VA may need larger budget

By Kathy Helms-Hughes
STAR STAFF
khelms@starhq.com

   JOHNSON CITY -- If the United States fails to swiftly crumble Iraq's defense, resulting in a protracted engagement, the war could pose grave risks for U.S. troops, especially if Saddam Hussein uses chemical or biological weapons on the 250,000 U.S. soldiers poised for confrontation.
   But it's not only immediate risks that concern veterans. It's a question of whether veterans hospitals have sufficient funding to accommodate a new wave of veterans resulting from the war with Iraq.
   "The thing I'm concerned with is that the VA (Veterans Administration Hospital, Mountain Home) is not prepared for mass casualties. We've got waiting lists for primary care of over 2,000, and we've got Category 8 people that right now are being turned away. If your income exceeds the poverty rate for this area, the VA will not take you as a new patient," said Randy Lingerfelt, veterans service officer for Carter County.
   The VA alreadys refuses care to some local veterans and if the number of those who need care rises, how will the VA provide it is the question Lingerfelt and other officials are asking.
   "They (VA hospitals) haven't even got the money they've been promised so far," Lingerfelt said.
   Michael "Doc" Murphy, senior vice commander for the Military Order of the Purple Heart for the state of Tennessee, said the government feels that military action in Iraq will be swift. "They won't be prepared if we end up having a lot of people with serious problems," Murphy said, noting that the VA already has a backlog on processing claims of 165 days.
   Ward "D" at the VA Mountain Home has been shut down and there has been a freeze on hiring new employees, according to Lingerfelt.
   "What are they going to do about the budget and the funding if we need emergency care for our veterans in a war time? The VA Hospital is doing a good job, but they're being asked to do more with less money," he said.
   Lingerfelt said when he served in the armed forces, he was told that if he served honorably for two or more years he would be able to go to the VA Medical Center and receive medical care.
   "That's not true. What's true now is they look at your income. It's not my fault that I have a good income; it's not my fault that I go out here and work. I was told that if I served my country, I would have medical care at the VA hospital."
   The VA Mountain Home also is not set up for long-term care because the system is now gearing more toward outpatient clinics, according to Lingerfelt.
   "We don't have a nursing home. The nursing home over there right now is for recovery and rehabilitation. ... A lot of people in this area think Mountain Home is a veterans home, but old veterans don't live over there," he said. "The VA will pay for 30 days of nursing home care and after that 30 days Medicaid is to kick in. What Medicaid doesn't pay, the family has to pay."
   Judy Fowler, public affairs officer at VA Mountain Home, remains optimistic about federal funding in the future, though she couldn't speculate what the potential funding might be.
   "I would certainly think that Congress would address any need based on what may happen," she said.
   The VA Hospital treats about 23,000 veterans annually and, according to Fowler, mades room if there are a lot of new veterans that need to be treated.
   "I wouldn't anticipate a large influx here because we haven't had that many activated from our area," she said. Fowler also said that most of those from the Tri-Cities are already served by the VA Mountain Home.
   The VA is now operating approximately 111 beds due to low demand, "but we have other beds we could activate if that need ever was identified," Fowler said.
   The hospital's budget last year was approximately $125 million, according to Fowler. This year's anticipated budget is $137 million. "We're funded based on patients treated. As we treat more patients, we are given more funding," she said.
   The VA's patient load would increase in the event of a terrorist attack, according to Murphy, because of its participation in homeland defense.
   Dr. Felix Sarubbi, chief of infectious disease, has been looking at how the VA might respond, according to Fowler.
   "He's spearheading the smallpox inoculations for our VA. We have a core group of health care providers who have taken the inoculation in the event that would be one of the acts of terrorism. Then we would be prepared as a health care institution to take care of our veterans or anybody that came to our facility."
   Lingerfelt and Murphy both are team members in the nationwide Capital Asset Realignment for Enhanced Services (CARES) plan, which examines how the VA is going to do business in the next 20 years.
   According to Murphy, the plan estimates that the veteran population will spike until the year 2012, then drop slightly in 2022. "They said they figured in possible casualties, but I think the figures might be very low if the war with Iraq is more than what we expect," he said.
   The plan calculates the loss of 1,500 World War II veterans a day, according to Lingerfelt. "Look in your newspaper. You don't pick it up unless there's an American flag by somebody's obituary."
   Also, he said, this is the 50th year since the Korean war ended. "Those veterans, if they went to war when they were 18, are now 68 years old. We're going to start losing them.
   "The government is doing its budget for veterans based on the fact that we're not going to have a war or we're not going to have an increase of veterans," Lingerfelt said.