by Tom Zampieri
A Fond Farewell to WRAMC, Tom Miller
It was a pleasure for me to interact with many of our wonderful members and their families at our recent national convention. I appreciated the large turnout for my Saturday presentation, which provided me with a much-needed opportunity to elaborate on the issues that I can only briefly outline in my periodic Legislative Alerts and quarterly updates in the Bulletin.
Two of BVA's longtime associates have either already said their good-byes or soon will do so. The first of these is actually a structure while the second is a heralded blinded veteran.
Since 1986, the BVA legislative legacy has been created, developed, and refined by the priorities and agenda established by Tom Miller. Tom Zampieri, left, became part of the legacy in 2005.
During the final weekend in August, the renowned 117-year-old Walter Reed Army Medical Center in the Nation's Capital closed its doors and lowered its flags for the last time. The facility had treated service members since before the Spanish-American War. Its health care patients included Privates and every other rank up to and including General, most notably Generals Jack Pershing and Dwight D. Eisenhower.
All patients and most staff at Walter Reed were immediately transferred up the road northward a few miles to Bethesda, Maryland. Their new home became what has traditionally been called the National Naval Medical Center. The large campus now housing these new patients will now be known as the Walter Reed National Military Medical Center. Many who work there now refer to it as simply "The New Walter Reed," the expansions of which have made it the largest military medical center in the world today.
The planned merger and much-needed construction to expand the Bethesda facility had been in the works for the better part of six years. At press time, several sections of the expansion were still being completed.
The second good-bye for me is a unique one involving the upcoming retirement of Tom Miller as Executive Director. As a result of Tom's experience, contacts, and knowledge, my job has been much easier than it would otherwise have been the past six years. It has been a special privilege to learn the skills of the trade from the true BVA government relations guru. Many of our recent successes can yet be traced to Tom's influence.
Well done, Tom, and best wishes in retirement. Godspeed and Semper Fi!
Research Funding Reductions
We expected a busy month of September upon our return from Las Vegas and we certainly got one. With Congress so heavily involved in appropriations legislation, the gridlock continued. For the third time in less than six months, an approaching federal government shutdown was once again averted at the 11th hour.
Amid larger fights, we expressed frustration that the Defense Appropriations Committee in the Senate voted to reduce combat eye trauma research funding by 20 percent—from $4 million in Fiscal Year (FY) 2011 to $3.2 million in 2012. This occurred after the House Committee had voted the same way in June.
We were disappointed that none of the Senate Committee Members offered an amendment to the bill during the mark-up process. BVA had urged for such an amendment that would actually add $7 million to the original $4 million instead of reduce the funding. While there seemed to be bipartisan support for this in both the House and Senate Appropriations Committees among some Members, the Senate actually deferred to House funding levels set in its June mark-up for the Congressionally Directed Medical Research Program of which vision research is a part.
We were sufficiently disturbed by this outcome that we distributed a press release to express our thoughts. We pointed out that former Defense Secretary Robert Gates had testified in a Senate hearing in June that even in a time of budgetary restraints, combat traumatic injury research on behalf of our wounded warriors must remain a priority in Congressional appropriations.
Our press release also stated that of all service members with Improvised Explosive Device injuries, 82 percent of these have included severe eye blast injuries and 65 percent open-globe penetrating wounds. We mentioned further that visual dysfunction is an issue for 54 percent of the service members returning from Iraq or Afghanistan with a Traumatic Brain Injury (TBI).
The House mark-up included increased funding by $31 million for TBI and orthopedic limb injury research. It also added funding for other war fighter research. Why, we asked, would eye trauma research be less important for front-line troops and be funded at such unacceptably low levels? Such misguided priorities send a terrible message that an eye injury is not as important as a limb or other injury.
Renewed Collaborative Efforts
Fortunately, we are not completely alone in our advocacy of defense-related vision research. The National Alliance for Eye Vision Research (NAEVR), the American Optometric Association (AOA), and the American Academy of Ophthalmology (AAO) are all involved in the effort. We all see the folly in funding this research at $4 million when the Department of Defense (DoD) has received 126 eye injury grant submissions this year.
