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National Commander Marty Conatser urged Congress to enact the legislative proposals of The American Legion during testimony before a joint session of the House and Senate Veterans Affairs Committees on Sept. 20. The following is the text of his testimony:

Chairman Akaka, Chairman Filner, and Members of the Committees, it is an honor for me to appear before this distinguished body to present The American Legion’s legislative priorities, as they affect the delivery of healthcare and benefits through the Department of Veterans Affairs.

Congressman Johnson, thank you for introducing me today.  And thank you for your selfless dedication to doing what’s right for America.  I look forward to working with you during my term as National Commander. 

With your permission, Mr. Chairman, I would like to recognize a few outstanding leaders and veterans’ advocates in the audience today.  First, please allow me to introduce my National Vice Commanders:

National Vice Commander Thomas L. Burns, Jr.  --  (Delaware)
National Vice Commander Peggy G. Dettori  --  (Alaska)
National Vice Commander Randall A. Fisher  --  (Kentucky)
National Vice Commander Donald Hayden  --  (Minnesota)
National Vice Commander David A. Korth  --  (Wisconsin)

Also with us today are a number of past National Commanders of The American Legion.  I would ask that they stand now and be recognized.

It is my pleasure now to introduce the President of the nation’s largest patriotic women’s organization, The American Legion Auxiliary, Mrs. Jan Pulvermacher-Ryan (Wisconsin). 

With President Pulvermacher-Ryan are a number of Past National Auxiliary Presidents, and I would ask that they stand and be recognized. 

I would also like to recognize the Commander of the Sons of The American Legion, Raymond Geihll, (Geel) Jr. (Indiana).

I would like to take this opportunity to recognize the one person who has been the key to my success in this organization and in life.  The road to becoming National Commander is paved with sacrifices, and this wonderful woman has sacrificed quite a bit in her support of my service with The American Legion.  I would not be here today without her help – my lovely wife, Sharon.

Chairmen and Members of the Committees, The American Legion has a proud tradition of advocating on behalf of America’s veterans, and this testimony reaffirms our commitment to ensuring all eligible veterans of this country receive the benefits and healthcare that they have earned through their service.  I would like to personally thank both of the chairmen for listening to the voice of America’s veterans and re-instating these important joint hearings.  

Providing the Legislative Priorities of our organization before a joint session is an extremely valuable opportunity, and I am proud to be representing The American Legion here today.

Each generation of America’s veterans has earned the right to quality health care, disability compensation, rehabilitation and transitional programs available through the Department of Veterans Affairs (VA).  With this in mind, I applaud the actions of the 110th Congress for finishing the FY 2007 VA budget with an increase.  Also, FY 2008 funding allocations for many VA accounts meet or exceed funding targets proposed by The American Legion in testimony presented earlier this year.  The American Legion commends these actions.  Congress has not exceeded the funding targets of The American Legion in many years. 

The American Legion will continue to work with both Committees to ensure that VA is capable of providing  “care for him who shall have borne the battle, and for his widow and his orphan.” 

As a nation at war, and as stewards of the trust of America’s service members and veterans, it is our obligation to work together to provide a system of healthcare and benefits that will serve to truly assist transitioning service members, as well as those who have served in the past and are now turning to VA for help. 

The conditions at Walter Reed Army Medical Center exposed a terrible gap between the appearance and the reality of a seamless transition for our severely injured service members.  While the physical conditions at Walter Reed were not the fault of VA, deficiencies in the entire transition process were exposed. 

Besides the horrible living conditions that were brought to light at Walter Reed, the most often heard complaint from service members concerned confusion over the transition process itself. 

Often it was the transition process that delayed the receiving of quality VA health care and other earned benefits for our newest generation of wartime veterans. 
All have agreed that this is a failure on the part of The Department of Defense and VA.

After four short months, the “President’s Commission On Care for America’s Returning Wounded Warriors” has made six recommendations to assure a seamless transition for the severely wounded.  The American Legion is aware that these recommendations are being put into legislative form.  Some of these reforms have already been suggested by Members of Congress.  

We commend the Commission’s efforts to embrace a “patient-centered” approach that also recognizes the needs of family members.

The American Legion strongly urges the enactment of reforms that will simplify the transition process not only for the severely injured, but also for any service member facing medical discharge – whether in time of war or peace. 

