HJR 33-SUPPORTING IN-STATE MED. CARE FOR VETS 1:38:52 PM CHAIR LYNN announced that the final order of business would be HOUSE JOINT RESOLUTION NO. 33, urging the Alaska Department of Health and Social Services to seek authority and funding from the United States Department of Veterans Affairs to establish a system allowing Alaska veterans treatment in both public and private Alaska facilities. 1:39:19 PM REPRESENTATIVE PETE KOTT, Alaska State Legislature, speaking as the sponsor, explained that HJR 33 encourages the [U.S.] Department of Veterans Affairs to consider allowing Alaska veterans who currently receive [health care] services in the Lower 48, primarily in Portland or Seattle veterans' hospitals, to receive health care services in Alaska. He noted that in 2004, [the State of Alaska] spent approximately $2 million in transporting Alaska veterans to Portland or Seattle veterans' hospitals. In addition, HJR 33 is requesting the consideration of a credit-like card, which would allow veterans to receive health care services from their provider in Alaska. The provider would be reimbursed by the Alaska Department of Health and Social Services, which would be reimbursed by the U.S. Department of Veterans Affairs. He mentioned that Alaska doesn't have the population to justify building a veterans' hospital. 1:41:59 PM REPRESENTATIVE KOTT, in response to Chair Lynn, confirmed that the concept of a credit-like card, which would allow veterans to receive health care services from their provider in Alaska, is a novel one. He opined that it would be more efficient, and added that it would alleviate the burden of paperwork placed on veterans. 1:46:17 PM RIC DAVIDGE, President, Vietnam Veterans of America, Chapter 904; Chairman, Alaska Veterans Foundation, provided the following testimony: As most of you know, over the last three years, all of the nine National Veterans Organizations of America have been working together, which is a unique thing, to address the failure of Congress and our various administrations to meet the legally required, and certainly morally obligated needs, of our current and future veterans (indisc.) in their health care area. But we've seen little progress. The problems actually, in our study, appear to be structural and it's time for some new ideas. I think, as a nation, we recognize that we ensure the health care of the poor, the old, and even our illegal immigrants, but not for the men and women who stand guard for America. Alaska is now, and will likely continue to be, at its highest military deployment since World War II. It means more and more Alaskans are serving in harm's way overseas. Alaskans are being killed and wounded, and their families are hurting. Not just because their husbands, wives, or family members are in harm's way, but also because they're financially distressed. If you have a copy of our talking paper, one of the interesting things that Alaskans don't understand is if you're in the active reserve or National Guard and you're activated and you have a full-time job, you have just lost the health care from that full-time job, although you may be guaranteed to return to that job. Your family has lost the full-time health care that's provided by that job. Now they certainly receive a certain amount of health care while you're in service, but when you come back from overseas service, and probably/possibly with some injury, those injuries are excluded from new health care programs that you may apply for, and Alaskans are being hurt because of that. One of the problems I'm going to speak off the paper for a minute, and I hope that the staff has provided you with our talking paper, and this is an active talking paper that goes through the structural programs and what this program would try to do. I think we have an opportunity in Alaska because of our nature, because we're so rural, because we have veterans spread literally thousands of miles around, to look at some new ideas. The VA does encourage what they call demonstration programs. We think Alaska would be an excellent demonstration project and in recent conversations from (indisc.) with our president in Washington, D.C. of the Vietnam Veterans of America, he's very encouraged with this idea. I just provided you today a copy of his recent testimony before Congress, playing out that this $4.7 billion short in the VA health care program. What we're trying to do here is stop setting up new hospitals/new clinics, shipping veterans out of Alaska at the cost of millions of dollars, and at the economic loss to the medical community in Alaska in the tens of millions. Because the services are here, but the bureaucracy has a certain mind set. We think we could go back to what would be characterized as the old system. We actually have VA people working at Providence Hospital in the intake/services area. These are VA employees, VA doctors, VA nurses, public health people as well, who are providing services to veterans. The veteran would go to the hospital, show their veteran card, which showed that they had a certain connected disability or they were retired or whatever, and then take advantage of the services of that private health care claim or hospital. 