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REPUBLICAN
PRESS RELEASE
June 29, 2007
Buyer to Dole-Shalala Commission: DoD and VA transition systems must be
‘soldier-centric’
For more information, contact: Jeff Phillips (202) 225-3527
Washington, D.C. — House Committee on Veterans’ Affairs Ranking Member
Steve Buyer (R-Ind.) testified today before the President’s Commission
on Care for America’s Returning Wounded Warriors, co-chaired by former
Senator Robert Dole and former Secretary of Health and Human Services
Donna Shalala. From his testimony, Buyer released the following
statement:
“Senator Dole and Secretary Shalala, in response to your gracious
request for my insights in March, I advised that in the short amount of
time available, you should pick several topics and go deep. I advised
that in doing this, you should do your work through the eyes of a
soldier.
That said, I did offer for consideration three areas of focus that in my
experience would profoundly improve the seamless transition of
servicemembers between the military and the VA systems.
First, are the systems patient-centric? Or is the underlying culture
attuned primarily to the exigencies and conveniences of practitioners
and bureaucrats, and the wellbeing of ‘the system’?
Next among challenges is how a patient progresses along the ‘medical
chain of mercy’. How seamless is the transition from first encounter
with military medicine – perhaps on the battlefield under a medic’s care
– to aid station and combat support hospital, to theater hospital and
perhaps ultimately into the VA system?
One of our biggest challenges has been the transition between military
treatment facilities and VA, and managing sub-acute care and follow-on
care, such as rehabilitation, from that point forward. Our wounded
shouldn’t sense any difference or interruption in this transition, but
in reality they do.
I invited you to visit a VA polytrauma rehabilitation center and am glad
that you have done so. VA takes pride in the clinicians working at the
polytrauma rehabilitation centers.
Finally, I asked you to examine the issue of contract care. If we are
truly going to be soldier-centric, we must find and use the best care
our nation can provide – the closer to the warrior’s home and family,
the better.
If we have the required health care services in the military or the VA,
we should use them; if not, we should contract for them. To do anything
less is to place the system’s demands over the patient’s wellbeing.
The Department of Defense and VA, after more than two decades, are
cooperating better in the care of discharged servicemembers
transitioning to VA care, as well as those staying on active duty and
recovering in VA facilities.
The men and women providing health care at DoD and VA do a superb job,
and for that we should all be grateful. The two departments must do much
more: medical information sharing is still neither bi-directional nor
conducted in real time, which can prevent timely and seamless continuity
of care. When the Secretary of the VA and I were at Landstuhl [Regional
Medical Center, in Germany], for example, we saw wounded soldiers
arriving from Balad, Iraq, with paper medical records strapped to their
chests.
I am pleased with the bipartisan cooperation on care for returning
servicemembers between the House Veterans’ Affairs and Armed Services
Committees.
As a sign of that cooperation, the National Defense Authorization Act
for Fiscal Year 2008, which the House passed, includes provisions
similar to an amendment I developed for the Wounded Warriors Assistance
Act of 2007. I bring it to your attention because I do not know if the
Senate will accept this in conference.
One of the provisions requires real-time, interoperable, and
bi-directional transfer of critical medical information on wounded
servicemembers from DoD medical facilities to the VA. This will be
expensive, but the benefits will be great.
If DoD and VA can achieve such cooperation, we will be well on our way
to seamless transition.
Section 111 of the act also requires use of a uniform separation and
evaluation physical by DoD and VA that VA could use for disability
rating. It also requires co-location of VA benefit teams at military
treatment facilities and other sites to facilitate the transition of
recovering servicemembers, and it also requires use of an electronic
DD-214. These provisions are now in the NDAA, but that is no guarantee
of right action on the part of the departments, especially the Defense
Department.
I have not discussed the critical challenge of VA’s backlog in
disability compensation claims, which is equally unacceptable. Timely
and accurate claims decisions are integral to the quality of a
servicemember’s transition into civilian life, yet the system produces
long waiting times and too many flawed, inconsistent decisions. I ask
that you not go too deep as this issue as Congress has a claims
commission and I look forward to seeing their report soon.
Procurement reform is the next frontier between DoD and VA, in
particular compatible medical equipment. We intend that information
technology be seamless and bi-directional; the same should apply to
compatible and interoperable medical equipment.
Ladies and gentlemen, we do not always need legislation to do the right
thing for our servicemembers and our veterans – we need good management.
Regarding the Transition Assistance Program, it is an integral part of
the Benefits Delivery at Discharge [BDD] program. DoD should make BDD
mandatory; it has not. If it did, all VA benefits programs would be
explained to all transitioning servicemembers.
Those seeking compensation and pension benefits would be able to begin
the lengthy process while on active duty and where all medical and
personnel records are located on station. Far fewer transitioning
warriors would fall through the cracks.
I have learned that seamless transition is as much a matter of will as
it is budgets and programs and task forces. Seamless transition is a
goal that I personally have been working to achieve since I came to
Congress 15 years ago.
I was heartened when the president formed this commission and selected
two proven leaders to guide its progress. It indicates that the
willpower exists, that there is a measure of top cover for change.
I remain hopeful, even confident, that your work will take advantage of
that support and bring us significantly closer to this worthy goal,
which all of us must certainly embrace without reserve.
Thank you."
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Larry Scott
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