supports this bill.

 

S. 2091 (Heller): 21st Century Veteran Benefits Delivery Act

 

To amend title 38, United States Code, to improve the processing by the Department of Veterans Affairs of claims for benefits under laws administered by the Secretary of Veterans Affairs, and for other purposes.

 

This bill calls for many improvements in the claims process brought about by the understanding gleaned in the March 2014 report of the VA Claims Backlog Working Group.  The American Legion is proud to have worked with the bipartisan group, initiated by Senators Heller and Casey, because they built their legislation by working from the very beginning with Veteran Service Organizations (VSOs).  By reaching out directly and first to the VSOs, the Working Group was able to receive knowledge from the frontline troops in the battle to tame the disability claims backlog.

 

This bill gives veterans tools to better understand what process best suits their needs when applying for benefits, enabling eligible veterans to better take advantage of programs such as the Fully Developed Claims (FDC) initiative, which American Legion service officers helped implement to speed up wait times in Regional Offices across the country.  The legislation increases transparency from Regional Offices, long a goal of The American Legion[21], and it aims to improve transfer of information between government agencies, something that has long delayed the claims process.

 

The American Legion supports this legislation.

 

 

S. 2128 (Cornyn):

 

A bill to name the Department of Veterans Affairs medical center in Waco, Texas, as the "Doris Miller Department of Veterans Affairs Medical Center".

 

The American Legion has no position on this legislation.

 

S. 2145 (Feinstein): Veteran Voting Support Act

 

To require the Secretary of Veterans Affairs to permit facilities of the Department of Veterans Affairs to be designated as voter registration agencies, and for other purposes.

 

The American Legion, since its inception in 1919, has promoted vigorous and active involvement by its members, posts and departments in the electoral process of the United States.  The American Legion has a longstanding commitment of service to the United States of America and recognizes that taking personal responsibility for government by voting and participating in supporting voting is one of the greatest public declarations of citizenship[22].

By opening VA facilities to voter registration, the voice of America’s veterans is enhanced.  Veterans already have shown their dedication to citizenship through their service, and making it easier for them to register to vote where they receive their benefits helps increase the volume of the voice of veterans.  When less than one percent of the population is serving at any given time, and indeed less than ten percent of the population has ever served, we must support efforts to ensure their voice is heard.

 

The American Legion supports this legislation.

 

S. 2179 (Murray): Homeless Veterans Services Protection  

 

To amend title 38, United States Code, to waive the minimum period of continuous active duty in the Armed Forces for receipt of benefits for homeless veterans, to authorize the Secretary of Veterans Affairs to furnish benefits for homeless veterans to homeless veterans with discharges or releases from service in the Armed Forces under other than honorable conditions, and for other purposes.

 

Due to our extensive work with homeless veterans and their families, The American Legion understands that homeless veterans need a sustained coordinated effort that provides secure housing and nutritious meals; essential physical healthcare, substance abuse aftercare and mental health counseling; as well as personal development and empowerment. Veterans also need job assessment, training and placement assistance. The American Legion believes all programs to assist homeless veterans must focus on helping veterans reach their highest level of self-management. 

 

This bill would ensure that community service providers could continue to serve homeless veterans through the Grant and Per Diem (GPD) Program to veterans who may not meet certain length of service or discharge requirements when calculating the federal GPD allotment that often allows these facilities to operate. The bill would also affect those community service providers that have been awarded the Supportive Services for Veterans Families (SSVF) grant from VA as well.

 

Should this bill fail to be approved, there is a real possibility that GPD and SSVF providers will not be able to serve the most vulnerable demographic within the veteran community (extremely low-income and homeless veterans), due to the pending opinion from the VA Office of General Counsel on the eligibility criteria for the GPD Program. That possibility would have damaging effects on meeting the VA’s 2015 goal of eliminating veteran homelessness as well as the prevention of homeless veterans beyond that point.

 

The American Legion supports this bill[23].

 

S. 2182 (Walsh): Suicide Prevention for American Veterans Act

 

To expand and improve care provided to veterans and members of the Armed Forces with mental health disorders or at risk of suicide, to review the terms or characterization of the discharge or separation of certain individuals from the Armed Forces, to require a pilot program on loan repayment for psychiatrists who agree to serve in the Veterans Health Administration of the Department of Veterans Affairs, and for other purposes.

