02/24/2009 01:00 PM House MILITARY & VETERANS' AFFAIRS

HJR 10 - VETERANS' HEALTH CARE                                                                                                
                                                                                                                                
CHAIR GATTO  announced that the  next order of business  would be                                                               
HOUSE JOINT RESOLUTION NO. 10,  Urging the United States Congress                                                               
to improve health care for veterans.                                                                                            
                                                                                                                                
1:10:59 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KAWASAKI moved  to adopt  the proposed  committee                                                               
substitute  (CS)   for  HJR  10,  Version   26-LS0313\E,  Bailey,                                                               
2/24/09, as the work draft.   There being no objection, Version E                                                               
was before the committee.                                                                                                       
                                                                                                                                
1:11:20 PM                                                                                                                    
                                                                                                                                
CHRIS  REID, intern  to Representative  David Guttenberg,  Alaska                                                               
State Legislature, introduced HJR  10 on behalf of Representative                                                               
Guttenberg, prime sponsor.   Ms. Reid said HJR  10 encourages the                                                               
U.S.  Congress  to  improve  health  care  for  U.  S.  veterans.                                                               
Although  there are  many programs  available  for veterans,  the                                                               
existing  programs  need  improvement,  especially  for  veterans                                                               
living in rural areas of  Alaska.  Furthermore, HJR 10 encourages                                                               
the  U.S. Department  of Veterans  Affairs (VA)  to partner  with                                                               
community health  care services.   She  addressed the  changes in                                                               
Version E  of the  resolution and  explained the  fifth "Whereas"                                                               
now  includes a  reference to  "post-traumatic stress  syndrome."                                                               
In addition, after  research indicated that having  a VA hospital                                                               
in Alaska  would require all  veterans to travel there  for care,                                                               
even though  it may  be better  for veterans  to remain  in their                                                               
communities  with family,  the  reference to  a  VA hospital  was                                                               
deleted  from the  sixth "Whereas."   Ms.  Reid then  pointed out                                                               
that the last nine "Whereas"  clauses have been incorporated into                                                               
HJR  10 with  the  recommendation of  Shelley Hughes,  Government                                                               
Affairs Director, Alaska Primary Care Association (APCA).                                                                       
                                                                                                                                
1:15:04 PM                                                                                                                    
                                                                                                                                
SHELLEY HUGHES, Government Affairs  Director, Alaska Primary Care                                                               
Association,  informed  the  committee  that  her  husband  is  a                                                               
Vietnam veteran  and her  son served  three tours  in Iraq.   She                                                               
then  relayed  that  clinics  across the  state  are  caring  for                                                               
veterans  in outlying  areas  who  do not  have  access to  their                                                               
earned  health care.    The criteria  for  approval of  veteran's                                                               
travel  prevent veterans  from obtaining  health care  in veteran                                                               
facilities;  therefore,  community  clinics  are  providing  care                                                               
without  reimbursement.   The  APCA  is  trying to  resolve  this                                                               
problem,  but progress  is slow  and mired  in federal  red tape.                                                               
She explained  that the APCA is  of the opinion that  there needs                                                               
to  be  collaboration  at  the  federal  level  between  the  VA,                                                               
community  health  centers,  and  Tribal  health  clinics.    For                                                               
example,  one of  the  barriers  has been  the  VA's  use of  the                                                               
Computerized  Patient Records  System  (CPRS).   Ms. Hughes  also                                                               
emphasized  the  need  for  health  care  for  current  returning                                                               
veterans  and for  aging veterans  with increasing  health needs.                                                               
She reiterated her agency's support of the resolution.                                                                          
                                                                                                                                
1:17:51 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  BUCH, noting  that  a new  VA  facility is  under                                                               
construction  at  Elmendorf  Air   Force  Base,  asked  how  that                                                               
facility would be  defined, and also asked for  its functions and                                                               
capabilities.                                                                                                                   
                                                                                                                                
1:18:26 PM                                                                                                                    
                                                                                                                                
MCHUGH  PIERRE, Legislative  Liaison,  Department  of Military  &                                                               
Veterans'  Affairs,   explained  that  the  new   facility  is  a                                                               
veteran's hospital/clinic, but is  not a full-scale hospital like                                                               
those  in the  Lower 48.    The facility  will be  joined by  the                                                               
existing new base  hospital that serves Elmendorf  Air Force Base                                                               
and  Fort  Richardson  Army  Base   service  members.    The  two                                                               
facilities will be  connected via a sky bridge in  order to share                                                               
care.   Mr. Pierre pointed out  the new facility is  the first of                                                               
its kind in Alaska.                                                                                                             
                                                                                                                                
