Vva.org

CONVENTION RESOLUTIONS
15TH NATIONAL CONVENTION
RENO, NEVADA
AUGUST 17-21, 2011
HEALTH CARE
VETERANS HEALTH CARE
History:
First adopted in 1983 as V-9-83
Amended in 1987 as V-5-87
Amended in 1989 as V-4-89
Amended in 1991 as V-1-91
Amended in 1993 as V-1-93
Amended in 1995 as V-1-95
Amended in 1997 as V-1-97
Renumbered in 2003 as HC-1-03
Amended in 2005 as HC-1-05
Amended and renumbered in 2007 as V-1-05
Amended and renumbered in 2011 as HC-2

Issue: The Department of Veterans Affairs (DVA) Veterans Health Care Administration,
Veterans Integrated System Network/VISN, is responsible for providing health care to veterans
with service-connected disabilities and others as determined by eligibility rules established by
Congress. Concerns continue regarding quality of health care, access, and eligibility for
services.
Background: Many veterans have been adversely affected by what has been described as a
health-care system “in crisis.” This, in part, is due to budget and resource limitations. Other
significant factors are directly related to the massive size of the centralized DVA healthcare
system, its bureaucratic inertia, and its inability to organize itself into an effective instrument to
meet the changing healthcare needs of all veterans under its care. Both service-connected and
non-service-connected veterans have experienced a consistent unavailability of access to DVA
health care, including mental health, outpatient contract, and inpatient care.
Issues of access involve the need for many veterans to travel long distances to obtain care, as
occurs with veterans living in rural communities or on island communities in Puerto Rico, the
U.S. Virgin Islands, and Hawaii. Non-U.S. citizen veterans of the U.S. Armed Forces may
receive DVA treatment for service-connected disabilities only if residing in the U.S. The statute
allows payment for the treatment of service-connected disabilities outside the U.S. for veterans
of the U.S. Armed Forces, only if such veterans are U.S. citizens, reside in the Republic of the
Philippines, or are Canadian nationals.
The quality of health care in DVA remains suspect as revelations of questionable practices and
adverse outcomes continue to emerge. DVA has lost sight of its obligation to provide quality
health care as defined by veterans and their families, opting instead for quality as defined by
health administrators and medical school affiliations.
Resolved, That: Vietnam Veterans of America maintains that veterans who have sustained
injuries or illnesses during and/or as a result of their military service have the right to the highest
quality medical and psychological services for treatment of those injuries and illnesses.
The first priority of the DVA must be to provide the highest quality evidence-based medical and
psychological treatment at no cost to veterans for illnesses and injuries incurred during and/or
as a result of their military service. Therefore, it is the obligation of the Veterans Health
Administration (VHA) to fulfill its affirmative responsibility to treat diseases, illnesses and
conditions that have been diagnosed in veterans under its care.
DVA must insure that the highest quality evidence-based care is provided in DVA healthcare
facilities. Monitoring activities conducted by Quality Assurance Programs must be scientifically
based and include regular and consistent review by the Under Secretary for Health, Deputy
Under Secretaries for Health, VISN Directors, and the director and chief of staff of the institution.
Quality data should be easily available to the public.
When DVA cannot provide the highest quality care within a reasonable distance or travel time
from a veterans’ home (fifty miles) and in a timely manner (thirty days), DVA must provide care
via fee-basis provider of choice for service-disabled veterans. Additionally, DVA must provide
beneficiary travel reimbursement at the government rate. DVA should report at least annually
on the use and cost of fee basis and contract care, including the type of care and the reasons
DVA could not provide it.
Congress should remove restrictions against providing DVA medical care to non-citizen,
service-connected disabled veterans of the U.S. Armed Forces in order to treat equitably all
those who served in the U.S. Armed Forces regardless of their country of origin, citizenship, or
current country of residence.

DVA healthcare policies must allow the veteran client to have input in VA Medical
Center/Outpatient Clinic operations. This should include establishment of veterans’ advisory
boards at the local level. DVA should report on how many facilities have such boards, how
often the boards meet, how members are selected, and how meetings are publicized in the
community and among veterans’ service organizations.

