by Tom Zampieri
11th Hour Victory!
At the very end of the 109th Congress, with less than 72 hours left in the session, the long sought-after BROS bill, H.R. 3579, was included in a vote in the House Veterans Affairs Committee. The bill was then wrapped into S. 3421 on the Senate side, passing at midnight on the final day of the session, December 8, 2006!
S. 3421 included the provisions of S. 1190 passed by the Senate one year before. It authorized, during a 30-month period, the hiring of 35 new Blind Rehabilitation Outpatient Specialists (BROS) at VA Medical Centers that do not already have a BROS on staff. More than eight major pieces of legislation on benefits, health care, information technology reforms, education, homeless veterans, mental health services, and many other issues were all packaged into S. 3421. President Bush signed the Veterans Benefits, Health Care, and Information Technology Act of 2006 into public law on December 20.
House and Senate Committee staff of the Democratic minority worked diligently with Senate Chairman Larry Craig’s (R-ID) staff to assure that the BROS provision was included in the House version of the bill. They fought back two attempts earlier in the week to have the provision dropped.
Former Ranking Member Lane Evans’ (D-IL-17) Committee staff, especially Linda Bennett on the Health Subcommittee, helped us a great deal during that final week. She persevered to ensure the passage of the bill with the same commitment and passion on behalf of veterans as did Representative Evans throughout his Congressional tenure.
Amid the joy and excitement of having been able to get this bill passed, we also felt some sadness over Evans’ retirement during this past session. Adding to the bittersweet feelings is the departure of several key staff members originally hired by Evans, including Bennett.
Newly appointed House Committee Chairman Bob Filner (D-CA-51) is bringing in new Committee staff. He is also in the process of appointing new members to the Committee from the Democratic majority. I will report on all of the new Committee members in the spring issue of the Bulletin.
FY 07 Appropriations Still Not Complete
Despite the positive results inherent in the passage of the BROS bill, there is still unfinished business left over from the 109th Congress. Some 11 major federal appropriations bills still need to be passed in order for the federal agencies to operate in FY 2007.
One of the bills requiring action is the MILCOM/VA FY 2007 appropriation, which affects VA. Veterans health care was to be funded at the FY 2006 funding levels until February 15 as a result of a Continuing Resolution. Without passage of the MILCOM/VA appropriations, VA would not have the funds to meet the demands for this year. It means further that the new BROS positions approved in S. 3421 cannot yet be filled.
Key hill staffers have told us that there are now two options. One is for Congress to pass the MILCOM/ VA appropriations for FY 2007 that was blocked during the final two weeks of the 109th session. The other option is passage of a yearlong Continuing Resolution containing an amendment to cover the extra $3.1 billion necessary to operate the VA health care system for the remainder of the year. Dr. Michael Kussman, Acting VA Under Secretary for Health, informed Veterans Service Organizations (VSOs) in a January 10 meeting that the Veterans Health Administration (VHA) would need the additional $3.1 billion in order to operate for the remainder of the year on the current Continuing Resolution.
VA Commits to Expand Services
On January 25, VA made a public announcement and issued an official press release that called for a reorganization of its rehabilitation services to provide visually impaired veterans with vision health care closer to their homes. For BVA, this was a landmark announcement.
Some $40 million is to be made available during the next three years to establish a nationwide rehabilitation system for veterans and active duty personnel with vision impairments. The system will enhance inpatient services and expand outpatient services throughout the 1,400 locations where VA provides health care.
More specifically, the reorganization blueprint calls for each Veterans Integrated Service Network (VISN) to implement a plan to provide eye care to veterans with visual impairments ranging from 20/70 to total blindness. Basic low-vision services will be available at all VA eye clinics, and every network will offer intermediate and advanced low-vision services, including a full spectrum of optical devices and electronic visual aids.
VA’s ten existing inpatient Blind Rehabilitation Centers will continue to provide the Department’s most intensive eye care programs, but each VISN will now provide outpatient-based blind rehabilitation care.
BVA considers this announcement to be significant because we have adopted resolutions at our conventions for the past several years supporting this very initiative. We have also emphasized the need for a “Continuum of Care” for blinded veterans in our annual Congressional testimonies during the same time period.
The big caveat is that Congress must fund this initiative. In a climate of Continuing Resolutions, VA health care is already suffering. If, for example, VA were to provide the $40 million for this plan right now, it would have to remove funds from other programs and services, a highly unlikely scenario. We will continue the fight to secure additional funding for this important and much-needed initiative.
Our recent advocacy in this area has been supported by the fact that VA itself estimates some 1.2 million visually impaired veterans over the age of 45 in the United States. Within this group, about 157,000 are legally blind and 1,026,000 have low vision. About 80 percent of all visually impaired veterans have a progressive disability caused by age-related macular degeneration, glaucoma, or diabetic retinopathy.
