[House Hearing, 112 Congress]
[From the U.S. Government Publishing Office]

JOINT HEARING TO RECEIVE LEGISLATIVE PRESENTATION OF VETERANS SERVICE
ORGANIZATIONS

=======================================================================

JOINT HEARING

of the

COMMITTEE ON VETERANS' AFFAIRS

before the

U.S. HOUSE OF REPRESENTATIVES

and the

U.S. SENATE

ONE HUNDRED TWELFTH CONGRESS

SECOND SESSION

__________

THURSDAY, MARCH 22, 2012

__________

Serial No. 112-51

__________

Printed for the use of the Committee on Veterans' Affairs

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U.S. HOUSE OF REPRESENTATIVES,

COMMITTEE ON VETERANS' AFFAIRS

JEFF MILLER, Florida, Chairman

CLIFF STEARNS, Florida BOB FILNER, California, Ranking
DOUG LAMBORN, Colorado CORRINE BROWN, Florida
GUS M. BILIRAKIS, Florida SILVESTRE REYES, Texas
DAVID P. ROE, Tennessee MICHAEL H. MICHAUD, Maine
MARLIN A. STUTZMAN, Indiana LINDA T. SANCHEZ, California
BILL FLORES, Texas BRUCE L. BRALEY, Iowa
BILL JOHNSON, Ohio JERRY McNERNEY, California
JEFF DENHAM, California JOE DONNELLY, Indiana
JON RUNYAN, New Jersey TIMOTHY J. WALZ, Minnesota
DAN BENISHEK, Michigan JOHN BARROW, Georgia
ANN MARIE BUERKLE, New York RUSS CARNAHAN, Missouri
TIM HUELSKAMP, Kansas
MARK E. AMODEI, Nevada
ROBERT L. TURNER, New York

Helen W. Tolar, Staff Director and Chief Counsel

U.S. SENATE,

COMMITTEE ON VETERANS' AFFAIRS

PATTY MURRAY, Washington, Chairman

JOHN D. ROCKEFELLER IV, West RICHARD BURR, North Carolina,
Virginia Ranking
DANIEL K. AKAKA, Hawaii JOHNNY ISAKSON, Georgia
BERNARD SANDERS, (I) Vermont ROGER F. WICKER, Mississippi
SHERROD BROWN, Ohio MIKE JOHANNS, Nebraska
JIM WEBB, Virginia SCOTT P. BROWN, Massachusetts
JON TESTER, Montana JERRY MORAN, Kansas
MARK BEGICH, Alaska JOHN BOOZMAN, Arkansas

Kim Lipsky, Staff Director

Lupe Wissel, Republican Staff Director

Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public
hearing records of the Committee on Veterans' Affairs are also
published in electronic form. The printed hearing record remains the
official version. Because electronic submissions are used to prepare
both printed and electronic versions of the hearing record, the process
of converting between various electronic formats may introduce
unintentional errors or omissions. Such occurrences are inherent in the
current publication process and should diminish as the process is
further refined.

C O N T E N T S

__________

March 22, 2012

Page

Joint Hearing To Receive Legislative Presentation of Veterans
Service Organizations.......................................... 1

OPENING STATEMENTS

Chairman Jeff Miller, U.S. House of Representatives.............. 1
Prepared Statement of Chairman Miller........................ 33
Senator Patty Murray, Chairman of The Senate Committee On
Veterans' Affairs.............................................. 3
Hon. Timothy J. Walz, U.S. House of Representatives.............. 23
Hon. Bill Johnson, U.S. House of Representatives................. 25
Hon. Jerry McNerney, U.S. House of Representatives............... 25
Hon. Bob Filner, Ranking Democratic Member, prepared statement
only........................................................... 34

WITNESSES

Charles Susino, Senior Vice Commander, American Ex-Prisoners of
War............................................................ 4
Prepared Statement of Mr. Susino............................. 35
John R. Davis, Director of Legislative Programs, Fleet Reserve
Association.................................................... 5
Prepared Statement of Mr. Davis.............................. 37
Colonel Bob Norton (USA-Ret), Deputy Director of Government
Relations, Military Officers Association of America............ 7
Prepared Statement of Mr. Norton............................. 47
Executive Summary of Mr. Norton.............................. 55
Jamie H. Tomek, Chair, Government Relations Committee, Gold Star
Wives.......................................................... 9
Prepared Statement of Mrs, Tomek............................. 58
Allen E. Falk, National Commander, Jewish War Veterans........... 10
Prepared Statement of Mr. Falk............................... 64
Bill Lawson, National President, Paralyzed Veterans of America... 13
Prepared Statement of Mr. Lawson............................. 74
Sam Huhn, National President, Blinded Veterans Association....... 15
Prepared Statement of Mr. Huhn............................... 80
John R. ``Doc'' McCauslin (CMSGT-Ret), Chief Executive Officer,
Air Force Sergeants Association................................ 17
Prepared Statement of Mr. McCauslin.......................... 88
MG Gus Hargett, President, National Guard Association of the
United States.................................................. 20
Prepared Statement of Mr. Hargett............................ 96
Gary L. Fry, National Commander, AMVETS.......................... 22
Prepared Statement of Mr. Fry................................ 106

MATERIALS SUBMITTED FOR THE RECORD

Anthony A. Wallis, Legislative Director/Director of Government
Affairs, Association of the United States Navy................. 111

JOINT HEARING TO RECEIVE LEGISLATIVE PRESENTATION OF VETERANS SERVICE
ORGANIZATIONS

Thursday, March 22, 2012

U.S. House of Representatives,
and U.S. Senate,
Committee on Veterans' Affairs,
Washington, D.C.
The Committee met, pursuant to notice, at 10:01 a.m., in
Room 345, Cannon House Office Building, Hon. Jeff Miller,
[Chairman of the House Committee on Veterans' Affairs]
presiding.
Present: Representatives Miller, Bilirakis, Johnson,
Runyan, Huelskamp, Turner, McNerney, Donnelly, Walz, and
Barrow.
Senators Murray, Burr, and Boozman.

OPENING STATEMENT OF CHAIRMAN JEFF MILLER

The Chairman. Thank you for being with us today. In the
interest of time and after hearing from Chairman Murray,
Ranking Member Filner and Ranking Member Burr upon their
arrival, they will make opening statements. I'd ask all the
other Members that will be here and arriving, if they would
waive their opening statement. We will have them entered into
the record in the appropriate place.
I see no objections. So ordered. And it is indeed my honor
to welcome all of you here today. I'm looking forward to the
testimony from some friends and new friends that I have made
who are sitting at the witness table this morning. We look
forward to hearing all of your testimony and, of course,
working with each and every one of you in the coming year on
your legislative issues, as well as those from the House and
the Senate.
I also want to say welcome to all of the guests present
today who comprise the national auxiliaries of the various
organizations represented today. We know how important your
commitment is to our veteran community, and to the different
groups that you serve as well.
I'd also like to take a moment to recognize those who are
visiting from the Sunshine State of Florida. If you're able, if
you would, please stand or wave a hand. It's great to see you.
And it's always a pleasure to join with my colleagues from
across the aisle and across the capital complex. Yesterday we
were over on Senator Murray's side of the capital hearing
testimony over in the Senate. And we appreciate the bipartisan
cooperation that we have received from the Senate. It seems
like the Veterans' Affairs Committees are about the only ones
right now that are able to get together, work, and have things
passed.
Before we begin today's hearing, I'd like for everybody to
turn their attention to the chair that's in the very center of
the room. Some of you in the very back won't be able to see it,
but you will certainly understand in a moment what we're doing.
As part of a long standing military tradition, and as long
as I am Chairman of the House Committee on Veterans' Affairs,
we will display an empty chair, draped with the POW-MIA flag at
every one of our hearings. This chair is to be a daily reminder
of the more than 83,000 servicemembers who have yet to return
and represents our hope that they will come home to us one day.
With that, everybody who is able, would you please stand
and direct your attention to the empty chair before me. Today,
as a patriotic American, each of us are grateful to those who
have sacrificed and continue to sacrifice. This Committee
pauses to recognize the plight and the circumstance of a unique
group of Americans. They are our prisoners of war and missing
in action.
From this day forward, the House Committee on Veterans'
Affairs will remember this through the placement of a POW-MIA
empty chair at all of our official meetings. This chair will
serve as a physical symbol of the thousands of American POW-
MIA's still unaccounted for from all wars and conflicts
involving the United States of America.
This is a reminder for all of us to spare no effort to
secure the release of any American prisoners from captivity.
The repatriation of the remains of those who died bravely in
defense of liberty and have a full accounting of all of those
missing.
I now call on Vice-Commander Charles Susino of the American
Ex-Prisoners of War to lead us in the Pledge of Allegiance.
Mr. Susino. Ladies, guests, gentlemen, would you please
follow me and recite the Pledge of Allegiance to our honored
flag. Attention, one, I pledge allegiance to the flag of the
United States of America, and to the Republic for which it
stands, one Nation under God, indivisible, with liberty and
justice for all. Thank you.
The Chairman. You may be seated. The House Committee on
Veterans' Affairs has been working on several fronts to address
the many needs of our Nation's veterans, and there are three
specific areas that I quickly want to discuss with you this
morning. First of all is the critical need to increase veterans
employment in this country. Second, is overseeing substantive
change to the VA benefit process with an end goal that you all
share, and that is ending the backlog of disability claims. And
third, the most recent issue is ensuring your medical care and
benefits are protected from the reach of sequestration cuts in
our Federal budget over the coming months.
And I am proud to report that substantial progress is being
made on all three fronts. This morning, we have votes that are
going to be called in the House in about an hour. I have a full
written statement that I'm going to ask to be entered into the
record.
Seeing no objections, so ordered. And instead of me saying
my piece, I think it's important that we hear from the
witnesses who have come from a great distance today to testify
before this Committee. So I would like to yield at this time to
the Chairman of the Senate VA Committee, Senator Patty Murray.

[The prepared statement of Chairman Miller appears in the
Appendix]

OPENING STATEMENT OF HON. PATTY MURRAY

Senator Murray. Thank you very much, Chairman Miller. I
echo your statements, and I specifically highlight the moving
dedication ceremony. The empty chair is obviously a very solemn
reminder of our obligation to those servicemembers who have not
returned from action abroad.
I will submit my statement for the record per your request.
We too have votes in the Senate today. But I did quickly want
to acknowledge some veterans from my home state of Washington,
not the Sunshine State, but we have a beautiful state despite
that.
With us from the Paralyzed Veterans of America are Ernie
Butler, Dave Zurfluh, and Tom Bungert, and from the Air Force
Sergeants Association, Bryan Winston. Welcome to all of you,
and thank you for traveling here.
I look forward to the testimony of all of our witnesses,
and thank you all for your tremendous dedication to our service
men and women. Thank you.
The Chairman. Thank you very much. We don't have either of
the Ranking Members with us at this point. We'd ask that their
statements be entered into the record in the appropriate place.
So at this time, I would like to go ahead and introduce today's
witnesses. I will introduce the entire table, and then we'll
begin with Mr. Susino.
But first, and you've already heard from him once, is
Senior Vice President Commander, Charles Susino of the American
Ex-Prisoners of War. Then we will hear from Mr. John Davis, the
Director of Legislative Programs for the Fleet Reserve
Association.
Next, Colonel Bob Norton, the Deputy Director of Government
Relations for the Military Officer Association of America.
Next, Ms. Jamie Tomek, Chair of the Government Relations
Committee for Gold Star Wives. Next is the Commander of the
Jewish War Veterans, Allen Falk.
Then we will hear from Mr. Bill Lawson, the National
President of Paralyzed Veterans of America. Next, Mr. Sam Huhn,
National President of Blinded Veterans Association. Next is
Chief Master Sergeant John McCauslin, the CEO of the Air Force
Sergeants Association.
Next, Major General Gus Hargett, President of the National
Guard Association of the United States. And finally, we will
hear from Commander Gary Fry of AMVETS.
I want to thank you again, each of you for coming here to
testify before this Joint Committee. Vice Commander Susino, you
are now recognized for your opening statement, sir.

STATEMENT OF CHARLES SUSINO, SENIOR VICE COMMANDER, AMERICAN
EX-PRISONERS OF WAR; JOHN R. DAVIS, DIRECTOR OF LEGISLATIVE
PROGRAMS, FLEET RESERVE ASSOCIATION; COLONEL BOB NORTON, DEPUTY
DIRECTOR OF GOVERNMENT RELATIONS, MILITARY OFFICERS ASSOCIATION
OF AMERICA; JAMIE H. TOMEK, CHAIR, GOVERNMENT RELATIONS
COMMITTEE, GOLD STAR WIVES; ALLEN E. FALK, NATIONAL COMMANDER,
JEWISH WAR VETERANS; BILL LAWSON, NATIONAL PRESIDENT, PARALYZED
VETERANS OF AMERICA; SAM HUHN, NATIONAL PRESIDENT, BLINDED
VETERANS ASSOCIATED; JOHN R. ``DOC'' MCCAUSLIN, CHIEF EXECUTIVE
OFFICER, AIR FORCE SERGEANTS ASSOCIATION; MAJOR GENERAL GUS
HARGETT, PRESIDENT, NATIONAL GUARD ASSOCIATION OF THE UNITED
STATES; AND GARY L. FRY, NATIONAL COMMANDER, AMVETS.

STATEMENT OF CHARLES SUSINO

Mr. Susino. Thank you, Mr. Chairman. Messrs. Chairmen and
Members of the Veterans' Affairs Committee, my name is Charles
Susino, Senior Vice Commander of the American Ex-Prisoners of
War. I am honored to testify before you again today on behalf
of our National Commander Carroll Bogard. You all have our
prepared testimony in front of you.
Now I'd like to speak from my heart in more depth of this
testimony. Senator Murray, Senator Burr, Representative Miller,
Representative Filner and Committee Members, this year marks
the 70th birthday of the American Ex-Prisoners of War.
On April 14, 1942, two mothers whose sons were captured on
Bataan, formed the Bataan Relief Organization. In 1945, the
prisoner of war returning from home became the Bataan Veterans
Organization. And in 1949, expanding our membership to
encompass all members of all wars, we became the American Ex-
Prisoners of War.
Since our beginning, we have closely aligned with our
slogan, we exist to help those who cannot help themselves. It
is our mission statement, not mere words, but a way of life for
the American Ex-Prisoners of War. We consider it an honor and
duty to reach out to all these veterans who have been unaware
of the assistance and benefits they are entitled to.
Nearly 21 million Americans proudly served this country
during World War II, the Korean War, the Vietnam War. Less than
3 million survive today. And of all ages, many of them in poor
health and need care. As a national service officer with the
Ex-Prisoners of War, I see firsthand veterans from all
conflicts. Only a few are former prisoners of war. And an
average of 892 for World War II veterans, 85 for Korean War
veterans, and 65 for Vietnam veterans, those with us live
longer than expected.
Some World War II and Korean veterans have far exceeded
their average life's expectancy tablets. For Vietnam veterans,
the life expectancy pegged at 64 or 65, ten years less than the
average male of non-veteran population. These figures are the
compliments of the Blue Water Navy Vietnam Veterans'
Association.
Unfortunately, all of them are not entitled to use the
Veterans Administration facility. After putting their lives on
the line for their country, many fall through the cracks, and
the care and ruling enacted decades ago for the fighting
possibility of many millions applications to the Veterans
Administration.
Most of these war veterans are in VA category 8 or lower.
Which means, they're not entitled to VA care at all. These
veterans designated as category 8 with their income exceeding a
pre-set threshold classifying them as affluent.
They are mostly not affluent in that category, yet some
earn as little as $28,430 a year. Hardly affluent. A
significant change was made in health care eligibility in 1986.
Congress mandated health care for veterans, with service-
connected disabilities, as well as special groups of veterans,
such as the prisoners of war and veterans exposed to herbicides
and ionizing radiation and World War I veterans. The average
age of a World War veteran was 88 in 1986, younger today than
World War II veterans; which is virtually the same age as the
veterans in the Cold--Korean War.
Today, we request of you, the 112th Congress, please update
the law to add World War II, Korean, and Vietnam veterans to
this special group of veterans to make them available for
health care. Please consider to include the Gulf War veterans
in this special group of veterans. It is overdue for Congress
to update this action in 1986.
From a health benefits standpoint, they put these war-time
veterans on a par with World War I veterans, the special
groups, and the current warriors who are fighting in the Middle
East, all of which we strongly support. Please let them not be
forgotten. It is the right thing to do. Please do not continue
to allow these war time veterans to be excluded from depriving
them of health care.
We are willing and able to work with you and your staff on
drafting this amendment. Messrs. Chairman, Committeemen, this
completes my testimony. Thank you for allowing me the
opportunity to appear before you on behalf of the American Ex-
Prisoners of War to share this goal for the 112th Congress.
Thank you also, all of you, your Committee have done for all of
us, and the Nation's veterans, and the families in the future.
If you have any questions for our organization, I will
attempt to answer them. If I do not have the answers, I will
make sure I get them for you. God Bless America, and thank you
very much.

[The prepared statement of Charles Susino appears in the
Appendix]

The Chairman. Mr. Davis.

STATEMENT OF JOHN R. DAVIS

Mr. Davis. I thank you for allowing me the opportunity to
come share FRA's views on veterans' issues with you today. FRA
joins with the other associates to state that the VA should be
exempted from sequestration and the Association appreciates
Chairman Miller's introduction of the Protect the VA Healthcare
Act that excludes the VA health care programs from automatic
sequestration cuts next year.
FRA strongly believes that the cost of war should include
treating the Nation's wounded wars, and is deeply concerned
about the backlog of claims at the VA. Currently there are more
than 900,000 veterans awaiting decisions and 66 percent are
pending for more than 125 days. That's an increase of more 100
percent over the last three years.
Despite thousands of additional adjusters, the backlog of
disability claims continues to increase. Put simply, veterans
injured in the service of their country deserve accurate,
consistent, and timely disability determinations. There is
strong bipartisan support to eliminate bureaucratic delays and
ensure more uniformity between the branches of the military and
the VA on how they rate disabilities.
But the VA can promptly deliver benefits to veterans only
if it has modern technology to do so. The Joint Virtual
Lifetime Electronic Record shows great promise, as does the
Benefits, which is an electronic portal for veterans who will
eventually get timely updated on the status of their disability
claims.
FRA's National Veterans Service Officer, Chris Slawinski
tells that he continues to receive phone calls from association
members and their surviving spouses to express concerns about
having been denied benefits by the VA based on inaccurate,
incomplete, and missing information or evidence. These errors
by the VA contribute to the growing number of appeals and
further strains on the claim adjudication backlog.
The goal of truly seamless transition for wounded warriors
transitioning from DoD to VA still remains an elusive goal.
Community Chairwoman Senator Murray and Ranking Member Senator
Richard Burr in hearings have both acknowledged improvements,
but also have expressed frustration with bureaucratic in-
fighting and the pace of reform almost five years after the
2007 media firestorm over conditions for wounded warriors at
Walter Reed Army Medical Center.
A top priority of the association is to ensure adequate
funding for DoD and VA health care resource sharing in
delivering seamless cost-effective quality services to wounded
or injured personnel. Clearly, additional oversight hearings
are required to ensure that the Department's respective
bureaucracies are held accountable for future progress.
FRA appreciates the VA's effort to expand presumption to
ships exposed to Agent Orange during the Vietnam era. In
January 2012, the Department added 47 ships to the list of Navy
and Coast Guard vessels that have been exposed to Agent Orange
herbicide. The list is expanded as VA staff determine that a
ship was anchored, operated close to the shore, or traveled on
the inland waterways, and was exposed to the toxic herbicide.
While the expanded VA policy to include veterans on inland,
waterways, and ships is appreciated, FRA believes it does not--
go far enough. FRA receives hundreds of calls from blue water
sailors and their surviving spouses, stating that due to
service on their ships in Vietnam waters, they too suffer and
have died from illnesses associated with the exposure to the
herbicides.
The association strongly supports the Blue Water Navy
Veterans Act, sponsored by Representative Christopher Gibson in
the House and Senator Kirsten Gilldebrand in the Senate, and
the Agent Orange Equity Act sponsored by Ranking Member Bob
Filner. These proposals clarify that veterans who served off
the coast of Vietnam may presume exposure, and should be
compensated for their service-connected disabilities.
As more and more ships are determined to have anchored in
Vietnam coastal waters, the cost of the Blue Water legislation
goes down. The association urges both these Committees to
schedule hearings on this important legislation, to determine
how this can be corrected.
We also want to thank Chairman Miller for his hearings last
year in February 2011, regarding the abuses of servicemembers
with their Service Member Civil Relief Act rights. That hearing
originally exposed just one financial institution making errors
against servicemembers.
Also, we want to thank the President's blueprint for an
American Built to Last, which includes provisions intended to
assist veterans and active duty servicemembers with their
housing that is being coordinated by the Department of Justice,
Civil Rights Division. I'd be glad to answer any questions you
might have.

[The prepared statement of John R. Davis appears in the
Appendix]

The Chairman. Thank you, sir. Colonel Norton.

STATEMENT OF COLONEL BOB NORTON

Colonel Norton. Thank you, Madame Chair, Chairman Miller,
Members of the Committees. It's been an honor for the past 15
years to have testified before the Committees. Over that span,
the leadership of the Committees and the support of the entire
Congress for our Nation's veterans has been most gratifying,
and we are deeply grateful for all of the work and all of the
support from the Committees. It's a long list that includes
full funding for VA health care, advance appropriations, the
Caregiver's Act, the VOW to Hire Heroes Act, the Post 911 GI
Bill, and the list goes on. We are very grateful.
On behalf of our 377,000 members, I would like to highlight
the following issues from my prepared statement. First is the
coordination of caregiver support between the Defense
Department and the VA for our most severely wounded warriors.
Thanks to your efforts and the Armed Services Committees,
caregiver programs have been upgraded to help the spouses,
parents, and others who have taken on the enormous
responsibilities of providing full-time care for our most
severely disabled veterans.
But more needs to be done to streamline the hand-off and
coordination of the VA and DoD care coordination programs.
There are still too many gaps between the two that cause
confusion, anger, and helplessness among some caregivers of our
most severely disabled warriors. We need to do more so that
those families who have given so much are not left to their own
devices to navigate between the two bureaucracies.
MOAA urges the creation of a joint VA/DoD oversight office
that would better coordinate the Federal recovery coordination
program, basically run by the VA, and the Defense Department's
program. In this era of diminishing resources, we need a more
efficient, effective coordination of these efforts for the
people who are delivering care to our most severely wounded
warriors.
In a similar vein, MOAA recommends the Committees continue
to provide vigorous oversight of VA programs that address the
needs of today's veterans suffering from post-traumatic stress,
traumatic brain injury, or who have been victims of sexual
assault in military service.
This week's Army Times, for example, highlights an informal
survey performed by the Service Times media that indicates a
rising number of women warriors are reporting for post-
traumatic stress. And the Army has increased the number of
cases it has taken to courts martial for sexual assaults, and
the number of convictions is on the rise.
But more needs to be done when these American heroes come
over to the VA system to meet their unique needs. This is the
fastest growing group of veterans needing health care and
benefits from the VA.
We are very grateful for the bipartisan support for the
``VOW to Hire Heroes Act'' (Title II, P.L. 112-56), which is
now being implemented. In that regard, we recommend the
following among the actions that are listed in my statement.
One, extend the timeline for veterans who enroll in the
special training provision under the Montgomery GI Bill. We are
concerned that many will not gain the employment credentials or
licenses they need in the compressed-timeframe authorized. We
believe that once in the program, these older veterans should
be grandfathered so that they can complete all of their
training needed for meaningful employment.
We also recommend that the Committees working with the
Armed Services Committees to make sure that the reforms sought
for the military Transition Assistance Program, or `TAP,'
actually work for today's veterans. Veteran unemployment starts
on active duty. Meaningful TAP reform is urgently needed to
ensure that our service men and women have the tools they need
to make a successful readjustment in this very difficult jobs
market. And, we appreciate your ongoing efforts concerning
veteran employment.
The Defense Department is doing more on civilian
credentialing and licensing, but even more needs to be done in
that arena to take advantage of the tremendous training and
experience of our serving men and women.
Finally, MOAA recommends the Committees take strong action
to protect the GI Bill from certain unscrupulous for profit--
schools, not all, just a few, and provide the tools that will
enable our student veterans to take full advantage of the
greatest GI Bill since the great World War II GI Bill.
Among the recommendations in our statement, MOAA believes
veterans need more support on campus. We suggest, for example,
that the campus-based ``VetSuccess'' Program be expanded above
the 80 campus level recommended in the administration's budget
request for next year.
In addition, all schools should be made to comply with
Department of Education accreditation and other requirements
that apply now only to Title IV participating schools. And we
recommend that the Committees direct the VA to work with the
Department of Education to develop an online dashboard, if you
will, similar to the new `College Navigator,' so that student
veterans can compare schools, costs, accreditation, graduation,
drop-out rates, and other facts.
In other words, it would be something like an online
shopping tool like Amazon, but for veterans who are doing their
research into the kinds of opportunities they have for college.
Mr. Chairman, we deeply appreciate your recognizing our
POWs. For our surviving spouses of those who have given their
all in the recent conflicts in Iraq and Afghanistan, MOAA
continues to strongly recommend the Committee's endorse
legislation to authorize that they have the same educational
benefits as their children do under the Fry Scholarship
Program. They won't be able to raise their children without
having a strong GI Bill program including a housing allowance
and a book allowance, if they are left to the DEA, the legacy
educational program for surviving spouses.
I thank you again for this opportunity to present our views
to the Committees, and I look forward to your questions.

[The prepared statement of Colonel Bob Norton appears in
the Appendix]

The Chairman. Thank you, Colonel. Ms. Tomek.

STATEMENT OF JAMIE H. TOMEK

Ms. Tomek. This is new to me, so I'm going to have to try
it out a little bit. Thank you for inviting Gold Star Wives to
be here to testify at this table. I am pleased to be here on
behalf of them. Gold Star wives are Abraham Lincoln's widows
and orphans, because we work with those children that are left.
In our case now, we call ourselves surviving spouses, because
there some men among us, but for the most part we are women and
widows.
The survivor populations served by VA is a separate
category of beneficiaries that should be equally recognized by
government officials, and sometimes we're not. We do not
qualify as family members once our spouse has been killed or
dies of a service-connected disability. And often people forget
to remember survivors.
We have several issues to talk with you about today. First
is the Office of Survivor Assistance with VA, it has not yet
been fully staffed. There is still two program analysts
positions open. They have once hiring action going on, but we
would like to see that office fully staffed to provide adequate
advice to the Secretary of Veterans Affairs.
The staff who answer the 1-800-VA phone number often don't
provide adequate, consistent, or accurate information on behalf
of survivors. We ask that specific survivor training be
provided to those employees, so that they can understand that
survivor benefits are different than veteran's benefits. And we
often have to go to the Veteran's Benefits Administration and
we can do that, but we'd like to have that initial information
provided accurately.
The dependency and indemnity compensation is currently paid
to surviving spouses at 41 percent of the 100 percent disabled
compensation. Other Federal survivors receive a 55 percent
benefit of retirement pay from their employees. We only get 41
percent.
We are going to be asking people in Congress to help us
raise that benefit. We have women--44 percent of the DIC widows
live on $20,000 or less, because maybe they took care of the
children, or maybe they took care of a spouse who was wounded,
died of a service-connected cause. $20,000 in today's economy
is not really sufficient to live on, and we have 44 percent of
surviving spouses living on that.
The dependents and education assistance which Colonel
Norton mentioned, the monthly payment for that for a surviving
spouse currently is $957. The GI--post GI Bill beneficiaries
receive more in housing allowance than our widows receive in
tuition assistance.
Eighteen months have passed since you all past a Champ VA
Dental Insurance bill, and nothing has happened. Nothing has
been posted on policy, no pilot has been implemented, we'd like
to ask you to check into that.
We ask you to eliminate the SBPDIC offset by passing S-260
and 178. The Veterans Disability Benefits Act of 2003
eliminated the SBPDIC offset for surviving spouses who
remarried after the age of 57. But we don't understand the
logic of Congress to abandon those of us who have chosen not to
remarry.
And finally, TRICARE proposed benefit health care plan
has--we as surviving spouses have no retired pay, and so we
can't figure out how we're going to pay for the premiums. It
exempts post 9/11 surviving spouses and children from pre-PBMs,
but those of us who had husbands die prior to 9/11 or whose
husband died of service-connected disability have no retirement
pay, and we are not exempt under that proposal.
We hope you take a look at that as it comes through the
Congress. Thank you all for letting me testify. We look to you
as our protectors, and we work--we hope to change some of these
inequities. We can't accomplish it without your help, and I
believe that you are--feel similarly and you'll help us--let us
move into action and I thank you for being here today.

[The prepared statement of Jamie H. Tomek appears in the
Appendix]

The Chairman. Thank you very much. Mr. Falk, you're
recognized.

STATEMENT OF ALLEN E. FALK

Mr. Falk. Okay. Thank you. Chairman Miller, Chairwoman
Murray and Members of the Committees, my name is Allen Falk,
and I am the National Commander of the Jewish War Veterans of
the United States of America.
The Chairman. Try to pull the mic a little bit closer to
you.
Mr. Falk. I'm sorry. I'm the National Commander of the
Jewish War Veterans of the United States of America.
This is my first time testifying before the Committee, as
you can see, I can't find the button. However, I have the honor
of representing the oldest veterans organization in our
country. This is our 116th year, and we have a long history of
dealing with veterans' programs and working with the Congress.
At our annual convention, our last annual convention in
Jacksonville, we prepared the detailed priority papers on all
our positions, it has been submitted, in the limited time we
have to make a verbal presentation, I'm going to cut right to
the priorities that were determined by the convention this
year. Which is the welfare of the service men and women in
Afghanistan and Iraq and the--especially the returning veterans
and the problems that they are facing now, both in-country and
as a transit--and make a transition back home.
There are severe problems. You've heard some of them
generally referred to here. The issue of TBI, Traumatic Brain
Injuries caused by the high exposure to IEDs, we know it's a
problem, but we don't know--in effect what we don't know. We
know there are great questions about the severity, of the
duration, and the effect of these conditions, and there's even
great issues and disputes within the medical community as to
the ratings, what constitutes a mild, a moderate, or a severe
TBI.
Even without the traumatic effects of TBI, we know we have
enormous problems with PTSD, and there are a number of reasons
why that's occurring, which are basically unique to the
stresses our service people are suffering in Afghanistan and
Iraq. A number of those considerations we have faced for the
first time.
You have to go back to World War II, when you had really a
clarity of purpose within the Armed Services as people went off
to fight. In the beginning early years of World War II, the
physical sacrifice and danger that all our personnel were
reporting was enormous, but the one thing they had was clarity
of purpose. They knew what they were doing, what they had to
do. They either headed west towards Berlin or east--or rather
east to Berlin or west to Tokyo. And when they got there, their
task was done, and they knew it was well worth doing.
In Vietnam, we had the same problem that we have now. We're
in a situation we don't really understand what our tasks are in
the military. We even discuss now whether there's still counter
insurgency or counter terrorism. There's no victory in sight,
there's no easy way of defining a victory. We don't hear the
phrase we lived with in Vietnam, ``there's no end at the light
of the tunnel,'' but physically it may not be so effective, but
it effects morale, and morale effects depression. There's still
a lot of work that has to be done on that.
The conditions in Afghanistan now, place additional stress
on combat personnel, because in effect, everyday they're
constantly a target, and yet many personnel will come back
through a whole tour, or wounded seriously, and never even had
a chance to take a shot at the enemy. That puts an enormous
amount of stress on personnel.
There's--of course, the problems with the repeat and even
extended tours. That is something completely new, and we wonder
how this was all put together, to where we have to rely on
extending tours and repeating tours, even involuntarily, and
the psychological effect that has.
We Vietnam veterans had one advantage. When we got there,
on the first day, you put a calendar on the wall, they start
putting crossed-out marks on each day. You knew what the end
was, you knew when you got short, you were going to be even
protected because everybody wanted to go to the end and get
out, have their job done. That's not what they face today, and
I don't think we have any idea really about the psychological
stress and damage that places on personnel that don't know if
they're going to be called back in, both career personnel and
especially in Reserve and National Guard personnel.
There's a new type of stress that's placed on personnel
that I've never seen discussed anywhere, and it's actually
looked on as a benefit, but I think it creates new stress. And
that is the instant communication that the combat personnel
have through Internet and Skype. Even as late as Vietnam, you
sent home letters and photos and packages, that was the only
contact we really had. We had what was called ``Mars calls''
where you could actually go up on a hill top and make a phone
call through all the ham operators around the world. If you
were lucky, you'd have that twice.
Now, we have, in effect, virtual war, and combat personnel
that are practically commuting back and forth to battle. They
come back to their little shack or wherever they happen to be,
and they're able to turn on their computer, and turn on the
Skype and talk to the kids, and try and pretend nothing
happened, and listen to all the problems that are going back at
home. It can be--it's a double-edged sword. It's a great way of
maintaining contact with the family, but it puts all the
problems of the family right back in the lap of the combat
soldiers.
That's while they're there. There's a whole new area of
problems on return when they do get back to the country. The
problems with employment, the re-employment issues, the
employment training, college, attempting to get better
education, the bad economy, it's a tough time trying to pick up
the American dream. There's a disconnect with almost 99 percent
of the population.
As was indicated earlier, there's three million veterans
now, in World War II alone, we had 16 million out of 140
million. There is a disconnect from American society and
returning combat veterans. There, of course, are the issues
that have been raised about the problems that women veterans
encounter. All of this leads to problems that transition from
constant adrenalin alerts to the boring routines of getting
back at home and trying to earn a living and support your
family. All this leads to suicide rates which are very high,
and we still believe to be under-reported.
As far as solutions, I can't give you, and JWV can't give
you, answers, immediate answers to these problems. But we know
what we have to do. We have to have more effective independent
autonomist and trusted studies. Studies so far have been by DoD
or other military agencies, and they have even been
conflicting. The Armed Forces Health Center study apparently
found that repeated deployments did not prove to be harmful to
vets, and actually they were healthier because the vets with
problem dropped out. That was different than the Army Surgeon
General's report that clearly found additional combat exposure
created more PTSD and correlated.
We need these studies. These studies should be free of
conflicts, real or apparent, sufficient for peer review, and
publication by respected scientific journals. The situation is
unique, as I indicated, but it's analogous to the Agent Orange
issue, which has been raised here.
As Mr. Davis indicated, we're now talking about Blue Water
and Navy ships and what constitutes exposure in Vietnam. We had
a fight, one heck of a battle with the Federal government and
the VA to even acknowledge that there were any affects from
Agent Orange exposure. I served as Chairman of the New Jersey
State Commission on Agent Orange. We had an association of
Agent Orange commissions, because it went back to the states
when the states still had money, when the feds weren't really
acknowledging the research that was out there.
It was only after scientific journals started publishing
the results of correlating dioxin exposure to at least highly
elevated levels of dioxin that Congress did act. I had
additional comments, but I see I'm way over the time limit. I
would just ask that staff note that we offer the services of
Lieutenant Colonel Dr. Jacob Romo who recently retired from the
VA, and had a 30-year Army career Vietnam veteran as an expert
on the issue of veteran suicides, and helpful ways of
preventing and lessening that.
Finally, my--I'm grateful personally for all the work that
the Committees have done on the economic issues, but our policy
board has directed that I state JWV points out that Congress
and the administration, both present, and over the last decade,
have not fully faced these issues I've indicated.
We've recently seen the results in the case of Sergeant--
Staff Sergeant Bales, how serious the consequences of these
failures can be. Thank you for your attention.

[The prepared statement of Allen E. Falk appears in the
Appendix]

The Chairman. Thank you, Mr. Falk. Mr. Lawson.

STATEMENT OF BILL LAWSON

Mr. Lawson. Good morning, Chairman Murray, Chairman Miller
and Members of the Veterans' Affairs Committees. I'm Bill
Lawson, National President of Paralyzed Veterans of America.
On behalf of our members, officers, and staff of the
paralyzed veterans, it is an honor and a privilege to present
this testimony which highlights issues of critical importance
to the well-being of veterans with spinal cord injury or
dysfunction, and in fact, all veterans.
For 66 years, Paralyzed Veterans has represented the
interest of veterans with catastrophic spinal cord injury and
disease, working to ensure that their medical, economic, and
social needs are met. I appear here today to continue that
tradition.
The full range of our concerns is detailed in my written
statement, and in this year's independent budget, of which we
are a proud co-author. During the 1947 Paralyzed Veterans'
Convention, then President Gill Moss stated, and I quote, ``We
are strongly opposed to the tenancy of cutting appropriations
to the Veterans Administration as an economy move of
government.'' Unfortunately, 65 years later, we're still
addressing that same concern.
Discretionary spending in VA accounts for approximately $62
billion. Nearly 90 percent of that funding is directed toward
VA medical care programs. The VA is the best health care
program for veterans. Providing primary care and specialized
health services is an integral component of the VA's core
mission and responsibility to veterans.
Across the Nation, VA is a model health care provider that
has led the way in various areas of medical research,
specialized services, and health care technology. However,
Paralyzed Veterans is deeply concerned about steps VA has taken
in recent years to generate resources to meet ever growing
demand on the health care system.
In fact, the FY2012 and 2013 advanced appropriation budget
proposal released by the administration last year included
management improvements. This is nothing more than a gimmick
used by previous administrations to generate savings and offset
the growing cost to deliver care.
Additionally, the 2013 budget request and 2014 advanced
appropriation recommendation includes many of the same
gimmicks. Unfortunately these savings are never realized,
leaving VA short of resources.
We believe that continued pressure to reduce Federal
spending will only lead to greater reliance on gimmicks and
false assumptions, which generate apparent but illusory
funding. This is particularly true given the VA's claim that it
was provided nearly $3 billion in excess resources in 2012. We
question how the VA could make such a claim when there still
remains fully seven months in this current fiscal year. This
information deserves the highest level of scrutiny and
oversight that your Committees can provide.
Finally in light of the administration's continued
inability to determine its position with regards to
sequestration, we have serious concerns about VA's claims to
have nearly five percent in excess resources, when it faces the
prospect of up to two percent reduction in funding under the
rules of sequestration.
We cannot emphasize enough, the VA--the need for VA to
state that without a doubt that its programs will not be cut
through sequestration. Otherwise, it is imperative that the
Senate and the House approve Senate 2128 and House 3895
respectfully to ensure that VA health care programs are
protected from consideration for spending reductions.
Our concern for the adequacy of the VA funding possible
gimmicks and statements asserting excess resources is more than
just curiosity for budgetary gamesmanship. Most notably, they
illustrate a real disconnect between the health care needs of
our members, and available VA resources.
Paralyzed Veterans' professional medical staff compiles a
monthly survey of available beds and health care personnel
within the VA's spinal cord injury system of care. These
staffing reports consistently reveal deficiencies in staffing,
particularly in the field of nursing.
Our most recent bed staffing survey that was completed just
last month indicates the actual number of nurses personnel
providing care at the bedside was 161 below, and I emphasize
below the minimum requirement. Similarly, this survey indicates
a shortage of physicians, social workers, psychologists, and
therapists throughout the system, resulting in a deficit of 120
acute care beds across the system.
My question is how can the VA boast about having a $3
billion excess, while at the same time, the VA is severely
under-staffed, it just doesn't make sense, and I would ask if
you agree.
In closing, I would like to say on behalf of all veterans,
please understand, we volunteered, we served, we fought, and we
sacrificed for the freedoms that all of us enjoy today. Do you
think it's just reward that we return home only to find
ourselves having to fight for what we were promised?
Again, on behalf of the Paralyzed Veterans of America, I
thank the Committees for the opportunity to come before you
with our concerns. We look forward to working with you in
providing the services and benefits that America's veterans
have earned.

[The prepared statement of Bill Lawson appears in the
Appendix]

The Chairman. Thank you, Mr. Lawson. Mr. Huhn, you're
recognized.

STATEMENT OF SAM HUHN

Mr. Huhn. Good morning, Mr. Chairman, Chairman Murray,
Members of the Veterans' Affairs Committee, the House and
Senate. My names is Sam Huhn. I am the National President of
the Blinded Veterans Association, and I have a couple of items
that I would like to bring to your attention of bills that we'd
like to get passed in this session.
Our first bill is the Special Adaptive Housing Bill,
introduced before and passed through the Committee, passed the
House, but didn't get anywhere in the Senate. Introduced again
this year by Senator Sanders of Vermont. It's S-914.
What this bill does is, currently you can get the housing
grant if you're blind in both eyes, and have a visual acuity of
5 over 200. We want to change that to 5--20 over 200 which is
the legal blindness standard. The reason for that change is
because some of these veterans with traumatic brain injury have
what they call functional blindness where their eyes are
healthy, but their brain and their optic nerve don't allow them
to see. And therefore, they grant them the 20 over 200 rating.
The VA wants the bill, the Blinded Veterans wants the bill,
and I hope it can get passed out this session. It is a good
bill, it's clean, and it's the right thing to do.
The other bill that has been introduced is Beneficiary
Travel Bill. Now what happens, according to Chapter 38 of the
Veterans Benefits, their Section 322, paragraph 11.1 is where
the VA allows the payment of transportation for veterans to go
to the hospital for treatment.
Now, they only pay for the transportation for those who are
20 percent service-connected up to 100 percent service-
connected. Now, we want the bill which has been introduced by
Senator Tester and 1755 and supported by Senator Begich of
Alaska, Senator Leahy and Senator Sanders have also backed this
bill, introduced in the House by Congressman Michele and I
believe some other Congressman have also signed up on the bill
as of this morning.
And what this--what we want added to is the non-service-
connected blinded veterans who have incomes less than $20,000 a
year. These men and women come from places like America Samoa,
the Hawaiian Islands, they have to go to Palo Alto, California
for their blind rehabilitation. Those from Alaska, Montana and
Idaho, they have to go to American Lake up in Washington State.
Very expensive travel.
Those from the far northeast of the United States, up in
Maine, New Hampshire, Vermont, they have to take long distance
travel to go to the only blind center in the eastern part of
the country is at West Haven, Connecticut. And the problem is,
these guys need this blind rehabilitation. It gives them skills
of orientation of mobility, how to use a cane to get around
safely. It gives them psychological help for their loss of--
coping with the loss of vision, independent living skills. Some
of them lie to their wives about what they learn up there,
because they teach them how to make their own beds, and clean
their own clothes, and so they never tell their wives they
learned that part of it when they go home.
And they learn these manual skills and all this stuff at
the blind centers. And so it's a good bill. The VA likes it. We
spoke to the VA benefits business people, and they can absorb
the cost. It's clean. It's a clean bill, and it's good, and I
think it's the right thing for you guys to pass out this year.
I told--yeah, and the House version of the bill I believe is
3687, S or HR-3687.
The last thing I'd like to talk about and it's not the
least on my agenda is the Defense Appropriations Bill of 2008.
That bill gives me augina, and I'll tell you why. They
appropriated this money and guess what, the only thing they did
was they appointed a director and deputy director for the
Vision Center of Excellence, Hearing Center of Excellence, and
Len Restoration Center of Excellence. No money in `09, no money
in `10, and in `11, three or four of us went to see the
Secretary of Veterans Affairs and asked him to intercede for us
with the Department of Defense, which he did, and miraculously
now we have a facility over in Bethesda. We have personnel, 12
people, we have computers, and the whole point of the computers
was to make this place a depository for the diagnosis and
treatment of 58,000 brain damaged service people, that will all
be in this database. And when they transfer seamlessly,
hopefully, into the VA system, that information will go with
them. So nothing contra-indicated to their condition of say
medication or therapy that would hurt them, would be known. You
know, like someone have an eye problem, and they treat them for
a sinus infection, that's a no/no.
And so by having this information now, that's fine. And the
other part of this appropriation was to do research on the--see
how repair--we could do repairs to the optic nerve, and to that
part of the brain that affects sight and hearing.
Now, it got $4 million in the budget. By the time the
appropriators got done with it, they cut it by $800,000 down to
3.2. Now, you know what, a strange way that people on the hill
think, especially these appropriators. They can sit here and
appropriate hundreds of millions of dollars for a breast cancer
cure, prostate cancer cures, you know, all these cancer cures,
then--and then they go to the Department of Defense and they
get hundreds of millions again appropriated through that for
the same cures. Something wrong with this picture, when we've
got 58,000 traumatically brain injured service people who are
losing their hearing, losing their sight, possibly beyond the
dole for the next 50, 60, 70 years when they--when there's
research maybe stop the onslaught of their vision loss and
their hearing loss, and they could become productive citizens
and they don't have to be on the dole.
There's just something wrong with the priorities up here on
the hill, that they would give all this money for these cancer
cures and nothing wrong with that, I've had cancer myself. But
the problem is, is that you know, our veterans, you know, you
people calling it our treasure, these are 20-year-old men and
women who we send off to war, and they're coming back damaged,
and that's what we think about them, that we can cut four
million--take our $800,000 out of that appropriation, so that
they can use this--you know, it's just disgraceful.
Let me finish up by saying one other thing. I saw a line
item 2 in appropriations that they were building a soccer field
for these terrorists down in Gitmo, and that was 800,000. And
so I think to myself, these guys down there, they'll be getting
soccer shoes and shirts, and all this nice equipment down
there, and our service people come back and they get the shaft.
This shouldn't happen. This should not happen in this country.
I think my time is up. Thank you very much for inviting me.
Thank you very much for listening, Mr. Chairman and Committee.

[The prepared statement of Sam Huhn appears in the
Appendix]

The Chairman. Thank you very much, Mr. Huhn. We appreciate
your comments, and I don't think there's a Member on this dais
who believes that it was an appropriate expenditure of funds to
build a soccer field at Gitmo for anybody.
Chief Master Sergeant McCauslin, you are recognized.

