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TREA WASHINGTON UPDATE February 8, 2008
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TREA Washington Update for February 8, 2008
Well the raise for the Republican nomination for President has shaken out but it is still a horse race for the Democratic nomination so the next few days in political Washington will be focused on next Tuesday’s primaries in DC, Maryland and Virginia.
This week the main focus was on the economic stimulus plan. In just two weeks the House of Representatives and the Administration negotiated a package; the House passed it; the Senate took it up tried to make it much larger but settled for the House package with the addition of payments for poor seniors and disabled veterans and veterans’ widows; passed it; sent it back to the House; where last night they passed the modified bill. The President praised the bill and said that he would sign the $152 billion plan. So all this means is, that not only will most of you see checks in your mailboxes in May; it means that the government can act quickly some times.
2) Administration Rolls Out Proposed VA Budget
3) Chief Of National Guard Bureau Becomes A 4 Star
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Click here for a Printable Version of this Update
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1) Administration Includes Task Force’s Proposed Retiree Enrollment Fees And Co-Pays In Its FY09 Proposed DoD Budget-In the proposed FY09 budget DoD included the “Task Force for the Future of Military” recommendations to dramatically raise the TRICARE enrollment fees, co-pays and deductibles for working age military retirees and their families. They estimate a savings to them (and a cost to the retirees) of $1.2 billion. The increases proposed for 2009 are as follows:
For retirees with retired pay from $0 to $19,999 for TRICARE Prime (presently $230 for an individual and $460 for a family) up to $364 for an individual and $728 for a family. For TRICARE Standard (presently there is no yearly enrollment fee and the deductible is $150 for an individual and $300 for a family) there will be an enrollment fee of $32 for an individual, $64 for a family, a deductible of $209 for an individual and $407 for an family.
For retirees with retired pay from $20,000-$39,000 for TRICARE Prime (presently $230 for an individual and $460 for a family) up to $444 for an individual and $888 for a family. For TRICARE Standard (presently there is no yearly enrollment fee and the deductible is $150 for an individual and $300 for a family) there will be an enrollment fee of $32 for an individual, $64 for a family, a deductible of $252 for an individual and $503 for an family.
For retirees with retired pay from $40,000 and above for TRICARE Prime (presently $230 for an individual and $460 for a family) up to $594 for an individual and $1,188 for a family. For TRICARE Standard (presently there is no yearly enrollment fee and the deductible is $150 for an individual and $300 for a family) there will be an enrollment fee of $32 for an individual, $64 for a family, a deductible of $337 for an individual and $675 for an family.
The budget also proposes to dramatically increase almost all Pharmacy co-pays (with one notable exception). The present co-pays in retail for a 30 day supply are $3 for a generic drug, $9 for a brand name and $22 for a non-formulary drug. Under this proposal it would increase to $15 for a generic; $25 for a brand name and $45 for a non-formulary drug. Presently for Mail order a 90 day supply co-pays are $3 for a generic, $9 for a brand and $22 for a non-formulary. Under the proposal the generic would have $0 co-pay, $15 for the brand and $45 for the non-formulary.
We kept saying that the proposed increases that we stopped for this year would reappear. Well here they are. Yesterday, representatives from The Military Coalition (a group TREA is very active in) testified against these proposals before the House Armed Service Committee’s personnel subcommittee. Certainly we will be telling you more about this in the future.
2) Administration Rolls Out Proposed VA Budget-This week the Administration also rolled out its proposed VA budget. The new Secretary of the VA Dr. James Peake presented his first budget to a group of VSO’s, including TREA, on Monday. The $93.7 billion proposal covers mandatory programs (disability payments etc), medical programs, information technology, and construction. The proposals included increases in programs for mental health, prosthetics, dental care, rehabilitative care, nursing home care and of course a focus on veterans returning from OEF/OIF. The VA says that its budget will “virtually eliminate the patient waiting list by the end of 2009” and will improve the time it takes to process compensation, pension and education benefit claims. They also say that 88% of veterans will have a burial option in a National or State Veterans Cemetery within 75 miles from their homes.
The budget, once again, proposes an annual enrollment fee for veterans in priority 7 and 8 and an increase in the pharmacy co-pays. Fortunately, unlike DoD the VA did not budget the “savings” that adoption of such proposals would bring into to the healthcare budget. Therefore, if we are successful, once again, at stopping these proposed increases there will not be a hole in the VA’s healthcare budget. Below please find the proposals.
