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Statement for the Record of
VIETNAM VETERANS OF AMERICA
Submitted by
Thomas H. Corey
National President
Before the
Subcommittee on Health
House Committee on Veterans Affairs
Regarding
H.R. 3253 and H.R. 3254
April 10, 2002
Chairman Moran, Ranking Member Filner,
and other distinguished members of
the subcommittee, Vietnam Veterans of America (VVA) is pleased to have
this opportunity to provide a statement for the record on H.R. 3253,
the National Medical Emergency Preparedness Act of 2001, and H.R. 3254,
the Medical Education for National Defense in the 21st Century Act. VVA
will address each bill in turn.
H.R. 3253 National Medical Emergency
Preparedness Act of 2001
Since the war on terrorism began last year,
VVA has testified repeatedly on the need for the VA to be properly
prepared to meet the obligations of the VA’s “Fourth Mission,” and be
prepared to handle mass casualty contingencies, particularly those
involving weapons of mass destruction (WMD). Accordingly, in the
broadest terms, we share this committee’s view that VA must do more to
address this critical “fourth mission” problem area. However, H.R. 3253
as currently drafted is not the vehicle for achieving our common goal.
Given the abundant evidence that VVA and our
fellow Veteran Service Organizations have presented to this committee
about the funding shortfalls in veterans health care, VVA was surprised
to find the following language in H.R. 3253:
`(e) FUNDING- (1) Amounts appropriated for
the activities of the centers shall be appropriated separately from
amounts appropriated for the Department for medical care.
`(2) There are authorized to be appropriated
for the centers under this section $20,000,000 for each of fiscal years
2002 through 2006.
`(3) In addition to funds appropriated for a
fiscal year pursuant to the authorization of appropriations in paragraph
(2), the Under Secretary for Health shall allocate to such centers
from other funds appropriated for that fiscal year generally for the
Department of Veterans Affairs medical care account and the Department
of Veterans Affairs medical and prosthetics research account such
amounts as the Under Secretary for Health determines appropriate to
carry out the purposes of this section. (emphasis added)
VVA believes that while this proposal needs
significant refinement, the most important point is that this effort
should be funded from the $24 billion that the Congress appropriated for
P.L. 107-38 the Homeland Defense in the Fall of 2001. Thus far VA has
only asked for $77 million from this fund and received far, less than
this amount. Given the overall downsizing of the VA medical system, and
the fact that every VA hospital in the country is reducing staff and
services by at least 5 to 7% this fiscal year (not even counting the
$500 million to $700 million shortfall), there is not even enough
organizational capacity to take care of the veterans whom the VA
currently serves, much less possible military casualties returning from
overseas or civilian casualties at home. VVA respectfully urges the
Committee to work with other appropriate committees in the Congress as
well as the Executive branch to ensure that adequate funds are
transferred from the Homeland Security (P.L. 107-38) accounts to
properly fund this effort and to restore vitally needed organizational
capacity in the VA health care system now and in the future. VVA
estimates this requires a minimum of $500 million over the next two
years.
Additionally, VVA finds the following
language in the bill equally problematic:
`(g) PEER REVIEW PANEL- (1) In order to
provide advice to assist the Secretary and the Under Secretary for
Health to carry out their responsibilities under this section, the Under
Secretary shall establish a peer review panel to assess the scientific
and clinical merit of proposals that are submitted to the Secretary for
the designation of centers under this section.
`(2) The peer review panel shall include
experts in the fields of toxicological research, bio-hazards management
education and training, radiology, clinical care of patients exposed to
such hazards, and other persons as determined appropriate by the
Secretary. Members of the panel shall serve as consultants to the
Department.
`(3) The panel shall review each proposal
submitted to the panel by the officials referred to in paragraph (1) and
shall submit to the Under Secretary for Health its views on the relative
scientific and clinical merit of each such proposal. The panel shall
specifically determine with respect to each such proposal whether that
proposal is among those proposals which have met the highest competitive
standards of scientific and clinical merit.
`(4) The panel shall not be subject to the
Federal Advisory Committee Act (5 U.S.C. App.).
This language makes
no provision for the inclusion of veteran advocates on the proposed peer
review panel, an omission VVA finds extremely curious. VVA recommends
that if this proposal advances, that VSO representation is key to its
success.
VVA also notes that there is no language
defining outcome measures included in the bill. The principles in both
the letter and the spirit of the Government Performance & Results Act (GPRA)
should be the guidelines followed in all programs. If the VA
subsequently asserts that it has trained a certain number of medical
professionals at each center to deal with WMD casualties, how will the
committee know this is in fact the case? What types of individual
standardized proficiency tests will these personnel be required to take
on a regular basis? How will unit performance be measured? How
frequently will WMD exercises be held, and how will such exercises be
graded? What mechanisms will be established to ensure that individual
and unit proficiency and training shortfalls are successfully addressed?