STATEMENT OF CHIEF MASTER SERGEANT JOHN R. ``DOC'' MCCAUSLIN

Sergeant McCauslin. Chairman Murray, Chairman Miller, and
Members of these Committees, good morning. On behalf of our
110,000 members of the Air Force Sergeants Association, I thank
each of you for this opportunity to offer our views of our
members for your FY2013 funding priorities for the Department
of Veterans' Affairs.
This annual hearing is always special to us because it
clearly illustrates that our Nation is well served by your
nonpartisan approach that characterizes these Committees.
Historically, your Committees have simply done the right thing
for those who serve this Nation, and AFSA is very proud to have
the opportunity to work with you.
Joining us today are a considerable number of active and
retired airmen and officers from the active duty force, Guard
and Reserves behind me. They are spouses and DAF employees that
are stationed at six military installations here in the
national capital region. I'm told they represent 36 states and
the District of Columbia. And I am pleased, as I'm sure you
are, that they are able to be here today. Schedule permitting,
I encourage each of you to take time at the end of this hearing
to speak to them directly, and hear their firsthand concerns,
and how about a group photo with these deserving folks.
I'll begin by telling you that AFSA is very concerned with
the prospect of sequestration, and how it could undermine VA
funding in the coming years. We thank Chairman Miller for his
leadership in introducing legislation that will provide clarity
on this matter to our veterans. And we also ask that your
Committees act promptly on his bill, HR-3895, the Protect VA
Healthcare Act of 2012.
Regarding our women veterans, we applaud your Committees
for championing women veterans' issues in recent years;
however, the issue of unique health care of women veterans must
be addressed with higher urgency. There are more than 214,000
women serving in our DoD today, many of whom have served in
Iraq and Afghanistan. Nineteen percent of our Air Force are
women, and they also suffer from the same effects of battle, as
many of their male counterparts.
Something about our family caregivers. Family caregivers
provide critical and crucial support in caring for our
veterans, and AFSA greatly appreciates the work of your
Committees in passing the Caregivers and Veterans Omnibus
Health Services Act of 2010. This is a program that is indeed
actively meeting the needs.
Related to taking care of these veterans, the VA backlog
for compensation and pensions, education and appeals claims is
a total disgrace. At the time of my written statement to you
last Friday, VA Monday's morning workload report showed more
than 1.4 million claims still pending. 600,000 or 66 percent of
them for more than 125 days, and that's totally unacceptable.
Regarding the Transition Assistance Program, the VOW to
Hire Heroes Act made the Transition Assistance Program an
interagency workshop, coordinated by DoD, Labor, and Veterans'
Affairs, and it's a mandatory program for servicemembers to
help them to secure employment at the end of their service, and
not further exasperate the employment situation.
AFSA verified that the content of TAP has changed very
little in the last 25 years, and we're aware that a new program
is in the works. Hopefully, it will provide veterans with
current information and tools that they need to successfully
transition into the civilian sector.
Let me briefly discuss modification of enhanced per diem
for your State Veterans Homes. The State Veterans Homes program
continues to provide over 50 percent of long-term care for
veterans, providing over 30,000 beds in 140 State Veterans
Homes in all 50 states. These homes are an excellent Federal
investment, since the states provide funding for two-thirds of
the total operating cost.
To correct the enhanced per diem problem, the House on
October 11th last year, voted unanimously on HR-2074 to approve
language authored by Representative Mike Michaud and Chairman
Miller which would modify the program by allowing VA to enter
into contracts or agreements with each of these homes.
Identical language was included in S-914, authored by Senator
Mark Begich, and approved unanimously by the Senate Veterans'
Affairs Committee back on June 29 last year. Unfortunately, the
Senate has not moved on either bill since last year.
Next, homeless veterans. Ending veterans homelessness is a
top priority for VA and this Association. Thanks to your
efforts, sir, VA now has the resources to attack the program
head on. The news of a 12 percent decrease this last year is
indeed encouraging, but there are still 67,500 homeless
veterans. A particular concern among our homeless veterans,
male and female, that have young children, because we
understand those numbers are increasing. No one, repeat no one
who has served this Nation in uniform should ever have to be
living on the streets.
How about concurrent receipt. AFSA continues its advocacy
for its legislation that provides concurrent receipt for our
military pay and veteran's disability compensation for all
disabled retirees without offset. Support of our survivors with
current military deployments and increasing casualties, it's
imperative that we plan to properly take care of those who may
be left behind when a military member makes that ultimate
sacrifice.
AFSA strongly believes that surviving spouses with the SBP
plan annuities should be able to receive their earned SBP
benefits and the DIC payments related to their sponsor's
service-connected death.
We want to thank Congressman Joe Miller for introducing HR-
178, and Senator Bill Nelson for introducing S-260, which would
repeal the SBP DIC offset. We also thank the 177 and 49 co-
sponsors respectively who support this important legislation.
Defining veterans status for certain reserve component
members, AFSA supports full veterans status for reserve
component members with 20 years or more of service, who do not
otherwise quality for veteran status under current law.
The House on October the 21st last year, passed 1025, which
was introduced by Congressman Tim Walz. Thank you, sir. We now
urge the Senator Veterans' Affairs Committee to move forward on
Senator Mark Pryor's bill, S-491 that would grant the status to
these deserving individuals that are veterans in every sense of
the word.
I want to speak just briefly about cemeteries, specifically
the Clark Veterans Cemetery. The United States Air Force left
Clark Air Base in the Philippines in the 1991, following
destruction of the base by Mount Pinatubo volcanic eruption and
the collapse of base agreement negotiations. No provisions were
made for the perpetual care of its military post cemetery,
known as the Clark Veterans Cemetery. Known by many as the
cemetery America forgot, the cemetery is the final resting
place for 8,600 U.S. military veterans.
Recently Frank Guinta introduced HR-4168, which addresses
the neglected condition of that cemetery. ABMC says the
decision rests with you, the Members of Congress, to act
favorably on HR-4168, which by the way is cost neutral. Repeat
cost neutral, and it would certainly ensure veterans interred
at Clark where they're properly honored for generations to
come.
Moving on to the Post 911 GI Bill, arguably the very best
legislation ever passed by Congress, and thanks to many of you,
it's providing unprecedented educational opportunities for the
thousands of men and women who served in uniform since 9/11.
AFSA is concerned with the statistics that show the cost of
sending a veteran to a not-for-profit school is more than
double the cost of a public university, and that eight out of
ten educational institutions collecting the most VA benefits
are for profit schools. By no means are we suggesting
impropriety with these or other educational facilities that are
receiving Federal money. Many institutions are indeed offering
high quality degrees that servicemembers can use in conjunction
with their military career or aid them in employment once they
separate.
AFSA strongly endorses S-2179, the Military and Veterans
Educational Reform Act of 2012, which was recently introduced
by Senator Jim Webb to make critical reforms to protect the
integrity of that post 9/11 GI Bill, and the military's Tuition
Assistance Program.
Our retirees our truly national treasures. At its surface
is the last issue I'd like to comment, which might not appear
under purview of your Committee, but I feel it's ancillary.
The Administration's proposed 2013 budget cuts for higher
TRICARE fees, the establishment of new ones and the creation of
a BRAC-like panel that would review current military
compensation and recommend changes, probably reductions, for
Congress to consider. The President and many senior civilian
leaders have repeatedly said they will not balance the budget
on the backs of our veterans. We took them at their word, but
now this is in fact, exactly what they are proposing to do.
Apparently they've lost sight of the fact that military
retirees are veterans, and now they've created an air of
mistrust among those who have served and are now serving.
Senior civilian and military leaders openly speak of the
importance of ``keeping the faith'' with our military members,
particularly where earned benefits are concerned. Benefits like
the VA offers, retired pay and health care.
Right now, Airmen seated behind me are asking ``where is
the faith'' and they're looking to you, the Members of
Congress, to provide that answer. Passing the buck to
servicemembers instead fulfilling promised benefits, only
serves to undermine long-term retention and readiness.
In conclusion, sir, I'd like to thank you again for the
opportunity to express the views of our members on these
important issues. We understand tough decisions are ahead, but
AFSA contends that it's of paramount importance for our Nation
to provide quality health care and top notch benefits, in
exchange for the devotion, sacrifice and service of our
military members. So too must those making the decisions take
into consideration the decisions of the past, the trust of
those impacted, and the negative consequences of those who
based their trust in our government. Thank you again, sir.

[The prepared statement of John R. ``Doc'' McCauslin
appears in the Appendix]

The Chairman. Major General Hargett.

STATEMENT OF MAJOR GENERAL GUS HARGETT

General Hargett. Mr. Chairman, thank you for the
opportunity to testify here today on behalf of the 470,000
Guard men and women and our veterans across the Nation.
As you know, the Guard is a unique organization, that we
train for both the state and Federal mission. In fact, more
than 700 Guard men and women were recently called up as
tornados ravaged several communities in the south and Missouri.
Whenever called, I remind everyone, that our National
Guardsmen uproots from his family and civilian community, and
he doesn't go back until the mission is complete. They return
to a non-supported community.
Since 9/11, more than 460,000 National Guard members have
deployed in contingency operation. These Guardsmen compose of
substantial amount of our post 9/11 veteran population. When
Guard members return from deployment, they do not live within
the 24/7 supported structure of an active duty military
installation. A key issue for the National Guard community is
HR-1025, as you've heard described, which would provide
recognition as veterans to members of National Guard and
Reserve who have served 20 years and earned military retired
pay.
HR-1025 unanimously passed the House last year, but has not
been taken up in the Senate. The bill would authorize veteran
status under Title 38 of the USC for National Guard and Reserve
members of the Armed Services specifically members who draw a
non-traditional retirement.
HR 1025 is cost neutral, because it would provide no
benefits other than the honor of being a veteran who has served
20 years honorably for our service. Many serving and retired
National Guard Reserve members may not even know that they do
not qualify as a veteran.
Some National Guard members who have been protecting the
homeland on aerospace controlled mission, formerly known as
Operational Noble Eagle, the southwest border on Title 32
orders, may one day retire from the Guard, and not have the
privilege of calling themself a veteran.
I could offer several illustrations of people who have
served as much as 30 years, and who now draw their military
retirement, have deployed but in a training status overseas,
but are unable to claim veteran status. This is simply not
right and needs to be adjusted.
As you may recall, a predecessor bill HR 1025 passed the
House unanimously in 2010, thanks to Congressman Walz. HR 1025
is now back before the Committee where it warrants the proper
consideration. Critics of the legislation have charged that it
would allow the camel's nose under the tent, that is simply not
true. If signed into law, 1025 would help tear down the
remnants of a wall of prejudice that still exists in some
quarters against National Guard and Reservists, a force that's
always ready and always there, as a cost neutral stand alone
bill, HR 1025 provides an excellent opportunity for Congress to
come together and honor the National Guard and Reserve members.
NGAUS respectfully requests that Members of the Senate
Committee on Veterans' Affairs please join our colleagues in
the House and move this bill forward. Our career National Guard
and Reserve members deserve nothing less. We have offered
written testimony in support of several other bills, and stand
prepared to answer questions on those bills.
Mr. Chairman, thank you for the opportunity to testify here
today and thank you for what you do for our veterans.

[The prepared statement of Major General Gus Hargett
appears in the Appendix]

The Chairman. Thank you, General. Mr. Fry.

STATEMENT OF GARY L. FRY

Mr. Fry. Chairman Miller, distinguished Committee Members,
as the National Commander of AMVETS, I am honored to share our
concerns and comments on the issues under the purview of your
Committees.
Today, with a decade of war behind us and horrific budget
cuts staring us in the face, our men and women in uniform
remain steadfast in their mission to defend this great Nation.
This dedication and sacrifice must never be forgotten.
President Obama once said that the national budget would
not be balanced on the backs of veterans, and AMVETS adamantly
supports this concept of preserving all earned veterans'
benefits. Our servicemembers and veterans do not deserve to be
asked to continue making sacrifices. They don't deserve excuses
or broken promises. They deserve nothing less than this
Nation's full support. They've done the hard work on behalf of
Americans, now it's time for all Americans to relieve them of
their heavy burdens.
Today's military and veterans community is faced with many
challenges and AMVETS is dedicated to aggressively tackling
these issues on behalf of American Veterans everywhere
including topics such as veterans unemployment, VA and DoD
health care, veterans' benefits, womens veterans, National
Guard and Reserve servicemembers, homeless and rural veterans,
POW and MIA recovery and identification and mortuary affairs.
The problem of veterans unemployment should be seen as a
national disgrace while everyone appears to be talking about
the problem, few real solutions have been offered. In
recognition of those who honorably fought to maintain the
freedoms of those who stayed behind, we as a Nation, cannot do
enough to ensure that the American veteran gets the proper
skills, certifications and education necessary to be successful
in life.
AMVETS is promoting the idea of making veterans a protected
class under the current Affirmative Action law. This would only
require a change in a few words. Veterans are among the
smallest minority groups in this country, with fewer than seven
percent of Americans ever having served in the Armed Forces and
less than one percent wearing the uniform today.
One of the chief responsibilities of VA is providing
primary and specialty, physical and mental health care to
American veterans. AMVETS has serious concerns that any
reduction in spending on a VA health care program will lead to
catastrophic reduction in these critical services.
AMVETS calls on Congress and the Administration to ensure
that VA health care programs are fully funded in a timely
manner. AMVETS believes promises made to our military members
and veterans when they agreed to leave their homes and
families, in our stead, it's critical that veterans' benefits
become a national priority because of sacrifices performed by
these men and women.
Among the most critical issues facing women veterans today
are homelessness, military sexual trauma, and a lack of gender
specified health care. These three issues are a trifecta of
humiliation and deprivation for women veterans. How can we as a
Nation allow some of our most vulnerable veterans, many of whom
also have children, to be living on the streets of our cities?
Is it right that a woman should have to fear for her personal
safety, not only from foreign enemies, but from her comrades-
in-arms simply because she made a conscious decision to serve
in the military?
We certainly concur with the General here on the National
Guard bills. AMVETS fully supports 1025, and I'd like to
emphasize this cost neutral bill would not bestow any new or
unearned benefits, would simply provide career reserve
component members, the honor of being recognized as veterans.
AMVETS urges the House and Senate Veterans' Affairs
Committee to consider the importance of supportive housing
facilities for homeless veterans, many of which are situated on
VA property and/or owned by the VA. Consistent with Secretary
Shinseki's goal of eliminating homelessness among veterans by
the year 2015, these facilities are vital to the approximately
68,000 homeless veterans that rely upon them for shelter,
health care and other services.
We at AMVETS are deeply disturbed by the on-going reports
of mishandling of the remains of our fallen heroes. There is no
more sacred responsibility than the dignified and respectful
recovery, return and burial of those killed in action. While
AMVETS acknowledges that there's been a great deal of positive
improvements, more needs to be done to ensure that these don't
ever happen in the future. We recommend continued and increased
oversight on all mortuary operations facilities.
Mr. Chairman and the Committee, it's my privilege to have
been here, and I think I speak for everybody else at the table,
we appreciate what the Committee has done. You have a very good
reputation, and we're sure that that will continue in the
future. Thank you.

[The prepared statement of Gary L. Fry appears in the
Appendix]

The Chairman. I thank you very much, Mr. Fry. Thank you
everybody for your testimony today, we appreciate it. In case
some of you have looked up here at the clock on the wall, you
see there's two lights and a red light, that means that the
House has been called into----
Mr. Walz. That's what that means?
The Chairman. Yes, that's what that means. It means the
House has been called in to vote. Some of the House Members
will have questions that we'll submit to you for the record. I
would also now like to call on my good friend and former Member
of the House, now a Member of the United States Senate from
Arkansas, John Boozman to take the chair.
Senator Boozman.[Presiding] Thank you, Mr. Chairman. And I
know that our House guys have to leave, so I think we'd like to
go right to Mr. Wallis.

STATEMENT OF HON. TIMOTHY J. WALZ

Mr. Walz. Well, thank you, Senator. Always a true gentleman
and a real asset to this Committee. We're glad to have you on
that side. Chairman Miller, thank you, just a quick moment if
that's okay, and I want to thank you for putting our focus on
our POW-MIA issue. That's an issue of moral consciousness that
permeates all the other things we do here, and so I think
that's absolutely appropriate. And thank you to all of you, and
all of you sitting there. They know they come with millions
behind them, and many places you could be today, you could take
your time and resources and be elsewhere, but you don't for one
simple reason, you love this country, and you know it's
important that you're here to make this right.
I too share, and I have to tell you, I am right with the
Chairman on this. Sequestration is not only wrong-headed, it's
dangerous. It's--I have to tell you, I don't see anywhere in
here, and I have to very clear, anywhere in the Constitution be
very clear, we failed at our job, we absolutely capitulated our
responsibilities over political issues, and now we're stuck in
a situation where we're not willing to make the hard choices
and prioritize this Nation's concerns.
There's no doubt that we have financial issues to deal
with. We can do that. But to come into this room and ask us to
start that conversation here, when there's other places we can
start it, when there's other things we can do, because we
didn't have the courage, and I would argue the moral courage to
make the hard choices and tell the population, and tell our
neighbors, it's going to cost some money to care for our
veterans. We should do that as efficiently and effectively as
possible, but don't tell them you get something for nothing,
and don't tell them that these wounded warriors, and don't
come, as we heard Ms. Tomek say, I have to tell you, if we're
telling our widows that we simply can't fix the DIC, because
you won't find anyone who will tell you this makes any moral
sense whatsoever. It's simply wrong.
But the argument always is, we don't have the resources to
fix it because we're broke. Well, I have to tell you, a Nation
that cannot care for those and the widows who sacrificed so
much is just not financially broke, they are morally broke. We
are neither. We are neither.
So it's such a pleasure to be here. And I have to tell you
I believe if this Committee were running the Congress, things
would be different because the bipartisan nature of this, the
folks that testify here are here for the conscious of this
country, not for short-term personal gain. And it's always
gratifying for me to see you here, to see the effort that it
took to get here, to testify with these things, and watch
democracy work. So on behalf of my constituents in southern
Minnesota, thank you for having faith in the system, thank you
for advocating for the right things, and thank you for helping
us together write legislation that makes a difference.
So I yield back and thank you for the time, Senator.

[The prepared statement of Hon. Timothy J. Walz appears in
the Appendix]

Senator Boozman. Thank you, Mr. Wallis. Mr. Wallis, you
know, being a retired sergeant major truly does understand. My
dad was a retired master sergeant. When I'm around him, I feel
like I'm--you know, I need to be doing something.
Let's go down to Mr. Johnson. These guys have to go. If he
would speak for a couple of minutes, and then we'll go down to
Mr. McNerney real quick so they can get their vote.

OPENING STATEMENT OF HON. BILL JOHNSON

Mr. Johnson. And, Senator, I'd like to tell you, you both
have got me out-ranked, because I started out as a staff
sergeant, before I retired as a lieutenant colonel in 1999. So
I get to follow all of you. So thank you very much. And thank
you--I want to thank the Chairman for having this hearing
today.
I'd first like to thank all the veterans and the members of
the service organizations who've come to Washington today,
especially from my home state of Ohio, I appreciate so very
much your efforts to advocate on behalf of our Nation's heroes.
And as many of you are veterans yourselves, I'd also like to
thank you for your service to our country.
Would everyone from Ohio please raise your hand or stand to
be recognized? They're kind of scattered throughout the
audience. All right. Thank you very much.
Each organization plays an important role in improving the
lives of our Nation's veterans, their families and survivors,
and also connecting them with the assistance, the benefits, and
the services that they are entitled to. And I'm truly grateful
for your service to our veterans' community, especially in
Ohio.
Be assured that I share your dedication to those who have
sacrificed so much for our great Nation. I look forward to
working with you and my colleagues here on the Committee to
ensure that our veterans are receiving the care and benefits
that they have earned with their selfless sacrifice for our
country. And with that, I'll yield back.
Senator Boozman. Let's go to Mr. McNerney, another former
House colleague that I very much enjoyed working with while I
was here.

[The prepared statement of Hon. Bill Johnson appears in the
Appendix]

OPENING STATEMENT OF HON. JERRY MCNERNEY

Mr. McNerney. Thank you, Mr. Chairman. I too miss your
service on the House Committee, but I'm glad you're on the
Senate Committee. You've been of real service to our veterans.
What I want to say is that I really do appreciate the
testimony that was given this morning. I missed the first few,
but we have the hard written testimony, I'll read that on the
airplane this afternoon.
Every veteran out there, man or woman, has his or her own
story. I've been listening to these stories for the last five
or six years, many of them are very touching stories, they've
served hard, and now they have earned rights and benefits in
this country, and it's our duty as Members of this Committee to
make sure that those benefits and services are there when
they're needed. And there's still holes in the system, we've
seen improvements, but we hear testimony about the grave
markers that were misplaced, about the travesties that took
place at Arlington National Cemetery, about our National Guards
not being recognized as veterans, and so on.
There's so much more that needs to be done. And I'm really
proud to work here on this bipartisan Committee of men and
women, Democrats and Republicans that want to do what our
Nation needs to do to serve the people, the men and women who
have put on the uniform in this country and served in good
times and bad, and made this country the great country that it
is. So I'm proud to be a Member of the Committee, and I'm proud
that you all are here to give us your testimony. Thank you.

[The prepared statement of Hon. Jerry McNerney appears in
the Appendix]

Senator Boozman. Thank you very much and again we
appreciate your service now on the Committee for many, many
years.
Let me just apologize for being late. The--right now,
there's just lots going on, and you just feel like you need to
be in two or three places. But again it's so important. You
know, I did away with a couple of other places because I
understand how important it is to be here. And it's important
that you're here.
You know as we look out, I know myself and the staff that's
here, and the rest of the people on the Committee so much
appreciate you all. I mean, we're here as a Committee, you
know, trying to fight the battle with your help, but I can't
tell you how important it is for you to be here, talking to
your representatives, talking to their staff, talking to the
senators, and telling them how important these issues are.
The other thing is, I really want to thank the Auxiliaries.
I've got a wife and three daughters, I understand who does the
work, and we really do appreciate all of your efforts and, you
know, what you do for these organizations, and how blessed we
are to have you all.
Let me just ask two or three questions real quickly and--I
know, Mr. McCauslin, our Chairwoman in the Senate, you know,
she mentioned in her opening statement that she was planning on
introducing a bill in the coming days that will provide
veterans with information that will help them make informed
educational choices.
Her bill would also require DoD and VA to work together to
develop a policy on misleading marketing and aggressive
recruitment of servicemembers and veterans. I guess the
question is, as the Committee looks at the issue in the coming
weeks and months, what are some of the key points that we
should keep in mind?
Sergeant McCauslin. Yes, sir. All right. Thank you, sir,
for your question. I think some of the key points are these so-
called scam schools that are producing diplomas that, you know,
have no real value on the outside. They're not jobs. They're
basket weaving, tennis or something else that doesn't produce
employment for our folks.
And just this morning at a reception, I was talking with a
congressman from Pennsylvania, and he gave me some ideas, and
I'm going to go up there and meet with him on their--I think
it's called PIE, Partners in Education Program, where the
schools are hooked up with local industries to teach what are
the job needs in that respective area. That needs to be pursued
and we plan on meeting and talking about that and try to get
the VA to take that on.
Senator Boozman. Very good. Colonel Norton, in--and you
know, just in visiting with veterans in the state and really
just, you know, throughout the capacity, in my capacity, I know
the Committee's capacities, you know, we've got a situation now
where you almost have veterans as they're applying for jobs
that are not volunteering the fact that they are veterans,
because of some of the stigmas that are being, you know, put on
them, and you know, the many deployments, you know, all of
those kinds of things. And, you know, we have a lot of veterans
coming back with wounds that aren't visible, and yet are
certainly as important as the visible wounds that others have
suffered in the war.
There's a lot of work to do to kind of address, you know,
the misinformation, you know, about veterans that are having
those difficulties. I guess what I'd like to know from you is
perhaps what are the--some of the strategies that you found,
you know, to be most helpful, most effective perhaps in
fighting against this type of misinformation, and to make the
case, the so important case for employers to hire veterans. And
I can tell you, you know, that's the right thing to do, but as
a Committee Member, you know, and as a person that's trying to
make the system work, and as somebody that was the Ranking
Member and the Chairman at one time on the Committee in the
House, you know, that had to do with veterans employment, you
know, the better job that we do that, if you get people, you
know, where they can earn a living, a wage, support their
families, that takes care a lot of the problems, you know, with
future abuse down the line.
So, you know, it's so important for so many reasons. And as
you know better than anybody, the--our unemployment numbers,
and I think increasing discrimination are a real problem. Yes,
sir.
Colonel Norton. Thank you, Mr. Chairman. Let me just say
first that we really appreciate all your work over the years
here in the House, and now on the Senate Veterans' Affairs
Committee. I had the honor of testifying before you in your
district in Rogers, Arkansas about five years ago on the GI
Bill----
Senator Boozman. Right.
Colonel Norton. --and during that period, that work led to
the post 9/11 GI Bill. We greatly appreciate your leadership.
I think the issue of misinformation as relates to veteran
employment, can be tackled primarily at the local level. For
example, we're involved now in three pilot projects that we
call the Community Blueprint. One of them is Valdosta, Georgia,
and we're bringing together community partners, local
officials, the VA, and at present, what we're doing is, we are
recruiting 200 young men and women veterans to enter into a
construction employment training program. They will be using GI
Bill benefits for that certification and training, and the
local employers are guaranteeing them employment positions at
the end of their training.
So I think the idea of overcoming misinformation starts
with bringing together the resources and the assets at the
community level. So you have the mental health resources, you
have the social support services. You have the military and
veterans groups. There is an active collaboration called the
Community Blueprint that is bringing people together,
recruiting veterans, and then helping them get into formal
training programs. And at the end of that process, they get
jobs.
We're hoping that that can be expanded. We think a lot of
this misinformation has to do with making sure that local
community partners understand not only the opportunities that
veterans can bring to employment, but also the challenges and
work together. That can overcome the misinformation that's out
there.
Senator Boozman. Very good, thank you. Ms. Tomek, we
appreciate you and all that you represent, and your
organizations hard work. I noted in your testimony that the
Gold Star Wives are often contacted by surviving spouses, who
have called the VA Hotline and got wrong or misleading
information or inaccurate information.
Again, you know, we've heard similar concerns about the
education call centers. Can you tell us the ramifications, what
it means, you know, as you talk to these people, your members
when VA gives them bad information?
Ms. Tomek. I can tell you a story or two. Yesterday I
walked around the Longworth Building with my friend, Mary
Morgan. Mary is one of those ladies who reaches out often to
other people. She talks at community centers about widows and
what it is to be a Gold Star wife.
She talked about visiting with a lady in Kansas City,
Missouri who she knew was eligible for DIC. Mary finally got
the woman to agree. Her husband had served for 27 years to go
to the VA to ask for DIC. Mary says that it took three or four
people within the VA, and Mary was very persistent in getting
and insisting that this woman was eligible for DIC, because she
knows her benefit book.
And finally after she handed them a Gold Star Wives'
brochure, that they looked at and took back to copy, they began
to admit that maybe they needed to look at the dates of
service, and where the servicemember had served his 27 years
with service-connected cause, to give that lady her DIC.
But we often find those kinds of things. If you're not
persistent and maybe aggressive, depending on what you consider
that attitude, you miss those VAs, and those ladies don't--and
men don't get the VA benefits that their husbands earned.
Senator Boozman. Uh-huh. Well, we appreciate your efforts
in that regard, and certainly your story I think, you know,
really does put the salt. In here, we look at facts and
figures, and you know, that really brings to light how it does
affect individuals and how not doing as good a job as we should
be doing really does impact lives. So thank you very much.
Let me just ask a couple of more things. When it comes to
claims processing, a number of performance metrics have been
heading in the wrong direction, including quality, timeliness
and the size of the backlog. You know, VA has a number of
initiatives working hard trying to fix these issues, but it
appears that literally it could take years before veterans see
major improvements as results of the measures if they work.
So I guess, you know, two or three of you that like to jump
in, if you could give us some suggestions from your standpoint
as to how the--you know, yourselves, VA, Congress, you know,
all of us working together could perhaps improve that situation
in the near term, rather than some of these things that it
looks like it's going to take a long time.
Mr. Davis.
Mr. Davis. Yeah, I think that one of the things we need in
that area, is to make sure that both DoD and VA work together
to make sure that there's a seamless transition from DoD to VA.
And I know that brings about certain jurisdictional problems
for this Committee and for the Armed Services Committee because
there's sort of a gray area there where they overlap. But I
think that's one of the critical things to look at, is to make
sure that when this person goes through the transformation that
it can be done seamlessly, and those veterans particularly for
those that are injured, we think that, you know, we need to
make sure that both bureaucracies at DoD and VA are working
together to help the injured veteran.
And I think, you know, Committee oversight hearings in that
regard, both the Veterans' Committees in both Houses and the
Armed Services Committee in both Houses can play an invaluable
role in making sure that these bureaucracies are responsive to
the needs of the wounded warrior and the veteran.
Senator Boozman. Yes, sir, Mr. Lawson.
Mr. Lawson. Yes, sir. I'd add one thing too that I think is
clogging up the system as well is decision errors. You have
thousands of claims that go up, and a decision is made to deny
it. It comes back down to the veteran, and then most of them
using veteran service organizations then have to appeal that
decision. So let's just say you had 500,000 claims that were
denied, you're going to have 500,000 claims going back up
again. So it's just a constant thing of claims going up and up.
In my personal experience, it took me 13 years before they
were finally able to understand what was going on.
Senator Boozman. Thank you. Yes, ma'am, Ms. Tomek.
Ms. Tomek. I--in our testimony, we include a statement that
perhaps in the Veterans Benefit Administration there should be
some Committee--some advisors, some stakeholders who serve as
advisors to the department. So that they understand some of
this at the high levels, where the administration is taking
place. We call those stakeholders, surviving stakeholders, and
I think that could also be veteran stakeholders providing some
advice and listening to what the kinds of experiences we've all
had.
Senator Boozman. Very good. Thank you. Yes, sir.
Mr. Susino. Dealing with Vietnam veterans and the checking
out of a PTSD, there's cases of dog handlers, persons who have
these dogs and go to the front lines, and they submit a claim
for PTSD, and they are denied, and say they don't have PTSD. I
don't understand that. And then there's a report that comes out
that his dog has PTSD and he doesn't. So I don't understand why
claims are not looked at more thoroughly, and not just thrown
aside.
My problem is when I--in our regional office, they're
training many people to do the job, and sometimes, and I think
many times, they don't know what they're looking at, and they
don't realize what veterans go through when they're in the
front lines. He doesn't have a CIB, but yet again, he carries a
rifle, and he does shoot at the enemy, he keeps the dog there,
and turn him down, and we have to resubmit and ask for PTSD.
Again, I think it's asinine that they do this. It's not one
case.
So reappealing, it's taking time away from other cases, and
why they are not trained better to look at it the way it should
be looked at. Thank you.
Senator Boozman. Good, thank you. I think you make a good
point. Thank you very much.
Mr. Falk.
Mr. Falk. I recall Secretary Shinseki talking about the
transition from the paper files, which we all were used to in
the old days, your record followed you in the transition to
electronics today, and I don't know if that has been completed
or whether the VA has enough staff adequately to make the final
transition. Because I believe that may be part of the delay
problem is still there, are old records that have yet to be
placed into computer files.
Senator Boozman. Very good, thank you. Let me just ask one
more thing and then we'll close. And I really do think it's
important. You know I've been around here not a long, long
time, but I've been around here for ten years. And I've really
in noticing I think the VA is doing a much, much better job of,
you know, handling the problems that we have with returning
women veterans, just women veterans in general. And, you know,
our VA's were not set up, you know, for the influx that we've
had. And again I know we've worked hard, and you know, we've
had progress in improving services, you know, more veteran
program managers available, you know, changing the way some of
the disability claims are handled.
I guess very quickly, and you might start with this, Mr.
Norton, the--as we continue on this path, and like I said, I
think we're working hard, the Committee is working hard, and
really the most important thing as you solve problems is to
realize you've got a problem. And, you know, I think we've
realized that, and are working hard to solve it.
Do you have any suggestions where we can, you know, again
improve the quality and the services that we're providing for
women? As someone with a wife and three daughters.
Colonel Norton. Just in general, Mr. Chairman, and we could
submit more detail for the record, one I think obvious approach
is to hire more medical specialists who focus on the unique
health care needs of women veterans. That's everything from
physical health care, mental health care, newborn care, et
cetera. But over and above that, I think frankly that General
Shinseki and the VA are working toward this, and making some
progress. And that is a cultural change.
There needs to be a cultural change within the VA. As you
well know, a lot of women veterans when they first encounter a
VA facility, find that they feel unwelcome, they feel like
outsiders, they don't feel like this is the place for them.
Frankly, the reality is that there are still a lot of old guys
like me who are going to VA facilities, and some of our younger
women warrior veterans don't feel quite at home, and so that's
a cultural challenge.
I think they're working on that, but I would urge the
Committees to double down your efforts on that kind of thing,
along with the increased capacity, increased resources, not
necessarily additional money, but the hiring of specialists who
can take care of our women veterans.
Senator Boozman. Good, very good point. Does anybody else
want to jump in?
Mr. Fry. Yeah, if I could give a less than 24-hour's old
example of some of the slow downs. It was necessary for me to
use the VA health care system yesterday. I live in northwestern
Pennsylvania and when I went over to the clinic in Greenbelt,
they were very nice to me, very accommodating. But there's no
common server. They had to start the process all over again,
and I sat an hour with a lady in there getting all the
information again.
And all that does is--that's some of the bottlenecks that
me and my constituents are talking about. In this day and age,
I can't believe that they can't access records from one common
server.
You take my little situation across the country, and it
would be a thousands and thousands of man hours saved, and more
people could be taken care of at one time. I'm not complaining
about the employees, because that lady, she was a real trooper.
She knew what she was doing, and that's a fresh one. That's
less than 24 hours old. And I've been in the VA health care
system for a long, long time. Thank you.
Senator Boozman. No, and I appreciate that. And I think
that's an important distinction. You know, you've got good
people that are working hard. Sometimes we put them in a
position where they can't be very efficient, you know, trying
to perform the function. Mr. Davis.
Mr. Davis. Before closing, I just wanted to say you had
talked about the GI Bill earlier, and I know that there's been
some problems regarding for profit schools and what not, but I
just want to also reiterate that the GI Bill has been an
enormous moral booster for our soldiers, sailors, Marines, and
airmen that have been involved with the War on Terror. And we
go out from time to time, and I'm sure a lot of these people do
as well, and talk to people in uniform at meetings and what
not. And when that bill was passed, and a year or two later
after that, there were a lot of questions, and a lot of people
that were using it, and they were very, very appreciative of
that benefit change.
Senator Boozman. No, I agree. It really is a tremendous
benefit, and as you all know, you know, we had some problems in
implementing it, because it was just such a significant
improvement, such a rapid departure from what we were doing,
but to their credit, VA worked really hard to overcome those
problems. And for the most part, you know, we've got those
solved, so I think that we can be very appreciate of their hard
work.
Let's close with Mr. Lawson.
Mr. Lawson. I just wanted to talk a little bit more about
employment. You know, we always--we hear about the problem with
veterans employment. One thing that we don't hear a lot about
is the problems with unemployment for catastrophically disabled
veterans.
It's nearly 85 percent unemployment rate for
catastrophically disabled veterans. At Paralyzed Veterans for
the last six years, we have launched our own voc rehab programs
to put a lot of these people through, and we're being quite
successful in getting these employed.
The VA's voc rehab program really needs to be modernized.
There's a lot of red tape, a lot of things that a veteran has
to go through in order to--and the hands are tied of those voc
rehab representatives. And I think that's one of the reasons
why we're so successful with ours, because we don't have to go
through all that. And--but I just think that there needs to be
a little bit more conversation about those with catastrophic
disabilities finding jobs.
Senator Boozman. Good. Thank you very much.
Again, I agree, and you know, that's the importance of
these kind of hearings, you know, these kind of soliciting
information, you know, as everybody working together, you know,
on both sides of the aisle. Again, you all with your different
groups working together, this is a time for all of us, you
know, to band together, and understand, help the public
understand, help Congress understand, continue to understand,
that the benefits that we're talking about are earned benefits.
These are something that, you know, a great deal of sacrifice
was expended, you know, to have these earned benefits, and we
do want to protect them.
So thank you very much for being here. Again, I think the--
you know, yawl had a tremendous job, it was very instructive.
Before we finish, I have a couple of things. I ask unanimous
consent that all Members have five legislative days in which to
revise and extend their remarks, and include any extraneous
material for today's joint hearing.
And hearing no objection, so ordered. And with that, the
hearing is dismissed. Thank you.

[Whereupon, at 11:52 a.m. the Joint Committee was
adjourned.]

A P P E N D I X

----------

Prepared Statement of Chairman Jeff Miller

Good morning everyone. First, I want to thank all of you for coming
here today.
In the interest of time, after hearing from Chairman Murray,
Ranking Member Filner, and Ranking Member Burr, I would like to ask
Committee Members to waive their opening statements. There will be an
opportunity for remarks during the question and answer period following
today's testimony.
Hearing no objections, so ordered.
It is my honor to be here this morning and a source of inspiration
every time I look out into a crowd and see some of our Nation's most
dedicated and honorable citizens serving here as a voice to veterans
across this great land. It is my hope that we can use today as an
opportunity to better support our Nation's veterans.
To all of you who have traveled here today, I thank you for making
the trip to Washington to share your legislative agenda with our
Committees and the Congress, and more importantly for your continued
service and dedication to help better the lives of our veterans, their
families, and survivors.
All have sacrificed on behalf of our Nation and each of you here
today represents those we honor, including veterans who put this
country first; those who have been wounded in the line of the duty; and
those we have lost.
I also welcome our guests present today who comprise the national
auxiliary commanders. Thank you for being here today and for all of the
good work that members of the auxiliary do for our country.
I would also like to take a moment to recognize the members of the
different organizations who - like myself - are proud to call Florida
home. Gentlemen and ladies, would you please stand.
I am pleased to be joined by my colleagues from across the aisle
and across the capitol including Ranking Member Filner, Ranking Member
Burr, and Members of both the House and Senate Veterans' Affairs
Committees.
In particular, I want to extend a warm welcome to Chairman Patty
Murray of the Senate Committee on Veterans' Affairs. Senator Murray, it
was a pleasure to work with you last year in constructing and passing
the V.O.W. to Hire Heroes Act of 2012.
I look forward to working further with you this year to help our
Nation's veterans.
Before we begin today, I ask that everyone turn their attention to
the center of the room. As part of a longstanding military tradition,
as long as I am Chairman, the House Committee on Veterans' Affairs will
display an empty chair draped with the P.O.W./M.I.A. flag at every
hearing.
This chair is to be a daily reminder of the more than 83,000
servicemembers who have yet to return and represents our hope that they
will come home to us one day.
With that, will everyone who is able, please stand and direct your
attention to the empty chair before me.
Today as patriotic Americans who are grateful to those who have
sacrificed and continue to sacrifice, this Committee pauses to
recognize the plight and circumstance of a unique group of Americans.
They are our prisoners of war and missing in action. From this day
forward, the House Committee on Veterans' Affairs will remember this
through the placement of a P.O.W./M.I.A. empty chair at all official
meetings.
This chair will serve as a physical symbol of the thousands of
American P.O.W./M.I.A.s still unaccounted for from all wars and
conflicts involving the United States of America.
This is a reminder for all of us to spare no effort to secure the
release of any American prisoners from captivity, the repatriation of
the remains of those who died bravely in defense of liberty, and a full
accounting of those missing.
I now call upon Vice Commander Charles Susino of the American Ex-
Prisoners of War, to lead us in the pledge of allegiance.
The House Committee on Veterans' Affairs has been working on
several fronts to address the many needs of our Nation's veterans, and
there are three specific areas I would like to discuss with you this
morning.
First is the critical need to increase veteran employment around
the country. Second is overseeing substantive change to the VA benefits
process with the end goal of ending the backlog of disability claims.
The third and most recent issue is ensuring your medical care and
benefits are protected from the reach of sequestration cuts to the
Federal budget.
I am proud to report substantial progress being made on all three
fronts.
Several months ago congress passed into law the bipartisan V.O.W.
to Hire Heroes Act of 2012, a comprehensive veterans retraining and
employment package which, among other things, provide nearly 100,000
unemployed veterans with the skills they need to find meaningful
employment in today's economy.
This legislation aims to provide both long term and short term
employment for all veterans. I would like to thank each of your
organizations for your support in enabling this legislation to be
passed and enacted into the law of the land.
In addition, as I mentioned before, another area needing critical
attention is the backlog of disability claims. A dramatic reduction in
this backlog is fundamentally important, if for no other reason than to
ensure the promise our country made to each of our service men and
women who defended our freedoms is fulfilled.
To this end, I am pleased to see the benefits system being brought
into the 21st century with the rollout of the electronic claims
processing system throughout the next two years.
While I understand much more needs to be done to fully cure the
backlog problem, equipping the Veterans Benefits Administration with
modern technology is a solid step in the right direction.
In addition, our Committee will continue to place an increased
focus on quality of care, with the end goal of ensuring decisions are
done correctly the first time.
The last area I'd like to touch on is our collective need to know
with absolute certainty that your health care needs and benefits are
protected from the reach of sequestration.
As many of you are aware, such a cut would severely impact VA's
ability to provide the high quality health care America's veterans have
earned and deserve. Our government made a commitment to every one of
you as you stood ready to defend our great Nation.
Since august, when the Budget Control Act of 2011 was passed, I
have sought assurances from both Secretary Shinseki and President Obama
that VA would be exempt from sequestration, as the law intended.
Unfortunately, we have failed to receive any assurances from the
administration that our veterans will be exempt from the negative
effects of sequestration.
So let me be clear: we will fight for your rights just as you once
fought for ours. As such, I introduced H.R. 3895, the protect VA health
care act of 2012 (H.R. 3895).
This bill would remedy this issue once and for all and ensure that
future generations of veterans are not held hostage to the type of
political gamesmanship that i believe is holding up the president's
decision.
So I ask you this, as you meet with your representatives, I ask
that each of you in our audience ask them to join me in cosponsoring
this bill, H.R. 3895, to protect the VA health care system on behalf of
the men and women serving our Nation who have already sacrificed
enough.
I want to thank you all again for being here, and I look forward to
hearing your recommendations and concerns for the remainder of this
legislative session.
Now, I would call on the distinguished Chairman of the senate
Committee veterans' affairs Senator Patty Murray for her opening
comments.

Prepared Statement of Hon. Bob Filner,
Ranking Democratic Member

Good morning! I want to thank everyone for being here today to
discuss your organizations legislative priorities and share your views
on how the Department of Veterans' Affairs can better serve veterans. I
would also like to thank you and your organizations for your service
and hard work over the years in support of our country and veterans.
Also, I would like to welcome and acknowledge everyone who traveled
from outside Washington, DC to be here. I particularly want to
recognize the California delegations and especially your Members from
my district in California. Let me also commend all of your hard working
staff here in Washington, DC. You should be proud of the continued
professionalism and advocacy that they share with this Committee and
the expertise they bring in producing the Independent Budget every
year.
This Committee continues to depend on the Independent Budget for
direction on funding the VA programs so we can meet the needs of
veterans. We should continue to ask the VA tough questions on their
programs and outcomes, and be able to have an honest discussion on any
gaps or shortfalls to understand the true need. At the end of the day,
we must provide veterans the benefits they have rightfully earned.
As we are all aware the military will begin to downsize and reduce
its numbers. There will be more veterans coming home that will need
physical health care and mental health care. We should continue to work
on ideas to improve medical services for veterans and solve our backlog
of pending claims. There is a lot of hard work that needs to be done
and we are open to all ideas that improve the VA.
The President announced the budget request for VA for fiscal year
2013 and the Advance Appropriations request for 2014. In discretionary
funding, VA requested a 4.5 percent increase, and a 16.2 percent
increase in mandatory funding, for an overall budget increase of 10.5
percent in fiscal year 2013.
I will continue to support of the President and Secretary
Shinseki's efforts to transform the VA into a 21st Century agency. I
remain committed to work with my colleagues to ensure that we get the
correct funding and policies that we need.
I want you to know that our Committee remains steadfast in our
determination that VA is excluded from any potential funding cuts
designed to help balance the budget. We WILL NOT balance the budget on
the backs of veterans. Our veterans stood up to protect and defend our
Nation . . . and we will stand up to provide for our veterans and their
families when they come home . . . by ensuring they have the health
care and benefits they have earned.
This will be an interesting discussion and I look forward to
hearing your priorities and ideas.
Thank you Mr. Chairman. I yield back.

Prepared Statement of Charles Susino

Messrs. Chairmen and Members of the Veterans' Affairs Committees:
My name is Charles Susino, Sr. Vice Commander of the American Ex-
Prisoners of War. I am honored to testify before you again today on
behalf of National Commander Carroll Bogard.
Senator Murray, Senator Burr, Representative Miller and
Representative Filner, I congratulate your efforts as you navigate your
committees through the second half of the 112th Congress. Our
organization has watched you and your colleagues grapple with hard
decisions while attempting to provide for America's veterans, their
families and survivors.
This year marks the 70th birthday of the American Ex-Prisoners of
War. On April 14, 1942, two mothers whose sons had been captured on
Bataan formed the Bataan Relief Organization; in 1945, after the POWs
returned home, we became the Bataan Veterans Organization; and in 1949,
expanding our membership to encompass ALL former prisoners of war from
ALL wars, we became the American Ex-Prisoners of War.
Since World War I, more than 142,000 Americans - including 85 women
- have been captured and interned as POWs.
Today, former POWs number just about 15,000. And soon the concerns
of our tiny group of heroes will matter not--to this committee or any
other.
Some of our youngest members are in their early thirties; however
instead of 142,000, as in the past, we're talking of just 23 former
POWs from current conflicts.
We are immensely grateful for past Congressional actions to help
ex-POWs. It was our organization who pushed in the early 1980s for
``Presumptives'' and because of the efforts of your committees, the
Veterans Administration and the heroes in red jackets walking the halls
of Congress telling the stories of former prisoners of war, we now have
benefits and entitlements that protect us...and the POWs that will
surely come after we are gone.
As we look to the future, we want to lend our small voice and
support to America's aging veteran population from WWII, Korea and
Vietnam - veterans who may have fallen through the cracks of care
because of rulings enacted to cope with the frightening possibility of
many millions of applicants to the Veterans Administration.
16,112,566 individuals were members of the United States armed
forces during World War II. In November 2011, the Department of
Veterans Affairs estimated that approximately 1,711,000 American
veterans were still living. More than 1,100 WWII veterans die each day.
The average age of a WWII veteran is 92.
1,800,000 individuals were members of the United States armed
forces serving in Korea during the 3-year period of the Korean War.
Only about 1/3 of that number are still alive today. The average age of
a Korean War veteran is 85.
2,594,000 individuals served in South Vietnam Jan. 1, 1965 - Mar.
28, 1973. Of this number of Americans who served in Vietnam, less than
850,000 are estimated to be alive today. The average age of a Vietnam
veteran is 66. These are our ``youngsters'' in the time frame I'm
speaking on today.
The clock is ticking and time is running out for the brave men and
women who fought the good fight to keep America free. And while the
debt we owe them can never be repaid in full, you can make their next
days, months, years better.
There are less than 3 million heroes alive from these three great
conflicts. You could fit them all into the city of Chicago. As they
have aged, their disabilities have left many of them with poor quality
of life and financially burdened.
Many of these Wartime Veterans are in the VA Category 8 or lower,
which means they are not entitled to VA care at all. These Veterans are
designated as Priority 8 when their income exceeds a pre-set threshold
classifying them as ``affluent''. They are the most affluent category
of vets, yet some earn as little as $28,430 a year - hardly affluent.
A significant change was made in health-care eligibility in 1986.
Congress mandated VA health care for veterans with service-connected
disabilities as well as other special groups of veterans, such as
former prisoners of war, veterans exposed to herbicides and ionizing
radiation and veterans of World War I. The average age of the WWI
veterans was 88 in 1986 . . . younger than today's WWII veteran;
virtually the same age as today's Korean War veteran.
Today, we have a request of you, the 112th Congress: please update
the 1986 law to add WWII, Korean, and Vietnam War veterans to this
special group of veterans to make them eligible for health care. Please
also consider including the Gulf War veterans in this special group as
well. It is overdue to update Congress' actions in 1986. From a health
benefits standpoint, this puts these war-time veterans on par with WWI
veterans, the special groups, and the current warriors who are fighting
in the middle-east, all of which we strongly support. Please let them
not be forgotten. Please do not continue to allow these war time
veterans to be excluded and deprived health benefits.
It's the right time to add these heroes to this special group of
veterans. It's the right thing to do.
We are willing and able to work with you or your staff on drafting
this amendment.
We would also like to join our brother veteran service
organizations in asking your consideration of the following bills:
HR 813, introduced by Representative Bob Filner (CA), which would
amend section 1318(b)(1), title 38, United States Code, to allow
dependency and indemnity compensation (DIC) to be paid to the survivor
of a veteran whose was continuously rated totally disabled for at least
one (1) year immediately preceding death, whereas, eligibility under
current law requires the veteran to be rated totally disabled for a
minimum of ten (10) years.
S423 introduced by Richard Burr (NC). Authorizes the Secretary of
Veterans Affairs (VA) to provide an effective date of an award of
disability compensation, in the case of a veteran who submits a fully-
developed claim, of up to one year before the date of receipt of such
claim.
HR28 introduced by Mike McIntyre (NC). Veterans Outreach
Improvement Act of 2011. A bill to amend title 38, United States Code,
to improve the outreach activities of the Department of Veterans
Affairs, and for other purposes.
HR23 introduced by Bob Filner (CA) Belated Thank You to the
Merchant Mariners of World War II Act of 2011. A bill to amend title
38, United States Code, to direct the Secretary of Veterans Affairs to
establish the Merchant Mariner Equity Compensation Fund to provide
benefits to certain individuals who served in the United States
merchant marine (including the Army Transport Service and the Naval
Transport Service) during World War II.
HR178/ S.260 introduced by Joe Wilson (SC)/Bill Nelson (FL).
Military Surviving Spouses Equity Act. A bill to amend title 10, United
States Code, to repeal the requirement for reduction of survivor
annuities under the Survivor Benefit Plan for military surviving
spouses to offset the receipt of veterans dependency and indemnity
compensation.
HR309 introduced by John Mica (FL). Samuel B. Moody Bataan Death
March Compensation Act. A bill to provide compensation for certain
World War II veterans who survived the Bataan Death March and were held
as prisoners of war by the Japanese.
HR303 introduced by Gus Bilirakis (FL). Retired Pay Restoration
Act. A bill to amend title 10, United States Code, to permit additional
retired members of the Armed Forces who have a service-connected
disability to receive both disability compensation from the Department
of Veterans Affairs for their disability and either retired pay by
reason of their years of military service or Combat-Related Special
Compensation and to eliminate the phase-in period under current law
with respect to such concurrent receipt.
HR812 introduced by Bob Filner (CA). Agent Orange Equity Act of
2011. A bill to amend title 38, United States Code, to clarify
presumptions relating to the exposure of certain veterans who served in
the vicinity of the Republic of Vietnam.
HR3712 introduced by Martin Heinrich (NM). Bataan Defenders
Congressional Gold Medal. A bill to grant the Congressional Gold Medal
to the troops who defended Bataan during World War II.
The American Ex-Prisoners of War are proud supporters of The
Independent Budget. The FY2013 edition represents the 26th consecutive
year that our partnership of veterans service organizations has joined
together to produce a comprehensive budget document that highlights the
needs of every generation of veterans. During that time, The
Independent Budget has improved significantly while gaining much more
respect and recognition.
Messrs. Chairmen and Committeemen, this completes my testimony.
Thank you for allowing me the opportunity to appear before you on
behalf of the American Ex-Prisoners of War to share our goals for the
112th Congress. Thank you also for all that your Committees have done
and for all that you will do for our nation's veterans and their
families in the future.
God bless America.

