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Congressional Updates

Both the U.S. House of Representatives and the Senate were in session this week. The House is scheduled to be in recess during the week of June 11-15.

House Passes FY 2013 MilCon-VA Funding Measure

On May 31, the full House approved H.R. 5854, the fiscal year (FY) 2013 funding measure for Military Construction programs and the Department of Veterans Affairs (VA) and related agencies. The vote for passage was 407-12. The bill would fund VA operations at $125.4 billion, an amount that is $259 million below the President’s request, yet is $13.1 billion above the current year’s funding totals. Total VA mandatory funding in the bill is $74.6 billion, with discretionary spending set at $62.7 billion. The House began debate on H.R. 5854 in mid-afternoon, and the final vote occurred that evening at about 10:00 pm.

The House bill also funds military construction programs at $10.6 billion, a decrease of $2.4 billion from current year spending, and is $573 million less than the President’s request. These decreases reflect the lessening need for military construction projects as the War on Terrorism in Iraq and Afghanistan wind down.

The Senate version of the MilCon-VA spending bill – S. 3215 – is still awaiting action by that body. To date, the House has passed two of the twelve appropriations measures needed to fund U.S. government operations for the coming fiscal year; by contrast, the Senate has not passed any of the needed bills. [A chart with a detailed comparison of the two measures was included in last week’s Weekly Update.]


Legion Rep Testifies on Aid & Attendance Predatory Practices

The dramatic increase in pension claims by veterans – and numerous reports of predatory practices in the private sector – was reported in American Legion testimony at a congressional hearing relating to aid and attendance benefits provided by the Department of Veterans Affairs.

Lori Perkio, assistant director of the Legion’s Veterans Affairs & Rehabilitation Division, testified on June 6 before the Senate Special Committee on Aging. "It has become clear America’s aging veterans are at particular risk from predatory actors," Perkio said. "These ill-intentioned organizations seek to take advantage of gaps and loopholes in the system to separate veterans from their hard-earned savings with promises of long-term care that often do not deliver as promised."

The Legion’s testimony pointed out that predatory businesses often charge veterans substantial fees for their questionable services. While these businesses may operate legally, it is unclear as to whether their practices are in the best interest of veterans and their families. Little oversight exists to control these numerous companies that claim to help veterans get their aid and attendance benefits.

When VA first began tracking pension claims separately in October 2009, there were 55,546 pension claims pending. As of last month, that number had ballooned by nearly 75 percent to 74,987. To make matters worse, this spike in claims is clearly impacting the processing times at VA’s three Pension Management Centers. Over the same time period, the number of claims pending more than 125 days (VA’s standard for what claims constitute a backlog) has more than doubled, from 15,637 in 2009 to about 35,000 current claims.

Perkio, who was an American Legion service officer for nearly 20 years, still is in regular contact with the Legion’s 2,000-plus service officers across the country who are "on the front lines, and what they see on a daily basis regarding these predatory businesses seeking to worm their way into the veterans elder-care industry raises serious concerns in our organization."

The Legion testimony included several examples of how veterans are being scammed by unethical business entities:

• In Alabama, a veteran and his wife were contacted regarding assistance with a local assisted-living facility. They were told their $800,000 in savings would be "diverted" to allow them to qualify for VA Aid and Attendance benefits. This couple contacted the Alabama VA for clarification and did not follow through with the application for Aid and Attendance, understanding they did not qualify for the pension benefit.

• In California, an organization provided assistance to a veteran, promising assistance in filing a claim for Aid and Attendance benefits in order to live at an assisted-living facility. The veteran was told he had to pay $1,700 in advance to complete the paperwork in order to receive a monthly benefit of $1,800.

• In Montana, the daughter of a veteran was working with an agency that provided a seminar at the local assisted-living facility and promised assistance to veterans and surviving spouses of wartime veterans in obtaining VA Aid and Attendance benefits. The daughter contacted the Montana Veterans Affairs Division, requesting clarification of the VA program. The company providing the assistance told her she needed to divert her father’s assets and made an appointment for her to meet with a financial advisor located more than 100 miles away.

• In Florida, American Legion service officers have run across a growing number of lawyers specializing in elder law who contact veterans directly through assisted living facilities, with promises of how to divert income and assets to qualify for VA pensions. Many of these attorneys do not provide follow-up assistance, but try to get themselves appointed as powers-of-attorney for the veterans, initiating an additional problem when veterans ultimately seek help from veterans service organizations. It can take several weeks to change a veteran’s power of attorney.

