DC Dispatch Spring 2012:Veteran Health Insurance, For-Profits

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Ben Krause with Director Ruth Fanning

“My old counselor refused to respond to phone calls, emails, certified letters, or messages to her boss,” said Steve Luck, a disabled veteran from Michigan. “I’ve requested a new [Vocational Rehabilitation] counselor. That was December. Three months later and I still haven’t been given any indication if my request will be honored.”

“I need a little help. My daughter, Honey Sue is enrolled in the VA Spina Bifida Program for children of Vietnam Vets born with Spina Bifida.” Ron’s letter went on to state that the VA has refused to provide the care required for his daughter and has ignored him for years.

Arthur was concerned about a for –profit college that used a laptop as an incentive to take classes. “$2700 for two online classes with Allied Business School.  Free $500 laptop.  I went over the deadline.  Now I only need to pay $150 per class to get back on it.  Come to find out there are weekend classes that offer the same thing for less than $200. “

Armed with concerns about Vocational Rehabilitation, healthcare benefits and predatory recruiting of veterans by for-profit colleges, I trekked to D.C. to get answers for all of you.

Joined by Patrick Bellon, Executive Director of Veterans for Common Sense (VCS), we held over 25 meetings during the week of March 13, 2012.

 

Washington D.C in March

I packed my bags, ready for a bitter cold walk between the House and Senate while knocking head and knocking on doors for veterans.

What greeted me: 80-degree weather, cherry blossoms, and probably the happiest Hill staffers during the month of March in years. I stepped off the plane and immediately realized my sweaters would be of no use.

The cab driver dropped my off at the Washington Court Hotel around 11pm, 8 blocks from the Capitol. Since the weather was fantastic, I dropped off my bags and walked up the Hill to enjoy the view.

I could hear myself think with just the crunch of dirt and grit beneath my feet. Six people walked around between the Capitol and the Supreme Court. The air smelled like clean, somewhat uncharacteristic for D.C. at any time of the year.

Countless battles have been fought over the years between our nation’s legislators far before I was even a twinkle in my parents’ eyes.

Yet, there I stood, ready to suit up for a few grueling days on the Hill fighting the same fight for disabled veterans that have been ongoing for a century or longer. It made me pause and wonder, “How can I change a seeming anti-veteran system?”

Educating legislators and staffers about your plight is the only main way to change anything. As I have recently learned, probably half of our country has little to know understanding of veterans much less disabled veterans.

One civilian recently asked me, “Why should veterans get disability benefits? I mean, they knew going into the military would be risky. They were paid. I just don’t get it.” The person asking me this question was very well educated; she was a doctor in fact.

Of course, this logic is skewed and basically anti-veteran. Doctors, federal employees, practically every employee, will receive some workers’ compensation or have disability insurance if the person is permanently injured. Police and fireman all have amazing benefits in case they are killed or injured. Plus, these people can quit whenever they want.

Civilians in car crashes who experience traumatic brain injuries (TBI) and PTSD receive upwards of $60 million for settlements. Civilians exposed to asbestos have received over $1 billion court awards.

The difference is that the Department of Defense (DOD) has chosen to essentially “self-insure” its military operations by paying out directly for the long-term injuries veterans receive.

Even if this wasn’t true, my doctor friend was comparing apples to oranges. Veterans did not have the option of quitting during a tour, especially those who were drafted. Many veterans were so greatly compensated that they qualified for food stamps while enlisted. You got sent into foreign lands with no control over your fate in many circumstances. And while there, if you were truly unlucky, the US Government would conduct DOD human experiments on you that have left many veterans damaged for life.

Despite these differences, we learned recently that psychologists, psychiatrists and other doctors in Madigan are trying to save taxpayers money by cutting back on correctly diagnosing PTSD and TBI.

The justification? We must be “good stewards of the public’s money.” God forbid one veteran get more disability compensation than a shrink thinks they should receive at the cost of wrongly denying hundreds if not thousands of veterans the care and compensation they deserve.

How much are we talking? A veteran would receive a fair shake and “cost” the taxpayer a maximum of $1.5 million over 40 years for a truly debilitating TBI incident from an IED explosion or worse. When compared to civilians receiving more than $60 million for an equivalent injury, it seems hardly justifiable to question why veterans should received disability compensation.

Given the three top issues and my hope to generally educate anyone who would listen, I set out to tell the story of why veterans deserve the benefits they are currently guaranteed. If the country doesn’t like it, they should feel free to insure the soldiers, just like most companies insure their workers. Insurance is just a cost of doing business, and disability compensation is just a cost of going to war.