Family Income Annual Enrollment Fee
Under $50,000 None
$50,000 -$74,999 $250
$75,000 -$99,999 $500
$100,000 and above $750
Last year Congress passed historic increases in the VA budget; $3.7 billion additional funding was given to the VA in emergency funding for this year. Hopefully, permanent additional funding can be added to this already increased budget. (below you can find two VA press releases on the their proposed budget and their reasoning)
3) Chief Of National Guard Bureau Becomes A 4 Star-The FY08 NDAA made the position of the Chief of the National Guard Bureau a 4 star billet. This dramatic change was 100 years in the coming. The Chief was also made a principal advisor to the SecDef through the Chairman of the Joint Chiefs of Staff, but was not made part of the Joint Chiefs. The NDAA also included several other important provisions concerning the National Guard. These include:
• A bipartisan council of governors advise the secretary of defense, the Department of Homeland Security and others on National Guard matters.
• The chairman of the Joint Chiefs of Staff determines the feasibility of increasing the number of U.S. Northern Command reserve-component members.
• Up to 15 reserve-component general officers serve at combatant commands, an increase from 10.
• The National Guard Bureau becomes a joint activity of the Department of Defense. Previously, it was a joint bureau of the Army and the Air Force.
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VA Press Release:
FY ‘09 VA Budget Request
Honoring the nation’s commitment to care for the newest generation of combat veterans and service members from other conflicts and eras, Secretary of Veterans Affairs Dr. James B. Peake announced today President Bush is seeking a budget of $93.7 billion in fiscal year 2009 for the Department of Veterans Affairs (VA), with health care and disability compensation for veterans targeted for most of the spending.
Medical Care
· The President’s 2009 request includes total budgetary resources of $41.2 billion for VA medical care, an increase of $2.3 billion over the 2008 budget. VA’s total medical care request is comprised of funding for medical services ($34.08 billion), medical facilities ($4.66 billion), and resources from medical care collections ($2.47 billion).
· The budget will provide resources to treat nearly 5.8 million patients, including about 3.9 million veterans who are VA’s highest priority patients—veterans returning from service in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF), veterans with service-connected disabilities, those with lower incomes, and veterans with special health care needs.
· VA will treat about 333,000 OIF/OEF veterans in 2009, a 14 percent increase over the estimated 2008 figure. Medical care funding for these patients will climb to nearly $1.3 billion in 2009, or 21 percent more than in 2008.
· The budget will provide resources for VA to virtually eliminate the patient waiting list by the end of 2009.
· VA will be able to continue to provide timely, accessible, and high-quality health care that sets the national standard of excellence for the health care industry. For the 8th consecutive year, customer satisfaction with VA’s health care system in 2007 was higher than the private sector. Patients at VA medical centers recorded a satisfaction level of 83 out of possible 100 points, or 6 points higher than the private-sector health care industry.
· Resources for mental health care will reach $3.9 billion in 2009. This is $319 million (or 9 percent) above the 2008 level and will strengthen efforts to ensure VA provides equitable access throughout the nation for veterans with mental health disorders.
· VA is requesting $762 million in 2009 for non-institutional long-term care, an increase of 28 percent over 2008. This will allow veterans to receive extended care services in the most clinically appropriate setting and in the comfort and familiar settings of their homes. The number of patients receiving this type of care, as measured by the average daily census, is expected to reach 61,000, or 38 percent higher than the estimated level for 2008.
· Resources in 2009 for the Civilian Health and Medical Program of the VA (CHAMPVA) will total just over $1 billion. CHAMPVA allows VA to provide health benefits for the dependents and survivors of veterans who are, or were at time of death, 100 percent permanently and totally disabled from a service-connected disability, or who died from a service-connected condition.
· VA’s medical care request includes nearly $1.5 billion to support the increasing workload associated with the purchase and repair of prosthetics and sensory aids to improve veterans’ quality of life, including those returning from combat in Iraq and Afghanistan. This is 10 percent above the funding level in 2008.
· VA’s 2009 budget includes $83 million (or 19 percent more than in 2008) for facility activations where needed to purchase equipment and supplies for newly constructed and leased buildings as VA completes projects from the Capital Asset Realignment for Enhanced Services (CARES) program.
· The budget also provides funding for investments in VA’s capital infrastructure including the continued development of new hospitals in Orlando, Fla. ($120 million) and Denver ($20 million), and beginning three new projects to enhance mental health and polytrauma care at the Palo Alto, Calif. ($38 million), Bay Pines, Fla. ($17 million) and Tampa, Fla. ($21 million) medical centers.
