CONSIDERING VETERANS' NEEDS

A Report to the Governor
and the
55th Legislature
of the Joint Interim Subcommittee
on Veterans' Needs

October 1996

  "The people declare that Montana servicemen,service women, and veterans may be given specialconsiderations determined by the legislature." (Art. II, Section 35. Montana Constitution)

Prepared by Susan Byorth Fox
Legislative Research Analyst
Office of Research and Policy Analysis
Montana Legislative Services Division

JOINT INTERIM SUBCOMMITTEE ON VETERANS' NEEDS

MEMBERSHIP

Representative John Johnson, Presiding Officer

Senator Don Hargrove, Vice Presiding Officer

Senator Jim Burnett

Senator Bob Pipinich

Senator Bill Wilson

SUBCOMMITTEE STAFF

Susan Byorth Fox, Legislative Research Analyst
Eddye McClure, Attorney
Christen Vincent Tecca, Secretary

Published by:

Montana Legislative Council
Senator John "J.D." Lynch, Presiding Officer

Montana Legislative Services Division
Robert B. Person, Executive Director
David D. Bohyer, Director, Office of Research and Policy Analysis
Gregory J. Petesch, Director, Legal Services

TABLE OF CONTENTS

House Joint Resolution No. 19

Introduction

Subcommittee Activities and Review of Recommendations

Issues and Recommendations

Appendices

References and Resources

HOUSE JOINT RESOLUTION NO. 19

INTRODUCED BY REPRESENTATIVE BOB PAVLOVICH

A JOINT RESOLUTION OF THE SENATE AND THE HOUSE OFREPRESENTATIVES OF THE STATE OF MONTANA REQUESTING AN INTERIMSTUDY OF THE NEEDS OF MONTANA VETERANS; AND REQUIRING A REPORTOF FINDINGS AND RECOMMENDATIONS OF THE STUDY TO THE 55THLEGISLATURE.

 WHEREAS, Montana has the third highest per capita number of veteransin the United States; and
 WHEREAS, 26%, or 26,291, of Montana's veterans are 65 years of ageor older; and
 WHEREAS, Montana currently provides a total of 175 beds for veteranswho require nursing home care, which are insufficient to provide for the nursingcare needs of Montana's veterans; and
 WHEREAS, federal guidelines suggest that Montana needs between 255and 408 state nursing home beds, and the guidelines provide that these bedscan be built and operated with federal funding assistance from the federalDepartment of Veterans Affairs; and
 WHEREAS, the state veterans' nursing home at Columbia Falls servesveterans in northwestern Montana, and the state veterans' nursing home atMiles City serves veterans in eastern Montana, leaving southwestern andcentral Montana unserved, and the area of Deer Lodge and Silver Bow Countieswould provide an ideal location in which to establish a state veterans' nursinghome that is accessible to veterans in the southwestern and central regions ofMontana; and
 WHEREAS, health care reform has stalled at the federal level, andincremental insurance-based reforms will not address all of the needs ofMontana's veterans; and
 WHEREAS, there may still be a significant effect on the health care ofveterans because of impending changes at the national level regarding federalhealth care policy for veterans; and
 WHEREAS, the Joint Interim Subcommittee on Veterans' Needs createdby the 1993 Legislature provided an important liaison between stategovernment and veterans, and the continuation of a similar subcommittee wouldbe of great service to Montana veterans.

NOW, THEREFORE, BE IT RESOLVED BY THE SENATE AND THE HOUSE OFREPRESENTATIVES OF THE STATE OF MONTANA:
 That the Legislative Council designate an appropriate interim committeeto continue to study the needs of Montana veterans and that the study include:
 (1) the feasibility of providing long-term nursing home care and homehealth care as it relates to Montana veterans and the role of the federalDepartment of Veterans Affairs and any changes in state or federal policybecause of health care reform;
 (2) a review of the extent of access, geographically and otherwise, ofveterans to health and nursing home care within Montana; and
 (3) the continuum of veterans' services available throughout the stateand determination of the role and potential for additional federally fundedveterans' programs in Montana.
 BE IT FURTHER RESOLVED, that the interim committee may requeststaff assistance and information from the Department of Military Affairs, theVeterans' Affairs Division, the Department of Corrections and Human Services,and other legislative or executive agencies that may have information relevantto veterans' affairs.
 BE IT FURTHER RESOLVED, that the interim committee report itsfindings, conclusions, and recommendations to the 55th Legislature.

