The3rd meeting of the Interim Joint Committee on Seniors, Veterans, Military Affairs, and Public Protection was held on Thursday, September 4, 2008, at 1:00 PM, in Room 169 of the Capitol Annex. Representative Tanya Pullin, Chair, called the meeting to order, and the secretary called the roll.
Members:Senator Elizabeth Tori, Co-Chair; Representative Tanya Pullin, Co-Chair; Senators Perry B. Clark, Carroll Gibson, Denise Harper Angel, Joey Pendleton, Jerry P. Rhoads, Dorsey Ridley, Dick Roeding, Katie Stine, and Jack Westwood; Representatives Larry Belcher, Tom Burch, Dwight D. Butler, Larry Clark, Tim Couch, Ron Crimm, Bill Farmer, David Floyd, Jeff Greer, Jimmie Lee, Tim Moore, Rick G. Nelson, Fred Nesler, Steve Riggs, Tom Riner, Carl Rollins II, Steven Rudy, Sal Santoro, Charles Siler, Dottie Sims, and Ancel Smith.
Guests: Keith Kappes, Vice President for University Relations Institute; Art Craig, Director, Kentucky Community and Technical College System, Kentucky Approving Agency for Veterans Education; Larry Cook, Executive Vice President for Health Affairs, and Shannon Turner, Assistant Vice President for Health Affairs, University of Louisville.
LRC Staff: Erica Warren, CSA, Mustapha Jammeh, Andrew Coyle, Clint Newman, and Rhonda Schierer.
Co-Chair Pullin asked members to take note of the minutes from the August 18, 2008 committee meeting. After a motion and a second, the minutes approved by a unanimous voice vote.
Co-Chair Pullin mentioned that Sergeant Keith Cooper was recently killed in Iraq and there would be a resolution at our next meeting. She asked members to keep his family in their prayers. Co-chair Pullin also mentioned that the National Guard had been deployed to the hurricane zone in Louisiana.
Co-Chair Pullin read a resolution for a fallen soldier, Second Lieutenant Howard C. “Cliff” Enoch Jr., who died on March 19, 1945, when flying a World War II combat mission over Germany. His remains were discovered and identified by the United States Army on April 19, 2008. Co-Chair Pullin asked the committee to observe a moment of silence to honor his memory and also for all those who remain missing in action.
Co-Chair Pullin recognized a special guest, Brigadier John Heltzel, the new Director of Emergency Management for Kentucky.
Co-Chair Pullin introduced Keith Kappes, Vice President for University Relations Institute at Morehead State University and asked him to tell the committee about the Eagle Monument Veterans Memorial. He shared with the committee what their institution is doing to honor veterans and to encourage them and their families to take advantage of higher education. He stated that the first project in their efforts is to honor Captain William E. Barber, USMC, of Morgan County; by installing and dedicating a marker for alumnus Captain Barber on Veteran’s Day. Captain Barber’s name and achievements during WWII and the Korean War will be displayed on the University’s Eagle Monument.
Co-Chair Pullin introduced Art Craig, Director of the State Approving Agency for Veterans Education for the Kentucky Community Technical College System (KCTCS). Mr. Craig shared KCTCS’s role in veterans’ education and training. He stated that when the legislature approved the creation of the community and technical college system, it provided a vehicle and environment that allowed their agency to best fulfill their role and responsibilities in the approval of programs eligible for GI Bill benefits.
Mr. Craig stated that their missions primary function is that of an approval agency of programs eligible for GI education benefits. They provide technical assistance, evaluate application information, conduct inspection visits, and notify public and private schools and training establishments of their approval or disapproval. Mr. Craig stated that in order for our veterans to receive educational assistance benefits while in the training phase of their employer, the agency approves on-the-job apprenticeship training in business and industry, joint apprenticeship training councils, and in the public sector.
