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Resolved, That PVA request from the Congress or arrange directly with the military for an integrated nationwide program for picking up SCI injuries at accident sites and transporting them directly to the nearest SCI facility.

15. Resolution 72-C-18 Increased NSLI Coverage

Whereas the present normal practices of normal individuals renders the sum of $10,000 as totally unrealistic for insurance coverage, and

Whereas due to their service-connected disabilities, spinal cord injured veterans are denied the right to acquire insurance protection at normal rates: Therefore be it

Resolved, That the Paralyzed Veterans of America recommends that the Veterans' Administration be authorized to issue policies of insurance to the amount of $50,000 to replace the present $10,000 life insurance policies.

16. Resolution 72-C-21 Exclusion of A & A as Income in Public Housing Whereas many wheelchair-bound paraplegic veterans make their home in public housing developments, and

Whereas said severely disabled veterans, who receive nonservice-connected pension payments, may be entitled to an additional allowance known as "Aid and Attendance," and

Whereas certain city, state, county, and federal housing authorities will increase the rent of such veterans due to their receipt of "Aid and Attendance," and

Whereas said "Aid and Attendance" allowance is provided by the Veterans' Administration to said paralyzed veterans to permit them to hire necessary, personal, medically indicated, daily assistance: Therefore be it

Resolved, That the Paralyzed Veterans of America petition the Department of Housing and Urban Development in order to put a stop to the widespread and unfair practice of including in the computation of the annual income for the purpose of determining rental rates of paralyzed veterans that portion of their Veterans' Administration pension payment known as "Aid and Attendance."

Mr. DEGEORGE. Thank you.

Mr. Chairman and honored members of the committee: On behalf of the Paralyzed Veterans of America I wish to thank you for this opportunity to present before you our legislative proposals on veterans affairs as they pertain to the spinal cord injured and diseased veteran.

Accompanying me today are members of the national office staffour executive director, Mr. James A. Maye, and the national service director, Mr. Alan S. Langer-who will be happy to answer any questions you might have regarding our suggested programs. I would like to add that the PVA is proud of the fact that these two top administrative positions are filled by Vietnam veterans deeply committed to the needs of our organization's members of all ages and from all wars.

You may note in our presentation that Mr. Schweikert is stated as being present, but unfortunately due to certain circumstances he cannot be with us. I would like to point out that we do have members of our organization sitting right to my immediate back, I would like to present at this time.

As we present our testimony, we would like to take this opportunity to acknowledge what we consider a very fine example of legislative responsibility-the introduction of H.R. 2900, "The Veterans Health Care Expansion Act of 1973." This bill would provide an added dimension to the Veterans' Administration continued program of service to the disabled veteran. Due to the high cost of medical care and hospitalization, the disabled veteran must allocate a part of his limited and fixed income to insure against financial disaster in the form of a major illness or accident to a family member. For the paraplegic, purchase of life insurance and standard family health insurance is financially re

strictive. The proposed expansion of health care to include hospitalization and medical care for his wife and dependents would insure the veteran against the crippling cost of prolonged hospitalization of a family member.

The inclusion of hospital and domiciliary care for the non-serviceconnected veteran unable to defray the expense of necessary hospital care; the inclusion of the family in professional counseling on the aspects of the veteran's disability, and extended home health care services are major points of importance of this bill which we heartily support.

This action on the part of the committee is an important step toward alleviating vast discrepancies in the medical care of the veteran. But it is only one step on a long path. There is much to be done before the people of this Nation can say their war veterans are properly cared for. A citizen of this country who is asked to place his life in jeopardy by taking up arms and performing at his best should not be expected to settle for second best when a disability intervenes in his pursuit of life. Nor does he expect to lavish in financial wealth or personal partiality. An equal break is what he asks. That equal break begins with the best medical care his country can provide. Can you honestly say that today's veteran is receiving the best care this Government can provide? That his rehabilitation program is second to none? Most assuredly not. Measures must be taken to see that hospitalization, medical care, and the veteran's rehabilitation are the equivalent of any that could be provided by the best civilian hospital in America, and for that matter the world. To achieve this goal we make the following suggestions:

(1) Promotion of VA hospital construction to replace antiquated facilities now in use. A strong emphasis must be placed on the inclusion of modern spinal cord injury centers and the latest in technological equipment.

