|07-20-2002, 08:42 AM||#1|
VA Gets Budget Increase, But Not Enough For VSOs
VA Gets Budget Increase, But Not Enough For VSOs
By Mary Ellen Butler
WASHINGTON-The Department of Veterans Affairs came out about $350 million ahead of the president's Fiscal 2002 budget request under a VA budget approved by Congress and signed into law by the President Bush in November. However, veterans' advocates say the number is still too low to meet veterans' health care needs, especially with reports from VA that it is already facing a $400 million shortfall for this fiscal year.
The VA budget approved by Congress provides a $1.05 billion increase in discretionary spending over last year and puts the total discretionary funding at $21.3 billion plus an anticipated $812 million in receipt collections. The funding also includes $371 million for VA medical and prosthetic research, an increase of $20 million over last year.
Dennis Cullinan, legislative director for the Veterans of Foreign Wars (VFW), said the funding isn't as high as they had hoped, but that they appreciated efforts by Congress to increase the figure over the president's request. In particular, the budget does provide increased funds to the Veterans Benefits Administration, which will aid the agency in cutting down its large claims backlog.
However, Richard Fuller, national legislative director for the Paralyzed Veterans of America (PVA), was less pleased with the final funding level agreed to by Congress. He said the FY 2002 budget for medical care is "woefully inadequate" and falls approximately $1.6 billion short of the levels cited in the Independent Budget, a detailed budget document produced each year by a consortium of veterans' service organizations.
He said the budget approved by Congress fails to counter inflation and provide enough money to care for VA's aging patient population.
Congress also approved more than $180 million in funding for major construction projects, and $210 million for minor construction. The final House-Senate bill specified that $60 million of the minor construction dollars would go toward VA's Capital Asset Realignment for Enhanced Services (CARES) activities. CARES is a VA initiative that uses actuarial data about the projected veterans' population and needs in 2010 to determine how to realign its facilities.
The pilot phase of the CARES project was completed this summer and VA secretary Anthony J. Principi is currently weighing the options developed. He is expected to make a final decision sometime this year. However, under the House-Senate conference committee report on the VA budget, which explains its allocations and gives instructions to the federal agencies, Principi has been instructed to certify the openness of the project and announce his decision by Jan. 15.
In that report, the conferees also instructed that $40 million of the $60 million CARES construction funding should be used for the construction of a new blind and spinal cord injury center at the Hines VA medical center in Illinois, should Principi choose that option of the CARES pilot study.
That plan, called option B, was a preliminary choice of the National CARES Steering Committee. However, it has also been criticized by veterans in the Chicago area and the VA affiliate Northwestern University because it calls for closing inpatient services at the Lakeside VA medical center.
"The conferees remain strongly supportive of CARES," the conferees said in their report. "This nationwide review is critical to ensuring VA's capital assets can support current and long-term health care needs and are rehabilitated and aligned for optimal efficiency and access."
The conferees said they were strongly encouraged by the pilot phase recommendations and the estimate that restructuring in the Chicago area could save $270 million over 20 years, which could then be reinvested into patient care and access.
Other Reports, Demonstrations
The House-Senate conference committee has also instructed VA to submit a number of reports to Congress on topics ranging from VA and Department of Defense sharing to technology transfer.
"For a number of years [the General Accounting Office] and Congress have been encouraging the VA and [DoD] to work together to find ways to share resources and provide better health care for our nation's military, military retirees, and veterans," the report said.
As a result, the conferees directed the VA secretary, along with the secretary of defense to submit a "credible plan" by Sept. 1, 2002 for no less than three demonstration sites where the VA and DoD will fully integrate operations, pharmacy services, billing and records, and treatment. In addition, those sharing activities should be consistent with the CARES process. In particular, the report directs VA and DoD to consider opportunities at Tripler Army Medical Center in Honolulu.
Conferees on the bill also noted that they were troubled by a lack of uniformity in information within VA about atypical anti-psychotic medications.
The conference committee instructed the VA secretary to communicate to doctors, facility managers and pharmacy managers that atypical anti-psychotic pharmaceutical prescribing practices are not to be used as a measure of job performance, and the secretary should explain that VA's policy is that physicians should use their best clinical judgement when choosing these medications. The conference report said the department should feel free to communicate relative cost data on all of these drugs to physicians.
In addition, the conferees directed VA to report by Feb. 1 on the concerns of universities that the department's technology transfer policy, announced earlier this year, is inconsistent with the Bayh-Dole Act and other similar technology transfer policies at other federal agencies. The Bayh-Dole Act instructs universities that receive grants from the National Institutes of Health to aggressively market the technology developed as a result. However, university researchers often receive funds from both NIH and VA, and it is unclear who should benefit in such circumstances.
In preparing the report to address these concerns, VA should consult with universities and university associations, including the American Association of Medical Colleges, the Association of University Technology Managers and the Council on Government Relations, the conference report said.
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