Remember: Follow The Money

Vietnam Veterans of America is delighted that we now have advance appropriations and an appropriation over the last years, including FY 2010/2011, that includes significant increases for health care for veterans, including funding for mental health (especially PTSD) treatment. However, VVA National President John Rowan wrote to the VA last April, asking for the allocation of FY2009 funds by Medical Center and by Veterans Integrated Service Network (VISN), as well as a similar breakdown of the FY2008 allocation for comparison purposes. We received the FY2008 figures about five weeks later. VA told us they did not know where the money was and could not tell us until December, or about 60 to 80 days after the end of FY2009. We have yet to receive the figures for FY2009.

The reason this issue came up is that we have yet to hear from any VA Medical Center in the country that they received more than a 3 percent increase from FY2008 to FY2009. Many said they only received a 1 percent increase, which is effectively a cut.

Overall, the VHA received an increase of 11.9 percent from FY 2008 to FY 2009. So, where is the money? Where did it go?
This is not just a theoretical argument that engages people inside the Beltway. It means that veterans are told there is no money for an additional PTSD counselor to do outreach to Fort Drum in upstate New York, the home of the 10th Mountain Division, which has seen some of the bloodiest combat in Iraq and Afghanistan. It means that vacancies have not been filled in desperately needed specialty positions to treat diabetes at a Medical Center in the southern United States, and that many other needs of veterans are going unfulfilled because the money is not getting to where it is needed.

So, where is the money? VVA looks forward to finding out. We will work with our friends in the Congress, such as Rep. Chet Edwards (D-Texas), to demand much more accountability from the VA in how and where the additional resources we fight for are being spent.

As the old adage says, if you want to get to the bottom of things and find out what is really going on: Follow the money.

VA TO GET $135 BILLION IN BUDGET LEGISLATION

A House-Senate conference committee agreed to allocate $134.6 billion, including $53 billion in discretionary budget authority, for the Department of Veterans Affairs and $56.6 billion in mandatory authority for the VA.

And, for the first time, budget legislation provides advanced appropriations for veterans’ medical accounts, allocating a minimum of $48.2 billion in discretionary spending for veterans’ health care for FY 2011 to ensure a stable and uninterrupted source of funding. This represents a hard-fought and long-sought victory for veterans, for VVA, and for our colleagues in other VSOs.

The emphasis now shifts to encouraging Congress to hold the VA accountable for how it spends every dime. We have long held that accountability goes hand in hand with the increased funding that the VA healthcare accounts have needed.

VVA also expects to push the VA to do a far better job of outreach than it currently does—and historically has done. Far too many veterans—and we don’t mean only the freshly minted ones—do not know anything about the benefits to which they are entitled, benefits which they’ve earned by virtue of their service in uniform, and the health conditions and health care risks that may derive from their time in service.

In this realm, we applaud the VA for having launched a long-overdue national survey of veterans, active-duty service members, activated National Guard and Reservists, and family members and survivors in an attempt to assess their awareness of the benefits that are available to them. The National Survey of Veterans also will collect health care, benefits, employment, and demographic information that the VA will use “to inform policy decisions and improve benefits, ” as noted in a VA press release.

The VA is now mailing out survey screeners to more than 130, 000 households to identify potential survey participants. The screener asks if anyone in the household is a member of one of the identified survey groups. Eligible survey participants then may be requested to participate in a full-length survey. Participants will be able to select a preferred survey method: through U.S. mail, telephone, or a password-protected Internet address. This is the sixth VA National Survey of Veterans to be conducted since 1978. The data collection is expected to be finished by the end of February and the final report released by December 2010.

TO END HOMELESSNESS
AMONG VETERANS

At what was billed as the “VA National Summit Ending Homelessness Among Veterans, ” VA Secretary Eric K. Shinseki unveiled the department’s comprehensive plan to end homelessness among veterans by marshaling the resources of government, business, and the private sector.

“President Obama and I are personally committed to ending homelessness among veterans within the next five years, ” Shinseki said. “Those who have served this nation as veterans should never find themselves on the streets, living without care and without hope.”
We agree with the Secretary’s and the President’s desire and their goal. By setting such a lofty goal, they are, however, setting themselves up for disappointment. The unhappy fact is that there always will be a segment of the veteran population that, for a variety of reasons not unconnected to their time in service, will live without a permanent address.