(2) The provision of a system of emergency transportation for newly injured spinal cord patients to minimize the disabling effects of the injury. One logical solution would be the use of military air evacuation from the scene of an accident to an SCI Center.

(3) Adequate funds appropriated to insure medical research for cure/research of spinal cord injury related dysfunctions, such as renal failure, a major cause of death for paraplegics. A greater emphasis placed on research of spinal cord regeneration must also be employed.

(4) A strong program for veterans who become addicted to drugs or alcohol. The Alcohol and Drug Treatment and Rehabilitation Act of 1973, is just the beginning, but steps must be taken to insure that VA hospitals which undertake such treatment are properly staffed and that a comprehensive program of rehabilitation is instituted. Presently the environment of the majority of VA hospitals is depressing and the source of mental anxiety, a conducive atmosphere for illicit drugs.

(5) Increased emphasis must be placed upon a complete program of rehabilitation. This should include a procession of educational, vocational, and recreational preparation for the veteran. This expanded scope of rehabilitation services would aid in the sociopsychological adjustment of the severely disabled veteran and better facilitate his total rehabilitation and subsequent return to society.

(6) The elevations of the treatment of spinal cord injury to the level of that of a medical specialty with specialized training for medical and paramedical personnel.

(7) The expansion of outpatient care and hospital based home care programs in order that severely disabled patients may reside outside the hospital.

The implementation of these proposals could effectuate a medical and rehabilitation program second to none and equal to the justifiable need of the disabled veteran.

Moving away from hospitalization and medical care, the next factor encountered in the restoration of the disabled veteran is a benefits program. In the situation of the paralyzed veteran, with rare exception, he is left without a vocation until reeducated and retrained. He must at first depend upon some outside source to provide him with financial assistance in order to survive. If this disability occurred in the line of military duty, he will be compensated by the Veterans' Administration for his loss. If he served in the uniformed services during wartime and suffered his disability after discharge, he will receive a pension. But if his tenure of service occurred during a time of peace, his only recourse for financial aid would be family and friends or public welfare. No one would dispute the right of a service-connected veteran to his benefits of compensation and necessary adaptive equipment. Nor would any rational individual believe any financial remuneration could replace his loss. Why then can Congress offer only a pittance of a pension to an equally incapacitated veteran who suffered his misfortune after honorable service to his country during a declared time of hostility and let the unpropitious peacetime nonservice-connected veteran fend for himself? It doesn't take a great deal of insight to see inequities in the manner in which financial assistance is made available to disabled veterans.

It all seems ludicrous to say that the peacetime veteran is less deserving because there was no war. It is the basic principle of a strong defense force to prevent war. Therefore, the peacetime veteran performed the most honorable service known to humanity by acting as a deterrent to war. For his effort are we to say, "Sorry, but you are not deserving of aid for your time of service because our Nation wasn't in the act of war?" Gentlemen and ladies, there is no justification for denving the peacetime veteran financial aid when his need is just.

The plight of the nonservice-connected veteran in receipt of a pension is only one rung up the ladder from the peacetime nonserviceconnected. For example, a veteran who has an income of less than $300 per year receives $130 per month. This is $540 per year below the $2,100 that the Department of Health, Education, and Welfare has designated as the poverty level. The poverty level for a family of four is $4,400; the pension scale does not allow the veteran to earn more than $3,800 before stopping his pension completely. For those veterans so disabled as to need regular aid and attendance a special allowance of $100 per month is paid to the catastrophically disabled nonserviceconnected veteran. Under this medical determination he is given medicine and prosthetic devices necessary to sustain him. This too is subject to termination when he exceeds his income limitation. What type

of aid and attendance will $110 a month buy? Based upon a 40-hour week, it amounts to 61 cents an hour. It is time to take under consideration the provision of adequate funds for aid and attendance to the entitled nonservice-connected disabled veteran.

What if the nonservice-connected veteran is physically able to return to work despite his disability? For the sake of argument we put his annual income at $6,882, the beginning salary for a GS-4 training position with the Government. First of all, he will lose his pension of up to $1,540 per year, also his aid and attendance which would account for another $1,320 per year, plus the medications and prosthetics service. We have now reduced his salary to $4,022 per year. After Federal, State, and social security taxes are deducted, he will have approximately $3,282 or $422 more than before he started work. We did not take into account the extra cost of travel he incurred or any of the other expenses entailed with working. Consider this, is there much wonder in your minds why he doesn't see work as gainful employment?