Armed with your comments and concerns, I proceeded to do my best to stitch together a conversation between Democrats and Republicans to provide clarity on many veterans’ benefits.

This D.C. Dispatch has the results, in no particular order.

Problems for For-Profit Colleges

One boondoggle on Capitol Hill is the for-profit college dilemma, currently covered extensively by Huffington Post. There are currently at least 5 different bills recently drafted to heavily regulate these companies.

Knowing that this is a hot topic, we scheduled meetings with the Republican side of the Senate Health, Education, Labor, and Pension Committee (HELP). We also met with the offices of Senators Jim Webb and Al Franken, both of which have come out in opposition to the current position of for-profit colleges.

Here’s some background. Many for-profit colleges have been linked to predatory recruiting practices. Recently, Huffington Post has come up with a series of articles exposing problems within the industry.

One issue examined was the difference in compensation for executives. The president of Yale University receives $1.6 million in compensation per year. The CEO of the University of Phoenix received $25 million in yearly compensation. When comparing the job prospects for graduates of both institutions, the difference raises questions.

Graduation rates are another issue. These schools experience an 85 percent dropout rate and a much higher default rate than traditional brick and mortar schools. Skeptics believe this is the result of high pressure recruiting tactics used to pressure students into enrolling. Students who enroll under pressure may not have been ready to attend college and as such drop out after incurring a significant debt load.

In addition to these issues, many of the schools target veterans because GI Bill funding does not count toward their 90-10 rule cap. The 90-10 rule requires that no more than 90 percent of the school’s funding come from federal funds, except the GI Bill. The remaining 10 percent must come from other sources, including the GI Bill. This has caused for-profits to target veterans. According to Trent Lott, lobbyist for for-profits, Republicans may revolt from the party because of Republican support for these schools despite problems.

In attendance of HELP was Wendy Gnehm, Senior Legislative Assistant for Committee Chair Senator Enzi (WY-R), Chris Eyler, Committee Counsel, and Beth Buehlmann, Ph.D., Committee Education Policy Director.

The consensus from this meeting was to not throw the baby out with the bathwater. Despite there being some bad actors and some predatory recruiting, legislation currently proposed to protect veterans would handcuff the industry. With its passage, according to the Senate Minority HELP committee, veterans would not have as many educational options on which to use their GI Bill and Vocational Rehabilitation benefits.

Bellon and I disagreed with this logic claim. It asserts that somehow allowing veterans to be strategically targeted with high-pressure tactics increases the schooling options to veterans. But, would veterans have fewer options if they were not strategically targeted?

According to the Minority opinion, the answer was no, because they would still be as welcome as any other candidate. However, schools focusing solely on profit from the GI Bill would be forced to market more broadly instead of just marketing to veterans.

We believe that legislation should be changed to support a 90-10 rule wherein GI Bill funds would be lumped in with all Department of Education funding. This way, all potential students would be marketed to in the same way. We believe all students should be treated fairly irrespective of their background or funding sources.

Big Changes to Vocational Rehabilitation

Wednesday morning I set up a meeting with the Department of Veterans Affairs (VA). Director Ruth Fanning and Communications Director Steve Westerfeld were kind enough to talk with me.

Prior to going to DC, I asked my readers to tell me what they wanted me to ask the VA concerning Vocational Rehabilitation & Employment. There were many topics of concern but the top issues were about: how to change counselors, Independent Living applications, and health insurance.

Hands down, Chapter 31 Voc Rehab is one of the most robust retraining programs available through the government. The program provides customized retraining through education and technical training for disabled veterans throughout the U.S.

Unfortunately, veterans have long struggled in understanding the nuances of the Chapter 31 program.

Two areas of confusion were changing counselors and health insurance. First, veterans have been unable to learn how to effectively request changing their counselor. This issue is central to any rehabilitation counseling relationship, where the client must be comfortable with the service provider. If the counseling relationship is strained, the outcome will not be as favorable.

Director Fanning told me that a veteran can request to change counselors.

According to Fanning, the process is simple. Merely contact the next level supervisor with the request. Accompany the request with a well-supported argument. If the request is well supported, such as issues relating to an adversarial relationship or communication problems, the supervisor should approve the change.

For regional offices with limited counselors available, the VA may contract outside of the regional office with a contractor in order to resolve conflicts.

