Saturday, March 12, 2011







"Mr. [Ranking Member Mike] Michaud has a distinguished history of support for our veterans and I look forward to working closely with him to ensure that those who have honorably served our nation receive the highest quality care that they so, so deserve," Chair Ann Marie Buerkle as she brought the US House Veterans Affairs Subcommittee on Health hearing to a start this morning, setting a strong bi-partisan tone. She also recognized Sarah Wade and Patty Horan who are full time caregivers for their husbands who were wounded while serving in Iraq. Chair Buerkle asked the two women to stand and then led a round of applause for them. But she and Michaud had serious concerns that echo those raised in the March 2nd Senate Veterans Affairs Committee hearing.
The Senate hearing was covered in that day's snapshot and Kat covered it in "Burr promises VA 'one hell of a fight'" and Ava covered it at Trina's site with "The VA still can't get it together." In the Senate hearing, the VA Secretary Eric Shinseki and Under Secretary Robert Petzel were the witnesses.
Chair Patty Murray: Mr. Secretary, I have a great deal of respect for the work that you've done on homeless and women's issues and I know you're working diligently in a number of ways. But I wanted to bring up an issue that I'm very concerned about. I've already discussed the caregiver issue with you, I've talked about it with Jack Woo, I've talked with senior staff at the White House and I have spoken directly with the president of the United States. VA's plan on the caregivers issue was overdue and once submitted it hardly resembled the bill that unanimously cleared this Congress. Three weeks ago, my Committee staff requested information on how that plan was developed and to date no information has been provided. Rather than following the law, the administration set forth some overly stringent rules bureaucratic hurdles that would essentially deny help to caregivers. Sarah and Ted Wade who were staunch advocates and worked hard with us to get this passed were invited by the president to attend the bill signing at the White House, they won't be eligible for the program under the plan that the department submitted. We're also hearing a lot from veterans and caregivers from across the country who fall outside of this new line in the sand the VA has drawn, who have been left in limbo and now don't know if this benefit that they advocated and worked so hard for will support them. Mr. Secretary, it appears your that department is not complying with the law as we have written. Can you please tell this Committee why?
And he couldn't. As Kat reported, Ranking Member Richard Burr informed Shinseki that either the law was implemented as written or Shinseki better be prepared for "one hell of a fight." As they should. DAV notes, "The veteran population aged 65 and older is expected to increase from 37.4 percent to 44.8 percent by the year 2020. VA is also treating a new era of younger, severely injured servicemembers. Many veterans from Iraq and Afghanistan will need lifetime care."
The Subcommittee heard from two panels. The first panel was Disabled American Veterans' Adrian Atizado, Wounded Warrior Project's Ralph Ibson, Iraq and Afghan Veterans of America's Tom Tarantino and National Military Family Association's Barbara Cohoon. The second panel was the VA's Robert Petzel (Under Secretary for Health) who lawyered up with Walter Hall and Deborah Amdur. We'll note this exchange from the first panel.
Chair Ann Marie Buerkle: This question is for each of the members on this panel, based on your expertise and all of the investigation and work you've put into this law and looking at its implementation, could each one of you identify for me what it is that you see as the single most serious deficit in the implementation of this law and what your solution would be for that deficit? And if you could just limit your remarks so that everyone could have a chance to respond, I would really appreciate it. We'll start with Mr. [Atizado] --
Adrian Atizado: Chairman Buerkle, I appreciate that question but, again, I have to caution the Committee that eligibility is only one of a number of gateway provisions in this law. Certainly if a service member and their caregiver -- veteran and their caregiver are deemed eligible and meet other gateway provisions that don't allow them the appropriate services then being eligible becomes a moot point in the end. As the other panelists have mentioned, it appears that VA's eligibility criteria does raise the bar that a caregiver and veteran must meet to be entitled or at least considered eligible and my testimony has a specific example of that. But I think in all -- In all fairness, I believe, VA has -- VA clinicians know what they need to do. And I think we know what -- we know what we want them to do. And I think there's -- There may have been a little bit of a misinterpretation on both sides. My point is -- is that we all have to step back a little bit from this very emotionally charged situation, reassess ourselves and come together on equal grounds because I fear that no matter what we say today, if we continue down this path, we will not come to a very amicable solution.
Chair Ann Marie Buerkle: Thank you. Mr. Ibson?
Ralph Ibson: I share -- I share my colleagues -- thank you [to Tom Tarantino, who helped him with his microphone] -- I share my colleagues view that it's difficult to isolate a single factor because there really are a great many flaws but -- but honoring your question, I do think that the imposition of very, very restrictive eligibility criteria that are inconsistent with the law and have the effect of disqualifying three of every four caregivers who probably should be covered under this law is the most profound of the many problems we have discussed this morning.