Prepared Statement of John R. Davis
THE FRA

The Fleet Reserve Association (FRA) is the oldest and largest
organization serving enlisted men and women in the active, Reserve, and
retired communities plus veterans of the Navy, Marine Corps, and Coast
Guard. The Association is Congressionally Chartered, recognized by the
Department of Veterans Affairs (VA) and entrusted to serve all veterans
who seek its help.
FRA was established in 1924 and its name is derived from the Navy's
program for personnel transferring to the Fleet Reserve or Fleet Marine
Corps Reserve after 20 or more years of active duty, but less than 30
years for retirement purposes. During the required period of service in
the Fleet Reserve, assigned personnel earn retainer pay and are subject
to recall by the Secretary of the Navy.
The Association is actively involved in the Veterans Affairs
Voluntary Services (VAVS) program and a member of the National
Headquarters' staff serves as FRA's National Veterans Service Officer
(NVSO) and as a representative on the VAVS National Advisory Committee
(NAC). FRA testifies regularly before the House and Senate Veterans'
Affairs Committees and Appropriations Subcommittees.
FRA's National Veterans Service Officer also oversees FRA's
Veterans Service Officer Program and represents veterans throughout the
claims process and before the Board of Veteran's Appeals. In addition,
171 FRA Shipmates provided almost 12,000 volunteer hours of support at
59 VA facilities throughout the country in 2011, enabling FRA to
achieve VAVS ``Service Member'' status. Members of the Auxiliary of the
Fleet Reserve Association are also actively involved in the VAVS
program and hold an Associate Membership seat on the committee which
requires involvement at 15 or more VA facilities.
In August 2007, FRA became a member of the Veterans Day National
Committee joining 24 other nationally recognized Veterans Service
Organizations on this important committee that coordinates National
Veterans' Day ceremonies at Arlington National Cemetery. FRA also is a
leading organization in The Military Coalition (TMC), a group of 34
nationally recognized military and veteran's organizations collectively
representing the concerns of over five million members. In addition,
FRA senior staff members serve in a number of TMC leadership roles.
FRA celebrated its 87th anniversary on November 11, 2011. Nearly 90
years of dedication to its members has resulted in legislation
enhancing quality of life programs for Sea Services personnel,
retirees, veterans and their families and survivors.
FRA's motto is: ``Loyalty, Protection, and Service.''

CERTIFICATION OF NON-RECEIPT OF FEDERAL FUNDS

Pursuant to the requirements of House Rule XI, the Fleet Reserve
Association has received no federal grant or contract during the
current fiscal year or either of the two previous fiscal years.

INTRODUCTION

Distinguished Chairman, Chairwoman, Ranking Members and other
Members of these Committees, FRA's membership appreciates this
opportunity to present the Association's 2012 legislative goals. The
foundation for this statement is the fact that veteran's benefits are
earned through service and sacrifice in the defense of this great
Nation and are not entitlements or social welfare benefits.

THE 2013 VA BUDGET & SEQUESTRATION

A high priority for FRA is to clarify that the entire Department of
Veterans Affairs (VA) budget is exempt from sequestration as mandated
by the 2011 Budget Control Act (BCA) that will take effect January
2013. This concern stems from vagueness in the current law and the
Association appreciates Chairman Rep. Jeff Miller's (Fla.) attention to
this issue and the introduction of the ``Protect the VA Health Care
Act'' (H.R. 3895) that excludes the VA health care programs from
automatic sequestration cuts next year.
The VA FY 2013 budget request includes a 10.5 percent increase
($140.3 billion) over the current fiscal year plus $54.5 billion in
advanced appropriations for VA health care in FY 2014. Funding for non-
VA outpatient care is increased by almost 14 percent over the FY 2012
budget. The increased funding is in response to estimates that more
than one million current active duty personnel will become veterans
over the next five years. The budget also addresses a number of other
VA priorities, including efforts to reduce the backlog of unresolved
disability claims and reduce unemployment and homelessness among
veterans.
FRA strongly supports these proposed increases and notes that the
FY 2013 Independent Budget (IB) recommends just over $68 billion in
discretionary spending for next year while the Administration's FY 2013
budget recommends nearly $64 billion in discretionary funding
FRA supports the recommendations of the IB which was recently
released by AMVETS, Disabled American Veterans (DAV), Paralyzed
Veterans of America (PVA) and the Veterans of Foreign Wars (VFW). The
IB provides detailed funding analysis of the proposed VA budget and is
intended to be used as a guide to policy makers to make necessary
adjustments to meet the challenges of serving America's veterans.

DISABILITY CLAIMS BACKLOG

The cost of defending the Nation includes treating the nation's
wounded warriors, and FRA is deeply concerned about the backlog of
claims at the VA. Veterans injured in service to their country deserve
accurate and timely disability determinations. Our military's
involvement in Iraq is ending and the war in Afghanistan is winding
down yet there are additional demands on VA health care resources. For
years, FRA has advocated for new and improved technology to better
manage the deluge of disability claims associated with the war efforts
and to eviscerate the disability claims backlog. However, as of January
2012, the VA reports that more than 800,000 veterans are awaiting
decisions, 60 percent of which are pending 125 days or more - an
increase of more 100% over the past three years.
FRA notes that thousands of additional claims adjusters have been
hired since January 2007. Yet despite the additional resources and
manpower, the backlog of disability claims continues to increase.
Adding to this backlog are errors due to inadequate examination,
inaccurate processing and lack of oversight.
Two recent VA Inspector General Regional Office inspections \1\
indicated that the Veterans Administration Regional Office staff did
not accurately process disability claims, and used insufficient medical
examination reports to process TBI claims. VBA claims processors
perform a vital role in adjudicating these claims, and it is clear that
VA needs to ensure that decisions in disability compensation and
pension cases are accurate, consistent, and timely. New personnel must
become proficient in the claims process and maintain their knowledge
and skills proficiency in this field.
---------------------------------------------------------------------------
\1\ Office of Inspector General Inspection of VA Regional Office
Pittsburgh, PA (February 27, 2012) and VA Regional Office St.
Petersburg, FL (February 8, 2012.)
---------------------------------------------------------------------------
FRA's National Veterans Service Officer (NVSO), Christopher
Slawinski, states that he continues to receive calls from Association's
members and/or their surviving spouses who express concerns about
having been denied benefits by the VA based on inaccurate, incomplete
or missing information or evidence. These errors by the VA contribute
to the growing number of appeals and a further strain on the claims
adjudication backlog.
FRA continues to believe there is strong bi-partisan support to
reform the system and lawmakers have made clear that they want to
improve claims processing to eliminate bureaucratic delays and ensure
more uniformity between branches of the military and the VA in how they
rate disabilities. The VA must maintain an effective delivery system,
taking decisive and appropriate action to correct deficiencies and
improve processes. That said, VA can promptly deliver benefits to
veterans only if it has modern technology, adequate resources,
sufficient personnel training and staffing.
FRA strongly supports the Administration's efforts to create a
Joint Virtual Lifetime Electronic Record (VLER) and an integrated
Electronic Health Record (iEHR). A VLER for every service member would
be a major step towards the Association's long-standing goal of a truly
seamless transition from military to veteran status for all service
members and would permit a DoD, VA, and private health care providers
immediate access to a veteran's health data. There is some sharing now
between DoD, VA and the private sector, but more needs to be done.
Wider expansion of data sharing and exchange agreements between VA, DoD
and the private sector is needed. VA's ``Blue Button'' initiative
permits veteran's online access to some medical history, appointments,
wellness reminders and military service information, but most is only
accessible only after an in-person authentication. The VLER strategy
utilizes secure messaging standards, similar to that which is used for
email, to securely relay information between sources. The VLER working
group is collaborating with VBA and its paperless processes and while
being HIPPA (Health Insurance Portability and Protection Act)
compliant, there are legislative hurdles to overcome, similar to that
which the VBA is facing with its paperless process.

WOUNDED WARRIORS & SEAMLESS TRANSITION

FRA believes post traumatic stress should not be referred to as a
``disorder.'' This terminology adds to the stigma of this condition,
and the Association believes it is critical that the military and VA
work to reduce the stigma associated with PTS and TBI.
The goal of a truly seamless transition for wounded warriors
transitioning from DoD to VA still remains elusive. The Senate Veterans
Affairs Committee heard testimony in May 2011 from Scott Gould, VA
Deputy Secretary, and DoD Deputy Secretary William Lynn on the progress
the two agencies are making in achieving the goal of a seamless
transition for disabled veterans from the Department of Defense (DoD)
to the VA. Committee Chairwoman Sen. Patty Murray, and Ranking Member
Sen. Richard Burr acknowledged improvements but also expressed concern
and frustration with bureaucratic infighting and the pace of reform
almost four years after the 2007 media firestorm over conditions for
wounded warriors at Walter Reed Army Medical Center in Washington, DC.
FRA agrees and a top priority for the Association is to ensure adequate
funding for DoD and VA health care resource sharing in delivering
seamless, cost effective, quality services to wounded or injured
personnel. There has been progress, however additional oversight
hearings are needed to ensure that the Department's respective
bureaucracies are held accountable for further progress on this issue.
FRA remains concerned that the military service commands continue
to either bypass the medical evaluation board (MEB) process through
administrative measures, or ``lowball'' disability ratings to deny
service connected injured military members their full benefits. FRA is
currently working with a service member through this process who stated
that his MEB was not handled properly and evidence which would have
confirmed disability was not considered in the decision process.
The VA has launched a streamlined version of its online application
for VA health benefits (VA Form 1010EZ) for active duty personnel and
Reservists returning from deployment at 61 demobilization sites
nationwide and expects the form to reduce processing time by seven
days. The new online application will be completed as part of a their
demobilization and regularly scheduled briefing on VA benefits, which
outlines five years of free healthcare and medications for returning
service members eligible for VA health care.
The new application is a joint venture between the VA and DoD, and
is a positive step toward a seamless transition from DoD to VA
benefits. Additionally the VA and other federal agencies must work
collaboratively to improve the Transitional Assistance Program (TAP) to
help veterans return to civilian life as easily as possible per
provisions of the recently enacted Veterans Opportunity to Work Act
(VOW.)
The Armed Services Committees and Veterans Affairs Committees must
also remain vigilant regarding their oversight responsibilities
associated with ensuring a ``seamless transition'' for our Nation's
wounded warriors. In conjunction with this, FRA notes with concern the
shifting of departmental oversight from the Senior Oversight Committee
(SOC) comprised of the DoD and VA secretaries per provisions of the FY
2009 National Defense Authorization Act, to the more junior Joint
Executive Council (JEC) which is now responsible for supervision, and
coordination of all aspects of DoD and VA wounded warrior programs.
Related to essential transition programs, according to Navy Times
editors, ``Even before sequestration takes effect budget cuts have
impacted the (DoD) Office of Wounded Warrior Care and Transition Policy
with the elimination of 40 percent (44 positions) of the staff, and all
15 contract employees in the transition policy section that leaves only
two full-time civilian employees.'' \2\ FRA also notes the importance
of the Virtual Transition Assistance Program (VTAP) website that was
scheduled to replace the current Turbo TAP website. The VTAP is
envisioned to enhance access to online and digital resources, virtual
classrooms, social media and other 21st century information platforms.
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\2\ Navy Times Editorial, January 16, 2012, Page 4
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VTAP is in tune with the current generation of service members and
their families and enables them to tailor their own transition
experience
The existing Turbo TAP program has been moved to the Office of
Civilian Personnel Policy and is under review to try to make the
program more useful for troops. Program changes include greater focus
on improving resumes with links to Defense Manpower Data Center to
allow potential employers to confirm military education and training,
automatic translation of military skills into language employers can
understand, access to job banks, and search for accredited schools for
continuing education.
The Association notes the potential of the eBenefits web site which
serves as an electronic portal for veterans, service members and their
families to research, find, access, and in the near future manage their
VA benefits. The program is a service of the VA and DoD and was one of
the recommendations of the President's Commission on Care for America's
Returning Wounded Warriors (Dole/Shalala).
The Association also encourages support for the Navy's Safe Harbor
Program and the Marine Corps Wounded Warrior Regiment (WWR), programs
that are providing invaluable support for these personnel before they
transition to veterans' status.
Finally, Congress should expand the VA Caregivers Act to full-time
care givers of catastrophically disabled veterans before September 11,
2001. In addition, the Defense Centers of Excellence should be
adequately funded and staffed.

CAMP LEJEUNE CONTAMINATED WATER

The Federal Agency for Toxic Substance and Disease Registry efforts
last year are important in determining the impact the contaminated
water at Camp Lejeune had on those Marines, their families, and others
assigned to the base between 1957 and 1987. Their survey is the largest
ever carried out by the agency and is intended to determine the impact
on birth defects, childhood cancers, and mortality rates due to
exposure to pollution at Camp Lejeune. Statistical analysis is expected
to be available in early 2014. FRA appreciates the efforts of House VA
Committee Chairman Rep. Jeff Miller and Senate VA Committee Ranking
Member Sen. Richard Burr in addressing this issue.
The Association supported the original version of the ``Caring for
Camp Lejeune Veterans Act'' (S. 277), sponsored by Sen. Burr that
authorizes VA health care for former military family members, veterans,
and family members stationed at Camp Lejeune for three decades
beginning in 1957, when the water at the base was acknowledged to have
been contaminated with carcinogens. That said, the Association strongly
opposes funding the legislation by eliminating appropriations for the
Defense Commissary Agency (DeCA) and directing consolidation of all DoD
commissaries and exchanges.
FRA also supports the Janey Ensminger Act (H.R. 1742) sponsored by
Rep. Brad Miller which is similar to Senator Burr's S. 277, however the
legislation does not require DoD to reimburse VA for the cost of care
for affected veterans and family members.

DISABILITY RATING REVIEW

The Association urges aggressive committee oversight of the
Integrated Disability Evaluation System (IDES) to ensure that
disability ratings established by this system are fair and consistent.
FRA supports the modernization of the VA Schedule of Rating
Disabilities to ensure that the ratings are uniform between the
different services, between enlisted and officers, and uniform between
DoD and VA.
According to a May 2011 GAO report (GAO-11-633T) the IDES pilot
evaluation results were promising, but degree of improvement was
unknown, and timeliness for disability claim adjudication has since
worsened. The report noted that service members who went through the
IDES pilot were more satisfied than those that went through the
previous legacy system which took on average 540 days. The IDES process
adjudicated claims for active duty personnel on average of 295 days and
Reserve Component claims took 305 days on average. Although IDES is an
improvement over the legacy system is still currently falls short of
the VA's goal of adjudicating claims at 125 days or less.
The Independent Budget (IB), a recent Institute of Medicine report
(IOM), the final report (2007) of the Veterans Disability Benefit
Commission (VDBC), and the Dole -Shalala Commission all agree that the
current disability rating should be reformed to more fully take into
account non-economic loss and quality of life factors when determining
compensation.
The Association also recommends that Congress change the current
practice of rounding down veterans and survivors benefits to the next
lowest dollar. Over time, the effect of rounding down can be
substantial and our members have expressed concern about these effects.
A Senate floor amendment to the FY 2012 Military Construction and
Veterans Affairs Appropriations bill was offered as a cost-savings
measure that would change the manner in which presumptive disabilities
related to exposure to Agent Orange would be determined. Sick Vietnam-
era veterans would be required to prove a ``clausal relationship''
between Agent Orange exposure and one or more of the 15 presumptive
illnesses that the VA now recognizes. This onerous amendment was tabled
by a vote of 69-30. FRA strongly opposes this type of budget-saving
gimmick that would do serious harm to many disabled veterans and would
further delay disability rating evaluations. Current law requires that
a disease or injury be incurred concurrently with military service that
has been a reliable standard of proof. Congress through the important
oversight of these distinguished committees, much remain vigilant
regarding other attempts to restrict service connection for disability
benefits.
In 2010 Congress excluded the requirement that a veteran with PTS
must provide a specific instance that caused the problem. The change
allowed veterans, displaying PTS symptoms, to only prove that they
served in a combat zone. This change was intended to streamline the
disability rating process for veterans with PTS, however, the VA now
requires that PTS cases to be confirmed only by a department
psychiatrist or psychologist. Allowing a qualified psychiatrist or
psychologist to determine a PTS diagnosis outside the VA network would
reduce demand on scarce VA resources and personnel and speed-up the
disability rating process.
The Association urges Congress to authorize a presumption of
service-connected disability for combat veterans and veterans who are
exposed to high levels of noise and subsequently claim hearing loss or
tinnitus. Currently, veterans must prove that the hearing problem was
caused by military service.

PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)

FRA salutes Sen. Mark Udall for his efforts to get the VA to assist
the Physical Disability Board of Review (PDBR) in communicating with
more than 40,000 veterans with disability ratings of 20 percent or less
via a series of PDBR info packet mailings to them from VA. FRA also
published articles on the PDBR in its weekly electronic newsletter and
monthly magazine.
The PDBR was mandated by the FY2008 Defense Authorization Act to
reassess the accuracy and fairness of disability claims that resulted
in combined disability ratings of 20 percent or less for service
members who were separated from service due to medical conditions
rather than being medically retired. To be eligible for a PDBR review,
service members must have been medically separated between September
11, 2001, and December 31, 2009, with a combined disability rating of
20 percent or less, and found ineligible for retirement. PDBR can not
downgrade a disability for veterans seeking a review if their rating.
Since January 1, 2009 only 2,842 of the more than 77,000 eligible for
reassessment have applied. Nearly half of those reviewed have been
upgraded to 30 percent or more. FRA urges that adequate staff and
resources be provided to the PDBR to be able to process an increase in
the volume of veterans seeking a review of their ratings.

AGENT ORANGE REFORM

FRA appreciates the VA's efforts to expand presumption to ships
exposed to Agent Orange during the Vietnam era. In January 2012 the
Department added 47 ships to its list of Navy and Coast Guard vessels
that may have been exposed to the Agent Orange herbicide. The list
expanded as VA staff determined that a ship anchored, operated close to
shore or traveled on the inland waterways and was exposed to the toxic
herbicide.
While the expanded VA policy to include veterans who sailed on
``inland waterway'' ships is appreciated, FRA believes it does not go
far enough. FRA receives hundreds of calls from ``blue water sailors''
and their surviving spouses, stating that due to service on ``their
ships'' in Vietnam waters, they too suffer or have died from many of
the illnesses associated to presumed exposure to herbicides as their
``brown water'' and ``boots on the ground'' counterparts.
The Association strongly supports the ``Blue Water Navy Vietnam
Veterans Act'' (H.R. 3612, S. 1629) sponsored by Rep. Christopher
Gibson and Sen. Kirsten Gillibrand respectively and the ``Agent Orange
Equity Act'' (H.R. 812) sponsored by Ranking Member Rep. Bob Filner.
These proposals clarify that veterans who served off the coast of
Vietnam may presume exposure to herbicides in determining disability
ratings and would allow ``Blue Water'' veterans to be compensated for
their service-connected disabilities. In addition, the Association
urges the distinguished committees to schedule hearings on this
legislation.

ACCESS TO VA CARE

FRA appreciates the lifting of the ``temporary'' 2003 ban on
enrolling Priority Group 8 veterans, and was encouraged that the VA
opened enrollment for some of these beneficiaries. The ban
significantly limited access to care and more than 260,000 veterans
have been impacted by the policy, however the gradual elimination on
the ban has stopped. Our Nation made commitments to all veterans in
return for their service and limiting enrollment conveys the wrong
message to service members currently serving in Iraq and Afghanistan
and those who have served in the past.
Expanding access to VA Hospitals and Clinics for TRICARE
beneficiaries is important and FRA supports opportunities to expand
DoD/VA joint facilities demonstration projects such as combining the VA
Hospital and the Naval Hospital at Great Lakes Naval Base, Illinois,
and ensuring that military retirees are not required to pay for care in
VA facilities. All 153 VA medical centers accept TRICARE beneficiaries
except for TRICARE for Life beneficiaries.

MEDICARE SUBVENTION

FRA believes authorization of Medicare subvention for eligible
veterans would improve access for Medicare-eligible veterans and
enhance health care funding for the Department of Veterans Affairs
(VA).The Association supports the ``Medicare VA Reimbursement Act''
(H.R. 814) sponsored by House VA Committee Ranking Member Rep. Bob
Filner that would authorize Medicare reimbursements to Department of
Veterans' Affairs (VA) medical facilities for care provided to
Medicare-eligible veterans for non-service-connected conditions. Under
current law, Medicare is not authorized to reimburse VA hospitals for
care provided to Medicare eligible veterans. This results in veterans
being forced to decide between receiving medical care through the VA or
using Medicare at a non-VA facility and foregoing the personalized care
of a VA hospital. Most veterans pay into Medicare for most of their
lives, yet the law prohibits them from benefitting from this via care
at VA facilities later in life.

WOMEN VETERANS

During the past decade military roles and responsibilities have
been broadened and the number of women serving has significantly
increased. There are more than 1.8 million women veterans and today
they make up more than 15 percent of our active duty forces and 18
percent of the Reserve Component (RC). ``Traditionally women veterans
have under utilized VA health care. Women veterans who use VA are
younger than their male counter parts.'' \3\ The average female veteran
age is 48, and the male veteran average age is 61. According to IB the
number of female veteran patients doubled from FY 2000-FY 2010 during
which the population of female veteran's patients went from 150,000 to
300,000. Looking back, in 1999 more than 44 percent (of women veterans)
had enrolled in VA as compared to only 15 percent utilization by women
vets from earlier eras.
---------------------------------------------------------------------------
\3\ US General Accounting Office. VA Health Care for Women:
Progress Made in Providing Services to Women Veterans. 1999. GAO/HEHS-
99-38.
---------------------------------------------------------------------------
A recent Military Times poll indicates women veterans serving in
the combat zone have a slightly higher rate of PTS with 20 percent of
women serving in Iraq and Afghanistan displaying symptoms of PTS. A
Rand Corp. study released in 2008 indicates that 14 percent of all
combat veterans develop PTS.
FRA supports the VA efforts to create an appropriate model of care
for women veterans and the pilot program to provide child care services
for women veterans who come to the VA for treatment of their wounds and
injuries. Further, VA should enhance its sexual trauma and other gender
specific programs and continue to improve services tailored to women
veterans in all VA facilities.

SCRA ENFORCEMENT

Abuses of service members' Servicemembers Civil Relief Act (SCRA)
rights were originally exposed by the House Veterans Affairs Committee
under the leadership of Chairman Rep. Jeff Miller during a February
2011 hearing. The hearing revealed J.P. Morgan Chase Bank violated the
SCRA by improperly charging higher-than-allowed interest on 4,500
active duty service members' mortgages and foreclosing on 18 service
members' homes while they were deployed. The Association thanks the
Administration for the efforts referenced above and appreciates
Chairman Miller's leadership in scheduling oversight hearings on these
abuses.
In addition, the President's ``Blue Print for an America Built to
Last'' includes provisions intended to assist veterans and active duty
service members with their housing. In conjunction with this, financial
institutions that provide mortgages will be required to conduct a
review of every service member foreclosed upon since 2006 and provide
compensation for any who where wrongly foreclosed upon. This process is
being coordinated by the Department of Justice's Civil Rights Division.
The review will also search for deployed service members who were
wrongfully charged a mortgage interest rate in excess of six percent in
violation of the SCRA. Further the DoD's Homeowners Assistance Program
(HAP) to help certain service members who were forced to sell their
homes at a loss due to Permanent Change in Station (PCS) has been
extended to include those who received a PCS after October 1, 2010.
Currently the program is limited to PCS moves between July 1, 2006-
December 31, 2008. Certain mortgage institutions will also collectively
pay $10 million into the Department of Veterans Affairs (VA) home loan
program.

VETERAN'S EMPLOYMENT

Veterans' unemployment and programs to assist them in finding jobs
throughout our Nation is a major concern for our members. The recently
enacted Veterans Opportunity to Work to Hire Heroes Act (VOW) addresses
veterans' employment and related programs and along with other MSO/VSO
leaders FRA attended a recent meeting with White House staff for an
update on implementing employment initiatives and programs to address
these challenges. The agenda included briefings on job fairs being
scheduled throughout the country in conjunction with the White House
Business Council, updates on related initiatives and the publication of
a new 22-page Guide to Hiring Veterans that includes information on
legal and policy developments, skills transition, how to hire veterans
and appropriate interview questions, veterans benefits, resources and
contacts, plus appendixes on disability employment and VOW tax credits
for employers. The Guide is now posted on FRA's web site (www.fra.org)
and our leadership is encouraging our Branch leaders and others to
check this out and become more familiar with resources and support that
are now available to our Nation's veterans. In addition, VA Career
Fairs are being scheduled throughout the country to help veterans'
connect with potential employers and find jobs.
According to Navy Times (March 9, 2012), the unemployment rate for
veterans between the ages of 18-24 is 31 percent. FRA thanks the
distinguished leaders of these Committees, Rep. Miller and Sen. Patty
Murray, for working to advance legislation to authorize tax credits to
employers that employ veterans and disabled veterans. The Association
also appreciates the White House Jobs Bank powered by the National
Resource Directory which provides a central source for veterans seeking
job opportunities without having to visit multiple sites.
FRA supports the enforcement of The Uniformed Services Employment
and Reemployment Rights Act (USERRA) which is a federal law intended to
ensure that persons who serve or have served in the Armed Forces,
Reserves, National Guard or other ``uniformed services:'' (1) are not
disadvantaged in their civilian careers because of their service; (2)
are promptly reemployed in their civilian jobs upon their return from
duty; and (3) are not discriminated against in employment based on
past, present, or future military service.
Many assume that the federal government leads by example and were
surprised by a February 29, 2012 story in the Washington Post claiming
that the federal government could be one of the biggest offenders of
USERRA. The article stated that the Departments of Labor, VA, DoD and
the U.S. Postal Service are the biggest offenders of USERRA. FRA urges
continued attention to veteran's employment issues to ensure that
veterans returning home are not penalized for their military service.

MENTAL HEALTH

FRA is deeply concerned about the long waits for mental health care
appointments at some VA facilities across the country, and reports that
as many as 18 veterans are committing suicide daily. At the request of
Senate VA Committee Chairwoman Sen. Patty Murray, the VA surveyed
mental health providers revealing that in many areas of the country
wait times far exceeded the VA's mandated 14-day window. In addition 70
percent of providers said they did not have adequate staff or space to
meet the mental health care needs of the veterans, and 46 percent said
the lack of off-hour appointments prevented veterans from accessing
care. FRA shares Sen. Murray's concerns that with 33,000 more troops
coming home from Afghanistan next year, the demands on the VA mental
health program will only increase.
The Committee's Ranking Member, Sen. Richard Burr expressed
disappointment with the VA mental health program even though the
program funding has increased by 136 percent and staff increased by 47
percent since FY 2006. The Senator believes that 70-80 percent of PTS
patients will recover if they get adequate and timely treatment. FRA is
likewise concerned about the situation and supports the Committee's
call for an investigation and audit to determine what is causing the
long waits in the VA mental health program.
The IB expresses concern that potential changes to mental disorders
rating table being developed by the Veterans Benefit Administration
(VBA). This entirely new rating methodology for mental health disorders
would focus on work impairment rather than the current ``average
impairment of earnings capacity'' that also includes non-employment
functional impairment. The IB expresses additional concern about the
lack of transparency and lack of input from the VSO community in the
new mental health rating methodology. FRA advocates that any rating
changes should not reduce any disabled veterans benefits.

SBP/DIC

FRA supports the ``Military Surviving Spouses Equity Act'' (H.R.
178) sponsored by Rep. Joe Wilson, and Senate companion legislation
sponsored by Sen. Bill Nelson (S. 260). This legislation addresses the
reduction of SBP annuities for survivors by the amount of DIC they
receive. Current DIC payments are $1,154 and enacted legislation in
2009 partially addressed this inequity by authorizing an increase via
the Special Survivor Indemnity Allowance of only $50 per month for that
year, with increases to $100 in 2014. The above referenced legislation
would increase the allowance to $150 per month in 2014 with gradual
increases to $310 per month in 2017.
SBP and DIC payments are paid for different reasons. SBP coverage
is purchased by the retiree and intended to provide a portion of
retired pay to the survivor upon his/her death, while DIC is indemnity
compensation paid to survivors of service members who die of service
connected causes. And it's important to note that surviving spouses of
federal civilian retirees who are disabled veterans and die of service
connected causes receive DIC without offset to their federal civilian
SBP benefits.

POST 9/11 G I BILL

The Post 9/11 GI Bill is a tremendous benefit for service members
who qualify for benefits under the new program and has significantly
improved the morale of those currently serving. The Association urges
the committees to continue its oversight of the program to ensure that
the changes in the law do not delay timely processing of benefits.
FRA supports upgrading Vocational Rehabilitation and Employment
(VRE) to ensure parity with Post 9/11 GI Bill benefits. Also OIF/OEF
survivors should have the same benefits provided to dependent children.
There should be transparency and better oversight of Post 9/11 GI Bill
benefits to ensure beneficiaries are getting benefits at a reasonable
cost, and allow catastrophically disabled veterans to transfer
education benefits to their full-time care givers when the transfer did
not occur prior to the disabled veterans discharge.
The Association appreciates enactment of the ``Restoring GI Bill
Fairness Act'' (Public law 112-26) sponsored by House VA Committee
Chairman Miller, that increases the tuition cap from $17, 500 to
$27,000 for veterans attending private schools if they were enrolled in
the private school before the Post 9/11 Veterans Assistance Improvement
Act took effect. Last year's bill reforming the Post 9/11GI Bill
included a tuition cap ($17,500) for private schools. The legislation
ensures that veterans already attending private schools before the
legislation passed last year, are able to complete their education that
was promised them when the original Post 9/11 GI Bill was enacted in
2008.

NATIONAL CEMETERY ADMINISTRATION

Chairman Miller's call for to complete an audit of veteran's
gravesites to ensure all veterans and their dependents are buried in
the correct graves, is important and our members appreciate the House
Committee's ongoing investigation to ensure that these problems do not
ever arise again at veterans cemeteries.
The National Cemetery Administration (NCA) maintains over three
million gravesites at 131 national cemeteries in 39 states, the
District of Columbia, and Puerto Rico that are composed of 3.1 million
gravesites. The VA estimates that about 22.4 million veterans are alive
today. They include veterans from World War II, the Korean War, the
Vietnam War, the Gulf War, and the War on Terror, as well as peacetime
veterans. It is expected that one in every six of these veterans will
request burial in a national cemetery. Annual internments are estimated
to gradually increase to 116,000 in FY 2013 and remain at that level
until 2015.
FRA appreciates the increased burial plot allowance from $300 to
$700 effective October 1, 2011, although there is still a gap between
the original value of the benefit and the current benefit. The
Association also supports the IB recommendations to increase the plot
allowance to $1150. Further NCA's Operations and Maintenance budget
should be increased by $20 million for FY 2013 so it can meet
increasing demands created by the aging veteran population.

FULL VETERANS STATUS FOR RESERVE COMPONENT SERVICE

FRA supports full veteran status for Reservists with 20 years or
more of service, who do not otherwise qualify for same with associated
benefits under current law. The Association appreciates Sen. Mark
Pryor's leadership by introducing the ``Honor American's Guard-Reserve
Retirees'' (S. 491) bill and appreciates the leadership of Rep. Timothy
Walz's companion bill (H.R. 1025) that has passed the House by voice
vote.

COURT-ORDERED DIVISION OF VETERANS COMPENSATION

The intent of service-connected disability compensation is to
financially assist a veteran whose disability may restrict his or her
physical or mental capacity to earn a greater income from employment.
FRA believes this payment is that of the veteran and should not be a
concern in the states' Civil Courts. If a court finds the veteran must
contribute financially to the support of his or her family, let the
court set the amount allowing the veteran to choose the method of
contribution. FRA has no problem with child support payments coming
from any source. However, VA disability should be exempt from
garnishment for alimony unless the veteran chooses to make payments
from the VA compensation award. The Federal government should not be
involved in enforcing collections ordered by the states. Let the states
bear the costs of their own decisions. FRA recommends the adoption of
stronger language offsetting the provisions in 42 USC, now permitting
Federal enforcement of state court-ordered divisions of veterans'
compensation payments.

CONCURRENT RECEIPT

FRA continues its advocacy for legislation authorizing the
immediate payment of concurrent receipt of full military retired pay
and veterans' disability compensation for all disabled retirees. The
Association appreciates the progress that has been made on this issue.
There still remain disabled service members collecting Concurrent
Retirement and Disability Payments (CRDP) that are 50 percent disabled
or greater that are slowly being phased in over a ten-year period
(2004-2014). They should receive full benefits starting in 2014.
Additionally, those Chapter 61 retirees receiving CRDP and retirees
with less than 50 percent disability rating should also receive full
military retired pay and VA disability compensation without any offset.
The Association strongly supports Rep. Sanford Bishop's ``Disabled
Veterans Tax Termination Act'' (H.R. 333) and Senate Majority Leader,
Harry Reid's ``Retired Pay Restoration Act'' (S. 344). Both proposals
would authorize comprehensive concurrent receipt reform, and Rep. Gus
Bilirakis' ``Retired Pay Restoration Act'' (H.R. 303) would authorize
concurrent receipt for retirees receiving CRDP with a disability rating
of 50 percent or less.
FRA also strongly supports House Personnel Subcommittee Chairman
Joe Wilson's bill (H.R. 186), that expands concurrent receipt for
service members who were medically retired with less than 20 years of
service (Chapter 61 retirees) and would be phased-in over five years.
This proposal mirrors the Administration's proposal from the 110th
Congress. In 2008, Congress voted to expand eligibility for Combat-
Related Special Compensation (CRSC) coverage to Chapter 61 retirees and
the proposed legislation would, in effect, extend eligibility for CRDP
to all Chapter 61 retirees over five years. FRA supports Rep. Robert
Andrews bill (H.R. 1979) that among other provisions also expands
concurrent receipt. A less costly improvement in an austere budget year
would be fixing the so-called ``glitch'' for CRSC that result in
compensation declining when the VA disability rating increases -
another enhancement supported by the Association.

UNIFORMED SERVICES FORMER SPOUSES PROTECTION ACT (USFSPA)

FRA urges Congress to take a hard look at the USFSPA with a sense
of purpose to amend the language therein so that the Federal government
is required to protect its service members against State courts that
ignore provisions of the Act.
The USFSPA was enacted 29 years ago; the result of Congressional
maneuvering that denied the opposition an opportunity to express its
position in open public hearings. The last hearing, in 1999, was
conducted by the House Veterans' Affairs Committee rather than the
Armed Services Committee which has oversight authority for amending the
USFSPA.
Few provisions of the USFSPA protect the rights of the service
member, and none are enforceable by the Department of Justice or DoD.
If a State court violates the right of the service member under the
provisions of USFSPA, the Solicitor General will make no move to
reverse the error. Why? Because the Act fails to have the enforceable
language required for Justice or the Defense Department to react. The
only recourse is for the service member to appeal to the court, which
in many cases gives that court jurisdiction over the member. Another
infraction is committed by some State courts awarding a percentage of
veterans' compensation to ex-spouses, a clear violation of U. S. law;
yet, the Federal government does nothing to stop this transgression.
There are other provisions that weigh heavily in favor of former
spouses. For example, when a divorce is granted and the former spouse
is awarded a percentage of the service member's retired pay, the amount
should be based on the member's pay grade at the time of the divorce
and not at a higher grade that may be held upon retirement.
Additionally, Congress should review other provisions considered
inequitable or inconsistent with former spouses' laws affecting other
Federal employees with an eye toward amending the Act.

CONCLUSION

In closing, allow me again to express the sincere appreciation of
the Association's membership for all that you and the Members of both
of the House and Senate Veterans' Affairs Committees and your
outstanding staffs do for our Nation's veterans.
Our leadership and Legislative Team stands ready to meet with you,
other members of the Committees or their staffs at any time, to improve
benefits for all veterans who've served this great Nation.

Prepared Statement of Colonel Robert F. Norton, USA (Ret.)
MADAM CHAIR MURRAY, CHAIRMAN MILLER AND DISTINGUISHED MEMBERS OF
THE COMMITTEES, on behalf of the 375,000 members of the Military
Officers Association of America (MOAA), I am grateful for the
opportunity to present testimony on MOAA's major legislative priorities
for veterans' health care and benefits this year.
MOAA does not receive any grants or contracts from the federal
government.

VETERANS' HEALTH CARE
MOAA thanks the Committees for their leadership and steadfast
resolve to preserve and protect veterans' health care and benefits. We
are also extremely appreciative of the Administration and VA's
commitment to maintaining viable and robust funding for VA programs as
highlighted in the Fiscal Year (FY) 2013 President's Budget submission.
The advance appropriations process has once again allowed the VA to
continue health care system operations and not get caught up in the
budget battles that caused delay in earlier appropriations cycles.
We appreciate Secretary Shinseki's commitment to breaking down
bureaucratic barriers while continuing to aggressively push for
transformation of VA health and benefits systems in the interest of our
nation's veterans. MOAA is grateful for the Secretary's outreach
efforts to military and veterans' service organizations through monthly
and quarterly meetings and we look forward to a continuing
collaboration with the Department and the Committees.
Integrity, Management, Finances, and Accountability of VA-Health
Systems--While the Secretary's efforts to transform the VA have been
significant, they have not been without difficulty. The transformation
of the health system into a more agile, uniform and patient-centered
system that is fully integrated with other VA functions has not yet
been achieved.
Many of the bureaucratic issues plaguing the health care system are
also barriers to progress across the VA enterprise--issues which
inhibit uniformity, consistency of operations, increase costs and limit
achievement of a system that can respond to changing requirements.
These issues include:

Lack of systematic compliance, accountability and
oversight;
Limitations on information sharing, accuracy of
information, and communications; and,
Multiple segregated policies, programs, and services that
are duplicative, inefficient, ineffective, and add to the already
confusing institutional morass.

Transforming VA will require a major cultural shift and steadfast
long-term commitment and investment in funding health and associated
benefits systems by leaders and across government agencies.
While Congress has been generous in supporting record levels of VA
health funding in recent years, we know that budget pressures may make
it challenging to sustain these levels in future years.
We adamantly believe that any reductions or delays in funding VA
health care and benefits ultimately devalue veterans' service and erode
the Department's ability to deliver services to veterans.
As a strong proponent of the 2013 Veterans' Independent Budget,
MOAA urges the Committees to consider this resource in deliberating the
VA budget requirements.

MOAA recommendations:

Preserve funding of the health system and streamline
financial accounting systems to achieve more real-time and accurate
fiscal projections and advanced appropriation requirements.
Prevent targeting of VA programs as offsets for budget
shortfalls; oppose higher usage and drug co-payment fees for VA
services.
Enact legislation to exempt VA health care funding from
automatic Sequestration cuts should Congress fail to reach agreement on
national debt reduction.
Maintain critical infrastructure and continue capital
investments, modernization efforts, and veteran-patient-centric
transformation initiatives, including full operability of electronic
data and records to better meet the evolving and emergent needs of the
21st Century military and veteran populations.
Oppose proposals that would combine VA and the Military
Health Care System/TRICARE on the premise of creating efficiencies or
alleged cost-savings in order to address mounting pressures resulting
from the federal deficit or as a consequence of the Patient Protection
and Affordable Care Act (P.L. 111-148).
CHAMPVA-26. Pass legislation (H.R. 115, Rep Filner, D-CA)
to permit adult children of Survivors entitled to CHAMPVA to be carried
on their parent's insurance up to age 26 under specific circumstances.
All other government and private sector plans mandate that such
coverage must be made available.

Wounded, Ill and Injured Warrior Care & Support--Since 2007, every
VA-DoD authorization and appropriations bill has sought to
institutionalize a seamless and unified approach to caring and
supporting America's combat and disabled troops, veterans and their
loved ones.
After more than ten years of conflict, cultural impediments,
insufficient oversight and inconsistent implementation of policy
continue to hamper wounded warrior care and support--preventing the VA
and DoD from leveraging the full extent of possibilities for
collaboration, cooperation, and communication.
One of the most troubling issues that emerged from the Walter Reed
scandal was the finding that the Services were ``low-balling'' disabled
servicemembers' disability ratings, with the result that many
significantly disabled members were being medically separated and
transferred to the VA rather than being medically retired (which
requires a 30% or higher disability rating)--a trend that continues
today, especially for those in the National Guard and Reserves.
Congress has taken positive steps to address this situation,
including establishment of the Physical Disability Board of Review
(PDBR) to give previously separated servicemembers an opportunity to
appeal too-low disability ratings.
A jointly executed VA-DoD Integrated Disability Evaluation System
(IDES) pilot has been implemented and expanded, but experience under
IDES has shown that the fundamental goals it was to achieve - to be
more streamlined, faster, less complex, and non-adversarial - have for
the most part yet to be realized. The service member, typically without
effective assistance, must navigate a still-complex adversarial system
that is compromised by incomplete medical evaluations, overlooked
conditions, and examinations omitting diagnoses - resulting in gaps in
care, delays in decision-making, and lack of timely adjudication.
MOAA will continue to monitor the IDES. We request that the
Committees work with the Armed Services Committees to streamline the
system to ensure the fairest possible outcomes for our wounded
warriors. Further, MOAA urges the Committees to ensure any
restructuring of disability and compensation systems does not
inadvertently reduce compensation levels for disabled servicemembers-
veterans.
MOAA also urges continuing oversight for fully implementing
interoperability of VA-DoD electronic medical records (EMR) to help
reduce barriers to care and roadblocks in agency-patient relationships.
MOAA is concerned that the timelines for achieving interoperability of
EMR data keep getting pushed back. Should VA's technology budget be
reduced, the initiative would be at risk of being pushed far out into
the future.
Though the war in Iraq has officially ended and the country looks
at an exit strategy in Afghanistan, MOAA has serious concerns whether
the longer-term stability and viability of policies, programs and
services that have been put in law and executed for our wounded, ill,
injured, and disabled members and their families remain a top priority.
MOAA recently learned that the VA and Defense officials have
disbanded the Senior Oversight Committee (SOC), which was co-chaired by
both Department Secretaries and was supposed to provide high level
oversight, visibility and resolution on wounded warrior issues. The
functions of the SOC have transferred to the lower-level Joint
Executive Council (JEC).
MOAA has voiced concerns in previous years to the Committees and
the Armed Services Committees, that such a move would lower functional
responsibility to a significantly lower level within both Departments
and reduce visibility and continued progress on these issues.
At a minimum MOAA believes the Veterans Affairs and Armed Services
Committees should conduct joint hearings addressing the JEC's role,
responsibilities, and effectiveness in daily oversight, management,
collaboration between the Departments, and address issues highlighted
in reports, investigations, and studies related to wounded, ill,
injured and disabled programs.
MOAA recognizes the collaborative efforts of VA and DoD in care
coordination, particularly in their efforts to support our
catastrophically wounded, ill and injured. After a bumpy start, VA has
implemented regulations and policies to compensate caregivers and help
wounded warriors' caregivers coordinate care across government agencies
and local communities through its Caregiver Support and Federal
Recovery Coordination (FRCP) Programs.
However, the impact and experiences of wounded warriors and their
caregivers with care coordination programs continue to be all over the
map. Much of the confusion stems from having two programs; the FRCP and
the DoD Care Coordination Program (RCP) are separately managed and
operated. Rather than fulfilling the objective of jointness and
seamlessness, the various bureaucracies too often end up putting their
separate organizational interests ahead of those of wounded members and
families.
We believe that Congress should revise and expand Sec. 1611 of
Public Law 110-181 to mandate a single, joint VA-DoD program and
establish an office for managing, coordinating and assisting wounded,
ill, injured, and disabled members through recovery, rehabilitation,
and reintegration. MOAA believes care coordination should encompass
both medical and non-medical aspects to fully meet the range of needs
veterans will experience over their lifetime. Integrating VA-DoD
programs into a single Care Coordination Program will streamline
processes, eliminate redundancies, reduce expenditures, and expedite
services.

MOAA recommendations:

Institutionalize medical and transitional support
policies, programs and procedures across the VA health care and
benefits systems to ensure those most catastrophically injured, ill or
disabled transfer seamlessly from military status to veteran status
with no break in continuity of care and services in both the short-term
and over the lifetime of the veteran.
Enforce accountability of congressionally-mandated VA and
DoD wounded warrior policies and programs and establish permanent base-
line funding for policy and program execution, research, staffing, and
other resource requirements, including the integrated and legacy
disability evaluations systems and caregiver programs.
Establish a single, joint VA-DoD Care Coordination
program office, consolidating the Federal Recovery Coordination Program
(FRCP) and the military Recovery Care Coordination Program charged with
managing, coordinating, communicating, outreaching, and assisting
servicemembers, veterans and their families-caregivers through
recovery, rehabilitation, and reintegration.

Psychological-Cognitive Health and Suicide Prevention--MOAA thanks
the Committees for championing initiatives, policies and funding that
address post-traumatic stress disorder (PTSD) and traumatic brain
injuries and your commitment to improving the psychological health and
well-being of our veterans.
Additionally, we commend the VA for its staunch commitment to
enhancing mental and behavioral health programs by working with the DoD
and other government and non-government entities to address veterans'
physical and psychological needs as a result of deployment-combat-
related stressors and trauma injuries and wounds.
However, a decade of war has placed unprecedented demands and
stressors on our warriors and families that will leave scars and
unintended consequences for generations to come.
Our Association is deeply concerned about the exponentially growing
need to address mental health, behavioral and cognitive conditions in
light of the rising suicides, alcohol and substance use playing out
across the veteran and military communities.
Veterans and their families tell us that they have seen much
progress in improving policies and programs at the national level.
However, they don't always see these policies and program implemented
and interpreted consistently across all VA medical facilities.
The real tragedy for some veterans who really need help is that
they may give up, or lose hope or trust in the system.
We hear frequent comments like:

``I don't trust the VA. I am constantly fighting with people in the
VA medical center every step of the way to get help. It's like the VA
is fighting with itself--why can't they just do what is right?'' (PTSD
Veteran Spouse-Caregiver)
``I'm frustrated because my providers seldom ask me how I'm doing.
They talk to my wife as though I'm not in the room . . . when they
don't talk to me it makes me feel like they don't care about me.''
(Amputee-TBI Veteran)
``The typical VA response to care is to give the patient a machine
or medication.''(PTSD-TBI Veteran Spouse-Caregiver)

VA acknowledges mental health and staffing shortfalls. MOAA urges
Congress to continue to appropriate necessary funds which would allow
continuation of the VA's expansion efforts of its mental health
capacity to improve access, timeliness, quality, delivery, and follow-
on care and information.
Expansion efforts and funds should include marketing and outreach
to encourage enrollment of eligible veterans, with special emphasis on
Guard-Reserve members, rural veterans and high risk populations.
We also encourage the Committees' support in establishing a single
VA-DoD strategy and a joint Suicide Prevention Office that reports
directly to the Department Secretaries.

MOAA recommendations:

Ensure sufficient funding and access to psychological,
trauma and cognitive treatment, including evidenced-based mental/
behavioral health, marital/family counseling services, and non-
traditional and/or recreational therapies.
Establish a joint VA-DoD strategy and joint program
office for more uniform delivery and synchronization of critical care
and services for reducing servicemember-veteran suicides.

Women Veterans--Today's force has changed significantly over the
past decade and women are helping to change the face of the military as
they join the service at higher rates than at any other time in
history. As such, these women are also changing the face of the VA.
Over 1.8 million women veterans are enrolled in VA care and that number
is expected to grow by 30 percent over the next five years.
In FY2009 and 2010, PTSD, hypertension, and depression were among
the top three diagnoses for women treated in VA facilities--and one in
five women reported they had been a victim of military sexual trauma.
MOAA believes additional legislative authority is needed to help VA
more effectively and efficiently deliver services and care, not only to
women veterans, but also to the growing population of veterans who are
married and/or have family responsibilities.

MOAA recommends the Committees continue to oversee issues affecting
women veterans by

Fully implementing P.L. 111-163, Caregivers and Veterans
Omnibus Health Services Act of 2010 that provide equitable medical care
and improved support services for female veterans including newborn
care.
Reconciling discrepancies related to reporting and
supporting women impacted by military sexual trauma-assault in VA and
DoD systems.
VETERANS BENEFITS
Disability Claims Management: Quality, Training, and Technology
Upgrades

MOAA continues to support a comprehensive, integrated strategy for
improving the claims-management system with primary emphasis on quality
decisions at the initial stage of the process.
The Administration's budget request projects the VA will receive
about 1.25 million claims for disability for the next fiscal year.
MOAA believes that the VA is making progress in attacking the
claims backlog. Further progress won't come easily as the number and
complexity of claims continues to rise after more than 10 years of
conflict in Afghanistan and Iraq. Moreover, recently added diseases
presumed caused by exposure to Agent Orange among Vietnam War veterans
will further drive up the number of claims. Consistent, quality
decisions on initial claims remain a crucial challenge for the VA.
An over-arching concern is that the quality of initial claims
decision is a disappointing 84% system-wide.