In short, how will the Congress measure VA’s WMD defense efforts in the
absence of clearly defined outcome measures that are directly tied to
managerial performance? VVA respectfully urges the Committee to correct
this omission in the proposal.
VVA feels that efforts to confront WMD
contingencies must be part of a larger overall effort, spearheaded by
the Department of Health and Human Services, to establish national
training and education standards and procedures for dealing with WMD
events. VA does not exist in a public health vacuum; its approach to WMD
defense must be directly connected to the larger overall public effort
to address this issue. VVA urges the committee to work with other
committees in the House that deal with civilian public health issues to
develop a unified approach to this problem.
H.R. 3254 Medical Education for
National Defense in the 21st Century
Last fall’s anthrax letter attacks
forcefully demonstrated how disruptive (and deadly) such unconventional
attacks could be on a vulnerable public health system. VVA agrees with
this committee that public health professionals generally should become
far more acquainted with WMD-related health threats than is currently
the case. In fact, VVA strongly believes that VA should also be engaged
in a major effort to educate the private sector medical providers in the
importance of discovering if their patients are veterans and, if so,
taking a complete military history for use in diagnosis and treatment.
Perhaps what is needed is a comprehensive approach to the problem, one
that must include the Department of Health and Human Services (HHS) as
the lead agency and executive agent for any such program, but of course
include VA and the Department of Defense as cooperating and
participating agencies.
HHS, university medical centers, and private
medical centers must play the lead role in formulating America’s public
health response to WMD contingencies. VA and DoD can and should be
partners in this effort, but in a supporting role. Thus, HHS and the
larger public health policy community should come together to develop
the kinds of WMD-related curricula, training, and exercise programs
necessary for properly equipping the United States to deal with domestic
WMD contingencies. VVA would suggest that the President direct the
creation of a national WMD medical preparedness center within HHS. VA,
DoD, and the relevant state agencies would all be full partners in this
new center, which would focus on all aspects of domestic WMD medical
preparedness and response: education, individual and unit training, and
exercises.
Further, research into the effects of WMD
agents should be led by the National Institutes of Health, and should
include an emphasis on the health effects of sublethal exposures to WMD
agents. VVA believes that this area of research remains significantly
under-funded and inadequately explored. We hope this committee will work
with its sister committees in the House with jurisdiction over HHS to
develop the kind of comprehensive approach we have outlined here today.
Mr. Chairman, this concludes our statement.
Please accept our thanks for the opportunity to share our views with you
and the committee on this very important topic.
VIETNAM VETERANS OF AMERICA
Funding Statement
April 10, 2002
Vietnam Veterans of America (VVA) is a
national non-profit veterans membership organization registered as a
501(c)(19) with the Internal Revenue Service. VVA is also appropriately
registered with the Secretary of the Senate and the Clerk of the House
of Representatives in compliance with the Lobbying Disclosure Act of
1995.
VVA is not currently in receipt
of any federal grant or contract, other than the routine allocation of
office space and associated resources in VA Regional Offices for
outreach and direct services through its Veterans Benefits Program
(Service Representatives). This is also true of the previous two fiscal
years.
For Further Information, Contact:
Director of Government Relations
Vietnam Veterans of America
(301) 585-4000, extension 127
THOMAS H.
COREY
Tom Corey currently serves a National
President of Vietnam Veterans of America, the nation’s only
congressionally chartered organization devoted to serving the needs of
Vietnam-era veterans and their families.
A native of Detroit, Corey was drafted into
the U.S. Army and sent to Vietnam in May 1967. He served as a squad
leader with the 1st Air Cavalry Division. While engaged in
an assault against enemy positions in January 31, 1968, he received an
enemy round in the neck which hit his spinal cord and left him
quadriplegic. He was medically retired in May 1968.
After an extended period of hospitalization,
Corey returned to his family in Detroit where he spent much of his time
in and out of the local VA hospital. He relocated to West Palm Beach,
Florida, in 1972, where he is involved in community affairs and serves
on many advisory boards. He has received awards for speaking out for
veterans and disabled persons rights.
Corey was the first recipient of the Vietnam
Veterans of America’s Commendation Medal, VVA’s highest award for
service to veterans, their families, and the community.
He has served as a member of the board of
directors and President of the Paralyzed Veterans Association of
Florida. He also serves on advisory boards at the VA Medical Center in
West Palm Beach, the VA Research Foundation of the Palm Beaches, and
VISN 8 Management Assistance Council.
Corey was the founding President of VVA Palm
Beach County Chapter 25, in 1981. In 1991 the chapter was named the
Thomas H. Corey Chapter at its tenth anniversary celebration. In 1985,
he was elected to a two-year term as a VVA national board member. In
1987, he was elected VVA National Secretary and was re-elected in 1989,
1991, 1993, and 1995 to that position. In 1997, he was elected VVA’s
national Vice-President.
Tom Corey currently resides in West Palm
Beach. He has a 19-year-old son, Brian.
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