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Wednesday, July 25, 2007

Reaction to Dole-Shalala Commission Recommendations

As the Senate approved -- by unanimous consent -- its Wounded Warrior package (see details below the fold), the long-awaited draft recommendations stemming from the presidential commission set up in the wake of the Walter Reed scandal were made available online [MS Word].

Commission press release [MS Word]:

Calling its recommendations a “bold blueprint for action” to serve, support and simplify the care for our injured service members, the President’s Commission on Care for America’s Returning Wounded Warriors today approved six recommendations that make sweeping changes in the delivery of health care and services.

The recommendations include the first major overhaul of the disability system in more than 50 years; creation of recovery plans with recovery coordinators; a new e-Benefits website [PowerPoint]; and guaranteeing care for PTSD from the VA for injured service members from Iraq and Afghanistan.

The nine-member Commission called upon the White House and Congress to implement its recommendations as quickly as possible to ensure that those who have served in Iraq and Afghanistan are able to successfully transition back to civilian life or active duty service.

Click on 'Article Link' below tags for more...

A few details from Air Force Times:

If adopted, the commission’s recommendations would radically overhaul the current system, described by the commission as a “patchwork of programs, rules and regulations” that has become “tremendously complex” and often leads to “real or perceived inequities.” Of 35 total recommendations — only two of which were directed specifically at Walter Reed — just six would require legislation. The other 29 can be acted upon by the Pentagon or Veterans Affairs Department.

Under one recommendation, injured service members found unfit for continued military service would receive annuity payments from the Defense Department based solely on rank and length of service, as well as a “quality-of-life disability payment” from VA. Currently, only troops who have served more than 20 years and received a 50 percent or greater disability rating from VA can receive payments from both departments. ...

The commission also recommended making veterans eligible for transition payments after leaving the service. Those returning directly to their communities would receive short-term payments equaling three months of basic pay, as well as Tricare coverage for themselves and their families. Those taking part in VA education and training programs would receive longer-term payments. They also would be eligible for payments for earnings loss, to make up for reduced earning capacity, and quality-of-life payments to compensate for permanent physical or mental losses.

The rating system itself would be streamlined with a single, comprehensive, standardized medical exam administered by the Defense Department. Based on the results of that exam, defense officials would determine fitness for duty and VA would determine the initial disability level. The proposal resembles a Pentagon initiative announced last week.

The commission wants the Pentagon and VA to create integrated care teams of doctors, nurses, other health professionals, social workers, and vocational rehabilitation workers who would implement the recovery plan, all under the purview of a recovery coordinator — a single point of contact for patient and family.

A few stats:

According to figures provided by the commission, 3,082 of the 28,000 troops wounded in action are considered seriously wounded — that is, they have been awarded Traumatic Servicemembers’ Group Life Insurance, a one-time payment that varies with the severity of the injury. Of these, 2,726 have suffered a traumatic brain injury; 644 are amputees; 598 have serious burns; 391 are “polytrauma” victims; 94 suffered spinal cord injuries and 48 have been blinded.

[UPDATE July 27, 2007]: Dole and Shalala appeared on the PBS NewsHour to speak of their recommendations:

Part 1


Part 2


Immediate reaction by President Bush, according to the the Washington Post, whose reporters managed to break the long-simmering story into the national spotlight back in February:

"Making the significant improvements we recommend requires a sense of urgency and strong leadership," [the recommendations] said. Bush said his hand-picked investigative panel had interesting suggestions on improving health care for those wounded in battle. But the White House said not to expect action right away.

Short clip of the president's statement:



Other reactions included in the piece:

"It has been hurry up and wait for the results of this commission report and now the White House is telling our vets to wait even longer," said Sen. Patty Murray, D-Wash. "That's why the Senate has moved ahead with our Wounded Warriors Act. The public is waiting, our veterans are waiting."

Paul Rieckhoff, executive director of Iraq & Afghanistan Veterans of America, agreed. "It is important for the American public to understand that the Walter Reed fiasco is not over," he said. "Everything is not fixed. The follow-through will be the most important part."

Veterans Administration Secretary Jim Nicholson:

Secretary of Veterans Affairs Jim Nicholson today thanked the members of a special presidential commission for their work examining the federal government's response to the health care needs of returning combat veterans. "We at VA are caring for the whole veteran," Nicholson said. "I look forward to reviewing the commission's final report as we work to improve our efforts to return our wounded warriors to full function, while helping all veterans receive the jobs and educational benefits they deserve."

ABC World News report:



Meanwhile, the Wounded Warrior legislation passed today:

The following is a summary of the issues confronted by the Wounded
Warriors bill passed by the Senate today:

-- The substandard facilities at Walter Reed and other military
hospitals;

-- The lack of seamless transition when medical care for troops is
transferred from the Department of Defense to the Veterans
Administration, which often leads to diminished care;

-- The inadequacy of severance pay to help those who have sacrificed
so much already support their families while they recover;

-- The need to improve sharing of medical records between the
Department of Defense and the Department of Veterans Affairs;

-- The inadequate care and treatment for traumatic brain injury
(TBI) and post-traumatic stress disorder (PTSD) by authorizing $50
million for improved diagnosis, treatment and rehabilitation; and

-- The challenges facing wounded troops whose health insurance
programs, like the Tricare program for retired veterans, have
allowed gaps in coverage and medical treatment.



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