Most of these cases involve "helping" a veteran file for his or her pension, but there is little follow-up help, as many of these organizations are not even familiar with the intricacies of VA pension eligibility and cannot provide accurate information to veterans on the best way to proceed with their claims.

One attorney bragged in his own newsletter of "earning over $200,000 helping people receive VA benefits."

American Legion service officers across the country express great frustration from seeing veterans and their families, at a difficult and vulnerable crossroads in their lives, being manipulated and taken advantage of by unscrupulous organizations that often succeed in separating veterans from their assets with false promises about VA benefits.
In its testimony, the Legion said that aid-and-attendance scamming "is an issue that deserves greater scrutiny. We cannot allow these veterans to be defenseless ... when they have so selflessly offered the sacrifice of their lives and well-being in defense of this nation."

During the two and a half hour hearing, The American Legion was repeatedly lauded for its own investigation, through its network of service officers, into predatory "pension poaching". It was also pointed out that the Legion, as well as other veterans’ service organizations, provides VA Aid & Attendance Pension Program enrollment assistance free of charge, thus making the payment of legal fees for such aid unnecessary.

Toward the end of the hearing, Sen. Claire McCaskill (MO) announced her desire to see criminal charges pressed against practitioners of "pension poaching." Sen. Ron Wyden (OR), who conducted the hearing in the absence of Chairman Herb Kohl, agreed, saying, "We’re going to pursue this. We’re going to get them."

Senate Subpanel Meets on Veterans Employment and Government Contractors

On Tuesday, June 5th, the Ad Hoc Subcommittee on Contracting Oversight of the Senate Homeland Security and Governmental Affairs Committee held a hearing to examine the status of veteran employment, and particularly to examine the relationship between government contractors and veteran employment.

The witness list included: Ted Daywalt, President and Chief Executive Officer of VetJobs; Spencer Kympton, Chief Operating Officer of The Mission Continues; Ramsey Sulayman, Legislative Associate, Iraq and Afghanistan Veterans of America; Pamela Hardy, Senior Manager, Diversity and Inclusion, Team Booz Allen Hamilton; and Sally Sullivan, Executive Vice President, ManTech International Corporation.

Mr. Daywalt’s testimony emphasized the need to understand the differences between the segments of veterans. The three distinctions he enumerated were: formerly active duty veterans who no longer have any military obligation; members of the federal Reserve forces; and members of the various state National Guard forces. The most desirable to employers of the three are former members of the active duty veterans who no longer retain any obligation. The least desirable are members of the National Guard who return from deployments of up to a year or more as veterans, but who, like members of the federal Reserve forces, retain a further obligation to train one weekend per month and two weeks per year. These personnel further retain a possibility for future call up, and unique to the National Guard, the potential for call ups relating to state emergencies, such as civil disturbances or natural disasters. Mr. Daywalt noted that there is no “silver bullet” which is likely to constitute a comprehensive fix for the problems entailed in the hiring of veterans associated with the National Guard and Reserves, and further stated that many of the programs which have been instituted by the government to address these issues often have detrimental unintended consequences. He further noted that contractors are leading the way in terms of ensuring that veterans, and particularly veterans who continue to serve, are able to put their unique skills into action.

Mr. Sulayman addressed many of the issues covered by Mr. Daywalt, noting problems with several of the government programs designed to address the problem of veteran unemployment. Additionally, Mr. Sulayman discussed two areas in particular: the promotion of veteran-owned businesses and the need to allow skills gained through military training to count toward civilian certifications.

Mrs. Hardy and Mrs. Sullivan, both representing major government contracting firms, emphasized their commitment to the employment of veterans, and offered some criticisms of the government programs designed to address these issues, particularly the lack of access to reliable data and statistics associated with certain programs, as well as the difficulty associated with the navigation of the data that is available.

House Subcommittee Examines Waste, Fraud and Abuse in Afghanistan

On June 6, the House Foreign Affairs Subcommittee on Oversight and Investigations held a hearing aimed at examining the status of the American intervention in Afghanistan, specifically the non-military foreign aid provided by the U.S. Agency for International Development (USAID).

The witnesses included: John P. Hutton, Director, Acquisition and Sourcing Management and Charles Michael Johnson, Jr., Director, International Affairs and Trade, both of the Government Accountability Office (GAO); and Donald “Larry” Simpler, Senior Deputy Assistant to the Administrator and Deputy Director of the Office of Afghanistan and Pakistan Affairs at USAID.