The next issue involved health insurance. For years, colleges have required their students to carry health insurance. During that time, regional offices required disabled veterans to waive the insurance requirement by providing their social security number as the insurance policy number. The claim was that VA healthcare is the same as insurance. However, it is not. When a veteran is injured away from a facility, the VA has left many veterans stuck with the bill.

Director Fanning considered the issue and decided to take a stand in support for student veterans’ healthcare. This is a significant position, and she was more than willing to address a longstanding grey area within DVA policy.

Last, the Independent Living Program has long been considered the pearl of Voc Rehab. If the disabled veteran is deemed to be too disabled to be employable, the Voc Rehab Counselor can approve the veterans for an Independent Living track.

According to Director Fanning, the goal of Independent Living is to provide accommodations that will allow the disabled veteran to be as “independent as possible” with the “least reliance on others” in the “least restrictive environment.”

The process for services under the Independent Living Program includes two things. First, the disabled veteran must be considered too disabled for employment following an in-office assessment. Second, the Voc Rehab Counselor will set up an in-home assessment.

This program lasts for approximately 18 months. The disabled veteran can be approved for up to $100,000 and beyond for things like ramps, customized home apparatus, vehicle modifications and more.

In all, Director Fanning and Mr. Westerfeld were great hosts and very proud of the efforts Voc Rehab is making to reverse negative perceptions of the program from the past. Today, disabled veterans have more access to more resources than every before, as a result of the efforts of Fanning and her staff.

One Vet to Another

Another effective meeting was with Senator Johann’s office while speaking with Major Gen. Roger Lempke (retired). Senator Johann and his team are heavily committed to veterans’ benefits. Problem spots in Nebraska seemed to be felt in numerous other states. Top on his list was:

  1. Poor quality of Disability & Compensation decisions
  2. Access to healthcare for rural veterans
  3. Reimbursement for 3rd party fees

This issue was covered during my last trip to D.C. and subsequent meetings with the Disability and Memorial Affairs (DAMA) subcommittee House Committee on Veterans Affairs. Currently, the VA has a current disability compensation caseload of 1.3 million claims. Only 300,000 of these are new meaning that approximately 1 million claims are the result of poor decision quality by VA claims adjudicators.

The VA claims the silver bullet will be converting paper files into electronic claims files. While no doubt this will help, understaffing and poor training is likely the issue needing to be addressed. Regardless of how fast a claim is processed, poorly decided claims will always increase the backlog and cost taxpayers more in the long run.

Insiders claim the strong push for electronic conversion has more to do with political positioning during an election year than fixing the problem.

Veterans’ Rural Healthcare

Access to healthcare for rural veterans was a huge issue many legislators were concerned with and exploring options to fix. The problem is that veterans in remote locations need to travel up to 3 hours and beyond in order to get healthcare from the VA. The veteran will lose at least one day from work. The VA in turn compensates the veteran with gas money at the federal rate. Meanwhile, there may be a more economical solution in sending the veteran to a local care provider in the community with a voucher.

Currently, veterans with higher disability ratings are sometimes allowed to do this so long as their condition is dire. The VA has had a difficult time approving these kinds of care despite regulations allowing it. Our legislative fix would be to provide all veterans with at least a 50 percent disability rating with a voucher. They could use the voucher to pay for healthcare at the local doctor’s office rather than lose the day of work and waste gas.

According to the offices we visited, opponents to this kind of fix would be unions and more traditional veteran service organizations. Their fear is that a voucher system would remove veterans from the VA healthcare system. Once removed, the DVA would reduce health provider jobs and financial support from the respective Regional Office.

Bellon and I disagree with this position. Many times, veterans will forego healthcare because of the severe inconvenience of traveling long distances. These veterans are not part of the demand on the system. Further, VA healthcare is still understaffed, especially in the mental health fields. Veterans wait months for care when the same waiting period “on the economy” would be days.

Then there is the opportunity cost. Taxpayers fund the travel reimbursement, upwards of $100 per trip or more for great distances. Veterans required to commute lose a day from work. This means, for every $100 in lost wages, the country loses $33 in taxes, not to mention the lost state taxes. Additionally, the local doctor would see an injection from the VA. Much of that money would then be injected into the local economy.

VA Payment for Service Rendered

The big issue is that the VA struggles to pay third parties in a timely manner for services rendered. This includes burial benefits, emergency healthcare, spina bifida care for children of Vietnam Vets, and mental healthcare. The voucher system would at least alleviate the issue of case-by-case reimbursement, which causes a lot of care providers to refuse to work with veterans.