However, The American Legion has serious concerns that the recommended changes to the VA disability system will create two separate compensation programs.  Creating a completely different compensation program will only add to the complexity of an already overburdened system. 

The American Legion is also concerned that the new earning loss payment proposed by the Commission will be subject to FICA tax and will also cease once a veteran begins receiving Social Security.  This recommendation fails to recognize that the benefit is not merely to compensate for economic impairment, but is also the thanks of a grateful nation in recognition of the sacrifices of our service disabled veterans.  To tax it and eventually replace it with Social Security is simply not acceptable.  Congress must be careful that in its attempts to fix perceived problems they do not, in fact, create additional problems.  Creating more layers of bureaucracy will only cause more frustration to service members and veterans.  Any real solution must reduce paperwork, increase cooperation between DoD and VA, and consider the impact on service members, veterans and their entire families.

As we bring home a new generation of veterans, VA must be capable of striking that balance between meeting their needs and the needs of past veterans already in and just beginning to access the system.  By working together, we can provide a strong VA for all veterans – Past, Present and Future.

The American Legion stands ready to work with you to accomplish this goal.

Another area of concern for The American Legion is the current prohibition on enrollment of new Priority Group 8 veterans.  Denying any veteran his or her earned benefit is a broken promise of a grateful nation.

FY 2007 saw the continuation of the suspension of enrollment of new Priority Group 8 veterans due solely to limited resources. 

Simply denying earned benefits does not solve the problems resulting from an inadequate federal budget.

As the Global War on Terrorism continues, fiscal resources for VA will continue to be stretched.  A viable VA is one that cares for all veterans, not just the most severely wounded among us  or recently separated veterans. 

The American Legion recommends $38.4 billion in discretionary funding for veterans’ healthcare in Fiscal Year 2009.

In an effort to provide a stable and adequate funding process, The American Legion fully supports Assured Funding for veterans’ health care. 

The current discretionary funding process leaves VA facility administrators unable to establish a clear plan for the future because of the continuous mismatch between patient demands and uncertain funding. 

Assured funding for VA medical care would provide more realistic appropriations based on the actual patients’ population like Medicare, Social Security, and VA compensation and pension.

The American Legion believes health care rationing for veterans must end. It is time to guarantee health care funding for all enrolled VA patients.

In addition, The American Legion believes that Congress should allow VA to bill, collect and retain third-party reimbursements from Medicare on behalf of Medicare-eligible veterans.

Nearly all veterans pay into Medicare for their entire working lives.  However, when they are most likely to need medical services from the one hospital system designed specifically for them, they must turn elsewhere because VA cannot bill Medicare.  This is wrong, and I urge you to correct this injustice.

The American Legion firmly believes that making VA a Medicare provider and designating VA medical care as a Mandatory Funding item within the Federal budget will enable VA to fulfill its health care delivery mission.

Another area of concern is VA’s Long-Term Care. This has been the subject of discussion and legislation for nearly two decades.

VA has yet to develop a long-term care strategic plan with well-articulated policies that address the issues of access and integrated planning for the long-term care of mentally ill veterans. 

The American Legion supports the publishing and implementation of a Long Term Care strategic plan that addresses the increasing long-term care needs of America’s veterans. 

Additionally, The American Legion will continue to support legislation that will ensure appropriate payments for the cost of Long-Term Care provided to veterans in State Veterans’ Homes; stronger oversight of payments to State Veterans’ Homes; full reimbursement for the treatment of veterans 70 percent service-connected or higher; and the more efficient delivery of pharmaceuticals.

The American Legion urges Congress to support adequate funding for VA to meet the long-term care needs of America’s veterans.

In 2002, The American Legion visited 60 VA Medical Centers nationwide and compiled a report highlighting the issues affecting VA as a result of years of inadequate funding.  This initial report, titled “A System Worth Saving,” covered issues from Medical Care Collection Fund targets, to timely access standard, to budgetary shortfalls, to staffing shortages.  This comprehensive report was presented to Congress and shared with VA in an attempt to bring attention to the budgetary needs of the VA health care system.

This year marks the printing of the fifth “A System Worth Saving” report. 

