In our opinion, the proposed intent of this measure is to create a mechanism whereby veterans requiring medical services who have no eligibility or whose eligibility to receive care falls at the lower end of the scale will be offered the maximum assistance possible to insure treatment is received from non-VA entities. (Some VA medical facilities now provide similar services, although smaller in scope, through established social work services.)

It is commendable, Mr. Chairman, that this Committee advances the desire to be of assistance to all veterans in need of medical services and proposes to establish a vehicle for doing so.

The DAV has no objection to the enactment of this legislation, with the following caveat:

The "particular emphasis" to be placed on the referral needs of service-connected veterans should be employed when, and only when, it is not advantageous or feasible to such veterans to receive care in a VA facility or at VA expense.

As you are well aware, Mr. Chairman, Section 612(f),

Title 38, United States Code, states: "the Administrator, within

the limits of Veterans Administration facilities, may furnish

medical services for any disability on an outpatient or

ambulatory basis...to any veteran who has a service-connected disability rated at 50% or more....

As presently written, VA personnel at various medical facilities could misinterpret S. 2514 as a mandate to refer the service-connected disabled veteran to medical care sources outside of the VA system rather than furnish the needed medical services within the confines of VA health care facilities.

Referral of service-connected veterans must not be the norm, but the exception, and only after all other means of providing services have been explored, including the VA fee-basis program. We ask appropriate modification of the present language.

Finally, Mr. Chairman, we have not been mandated by our membership to pursue legislation regarding certain objectives contained in provisions of the various bills being considered today. Specifically, those provisions which address: amending the definition of the Vietnam Era; the authority to provide counseling services to family members or survivors of deceased veterans; extension of eligibility for readjustment counseling; VA protective services personnel; amending the time period for the Comptroller General to report to the Veterans Affairs Committees regarding medical personnel staffing levels; state home facility grant application approval; alternatives for federal government assistance to individuals who served in Vietnam as civilians; excluding payment for therapeutic and rehabilitation activities from annual income for purposes of nonservice-connected pension payments; contract care in Puerto Rico and the Virgin Islands; programs of the VA in providing hospice and respite care to certain veterans; and alcohol treatment and rehabilitation.

Although we have no official position on these measures, Mr. Chairman, we would not object to their enactment.

This concludes my statement, Mr. Chairman, I wish to again thank you and the members of the Committee for allowing us this opportunity to express our views on these important subjects.

Mr. PRINCIPI. Mr. Powell.

Mr. POWELL. I was out of town yesterday, but the comments I got said to keep it to 5 minutes. It will not necessarily be on one subject, however.

First of all and perhaps most importantly, PVA strongly supports amendment No. 2850 to S. 2269, which would remove from accountability of income, income received from therapeutic or rehabilitative activity for the purposes of pension purposes. We believe this to be an effective, cost effective, humane, and a far-reaching proposition, which would substantially provide an opportunity to many young, non-service-connected veterans to attain rehabilitation or therapeutic training, which would allow them to become productive members of our society and get over that initial period with the problem of loss of income.

Second, PVA supports S. 2269. We believe, however, that it does not quite go far enough. We strongly believe that those veterans who served in Lebanon and Beirut and who watched their friends get killed and who had hostile fire pass by them suffered every bit of the anxiety, fear, and terror that was suffered by those of us who served in Vietnam or World War II and that they should, in fact, be entitled in total to the full range of readjustment benefits that have been provided to veterans of other conflicts. We consider this to be especially important, considering the fact that according to all of the wits on defense, this is the kind of situation that American military personnel will most probably face in the future. So we support S. 2269, but would like to see the provisions extended to provide full readjustment benefits for those who served in hostile fire areas.

Third, it certainly would not be appropriate if I did not comment on S. 2210, which is an ongoing saga of some 3 years of experience, and I know many of the staff members are certainly aware of that. First of all, PVA can understand no reason whatsoever for the retraction of an entitlement which has been appropriately, prudently, conservatively safeguarded by those beneficiaries who are eligible for that entitlement.

As a matter of fact, the Veterans' Administration claims that some 51,000 service-connected disabled veterans are eligible for the auto adaptive equipment program. In 7 years, from 1976 to 1983, those 51,000 veterans purchased and obtained approximately 56,000 vehicles, also from VA records.

I would like to point out that during that period of time under the present provisions, they were entitled to 450,000 automobiles. They, again, obtained only 56,000. It seems to me somewhat improper to retract eligibility for a benefit simply because it has not been utilized. In the VA's own analysis of what the benefits would be of reducing eligibility, the dollars. Out of a $25 billion area, it seems awful funny to be looking at the catastrophically disabled. However, we can recognize that three automobiles in 2 years may be too many. We, therefore, strongly support the compromise recommendation proposed here today by Senator Cranston, proposing that the eligibility be two automobiles in a period of 3 years, also with a waiverability of ownership, so as to ensure that the disabled veteran is provided with backup transportation so he may continue the style of life the VA has rehabilitated him to lead.

37-524 0-84-27

With that, I am going to stop, because we have other comments that have already been submitted for the record.

Mr. PRINCIPI. Thank you.

[The prepared statement of R. Jack Powell, executive director, Paralyzed Veterans of America, follows:]

PARALYZED

VETERANS

OF

AMERICA

CHARTZARD BY THE CONGRESS OF THE UNITED STATES

PREPARED STATEMENT OF R. JACK POWELL, EXECUTIVE DIRECTOR, PARALYZED VETERANS

OF AMERICA

Mr. Chairman and Members of the Committee, it is a pleasure for Paralyzed Veterans of America to appear today and present the views and concerns of its members on the various legislative proposals being addressed. These proposals cover a wide range of health care issues, which affect our members and other veterans. I am R. Jack Powell, Executive Director of Paralyzed

Veterans of America.

The first issue I must address is S. 2210, a legislative proposal to revise and clarify the eligibility of certain disabled veterans for automotive adaptive equipment by amending Title 38, United States Code, to restrict an eligible veteran to obtaining adaptive equipment for only one vehicle in a three-year period. PVA strongly opposes the passage of S. 2210 on the basis

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