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Mr. Chairman and other distinguished members of the subcommittee, on behalf of Vietnam Veterans of America (VVA) and our National President, Thomas H. Corey, we are pleased to have this opportunity to present our views with respect to several important pieces of veterans healthcare–related legislation pending before the Subcommittee today.

As an overall statement on several of the proposals to be considered here today, it must be noted that the nursing shortage is a national problem. This shortage is reminiscent of the so-called “worker shortage” of the early and mid 1990s when employers and the Department of Labor claimed that we had a shortage of qualified workers to fill all the jobs in America. This was a false shortage then and it is the same today. At that time there was no shortage of bright, intelligent hard-working people in America. Rather there was a shortage of bright, hardworking people who either were qualified or could easily be trained to be fully qualified who were willing to work for low wages and not so good benefits and/or status that was being offered. VVA believes that the same is true of nurses and the so-called “nurses shortage” today.

As you all are no doubt aware the Bureau of Labor Statistics (BLS) predicts that there will be 1.1 million more nursing jobs created in this decade, beyond those positions that exist today. As the average age of Americans grows older, more and more nurses, and clinicians of all types, and health care workers of all types will be needed to keep up with that growing demand. With the retirement of so many “baby boomers” and the lure of better pay and less pressure in other occupations, this need will be more acute. The genius of our economic system is that when the demand exceeds the supply of anything, the price will go up if the society truly values that good or service. When the price goes up, the supply will start to come back into balance with the demand. So it is with the labor market as well. The reality of overall nurses’ pay, status, and working conditions, as well as the perception of same by those who might be interested in entering that profession, is the key to restoring balance.

H.R. 4020 State Veterans Home Nurse Recruitment Act of 2004
This proposal would amend the Federal veterans' benefits provisions to direct the Secretary of Veterans Affairs to make payments to States for assisting State veterans' homes in the hiring and retention of nurses and the reduction of nursing shortages at such homes. The proposed legislation also makes eligible for such assistance State homes that: (1) currently receive per diem payments from the Secretary for the care of veterans; and (2) have in effect an employee incentive scholarship or other program designed to promote the hiring and retention of nursing staff and reduce nursing shortages. The proposal limits such assistance to no more than 50 percent of the fiscal year costs of such a program.
The pending legislation also requires the assistance program to be implemented as expeditiously as possible, so that payments are made to eligible States commencing no later than January 1, 2005. VVA does favor this modest program, as it will provide some assistance to the State Homes operated by the State in the recruitment and the professional development of vitally needed staff. The main problem with this proposal is that many states are in such difficult circumstances with their budget, that many may not be in a position to participate, even though they have the need.
H.R. 4231, the Department of Veterans Affairs Nurse Recruitment and Retention Act of 2004
This proposal provides for a pilot program in the Department of Veterans Affairs to improve recruitment and retention of nurses, and for other purposes. The flexibility envisioned by these provisions (and other possible such creative means) may prove to be useful to VA in some labor markets in meeting their base nursing needs. The idea of “streamlined hiring procedures” however, does trouble VVA, as this is usually code language for “getting around that pesky veterans’ preference law.” VVA will oppose any further diminishment of enforcing protection of the earned rights of veterans preference and disabled veterans preference in hiring and retention by the VA, especially given the less than good record of the Veterans Health Administration in this regard.
H.R. 3849 Military Sexual Trauma Counseling Act of 2004
Women have served our nation in every war since the American Revolution. In our war, most of the 7,500 women who served in-country were nurses who saw the detritus of war, the shattered bodies of young boys hardly grown to men, who experienced the horrors of war as profoundly as any grunt. They will always have our undying respect and gratitude.
Today, women comprise some 17 percent of our Armed Forces. And we must ensure that their special needs, particularly the emotional scars borne of sexual trauma, are met with understanding and compassion. Public Law 102-585, which was passed in 1992, authorized the VA to include outreach and counseling services for women veterans who experienced incidents of sexual trauma while on active duty. Public Law 103-452 amended that law to provide counseling for male veterans as well. However, the law fails to give the VA authority to provide sexual trauma counseling on a permanent basis: it is due to sunset at the end of this calendar year. To remedy this, VVA strongly supports H.R. 3849, the Military Sexual Trauma Counseling Act of 2004, introduced by Congressman Ciro D. Rodriguez, the Ranking Democratic Member of the House Veterans’ Affairs Subcommittee on Health. This legislation would permanently extend the VA’s authority to offer services to women and men who experienced sexual harassment, abuse or assault while serving on active-duty in the armed services. VVA requests that Congress enact this legislation making sexual trauma counseling a permanent facet of VA health care for men and women.
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H.R. 4248 Homeless Veterans Assistance Reauthorization Act of 2004
In todays funding arenas, many municipalities utilizing federal dollars pursuant to the Stewart B. McKinney Act have placed an emphasis on permanent housing. Transitional housing dollars are literally inaccessible to non-profit agencies that provide services to homeless veterans, except through the VA. If chronic homelessness is to be ended, as stated by both the Secretary of Veterans Affairs and by the President, before the end of this decade, the Secretary's authority to make grants under Chapter 11, Section 2011 must be extended to September 30, 2008. By extending this authority, resources can be allocated to address the issue in a realistic timeframe. More funds must become available to the Secretary for this purpose. Similarly, chronic homelessness cannot be addressed without extensive outreach extending beyond September 30, 2005.
The Homeless Grant & Per Diem Program has enabled non-profit service providers the revenue needed to establish and maintain nearly 10,000 transitional residency beds nationwide. VA has invested many resources into these programs and attained great success. Through Grant & Per Diem dollars accessed by the non-profits, the non-profits availability to provide the services for homeless veterans in a transitional setting is much less expensive than VA residential care and the non-profits are able to provide a safe, stable, focused recovery environment for a longer period of time, thereby also increasing opportunities for the homeless veterans the opportunity to transition into the community with a steady job, dollars in the bank and resolution of both financial debts and debts to society.
VVA fully supports increasing the authorization allocation to $100,000,000 for fiscal year 2005 and extending and authorizing $100,000,000 for FY 06, 07 & 08 will enable the additional of homeless grant and per diem beds as so stated in H.R. 4248.
A draft bill to reform the qualifications and selection requirements for the position of the Under Secretary for Health
Vietnam Veterans of America does not favor this draft bill as written. VVA believes that the Undersecretary should always be a licensed medical clinician, including but not limited to Medical Doctor or advanced degree Nurses, and other similar clinical disciplines. The military model works well, and should be the model for the VA to follow in this regard. In the Army, the Medical Company Commander or the hospital Commander is always a clinician. This used to mean an M.D., but in recent years advanced degree nurses and nurse practitioners have been eligible for command slots as well. The Executive Officer (or Deputy) is almost always in the Medical Service Corps, and trained in logistics, finance, control of personnel, and all the myriad skills needed in order to successfully operate a medical facility or medical system.
VVA believes this model, used by both the Army and the Navy, is the one that can and should be adopted by the Congress for the Veterans Health Administration. In other words, the Undersecretary should be a clinician, and in the future the similar requirement for the Deputy Undersecretary should be removed in favor of strong administrative skills and experience.
As to changing the nature of the committee mandated by law from a selection committee to an advisory committee, VVA favors this change, as long as the final report of the proceedings of the Advisory Committee are transparent to the public at some point.
VVA strongly believes that the Secretary should be held fully accountable for performance, as should a President. Similarly, the Secretary should be able to choose his or her candidate(s) subject to the Senate confirmation process. VVA also favors elimination of the so-called 4-year contracts, and holding senior managers and clinicians fully accountable for their perf0ormance in every facet of their job. While executive pay and clinician pay should both be raised to be competitive in the marketplace, the ending of virtually automatic bonuses and cash awards to the “good old boys & girls club” that is to some degree still extant within the Veterans Health Administration must end.
CONCLUSION:
Vietnam Veterans of America sincerely appreciates the opportunity to present our views on these extremely important issues, and we look forward to working with you, Mr. Chairman, and your distinguished colleagues on this subcommittee to address and resolve these and other important matters of concern to our nation’s veterans.

