I am writing to express my support for revising Section 101 of the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act. It is critical for this bill to move forward so that veterans can benefit from the comprehensive improvements included in the legislation. Additionally, the advancement of this bill will enable the House Committee on Veterans Affairs to address other pressing issues affecting our nation's veterans.

To this end, I propose the following language for Section 101, which I believe balances the need for oversight with the essential finality of decision-making between veterans and their referring clinicians:

101. Finality of decisions by veteran and referring clinician under the Veterans Community Care Program.

(a) In general. During the period specified in subsection (c), and subject to subsection (b), an agreement under section 1703(d)(1)(E) of title 38, United States Code, between a covered veteran and the referring clinician of such veteran about the best medical interest of the veteran shall be regarded as a strong recommendation for care options. This agreement will not be subject to review, approval, or alteration by the Department of Veterans Affairs unless a statutory or regulatory barrier prevents the Department from providing the required care or services. However, the Department may establish a process for monitoring the implementation of these agreements to ensure adherence to quality standards and best practices.

(b) Correction of errors. A covered veteran and the referring clinician of such veteran may address and correct any errors related to an agreement described in subsection (a), ensuring that any misunderstandings can be rectified without undue delay. The Department of Veterans Affairs shall also have the authority to provide guidance on correcting such errors to facilitate a smooth resolution process.

(c) Period specified. The period specified in this subsection is the two-year period beginning on the date that is 180 days after the date of the enactment of this Act.

(d) Annual report. Not later than one year and not later than two years after the commencement of the period specified under subsection (c), the Secretary of Veterans Affairs shall submit to Congress a comprehensive report on the care provided under section 1703(d)(1)(E) of title 38, United States Code, during the one-year period preceding the date of the report, which shall include:

1. The total number of instances of care provided;

2. The types of care provided;

3. A detailed breakdown of the costs associated with such care;

4. An assessment of the quality of care provided, based on feedback from covered veterans and referring clinicians.

(e) Covered veteran defined. In this section, the term “covered veteran” has the meaning given that term in section 1703(b) of title 38, United States Code.

These proposed changes would establish a dedicated monitoring effort focused on evaluating the efficacy of decision-making in the Veterans Community Care Program. This will allow Congress to regroup and make any necessary adjustments to enhance the quality of care for veterans.

It is essential that both sides engage in constructive dialogue and find common ground on this issue. Failure to compromise would be viewed as an abandonment of our collective duty to care for those who have served our nation.

Thank you for your leadership on these critical issues. VVA is available to provide any assistance you may need as we work toward advancing this legislation.

Sincerely,

Jack McManus

President

Vietnam Veterans of America