Paired Organ Legislation
As I reported in my last update, we fully expected to lose the fight, at least temporarily, for the Paired Organ bill, H.R. 2963. House Committee Chairman Steve Buyer (R-IN-4) refused to allow the legislation to be moved with other bills although our efforts had resulted in 80 bipartisan co-sponsors.
Buyer managed to block the bill throughout the session because of costs associated with it. He viewed it as adding a new entitlement in benefits although we argued that the Paired Organ bill for veterans had already been on the books since 1964. Representative Tammy Baldwin (D-WI-2) tried several times unsuccessfully to convince the Chairman that the bill was necessary and that costs could be offset.
Once the 110th Congress had appointed its Subcommittee Chairmen in late January, Baldwin planned to once again introduce Paired Organ legislation. Incoming Chairman Filner has already agreed to fully support and give the bill a green light. He has indicated that he will become an original co-sponsor along with Representative John Boozman (R-AR-3), thereby ensuring bipartisan support for the bill early in the session.
The need for the aforementioned legislation exists because Title 38 of the United States Code Paired Organ law did not define legal blindness when it was enacted in 1964. Since that time, the Social Security Administration and every state law governing motor vehicle licenses has defined blindness as visual acuity of 20/200 or less. The World Health Organization also accepts this definition.
In its own manual, the Veterans Benefits Administration (VBA) has nevertheless used a much stricter standard in defining blindness. The standard, located in Paragraph L of Section 1160, defines blindness at 5/200 (20/800). This means that veterans who have lost vision in a second eye have often had claims denied that would not have been denied to those applying for Social Security disability. In Congressional testimony last April (2006), we questioned both orally and in writing the fairness of this scenario to our blinded veterans.
Changing the Paired Organ statute to reflect the more commonly used definition of blindness would affect an estimated 5 percent of the 13,109 veterans between the age of 40 and 80 who are currently service connected for blindness and loss of vision in one eye, a fact we also emphasized in our April testimony to illustrate how little the legislation would cost. The Congressional Budget Office has projected that the enacted legislation would cost less than $500,000 in FY 2007 and less than $2 million during the subsequent three years.
Senator Daniel Akaka (D-HI), the new Chairman of the Senate Veterans Affairs Committee, is reportedly supportive of the introduction of a Paired Organ companion bill in the Senate. We are strongly encouraged to have both the House and Senate Committee Chairmen supportive of this effort to repair an injustice that has long remained unresolved.
Critical Issues and Upcoming Testimony
BVA is preparing Congressional testimony on key issues and once again providing input into the VSO Veterans Health Care Independent Budget for FY 2008. We have been told that Chairman Filner will definitely return to the traditional format of joint legislative hearings for VSOs.
Just before press time, we learned that the BVA hearing is scheduled for Thursday, March 8 at 9:30 a.m. In order to secure hotel reservations and less expensive fares for the BVA Board and field staff, we had already gone ahead with plans for our mid-winter Board and legislative meetings for the first full week in March.
We hope that a new bipartisan House Veterans Affairs Committee can emerge, recommitted and dedicated to seriously examining issues such as mandatory funding for the VA health care system. We agree with other VSOs that the system cannot continue to be supported by an annual discretionary process that has become so hotly political. This is because fiscal years are ending with Continuing Resolutions that extend into the second budget quarter, resulting in delays in hiring staff, repairing equipment, and in initiating construction projects.
To further emphasize my point, we were scheduled to receive the FY 2008 budget from the White House during the first week of February. At that point, we probably had not yet completed the FY 2007 budget cycle. The current process uses data from 2005 to project what is needed for this year’s budget. Going back to 2005 forces those making projections to include new efficiency measures and increased fees to offset the almost certain deficits.
In addition, Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF, Afghanistan) veterans recently sought health care. This is 45,000 above the already projected number. In FY 2006, more than 16,000 new cases of Post Traumatic Stress Disorder were treated in VA Medical Centers, double the number from 2005.
The concept of “Seamless Transition” is also of great concern to BVA. We have found that the Department of Defense (DoD) has no central tracking system for service personnel with severe eye injuries or blindness resulting from direct eye trauma. It is unacceptable that DoD has not communicated nor coordinated effectively with VA Blind Rehabilitation Services regarding the initial rehabilitation of those with eye injuries. In some cases, several weeks have gone by before DoD has asked a VA Visual Impairment Services Team (VIST) Coordinator or BROS to make a visit to the military facility. This delay adds unnecessary strain to both the service members and their families as they worry about the future.