The American Legion’s 2007 “System Worth Saving” report focuses on the services provided through VA Vet Centers, Polytrauma  Rehabilitation Centers and  Polytrauma Network sites.

The American Legion visited Vet Centers that were located near demobilization sites, select Polytrauma Rehabilitation Centers and Polytrauma network sites to ascertain the effects of the number of returning veterans on the services provided.  47 Vet Centers, 4 Polytrauma Rehabilitation Centers and 16 Polytrauma Network Sites were visited.  Each report has highlighted key issues in determining quality care:  staffing levels, funding, physical plant, and obstacles and challenges to providing care.

I encourage you to review this valuable publication at your convenience. 

The American Legion believes that all Vet Centers need to be fully staffed with qualified providers to ensure that combat veterans seeking care for readjustment are afforded the same standard of quality care, no matter which Vet Center they use.

We are all aware of the July 2006 report entitled “Health Status of and Services for OEF and OIF Veterans after Traumatic Brain Injury Rehabilitation,” in which the VA’s Office of Inspector General examined VA’s ability to meet the needs of veterans who suffered from traumatic brain injury (TBI). 

Some 52 patients from around the country were interviewed at least one year after completing inpatient rehabilitation from a Polytrauma Rehabilitation Center that included those who lived in a state with a rural veterans’ population. 

Some of the challenges noted by family members who care for these veterans in rural settings include the necessity for complicated special arrangements and the absence of VA rehabilitative care in their communities. 

Case managers working at Polytrauma Rehabilitation Centers and several Polytrauma Network Sites centers noted limited ability to follow patients after discharge to rural areas, and the lack of adequate transportation.

These limitations place undue hardship on the veterans’ families as well.  Veterans have shared many examples of families devastated by the demands of caring for TBI injured veterans.  They have sacrificed financially, have lost jobs that provided the sole income for the family, and have endured extended separations from children. 

It is important that the veterans turning to VA for care of Traumatic Brain Injury receive the highest level of treatment and rehabilitation available.  

Initially, VA designated four Polytrauma Rehabilitation Centers and recently announced the creation of a fifth Polytrauma Rehabilitation Center in San Antonio. 

These state of the art facilities provide specialized rehabilitation to help severely-injured patients optimize the level of independence and functionality they are capable of achieving.  Another unique aspect of the Polytrauma Rehabilitation Center is that those needing care for traumatic brain injury, amputations, blindness and mental health issues can receive that care in one location.

During the “System Worth Saving” site visits to the Polytrauma Rehabilitation Centers, many had vacancies for highly specialized rehabilitative fields and nursing.  The biggest challenge to filling the vacancies was the inability to offer competitive salaries. 

VA must be adequately staffed in order to maintain or enhance services provided to veterans and service members who are recovering from multiple injuries. 

Research conducted by VA has indicated that veterans residing in rural areas are in poorer health than their urban counterparts.  Providing quality health care in a rural setting has proven to be very challenging, due to limited availability of skilled care providers and inadequate access to care.

Even more challenging will be VA’s ability to provide treatment and rehabilitation to rural veterans who suffer from the signature ailments of the on-going Global War on Terror, such as traumatic blast injuries, and combat-related mental health conditions.  VA’s efforts need to be especially focused on these issues.

The Veterans Integrated Services Networks rely heavily upon VA’s Community Based Outpatient Clinics, or C-BOCs, to close the gap in rural care.

Many of the C-BOCs are at or near capacity, and many still do not provide adequate mental health services to veterans in need. 

Providing mental health services in C-BOCs is even more critical today than ever before with the ongoing wars in Iraq and Afghanistan.  It has been estimated that nearly 30 percent of the veterans who are returning from combat suffer from some type of mental stress.  Further, statistics show that mental health is one of the top three reasons a returning veteran seeks VA health care.

The American Legion believes that all veterans, regardless of where they live, should have access to VA health care.

Providing contracted care in highly rural communities--when VA health care services are NOT possible--would alleviate the unwarranted hardships that these veterans encounter when seeking access to VA health care.

Chairmen, The American Legion remains committed to ensuring that VA carries out its historic and statutory responsibility to also provide other benefits to veterans.

VA reported that its Veterans Benefits Administration (VBA) regional offices issued more than 774,000 disability determinations in FY 2006. 