REPRESENTATIVE  BUCH   offered  his   understanding  the   VA  is                                                               
recognized  as  a  leader  in  medical  recordkeeping;  in  fact,                                                               
because  of  the  transient  nature   of  its  patients,  it  has                                                               
established and  maintained a quality  recordkeeping system.   He                                                               
noted his  personal experience with  the VA and  acknowledged the                                                               
success of that  component.  He disclosed a  possible conflict of                                                               
interest in  that he has  been a beneficiary of  services through                                                               
the  VA.   Representative  Buch  opined  the  issue is  not  only                                                               
finding veterans,  but informing them of  the connections already                                                               
available in the state.                                                                                                         
                                                                                                                                
1:22:35 PM                                                                                                                    
                                                                                                                                
CHAIR GATTO, after ascertaining that no one else wished to                                                                      
testify, closed public testimony on HJR 10.                                                                                     
                                                                                                                                
1:22:46 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KAWASAKI made a motion to adopt Amendment 1,                                                                     
which read [original punctuation provided]:                                                                                     
                                                                                                                                
         Page 2, lines 5 and 6, following "services for                                                                         
     Alaska's veterans,"                                                                                                        
                                                                                                                                
     Delete: "but Alaska remains [one] of three states that                                                                     
     does not have a veteran's hospital that provides acute                                                                     
     care inpatient services"                                                                                                   
                                                                                                                                
                                                                                                                                
        Page 2, line 23, following "Alaska Native health                                                                        
     system"                                                                                                                    
                                                                                                                                
     Delete: ", which is"                                                                                                       
     Insert: "and Community Health Centers, which are"                                                                          
                                                                                                                                
                                                                                                                                
     Page 2, line 25, following "Alaska Native health"                                                                          
                                                                                                                                
     Delete: "system's"                                                                                                         
     Insert: "system and Community Health Centers'"                                                                             
                                                                                                                                
                                                                                                                                
     Page 3, line 25, following "the existing"                                                                                  
                                                                                                                                
     Delete: "community"                                                                                                        
     Insert: "Community Health Center"                                                                                          
                                                                                                                                
                                                                                                                                
     Page 3, lines 28 and 29, following "with individual"                                                                       
                                                                                                                                
     Delete:  "community or tribal health centers"                                                                              
     Insert: "Community Health Centers or tribal clinics"                                                                       
                                                                                                                                
                                                                                                                                
     Page 3, line 30, following "Whereas"                                                                                       
                                                                                                                                
     Delete: "community"                                                                                                        
     Insert: "Community Health Centers"                                                                                         
                                                                                                                                
                                                                                                                                
     Page 4, lines 1 and 2, following "and populations"                                                                         
                                                                                                                                
     Delete:    "and   to    uninsured   and    underinsured                                                                    
     individuals,  low-income  families, veterans,  seniors,                                                                    
     seasonal    workers,     and    non-English    speaking                                                                    
     individuals"                                                                                                               
                                                                                                                                
     Insert: "including  veterans who  do not reside  in the                                                                    
     vicinity of a VA health care facil[i]ty"                                                                                   
                                                                                                                                
                                                                                                                                
     Page  4,  line  18,  following  "quality  health  care,                                                                    
     including"                                                                                                                 
                                                                                                                                
     Insert: "at Community Health Centers,"                                                                                     
                                                                                                                                
                                                                                                                                
     Page 4,  line 18, following "substance  abuse treatment                                                                    
     centers,"                                                                                                                  
                                                                                                                                
     Delete: "and"                                                                                                              
                                                                                                                                
                                                                                                                                
     Page   4,    line   19,   following    "tribal   health                                                                    
     organizations"                                                                                                             
                                                                                                                                
     Insert: ["] and other appropriate local providers"                                                                         
                                                                                                                                
REPRESENTATIVE HARRIS objected.                                                                                                 
                                                                                                                                
REPRESENTATIVE KAWASAKI, after reading Amendment 1, explained                                                                   
that Amendment 1 is a technical clean up in nature.                                                                             
                                                                                                                                
1:25:39 PM                                                                                                                    
                                                                                                                                
MS. REID said [Amendment 1] is important and works with the                                                                     
original resolution.                                                                                                            
                                                                                                                                
1:26:20 PM                                                                                                                    
                                                                                                                                
MS. HUGHES added that the APCA supports Amendment 1.                                                                            
                                                                                                                                
CHAIR GATTO, after  stating that the objection  had been removed,                                                               
announced that Amendment 1 was adopted.                                                                                         
                                                                                                                                
1:26:51 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  HARRIS moved  to  report  the proposed  committee                                                               
substitute  (CS)   for  HJR  10,  Version   26-LS0313\E,  Bailey,                                                               
2/24/09,   as  amended,   out   of   committee  with   individual                                                               
recommendations and  the accompanying fiscal notes.   There being                                                               
no objection, CSHJR  10(MLV) was reported from  the House Special                                                               
Committee on Military and Veterans' Affairs.