Mr. Craig stated that state approving agencies are both the face and gatekeeper of the GI Bill at the state level. The U.S. Department of Veterans Affairs Education Service no longer maintains a presence in the Commonwealth of Kentucky. Without the presence of Veterans Affairs (VA) staff in Kentucky, the Kentucky Approving Agency for Veterans provides services mandated in federal legislation as well as value added services that benefit the veterans of Kentucky. Mr. Craig stated that they currently have four full-time employees. Mr. Craig added that the newly passed Post 9/11 GI Bill created a sound base for funding state approving agencies in the future.
Mr. Craig shared information about the GI Bill and its impact on veterans and other eligible persons in Kentucky. He stated that in 2007 veterans and other eligible persons received $46,140,000 in education and veteran’s rehabilitation benefits for the year. Mr. Craig added the Post 9/11 GI Bill payment of benefits will begin for training pursued on or after August 1, 2009. He noted that individuals will remain eligible for 15 years after discharge. The new bill will also pay tuition and fees, monthly housing allowances, and a stipend for books and supplies. Mr. Craig concluded that this bill not only addresses readjustment into civilian life, but also contains stipulations that promote retention and reenlistment. Administration of the new GI Bill will be outsourced.
Co-Chair Pullin asked whether there was ever a VA education office in Kentucky. Mr. Craig stated that there was an Education Liaison Representative only and that the VA is consolidating offices around the country, and Kentucky’s contact is now in Nashville, TN.
Co-Chair Tori asked about the outsourcing of the administration of the new GI Bill. Mr. Craig stated that the Education Service in the VA office and their staff have started the process. Mr. Craig stated that it has to be before August 1, 2009. He added that the VA Central Office staff claims it would take an additional 1000 staff to administer the program and that is why they are outsourcing it. Co-Chair Tori commented that she feels when the new GI Bill is put in place and troops are informed about benefits, it will swell enrollment in the KCTCS system.
Co-Chair Pullin called on General (Ret.) Les Beavers, Commissioner, David Worley, and Marty Pinkston, Deputy Commissioner, Kentucky Department of Veterans’ Affairs (KDVA). Gen. Beavers gave a presentation on the KDVA’s budget and legislation passed during the 2008 Regular Session. Gen. Beavers stated that the general fund in FY08 Actual was $17,813.800 and the restricted funds for FY08 are $26,643.100. He stated that the cost break down in the nursing homes is roughly 1/3 by the state general fund, 1/3 by the federal government, and 1/3 by the veterans themselves. Gen. Beavers stated that the only other operational offset they get is a $300 plot interment allowance for every veteran that is buried. The FY09 revised shows that there is a 6% cut which amounts to over $1 million. General Beavers gave a projected reduction plan of $1,834,000 to include reductions in personnel through attrition, reduction in printing, fleet, outreach, contracting pharmacy services, eliminating daycare for staff, increasing maximum resident charges, abolishing chaplain positions, reducing non-nursing staff, and reducing or eliminating travel in field operations.
Gen. Beavers continued the presentation and discussed key operational cost increases of up to $632,114 due to the rising cost of supplies, food, medications, utilities, and fleet. Gen. Beavers stated that the daycare services would cease September 19, 2008, for the facilities staff for the Thompson-Hood, Eastern Kentucky, and Western Kentucky Veterans Centers. He stated that 21 employees will lose their positions in daycare but KDVA is trying to place them within the agency as positions become available. 14 employees have been placed into positions already.
Gen. Beavers stated that the Veterans Service Organization (VSO) training grant allocation for FY08 is $67,500 and $100,000 for FY09.
Rep. Riggs asked Gen. Beavers about the disparity of the number of veterans field representatives per region population. General Beavers stated that staffing is based on access, travel distance, number of claims in each region, and time for the veteran to get to the field office or veterans service organization. Gen. Beavers stated that veterans can file a claim online; Gen. Beavers noted that there can be a $6,000 positive difference in an award for a veteran who has an advocate with expertise filing claims and providing representation; which is crucial for the veteran.
Sen. Stine asked about the governor’s 4.5% cut reduction and if there was an explanation for it. Gen. Beavers stated that it shows their portion based on revenue shortfalls. Senator Stine asked about dental services for veterans. Gen. Beavers stated that the VA does not provide dental services. Co-chair Pullin suggested that the Veteran’s Benefits Officer might be aware of dental clinics for veterans’ dental needs.
