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Witness Testimony of Timothy M. Tetz, Director, National Legislative Commission, American Legion

Mr. Chairman and Members of the Committee:

The American Legion welcomes this opportunity to comment on the President’s budget request. 

President Obama has issued the challenge to invest in the future of America.  The American Legion believes strongly in this ideal.  Investment in the future means taking care of the needs of veterans today.  Investing in the future means solving problems at their onset rather than reaping heavy debts down the road as the problems grow to unmanageable levels.  Investing in the future means having the foresight to see tomorrow’s problems today, and avoiding the errors of the.  Imagine how the lives of veterans today would be changed had this nation had the foresight to invest in preparation to deal with the full consequences of Agent Orange, the ever-growing claims backlog, and substandard medical facilities as in days past.

Challenging tasks require aggressive solutions.  The American Legion supports the value of fiscal responsibility and recognizes the economic stability of this nation is vital to its overall security.  Even in difficult times, however, there is always the duty to ensure that vital needs are not neglected.  The budget, at a proposed 10.6 percent increase over fiscal year (FY) 2010 levels, recognizes meeting the needs of veterans continues to be an area where we must ensure proper funding.

Furthermore, with advance appropriations for the Department of Veterans Affairs (VA) now the law of the land, The American Legion is encouraged to see the proposed advance appropriations as the fruition of many years of hard work by our organization and others to ensure the stability and ability for long term health care planning in this sector.

The veterans’ community is paradoxically vulnerable in many ways.  Our nation’s defenders are visualized justly as brave and true sentinels, yet as they transition from warrior to citizen they face challenges not commensurate with the rest of the population.  The twin scourge of joblessness and homelessness are growing and remain challenges.  Veterans make up less than 10 percent of the population, yet face unemployment at rates two thirds higher than the overall average of America and while the numbers are being reduced, still the staggering figure of over 75,000 of our nation’s homeless are believed to be veterans.  Clearly these are areas where we are not meeting the duty to care for our nation’s heroes.

These numbers of veterans in need are only going to grow.  Already Defense Secretary Gates speaks of force reduction for those on Active Duty, and this will contribute more to the growing rolls of veterans as those service members step down from active service.  While it may not make the glamorous front page news, The American Legion has not forgotten that every single day the brave men and women of our armed forces overseas “leave the wire” to face roadside bombs, ambushes, combat and other hazards which continue to send service-disabled service members back home to cope with the aftereffects of war.  This is the true and on-going cost of war, and even in tough times this country cannot shirk the duty of paying that cost.

Therefore, it is absolutely critical the entire military and veterans’ community (active duty, Reserve Component, and veterans) continue to remain supportive of honorable military service.  No service member should ever doubt:

  • the quality of health care he or she will receive if injured;
  • the availability of earned benefits for honorable military service upon discharge; or
  • the quality of survivors’ benefits should he or she pay the ultimate sacrifice.

When National Commander Jimmie Foster testified on September 22, 2010 before a Joint Session of the Committees on Veterans’ Affairs, he clearly outlined the funding recommendations of The American Legion for FY 2012.  Our testimony today re-emphasizes those recommendations for certain specific areas.

MEDICAL SERVICES

The American Legion strongly supports the overall funding level for total medical services proposed by the administration.

The American Legion fully supports funding “the best health care anywhere”. VA reports that 6.1 million veterans will need to receive timely access to quality health care in this upcoming year alone.  This represents an anticipated increase of 168,904 new patients who will “vote with their feet” in making VA their health care provider of choice.  VA medical care is still America’s best investment in quality health care delivery – the right care, at the right time, in the right facility.  The Legion would further urge Congress to act now and ensure the passage of the full budget for FY 2011 so that a continuity of funding, to include all advanced appropriations, is available for full use and planning purposes. 

Medical and Prosthetic Research

The American Legion recommends $600 million for Medical and Prosthetics Research in FY 2011.

The American Legion believes VA’s focus in research must remain an understanding and improving treatment for medical conditions that are unique to veterans and their military service.  Service members are surviving catastrophically disabling blast injuries due to the superior armor they are wearing in the combat theater and timely access to quality combat medical care.  The unique injuries sustained by the new generation of veterans clearly demand particular attention.  It has been reported that VA does not have state-of-the-art prostheses like DOD and that the fitting of prostheses for women has presented problems due to their smaller stature.  Clearly, adequate funding is needed to ensure that VA does not continue to lag behind DOD in this capacity, and both agencies should be pushing forward in the field of innovations in prosthetic technology. 

There is a need for adequate funding of other VA research activities, including basic biomedical research and bench-to-bedside projects.  Congress should continue to encourage acceleration in the development and initiation of needed research on conditions that significantly affect veterans, such as prostate cancer, addictive disorders, trauma and wound healing, post-traumatic stress disorder (PTSD), rehabilitation; in addition, VA must have direction and funding to support supplementary research conducted jointly with DOD, the National Institutes of Health (NIH), other Federal agencies, and academic institutions.