INTRODUCTION

House Joint Resolution No. 19

House Joint Resolution No. 19 was introduced to address an ongoing concernfor veterans' needs in the State of Montana. The resolution was recommendedby a 1993 Joint Interim Subcommittee on Veterans' Needs. It was successfulin providing an opportunity for those interested in veterans' issues to focus theirenergies, to discuss veteran-related issues, and to sort through the manychanges at the state and federal level.

A change at the state level included a new state facility for the nursing care ofelderly veterans that was built in Glendive after many years of effort andlegislative attention. The Subcommittee was interested in overseeing theprogress of the facility because it represented a new form of public and privatepartnership. The state built the facility in conjunction with the federalDepartment of Veterans Affairs (VA). The state then contracted the operationof the facility to a private entity, the Glendive Medical Center.

Health care was a major issue at both the state and federal level, and reformefforts resulted in general health insurance reforms. The lack of overall reformresulted in concerns for veterans' programs, most of which are funded at thefederal level. This concern was reflected in the resolution.

The more general liaison function was valued from the 1993 interim and desiredfor the 1995 interim as well. The opportunity was valued for legislators,veterans' service organizations, and state agencies to share information in theinterim between sessions, to sort through issues, and to have time for researchand reflection. House Joint Resolution No. 19 was passed by the 1995Legislature, and a separate appropriation of $10,000 of cigarette tax revenuewas approved to fund the Subcommittee.

State Agencies With Veteran-Related Concerns

There are two state agencies that deal directly with veterans and veterans'issues. The Veterans' Affairs Division is administratively attached to theDepartment of Military Affairs. The Division is under the administration of theBoard of Veterans' Affairs, whose members are appointed by the Governor. The functions of the Board are to "establish a statewide service for dischargedveterans and their families, actively cooperate with state and federal agencieshaving to do with the affairs of veterans and their families, and promote thegeneral welfare of all veterans and their families" (10-2-102(1), MCA). Thereare five members on the Board representing different areas of the state.

The Veterans' Affairs Division executes the Board's duties. The Division isadministered in Helena and has eight field service offices. The field serviceoffices are in Helena, Billings, Butte, Bozeman, Great Falls, Kalispell, Missoula,and Miles City. The Division also works with a State Veterans' CemeteryAdvisory Council on the administration of the Montana State Veterans'Cemetery at Fort Harrison.

The Division assists veteran and surviving spouses in preparing and filing claimsfor state and federal benefits, obtains copies of military service records,coordinates with veterans' service organizations, operates and maintains theState Veterans' Cemetery at Fort Harrison, maintains burial records for the StateVeterans' Cemetery, and provides legislative liaison services.

As a result of executive reorganization proposed by the Governor and passedby the 1995 Legislature, the veterans' nursing home care and domiciliary careprograms were transferred to the Senior Support Services Division in theDepartment of Public Health and Human Services from the Special ServicesDivision of the Department of Corrections and Human Services.

The Senior Support Services Division is responsible for the administration of theMontana Veterans' Home at Columbia Falls and the Eastern Montana Veterans'Home at Glendive. The Montana Veterans' Home is owned and operated by theState of Montana, and as previously stated, the Eastern Montana Veterans'Home is owned by the state and leased to a private entity for operation andmaintenance.