A key component of any plan to “end” homelessness is to prevent homelessness in the first place. And the sooner supportive services are made available to veterans who find themselves homeless (because they have lost their jobs or because their problems with alcohol or other substances have overcome them), the greater the chances are of helping them get back on their feet.

PETZEL TAKES REINS AT VHA

Dr. Robert Petzel, who had been director of the VA Midwest Health Care Network based in Minneapolis, is the new Under Secretary for Health, which means he leads the Veterans Health Administration (VHA). His nomination by the President and confirmation by the Senate came after almost one full year into the Obama administration. Among his credentials, Dr. Petzel co-chairs the National VHA Strategic Planning Committee and the VHA System Redesign Steering Committee. He graduated from St. Olaf College in 1965 and from Northwestern University Medical School in 1969. He is board-certified in Internal Medicine and is on the faculty of the University of Minnesota Medical School.

VVA wishes Dr. Petzel well, and looks forward to working with him to improve medical care to veterans and the transparency with which the VHA does business. We believe that there needs to be a drastic shift toward openness in every aspect of decision-making in VHA, and a need for VHA management—at every level—to regain an understanding that the veterans’ service organizations and individual veterans must be equal partners in this business of health.

VHA needs to change its corporate culture to focus on the health of veterans. The only way to do that effectively is to change the relationship between the veteran and the VA. It has to start at the top, and we hope that Dr. Petzel is equal to the task.

OFFSETTING THE COST OF WAR

The Senate backed a package of veterans bills that had been stalled for several days over cost concerns raised by Sen. Tom Coburn (R-Okla.). The Senate voted 98-0 to pass the measure (S. 1963) after rejecting a Coburn amendment that would have offset the cost of the bill.

Among its provisions, the bill authorizes some $3.7 billion for programs aimed at caregivers for veterans of the Iraq and Afghanistan wars. It would provide caregivers with health care, counseling, support, and a stipend.

The legislation also expands services in rural areas and insures that veterans who are catastrophically disabled or who need emergency care are not charged for those services.

Sen. Coburn objected to the bill because it would authorize new spending that would not be offset.

To this charge, Sen. Daniel K. Akaka (D-Hawaii), chair of the Senate Veterans’ Affairs Committee, said: “The cost of veterans health care is a true cost of war and must be treated as such. The cost of the underlying bill does not need to be offset. The price has already been paid, many times over, by the service of the brave men and women who wore our nation’s uniform.”
MED SCHOOL PARTNERSHIPS

The VA manages the largest medical education and health professions training program in the nation. VA facilities are affiliated with 107 medical schools, 55 dental schools, and more than 1, 200 other schools for health care professionals. Each year, 100, 000 health professionals are trained in VA Medical Centers. About two-thirds of the physicians practicing in the United States have had some of their professional education in the VA health care system.

To strengthen the 60-year partnership between the VA and the schools that train the nation’s health care professionals, Secretary Shinseki is implementing many of the recommendations of a blue-ribbon panel appointed to advise the VA on strengthening relationships with medical schools and other colleges and universities for health care professionals. Two key recommendations from that report are the formation of a standing, federally chartered advisory committee to help the VA realize the full potential of its partnerships with health professional schools and the examination and streamlining of policies and procedures that impede those partnerships.

A MODEL FOR HIRING VETERANS?

President Obama issued an executive order creating a new Veterans Employment Initiative that will make the federal government a “model employer of America’s veterans.” The program will open new offices in each federal department to focus on recruiting and hiring veterans.

As part of this new initiative, Homeland Security Secretary Janet Napolitano an-nounced that her department will add some 50, 000 veterans to its workforce by 2012. To support that goal, a new veterans web page was unveiled that will highlight veterans employment and contracting opportunities. More information is available at http://www.dhs.gov/ynews/releases/pr_1257889987186.shtms
“Honoring our sacred trust with America’s veterans, ” President Obama said, “means doing all we can to help them find work when they come home so they never feel as if the American Dream they fought to defend is out of reach for them and their families.”
Creating these offices is, certainly, a good idea. But the proof is in the pudding. Only if human resources officials at all federal departments take the President’s executive order seriously, and only if the secretaries of these departments make hiring veterans a priority, will the President’s sentiments be realized.

