Action in Congress

May 1, 2007

Wounded Warrior Assistance

The House unanimously approved a legislative package designed to improve support services for all wounded troops and their families in the wake of the scandal at Walter Reed Army Medical Center, Washington, D.C.

The Wounded Warrior Assistance Act passed in late March by a vote of 426-zero. The Senate must pass a companion measure.

At Walter Reed, many wounded troops lived in poorly maintained quarters and faced numerous bureaucratic hassles in attaining needed care. Housing conditions came under special scrutiny after the Washington Post reported poor conditions in about half of the 54 rooms in Building 18 at the complex.

The legislation would give war wounded and their families a stronger team of advisors and advocates to guide them through treatment, recovery, and disability evaluation.

Highlights of the Bill

Rep. Vic Snyder (D-Ark.), chairman of the House Armed Services military personnel subcommittee, and Rep. John McHugh (R-N.Y.), the panel’s ranking Republican, called the package a good “first step” toward ensuring that wounded service members get the support and care they need.

Specific provisions included:

  • Assignment of a case manager for all outpatients to oversee medical and dental care. No case manager would be responsible for more than 17 patients at a time.
  • Creation of service member advocates to assist outpatients and their families with any welfare or quality of life challenges, regardless of whether family members have moved near to the hospital or still reside at home. Advocates would have no more than 30 cases at a time.
  • Twice-yearly surveys of wounded troops on quality and timeliness of care, adequacy of living conditions and case management, and fairness and timeliness of the disability evaluation process.
  • A hotline for outpatients and families to report on deficiencies in medical support facilities including housing. Staff would have 96 hours to substantiate and rectify problems, to include relocating outpatients with complaints about adequacy of quarters.
  • Military medical facilities will notify members of Congress when a service member has been evacuated from a theater of operations for care, if the injured member consents. Presumably this would allow lawmakers to keep track of injured constituents.
  • Assignment of an independent medical advocate for service members going before medical evaluation boards.
  • A maximum caseload of 20-to-one, and standardized training, for physical evaluation board liaison officers. These officers help members through the disability evaluation system.

More Walter Reed Fallout

Former Sen. Bob Dole and former Health and Human Services Secretary Donna E. Shalala were named to co-chair a comprehensive review of military medical care at the Department of Defense and Department of Veterans Affairs.

The review was commissioned by President Bush on March 6 to recommend ways to improve the care, rehabilitation, transition to civilian life, and access to benefits and services for war veterans and disabled retirees.

Secretary of Defense Robert M. Gates directed the Army to provide an action plan to fix the outpatient situation at Walter Reed. Gates said part of the problem clearly was caused by caseworkers who were “overwhelmed” by the numbers of outpatients they had to monitor.

Gates also tasked David S.C. Chu, undersecretary of defense for personnel and readiness, to conduct a comprehensive review of all military medical care programs, facilities, and procedures.

Pentagon officials have maintained that the quality of patient care at Walter Reed was not at issue. Problems instead centered on bureaucracy, delays in determining disability ratings and, for some soldiers, dilapidated housing.

War Mail

Rep. Vito Fossella (R-N.Y.) has reintroduced legislation that would give military families free mail privileges when sending letters or packages to service members serving in Iraq and Afghanistan or to loved ones hospitalized as a result of war-related injury or illness.

Fossella said some military families are spending hundreds of dollars out-of-pocket to sustain a flow of “care packages” to loved ones assigned to war zones. These troops are often forward deployed to dangerous areas for a year or more. That is putting additional strain on family budgets.

In a news release, he said it is “common for a typical family to spend at least $1,500 annually on postage for care packages, which often consist of necessities like shampoo, powder, blankets and linens, phone cards, and toothpaste.”

Fossella said that to “help make life better for our soldiers and to ease the financial burden on those back home, this bill will cover the cost of mailing a monthly package to our servicemen and -women in Iraq and Afghanistan.”

He had introduced an identical bill in the 109th Congress and it cleared the House but was dropped during final negotiations with the Senate.

Supplemental Fight

As President Bush and Congress this April headed toward their clash over troops in Iraq, billions of dollars in military and veterans health care were on the line.

The new defense supplemental bill, HR 1591, set a 2008 deadline to get US combat troops out of Iraq, which set it up for a Bush veto. That would also take down money to close a funding shortfall for military and veterans health care.

The legislation included:

  • $2.8 billion for defense health care, or $1.7 billion more than requested by the Bush Administration.
  • $730 million that would help finance Tricare and obviate the need for fee increases.
  • $450 million for post-traumatic stress disorder treatment and counseling.
  • $450 million for traumatic brain injury care and research.
  • Some $20 million to address problems experienced by outpatients at Walter Reed hospital.
  • About $14.8 million for expanded burn care.

Another $1.7 billion is earmarked for VA health care, including $550 million for a maintenance backlog at VA facilities and almost $500 million more to improve VA health administration treatment for a rising number of patients. And $100 million would be provided to allow veterans to use private mental health care providers. Finally, $62 million is to speed claim processing of returning veterans.