DVA healthcare policies must be based on patient needs. Healthcare implementation should be
decentralized to the local level, and budgeting should allow local facilities to plan for their own
needs with significant consultation by the local veterans’ advisory board. Congress must enact
and the President must sign into law legislation that creates an assured reliable funding stream
for DVA healthcare programs, indexed to medical inflation and the per capita use of the DVA
Health Care System. VVA vigorously opposes any philosophy or language that would limit
the delivery of the VA healthcare treatment and services to only a small group of veterans in
order to save money. VVA is committed to protecting the rights of veterans and access to
DVA programs and services as defined in title 38 US Code.
Additionally, to maintain medical competency and expertise in the provision of
healthcare services, the DVA healthcare system needs to maintain a critical mass of
patients if it is to continue as a highly cost-effective integrated managed care system.
VVA vigorously resists any attempt to degrade this system by eliminating eligibility for
“Priority 7” and “Priority 8” veterans – veterans who do not have service-connected
health conditions and who agree to modest co-payments for their care.
Furthermore, VVA wants to go on record as applauding the DVA Secretary, General Eric
K. Shinseki, for his initiative and commitment to achieve greater transparency by posting
information about quality issues in DVA medical centers and community-based
outpatient clinics.
VETERANS WITH HIV INFECTION

History:
First adopted in 1987 as V-2-87
Amended and renumbered in 1991 as V-23-91
Amended and renumbered in 1993 as V-6-93
Amended and renumbered in 1995 as V-3-95
Amended in 1997 as V-3-97
Renumbered in 2003 as HC-2-03
Renumbered in 2005 as HC-2-95
Renumbered in 2007 as V-2-95
Renumbered in 2009 as HC-3-09
Renumbered in 2011 as HC-3

Issue: Care of veterans with HIV infection, education and counseling services of veterans and
their families regarding the prevention of HIV infection.
Background: Human Immunodeficiency Virus (HIV) infection remains a major health issue in
the U.S. Approximately six to seven percent of all persons with AIDS in the U.S. are cared for in
Department of Veterans Affairs (DVA) medical facilities, and many other veterans receive care
for HIV infection/AIDS elsewhere.
Resolved, That: Vietnam Veterans of America takes the following position:
Urges DVA to continue making available educational materials reflecting the latest research and
developments in HIV care for both staff and patients at all DVA medical centers, outpatient
clinics, Vet Centers, and Regional Offices.
Urges DVA to ensure currently recommended treatments for HIV are available to veterans in
DVA facilities or through fee basis or contract care.
Continues its commitment to serving veterans with HIV infection through its service
Representatives.
PROSTATE CANCER RESEARCH AND TREATMENT

History:
First adopted as V-18-01 in 2001
Renumbered as HC-5-03 in 2003
Renumbered and amended as HC-18-05 in 2005
Amended and renumbered as V-18-05 in 2007
Amended and renumbered in 2011 as HC-5
Issue: Prostate cancer afflicts over 200,000 American men each year and over 30,000 lives
are lost. Studies indicate individuals exposed to Agent Orange present at a younger age, have
higher Gleason scores, and have a greater likelihood of developing metastasis than their
unexposed counterparts.
Background: The Department of Veterans Affairs (VA) has determined that a presumption of
service-connection based on exposure to herbicides while in military service is warranted for
prostate cancer.