This represents an increase of about 11,000 decisions from the previous fiscal year.   VA received 806,000 rating claims in FY 2006 and this number will undoubtedly increase in FY 2007. 

According to VBA, as of August 25, 2007, there were 400,000 rating claims pending, 25 percent of which were pending more than 180 days.

According to the Government Accountability Office, although VA made progress earlier this decade in reducing the size and age of its pending claims backlog, it is currently losing ground due, in part, to increased filing of claims, including those filed by OIF and OEF veterans. 

Inadequate staffing levels, and increased pressure to make quick decisions, which results in an overall decrease in the quality of work, has been a consistent complaint among service center employees interviewed by our staff during our regional office quality checks. 

In order to ensure VA and VBA are meeting their responsibilities, The American Legion strongly urges Congress to scrutinize VBA’s budget request to ensure that it reflects the needed increase in full-time employees to address the ever-increasing and unmanageable backlog. 

The American Legion strongly supports additional staffing. Our current wartime situation provides an excellent opportunity for VA to actively seek out returning veterans from OEF and OIF, especially those with service-connected disabilities, for employment opportunities within VBA. 

Over the past few years, The American Legion’s Quality Review Team has visited more than 40 VBA regional offices for the purpose of assessing overall operations. 

The American Legion site visits reveal too few experienced supervisors to provide trainee adjudicators proper mentoring and quality assurance. 

In addition, at many stations, ongoing training for staff is postponed or suspended, in order to focus maximum effort on production. 

Despite the assurances of the Under Secretary for Benefits that training is a top priority within VBA, the inconsistency in VBA’s training approach needs to be thoroughly reviewed and addressed. 

Each of VBA’s 57 regional offices appears to have different approaches to training and they also differ in the importance they place on training. 

A national training standard, in addition to the centralized training conducted by Compensation and Pension Service for regional office personnel, is also needed. 

The emphasis on production continues to take priority over training and quality assurance.  Although VBA’s policy of “production first” has resulted in many more veterans getting faster action on their claims, the downside has been that tens of thousands of cases have been prematurely and arbitrarily denied. 

The American Legion strongly recommends a substantial change in VBA’s work measurement system.  A more accurate reliable work measurement system would help to ensure better service to veterans. 

Ultimately, this would require the establishment of a work measurement system that does not allow work credit to be taken until the decision in the claim becomes final.

Another area of concern is the review of VA’s compensation program being conducted by the Veterans’ Disability Benefits Commission (VDBC).   We eagerly await the final recommendations of the VDBC after their two-year review of the system.  It is our hope that Congress will thoroughly consider the recommendations of this Commission before any reforms are made.  Including those recommendations by the Dole/Shalala Commission after their four-month study.

The American Legion welcomes recommendations that will improve the delivery of benefits to veterans and their dependents.  However, we will adamantly oppose any recommendation that will take away or restrict current benefits or is otherwise unfair to veterans.

In addition to improved delivery of health care, veterans must be provided effective programs to ease transition from the military.  A strong educational package is vital to improving the lives of veterans after discharge. 

Today’s GI Bill falls short of meeting the actual cost of education in America.  Today’s service members deserve a GI Bill that will allow them to attend college without paying into the system and without the threat of losing their benefit after 10 years.

Congress must strengthen the current GI Bill to a level comparable to the original Servicemen’s Readjustment Act of 1944 and include Guard and Reserve members with Federal Active Duty service commitments. 

Chairmen, while I have highlighted key issues of concern to The American Legion this morning, I urge each of you to review my full testimony that has been submitted for the record.

The American Legion appreciates the strong relationship we have developed with these Committees.  With increasing military commitments worldwide, it is important that we work together to ensure that the services and programs offered through VA are available to the new generation of American service members who are now returning home without compromising VA’s ability to serve the current population of veterans already enrolled. 

You have the power to ensure that their sacrifices are, indeed, recognized, honored, and consecrated by the gratitude of a grateful nation.

The American Legion is fully committed to working with each of you to ensure that America’s veterans receive the entitlements they have earned.

The brave men and women who are serving and have served in our Armed Forces throughout the world deserve no less.  I look forward to working with each of you throughout the next year to improve the lives of all of America’s veterans.

Thank You.

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