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I am not acquainted with all of that. But the particular problem of regeneration has not had the emphasis that we would like to have.

Senator YARBOROUGH. Here is another comment by the VA in their testimony. I would like to get your thoughts on this.

Dr. Engle said: I would like to point out in the beginning that by its terms and in its content the bill

Speaking now of H.R. 203— would require the use of funds provided for prosthetics research rather than funds appropriated generally for medical research. The research covered by this biilsis not directed to the field of prosthetics and orthopedic appliances and it is our thought that if the bill is favorably considered it should be amended to provide that funds shall be set aside from the general appropriation for medical research.

In other words, this fund should not come out of the prosthetics and orthopedic research, but out of research generally.

Mr. SCHWEIKERT. The previous witnesses were correct. The text of the bill, H.R. 203, does seem to imply that the funds for research on spinal cord would come from the prosthetics fund, and probably this would be incorrect, I believe. It probably should come from a special fund, the general fund or a special fund which would be earmarked for this special regeneration.

Senator YARBOROUGH. Thank you.

Are there any further questions by counsel for the minority or majority?

Mr. CHRISTIAN. Senator, we have a further statement on your other bills. We shall submit that for the record, if you approve.

Senator YARBOROUGH. Thank you very much. We would like to have that statement. That is appended to your statement?

Mr. CHRISTIAN. Yes, sir.

Senator YARBOROUGH. If you will file that for the record, unless you have some special point you want to make that has been called to your attention by the testimony here, I would appreciate it.

Mr. CHRISTIAN. I do not think so, Senator; thank you.
(The unread portion of Mr. Christian's statement follows:)



There is an inexorable march to coordination of the medical potential of our Nation into a pyramidal complex starting at the community level and ending in ultra-Federal regional centers. Mr. Chairman, our organization could do no other than fully support any and all programs which would tend to increase the efficiency of medical administration and the quality of medical care. Bills such as S. 2666, S. 2748, S. 3086, and H.R. 11631, would lead toward that end. But we are concerned with the effect such legislation would have on the VA medical program and the resultant care of paraplegic and quadriplegic veterans. The VA has long recognized the need for specialized services to treat the spinal cord injured. For those with such catastrophic injury, it is essential to have immediate and constant experienced care through the early phases of treatment. The quality of this early treatment will determine whether the patient will become a hopeless invalid or a useful member of society.

The spinal cord injury services of the Veterans' Administration accomplished miracles, during the early years, in the treatment of paraplegics and quadriplegics. Although the program has been stagnating to some extent over the last 10 years, it is still far better than what our nonveterans have. Too many times have re witnessed the devastating effects of poor and inexperienced treatment of the spinal cord injured in smaller VA hospitals and non-VA hospitals, which do not have the experienced personnel of the VA's spinal cord injury service. We are therefore opposed to any legislation that would permit cross-servicing in VA hospitals and would directly affect these services. It is our sincere hope, however, that the long-range design of our Great Society has in its plans a special place for the spinal cord injured of our Nation. Our immediate concern, however, is the shrinking bed space which is allotted in VA hospitals for the care of our spinal cord injured veterans. Our spinal cord injury services were working at capacity previously. With increasing casualties from the Vietnam war, and the extension of eligibility for medical treatment to peacetime veterans, this number of beds must be increased or our offer of medical care for disabled veterans becomes a hollow gesture. To bring these services, and the entire medical program of the Veterans' Administration up to par with the quality of care offered at university medical centers, we urgently recommend increased budgetary allowances for the VA educational, medical, and research programs.

Thank you very much for giving us the opportunity to record the opinions of our organization.

Senator YARBOROUGH. The next witness will be Mr. Francis W. Stover, director of the National Legislative Service, Veterans of Foreign Wars.



Mr. STOVER. Mr. Chairman, with me on my right this morning is Mr. Norman Jones, our national rehabilitation director. On my left is my assistant, Mr. Harry Donohue, who just recently joined our staff.

Senator YARBOROUGH. All right, Mr. Stover, proceed in your own way:

First, I want to thank you for the very effective aid you gave us on S. 9 and the prior bills. The Veterans of Foreign Wars supported that legislation long in advance of some other veterans' organizations, and your effective statement on the substitute bill—the hot spot bill--that was introduced in January in the House, in an effort to substitute it for the general cold war GI bill, was the most effective statement that was made by anyone. I placed it in the Congressional Record and it was circulated nationally. It was most effective in getting rid of the little hot spot bill and having a real cold war GI bill that will cover 3 million men already discharged and, by 1970, over 5 million men.