Veterans' Nursing Care Homes

The 1989 Legislature authorized the building of a 100-bed veterans' nursingcare home in eastern Montana, increased the cigarette tax by 2 cents to helpfund construction, and appropriated the necessary funds (Ch. 681, L. 1989). The former Department of Corrections and Human Services initiated theconstruction funding application to the VA. A site selection committee choseGlendive in early 1990. The project did not make the final cut for VAconstruction, and the project was delayed because of a provision that requiredwritten confirmation of the allocation of federal funds before construction couldbegin (Ch. 683, L. 1989). State funding was to be used as a 35% match to VAfunding for the construction of the facility. The 1991 Legislature reappropriatedthe funds (Ch. 624, L. 1991), and the application was reactivated. InDecember of 1991, the VA notified the state that federal funds had becomeavailable. In 1992, the design development was completed and the size of thefacility reduced to 80 beds due to budget restraints.

The VA approved the design in December of 1992. The 1993 Legislaturereconsidered the project and approved the construction (Ch. 624, L. 1993) aftera compromise was reached with representatives from the veterans'organizations, the Glendive community, and state officials. The compromisewas that the state would build the facility but would contract with a privatecorporation to operate it. During the debate, it was made clear that becausethe state would provide no funding to the Eastern Montana Veterans' Home forongoing operation or veterans' assistance, the cost to the individual veteran atthe Eastern Montana Veterans' Home would be higher than the cost at theMontana Veterans' Home.

Legislation was also passed that appropriated a percentage of the 2-centcigarette tax (established by the 1989 Legislature) for the maintenance andoperation of state veterans' nursing homes (Ch. 548, L. 1993). Using apercentage of this revenue for maintenance and operation was a significantdeparture from the past use of the revenue, historically dedicated exclusivelyto debt service and the long-range building of capital projects.

The 1993 Legislature required the former Department of Corrections and HumanServices to negotiate an agreement with a private vendor to maintain andoperate the state-owned Glendive facility (Ch. 624, L. 1993). As a conditionfor VA funding, the state must have one full-time employee onsite. TheLegislature appropriated $290,000 in startup costs for the 1995 biennium. Construction of the 80-bed facility began in October of 1993 and wascompleted in February of 1995. The contract with the private vendor, GlendiveMedical Center, specified that the facility would not begin operation until 37eligible individuals were on the waiting list.

Because of difficulty in ensuring that the 37 beds at the Eastern MontanaVeterans' Home could be filled within time restraints imposed by the VA as acondition for matching funds, the 1995 Legislature appropriated an additional$136,464 for startup costs at the Eastern Montana Veterans' Home andremoved the requirement that would have delayed opening the facility untilthere were 37 eligible individuals on the waiting list. The amount of $90,000was appropriated for FY 1996, and the remaining $46,464 was paid July 1,1996, as appropriated for FY 1997, because the number of residents had notyet reached 37.

As of September 18, 1996, the Eastern Montana Veterans' Home had 68admissions and the census was 47 residents.See footnote 1 The administrator and thestate agency representative actively market the facility through writtencorrespondence and visits in Montana, South Dakota, North Dakota, andWyoming and in a quarterly newsletter and advertisements.

A special feature of the Eastern Montana Veterans' Home is a 10-bedAlzheimer's Unit that is designed for the special needs of residents withAlzheimer's disease. The Alzheimer's Unit is full to capacity at 10 residents.

SUBCOMMITTEE ACTIVITIES AND OVERVIEW OF RECOMMENDATIONS

The Subcommittee held its first meeting in December 1995. Staff reported ongeneral veteran-related issues and a proposed study plan. An update was givenon the status of the 1993 recommendations and legislation.

The 1995 Subcommittee had also solicited testimony from the interestedpersons of the 1993 Joint Interim Subcommittee on Veterans' Needs seekingitems of interest and concern for study during the 1995 interim. The 1995Subcommittee made recommendations and adopted additional items for study. Recommendations included the sending of letters opposing proposed cuts atFort Harrison, opposing regulating tobacco as a drug, and expressing concernsfor changes in residency requirements for the Director of Veterans' Preferenceand Training. Additional study items included a staff followup on Board ofHousing variables for future housing surveys, a proposal for an eastern Montanastate veterans' cemetery, parity between the two state veterans' nursing carehomes, National Guard proposals for a tuition fee waiver and a scholarshipprogram, and information on the veterans' preference law and consideration ofa proposal for changes to it.