MOAA recommends the Committees sustain vigorous oversight of VA's
plans to modernize the claims system:

Ensure the VA's approach is grounded in ``deciding claims
right the first time,'' not just meeting numerical quotas.
Oversee the new case management model for claims
processing and monitor other field-tested initiatives directed at
improving quality and accuracy.
Ensure that the Veterans Benefits Management System
(VBMS) is provided sufficient and timely resources to develop into a
comprehensive, paperless, and rules-based platform.
Ensure that VA provides standardized training to
employees, and tests all employees, including coaches and managers, on
the skills, competencies, and knowledge required to do their jobs.
Monitor employee performance standards and work-credit
system, and support adequate incentives for quality and accuracy, not
just production quotas.

Veteran Transition, Readjustment and Employment

MOAA is grateful for the Committees' bi-partisan collaboration on
the ``VOW to Hire Heroes Act'' (P.L. 112-56), which the Association
strongly supported.
When fully implemented the ``VOW Act'' can help address rising
unemployment in the veteran population. The Veterans Retraining
Assistance Program (VRAP) provision in the VOW Act offers the potential
to address chronic unemployment in older (age 35-64) veterans by
opening access to Montgomery GI Bill benefits for up to 100,000 of
these veterans over the next few years.
Re-tooling the military transition assistance program (TAP) is
another core feature of ``VOW''. Generations of separating and retiring
service men and women have endured `death by PowerPoint' presentations
under TAP. A concerted effort by all stakeholders is needed to ensure a
newly designed program will be useful to military men and women when
they complete their service.

MOAA recommendations:

Conduct oversight hearings soon after the implementation
of the Veterans Retraining Assistance Program (VRAP) program in July,
2012 to ensure that outreach, recruiting and MGIB enrollments are on
track.
Grandfather VRAP participants whose licensing, training,
or associate's degree program - leading to employment - won't be
completed in the compressed timeframe authorized.
Assess the TAP redesign at a joint hearing with the Armed
Services Committees to ensure it meets the needs of separating service
men and women.
Extend the 31 December 2012 sunset date for the employer
tax incentives in the Act to ensure sufficient information on the
effectiveness of these incentives in hiring veterans and disabled
veterans.

GI BILL PROGRAMS
Oversight, Outcomes, Transparency

The Post-9/11 GI Bill authorized under Chapter 33 of 38 U.S. Code
is the most generous educational assistance program since the great
World War II GI Bill.
The VA has made over 680,000 payments to colleges, universities and
training programs on behalf of veterans, active duty service men and
women and dependents who have received transferred benefits.
However, a year-long Senate investigation detailed troubling trends
in GI Bill outcomes and oversight:

33% of new GI Bill payments went to For Profit colleges,
which trained only 25% of enrolled veterans in 2009 - 2010, the first
year under the new program
8 of the top 10 recipients of Chapter 33 funds were For
Profit colleges
The government spends more than twice as much per veteran
at For-Profit colleges compared to public not-for-profit colleges
Recruiting expenditures at certain For Profit schools
greatly exceed student services for veterans, which in some cases
essentially do not exist
The Attorney General and multiple states have brought
suit against certain For Profit schools for misrepresentation,
recruiting abuses, inflated job placements and other deceptive
practices.

MOAA recommends the Committees:

Direct the Department of Veterans Affairs to work with
the Department of Education to create an online ``dashboard'' so that
prospective GI Bill users can more easily compare costs, credit and
transfer policies, outcomes and graduation rates and related consumer-
friendly information about colleges in all sectors.
Further expand the VA's on-campus VetSuccess program
beyond the 80 campus, $8.8 million program requested in the
Administration's budget request for FY 2013.
Amend the educational counseling provisions in Chapter
36, 38 U.S. Code to mandate such counseling via appropriate means,
including modern technologies, and permit veterans to ``opt out''. It
will be necessary to raise the $6 million cap in the counseling
provision to meet the enormous demand of new GI Bill enrollments.
Establish a centralized complaint reporting and
resolution process for veterans using GI Bill entitlement.
Require that all programs receiving funding under the GI
Bill be ``Title IV'' eligible; in other words, all post-secondary
programs would have to meet Dept. of Education standards for
accreditation and other requirements.
Support legislation to account for all Federal
educational assistance funding under the Title IV category. Changing
the so-called ``90/10'' rule would compel all colleges and universities
to demonstrate that their product is valuable enough to attract private
sector students to pay for the education offered.
Trademark the term ``GI Bill'' so that the Dept. of the
VA can control the use of that term for GI Bill-related websites and
deter other promotional media that present themselves as quasi-
governmental sources of information on the GI Bill.

Towards A 21st Century GI Bill Architecture

MOAA continues to recommend the Committees work toward an
integrated platform for GI Bill programs.
A streamlined architecture for the GI Bill is needed to support
recruitment, reenlistment and readjustment outcomes for our nation's
Armed Forces in the 21st century. Veterans, lawmakers, military
recruiters, college administrators, non-degree trainers and the general
public need a simple, transparent and clear understanding of the
service that is required for earning entitlement to the GI Bill.
To maintain multiple, overlapping GI Bill program authorities
causes confusion, increases administrative cost, and weakens the
potential of these programs to efficiently support intended outcomes.

MOAA recommendations:

Integrate all active duty and reserve duty programs in a
single chapter in Title 38. Benefit eligibility should be based on two
metrics: the length and type of military duty performed.
Repeal Chapter 30, the Montgomery GI Bill - with
appropriate grandfathering of remaining participants--and amend
language in the preamble to Chapter 33 to indicate that the program is
intended to support recruitment, reenlistment and readjustment outcomes
for the Armed Forces.
Repeal Chapter 1607, 10 USC. MGIB benefits for
operational active duty service performed by National Guard and Reserve
servicemembers after 11 September 2001 were superseded by the P911 GI
Bill.
Consolidate the Selected Reserve GI Bill with the new GI
Bill. Benefits authorized under Chapter 1606 of Title 10 USC were last
raised (except for annual COLAs) in 1999. The ratio between Chap. 1606
benefits and the MGIB benefits has plunged to 23.6% against a
historical ratio of 47-48%.

Vocational Rehabilitation and Employment (VR&E)

MOAA is grateful for the provisions in the ``VOW to Hire Heroes
Act'' that improve VR&E and extend automatic eligibility through 2014
for active duty servicemembers referred by DoD with severe illnesses or
injuries. The provision enables VR&E to provide rehabilitative services
early in the disability evaluation process. The law also expands the
Special Employer Incentive program to employers who hire veterans
participating in VR&E even in cases where the veteran has not completed
training. We also appreciate the VR&E upgrades in P.L. 111-377 that
raised the subsistence allowance under the program to the housing
allowance available under the P911 GI Bill.

MOAA recommends further extending the delimiting period for VR&E
from 12 to 15 years after service and examining the reach and
effectiveness and VR&E outreach programs.

SURVIVORS' and DEPENDENTS' BENEFITS
Survivors' Educational Benefits. The Gunnery Sergeant John D. Fry
Scholarship program (P.L. 111-32) established Post-9/11 GI Bill benefit
entitlement for the children of Fallen members of our Armed Forces who
died in the line of duty after September 10, 2001.
Unfortunately, surviving spouses are ineligible for ``Fry
Scholarships.'' At the time the legislation was being considered, no
one stopped to think that the surviving spouses themselves would need a
robust benefit in order to attain the skills and education to provide
for their children and prepare them for college.
Survivors and Dependents Educational Assistance (DEA) program
benefits under Chapter 35, 38 USC simply do not afford surviving
spouses a realistic opportunity to raise young (in most cases) children
and go to school concurrently without shouldering substantial financial
debt while dealing with substantial life challenges.
For surviving spouses of the Iraq and Afghanistan conflicts, DEA
translates to ``college is unaffordable.'' For full-time college
enrollment, a Survivor receives only $936 per month, no cost-of-living
(housing) allowance, and no book stipend.
Today, the total potential DEA benefit is $43,065 compared to
$53,028 under the MGIB. But, the Fry Scholarships pay the full cost of
enrollment at any public college or university, a housing allowance
based on a Sergeant's (E-5) ``with dependents'' housing rate for the
zipcode of the college, and up to $1000 annually for books.

MOAA recommends the Committees support S. 1952 (Sen. Merkley, D-OR)
to authorize P911 GI Bill benefits (Chapter 33, 38 USC) for Survivor
Spouses of members who died in the line-of-duty after 10 September 2011
in lieu of Survivors and Dependents Educational Assistance (DEA)
benefits. As an interim measure, if resources are not available for
P911 GI Bill-level benefits, authorize DEA participants a housing
allowance and book stipend.

Dependency and Indemnity Compensation (DIC) Equity. DIC, which is
paid to survivors of those who paid the ultimate sacrifice, is set at a
flat rate for all. MOAA believes DIC should be set at 55% of the
compensation paid to 100% service-disabled veterans and placed on an
equal footing with survivors of disabled civil service employees.
Survivors of federal workers have their compensation set at 55% of
their Disabled Retirees' Compensation. The November 2009 GAO report on
Military & Veterans' Benefits (GAO 10-62) found that ``DIC payments are
almost always less than workers' compensation payments for survivors of
federal employees who die as a result of job-related injuries.'' MOAA
supports establishing the annual DIC rate at 55% of the compensation
rate for a 100% service-connected veteran.
Caregivers of Catastrophically Disabled Veterans. Catastrophically
disabled veterans, whose spouses serve as primary care givers, receive
additional allowances due to the severity of their service-connected
multiple disabilities. Spouses who are full-time caregivers are
precluded from earning a retirement or Social Security benefits in
their own right. When the veteran dies, the widow(er)'s income is
reduced to the same DIC rate that other surviving spouses of veterans
receive when the death was service connected. The percentage of
replacement income can be as little as 15%. The income replacement of
other federal survivor benefit plans is close to 50% of the benefit
upon which they are based. MOAA recommends the Committees increase the
income replacement rate for widow(er) s of catastrophically disabled
veterans.
Retain DIC on Remarriage at Age 55. Legislation was enacted in 2003
to allow eligible military survivors to retain DIC upon remarriage
after age 57. At the time, Congressional staff advised that age-57 was
selected only because there were insufficient funds to authorize age-55
retention of DIC upon remarriage. MOAA recommends authorization of age-
55 for retention of DIC upon remarriage in order to bring this benefit
in line with rules for the military SBP program and all other federal
survivor benefit programs.
CHAMPVA Dental. MOAA supports allowing Survivors qualified for
CHAMPVA health care to be allowed to enroll in a proposed CHAMPVA
Dental program. The proposal, which is modeled on the TRICARE Retiree
Dental Plan, would have no PAYGO offset requirement since it would be
fully funded by enrollees' premiums.

NATIONAL GUARD AND RESERVE VETERANS
National Guard and Reserve servicemembers who have served a
qualifying period of active duty are unique in the veterans' community,
as many continue to serve in uniform. These `dual-status' veterans face
special challenges associated with their status including rising
unemployment rates.
Since September 11, 2001, more than 842,000 Guard and Reserve
members have served on operational active duty (as of 21 February
2012), and approximately 300,000 or more have served on multiple tours.
The FY 2012 National Defense Authorization Act further expanded
DoD's ``operational reserve'' policy by authorizing non-emergency
access to the Guard and Reserve. The NDAA contains a provision that
permits the Service Secretaries to activate up to 60,000 reservists for
up to one year to perform pre-planned, budgeted missions that will no
longer require a national emergency declaration by the Commander in
Chief.
Routine Federal call-ups for non-emergency missions are
unprecedented in our nation's history. With this sea-change in reliance
on the Reserves, it will be critical for the Committees, working with
the Armed Services Committees, to ensure that this expansion of policy
does not adversely affect Guard and Reserve members, their families and
employers.

MOAA recommends the Committees:

Closely monitor the Office of Special Counsel's pilot
project regarding enforcement of reemployment rights protections for
Federal agency workers under the Uniformed Services Employment and
Reemployment Rights Act (USERRA).
Support legislation to strengthen the USERRA as
recommended by the Department of Justice in a forwarding letter to
Congress from Vice President Biden (20 September 2011).
Consider additional USERRA protections such as: requiring
states to waive their sovereign immunity in cases requiring the
enforcement of the statute; making workplace arbitration agreements
unenforceable in disputes arising under USERRA; authorizing punitive
damages against egregious violations of the statute and providing for a
jury trial in such cases; and, requiring (under current law,
``authorizing'') a court to use equitable relief, including injunctions
and restraining orders when appropriate, for USERRA violations.
Assess the ongoing work of the GAO, tasked by the House
Committee on Veterans Affairs, to study financial institutions'
compliance with the Servicemembers Civil Relief Act (SCRA) prohibitions
against mortgage foreclosure during periods of military service.
Consider adopting additional improvements to the SCRA:
imposition of civil fines for violations of the law; criminal penalties
in egregious cases of SCRA violation; and recovery of reasonable
attorneys' fees by servicemembers from SCRA violators.
Working with Armed Services Committees, support
authorization for employers to pay TRICARE Reserve Select premiums as
an incentive to hire and retain Guard and Reserve members.
Ensure that the modified Transition Assistance Program
(TAP) mandated in the ``VOW to Hire Heroes Act'' is tailored to meet
the needs of de-activating Guard / Reserve members including local /
regional adaptation.
Support collaborative efforts with States and others that
result in civilian credentialing / licensure for military skill
training in designated employment fields

Recognition of Career National Guard and Reserve Veterans

National Guard and Reserve members who complete a full Guard or
Reserve career and are receiving or entitled to a military pension,
government health care and other benefits are not ``veterans of the
Armed Forces of the United States,'' unless they have served a
qualifying period of active duty.
This strange situation exists because the definitions of
``veteran'' in Title 38 limit the term to service men and women who
have served on active duty under Title 10 orders.
For example, National Guard members who served on military duty
orders (other than Title 10) at Ground Zero in New York City on Sept.
11, 2001, the Gulf Coast following Hurricane Katrina, the BP oil spill
catastrophe off the Gulf Coast, or conducted security operations on our
Southwest border, and subsequently retired from the National Guard are
not deemed to be veterans under the law unless at some point they had
served on Title 10 orders.
Due to military funding and accounting protocols, many reservists
performed operational missions during their careers but the orders
purposely were issued under other than Title 10 to avoid crediting the
service as de facto ``active military service.''
Ironically, these career reservists have earned specified veterans'
benefits, but they can't claim that they are veterans.
MOAA is grateful to the House Veterans Affairs Committee and the
full House for twice passing enabling legislation. H.R. 1025 (Rep.
Walz, D-MN) passed the House on 11 October 2011 and has been referred
to the Senate. The bill would establish that National Guard and Reserve
members who are entitled to a non-regular retirement under Chapter 1223
of 10 USC and who were never called to active federal service during
their careers are veterans of the Armed Forces. The legislation would
prohibit the award of any new or unearned veterans' benefits.

MOAA recommends the Senate Committee on Veterans Affairs approve
the ``Honor America's Guard and Reserve Retirees Act'', S. 491 (Sen.
Pryor, D-AR) to authorize that career members of the National Guard and
Reserve who were never called up to Federal active duty and are
entitled to or receiving military retired pay are veterans of the Armed
Forces.

(Former) Clark Air Force Base, Philippines, Military Cemetery

When U.S. forces hastily departed the Philippines in 1991, no
provision was made for the long-term maintenance and upkeep of the
Clark Air Force Base (AFB) Military Cemetery. The cemetery contains the
remains of 8600 American service members, veterans and family members
from the Spanish American War through the present conflicts. The U.S.
Air Force maintained the cemetery from 1951 until 1991.
Clark AFB Military Cemetery remains in operation. Last year, an
Iraq conflict serviceman and a Vietnam War Silver Star recipient were
interred in the cemetery.
Thanks to the extraordinary efforts of a local VFW Chapter and
private support from the ``Clark Veterans Cemetery Restoration
Association'', the Cemetery has not been allowed to slip into complete
disrepair.
But Clark AFB Military Cemetery has been abandoned by the United
States government. We have dishonored the memory of the fallen that lie
buried there.

MOAA recommends the Committees approve bi-partisan legislation
(H.R. 4168, Rep. Guinta, R-NH) to place the Clark AFB Military Cemetery
under the control of the American Battle Monuments Commission.

Conclusion

MOAA is grateful to the Members of the Committees for your
leadership in supporting our veterans and their families who have
``borne the battle'' in defense of the nation.

Executive Summary
Selected Recommendations

VETERANS' HEALTH CARE

Integrity, Management, Finances, and Accountability of VA-Health
Systems

Fully fund the VA health system and streamline financial
accounting systems to achieve more real-time and accurate fiscal
projections and advanced appropriation requirements.
Prevent targeting of VA programs as offsets for budget
shortfalls; oppose higher usage and drug co-payment fees for VA
services.
Exempt VA health care funding from automatic
Sequestration cuts should Congress fail to reach agreement on national
debt reduction (H.R. 3895, Rep. Jeff Miller, R-FL).
Maintain critical infrastructure and continue capital
investments, modernization efforts, and veteran-patient-centric
transformation initiatives, including full interoperability of
electronic data and records to better meet the evolving and emergent
needs of the 21st Century military and veteran populations.
Oppose proposals that would combine VA and the Military
Health Care System/TRICARE on the premise of creating efficiencies or
alleged cost-savings in order to address mounting pressures resulting
from the federal deficit or as a consequence of the Patient Protection
and Affordable Care Act (P.L. 111-148).
CHAMPVA-26. Pass legislation (H.R. 115, Rep Filner, D-CA)
to permit adult children of Survivors entitled to CHAMPVA to be carried
on their parent's insurance up to age 26 under specific circumstances.
All other government and private sector plans mandate that such
coverage must be made available.

Wounded, Ill and Injured Warrior Care & Support

Institutionalize medical and transitional support
policies, programs and procedures across the VA health care and
benefits systems to ensure those most catastrophically injured, ill or
disabled transfer seamlessly from military status to veteran status
with no break in continuity of care and services in both the short-term
and over the lifetime of the veteran.
Enforce accountability of congressionally-mandated VA
and/or joint Departments of VA and Defense (DoD) wounded warrior
policies and programs and establish permanent base-line funding for
policy and program execution, research, staffing, and other resource
requirements, including the integrated and legacy disability evaluation
systems and caregiver programs.
Establish a single, joint VA-DoD Care Coordination
program office, consolidating the Federal Recovery Coordination Program
(FRCP) and the military Recovery Care Coordination Program charged with
managing, coordinating, communicating, outreaching, and assisting
servicemembers, veterans and their families-caregivers through
recovery, rehabilitation, and reintegration.

Psychological-Cognitive Health and Suicide Prevention

Ensure sufficient funding and access to psychological,
trauma and cognitive treatment, including evidence-based mental/
behavioral health, marital/family counseling services, and non-
traditional and/or recreational therapies.
Establish a joint VA-DoD strategy and joint program
office for more uniform delivery and synchronization of critical care
and services for reducing servicemember-veteran suicides.

Women Veterans

Fully implement P.L. 111-163, Caregivers and Veterans
Omnibus Health Services Act of 2010 that provides equitable medical
care and improved support services for female veterans including
newborn care.
Reconcile discrepancies in reporting military sexual
trauma / assault and ensure support for women who have been victims of
such attacks.

VETERANS' BENEFITS

Claims Backlog

Ensure the VA's claims management system is grounded in
``deciding claims right the first time,'' not just meeting numerical
quotas.
Oversee the new case management model for claims
processing and monitor other field-tested initiatives directed at
improving quality and accuracy.
Ensure that the Veterans Benefits Management System
(VBMS) is provided sufficient and timely resources to develop into a
comprehensive, paperless, and rules-based platform.
Ensure that VA provides standardized training to
employees, and tests all employees, including coaches and managers, on
the skills, competencies, and knowledge required to do their jobs.
Monitor employee performance standards and work-credit
system, and support adequate incentives for quality and accuracy, not
just production quotas.

Veteran Transition, Readjustment and Employment

Conduct oversight hearings soon after the implementation
of the Veterans Retraining Assistance Program (VRAP) program in July,
2012 to ensure that outreach, recruiting and MGIB enrollments are on
track.
Grandfather VRAP participants whose licensing, training,
or associate's degree program - leading to employment - won't be
completed in the compressed timeframe authorized.
Assess the TAP redesign mandated in the VOW to Hire
Heroes Act at a joint hearing with the Armed Services Committees to
ensure it meets the needs of separating service men and women.
Extend the 31 December 2012 sunset date for the employer
tax incentives in the VOW Act to ensure sufficient information on the
effectiveness of these incentives in hiring veterans and disabled
veterans.

GI BILL PROGRAMS

Oversight, Outcomes, Transparency

Direct the Department of Veterans Affairs to work with
the Department of Education to create an online ``dashboard'' so that
prospective GI Bill users can more easily compare costs, credit and
transfer policies, outcomes and graduation rates and related consumer-
friendly information about colleges in all sectors.
Further expand the VA's on-campus VetSuccess program
beyond the 80 campus, $8.8 million program requested in the
Administration's budget request for FY 2013.
Amend the educational counseling provisions in Chapter
36, 38 U.S. Code to mandate such counseling via appropriate means,
including modern technologies, and permit veterans to ``opt out''.
Raise the $6 million cap in the counseling provision to meet the
enormous demand of new GI Bill enrollments.
Establish a centralized complaint reporting and
resolution process for veterans using GI Bill entitlement.
Require that all programs receiving funding under the GI
Bill be ``Title IV'' eligible; in other words, all post-secondary
academic programs should meet Dept. of Education standards for
accreditation and other requirements.
Support legislation to account for all Federal
educational assistance funding under the Title IV category. Changing
the so-called ``90/10'' rule would compel all colleges and universities
to demonstrate that their product is valuable enough to attract private
sector students to pay for the education offered.
Trademark the term ``GI Bill'' so that the Dept. of the
VA can control the use of that term for GI Bill-related websites and
deter other promotional media that present themselves as quasi-
governmental sources of information on the GI Bill.

Towards A 21st Century GI Bill Architecture

Integrate all active duty and reserve duty programs in a
single chapter in Title 38. Benefit eligibility should be based on two
metrics: the length and type of military duty performed.
Repeal Chapter 30, the Montgomery GI Bill - with
appropriate grandfathering of remaining participants - and amend
language in the preamble to Chapter 33 to indicate that the program is
intended to support recruitment, reenlistment and readjustment outcomes
for the Armed Forces.
Repeal Chapter 1607, 10 USC. MGIB benefits for
operational active duty service performed by National Guard and Reserve
servicemembers after 11 September 2001 were superseded by the P911 GI
Bill.
Consolidate the Selected Reserve GI Bill with the new GI
Bill. Benefits authorized under Chapter 1606 of Title 10 USC were last
raised (except for annual COLAs) in 1999. The ratio between Chap. 1606
benefits and the MGIB benefits has plunged to 23.6% against a
historical ratio of 47-48%.

Vocational Rehabilitation and Employment (VR&E) - MOAA recommends
further extending the delimiting period for VR&E from 12 to 15 years
after service and examining the effectiveness of VR&E outreach
programs.

SURVIVORS' and DEPENDENTS' BENEFITS
Survivors' Educational Benefits - Support S. 1952 (Sen. Merkley, D-
OR) to authorize P911 GI Bill benefits (Chapter 33, 38 USC) for
survivor spouses of members who died in the line-of-duty after 10
September 2011 in lieu of Survivors and Dependents Educational
Assistance (DEA) benefits. As an interim measure, if resources are not
available for P911 GI Bill-level benefits, authorize DEA participants a
housing allowance and book stipend.
Dependency and Indemnity Compensation (DIC) Equity - MOAA supports
establishing the annual DIC rate at 55% of the compensation rate for a
100% service-connected veteran.
Caregivers of Catastrophically Disabled Veterans - MOAA recommends
the Committees increase the income replacement rate for widow(er)s of
catastrophically disabled veterans.
Retain DIC on Remarriage at Age 55 - MOAA recommends authorization
of age-55 for retention of DIC upon remarriage in order to bring this
benefit in line with rules for the military SBP program and all other
federal survivor benefit programs.
CHAMPVA Dental - MOAA supports allowing Survivors qualified for
CHAMPVA health care to be allowed to enroll in a proposed CHAMPVA
Dental program.

NATIONAL GUARD AND RESERVE VETERANS
Closely monitor the Office of Special Counsel's pilot
project regarding enforcement of reemployment rights protections for
Federal agency workers under the Uniformed Services Employment and
Reemployment Rights Act (USERRA).
Support legislation to strengthen the USERRA as
recommended by the Department of Justice in a forwarding letter to
Congress from Vice President Biden (20 September 2011).
Consider additional USERRA protections such as: requiring
states to waive their sovereign immunity in cases requiring the
enforcement of the statute; making workplace arbitration agreements
unenforceable in disputes arising under USERRA; authorizing punitive
damages against egregious violations of the statute and providing for a
jury trial in such cases; and, requiring (under current law,
``authorizing'') a court to use equitable relief, including injunctions
and restraining orders when appropriate, for USERRA violations.
Assess the ongoing work of the GAO, tasked by the House
Committee on Veterans Affairs, to study financial institutions'
compliance with the Servicemembers Civil Relief Act (SCRA) prohibitions
against mortgage foreclosure during periods of military service.
Consider adopting additional improvements to the SCRA:
imposition of civil fines for violations of the law; criminal penalties
in egregious cases of SCRA violation; and recovery of reasonable
attorneys' fees by servicemembers from SCRA violators.
Working with Armed Services Committees, support
authorization for employers to pay TRICARE Reserve Select premiums--a
lower-cost alternative to employer-provided coverage--as an incentive
to hire and retain Guard and Reserve members.
Ensure that the modified Transition Assistance Program
(TAP) mandated in the ``VOW to Hire Heroes Act'' is tailored to meet
the needs of de-activating Guard / Reserve members including local /
regional adaptation.
Support collaborative efforts with States and others that
result in civilian credentialing / licensure for military skill
training in designated employment fields.

Recognition of Career National Guard and Reserve Veterans - MOAA
recommends the Senate Committee on Veterans Affairs approve the ``Honor
America's Guard and Reserve Retirees Act'', S. 491 (Sen. Pryor, D-AR)
to authorize that career members of the National Guard and Reserve who
were never called up to Federal active duty and are entitled to or
receiving military retired pay are veterans of the Armed Forces.
(Former) Clark Air Force Base, Philippines, Military Cemetery -
MOAA supports legislation (H.R. 4168, Rep. Guinta, R-NH) to place the
Clark AFB Military Cemetery under the control of the American Battle
Monuments Commission.

Prepared Statement of Jamie H. Tomek

Madam Chair Murray, Chairman Miller, Ranking Members Burr and
Filner, and Members of both the Senate and House Committees on Veterans
Affairs, I am pleased to be here today to testify on behalf of Gold
Star Wives on legislative issues pertinent to our nation's military
widows and widowers. My name is Jamie Tomek, Chair of the Gold Star
Wives' Government Relations Committee. I became the widow of First
Lieutenant Glen D. Tomek, when he was killed in action April of 1969 in
Vietnam. I am proud to represent Gold Star Wives here today, but would
prefer to have not lost my husband 43 years ago . . . as is the case of
every one of us here today.
Gold Star Wives of America (GSW), founded in 1945, is a
Congressionally Chartered organization of surviving spouses of military
members who died while serving on active duty or died from a service-
connected cause. GSW is a volunteer organization.
We provide information about survivor benefits and assist survivors
experiencing difficulties accessing their benefits. We strive to raise
the awareness of Congress, the public, the military and veterans'
communities and GSW about the many inequities existing in our survivor
programs and benefits. Many of our members volunteer in Department of
Veterans Affairs (VA) hospitals and clinics and visit service members
hospitalized at Department of Defense (DoD) medical treatment
facilities. In 2010, GSW members reported volunteer hours and
contributions valued at more than $200,000.
GSW's current members are the surviving spouses of military members
who served during World War II, the Korean War, the Vietnam War, the
Gulf War, the conflicts in both Iraq and Afghanistan, and every period
in between. For this written testimony, we will refer to all of members
as surviving spouses.
Because the survivor population is a separate category of
beneficiaries, we strongly encourage and suggest the use of the term
survivor when speaking about veterans and their families or military
personnel and their families.
We would like to thank Congressman Filner for including surviving
spouses in the Mortgage Amendment to the Servicemembers Civil Relief
Act; Congressman Bilirakis and his staff for intervening with the VA to
ensure that DEA benefits were paid by direct deposit; and Senator
Begich and Congressman Dan Young for legislation that would provide
space available travel on military aircraft for many of our members.
We would also like to thank Senator Bill Nelson, Senator James
Inhofe, and Representative Joe Wilson for their continued support of
bills to eliminate the Dependency and Indemnity Compensation DIC offset
to the Survivor Benefit Plan (SBP).
GSW's most important issues are as follows:

Office of Survivors Assistance

The Office of Survivors Assistance was Congressionally mandated by
Public Law 110-389, Title II Section 222 (Veterans' Benefits
Improvement Act of 2008) to serve as a resource regarding all benefits
and services furnished by VA to Survivors and dependents of deceased
veterans and survivors and dependents of deceased members of the Armed
Forces. OSA serves as the primary advisor to the Secretary of Veterans
Affairs on all matters related to policies, programs, legislative
issues, and other initiatives affecting veterans' survivors and
dependents.
OSA honors the commitment made to its constituents for access to
applicable benefits and services under the law. OSA also serves as an
advocate for their special needs in the policy and programmatic
decisions of the VA.
Since FY 2011, the office has been staffed by a Director and a
Program Analyst. Currently, there is an active hiring action for a
Staff Assistant to complement the staffing levels. GSW urges you to
encourage VA to fully staff the Office of Survivors Assistance to
ensure the purpose and intent of the Public Law is fulfilled.
We have established and maintained excellent contacts within the
various organizations in VA to assist us with cases that involve
extenuating circumstances. VA, in particular the Veterans Benefit
Administration, has made and we are confident they will continue to
improve processing times for claims. Perhaps the inclusion of survivor
stakeholders should be considered as we can provide valuable input that
could be included in the improvement process and we offer our
assistance and look forward to collaborative efforts.

Training on Survivor Issues

GSW is often contacted by surviving spouses who have called the
national VA phone number for information. In many cases, they were
given incorrect or inadequate information about the benefits to which
they were entitled. GSW suggests that the VA provide training on
survivor benefits and issues for those who provide information on
benefits. Such training would ensure that accurate, consistent, and
timely information is provided to survivors.

Increase Dependency and Indemnity Compensation (DIC)

The Servicemen's and Veterans Survivor Benefit Act of 1956
established DIC (P. L. No. 84-881). The purpose of DIC is an indemnity
payable to survivors when a military member dies of a service-connected
cause.
GSW seeks parity with other Federal survivor programs when
calculating DIC. DIC is currently paid to widows at 41% of the VA
Disability Compensation received by the veteran with a 100% service-
connected disability. The monthly flat-rate DIC is $1195. Other Federal
survivor programs provide 55% of the retirement pay of the Federal
employee to the widow. Bringing DIC's computation to 55% would provide
parity with other Federal survivor programs and would increase DIC by
approximately $300 per month.
The continued economic stresses our country is now enduring places
surviving spouses one step away from a car that stops running or an
unpaid house payment or utility bill. In statistics received from OSA
44% of surviving spouses reported income below $20,000. Many surviving
spouses are in financial distress, unable to pay for food, medical co-
pays and utilities. Equalizing the computation of DIC would offer some
relief from worry and would improve financial independence and
confidence for GSW members. An increase in DIC should not subject the
Survivor Benefit Plan (SBP) beneficiaries to further offset.
Congress should make the ethical decision now to change the DIC
compensation to 55% that is afforded other Federal survivors. Why
military surviving spouses must accept a lower percentage than other
Federal survivor programs is incomprehensible to GSW. There has been no
increase in DIC except for COLAs since flat rate DIC was implemented in
1993.

CHAMPVA Dental Plan

Congress enacted legislation requiring the VA to provide access to
dental insurance plans through the CHAMPVA health insurance program.
Eighteen months has passed and the policy is not yet in place. CHAMPVA
recipients need access to both dental insurance plans to maintain their
overall health.
GSW is thankful for this needed piece of legislation for our
surviving spouses and children but we are perplexed and concerned at
the length of time that has passed without implementation.
The new law directs the VA to determine how reasonable it is to
sell dental insurance to veterans by conducting a feasibility study.
However, the law is rather vague on specifics and leaves much left for
the VA to decide. Although the legislation is very positive, it still
leaves a lot that is yet to be determined.
This new insurance plan is intended to be voluntary. The VA will
contract with a dental insurance agent to administer the program and
will charge sufficient premiums to ensure the costs are covered. So
far, there has been no information other than the bill's text, which
leaves key questions unclear, such as how patients and providers can
sign up and where the pilot program will take place.

Dependent Education Assistance Program (DEA)

The DEA or Chapter 35 benefits need to be increased. Current
benefits do not cover the costs of today's tuition much less books,
fees and living expenses. As quoted in Forbes, ``For the past quarter-
century, the cost of higher education has grown 440%, according to the
National Center for Public Policy and Education.''
Surviving children of those who died on active duty after 9-11
receive benefits under the Marine Gunnery Sergeant John David Fry
Scholarship. All other beneficiaries, including surviving spouses of
those who died on active duty after 9-11, receive benefits under the
DEA program.
The lack of adequate DEA benefits means that these surviving
spouses and children require student loans and leaves the beneficiaries
with a significant debt load.
In its 2005 report ``Rising Above the Gathering Storm,'' the
National Academy of Science points out that for the United States to
remain economically competitive and a world leader, our nation must
invest in a future quality workforce (Tucker et.al. 2005).
According to the President's Council of Advisors on Science and
Technology, ``The problem is not just a lack of proficiency among
American interns; there is also a lack of interest in Science,
Technology, Engineering, and Math (STEM) fields among many interns''.
According to the Department of Commerce, female STEM majors earn 30
percent more an average income then non-stem graduates. (Surviving
spouses are 98.2 percent female.) Therefore, GSW encourages the VA to
embrace government incentive programs such as STEM and SMART Grants to
ensure that qualified survivors receive the benefits of these programs.
Recent VA reports indicate that 49 percent of survivors are unaware
of their education benefits. GSW encourages further outreach to
surviving spouses about benefits. The reports also indicate that the
majority of surviving spouses have only a high school education (from
the 2010 National Survey of Veterans). The VA cannot currently provide
statistics on the percentage of surviving spouses and children who use
DEA benefits. The only available statistics indicate that there were a
total of 90,657 participants, 14,904 of which are spouses and 75,753
are children. This is less than 2.9 percent of the survivor population.

Elimination of the DIC Offset to the SBP

Disabled military retirees view the Committee on Veterans Affairs
as their protector and advocate. We are asking this Committee to be a
protector of surviving spouses and ensure that our deceased husbands
receive a benefit of retirement they worked hard to earn and for which
they paid substantial premiums. In 1999, Congress decided to eliminate
the offsets to military retired pay with an incrementally phased in
plan.
Representative Jeff Miller, Chairman of the House Committee on
Veterans Affairs played a key role in restoring full SBP by eliminating
the Social Security Offset to SBP [P.L. 108-375]. Unfortunately,
military surviving spouses whose military spouse died on active duty or
of a service-connected cause endured a second unjust offset - the DIC
offset to SBP. Congress and DoD policy makers who have not suffered the
misfortune of an early death due to military service should honor this
selfless, responsible act of purchasing an annuity to provide for their
family with utmost dignity.
There are 33,280 of the 57,134 surviving spouses whose husbands
earned and purchased SBP receive nothing from the SBP annuity.
Public Law 108-183 [NDAA FY 2005] eliminated the DIC offset to SBP
for surviving spouses who remarried after the age of 57. GSW
appreciates the Committee's ``first step'' to provide ``survivor
concurrent receipt'' to remarried widows; however, we do not understand
the logic used to abandon those of us who have not remarried.
GSW believes that Congress is ignoring the sacrifice of America's
Fallen Heroes by not recognizing their service and sacrifice with the
dignity of earned and purchased retirement benefits. We believe the
price of an early death, coupled with the responsible act to purchase a
survivor annuity should be compelling when Congress is determining
funding priorities. SBP is actually an employment benefit promised to
the deceased service member. How is it that Congress placed a higher
priority on granting full military retired pay to living disabled
retirees but did not consider the benefits that deceased service
members earned for their surviving spouses?
We ask that the members of the Committee on Veterans Affairs be
more pro-active in finding the funding to pay full SBP to the surviving
spouses of deceased service members. Surviving spouses of those who are
acknowledged to have died in service to their country should not be
victimized so that DoD can profit from the loss of the retiree. (For
more detailed information, please see the GSW Fact Sheet at Attachment
1.)

TRICARE Dental Program (TDP)

The NDAA FY 2010 created new dental insurance provisions for
surviving spouses and children of those who died on active duty after
9-11. These new dental insurance provisions align with the medical
benefits these surviving spouses and children receive. Under the new
provisions of TDP surviving spouses receive premium-free dental
insurance under the active duty TDP for 3 years after the death of
their military spouse, and surviving children receive premium-free
dental insurance until they reach the age of majority.
When DoD implemented these changes to TDP, many of the eligible
surviving spouses and surviving children were not notified the new
benefit was available in a timely manner. Because of this delay in
notification many of the surviving spouses who were participating in
the TRICARE Retired Dental Plan (TDRP) continued to pay premiums for
several months after they were entitled to premium-free dental
insurance under TDP. Some surviving spouses paid as much as $500 in
premiums to TDRP for themselves and their children because DoD failed
to notify them in a timely manner.
These surviving spouses and children should be reimbursed for the
expenses incurred due to this delayed notification.

TRICARE Fees

The currently proposed ``tiered'' TRICARE fee system is based on
the amount of military retirement pay retired service members receive.
Surviving spouses and surviving children receive no military retirement
pay.
Although the proposal includes provisions to exempt post 9-11
surviving spouses and children whose sponsor died on active duty the
proposal failed to address fees for surviving spouses and children
whose sponsor died on active duty before 9-11 or whose sponsor died of
a service-connected cause.
When Congress processes the DoD proposal, they need to take into
consideration that those who use:

TRICARE Prime, already pay an annual enrollment fee and
may have co-pays for medical appointments and hospitalization.
TRICARE Standard, already pay 25% of the charges for
medical care, the annual deductible and co-pays for any medications
they obtain from the mail order or retail pharmacy programs.
TRICARE for Life, already pay a minimum of $99.90 monthly
for Medicare Part B ($1198.80annually), plus co-pays for medications
purchased by mail or a retail pharmacy.

There are many complications involved in this issue:

Surviving spouses do not receive military retirement pay;
some surviving spouses of retired service members receive SBP, which is
an annuity based on a portion of the deceased service member's military
retirement pay, but not all deceased retired service members purchased
SBP.
Surviving spouses who receive only DIC of $1195 monthly
cannot afford to pay these proposed fees. Would these spouses no longer
be entitled to TRICARE if they could not pay the fees? Would they be
entitled to military medical care in a military facility? Given the low
priority of retired surviving spouses for military medical care would
these surviving spouses ever be able to get an appointment for medical
care?
Other surviving spouses receive none of the SBP purchased
by their sponsor because it is totally offset by DIC.
Pre 9-11 surviving spouses of service members who died on
active duty only receive SBP if their military spouse was retirement
eligible when he died.
Surviving spouses of retired service members who died of
a service-connected cause are currently required to pay the higher
family premiums if the children are to be covered by TRICARE Prime.
TRICARE Prime is currently the only version of TRICARE that has a fee.
If the service member had children from a previous
marriage or relationship, would the family enrollment fee the legal
surviving spouse pays cover TRICARE fees for the children of other
marriages or relationships?

Surviving spouses look to us as their voice in Congress as we are
the vanguards with changing the inequities of survivor benefits,
educating the public as well as elected officials. However, this cannot
be accomplished without your support. We are that family minus one - we
are spouses and children, all having suffered the unbearable loss.
I believe that you who serve on these two committees feel
similarly. Let us work to make this statement one of action and not
just rhetoric. I appreciate the opportunity to be here and am happy to
answer questions. Thank you.

Attachment 1
REPEAL THE SURVIVOR BENEFIT PLAN/DEPENDENCY AND INDEMNITY
COMPENSATION (SBP/DIC) OFFSET

Objective: To repeal the law that requires a $1.00 reduction in a
DoD Survivor Benefit Program (SBP) for each $1.00 received from the
VA's Dependency and Indemnity Compensation (DIC) program. SBP is a
premium-based voluntarily selected benefit of retirement.

Legislation: 112th Congress
HR 178 Rep. Joe Wilson, SC
177 Co-sponsors (3/15/2012)

S 260 Sen. Bill Nelson, FL and Sen. James lnhofe, OK
49 Co-sponsors (3/15/2012)

Cost FY11:
Military Retirement Trust Fund Outgoing $55 Billion to military
retirement and survivor payments
$3.62 Billion to 294,000 Surviving Spouses

CBO score:
$536 Million (2012) owed to 54,778 offset Widows (less than 1% of
$55 B)

Original Survivor Benefit Bill HR 10670, signed by President
Richard Nixon, Sept 21, 1972, House Report 92-481 passed as a free-
standing bill

For more information please contact:
Gold Star Wives of America, Inc.
888-751-6350
703-351-6246 www.qoldstarwives.org

Surviving Spouses Deserve Equal Beneficiary Status:

No DIC offset for other beneficiary categories, such as:

Remarried surviving spouses over age 57 receive both SBP
and DIC payments (2004)
Surviving children do not have offset between SBP and DIC
Former spouses may receive SBP and current spouse
receives DIC
Surviving spouses receive SBP from first marriage and DIC
from second marriage
Surviving spouses of non-service connected death receive
full SBP up to 55% (SBP/62)
Federal Civilian surviving spouses do not have offset
with DIC
31,000 surviving spouses have NO SBP to pay TRICARE
premiums, CHAMPVA has no premiums
Federal Civil Service Annuity is not offset by DIC and no
premiums are paid for survivor benefit by civilian employees who die in
active employment

Favorable Recommendations Eliminate Offset to SBP/DIC:

The Veterans Disability Benefits Commission (2007)
Commission on Care for America's Returning Wounded
Warriors (2007)

Philosophical Basis of DoD's Survivor Benefit Plan:

To supplement the survivor benefit of Social Security at age 62.
(Repealed in 2003)

To establish a survivor benefit similar to the Federal
Civil Service Annuity or 55% of retired pay with a reasonable ``cost
sharing'' premium
2001, all military active duty deaths included in SBP, no
premiums paid
Federal Civilian Employee death... no premiums paid for
survivor annuity

[GRAPHIC] [TIFF OMITTED] T3772.001

Prepared Statement of Allen E. Falk

INTRODUCTION

Chairman Miller, Chairwoman Murray, and Members of the House and
Senate Committees on Veterans' Affairs, my fellow veterans and friends,
I am Allen E. Falk, the National Commander of the Jewish War Veterans
of the U.S.A. (JWV). JWV is Congressionally Chartered and also provides
counseling and assistance to members encountering problems dealing with
the Department of Defense (DoD), the Department of Veterans Affairs
(VA), and other government agencies. JWV is an active participant in
The Military Coalition, a select group of over 30 military associations
and veterans' organizations representing over five million active duty,
reserve and retired uniformed service personnel, veterans, families,
and survivors on Capitol Hill. In fact, I am very proud that our
National Executive Director, Colonel Herb Rosenbleeth, who is here with
me today, is the President of the Military Coalition.
On March 6th, 7th and 8th, our National Executive Committee members
were here in Washington to meet with their Representatives and Senators
as part of JWV's Capitol Hill Action Day(s). Our members prepared
diligently for these important meetings and successfully presented many
of JWV's legislative priorities to your colleagues, their members of
Congress and congressional staff.
Members of the committee, it was a singular honor for me to present
the prestigious JWV Medal of Merit to you, Chairman Miller (R-FL), at
our Congressional Reception during our days on Capitol Hill. It was
equally rewarding to JWV to have so many of you participate with us!
JWV's presentation to the Chairman of the House Foreign Affairs
Committee reflects our strong interest in and great concern for world
events. While we advocate health care and compensation for veterans,
JWV is also deeply involved in U.S. interests overseas. We must be
always vigilant to protect the freedoms won by our brave veterans!
Also Madame Chairwomen, I recall with the greatest pride and
pleasure that we presented you with the JWV Medal of Merit at our
Congressional Reception in 2006. Our sincere congratulations to you on
your subsequent selection as Chairwoman of the Senate Committee on
Veterans' Affairs.
Mr. Chairman, on March 15th, we at JWV celebrated our 116th
birthday. For all of these 115 years, JWV has advocated a strong
national defense, and just and fair recognition and compensation for
veterans. The Jewish War Veterans of the USA prides itself in being in
the forefront among our nation's civic and veterans groups in
supporting the well-earned rights of veterans, in promoting American
democratic principles, in defending universal Jewish causes and in
vigorously opposing bigotry, anti-Semitism and terrorism both here and
abroad. Today, even more than ever before, we stand for these
principles. The Jewish War Veterans of the U.S.A. represents a proud
tradition of patriotism and service to the United States of America.
As the National Commander of the Jewish War Veterans of the USA
(JWV), I thank you for the opportunity to present the views of our
100,000 members on issues under the jurisdiction of your committees. At
the conclusion of JWV's 116th National Convention in Jackson, Florida,
our convention delegates adopted our resolutions for the 112th
Congress. These mandates establish the legislative agenda for JWV
during my year as National Commander.
JWV believes Congress has a unique obligation and compelling
opportunity to ensure that veterans' benefits are regularly reviewed
and improved to keep pace with the needs of all veterans in a changing
social and economic environment. JWV salutes the Chairs and Members of
both the House and Senate Veterans' Affairs Committees for the landmark
veterans' legislation enacted over the past several years. Eligibility
improvement, patient enrollment, long-term care, access to emergency
care, presumptive Agent Orange disability, enhanced VA/DoD sharing,
improved preference rights of veterans in the federal government and
other records recognize the debt this great country owes to those who
have so faithfully served.
We must improve access to veterans' health care, increase
timeliness in the benefit claims process, and enhance access to
national cemeteries and to state cemeteries for all veterans.

NO GOVERNMENT FUNDING

For the record, the Jewish War Veterans of the USA, Inc. does not
receive any grants or contracts from the federal government. This is as
it should be.

THE MILITARY COALITION

JWV continues to be a proud member and active participant of the
Military Coalition (TMC). PNC Robert M. Zweiman, JWV's National
Chairman, serves on the Board of Directors of the Coalition and, again,
our National Executive Director, Colonel Herb Rosenbleeth, USA (Ret),
continues to serve as the President of the Military Coalition and as
Co-Chair of the Coalition's Membership and Nominations Committee.
JWV requests that the House and Senate Committees on Veterans'
Affairs do everything possible to fulfill the legislative priorities of
the Military Coalition which are applicable to your committees. These
positions are well thought out and are clearly in the best interests of
our military personnel, our veterans and our great nation.

THE PARTNERSHIP FOR VETERANS HEALTH CARE BUDGET REFORM

JWV is proud to be a member of the Partnership for Veterans Health
Care Budget Reform.
The Partnership is a coalition of nine veteran service
organizations which meets regularly at the DAV. JWV fully supports the
partnership's two main concerns, i.e., the quality, accuracy and the
timeliness of VA claims, and the threat to advanced funding for the VA.
Our thanks to Peter Dickinson and Joe Violante of DAV, for their
outstanding leadership and expertise.

MANDATORY FUNDING

JWV continues to maintain that the Congress has an unbreakable
obligation to its veterans. Adequate VA funding must be guaranteed by
the Congress.
This country has a sacred obligation to those who have served and
defended our nation to fully provide for their needs when they return
from battle. Mandatory funding is necessary so that all category eights
receive the care they need, so that veterans receive long term care,
and so that VA medical research will be second to none! This is
especially important now that we know more about the real challenges
and expenses resulting from injuries to the brain, eyes, amputations,
and other catastrophic injuries.
Only when the VA not only knows in advance the level of its funding
but also knows with certainty that its funding levels will be adequate
for all of its requirements can our veterans be assured that all of
their health care needs can and will be met.

IRAQ AND AFGHANISTAN VETERANS

One of the greatest concerns of the Jewish War Veterans at this
time is to assure that our servicemen and women returning home from
Iraq, Afghanistan, and other overseas duty are being provided with the
very best assistance available to them.
This is not merely a matter of convenience and comfort. The list of
serious problems they face today is substantial:
Our present poor economic conditions have resulted in a rate of
unemployment for veterans much higher than non-veterans. According to
the US Bureau of Labor Statistics, veterans aged 18 to 24 had a 30.4
percent jobless rate compared to 15.3 percent for non-veterans in the
same age range. These figures are disappointing, especially in view of
the protections in the Uniformed Services Employment and Re-employment
Rights Act.
There are a lot reasons why this employment gap is emerging. Our
youngest veterans may not yet have the skills that many employers find
essential, like college educations and experience in office settings.
They also have to contend with employees who may unfairly fear the
aftereffects of service in a combat zone. As young veterans make the
transition to civilian life, it is important that programs exist to
help ease this change. The new Veterans Jobs Bill, which includes
credits for employers who hire veterans and an extra year of GI Bill
benefits for employed veterans, gives some additional assistance to
unemployed veterans. More needs to be done and more should be done.
These are the men and women who volunteered to serve our country -
every single one of them should have the resources they need to find
permanent employment after his or her service.
There are many family and relationship issues resulting from
multiple deployments. Any veteran who has spent a substantial period of
time separated from loved ones can understand the additional stress
resulting from multiple deployments. Family members can never be sure
if, and when, this can occur. This is especially true in the Reserve
and National Guard components.