Together, we certainly understand the budget issues confronting our current Congress. We also recognize that every single lobbying organization and advocacy group with a presence in the Nation's Capital is constantly working to protect and safeguard its special programs. Even so, it is our firm conviction that we should not permit our leaders to cut eye injury battlefield research that could very well lead to vision preservation and/or vision restoration in the future.
Our collaboration with NAEVR, AOA, and AAO will continue indefinitely. We are hopeful that we can make progress in reversing these reductions in research funding even as Congress works to trim the federal budget by billions and perhaps trillions as time goes on. We must educate the public and our Members of Congress that vision research is no area from which to trim.
VOW Act Addresses Veteran Unemployment
As Veterans Day 2011 approached amid unprecedented partisan bickering, Congress brokered a deal that will hopefully help veterans find more jobs than they otherwise would.
The VOW to Hire Heroes Act of 2011, passed November 7, contains provisions to ensure that all service members transitioning to civilian life receive the job training skills they need to be competitive in the job market and eventually find a job in today's very difficult economic climate.
Key provisions of the legislation include a tax credit of up to $5,600 for hiring veterans who have been looking for a job for more than six months, as well as a $2,400 credit for veterans who are unemployed for more than four weeks but fewer than six months.
Perhaps most significant is a wounded warriors tax credit within the bill. Up to $9,600 in tax credits will be available to employers who hire post-9/11 veterans with service-connected disabilities who have been looking for a job for more than six months.
The legislation also expands education and training opportunities for older veterans by providing nearly 100,000 unemployed veterans of past eras and wars with up to a year of additional Montgomery GI benefits. Veterans can use these benefits in education or training programs at community colleges or technical schools for high-demand jobs.
Working together in the legislative process for this bill, a phenomenon fairly uncommon among House and Senate leaders recently, were House VA Committee Chairman Jeff Miller (R-FL-1) and Senator Patty Murray (D-WA).
"The VOW Act includes both Republican and Democratic ideas because getting our veterans the financial security and dignity a job provides should never be a partisan effort," said Chairman Murray. "By advancing this legislation we are giving veterans the job skills to get their foot in the door and providing incentives to employers to make sure that the door is open to them."
In a November 16 statement, Chairman Miller praised Veterans Service Organizations for their influence and perseverance that helped move the legislation through Congress and then to the President for his signature.
"I would particularly like to express my gratitude to our VSOs who have been steadfast partners throughout this process," he said. "They deserve the real credit in bringing veteran unemployment to the public's attention and getting this legislation signed into law this year."
BVA and the Postal Service
Budget battles over reducing the national debt have spilled into another area of concern to BVA.
On June 23, Representative Darrell Issa (R-CA-49) introduced H.R. 2309, the Postal Reform Act of 2011. The bill was approved by the House Oversight Subcommittee on Workforce, U.S. Postal Service and Labor Policy on September 21. The legislation, if passed, will make significant changes to the organizational structure and function of the U.S. Postal Service.
Section 403, entitled "Rate Preferences for Nonprofit Advertising," proposes a 10 percent postal increase per year over six years. This change would be effective on the first day of each calendar year beginning after the date of the law's enactment.
BVA's postal expenses will quickly double under such a scenario. As is the case for other VSOs, direct mail is our largest source of fundraising revenue.
This dramatic increase in one expense category would require BVA to drastically reduce some portions of its fundraising mailings. Significant reductions to the number of first-class stamps to be affixed to return envelopes would also be necessary. These changes would obviously impact negatively BVA's operational expenses, resulting in tough future decisions regarding reductions in mailings and increases in membership dues.
During times of economic uncertainty like the one we currently face, charities like BVA struggle with ever-growing needs. Blinded veterans are disproportionately affected even more by unemployment, especially those who have returned from Iraq and Afghanistan and who may have endured multiple combat tours. We strongly believe that veterans from all generations are our nation's heroes, deserving the finest services and advocacy the country can provide.