As you pointed out in your statement, that little hot spot bill would cover only about 126,000 men. June 1 would have made 126,000 men eligible for education, whereas, now, 3 million men are eligible for educational assistance.

Mr. STOVER. Thank you very much.
Senator YARBOROUGH. It was a most effective statement.
Proceed, please, with your statement on these bills.

Mr. Srover. Mr. Chairman and members of the subcommittee, thank you for this opportunity to express the views of the Veterans of Foreign Wars concerning the several bills under consideration which would amend existing law concerning the administration of the Veterans' Administration Department of Medicine and Surgery.

My name is Francis W. Stover and my title is national legislative director.

The Veterans of Foreign Wars was deeply disturbed when in January 1965 the administration announced without notice that it was planning to close down permanently 32 Veterans' Administration facilities. Included in this large group of installations were 15 Veterans Administration hospitals and domiciliaries. Most of these facilities, which were scheduled to be closed down, serve veterans residing in small towns and rural areas.

Our organization was deeply concerned over this massive closing and every effort was utilized to counteract the order. The Veterans of

. Foreign Wars was extremely pleased when this subcommittee took the lead and promptly held hearings on the closings. With the majority leader, Senator Mike Mansfield, of Montana, and the minority leader

, Senator Everett Dirksen, of Illinois, as leadoff witnesses, the subcommittee dramatically brought to the attention of the Senate, the Congress, and the Nation the gravity and seriousness of the proposed closings.

This subcommittee, after listening to many Members of Congress, Government officials, and public witnesses, including the Veterans of Foreign Wars, produced evidence that demonstrated in overwhelming fashion that a mistake had been made in the closing order. As we all know, the President subsequently reversed his closing order and 17 of the facilities ultimately were saved.

All of this is mentioned only as a background for the position of the Veterans of Foreign Wars with respect to several of the bills under consideration which proposed to strengthen the Veterans' Administration hospital system.

We hope, parenthetically, that it will help stall or prevent or stall any further closings in the future, as a remedy for getting rid of VA hospitals.

One of these bills has already engaged our attention and is H. R. 11631, which has passed the House and would clarify responsibility of the Veterans' Administration with respect to the training and education of health service personnel.

Another bill, S. 2748, introduced by the chairman of this subcommittee, proposes to assure adequate and complete medical care for veterans by providing for participation by the Veterans' Administration in medical community planning and for the sharing of advanced medical technology and equipment between the Veterans' Administration and other public and private hospitals.

A third bill, S. 3086, offered by the chairman of this subcommittee, and I notice the cosponsor is the distinguished majority leader, Senator Mike Mansfield, whom I mentioned previously, proposes to improve the quality of medical care provided veterans by authorizing the Veterans' Administration to enter into cooperative agreements with medical schools, hospitals, and research centers throughout the country so that the Veterans' Administration can share with these institutions the most advanced medical information, equipment, and facilities in the treatment of veterans.

The other bill is H.R. 203 and would set aside at least $100,000 in research funds for the Veterans' Administration to be spent on research into spinal cord injuries and related diseases. This bill also has passed the House and has been under consideration by this subcommittee and I believe favorably reported in a previous Congress.

First, the Veterans of Foreign Wars favors H.R. 203 and feels that any moneys spent in the research of spinal cord injuries is most meritorious and desirable. While not directing ourselves to the carry

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ing out of Veterans' Administration research programs, it would seem that with the increased casualty in Vietnam more money should be spent in determining the best ways and means to take care of those who suffer horrible spinal injuries, which leave them, for the most part, as paraplegics and confined to wheelchairs for the rest of their lives.

We know, for example, that the Vietnamese nationals have suffered many casualties in this regard and that our Government is taking care of a large number of Vietnamese paraplegics in the VA hospitals in Castle Point, N.Y. It is a very worthwhile humanitarian program and more research in this field would seem to be in order.

Respecting the other bills, it is noted that they overlap in some regard. H.R. 11631 simply recognizes that the Veterans Administration in the care and treatment of veterans carries out many educational and training programs as a part of that treatment. The Veterans' Administration, for example, has long engaged in the teaching of doctors, nurses, therapists, and the like Unfortunately, there has been no official recognition of this great contribution by the Veterans' Administration hospital system.