We have learned that more than 3,000 service members exposed to traumatic brain injuries, as well as those with mild or moderate injuries, have a high incidence of Post Traumatic Visual Syndrome (PTVS). These cases are apparently not being screened effectively, which results in inadequate follow-up.
The issue of “Concurrent Receipt” for those who have earned retired pay and who have a VA service-connected disability is also significant to BVA. Having retirement offset by VA disability is inherently wrong, and BVA will continue to work for change. A related issue is the wrongful offset of retired and survivor pay with the elimination of the Survivor Benefit Plan (SBP) and Dependency and Indemnity Compensation (DIC), known as the SBP-DIC offset. DIC is paid by VA to survivors of service members who died of a service-connected disability, but it is currently reduced dollar for dollar by the SBP benefit.
It is perhaps noteworthy at this point that the percentage of legislators who are veterans is still in decline. Only 29 members of the Senate and 23 members of the House have served in uniform on active duty. In 1991, 68 members of the Senate and 48 members of the House were veterans, many still from World War II. While many non-veterans are very supportive of our efforts to serve veterans, there is often an added challenge in educating them on the importance of the aforementioned issues. BVA has recently become a key VSO in these educational efforts and requests for hearings.
Operation Peer Support
BVA has recently been the recipient of some excellent media coverage. Our Operation Peer Support program has been the focus of this coverage as we continue to reach out to our service personnel blinded in Iraq and Afghanistan. We will continue to support and assist, as much as possible, these brave Americans who volunteered to protect our freedoms.
As reported in the last couple of Bulletin issues, we were honored to have eight servicemen with us in Buffalo last August for the 61st National Convention. Since then, we have made regular trips to Bethesda, Maryland, stopping at both Walter Reed Army Medical Center and the National Naval Medical Center to call on other recently blinded service members and their families. In January, the Deputy Commander for Clinical Services at Walter Reed granted Operation Peer Support “official recognition” within the hospital. This recognition means we now have endorsements and strong support from both the Chief of Rehabilitative Medicine and the Chief of Optometry Service.
DoD has reported that between March 2003 and April 2006, 16 percent of the wounded personnel evacuated from Iraq had eye trauma. We are attempting to locate and offer our services to as many of these individuals as possible. If your regional group has not made an effort to locate them at your local VA Medical Center, we would certainly encourage you to do so. Additionally, please let us know when you locate recently blinded veterans interested in receiving more help or information.
We are again raising funds from individuals, organizations, businesses, and corporations to bring more of these brave American veterans to the 62nd National Convention. Bulletin readers with potential key corporate contacts interested in this program may notify me at BVA National Headquarters. You may also refer interested parties to the Advocacy page on our website for additional details. Our ambitious goal is to double our efforts and bring some 16 OIF and OEF personnel, accompanied by a family member, to Albuquerque. We also hope to expand the range of activities available to them, including speakers on employment opportunities, technology, and new medical treatments for blindness and low vision.
Member Efforts Make Difference
Many BVA members made phone calls, sent letters or emails, or visited their representatives during the 109th Congress in an effort to educate them on the many key issues of concern to us. Our recent success also included passage of the White Cane Resolution last summer. The Senate Appropriations Committee also included an amendment directing VA to implement and fund the full continuum of blind services for veterans, a directive that appears more realistic than ever before. The aforementioned BROS bill was then passed in a very adverse and difficult environment.
These latest victories are also a reflection of the influence and credibility that BVA has developed over several decades in educating members of Congress on the needs of blinded veterans and their families.
We also thank our members who have supported these key efforts by sending in your name, email address, postal address, and regional group affiliation so that we can include you in our periodic legislative email alerts. Those still wishing to be on the alerts mailing list should send the aforementioned information to our volunteer moderators at firstname.lastname@example.org.
Trying to make heads or tails of the legislative process is daunting at best. This is true even for seasoned professionals. It is even true without the partisan bickering and gamesmanship that have recently pervaded Capitol Hill. The process can be especially confusing for the average citizen trying to figure things out in the current political climate. Familiarity with a few key terms may help when reading about new bills and amendments that affect active duty military and veteran funding.
An Authorization Act authorizes a program, specifies its general aims, and sets a general ceiling on the monies that can be used to finance it.
An Appropriation Act grants the actual money to be spent, usually after the adoption of an authorization act.
A Supplemental Appropriation Act is legislation that adds money to an appropriation act previously passed by Congress.
Direct Spending is budget authority to spend what was provided in an authorization or entitlement act, including mandatory spending clauses contained in appropriations acts.
Discretionary spending occurs with programs whose funding levels are determined through the appropriations process.
Entitlements are programs that make payments to any person, business, or unit of government that seeks the payments and meets the criteria of law. Congress controls these programs indirectly by defining eligibility and setting the benefit or payment rules.
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