 

According to VA statistics 22 veterans a day commit suicide[24].  That statistic is unacceptable and it is the responsibility of all stakeholders to do whatever possible to ensure veterans get the help they need before succumbing to this terrible fate.  Expansion of care related to mental health is important.  Furthermore The American Legion has long advocated for veterans victimized by a discharge system that seemed to work against them.  Whether it was the controversial Separation Personnel Codes (SPN codes) of the 40’s through the 70’s or the present day problems brought to light at Madigan Army Medical Center in Washington state, The American Legion has supported ensuring veterans get a fair shake in discharge and to study whether discharge procedures are being properly used for veterans who suffer from Post Traumatic Stress Disorder (PTSD), Traumatic Brain Injury (TBI) and Military Sexual Trauma (MST)[25].

 

Veterans deserve a fair discharge, and they deserve access to mental health care.

 

The American Legion supports this legislation.

 

S. 2184 (Wyden):

 

A bill to designate the community based outpatient clinic of the Department of Veterans Affairs located in The Dalles, Oregon, as the "Loren R. Kaufman Memorial Veterans' Clinic".

 

The American Legion has no position on this legislation.

 

S. 2243 (Murray): Military and Veteran Caregiver Services Improvement Act of 2014

 

To expand eligibility for the program of comprehensive assistance for family caregivers of the Department of Veterans Affairs, to expand benefits available to participants under such program, to enhance special compensation for members of the uniformed services who require assistance in everyday life, and for other purposes.

 

The struggle to care for veterans who have been grievously wounded in the defense of this nation takes a terrible toll on their families.  In recognition of this, Congress passed, and President Obama signed into law, the Caregivers and Veterans Omnibus Health Services Act of 2010 in May of that year.  However the toll of war does not discriminate between periods of service.  The families of veterans of Vietnam and other battles suffer no less than veterans of the Post 9-11 era. 

 

The American Legion does not distinguish between periods of service.  Simply put a veteran is a veteran is a veteran, and all veterans are entitled to receive the same level of benefits[26].  This legislation would remove a restriction limiting the benefits to the families of veterans “on or after September 11, 2001” as well as adding additional enhancements to the Caregiver program.  The American Legion urges Congress to act to restore consistency and equitability to veterans’ support programs and care for the families of our nation’s critically wounded veterans.

 

The American Legion supports this legislation.

 

S. 2258 (Begich): Veterans’ Compensation Cost-of-Living Adjustment Act of 2014

 

To provide for an increase, effective December 1, 2014, in the rates of compensation for veterans with service-connected disabilities and the rates of dependency and indemnity compensation for the survivors of certain disabled veterans, and for other purposes.

 

The American Legion strongly supports a periodic cost-of-living adjustment (COLA) for veterans reflective of increased expenses due to inflation and other factors.  However, there are many factors currently being considered regarding the calculation of COLA that merit discussion.

 

Within The American Legion’s Code of Procedures, accredited representatives are advised under no circumstances should they cause harm to veterans’ claims for benefits.  Current provisions contained in the President’s 2014 proposed budget, as well as in amendments to other bills that have been introduced from time to time, would replace the current Consumer Price Index (CPI) used to calculate increases to Social Security COLA with a so-called Chained CPI (C-CPI).  Through chaining VA benefits to the new C-CPI and COLA for Social Security benefits, the veteran community would indeed be harmed.  On December 19, 2012, Dean Stoline, Deputy Director of The American Legion Legislative Division, stated that a chained CPI is misguided policy and “would have significant deleterious effect on the benefits of millions of veterans”. 

 

There is a long term negative effect upon the veteran community should Congress mandate a C-CPI approach to determining COLA increases.  According to a press release from Sen. Sanders’ office, the proposal would cut VA disability benefits for a 30-year-old veteran by more than $13,000 a year by age 45, $1,800 a year by age 55, and $2,260 a year by age 65.  Senior citizens who retire by age 65 would see their Social Security benefits reduced by about $650 a year by the time they reach 75, and more than $1,000 a year when they turn 85[27].  These cuts would certainly place many veterans and their families’ economic security in peril.

 

By resolution[28] “The American Legion support[s] legislation to amend title 38, United States Code, section 1114, to provide a periodic COLA increase and to increase the monthly rates of disability compensation; and…oppose[s] any legislative effort to automatically index such [COLA] adjustments to the [COLA] adjustment for Social Security recipients, non-service connected disability recipients and death pension beneficiaries.”  The opposition to direct and automatic connection to the Social Security policies reflects the understanding that veterans and specifically disabled veterans represent a unique subsection of the American community, and their unique concerns should receive individual consideration when determining the need for periodic increases for cost of living.

 

The American Legion also raises objection to the practice of “rounding down” to the next lower whole dollar amount as noted in Section 2(c)(2).  The American Legion does not support this policy of shortchanging America’s veterans.

