how much VA contributes, and it is a subject of some annoyance to me that our Government does not understand that. So, in order to highlight the VA's already enormous commitment to providing medical care during disasters, I introduced, with Senators Specter and Akaka, legislation to recognize VA's emergency missions. The legislation before us would also turn VA's research expertise to preventing the illnesses and the injuries that might arise from the use of terrorist weapons and would create an office to coordinate VA's disaster planning. In other words, that is my way of trying to help VA get a seat at the planning table. We also have legislation before us to waive the drug copayment for veterans with incomes between $9,000 and $24,000, all of whom are struggling to meet VA's new copayment rate of $7 per prescription. Despite, as I made clear at our last hearing, the VA's embarrassing failure to provide our Nation's aging veterans with a true spectrum of extended care services, the authority for doing such expires very soon. I have introduced legislation to extend those authorities while we continue to push VA to step up its long-term care efforts. Other issues press our aging veterans, including hearing loss and tinnitus that may, for some, result from their military service. Legislation before us would help VA rate service-connected hearing loss more fairly and determine scientifically whether service in certain military specialties might be associated with an increased risk of hearing loss later in life. This would help solve the problem of looking at everybody in the world who has a hearing problem and figuring out the fairest way to limit who gets to be presumed eligible for benefits? Other legislation on today's agenda would authorize the VA to extend its sexual trauma counseling and treatment programs beyond their current expiration date. We have a very ambitious agenda before us, including many bills sponsored by many colleagues on this committee, including one who will be coming, Senator Nelson, Bill Nelson, the lesser Nelson. [Laughter.] [The prepared statement of Senator Rockefeller follows:] PREPARED STATEMENT OF HON. JOHN D. ROCKEFELLER IV, U.S. SENATOR FROM WEST VIRGINIA Good morning. We meet today, as I'm sure I don't have to remind our witnesses, in a world where priorities have changed from "business as usual." The attention of the government, certainly here in Congress, has been focused on protecting our Nation against the possibility of future terrorist attacks. The challenge that VA-and all of us-must face is preparing for emergencies without forgetting the reason that we are here today: to serve the men and women who served this nation. This morning, we will be reviewing legislation that would affect almost every aspect of veterans' lives, from the annual cost-of-living adjustment for compensation, to changes in education benefits, care and services for women veterans, and mental health care and research. I would like to highlight a couple of items in particular. Several pieces of legislation before us recognize that VA-the Nation's largest integrated health care system-can and must play a larger role in emergency preparedness. VA has shared skilled caregivers and supplies with overwhelmed communities following every major domestic disaster of the last two decades, including the Oklahoma City bombing, Hurricanes Andrew and Floyd, and the September 11th attacks, but too many in government, and in public health, still have no idea how much VA contributes. In order to highlight VA's already enormous commitment to providing medical care during disasters, I introduced with Senators Specter and Akaka legislation to recognize VA's emergency missions. Legislation before us would also turn VA's research expertise to preventing the illnesses or injuries that might arise from the use of terrorist weapons, and would create an office to coordinate VA's disaster planning. We also have legislation before us to waive the drug copayment for low-income veterans. Although veterans with incomes of less than $24,000 a year are exempt from copayments for most VA health care services, the income threshold when it comes to prescription drugs is just $9,000 a year. This problem was compounded by VA's decision last year to increase prescription copayments from $2 to $7—an increase that may be reasonable by industry standards, but unduly burdens veterans with incomes between $9,000 and $24,000. I have been joined by many colleagues in offering a bill that would exempt those veterans from prescription copayments. We met in this room just a week ago to highlight again how desperately our nation's aging veterans need a true spectrum of extended care services. In 1999, Congress passed legislation that required VA to provide nursing home care to any veteran who is 70% or more service-connected disabled, and non-institutional care to all enrolled veterans. We placed a four-year expiration date on these programs so that we could adequately study and adjust them if needed. VA's embarrassing failure to make non-institutional long-term care programs a reality has denied crucial services to veterans, and has certainly prevented us from studying their effects. I have introduced legislation on today's agenda to extend these authorities for five more years, and will demand that VA step up its long-term care efforts. Other issues press our aging veterans, including hearing loss and tinnitus that may, for some, result from their military service. Legislation before us would help VA rate service-connected hearing loss more fairly, and determine scientifically whether service in certain military specialties might be associated with an increased risk of hearing loss later in life. Other legislation on today's agenda would authorize VA to extend its sexual trauma counseling and treatment programs beyond