The second meeting was held in May 1996 at the Eastern Montana Veterans'Home in Glendive. The Subcommittee received a tour and an update of theprogress of the facility. Members of the Subcommittee also toured the federalVeterans Affairs Medical Center at Miles City. At this meeting, theSubcommittee discussed parity in costs to the veteran between the EasternMontana Veterans' Home and the Montana Veterans' Home in Columbia Falls. The Subcommittee made an initial review of draft legislation on the siting of aneastern Montana state veterans' cemetery, the National Guard tuition fee waiverand scholarship program proposals, and changes in the veterans' preferencelaw.

The third meeting was held in Helena in August 1996. There were five issuesbefore the Subcommittee for which the Subcommittee held a public hearing andconducted executive action. Issue one was the eastern Montana stateveterans' cemetery proposal for which the Subcommittee adopted proposedlegislation. Issue two was the National Guard tuition waiver for which theSubcommittee adopted proposed legislation. Issue three was the NationalGuard scholarship program for which the Subcommittee adopted proposedlegislation. Issue four was consideration of changes in the veterans' preferencelaw. The Subcommittee did not pursue this proposal, but did adopt a proposalto send a letter to each Executive Branch agency expressing theSubcommittee's concern that veterans' preference was not being applied. Issuefive was consideration of a Department of Public Health and Human Servicesproposal for a subsidy for the Eastern Montana Veterans' Home in order toprovide parity with the Montana Veterans' Home in Columbia Falls. TheSubcommittee adopted a motion to send a letter to the Governor in support ofthe subsidy.

The Subcommittee also approved a recommendation to draft legislation for thecontinuation of a study committee and for a $10,000 appropriation for thatstudy from a portion of state special revenue collected through the cigarettetax. The Subcommittee also requested further information on the possibility ofusing space at the former Anaconda Hospital for veterans' nursing home beds,the possibility of having veterans' license plates with a handicapped designationon them, and the possibility of having a name or label for the various armedforces insignias on veterans' license plates.

ISSUES AND RECOMMENDATIONS

Veterans Benefits Administration Proposed Cuts at Fort Harrison

The Subcommittee received public testimony at the December 1995 meetingexpressing concern about a VA proposal to consolidate claims and benefitsprocessing and to move the functions from Fort Harrison to Phoenix and SiouxFalls. The proposal would have resulted in cuts of approximately 20 jobs in thedisability claims processing functions at Fort Harrison.

The Subcommittee agreed to send a letter opposing the cuts at Fort Harrison(see Appendix A). Responses to the Subcommittee's letters were received fromR.J. Vogel, Undersecretary of Veterans Affairs for Benefits, Senator MaxBaucus, and Joseph Underkofler, Administrator of Fort Harrison.

At the August 1996 meeting, the Subcommittee was informed that theSecretary of Veterans Affairs had stopped the proposal from going forward andthat there would be no further action or research on the matter. In order to dealwith the backlog of claims, the VA had intended to pursue greater use ofcomputerized technology, including the transfer of paper claim files to CD-ROMtechnology and generally streamlining the processes. Lack of technology andof completed and updated information contributed to the volume of the claimsbacklog, and moving the benefits processing elsewhere in the country wouldnot have solved that problem. Moving all files to CD-ROM for universal accesswould likely take up to 5 years to complete, but the upgrading of technologywas already beginning and was expected to be completed within a year.