 

The American Legion encourages Congress to seriously examine the disastrous long term negative consequences of C-CPI for veterans. The long-term negative effects created through permitting C-CPI for VA benefits could cause serious financial harm to millions of veterans.

 

The American Legion supports an increased Cost-of-Living Adjustment for veterans, but would like to see the legislation amended to ensure veterans’ COLA is protected from being changed to reflect a C-CPI model to the detriment of disabled veterans.

 

S. 2296 (Shaheen) Veterans Appeals Improvement of Act of 2014

 

To require the Secretary of Veterans Affairs to employ at least three decision review officers at each regional office of the Department of Veterans Affairs, and for other purposes.

 

This bill seeks to require at least three Decision Review Officers (DROs) at each regional office in the VA.  The American Legion recognizes the importance of the DROs, as they represent a faster path to appeal that can potentially alleviate a multi-year wait for veterans while their cases are transferred to the Board of Veterans Appeals (BVA).  DROs are often some of the most experienced claims workers in VA, and their expertise helps them avoid many mistakes that more junior or lower level employees may commit.  Most DROs are more familiar with the proper manner of applying case law, where precedential decisions of the Court of Appeals for Veterans Claims (CAVC) have changed the way the benefits regulations must be interpreted.  This knowledge is critical, and many lower level employees fail to properly understand changes in the law.

 

Unfortunately, in VA’s haste to address the backlog of initial claims, we have reports of many DROs being removed from their vital work on appeals to pursue initial claims.  This could be disastrous.  While VA claims to have reduced the backlog to just over 291,000[29] the number of appeals has skyrocketed to over 275,000[30].  In essence, VA is robbing Peter to pay Paul with their backlog numbers.  Increasing the number of DROs won’t help if they aren’t allowed to work on the claims they need to.

 

The American Legion wants to work with Senator Shaheen and others to understand what the proper number of DROs should be to accomplish the work for any office.  It will vary, but we must ensure it’s being based on DROs doing DRO work.  The American Legion absolutely believes VA offices must receive adequate staffing to address the problems of the backlog.  With massive force reductions in the military, cutting troop strengths to dangerous lows not seen since before World War II, and the generation of Vietnam veterans continuing to reach retirement age, VA’s problems are not going anywhere, nor will the volume of claims diminish simply because combat operations in one country draw to a close.  The claims process will need proper staffing at all levels now and for the future.

 

The American Legion is supportive of this legislation, with the caveat of ensuring the numbers represented are derived to address the needs of the ROs properly.

 

S. 2311 (Tester):

 

A bill to amend title 38, United States Code, to include licensed hearing aid specialists as eligible for appointment in the Veterans Health Administration of the Department of Veterans Affairs, and for other purposes.

 

The American Legion has no position on this legislation.

 

S. 2316 (Thune):

 

A bill to require the Inspector General of the Department of Veterans Affairs to submit a report on wait times for veterans seeking medical appointments and treatment from the Department of Veterans Affairs, to prohibit closure of medical facilities of the Department, and for other purposes.

 

On January 10-11, 2012, The American Legion System Worth Saving (SWS) Task Force conducted a site visit to the VABHHCS, Hot Springs, South Dakota to discuss their December 2011 reconfiguration proposal. 

The Medical Center Director and staff pointed out that one of the major challenges at the Hot Springs VA Medical Center is recruitment of licensed practical nurses, registered nurses and physician hospitalists.  The average time frame for filling any vacancies in FY 2013 was 51 days and the average in FY 2014 is 42 days.  Another concern expressed were the steep ramps throughout the domiciliary, which the medical center staff indicated pose a safety concern and are not in compliance with the Americans with Disabilities Act of 1990.

On February 17, 2014, The American Legion System Worth Saving (SWS) Task Force conducted a Town Hall meeting and follow-up site visit at the VABHHCS, Hot Springs, South Dakota.  The purpose of the visit was to hear from veterans firsthand about their concerns with VA’s proposed reconfiguration of services at the VABHHCS.  Following the town hall meeting, from February 18-20, 2014, the task force met with VABHHCS Executive Leadership team and staff to discuss their proposed reconfiguration of services, recommendations from the 2012 SWS site visits, Secretary Shinseki’s announcement to move forward with the Environmental Impact Statement (EIS), and concerns addressed by the veteran community during the town hall meeting.  Additionally, on February 19, 2014, the task force met with the Fall River Health Services (FRHS) Board of Directors and the Save the VA Committee.