Resolved, That:
Vietnam Veterans of America calls upon the VA Under Secretary for Health to establish a National Vietnam Veterans Prostate Cancer Protocol to be implemented at
all VA facilities. This protocol must include provisions for a) comprehensive outreach and
education for the Vietnam veteran population and all VA healthcare providers to the increased
risk for prostate cancer; b) utilization of a complete military history as a standard assessment
tool for all veterans; c) appropriate, timely and effective early detection screening and treatment;
d) judicious monitoring of baseline changes; and e) the development of a “best practices model”
which incorporates emerging evidence-based technology and treatment modalities.
Vietnam Veterans of America urges that federal funding for prostate cancer research, treatment,
and therapies at NIH, DoD, and VA be increased; that the Congress and the Administration re-
double efforts to find a cure for prostate cancer; and that the Veterans Health Administration
increase its investment in prostate cancer clinical research, improving and accelerating clinical
trials at VA hospitals and affiliated university medical centers and research programs.
MILITARY HEALTH CARE
History:
First adopted in 1993 as V-14-93
Renumbered in 2003 as V-4-03
Renumbered in 2005 as V-7-95
Renumbered in 2009 as VB-21-09
Amended and renumbered in 2011 as HC-6
Issue: Upholding individual rights and traditional patient-centered ethics within the Department
of Defense (DoD) medical-care system.
Background: During Operation Desert Storm concerns were raised by requests from the DoD
to the Food and Drug Administration (FDA) to obtain waivers for the administration of
unlicensed drugs without informed consent. Although both of the drugs in question
(pyridostigmine, for the pre-treatment of organophosphate nerve-agent intoxication, and
botulinum-toxoid vaccine) have been used either for the licensed treatment of other conditions
or with informed consent, and are known to be safe, the general concept of blanket waivers
raises the specter of previous drug and chemical experiments conducted by the military. The
issue of consent in a war zone is complex as some might choose to use failure to consent as an
excuse for removing themselves from the dangers of a war zone. Conversely, requiring an
unvaccinated or untreated individual to remain in a danger zone when use of chemical or
biological warfare is anticipated also is unethical.
Also of concern is whether or not military medical personnel are primarily responsible for the
health and well-being of those under their care if they must subordinate the medical interests of
individual patients to the military mission. While the treatment of multiple casualties often
requires prioritizing the use of personnel and material resources by triaging patients, the care
provided by military medical personnel should adhere to the same standards of medical care
and medical ethics required by state licensing boards.

In 1999, President Clinton signed Executive Order 13139 which provides some controls on the
use of investigational new drugs or drugs which have not yet been approved by FDA for their
intended use. Under this Executive Order, which is still in effect, only the President of the
United States may waive informed consent requirements on the grounds that obtaining consent
is 1) not feasible; 2) contrary to the best interests of the service members; or 3) not in the
interests of national security. The Executive Order requires that the Secretary of Defense submit
a plan for tracking use and adverse effects of the investigational drug(s) as a part of the waiver
request and for notifying military personnel receiving the investigational drug(s). If granted, the
waiver must be communicated to Congress and a public notice printed in the Federal Register.
Waivers, when granted, will expire after no more than one year but can be renewed using the
same procedures required for an original waiver.
Resolved, That: Vietnam Veterans of America takes the following positions:
1. Affirms its support for requiring fully informed consent of military personnel, even in wartime,
for the use of experimental and investigational drugs;
2. Calls on the DoD to develop a policy stating the ethical responsibilities of military medical
personnel as well as all military leaders, and to develop a patient’s bil of rights similar to that
adopted by Department of Veterans Affairs (VA); and
3. Affirms its belief in leadership by example and that everyone in the theater of operations from
the Commanding General on down should be subject to the same immunization
requirements/protocols.
PARTICIPATION IN THE PROCESS OF ACCREDITING
VA MEDICAL CENTERS
History:
First adopted in 1993 as V-13-93
In 1995 renumbered as V-6-95
In 2003 renumbered as V-3-03
In 2009 renumbered as VB-20-09
Amended and renumbered in 2011 as HC-7
Issue: Consumer input into the accreditation process.

Background: The Joint Commission on Accreditation of Health Care Organizations (JCAHO
accredits hospitals and other health-care facilities in the U.S. Although a private nonprofit
organization, JCAHO, with input from professional and consumer groups, establishes the
standards by which health-care facilities are evaluated. Accreditation status is used to establish
eligibility for non-federal institutions to receive Medicare funds and, in some cases, to determine
eligibility for licensure. Although Department of Veterans Affairs (VA) facilities can continue
operating without accreditation, all VA Medical Centers (VAMCs) participate in the JCAHO
accreditation process, and loss of accreditation or conditional accreditation is viewed as an
extremely serious matter by VA Central Office management.
The Commission on Accreditation of Rehabilitation Facilities (CARF) similarly accredits
specific programs within VA facilities. Examples of programs that may be accredited by
CARF include: medical rehabilitation; DMEPOS (Durable Medical Equipment,
Prosthetics, Orthotics, and Supplies); behavioral health; opioid treatment; and
employment services.