One example of this is the unfortunate case of Ron Nessler. His daughter is the daughter of a Vietnam Veteran whose spina bifida was linked to Agent Orange. Ron has struggled to get the VA to pay for his daughter’s healthcare despite the VA mandate to do so. The regulations are clear; the VA must provide habilitative care in addition to other services. DC insiders state the VA has refused to provide anything other than nursing home care, which is not what the majority of these children need.

According to Nessler, VA has made the approval process difficult and has refused to acknowledge that it is require to provide habilitative care. Nessler stated than numerous 3rd party care providers have been referred to the DVA for approval. Each time, the provider was unable to complete the process due to poor communication an inability to understand the process.

Due to these problems, Nessler has taken it upon himself to advocate for his daughter. Since at least 2007, he has been contacting Lisa Brown, Chief of Policy Management, and Kevin Jobes with the hope of getting a response, either an approval or denial. With a denial, he can proceed in his benefits claim. I was included in this email chain.

After reviewing the claims, I responded to the email list with my concerns. Included in these was the possibility that the decision makers ignoring Hessler’s claim could be guilty of constitutional violations. If guilty, they could be liable under §1983: Civil Action for Deprivation of Rights.

Needless to say, Brown contacted Nessler within days stating that the VA was drafting a response to his concerns. Nessler has been waiting for the VA’s formal response for the past 2 weeks and is hopeful that he will receive at least some answer after waiting years.

Nessler is not alone. Veterans throughout the country have struggled to get reimbursement for services they are provided (or supposed to be provided) despite VA obligations to pay. General Lempke said veterans are experiencing huge delays in burial benefits, many of which are processed out of the Fort Snelling, MN Regional Office.

Veterans in Florida are experiencing issues with custom prosthesis. Senior Legislative Assistant Tom Power, of Rep. Cliff Searns’ office, said the DVA was moving all prosthesis in house and utilizing bulk contractors versus using customized solutions. While this may be cheaper and benefit one large government contractor, individual veterans and local medical providers will suffer.

Veterans in northern Maine and Michigan still struggle to receive their healthcare due to the remoteness issue. Similarly, veterans in Minnesota, Georgia and Tennessee are also experiencing similar hardships.

Some legislative offices have begun taking matters into their own hands. Congressmen from Nevada and Michigan have started making trips to their Regional Offices to get answers. The trick? Each Congressman asked to see the 3 oldest claims on hand.

Like magic, days after visiting their respective Regional Office, the VA would immediately give that claim the attention necessary to resolve any discrepancies quickly.

Homecoming for DisabledVeterans.org

On the way home, I had a chance to think about the trip and some of the big wins.

We were able to pinpoint major problems within the VA regarding third party provided benefits. Chapter 31 Vocational Rehabilitation & Employment decided to reverse an old policy that will now allow disabled veterans access to greater health care. For-profit colleges will be held to a higher level of oversight. These are all good things.

On Tuesday, during my first day on Capitol Hill, I asked Bellon why it is we do what we do. “Is it worth it or at the end of the day am I just chasing the other end of a rainbow?” After all, disabled veterans have been plagued with the same problems for years.

The VA has still been unable to resolve even the most basic problems over the past 60 years, like disability compensation. The same Veterans Service Organizations (VSO) provide a sometimes too cozy of a buffer between veterans and the VA. Cronyism, entrenchment, and turf wars sometimes seem insurmountable in the veterans’ benefits arena.

Following my success with the Voc Rehab Director Fanning and the policy change on health insurance, Bellon asked me the question, “So is it worth it?” I smiled and answered with a simple, “Yes.”

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6 COMMENTS

  1. Thanks for the update.. As I mentioned in my more recent comment…. I recently requested a ILP.

    Even though my application stated I wanted an ILP, and even though the rehab folks knew I was rated 100%, ( with a prior TDIU rating) I as still required to attend a useless 1.5 hour brief about attending college and returning to work. My first suggestion to the VA is too stop wasting time of those looking for an ILP. For me to sit in a group setting with my oxygen condensor buzzing loudly, and my wheelchair in the asile just doesn’t serve any purpose and is a distraction to others trying to watch the video and ask questions.