Regulating Tobacco as a Drug

The Subcommittee received testimony that the Veterans Coalition was opposingaction of the Food and Drug Administration (FDA) in regulating of tobacco asa drug. The concern was that it would negatively affect the revenue from the2-cent cigarette tax that funds the maintenance and operation of the stateveterans' homes. Representative Pavlovich also shared correspondence that hepersonally sent to the FDA stating his opposition to the FDA's proposedregulations restricting the sale, distribution, advertising, and promotion ofcigarettes and smokeless tobacco products to youth. The Subcommitteeadopted a motion to send a letter to the Montana Congressional delegation andthe FDA protesting the regulation of tobacco as a drug (see Appendix B). Aresponse was received from Senator Conrad Burns.

Residency Requirements for the Director of Veterans' Employment and TrainingServices

The Subcommittee received testimony concerning the federal Department ofLabor and the residency requirement for the Director of Veterans' Employmentand Training. The initial concern was that it might prevent a Montanan fromholding that position in the future. The Subcommittee adopted a motion tosend a letter to the Secretary of Labor concerning the residency requirementsfor the position of Director of Veterans' Employment and Training.

Further staff research indicated that the proposal had been to delete a 2-year,in-state residency requirement for a person to hold that position. The proposalwas being explored in order to assist persons who may have held that positionor a deputy position in other states who may have been let go due to federalgovernment downsizing. A letter was sent to the federal Department of Laborupon clarification from the Subcommittee (see Appendix C). A response wasreceived from Richard E. Larson, Director of Operations, Office of the AssistantSecretary for Veterans' Employment and Training, Department of Labor (seeAppendix C).

Board of Housing Updates

The 1993 Joint Interim Subcommittee on Veterans' Needs had recommendeda resolution (HJR 1) passed by the 1995 Legislature that the MontanaDepartment of Commerce include a variable on veteran status in future housingstudies and surveys and that the Board of Housing (Board) use information onveteran status to develop special housing programs for veterans as allowed bystatute. The administrator of the Housing Division of the Department ofCommerce updated the Subcommittee at each meeting.

At the first meeting, the Subcommittee received handouts on the Boardprograms and the consolidation of the housing programs in the Department ofCommerce into a single Housing Division. The Subcommittee was informedthat veterans are eligible for any of the Board's single-family, home buyerprograms because of the VA guarantee. Staff was directed to follow up withthe Board on relevant variables for the next housing survey (see Appendix D).
In April, the Board agreed to provide home-ownership loans with nodownpayment to veterans who are eligible for a Certificate of Eligibility for LoanGuaranty Benefits. This program had been discontinued in the 1980s becauseof a high default rate. More recently, the Board had given VA-guaranteed loansbut required the same downpayment as Federal Housing Administration loans. The interest rate of a no-downpayment loan will be 0.25% higher than a loanwith a downpayment; however, the loan rate will still be 1% to 1.25% lowerthan a loan at market interest rates. In addition, veterans continue to be eligiblefor the Board's Cash Assistance Program and for VA programs such asrehabilitation grants.

The Department of Commerce Consolidated Planning process was initiated for1996. In response to the 1993 Subcommittee's request in HJR 1, topics forstudy included information on the housing needs of veterans and disabledveterans, as well as information from the U.S. Bureau of the Census regardingrace, income, ethnicity, age, etc. The Department of Commerce will gatherstatistical information from the VA and from Board information on income levelsand on veterans served by existing programs. Results from the study areanticipated by the fall of 1996, and a report will be made available to the 1997Legislature. This will be the first time that veteran-specific housing informationis collected, and it will be helpful to the Board for identifying housing needs ofMontana veterans.

Eastern Montana State Veterans' Cemetery

The Montana Veterans' Affairs Division is responsible for the administration ofthe State Veterans' Cemetery at Fort Harrison near Helena, Montana. Both the1993 and 1995 Legislatures approved cemetery improvements that are plannedfor completion by the summer of 1997. The Division recommended anadditional state veterans' cemetery to serve veterans in eastern Montana. TheVA will provide 50% matching funds for construction of a state veterans'cemetery. The maintenance and operation of the cemetery would be fundedthrough sales of veterans' license plates, donations, and plot allowances, as isthe current cemetery. At the first meeting, the Subcommittee approved thedrafting of legislation.