The local community is opposed to the VABHHCS reconfiguration proposal and is adamantly against further reduction of services at the Hot Springs VA Medical Center, which includes relocating the domiciliary from Hot Springs, SD to Rapid City, SD.  Communication between the VABHHCS and the local community appears to be at a stalemate, with neither side willing to concede.  The VABHHCS has based its reconfiguration proposal on data obtained from the Veterans Health Administration’s Office of Policy and Planning, which depicts a declining veteran population in Hot Springs. 

The veterans in this community do not want to be faced with traveling to a new site that is over a 120 mile round trip away.  Especially in light of recent concerns about access to veterans’ health care, when veterans in a community are screaming to retain their facilities, VA must become more transparent and more responsive to the needs of the communities. 

The American Legion considers itself a leader in the fight, not solely to protect the veterans of Hot Springs, South Dakota, but to protect access for veterans everywhere, especially in rural communities[31].  This legislation would increase VA transparency about wait times at a time when letting sunlight into the process is essential to regaining veteran trust.  The American Legion urges VA to work with the community in Hot Springs and other locations to find a solution to their health care puzzle and make sure they don’t lose access.  Now, more than ever, access to health care is critical for veterans.

The American Legion supports this legislation.

 

S. 2337 (Murkowski): Hmong Veterans Service Recognition Act

 

To amend title 38, United States Code, to authorize the Secretary of Veterans Affairs to inter in national cemeteries individuals who supported the United States in Laos during the Vietnam War era.

 

The American Legion is deeply committed to the indigenous people of Vietnam, and by resolution has called upon Congress and the administration to work to affect real change to assist those peoples in their native homeland[32].  The American Legion believes in basic human rights for the Hmong, the Montagnards and all others within that country.

 

The issue of burial in national cemeteries is complex, and must balance consideration of American service members, veterans and their families with the needs of those who have served maintaining primacy.  As an organization of 2.4 million members, positions must derive from resolutions passed by the membership to ensure they represent the views of the organization.  At this time, no consensus on this issue has been passed, and the appropriate commissions and committees who study national security and cemeteries continue to deliberate and determine the best option.

 

The American Legion recognizes the heroic sacrifices and service of the indigenous people of Vietnam, but has no clear position on this legislation at this time.

 

The American Legion has no position on this legislation.

 

S. 2362 (Fischer):

 

A bill to prohibit the payment of performance awards in fiscal year 2015 to employees in the Veterans Health Administration, and for other purposes.

 

This legislation would prohibit the paying of bonuses to Veterans Health Administration (VHA) employees in FY 2015.  Secretary Eric Shinseki, before his resignation on Friday, May 30, 2014, suspended all executive bonuses within VHA for the remainder of that fiscal year.  The American Legion believes any employee bonuses must be tied to transparent measures that are quantifiable and qualitative[33].  Furthermore, The American Legion would question why some VA executives, whether in the VHA or VBA receive bonuses even when the offices or hospitals they manage are found to be problematic.

 

While The American Legion strongly supports a full scale overhaul of the VA bonus system from top to bottom, wholesale elimination of bonuses may not be the answer as well.  To be sure, bonuses must be examined.  Dr. Thomas Lynch, VA’s Assistant Deputy Under Secretary for Health for Clinical Operations admitted as much when he noted “we may have lost our North Star[34].”  Dr. Lynch further allowed that bonus goals may have contributed to gaming the system when 50 percent of executive bonuses in VA hospitals were based on whether or not they reported having seen all patients within the target time for appointments.  By creating a system with so much monetary gain – bonuses in the tens of thousands of dollars – VA created incentive to lie about information that was critical to determining whether or not patient care needs were being met.  Clearly that system can no longer continue.

 

Certainly VA must overhaul bonus structures from top to bottom before moving forward with employee bonuses.

 

The American Legion has no position on this legislation.

 

S. 2404 (Whitehouse): Foreclosure Relief and Extension for Servicemembers Act of 2014

 

A bill to make permanent the extended period of protections for members of uniformed services relating to mortgages, mortgage foreclosure, and eviction, and for other purposes.

 

The strained economy of the past several years has resulted in an increase in foreclosures across the country, and service members are no exception. Since 2012, service members have been afforded expanded foreclosure protections for one-year after the term of their active-duty service ends. This bill would make permanent the one-year of foreclosure protection for service members. The American Legion believes the one-year period will allow service members to get their financial bearings and stabilize themselves in order to keep their homes and/or properly adjust.

 

The American Legion supports this legislation[35].

 

S. RES. 399 (Cornyn):

 

A resolution expressing support for the American GI Forum

 

The American Legion has no position on this legislation.

 

S. XXX (Sanders): Draft Legislation

 

A bill to amend title 38, United States Code, to provide for the removal of Senior Executive Service employees of the Department of Veterans Affairs for performance, and for other purposes.

