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Bill to fix care of wounded passes committee

A bill aimed at making immediate improvements in the treatment — medical and otherwise — of wounded combat veterans passed the House Armed Services Committee by a 59-0 vote Tuesday, with some concerns that lawmakers may be moving too fast.

The bill, called the Wounded Warrior Assistance Act of 2007, is a blueprint for fixing many of the problems that have surfaced for outpatients at the Walter Reed Army Medical Center, but it also does more.

Michael Higgins, an armed services committee staff member, described the bipartisan bill as representing solutions — some of them only temporary — to problems uncovered over several years of studying the care for wounded service members. Cutting red tape, or at least getting help for wounded service members and their families in reducing the snarl, is a key part of the package.

It requires, for example, that medical care case managers for outpatients handle no more than 17 cases and review each case at least once a week to better understand patient needs and make certain they are getting the proper care. The bill requires service member advocates be assigned to fight, if necessary, for outpatients to get the right treatment, with a ratio that limits each advocate to no more than 30 cases. It also establishes an independent medical advocate to serve as a counselor and advisor for service members being considered by medical evaluation boards.

The bill tries to take some substantive steps in reducing the turmoil of being transferred from military to veterans’ medical care for service members who are discharged. While the committee initially wanted to try a pilot project for smoother transitions, Rep. Steve Buyer of Indiana, ranking Republican on the House Veterans’ Affairs Committee, convinced the committee that there had been enough trials and studies done previously.

At Buyer’s urging, and with the support of armed services committee leaders, the bill creates a formal transition process for service members who are being retired or separated for health reasons. The transition is to include an official handoff between the two systems with the electronic transfer of all medical and personnel records before the member leaves active-duty.

Buyer said he has been fighting for 15 years to make the system work so a service member never suffers when transferring between the Defense Department and VA health care systems, but changing two has proven hard.

“Fighting these guardians of bureaucracy s is challenging,” he said.

The bill also orders the VA and DoD to agree on a uniform standard for separation and evaluation physicals rather than requiring a service member to get two or more physicals, which can result in different results and unfair disability and physical evaluations.

Buyer is among those complaining that the bill is moving too fast. In particular, he is unhappy that Rep. Bob Filner, D-Calif., the House Veterans’ Affairs Committee chairman, did not insist that the Wounded Warrior bill be referred to the veterans’ committee, which has jurisdiction over some of the issues. Filner waived jurisdiction, allowing the bill to go directly from the armed services committee to the House floor.

“It is unconscionable Chairman Filner would turn off the lights” on the veterans committee by not letting it work on the bill, Buyer said.

Filner, though, said he was only trying to get the bill enacted as soon as possible.

“If Mr. Buyer would stop worrying about committee turf and start worrying more about veterans, this wouldn’t be an issue,” Filner said. “The question for America is whether we are going to respond to the problems we have learned about in military and veterans care. My job is trying to get this bill to become law as fast as possible,” he said.

Rep. Ike Skelton, D-Mo., the armed services committee chairman, said the bill is being moved quickly at the urging of House Democratic leaders, who want military members, veterans and their families to see that Congress is trying to react to problems at Walter Reed and elsewhere. There will be time for other legislation, after two separate commissions looking at disability benefits and treatment of wounded combat veterans make recommendations later this year, he said.

“This bipartisan legislation is our first step to address the problems brought to light at Walter Reed,” Skelton said. “We will have the opportunity to examine more comprehensive reforms to ensure that our forces receive the high-quality care our nation has an obligation to provide.”

“We cannot do nearly enough,” said Rep. John McHugh, R-N.Y., one of the chief sponsors of the package.

The biggest bit of controversy over the bill came on an amendment offered by Rep. Jeff Miller, R-Fla., that would have prohibited wounded service members from being hospitalized at any base within 50 miles of foreign nationals detained since March 20 at the Guantanamo Bay, Cuba, naval base. Miller said he had two goals in mind: First, he thought it was wrong to be treating wounded combat veterans at the same base as a person who may have been responsible for their injuries. Second, he was trying to prevent the detention center at Guantanamo Bay from being closed, something some Democrats have talked about.

The Miller amendment failed, 33-27, on vote along party lines. Skelton called it legislation being offered at the “wrong place and wrong time” and Rep. Robert Andrews, D-N.J., warning that it could end up jeopardizing military medical treatment by potentially limiting places where injured service members could receive care.