Legion testifies on Choice Program, CARE Act proposal

American Legion National Veterans Affairs & Rehabilitation Health Care Deputy Director Roscoe Butler testified before Congress on Oct. 24 regarding draft and pending House resolution bills that will affect veterans and their families.

Butler was among 11 other witnesses at the hearing as the House Committee on Veterans’ Affairs considered the following bills:

• Draft legislation to establish a permanent, improved Department of Veterans Affairs (VA) care in the community program; 

• Draft legislation to address VA’s agreements with State veteran homes, graduate medical education residency positions, community care obligations and telemedicine licensing issues;

• Draft legislation to direct VA to conduct a study of the Veterans Crisis Line;

• Draft legislation to direct VA to furnish mental health care to veterans at community or non-profit mental health providers participating in the veterans Choice Program;

• VA’s legislative proposal for the Veteran Coordinated Access and Rewarding Experiences (CARE) Act;

• Veterans Transplant Coverage Act of 2017 (H.R. 1133);

• Veterans E-Health and Telemedicine Support, or VETS Act of 2017 (H.R. 2123);

• Veterans Increased Choice for Transplanted Organs and Recovery, or VICTOR ACT of 2017 (H.R. 2601); and

• Military Sexual Assault Victims Empowerment, or SAVE Act (H.R. 3642)

According to Butler’s written testimony, he said despite VA’s challenges in the past, it has emerged as a world-class leader in a number of veteran-centric medical disciplines. VA has also conducted groundbreaking research and lifesaving emergency disaster preparedness, leading the nation in medical and residency programs and partnerships.

“Where there is a vision, anything can be accomplished,” Butler said. “The draft legislation introduced by this committee, combined with the legislative requests from VA, begins to address Congress and VA’s vision for the evolution of 21st century medicine in a way that will allow the department to provide greater access and develop stronger relationships with non-VA providers, moving toward a more integrated system.

“This is just the first step in a long overdue transformation. The American Legion expects greater emphasis on VA’s modernization in successive legislation that is able to capitalize on VA’s strengths and core competencies, while ensuring that veterans continue to have access to the best care anywhere.”

Butler said the Legion is aware of criticisms that suggests this transformation moves dangerously close to increased privatization of VA services. In the final legislation, the Legion requests that there be a requirement for VA to issue an annual report addressing the:

• Number of patients it intends to provide health care to through Veteran Care Agreements (VCAs);

• Number of patients that received health care through VCAs over the preceding year;

• VA’s plan to reduce dependency on VCAs for its primary and core services;

• Projected costs associated with providing patient care through VCAs;

• Costs for providing patient care through VCAs over the preceding year; and

• Health care services that VA believes is more cost effective to provide through VCAs.

“This effort to refine and make permanent a consolidated community care program begins with a redesign of VA’s infrastructure and capabilities that will next cause a review of what services VA hospitals and community-based outreach centers perform, and how,” Butler said. “The legislative language introduced by this committee provides greater detail in a number of areas that VA’s request lacks.”

VA’s CARE Act Proposal

According to Butler, The American Legion believes Section 202, Improving Veterans’ Access to Walk-In Care, will be a benefit for VA patients and will decrease the prevalence of illnesses that are left untreated.

“Patients are deterred from going to the emergency room until their illness or injury becomes so severe that costlier and time-consuming measures are needed to stabilize and cure the patient,” Butler said. “The American Legion is concerned about the introduction of a co-pay feature that would be assessed for care directly related to an illness or injuries caused by a veteran’s honorable service.”

Butler said the Legion looks forward to working with VA and Congress to come up with a plan to mitigate such charges.

“Overall, The American Legion is extremely pleased with these proposals and with some minor adjustments, we believe this will begin the type of transformation the VA has needed for a very long time,” he said.

Click here to read Butler’s full written testimony, including the Legion’s positions on other bills.