their current expiration date, so that veterans who experienced assault or harassment during military service can continue to depend on these critical programs. We have a very ambitious agenda before us, including many bills sponsored by my colleagues on this Committee. This hearing gives us an opportunity for public debate on the important issues that the proposed bills would affect, so that the Committee can give them full consideration. I look forward to hearing from my colleagues and our witnesses. Chairman ROCKEFELLER. This hearing gives us an opportunity to discuss this, for you all to discuss it, for the VSO's to discuss it, and I look forward to what my colleagues might have to say in the way of opening statements, starting with my most special colleague, Senator Specter. Senator SPECTER. Thank you very much, Mr. Chairman. Thank you for convening this hearing on a variety of legislative subjects. The issues which veterans confront today are numerous. We face increased demands for veterans' health care and veterans' longterm nursing care, and the budget is never adequate. Each year, through the efforts of Chairman Rockefeller and others on this committee, and others in the Senate, we have increased VA's medical care budget-but still there is a decisive shortfall. So we welcome an opportunity to hear VA's testimony today. Today is an especially busy day with Senator Byrd-you know Senator Byrd-having scheduled hearings on homeland defense all day, and there is also a Judiciary Committee executive meeting today, so, while I will stay as long as I can, I will have to depart early. But I will review the transcript of today's hearing. Mr. Chairman, I appreciate your being here today, and appreciate your statement for the hearing record. Thank you, Mr. Chairman. [The prepared statement of Senator Specter follows:] PREPARED STATEMENT OF HON. ARLEN SPECTER, U.S. SENATOR FROM PENNSYLVANIA Good morning, Mr. Chairman. It is a pleasure to be with you this morning at this hearing to gain the on-the-record views of VA, and the veterans service organizations, on the large agenda of legislation that the Committee will consider before the end of the year. I am pleased that you have asked the interested parties to provide their views on the record-and that they provide them early in the process; I support that goal. We do not want to rely entirely on informal communications in fashioning our markup agenda. Nor do we want a repeat of last year's experience when VA voiced its views on certain legislative issues only after those issues had already been informally conferenced with the House. This year, VA will need to speak up now so that we can benefit from its thinking early in the process. With the assistance of staff to sort through the views of the witnesses on all 27 bills on this agenda, we will then be postured to act wisely on the important policy questions before the Committee. Of course, I hope to learn this morning that there is unanimous support for the bills on the agenda that I have introduced. We have done good work in this Committee in updating and increasing VA educational assistance benefits, but we need to do more especially for the widows and surviving children of service members who were killed in action. I look forward to testimony on S. 1113, S. 1517, and S. 2231. VA-in a departure from its recent position that Congress enacts too many “unfunded mandates"-has proposed that we enact a ground-breaking new mandate: that VA be obligated to provide (or pay for) care to women veterans' newborn babies during the first 14 days of life in cases where VA provided delivery services. We need to look carefully at that proposal. In addition, we need to look closely at four key bills designed to enhance VA's preparedness for response to terrorism. I look forward to the witnesses' views on these, and other, proposals. If the witnesses cannot support certain items on the agenda, we need to hear that now—and we need to hear how they would improve these bills. For all of us have the same goal in mind: to fulfill our commitment to the Nation's veterans. As I have said many times, I am here in Congress to, figuratively, collect the bonus denied to my father, Harry Specter, and other World War I veterans. Working with VA and the service organizations, we will fulfill that commitment. Chairman ROCKEFELLER. Thank you, Senator Specter. Senator AKAKA. Thank you very much, Mr. Chairman, and welcome to our panel to the committee. Along with my friend, the chairman of the committee, I am cosponsor of two important bills that represent the first step in acknowledging the Department of Veterans Affairs' critical role in preparing for, and responding to, natural disasters and terrorist attacks. S. 1561, strengthening the bioterrorism preparedness through expanded natural disaster medical systems training programs is one of them. Contrary to current press reports, the Federal Government is not unprepared for a biological attack. However, preparedness levels are not uniform or consistent across the United States, and there are serious problems. So, while not unprepared, we are clearly underprepared. Strengthening the public health system is very important and is being addressed by several congressional and administrative initiatives. Creating a critical line of defense against bioterrorism must involve health care professionals. Senator Rockefeller and I have proposed to use the existing emergency communication infrastructure, disaster training programs and community partnerships within the Nation's 163 Veterans Affairs hospitals to train both VA hospital staff and local health care providers in recognizing and treating victims of biological weapons. We must make sure that first-line responders to bio terrorism events, doctors and nurses, have the training and resources necessary to respond immediately to an