Mr. Hutton delivered testimony highlighting some of the issues the GAO has found as concerns the foreign aid administered by USAID. Key challenge, he noted, include gaps in planning for the use of contractors and assistance recipients and having visibility in their numbers. Thus, because no good records have been kept, and because what records do exist are less than transparent, large sums of money are or are potentially unaccounted for. This provides rich soil for the furtherance of corruption in the Afghan government. Additionally, Mr. Hutton testified that the GAO has found systematic weaknesses in USAID’s oversight and monitoring of project and program performance in Afghanistan, and additionally USAID has failed to consistently follow established procedure for performance management and evaluation for agriculture and water projects. Finally, Mr. Hutton testified that while USAID has generally complied with the various financial and other controls in its direct assistance agreements which assist in preventing fraud and corruption, the GAO found in 2011 that USAID has not always assessed the financial risks in providing direct assistance to Afghan government entities before awarding the funds, thereby leaving the funds vulnerable to misappropriation and corruption.

Mr. Simpler began his testimony by highlighting many of the positive results which USAID has been able to attain over the past ten years, since the United States intervened in Afghanistan following 9/11. After acknowledging the problems pointed to by the GAO, Mr. Simpler testified that the mission in Afghanistan is complex and difficult. Given the difficulties posed by the mission, Mr. Simpler then laid out some of the steps being taken by USAID in order to address the issues. First, they are engaging in financial management training with members of the Afghan leadership, in order to assist them in understanding the importance of regular reporting and the scope of their fiscal responsibilities particularly in regard to the foreign aid received from the United States. Second, USAID is taking steps to revise their contracting practices by reducing the number of large agreements, and increasing the number of smaller, more flexible agreements. Finally, USAID is tailoring oversight to help ensure the highest degree of accountability as assistance dollars become more concentrated directly into the Afghan government.

House Veterans Affairs Committee Reexamines Prescription Purchasing

In a followup to a February hearing on pharmaceutical purchasing, the House Veterans Affairs Committee held a hearing on June 6th focusing on efforts taken by VA to address illegal purchasing of pharmaceuticals. It’s important to note that committee testimony and committee members seemed to agree that at no time were veterans in danger due to these purchases. However, because of large scale failures within the procurement process, VA could have been squandering millions of dollars.

VA policy and federal law directs that a majority of pharmaceutical purchases for veterans occur with a Pharmaceutical Prime Vender (PPV). For more than a decade, this process and program had significant flaws and loopholes. In the February hearing, testimony described where illegal purchases – because they didn’t follow proper procedures and protocols – were occurring because it was either easier or had always been done that way.

VA witnesses provided data that indicated these illegal purchases have been nearly eliminated and those responsible for violations had been counseled so that the best interests of the veteran and tax payers are balanced appropriately. According to documents presented, the PPV contract totals approximately $4 billion and is the largest contract for the VA. The new processes and programs allow for “just-in-time” fulfillment of pharmaceutical needs while not jeopardizing costs to the VA and safety for the veteran.

Legion Attends Senate Hearing on Defense Spending

On June 6 The American Legion attended the Senate Appropriations Committee Subcommittee on Defense hearing which took testimony from public witnesses. Each year, the subcommittee solicits input from a wide variety of witnesses outside the Pentagon on how to spend Defense funds. Much of this discussion focuses on potential areas for research, often within the Peer-Reviewed Medical Research Program (PRMRP) and the Congressionally Directed Medical Research Program (CDMRP).

Witness testimony of interest to The American Legion:

The Air Force Sergeants Association talked about quality of life improvements and praised Congress for the military pay raises in recent years. They noted retirement pay and lifetime healthcare are primary incentives to recruit men and women to the Armed Forces. They said President Obama’s proposals asking retirees to pay increased TRICARE fees was an “extreme breach of faith” with those who have served faithfully for many years. These retirees have completed their military careers and it is not right for the government to now unilaterally ‘re-negotiate’ the contract made with them.

The International Foundation for Functional Gastrointestinal Disorders (FGIDs) opened their remarks by explaining what FGIDs are. FGIDs can be triggered by severe stress, such as deployment. They emphasized the importance of researching the incidence of FGIDs among servicemembers and how to treat them. In VA, FGIDs are presumed to be service-related for those who served in the Southwest Asia region during the first Gulf War. The Gulf War Illness research program already addresses the relationship between military service and various exposures. The witness encouraged continued funding of research efforts and Chairman Inouye assured them Congress has a “moral obligation” to take action in this area.

The Pulmonary Hypertension Association requested the Senate continue to include pulmonary hypertension in the list of conditions eligible for study through the PRMRP, and that $50 million be provided for PRMRP, within the CDMRP.