Health and medical problems caused by exposures in combat
areas. Medical advances have reduced the number of fatal injuries in
combat. But the extensive use of improvised explosive devices by the
enemy has caused a great number of serious injuries, burns,
amputations, and brain damage.
Depression and anger from the above conditions has
resulted in a large number of cases of post traumatic stress being
reported in returning veterans. They often have problems transitioning
from constant ``adrenaline alerts'' to ``boring routines'' back home.
In addition, only 1% of the US population is presently serving in all
of the armed forces. This can result in social and cultural differences
with those who have never served. Unfortunately, these factors have
contributed to a very high suicide rate amongst our returning vets.

I urge our membership at every echelon to bring up these issues as
soon as possible and report back to me about successful programs for
returnees. We at National will pass on this information.
We also will, through our active participation in The Military
Coalition, work with all the other major veterans organizations to
assure our military returnees receive the maximum assistance they so
rightly deserve.

RETURNING VETERANS

This nation has sent hundreds of thousands of young men and women
into some of the toughest fighting and harshest conditions ever faced
by U.S. military personnel.
Now these returning veterans are facing high unemployment,
homelessness, and serious family and relationship issues due to or
aggravated by these often repeat combat tours, and sometimes
devastating health and medical problems such as PTSD and TBI. This
country must provide sufficient funding to solve these issues.

TRAUMATIC BRAIN INJURY

Traumatic Brain Injury (TBI) is often called the signature wound of
the Iraq and Afghanistan wars. TBI occurs when a sudden trauma or head
injury disrupts the normal functions of the brain. Common causes of TBI
for military personnel include falls, vehicle accidents and explosive
devices. Most reported TBI among Operation Enduring Freedom and
Operation Iraqi Freedom service members and veterans has been traced
back to improvised explosive devices, or IEDs, used extensively against
Coalition Forces. Our Armed Forces in Iraq and Afghanistan have
sustained repeated attacks from weapons such as rocket propelled
grenades and land mines in addition to IEDs. Battle injuries from these
attacks often result in a TBI. Over half of reported TBIs are blast
related. Of the servicemembers who required medical evacuation for
these battle related injuries to Walter Reed Army Medical Center from
January 2001 to March 2008, 32% were diagnosed with TBI. Army Vice
Chief of Staff Peter Chiarelli recently reported that the Army had over
126,000 diagnosed cases of TBI from 2000 to 2010. That included more
than 95,000 mild cases such as concussions, 20,000 moderate cases and
more than 3,500 with severe, penetrating injuries.
Not all blows or jolts to the head will result in a TBI. The
severity of such an injury may range from ``mild'' i.e., a brief change
in mental status or consciousness to ``severe'', i.e. an extended
periods of unconsciousness or amnesia after the injury. Each of the
different forms of TBI, mild, moderate and severe, display different
symptoms. It is imperative that service members in a combat zone be
screened for mild TBI as early as possible as TBI and PTSD symptoms may
initially be very similar. Early intervention is important to speed
recovery and maximize functional outcomes. The initial focus of
treating a TBI is to stabilize the injured service member in order to
minimize secondary complications. After individuals with moderate or
severe TBI have been stabilized, the treatment plan generally involves
rehabilitation efforts to teach patients who continue to have medical
and functional problems how to cope with their specific injury-related
symptoms. Most existing research on TBI is focused on injuries
sustained from automobile accidents and more research is needed on
combat related traumatic brain injuries where service embers may
experience more than one blast episode.
TBI is a complex brain trauma, experienced differently by each
person depending upon several unique characteristics, such as the type
of injury and an individual's personal health and resilience. While it
is true that most service members who suffer traumatic brain injuries
return to duty, individuals with severe TBIs may need inpatient care at
a military treatment facility (MTF) a VA polytrauma hospital, or a
civilian rehabilitation center. Data has also shown that having a TBI
increases the risk for suicidal behavior. In comparison to the general
population, TBI survivors are at increased risk for suicide attempts
and death by suicide.
The Jewish War Veterans supports efforts by the Department of
Defense and the Department of Veterans Affairs to fund increased
research efforts into the most effective and feasible ways to prevent
TBIs in theatre and to develop a range of rehabilitation interventions
for those personnel who are impacted by IED and other TBI injuries.

POST TRAUMATIC STRESS

Stress is a normal response of the body and mind. While stress is
normal, there are some stressors, such as military combat, when the
body's instinct to defend itself may be challenged by witnessing or
experiencing traumatic events involving a direct or indirect threat of
serious injury or death. These traumatic events may be experienced
alone, or in the company of others, as in military combat operations.
Feeling stress in a war zone has been called ``a normal reaction by a
normal person to an abnormal event''. Post Traumatic Stress Disorder,
which is commonly referred to as PTSD, is a psychiatric condition which
some soldiers develop after they have experienced or witnessed some
very traumatic and sometimes life-threatening events or stressors as a
result of military combat. Some researchers and clinicians define PTSD
as a failure to recover from that psychiatric disorder.
Our troops in Iraq and Afghanistan who have repeated and prolonged
exposure to the combat stressors of killing, maiming, and dying are
much more likely to generate the risk of developing PTSD symptoms and
to bring those problems home. It is common for anyone participating in
combat, or seeing its aftermath, to be filled with complicated and
conflicting emotions - including fear, sadness, and horror - all
legitimate reactions to the combat experience. These strong feelings
are a natural reaction to being confronted with danger. Memories of
those stressful events may be so strong that they impair an
individual's ability to perform day to day functions, interact normally
with family and friends, and maintain gainful employment.
Observers have noted that there may have been no war better
designed to produce combat stress and trauma than Operation Iraqi
Freedom which was a round the clock, unrelenting danger zone. Nearly
half of Afghanistan and Iraq veterans treated by the Department of
Veterans Affairs suffer from mental health issues, and PTSD is the most
common, affecting nearly 200,000. According to Army Vice Chief of Staff
Gen. Peter Chiarelli ``post traumatic stress remains a particularly
difficult and prevalent injury coming out of this war''. Estimates of
the incidence and prevalence of PTSD vary; however, health care experts
say that the wars in Afghanistan and Iraq have produced more diagnosed
cases of PTSD per capita than any other war in our nation's history.
Estimates by organizations including Stanford University and the Rand
Research Center contend that about one-third of the nearly 2 million
men and women who have served in Iraq or Afghanistan have suffered from
PTSD. Calling PTSD an epidemic, the Army estimates that there could be
472,000 service members with the condition, half of them in the Army.
Individual or group therapy, in addition to some medications, may be
used in the treatment of PTSD. Therapy helps those with PTSD work
through the traumatic events and feelings that caused the condition.
Certain antidepressant medications and mild tranquilizers are at times
prescribed to help lessen some of the painful symptoms associated with
PTSD.
The Jewish War Veterans supports efforts by the Department of
Defense and the Department of Veterans Affairs to fund research efforts
testing therapies that will help our service members overcome the
debilitating symptoms of PTSD. Among these therapies currently being
investigated are Cognitive Rehabilitation Effectiveness, Exposure
Therapy, and Hyperbaric Oxygen Treatment.

MILITARY AND VETERAN SUICIDES

According to the Center for a New American Security's Suicide
report, Military suicides have increased since the start of the wars in
Iraq and Afghanistan. The surge in suicides, which have risen five
years in a row up until 2011, has become a major problem for the US
military. New research suggests that repeated combat deployments seem
to be driving the suicide surge. About a third of Army suicides happen
in war zones, and another third are among personnel who had never
deployed. However, two-thirds of Army suicides have deployed, many
returning home with emotional disorders such as PTSD, which make them
prone to take their own lives. Army Vice Chief of Staff General Peter
Chiarelli informed the House Armed Services Committee in December 2010
that ``The greatest single debilitating injury of soldiers returning
from Iraq and Afghanistan is post traumatic stress''.
Nearly 1 in 5 soldiers comes home from the wars reporting symptoms
of PTSD. Marine Corps suicide statistics are reported differently than
the Army's and are not easy to intermingle with the Army's figures,
however, Marine Corps suicides increased from 2006 to 2009, though it
dipped slightly in 2010. The Army reported that for 2011 suicides
decreased about 10% from the previous year, however, within that total
the number of active duty soldier suicides reached an all time high of
164 soldiers, 5 more than 2010 and two more than 2009. The Army saw an
increase in the number of soldiers hospitalized for suicidal ideation -
from 1,500 hospitalizations in 2007 to more than 3,500 in 2010. It
appears that Army emphasis on getting the soldiers help that they need
may explain the increase in hospitalizations and the modest decrease in
suicides.
Because of repeated deployments of Regular Army as well as National
Guard and Reserve soldiers to the combat zone, there has been a
documented increase in PTSD among our military. The combination of
repeated combat exposure and ready access to weapons can be lethal to
anyone contemplating suicide. About half of soldiers who kill
themselves use weapons, and the figure rises to 93% among those
deployed in war zones. It appears the military finds itself in a Catch
22 situation as combat increases fearlessness about death and the
capability for suicide. The very qualities for soldiers to be
successful in combat are also associated with increased risk for
suicide.
It has been suggested that the Army's most effective suicide-
prevention strategy would be to make its troops suicide-resistant
rather than trying to intervene once soldiers have decided to kill
themselves. General Chiarelli stated that the Army's goal is more aimed
at ``holistically improving the physical, mental and spiritual health
of our soldiers and their families than solely focusing on suicide
prevention''. Additionally, the Army has launched a five year study
with the National Institute of Mental Health to identify possible
suicide indicators, in order to enable soldiers most at risk to get the
help they need. The Army has recently rewritten its Army Suicide
Prevention pamphlet and created numerous task forces and suicide-
prevention programs. Combat veterans will undergo twice as many mental
health screenings under the new Defense Authorization Act for 2012,
That law requires troops who deploy to contingency operations to
receive a mental health assessment within 120 days before deploying,
another 90 to 180 days after returning from deployment, a third within
a year after returning, and a fourth 18 to 30 months after returning.
The assessments aim to identify mental health concerns such as post-
traumatic stress disorder and suicidal ideation.
The Jewish War Veterans supports the efforts by the Department of
Defense and the Department of Veterans Affairs to develop ways of
intervening before veterans act on their suicidal ideation. To that end
the JWV supports the VA's National Suicide Call Center which has
received thousands of calls from veterans referring many to local VA
suicide prevention coordinators for same-day or next-day service.
Suicide among veterans id double the rate as it is in the regular
population. It is triple the rate among Iraq and Afghanistan veterans
who generally comprise a younger population of veterans. Therefore the
JWV strongly supports expanding crises hotline services through the
development and utilization of texting and social media outlets,
technologies increasingly adopted by our younger veterans.

CLAIMS BACKLOG

The VA disability claims backlog has reached nearly one million
cases. Veterans must wait approximately a half a year to find out
whether their claim has been processed. Veterans currently wait far too
long to receive benefits for disability.
At no time in recent history has so much attention been focused on
VA's Compensation and Pension delivery mechanisms. VA is struggling
under an outrageous backlog of claims, and facing volume of an
unprecedented level.
As the country struggles to cope with returning veterans from two
wars overseas and an aging population of veterans of our previous wars,
VA's performance has been found wanting by nearly all concerned
stakeholders.
VA must be authorized adequate technology and sufficient claims
processors to be able to speed up the process. The wait must be
reduced.
JWV endorses coordinated, comprehensive approach to improve quality
of claims decisions and timeliness.

Claims workers. Monitor VA actions to hire / train high-
quality claims workforce.
Automate technologies supporting claims. Support various
'back office' process claims initiatives in VA ``test bed'' sites.
Presumptive Service Connection. Promote distribution of
'brown' and 'blue' water Navy ship logs as they become available for
TMC members to apply for Agent Orange-related diseases. Support passage
of S. 1629 (Sen. Gillibrand), the Agent Orange Equity Act of 2011, to
establish eligibility for presumptive service-connection for 'blue
water' Navy Vietnam-era sailors.
Defend against budget-based attacks on VA claims-
processing laws and system.
Monitor ongoing DOD disability review process under USAF
Executive Agency, as established by Congress, to provide a fair re-look
for servicemembers whose Service disability ratings were low-balled.
Support modernization of the VA Schedule of Rating
Disabilities based on current medical science

BLINDED VETERANS

Blinded veterans are of special concern to JWV. The large number of
IED explosions in Iraq and Afghanistan have led to a huge number of eye
injuries and blinded veterans. In fact, orbital blast globe injuries,
optic nerve injuries, and retinal injuries have been all too common.
JWV strongly urges the congress to insure adequate funding to care for
our thousands of veterans with eye injuries.

VA BUDGET

The business of government must not be calculating how to cut from
what we do for veterans, but rather how we can ensure what we do is
delivered without fail and without delay.
America may suffer, but America will not be broken so long as we
keep faith with those who serve. We cannot look to the military and
veterans of America for cheap savings in the short term, or we will
surely feel the effects of the weakening of the foundations of this
country in the long run.
Our military and veterans made this country great, and the Jewish
War Veterans remains dedicated to the principle that sound investment
in a strong national defense, and fulfillment of the sacred duty to
provide for those who bear the battle, will carry us as a country
through whatever storms may come.

VA HEALTH CARE

It is unclear whether veteran's health care funds are, in fact,
protected from possible automatic, across the board cuts in federal
spending which could begin in 2013. Sequestration is not covered in the
new VA budget.

With the VA health care budget of about $51 billion which
serves 6.2 million patients, a sequestor could result in a one billion
dollar cut. No funding shortfall should be covered by VA co-pay
increases or by denying care to any category of veteran.
Sustain VA advance health care appropriations to ensure
fully-funded access to care for returning Iraq and Afghanistan
veterans, and veterans of all conflicts.
Urge investment, training and cultural awareness in the
VA health system of the unique health needs of women veterans. Ensure
full implementation of all VA Caregivers Law (P.L. 111-163) provisions,
including those supporting women veterans.
Extend the VA Caregivers Act to full-time Caregivers of
catastrophically disabled veterans of conflicts before Sept. 11, 2011
Support programs and funding to expand / improve care,
rehabilitation and research for veterans suffering from PTSD / TBI.
Increase behavioral health staff and resources including outreach to
address rising suicide rate in veterans
Oppose fee hikes for currently enrolled veterans in all
categories.
Urge completion of VA strategic plan for rural veteran
access to care and services
Support further collaboration of DoD - VA to achieve real
``seamless transition'' for injured, ill and wounded warriors as well
as other service members and veterans transiting the two systems;
preserve integrity and access to both systems for dually eligible
members.
Enact technical amendment to establish CHAMPVA
entitlement for adult children of survivors eligible for CHAMPVA as
required in the National Health Care Reform Act.
Support passage of OIF / OEF 'burn pit' registry and
other toxic exposure registries as necessary to track long-term health
effects of deployments in Iraq and Afghanistan
Expand VA research including research into the etiology,
diagnosis and treatment of gastrointestinal and respiratory syndromes
that are increasing among OIF / OEF veterans
Support research on the long-term health of veterans'
progeny
Urge passage of corrective legislation to authorize
Medicare / Medicaid reimbursement to State Veterans' Homes to offset
cost of care.

LONG TERM CARE

As the VA care shift from an inpatient to an outpatient system, VA
must ensure the needs of our aging veteran population are being met.
JWV believes that VA should take its responsibility to America's
aging veterans seriously and provide the care mandated by Congress.
Congress should do its part and provide adequate funding to VA to
implement its mandates.
JWV recommends Congress provide designated funding for Long-Term
Services (i.e. staffing, capacity, and program development).

AGENT ORANGE BENEFITS EXPANDED TO OTHERS

The Department of Veterans Affairs refuses to recognize that men
and women who served on ships off the coast of Vietnam and other sites
in Southeast Asia were exposed to Agent Orange as well as other toxins.
The Department's refusal to recognize that these service members
were exposed by air currents, polluted drinking water, handling toxin
tainted items such as clothing, airframes, etc. The main reason for the
Department's stance appears to be monetary rather than scientific or
compassionate. The men and women suffering from the results of toxic
poisoning arising out of their military service are now being denied
the medical services they desperately require because of the stance by
the Department of Veterans Affairs.
Therefore, the Jewish War Veterans of the USA calls upon Congress
to designate any veteran who served anywhere proximate to where any
toxin was used manufactured or distributed to be presumptively eligible
for services and benefits deemed a disabled veteran.

ENDING HOMELESSNESS FOR VETERANS

Two years ago, VA Secretary Eric Shinseki announced VA's commitment
to a five-year plan to end veteran homelessness. Committed to the ideal
that ``no one who has served this nation as veterans should ever be
living on the streets,'' Shinseki unveiled a multi-billion dollar plan
that seeks to understand, end and prevent future homelessness.
According to figures released this summer by VA, the average number of
veterans who are homeless on any given night has dropped from over
131,000 in 2009 to 75,700 in June of 2010. This represents an important
and commendable first step, but we cannot let up on this effort as we
begin to address the most difficult and entrenched cohort of veterans
within the homeless population. These figures clearly show the approach
is working at reducing homeless numbers, so we must ensure these
efforts continue until we can end the national embarrassment that
created a scenario where nearly one of every four homeless is a veteran
who once served in the Armed Forces.
It appears that today there are at least 150,000 Iraq and
Afghanistan veterans homeless or in programs aimed at keeping them off
the streets.
The Department of Veterans Affairs had stated that this number has
tripled since 2006, and that 70% of these veterans have psychological
problems because of their combat exposure, and 13% of these homeless
veterans are women.
Therefore, the Jewish War Veterans of the USA demands that the
Department of Veterans Affairs and State governments immediately take
all steps necessary to provide services to transition these homeless
veterans back into society.

OPPOSITION TO TRICARE COST INCREASES

The Department of Defense (DoD) seeks increases to TRICARE costs
for military retirees. JWV members are strongly opposed to DoD's
proposals concerning TRICARE fee increases. This is a powerful moral
commitment that has been made to our military personnel that must not
be broken. DoD has failed to keep faith with military personnel.
Those who wear the uniform of their country for twenty or more
years are, for all practical purposes, enrolled in a 20- to 30-year
pre-payment plan that they must complete to earn lifetime health
coverage. In this regard, military retirees and their families pay
enormous ``up-front'' premiums for such coverage through decades of
service and sacrifice. Once that pre-payment is already rendered, the
government cannot simply ignore it and focus only on post-service cash
payments - as if the past service, sacrifice, and commitments had no
value.
DoD and the nation - as good-faith employers of the trusting
members from whom they demand such extraordinary commitment and
sacrifice - have a reciprocal health care obligation to retired service
members and their families and survivors that far exceeds any civilian
employer's.
JWV is strongly opposed to any increases whatsoever in TRICARE
costs for career military personnel. Only Congress can now preserve
TRICARE benefits.

HEALTHCARE DISPARITIES

The Department of Veterans Affairs Center for Minority Veterans
Advisory Panel has repeatedly identified a serious disparity between
the quality of services made available to female and minority veterans
as compared to all other veterans.
The National Institute of Health has identified this disparity of
services as the number three issue among its top five priorities at the
Department of Veteran Affairs. This pattern of a lower quality of
health services for the poor, disadvantaged, female and minority ethnic
and racial groups equates to higher levels of morbidity and mortality.
The Jewish War Veterans of the USA finds such disparity unconscionable
and inexcusable.
Therefore, the Jewish War Veterans of the USA demands that Congress
and the Department of Veterans Affairs immediately take any and all
steps necessary to close this disparity of services.

CORRECT THE SURVIVOR BENEFIT PROGRAM (SBP)

Survivors of military retirees who die of service-connected causes
and who paid into SBP, and survivors killed in active-duty, should
receive both SBP and DIC (Dependency and Indemnity Compensation)
benefits without the current dollar for dollar offset. JWV strongly
supports legislation to end this offset.
JWV strongly supports HR 178, The Military Surviving Spouses Equity
Act, which would correct this inequity.

MIA/POW

JWV has always been an ardent, active supporter of the National
League of Families of American Prisoners and Missing in Southeast Asia.
JWV will always remember those who are still unaccounted for and their
families. We fly the MIA-POW flag in the lobby of our headquarters and
place that flag in front of our meeting rooms.
JWV specifically advocates adequate funding for the Joint Prisoners
of War, Missing in Action Accounting Command (JPAC) and the continued
accounting for all those still missing from the Vietnam conflict until
each and everyone is accounted for.

PROTECT EARNED VETERANS' BENEFITS

Promote public and political recognition that veterans'
benefits are earned through service and sacrifice in defense of the
nation and are not ``entitlement'' or ``social welfare'' programs
Oppose deficit-driven political decisions that would lump
earned veterans' benefits with unrelated civilian entitlement programs
Reject political pandering that would ask veterans to do
their ``fair share'' in overcoming national economic woes
Support final passage of the Honor America's Guard-
Reserve Retirees Act (S.491 / H.R. 1025) to establish that career
members of the Guard and Reserves who are entitled to a reserve
pension, TRICARE and earned veterans' benefits, but never served on
Title 10 Federal active duty, are ``veterans of the Armed Forces''
under the law.

UPGRADE VETERANS' EMPLOYMENT, EDUCATION AND TRAINING PROGRAMS

Monitor implementation of the ``VOW to Hire Heroes Act of
2011,'' which upgrades transition support services, employment
assistance, and targeted employment training assistance for military
men and women and veterans.
Support other initiatives for employers to recruit, hire
and retain veterans including returning veterans of the Guard and
Reserve.
Vocational Rehabilitation and Employment (VRE) benefits.
Upgrade VRE to ensure parity with P911 GI Bill by establishing a cost-
of-living (housing) stipend.
Support VA plan to reduce / eliminate veteran
homelessness
Survivors and Dependents Educational Assistance.
Authorize Survivors of OIF / OEF Post-9/11 GI Bill benefits (Chap. 33,
38 USC), the same benefit available to their dependent children.
Raise DEA (Chap. 35) rates for pre-11 Sept. 2001
Survivors to match the Montgomery GI Bill; establish a housing stipend
for DEA.
Support legislation that promotes veterans' success in
their use of GI Bill benefits; upgrade 'consumer education' resources
for military students and student veterans; demand greater transparency
and oversight of all GI Bill programs including tracking outcome
metrics of all public, private, and proprietary programs
Authorize transfer-of-benefits under the P911 GI Bill
from catastrophically disabled veterans to their full-time Caregivers
in cases where a transfer action did not occur prior to the veterans'
medical discharge or retirement
Basic Reserve GI Bill benefits. Urge proportional
upgrades to Title 10 Reserve GI Bill program to keep pace with cost of
education.
GI Bill Integration for 21st Century Force. Urge hearings
for a unified architecture for all GI Bill programs for active duty,
Guard & Reserve service members under the principle of awarding
benefits according to the length and type of duty performed.

STRENGTHEN LEGAL / FINANCIAL PROTECTIONS FOR MILITARY FAMILIES
Monitor Congressionally-directed 3-year reemployment
rights pilot project for Guard - Reserve Federal workers under the
Office of Special Counsel. Arrange for periodic updates for TMC with
the OSC.
Establish employment and reemployment rights under the
USERRA for Transportation Security Administration (TSA) workers who are
members of the Guard and Reserve
Authorize veterans' preference appeal rights for veterans
in the TSA
Ensure implementation of upgrades to Servicemembers'
Civil Relief Act (SCRA) protections regarding telephone service
contracts, residential and motor vehicle lease termination fees, and
enforcement by U.S. Attorney General of 'right of private action'.
Review and endorse appropriate provisions in a Dept. of
Justice legislative package (Sept. 2011) submitted to Congress that
would strengthen the USERRA and SCRA.
Strengthen SCRA coverage for military spouses and
families

BUSINESS CREDITS FOR FIRMS THAT HIRE VETERANS
The percent of veterans unemployed and underemployed is greater
than that of the general population.
There is a generalized sense that the civilian employers do not
seek out nor select otherwise qualified candidates because they are
veterans, and businesses that reach out to the veterans' population
deserve to be rewarded for their efforts.
Therefore, the Jewish War Veterans of the USA calls upon Congress
to enact legislation, which would give tax incentives to businesses
that hire veterans and increased tax incentives to businesses that hire
disabled veterans, and the Jewish War Veterans of the USA calls upon
the states to grant recognition to military schooling and certificates
of proficiency given by the military.
Furthermore, the Jewish War Veterans of the USA calls upon the
Department of Veterans Affairs to perform a study of the attitudes of
private employers as to the veracity of the sense of animus toward
veterans and to develop programs to reverse those prejudices if and
where they exist.

CLARIFICATION OF MILITARY MEDICAL RECORDS
A veteran's military records contain a plethora of information, not
all of which is readily available to someone not familiar with the
military shorthand and abbreviations.
A medical professional at a Department of Veterans Affairs facility
should be able to obtain quickly the information contained within the
veteran's military records without the need of trying to decipher the
entire record, and by having the military records in plain English
available to medical professional services for the veteran would be
improved and expedited.
Therefore, the Jewish War Veterans of the USA requests that the
Department of Veterans Affairs and the Department of Defense coordinate
their efforts to make the records of all veterans understandable to
medical professional who may need the information contained therein to
treat the veteran.

EXPOSURE TO TOXINS
It appears that the exposure to toxins was more wide-spread than
currently recognized.
This exposure includes chemical, biological and nuclear toxins, and
the Department of Defense appears not to have revealed all the sites of
toxic contamination.
There are strong indications that there was chemical contamination
at Fort McClellan as well as other installations where chemicals were
stored.
Therefore, the Jewish War Veterans of the USA demands that the
Department of Defense immediately put forward a complete and accurate
list of all sites, regardless of location, where there was any
contamination and provide treatment and compensation to the victims of
the contamination.

GRAVE MARKERS FOR ALL VETERANS
The Department of Veterans Affairs offers grave markers for men and
women killed in active service since 1990.
The date of eligibility is arbitrary and not related to any
specific event, and those men and women who were killed in action prior
to the eligibility date are just as worthy as those who died after that
date.
Therefore, the Jewish War Veterans of the USA calls upon the
Department of Veterans Affairs to offer to the families of those killed
in action defending this Nation a grave marker regardless of the date
lost.

MORTGAGE SERVERS FAILURE TO ABIDE BY THE SERVICEMEMBERS CIVIL RELIEF
ACT
The Servicemembers Civil Relief Act provides very clearly defined
rights of members of the military.
There are a number of mortgage service providers who have moved to
foreclose on homes owned by members of the military, both the active
and reserve components during their deployments, in violation of the
SCRA.
There are a number of mortgage service providers who have over-
charged fees they allege are due, and a servicemember may lose his/her
security clearance as a result of an illegal foreclosure by a mortgage
service provider.
Therefore, the Jewish War Veterans of the USA demands that the
Department of Justice and the federal prosecutors to move vigorously
against any mortgage service provider who violates the Servicemember
Civil Relief Act and to send each and every one of them to trial,
seeking restitution and fines.

VETERANS CEMETERY AT THE FORMER CLARK AIR FORCE BASE
There is a military cemetery at the former Clark Air Force Base in
the Republic of the Philippines which has fallen into disarray and
disrepair.
The United States had transferred Clark Air Force Base to the
Philippine government, including the property upon which the military
cemetery is located, and this military cemetery is the final resting
place of some of America's war dead.
This Nation has a duty to honor these men and women who died to
protect our freedom and way of life.
Therefore, the Jewish War Veterans of the USA requests the
President and Congress to move forward to reacquire the land upon which
the military cemetery lies and to maintain the cemetery in a proper and
appropriate fashion.

SEXUAL TRAUMA OF WOMEN IN THE MILITARY
There are more women serving in the military now than ever before.
These women are serving in combat-like roles in dangerous areas, and
the number of complaints of sexual harassment and sexual assault are
increasing in alarming numbers.
It appears that the military is not vigorously investigating and
prosecuting the perpetrators of these crimes, and it appears that there
is a systemic effort to downplay the problem rather than aggressively
confront it.
The counseling and treatment of such victims must be more than
merely adequate but must be a top priority of the military. Many of
these victims are separated from the military and then fall within the
scope of services of the Department of Veterans Affairs where the level
of services available to them varies widely across the country, often
depending upon the priorities set by the local director.
Therefore, the Jewish War Veterans of the USA demands that the
Department of Defense thoroughly investigate every allegation of sexual
harassment and sexual assault and, if found to be true, to prosecute to
the fullest the perpetrators, regardless of rank or whether the
perpetrators is in the military or is a contract employee.
Furthermore, the Jewish War Veterans of the USA demands that the
Department of Defense provide the best available treatment and
counseling program to such victims and not to discharge them from the
military until they are able to function within the greater society at
the best level possible.
The Jewish War Veterans of the USA demands that the Department of
Veterans Affairs provides a complete array of services to such victims
upon their discharge from the active military so that there is no break
in services and no need for the victim to go through a period when she
must be re-qualified and re-rated before being eligible for ongoing
services.

DOD MISSION IN DANGEROUS TIMES
The Department of Defense is facing large cuts in the near future.
JWV believes this nation must maintain adequate force levels and
adequate equipment levels. Military readiness does not come cheaply.
Our military personnel should all have a reliable benefits package that
will never be reduced.
Today's active-duty service members and those who serve in the
National Guard and Reserve components, have volunteered to stand watch
in this nation's defense. Yet few stand watch for them. Basic benefits
of their service, from retirement to TRICARE, are under assault. The
defenders of the country need to be able to focus on defending this
country. They must not worry their benefits will be pulled out from
beneath them while they are focused on more pressing concerns such as
terror plots, IEDs, and insurgents seeking to undermine hard-fought
gains.
The Congress must insure that DoD is funded to meet all its
missions including possible overseas threats from Iran, North Korea,
and even China.

BACK-UP TO DOD
VA Hospitals must be adequately funded, staffed and equipped to
perform their vital role as this nation's only back-up for DoD medical
facilities. U.S. military personnel could possibly suffer casualties
exceeding the capacity of the combined military medical treatment
facilities.
In such a case, the VA would be vital to the nation. JWV strongly
urges the Congress to fund the VA to fully handle this potential
workload.

CONCLUSION
Chairman Miller and Chairwoman Murray, our great nation is still
sending thousands of brave young men and women off to war in Iraq and
Afghanistan. Our country must, therefore, pay for the costs involved.
At our annual national conventions our members work diligently to
develop our legislative priorities. Our dedicated resolutions chairman,
PNC Michael Berman, works very diligently to develop our resolutions
and to bring them before our convention delegates. Following further
fine-tuning by our convention delegates, our resolutions are finalized,
and become our legislative priorities for the coming year. We thank you
for the opportunity to present them to you today.

Prepared Statement of Bill Lawson

Chairman Murray, Chairman Miller and members of the Committees, I
appreciate the opportunity to present the legislative priorities for
2012 of Paralyzed Veterans of America (Paralyzed Veterans). Since its
founding, Paralyzed Veterans has developed a worthy record of
accomplishment, of which we are extremely proud. Again, this year, I
come before you with our views on the current state of veterans'
programs and services and recommendations for continued improvement in
the services and benefits provided to veterans.

BACKGROUND--Paralyzed Veterans was founded in 1946 by a small group
of returning World War II veterans, all of whom had experienced
catastrophic spinal cord injury and who were consigned to various
military hospitals throughout the country. Realizing that neither the
medical profession nor government had ever confronted the needs of such
a population, the returning veterans decided to become their own
advocates and to do so through a national organization.
From the outset the founders recognized that other elements of
society were neither willing nor prepared to address the full range of
challenges facing individuals with a spinal cord injury, be they
medical, social, or economic. Paralyzed Veterans' founders were
determined to create an organization that would be governed by the
members, themselves, and address their own unique needs. Being told
that their life expectancy could be measured in weeks or months, these
individuals set as their primary goal actions that would maximize the
quality of life and opportunity for all veterans and individuals with
spinal cord injury--it remains so today.
To achieve its goal over the years, Paralyzed Veterans has
established ongoing programs of research, sports, service
representation to secure our members' and other veterans' benefits,
advocacy in promoting the rights of all citizens with disabilities,
architecture promoting accessibility, and communications to educate the
public about individuals with spinal cord injury. We have also
developed long-standing partnerships with other veterans' service
organizations. Paralyzed Veterans, along with AMVETS, Disabled American
Veterans, and the Veterans of Foreign Wars, co-author The Independent
Budget--a comprehensive budget and policy document that has been
published for 26 years.
Today, Paralyzed Veterans is the only congressionally chartered
veterans' service organization dedicated solely to the benefit and
representation of veterans with spinal cord injury or disease.

SUFFICIENT, TIMELY AND PREDICTABLE FUNDING FOR VA HEALTH CARE--As

the country faces a difficult and uncertain fiscal future, the
Department of Veterans Affairs (VA) likewise faces significant
challenges ahead. Paralyzed Veterans has serious concerns about
potential reductions in VA spending. We are especially concerned about
steps VA has taken in recent years in order to generate resources to
meet ever-growing demand on the VA health-care system. In fact, the FY
2013 Budget Request and FY 2014 advance appropriation budget proposal
released by the Administration includes ``management improvements,'' a
popular gimmick used by previous Administrations to generate savings
and offset the growing costs to deliver care. Unfortunately, these
savings are often never realized leaving VA short of necessary funding
to address ever-growing demand.
Of even greater concern to Paralyzed Veterans is the VA's claim in
the FY 2013 Budget Request that it was provided nearly $3.0 billion in
excess resources in FY 2012 and more than $2.0 billion in excess
resources in FY 2013. We question how the VA can make such a claim,
particularly about FY 2012, when there remains fully six months in this
current fiscal year (FY 2012). The claim of excess resources does not
seem to match the all-too-common reports that we receive of
understaffed facilities and unavailability of services.
Additionally, with regards to the FY 2013 Budget Request, Paralyzed
Veterans has serious concerns about funding provided for Major
Construction and non-recurring maintenance. While The Independent
Budget recommends approximately $2.7 billion for Major Construction for
FY 2013, the Administration proposes to actually reduce funding from FY
2012 to FY 2013. For FY 2013, the Administration recommends
approximately $532 million, $58 million less than the amount
appropriated for in FY 2012. We also believe that the Administration
continues to insufficiently fund non-recurring maintenance needs. By
underfunding the infrastructure needs of the VA, the actual ability of
the VA health care system to provide timely, quality health care is
jeopardized thereby placing the health of veterans themselves at risk.
It is time for the Administration and Congress to get serious about
funding the construction and maintenance needs of the VA.
For FY 2013, the Administration recommends $55.7 billion for total
Medical Care spending. The Independent Budget recommends approximately
$57.2 billion for total medical care. In light of the VA's claims of
excess resources, we urge Congress to remain vigilant to ensure that
the proposed funding levels for FY 2013 are in fact sufficient to meet
the continued growth in demand on the health care system.
As for the specific recommendations for advance appropriations for
FY 2014 offered by the Administration, considering our concerns about
the funding levels provided for FY 2012 and FY 2013, we believe that
those estimates may be insufficient to meet the continuing increase in
demand for health care services. We are also skeptical of the
substantial increase in funding that the Administration calls for in
the Medical Support and Compliance account for FY 2014. Given the
scrutiny on funding for administrative functions within the VA health
care system, we are not certain that this projected increase truly
reflects a wise investment in resources.
Moreover, we have serious concerns about the significant reduction
in funding projected for Medical Facilities in FY 2014. While we
understand that the Administration intends to transfer approximately
$320 million in resources and 1,080 FTE from Medical Facilities to
Medical Services in FY 2014, this does not fully account for the
reduction in funding. The Administration's proposal also reflects a
plan to reduce funding for Non-Recurring Maintenance (NRM) by nearly
$300 million as well. This substantial decrease in NRM funding
certainly cannot be justified given the massive backlog of maintenance
and construction projects that currently exists. This fact is even more
troubling given the Government Accountability Offices (GAO) findings in
its report released last year on advance appropriations that identified
deficiencies in NRM funding. We encourage the Committee to conduct
aggressive oversight to ensure that the Administration is not cutting
funding in these critical areas simply as a way to drive down its
spending projections.
Finally, in light of the Administration's continued inability to
determine its position with regards to sequestration, we have serious
concerns about the fact that the VA claims to have nearly five percent
in excess resources when it faces the prospect of up to a two percent
reduction in funding under the rules of sequestration. We cannot
emphasize enough the need for VA to state unequivocally that its
programs will not be cut through sequestration. Otherwise, it is
imperative that the Senate and House approve S. 2128 and H.R. 3895
respectively to ensure that VA health care programs are protected from
consideration for spending reductions.

PROTECTION OF THE VA HEALTH CARE SYSTEM, WITH A FOCUS ON
SPECIALIZED SERVICES--The VA is the best health care provider for
veterans. Providing primary care and specialized health services is an
integral component of VA's core mission and responsibility to veterans.
Across the nation, VA is a model health care provider that has led the
way in various areas of medical research, specialized services, and
health care technology. In fact, the VA's specialized services are
incomparable resources that often cannot be duplicated in the private
sector. However, these services are often expensive, and are severely
threatened by cost-cutting measures and the drive toward achieving
management efficiencies.
Over the years, the VA has earned a reputation as a leader in the
medical field for its quality of care and innovation in both the health
care and medical research fields. However, even with VA's advances as a
health care provider, some political leaders and policy makers continue
to advocate for VA enrollment restrictions, use of vouchers, or
increased fee basis care. Such changes to the Veterans Health
Administration (VHA) would result in moving veterans from ``veteran-
specific'' care within VA and into the private health care industry.
Ultimately, these proposals would lead to diminution of VA health care
services, and increased health care costs in the federal budget.
Despite these recent calls for providing veterans with vouchers for
private care or the expansion of fee basis care, Paralyzed Veterans
strongly believes that VA remains the best option available for
veterans seeking health care services.
The VA's unique system of care is one of the nation's only health
care systems that provide developed expertise in a broad continuum of
care. Currently, VHA serves more than 8 million veterans, and provides
specialized health care services that include program specific centers
for care in the areas of spinal cord injury/disease, blind
rehabilitation, traumatic brain injury, prosthetic services, mental
health, and war-related poly-traumatic injuries. Such quality and
expertise on veterans' health care cannot be adequately duplicated in
the private sector.
Specialized services, such as spinal cord injury care, are part of
the core mission and responsibility of the VA. These services were
initially developed to care for the unique health care needs of
veterans. The provision of specialized services is vital to maintaining
a viable VA health care system. Specialized services are part of the
primary mission of the VA. The erosion of these services would lead to
the degradation of the larger VA health care mission. Reductions in
beds and staff in both VA's acute and extended care settings have been
reported, even though Public Law 104-262, ``The Veterans' Health Care
Eligibility Reform Act of 1996,'' mandated that VA maintain its
capacity to provide for the special treatment and rehabilitative needs
of veterans. In addition, Congress required that VA provide an annual
capacity reporting requirement, to be certified or commented upon, by
the Inspector General of the Department. Unfortunately, this basic
reporting requirement expired in 2004.
Furthermore, restructuring plans and moves by some to begin moving
down the path of privatization heighten the risk not only to
specialized services, but to the entire VA health care system. With
growing pressure to allow veterans to seek care outside of the VA, the
VA faces the possibility that the critical mass of patients needed to
keep all services viable could significantly decline. All of the
primary care support services are critical to the broader specialized
care programs provided to veterans. If primary care services decline,
then specialized care is also diminished.
As VA services are catered to the needs of veterans, VHA has
received excellent ratings from patient satisfaction surveys, and
garnered much recognition for its national safety program. The VA's
system of patient-centered and coordinated care helps to ensure safe
and consistent delivery of services. Additionally, independent research
organizations have also found VA to be the lowest cost provider when
compared to private health care systems. Paralyzed Veterans will
continue to oppose any efforts that place the VA health care system at
risk of being unable to properly meet the health care demands of
veterans, particularly veterans with spinal cord injury or dysfunction.

LONG-TERM CARE--Paralyzed Veterans continues to be concerned about
the lack of VA's long-term care services for veterans with spinal cord
injury or dysfunction (SCI/D). Approximately 6,000 of our members are
now over 65 years of age and another 7,000 are currently between 55 and
64. These aging veterans are experiencing an increasing need for VA's
home and community-based services and VA's specialized SCI/D nursing
home care.
The ability to remain in the home for many of these veterans is
based on their ability to receive VA home and community-based services
such as hospital based home care or respite services. For others, their
living status and independence is based on the health of a primary
caregiver, usually a spouse, who is also aging and may no longer be
able to provide the level of support they once could. VA's non-
institutional long-term care services are keys to supporting aging SCI/
D veterans and their caregivers and their desires to remain home as
they grow older.
Unfortunately, the ability of veterans with SCI/D to access a full
range of VA home and community-based care varies across the country.
Waiting lists exist at almost all VA facility locations and many other
VA facilities don't offer the full range of services mandated by the
``Millennium Health Care Act.'' Additionally, VA program geographic
boundaries often limit access to long-term care services provided by a
regional VA SCI center.
The availability of these services is necessary to support veterans
with SCI/D and their aging caregivers in their own homes, where they
most want to be, and at a dramatically lower cost of care to VA.
Paralyzed Veterans requests that your Committees encourage VA to
provide the full range of home and community-based long-term care
services, as mandated by P.L. 106-117, the ``Veterans Millennium Health
Care and Benefits Act of 1999,'' at each and every VA facility within
the system.
Regarding specialized SCI/D nursing home care, VA currently only
provides specialized nursing home care services for veterans with SCI/D
in four locations. Combined these four locations only provide 152
staffed specialized nursing home care beds and they are all located
east of the Mississippi River. While the VA CARES process called for
additional SCI/D nursing home care beds the VA construction process has
been slow to respond. CARES called for additional beds to be located in
Cleveland, Ohio; Long Beach, California and in Memphis, Tennessee. Of
those recommended sites for expansion of capacity, only Cleveland has
been placed into service within the VA system providing long-term care
services to SCI/D veterans. Additionally, several sites are in various
stages of the design process for expansion of long-term care capacity,
with Dallas, Texas being included in the funding request for Major
Construction for FY 2013. After almost 10 years, Paralyzed Veterans is
still pushing VA to proceed with the additional recommendations.
Similarly, the provision of Special Monthly Compensation (SMC) and
Aid & Attendance (A&A) benefits afford veterans with catastrophic
disabilities the opportunity to access long-term care options that
ordinarily may cost too much. With this in mind, we believe that the
Committees need to address the well-established shortfall in the rates
of Special Monthly Compensation (SMC) paid to the most severely
disabled veterans that the VA serves. SMC represents payments for
``quality of life'' issues, such as the loss of an eye or limb, the
inability to naturally control bowel and bladder function, the
inability to achieve sexual satisfaction or the need to rely on others
for the activities of daily life like bathing, or eating. To be clear,
given the extreme nature of the disabilities incurred by most veterans
in receipt of SMC, we do not believe that the impact on quality of life
can be totally compensated for; however, SMC does at least offset some
of the loss of quality of life.
Paralyzed Veterans believes that an increase in SMC benefits is
essential for veterans with severe disabilities. Many severely injured
veterans do not have the means to function independently and need
intensive care on a daily basis. Many veterans spend more on daily
home-based care than they are receiving in SMC benefits. This fact was
supported by the testimony of numerous witnesses at a hearing conducted
by the House Veterans' Affairs Subcommittee on Disability Assistance
and Memorial Affairs in July 2009.
Additionally, one of the most important SMC benefits to Paralyzed
Veterans is Aid and Attendance (A&A). Paralyzed Veterans would like to
recommend that Aid and Attendance benefits should be appropriately
increased. Attendant care is very expensive and often the Aid and
Attendance benefits provided to eligible veterans do not cover this
cost. In fact, many Paralyzed Veterans members who pay for full-time
attendant care incur costs that far exceed the amount they receive as
SMC-Aid and Attendant beneficiaries at the R2 compensation level (the
highest rate available). We encourage the Committees to consider
legislation that specifically address increases to the R1 and R2 rates
for SMC and A&A benefits soon.

PROTECTING VETERANS BENEFITS WHILE MODERNIZING THE VA CLAIMS
PROCESS--Paralyzed Veterans believes that VA benefits have no place in
deficit reduction efforts. VA disability compensation is a benefit
provided because an individual became disabled in service to the
country. In addition, many ancillary benefits--particularly Specially
Adapted Housing benefits, adaptive automobile assistance, and
vocational rehabilitation--are provided to service connected disabled
veterans. Moreover, education benefits, such as the Post-9/11 GI Bill,
are earned through service. These benefits reflect the debt of
gratitude this nation owes the men and women who served in uniform and
recognize the challenges they face every day as a result of their
service. Any attempt to reduce or modify eligibility criteria would be
considered an abrogation of the responsibility that this nation has to
veterans and would be wholly unacceptable. Additionally, reduction in
funding for VA pension programs would place veterans who live on the
financial margins to face the prospect of poverty and homelessness.
At the same time, we must remain engaged as the VA claims process
evolves and as the VA continues an extensive revision of the VA
schedule of rating disabilities (VASRD) even as Congress begins to
express interest in leaving its own mark on how the VASRD should be
rewritten. The Veterans Benefits Administration (VBA) is currently
engaged in the process of updating all 15 of the body systems governed
by the VASRD. Additionally, it has committed to regularly updating the
entire VASRD every five years. VBA indicated in testimony earlier this
year that the review process for all 15 body systems is in various
stages of completion, ranging from interim final rules being written to
already having been posted for public review in the Federal Register.
As this review process continues, Paralyzed Veterans must emphasize
what we believe is one of the most important aspects of a revision to
the ratings schedule--the consideration of quality of life as a
component of a new ratings schedule. Members of Congress, the VA, and
various stakeholders including the veterans' service organization
community have expressed support for this idea as well. The schedule
for rating disabilities is meant to reflect not just the average
economic impairment but the impact of a lifetime of living with a
disability and the everyday challenges associated with that disability.
Paralyzed Veterans also appreciates the interest and effort that
has been given to updating and modernizing the VA disability system in
recent years. However, it is important to note that success in
reforming the VA claims processing system will require the Veterans
Benefits Administration (VBA) to institutionalize the ongoing
transformation process at all levels to develop a work culture that
values, measures, reports and rewards quality and accuracy over speed
and production.
The VBA is entering its third year of its most recent effort to
transform an outdated, inefficient, and inadequate claims-processing
system into a modern, automated, rules-based and paperless system. VBA
has struggled for decades to provide timely and accurate decisions on
claims for veterans' benefits, especially disability compensation.
However, despite repeated prior attempts to reform the system, VBA has
never been able to reach the goals it has set for itself. Whether VBA
can be successful this time depends to a large extent on whether it can
complete a cultural shift away from focusing on speed and production to
a business culture of quality and accuracy.
There have been some encouraging steps towards such a cultural
shift over the past two years; however, this early progress must be
institutionalized in order to create the long term stability needed to
eliminate the current backlog of claims, and more importantly, prevent
such a backlog from returning in the future. VBA must change the way it
measures and reports the work it performs as well as the way in which
employees are rewarded, in order to reflect the principle that quality
and accuracy are at least as important as speed and production.
Ensuring that decisions are correct the first time will, over time,
increase public confidence in the VA and decrease appeals.
One of the more positive steps that has occurred as a part of VBA's
transformation has been the open and candid attitude of VBA's
leadership over the past several years, particularly progress towards
developing a new partnership between VBA and veterans' service
organizations who assist veterans in filing claims. Veterans' service
organizations have vast experience and expertise in claims processing,
with local and national service officers holding power of attorney
(POA) for hundreds of thousands of veterans and their families. We can
make VBA's job easier by helping veterans prepare and submit better
claims, thereby requiring less time and resources to develop and
adjudicate them. Veterans' service organizations have been increasingly
consulted on a number of the new initiatives underway at VBA, including
Disability Benefit Questionnaires (DBQs), the Veterans Benefit
Management System (VBMS), and many, but not all business process
pilots, including the I-LAB at the Indianapolis VA Regional Office.
Building upon these efforts, VBA must continue to reach out to its
veterans' service organization partners, not just at central office,
but also at each of the 57 Regional Offices.
Ultimately, we remain hopeful that the VA may finally be making
real progress towards meaningful reform to the claims process that will
ensure veterans receive accurate decisions the first time. However, it
will be incumbent upon the Committees to conduct substantive oversight
on VBA's activities to ensure that the primary objective--accurate
decisions the first time--is being achieved.