incident and the capacity to cope for the several hours or days it will take before Federal help can arrive. The second bill, S. 2187, the Department of Veterans Affairs' Emergency Medical Care Act of 2002, is pending. When VA has offered medical care to the general public during every major U.S. disaster since Hurricane Andrew, it has done so without the statutory authority to care for nonveterans and nonactive military personnel. Our legislation would provide this authority. Already an active participant in disaster response and preparedness, VA partners with DOD, FEMA, HHS to form the National Disaster Medical System. VÁ, also, is an emergency responder through the Federal Response Plan. Because of the hard work done by VA employees, this legislation does not need to create new VA programs, nor authorize any additional funds. I commend the dedication and initiative of the 225,000 VA personnel and am confident that they will continue helping all Americans respond to major disasters and medical cri ses. Thank you very much, Mr. Chairman, for having this hearing on pending legislation. Chairman ROCKEFELLER. Thank you, Senator Akaka. Senator Nelson? Senator NELSON. Thank you, Mr. Chairman. I certainly want to thank our witnesses for being here today to discuss legislation that will affect our Nation's veterans and extend my appreciation for all of your efforts, as well as yours, Mr. Chairman, on behalf of our Nation's and certainly Nebraska's veterans. There are clearly some excellent initiatives that are on the discussion list for today, and in a perfect world, we could afford, and we could pass every bill that is put before us. But the truth is that we are faced, though we are a great country with vast resources, we are faced with a limited amount of those resources when it comes to tax dollars. As a former Governor, I have some experience with finding ways to balance budgets and make them work. But we must, in fact, take care of our Nation's veterans, provide the best benefits that we possibly can, certainly those that we can afford. Now this may require our committee, with the help of people like we have here today to prioritize the initiatives, because very often the prioritization will help us reduce the number of initiatives to those that are most important and that we can, in fact, afford. But one issue that comes to mind is in a rural area or a metropolitan area that veterans are affected differently by their circumstances, and one issue that comes to mind and which has caused me a great deal of concern is that a farmer's farm equipment is counted in his assets for eligibility determination, and that creates a hardship to where you can be equipment rich and otherwise income poor and unable to, one should not have to sell their farm equipment in order to make their ends meet because of the need for health care, particularly if we can find a way to establish need on the basis of true ability to pay. I hope that we are going to be able to work our way through that, and other issues today, and I appreciate very much, again, your being here. Thank you, Mr. Chairman. Chairman ROCKEFELLER. Thank you, Senator Nelson. Senator Wellstone? Senator WELLSTONE. Mr. Chairman, if Senator Nelson needs to be in and out, I will follow him. I cannot stay real long, but my understanding is that you were in a real hurry, Bill, is that right? Bill, do you want me to follow? I can follow you if you are in a real hurry. I heard you wanted to-I will follow you. Go ahead. Senator NELSON of Florida. Too much protocol here. Senator WELLSTONE. Go ahead. Chairman ROCKEFELLER. Senator Nelson from the great State of Florida. STATEMENT OF BILL NELSON, U.S. SENATOR FROM THE STATE OF FLORIDA Senator NELSON of Florida. Mr. Chairman, you have the full Nelson here at this end of the table. [Laughter.] Chairman ROCKEFELLER. I spent my entire life growing up with another Nelson, who was Governor of New York. [Laughter.] And now I have two of them. Senator WELLSTONE. Mr. Chairman, I cannot resist this. Having been a college wrestler, a full Nelson is illegal. [Laughter.] Senator NELSON of Florida. Mr. Chairman, I wanted to bring to the attention of the committee a matter that you are going to consider, which has grave consequences for veterans. I might say that we have another piece of legislation to rename a veterans center down in Florida after one of the great heroes in Florida, but let me address my remarks to the matter of grave concern. Veterans' disability payments by law cannot be assigned. There is reason for that, and that is that the Nation is trying to compensate the veteran for their disability that has been caused in the line of duty, and therefore the law said that that is a personal payment to the veteran for the disability that that veteran has incurred in the service to his country-thus, no assignment to another person. But some "get rich quick" operators have figured out a scheme that if the veteran deposits his disability check in a joint checking account, then that other entity can draw out the money, and does so with the concurrence of the veteran by offering quick cash to the veteran, paying as low as 30 cents on the dollar for a period of 8 or 10 years of the veteran's payments. Now that is a total bastardization of what was intended to be the veterans' disability payments system, where we are trying to honor the veterans for their service to this country. Of course, it is enticing that a veteran might have a quick cash need, and so he exchanges 10 years of his payments, and he only gets 30 cents on the dollar, and yet it is legal because they are taking it out, but it is not the spirit of the law, ergo the law says clearly you cannot assign a veteran's benefits. So the legislation would make this practice illegal. Now this is happening, and there are some 30 websites nationally. It has par |