The Dystonia Medical Research Foundation described dystonia as a disorder caused by minor neurological trauma, such as blast exposures, which can only be helped with brain surgery. They stressed that PRMRP is “critical” to studying this issue in order to help servicemembers who are likely to develop dystonia in the future. Mr. Inouye assured them of “continued research” if the condition is service-related.

The American Foundation for Suicide Prevention thanked DoD, particularly the Army, for what they have done in recent years to express the message that it is okay to seek help rather than commit suicide. The numbers indicate suicide rates in the Army, active and reserve components, will continue to rise in 2012. They noted that much of the money provided by Congress for suicide prevention remains unused because it is targeted for healthcare delivery. They asked for clarifying language allowing those funds to be used for prevention and education efforts, before treatment is actually needed. Mr. Inouye said the committee will ensure that funds can be used for research and prevention, not just treatment.

The American Lung Association said tobacco is an “insidious enemy” to military readiness. Over $1 billion in healthcare costs can be traced to tobacco usage among the military and their families. They recognized Navy and Air Force efforts concerning limitations on tobacco usage. They brought up the fact TRICARE covers tobacco cessation programs. They called upon Congress to remove statutory barriers to eliminating tobacco use within the Armed Forces because the industry, with the help of their “friends in Congress”, has made it difficult to remove tobacco use from the ranks. They asked that tobacco research funding be restored to $20 million, and that it once again be used for competitive research on treating and preventing lung cancer. They also addressed the fact that deployed servicemembers are exposed to high levels of airborne pollutants. They called upon DoD to take action to reduce exposure to such pollutants.

The Associations for America's Defense spoke against the planned force reduction and said that European allies will not be capable of filling any of the gaps, as the new national military strategy requires. They also said the threat of sequestration only makes the picture worse. Inouye assured the witness the committee is doing everything possible to avoid sequestration, although this will require some “painful” decisions.

The Reserve Officers Association emphasized that reserve component forces cost the country significantly less than active duty forces, as they do not require things such as healthcare and base housing. There will need to be a viable reserve component for the Administration’s reversibility policy to succeed, as laid out in the new national strategy. They also called for continued equipping of the reserve components with full sets of modern equipment as it is not right to expect them to return from deployment to train on equipment less than what they used in combat.

The Fleet Reserve Association stressed the importance of retaining current retirement and health programs for military retirees. The proposed TRICARE fee increases are viewed as a direct attack upon all military retirees. FRA also opposes creation of a Military Retirement Commission, as it would bypass the regular Congressional process in creating new legislation.

The Arthritis Foundation requested funding of competitive, peer-reviewed research on arthritis. This disease can be treated, but not cured. Servicemembers are over 30% more likely to develop arthritis than the general population. One-third of combat personnel evacuated from combat theaters suffer from musculoskeletal injuries, which can easily lead to arthritis in later years. Further research in both regular arthritis and rheumatoid arthritis will benefit diagnosis and treatment. When asked by Mr. Inouye, the witness agreed that carrying 100-pound loads are very likely contributing to the high levels of musculoskeletal injuries among servicemembers.

The Mefloquine Research witness talked about the neuro-toxicity of mefloquine exposure. Mefloquine was developed as an anti-malarial drug but the witness charged that the drug causes a severe intoxication syndrome, characterized by vivid nightmares, profound anxiety, aggression, delusional paranoia, dissociative psychosis, and severe memory loss. The drug has a strong link to suicide and violence. The witness further said that this can even make diagnosis of TBI and PTSD more difficult. They called for expanding the scope of the National Centers of Excellence to include research in this area. The initial investment should equal the investment in developing mefloquine in the first place. Chairman Inouye asked whether the effect can be reversed. The witness said that existing treatments can fully treat and rehabilitate these conditions, however, the patient must be properly diagnosed and referred to the appropriate specialists. Thus, providers must be made more aware of these diagnoses. Many servicemembers are currently misdiagnosed with things such as personality disorders and malingering.

Chairman Inouye closed the hearing with a promise that all issues will be considered as the subcommittee creates its funding legislation. The subcommittee next meets on June 13 to receive testimony from Secretary Gates and Chairman of the Joint Chiefs of Staff General Mullen. This is traditionally the last hearing of the legislative cycle.

Letters of Support

The American Legion on June 7 sent a letter of support to Sens. Mark Pryor (AR) and Mike Johanns (NE), giving our organization’s support for S. 3235, legislation entitled the “Helping Iraq and Afghanistan Veterans Return to Employment at Home Act.” This measure require states to align their certification to be state tested nursing assistants or certified nursing assistants, emergency medical technicians (EMTs) and paramedics, or earn a commercial driver’s license.