With the authorization of a preponderance of new Federal health programs for all citizens, the most notable of which is medicare, our Government should take advantage of this great national asset, which is the Veterans' Administration hospital system.

It is our only national hospital system, and it has proven to be a highly successful one. The teaching and training possibilities of this system are limitless. Training programs will help provide the finest medical care that this Nation can give its veterans. It is only fitting and proper that the Congress provide recognition of this education and training service of the VA in the health field by providing funds specifically earmarked for this purpose.

This is what is referred to in H.R. 11631, a bill which it is hoped will make a contribution to the training and education of vitally needed medical and health personnel. This bill will see to it that it will no longer be necessary to have the Veterans' Administration use funds which are now earmarked only for the care and treatment of patients. And by using the VA our Government can save millions of dollars since it will not be necessary to set up new training programs.

In the same vein is S. 3086, the main purpose of which is to improve and strengthen the VA system.

Since this bill was just introduced on March 15, there has been insufficient time to properly study its many sections.

It is noted that it would provide for sharing of equipment and facilities with other than VA hospitals and private medical facilities,

The Veterans of Foreign Wars has been and continues to be deeply disturbed over the use of VA hospital beds for other than veterans. In this regard, your attention is directed to section (d) of S. 3086 which states, among other things, that "funds authorized under this section shall not be available to pay the cost of hospital, medical, or other care of patients, and so forth." This section could be construed as authority to admit nonveterans to VA facilities for care and treatment.

It is recommended that in your report on this bill or any of the other bills should spell out in clear, unequivocal language that it is the intent of Congress that VA hospitals and medical facilities are for the care and treatment of veterans and that this legislation shall not be construed or interpreted in any way as permission or authorization to the VA to render care and treatment of nonveterans in any VA facilities.

S. 2666 is a technical bill which addresses itself to the operation of the Department of Medicine and Surgery of the VA. Our organization has no official position on this bill, but certainly would not object to it if, in the opinion of the VA, such legislation is necessary to render better and more effective treatment to veterans from both a quantitative and qualitative standpoint.

One further comment on S. 2666. Section 5004 of this bill, subsection (b) authorizes the Administrator to establish and maintian in conjunction with VA hospitals and domiciliaries parking facilities for the accommodation of privately owned vehicles of visitors and other individuals having business at a VA facility.

Of great and immeasurable therapeutic value are the visits to patients in VA hospitals by their family and friends. The levying of in parking fees on those visiting veteran patients could, in some instances, act as a deterrent to visitations to the hospital. It is recommended, therefore, that language in this particular section be amended i to make sure that free parking space be afforded to those who are visiting patients at VA hospitals, and if parking fees are authorized they be charged to employees and business invitees at the facility.

The Veterans of Foreign Wars is most apprehensive over the possibility of future closings of VA facilities, especially those serving veterans living in small towns and rural areas. Instead of the traumatic experience of last year which would have simply closed down VA hospitals, which did not in the opinion of the Administration measure up, this legislation will help forestall a similar massive closing in the future.

What these bills in the main propose is to take full advantage of a great national asset of our Nation, the Veterans' Administration hom pital and medical system, by putting to its maximum and most beneficial use, so that it will not only greatly strengthen the l'A hospital system but will provide much better and improved and up-to-date care for veterans.

Concurrently and at the same time the programs contemplated by these bills will be providing an improved service to all citizens by helping to train and educate the necessary personnel to carry out the large number of new and mushrooming medical and health programs. All of this will be done at the local community level, and will continue to make the VA hospital system the finest anywhere.

Thank you.

Senator YARBOROUGH. Thank you, Mr. Stover, for that concise statement. I recall the very valuable contribution you made to the investigation held by this subcommittee on the Director of the las order that these 17 hospitals be closed. I think that out of that hearing some very remedial action came.

The purpose generally of this legislation, as it is pointed out, is to improve not merely the care of the veterans but to improve training and to bring the latest information by means of electronic media of communication to the smallest, most remote hospital, wherever it may be.

Are there any questions by the staff? Thank you very much. You have handled this so well that we shall not go into extensive questions

Mr. STOVER. Thank you, Mr. Chairman.

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