Sen. Akaka questions VA overhaul

Jason Perry

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Well, it looks like the debate continues...

Akaka Urges Bush to Organize GOP Support for Veterans' Care Legislation

Dole-Shalala Proposals Similar to Existing Legislation, Say Committee’s Majority Members

October 22, 2007

WASHINGTON, D.C.- U.S. Senator Daniel K. Akaka (D-HI), Chairman of the Veterans' Affairs Committee, and the Committee's Majority members,sent a letter to President George W. Bush today regarding the Dole-Shalala Commission. The Senators praised the Commission's concern for veterans, and called attention to legislative solutions which are already underway to carry out many of the Commission's recommendations. "The Committee has already recognized and taken action on many of the needs and initiatives outlined by the Dole-Shalala Commission, especially with regard to health care. We are asking for the President's support so that these changes can be made as expeditiously as possible to get returning servicemembers the health care they need and deserve," said Senator Akaka.
The Majority members expressed concerns about some of the Commission's recommendations that cannot be made overnight, citing the sheer magnitude of the changes being proposed to VA's disability compensation system in particular.
Senator Akaka and his colleagues also urged President Bush to expedite the nomination of a new VA Secretary, noting that any major change to the current system of administering veterans' benefits would be extremely difficult without a confirmed Secretary at the helm of the Department. Former Secretary Nicholson left VA on October 1, 2007, after announcing his resignation on June 17, 2007.
The full text of the letter is copied below:
The Honorable George W. BushPresident of the United StatesThe White HouseWashington, DC 20500 Dear Mr. President:
We take this opportunity to address the proposed "America's Wounded Warriors Act." While we have not officially received the bill, we have seen what we understand is the final version, which is based on the work of the Commission on Care for America's Wounded Service Members (the Dole-Shalala Commission). We appreciate your work on this issue which is so important to veterans and their families.
As you have noted, we share the common goal of improving the lives of servicemembers and their families. Just last week, the Committee held a hearing at which the Dole-Shalala Commission's findings were examined, along with the work of other entities that have been working on these issues. Congress is already acting on the very same solutions as the Commission, particularly on matters of health care.
For example, the Committee on Veterans' Affairs has moved to improve both TBI and mental health care. Provisions comparable to the Commission's recommendations on health care have already been integrated into the National Defense Authorization Act (H.R. 1585) through the Dignified Treatment of Wounded Warriors Act (H.R.1538), and are addressed in the proposed "Veterans Traumatic Brain Injury Rehabilitation Act of 2007" (S. 1233), and the proposed "Mental Health Improvements Act of 2007" (S. 2162).
We are pleased to note that your draft bill includes an expedited initial evaluation for PTSD to combat veterans. In section 204 of S. 1233 and section 1709 of H.R. 1585, the Committee has moved to require VA to provide a preliminary mental health evaluation to any recently discharged combat veteran not later than thirty days after a request for such an evaluation. While VA has made significant efforts to provide veterans with mental health evaluations in a timely manner, there is much room for improvement. VA has made progress in reaching out to servicemembers in need of mental health care services, and should continue to work diligently to provide those services in a timely way.
Similarly, your draft legislation seeks to ensure that evaluation for PTSD is afforded to veterans regardless of existing restrictions on enrollment. Section 201 of the Committee-reported bill, S. 1233, and section 1708 of H.R. 1585, extend the period during which veterans of combat have eligibility for VA health care, without regard to other criteria, from two to five years. We believe that this extension is necessary to ensure combat veterans receive health care during their transition to civilian life. With this extension, physical and mental health disorders which may take years to manifest and treat, including PTSD, will be better addressed. We are pleased that the Administration supports this change in law.
Finally, we are gratified that the Commission recognized the importance of services for veterans' family members. The Committee is presently considering a comprehensive mental health bill, S. 2162, which, among other things, would clarify and expand VA's existing authority to provide services to the family members of a veteran, when such services are deemed to be in the interest of the veteran. This legislation would establish authority to provide to families the full range of VA care, including mental health services. We share the Administration's interest in improving resources and services available to the families of America's veterans.
We have deep misgivings about the provisions of your bill that would provide a basis for drastic changes to VA's disability compensation system. As you know, these provisions would abrogate Congressional authority, and would give the Secretary of Veterans Affairs the authority to comprehensively rewrite VA's compensation system. Further, it would inappropriately require the Secretary to accomplish this monumental task over the span of mere months. Based on testimony at the Committee's recent hearing, especially from the Chairman of the Veterans' Disability Benefits Commission, we do not believe this time line is realistic.
In addition, as you have not yet sent a nomination to Congress for a successor to Secretary Nicholson, we are understandably concerned that a task of this magnitude and importance should not be undertaken during a time when there is no permanent leadership at VA. In that regard, we urge you to expedite the process of selecting a nominee, and send that nomination to Congress. When a nomination is received by our Committee, we will fulfill our Constitutional duty to provide advice and consent on the nomination.
Mr. President, in closing, we urge you to work with the Republican leadership in the Senate to ensure prompt passage of the health-related legislation discussed above which addresses matters recommended by the Dole-Shalala Commission.