Both the JCAHO and CARF reviews are conducted at least every three years and include on-
site visits to the healthcare facility. Accrediting agencies require that the facility provide an
opportunity for the presentation of information by consumers and the public. Anyone who has
information about a hospital’s compliance with the accreditation standards may request a public-
information interview using the procedure established by the accrediting agency.
Both JCAHO and CARF post a searchable list of accredited programs on their websites.
Resolved, That: Vietnam Veterans of America takes the following positions:
1. Encourages chapters and state councils to become familiar with the accreditation standards
currently used by JCAHO and CARF;
2. Encourages chapters and state councils to participate appropriately in providing consumer
input, both positive and negative, during accreditation surveys by requesting public information
interviews; and
3. Will act to ensure that veterans’ service organizations are informed and encouraged to
participate in accreditation processes at VA medical facilities.

HOURS OF OPERATION OF VA MEDICAL FACILITIES
History:
First adopted in 1993 as V-17-93
In 1995 renumbered as V-10-95
In 1997 renumbered as V-9-97
In 2003 renumbered as V-6-03
In 2005 renumbered as V-9-95
In 2009 renumbered as VB-23-09
Amended and renumbered in 2011 as HC-9
Issue: Accessibility and timeliness of health care at Department of Veterans Affairs (VA)
facilities.

Background: The hours of operation for outpatient care at many VA hospitals and clinics are
generally from 8-9 a.m. to 4-5 p.m. Veterans who are employed or have personal
responsibilities may find it difficult to make appointments during these hours. Saturday
and evening clinics, as well as measures to decrease waiting times, would facilitate use of VA
facilities by these veterans.

Resolved, That: Vietnam Veterans of America
1. Encourages all VA hospitals and clinics to provide weekend and evening appointments
for veterans through use of flexible employee scheduling; 2. Encourages hospitals and clinics to diligently evaluate and improve scheduling to 3. Will establish metrics to determine if VA medical facilities are being flexible in
their hours of operation in order to meet the changing needs of an evolving
veteran population.
DEPARTMENT OF VETERANS AFFAIRS RESEARCH

History:
First adopted in 2011 as HC-10
Issue: Research funded by the Department of Veterans Affairs (VA) too often does not
address the needs and interests of the veterans it serves.
Background: Areas of importance for include the efficacy of various PTSD treatment
modalities for different populations; long-term consequences of PTSD, Traumatic Brain Injury
(TBI), infectious diseases endemic to areas where the U.S. military serves; and the efficacy of
long-term care options for aging veterans.
Resolved, That: Vietnam Veterans of America urges that the Secretary of Veterans Affairs
direct the Office of Research and Development and the various Research, Education, and
Clinical Centers to focus on the wounds, maladies, injuries, and traumas of military service and
war, research targeted to issues unique to specific wars and deployments.
TESTING FOR HEPATITIS C

History:
First adopted in 2011 as HC-11
Issue: Vietnam Veterans are known to have a significant higher prevalence of Hepatitis C
than non-veterans of the same generation.
Background: Not all Veterans Affairs facilities are ensuring that all Vietnam-era veterans are
offered testing for Hepatitis C.
Resolved, That: Vietnam Veterans of America request that the Secretary of Veterans Affairs
ensure all Veterans Health Administration (VHA) facilities comply with existing VHA Hepatitis C
protocols, that all Vietnam-era patients are offered the blood test for Hepatit6is C and, if the test
is positive, be accorded appropriate follow-up and treatment.

Source: http://www.vva.org/Committees/VetsHealth/resolutions.pdf