As challenging health concerns such as the long term effects of Traumatic Brain Injury (TBI), exposures to environmental hazards in domestic and overseas deployment, and the mental health impact of exposure to combat conditions as well as military sexual trauma and assault develop, it is essential that VA lead the way in research and development to combat and treat these conditions.  Service members afflicted by these conditions will have a deep and lasting effect on the economy through their reduced ability to contribute if these conditions are treated and mitigated.  Quite simply, the more that can be learned about diagnosing and treating these conditions, the more likely this nation can avert catastrophic impact in the future.

Truly, investing in research at the onset is investing in the future.  While The American Legion applauds the budget’s stated research priorities of Mental Health, Gulf War Illness and Environmental Exposures, Prosthetics, and TBI and Spinal Cord Injuries, the allocated $509 million should be made more robust.  As the lesson learned from Agent Orange exposure in Vietnam should have taught us, research delayed can have devastating economic impact down the road.  Money invested now in this research has the potential to not only save this nation money in the long run, but also ameliorate and alleviate the suffering of veterans at a time when the long term impact can be minimized.

 DEPARTMENTAL ADMINISTRATION 

                                                  Construction – Major and Minor      

The American Legion recommends that the President’s budget request for $590 million for Major Construction and $550 million for Minor Construction in FY 2012 be increased to $1.2 billion for Major Construction projects and $800 million for Minor Construction projects to provide for additional facilities particularly the aforementioned improvements to infrastructure, as well as Community-Based Outpatient Clinics in rural and highly rural areas and additional Vet Centers.

The American Legion has seen firsthand the structural deficiencies and challenges facing the infrastructure of the VA Health Care system as a part of the preparation for the annual System Worth Saving reports.  During those site visits, many VA Medical Center staff have informed Legion personnel they are unable to dedicate needed funds towards construction projects due to the funding needs of actual medical care.  Furthermore, many VA construction projects were only made possible through the use of funding from the America Reinvestment and Recovery Act.  Such money is no longer available to meet the construction needs to shore up VA infrastructure in areas such as seismic criteria, aging electrical systems, insufficient parking and space utilization, and other needed areas.  Therefore, the need to fully fund this area of the budget is even more apparent.

Recent reports of the VA Regional Office in Roanoke, VA noted the floors of the building were in danger of collapsing due to the aggregate weight of the claims files.  While this highlights yet another major implication of the claims backlog, it also underlines this is not an area where VA can afford to scrimp and save.  Substandard facilities do not serve the veterans of this country, and are a hazard to VA employees as well.

If we are to truly invest in the future of this country, there are few more sound decisions to be made than investing in infrastructure.  Just as the roads and bridges of America must be upgraded to support the crumbling infrastructure and prevent even greater costs down the road, so too must the infrastructure of VA solidify to meet the needs of the growing veterans’ community.

Whether it is much needed medical facilities in the rural regions of the country, repairs to aging urban hospitals, proper laboratory facilities, adequate parking or other needs, it is short-sighted to see opportunities to cut and save on immediate construction, for cuts to this area now will only bring far greater construction costs down the road.  The wise fiscal decision is to invest carefully now to head off ballooning costs in the future.

Information Technology Systems

The American Legion urges Congress to ensure this key component receives full funding as VA transitions towards paperless processing, but also that this budget continues to fund the efforts towards a truly seamless electronic health records from induction in service through the rest of a veteran’s life.

Since the data theft occurrence in May 2006, VA has implemented a complete overhaul of its Information Technology (IT) division nationwide.  The American Legion is hopeful VA continues to take the appropriate steps to strengthen its IT security to regain the confidence and trust of veterans who depend on VA for the benefits they have earned.  The American Legion urges Congress to maintain close oversight of VA’s IT restructuring efforts and fund VA’s IT to ensure the most rapid implementation of all proposed security measures.

As acknowledged by the GAO Report 11-265 “Electronic Health Records - DOD and VA Should Remove Barriers and Improve Efforts to Meet Their Common System Needs” there are still major hurdles to be overcome to achieve the goals set forth of a Virtual Lifetime Electronic Record for service members from induction through the rest of their lives as active duty and veteran.  The President’s budget sets aside monies for this purpose, but it is vitally important to ensure that this component is not left behind, nor allowed to falter.  Achieving this goal should remain a major priority of both DOD and VA in cooperation with one another.

Obviously, with VA’s transformation of the VBA to a “paperless” processing system through the Veterans Benefits Management System (VBMS) this can be an area of great savings overall for VA as VBA moves out of the research and piloting stage of this system and into regular operations.  Start up costs can now be eliminated and hopefully VA will be vigilant in ensuring that this new system offers the speed and accuracy promised.

Homelessness

The American Legion supports sustaining funding levels addressing homelessness in the veterans’ community and urges complete support through other Departments such as Housing and Urban Development to help eliminate homelessness among veterans.