INCREASE IN CHAMPVA BENEFICIARY AGE--The Civilian Health and
Medical Program of the Department of Veterans Affairs (CHAMPVA) is a
comprehensive health care program in which the VA shares the cost of
covered health care services for eligible beneficiaries, including
children up to age 21. Due to the similarity between CHAMPVA and the
Department of Defense (DOD) TRICARE program the two are often mistaken
for each other. However, CHAMPVA is a VA managed program whereas
TRICARE is a health care program for active duty service members,
military retirees and their families and survivors.
All commercial health insurance coverage along with TRICARE has
increased the age for covered dependents from 21 years of age to 26
years, in accordance with the provisions of P.L. 111-148, the ``Patient
Protection and Affordable Care Act.'' At this time the only qualified
dependents that are not covered under a parent's health insurance
policy up to age 26 are those of 100 percent service-connected disabled
veterans covered under CHAMPVA.
To address this issue legislation has been introduced in the 112th
Congress that would increase the age for dependents covered by CHAMPVA
to 26 years old. The House bill is H.R. 115, and its Senate companion
is S. 490. We believe that these bills should be passed by Congress and
quickly enacted into law to ensure that dependent children of severely
disabled veterans are afforded the same health care protection as all
other children.

IMPROVE TRAVEL BENEFITS FOR CATASTROPHICALLY DISABLED VETERANS--
Currently the VA does not provide travel reimbursement for
catastrophically disabled non-service connected veterans who are
seeking inpatient medical care. Expanding VA's beneficiary travel
benefit to this population of severely disabled veterans will lead to
an increasing number of catastrophically disabled veterans receiving
quality comprehensive care, and result in long-term cost savings for
the VA.
Too often, catastrophically disabled veterans choose not to travel
to VA medical centers for care due to significant costs associated with
their travel. When these veterans do not receive the necessary care,
the result is often the development of far worse health conditions and
higher medical costs. For veterans who have sustained a catastrophic
injury like a spinal cord injury or disorder, timely and appropriate
medical care is vital to their overall health and well-being. When
these veterans do not receive the prescribed care, associated illnesses
quickly manifest and create complications that often result in
reoccurring hospitalizations and long-term, if not permanent, medical
conditions that diminish veterans' overall quality of life and
independence.
It is for this reason that legislation in both the House and Senate
Committees on Veterans' Affairs, H.R. 3687 and S. 1755, respectively,
proposes to change Section 111 of title 38 U.S. Code to extend travel
reimbursements for inpatient care to catastrophically disabled non-
service connected veterans who have incurred a spinal cord injury or
disorder, visual impairment, or multiple amputations. For this
particular population of veterans, their routine annual examinations
often require inpatient stays, and as a result, significant travel
costs are incurred by these veterans. Eliminating the burden of
transportation costs as a barrier to inpatient care, will improve
veterans' overall health and well being, as well as decrease, if not
prevent, future costs associated with both primary and long-term
chronic acute care. Most importantly, extending VA's travel
reimbursement benefit to catastrophically disabled, non-service
connected veterans will improve their access to health care and help
support full rehabilitation.
Paralyzed Veterans of America appreciates the opportunity to
present our legislative priorities and concerns for the second session
of the 112th Congress. We look forward to working with the Committees
to ensure that sufficient, timely, and predictable resources are
provided to the VA health care system so that eligible veterans can
receive the care that they have earned and deserve. We also hope that
the Committees will take the opportunity to make meaningful
improvements to the benefits that veterans rely on.
Chairmen Murray and Miller, I would like to thank you again for the
opportunity to testify. I would be happy to answer any questions you
have.

Information Required by Rule XI 2(g)(4) of the House of Representatives
Pursuant to Rule XI 2(g)(4) of the House of Representatives, the
following information is provided regarding federal grants and
contracts.
Fiscal Year 2012
No federal grants or contracts received.
Fiscal Year 2011
Court of Appeals for Veterans Claims, administered by the Legal
Services Corporation--National Veterans Legal Services Program--
$262,787.
Fiscal Year 2010
Court of Appeals for Veterans Claims, administered by the Legal
Services Corporation--National Veterans Legal Services Program--
$287,992.

Prepared Statement of Sam Huhn

INTRODUCTION
Madame Chair Murray, Chairman Miller, Ranking Members Senator Burr
and Congressman Filner, and other Members of the Committees on Veterans
Affairs, on behalf of the Blinded Veterans Association (BVA), I express
appreciation for this invitation to present our legislative priorities
for 2012. BVA is the only congressionally chartered Veterans Service
Organization exclusively dedicated to serving the needs of our Nation's
blinded veterans and their families. The Association has worked to
improve the lives of blinded veterans throughout the 67 years of its
service. As more wounded service members continue to return after more
than ten years of Operation Enduring Freedom (OEF), the recently
terminated Operation Iraqi Freedom (OIF), and Operation New Dawn (OND),
a new generation of seriously eye injured is being added to the decades
of combat wounded from previous wars. It is vital that we ensure that
these newly injured combat veterans, and all veterans from previous
wars, have the full continuum of high-quality vision care and benefits
they have earned from the Department of Veterans Affairs (VA) and
through the actions of this Congress.

CENTERS OF EXCELLENCE
The establishment of a Vision Center of Excellence (VCE) for the
prevention, diagnosis, mitigation, treatment, and rehabilitation of
military eye injuries was authorized by the Fiscal Year (FY) 2008
National Defense Authorization Act (NDAA, Public Law 110-181, Section
1623). The Hearing Center of Excellence (HCE) and Extremity Trauma and
Amputee Center (LEIC) were established in the FY 2009 NDAA (Public Law
110-417). Congress established these three Centers of Excellence (COEs)
three years ago. The intent was that all three be joint initiatives of
the Department of Defense (DoD) and VA. The overall objective was to
improve the care of American military personnel and veterans affected
by combat eye, hearing, and limb extremity trauma, and to improve
clinical coordination between DoD and VA for the treatment of wounded
service members. These three Centers are also tasked with developing
clinical registries containing up-to-date information on the diagnosis,
treatment, surgical procedures, and follow-up examinations for the
injuries experienced by our nation's military personnel.
Despite the legislative mandate to the contrary, the Defense
Department-Veterans Affairs Centers of Excellence have generally
struggled to meet even their start-up goals. In the case of the Hearing
Center of Excellence and the DoD -VA Extremity Trauma and Amputee COE,
at this time there are fewer than half a dozen employees between them
organizationally even though DoD operates three amputee clinical
centers.
Former Defense Secretary Robert Gates included the three Centers as
his second top priority in the February 2010 Quadrennial Defense Report
(QDR). Bureaucratic issues, governance questions, and limited budgets
have all hindered significant progress toward the full operational
establishment of the Vision Center of Excellence, the Hearing-Audiology
Center of Excellence, and the Extremity Trauma and Amputee Center of
Excellence. While we can report some progress during the past year with
VCE now having employed a DoD Director, a VA Deputy Director, and 11
full-time support staff, the other two Centers still lack necessary
personnel, thus hampering their progress. They also continue waiting
for Memos of Understanding and Operational Agreements. These three
Defense Centers of Excellence now face additional major challenges in
meeting their mandated objectives without strong governance oversight
and sufficient funding levels.
DoD and VA Information Technology, along with contractor
assistance, have developed the Defense Veterans Eye Injury and Vision
Registry (DVEIVR) as the very first clinical electronic health registry
having the ability to exchange with VA providers all eye-injury
clinical notes, diagnostic records, and surgical records from the
battlefield. DVEIVR was tested this past year and began extracting
information from the Joint Trauma Tracking Registry (JTTR) and Armed
Forces Health Surveillance Center on vision injured. During the next
six months DVEIVR will enter into its second stage of the pilot testing
of data exchange. Later, information technology data extractors will
take approximately 59,000 records of eye-injured personnel in Military
Treatment Facilities (MTFs) and VA Medical Centers (VAMCs.) The data
extractors will then securely download them into the DVEIVR in the next
several months. Despite this plan, cuts to DoD Information Technology
could slow or even stop this joint effort.
BVA requests that Congress appropriate $10 million for the VCE
operations budget FY 2013 and it require DoD and the VA Veterans Health
Administration (VHA) to report quarterly on their functional plans for
DVEIVR. BVA also requests status updates for HCE and LEIC. We believe
that within the framework of VCE and DVEIVR, Seamless Transition of eye
care and vision rehabilitation services, as well as veteran and family
education, can be developed and refined to improve long-term care of
veterans.

SEAMLESS TRANSITION
During the past three years, BVA has worked with Members of these
VA Committees, in addition to both the House Armed Services Committee
(HASC) and Senate Armed Services Committee (SAC). We have explained the
need to hold both DoD and VA jointly accountable for the many
organizational problems associated with the Seamless Transition process
that have so much affected the battle eye-injured and those with visual
system dysfunction complications associated with Traumatic Brain Injury
(TBI). VA last reported that DoD had the ICD-9 diagnostic code
information for 58,000 eye-injured service members and that VA had it
for 46,000. Within those numbers 16 percent of all evacuated wounded
had sustained eye trauma. Specific numbers from December 2010 data are
as follows:

Department of Veterans Affairs 46,000*
DoD Vision Center Excellence 58,000
Optic nerve injury 1,200
Retinal injuries 8,441
Chemical/ thermal burns 4,294
Orbital blast injuries globe 4,970
*Includes mild, moderate, severe eye injuries. \1\
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\1\ ``Analysis of VA Health Care Utilization Among OEF and OIF
Veterans'' Office VA Public Health and Enviromental Hazards Cumulative
Data from 1st Quarter 2002 to 4th Quarter 2010

Of the eye injured, 2,089 are reported by VHA to have a diagnosis
of low vision and 190 have been blinded, requiring treatment for both
groups at one of the 12 then existing VA Blind Rehabilitation Centers
(BRCs), or at low-vision clinics. Combat blinded veterans often suffer
from multiple traumas that include TBI, amputations, neuro-sensory
losses, PTSD (found in 44 percent of TBI patients), pain management,
and depression (affecting 22 percent of those diagnosed with TBI). The
Defense and Veterans Brain Injury Center (DVBIC) reports that an
analysis of the first 433 TBI-wounded found that 19 percent had
concomitant amputation of an extremity. Mild TBI was found in 44
percent of these 433 patients and 56 percent were diagnosed with
moderate-to-severe TBI. Some 12 percent of those with moderate to
severe TBI had penetrating brain trauma. \2\
---------------------------------------------------------------------------
\2\ ``Pain and Combat Injuries in Soldiers from OIF and OEF,''
Journal of Rehabilitation Research & Development 44 (November 2, 2007):
179-94.
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IED BLAST SURVIVAL
Improvised Explosive Device (IED) survivors face challenges that
range from the minor to the monumental: fractures, amputations,
disfigurement, sensory deficits, cognitive and motor impairments,
dysphagia, emboli and stroke, headaches, personality changes, visual
and auditory disturbances, altered affect, hypersensitivities and
dulled judgment. \5\ The mortality from blast violence has been reduced
by rapid medical interventions but blast injuries, by their nature,
usually include eye, ear and brain trauma. The resulting trauma is
sufficiently great that service members returning home will need years
of neurological, psychological, otolaryngological, and ophthalmologic
follow-up.
``The majority of soldiers we saw were injured by a blast of some
sort, rather than, for example, a gunshot wound,'' said Prem S.
Subramanian, MD, PhD. Dr. Subramanian, now an associate professor of
neuro-ophthalmology at Wilmer Eye Institute, spent several years on
staff at Walter Reed Medical Center in Washington, D.C., where he
managed many polytrauma patients who had sustained serious head and eye
combat injuries in Iraq or Afghanistan.
Stop the bleeding, keep them breathing. For troops who sustain
multiple injuries, this is a sober logic that governs the sequence of
interventions. ``In combat theater, surgeons and medics apply the
medical priority of `Save Life, Limb and Eyesight' approach to
prioritizing injuries, with limbs and eyes earning equal attention, and
both of those deferring to life-threatening injuries,'' Dr. Subramanian
said. ``If patients had a severe intra-cerebral hemorrhage, for
example, or subdural or subarachnoid hemorrhage, causing brain
herniation or depression of their vital signs, obviously that would
command the greatest precedence. Many would arrive at Walter Reed in
severe shock because of blood loss or a closed head injury.'' \3\ BVA
urges Members of Congress to support all battlefield research funding.
---------------------------------------------------------------------------
\3\ Eye Net Magazine, American Academy Ophthalmology Nov/Dec. 2008
Brain Injury and Vision Loss From Blast Trauma Clinical Update: The
Wounds of War by Dennis Smith Editor
---------------------------------------------------------------------------
TBI vision dysfunction was noted in a New England Journal of
Medicine study performed by doctors practicing at the Palo Alto VA
Polytrauma Center. The doctors had studied polytrauma patients
diagnosed with TBI who had no knowledge of an eye injury or who had not
previously reported eye injury (eyes with open injury were excluded
from analysis). Upon comprehensive eye exams, 43 percent of the
polytrauma patients had a closed eye injury in at least one location.
These data, combined with the 16 percent of those with known, or open,
vision injuries, imply that approximately 200,000 veterans may be
experiencing mild, moderate, or severe neurological vision dysfunction.
\4\ & \5\
---------------------------------------------------------------------------
\4\ Veteran Service Organizations Independent Budget VSOIB.Org,
page 75-76 Vision Injuries of Wars
\5\ Cockerham G. C., et al., ``Closed-eye ocular injuries in the
wars in Iraq and Afghanistan.'' N Engl J Med 364 (June 2, 2011): 2172-
2173.
---------------------------------------------------------------------------
Added to the number of penetrating eye injuries are the 75 percent
of mild, moderate-to-severe TBI service members who have suffered
visual system dysfunction. The data now come from various VA research
findings based on veterans tested by neuro-ophthalmologists or low-
vision optometrists. With increased visual screenings, each month they
are diagnosing higher numbers of vision impairments from blasts.
Although TBIs rarely result in legal blindness, researchers have found
rising numbers with TBI functional blindness and the VA Polytrauma
Centers in Palo Alto, Richmond, and Tampa reported that 75 percent of
all TBI patients have complained of visual symptoms as a result of
their blast exposure. VA research has further revealed that individuals
with a diagnosis of TBI visual system dysfunction have at least one,
and often three, of the following associated visual disorders:
diplopia, convergence disorder, photophobia, ocular-motor dysfunction,
color blindness, and an inability to interpret print. \6\ One research
study that examined 25 TBI veterans found, in the percentages
indicated, none of the following visual complications diagnosed early
in the normal medical evacuation process: corneal damage, 20 percent;
cataracts, 28 percent; angle recession glaucoma, 32 percent; retinal
injury, 22 percent. These complications place veterans at high risk of
progressive visual impairments if not diagnosed and treated early. \7\
---------------------------------------------------------------------------
\6\ Brahm, Karen D. Kirby, Jennine, Goodrich, Greg Ph.D. Vision
Impairment and Dysfunction in Combat Injured Servicemembers with
Traumatic Brain Injury, Optometry and Vision Science Volume 86, No. 7
Pg. 817-825
\7\ Cockerham, Glen MD. Palo Alto VAMC Poly Trauma Power Point, TBI
Vision June 2009
---------------------------------------------------------------------------
Service members with visual system impairment, or a penetrating eye
injury, must be tracked, especially those of the Army National Guard or
Army Reserve, so that their care is ensured and facilitated. The
failure to make an early diagnosis of a TBI visual impairment and to
appropriately treat it may prevent such veterans from performing basic
activities of daily living, resulting in increased unemployment,
inability to succeed in future educational programs, greater dependence
on government assistance programs, depression, and other psychosocial
complications.

PEER REVIEWED VISION TRAUMA RESEARCH PROGRAM (VTRP)
BVA, along with six other Veterans Service Organizations dedicated
to serving our Nation's veterans, are joined in supporting the
programmatic request of continuing directed funding in FY 2013 for the
for the Peer Reviewed Vision Trauma Research Program (VTRP) extramural
research line item, funding requested at $10 million for core vision/
eye research. This programmatic line item, managed by DoD's
Telemedicine and Advanced Technology Research Center (TATRC), was
initially created by Congress in FY 2008 appropriations and funded at
$4 million. In FY 2012, it was funded at the lowest level of $3.25
million in the past four years, resulting in lack of funding for
several vital deployment related eye trauma research grants. Defense-
related vision trauma research warrants a far more vigorous investment,
especially since TATRC and DoD experts identified vital research gaps
into restoration of sight and eye care as a priority for funding.
Today, battlefield conditions in OEF have resulted in the
classification of 10 percent of all eye wounds as severe global
injuries. In addition, and more generally, among those wounded and
evacuated, 48 percent of the eye injured have wounds of a higher level
of penetration and include TBI-related visual system dysfunction. This
is due to service members' exposure to the blasts when dismounting from
vehicles and being subjected to the full force of IEDs. According to
DoD, serious combat eye trauma from OIF and OEF was the fourth most
common injury (58,000 injuries) and trails behind only TBI (229,106)
PTSD (estimated at 300,000), and hearing loss (198,921). The majority
of the wounded have also suffered from polytrauma.
The November 2008 Medical Surveillance Defense Monthly Report from
the Armed Forces Health Center reported that a ten-year active duty eye
injury review from 1998 to December 2007 revealed a total of 188,828
ocular injuries. While 63 percent of the injuries were mild, there
were; 8,441 retinal and choroidal hemorrhage injuries (including
retinal detachment), 686 optic nerve injuries, and 4,294 chemical and
thermal eye burn injuries. \8\
---------------------------------------------------------------------------
\8\ Armed Forces Surveillance Center MSMR Volume 15, No 9, November
2008 Eye Injuries Active Duty Force 1998-2007 pg 2-4
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BVA demands to know why the Peer Reviewed Vision Trauma Research
Program is the lowest funded of all of CDMRPs for battlefield research.
Vision TBI screening programs and accompanying research are vital to
ensuring more front line deployment screening and treatment options for
these visual complications. Not unlike the existing specialized
research programs on burns, blood transfusions, limb extremity, and
spinal cord injuries, a more vigorously funded VTRP extramural research
program will enable the exploration of new and promising research
opportunities that directly meet battlefield needs. In light of this
urgent need, BVA strongly disagrees with the determination of Congress
to cut the Defense VTRP by 20 percent, down from $4 million in 2011 to
$3.2 million for FY 2012.
BVA requests that eye and vision trauma research within defense
appropriations be increased for the Vision Trauma Research Program VTRP
within the Congressionally Directed Medical Research Program (CDMRP).
We request, for FY 2013, $10 million as a dedicated line item for
Vision Trauma Research Program and point out that eye injury research
provides combat surgeons with new treatments that will preserve vision.
We also emphasize that the PRMR-Vision line item in defense
appropriations is a dedicated funding source for extramural research
into immediate battlefield needs. Although we were repeatedly told
there was no funding for FY 2012 and that tough choices therefore had
to be made, we point to a Floor statement on December 15 by Senator
John McCain: ``Mr. President, the Armed Services Committee authorized,
and the Congress will soon appropriate, some $290 million for research
into post-traumatic stress disorder, prosthetics, blast injury, and
psychological health. These are critical to improving actual
battlefield medicine. Yet, once again, the appropriators inserted
unrequested funding for medical research, this time to the tune of $600
million. Let me remind my colleagues that these unrequested projects
are funded at the expense of other military priorities.''
This type of eye trauma research for wounded warriors is not
conducted by the National Eye Institute (NEI) within the National
Institutes of Health (NIH) and is not funded by VA or other agencies.
DoD engages representatives of VA and NEI in a programmatic review of
the vision trauma research grants it receives. Each year, dozens of eye
trauma research grants cannot be funded because of the limit funded in
CDMRP. Despite the identification by TATRC of the urgent need to fill
the vision trauma battlefield research gaps in both eye trauma and TBI
vision programmatic research, Congress substantially reduced vision
funding for FY 2012. \9\ Although the VCE Director reviews defense
vision trauma research grants that can facilitate data-analyzed
documentation of the findings and the publication of combat
translational clinical plans to improve both acute eye injury care and
the long-term vision rehabilitation outcomes, VCE has no internal DoD
research funding.
---------------------------------------------------------------------------
\9\ ``Description of Research Gap Power Point `Inadequate War
Related Vision Trauma Research' DoD PP Nov 2010
---------------------------------------------------------------------------
We urge members of congress to review the GAO Report GAO-12-342SP,
Section 14, 2012. The majority of federal funding for health research
and related activities is spent by the National Institutes of Health
(NIH), within the Department of Health and Human Services (HHS), the
Department of Defense (DOD), and the Department of Veterans Affairs
(VA). In fiscal year 2010, NIH, DOD, and VA obligated about $40
billion, $1.3 billion, and $563 million, respectively, for activities
related to health research. \10\ While other federal funds may provide
research to wide variety of medical conditions listed in the CDMRP,
battlefield deployment research should be considered vital to DoD
budgets and taken into strong consideration with traumatic injury
research programs receiving priority funding to save life, limb and eye
sight.
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\10\ ``Opportunities to Reduce Duplication, Overlap, and
Fragmentation, Achieve Savings, and Enhance Revenue'' GAO12-342SP Feb
28, 2012 Section 14, Health Research Funding, Annual Report
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DoD-VA HEARING CENTER OF EXCELLENCE AND RESEARCH
Noise-Induced Hearing Loss and Tinnitus. During present-day combat,
a single exposure to the impulse noise of an IED can cause immediate
tinnitus and hearing damage. Nevertheless, rarely do Members of these
Committees receive testimony regarding the third most common injury
from the wars. The figure now stands at 198,921 for OIF and OEF service
members with service-connected hearing loss. Another 214,428 have been
rated for tinnitus. \11\
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\11\ Beck, Lucille Ph.D. Chief of VA Audiology, DVA Congressional
Briefing House Hearing Caucus Feb 8, 2012
---------------------------------------------------------------------------
An impulse noise is a short burst of acoustic energy, which can be
either a single burst or multiple bursts of energy. According to the
National Institute for Occupational Safety and Health, prolonged
exposure from sounds at 85+ decibel levels (dBA) can be damaging,
depending on the length of exposure. At 140+ dBA, the sound pressure
level of an IED, damage occurs instantaneously. Many common military
operations and associated noise levels, all exceeding the 140 dBA
threshold, occur on the battlefield, making hearing loss and tinnitus
the number one injury from the wars. According to Air Force Director of
HCE Colonel Mark Packer, MD, more than 233,000 active duty OIF and OEF
service members have now documented various levels of hearing loss.
\12\
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\12\ VSO Independent Budget 2012 pgs 113-114 Tinnitus and Hearing
Loss OIF and OEF
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HCE has a staff of one Air Force officer assigned in San Antonio's
Wilford Hall. There is no full-time VA staffing. While BVA appreciates
that total funding for HCE operations is $5 million for FY 2012, there
is a clear lack of strong oversight from the DoD-VA Health Executive
Committee (HEC). A January 31, 2011 Government Accountability Office
Report (11-114) on Hearing Programs found that while hearing loss is a
major physical injury from the wars, the progress on starting a hearing
injury registry to track and develop coordinated care between the two
health care systems lags far behind. \13\ BVA has become increasingly
frustrated that the two major sensory injuries from the wars, vision
and hearing, are the least funded for research. The high numbers of
invisible wounds that result in hearing and visual impairments, and
that negatively affect ability to function in society, are the least
funded when it comes to research budgets related to other injuries. BVA
supports the Defense Health Programs (DHP) DoD request of Sensory
Injury Research FY 2013 for $14,796,000 for hearing, vision, and gait
injuries to meet this challenge.
---------------------------------------------------------------------------
\13\ ``Hearing Loss Prevention: Improvements to DOD Hearing
Conservation Programs Could Lead to Better Outcomes'' GAO-11-114
January 31, 2011
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Translated into other financial terms, the government paid out
approximately $1.1 billion in VA disability compensation for tinnitus
in 2010. At the current rate of increase, service-connected disability
payments to veterans with tinnitus will cost $2.26 billion annually by
2014. While the government will spend increasing amounts to compensate
veterans with tinnitus, its investment in hearing trauma defense
research pales in comparison (less than 1 percent of current
compensation payments combined). The number of veterans affected is not
small either--as of the end of the second quarter of FY 2011, there
were 198,921 from OIF and OEF operations with a service connected
hearing loss.

BENEFICIARY TRAVEL FOR BLINDED VETERANS: H.R. 3687 AND S. 1755
BVA thanks Congressman Michaud, and Senator Tester for introducing
legislation for disabled SCI and blinded veterans who are currently
ineligible for travel benefits, thus assisting low income and disabled
veterans' the travel financial burdens. Veterans who must currently
shoulder this hardship, which often involves airfare, can be
discouraged by these costs to travel to a BRC. The average age of
veterans attending a BRC is 67 because of the high prevalence of
degenerative eye diseases in this age group. BVA urges that these
travel costs be covered by the VISN from which the veteran is referred
and not be an added burden for the disabled blinded veteran obtaining
the crucial rehabilitation training needed to gain independence through
VA Blind Rehabilitation Service (BRS). BVA therefore requests enactment
of HR 3687ensuring that VHA cover such travel costs by changing Title
38 Section 111 to ensure that VA provided public transportation costs
for travel to special rehabilitation program.
It makes little sense to have developed, over the past decade, an
outstanding blind rehabilitative service, with high quality inpatient
specialized services, only to tell low income, disabled blinded
veterans that they must pay their own travel expenses. To put this
dilemma in perspective, a large number of our constituents are living
at or below the poverty line but the VA Means threshold for travel
assistance sets $14,340 as the income mark for eligibility to receive
the benefit. The Congressional Budget Office scored the cost that would
result from S. 1755--$2 million for FY 2013 and $4 million each year
thereafter to travel for admission to either a Spinal Cord Injury
Center or a BRC. VA utilization data revealed that one in three
veterans enrolled in VA health care was defined as either a rural
resident or a highly rural resident. The data also indicate that
blinded veterans in rural regions have significant financial barriers
to traveling without utilization of public transportation.
To elaborate on the challenges of travel without financial
assistance, the data found that for most health characteristics
examined, enrolled rural and highly rural veterans were similar to the
general population of enrolled veterans. The analysis also confirmed
that rural veterans are a slightly older and a more economically
disadvantaged population than their urban counterparts. Twenty-seven
percent of rural and highly rural veterans were between 55 and 64.
Similarly, approximately twenty-five percent of all enrolled veterans
fell into this age group. \14\ In FY 2007, rural veterans had a median
household income of $19,632, 4 percent lower than the household income
of urban veterans ($20,400) \15\. The median income of highly rural
veterans showed a larger gap at $18,528, adding significant barriers to
paying for air travel or other public transportation to enter a VA BRC
or other rehabilitation program. More than 70 percent of highly rural
veterans must drive more than four hours to receive tertiary care from
VA. Additionally, states and private agencies do not operate blind
services in rural regions. In fact, almost all private blind outpatient
agency services are located in large urban cities. With the current
economic problems with state budgets clearly in view, we expect further
cuts to these social services that will bring even more challenges to
the disabled in rural regions.
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\14\ Department of Veterans Affairs, Office of Rural Health,
Demographic Characteristics of Rural Veterans Issue Brief (Summer
2009).
\15\ VSO IB 2013 Beneficiary Travel pg 119-120, 124-125
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VETERANS PROGRAMS IMPROVEMENT ACT OF 2011, S. 914
The current Special Adaptive Housing (SAH) requirement has a visual
acuity standard of 5/200 for eligibility. The 5/200 requirement should
be modified for the service-connected blind to 20/200 or less, or to a
loss of peripheral visual fields to 20 degrees or less. The Veterans
Benefits Administration testified before the VA Subcommittee on
Economic Opportunity in June 2010, expressing support for this change
since the 5/200 visual acuity standard is not used to deliver any other
VBA benefits. In addition, VHA has a visual acuity standard of 20/200
or less for legal blindness. BVA was grateful that H.R. 5290 was passed
by the House VA Committee with full bipartisan support and then
approved on the House Floor in September 2010. We also thank Senator
Begich and other Members for including this legislation in Section 306
of S. 914, the Veterans Programs Improvement Act of 2011.
If accessible housing grants and beneficiary travel assistance is
not allowed so that disabled veterans can live independently at home,
the alternative high cost of institutional care in nursing homes will
become the much less desirable alternative. According to a 2008 MetLife
survey, the average private room charge for nursing home care was $212
daily ($77,380 annually). For a semi-private room it was $191 ($69,715
annually). Even assisted living center charges of $3,031 per month
($36,372 annually) rose another 2 percent in 2008. These options are
far more costly and considerably less attractive than for VA to provide
adaptive housing grants for veterans to remain in their homes and
function there with some independence. \16\ In the United States, the
fifth most common cause of admission to nursing homes is blindness.
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\16\ BVA Testimony, Subcommittee on Economic Opportunity HVAC June
2010 Hearing
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BLIND REHABILITATION CENTERS (BRCs)
After more than 64 years of existence and progress, VA BRCs still
provide the most ideal environment in which to maximize the
rehabilitation of our Nation's blinded veterans. BRCs help blinded
veterans acquire the essential adaptive skills to overcome the many
social and physical challenges of blindness. Only the inpatient VA BRCs
have all of the diverse, specialized nursing staff, orthopedics,
neurology, rehabilitative medicine, occupational and physical therapy,
pharmacy services, and lab services to treat the complex war wounds of
service members and veterans.
The VHA Director of BRS must have more central control over blind
center resources and funding levels. The full Continuum of Care model
by VHA should ensure that both the outpatient programs and inpatient
BRCs have adequate staffing. Some VISN directors might attempt to force
medical centers or BRC directors to cut the staff and the BRC training
that is inherent in the success of these highly specialized
rehabilitation programs.
We caution that private agencies for the blind do not have the full
specialized nursing, physical therapy, pain management, audiology and
speech pathology, pharmacy services, neuro-radiology support services,
along with the subspecialty surgery specialists, to provide the
clinical care necessary for the newly complex, polytrauma war wounded.
The lack of electronic health care records is also a major problem when
veterans return to DoD or VA for follow-up care. BVA requests that all
private agencies be required to demonstrate peer reviewed quality
outcome measurements that are a standard part of VHA BRS, and that they
must also be accredited by either the National Accreditation Council
for Agencies Serving the Blind and Visually Handicapped (NAC) or the
Commission on Accreditation of Rehabilitation Facilities (CARF). Blind
Instructors should be certified by the Academy for Certification of
Vision Rehabilitation and Education Professionals (ACVREP). Agencies
should also have the specialized medical staffing necessary for complex
wounds. Additionally, no private agency should be used for newly war
blinded service members or veterans unless it can provide clinical
outcome studies, evidence-based practice guidelines, and joint peer-
reviewed vision research.

FUNDING VHA BRS
BVA supports the VSO Independent Budget (IB) for FY 2013 and the
IB's Advance Appropriations budget for FY 2014. This document was sent
to Congress earlier this year. The section of greatest interest,
however, and which most affects our membership, is the one dedicated to
VA BRS. The FY 2012 budget for BRS was $126 million. For FY 2013, it
would increase to $134 million. Advance Appropriations for FY 2014
would bring another increase, this one to $143 million. The VA budget
for BRS covers 13 BRCs and 45 outpatient programs.
Currently, 50,574 blinded veterans are now enrolled in BRS with
specialized care at those sites and within those programs. \17\ Studies
estimate that there are 156,854 legally blinded veterans and
epidemiological projections indicate that there are another 1,160,407
low-vision impaired veterans in the United States. Considering the
large number of veterans who may seek these services, ensuring that
each VA VISN Director continues to fully fund the Blind Rehabilitation
Clinics and BRCs is a high priority for BVA. We urge members to protect
VHA funding special disability programs from cuts.
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\17\ Blind Rehabilitation Service, BR Data (VHA, October 14, 2010).
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VISUAL IMPAIRMENT SERVICES TEAMS (VIST) AND BLIND REHABILITATION
OUTPATIENT SPECIALISTS (BROS)
The mission of each Visual Impairment Service Team (VIST) program
is to provide blinded veterans with the highest quality of blind
rehabilitation training. To accomplish this mission, the VIST program
has established mechanisms to maximize the identification of blinded
veterans and to offer a review of benefits and services for which they
are eligible. VIST Coordinators are in a unique position to provide
comprehensive case management and Seamless Transition services to
returning OIF/OEF service personnel for the remainder of their lives.
They can assist not only newly blinded veterans but can also provide
their families with timely and vital information that facilitates
psychosocial adjustment.
The VIST program now employs 115 full-time Coordinators and 43 who
work part-time. VIST Coordinators nationwide serve as the critical key
case managers. As state governments slash social services budgets,
these actions could draw more blind and low-vision veterans into the
system for care. Given the demographic projections of visually impaired
and blinded veterans, BVA believes and has always maintained that any
VA facility with 150 or more blinded veterans on its rolls should have
a full-time VIST Coordinator. Although VISTs and BROS ensure that
rehabilitation training occurs, some medical center directors are
delaying for months the filling of vacant positions for these key
personnel. We ask for stronger oversight and authority from VA BRS to
ensure that positions are filled. We ask Congress to request a
timetable for the BROS scholarship program that was included in S 1963
more than a year ago.

GUIDE DOG AND SERVICE DOG POLICY
BVA has more experience with guide dogs than most Veterans Service
Organizations. For 67 years, BVA has worked with both VA and the
original guide dog training programs to ensure that veterans who want a
guide dog can obtain one. For decades, hundreds of blinded veterans
have received guide dogs from a handful of well-known high quality
programs that never charged a veteran to receive a dog. The demand,
however, is now growing rapidly for expansion of this new benefit from
VA Prosthetics so that VA would cover all the costs associated with all
service dogs.
When it comes to service dogs for disabled veterans, Members of
Congress should understand that the private sector is virtually
unregulated. There are 49 states that have no laws concerning licensure
of service dog programs and no certification requirements for
instructors or trainers. BVA points out that while some advocates of
these programs attempt to use the International Association of
Assistance Dog Partners (IAADP) or the Americans with Disabilities Act
(ADA) as enforcement and regulatory mechanisms, the international
service animal standards are totally voluntary and there are no clear
federal statutory standards for the service animal programs. ADA rules
are only about public access to facilities for the disabled with a
marked ``service animal'' but the statute is silent on the licensing or
certification of the service dog program.
On the IAADP website, please note the following statement:
``Certification is not required in the USA.'' Most states therefore
lack programs to certify dogs if they did not go through the IAADP
training course. The Department of Justice decided to foster ``an honor
system,'' making the tasks the dog is trained to perform on command or
cue to assist a disabled person the primary way to differentiate
between a service animal and a pet rather than requiring yearly
certification for programs. This opened the door for people to train
their own assistance dog. Only nine service dog programs voluntarily
cooperate with the IAADP standards while 86 programs do not participate
in these standards. Although we hear about cost concerns regarding
nearly everything else, we have not heard that covering all future
costs associated with service animals. Furthermore, Physicians, Nurses,
Occupational Therapists, and Physical Therapists also lack knowledge
and training in this area to determine prescribing of service dog.
All factors considered, we ask: Who within VA will ``prescribes''
and decide if a service dog is necessary? Will it be only the veteran
and the service dog program? With other VA benefits, the providers must
prescribe devices or prosthetics. What then will occur with this
policy?
We strongly caution Members to reassess this situation for the
protection of disabled veterans against the potential risk of fraud and
poor training, and to consider the potential cost to VA. BVA requests
further consideration of the aforementioned problems. We request that
our views be considered in any future hearings on this issue.

CONCLUSION
On behalf of BVA, thank you for your efforts on behalf of all
veterans and their families. We look forward to working with all
Members of Congress in an effort to better serve our brave men and
women who have sacrificed on the battlefield and who are now seeking
care within the DoD and VA systems. We hope to also continue our
dedicated service to the veterans of previous generations to whom we
also owe our freedom. I will now gladly answer any questions you may
have concerning our testimony.

RECOMMENDATIONS
BVA endorses the VSO Independent Budget recommendation
regarding the advance funding for veterans health care for FY 2013-
2014. We again question why medical centers often have vacant clinical
positions while the VISNs and VHA have added administrative FTEEs.
Congress must ensure full establishment and Programmatic
Operational Management (POM) of the budget requested by DoD for FY 2013
for the Vision Center of Excellence (VCE) and Defense Veterans Eye
Injury Registry (DVEIR). DoD/VA staffing resources are critical to the
success of each Center of Excellence. The Health Executive Council
(HEC) must provide Congress with quarterly updates on all three DoD-VA
Centers of Excellence for Vision, Hearing, and Limb Extremity Injuries.

The following needed funding levels for the Centers of
Excellence have been identified for POM for FY 2013: $5 million for the
Defense Department-Veterans Affairs Extremity Trauma and Amputee Center
of Excellence, $10 million for VCE, and $5 million for HCE.
BVA firmly supports the position that extramural vision
research funding through the dedicated Peer Reviewed Vision Trauma
Research Program VTRP is critical. BVA urges that VTRP be funded at $10
million in FY 2013 for vision/eye research.
BVA requests passage of S. 914 legislation to correct the
Special Adaptive Housing standard for legal blindness, the Veterans
Benefits Administration must use legal standard 20/200 or less, or 20
degrees of visual field loss or less.
Beneficiary travel to VA Blind Rehabilitation Centers
(BRCs) should be provided by amending Title 38 of U.S.C. Section 111.
BVA requests support of S. 1755 and H.R. 3687 to cover any modes of
commercial travel for blind or spinal cord injured disabled veterans
for admission to inpatient rehabilitation services.
VA must maintain a ``critical mass'' of capital, human,
and technical resources to promote effective, high-quality
rehabilitative care, especially for those returning wounded with
complex health problems such as blindness, multiple amputations, spinal
cord injury, or TBI with mental health problems.
BVA supports FY 2013 Sensory System Injury programmatic
request from Defense Health Program (DHP) for $14,796,000 for all
sensory deployment injury research to meet this vital need.
BVA has repeatedly requested in its annual resolutions
that VA Information Technology be compliant with Section 508 of the
Americans with Disabilities Act. This compliance problem has still not
been fixed after many years. Recently, 50 percent of the IT budget to
meet compliance was cut within VA IT. Blind VA employees and BVA Field
Service Representatives are frequently unable to access the current VA
system because of its lack of ADA-compliant features. We request
oversight for compliance with this program.

DISCLOSURE OF FEDERAL GRANTS OR CONTRACTS BLINDED VETERANS ASSOCIATION
The Blinded Veterans Association (BVA) does not currently receive
any money from a federal contract or grant. During the past two years,
BVA has not entered into any federal contracts or grants for any
federal services or governmental programs.
BVA is a 501c (3) congressionally chartered, nonprofit membership
organization.

Prepared Statement of CMSGT (RET) USAF John R. ``Doc'' McCauslin

Chairman Murray and Miller, on behalf of the 110,000 members of the
Air Force Sergeants Association, I thank you for this opportunity to
offer the views of our members on the FY 2013 priorities for the Second
Session of the 112th Congress. This hearing will address issues
critical to those serving and who have served our nation.
For more than 50 years, the Air Force Sergeants Association has
proudly represented active duty, guard, reserve, retired, and veteran
enlisted Air Force members and their families. Your continuing effort
toward improving the quality of their lives has made a real difference
and our members are grateful. In this statement, I have listed several
specific goals that we hope this committee will pursue for FY 2013 on
behalf of current and past enlisted members and their families. The
content of this statement reflects the views of our members as they
have communicated them to us. As always, we are prepared to present
more details and to discuss these issues with your staffs.
How a nation fulfills its obligations to those who serve reflects
its greatness. Since 1973 with the inception of the all volunteer
force, we have continued to meet our objectives in recruiting. It is
evident that today's treatment of the military influences our ability
to recruit future service members, since a significant percentage of
those wearing the uniform today come from of military families.
It is important that this committee view America's veterans as a
vital national resource and treasure rather than as a financial burden.
As you deliberate on the needs of America's veterans, this Association
is gratified to play a role in the process and will work to support
your decisions as they best serve this nation's veterans. We believe
this nation's response for service should be based on certain
principles. We urge this committee to consider the following principles
as an underlying foundation for making decisions affecting this
nation's veterans.

GUIDING PRINCIPLES

1. Veterans Have Earned a Solid Transition from Their Military
Service Back into Society: This country owes its veterans dignified,
transitional, and recovery assistance. This help should be provided
simply because they faithfully served in the most lethal of
professions. For example - America lost 36,500 in the Korean War,
58,000 died in the Vietnam conflict; another 4,484 were lost in Iraq
and most recently, more than 1,800 in Afghanistan.
2. Most Veterans Are Enlisted Members: Enlisted veterans served
with great pride and distinction. Our volunteer force has deployed over
3.3 million servicemembers and over 900,000 have deployed more than
once during the last eleven years. 45,000 of those who have deployed
have Traumatic Brain Injuries (TBI). 700,000 children of our
servicemembers have had one parent deployed during their lifetime. We
should factor in the unique circumstances of enlisted veterans,
especially in the area of the needs of the servicemember and their
families once they have completed their tour of service to our country
3. Decisions on Veterans' Funding Should be Based on Merit: Funding
for military veterans must, of course, be based on fiscal reality and
prudence. However, Congress and, in turn, the VA must never make
determinations simply because ``the money is just not there'' or
because there are now ``too many'' veterans. Funding for veterans'
programs should be viewed as a national obligation--a ``must pay''
situation. If congress can vote, fund, and send our servicemembers to
war, they need to facilitate, fund, and provide care for those who have
returned.
4. Remember that the Guard and Reservists are Full-fledged Veterans
Too! In Iraq, Afghanistan, and around the world, reserve component
members are valiantly serving their nation, ready to sacrifice their
lives if necessary. Since September 11, 2001, record numbers have been
called up and continue to support operations. Nearly half of U.S.
forces that served in Iraq have been guardsmen and reservists. Without
question, enlisted guard and reserve members are full-time players as
part of the ``Total Force.'' Differences between reserve component
members and the full-time force, in terms of VA programs or
availability of services, are well overdue for review and updates.
5. The VA Must Openly Assume the Responsibility for Treatment of
the Maladies of War: We are grateful for VA decisions in recent years
that show a greater willingness to judge in favor of the service
member. The VA focus on health care conditions caused by battle should
be on presumption and correction, not on initial refutation, delay, and
denial. It is important that the decision to send troops into harm's
way also involves an absolute commitment to care for any healthcare
condition that may have resulted from that service. Many veterans call
and write to this Association about our government's denial, waffling,
and reluctant recognition of illnesses caused by conditions during past
conflicts. We applaud past decisions of your committees toward
reinforcing a commitment to unconditional care after service, and
encourage you to do the same in the future.
6. Taking Care of Families: Taking care of families is as essential
as taking care of our Veterans. This is especially true for family
members who now serve as the primary caregivers of ill or injured
Veterans. By taking care of these family members, we honor a commitment
made by our country to our Veterans and military members.

ADMINISTRATION'S FY 2013 PROPOSAL

Proposed FY 2013 Funding: The Administration requested $140.3
billion for VA in FY 2013; $76.3 billion for mandatory benefits like
disability compensation and $64 billion is in discretionary funding,
primarily for the Veterans Health Administration. These amounts
represent a welcomed 10.5 percent increase over FY 2012 levels but
falls roughly $4 billion short of funding levels recommend by The
Independent Budget, a document co-authored by the VFW, AMVETS, Disabled
American Veterans, and Paralyzed Veterans of America. AFSA endorses the
Independent Budget because we believe this careful review of Veterans
programs reflects a more accurate assessment of the funding VA will
need in the coming year.
With thousands of service members slated to be released by DoD in
the coming months, many of them will turn to the VA for their care.
None of these patriots should be turned away or their care delayed and
it is imperative that VA receives a full complement of resources to
address this shift in the nation's obligation. We strongly urge these
committees to review the Administration's proposed funding levels and
boost them where appropriate.
Sequestration: Our members are concerned with the prospect of
sequestration and how it could undermine VA funding in the coming
years. Due to an unintended conflict in law, VA could still face a two
percent cut in their medical care budget as a result of last year's
budget deficit reduction agreement. Such a cut would severely impair
the department's ability to provide the life-saving healthcare
America's veterans have earned and deserve.
Although assurances have been given this will not happen,
nevertheless, this discrepancy exists and it must be resolved soon, and
with absolute certainty. Our Veterans deserve no less. The Air Force
Sergeants Association endorses Chairman Miller's bill, H.R. 3895, the
``Protect VA Healthcare Act of 2012,'' and the Senate companion
measure, S. 2128, offered by Senator Jon Tester which provides this
clarity.
We urge you not to delay in advancing this important legislation,
and call on Congress as a whole to pass it as quickly as possible so
Veterans and the department won't be left wondering when, or if the rug
will be pulled out from underneath them.

