White House Seeks $125 Billion for Veterans in 2011:
Homelessness, Claims Increases and Access Are Priorities in VA Budget
Thursday 04 February 2010
by: Mary Susan Littlepage, t r u t h o u t | Report
Source:
http://www.truthout.org/white-house-seeks-125-billion-veterans-201156652
The White House has announced a proposed $125 billion budget next year for the
Department of Veterans Affairs (VA). The proposal calls for expanding health
care to a record number of veterans, reducing the number of homeless veterans
and processing a dramatically increased number of new disability compensation
claims.
"Our budget proposal provides the resources necessary to continue our aggressive
pursuit of President Obama's two over-arching goals for veterans," said
Secretary of Veterans Affairs Eric K. Shinseki. "First, the requested budget
will help transform VA into a 21st century organization. And second, it will
ensure that we approach Veterans' care as a lifetime initiative, from the day
they take their oaths until the day they are laid to rest."
The $125 billion budget request, which has to be approved by Congress, includes
$60.3 billion for discretionary spending (mostly health care) and $64.7 billion
in mandatory funding (mostly for disability compensation and pensions).
"VA's 2011 budget request covers many areas but focuses on three central issues
that are of critical importance to our Veterans - easier access to benefits and
services, faster disability claims decisions, and ending the downward spiral
that results in veterans' homelessness," Shinseki said.
Veterans advocacy group Veterans for Common Sense (VCS) strongly endorses the
VA's $125 billion budget, according to spokesperson Paul Sullivan.
"Specifically, we thank President Barack Obama and VA Secretary Eric Shinseki
for increasing funding by nearly $300 million to end homelessness by the end of
2014," he said.
However, Sullivan said he thinks our new Iraq and Afghanistan veterans as well
as our Gulf War veterans should get more funding. "Tragically, the scope of the
Iraq and Afghanistan war casualties reached far above any worst case scenario,"
he said. "As of June 2009, VA reported 480,000 veteran patients from the two
wars. VA also reported 442,000 disability claims filed. Nearly 300 first-time
Iraq and Afghanistan war veterans flood into VA medical facilities every day."
VCS is disappointed that the VA does not have an accurate casualty estimate and
a long-range strategic casualty plan, Sullivan said. Two months ago, the VA
estimated 419,000 Iraq and Afghanistan war veteran patients treated by the VA
through the end of September 2010.
"VA's estimate was wrong," Sullivan. "At the current rate of nearly 9,000 new
patients per month, a more realistic VA estimate should have been a cumulative
total of 615,000 patients treated as of September 2010. VA's 200,000 patient
underestimation is a colossal failure because VA may lack the mental healthcare
providers, disability claims processors, and education benefit processors to
meet the need of this increasing cohort of veterans."
Reducing Claims Backlog
The president's budget proposal includes an increase of $460 million and more
than 4,000 additional claims processors for veterans benefits. This is a 27
percent funding increase from the 2010 level.
The 1,014,000 claims received in 2009 were a 75 percent increase over the
579,000 received in 2000. Shinseki said the department expects a 30 percent
increase in claims - to 1,319,000 - in 2011 from 2009 levels.
One reason for the increase is the VA's expansion of the number of Agent
Orange-related illnesses that automatically qualify for disability benefits.
Veterans exposed to the Agent Orange herbicides during the Vietnam War are
likely to file additional claims that will have a substantial impact upon the
processing system for benefits, the secretary said.
"We project significantly increased claims inventories in the near term while we
make fundamental improvements to the way we process disability compensation
claims," Shinseki said.
Long-term reduction of the inventory will come from additional manpower,
improved business practices, plus an infusion of $145 million in the proposed
budget for development of a paperless claims processing system, which plays a
significant role in the transformation of the VA.
According to the Veterans Benefits Administration (VBA), more than one million
veterans now wait 161 days for an initial answer for a disability claim,
Sullivan said. "VCS is highly alarmed that VA's 2011 budget request shows VBA
taking a staggering 190 days to process an initial claim - that's an
unacceptable one month addition to the current delays facing our veterans and
families," he said.
Targeting Mental Health, Preventing Suicides
"The 2011 budget proposal continues the department's keen focus on improving the
quality, access and value of mental health care provided to veterans," Shinseki
said.
The spending request seeks $5.2 billion for mental health, an increase of $410
million (or 8.5 percent) over current spending, enabling expansion of
in-patient, residential and out-patient mental health services, with emphasis on
making mental health services part of primary care and specialty care.
The secretary noted that one-fifth of the patients seen last year in the VA's
health care facilities had a mental health diagnosis, and that the department
has added more than 6,000 new mental health professionals since 2005, bringing
to 19,000 the number of employees dedicated to mental health care.
The budget request will enable the department to continue expanding its programs
for post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI),
along with the diagnosis and treatment of depression, substance abuse, and other
mental health problems. Shinseki called PSTD treatment "central to VA's
mission."
The proposed spending will continue the VA's suicide prevention program. Since
July 2007, the department's suicide prevention hotline has received nearly
225,000 calls from Veterans, active-duty personnel and family members. The
hotline is credited with saving the lives of nearly 7,000 people.
Michael Blecker, executive director of Swords to Plowshares, said he appreciates
the proposed increased spending on mental health. Swords to Plowshares is a San
Francisco-based veterans service agency that provides a full continuum of care
to low-income and homeless veterans.