The American Legion notes that by the VA Secretary’s own recent estimates there are approximately 75,600 homeless veterans on the street each night as of 2009.  This number represents a significant improvement over previous years.    As far back as 2007 the estimates were over 150,000 and each year of concerted effort has brought further improvement and reduction of these numbers.  Clearly the good work in this area must retain the funding to continue so that the levels will never again reach those seen in the past. 

With 300,000 service members entering the civilian sector each year since 2001 with at least a third of them potentially suffering from mental illness, such as the effects of Combat Stress, PTSD and TBI, nothing could more clearly indicate programs to prevent and assist homeless veterans are vitally needed.  The American Legion applauds VA’s continued emphasis as one of its priority items the elimination of homelessness among America’s veterans.

FISCAL RESPONSIBILITY 

Fiscal responsibility is of course a vital concern in the difficult times we are facing as a nation.  The American Legion strongly believes money spent must be spent wisely.   To this end, all aspects of operation must be scrutinized, and where waste and mismanagement contribute to an inflated budget, these must be eliminated.  Rather than wholesale cutting of necessary infrastructure, areas of redundancy must be sought, and targeted cuts to those areas serve a far better purpose in managing the budget of VA.

Better coordination with outside evaluations can help reduce internal costs of evaluation.  For example, State Veterans’ Homes are evaluated not only by VA internal evaluation, but also by outside Centers for Medicare and Medicaid Services (CMS) evaluation.  Better coordination and standardization of evaluation could result in reduced costs of VA evaluations by millions of dollars by reducing this level of redundancy.  The American Legion has also called for some time for VA to accept outside, third party evaluation of accuracy and quality rates in the benefits management and claims system.  Such outside evaluation could further reduce costs where areas of redundancy with VA’s own evaluative process can be found.  Surely, though savings of this type may only rank individually in the tens of millions, these are funds that could be directed towards better use addressing shortfalls elsewhere.

Better Central Office oversight is further needed at the local level to ensure that money directed to the VISNs and Regional Offices are being spent in accordance with the direction of the administration.  All too often in The American Legion visits to local areas as a part of the System Worth Saving (SWS) Reports and Regional Office Action Reviews (ROAR), discover wide variances in execution of basic policies and directives from region to region.  To truly manage the budget of VA most effectively, developing uniform consistency is vital across the country.

CONCLUSION

In conclusion, The American Legion believes a true investment in the future means investing in key areas of infrastructure now and not making short-sighted cuts to vital areas that will only bring greater costs in the future.

Full funding of essential projects such as research in emerging health risks and disabilities, as well as the physical infrastructure of VA facilities, will be the prudent choice now to stave off even greater financial burdens down the road.  VA must meet these challenges with an adequate budget to fund these necessary aims. 

The American Legion welcomes the opportunity to work with this Committee on the enactment of a timely, predictable and sufficient budget for the Department of Veterans Affairs.

 VA MEDICAL DISCRETIONARY PROGRAMS

 

P.L. 111-117
FY 2010 VA
Final Funding

P.L. 111-322
FY 2011
VA Funding

President’s
FY 2012 VA Budget Proposal

FY 2013
Proposed
Advance
Appropriations

American
Legion’s
FY 2013
Request

Medical Services

$34.7 billion

$37.1 billion

$39.5 billion

$41.3 billion

$38.1 billion

Medical Support & Compliance

$4.9 billion

$5.3 billion

$5.4 billion

$5.7 billion

$5.3 billion

Medical Facilities

$4.8 billion

$5.7 billion

$5.4 billion

$5.4 billion

$6.2 billion

Medical/Prosthetic Research

$581 million

$581 million

$509 million

------------------

$600 million

Medical Care Collections Fund

[$2.9 billion]

[$2.9 billion]

[$3.1 billion]

------------------

-----------------

Total Medical Care

$47.9 billion

$51.6 billion

$53.9 billion

$52.4 billion

$50.2 billion

VA NON-MEDICAL DISCRETIONARY PROGRAMS

 

P.L. 111-117
 FY 2010 VA
Final Funding

P.L. 111-322
FY 2011 VA Funding

President’s
FY 2012
VA Budget
Proposal

American
Legion’s
FY 2012
 Request

Major Construction

$1.2 billion

$1.2 billion

$590 million

$1.2 billion

Minor Construction

$703 million

$703 million

$550 million

$800 million

State Veterans’ Homes Construction Grants

$100 million

$100 million

$85 million

$100 million

State Veterans’ Cemeteries Construction Grants

$46 million

$46 million

$46 million

$60 million

General Operating Expenses

$2.1 billion

$2.5 billion

$2.5 billion

$2.6 billion

Information Technology

$3.3 billion

$3.3 billion

$3.2 billion

$3.5 billion

National Cemetery System

$250 million

$250 million

$251 million

$260 million