Proposed Changes to Nation's Tax Policy
Other legislation on the table could also affect BVA down the road. One proposed bill would eliminate some of the tax deductions and breaks for contributions made to charitable and nonprofit organizations once they reach 28 percent of an individual's income. Since virtually all of BVA's income is derived from a direct mail program, this change would reduce the incentive for potential donors to support our work on behalf of blinded veterans.
Shouts from Capitol Hill that everything must be cut often have far-reaching consequences. The implications of this are deep for organizations such as BVA.
A Senate Finance Committee hearing in the next several weeks will address charitable giving incentives. More than 40 leaders from large nonprofit organizations around the country will be in Washington for "Preserve Giving Day." In advance of the hearing, they will meet with members of the Committee privately and will also visit the offices of both House and Senate Members of the "Supercommittee on Deficit Reduction."
"Proposals to cap itemized deductions at 28 percent for individuals in the highest two tax rates would have long-lasting negative consequences for the charitable organizations that millions of Americans rely on for vital programs and services," said Executive Director Tom Miller for a recent press release.
One of the most frustrating things about this issue is the need to follow it while also keeping abreast of the routine VA Committee issues. Added to these after two overseas military conflicts the past eight years are Defense issues and Finance and Budget issues.
Our conclusion at this point can only be that as Congress attempts to deal with the budget deficit, the proposed changes could directly affect our organization and its members. Time will tell as to the extent to which this will occur and how.
Military and federal civilian retirees, survivor benefit annuitants, veterans with service-connected disabilities, and Social Security recipients will see a 3.6 percent cost-of-living adjustment in January, their first since 2009. The newest COLA will be effective December 1 and will be reflected in January retired pay, survivor benefit plans, and VA disability compensation checks.
On November 2, the House of Representatives passed S. 894, the Veterans' Compensation Cost-of-Living Adjustment Act of 2011. S. 894 passed the Senate on October 19. The legislation officially increased the rates of disability compensation for veterans and the rates of Dependency and Indemnity Compensation for survivors. It was signed into law by President Obama on November 9.
"I am relieved that veterans will finally be seeing a cost-of-living increase," said Representative Bob Filner (D-CA-51), Ranking Member of the House Committee on Veterans Affairs. "Veterans are in need of real help in this economy, and the Veterans' Compensation Cost-of-Living Adjustment Act of 2011 will provide some measure of assistance to our veterans."
Progress for VCE Staffing, Program Implementation
A relatively hot topic of discussion at our national convention focused on progress surrounding the staffing issues of the Vision Center of Excellence (VCE). We also discussed the implementation of the legislation that created the Center, which in the past has gone much slower than we hoped or expected.
The relevance of this topic was enhanced by the fact that VCE held a conference for eye trauma medical professionals that ran simultaneously with our convention at the Golden Nugget Hotel and Casino.
Approximately 85 military and VA physicians and optometry providers discussed subjects relating to vision technology and research throughout the week.
VCE Director Colonel Donald A. Gagliano at BVA 66th National Convention. Photo courtesy of Liesl Marelli.
We understand that the VA Blind Rehabilitation Service (BRS) conference of Visual Impairment Service Team (VIST) Coordinators and Blind Rehabilitation Outpatient Specialists (BROS) previously held at our convention hotel annually is, for financial reasons, no longer an annual event. The conference was not held this year in Las Vegas and will not resume next year in Galveston, Texas. The VCE meetings allowed our convention attendees, especially the Operation Peer Support participants, some unexpected but significant interaction with knowledgeable eye care professionals.
A milestone occurred last April when $9.3 million was appropriated to VCE in the final Continuing Resolution for FY 2011. It was a significant achievement because it was the first time VCE program operational management personnel would have their own program funding. Limited discretionary funding in FY 2008, FY 2009, and in early FY 2010 had greatly hindered progress to that point.
The best news is that the recent increase in funding has brought a more solid foundation to VCE. DoD, for example, now funds 13 full-time VCE positions while VA funds five.