The Subcommittee received a detailed description of the proposed process fromthe Veterans' Affairs Division administrator, including the request for proposalphase through the construction phase (see Appendix E). The Subcommitteealso reviewed the draft legislation. The proposal, presented to theSubcommittee for approval at the final meeting, specifies that the Board ofVeterans' Affairs is the site selection committee and that the criteria for sitingthe cemetery is according to the requirements in federal law and regulation andthe most recent federal Department of Veterans Affairs National CemeterySystem Program Guide for State Cemetery Grants. Site selection requires a sitevisit and public hearing at the three sites with the highest numerical score. Thelegislation proposes a $10,000 general fund appropriation for the 1999biennium for expenses for the site selection and staff support (see Appendix E). The Subcommittee believed that it was important for the state to support theeffort from the general fund. If that proposal is not approved by the Legislature,the Subcommittee will substitute license plate state special revenue for thegeneral fund appropriation.

National Guard Tuition Waiver

At each meeting, representatives from the National Guard presented informationregarding a proposal to allow the Board of Regents to grant a tuition waiver fora spouse or children of a National Guard member who is killed or subsequentlydies from injuries, disease, or other disability incurred while serving on stateactive duty.See footnote 2 This would be similar to other tuition and fee waivers that theRegents are authorized to grant, such as for those honorably discharged frommilitary service, for children of those killed while in the service of the armedforces of the United States, for spouses or children of prisoners of war, or forsurvivors of firefighters or peace officers killed in the course and scope ofemployment.

The legislation gives the Board of Regents the authority to waive the fees butcannot mandate that it do so. To date, no National Guard member has beenkilled on state active duty. The Subcommittee approved the draft legislation(see Appendix F).

National Guard Scholarship

At each meeting, the Subcommittee received information on a proposal thatwould create a Montana National Guard scholarship program. This programwould provide a benefit exclusive of any other federal benefit and is intendedto be applicable to Montana University System colleges and universities,community colleges, tribal colleges, and Veterans Benefits Administration-approved training programs. The legislation includes rulemaking authority forthe Adjutant General of the Department of Military Affairs to adopt rulesnecessary to develop selection and qualification criteria and to establishprocedures and forms. The proposal would require a general fund appropriationof $1.14 million for the 1999 biennium.

This proposal was brought before the Subcommittee as a tool that the MontanaNational Guard could use to compete with surrounding states' educationalassistance programs. Other military benefit and aid programs, such as theMontgomery G.I. Bill or enlistment or reenlistment bonuses, do not apply to allGuard members. In addition, the Guard has undergone two majorreorganizations in the last 6 years. The changes have negatively affected theretention of fully qualified and trained individuals and the recruitment ofadequate numbers of new members. The program was presented as providingan incentive to new members in order to be able to fill the vacancies currentlybeing experienced by the National Guard. The National Guard representativesalso presented information regarding potential economic benefit to the state. As of July 31, 1996, there were 876 vacancies in the Montana National Guard. The unrealized economic impact of these vacancies was estimated at$2,680,560.See footnote 3

The Subcommittee approved the draft legislation (see Appendix G) that includesa $1.14 million appropriation for FY 1998 and FY 1999. The estimated numberof scholarships for the first year is 450, with a ceiling of 900 scholarships foreach succeeding year. This proposal is intended to be an ongoing program.

Veterans' Preference Law

The Subcommittee received information for a proposal to amend the veterans'preference law, which applies to all public employers, to expand the pointpreference to promotion, to require a public employer to administer a new testor reopen the current test if no applicant receives the required minimum 70%,to provide that a substantially equivalent procedure be used for any selectionprocedure under which an applicant receives a weighted preference, and toexpand the notice and enforcement provisions to any preference procedure. The proposal is intended to prevent public employers from legally avoiding theuse of veterans' preference by not using a scored procedure and to provideprotection to those for whom a scored procedure is not used.