FLAGPOLE BASE CLEANING AT THE WALL
The National Park Service and the Vietnam Veterans Memorial Fund will begin scheduling monthly cleaning and waxing of the newly refinished flagpole base at the Vietnam Veterans Memorial. The flagpole, flagpole base, and five directory stands recently were stripped, cleaned, and refinished. All had received little attention and were in need of restoration.

The flagpole base includes the insignias of the five military service branches. In the past, individuals have independently cleaned the insignias, inadvertently scratching and removing the protective finish because of the harsh products they used. Now this cleaning will be more orderly and done correctly under supervision.

VVA applauds this move, as The Wall belongs to us all and needs to be cared for properly.

The cleaning will be scheduled once a month, year round, using gentle cleaning products and carnuba wax.

We Need Veterans Courts Nationwide
BY PATRICK W. WELCH
When my good friend and fellow Vietnam veteran Jack O’Connor explained his concept for a Veterans Court, I was on board before he even finished his pitch. Then he told me he already had a judge, Robert Russell, who would take on these duties and that the VA would be in court with a secure computer to gain access to veterans’ records. When Jack told me that one of the key elements was to have veteran mentors in the court working with the troubled veterans, I knew that the Buffalo Veterans Court would be a success.

I have served as one of the volunteer veteran mentors since the Buffalo Veterans Court was started. What follows will explain from the perspective of a veteran mentor why we have been so successful in providing help to our fellow veterans. These are men and women with mental health and substance abuse problems who have been charged with nonviolent crimes.When we serve in the military, we serve with people from all races, religions, cultures, and educational and family backgrounds. Yet we all work together to complete the mission. For most who have served, that bonding never leaves. This perhaps is the critical element in why the Veterans Court is more successful than other treatment courts.

The volunteer veteran mentors are dedicated to helping those who have been less fortunate in the transition from the military to the civilian world. The mentors’ presence and dedication are critical to the success of the court.

Most of the veterans who find themselves in the judicial system are not bad people; many got caught up with the wrong people in the wrong places at the wrong time. This is what Judge Russell stresses constantly to them: People, places, and things can lead to trouble that you did not intend to happen.

Many of these veterans who appear before the Buffalo Veterans Court did not have good support systems before serving in the military and lacked a support system when they returned. Yet while in the military, many thrived because of a strong and structured support system. So we believe they can, for the most part, become productive citizens if provided with some support structure. The Veterans Court, with a judge who believes in the idea behind it, the VA, and the veteran mentors provide just that.

A trust develops between veterans and mentors as they meet together after the judge has discussed the status of their cases and the next steps. In these one-on-one meetings, we offer words of encouragement along with straight talk that includes words that are not allowed in the courtroom. These “words of wisdom” are more in line with how we spoke in the military—very frank and to the point.

We try to explain that if they don’t work to get their s**t together, they will find themselves in jail. We can speak that way because the discussion is veteran to veteran, a very powerful element in the relationships that are developed.

One of the dynamics that I do not believe any of us initially considered was that a military-like command structure would develop. When you are in the military, if you have a good CO and good NCOs, you will follow them anywhere. What we have seen develop is that the judge is the CO; the veteran mentors are the NCOs, and those in the court system are the troops—and they do not want to let us down or disappoint us. There are bills before Congress—H.R. 2138 in the House, introduced by Rep. Patrick Kennedy (D-R.I.) and companion legislation, S. 902, in the Senate, introduced by Sen. John Kerry (D-Mass.)—that merit our support. The Services, Education, and Rehabilitation for Veterans Act would facilitate the establishment of “veterans’ treatment courts” by empowering the Attorney General to make grants “to states, state courts, local courts, units of local government, and Indian tribal governments for the purpose of developing, implementing, or enhancing veterans’ treatment courts or expanding operational drug courts to serve veterans.” Enactment of this legislation would provide compassionate responses by the criminal justice system to many veterans who have served honorably and well in the armed forces. It also would be a boon to a system that is overwhelmed with drug-related offenses.

To date, there has been little support for these bills in Congress. We urge you to contact your Representative and Senators to get them as co-sponsors.


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