PVA From The Top – Annual Congressional Testimony

PVA’s national president shares his congressional testimony

By Charles Brown

I’m afforded many honors as national president of Paralyzed Veterans of America (PVA), but one of my biggest takes place during PVA’s annual Advocacy/Legislation Seminar each March in Washington, D.C.

The seminar is an opportunity to instill in Congress the importance of veterans’ healthcare, benefits, civil rights and caregiver support. It’s also when I have the amazing privilege to speak before a joint session of the House and Senate Veterans’ Affairs committees.

I had the incredible honor of highlighting PVA’s mission and legislative priorities before the committees on March 1. It’s the tradition of PN to publish the PVA national president’s oral testimony from this hearing.

The following is mine:

“Chairman [Jon] Tester, chairman [Mike] Bost and members of the committees, thank you for the opportunity to speak with you today on behalf of the tens of thousands of veterans with spinal-cord injuries and disorders [SCI/D] who heavily rely on the benefits and health care available through the Department of Veterans Affairs [VA].

“My written statement addresses the full list of PVA’s 2023 priorities. In the interest of time, I would like to focus on two critically important issues that Congress must address: protecting access to VA’s specialized health care systems and expanding access to the VA long-term services and supports.

“VA is the best health care provider for veterans with catastrophic disabilities. The department’s spinal-cord injury and disorder, or SCI/D, system of care provides a coordinated

lifelong continuum of services for paralyzed veterans. Th re is no comparable private system of care. However, if VA continues to woefully underfund the system and understaff facilities, the department’s capacity to treat veterans will be diminished and could lead to the closure of facilities and service reductions.

“We are particularly concerned about VA’s current health workforce crisis. When I appeared before you last year, the SCI/D system was short 600 nurses; today, that number is relatively unchanged. Staffing shortfalls have a direct impact on the SCI/D system.

Due to an insufficient number of nurses, care at one of VA’s SCI/D units was suspended in 2022, and veterans with acute SCI/D needs were admitted to non-SCI/D units. Other facilities capped admissions due to insufficient numbers of SCI/D nurses and are still working to fill vacancies to meet the minimum requirements.

“We urge Congress to conduct oversight to ensure VA is fully utilizing the authorities granted last year to hire additional medical professionals, particularly doctors and nurses, to meet the demand for services in the SCI/D system of care. Congress should also provide VA with more tools to compete for highly qualified medical professionals and support training for current and future VA clinicians, including passing the bipartisan VA CAREERS Act.

“The SCI/D system of care has also been affected by the design and construction delays inherent in the VA infrastructure project funding and delivery system. In reviewing VA’s infrastructure, VA should place greater emphasis on funding facilities that support the types of services, like SCI/D care, which the department uniquely provides. Greater investment in both SCI/D acute and long-term care would strengthen VA’s specialty care services and ensure their future availability.

“The next issue I will address is improved access to long-term services and supports. In order to be here today, I had help from a paid caregiver. He helped me get dressed, out of bed and into my wheelchair, take my medicine and groom. My story is not unique. It’s the story of Robert, Tammy and Josue, who are behind me. Without that care, we are stuck at home in bed.

It’s also the story of one PVA member in Minnesota. Because of the shortage of direct care workers, he is fortunate when he has someone to come get him out of bed and help him through the day. He regularly spends weekends in bed because no staff is available to assist him, and he is depressed and frustrated because he can’t find the direct care he desperately needs.

“Another PVA member in Ohio is waiting for the Veteran Directed Care [VDC] program to be available at his facility. Even if the program is available, veterans may not be aware of it or given the opportunity to enroll. Although VDC is available at my VA medical center, I was not made aware of it until last year. After several attempts to access the program, I was told I had not been considered for it. Veterans should be given the opportunity and the choice to access this program if and when it is available.

“Another major issue is the cap on home care spending. VA is currently prohibited from spending on home care more than 65% of what it would cost if the veteran was provided nursing home care.

When VA reaches this cap, the department can either place the veteran into a facility at a much greater cost or rely on the veteran’s caretakers, often family members, to bear the extra burden. Some service disabled veterans are even forced to turn to their state’s Medicaid program to receive the care they need.

“One veteran with a form of multiple sclerosis who is ventilator-dependent and has other medical needs is on the verge of ending up in a facility.

His family needs VA to provide eight hours of care per day on the weekdays, but VA is only able to approve 16 hours per week due to the cost. Congress must allow VA to cover the full cost of home-based care services for these veterans and others like them without exhausting their caregivers and leaving them struggling to cobble together the services and supports they need to stay home with their families.

We urge Congress to pass the Elizabeth Dole Home and Community Based Services for Veterans and Caregivers Act as introduced, to improve VA home care for these veterans.

“Thank you again for this opportunity to share our views and your commitment to paralyzed veterans and their caregivers. I would be happy to answer any questions you may have.”

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