1:50:14 PM MR. DAVIDGE continued his testimony: What this does is ensure a more efficient use of the existing privately provided medical care facilities in the state. Why we send, as the sponsor said, we spent $2 million last year sending veterans out of the state for medical services, all of which are provided in the state. I've talked to the directors of Providence [Hospital], I've talked to the directors of Alaska Regional, and no one can find medical service need that is not provided in Alaska that these guys are being sent off to be treated for, other than residential [Post Traumatic Stress Disorder (PTSD)] programs. We think that we should really sit down, and the resolution directs basically the State of Alaska to sit down and think creatively about a partnership, if you will, with the veterans' administration in providing Alaska veterans this health care. We believe, in the work that we've done, and I think if you look at the material that we provided you, it would show that rather dramatically, we can not only save the veterans' administration a huge amount of money, but we can better take advantage and support the private medical facilities in our state. Why create a new hospital, a veterans' hospital, we don't have one up here. We sort of have one over at the Air Force base, but not really. When the veteran or their family can go to their doctor of choice, their hospital of choice, show their card, if they have a service-connected disability, a percentage of that disability would be taken off the bill, etc. It's a very easily put-together concept. One of the things that we discovered is that $9-$10 million a year is returned to the Alaska VA to a third party village. In other words, you go to the VA, you get treatment, and they say do you have any other medical insurance? Well I have Blue Cross, okay fine. The VA then bills Blue Cross for a percentage of your medical services. That money, we think, as is the case in Native health care program, should be returned to the state, not the VA. That would be seed money to begin a program within the Alaska Department of Health and Social Services to begin to provide Alaska veterans the medical services that they need in the state. We don't have all the answers, but the effort over the last three years by the nine National Veterans Organizations who finally have come together over this issue have also not found the answers. We need a program that ensures that those men and women from Alaska who stand guard for America get the medical services they need when they come. We think that this is a good, positive first step. We would hope that the state would put together a working task force, bring together the people involved in this, and sit down and look at a way to do this. My discussions with the doctors, leading doctors in Anchorage and both of the hospitals, clearly indicate that they would be very supportive of this. We would literally be returning tens of millions of dollars in medical services that are currently being provided in Oregon or Seattle, or even some cases back East for Alaska veterans. That money would be spent in Alaska, so it would have a huge economic benefit as well as a benefit to Alaska veterans. 1:53:39 PM MR. DAVIDGE continued his testimony: Being a disabled veteran who has to go outside of the state because the VA decides that I have to do that for medical services, at times when those services put significant multiple stress on wife, my children, and separates me from them. If we want to encourage care and healing, having families together at these critical times is very, very important. I have members within my organization, Vietnam Veterans of America, they have to go out monthly for radiation treatment. All of that service is provided here in the state of Alaska. But they have to absorb, on themselves, the cost of taking their wives, or their husbands in one case, with them so that they have that kind of emotional support. We think this is a good, very positive first step and we look forward to immediate action by your committee and this legislature to move this forward. CHAIR LYNN opined that HJR 33 is a "pretty good bill" and added that it would be a good idea to assemble a group to work on this issue. 1:54:52 PM REPRESENTATIVE CISSNA referred to page 2, lines 16-17, which says: "establish a system allowing Alaska veterans to be treated in public or private facilities in the state whenever possible", and asked Representative Kott: Was it your intention that we were really talking as close to home means that it would be essentially across the state people in say Hoonah, if there was in fact the facility that could give the service needed, could give that service in Hoonah, rather than the regional center? REPRESENTATIVE KOTT confirmed that Representative Cissna is correct. REPRESENTATIVE CISSNA said, "I'm very, very much in favor of this and I do appreciate that understanding that we're really talking about services truly, truly in Alaska, as close to home as possible." 1:57:16 PM REPRESENTATIVE DAHLSTROM moved to report HJR 33 out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, HJR 33 was reported out of the House Special Committee on Military and Veterans' Affairs.