VETERANS HEALTH CARE

Wounded Warriors: Nearly 48,000 service members have been wounded
in action over the past eleven years. Thousands of others have suffered
service-connected illness and injuries in related support actions. As a
nation, we have no greater responsibility than to care for our warriors
now suffering from the maladies of war. We are pleased that the budget
continues to show high levels of support for Wounded Warrior care. We
hope this support never wanes.
Continued emphasis and funding is needed for VA programs that
address Traumatic Brain Injury (TBI) and Post-Traumatic Stress Disorder
(PTSD), the two ``signature injuries'' of the most current conflicts.
Oftentimes TBI and PTSD do not produce visible signs until long after
the battle is over. Nor are they easy to treat. There is no ``one size
fits all'' treatment and VA must research and ensure a variety of
effective ones are readily available. At the same time, greater numbers
of Veterans are returning from the battlefield with significant visual
and auditory-impairments. We are concerned that VA may not have
adequate resources to address the influx of Veterans with auditory and
visual disabilities, and believe this area of care merits further study
by these committees.
Care for Women Veterans: We applaud the actions of your committees
in recent years for championing women Veteran issues! The unique health
care requirements of women Veterans must be addressed with a sense of
higher urgency from Congress. According to a recent VA Fact Sheet, more
than 1.8 of the nations 22.2 million Veterans are women. Currently,
women make up more than 19 percent of the active duty Air Force and
approximately 21 percent of the Air Force Reserve (Air Force Personnel
Center). We currently have more than 214,000 women serving in the DoD
today, many of whom served in Iraq and Afghanistan. Of those who have
served, VA estimates that more than 40 percent have already enrolled
for healthcare, a percentage that is expected to double in the next 20
years. They too suffer from the same effects of battle as many of their
fellow male service members; such as PTSD, TBI, and Wounded Warrior
issues that come with wearing the uniform. As the number of women
veteran's increases, VA must be funded accordingly to meet their
specific health care needs. We have been transitioning over the years
away from the large male population of previous wars and conflicts and
we must absolutely make sure that we do not neglect the needs of these
women who have volunteered to serve our country.
Defense Centers of Excellence: VA should actively support the
efforts of many Defense Centers of Excellence (DCOE) which have been
created to address specific areas of military related medicine. Their
participation with each of the individual DCOE's will contribute to the
diagnosis and treatment of the many types of severe injuries Veterans
are experiencing as a result of the conflicts in Iraq and Afghanistan.
Family Caregivers: Family Caregivers provide crucial support in
caring for Veterans and AFSA greatly appreciates the work of these
committees in passing the ``Caregivers and Veterans Omnibus Health
Services Act of 2010'' (P.L. 111-163), now commonly known as the
``Caregiver Bill.'' This important piece of legislation provides a
monthly stipend, respite care, mental and medical health care, and
secures necessary training and certifications required for caregivers
to meet the specific needs of injured OEF/OIF Veterans. VA recognizes
that Family Caregivers in a home environment can enhance the health and
well-being of Veterans under VA care. The families of these injured
Veterans want to provide this care and the Caregiver Bill turned that
into a reality for many. Anything we can do to further alleviate the
burden they have accepted would be most appropriate.
At the same time, AFSA strongly supports the full expansion of the
caregiver program to include Veterans of other engagements. There
should be no distinction in the sacrifices made by a severely disabled
veteran or their family, regardless of where or when they served. The
service of our veterans from previous wars must be honored similarly,
and Congress must support and oversee a timely and fair implementation
of P.L. 111-163 that provides these caregiver benefits to veterans of
all eras.
Support the judicious use of VA-DoD sharing arrangements: AFSA
supports the judicious use of VA-DoD sharing arrangements involving
network inclusion in the DoD health care program, especially when it
includes consolidating physical examinations at the time of separation.
It makes no sense to order a full physical exam on your retirement from
the military and then within 30 days the VA has ordered their own
complete physical exam with most of the same exotic and expensive
exams. The decision to end that duplication process represents a good,
common-sense approach that should eliminate problems of inconsistency,
save time, and take care of veterans in a timely manner. Initiatives
like this will save funding dollars. However, AFSA recommends that
these committees closely monitor the collaboration process to ensure
these sharing projects actually improve access and quality of care for
eligible beneficiaries. DoD beneficiary participation in VA facilities
must never endanger the scope or availability of care for traditional
VA patients, nor should any VA-DoD sharing arrangement jeopardize
access and/or treatment of DoD health services beneficiaries. One
example of a successful joint sharing arrangement is the new clinic
with ambulatory care services being in Colorado Springs, Colorado. This
will aid the large number of veterans remaining in the area and support
the increases in Colorado Springs as a result of BRAC initiatives. The
VA and DoD each have a lengthy and comprehensive history of agreeing to
work on such projects, but follow-through is lacking. We urge these
committees to encourage joint VA-DoD efforts, but ask you to exercise
close oversight to ensure such arrangements are implemented properly.
Support VA Subvention: With more than 40 percent of veterans
eligible for Medicare, VA-Medicare subvention is a very promising
venture, and AFSA offers support for this effort. Under this plan,
Medicare would reimburse the VA for care the VA provides to non-
disabled Medicare-eligible veterans at VA medical facilities. This
funding method would, no doubt, enhance elderly veterans' access to VA
health care and enhance access for many veterans.
Other Healthcare Issues: Other Veteran's health-care issues not
addressed in this statement but included in our Associations top
priorities are:

Limit user fees and prescription co-pay increases at VA
medical facilities
Require the VA to accept licensed civilian medical/dental
provider prescriptions
Pursue the VA to have chiropractic care where possible

GENERAL VETERANS ISSUES

``Seamless'' Transferable Medical Records - Speedier Claims
Processing and Improved Accuracy: For many veterans, association with
the VA begins with the claims process. Proposed increases in funding
and manpower mentioned in the Administration's budget plan are
admirable. The backlog for compensation and pension, education and
appeals claims is a disgrace! At the time this testimony was prepared,
VA's Monday Morning Workload Report showed more than 1.4 million claims
were pending. 600,979 or 66 percent have been pending for more than 125
days and this is unacceptable! I don't profess to be an expert here,
but I am aware larger VSOs have already made recommendations to these
committees in this area--changes my organization can and will support.
One thing is clear: the record numbers of veterans generated by the
wars in Afghanistan and Iraq underscore the importance of accelerating
DoD and VA plans to seamlessly transfer medical information and records
between the two federal departments. The implementation of a true,
Virtual Lifetime Electronic Record is long overdue and a welcomed step
into the 21st century. At the same time there needs to be greater
emphasis on accurately processing initial claims, which would reduce
appeals and secondary submissions. Most important, it would better
serve the needs of Veterans who rely on the timely approval of VA
benefits and services.
Transition Assistance Program: The VOW To Hire Heroes Act made the
Transition Assistance Program (TAP), an interagency workshop
coordinated by Departments of Defense, Labor and Veterans Affairs,
mandatory for service members to help them secure meaningful employment
at the end of their service. We appreciate the efforts of these
committees to make sure all separating members receive this important
transition benefit. At the same time, AFSA is concerned with the fact
that the content of TAP has changed very little in the last 25 years.
We understand the Department of Labor plans to unveil a new program in
the near future, and we encourage Members of Congress to ensure it
provides Veterans with current information and tools they need to
successfully transition out of the military and into the civilian
sector. We hope the new program will place greater emphasis on the
participation of military spouses because they too play a key role in
the successful transition of the entire military family.
Policy Consistency: We appreciate your committees' efforts to
reduce the pervading feeling among veterans that our government's
approach to providing adequate service to an ever-growing number of
veterans is to shrink the number of patients by excluding more classes
of veterans. Please continue to resist any effort that limits Priority
8 veterans who deserve to have the VA option available to them--even
though they may not be inflicted with service connected disabilities.
Provide a Written Guarantee: Many veterans are frustrated and
disappointed because existing programs they thought they could depend
on have been altered or eliminated due to changing budget philosophies.
That has created a perception among service members and veterans that
the covenant between the nation and the military member is one-sided--
with the military member/veteran always honoring his/her obligation,
and hoping that the government does not change the law or the benefits
upon which they depend. We urge your committees to support a guarantee
in writing of benefits to which veterans are legally entitled by virtue
of their service. This would demonstrate that the government is
prepared to be honest and consistent with its obligation to its service
members and ``Keep America's Promise to America's Military ``
Modification of Enhanced Per Diem for State Veterans Homes: The
State Veterans home program continues to be the preferred provider of
long term care for veterans providing over 30,000 beds in 140 state
veteran's homes in all fifty states. This is over fifty percent of our
veteran's long term population. Veterans Affairs has formed an ongoing
partnership with state governments and the State Veterans Homes, yet it
is essential that Congress and the VA recognize that veterans often
need a level of care greater than what the per diem reimbursement rate
provides. The current challenge is the enhanced per diem program that
went into effect twenty three months ago. These homes are an excellent
federal investment since the states provide funding for two-thirds of
total operating costs.
The State Home program for severely disabled veterans was approved
by Congress in 2006 to allow veterans with disabilities rated 70
percent or greater to have the same no-cost access to State Veterans
Homes that they already have to VA-operated nursing homes and community
nursing homes. Unfortunately, the new program's implementing
regulations did not achieve the congressionally-mandated purpose of
providing parity between State Home reimbursement rates and the
reimbursement rates provided to private contract nursing homes. As a
result, many State Homes that admitted severely disabled veterans
suffered financial losses and others interested in providing services
to these Veterans found they could not afford to provide such care.
More importantly, many of these Veterans have been effectively
prevented from the choice to receive their long term care at State
Veterans Homes.
To correct this problem, the House on October 11, 2011, voted
unanimously to approve language authored by Representative Mike Michaud
(D-ME) and Chairman Miller which would modify the program by allowing
VA to enter into contracts or agreements with State Homes for the care
of any veteran with a service-connected disability rated 70 percent or
greater. This provision was included in H.R. 2074 which addresses
several other veterans-related issues. Identical language was included
in S. 914, authored by Senator Mark Begich (D-AK) and approved
unanimously by the Senate Veterans' Affairs Committee back on June 29,
2011. Unfortunately, the Senate has not moved any further action on
either S. 914 or H.R. 2074, and we urge them to pass this legislation
and resolve this longstanding problem.
Protect VA Disability Compensation: Despite being clearly stated in
law, veterans' disability compensation has become an easy target for
former spouses and lawyers seeking money. This has been allowed to
transpire despite the fact the law states that veterans' benefits
``shall not be liable to attachment, levy, or seizure by or under any
legal or equitable process, whatever, either before or after receipt by
the beneficiary.'' Perhaps, enactment is needed to protect the
probation against court-orders or state legislation that would award VA
disability dollars to former spouses or third parties in divorce
settlements.
Homeless Veterans: Ending homelessness among Veterans is a top
priority for the President, VA Secretary Shinseki, many other federal
agencies and this Association. Thanks to your efforts, VA now has the
resources to attack this problem head-on and they appear to be
succeeding. Recent figures show homelessness among the nation's
Veterans declined by about 12 percent during a one-year period ending
January 2011, from 76,000 to 67,500. This news is encouraging but
67,500 veterans without a place to call home are still way too many. Of
particular concern: homeless Veterans, men and women, that have young
children because we understand their numbers are increasing. We urge
your continued support for VA's homeless assistance programs like
vouchers for housing and the National Call Center for Homeless Veterans
hotline which are critical to finally ending homelessness among
Veterans. No one who has served this Nation in uniform should ever have
to be living on the streets.
Legitimate, Sincere Veterans Preference: Commendable moves in
recent years by VA and the Department of Labor have enhanced the job
preferences available to Veterans. However, we need to ensure that OPM
guidelines that allow selective hiring practices within the federal
government are removed. Some Veteran applications are never even
considered for employment in the federal government, due to allowed
restrictive qualification wording and narrowed hiring practices. We
continue to urge your committees to support any improvement that will
put ``teeth'' into such programs so that those who have served have a
``leg up'' when transitioning back into the civilian workforce. One
example of giving veterans a preference is the recently created
Civilian Expeditionary Workforce (CEW). By meeting the goals of DoD and
the administration, we can at the same time hire qualified veterans who
have already gained the experience from the vast deployments in
previous years who are willing to serve their country in this capacity
as a full time government employee.
Concurrent Receipt: AFSA continues its advocacy for legislation
that provides concurrent receipt of military retired pay and veterans'
disability compensation for all disabled retirees without offset. Under
current statues, retirees with 50 percent or greater disabilities will
receive their full retired pay and VA disability in FY 2014. Congress
should now focus on eliminating this unjust offset for veterans with
lesser disabilities and in particular, individuals who were medically
retired with less than 20 years of service due to a service-connected
illness or injury. They are not treated equally!
Support of Survivors: With current military deployments and
increasing casualties, it is imperative that we plan to properly take
care of those who may be left behind if a military member makes the
ultimate sacrifice. We commend these committees for previous
legislation, which allowed retention of Dependency and Indemnity
Compensation (DIC), burial entitlements, and VA home loan eligibility
for surviving spouses who remarry after age 57. However, we strongly
recommend the age-57 DIC remarriage provision be reduced to age 55 to
make it consistent with all other federal survivor benefit programs.
We also endorse the view that surviving spouses with military
Survivor Benefit Plan (SBP) annuities should be able to concurrently
receive earned SBP benefits and DIC payments related to their sponsor's
service-connected death. We want to thank Congressman Joe Wilson, (R-
SC) for introducing H.R. 178 and Senator Bill Nelson, (D-FL) for
introducing S. 260 which would repeal the SBP-DIC offset. We also thank
the 177 and 49 cosponsors (respectively) who are co-sponsoring this
important legislation.
As you know, the fiscal year 2008 NDAA (Public Law 110-181) created
the Special Survivor Indemnity Allowance (SSIA) for surviving spouses'
whose military Survivor Benefit Plan (SBP) annuities were being offset,
in whole or in part, by Dependency and Indemnity Compensation (DIC)
which are paid by the Department of Veterans Affairs. It also applies
to the widows of members who died on active duty whose SBP annuity is
partially or fully offset by their DIC. Congress approved this
legislation in lieu of repealing the SBP/DIC offset.
SSIA began as a $50 monthly payment on October 1, 2008, and was
scheduled to increase by $10 each year through 2013 when the benefit
expired. In 2009, a provision in the Family Smoking Prevention and
Tobacco Control Act (Public Law No: 111-31) extended the allowance
another five years and increased projected monthly rates. Provisions in
the House version of FY 2012 NDAA would have extended the benefit
through 2021, and raise monthly rates slightly through FY 2017, but the
provision was dropped in Joint Conference. Needless to say we were
disappointed with this action and continue to call on Members of
Congress to eliminate this unjust offset altogether.
Finally, it is time to end the government's practice of
electronically withdrawing the last paycheck of military retirees upon
their death. Automatically withdrawing these funds can inadvertently
cause essential payments to bounce and place great financial strain on
a beneficiary already faced with the prospect of additional costs
associated with their loved one's death. Congressman Walter Jones, (R-
NC) introduced the ``Military Retiree Survivor Comfort Act,'' H.R. 493,
in January 2011 which would allow survivors to retain the full month's
retired pay for any month the retiree was alive for at least 24 hours.
To offset the cost associated with his proposal, a provision of the
bill would delay the first Survivor Benefit Plan (SBP) annuity payment
until the month after the retiree dies. Congress passed a similar law
in 1996 allowing surviving spouses to retain Veterans disability and VA
pension payments issued for the month of the veteran's death. AFSA
strongly believes military retired pay should be treated no
differently.
Veterans Status for Certain Reserve Component Members: AFSA
supports full veteran status for Reserve component members with 20
years or more of service, who do not otherwise qualify for Veterans
status under current law. The House on October 21, 2011, passed H.R.
1025, which was introduced by Representative Tim Walz (D-MN). We
greatly appreciate Senator Mark Pryor's leadership for introducing a
Senate companion measure, S. 491, the ``Honor American's Guard-Reserve
Retirees.'' We urge the Senate Veterans Affairs Committee to approve
this legislation which would grant this status to these deserving
individuals that are ``veterans'' in every sense of the word!
National Cemeteries: VA's National Cemetery Administration (NCA) is
responsible for providing final honors to many of our Nation Veterans.
Thanks to your efforts, many expansion projects and construction
projects have been completed, are underway or are being planned to
ensure everyone who served this Nation in uniform has a final resting
place. The NCA has come under fire recently due to a series of audits
that revealed over 240 mismarked or unmarked graves and eight veterans
or their loved ones buried in the wrong place at 13 cemeteries
nationwide. I want to publicly thank Rep. Jon Runyan (R-NJ), Chairman
of the Subcommittee on Disability Assistance and Memorial Affairs, for
holding a recent oversight hearing on the matter which stressed the
importance of fixing these mistakes at National Cemeteries. As he
correctly noted at that hearing, ``We have a solemn obligation to
cherish the memory and heroic actions of our veterans by holding
ourselves and our organizations to the highest of standards.'' It is
our mutual duty to honor our fallen heroes as best as we know how, with
all the resources we can muster, and these oversight hearings should
continue until each of these problems are resolved.
Clark Veterans Cemetery: The United States left Clark Air Force
Base in the Philippines in 1991 following destruction of the base by
the Mount Pinatubo vocanic eruption and the collapse of base agreement
negotiations. No provisions were made for the perpetual care of its
military post cemetery, known as the Clark Veterans Cemetery (CVC).
The CVC was established in 1948 by moving remains and head stones
of over 7,000 graves from several older U.S. military base cemeteries
located throughout the Philippines to include Fort McKinley in Manila,
Sangley Point Naval Station and two cemeteries located on Fort
Stotsenberg. Over 5,000 alone were disinterred from the old Fort
McKinley cemetery to make room for a new World War II American Military
Cemetery and Memorial on the same site, forever linking the Clark and
new Manila Cemetery. The Air Force continued military burials at Clark
until November 1991. The CVC then fell into disrepair with overgrown
vegetation, vandalism, ash damage and looting. In 1994 the local VFW
Post restored the cemetery as best they could and began a program of
maintenance as well as burial of our veterans. Today, over 8,600
American veterans and their families are interred, veterans who served
in every war since the Civil War, to include the Iraq War. It is an
abandoned and forgotten American Military Cemetery with over a hundred
years of history as rich as any other of our nation's military
cemeteries.
Recently, Rep. Frank Guinta (R-NH) introduced H.R.4168, the
``Caring for the Fallen Act'' which would designate the appropriate
entity, the American Battlefields Monuments Commission (ABMC), to care
for the Clark Veterans Cemetery. ABMC manages the Manila American
Cemetery and Cabanatuan POW Memorial, both a short equidistant drive
from the CVC. ABMC is our nation's professional organization for the
care and administration of all of our overseas memorials and
cemeteries. Ironically, the Air Force turned over the Clark cemetery
records to the ABMC in 1993, but not the cemetery. The appropriation
and authorization that created CVC in 1948 is the same one that created
the ABMC cemetery in Manila. The two are eternally linked. The ABMC
site in Manila would not exist today if those previously interred were
not moved to Clark. Clark itself is historic with a Monument to 1,055
Unknown Dead from the 1900-1906 Spanish and Philippine American Wars.
The ABMC is the logical manager on the basis of history, cost,
competence, and law; 36 U.S.C. 21 already provides the authority and
wide latitude. ABMC does not own its land; there are no sovereignty or
control issues. We are told the Philippine government is receptive to a
lease or similar usufruct type agreement.
The ``Warrior Ethos'' embedded in the character of our uniformed
men and women demands that we never forget the sacrifices of those who
have served this Nation. ABMC says a ``decision rests with the
Congress'' and we hope you will act favorably on H.R. 4168 to help
ensure the Veterans interred at Clark Veterans Cemetery are properly
honored for generations to come.
POW/MIAs: AFSA remains committed to provide the fullest possible
accounting of missing military members from all past and future
military actions, and promotes international compliance in recovery
efforts. We urge the members of these committees to fully support and
fund the efforts of the Joint POW/MIA Accounting Command (JPAC), a
joint task force within DoD whose mission is to account for Americans
who are listed as Prisoners Of War (POW), or Missing in Action (MIA).
Full accounting for those Missing in Action is not just a term for
us, it is a commitment to the memory of those missing in action and
their families. We, as a nation, owe these families our very best
efforts to account for all missing members of our Armed Forces.

EDUCATION

Post 9/11 GI Bill: Arguably the best piece of legislation ever
passed by Congress and thanks to the efforts of many of you here, the
Post-9/11 GI Bill is providing unprecedented educational opportunities
for the thousands of men and women who served in uniform since 9/11and
many of their family members. For years, GI Bill benefits have helped
to strengthen our country's workforce by raising the skill levels of
Americans who have served in our military and are returning to civilian
life and extending the benefit to eligible family members will produce
similar returns.
Providing in-state tuition rates at federally supported State
universities and colleges-regardless of residency requirements, is an
important goal for AFSA due to the rise in service members and their
families returning to institutions to further their education and
numerous PCS moves involved with the CONUS. A few AFSA members were
caught off guard by changes enacted last year that required them to pay
a significant portion of their children's out-of-state tuition rates
because the benefit no longer covers the entire tuition amount. Ideally
these institutions would cover the student under VA's Yellow Ribbon
program, lowering out of pocket expenses for the service member, but
the truth of the matter is not all schools do. For the ones that do
participate, the school identifies which of their programs are Yellow
Ribbon-covered, along with how many students they will accept under the
program and how much they can pay each student so there are additional
limitations. As the likely alternative given the nation's current
fiscal situation, Congress should urge VA to conduct greater outreach
to colleges and institutions on its Yellow Ribbon program.
Oversight of Educational Benefits: AFSA is concerned with
statistics that show the cost of sending a veteran to a for-profit
school is more than double the cost of a public university, and that
eight of 10 educational institutions collecting the most VA benefits
are for-profit schools. By no means are we suggesting impropriety with
these or any other educational institutions receiving federal money.
Many institutions are offering high quality degrees that service
members can use in conjunction with their military careers or aid them
in employment once they separate. But given the tremendous sum of money
involved, all of them tax dollars; we owe it to the American taxpayer
to ensure they are getting the best ``bang for their buck.'' That said,
AFSA endorses S. 2179, the ``Military and Veterans Educational Reform
Act of 2012'' which was recently introduced by Senators Jim Webb (D-
VA), Tom Harkin (D-IA), Tom Carper (D-DE), Claire McCaskill (D-MO) and
Scott Brown (R-MA) to make critical reforms to protect the integrity of
the Post-9/11 GI Bill and the military's Tuition Assistance Program. By
extending accreditation protections currently in place for federal
student aid recipients to veterans using the GI Bill, S. 2917 takes
much-needed steps towards strengthening the protections currently in
place for veteran and military students seeking to use their taxpayer
subsidized benefits. It also builds a stronger support network to help
our service members and their eligible family members navigate the
complicated process of picking a school.
Arm Students with Information: AFSA believes users of VA
educational benefits do not have access to the information they need to
make sound academic decisions. The findings of a recent Senate
investigation confirm many Veterans become victims of potential fraud,
waste and abuse at the hands of schools that consistently fail to
deliver on their educational promises. By arming students with better
information about degree expectations, use, and graduation rates, we
believe they can, and will make better choices with their earned
benefits. DoD recently mandated this type of counseling for users of
Tuition Assistance Programs; VA should suit. The department already
offers similar counseling as part of its Vocational Rehabilitation &
Employment Program (Chapter 36). S. 2917 would require DoD and VA to
provide this in person, one-on-one educational counseling to veterans
and members of the Armed Forces. Until such time as this or similar
legislation is passed, VA may be able to expand their current program,
on a voluntary basis, to users of GI Bill benefits.
Education Benefits for Survivors and Dependents: VA's Survivors &
Dependents Assistance (DEA) Program (Chapter 35) provides education and
training opportunities to the spouse and eligible children of certain
Veterans. Whereas most VA educational programs increased payment rates
in recent years, the DEA program has not. As a result, the value of
this benefit continues erodes as college costs continue to climb.
Congress should boost these rates to more closely match the current
cost of a four-year public university which was recently estimated by
the National Center on Education Statistics to be $19,620 per year in
2011.
Retirement Benefits: The Administration's proposed FY 2013 budget
calls for higher TRICARE fees, the establishment of new ones and the
creation of a BRAC-like panel that will review current military
compensation and recommend changes (most likely reductions) for
Congress to consider. The President and many senior civilian leaders
repeatedly said they will not balance the budget on the backs of
Veterans. We took them at their word but now this is in fact, exactly
what they are proposing to do. Apparently they lost sight of the fact
that military retirees are Veterans, and we ask that you bear this in
mind as deliberations on the Administrations proposed budget move
forward.
Senior military leaders often speak of the importance of ``Keeping
the faith'' with military members, particularly where earned benefits
are concerned--benefits like retired pay and healthcare. Right now,
Airmen are asking ``Where is the faith?'' And they are looking to you,
the Members of Congress, to provide that answer. ``Passing the buck''
to service members instead fulfilling promised benefits will only serve
to undermine long-term retention and readiness. Part of the success of
the all-volunteer force can be directly attributed to the robust
benefits we provide military members in return for their service and
sacrifice. Not just them, but their families too. Do we want to risk
this? We call on Congress to oppose these fee increases and to honor
the commitments made to those who have served and are now serving. All
of whom are Veterans.

CONCLUSION

Chairman Murray, Chairman Miller, in conclusion, I want to thank
you again for this opportunity to express the views of our members on
these important issues as you consider the FY 2013 budget. We realize
that those charged as caretakers of the taxpayers' money must budget
wisely and make decisions based on many factors. As tax dollars
dwindle, the degree of difficulty deciding what can be addressed, and
what cannot, grows significantly. However, AFSA contends that it is of
paramount importance for a nation to provide quality health care and
top-notch benefits in exchange for the devotion, sacrifice, and service
of military members, particularly while the nation remains at war. So
too, must those making the decisions take into consideration the
decisions of the past, the trust of those who are impacted, and the
negative consequences upon those who have based their trust in our
government.
We sincerely believe that the work the House and Senate Veterans'
Affairs Committees do is among the most important on the Hill. Year
after year, these two committees have illustrated the value of non-
political cooperation with the full focus of your efforts on the well-
being of those serving this nation. On behalf of all AFSA members, we
appreciate your efforts and, as always, are ready to support you in
matters of mutual concern.
The Air Force Sergeants Association looks forward to working with
you in this Second Session of the 112th Congress.
Respectfully submitted this 22nd day of March, 2012

Prepared Statement of MG Gus Hargett

Thank you for all you have done for our veterans since 9/11 and for
this opportunity to testify.
Background--Unique Citizen Service Member/Veteran
The National Guard is unique among components of the Department of
Defense (DoD) in that it has the dual state and federal mission. While
serving operationally on Title 10 active duty status in Operation Iraqi
Freedom (OIF) or Operation Enduring Freedom (OEF), National Guard units
are under the command and control of the President. However, upon
release from active duty, members of the National Guard return as
veterans to the far reaches of their states, where most continuing to
serve in over 3,000 armories across the country under the command and
control of their governors. As a special branch of the Selected
Reserves they train not just for their federal missions, but for their
potential state active duty missions such as fire fighting, flood
control, and providing assistance to civil authorities in a variety of
possible disaster scenarios.
Since 9/11, 455,461 National Guard members have deployed in
contingency operations to gain veteran status. When they return from
deployment, they are not located within the closed structure of a 24/7
supported active military installation, but rather reside in their home
town communities where they rely heavily on the medical support of the
Veterans Administration (VA).
While serving in their states, members are scattered geographically
with their families as they hold jobs, own businesses, pursue academic
programs, and participate actively in their civilian communities.
Against this backdrop, members of the National Guard remain ready to
uproot from their families and civilian lives to serve their governor
domestically, or their President in distant parts of the globe, as duty
calls and to return to reintegrate within the same communities when
their missions are accomplished.
Using the National Guard as an operational force will require a
more accessible mental health program for members and their families
post-deployment in order both to provide the care they deserve as
veterans and to maintain the necessary medical readiness required by
deployment cycles. It cannot be a simple post-deployment send off by
the active military of ``Good job. See you in five years.'' To create a
seamless medical transition from active duty to the VA, an improved
medical screening of our members before they are released from active
duty is essential to identify the medical issues that will be passed to
the VA. The Department of Defense must also recognize its
responsibility of sharing the burden with the VA in funding mental
health care for our National Guard members between deployments, which
remains an unmet readiness need.
Military service in the National Guard is uniquely community based.
The culture of the National Guard remains little understood outside of
its own circles. When the Department of Defense testifies before
Congress stating its programmatic needs, it will likely recognize the
indispensable role of the National Guard as a vital operational force,
but it will say little about, and seek less to, redress the benefit
disparities, training challenges, and unmet medical readiness issues
for National Guard members and their families at the state level
before, during, and after deployment. We continue to ask Congress to
give the Guard a fresh look with the best interests of the National
Guard members, their families, and the defense of the homeland in mind.

H.R. 1025-RECOGNITION AS VETERANS OF MEMBERS OF THE NATIONAL GUARD AND
RESERVE WHO SERVE 20 YEARS TO EARN MILITARY RETIREMENT PAY
Congress needs to continue to act proactively on a broad front to
appropriately recognize the value of National Guard service at home and
overseas. The Senate Committee on Veterans' Affairs could go far in
that effort by passing the budget-neutral H.R. 1025, which unanimously
passed the House last year. The bill would authorize Veteran status
under Title 38 for National Guard and Reserve members of the Armed
Forces who are entitled to a non-regular retirement under Chapter 1223
of 10 US Code, but were never called to active federal service during
their careers - through no fault of their own. Pertinent sections of
Title 38defiing ``veteran `` are set forth n the Appendix. H.R. 1025 is
cost-neutral because it would provide no benefits other than the honor
and recognition provided by allowing these members to simply call
themselves veterans for their careers of honorable service.
Most members of Congress and many serving and retired National
Guard and Reserve members may not know that a reservist can complete a
full Guard or Reserve career but not earn the title of ``Veteran of the
Armed Forces of the United States,'' unless the member has served on
Title 10 active duty for other than training purposes. As one National
Guard retiree has put it, ``we gave the government a blank check for 20
years of our service to send us wherever they wanted. It was their
choice, not ours.''
Some National Guard members who have been protecting the homeland
on Aerospace Control Alert (formerly known as Operation Noble Eagle)
and southwest border missions on Title 32 orders may one day retire
from the Guard, but will not qualify to be Veterans of our Armed
Forces. Contrast the character of service in these missions with that
of an active duty member serving his or her entire enlistment in the
continental United States (CONUS) who is fully recognized as a veteran
with full benefits. To bestow veteran status and benefits on the active
member in this instance and not allow the 20 year Guard or Reserve
retiree even to call himself or herself a veteran just does not add up.
Take the example from a message last year from a retired Guard
general officer who served 30 years in the Guard during the Cold War.
Although never deployed, he served on numerous reforger exercises and
on other training missions far from his home and family while occupying
a key leadership position in managing the National Guard in his state.
The general recalled ordering an AWOL Guard soldier to active duty who
then served 3 years in CONUS and was given full veteran status and
benefits. However, the general who served honorably for 30 years ready
and willing to answer any call for deployment cannot even call himself
a veteran. This is just not right.
We believe that Senate Committee on Veterans' Affairs (SCVA) has
uncertain plans about moving this bill forward. It may be inclined
toward folding it into an omnibus bill that would go back to the House
as a joint conference item with no guarantee that it would successfully
emerge from the pack in that secretive process.
As many may recall, a predecessor bill to H.R. 1025 passed the
House unanimously in 2010 only to stall in the Senate after it was
placed on the unanimous consent calendar and not moved forward because
members wanted it vetted by the SCVA. It is now properly before the
SCVA where it warrants proper consideration as a standalone bill. As it
is already approved by the House, it would likely become law if
separately approved by that committee without the risk of possible
rejection that it would face if sent back to House for reconsideration
as part of an omnibus bill in joint conference.
NGAUS is concerned from reports it has received that there exists
pushback exists against this bill from lower echelon staff within the
VA and congressional staff, feeling that passing this bill would be
``allowing the camel's nose under the tent.'' This metaphor is both
puzzling and deeply troubling to National Guard members. If any of you
before me can tell me what this means, please do so today so I can
respond. If it means that there is fear that National Guard members and
NGAUS will be asking for more Veterans' services and benefits if the
bill is passed, it's true - asking for better services and benefits is
what every veteran and veterans service organizations does, and should
continue to do, in asking for protection from Congress. If you expect
our National Guard members and veterans to be any less diligent and
responsible in asking Congress to address their needs and those of
their families than any high-priced lobbyist walking these halls, then
you are selling your National Guard short. The metaphor ``allowing the
camel's nose under the tent'' is really nothing more than bias-driven
code that the National Guard is not worthy of recognition by Congress.
If passed, H.R. 1025 would help tear down the remnants of the wall of
prejudice that sadly still exists in some quarters against the National
Guard, who is always ready and always there in cost effectively
protecting our nation.
As a cost-neutral standalone bill, H.R. 125 provides an excellent
opportunity for a divided Congress to come together to honor our
National Guard and Reserve. NGAUS respectfully asks members of the
Senate Committee on Veterans' Affairs to please join your colleagues in
the House and move this bill forward as a standalone bill to support
its passage into law. Our career National Guard and Reserve members
deserve nothing less.

REQUIRE THE VA TO FULLY IMPLEMENT SECTION 304 OF THE CAREGIVERS AND
VETERANS OMNIBUS HEALTH SERVICES ACT 0F 2009, PUBLIC LAW 111-
163, TO PROVIDE MENTAL HEALTH SERVICES TO IMMEDIATE FAMILY
MEMBERS OF OIF/OEF VETERANS
Post-deployment, our National Guard members and their families
heavily rely on the VA for mental health care. Congress recognized as
much in passing The Caregivers and Veterans Omnibus Health Services Act
of 2009, Public Law 111-163, enacted May 6, 2010, which now requires
the VA to reach out not just to veterans but to their immediate
families as well to assist in the reintegration process. Unfortunately,
the VA has not fully complied with this law.
Section 304 of the Family Caregiver Act (reproduced in the
Appendix) now requires the VA to make full mental health services
available to immediate family members of OIF/OEF veteran for three
years post-deployment. However, the VA refuses to comply with the law
by insisting that it does not have any obligation beyond providing the
counseling at Vet Centers, which it has been doing since well before
the law was passed. As terrific as Vet Centers are with their peer-to-
peer outreach, they do not have the full range of mental health
services that are present in the highly praised VA Office of Mental
Health Services (OMHS).To the best of our knowledge, the VA will not
make the full range of OMHS mental health services available to
immediate to families as required by Section 304.
Section 304 was enacted on May 6, 2010, but we still await any VA
regulations or instructions implementing this program. For many, the
three year post-deployment period during which the VA is required by
Section 304 to provide mental health services to immediate family
members of returning veterans will begin to lapse in 2013. The VA OMHS
needs to fully comply with Section 304. Our veterans and their
immediate families may be a small subset, but they are worth it.

IMPLEMENT COMMUNITY BASED MENTAL HEALTH CARE FOR VETERANS
Section 304 also authorizes the VA to contract with private
entities in communities to bridge the geographical barriers preventing
many of our veterans, and now their families, from receiving mental
health treatment. The issues of veterans' unemployment and mental
health maintenance cannot be separated. Before veterans can maintain
gainful employment in a challenging job environment, they must be able
to maintain a healthy mental status and establish supportive social
networks.
In 2007, the Rand Corporation published a study titled, ``The
Invisible wounds of War.'' It found that at the time 300,000 veterans
of Operation Iraqi Freedom and Operation enduring Freedom suffered from
either PTSD or major depression. This number can only have grown after
five more years of war. The harmful effects of these untreated
invisible wounds on our veterans hinder their ability to reintegrate
with their families and communities, work productively, and to live
independently and peacefully.
Rand recommended that a network of local, state, and federal
resources centered at the community level be available to deliver
evidence-based care to veterans whenever and wherever they are located.
Veterans must have the ability to utilize trained and certified
services in their communities. In addition to training providers, the
VA must educate veterans and their families on how to recognize the
signs of behavioral illness and how and where to obtain treatment.
To facilitate the leveraging of mental health care providers in our
communities, the VA can actively exercise its authority under section
304 to contract with private entities in local communities, or
creatively implement its fee-based option by issuing voucher cards that
would allow our veterans to seek fee-based treatment with VA certified
providers outside the brick and mortar of the Veterans Administration
facilities.
VA facilities are often located hundreds of miles from a veteran in
need, particularly our National Guard veterans living in rural areas.
Requiring a veteran, once employed, to drive hundreds of miles to
obtain care at a VA facility necessitates the veteran taking time off
from work, which most employees can ill afford, particularly after an
extended absence from deployment in the case of our Guard veterans. The
VA needs to leverage community resources to proactively engage veterans
and their immediate family members in caring for mental health needs in
a confidential and convenient manner that does not require long
distance travel or delayed appointments.
Several of our veterans have fallen through the cracks of the VA
health care system, and will continue to do so. According to the
Vietnam Veterans of America, only 30% of our veteran population has
enrolled in VA medical programs. Many veterans end up in the care of
state social service programs in cooperation with state and national
veteran organizations. The VA has the authority to assist in
maintaining this safety net of care for veterans in a stressful
economic climate for our states with a voucher program or expanded
contracting with private entities. It needs to act.

CONFIDENTIALITY MUST BE OBSERVED WITH MENTAL HEALTH CARE
Most of our National Guard veterans of OIF/OEF eligible for VA care
post-deployment are still serving with their units and subject to
redeployment. Given the evolving electronic medical records
interoperability between the VA and the Department of Defense (DoD), a
confidentiality issue exists relative to mental health treatment
records for these veterans who remain in the military who do not want
their records shared by the VA with their military commanders for fear
of career reprisals.
It is essential that confidentiality be maintained by the VA for
the mental health treatment records of these veterans to encourage
their treatment with VA providers. It is critical that this be
established as soon as possible legislatively, as the VA is believed to
be operating under advice from its legal staff that all VA medical
records can be transferred to DoD. Lack of confidentiality will chill
the treatment process and is likely contributed to the under
utilization of VA medical care by our veterans.

THE DEPARTMENT OF DEFENSE MUST COOPERATIVELY WORK WITH THE VA IN
SCREENING BEHAVIORAL HEALTH CARE NEEDS OF OUR MEMBERS BEFORE
THEY ARE RELEASED FROM ACTIVE DUTY
At all stages of PTSD and depression, treatment is time sensitive.
However, this is particularly important after onset, as the illness
could persist for a lifetime if not promptly and adequately treated,
and could render the member permanently disabled. The effects of this
permanent disability on the member's entire family can be devastating.
It is absolutely imperative that members returning from deployment be
screened with full confidentiality at the home station while still on
active duty by trained and qualified mental health care providers from
VA staff and/or qualified health care providers from the civilian
community. These providers could include primary care physicians,
physician assistants, and nurse practitioners who have training in
assessing psychological health presentations. Prompt diagnosis and
treatment will help to mitigate the lasting effects of mental illness.
This examination process must be managed by the VA in coordination with
the National Guard Director of Psychological Health for the respective
state, and the state's Department of Mental Health to allow transition
for follow up treatment by the full VA and civilian network of
providers within the state.
As an American Legion staffer at Walter Reed once stated, the main
problem for Reserve Component injured service members is that they are
``rushed out of the system'' before their service connected injuries
and disability claims have been resolved. Our injured members should
not be given the ``bum's rush'' and released from active duty until a
copy of their complete military medical file, including any field
treatment notes, has been transferred to the VA, their discoverable
service connected military medical issues have been identified, any
service connected VA disability physicals has been performed similar to
what is provided to the active forces before they are released from
active duty, and the initial determination of any service connected VA
disability claim has been rendered. Unless medically not feasible, our
members should be retained on active duty in their home state for
treatment to discourage them from reporting injures out of fear of
being retained at a distant demobilization site.
It is absolutely necessary to allow home station screening for all
returning members by trained health care professionals who can screen,
observe, and ask relevant questions with the skill necessary to elicit
medical issues either unknown to the self-reporting member, or
unreported for fear of being retained at a far removed demobilization
site. In performing their due diligence before the issuance of an
insurance policy, insurance companies do not allow individuals to self
assess their health. Neither should the military. If geographical
separation from families is causing some to underreport, or not report,
physical or psychological combat injuries on the PDHA, then continuing
this process at the home station for those in need would likely produce
a better yield at a critical time when this information needs to be
captured in order for prompt and effective treatment to be
administered.
Please see the copy of a November 5, 2008 electronic message to
NGAUS from Dr. Dana Headapohl set forth in the Appendix, which strongly
recommends a surveillance program for our members before they are
released from active duty. Dr. Headapohl opines the obvious in stating
that inadequate medical screening of our members before they are
released from active duty is ``unacceptable to a group that has been
asked to sacrifice for our country.'' (emphasis added)

ENHANCE EMPLOYABILITY FOR OUR NATIONAL GUARD VETERANS BY AMENDING 10
USC 1097c TO ALLOW EMPLOYERS TO OFFER ENROLLMENT IN TRICARE
RESERVE SELECT AND DECLINE MORE EXPENSIVE EMPLOYER SPONSORED
PLANS
Included among our unemployed Gulf War II veterans are members of
the National Guard and Reserve who are home from combat and, for the
most part, remain in the Select Reserve as they return to civilian life
and train for the next deployment. A prospective employer in a
challenged economy may think twice before hiring one of our deployable
members who has a guaranteed future ticket to war.
One potential solution worth considering is to remove statutory
prohibitions against employers offering incentives for National Guard
and Reserve members to enroll in TRICARE Reserve Select (TRS) in lieu
of the employer's more expensive plan, in order to make Guard and
reserve job candidates for employment more competitive.
According to the Department of Defense, TRS has been available to
members of the Reserve Components since October 2007, but it remains
under subscribed, with only 7 percent of the eligible population
participating. This is surprising, given the current low monthly
premium rates of $192.89 for family coverage and $54.36 for individual
coverage.
Under current law, 10 USC Section 1097c, employers of members of
the Select Reserve cannot offer incentives to members of the Select
Reserve to decline coverage under the Employer's more expensive health
care plan and enroll in less expensive TRICARE Reserve Select with the
premiums paid by the member from pre-tax dollars deposited into a
health savings account by their employers.
The current law prevents our member veterans from leveraging their
ability to be covered with low-cost health insurance as an inducement
for prospective employers to hire them. It is a challenge for all of
our unemployed members to convince employers that they are worth
hiring, especially in the face of disruptive, long-term absences due to
deployments. Amending 10 USC 1097c would have the beneficial effect of
making our member veterans more attractive to potential employers
because they would be less expensive to insure. This savings would be
significant for employers providing employees with health insurance.

STATUTORILY ESTABLISH AND SUSTAIN THE TRANSITION ASSISTANCE ADVISOR
PROGRAM
The Yellow Ribbon Program needs to statutorily establish the
Transition Assistance Advisor (TAA) Program, which currently operates
with 62 TAAs managed by the Joint Staff of the National Guard Bureau
under the auspices of the Department of Defense Office of
Reintegration. The ``go to'' feature of TAA makes it invaluable and
personal to our members and their families, by helping them learn and
understand the benefits programs that exist at the VA and elsewhere
before, during, and after deployments. So many programs have
proliferated during the current war that many members and family
complain that that the information thrown at them at PowerPoint benefit
briefings is like ``drinking from a fire hose.'' Because of this, the
reintegration briefers from the behavioral care staff of Johns Hopkins
refuse to use PowerPoint, because its lack of interactivity loses the
trust and attention of the audience. The TAA program provides a
necessary interactive and trustworthy alternative to the one-time
electronic briefing, or the many lost in the shuffle web sites. TAA has
staying power and, simply put, it works. It needs to be resourced and
sustained with statutory backing.
The National Guard Transition Assistance Advisor (TAA) program
differs from the active duty program primarily by the time and manner
in which assistance is delivered, as well as the content of assistance
programs. Where the active duty program will allow the TAAs to work
over a matter of days with a captured active duty audience by providing
training on job searching skills, the National Guard TAAs have time to
deliver only very short briefings during the limited time our members
remain on active duty at installations before returning to their homes.
However, the TAAs remain reachable to provide personalized service to
all callers, at all stages of deployments. A TAA program similar to the
active forces could be considered if our returning members remained on
active duty longer at National Guard installations after deployment.
The TAAs serve as statewide points of contact, primarily to provide
a professional person to assist in accessing veterans' benefits and
medical care for members and families before, during, and after
deployment. However, they can troubleshoot virtually all deployment-
related issues, ranging from processing medical compensation claims,
accessing veterans' benefits, pursuing medical care options, assisting
with job searches, financial assistance, referral for counseling, and
obtaining dependent care. The TAAs, 90% of whom are either veterans or
spouse of military members, make themselves available to members of all
components and veterans of any service. It is the ``go to'' feature and
personal interaction follow up that distinguishes the TAA program from
other reintegration assistance programs.
A description of what a TAA does is best provided by the following
message sent in response to a NGAUS inquiry by Marine, Steven B.
Sheppard, TAA for the Massachusetts National Guard.

``As the single point of contact for all Veterans of all branches
of all eras, TAA's are very busy. We track our troops through both the
Military and civilian healthcare sectors, which can be daunting to say
the least. Often the more complicated cases require significant follow-
up care. Veterans rarely call with just one problem.

A typical case that is brought to the TAA desk can include the
following:

- Unemployed Guard Member with no service connection has no
capability to travel because his vehicle needs service
- SM has been unemployed for 8 months with no end in sight
- Health problems due to Line-of-Duty injuries / illness
- Can't afford car payment / rent / vehicle repair

This means that the TAA has to:

- Help fill out need-based financial grant applications for
emergency aid
- Coordinate with financial planning and state resources to prevent
foreclosure
- Help coordinate military health services for possible return to
active duty for treatment
- Coordinate VA Healthcare services, i.e. enrollment, primary care
and specialty clinic care
- Provide compensation and pension evaluation and VA Disability
claim via Certified National Service Officer -employment consultation
with LVER/DVOP and Career Center Training/Services
- Arrange for legal consultation if necessary (home foreclosure,
child support modification, will/power of attorney, etc)

Multiply this by any number of cases that the TAA may be managing,
add in follow-up care, and you can see that this adds up quickly. This
is in conjunction with helping Veterans of all eras which present
additional hurdles. Though our primary mission is to focus on the OIF/
OEF era Veterans, coordinating end-of-life or elder care for WWII and
Korean era Veterans is a necessary and much needed skill-set.
This brings us to what I like to call my ``weekend job.'' At least
once a month, sometimes more, the TAA facilitates seminar and classroom
learning sessions at Yellow Ribbon reintegration events. We meet
individually and in groups with returning or deploying Veterans in
order to educate Guard/Reserve members on benefits and services.
Because of the large number of troops in both the outgoing and incoming
stages of deployment, this means that the TAA often works multiple
weekends a month, if not all of them.
Most TAA's also are on a number of planning committees to help
coordinate services and events in the future as well. Panel
discussions, coordination and feedback meetings with VHA and VBA, and
consultation with the military chain-of-command are additional duties
that help to forge the working relationships that we use on a daily
basis. The bottom line is that the TAA is, by definition, a central
point of contact, and we are used heavily by every state, federal,
military and Veteran organization on a regular basis.

Although necessarily different from the active duty program because
of the limited time our members remain on active duty at National Guard
our installations post deployment, clearly, the TAA program in the
National Guard performs a valuable service to members and families. The
program needs to be expanded.

VETERANS PREFERENCE STATUS FOR ALL WHO HAVE HONORABLY SERVED IN THE
NATIONAL GUARD AND RESERVE
NGAUS recently received a letter from Monique Elling, a former
member of the Delaware National Guard, who served honorably for 10
years in domestic assignments, but who has been denied veterans
preference points because her only Title 10 active duty time was in
training status after enlistment. With her permission, a copy of her
letter is set forth in the Appendix. Such restrictive definitions of
veteran disrespect the honorable service of our members and unfairly
restrict employment opportunities for otherwise qualified candidates.
Veterans' employment preference points must be extended to all those
who have served honorably in the Select Reserve and active forces.

Conclusion
Thank you for that you have done for our veterans since 9/11.
Please view our efforts as part of a customer feedback process to
refine and improve the ongoing vital and enormous undertaking of the
VA. Our National Guard veterans, both still serving and separated, will
remain one of your largest base of customers who will continue to
require your attention. Thank you for this opportunity to testify.

APPENDIX
Sec. 101. DEFINITIONS

For the purposes of this title----

(1) The terms ``Secretary'' and ``Department'' mean the Secretary
of Veterans Affairs and the Department of Veterans Affairs,
respectively.

(2) The term ``veteran'' means a person who served in the active
military, naval, or air service, and who was discharged or released
there from under conditions other than dishonorable

(21) The term ``active duty'' means----

(A) full-time duty in the Armed Forces, other than active duty for
training;

(B) full-time duty (other than for training purposes) as a
commissioned officer of the Regular or Reserve Corps of the Public
Health Service

(i) on or after July 29, 1945, or

(ii) before that date under circumstances affording entitlement to
``full military benefits'' or

(iii) at any time, for the purposes of chapter 13 of this title;

(22) The term ``active duty for training'' means----

(A) full-time duty in the Armed Forces performed by Reserves for
training purposes;

(B) full-time duty for training purposes performed as a
commissioned officer of the Reserve Corps of the Public Health Service

(i) on or after July 29, 1945, or

(ii) before that date under circumstances affording entitlement to
``full military benefits'', or

(iii) at any time, for the purposes of chapter 13 of this title;

(C) in the case of members of the Army National Guard or Air
National Guard of any State, full-time duty under section 316, 502,
503, 504, or 505 of title 32, or the prior corresponding provisions of
law;

(D) duty performed by a member of a Senior Reserve Officers'
Training Corps program when ordered to such duty for the purpose of
training or a practice cruise under chapter 103 of title 10 for a
period of not less than four weeks and which must be completed by the
member before the member is commissioned; and

(E) authorized travel to or from such duty.

The term does not include duty performed as a temporary member of
the Coast Guard Reserve.

The following Section 304 excerpted from S. 1963, signed into law
on May 5,2010 by President Obama as Public Law No: 111-163, requires
the VA to establish a program within 6 months of enactment to provide
mental health services to OIF/OEF veterans and their immediate family
members for 3 years post deployment.

SEC. 304. PROGRAM ON READJUSTMENT AND MENTAL HEALTH CARE SERVICES FOR
VETERANS WHO SERVED IN OPERATION ENDURING FREEDOM AND OPERATION
IRAQI FREEDOM.
(a) Program Required- Not later than 180 days after the date of
the enactment of this Act, the Secretary of Veterans Affairs shall
establish a program to provide----
(1) to veterans of Operation Enduring Freedom and Operation
Iraqi Freedom, particularly veterans who served in such operations
while in the National Guard and the Reserves----

(A) peer outreach services;

(B) peer support services;

(D) mental health services; and
(2) to members of the immediate family of veterans described
in paragraph (1), during the 3-year period beginning on the date of the
return of such veterans from deployment in Operation Enduring Freedom
or Operation Iraqi Freedom, education, support, counseling, and mental
health services to assist in----

(A) the readjustment of such veterans to civilian life;

(B) in the case such veterans have an injury or illness incurred
during such deployment, the recovery of such veterans from such injury
or illness; and

(b) Contracts With Community Mental Health Centers and Other
Qualified Entities- In carrying out the program required by subsection
(a), the Secretary may contract with community mental health centers
and other qualified entities to provide the services required by such
subsection only in areas the Secretary determines are not adequately
served by other health care facilities or vet centers of the Department
of Veterans Affairs. Such contracts shall require each contracting
community health center or entity----

(1) to the extent practicable, to use telehealth services for the
delivery of services required by subsection (a);

(2) to the extent practicable, to employ veterans trained under
subsection (c) in the provision of services covered by that subsection;

(3) to participate in the training program conducted in accordance
with subsection (d);

(4) to comply with applicable protocols of the Department before
incurring any liability on behalf of the Department for the provision
of services required by subsection (a);

(5) for each veteran for whom a community mental health center or
other qualified entity provides mental health services under such
contract, to provide the Department with such clinical summary
information as the Secretary shall require;

(6) to submit annual reports to the Secretary containing, with
respect to the program required by subsection (a) and for the last full
calendar year ending before the submittal of such report----

(A) the number of the veterans served, veterans diagnosed, and
courses of treatment provided to veterans as part of the program
required by subsection (a); and

(B) demographic information for such services, diagnoses, and
courses of treatment; and

(7) to meet such other requirements as the Secretary shall require.

(c) Training of Veterans for Provision of Peer-outreach and Peer-
support Services- In carrying out the program required by subsection
(a), the Secretary shall contract with a national not-for-profit mental
health organization to carry out a national program of training for
veterans described in subsection (a) to provide the services described
in subparagraphs (A) and (B) of paragraph (1) of such subsection.

(d) Training of Clinicians for Provision of Services- The Secretary
shall conduct a training program for clinicians of community mental
health centers or entities that have contracts with the Secretary under
subsection (b) to ensure that such clinicians can provide the services
required by subsection (a) in a manner that----

(1) recognizes factors that are unique to the experience of
veterans who served on active duty in Operation Enduring Freedom or
Operation Iraqi Freedom (including their combat and military training
experiences); and

(2) uses best practices and technologies.

(e) Vet Center Defined- In this section, the term `vet center'
means a center for readjustment counseling and related mental health
services for veterans under section 1712A of title 38, United States
Code.
E-mail from Dana Headapohl, MD, to NGAUS
Colonel Duffy - I am sending links to articles about the importance
of providing medical surveillance examinations for workers in jobs with
specific hazardous exposures. I believe this approach could be modified
to evaluate National Guard members returning from Iraq and Afghanistan
for PTSD, TBIs and depression.

