MR. CHAIRMAN AND MEMBERS OF THE SUBCOMMITTEE:

Thank you for the opportunity to provide testimony for this legislative hearing.   The 2.3 million men and women of the Veterans of Foreign Wars of the U.S. appreciate the voice you give them at these important hearings.

H.R. 3051, the Heroes at Home Act

The VFW strongly supports the Heroes at Home Act.  This legislation would dramatically improve the delivery of health care for those veterans suffering from traumatic brain injury.  We thank Representative Salazar and the original cosponsors of this legislation for its introduction, and we urge its passage.

We especially appreciate Section 2 of the legislation.  It would create a family caregiver program to train families or friends of veterans suffering from the effects of severe traumatic brain injuries.

The newest generation of war veterans is presenting VA with many new health care challenges.  Advances in technology and battlefield medicine are allowing many hundreds of men and women to survive injuries that previously would have been fatal.   This, however, is coming at a price; many of them are grievously wounded and suffering from complex and intertwined ailments that are stretching VA’s ability to adapt.  Once the worst of their ailments are addressed, a great number of these men and women are returning home to their immediate families.  In some cases, this is a spouse and in other cases – especially given the relatively young age of many of these men and women – to their parents.

The impact on these families is daunting.  Their loved ones have complex physical and emotional difficulties and they must battle the bureaucracy of VA and DOD to ensure that everything the veteran is due comes to him or her.  These families often have to put their lives on hold, delaying work, their education,  relationships and other aspects of their life because of their veteran’s illnesses and conditions, and the demands their intensive care require.   With the complexity of the overlapping bureaucracies, some veterans fall through the cracks and do not receive the pays or compensation they need to cover their care.  Further, in cases where parents – as opposed to spouses – are providing care, they may not be eligible for the full range of services and benefits the two departments provide.

Section 2 would go a long way towards fixing these problems, training and certifying family and friends to serve as caregivers, which would make them eligible for compensation for their time and service.

Section 3 would require the Secretary to conduct outreach to educate veterans and the public about PTSD and TBI, as well as to provide information about the range of services VA can provide for their treatment.  Additionally, it would require VA to release information about the best practices it develops so that health care practitioners can learn from VA’s experiences when dealing with these conditions for all Americans in the civilian world.  Both are worthy provisions.

Section 4 of the bill would expand telehealth and telemental health options through a pilot program that primarily focuses on rural areas.  It would determine the feasibility of using these technologies to assess the cognitive function of service men and women and veterans, as well as to help with rehabilitation.  This is a good goal and a creative approach to solving the difficulties some veterans experience when trying to access their care.  Should the program work, it would be of great benefit to many thousands of veterans suffering from these conditions.

H.R. 6153, the Veterans’ Medical Personnel Recruitment and Retention Act

The VFW is happy to offer our support to this legislation, which would improve VA’s ability to recruit and retain nurses and other health care practitioners.   This is a continuing challenge for VA and one that is shared by all health care facilities.  With the nursing shortage around the country, it is critical that VA have the tools and flexibilities it needs to adapt and be competitive in the marketplace as the workplace of choice for high quality health care providers.

This bill would improve pays for various health care specialties, including specific targeting for nurse executives and part-time nurses.  It also revises rules relating to overtime and weekend duty and work schedules, which could help ease the burden many nurses face.  Additionally, it reinstates the health professional educational assistance scholarship program, which is an excellent recruitment benefit that would make VA more attractive to various health care providers.

We believe that its passage would improve VA’s abilities to recruit and retain high-quality health care providers.  This can only serve to better the care VA provides to this nation’s veterans.  For this reason, we support this bill.

H.R. 6629

We understand that this bill was introduced to address a specific problem in New Hampshire.  New Hampshire is the only one of the contiguous 48 states that lacks a full-service veterans hospital.  As a result, veterans seeking certain types of basic care are forced to travel to hospitals in other states, whether in White River Junction, Vermont or near Boston, Mass.

This bill would require VA to either run a full-service hospital in each of the 48 contiguous states or it would require VA to fully contract out for all health care services.  It is the latter part that causes us to have some qualms with the bill.

First, we believe that New Hampshire veterans deserve better.  Many face long drives for basic care.  In 2007, for example, over 700 veterans were transferred out-of-state for acute care.  If they live in the northern part of the state, this could mean a travel time of 4 hours one-way just for basic services that the Manchester VA should otherwise be able to provide.  Only recently has the Secretary announced that Manchester will begin offering radiation therapy, meaning that veterans who needed this for the treatment of cancer had to travel hours for care.  Clearly, this is unacceptable.

We believe, however, that the mechanism of this bill could create some further inequities.  Should the contracting provisions be in force, a veteran living across the border from the White River Junction VA Medical Center in Lebanon, NH would be entitled to contract care for any service they would need.  Presumably, they could call up their private physician and have an appointment in a matter of hours or days.  The same veteran, should they live five miles to the west in Vermont, would be required to wait in line for their turn at the White River Junction Medical Center.  That is not fair.

We have supported contracted care in limited cases, namely where VA is otherwise unable to provide care – particularly in the case of specialized services.  This legislation, though, could lead to wide-spread contracting, which we oppose.

VA already has the authority to provide fee-basis care, and it uses it with great success in many areas, especially in some remote parts of the west.  We would urge the Committee to use its oversight authority to ensure that VA is doing the right thing for New Hampshire’s veterans.  If VA does not believe that the Manchester Medical Center requires full services, then we need the Committee to ensure that veterans who need these specific services receive contracted care when they would otherwise have to travel these long distances.  We need to adapt the lessons VA has learned from other areas to New Hampshire, even if most people have not previously considered New Hampshire to be a large state or one that would require significant travel.

This concludes my statement.  I would be happy to answer any questions you may have.