Submission For The Record of Military Officers Association of America
CHAIRMAN BENISHEK, RANKING MEMBER BROWNLEY AND DISTINGUISHED MEMBERS OF THE COMMITTEE, on behalf of the over 380,000 members of The Military Officers Association of America (MOAA), we are pleased to present the Association’s views on selected bills that are under consideration at today’s hearing.
MOAA does not receive any grants or contracts from the federal government.
Thank you for the opportunity to submit comments and recommendations on the following pending legislative provisions:
• Draft, Veterans Integrated Mental Health Care Act of 2013
• Draft, Demanding Accountability for Veterans Act of 2013
• H.R. 241, Veterans Timely Access to Health Care Act
• H.R. 288, CHAMPVA Children’s Protection Act of 2013
• H.R. 984, Direct the Secretary of Defense to Establish a Task Force on Urotrauma
• H.R. 1284, Amend Title 38 U.S.C. to Provide Coverage Under the Beneficiary Travel Program of the Department of Veterans Affairs (VA) of Certain Disabled Veterans for Travel for Certain Special Disabilities Rehabilitation
MOAA supports all the above provisions with only minor additions as noted below. We believe strongly that such legislation will strengthen existing programs and services under VA’s purview, addressing some existing gaps in care, while providing additional tools for oversight and accountability across the medical system.
Draft, Veterans Integrated Mental Health Care Act of 2013. This provision would require the Secretary of VA to furnish mental health care to eligible veterans that is provided by a non-Department facility.
MOAA recognizes that more needs to be done to address the rapidly growing demand for veterans’ mental health services. This provision allows more opportunities for care and provides an integrated model for addressing access issues by using network providers outside the VA. Further, greater coordination and oversight of contracts and data sharing between government and non-government entities is supported by this legislation.
We have long supported leveraging existing civilian network providers, such as the TRICARE purchased care network to address the demand. This provision will do just that, as well as help provide necessary data to effectively measure patient outcomes.
MOAA fully supports this provision.
Draft, Demanding Accountability for Veterans Act of 2013. The purpose of this bill is to improve the accountability of the Secretary to the Inspector General (IG) of the VA.
Specifically, the provision requires the IG to notify Congress should the Secretary not appropriately respond with significant progress to a report issued by the IG by the required deadline of the covered report.
MOAA is encouraged by this provision, allowing additional authority to address reporting shortfalls with the Secretary. We see this as a positive way for both the Secretary and Congress to exercise additional oversight capability to improve accountability across the Department.
MOAA fully supports the draft provision.
H.R. 241, Veterans Timely Access to Health Care Act. The bill mandates the Secretary to establish standards of access to care for veterans seeking health care from VA medical facilities.
Our Association believes this legislation provides the forcing mechanism needed for VA to standardize access—an important step in eliminating the significant wait times facing veterans trying to schedule initial and follow-on appointments.
MOAA is also concerned about veterans needing immediate follow-up care after presenting in a VA emergency room (ER). Recently a caregiver took her veteran to a VA ER and was told after discharge to make an appointment for immediate follow-up but was told the earliest appoint available was in 3 months—a common scenario we hear.
MOAA supports the draft provision and would ask the Subcommittee to consider adding language requiring:
• Completing appointments within 5-15 days (or some medically-appropriate timeframe) following an urgent care visit to an ER if prescribe by a VA provider.
• Breaking out and tracking of veteran access by Enrollment Priority Groups 1-8.
• Adding a patient satisfaction rate measurement as a metric of effectiveness.
H.R. 288, CHAMPVA Children’s Protection Act of 2013. The provision would amend Title 38, U.S.C. to increase the maximum age for children eligible for medical care under CHAMPVA program from age 23 to 26.
The expansion of eligibility for CHAMPVA for eligible children up to age 26 is in line with provisions in the Patient Protection and Affordable Care Act (ACA) and the TRICARE Young Adult benefit.
According to a new GAO Report on the relationship of TRICARE and VA care to the ACA, “[the] ACA requires that if a health insurance plan provides for dependent coverage of children, the plan must continue to make such coverage available for an adult child until age 26. This requirement relating to coverage of adult children took effect for the plan years beginning on or after September 23, 2010. Under ACA, both married and unmarried children qualify for this coverage. The authorizing statute for CHAMPVA currently does not conform to this ACA requirement.”
MOAA fully supports H.R. 288.
H.R. 984, Direct the Secretary of Defense to Establish a Task Force on Urotrauma. Subject to availability of appropriations, H.R. 984 would require the Secretary of Defense, in consultation with VA and the Department of Health and Human Services to establish a Task Force to conduct a study on urotrauma for a four-year period.
Given the severity of wounds and the changing combat environment, MOAA supports the need for more research and analysis, particularly in assessing incidents of urotrauma among our military members.
An important part of national security and readiness of our military force is to have a good understanding of the effects of war. This bill allows an opportunity to study significant injuries as a result of the wars in Iraq and Afghanistan. Timing is crucial for this provision as the need to capture useful data is essential in order to apply what we learn in these wars and to be able to deploy in future conflicts.
MOAA supports the provision and suggests adding to the Ex Officio members list, military and veteran patient(s)/beneficiaries to ensure the warrior’s perspective is considered in task force deliberations.
H.R. 1284, Amend Title 38 U.S.C. to Provide Coverage Under the Beneficiary Travel Program of the Department of Veterans Affairs (VA) of Certain Disabled Veterans for Travel for Certain Special Disabilities Rehabilitation. Under this provision travel would be authorized for a veteran with a vision impairment, a veteran with spinal cord injury or disorder, or a veteran with double or multiple amputations whose travel is in connection with care provided through a special disabilities rehabilitation program of the VA (including spinal cord injury center programs, blind rehabilitation center programs, and prosthetics rehabilitation center programs).
Veterans with catastrophic non-service connected (NSC) disabilities are currently ineligible for travel benefits associated with their visits to one of the 13 Blind Rehabilitation Centers or 29 Spinal Cord Injury locations around the country. These veterans must bear significant financial costs, including air travel which often deters them from getting the necessary training they need to live an independent lifestyle.
Additionally, 32 percent of the NSC blind veterans live at the poverty level and the average age of this population is 67 years old.
This issue is also outline in the Independent Budget, highlighting that, “When veterans do not meet the eligibility requirement for travel reimbursement, and they do not have the financial means to travel, the chances of their receiving the proper medical attention are significantly decreased…For veterans who have sustained a catastrophic injury like spinal cord injury, blindness, or limb amputation, time and appropriate medical care is vital to their overall health and well-being.”
We agree with our VSO colleagues that this provision is a ‘preventive medicine’ bill.
MOAA fully supports H.R. 1284.
The Military Officers Association of America is grateful to the members of the Subcommittee on Health. Thank you for your leadership in keeping these important issues before the Congress and for your commitment to our Nation’s heroes and their families.