· The Department will expand its telehealth program which is a critical component to improve access to health care for veterans living in rural and remote areas.
Medical Research
· VA is requesting $442 million to support the medical and prosthetic research program, which would fund nearly 2,000 high-priority research projects expanding knowledge in areas critical to veterans’ health care needs, most notably research in mental illness ($53 million), aging ($45 million), health services delivery improvement ($39 million), cancer ($37 million), and heart disease ($33 million).
· One of VA’s highest priorities in 2009 will be to continue an aggressive research program to improve the lives of veterans returning from service in OIF and OEF. The 2009 budget provides $252 million devoted to research projects focused specifically on veterans returning from service in Iraq and Afghanistan.
Benefits
· Disability compensation payments will be made to 234,000 more service-disabled veterans and their survivors in 2009 than were made in 2007. Total disability compensation payments will increase by $6 billion.
· Vocational rehabilitation and employment benefits for service-disabled veterans will increase by $14 million in 2009.
· Resources requested in the budget will allow VA to improve the timeliness with which compensation and pension claims are processed --average days to process these claims will be 145 days, a 21 percent improvement in timeliness over 2007. The number of claims processed will grow to over 940,000, an increase of 14 percent from 2007.
· The number of pending claims for compensation and pension benefits will fall to 298,000 by the end of 2009, or 24 percent below 2007.
· Timeliness will improve for original education claims from 32 days in 2007 to 19 days in 2009. The time it takes to process supplemental education claims will also improve, from 13 days in 2007 to 10 days in 2009.
· In 2009, VA and the Department of Defense will complete the pilot of a new disability evaluation system for wounded warriors at major medical facilities in the Washington, D.C., area. This initiative is designed to eliminate the duplicative and often confusing elements of the current disability process of the two departments. The pilot will include one medical examination according to VA protocols and a single disability rating determined by VA.
· The budget proposal includes $35.9 million to provide specially adapted housing grants to severely disabled veterans and service members, providing a barrier-free living environment that affords them a level of independent living they may not otherwise enjoy.
Memorial Affairs
· The President’s 2009 budget request for VA includes $181 million in operations and maintenance funding for the National Cemetery Administration, which is 71 percent above the resources available to the department’s memorial affairs program when the President took office.
· Resources are included in the 2009 budget request to allow VA to continue daily operations and to begin interment activities at six new national cemeteries --Bakersfield, Calif.; Birmingham, Ala.; Columbia-Greenville, S.C.; Jacksonville, Fla.; Sarasota, Fla.; and southeastern Pennsylvania.
· Major construction funding of $105 million will support the Department’s burial program in 2009, including resources for gravesite expansion and cemetery improvement projects at three national cemeteries --New York (Calverton, $29 million); Massachusetts ($20.5 million); and Puerto Rico ($33.9 million).
· VA will expand access to its burial program by increasing the percent of veterans served by a national or state veterans cemetery within 75 miles of their residence to 88 percent in 2009. That’s a 4.6 percentage point increase above the performance level at the close of 2007.
· VA expects to perform 111,000 interments in 2009 – 11 percent more than the interments performed in 2007.
· VA will continue to increase the percent of respondents who rate the quality of service provided by national cemeteries as excellent to 98 percent in 2009 – 4 percentage points higher than the level of performance reached in 2007.
Information Technology
· The President’s 2009 budget provides more than $2.4 billion for the Department’s IT program. This is $389 million (19 percent) above the 2008 budget, and reflects the realignment of all IT operations and functions under the control of the Chief Information Officer.
· The IT consolidation has given VA the opportunity to look at all aspects of the “State of VA IT” and to support efforts to provide improved, standardized IT services, leading to consistency and dependability across the Department. In some cases, this will involve shoring up areas which have suffered from neglect in the past.
· IT is critical to the timely, accessible delivery of high-quality benefits and services to veterans and their families. It is vital that VA receives a significant infusion of new resources to implement new systems and upgrades to existing systems , which have a direct impact on the medical care of veterans, the quality and safety of that care, and the underpinning IT infrastructure that makes health care delivery possible.
· The 2009 budget request contains $93 million in support of the Department’s cyber security program to continue the commitment to make VA the gold standard in data security within the Federal government.