Rep. Nelson asked about the cutting of $100,000 for chaplain services and if the KDVA is spending any money on chaplain services. Gen. Beavers stated that the chaplains had not been eliminated yet, but the $100,000 cut is programmed on the basis that the KDVA would eliminate the services and seek assistance from nearby pastors.
Sen. Roeding stated that Kentucky has lost 74 soldiers in the Iraq and Afghanistan Wars and wanted to know how many Kentucky soldiers were lost in Vietnam and in Korea. General Beavers stated Kentucky lost 1,100 in Vietnam and 90,000 served in Korea but he was unsure of the total of losses.
Rep. Floyd asked how long it took for the KDVA to go through the process of changing an administrative regulation. Gen. Beavers stated it took approximately 90 days. Rep. Floyd asked Gen. Beavers if they would like to keep the maximum charge for nursing home services specified by regulation or prefer more flexible language. Gen. Beavers stated it was only recently that they had to go to a KAR because their legal authority to set a rate was challenged.
David Worley discussed specifics on the Kentucky veterans homes. Mr. Worley stated that the Thompson-Hood Veterans Center in Wilmore, Kentucky is the largest veterans center, Western Kentucky Veterans Center stays at full capacity with a waiting list, and Eastern Kentucky Veterans Center is at full capacity with the exception of 2 rooms due to residents with contagious issues. Mr. Worley pointed out that the federal government and the VA helped in getting 2 new community-based outpatient clinics opened in Owensboro and in Grayson County and they are working on getting clinics in Berea, Maysville, and Hopkinsville.
Mr. Worley stated that Kentucky averages 510 residents in all 3 veterans nursing homes on a daily basis. Currently 282 residents receive free medication from the VA. He pointed out that federal regulation was recently changed for any veteran with a 70% service connected disability or higher to have their daily regular care paid by the VA. He added that effective July 1, 2008, the VA stopped charging those qualified for any cost of care and the VA will retroactively pay for those residents eligible back to March 22, 1987.
Co-Chair Pullin asked Mr. Worley if the residents eligible for free medicine from the VA can possibly be paid for by Medicare Part B or by private health insurance. Mr. Worley stated that Medicare Part B only pays for some supplies but not for medication. Co-Chair Pullin asked if they bill private health insurance. Mr. Worley said no, the VA pays and it cannot bill the private health insurance due to the way the laws are set up for the nursing homes. Co-Chair Pullin stated that if something can be changed in the law to make it possible to bill private health insurance for some of the medications that the general fund is now paying for, she would like to help work with Mr. Worley to get that accomplished. Mr. Worley said that the VA bills a flat rate at the veteran’s ability to pay.
Rep. Clark asked if the VA encourages and assists families enrolling people into the nursing homes. Mr. Worley said they help with paperwork and whatever they need. He added that they simply cannot bill their insurance company.
Sen. Westwood stated that last year they had a program called “Help Is On the Way” where a bus went through the state of Kentucky offering help with pharmaceuticals for those who would qualify. He asked Mr. Worley if the veterans homes are taking advantage of what that group offers. Mr. Worley stated that they had not because they get all their medications straight from the VA.
Rep. Nelson inquired about there being 510 residents and 724 employees and if the 724 employees included field representatives. Mr. Worley stated that the 724 employees includes all the nursing home employees such as administrative people, maintenance people, and the nursing care employees. He added that a lot of nursing homes contract out their maintenance such as grass cutting, food, cooking, etc. but the VA employs all of these. Rep. Nelson asked how many of the 724 employees are caregivers. Mr. Worley stated that 68% of their employees are direct care nursing staff.