The present pension formula does not meet the financial need of the catastrophically disabled veteran. In order to provide him with the opportunity to support himself without facing an immediate financial crisis, he must be permitted a reasonable amount of earned income before reducing his pension. In the case where a veteran is in receipt of regular aid and attendance, there must be provisions made to insure this financial aid is sufficient to meet his needs. The present rate does not meet his needs and is controlled by his earned income, so that any real attempt to help himself results in the penalty of loss of aid and attendance. It is your duty to provide the veteran the opportunity to advance himself beyond a poverty-scale. To do this means major changes in the pension program as it exists today. Therefore, we recommend the following:

(1) That aid and attendance regulations be amended to allow the veteran a greater amount of earned income before he loses the aid and attendance benefit. Also, we suggest that the veteran be allowed the continued benefit of medical and prosthetic supplies under aid and attendance without regard to income level.

(2) That the pension scale be readjusted and made more realistic to the needs of the severely disabled veteran.

(3) That some provision be made to prevent the continuing adjustment of social security benefits from eroding away VA pensions.

(4) An increase in the dependency income exclusion for the nonservice-connected veteran in order that a wife can pursue gainful employment without the penalty of a reduction in her husband's pension benefits.

We are knowledgeable of numerous bills introduced into the 93d Congress concerning pension. We hope that vou take a long and scrutinizing look at these proposals and evaluate their effectiveness to relieve the plight of the severely disabled veteran who must rely upon his pension to live. The answer to total rehabilitation of the disabled veteran, and the paraplegic in particular, does not lie in monetary benefits alone. Provisions must be made to educate, retrain, and employ each individual to his fullest level.

There is a tremendous need for counseling of young veterans with severe disabilities in order that they learn their potential and are motivated toward achieving that level. Jobs must be made available. This is not to say jobs should be created for the disabled veteran, only that they should be available for qualified individuals without prejudice to their disability. The Government itself is the most qualified and has the most to gain from employing disabled veterans. Yet the sad truth is that the Government seems to have lost interest in the creative capabilities of its veterans, once they have served their purpose as soldiers. This is intolerable, both from the standpoint of the indignation suffered by the veteran and the valuable waste of human resource. We must instigate a program of career opportunities which provides the disabled veteran the chance to retain his personal dignity, satisfy his vocational ambitions, and earn an equitable income. The restoration of a human being back into society after the ravages of war must be of an equal priority as national defense. For what is there to defend if those who must suffer the brunt of battle are discarded afterwards or receive only minimal survival care?

It is all very simple and as plain as the noses on our faces; it is time to do something for the veteran besides talk. I repeat; let us do something for the veteran and not to him. The Vietnam war has cost this Nation $130 billion, nearly 50,000 dead, 300,000 wounded, and at least 2,500 of these are suffering from some type of spinal injury.

With the proposal of $10 billion more to reconstruct Vietnam, whatever possesses those who make these proposals that veterans should suffer even further-that VA hospital bed space should be cut to 80.000 for fiscal year 1974 and that nonservice-connected pensions should be reduced because of social security increases and other pension plans. It has been further proposed to include wives' income in the computation of veterans' income for veterans' pension, sinking him to a lower poverty level of living.

It appears that there is an insidious move to place the nonserviceconnected veteran on welfare. If and when he is relegated to that level, the veteran will have lost any remaining self-respect.

Even though the President has rescinded the recomputation of the disability rating scale, there exists the real possibility that entitled benefits and programs are in jeopardy. How can this be tolerated?

With all due respect, I just wonder what would happen if a POW was discharged or was retired tomorrow and in 6 months he had the misfortune of becoming catastrophically disabled. What benefits would he and/or his dependents be entitled to as a nonservice-connected veteran?

You should know that the service-connected paraplegic veteran is concerned for the nonservice-connected paraplegic veteran, indicative of our testimony here today. Yes, the paralyzed veterans of America is highly concerned.

Gentlemen, I leave you with the definition of a paraplegic and the purpose of our organization: A paraplegic is an individual. The Paralyzed Veterans of America is an organization formed by and for the most seriously disabled in the world. It is devoting its life and effort to every problem of each paraplegic regardless of race, creed or color.

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