VIETNAM VETERANS OF AMERICA
Funding Statement
May 6, 2004

A national organization, Vietnam Veterans of America (VVA) is a 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 for the previous two fiscal years.

For further information, contact:

Director of Government Relations
Vietnam Veterans of America
(301) 585-4000 ext 127

RICHARD WEIDMAN
Richard F. “Rick” Weidman serves as Director of Government Relations on the National Staff of Vietnam Veterans of America. As such, he is the primary spokesperson for VVA in Washington. He served as a 1-A-O Army Medical Corpsman during the Vietnam War, including service with Company C, 23rd Med, AMERICAL Division, located in I Corps of Vietnam in 1969.
Mr. Weidman was part of the staff of VVA from 1979 to 1987, serving variously as Membership Service Director, Agency Liaison, and Director of Government Relations. He left VVA to serve in the Administration of Governor Mario M. Cuomo (NY) as statewide director of veterans employment & training (State Veterans Programs Administrator) for the New York State Department of Labor.
He has served as Consultant on Legislative Affairs to the National Coalition for Homeless Veterans (NCHV), and served at various times on the VA Readadjustment Advisory Committee, the Secretary of Labor’s Advisory Committee on Veterans Employment & Training, the President’s Committee on Employment of Persons with Disabilities - Subcommittee on Disabled Veterans, Advisory Committee on veterans’ entrepreneurship at the Small Business Administration, and numerous other advocacy posts in veteran affairs.
Mr. Weidman was an instructor and administrator at Johnson State College (Vermont) in the 1970s, where he was also active in community and veterans affairs. He attended Colgate University (B.A., (1967), and did graduate study at the University of Vermont.
He is married and has four children.