November 12, 2002
President George W. Bush
The White House
1600 Pennsylvania Avenue
Washington, DC
Dear Mr. President:
Yesterday, November 11, 2002, you led our National commemoration of Veterans Day during ceremonies at Arlington National Cemetery. You and millions of our fellow citizens paid tribute to the men and women who have honorably served in our Armed Forces.
During your remarks at Arlington National Cemetery you said, “America must, and will, keep its word to those men and women who have given us so much. Veterans have been promised good health care when they are sick and disabled; they must be treated with fairness and respect.” Mr. President for our nation’s veterans your commitment must be more than words.
Just as war has inescapable costs, so too are the costs of caring for those who have borne the battle, their widows and children. If our nation is to truly honor the service of our veterans, we must be willing to bear the costs of providing our veterans the benefits and services they have earned by their honorable service. As you so eloquently said yesterday, “America must, and will, keep its word to those men and women who have given us so much.” Mr. President, the time to fulfill this commitment to veterans is now.
I understand you will soon make critical decisions about the budget you will propose for fiscal year 2004. If, as a nation, we will honor the commitment which we have made and you have affirmed to our veterans, the budget you propose must request a substantial increase in funding for the Veterans Health Administration.
As you are aware, Congress is now giving serious consideration to a measure, H.R. 5250, the Veterans Health Care Funding Guarantee Act of 2002, introduced by House Veterans Affairs Committee Chairman Christopher H. Smith. This measure would require “mandatory funds” be provided to the Veterans Health Administration (VHA), the amount of mandatory funding increasing or decreasing annually in accordance with changes in the health care inflation rate and in the beneficiary
population. If Congress had enacted this bill in 2002, it would increase funding for FY 2004 (a baseline year) by 20% over the FY 2002 appropriation expected
to be enacted. This measure alone would require $27.6 billion in funding for fiscal year 2004.
In order to compensate for recent shortfalls in funding that have led to long waiting times for primary and specialty medical care and serious cutbacks in the delivery of mental health, I believe funding in addition to the $27.6 billion noted above will be necessary for fiscal year 2004. VA has recently indicated that almost 300,000 veterans were waiting for first-time appointments in VHA or for necessary follow-up care. I believe VA will require at least $260 million to address this problem with additional staffing, equipment and overhead expenses. Because of inadequate funding, tens of thousands of our veterans are not receiving timely and quality health care from the Department of Veterans Affairs today.
Last April, VA was due to submit its Report on the Capacity of Specialized Resources to Serve Seriously Disabled Veterans. VA’s claim that it is maintaining the capacity of its mental health programs as of the end of fiscal year 2001 was recently disputed by the VA’s Inspector General. Past reports from the Undersecretary for Health’s Committee on Care for the Seriously Mentally Ill indicate that VA may have shifted more than $600 million from its specialized mental health programs since 1996. In a more recent estimate calculating the value of funding still invested in VA’s mental health programs, my staff estimates that $400 million more is needed to restore funding to its fiscal 1996 level in current dollars. In addition, I also recommend funding initiatives authorized within P.L. 107-95 totaling to $32 million.
Finally, VA expects to complete the Capital Assets Restructuring for Enhanced Services (CARES) process within the FY 2004 funding cycle.
There are currently 21 health care networks in the Veterans Health Administration. One network, Veterans Integrated Service Network 12, the Great Lakes Health Care System, served as a prototype for the CARES process. Major construction costs for implementing the recommendations for this network alone were estimated to require about $140 million in appropriated funding. Congress has approved $40 million, but the Administration has not yet requested any funding for a new bed tower at the Westside division (to be completed by FY 2006) which will require $100 million. In addition, Secretary Principi indicated that about $150 million in minor construction and other types of spending would be necessary to implement CARES recommendations.
If the appropriated fiscal investment in VISN 12 is a reasonable indication of systemwide funding requirements, VA will need to fund about $6 billion to overhaul facilities in the 20 remaining networks. I am proposing that these funds be made
available in equal amounts ($1.2 billion/year) over the next five fiscal years, beginning in fiscal year 2004. Although the process is not scheduled for completion until Fall of 2004 (FY 2005), VA must take drastic steps, in the short term, to improve its aging, inefficient, and sometimes even unsafe infrastructure. In order for veterans to believe that CARES is
a process to better address their health care needs, the Administration must not hesitate to request appropriate funding to allow VA to restructure and improve its facilities.
Mr. President, based on the foregoing analysis, I respectfully request the budget you submit to Congress for fiscal year 2004 provide not less than $29.5 billion for veterans medical care. This baseline funding will provide resources for a CARES trust fund as well as addressing current fiscal year veterans’ medical care needs.
As always, Mr. President, I look forward to working with you on behalf of our veterans. Working together, I am confident America will keep its word to those men and women who have given us so much; veterans have been promised good health care when they are sick and disabled will receive quality and timely medical care and be treated with fairness and respect.
Sincerely,
LANE EVANS
Ranking Democratic Member