Jason Perry

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Sen. Akaka backs VDBC over Dole-Shalala

Here is the text of an article that appeared yesterday in the Washington Post. While I think reform is vital, I agree with many of his points.

Equitable Care for Veterans
By Daniel K. Akaka
Saturday, November 3, 2007; Page A19, Washington Post.
There has been much discussion recently, including in an Oct. 21 Post editorial, about the Dole-Shalala commission on veterans' disabilities and the need for prompt action on its recommendations. As chairman of the Senate Committee on Veterans' Affairs, I have reviewed the recommendations, which focus primarily on collaboration between the departments of Defense and Veterans Affairs on meeting the needs of service members injured in combat.
Most of the suggestions are worthy and, indeed, much work is underway on some of the points. There are, however, some conclusions about which I have serious concerns.

On the basis of its work over a relatively short period -- the members' first public meeting was in mid-April, and they issued their report in late July -- the commission recommended a restructuring of the Defense Department and VA disability systems. This recommendation has two key components that would fundamentally alter the manner in which the Pentagon and the VA administer those systems.
The first component -- merging the departments' existing systems -- has strong appeal. If enough obstacles can be overcome, it is possible that, for some subset of those leaving the military, it may prove feasible to have the two systems function collaboratively, with one physical exam and one disability rating for those who leave the service for medical reasons.
The second component, that the VA's compensation system should be fundamentally restructured, is far more problematic. The legislation that the White House drafted to carry out this recommendation would have Congress cede responsibility for the proposed retooling of the VA's compensation system to the secretary of veterans affairs, and it would require the secretary to accomplish this monumental task in just a few months.
Consider, in contrast, the findings of the congressionally mandated Veterans' Disability Benefits Commission. That commission took a more systematic approach, carried out over 2 1/2 years, that focused exclusively on the complex and often inefficient disability structure that applies to all service members and veterans. It conducted 28 public meetings, carried out extensive research and received significant input from outside entities, including CNA Corp., which analyzes public-sector proposals, and the Institute of Medicine. Lawyers reviewed many of the issues the commission explored and provided historical context for much of the legislation that lays out the benefits available to disabled veterans and their families. This was the most extensive overview of the benefits provided to this nation's disabled veterans in more than half a century.
The Veterans' Disability Benefits Commission, in its report issued Oct. 3, made 113 recommendations designed to improve and update the VA's disability compensation program. These recommendations collectively address the appropriateness and purpose of benefits, benefit levels and payment rates, and the processes used to determine eligibility.
Many significant proposals from the Veterans' Disability Benefits Commission were not contemplated by the Dole-Shalala commission and warrant review before any action is taken on the Dole-Shalala recommendations relating to the overall disability benefits system.
On the basis of testimony given during an Oct. 17 hearing of the Senate Committee on Veterans' Affairs, especially statements from the chairman of the Veterans' Disability Benefits Commission, I do not believe that the timeline in the president's legislation is remotely realistic.
The extent of the proposed change to the VA's compensation system would present a potentially insurmountable challenge even under the most capable leadership. I am concerned that the president is suggesting extraordinary change but has only recently selected his nominee to succeed outgoing Secretary Jim Nicholson, who announced his resignation in July. Our committee will address James B. Peake's nomination as expeditiously as possible, consistent with our obligation to give all nominations full, fair and focused consideration, but that process still takes time.
I am also greatly concerned that the VA disability system recommended by the Dole-Shalala commission would apply only to those who entered service during the current conflicts in Iraq and Afghanistan and would exclude veterans from earlier generations. Some have suggested that this recommendation would pit veterans of these recent conflicts against those from different eras. Such an outcome would be unacceptable. This nation must never forget the sacrifices made by those who served on the beaches of Normandy, at the Chosin Reservoir, in the jungles of Vietnam and on the sands of Kuwait. Congress should focus on creating a system that is equitable for all of our veterans -- young and old.

The writer, a Democratic senator from Hawaii, is chairman of the Senate Committee on Veterans' Affairs.


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While I rarely agree with anything that comes out of a Politician's mouth, I have to agree with Akaka this time.
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