 

S. XXX (Burr): Draft Legislation

 

These two pieces of legislation were received too close to the deadline for written testimony, and are too broad in scope and detail, to offer commentary in the written testimony.  The American Legion is conducting a detailed evaluation of both Chairman Sanders’ and Ranking Member Burr’s legislative plans to fix the ongoing crisis at VA.  American Legion staff will continue to work closely with both members and their staffs, and indeed all members of this committee, to ensure that meaningful, bipartisan legislation is passed to solve the problems that have led to VA’s crisis in health care delivery. 

 

The American Legion is dedicated to a full health care system that meets the needs of veterans, and intends to work through whatever present issues exist to get to a state where delivery of that system does not present significant obstacles to the Department of Veterans Affairs.  The American Legion will provide as detailed commentary as possible during oral remarks, and fully intends to work closely with this committee, with the House Committee on Veterans Affairs, with VA, the White House and with other Veterans’ Service Organizations to get meaningful legislation passed for veterans.

 

The American Legion looks forward to working with the Committee, as well as VA, to find solutions that work for America’s veterans.  For additional information regarding this testimony, please contact Mr. Ian de Planque at The American Legion’s Legislative Division, (202) 861-2700 or ideplanque@legion.org.

[1] Resolution No. 27 – Veterans GI Bill Education Improvement -  OCT 2013

[2] Ibid.

[3] Resolution No. 23: Improve Transition Assistance Program – OCT 2012

[4] Email between CBO and TAL dated June 11, 2013 at 3:59PM

[5] Congressional Budget Office report, Economic and Budget Issue brief, Third-party Financing of Federal Projects June 1, 2005

[6] ibid

[7] Resolution No. 24 Congressional Budget Office scoring on Department of Veterans Affairs leasing – MAY 2013

[8] Resolution No. 46 – Department of Veterans Affairs (VA) Non-VA Care Programs – OCT 2012

[9] Resolution No. 24 – Identify, Honor and Inter Unclaimed Cremated Remains of Veterans – MAY 2007

[10] Resolution No. 108: Request Congress Provide the Department of Veterans Affairs Adequate Funding for Medical and Prosthetic Research – AUG 2012

[11] Resolution No. 95: Environmental Exposures – AUG 2012

[12] http://www.legion.org/publications/164901/2012-sws-report-rural-health

[13] Resolution No. 220: Support for Enhanced Department of Veterans Affairs Rural Health Care – AUG 2006

[14] Resolution No 12: The Department of Veterans Affairs Enhanced-Use Leasing – AUG 2012

[15] Ibid.

[16] Resolution No. 47 – Prevent Exploitation of Veterans and Family members Applying for Aid and Attendance – OCT 2012

[17] Resolution No. 328: Support and Strengthen the Servicemembers Civil Relief Act (SCRA) – AUG 2012

[18] http://www.legion.org/publications/164901/2012-sws-report-rural-health

[19] Resolution No. 14 Department of Veterans Affairs Accountability – MAY 2014

[20] Resolution No. 27: Veterans GI Bill Education Improvements – OCT 2013

[21] Resolution No. 99: Increase Transparency of the Veterans Benefits Administration (VBA) Claims Processing – AUG 2012

[22] Resolution No. 4: Support for Voter Registration and Voting Program – OCT 2007

[23] Resolution No. 306: Funding for Homeless Veterans – AUG 2012

[24] http://www.va.gov/opa/docs/Suicide-Data-Report-2012-final.pdf

[25] Resolution No. 26: Mischaracterization of Discharges for Servicemembers with Traumatic Brain Injury (TBI) and Post Traumatic Stress Disorder (PTSD) and Military Sexual Trauma (MST) – MAY 2013

[26] Resolution No. 126: Veterans Receive Same Level of Benefits – AUG 2012

[27] http://www.sanders.senate.gov/newsroom/press-releases/statement-by-senator-bernard-sanders-on-the-chained-cpi

[28] Resolution No. 178: Department of Veterans Affairs (VA) Disability Compensation, AUG 2012

[29] Monday Morning Workload Report – May 26, 2014

[30] Ibid.

[31] Resolution No. 294: Department of Veterans Affairs Rural Health Care Program – AUG 2012

[32] Resolution No. 79 – Vietnam Human Rights – AUG 2012

[33] Resolution No. 99 – Increase the Transparency of the Veterans Benefits Administration (VBA) – AUG 2012

[34] House Veterans Affairs Committee (HVAC) Hearing To Receive Witness Testimony related to Committee Subpoena – May 28, 2014

[35] Resolution No. 328: Support and Strengthen the Servicemembers Civil Relief Act – AUG 2012