Chair Ann Marie Buerkle: Thank you. Mr. Tarantion.
Tom Tarantino: I associate myself with the comments of Adrian and Ralph. I think they're absolutely correct. There are multiple issues with the regulation of this law but if we needed to start somewhere, we have to start at eligibility because that's the first gateway. Uhm, and-and if you want to look at how to do it, I would suggest that they read the law because it's very explicit. It is in fact probably the most explicit piece of legislation that I've read since I started working in this field three years ago. But I-I actually do and I share Adrian's concern: We need to caution ourselves that we don't just stop there, that we have to actually look at how this program -- how this program is implemented holisticly and that once, if the elegibility criteria is fixed, that we don't just stop and say "Great!" put a win on the board and then move on. This is a very complicated program and we have to keep looking at it until it is -- We get it right.
Chair Ann Marie Buerkle: Thank you.
Barbara Cohoon: Our association would feel that it has to do with when you're actually going to be starting the benefits. It's not until there's all these other requirements that are met. And so therefore it pushes elegibility to all these benefits until further down the road and while it may be several months or years into veterans status. And we would like to see that start earlier because our caregivers need these benefits much earlier in the process than when they'll possibly be getting them. The VA's also rolling out all the benefits at the same time. So we feel that they should be able to start some of the benefits earlier in the process interjecting them at the time when the caregiver actually needs them so that they have the resources that they need, have the right skills to provide the care that they need and therefore the veteran gets the care -- or the service member's getting the care -- that they need. So our concern is the fact that they're waiting until all the wickets are met before they start any of the benefits and one of the major wickets has to be that the veteran has to be receiving care 100% in home and many of our service members are still going through the recovery phases where they might be having wound revisions or maybe they're having burns taken care of. So waiting until it's 100% in home as far as care, that could also delay either them leaving the military or starting this particular benefit. So that would be our concern. Elegibility also, but that's the biggest for us.
Elsewhere during the first panel, Tom Tarantino brought up what is considered "the signature wound" of the Iraq and Afghanistan Wars: Traumatic Brain Injury (TBI). If you're new to the topic of TBI, Barbara Mannino (Fox Business News) has a report on the topic, just published today. While the first panel was forthcoming, the second panel was a sad joke. It was the same performance from last week for Robert Petzel who still can't convincingly mouth words allegedly of regret.
Due to a vote about to take place, time was limited on the second panel and the Chair turned the questions over to US House Rep Phil Roe who is also Dr. Roe (medical doctor). We'll note a bit of the exchange.
US House Rep Phil Roe: Quickly, I've watched this now for the third year. It seems like all the programs we see are slow and glacial to get going. And I know it's a very complicated program but as you clearly pointed out, it's not nearly as complicated as having no arms or legs and getting around in your home or with a Traumatic Brain Injury where you can't balance the check book and someone has to be there to help you do that. That's a lot harder, as you just pointed out. I could not agree more. So why is it taking so long? And this program doesn't seem as complicated to me as many of the programs that the VA has.
Robert Petzel: Thank you, Congressman Roe. I will turn to Debbie Amdur to elaborate on this but I think the biggest aspect of this is that it is a completely new concept for us. We have never been in the business of providing a stipend to somebody who is providing caregiving services. And developing the regulations for this, getting all of the correct input before the regulations are actually in place, takes a long time. I-I-I think -- I apologize as I have before for the fact that we are so late in doing this but I think the fact that this was new and it required relatively complex regulations is part, at least of the explanation.
US House Rep Phil Roe: This reason? I mean we have regulations now for home health care people that go in. It looks to me like it would have been fairly simple to look at those and say "There's some criteria there." We've been pretty easy. I think we micro-manage this down to "what if? what if? what if? what if?" until it got to be almost -- and also the intent of Congress was to provide this to as many families. And I think right now, just like in the HUD-VASH voucher program we found out we've got 11,000 vouchers out there with no veterans, homeless veterans. So I think what you're going to find out with this is there's going to be a lot more need than we thought but we don't even know what that is now because it's so hard for people to get in and, as Mr. Tarantino pointed out, the gateway as eligibility, but that's just the first step. So we really don't know right now how many people -- And do you know how many people have applied or how many have to date?
Robert Petzel: Well, of course, there hasn't been application period yet, Congressman, But have an estimate of somewhere between 750 and a thousand people would probably be applying or would be eligible under the way the criteria are presently deliannated.
US House Rep Phil Roe: Well I guess that seems like an awfully small number to me in a country with millions of veterans. It seems to me like I'll be it will be ten or twenty or thirty times that many.
