Legion testifies on pending, draft health-care legislation

The American Legion's National Veterans Affairs and Rehabilitation Division Director Louis Celli testified at a House Committee on Veterans’ Affairs Subcommittee on Health hearing on April 17. Celli gave The American Legion’s positions on the following pending and draft House Resolution (H.R.) bills.

H.R. 1506: VA Health Care Provider Education Debt Relief Act of 2017

The American Legion is deeply troubled by the Department of Veterans Affairs (VA) leadership, physicians and medical specialist staffing shortages within the Veterans Health Administration (VHA), according to Celli’s written testimony. Currently, there are more than 43,000 vacancies throughout the VA in primary care, mental health care and dental care providers.

H.R. 1506 will provide an incentive to attract qualified providers to fill the above noted vacancies by increasing total educational loan repayment amounts from $120,000 to $150,000 and annual debt repayment amounts from $24,000 to $30,000.

During testimony before the joint House and Senate Veterans’ Affairs Committees this February, National Commander Denise H. Rohan called for raising the ceiling of the VA Debt Relief Reduction program to increase VA probability of attracting high-quality talent in its recruitment efforts.

“All of this negative exposure and lower pay standards is crippling the agency charged with taking of our nation’s warriors – we need to fix that,” Celli said. “H.R. 1506 can help fix that by making VA a more attractive employment option for our health care community by offering to pay off some of their student debt. Will this solve the problem? Not entirely, but what it will do is prove that we are willing to invest in high quality professionals that care for our wounded and ill veterans.”

According to Celli, a common theme the Legion’s System Worth Saving team hears from VHA medical center human resource staff and physicians is VA’s debt reduction program is not adequately funded and the amount VA can offer to a VA provider is not in keeping with what local community hospitals can pay.

Through its Resolution No. 377, Support for Veteran Quality of Life, The American Legion supports any legislation and programs within the VA that will "enhance, promote, restore or preserve benefits for veterans and their dependents, including, but not limited to, the following: timely access to quality VA health care, timely decisions on claims and receipt of earned benefits, and final resting places in national shrines and with lasting tributes that commemorates their service."

The VA Health Care Provider Education Debt Relief Act will grant this nation’s veterans better access to care by increasing the number of doctors available to be seen and will improve the overall quality of care that the VA is able to provide.

The American Legion supports H.R. 1506.

H.R. 2322: Injured and Amputee Veterans Bill of Rights

H.R. 2322 calls for a veteran to have the right to select a practitioner that best meets their orthotic and prosthetic needs, whether or not that practitioner is an employee of the VA, a private practitioner who has entered into a contact with the VA, or even a private practitioner with specialized expertise.

“At this time, we are unable to support H.R. 2322, the Injured and Amputee Veterans Bill of Rights, because it appears to be missing some language,” Celli said. “The American Legion is committed to ensuring all veterans, especially those with catastrophic injuries, receive expert care. We just have to be careful that we don’t create a mechanism whereby the VA has no control over how care is delivered or how the government will pay for it.”

The American Legion opposes any legislation or effort to close or privatize the VA through Resolution No. 372, Oppose Closing or Privatization of Department of Veterans Affairs Health Care System.

Celli concluded, “We wouldn’t have an issue with the bill if it contained the passage that is reflected in the VA handbook stating ‘or the veteran’s preferred prosthetist who agrees to accept the preferred provider rate,’ which unfortunately, this bill is missing.”

The American Legion opposes H.R. 2322.

H.R. 3832: Veterans Opioid Abuse Prevention Act

H.R. 3832 directs the VA to connect VA health-care providers to a national network of state-based prescription drug monitoring programs (PDMPs) databases which track controlled substance prescriptions. PDMPs ensure health-care providers do not accidently prescribe dangerous and potentially lethal combinations of drugs to patients who also see other healthcare providers.

“The Veterans Opioid Abuse Prevention Act will bring the VA online with state-based prescription monitoring programs,” Celli said. “This is in the best interest of patients and helps doctors provide holistic quality medicine at the federal level.”

The American Legion supports the use of Electronic Health Records as a method of coordinating care provided to veterans inside and outside VA medical facilities and the controlled sharing of electronic medical records so that veterans can receive the highest possible quality health care available through Resolution No. 83, Virtual Lifetime Electronic Record.

The American Legion supports H.R. 3832.

H.R. 4334: Improving Oversight of Women Veterans’ Care Act of 2017

H.R. 4334 would enhance the monitoring needed for effective oversight of women veterans health care in VA and community care programs. This legislation would require VA to report to Congress women veterans’ accessibility to gender-specific health care in any community of care program.