Currently, veterans' preference is applied only when a scored procedure is used(in about one-third of the state agencies) and only during the initial hiringprocess. An applicant must receive a score of at least 70% in order to have theveterans' preference applied. A veteran receives an additional 5 points, and adisabled veteran receives an additional 10 points.

The Subcommittee was not prepared to "open up" the veterans' preference lawat this time and did not act upon the proposal for legislative changes. However,the Subcommittee did adopt a proposal to send a letter to each departmentdirector of a state agency to express concern about veterans' preference notbeing applied, either through the lack of use of a scored procedure or throughthe administration of a scored procedure for which it is unreasonably difficultto attain a score of 70 percentage points (see Appendix H). A response wasreceived by the Governor.

Parity Between Veterans' Homes

The Subcommittee heard testimony from representatives of the veterans'service organizations regarding the perceived unfairness of the difference in thecost per day for residence at the two veterans' homes. The FY 1996 cost perday for the Montana Veterans' Home was $88.61 and for the Eastern MontanaVeterans' Home was $98 (see Appendix I).

Veterans at each home receive the same per diem from the VA. The MontanaVeterans' Home is a state-operated facility and receives state funding from the2-cent cigarette tax earmarked for the maintenance and operation of theveterans' homes, including assistance for veterans who are unable to pay thefull cost of care and who do not qualify for Medicaid or Medicare. General fundrevenue is not used to operate either home. The Eastern Montana Veterans'Home is a state-owned facility leased to a private contractor for maintenanceand operation, and funds were not appropriated to assist veterans for their costof care. However, startup funding for Glendive Medical Center wasappropriated.

The Subcommittee considered a proposal included in the Executive PlanningProcess for the Senior Support Services Division of the Department of PublicHealth and Human Services (see Appendix I). The proposal is to include$134,320 of state special revenue from the cigarette tax each fiscal year toeliminate the approximately $10 difference in cost per day between patients atboth homes who do not qualify for Medicare or Medicaid and who are not ableto privately pay the balance. At Columbia Falls, this is approximately 35% to40% of the population. Current law authorizes DPHHS to expend cigarette taxfunds to support the maintenance and operation of state veterans' homes. Although the veterans' home in Glendive is not currently receiving cigarette taxmoney for the purpose of subsidizing patient costs, no new legislation is notnecessary so long as the payments are similar to the types of maintenance andoperation costs now being paid at Columbia Falls. This proposal would notprovide direct payments to individual patients. The money would be used todefer costs overall as it is at Columbia Falls. This is a similar amount of moneyfrom cigarette tax revenue that was used for startup costs for the EasternMontana Veterans' Home in the 1997 biennium.

The Subcommittee adopted a proposal to send a letter to the Governorsupporting the Department proposal and received a response from the Governor(see Appendix I).

Continuation of the Subcommittee

At the final meeting, Subcommittee members and interested persons discussedcontinuation of the Subcommittee. Testimony was received that theSubcommittee was helpful and needed in order to provide more informationabout veterans' needs. The Subcommittee proposed use of $10,000 in revenuefrom cigarette tax money to fund continuation of the Subcommittee. In thepast, the Subcommittee was proposed in a resolution for an interim study. Withthe inclusion of the appropriation, the legislation for a committee will be in theform of a bill (see Appendix J).

Other Information Requests

At the final meeting, the Subcommittee requested that staff research the useof the former Anaconda Hospital as a veterans' home. Additional informationon special veterans' license plates was also requested.

As a part of the VA changes in the state, the former Anaconda Hospital is nowbeing partially occupied by a VA continuing care center for primary and stablepatient followup. These patients will be initially seen, examined, and placed ona care regimen at Fort Harrison, and if they live in the area, can receivefollowup care in Anaconda. They will likely expand their use of the AnacondaHospital, but are unlikely to use the entire bottom floor.

