In 1999, the VA will treat 750,000 patients in VA hospitals, 106,000 in nursing homes and 25,000 in domiciliaries (care for those with special rehabilitation needs and homeless veterans). This year, VA outpatient clinics will register approximately 35.8 million visits, and nearly 3.6 million people will receive care in VA health care facilities.
The VA's fiscal year 1999 appropriation is $43.7 billion: $23.5 billion for benefit programs and $18.3 billion for medical programs. Those are impressive numbers, but chiropractic benefits are often denied to patients in the VA health care system.
In the past year, the VHA has reorganized its health care into 22 networks of care to pool resources and to provide greater access to care for the 25 million veterans and their dependents. Still, there is a need to make the VHA more economical while providing broader services. There is now legislation to do just that: the Veterans Millennium Health Care Act - HR 2116.
HR 2116 was introduced in the House of Representatives June 9, 1999 by Rep. Stearns (R-FL) for himself and Congressmen Guttierrez (D-IL), Stump (R-AZ) and Evans (D-IL). It was referred to the Committee on Veterans' Affairs, where it was approved and reported out of committee on July 15.
The Associated Press reports that because of the joint lobbying efforts of the American Chiropractic Association (ACA) and the Association of Chiropractic Colleges (ACC), language has been added to the bill to establish chiropractic's role in the VHA.
Under section 304 of H.R. 2116 it states:
"Within 120 days after the date of the enactment of this Act, the Under Secretary for Health of the Department of Veterans Affairs, after consultation with chiropractors, shall establish a policy for the Veterans Health Administration regarding the role of chiropractic treatment in the care of veterans under chapter 17 of title 38, United States Code."
The Under Secretary for Health is Kenneth Kizer,MD,MPH. Dr. Kizer is the chief executive officer of the VHA and has held the office since October 1994.
The Associated Press said the chiropractic provision within HR 2116 could "potentially lead to the important goal of full integration of chiropractic care into the VA health care system."
The ACA and the ACC worked closely with the House Veterans' Affairs Committee for inclusion of the chiropractic language. The International Chiropractors Association (ICA), however, is "deeply concerned that this vague provision will serve as the basis for additional delay and postponement of the legitimate demand for full inclusion of chiropractic services."
The ICA has stated that "regardless of the outcome of this provision," it is "working on specific legislation that would mandate the establishment of a permanent division of chiropractic services within the VA, headed by a doctor of chiropractic," and requiring the hiring of permanent, full-time DCs in the VHA. The ICA also wants the VHA to "develop and implement an out patient program for eligible veterans within one year."
HR 2116 has broad bipartisan support and is now positioned for consideration by the House. There is a possibility that the House will vote on the measure before the August recess.
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