The OSHA medical surveillance model includes the following basic
elements:

1. Identification of potential hazardous exposures (chemical,
physical, biologic).

2. Screening workers for appropriateness of placement into a
specific work environment with such exposures. For example, individuals
with compromised liver functions should not be placed in environments
with unprotected exposures to hepatotoxins.

3. Monitoring workers after unprotected exposure incidents.
Examples- monitoring pulmonary function in a worker exposed to a
chlorine gas spill, or following hepatitis and HIV markers in a nurse
after a needle stick injury.

4. Conducting exit examinations at the end of an assignment with
hazardous exposures, to ensure that workers have not suffered adverse
health effects from those exposures.

(including concussive explosions or other traumatic events).

Surveillance exams of all types (OSHA mandated surveillance
programs, population health screening for chronic disease risk factors)
have been a part of my practice of Occupational and Preventive Medicine
in Montana for the past 22 years. Early diagnosis and treatment is
especially essential for potential medical problems facing military
members serving in Iraq and Afghanistan - post traumatic stress
disorder (PTSD), traumatic brain injury (TBI) and depression. Timely
diagnosis and aggressive treatment is essential especially for these
problems, to maximize treatment success and functioning and to mitigate
suffering.
There are a number of organizations that design and implement
medical surveillance programs. There is no reason the same approach
could not be applied to the specific exposures and potential medical
problems facing National Guard troops in Iraq and Afghanistan. With
proper program design and local provider training, this program would
not need to be costly. In my clinical experience, male patients
especially are more likely to report symptoms of PTSD, TBI, or
depression in the context of an examination rather than questionnaire.
Findings can present subtly, but if untreated can have devastating
effects on the individual, family and work place.
In my practice, I have seen a number of Vietnam veterans, and more
recently National Guard members who have returned from deployment in
Iraq or Afghanistan, who have been inadequately screened and/or are
suffering unnecessarily because of geographical barriers to adequate
treatment. This is unacceptable treatment of group that has been asked
to sacrifice for our country. They deserve better.
I applaud your organization's efforts to lobby for better post
deployment screening and treatment of the National Guard members
returning from Iraq and Afghanistan.

Dana Headapohl MD

http://www.aafp.org/afp/20000501/2785.html

https://www.desc.dla.mil/DCM/Files/QSRHealth%20Medical%20Exam--
1.pdf This is about military surveillance exams.

http://www.lohp.org/graphics/pdf/hw24en06.pdf

http://www.cdc.gov/niosh/sbw/management/wald.html

http://www.ushealthworks.com/Page.aspx?Name=Services--MedSur

-----Original Message-----
From: Elling, Monique A Mrs CTR US NG NGB ARNG
[mailto:Monique.Elling@us.army.mil]

Sent: Wednesday, March 17, 2010 1:14 PM

To: Richard Green

Subject: The Unstatus Soldier (UNCLASSIFIED)

Classification: UNCLASSIFIED
Caveats: FOUO

Mr. Green,

Thank you for taking time out of your schedule to listen to my
concerns. I was an officer in the Delaware National Guard who served
over ten years- seven of which were full-time as a ``military
technician''. I've recently been applying for federal jobs and on the
job application it asks ``are you a veteran of the armed forces?'' My
instinctive reply to the question was ``yes''.
Naturally ten years of service in the Army National Guard qualifies
me as a veteran. The question of my veteran status was preceded by the
quantifying statement ``served honorably on active duty in the armed
forces of the United States for 180 days or more (Reserve and National
Guard active duty for training does not qualify)''. It's not a matter
of wanting monetary benefits but the Federal Government's recognition
my years of service.
Counterintuitive to everything I had been trained to do and lived,
I had to put ``no''. No, my ten years of training, operational
exercises and drills are not quantifiable to 180 days of active duty.
No, having to meet the same standards and required to attend the same
schools as my active duty brothers is not quantifiable to 180 days of
active duty. Is it a matter of perceived sacrifice? I too, upon the
ramp-up of the war spent days and weeks away from my family preparing
Soldiers and families for deployments. In fact, during the first serge
of the war I was taking care of my father with cancer. I often found
myself teetering between traveling to mobilization stations preparing
my Soldiers and managing the care of my father. My father lost his
battle with cancer. A part of me blames myself for splitting my time
and not making him my sole priority. I share the next story not because
I fancy morbidity, but to use my personal experience to illustrate the
shared sacrifice of our ``Citizen'' Soldiers to their ``Active''
counterparts. I received my commission through the state OCS program.
The length of the program was approximately 15 months. Twelve months
into the program I became pregnant. Unaware of my pregnancy, I
continued training and subsequently miscarried. I was told it was more
than likely the physical stress I subjected upon myself. I've never
publicly shared this story with anyone. I now gladly share but for the
larger good it may do in the effort of changing the narrow definition
of a ``veteran''.
To add insult to injury, I recently interviewed and was chosen for
a position working for the National Guard Bureau but it was revoked due
to my reinstatement eligibility status. I found out that due to the
fact military technicians are ``excepted'' status federal employees
they cannot be considered for employment when the position is opened to
only competitive status and reinstatement eligible federal employees. I
researched the issue further and found out there were exceptions to
allowing certain ``excepted'' status candidates to compete through the
Department of Defense Interchange Agreement. Upon further investigation
I was shocked to find out that the National Guard does not have such an
agreement with Department of Defense. I am perplexed that the National
Guard Bureau, the very agency that oversees the various State National
Guards is closed to military technicians. Again I ask, what is my
status? I don't receive the same status of my fellow guardsmen who are
AGR and yet I'm not afforded the same treatment as a competitive
federal employee. Ironically, I'm hunted by a phrase I use to tell my
Soldiers about the equality of each Soldier regardless of color,
nationality or sex. ``Despite all of our differences we are all green
on the inside''.
Again, I thank you for your time and hope that my experience may
help another Soldier. Unstatus but still ``green'' on the inside.

Sincerely,

Monique A. Elling
IIF Data
Senior Analyst
703.601.7576

Don't wait to strike the iron when it's hot. Strike it and make it
hot!
Classification: UNCLASSIFIED
Caveats: FOUO

Prepared Statement of Gary L. Fry
Introduction
As the National Commander of AMVETS, it is my honor to share our
concerns and comment on the issues under the purview of your
committees. Since 1944, AMVETS has tirelessly served and represented
more than one million servicemen and women.
The purpose and goals of AMVETS, as spelled out in the
organization's 1947 Congressional Charter, still ring true today. Among
these aims are:

to preserve for ourselves and our posterity the great and
basic truths and enduring principles upon which this nation was
founded;
to maintain a continuing interest in the welfare and
rehabilitation of disabled veterans and to establish facilities for the
assistance of all veterans, to represent them in their claims before VA
and other organizations;
to dedicate ourselves to the service and best interests
of the community, state and nation to the end that our country shall be
and remain forever a strong and free nation;
to encourage universal exercise of the voting franchise
to the end that there shall be elected and maintained in public office
men and women who hold such office as a public trust administered in
the best interests of all people; and
to advocate the development and means by which all
Americans may become enlightened and informed citizens and this
participate fully in the functions of democracy.

Today, with a decade of war behind us and horrific budget cuts
staring us in the face, our men and women in uniform remain steadfast
in their mission to defend this great nation. During this same 10-year
time span many of these brave service members paid the ultimate price
for our freedom and others, at the completion of their service or due
to injuries, have joined the ranks of our nation's veterans. This
dedication and sacrifice must never be forgotten and the promises made
to this nation's heroes must be fully and faithfully honored.
Now is the time for the Administration and Congress to step up and
acknowledge all that our veterans have done for this country. We, as a
nation have, through the sacrifice of our veterans and military
members, incurred a solemn obligation to support them in every way
possible, now and into the future. President Obama once said that the
national budget would not be balanced on the backs of veterans and
AMVETS adamantly supports this concept of preserving all earned veteran
benefits. Our service members and veterans do not deserve to be asked
to continue making sacrifices; they don't deserve excuses or broken
promises, they deserve this nation's full support and nothing less.
They've done the hard work on behalf of all Americans; now is the time
for All Americans to relieve them of their heavy burdens.
Today's military and veteran community is faced with many
challenges and AMVETS is dedicated to aggressively tackling these
issues on behalf of American Veterans everywhere including:

fVeteran Unemployment
bReserve Component
bActive Component
bAffirmative Action Designation

fVA/DoD Health Care & Mental Health
bTraumatic Brain Injury (TBI) & Post-Traumatic Stress (PTS)
bProsthetic & Sensory Aides
bSuicide Prevention
bExtension of the VA Caregivers Compensation Program

fVeterans Benefits
bMaintain Military Retirement & Health Care Benefits
bConcurrent Receipt (Active & Reserve Component)
bVA Claims & Appeals Backlog

fWomen Veterans & Service Members
bMilitary Sexual Trauma (MST)
bCreation of a Sexual Assault Oversight and Response Office
bGender Specific Healthcare

fNational Guard & Reserve Service Members
bImproved USERRA Protections
bOn-going Transition Between State and Federal Service
bVeteran Status

fHomeless & Rural Veterans
bProvide a Full Continuum of Care for Homeless Vets (housing,
employment training, legal aid, etc)
bAccess to Health & Mental Health Care
bIncrease Travel Reimbursement Rates

fPOW/MIA Recovery/Identification & Cemetery Affairs
bImproved Over Site of Mortuary Affairs Operations
bClark Cemetery & Return the Crew of the Intrepid
bIncrease Veterans Burial Benefits

Veteran Unemployment
During this time of persistent unemployment in our country, the
problem of Veteran unemployment should be seen as a national disgrace
and while everyone appears to be talking about the problem, few real
solutions have been offered. Estimates from as recent as October 2011,
suggest that the unemployment rate among American Veterans returning
from Iraq and Afghanistan is at least 3 percent higher than the
national average. In recognition of those who honorably and selflessly
fought to maintain the freedoms of those who stayed behind, we as a
nation cannot do enough to ensure that American Veterans get the proper
skills, certifications and degrees necessary to be successful in the
civilian job market.
Veteran unemployment is a complex problem which will require the
efforts of federal and state governments, the business community and
the military/veterans community working in concert if any real progress
is to be made. The efforts of any one entity alone will be insufficient
to meet the challenges posed by this massive problem facing American
Veterans everywhere and it's important to keep in mind that veterans,
like their civilian counterparts, require not just a job, but living-
wage employment following their service. The vast majority of working-
age veterans want to continue to be productive citizens and they need
to be provided greater opportunities to achieve their career goals.
American Veterans have made unimaginable sacrifices for our nation; now
is the time for Congress and the Administration to make a concerted
effort to guarantee that veterans have access to employment and
training opportunities to ensure success in an unfavorable civilian job
market.
AMVETS believes that perhaps the greatest and most comprehensive
assistance this nation could provide for its veterans is to include
them as a protected class under the current Affirmative Action law.
Veterans are among the smallest minority groups in this country with
fewer than 7 percent of Americans ever having served in the Armed
Forces and less than one percent wearing the uniform today. While other
minority groups enjoy certain protections and advantages under the law,
those who have served and fought for their country currently enjoy no
such comprehensive legal consideration. In fact, just the opposite is
often true; frequently those who have served and sacrificed are at a
disadvantage in comparison to their peers.
Additionally there needs to be a better system to connect employers
with open positions to unemployed veterans; the current system of
merely posting jobs online, while beneficial, just isn't enough. There
are literally hundreds of online employment and career sites catering
to veterans and civilians alike, which unfortunately more often than
not, leave veterans confused and overwhelmed. What is needed is a
comprehensive `veteran employment resource guide' along with a single
portal or site where all of these opportunities can be accessed in one
place.
In addition to the previous issues, there is the very real problem
of licensing and credentialing which is required in certain career
fields. Due to the fact that licensing and credentialing are handled at
the state level rather than the national level, many veterans who hold
these designations in the states where they are stationed are faced
with the need to become re-licensed/re-credentialed if they move to
another state. This is an absurd requirement. If an individual is
certified in one state that should be sufficient in every state; the
formation on national standards for professions would alleviate this
impediment to veteran unemployment. These suggestions would go a long
way in minimizing the current lack of organized information and the
confusion caused by the vast number of disparate resources available.

Health Care & Mental Health
The Veterans Health Administration (VHA) is not only the largest
direct provider of healthcare services in the nation, it also provides
the most extensive training environment for health professionals and is
provides the most clinically focused setting for medical and prosthetic
research. One of the prime responsibilities of the Department of
Veterans Affairs (VA) is providing primary care to American Veterans.
The VA also provides specialized health care services including: spinal
cord injury, blind rehabilitation, traumatic brain injury, prosthetic
services, mental health, and war-related poly-trauma injuries. AMVETS
has serious concerns that any reduction in spending on VA healthcare
programs will lead to catastrophic degradation to these critical
services.
Perhaps the most important veteran healthcare issue is the need for
sufficient, timely and predictable funding. Without this provision
there won't be anything else. This is especially important given
congress' poor track record in passing the federal budget over the last
few years. AMVETS calls on Congress and the Administration to ensure
that VA healthcare programs are fully funded in a timely manner so that
all eligible veterans are able to receive all the medical services they
are entitled to.
Unfortunately, the VA also faces significant challenges ensuring
that newly returning war veterans have access to post-deployment
readjustment services and specialized treatments while guaranteeing
that all other enrolled veterans gain and keep access to effective,
timely, high-quality mental health services. Add these challenges to
the fact that ten years of war have taken a toll on the mental health
of American military forces. Unfortunately, the VA also faces
significant challenges ensuring that newly returning war veterans have
access to post-deployment readjustment services and specialized
treatments while guaranteeing that all other enrolled veterans gain and
keep access to effective, timely, high-quality mental health services.
The RAND Corporation published a study in 2008 ``Invisible Wounds
of War'' which noted that 18.4 percent of all post-deployed service
members presented conditions that met criteria for either PTS or major
depression and that 19.5 percent reported experiencing a probable TBI
incident during their deployments. The numbers of effected veterans are
significant and these are complex conditions to treat.
As previously mentioned, untreated/unhealed physical and mental
health combat injuries play a significant role in the number of
military/veteran suicides in this country. The data on these suicides
is startling: VA reports that 18 veterans take their own lives every
day which is equivalent to 6,750 veterans' suicides per year; multiply
this by 10 years of war and the total number of veteran's suicides is a
staggering 65,000+. And while the numbers of suicides have declined
since peaking in 2009, this continues to be a grave problem deserving
of our best efforts.

Veterans Benefits
AMVETS believes in the solemnity of the promises made to our
military members and veterans when they agreed to leave their homes and
families to go fight in our stead. In addition to providing physical
and mental healthcare to millions of veterans, the VA is also the
primary federal agency providing a variety of benefits to our nation's
veterans including: disability compensation, dependency and indemnity
compensation, pensions, retirement, education benefits, home loans,
ancillary benefits for service-connected disabled veterans, life
insurance and burial benefits. It is crucial, that veteran's benefits
become a national priority and they must be viewed in the context of
the service and sacrifice performed by our men and women in uniform.
These benefit programs however must not only be maintained, they need
to be monitored and improved so they maintain their value and
effectiveness.
AMVETS firmly believes that all military retirees should be
permitted to receive their full, earned military retirement as well as
any and all VA disability compensation they may be entitled to; in
other words there should be no offset between full military retired pay
and VA disability compensation. Each form of compensation is
individually earned, in its own right, by the veteran and other federal
employees are not unjustly penalized this same way when an identical
situation. AMVETS strongly urges Congress and the Administration to
enact legislation to repeal this inequity faced by so many American
Veterans.

Women Veterans and Service Members
Every woman who ever served in the military in America did so as a
volunteer! Their history of service to this country is long and proud
even though their service prior to the Civil War was strictly
unofficial; they have been involved in every battle, one way or
another, going back to the Revolutionary War. Today, women comprise
between 17% - 20% of the U.S. military and they are fully integrated
into the combat zones around the world.
Among the most critical issues facing women veterans today are:
homelessness, military sexual trauma (MST), employment and the lack of
gender specific health care. These three issues are the trifecta of
degradation and deprivation for women veterans. They are also somewhat
of a `Catch-22' in that each issue overlaps and effects the other two,
making it that much more difficult to escape this negative cycle. How
can we as a nation allow some of our most vulnerable veterans, many of
whom also have children, to be living on the streets of our cities? Why
is it that a woman should have to fear for her personal safety, not
only from foreign enemies, but from her comrades-in-arms simply because
she made a conscious decision to serve in the military? All veterans,
by their very service to their country, should be guaranteed some
basics: shelter, any necessary physical and mental health care, food,
job training or education, and an opportunity to support themselves and
their children upon exiting the military.
Some of these veterans are already victims of MST and PTS while on
active duty and now they are faced with the dangers and lack of
appropriate physical and mental health care inherent in being homeless.
These veterans are often unable to locate temporary housing at local
homeless shelters because many of these facilities are not set up to
house to accommodate the specific safety and privacy needs of women,
not to mention their children. It's a sad fact that homeless
individuals are not infrequently involved in the criminal justice
system for a variety of offences, including crimes against women and
children. This situation is truly a national disgrace and must not be
allowed to continue.
A new report from the Government Accountability Office shows that
the number of homeless women veterans doubled between 2006 and 2010,
with 3,328 women veterans unable to access shelter. Of these women,
``almost two-thirds were between 40 and 59 years old and over one-third
had disabilities.'' The numbers are not encouraging and they are
expected to get worse. With tens of thousands of troops leaving
military service and more slated over the next year, for women veterans
with families, it's especially difficult to find work and housing. As
of December 2011, The Veterans Administration estimated that of the
roughly 68,000 homeless veterans, more than 5,000 were women. To combat
the problem, the VA is training many of its 7,000 case managers to deal
with issues specific to women.

National Guard & Reserve Service Members
AMVETS fully supports H.R. 1025, Veterans Status, for National
Guard and Reserve members with 20 years or more in service. This cost
neutral bill would not bestow any new or unearned benefits, it would
simply provide career Reserve Component (RC) members the honor of being
recognized as a Veteran for their many years of service and sacrifice.
This bill would also provide an opportunity for Congress and the
Administration to show their support for America's military retirees.
What is a military retiree? A military retiree is what a National
Guard or Reserve Component member, who has completed a 20(+) year
career, is designated upon retirement. If these individuals have never
served on active duty (Title 10) orders for other than training
purposes they are not legally considered veterans. Mind you, they are
entitled to virtually all the same retirement benefits as their Active
Component brethren, but they are not considered veterans under the law.
This unjust situation is not widely known among members of Congress or
even among members of the RC themselves.
H.R.1025 would authorize Veteran status under Title 38 for National
Guard and Reserve members of the Armed Forces who are entitled to a
non-regular retirement under Chapter 1223 of 10 USC but were never
called to active federal service during their careers - through no
fault of their own. As an example, the service of our National Guard
members now serving on Operation Noble Eagle on our Southwestern border
on Title 32 orders would not qualify them to earn the status of
``Veterans of our Armed Forces'' because it is technically a
``training'' status.
Currently, the Code of Veterans' Benefits, Title 38, excludes from
the definition of ``Veteran'' career Reservists who have not served on
Title 10 active duty for other than training purposes. Drill training,
annual training, active duty for training, and Title 32 duty are not
qualifying service to qualify for ``Veteran'' status. It doesn't make
sense that an individual can serve three years on active duty, during a
time of war or not and upon leaving the military they are considered a
veteran; however, a National Guard or Reserve member who has 20(+)
years of service but has not called to federal service is not
considered a veteran - although they receive similar benefits.

Homeless Veterans
As the House and Senate Veterans Affairs Committees undertake the
important work of establishing their budget priorities for the VA,
AMVETS urges the committees to consider the importance of supportive
housing facilities for homeless veterans, many of which are situated on
VA property and/or owned and operated by the VA. Consistent with
Secretary Shinseki's goal of eliminating homelessness among veterans by
the year 2015, these facilities are vital to the scores of homeless
veterans - including those from Operations Enduring Freedom and Iraqi
Freedom - that rely upon them for shelter, health care, and other
services.
AMVETS appreciates the support that the committees have shown for
programs to mitigate the scourge of homelessness among veterans. We are
also grateful for the $333 million that Secretary Shinseki has proposed
for homeless veterans in the FY 2013 budget request, a one-third
increase in funding from FY 2012. We strongly support the Secretary's
goal of eliminating homelessness among veterans by 2015. The VA's
``housing first'' approach - which has largely been carried out via a
combination of increases in HUD-VASH vouchers, enhanced funding for the
grant and per diem program, and support for outreach coordinators - has
allowed the VA to make important progress toward its goal of
eliminating veterans' homelessness.
Even as this progress continues, AMVETS encourages the committees
and the VA to prioritize the construction or repurposing of facilities
on VA property to be used for supportive housing for homeless veterans.
The shortage of such housing is particularly acute in the Los Angeles
region, where approximately 8,000-10,000 veterans remain homeless. This
represents an approximate 10 percent share of all homeless veterans
nationwide. Remedying the homeless veterans' problem in Los Angeles is
essential to meeting Secretary Shinseki's goal of elimination.
Congress has repeatedly supported using vacant facilities on the
West Los Angeles VA Medical Center campus for homeless veterans'
housing and has resisted efforts to commercialize this valuable plot of
property. The Cranston Act, as amended, prohibits the VA from issuing
enhanced-use lease agreements on all 388 acres of the campus. The
Homeless Veterans Comprehensive Service Programs Act of 1992 permits
the VA to lease property to homeless organizations on the campus. In
the Master Plan for the West L.A. campus adopted last year, at least
three buildings - Buildings 205, 208, and 209 - are identified as
possible residential facilities for homeless veterans.
In the Veterans Health Care Facilities Capital Improvement Act of
2011, Congress - under the leadership of Chairmen Murray and Miller -
authorized $35 million in funding for VA to renovate Building 209 for
use as a permanent supportive housing facility for homeless veterans.
The completion of this renovation, which will provide 70-90 beds for
homeless veterans when operational, will increase the supply of housing
for Los Angeles's homeless veteran's population. This funding was an
essential first step, but only a first step. Authorization and funding
for renovations to Buildings 205 and 208 is needed to transform those
vacant buildings into supportive housing facilities for homeless
veterans. Once Buildings 205, 208, and 209 are completed, the VA will
have made significant progress toward the reduction of homelessness
among veterans in Los Angeles by giving hundreds of homeless veterans a
safe and secure place to reside while receiving the vital health
treatment that they need.

Mortuary Affairs
AMVETS is deeply disturbed by on-going reports of the mishandling
of the remains of our fallen heroes. There is no more sacred
responsibility than the dignified and respectful recovery, return and
burial of those killed in action. While AMVETS acknowledges that many
positive improvements have recently been established, more needs to be
done to ensure these events don't happen in the future. AMVETS
recommends continued and increased oversight of all mortuary operations
facilities.

MATERIALS SUBMITTED FOR THE RECORD
ANTHONY A. WALLIS, ASSOCIATION OF THE UNITED STATES NAVY

The Association of the United States Navy

The Association of the United States Navy (AUSN) continues its
mission as the premier advocate for our nation's Sailors and veterans
alike. Formerly known as the Naval Reserve Association, which traces
its roots back to 1954, AUSN was formally established on May 19, 2009
to expand its focus on the entire Navy. AUSN works for not only our
members, but the Navy and veteran community overall by promoting the
Department of the Navy's interest, encouraging professional development
of officers and enlisted and educating the public and political bodies
regarding the nation's welfare and security.
AUSN prides itself on personal career assistance to its members and
successful legislative activity on Capitol Hill regarding equipment and
personnel issues. The Association actively represents our members by
participating in the most distinguished groups protecting the rights of
military personnel. AUSN is a member of The Military Coalition (TMC), a
group of 34 associations with a strong history of advocating for the
rights and benefits of military personnel, active and retired. AUSN is
also a member of the National Military Veterans Alliance (NMVA) and an
associate member of the Veterans Day National Committee of the
Department of Veterans' Affairs (VA).
The association's members are active duty, reserve and veterans
from all fifty states, U.S. Territories, Europe and Asia. AUSN has 81
chapters across the country. Of our 18,000 members, approximately 95%
are veterans. Our National Headquarters is located at 1619 King Street,
Alexandria VA and we can be reached at 703-548-5800.
Contact Information:
National President: RDML Tim Moon, tim.moon@ausn.org
Executive Director: RADM Casey Coane, casey.coane@ausn.org
Legislative Director: Mr. Anthony Wallis, anthony.wallis@ausn.org
Summary
Chairmen, Ranking Members and Members of the House and Senate
Veterans' Affairs Committee, the Association of the United States Navy
(AUSN) thanks you and your Committee for the work that you do in
support of our Navy, retirees and veterans as well as their families.
Your hard work has allowed significant progress in creating legislation
that has left a positive impact on our military community.
Last year alone, AUSN was pleased to see passage and implementation
of legislation in the areas of Employment, Mental Health and Concurrent
Receipt. Bills such as S.894, the Veterans Compensation COLA Act,
S.1495/H.R.2751 The Joining Forces for Military Mental Health Act,
S.325/ H.R. 948 Embedded Mental Health Providers for Reserves Act and
Title II of H.R. 674 which contained provisions of S.951/H.R. 1941 The
Hiring Heroes Act which passed into law as part of the National Defense
Authorization Act (NDAA) for Fiscal Year 2012 (FY12) shows the
commitment and determination of Members of this Committee as well as
Congress to improve the lives of those who have served our country.
As part of a larger veteran community, AUSN recognizes the many
challenges ahead, especially with the release of the President's Fiscal
Year 2013 (FY13) Budget Request on February 13. Of great concern
amongst our membership and veterans are the increases in TRICARE rates
and enrollment fees. Such changes must be done in accordance with what
is fair to our veterans given the promises that were made when they
signed up to serve their communities and their country. In addition,
AUSN is pleased to see discussions underway to address concern for the
impact of sequestration and what it might or might not have on the
Department of Veterans' Affairs. AUSN is greatly concerned with the
heavy cuts that are already being implemented in the Department of
Veterans' Affairs' budget this fiscal year and the negative impact a
sequestration trigger would have on crucial programs to our veteran
community.
The Association of the United States Navy, working with our
members, veterans and alongside other Veteran Service Organizations
(VSO's), has devised our FY13 Legislative Objectives and Priorities as
described below that we would like both the House and Senate Veterans'
Affairs Committee's to consider.

Veterans' Healthcare

AUSN was pleased to hear that the President's Budget request seeks
$52.7 billion for medical care, a 4.1% increase over the $50.6 billion
approved by Congress for the current fiscal year and a net increase of
$165 million above the advance appropriations level enacted for FY13.
However, AUSN and its members must stress the importance and concern of
its members and the veteran community to all Members of Congress on the
proposed changes to the Military Healthcare System (MHS).

TRICARE
The Administration's FY13 Budget Request implements numerous
changes to the existing MHS, which is utilized by over 8.8 million
veterans. Changes include increases to TRICARE Prime Enrollment fees.
Last year, finally acknowledging Congress' long-standing concerns about
the inappropriateness of dramatic increases in beneficiary fees, the
Administration proposed a 13% increase in TRICARE Prime fees. In the
absence of congressional objection, the increase was implemented as of
October 1, 2011. However, the new proposal for FY13 through FY17 is a
dramatic departure, proposing to triple or quadruple fees over the next
five years (for example $520 across the board retired pay levels for
FY12 to $600/$720/$820 tiered across the retired pay levels for FY13 to
$893/$1,523/$2,048 by FY17). AUSN urges Congress to reject any increase
in TRICARE Prime fees that exceeds the COLA-based standard established
in the FY2012 Defense Authorization Act.
In addition, the FY13 Budget Request institutes an annual TRICARE
Standard Enrollment fee to be phased in over a five year period and
then indexed to increases in National Health Expenditures(NHE) after
FY17 (for example $0 in FY12 to $70 in FY13 for individuals and $0 in
FY12 to $140 in for families). The deductibles for TRICARE Standard
would also increase from $150 in FY12 to $160 in FY13 for individuals
and from $300 in FY12 to $320 in FY13 for families. TRICARE for Life
(TFL) would also see an implementation of enrollment fees for all three
tiers going from $0 for all three for FY12 to $35 for Tier 1, $75 for
Tier 2 and $115 for Tier 3 for FY13. In total, the FY13 Budget Request
contains $48.7 billion for the entire DOD Unified Medical Budget to
support the Military Health System (MHS), which is a difference of $4.1
billion less than the $52.8 billion that was enacted for FY12.
These proposed increases, which require Congressional approval, are
part of the Pentagon's plan to cut $487 billion in spending and seeks
to save $1.8 billion from the TRICARE system in the FY13 Budget, and
$12.9 billion by 2017. These rate increases amount to an overall change
of 30% to 78% increase in TRICARE premiums for the first year and
explodes for a five year span increase of 94% to 345%, more than three
times current levels!
AUSN, our membership and the veteran community continue to oppose
the establishment of any new fees where there are none now (such as the
enrollment fees for TFL or TRICARE Standard). Our veterans should get
guaranteed access for an enrollment fee which is not always the case
for those that rely on TFL or TRICARE STANDARD where many can't find
doctors to see them. Where a flat fee exists now (which DOD is trying
to dramatically increase and then index to health cost growth), we
assert that the same rules should apply to those that Congress applied
to the Prime enrollment fee in the FY12 NDAA . . . they should be tied
to Cost of Living Adjustments (COLA) and not health cost growth.
These changes in the FY13 Budget Request raise concerns amongst the
military community about the impact this will have on recruiting and
maintaining a high quality all volunteer military force. These benefits
have been instrumental in recruiting qualified servicemen and women and
keeping them in uniform.

Agent Orange
The Veterans' Affairs Committee has a longstanding working
relationship with veterans and the effects of Agent Orange on the
health of Vietnam veterans. What was once classified in the early
1980's as a, ``minor acne condition,'' has met with thorough study and
determination of an exposure to our servicemen that has caused severe
illnesses such as various forms of cancer, Parkinson's Disease,
Lymphoma and many others. During Vietnam, the United States military
sprayed more than 19 million gallons of various ``rainbow'' herbicide
combinations, but Agent Orange was used most often. The name ``Agent
Orange'' came from the orange identifying stripe used on the 55-gallon
drums in which it was stored from 1962 to 1971, used to remove trees
and dense tropical foliage that provided enemy cover. Often times U.S.
Navy and Coast Guard vessels were in the vicinity of disbursement of
these chemicals.
The Navy and Marine Corps Manual (SECNAVINST 1650.1H) defines the
area in which a ship must have operated during this time period as
follows; ``water areas from a point on the east coast of Vietnam at the
border of Vietnam with China southeastward to 21N, 108-15E, thence
southward to 18N, 108-15E; thence southeastward to 1-30N, 111E; thence
southward to 11N, 111E; thence southwestward to 7N, 105E; thence
westward to 7N, 103E; thence northward to 9-30N, 103E; thence
northeastward to 10-15N, 104-27E; thence northward to a point on the
west coast of Vietnam at the border of Vietnam wit Cambodia.'' Veterans
who served aboard U.S. Navy and Coast Guard ships operating on the
waters of Vietnam between January 9, 1962, and May 7, 1975, may be
eligible to receive Department of Veterans Affairs (VA) disability
compensation for 14 medical conditions associated with presumptive
exposure to Agent Orange.
AUSN was pleased last fall when the Department of Veterans Affairs
released an updated list of U.S. Navy and Coast Guard ships that were
confirmed to have operated on Vietnam's inland waterways, docked on
shore, or had crewmembers sent ashore. This list, which can be found by
going to the website at http://www.publichealth.va.gov/exposures/
agentorange/shiplist/index.asp, can assist Vietnam veterans in
determining potential eligibility for compensation benefits. AUSN
encourages the House and Senate Veterans' Affairs Committee to continue
its work on the Agent Orange issue and support hearings and further
actions on pending legislation such as H.R. 3612, the Blue Water Navy
Vietnam Veterans Act which would amend Title 38, to clarify
presumptions relating to the exposure of certain veterans who served in
the vicinity of the Republic of Vietnam.

Mental Health Treatment and Professional Development
There was great success last year in the passage of the FY12 NDAA
which included embedded mental health providers for our servicemen and
reservists as well as mental health screening legislation included in
the bill to help continue to identify individuals suffering from mental
ailments and to help curb the increasing problem of suicide amongst the
services. When the FY13 Budget for VA was released, AUSN was happy to
see that $6.2 billion was included to expand inpatient, residential and
outpatient mental health programs (a 5.3% increase, $312 million),
further building onto last year's initiatives. This increase in funding
will help with increasing the outreach for mental health screenings,
expand technologies for self-assessment and symptom management of Post-
Traumatic Stress Disorder (PTSD) and enhance other programs to reduce
stigmas of mental health.
However, despite previous successes, much work needs to be done in
addressing mental health treatment, especially providing adequate
professionals to treat such ailments as PTSD and Traumatic Brain Injury
(TBI). There have been numerous complaints amongst the veteran
community of the inadequate level of mental health care professional
available to them at clinics across the country. When asked at the
Senate Veterans' Affairs Committee hearing on February 29, Under
Secretary of Veterans Affairs for Health, Robert Petzel, stated that,
``the VA is developing a staffing model for VA mental health needs.''
Furthermore, when asked during that hearing about the recruitment of
mental health care professionals, Under Secretary Petzel noted that
despite recruitment efforts for VA hospital being overall successful,
there was a gap in recruiting MD psychologists. Despite the VA offering
competitive wages amongst other incentives, Under Secretary Petzel also
concluded that the current environment just doesn't have that many of
these types of professionals out in the field. AUSN strongly believes
much more work needs to be done in regards to mental health care and
looks for continued support for legislative efforts on identifying and
providing adequate care and professionals to help alleviate the
problems associated with mental illness amongst our veterans.

Remote Area Access for Veteran Healthcare
As the VA continues to improve its clinics and professional care to
our veterans, AUSN is also concerned about the access our nation's
veterans have to these clinics and providers through the Department of
Veterans Affairs. AUSN acknowledges that this country is large and many
of our veterans live in rural or sparse areas of the country and may
not have the ability to travel to more suburban or city areas to access
the care that they need. In addition, there are problems with the VA's
ability to meet staffing needs, not only at clinics in more popular
areas, but also to serve the rural community. Under Secretary of
Veterans Affairs for Health, Robert Petzel, has said that the VA has
implemented a Patient Align Care Team (PACT) program which is bringing
up physician and support staffing up to national levels and standards.
Despite such prior successes, such as the 2008 Rural Access to Health
Act, there is a problem not with pay, but with attracting physicians to
rural areas. Secretary of Veterans Affairs, Eric Shinseki, and Under
Secretary Petzel have testified that there are efforts within the VA to
encourage staffing in rural areas such as expanding Tuition
Reimbursement Programs for prospective physicians to come to rural
areas as well as targeting talented individuals in rural communities to
be medically trained by VA in addition to other incentives. AUSN
supports pending legislation such as S. 1849, the Rural Healthcare
Improvement Act, which would require a five year strategic plan for the
Office of Rural Health of the Veterans Health Administration of the VA
for improving access to, and the quality of, health care services for
veterans in rural areas. AUSN continue to urge the bot the House and
Senate Veterans Affairs Committees to look at this and similar
legislation to improve access for our veterans in rural communities.

Disability Compensation/Concurrent Receipt
The Department of Veterans Affairs projects it will receive about
1.25 million claims for Veterans disability benefits (a 4% increase
from the 1.2 million projected for this fiscal year). As it exists
today, a disability rating is assigned (a percentage) by the VA after a
physical examination for all body systems for which the veteran is
claiming disability. However, a cash benefit is only provided to
veterans with a rating of 10% or more. The basic benefit amount ranges
from $127 to $2,769 a month, depending on the disability rating.
However, given the economic situation faced by many of our veterans,
this compensation may not be adequate to meet their needs as costs of
living continue to rise. AUSN supports recently introduced legislation
such as H.R. 4114, the Veterans' Compensation Cost of Living Adjustment
Act and H.R. 4142, the American Heroes COLA Act. H.R. 4114 would
increase effective December 1, 2012, the rates of compensation for
veterans with service-connected disabilities and the rates of
dependency and indemnity compensation for the survivors of certain
disabled veterans. H.R. 4142 would amend Title 38, to provide for
annual cost-of-living adjustments to be made automatically by law each
year in the rates of disability compensation for veterans with service-
connected disabilities and the rates of dependency and indemnity
compensation for survivors of certain service-connected disabled
veterans.

Veteran Employment/Transition and Housing

The FY13 Budget Request included $233 million, a 14% increase over
2012 authorized levels, for the administration of the VA's Vocational
Rehabilitation and Employment Program (VR&E). The VR&E program is
designed to help veterans with service connected disabilities prepare
for, find and keep suitable jobs. Veterans with severe service
connected disabilities who cannot immediately consider work are offered
other services by the VR&E to improve their ability to live as
independently as possible. The VA stated that the increase would focus
on expanding services to wounded, ill and injured service members to
ease their transition to the civilian sector. With program participants
expected to increase from 108,000 in 2011 to 130,000 this next fiscal
year, AUSN was happy to hear of this increase. There are still concerns
regarding transitioning from active duty to the civilian sector amongst
the veteran communities. Amongst the ones described in this testimony,
are concerns regarding the experiences of a veteran while on active
duty, translating to certain civilian sector jobs and license
certifications. AUSN supports the bipartisan bill H.R. 4115, the Hire
at Home Act, which would amend Title 38 to require, as a condition on
the receipt by a State of certain funds for veterans employment and
training that the State ensures that training received by a veteran
while on active duty is taken into consideration in granting certain
State certifications or licenses. Other legislation AUSN supports is
H.R. 4155, Veteran Skills to Jobs Act, which would direct the head of
each Federal department and agency to treat relevant military training
as sufficient to satisfy training or certification requirements for
Federal licenses.

Transition Programs
AUSN is continuing to monitor the debate on whether or not to
mandate participation in the military's transition assistance program
(TAP). There are many current service members on active duty who
continue to not understand why they would need to participate in the
program. However, once service members left the military, many wondered
why they never received comprehensive training and information on how
to access their earned benefits and successfully transition from
military to civilian life. Unfortunately, some veterans have no way to
reasonably anticipate all of the challenges he or she may face once out
of the military. AUSN believes that TAP resources must be available to
veterans after they have transitioned off of active duty and looks for
continued support and consideration of H.R. 4051, the TAP Modernization
Act of 2012, and its pilot program to offer off-base TAP to communities
where veterans have been hit hard by difficult economic times.

Encourage Hiring of Veterans
Despite provisions of the Hire Heroes Act being included in Title
II of H.R. 674 (Public Law 112-56) being a great step in the right
direction, unemployment amongst veterans remains high and is a top
concern of AUSN. Currently there are over 857,000 unemployed veterans
(mostly Vietnam veterans) throughout the country. Furthermore, there
are alarming cases where veterans are afraid to put `veteran' on their
job applications in fear of employer's not wanting to hire them. The
FY13 Budget Request proposes $1 billion over five years for a Veterans
Job Corps, a new effort to leverage skills veterans develop in military
service for a wide range of jobs. The initiative would put up to 20,000
veterans to work on projects to restore America's lands and resources.
Although promising, AUSN is concerned with its implementation and
requests Congress review this proposal in detail to ensure that a large
group of veterans coming home and, consequently, unemployed veterans
can utilize this program. AUSN was pleased to participate in an open
forum discussion with other VSO's this month on the launch of the
Senate Veterans Jobs Caucus led by co-chairs, Senators Joe Manchin (D-
WV) and Mark Kirk (R-IL). On March 28, 2012 Senators Manchin and Kirk
will hold a press conference to announce the creation of the Caucus and
the unveiling of the Senate ``I Hire Veterans'' initiative, the first
step in strengthening Congressional support for Veterans employment
issues and will be the focus of the formal launch. AUSN is encouraged
by this effort and will be present at the launch of this new Caucus
initiative. AUSN continues to support legislation that promotes
employers and businesses hiring veterans including H.R. 743 and S. 367,
the Hire a Hero Act, both which target small business which hire
individuals who are members of the Reserve Component.

Homelessness
AUSN was pleased to hear in testimony before the Senate Veterans
Affairs Committee that there has been significant progress in the area
of combating veteran homelessness. The Department of Housing and Urban
Development (HUD) released annual reports since 2009 on the estimates
of homeless veterans and although there was an increase from 75,609 in
2009 to 76,329 in 2010, there was a substantial 12% decrease in 2011 to
67,495. However, the statistics on homeless veterans are still
staggering. Veterans in the groups of age 31-60 compose the greatest
percentages of homeless veterans, but Domiciliary Care for Homeless
Veterans (DCHV) has reported that of these homeless veterans that come
through, 90% suffer from Substance Use Disorders, 68% have serious
psychiatric problems and 61% are being dually treated.
Secretary Shinseki has testified that ending veteran homelessness
is one of his top three priorities for the Department of Veterans'
Affairs. AUSN was pleased to hear that the FY13 VA Budget Request
contained $1.35 billion to further VA's plan to end homelessness (an
increase of $333 million from FY12, 33%) which also includes $235
million for the Homeless Grants and per Diem program to aid community
organizations. In addition, $21 million to provide 200 coordinators who
will help homeless Veterans with disability claims, housing problems
and other issues. AUSN looks forward to hearing about the progress on
combating homelessness amongst veterans and urges the House and Senate
Veterans' Affairs Committee to consider legislation that addresses
these issues, such as H.R. 1911, Protecting Veterans' Homes Act and S.
1148, the Veterans Programs Improvement Act.

Claims Processing
Processing of claims within the Department of Veterans Affairs is
an ongoing problem as our veterans try to get the assistance needed for
a wide range of issues. AUSN was pleased to see that the FY13 Budget
Request included $2.164 billion, an increase of $145 million over 2012)
in support of benefits processing through increased staff, improved
business processes, and information technology (IT) enhancements. This
funding would support the completion of 1.4 million disability
compensation and pension claims and provide funding to complete 4
million education claims. The VA notes that by 2013, no more than 40%
of compensation and pension claims will be more than 125 days old which
is a significant cut from the 60% of claims exceeding that mark this
year. Even with the increase in funding and positive outlook, there
still appears to be much work to be done in processing claims. The
statistic heard by Senator Richard Burr at the Senate Veterans Affairs
Hearing on the FY13 budget was astounding, that it takes 645 to 747
days for appeals to claims to get processed and that the VA decides
hundreds of thousands less claims than it receives. With 1 million new
veterans expected to be utilizing the VA claims system, this needs to
improve. Although it was reassuring that Secretary Shinseki also made
this one of his top three priorities and that there are more options
for veterans to contact call centers, AUSN continues to be concerned
with the efficiency of the claims system for our nation's veterans and
would like Congress to be on the forefront of any efforts to monitor
and improve this process at the VA.

Veteran Education

There have been drastic improvements to education assistance
provided to our nation's veterans, of which AUSN has been pleased to
see over the years. In the Senate Veterans' Affairs Committee hearing
on February 29, Senator Mike Johanns stated that, ``I don't know what
we are doing with education benefits, but at least from our experience
something's working. Whatever model, if that could somehow be
transferred to the disability claims and I appreciate they're much more
complicated, but that seems to be working.''
The Post-9/11 G.I. Bill is a magnificent benefit for today's
veterans and improvements, such as correcting certain oversights within
the bill, have only made it run more smoothly for the more than 606,000
Service members, veterans and family members and survivors that
currently use it. The provision has potential to help shape and mold
future leaders and AUSN opposes any efforts to scale back the benefit
as disservice to the men and women who have fought in defense of our
nation for the last decade.
Since VA implemented the Post-9/11 G.I. Bill, the department has
primarily focused on ensuring student-veterans receive timely, accurate
payments to finance an education. Unfortunately, as more and more
veterans sought to take advantage of their earned educational
opportunities, VA was left without the proper resources to ensure that
veterans knew how best to use their benefits. Under Section 3697A of
Title 38, VA is obligated to offer educational and career counseling to
any separating service member or G.I. Bill eligible veteran.
Unfortunately, this counseling is only offered through an ``opt-in''
process, and the total available counseling is capped at $6 million
each year. In 2011, the VA announced that nearly 1 million veterans
were enrolled in G.I. Bill programs, but that same year, only 6,400
veterans received counseling on their benefits through Section 3697A.
Congress must remove the cap to VA's educational counseling and
mandate that VA contact veterans at different points prior to utilizing
their educational benefits in an effort to deliver this counseling.
Veterans who do not wish to receive educational counseling must still
have the option to refuse it, but the ``opt-out'' system ensures that
all potential student-veterans understand their benefit and understand
the importance of their educational choice.
AUSN supports H.R. 4057, the Improving Transparency of Education
Opportunities for Veterans Act of 2012, which offers a critical first
step in ensuring that student-veterans are properly informed about
their benefits and have proper recourse for fraud, waste and abuse.
AUSN believes that VA is already taking proactive steps to ensure
current service-members receive this kind of information through the
transition assistance program (TAP) and that veterans who apply for
G.I. Bill benefits are exposed to critical information before tapping
into their benefits. AUSN continues to advocate for legislative
solutions for issues that arise with veteran educational assistance. We
support other legislation such as H.R. 4140, the Restore the Promise
G.I. Bill as well as S. 2179, the Military and Veterans Educational
Reform Act which seeks to improve oversight of educational assistance
programs.

Navy Reserve

Veteran Status for Reservists
AUSN supports the classification of certain groups of our Navy
Reservist as veterans. Currently, as it exists in the U.S. Code, a
reservist can successfully complete a Guard or Reserve career but not
earn the title of, ``Veteran of the Armed Forces of the United
States,'' unless the member has served on Title 10 active duty for
other than training purposes. Currently, Title 38 excludes from the
definition of ``Veteran'' career those reservists who have not served
on Title 10 active duty for other than training purposes. Drill
training, annual training, active duty for training, and Title 32 duty
are not deemed qualifying service to qualify for ``Veteran'' status.
For example, the service of our Guard and Reserve members serving in
Operation Noble Eagle would not qualify them to earn the status of
``Veterans of our Armed Forces'' because it is technically a
``training'' status.
AUSN applauds the House of Representatives for passing H.R.1025,
the Honor America's Guard and Reserve Retirees Act, last fall on
October 11, 2011, sending the bill to the Senate for its approval where
it still awaits action by the Senate Veterans' Affairs Committee.
H.R.1025 would authorize Veteran status under Title 38 for Guard and
Reserve members of the Armed Forces who are entitled to a non-regular
retirement under Chapter 1223 of 10 USC but were never called to active
federal service during their careers, through no fault of their own.
The Senate has a companion version of this bill, S. 491, which had
hearing held last summer of 2011. These zero cost bills provide an
opportunity for Congress to come together to honor our Guard and
Reserve members.
The bills would not bestow any benefits other than the honor of
claiming Veteran status for those who honorably served and sacrificed
as career Reserve Component members. AUSN believes that our Reserve
Component deserve nothing less.

Other Veteran Items of Interest

AUSN recently learned of an important initiative done through the
Missing in America Project, identifying unclaimed remains of veterans
for proper burial. At funeral homes, and other entities across the
country, an unknown number of veterans' ashes are abandoned and
unclaimed, many of which are homeless veterans. AUSN was happy to hear
that there is legislation pending that addresses this issue. H.R. 2051
the Veterans Missing in America Act, would direct the Secretary of
Veterans Affairs to work with VSO's and other groups, like the Missing
In America Project, to provide assistance in determining if
unidentified or abandoned remains are those of a veteran eligible for
burial at a National Cemetery. AUSN supports continued efforts in
regards to proper burial efforts such as these by the House and Senate
Committee on Veterans Affairs.

Conclusion

The Association of the United States Navy understands that there
are difficult decisions ahead in regards to this year's FY13 Budget
Request. Amongst our Legislative Objectives/Priorities for FY13 is the
looming concern of the effects of an automatic sequestration trigger
upon the Department of Defense and the Department of Veterans Affairs.
AUSN is pleased that discussions are underway to check with the Office
of Management and Budget (OMB) to see if an exemption will be made for
the Department of Veterans' Affairs whereby in the Senate Veterans'
Affairs Committee hearing on February 29 this year, VA Secretary
Shinseki stated that for his purposes he, ``is not planning on
sequestration . . . . [he's] addressing requirements and presenting a
budget as expected and sequestration in pat or in whole is not
necessarily a good policy.'' Currently, there are two bills that AUSN
is tracking to address this concern of exempting veteran programs from
sequestration, H.R. 3895, Protect VA Healthcare Act of 2012 and S.
2128, Protecting the Health Care of Veterans Act of 2012. AUSN urges
that the Veterans' Affairs Committee looks at these bills as a means of
ensuring that veterans' programs aren't subject to sequestration. In
addition, we encourage members of both the House and Senate to look at
our website which has a daily updated Bills of Interest section where
we have more legislation that is within our priorities that we are
tracking on behalf of our members at http://www.ausn.org/Advocacy/
BillsofInterest/tabid/2668/Default.aspx. Thank you.