“We still need to address the inequities facing our women veterans who use the Choice Program for gender-specific health care needs,” Celli said.

The report must include the average waiting period between the veterans preferred appointment date and the date on which the appointment is completed, as well as driving time required for veterans to attend their appointments.

The bill would also require VA medical facilities to report to the Secretary the compliance and non-compliance of the facility to ensure they meet quality care standards for women veterans. Evidence gathered from the reports could potentially help the VA enhance and preserve the benefits and the medical care for women veterans while providing timely access to care.

The American Legion supports any legislation and programs within the VA that will enhance, promote, restore or preserve benefits for veterans and their dependents through Resolution No. 377, Support for Veteran Quality of Life.

The American Legion supports H.R. 4334.

H.R. 4635: To direct the Secretary of Veterans Affairs to increase the number of peer-to-peer counselors providing counseling for women veterans, and for other purposes

H.R. 4635 would help ensure that the VA’s existing peer-to-peer counseling program has sufficient female peer counselors for female veterans who are separating or newly separated from military service. This bill, as written, would also emphasize counseling for women who suffered sexual trauma while serving, have PTSD or another mental health condition, or are at risk of becoming homeless.

The American Legion supports the goal of this legislation, recognizing the risk of suicide is 2.4 times higher among female veterans when compared to their civilian counterparts. The American Legion also recognizes existing peer-to-peer counseling programs have been successful and this bill creates a more representative program for the veteran population.

“Peer counselors are veterans themselves and can relate in profound ways to the mental health challenges facing fellow veterans,” Celli noted in his written testimony. “By connecting female veterans with one another, peer-to-peer assistance can empower female veterans to connect with each other and their communities.”

The American Legion continues to exert maximum effort to ensure that the VA utilizes returning servicemembers for positions as peer support specialists in the effort to provide treatment, support services and readjustment counseling for those veterans requiring these services through Resolution No. 364, Department of Veterans Affairs to Develop Outreach and Peer to Peer Programs for Rehabilitation.

The American Legion supports H.R. 4635.

Draft bill: VA Medicinal Cannabis Research Act of 2018

The American Legion supports VA’s statutory medical research mission and has donated millions of dollars toward expanding their scientific research, according to Celli. VA innovation is widely championed for their breakthrough discoveries in medicine and has been recognized over the years with several Nobel Prizes for scientific work that has benefited the world over.

VA officials report that about 60 percent of veterans returning from combat deployments and 50 percent of older veterans suffer from chronic pain compared to 30 percent of Americans nationwide. Many veterans suffering from PTSD and chronic pain, especially those of the Iraq and Afghanistan generation, have told The American Legion that they have achieved improved health care outcomes by foregoing VA-prescribed opioids in favor of medical cannabis.

“And yet there isn’t a single physician who has been formally trained by an accredited U.S.-based medical school on what this plant can, and, or can’t do,” Celli said. “There is no education that discusses medicinal uses, drug interaction, placebo effect, dosage rates, strains, or anything else regarding this plant because the United States Drug Enforcement Agency continues to insist that cannabis has, and I quote, ‘No currently accepted medical use and a high potential for abuse.’”

Resolution No. 11, Medical Marijuana Research, calls on the Drug Enforcement Agency to license privately funded medical marijuana production operations in the United States to enable safe and efficient cannabis drug development research and urges Congress to remove marijuana from Schedule I and reclassify it in a category that, at a minimum, will recognize cannabis as a drug with potential medical value.

“This draft legislation will call on VA to conduct the research necessary to determine of the cannabis plant, marijuana, has medicinal value, or not,” Celli said. “Our veterans are asking for this research, and our nation has an obligation to provide it.”

In October 2017, The American Legion conducted a nationwide survey of veterans and the results reinforce The American Legion’s continued efforts under Resolution 11.

“We call on Congress to conduct oversight hearings and support legislation that enables research on cannabis,” according to Celli’s written testimony. “And the medical impact it could have for Americans suffering from opioid over-prescription, pain, depression and a host of other known ailments, and direct departments and agencies within the administration to fully cooperate in all federally authorized scientific research and offer assistance as needed to authorize extensive research.”

The American Legion supports this draft bill.

Draft Bill: To make certain improvements in the family caregiver support program of the Department of Veterans Affairs

The American Legion advocates for equal benefits for all veterans regardless of period of service, and will never support a reduction in benefits. This bill reduces benefits to the existing caregiver program.

The American Legion opposes this draft bill.