by Tom Zampieri
The ongoing struggle on Capitol Hill over Department of Defense appropriations for battlefield eye trauma research has taken us to a brick wall of sorts. The House Appropriations Committee for Defense passed a measure that included only $5 million for such research in Fiscal Year 2013. Similarly, the Senate Appropriations Committee has historically done very little to make such research a priority.
Unless a Member in either chamber offers an amendment to what has already been appropriated, perhaps initiating a floor fight, it is unlikely that the $5 million figure can change. As we have mentioned before, the frustration is especially deep for us at BVA since both the White House and the Office of the Secretary of Defense have been serious advocates of sensory injury research, which includes both vision and hearing trauma. Earlier this year, both proposed that Congress appropriate approximately $14.8 million for this type of research in 2013.
On June 22, senior leaders of the Department of Veterans Affairs (VA) Office of Research and Development visited BVA National Headquarters to update us on current VA research programs, both in general and as such programs currently relate to vision loss.
Left to right, Tom Zampieri, Dr. Patricia Dorn, Dr. Randy Kardon, and Al Avina.
Dr. Randy Kardon, an ophthalmologist from the Iowa City VA Medical Center, discussed his own research in the area of Traumatic Brain Injury Vision System Dysfunction while Dr. Joel Kupersmith, the Veterans Health Administration's Chief Research and Development Officer, presented an overview of VA research programs and accomplishments dating back to the 1930s. The meeting also included Dr. Patricia Dorn, Deputy Director of Rehabilitation Research and Development Service at VA Central Office.
We are grateful for VA's outreach to all of the Veterans Service Organizations in an effort to inform us of the Department's most significant research activities.
Two crucial legislative issues of interest to BVA members linger in the Senate Committee on Veterans Affairs. The first, the Special Adaptive Housing (SAH) legislation included in S. 914, has encountered several delays.
Numerous other bills have been joined with it, thereby making it more comprehensive and more difficult to push through. Because there are sections in dispute (unrelated to SAH) within the legislation, a vote may not take place until late July or even August.
The second important legislative piece, which includes both a House and a Senate bill, relates to beneficiary travel. The bills are, respectively, H.R. 3687 and S. 1755. Along with 14 other bills, the Senate actually debated the issue of beneficiary travel in a Senate VA Committee hearing on June 27. We stress that this is only a first step. Now that the hearing is over, we must wait for a decision about when a mark-up vote may occur and which bills will be selected for that mark-up. We are optimistic that this bill will make it to a mark-up sometime in July.
With time running out before a six-week summer recess that will include all of August, the possibility of a September vote on this legislation in the House or Senate is a long shot. Although we have 11 co-sponsors on the House side, at press time there were no scheduled hearings.
Charitable Organizations and Reputable Fundraising Activity
In early June, BVA was pleased when the Senate VA Committee issued a directive to the Department of Justice and the Department of the Treasury to investigate allegations of misrepresentation on the part of charitable organizations who claim to help the returning war wounded from Iraq and Afghanistan. They are, in reality, nonprofits that have ended up raising millions of dollars. In the end, veterans needing the help do not receive the help they need from such organizations.
We have been concerned about this issue for the past five years but are more alarmed now than ever before. Although exact numbers do not appear to be available, one VA source estimated that since 2005, 285 new organizations have been established. In each case the groups have been claiming to raise funds to help the seriously combat wounded and their families.
The purpose of the aforementioned directive is to determine whether organizations are violating federal law and abusing their tax-exempt status by misrepresenting their work on behalf of veterans. The suspicion is that these organizations are pocketing extraordinary amounts of money for excessive salaries and benefits for employees.
On May 30, Senate Committee Chairwoman Patty Murray (D-WA) and Senators Richard Blumenthal (D-CT) and Bill Nelson (D-FL) sent letters to both U.S. Attorney General Eric Holder and Secretary of the Treasury Timothy Geithner requesting an audit and, where possible, an investigation into potential violations of federal law by the Veterans Support Organization. The Senators were most concerned with abuse of tax-exempt status by the 501(c)(3) organization.
In a second letter sent to Secretary of Veterans Affairs Eric Shinseki, the same three expressed concern about the membership criteria used by VA's Voluntary Service National Advisory Committee (NAC) to evaluate prospective member organizations and NAC's failure to require any standards of conduct for its members. Senators Murray, Blumenthal, and Nelson pointed out the lack of internal controls as criteria for VA NAC membership. They called for the removal of any organization that fails to conduct itself in a manner befitting VA's mission or that exploits its relationship with VA for its own financial gain, is misleading, or falsely misleads its functions to the general public.
BVA National Headquarters strongly urges BVA members and the general public to examine a charitable organization's mandatory Federal Tax Form 990 before making a donation. Most organizations now make these forms available online or will at least provide a hard copy upon request. Look for membership with the Better Business Bureau and what percentage of the funds received are allocated to programs of the organization to help veterans and what percentage is allocated for other purposes.
Benefit Programs that Exploit Elderly Veterans
In May, BVA was contacted by the Senate Special Committee on Aging about concerns that elderly and disabled blinded veterans requiring VA aid and assistance may be targeted by financial companies in an effort to gain access to their assets.
