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Pending Health Care Legislation

STATEMENT OF
ERIC A. HILLEMAN, DEPUTY DIRECTOR OF THE
NATIONAL LEGISLATIVE SERVICE VETERANS OF FOREIGN WARS OF THE UNITED STATES
BEFORE THE
COMMITTEE ON VETERANS’ AFFAIRS SUBCOMMITTEE ON HEALTH UNITED STATES HOUSE OF REPRESENTATIVES
WITH RESPECT TO

PENDING HEALTH CARE LEGISLATION

WASHINGTON, D.C.     March 3, 2009

MR. CHAIRMAN AND MEMBERS OF THE SUBCOMITTEE:
On behalf of the 2.2 million men and women of the Veterans of Foreign Wars of the U.S. (VFW) and our Auxiliaries, I would like to thank you for the opportunity to provide our views on the bills under consideration at today’s hearing. These bills would make meaningful changes in the law, improving the quality of health care this nation’s veterans receive at the Department of Veterans Affairs (VA). We urge quick passage of all four.

H.R. 784, a bill to report quarterly on vacancies in mental health professional positions in the Department of Veterans Affairs (VA)

The VFW supports, this bill would require the Secretary of VA to report to Congress, no later than 30 days from the end of the quarter, each vacancy for: psychiatrists, psychologists, social workers, marriage and family therapists, and licensed professional mental health counselors. Each report would be required to state the Veterans Integrated Service Network (VISN) or region in which the vacancy existed. The date of termination for these quarterly reports would be December 31, 2014.

Currently, reporting on vacancies for mental health professionals is not shared with Congress. Reporting vacancies to Congress will elevate the issue of the healthcare professional shortage and draw much needed attention to developing theses professions nationally. In breaking out the data by VISN, Congress and the VA can address regional shortages and/or barriers to employing these essential health care professionals. Fully understanding the shortages and need for mental health care professionals may also aid in creating incentives for their employment.

VFW is proud to support this legislation.

H.R. 785, a bill to establish a pilot program from FY 2010 to 2013 to educate and engage in outreach to college and university mental health centers

The VFW enthusiastically supports this legislation, which would give the VA Secretary the authority to train college and university clinicians, administrators, and counselors to serve veterans returning from Operation Iraqi Freedom and Operation Enduring Freedom (OIF/OEF). The VA would highlight illnesses common to veterans, resources available, and any other service the Secretary determined necessary for this program. The reporting component of the program would require the Secretary to report to Congress not later than two years after enactment of this Act. The Authorization for Appropriations of this Act would be $3 million dollars.

This legislation follows the prevailing trend of engagement of and on behalf of OIF/OEF veterans. We believe this bill will help to combat stereotypes of veterans in the community, de-stigmatizing mental health issues related to military service. Through educating the education community this information can hopefully be broadly disseminated into the counseling and social work industry. Not only is this a benefit to schools and the community, it directly affects veterans on campuses across the nation and eases their transition/reintegration.

The timing of this bill is especially important due to the New GI Bill the VA anticipates an increase of veterans on college campuses in the coming years. Many veterans will encounter an entirely new culture and bureaucracy not designed to support older students with unique needs. It is for these reasons that the VFW enthusiastically supports this bill.

H.R. 1211, “Women Veterans Health Care Improvement Act”

VFW is proud to support H.R. 1211, legislation that would improve benefits and services to female veterans, especially those who have served or are serving in OEF/OIF operations. Recent data collected by VA’s Center for Women Veterans reports that the number of women serving on active duty is about 15%, and that female personnel serving in Guard and Reserve capacities is 17.6% and growing. VA reports that 44% of the transitioning female veterans are seeking care at VA. As the number of females in uniform grow, so too will the percentage of females seeking services at VA. VFW is encouraged by the improvements this bill, and we remain hopeful this legislation will ease access to servicers at VA by women veterans.

The VFW recognizes that VA has begun to compile data with the goal of better understanding the barriers facing women within VA. We encourage VA to continue studying with an eye toward creating a more accepting culture at VA for female veterans. The improvements cited in this bill are an excellent means for progressing toward that goal.

