March 25, 2014

Bio Implant Draft Legislation

To amend title 38, United States Code, to direct the Secretary of Veterans Affairs to develop or acquire a standard identification protocol for use in the procurement of biological implants by the Department of Veterans Affairs, and for other purposes.

The American Legion previously raised concerns about the lack of a robust tracking system in the Veterans Health Administration (VHA). The Department of Veterans Affairs (VA) Office of the Inspector General (OIG) conducted an audit in 2012 and made recommendations regarding VA’s management of their prosthetics supply inventory. In VHA’s response, they indicated that they would work to develop a plan to replace the Prosthetic Inventory Package (PIP) and the Generic Inventory Package (GIP) with a more comprehensive system. The target completion date is March 30, 2015. In the interim, VHA indicated they were working on a VA OI&T patch (VistA Prosthetics patch 101), which was 95 percent completed.

While reaching this goal by 2015 is indeed laudable, 2015 is rapidly becoming a critical year for VA to meet strategic goals including the elimination of veteran homelessness and the disability claims backlog. The American Legion would like to see a more detailed timeline implementing these changes and improvements for veterans. Reports through System Worth Saving Task Force visits and contact with VHA employees indicate responsibility for entering serial numbers of implant devices is manual, not automated, and is inconsistently implemented.

Although VHA claims to work to a standard of "removing recalled products from inventory within 24 hours of a recall", there is still no clear policy on how veterans who have already received implants are tracked. It is not enough to cut off the problem at the source, attention must be paid to veterans who are already downstream in the process. Without consistent tracking of implants, including positive identification by serial number and other identifying factors, uncertainty remains as to how veterans are served in the case of recalls. The American Legion noted we would like to see a more comprehensive procedure and policy clearly delineated by Central Office to ensure consistency in all Veterans Integrated Service Networks (VISNs).

The analysis of the current inadequacy of the tracking system for bio-implants derives directly from The American Legion’s System Worth Saving Task Force reports. The System Worth Saving Task Force was established to examine the State of VA Medical Facilities by resolution in 2004 . This annual report, provided to members of Congress and the veterans’ community is a vital resource as the primary third party analysis of the quality of VA facilities. The American Legion supports the passage of this legislation.

Gulf War Health Research Reform Act of 2014

To improve the research of Gulf War Illness, the Research Advisory Committee on Gulf War Veterans’ Illnesses, and for other purposes.

The American Legion has long encouraged the Department of Veterans Affairs (VA) to devote appropriate resources towards finding effective medical treatments for the unexplained physical symptoms of Gulf War veterans. Part of appropriate resources requires robust scientific research, and The American Legion has supported the implementation of reasonable recommendations in reports of the Institute of Medicine (IOM), as well as the Research Advisory Committee (RAC) on Gulf War Illnesses.

The recent, highly publicized struggles between VA officials and RAC members over the past year have been cause for concern. A healthy, working relationship between all parties, and the free exchange of scientifically valid information, is vital to a better understanding of the health issues resultant from deployment in the Gulf War theater of operations over the past two decades.

While this legislation aims to address some of the issues between VA officials and the RAC that led to the discord last year, The American Legion still has two primary concerns as to whether this is the appropriate vehicle to resolve the issue. It is unclear from the legislation whether this bill would actually resolve the differences between the scientists and the VA officials, and it is unclear whether it serves the ultimate goal of focus on veteran health. Because of these outstanding questions, The American Legion feels this bill falls outside the scope of what can be supported by existing resolutions.

Solving the impasse between the RAC and VA is a complex issue, with many moving pieces that will require careful deliberation by the Commissions of The American Legion to determine which course of action best suits the needs of veterans. As this will require a specific resolution targeting a solution, The American Legion cannot support the bill at this time.

Psychotropic Medication Draft Legislation

To amend title 38, United States Code, to provide for special rules relating to the informed consent of veterans who are prescribed psychotropic medication by health care professionals employed by the Department of Veterans Affairs.

This legislation aims to address deficiencies in the current consent regulations for prescription drugs for veterans. The American Legion has focused close scrutiny on the struggles of veterans returning from the wars in Afghanistan and Iraq as they cope with psychological disorders such as post traumatic stress disorder (PTSD). As a result The American Legion established the TBI and PTSD Committee in 2010 comprised of American Legion Past National Commanders, Commission Chairmen, respected academic figures, and national American Legion staff. The committee is focused on investigating existing science and procedures, as well as alternative methods for treating TBI and PTSD that are not being employed by the Department of Defense (DoD) and VA for the purpose of determining if such alternative treatments are practical and efficacious.

During a three-year study, the committee met with leading authorities in the DoD and VA, as well as academia, veterans, private sector mental health experts, and caregivers about treatments and therapies veterans have received or are currently receiving for their TBI and PTSD symptoms. As a result of the study, the committee released their findings and recommendations in a report titled "The War Within." "The War Within" report highlights these treatments and therapies and also identifies findings and recommendations to the DoD and VA.