Mr. Worley moved forward with the presentation to their Capital Projects which included a 3-unit renovation and installing elevators to the Thompson-Hood Veterans Center, expansion at Western Kentucky Veterans Center, and the new Central Kentucky Veterans Center in the Hardin County area. Mr. Worley ended with discussing the U of L Robot Project and stated that Dr. Remmel and U of L have looked at the estimate of how much installing wireless access at nursing homes was going to cost COT. That estimate was put as $40,000. He added that U of L is gathering data for a comprehensive proposal. Co-chair Pullin added that in the state budget there is a veterans service improvement trust fund and that is an effort to help the VA to keep monies found to remain for veterans services instead of going back into the general fund hopefully to assist with some of the budget cuts the KDVA will endure. Mr. Worley stated that it was greatly appreciated.
Gen. Beavers continued by briefing the committee on the state veterans cemeteries. He stated that the Kentucky Veterans Cemetery (KVC) West facility was opened in March, 2004, and has 27,600 burial sites with a total of 914 interments, KVC Central has 6,100 burial sites and there have been 546 interments, and KVC North was dedicated on August 22, 2008, and had a burial capacity of 5,736. He added that a KVC is being designed for the Northeast in Greenup County and the master plan for this project will be submitted on October 20, 2008. Gen. Beavers added that they are looking at land in Leslie County for the 5th cemetery. Gen. Beavers spoke on the Burial Honors Program stating that in FY08 there were nearly 2000 burial honors.
Marty Pinkston, Deputy Commissioner, KDVA and Trust Fund board member to spoke next on the Veterans Program Trust Fund. Mr. Pinkston is the Secretary of the Board, which is composed of two statutorily named members, KDVA Commissioner and KDVA Deputy Commissioner, and eight appointees by the Governor.
Mr. Pinkston introduced 6 other members of the board in attendance. Mr. Pinkston gave several sources of income for the Veterans Program Trust Fund. He added that its purpose is to provide services or assistance to veterans that is not otherwise provided. Mr. Pinkston told the committee that the Annual Report from July1, 2007, through June 30, 2008, for the Veterans Program Trust Fund was included in their folders and is a part of this record.
Mr. Pinkston asked Carlos Pugh, a member of the board who represents the VFW, to talk about the Honor Flight, which is a new program for the veterans. Mr. Pugh stated that there have been two Honor Flights, in which WWII veterans got to go to Washington, D.C. to see the WWII Monument. The cost is $250 for each WWII veteran which is covered by the trust fund. Along with the 40 WWII veterans there are 15 caretakers that go on the flight who pay their own way. He added that there are 33,000 WWII veterans living in the state of Kentucky today and expressed his desire to get as many on the Honor Flight as possible.
Next representation from the University of Louisville (UofL) gave an update on the Veterans Nursing Homes Quality Enhancement Program. Shannon Turner, Assistant Vice President for Health Affairs stated that Dr. James Ramsey at UofL is very excited to be working with the veterans nursing homes and working towards getting the new VA hospital in Louisville. Ms. Turner turned the presentation over to Dr. Larry Cook, Executive Vice President for Health Affairs, UofL. Dr. Cook stated that there is a great demand for the 3 current facilities and that each is currently at capacity with extensive waiting lists for services. He added that part of the reason that UofL is involved is to provide the veterans nursing homes access to 24/7 specialty care such as neurology, geriatrics, and geriatric psychiatry. Use of the RP-7 robot enables the highest quality of care to be delivered to even the most remote areas of the Commonwealth. The RP-7 robot enables remote delivery of health care and they have currently deployed a robot to 12 hospitals throughout Kentucky. He stated that the quality of interaction between the referring physician, patient, and UofL specialists at the home base is amazing. Dr. Cook explained that one of the instrumental concerns for the veterans nursing homes was the lack of access to psychiatric care so they have added it. Dr. Cook added that the next step will be to work with the KDVA to determine which wireless option best suits their needs and that UofL has planned to approve up to $50,000 of their grant to provide the wireless capacity. Co-Chair Pullin thanked him for their generosity. Dr. Cook concluded his presentation and said that the partnership between KDVA and UofL will make Kentucky the national leader in providing quality health care services to our veterans and that UofL is pleased to help provide leading edge care to those who have served our nation.
There being no other business, the meeting adjourned.