· VA is seeking $284 million in 2009 for development and implementation of the Veterans Health Information Systems and Technology Architecture (HealtheVet-VistA) program. This includes a health data repository, a patient scheduling system, and a reengineered pharmacy application. These applications are directly tied to programs which are intended to enhance or replace existing programs already serving patients.
· The budget proposal includes $23.8 million in 2009 to complete the transition of compensation and pension payment processing from the current system to VETsNET, enhancing claims processing efficiency and accuracy, strengthening payment integrity and fraud prevention, and positioning VA to develop future claims processing efficiencies via our Paperless Claim Processing Initiative; an important component of the recommendations presented in the Dole-Shalala Commission report to support the nation’s wounded warriors.
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VA Press Release:
VA Requests $94 Billion for Veterans in FY ’09 Budget
Peake: VA Will Provide Timely, Accessible and High-Quality Care
WASHINGTON – Honoring the nation’s commitment to care for the newest generation of combat veterans and service members from other conflicts and eras, Secretary of Veterans Affairs Dr. James B. Peake announced today President Bush is seeking a budget of $93.7 billion in fiscal year 2009 for the Department of Veterans Affairs (VA), with health care and disability compensation receiving most of the funding.
If Congress accepts the White House’s budget request, VA’s budget would be
$3.4 billion more than the current spending level and nearly double the budget in effect when President Bush took office seven years ago.
“This budget builds on VA’s past successes in providing veterans with timely, accessible delivery of high-quality benefits and services earned through their sacrifice and service in defense of freedom,” Peake said.
The FY ‘09 budget proposal calls for $47.2 billion in discretionary funding, mostly for health care. It also would provide $46.4 billion in mandatory funding for compensation, pension, educational assistance, home loan guaranties and other benefit programs.
Peake said the budget proposal will provide funding to ensure high-quality care to VA’s highest priority patients --veterans of the Global War on Terror, those with service-connected disabilities, lower-income veterans, and veterans with special health care needs.
Under the new budget, VA will strengthen its collaboration with the Department of Defense (DoD) for world-class health care and benefits to veterans, service members and their families, including progress toward the development of secure electronic patient health care records that can be used by both departments.
This proposed budget will also allow VA to continue implementing the recommendations of the President’s Commission on Care for America’s Returning Wounded Warriors (Dole-Shalala Commission). Peake said the commission’s report provides “a powerful blueprint to move forward with ensuring that service men and women injured during the Global War on Terror receive the health care and benefits necessary to allow them to return to full and productive lives as quickly as possible.”
The budget request includes:
o $1.3 billion to meet the health care needs of an estimated 330,000 veterans returned from service in Iraq and Afghanistan;
o $3.9 billion for mental health services;
o $762 million for non-institutional long-term care; and
o $1.5 billion for prosthetics and sensory aids.
The President’s budget request contains $252 million devoted to research projects focused specifically on veterans returning from service in Iraq and Afghanistan. This includes research in traumatic brain injury, polytrauma, spinal cord injury, prosthetics, burn injury, pain, and post-deployment mental health.
A major challenge in improving the delivery of compensation and pension benefits is the steady and sizeable increase in workload. The volume of claims is projected to reach 872,000 in 2009 --a 51 percent increase since 2000. VA will address its ever-growing workload challenges by acquiring greater access to DoD’s online medical information, by working to reduce the Department’s reliance upon paper-based claims folders and by aggressively hiring new staff. By the beginning of 2009, VA expects to complete a two-year effort to hire 3,100 new staff.
The President’s budget request includes $181 million in operations and maintenance for the National Cemetery Administration, a 71 percent increase from the resources available to the Department’s memorial program when the President took office. The budget request includes an additional $5 million to begin interment operations at six new national cemeteries --Bakersfield, Calif.; Birmingham, Ala.; Columbia-Greenville, S.C.; Jacksonville, Fla.; Sarasota, Fla.; and southeastern Pennsylvania.
The President’s 2009 budget would provide more than $2.4 billion for the Department’s information technology (IT) program. This is $389 million, or 19 percent above VA’s 2008 budget, and reflects the realignment of all IT operations and functions under the control of the chief information officer. The proposal contains $93 million to uphold VA’s cyber-security program to support the commitment to make the Department the gold standard in data security within the federal government. VA continues to take aggressive steps to ensure the safety of veterans’ personal information, including training and educating employees on the critical responsibility they have to protect personal and health information.
Highlights of the VA budget are available on the Internet at: http://www.va.gov/opa/pressrel/pressrelease.cfm?id=1448
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