"The War Within" recognized problems with over-reliance on prescription medication and exhorted VA and the DoD to examine alternative therapies either in addition to or in lieu of some of the more traditional therapies.

The scope of this bill and its attention to prescription drugs however, is outside the scope of the resolutions of The American Legion, or the findings of the report. The American Legion does endorse the examination of alternative therapies to psychological disorders, but does not have a specific position on this piece of legislation.

Small Business Draft Legislation

To amend title 38, United States Code, to improve the oversight of contracts awarded by the Secretary of Veterans Affairs to small business concerns owned and controlled by veterans.

At its Fall 2013 meetings, The American Legion’s National Executive Committee passed Resolution 73: Support Verification Improvements for Veterans’ Business Within the Department of Veterans Affairs and the Department of Defense, which endorses legislative efforts to ensure that contracts awarded pursuant to the Veterans First Program are awarded to companies that truly are entitled to receive these set-asides. The American Legion has long been an advocate and strong supporter of a robust veteran and service-disabled business owner contracting program. Businesses that prey on veterans by using their preferred contracting status pervert the system and rob opportunities from healthy veteran businesses that are prepared to perform a majority of the actual contract work. Companies that act as pass-thrus degrade the integrity and undermine the veteran contracting program. While The American Legion has not found this to be an alarming problem, we are saddened when we hear of even one situation where the preferred status of a Service Disabled Veteran Owned Company has been purchased by a no qualifying company for the purpose of securing contracts that have been specifically set aside for veterans. We believe that veterans would benefit from an added reminder of their responsibilities when it comes to accepting a contract that has been designated as a Service Disabled Veteran, or Veteran Owned Small Business contract, and would like to continue to work with this committee to serve and protect the veteran business community. The American Legion supports the passage of this legislation.

Information Technology Security Draft Legislation

To improve the information security of the Department of Veterans Affairs by establishing an integrated information security program, and for other purposes.

The American Legion is a grassroots organization that derives its operational mandate from resolutions passed by the membership in regular meetings. There are no resolutions that specifically address the content of this legislation. The American Legion has no position on this legislation.

H.R. 3593: The VA Construction Assistance Act of 2013

To amend title 38, United States Code, to improve the construction of major medical facilities, and for other purposes.

When American Legion National Commander Dellinger testified before a joint session of Congress on September 10, 2013, Congressman Coffman referred to the Dellinger’s construction background and asked Commander Dellinger if he would please offer his comments, based on his personal experience in the construction industry, about construction challenges that VA was facing in Colorado and other areas. Commander Dellinger responded, "Maybe the VA should get out of the construction business, and do what they do best – take care of our veterans."

Since September, American Legion leaders and staff have been researching and reviewing possible policy changes regarding VA’s major construction and leasing programs, and will be presenting our findings and recommendations to our voting members during our upcoming meeting in March 2014. It will be at this meeting that The American Legion will decide whether or not to develop and pass a resolution regarding the VA construction program.

As part of our research and investigation, The American Legion met with senior officials from the Army Corps of Engineers, The VA Office of Acquisition, Logistics & Construction, and the VA Office of Construction and Facilities Management to assess the viability of diversifying VA’s construction management responsibilities.

During our evaluation, we found that the Army Corps of Engineers:

  • Is adequately suited to undertake the long-term mission of managing VA’s construction portfolio
  • Has a track record that is equal to or better than the federal industry standard regarding on-time, on-budget construction projects
  • Would report directly to VA and not replace OALC
  • Has worked on VA construction projects in the past
  • Routinely builds hospitals for the Department of Defense

The Corps is not without its criticisms, however most of the criticisms suffered by the Army Corps of Engineers involve their Civil Construction arm and the amount of money Congress has dedicated to disaster relief, beach erosion and other civil engineering projects, not their construction projects. One note regarding this organization is that there is more transparency and ready access to information regarding overhead expenses and actual costs than with private firms as the Government Accountability Office has an entire collection of assessments and evaluations of the Army Corps of Engineers ready for public review. Information about Army Corps can also be found at the Congressional Budget Office, the Congressional Research Service, as well as other federal research activities and offices.

It is also important to note that inserting the Army Corps of Engineers into the VA construction program would not reduce VA’s authority or oversight in any way, as VA would always maintain the role of "customer" in any future relationship. Another advantage is the advocacy role that Army Corps assumes on behalf of VA. In the event of cost overruns not covered by the reserve fund, Army Corps takes on the responsibility of representing VA before Congress to request additional appropriated funds needed to complete the project.

The failures in Florida, Louisiana, Colorado and Nevada with major construction projects have made it clear that VA needs help. The Army Corps of Engineers has a proven track record of managing projects of this nature. This legislation would provide a helpful bridge. Efforts to exhort the VA to pursue this path on their own have not proven successful. The Congress needs to act and pass this legislation to help get the VA construction program back on track. The American Legion supports the passage of this legislation.