Another milestone occurred on November 17 when VCE began moving into newly renovated office space at the "New Walter Reed." During the last week of January 2012 on a date still to be determined, an official ceremony onsite will recognize the new location and hence a new chapter in tracking and treating battlefield eye injuries. Because BVA so strongly advocated for the legislation that created VCE, and later persevered when the implementation phase experienced extreme opposition and adversity, several BVA National Headquarters staff will most assuredly be on hand for this happy event that is so symbolic of many major accomplishments.
We are especially concerned about VCE progress on the Defense and Veterans Eye Injury and Vision Registry (DVEIVR), which is the first ever joint registry shared by DoD and VA. We are curious to find out how these entities will end up sharing information and records for the long-term betterment of the eye injured.
As we have reported before, DVEIVR will track the diagnosis, surgical intervention, operative procedures, related treatments, and follow-up of each significant eye injury incurred by members of the Armed Services while serving on active duty. Once fully functional, DVEIVR will provide the capability for analyzing longitudinal outcomes, assessing intervention strategies, enhancing performance improvement, and developing a common user/provider interface across DoD and VA. The end result will hopefully be enhanced data integrity, improved coding accuracy, and improved workflow processes for vision care.
The upcoming agenda for DVEIVR includes the importation of data from DoD's Combat Eye Injury Model and from VA records relating to TBI. Also included is the testing of program applications to process the eye wounded from the Joint Theater Tracking Registry (JTTR) into DVEIVR.
We commend the work of Colonel Donald A. Gagliano and his small but dedicated staff for spearheading the first clinical electronic registry ever developed on time and below budget. The "below budget" feat is truly amazing, especially since the registry was conceived, and the ideas creatively put together for it, in Washington, DC!
BRC Openings: A Milestone
We have followed with great interest the 2011 dedicatory events for three new BRCs, one in Cleveland that was dedicated in September (see "A Grand Opening Worth Celebration" on p. 30) and the other two in Long Beach, California, and Biloxi, Mississippi, both of which at press time had grand openings scheduled for later in the year.
The total number of VA residential centers now stands at 13. Worthy of note once again is the official name of the Long Beach facility, named after Major Charles R. (Rob) Soltes, Jr. OD, the first optometrist killed in action in Iraq. We are pleased to also mention again that although the center is still engaged in hiring staff, Dr. Sally Dang, widow of Major Soltes, was hired several months ago as the low-vision optometrist at the new center.
In late 2011, Dr. Sally Dang will take on her new role as a low-vision optometrist at the BRC named after her late husband. Photo courtesy of Liesl Marelli.
As still one additional sidenote, golfers competed on Veterans Day in the Rob Soltes Memorial Golf Tournament. The Riverside, California event was organized by Sally and sponsored by NVISION Laser Eye Centers, the latter of which has ten locations throughout Southern California from San Diego to Camarillo.
Golfers included blinded veterans and the general public. They played either as individuals or in a foursome. All proceeds were to be sent to BVA in support of upcoming Operation Peer Support activities.
Oversight Takes Higher Congressional Priority
We have made mention several times recently that most of the hearings of the House Committee on Veterans Affairs in the 112th Congress would belong in the category of oversight. In particular, the full Committee and its Subcommittees are examining ways to find cost savings in already existing veterans programs for which they are responsible rather than introducing and enacting the legislation that we believe is vital for blinded veterans in some cases and for all veterans in others.
Far fewer new veterans bills than usual have been introduced and even fewer are moving forward. Notwithstanding this obstacle, we continue to push ahead on legislation related to the Seamless Transition issue. We must not give up on any elements of the proposed legislation in any area. We must continue monitoring the progress or lack thereof. We must also continue to look at the big picture. For BVA, the big picture is that disabled veterans must not be deprived by the DoD or VA health care systems of the care and benefits they have earned.
The VA budgets for FY 2012 and FY 2013 have already been passed in the House and Senate. The overall amounts are lower than what the VSOs had recommended as acceptable funding levels through the traditional Independent Budget document.
Fortunately, with the advent of Advance Funding for VA health care a couple of years ago, VA is no longer subject to the Continuing Resolution budgets that Congress chooses to inflict on so many other departments of the federal government. The latest Continuing Resolution was passed at the end of September to quell yet another threat of a government shutdown. Despite the advantages presented by Advance Funding, however, FY 2012 and 2013 VA appropriations were still in danger of becoming a potential target as larger fights involving the new "Supercommittee" broke out.