A subsequent hearing called by the Special Committee occurred on June 6. Testifying were family members of elder veterans who had been tricked or forced into paying for services that were not legitimate. Individuals posing as financial service companies or law firms were charging such veterans thousands of dollars worth of retirement assets while promising to get them VA Aid and Attendance benefits for long-term care.
After hearing testimony from government officials, veterans advocates, and those who have been victimized by unscrupulous "pension poachers," Senator Jon Tester (D-MT) promised that the VA Senate Committee would proceed with legislation that would criminalize such activity.
On the same morning of the hearing, the Government Accountability Office (GAO) issued a report outlining problems with the VA pension program that allow it to become a marketing tool to sell inappropriate financial instruments to elderly veterans. We are also aware that, prior to the hearing, legal counsel of the Senate Aging Committee had received letters of complaint on this same subject from a number of Senators, including Ranking Member Richard Burr (R-NC), who also testified at the hearing.
One of the most common aspects of "pension poaching" results from VA's enhanced Aid and Attendance pension program. It is designed to provide a pension for needy seniors and/or their spouses to assist with essential daily activities that they cannot afford on their own. This assistance increases the quality of life for tens of thousands of senior veterans.
Unfortunately, problems with the design and administration of Aid and Attendance have led to a growing industry of predatory financial planners and attorneys who are using the program to target vulnerable seniors, convincing them that they are entitled to a pension for which they would not otherwise qualify.
Although elderly veterans must show that they are financially in need of the support, loopholes in the program allow for creative financial accounting that can make them appear less wealthy than they really are. The financial maneuvering can often affect a senior's ability to qualify for Medicaid benefits and other government assistance programs.
Part of this maneuvering involves financial professionals selling tools such as annuities and trusts to seniors that the latter cannot touch for years without paying a huge penalty. The poachers also promise to help the veterans apply for the Aid and Assistance benefit—for a fee, of course— while there are numerous government and Veterans Service Organizations that offer free assistance for the applicant.
BVA recently reviewed the aforementioned GAO report on this subject. Among other things, GAO selected a sample of 25 organizations that had nothing inherently in common with one another. The agency successfully contacted 19 of the 25 organizations while posing as a veteran's son seeking information on Aid and Attendance. All 19 said a claimant can qualify for pension benefits by transferring assets before applying, which is permitted under the program. Two organization representatives said they helped pension claimants with substantial assets, including millionaires, obtain VA's approval for benefits.
We expect further Senate VA Committee hearings on this subject. We may well see legislation that could restrict the application process further. While such actions may add bureaucracy to Aid and Attendance, they would also result in a decrease in the fraud and exploitation of elderly veterans.
In the meantime, we urge all blinded veterans and their families to be aware of this potential fraud and financial risk to those for whom the Aid and Attendance program was intended. Never hide financial assets. Please also be aware of individuals and organizations that wish to charge fees for filing VA claims when service officers from BVA or other veterans organizations are already there to assist at no charge to the veteran.
Prescription Information Access
BVA has followed and supported over the past few months some strong advocacy efforts by the American Council of the Blind (ACB). As a result of ACB's work, legislation regarding new prescription bottle access moved quickly forward until it passed on June 21 in the House of Representatives and on June 25 in the Senate.
At press time, it is expected that President Obama will sign the measure sometime in mid-July or, at the very latest, prior to the mid-summer Congressional recess.
The original bill can be attributed to the work of Representative Edward Markey (D-MA-7), who introduced H.R. 4087, the "Prescription Drug Labeling Promotion Act of 2012," on March 1. The companion bill in the Senate was S. 3187, the "Food and Drug Administration Safety and Innovation Act."
The new regulation ensures that people who are blind or visually impaired have safe, independent, and comprehensive access to their prescription drug information and labeling. It convenes a working group of pharmacy representatives, patient and consumer advocates, and federal regulators to develop guidance for pharmacists.
The guidelines will include a range of options that will address the needs of blind and visually impaired consumers, taking into account the challenges faced by smaller pharmacies.
"No one should have to sacrifice their independence or safety to take their medication," said Representative Markey. He also pointed to the unnecessary illness and added emergency room visits that result from an inability to read prescription labels.
"The Prescription Drug Labeling Promotion Act helps turn pharmacies into partners for empowering all Americans to take full control of their health. It is another important step to ensure that individuals who are blind can fully participate in a 21st century society."
Examples of best practices included in this legislation are enhanced visual aids such as large-print font, sans-serif font, and high-contrast printing for prescription labels. Non-visual aids will include Braille and auditory aids such as digital voice recorders attached to pill bottles.
The new law will direct GAO to review the degree to which pharmacies are in compliance, including the determination as to whether individuals who are blind or visually impaired still lack safe and independent access to prescription drug labeling.
Most BVA members know that VA Medical Centers have, over the past few years, offered Script Talk to our blinded veterans. We also know that there are many of them who, for a variety of reasons, go to local pharmacies to have their prescriptions filled instead of having it done at VA Medical Centers or Outpatient Clinics. With enactment of this legislation, the Food and Drug Administration will be empowered to make recommendations as to how pharmacies and pharmaceutical companies can best serve not only blinded veterans but the general public.