    When I was finally called to speak with a counselor, (I’ll call the counselor Jackie) The first thing she said was what can I do for you? I said you tell me. Jackie stared at me with a blank face… finally I said I wanted an ILP program, and asked if she had read my fine. She confessed she had not red my file. She continued to ask what I wanted, so I handed here a small list of items that because of my disabilities I know would inprove my standard of living. I asked for: a Door Bell visual Signaler, Small Riding Lawn Mower, Tempur-Pedic Mattress, Lift Chair/recliner, Whole House HEPA dust collection system, and a Phone system to work with my hearing aids . The fist thing she told me was no, it wasn’t going to happen. She said they have been told to refuse any ILP’s no computers no riding lawn mowers nothing.

    I told her I knew the rules as well or better than her. I quoted here the $25,000 limit that can be approved at the local level. She continued to insist that she could do nothing. Finally, after a ten minute conversation she stated she would have to have an in-home assessment completed before she could do anything. She told me for some of the items my PCP could request them thru the prosthetics department. She still insisted that a small lawn mower, and lift chairs would not be included in any program….

    Now I have seen some veteans list that include tools, greenhouses, sunrooms etc. I was not interested in providing a list of items that at first glance who generate an immediate disapproval. I was more interested in keeping with the stated goals of the program. That is improvement in daily living skills. I chose to request the items I listed becaue of my back, lung, and hearing disabilities. I feel that each item requested will improve my living conditons and will reduce my need to have others help me. Jackie made it very clear I wasn’t going to get a riding mower, but my arguement for this is simple. I pay $80.00 a month to have someone cut my front lawn, I could do it myself if I had a small lawm tractor. Because of my lung and back injury there is no way that I can push a mower. The other items requested are fairly inexpensive in comparision to what others ask for… but as I said I taylored my needs to my actual disabilities, I wasn’t interested in Hobby items or in just getting something to get something.

    I am waiting on the in home assessment and once that is completed will update you on the progress if any.

  2. Stay the good fight and know that we don’t want to be given anything we just want what is right.

  3. Good job and thank you for your advocacy! I want to shortly state why i actually CHOOSE to use Medicare and Medicare Part D Drug Plan-at considerable expense, rather than utilize the VA System. Firstly, I am 100% Svc. Connected Disabled with Individual Unemployability and also rec’v. SSDI (only allowable if veteran is found Service Connected, none other-FYI). So, I pay my Medicare Premium and Part D Drug Plan Premiums and copays for drugs because of following situation. In my state’s capitol in which I live, I had initially started using the VA when things really hit the fan healthwise and was awaiting both an SSDI and VA decision on my claim and near homeless. The VA Healthcare location did not have an infectious disease dept. so would have to ride in a van for over hour and half to the nearest one that did have an I.D. Dept–THEN it would be an all day affair and will just say some of my conditions make me pretty much live in bathroom as well, along with peripheral neuropathy pain and everything else that comes with HIV and the gift of Hepatitus B infection the military actually gave me from unsterile medical procedures (rated 0% Svc. Connected on THAT until it I am knocking at death’s door…but it’s Svc. Connected…the HIV is not considered Svc. Connected but all other issues/PSY/PTSD/Anxiety, et al give me the 100%). I did not have a car then because I sold everything I had to keep from being homeless after working a very well paying civilian job.
    My city built a brand new tens of millions $$ facility within two years of then and i had made it quite clear that they needed to have an Infectious Disease Dept. at this new and HUGE center. By this time I was utilizing the local AIDS Task Force and started using civilian healthcare because I could not ride van without getting very sick, etc, PLUS, due to the VA’s “FORMULARY”, (the amazingly large number of veterans with various infectious Disease issues, incl. HIV would astound you with the VA claiming to be the LARGEST health provider for HIV in the USA–I really doubt that last statement is true), the VA’s medication FORMULARY restrictions is actually like a decade behind in current research and they wanted to change all my medications to what THEY said “fit their formulary”, even though there’s an appeal process but being thrice-removed over an hour and half away, it was never going to happen. PLUS, the kick in the pants is the brand new tens of million $$ VA Clinic DID NOT even consider an Infectious Disease Clinic!!!!!! This actually was placing a HUGE burden on local AIDS Task Forces and Federal ADAP (AIDS Drugs Assistance Plans) because since you were a Veteran, the SYSTEM assumed the VA *should be able to take care of that*…got my SSDI and VA 100% Disability approved ONLY because my great Senator went to battle for me and even IF I were to use the VA Health System and am in Tier/priority 1; I still would have to use Medicare and then VA as last payer BUT the HIV is not Svc. Connected, so either way, I have to fork-over $2200. for 90 tablets/90 day supply HIV medicine as a copay because I do not qualify for the ADAP due to income and I live rather frugally in order to literally stay alive and take my meds. Lastly, the VA’s PSY Dept. refused to even look at the past Dr.’s letters of medications tried and did not work and justifying WHY I should continue taking the medications found to make a decent dent after over 12 years of therapy and medication regimines from hell! The VA Psy. Dept. refused to even make copies or READ those letters, rather wanted to actually place me on medications, again, ONLY on their “FORMULARY”…I was livid! THAT was what made me contact my Senator as well as the audacity to continue to farm-out at considerable time and expense, infectious disease patients rather than establish care in a brand new facility.
    yes, I am very thanful for my Senator along with my own tenacity in finally getting my benefits. However, my example is why it is not worth the stress and anxiety let alone risk my very health in using the VA’s Health System because I truely believe if i had, I may not be around to be writing this about just this ONE veteran’s plight with the messed-up system.
    Vouchers are a great idea and hope that addresses the needs of many Veterans. I will continue to use Medicare and pay all my premiums and copays because I really cannot even place a price on my sanity or quality of life. I cannot be an isolated case and I suggest Veterans to ALL start being the “squeeky wheel” and contact your Congress-person/Rep’s to do as I had to in order to light a fire under them to do their jobs! There’s MANY Vets that just give-up and is a BIG part of the large amount of homeless Veterans that have found it futile and discouraging to fight for the benefits they so deserve. These problems indeed need fixed from the top down but also at each State’s Regional office ALL on the SAME PAGE rather than Ego and bottomlines. President Bush wrote a blank check for wars that have now cost well over 95% more than he reported to Congress…are we still over there in an effort to not have to “deal” with Veteran’s issues during an election year? Politics pollute, yet my Country, I still SALUTE!