The VFW supports Section 101, which would require VA to study barriers in providing comprehensive health care for women including: scope of services provided to women, effective outreach, mental health care and gender sensitivity of its health care providers. For many years, VA has been a gender-focused institution. All health care, documents, outreach, and programs were focused on male veterans, institutionalizing a lack of sensitivity for the needs of female veterans. Studies such as this will enable VA to move beyond the one-size-fits-all ideals and tailor its services to the specific needs of female veterans. It is our understanding that VA has already successfully executed a sample study of women veterans, the “Women Veterans Ambulatory Care Use Project, Phase II,” in the West LA area and this study has contributed to VA’s health care providers understanding of female veterans in this area. For example, the study finds that female VA users are more likely than non-users to receive mental health services. We believe the results of this study have led to increased sensitivity and understanding of women veterans and could have positive and lasting impacts in the way female veterans are treated if implemented across the system.

The VFW also supports Section 102, which would require a comprehensive assessment of current health care programs and services provided to women by the VA. The study would examine services including specialized programs to treat PTSD, substance abuse and mental illness, as well as the availability of obstetric and gynecologic care throughout the VA system. Further, it collects data on waiting times, health care services offered, demographics, geographic distance, and other factors faced by female veterans. In time, we believe this data will aid to close the existing gender gap and provide care sensitive to the needs of female veterans.

We fully support the sections contained in Title II of the legislation, which deal with the improvement and expansion of health-care programs for women veterans.

We applaud the recommendation of section 201 to extend health care coverage, for up to 14 days, to female veterans’ newborns. The period of 14 days is essential to the health of the child and the veteran, allowing continuity in obstetrics and gynecologic care. The VFW would encourage research on birth defects of children born to female veterans; we are highly sensitive to unknown exposures and environmental factors related to OEF/OIF service. Further recommendations on this issue are found in the FY 2010 edition of the Independent Budget (IB).

The VFW extremely supportive of section 202, which would authorize VA to provide graduate level training, certification, and continuing medical education for counseling with specific focus on evidence-based treatment and care for Military Sexual Trauma (MST) and PTSD. This is all too common among combat theatre female veterans. In these cases, VA should strive to be hypersensitive to the environment, approach, and treatment options when providing care or evaluating veterans for their physical and mental health needs related to MST.

We also strongly support section 203, which would create a pilot program to provide childcare for veterans receiving health care through VA. This is a valuable proposal, which has the potential to eliminate a tremendous barrier for care, especially for single parents.

In addition, we applaud section 204, which adds two recently separated female veterans to the VA Advisory Committees on women veterans and minority veterans. The veteran population is increasing greatly with the return of OEF/OIF veterans. Veterans of the current conflict era have specific needs.

A Draft bill to close existing loopholes in law, allowing VA to cover unmet emergency room treatment for veterans in certain cases

The VFW is pleased to offer our support for the draft legislation that deals with an issue important to a number of our members. This bill would allow VA to pay for of emergency care for veterans enrolled in VHA under certain cases. It closes a loophole that sticks many veterans unfairly with a large hospital bill.

Section 1725 of Title 38 authorizes VA to reimburse veterans for medical expenses related to emergency care at non-VA facilities if the veteran is enrolled and using the VA health care system. This is an important safety net for many veterans who have no other means to pay for potentially life-saving care. However, veterans who receive a portion of their care cost from another source, such as an insurance settlement or judgment are not eligible for any reimbursement, even if that amount is a fraction of the cost of their care. This bill allows VA to be a secondary payer in those situations, so the vet will not have to pay out of pocket. Additionally, it removes care accidents where insurance pays out for medical coverage from the list of things that would bar VA from paying for emergency care.

This legislation lifts these restrictions, treating VA as a secondary payer to cover the remaining amount due for a veteran’s emergency room care. We fully support this legislation. VFW believes that all essential emergency room care should be covered for all veterans.
Mr. Chairman, this concludes my testimony. I would be happy to answer any questions that you or the members of the Subcommittee may have. Thank you.

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