"We certainly appreciate the increase [in mental health care spending]. That's
important to recognize," he said. There definitely is an increase in needs for
help tending to returning veterans' mental health concerns, Blecker said. Also,
he said, "It's important for us that the resources float down to the community"
and local organizations.
"Many veterans who need care first seek help at local organizations like Swords,
so we're happy that they've made commitments to improve care and increase
services, but they need to do more to collaborate with mental health
organizations who can reach out and help identify those who have untreated
mental health illnesses such as PTSD," he said.
Also, with budget cuts in California, any additional spending on mental health
care is welcome, Blecker said.
However, Sullivan said, "The VA and Department of Defense must hire more medical
professionals, especially mental health professionals." Furthermore, "our
government needs to perform pre- and post-deployment medical exams, launch a
broad national anti-stigma campaign encouraging veterans to seek medical care,
and place full-time, permanent VBA claims staff at every military discharge
location and every VHA medical center.
"
Reaching Rural Veterans
For 2011, the VA is seeking $250 million to strengthen access to health care for
3.2 million veterans enrolled in the VA's medical system who live in rural
areas. Rural outreach includes expanded use of home-based primary care and
mental health.
A key portion of rural outreach - which shows promise for use with veterans
across the country - is the VA's innovative "telehealth" program. It links
patients and health care providers by telephones and includes telephone-based
data transmission, enabling daily monitoring of patients with chronic problems.
The budget provides an increase of $42 million for the VA's home telehealth
program. The effort already cares for 35,000 patients and is the largest program
of its kind in the world.
Eliminating Homelessness
The budget proposal includes $4.2 billion in 2011 to reduce and help prevent
homelessness among veterans. That breaks down into $3.4 billion for core medical
services and $799 million for specific homeless programs and expanded medical
care, which includes $294 million for expanded homeless initiatives. This
increased investment for expanded homeless services is consistent with the VA
secretary's established goal of ultimately eliminating homelessness among
Veterans.
On a typical night, about 131,000 veterans are homeless. They represent every
war and generation, from the "Greatest Generation" to the latest generation of
veterans who served in Iraq and Afghanistan. To date, the VA operates the
largest system of homeless treatment and assistance programs in the nation.
Serving Women Veterans
The 2011 budget provides $217.6 million to meet the gender-specific health care
needs of women veterans, an increase of $18.6 million (or 9.4 percent) over the
2010 level. Enhanced primary care for women veterans remains one of the
department's top priorities. The number of women veterans is growing rapidly and
women are increasingly using the VA for their health care.
Shinseki said the expansion of health care programs for women veterans will lead
to higher quality care, increased coordination of care, enhanced privacy and
dignity and a greater sense of security among women patients.
Among the initiatives for women in the 2011 budget proposal are expanded health
care services in Vet Centers, increased training for health care providers to
advance their knowledge and understanding of women's health issues and
implementing a peer call center and social networking site for women combat
veterans. This call center would be open 24 hours a day, 7 days a week.
Delivering World-Class Health Care
During 2011, the VA expects to treat 6.1 million patients, who will account for
more than 800,000 hospitalizations and 83 million outpatient visits.
The total includes 439,000 veterans who served in Iraq and Afghanistan, for whom
$2.6 billion is included in the budget proposal. That's an increase of $597
million - or 30 percent - from the current budget.
The proposed budget for health care includes:
•$6.8 billion for long-term care, an increase of $859 million (or 14 percent)
over 2010. This amount includes $1.5 billion for noninstitutional long-term
care;
•Expanding access to the VA health care system for more than 99,000 veterans who
were previously denied care because of their incomes;
•$590 million for medical and prosthetic research; and
•Continuing development of a "virtual lifetime electronic record," a digital
health record that will accompany veterans throughout their lives.
The VA is requesting $54.3 billion in advance appropriations for 2012 for health
care, an increase of $2.8 billion over the 2011 enacted amount. Planned
initiatives in 2012 include better leveraging acquisitions and contracting,
enhancing the use of referral agreements, strengthening the VA's relationship
with the Defense Department and expanding the use of medical technology.
Preserving National Shrines
"VA remains steadfastly committed to providing access to a dignified and
respectful burial for Veterans choosing to be buried in a VA national cemetery,"
Shinseki said. "This promise requires that we maintain national cemeteries as
shrines dedicated to the memory of those who served this nation in uniform."
The requested $251 million for cemetery operations and maintenance will support
more than 114,000 interments in 2011, a 3.8 percent increase over 2010. In 2011,
the department will maintain 8,441 acres with 3.1 million gravesites. The budget
request includes $37 million to clean and realign an estimated 668,000
headstones and repair 100,000 sunken graves.
Building for the Future
Also, $1.15 billion requested for major construction for 2011 includes funding
for medical facilities in New Orleans; Denver; Palo Alto, California; Alameda,
California; and Omaha, Nebraska. Also budgeted for 2011 are major expansions and
improvements to the national cemeteries in Indiantown Gap, Pennsylvania; Los
Angeles; and Tahoma, Washington, and new burial access policies
that will provide a burial option to an additional 500,000 veterans and enhance
service in urban areas.
A requested budget of $468 million for minor construction in 2011 would fund a
wide variety of improvements at VA facilities