On TBI, Deborah Amdur declared, "And [I] was very concerned to hear the interpretation that we would not be covering veterans with Traumatic Brain Injury. When we put together the eligiblity crtieria we brought forward subject matter experts from across VA including leadership of our Federal Recovery Coordination from our programs our poly trauma programs, Traumatic Brain injury programs and so forth. And there was significant recognition of the challenges that are faced by family members caring for individuals with Traumatic Brain Injury." Dr. Roe wanted Adur to promise that by July, caregivers will be receiving money. And she did. She tried to go with "It is our intention" but she ended up promising. But that doesn't mean the VA will keep the promise, they never do. But we'll go ahead and note that the promise was made and we'll note it if it's kept or if it's broken.
Protests took place across Iraq today. AFP estimates that 500 Iraqis gathered in Baghdad's Liberation Square (Tahrir Square before the protests began last month) and they speak to Layla Saleh Yaseen who explains why she is protesting, "I demand the rights of Iraqis -- more rations and an improvement in services like electricity. I have four children and have to care for a disabled brother by selling simple goods in the streets." And that's the type of person the Iraqi military was advancing on, that's the type of person that scares Nouri so that he orders military helicopters to patrol the air space above Liberation Square. Jonathan Blakley (NPR's The Two-Way blog) reports, "Security forces lined the streets of central Baghdad with riot gear. Authorities didn't bother issuing a curfew or banning traffic in the normally congested city, but entrances into Baghdad province were blocked to motor vehicles. At times, traffic passed through Baghdad's Tahrir Square as the protesters, numbering between 500 and 1,000 shouted into megaphones and waved anti-government banners." Dar Addustour notes that the protesters are calling on Nouri al-Maliki to listen to them. Aswat al-Iraq quotes activist Emad Karim stating, "Dozens of citizens went to streets on Friday billed as 'Friday of Truth', calling for better services and fighting corruption." Yahya Barzanji, Bushra Juhi and Lara Jakes (AP) report protesters decried the way they had been treated by Iraqi forces in previous protests. Sami Majid pointed to the February 25th and explained, "They beat and kicked me, then forced me to sign a commitment that I would not participate in demonstrations or raise riots." Khalid Walid ( reports that riot police descended on the protesters late in the afternoon, using batons to intimidate and disperse them and that Ali Kamal declared that Nouri al-Maliki has stated reforms will come in 100 days and that they will continue demonstrating and that they have little to no confidence in the government.
Dar Addustour reports that protesters in Najaf carried flowers as they called for an end to corruption, improved basic services and ration card items. Aswat al-Iraq notes protesters in Nassiriya are criticizing the way security forces have treated protesters. In Falluja, Dar Addustour reports, protesters called for an end to random arrests. Aswat al-Iraq notes that Falluja saw a crackdown ahead of the protest with "a vehicle and bike ban around the protest region." Yahya Barzanji, Bushra Juhi and Lara Jakes (AP) report approximately 4,000 people turned out to protest in Sulaimaniyah. Saman Mahmoud Mawloud (Reuters) reports one Sulaimaniyah protester attempted to burn himself but was stopped by other activists, notes the protesters chanted for KRG President Massoud Barzani to step down and quotes Nasik Qadir stating, "There has been no response from the government. We are here to change the despotic system, end the corruption in Kurdistan. People feel the corruption and want jobs, justice and services."
Al Mada reports that Hilla saw two protests and the demands included that the govenor of Babel Province (Babylon Province is another term used for it and the term Al Mada uses) be elected directly and not via quotas. They also called for an end to unemployment, all ration card items being available and reductions in the costs of water and electricity. Those were some of the demands of the first group. The second group had overlapping demands and some of their own demands as well. They agree that a new governor is needed and they want qualifications for the office -- including that he or she must hold a bachelor's degree.
In an opinion piece, Al Mada argues that the protests taking place in Baghdad's Tahrir Square have dug a grave for and buried sectarian politics and forced sectarian politics to fall away by pulling sectarian politicians and their constituents apart, and that the biggest victors are young Iraqis who, among other things, trained themselves in something that was not possible in Iraq's previous five decades, protesting the rulers. This training creates a bond between today's Iraqi youths and those of the 1940s and 1950s who also engaged in cross-sectarian demonstrations. Al Mada sees the protests as strengthening the notion of "Iraqi" and of "citizen."

RECOMMENDED: "Iraq snapshot"
"Protests throughout Iraq"
"Another US soldier has died"
"I Hate The War"
"Senate Armed Services Committee"
"Roberta Flack should record Donovan"
"Learn from it"
"Marriage equality = full equality"
"the father of the movement"
"Somebody shut Bill Moyers up"
"Anti-Semite Jason Linkins"
"Music and Pop Chronicles"
"Puerto Rico"
"Bette and Marilyn"
"Martha T. Moore may be the only one"
"Eye For An Eye"
"TV of old"
"Karl Rove Leaves The Administration"
"Critical skills"
"Fringe is freaking trippy!!!!!!"
"Idiot of the Week"
"An explanation that makes sense"