The model for putting together the VA budget and funding the Department depends heavily on yearly enrollment numbers, which means that funding can potentially decrease as the number of veterans using VA health care decreases. Because of BVA's long history of perseverance to improve funding for VA health care, we must continue to ensure that VA BRS moves forward with adequate funding for all of its Continuum of Care programs and activities.
Pending Legislation and Miscellaneous Updates
We continue to follow the progress of the Federal Communications Commission in implementing the Twenty-first Century Communications and Video Accessibility Act of 2009, which took effect during the summer of 2010.
Two of the premises of the legislation most relevant to BVA members require that electronic communication devices be fully accessible for blind individuals and that emergency alerts issued through television include both audio and visual warnings for natural disasters and emergencies. Enforcement rules have been established and implemented. Individuals from the disabled community have also been appointed as representatives to monitor enforcement effectiveness.
Because of its potential impact on blinded veterans, we continue to frequently update our members through Legislative Alerts on any new developments. We will continue to provide Internet links to the proposed rules as they develop.
Mention has been made in our most recent half dozen Bulletins of efforts to help deserving blinded veterans secure the housing benefits they have earned through their service and sacrifice. This has certainly not been an easy chore. Eligibility for the Special Adaptive Housing grant, which amounts to $13,860, currently requires that veterans meet the 5/200 criteria for blindness rather than the more commonly accepted visual acuity standard of 20/200 or 20 degrees of field loss.
After eight months, a bill (H.R. 117) introduced by Ranking Member Filner has not yet seen a Subcommittee hearing. At our urging, and because of his willingness to do so with other bills the past four years, Senator Bernie Sanders (I-VT) introduced a companion bill in the Senate in May. Unfortunately, this bill has also not moved at all.
For quite some time, we have worked on a change to beneficiary travel eligibility for our nonservice-connected blinded veterans who must pay their own way to attend a VA specialized blind rehabilitation program by air, train, bus, or private vehicle. We are pleased to report that Senator Jon Tester (D-MT) has completed draft language on a bill to change such eligibility by altering Section 111 of Title 38 U.S. Code to read that "VA would provide any catastrophically disabled, nonservice-connected veteran travel by air, train, bus, or private vehicle when accepted for admission to a VA specialized rehabilitation program."
Senator Tester's bill, S. 1755, was introduced on October 20.
As always, however, the cost estimates involved with this legislation are going to be a huge issue for BVA, just as they have been during the more than ten years that this issue has been of serious concern to our organization and its members. No matter how daunting and improbable the venture seems, we will not let go of our advocacy responsibilities in this area.
We reported in our last Update that progress had been made in ensuring that service-connected blinded veterans would no longer be billed for co-payments for inpatient or outpatient medical care. The problem has been a technical one requiring a patch in the VA billing system.
The legislation eliminating these co-payments was part of a broader bill that provided assistance for caregivers. Because of the significance of the law as a major BVA legislative success, we continue to stress to our blinded veteran readers the need to confirm with their VIST Coordinators that they are entered as catastrophically disabled veterans in the VA billing system. Doing so should help them avoid being mistakenly billed for any future co-payment.
Together with our many sister organizations, especially those chartered by Congress, BVA continues to follow VA's progress and problems in the area of claims backlogs. The backlog figure is currently at 800,000. Disabled veterans are still caught at times in having to wait months if not years for DoD medical boards and VA ratings officials to provide rulings. Military disability ratings, for example, now take an average of 267 days.
Having frequently attended meetings and listened to numerous speeches over the years regarding the need to break this huge backlog, the problem seems only to get a little worse over time. Committees, councils, task forces, government consultants, panels, and more VA staff in regional offices don't seem to offer enough to make even a dent in the total number. While a few online programs for filing claims are being tested, we are in the early stages of this process. In addition, there is no real guarantee that going paperless is going to make a huge difference anyway.