  4. Ben, many thanks for using your precious time to go to bat for us disabled vets! Please let Ms. Fanning know that ILP is not working in Illinois and in many other states because the regional offices make up their own rules! Simply stating it is easy to change counselors doesn’t mean the ROs will do so when a vet requests it. Plus a bad counselor is only a small part of what is wrong with the Voc Rehab process.
    I applied for ILP in Sept 2010 and am still waiting to have my plan done. I have received nothing so far through ILP. I also had to watch the Voc Rehab movie and take the tests while in pain when it was not necessary since I was already 100% IU, 90% medical and on SS disability. I know what I needed was ILP not work/school. My counselor is not the problem; she is doing her best considering that the Chicago RO does not want to spend any $$ for anything in ILP. She was ordered by the R.O. to do my ILP home assessment herself even though she has no training to do one. The VA did not provide her with any type of assessment form to use. My disabilities are so varied/severe I really need a specially trained OT to come to my home especially to address quality of life issues. I have been labeled a complainer because I kept insisting the regs stated the need for a home assessment.
    At this point I am waiting to see if my SAH grant request is approved. If it is then it will pay for home remodeling 1st then the HISA grant will pay and then ILP. ILP is the only program that will pay for quality of life needs. If justified ILP will pay for a hot tub or walk in whirlpool tub. Then when I even mention an equivalent cost vinyl, small home therapy exercise pool all I get is a big “NO” ! If the pool is the only way I can exercise, helps reduce pain & weight and increase mobility then why can’t the VA even consider it ??? I guess it doesn’t matter that 4 of my civilian MDs including my Pain clinic MD and my VA Psychologist have “ordered” me to exercise. I have a PT eval report that objectively justifies that I can only use a home therapy pool. I wonder what the cost of the pool is compared to the money spent on the VA sports clinics and equipment (which I wish they would expand to more vets and more varied sports)?
    I keep fighting the fight not only for me but for other vets so maybe some day in the future the ILP in the Chicago Region will be timely and beneficial to those that need it.
    As with most other vets in rural areas all the VA specialists for me are 2+ hours away. However I have been very pleased with all my VA medical providers/support staff when I have seen them. Even being Priority 1 I still wait forever for some appts. I too use mainly civilians providers as I just can’t physically endure the long trip/daylong visit to VA specialists on a regular basis. Plus I use civilian pharmacies because the VA formulary is so outdated. The voucher proposal sounds wonderful to me!
    Again, thank you for fighting the fight! Liz
    PS I would be willing to visit Ms. Fanning and testify before Congress in person if necessary even though it would take a very large toil on me physically and mentally to travel and even just sit for short time in an office. Sometimes it takes a few to volunteer to help the many.

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