A Subcommittee member expressed interest in the former hospital becoming aVA hospital. The VA is currently restructuring its medical facilities across thenation. Currently, the VA Medical Center at Miles City is changing to anoutpatient clinic function, with some observation beds for immediate attentionand continuation of the nursing home care unit. The VA facility in Billings willbe moving toward a full-fledged clinic. Those who require furtherhospitalization would be moved directly to a VA Medical Center at FortHarrison, Salt Lake City, or Denver. It is unlikely that the VA would pursue anyuse of the former Anaconda Hospital at a time when it is consolidating inpatientresources at the regional level and trying to use more localized outpatientresources when possible.

It is also unlikely that the VA would consider the use of the former hospital asa possible veterans' nursing home. As in the case with the recommendation forrenovating the Galen facilities, the VA will not award matching funds forrenovation projects for a veterans' nursing home. If the state wishes to pursuethe facility as a nursing home, it will have to do so with state dollars.

The two areas of inquiry brought before the Subcommittee regarding veterans'special license plates were:
 (1) the desire for the name of the service unit on the veteran's speciallicense plate in addition to the word "VETERAN" and the symbol of the serviceunit; and
 (2) the desire to have a wheelchair or handicapped symbol on a specialveteran's license plate.

In order to accommodate either request, legislation affecting statutory changeswould be necessary. Both requests would require the Department of Justice toredesign the license plate. There would have to be a compromise in the size orquality of the current symbol because there may not be sufficient space for allof the required information on the license plate. The second request would alsorequire a veteran to provide the proof of disability, as required.

A representative at the Department of Justice Motor Vehicle Division stated thatthe symbols were reduced to accommodate personalization of license plates. They have been reduced to the smallest size possible that will allow the detailson the symbol to still be clear. If these other elements are to be incorporatedon a veteran's license plate, there may have to be a tradeoff in the size or thenumber of the element on a plate between the word "VETERAN", the symbol,and a reference to the appropriate service unit and additional tradeoffs if theveteran desires a handicapped symbol.

Conclusion

The Joint Interim Subcommittee on Veterans' Needs has accomplished the basicdirectives of House Joint Resolution No. 19. Although there is still interest inadditional long-term nursing home care in southwestern Montana, theSubcommittee was pleased to visit the Eastern Montana Veterans' Home andto see it successfully building its program. The Subcommittee addressed thesingle complaint heard in public testimony by encouraging and supporting aDepartment of Public Health and Human Services solution to mitigating theinequity perceived between the two veterans' homes.

The access geographically to veterans' services is improving because of stateand federal efforts. The state has built and is contracting for the operation ofthe Eastern Montana Veterans' Home. The Subcommittee is endorsing andrecommending a proposed veterans' state cemetery in eastern Montana, whichis a state effort that accesses federal funds. Finally the VA is restructuring, islocating clinic and other medical resources closer to veterans' homecommunities, and is accentuating outpatient, local resources that maintainveterans closer to home and family.

As the Subcommittee experienced in the 1993 session, the state agencyrepresentatives and veterans' service organizations were a valuable source ofinformation. Their effort that was greatly appreciated by the 1995 Joint InterimSubcommittee members and staff.

APPENDIX A

APPENDIX B

APPENDIX C

APPENDIX D

APPENDIX E

APPENDIX F

APPENDIX G

APPENDIX H

APPENDIX I

APPENDIX J

REFERENCES AND RESOURCES

Montana Veterans' Affairs Division, Service For Those Who Served, undated,presented December 14, 1995.

Susan Byorth Fox, General Information on Veterans-Related Issues in Montana,Montana Legislative Services Division, December 1995.

c25 6284sfxb.

Footnote: 1 As per telephone conversation with Sue Lesuer, Receptionist/Secretary, Eastern Montana Veterans' Home, 9/18/96.Footnote: 2State active duty means that orders are issued by the Governor that call the National Guard members to duty for the protection or benefit of the State of Montana.Footnote: 3 National Guard staff based this estimate on an annual salary for each new recruit of $2,000 and an economic multiplier of 1.5. If each position remained unfilled, then it would result in an unrealized economic impact of lost wages and less state income tax collected.

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