Statement of Administration Policy: S. 13 - Veterans Benefits and Health Care Act of 1989

(Senate)
(Cranston (D) CA and 8 others)

S. 13 includes provisions proposed or supported by the Administration — including the annual cost-of-living increase for VA disability and survivor benefits. It also contains, however, objectionable provisions, and the Administration urges that they be deleted:

• Section 260 would overrule a major 1988 Federal Court of Appeals decision recognizing the Secretary's authority to determine conditions of employment for title 38 health care professionals. Section 260 would negate the traditional medical peer-review process for managing health-care professionals' conditions of employment.
  
  
• Sections 404 and 405 would (1) require all loans sold, with or without recourse, to be credited as offsetting collections to the relevant fund, and (2) allow a veteran to purchase additional entitlement to loan guaranty benefits. Sales with recourse should not be credited as offsetting collections because this understates the Government's liability for such loans. Also, in view of the large program losses sustained by VA in recent years, the additional entitlement to loan guaranty benefits should not be authorized.
  
  
• Section 201 directs VA to provide priority medical treatment for veterans suffering from Post-Traumatic Stress Disorder (PTSD) whether service-connected or not. This provision would by-pass the long-standing system under which VA benefits for service-connected conditions are determined.
  
  
• Section 212(c) would mandate the establishment of specified therapeutic residence pilot programs, and use of nonprofit organizations to carry out VA compensation work therapy programs. The nonprofit organizations would be highly dependent on VA and VA resources, but would not be subject to VA supervision.
  
  
• Section 213 would require the establishment of a four-year pilot program to provide health-related social services as an alternative to institutional care. This provision would change VA's medical mission to one that involves the provision, or simply reimbursement, of nonmedical social Support services such as homemaker, chore, and personal care services.
  
  
• Sections 205, 224, and 269 would establish a special committee on PTSD, set up a task force to examine certain veterans benefits laws, and create a pilot program of pay and personnel management practices. Requirements contained in these sections infringe upon the constitutional authority of the President and his subordinates to manage the decision-making process within the Executive branch.

The Administration would oppose any amendment regarding presumptions concerning Agent Orange and service-connected disabilities. The Department of Veterans Affairs is currently amending its regulations in response to the court's decision in Nehmer v. Turnaqe. Until the regulatory process is completed, the legislating of such presumptions is premature.