Good morning, Mr. Chairman, Ranking Member and members of the Subcommittee.  On behalf of VVA National President John Rowan and all of our officers and members we thank you for the opportunity for Vietnam Veterans of America (VVA) to appear here today to share our views regarding Media Outreach to Veterans. We thank you for your leadership on this all important issue of vital importance to veterans of every generation.  I will briefly summarize the most important points of our statement.

It is a truism, but is none the less true that denial of knowledge of veterans’ benefits, health issues, and available medical care is tantamount to denying said health care, benefits, and services. This is the situation that all too many veterans find themselves today, and they are not even aware of it.

Vietnam Veterans of America (VVA) estimates that the majority of those in-country Vietnam veterans who have had prostate cancer and died, are battling prostate cancer today, or who have battled prostate cancer and are still surviving have no clue that it is related to their service in Southeast Asia during the war. Since about 80% of veterans do not go anywhere near a VA medical facility, and the majority of veterans do not belong to any veterans group, and the VA does virtually nothing to educate them and their civilian medical providers that prostate cancer is service connected presumptive at VA and that we are twice as likely to get prostate cancer as those who did not serve in SE Asia, this fact is not surprising.

Some may ask “what is the big deal about that?” Well, what it means for those veterans who get very sick and die is that often their families are left with enormous and crushing medical bills that endanger the retention of the home. Instead of VA paying for something that should be treated as service connected, and the veteran receiving compensation while he is too sick to work and the widow receiving dependency & Indemnity Compensation (DIC) if he dies, the widow and family are left with nothing but debts and in dire financial straights. This is just so wrong on every level. It is egregious that this situation is allowed to continue. Yet VA has done nothing about it, despite the fact that VVA has repeatedly used this example with the current and previous top leadership of VA, to no avail.

This is only one example that is specific to Vietnam veterans, but similar situations exist for the veterans of very generation, whether it be cold injuries and parasites endemic to the Korea, or the diseases, parasites, and extreme environmental exposures of Gulf War I veterans.

Part of the problem is a mind set of the VA that says “we do not have the resources to do anything new, so we will just deal with the overt presentations of those who happen to come to us” and can get into the system in the first place. As the distinguished Members of this panel know, as many as a million veterans have been denied entry into the VA since January of 2003 when a “temporary” hiatus was put into effect regarding accepting veterans who are not indigent or service connected. This has had a “chilling” effect on others who do not even try to gain entry.

Further, even within the VA the tools that exist are not used to full effect. An example is the “Veterans Health Initiative” (VHI) curricula that is a series of reasonably well done curricula (about 26 at last count) that are designed to teach clinicians and medical professionals about the wounds, illnesses, conditions, and maladies that stem from military service depending on what branch did one serve, when did on serve, where did one serve and when, what was your military occupational specialty (M.O.S.), and what actually happened to you in military service. These curricula range from “Caring for War Wounded” which is designed for ALL primary care physicians, to Military Sexual Trauma, to Cold Injuries, to Traumatic Brain Injuries. I have here a sampling of these curricula that are available at www.va.gov/vhi  to anyone at the VA or in the civilian medical world, or to veterans. However, this is one of the best kept secrets at VA.

Another well kept secret at VA is the existence of Military History cards that have a series of basic questions that should be asked of every veteran seeking services at the VA and used in the diagnosis and treatment protocols. As a matter of fact, it has been a requirement in Veterans Health Administration regulation to take a military history for each veteran since 1982….but they don’t do it as a matter of course. (See www.va.gov/oaa/pocketcard/  or attachment # 1).

VVA has been promised regularly by everyone from the VHA computer people to four different Undersecretaries of Health to three successive Secretaries of Veterans affairs to the Chief of Patient Care Services to others that the VA will move to make the military history part of the automated patient treatment record. These have all proven thus far to be “pie crust promises,” which are of course “promises” that are easily and facilely made….and easily broken. Were the existence of the VHI curricula known to all VA clinicians, and the military history part of the computerized patient treatment records then there could be proper clinical reminders based on a decision tree. To test for possible exposures and maladies/conditions/exposures that may stem from the nature of that individual veteran’s service. This will educate VA’s own clinicians in the wounds, maladies, conditions, and injuries of war who in turn will better educate the veterans whom they serve. Frankly the most credible outreach means available to reach and educate veterans is other veterans. Veterans will believe another vet long before they will believe a press release or a slick VA brochure.

How do you reach the average veteran when most do not have any contact with the VA nor do they belong to any veterans’ organization (except maybe a unit association which rarely even talks about benefits and health care)? All of this leads to the conclusion that the only ways to reach most veterans, and their families, is through the general media. That would include traditional media such as newspaper articles, radio, television. It also must today include FaceBook, Vets4Vets, YouTube, etc. and other modalities employing the medium of the Internet. But most of all it must be a stance of telling the unvarnished truth, and not the current stream of only self-congratulatory and/or defensive pronouncements. VA officials must “get it” before they can possibly hope to communicate effectively with individual veterans given the baggage of so much bad past history.

As the Members of this panel are also no doubt aware, VVA joined with the Honorable Ted Strickland (then a Member of this distinguished panel) and the Georgetown Center for Law and the Public Interest to sue VA over the now infamous VHA memo in August of 2003 that curtailed all marketing and publicity of available medical services by VA. What you may not be aware of is that we won that suit. The Federal Court gave VVA standing to bring the suit on behalf of our members, and ruled that VVA was correct that the Secretary of Veterans Affairs was compelled under Title 38 to exercise an affirmative responsibility to ensure that all veterans were informed of the rights, benefits, and medical services due to them by virtue of serving in the United States Armed Forces.

It was no accident that the theme of the 75th Anniversary of the VA was outreach to every living veteran to inform each of what services were available to them by virtue of their military service. It was in response to the order of the Federal Court. Of course, I need not tell the members of this panel that it is debatable whether the lofty stated goal was seriously pursued during that 12 to 15 month period. It was not, at least not in the view of VVA.

So where does that leave us today? VVA does support any and all of the good things that VA tries to do, such as the public service announcement about the Suicide Hotline (which VVA put on our home page the same day it was suggested), distribution of VVA materials ranging from videos, to bumper stickers, to brochures, to whatever is not a “puff piece” that is available from the VA.

There is of course a constant stream (if indeed not a torrent) of self laudatory press releases that emanates from the VA. Because it is generally so patently self serving and not “the rest of the story” as Paul Harvey would say it is taken less and less seriously by anyone who follows this stuff, particularly the press.

VVA is in the process of launching our own effort in association with organizations in the civilian sector to inform non-VA clinicians as to the wounds, maladies, conditions, and wounds of war as a way of educating the clinicians who see the majority of veterans. Since we have virtually given up on trying to convince the current VA leadership (both at the permanent top civil service level as well as the political level) to make VA what it was always intended to be” a “veterans’ health care system” and not a general health care system that happens to be for veterans, and on them doing anything meaningful or consistent in regard to educating the public or most veterans, we have, of necessity, embarked on a years long major effort to go around them in order to get the job done properly

Mr. Chairman, I again thank you for the opportunity to appear here today, and hope our remarks will prove helpful to you and your colleagues. I will be happy to answer any questions you or your colleagues may have.