May 2007

Rep. Filner, Coalition push VA bills

Rep. Bob Filner (D‑CA) has introduced two bills that will help make chiropractic available to all veterans of the US Armed Forces, and remove the onerous medical gatekeeper system. Rep. Filner has worked closely with representatives of the Chiropractic Coalition, made up of the World Chiropractic Alliance (WCA), International Chiropractors Association (ICA) and Federation of Straight Chiropractors and Organizations (FSCO).

The bills ‑‑ HR 1470 and 1471 ‑‑ are titled, respectively, the "Chiropractic Care Available to All Veterans Act" and the "Better Access to Chiropractors to Keep our Veterans Healthy Act (BACK Veterans Health Act)."

HR 1470 amends the Department of Veterans Affairs Health Care Programs Enhancement Act of 2001 to require the provision of chiropractic care and services to veterans at all Department of Veterans Affairs medical centers. It specifies that chiropractic services be made available at not fewer than 75 medical centers by not later than December 31, 2009, and at all medical centers by not later than December 31, 2011.

HR 1471 amends title 38, United States Code, to permit eligible veterans to receive direct access to chiropractic care. The bill calls for the eligible veterans to receive needed chiropractic care ‑‑ including preventative health care ‑‑ from a licensed doctor of chiropractic on a direct access basis at the election of the eligible veteran, if such services are within the State scope of practice of such doctor of chiropractic .

It also notes that "The Secretary shall not discriminate among licensed health‑care providers in the determination of needed services."

"Rep. Filner's willingness to introduce these two important chiropractic bills again affirms his status as one of our profession's most steadfast Congressional allies," stated WCA President Terry A. Rondberg, DC, one of Filner's constituents. Dr. Rondberg has established a close relationship with Filner over the past several years and has been active in fundraising for the San Diego area representative.

This isn't the first time Filner has introduced bills geared to helping ensure that all veterans had full access to chiropractic care.

In 2004 and 2005, he pushed for similar bills after the majority of members on the Veterans Affairs Chiropractic Advisory Committee (CAC) voted in favor of a "gatekeeper" system. The Committee's recommendation was to require patients to have a "consultation" with a medical provider before being allowed to see a doctor of chiropractic.

Only two members of the CAC voted for direct access, arguing that the long standing bias against chiropractors by medical doctors could make it nearly impossible for the veterans to see a DC. Dr. Leona Fischer of the WCA and Dr. Michael McLean of the ICA voted for direct access.

Voting against direct access were the three doctors nominated by and/or aligned with the American Chiropractic Association (ACA): Dr. Rick McMichael, DC, the ACA's Ohio Delegate; Cynthia Vaughn, DC, president and executive director of the Texas Board of Chiropractic Examiners and partner in the Chiropractic & Spine Center of Austin with James D. Edwards, DC, former president of the ACA; and Reed C. Phillips, president of Los Angeles College of Chiropractic who served as a member of the Mercy Center Consensus.

Siding with the ACA‑supported committee members was Charles Duvall, Jr., DC, president of the National Association of Chiropractic Medicine. The ACA had originally opposed Duvall's appointment, yet all chiropractors other than the WCA and ICA members voted with him on this key issue.

When introducing his previous bill, Filner made a impassioned plea before the House, stating: "Over the years ... representatives of the Department of Veterans Affairs have come before the House Veterans Affairs Committee, a panel on which I serve, and have insisted that chiropractic benefits are available to veterans and that no bias exists within the VA against the chiropractic profession.

"But, the facts ... speak otherwise. For all practical purposes access to chiropractic care has been non‑existent within the VA system. Chiropractic care has so seldom been offered to veterans that it can be fairly said to be a phantom benefit and for years, Mr. Speaker, the VA has done nothing to correct this deficiency. There is simply no evidence that the VA has ever acted proactively in any meaningful and substantive way to ensure that chiropractic care is made available to veterans ‑‑ and because of that track record of neglect the US Congress felt compelled to take action.

"As a result, Congress in recent years has enacted three separate statutes seeking to ensure veterans access to chiropractic care (Public Law 106‑117, Public Law 107‑135 and Public Law 108‑170). The last of those statutes gives explicit authority to the VA to hire doctors of chiropractic as full time employees. I'm proud to have worked with colleagues on both sides of the aisle to help advance those initiatives ‑‑ and I am hopeful that a reluctant VA has finally seen the light.

"I understand that, last year, former VA Secretary Principi released new policy directives regarding chiropractic care and that we may be on our way to seeing the true and full integration of chiropractic care into the VA. But, Mr. Speaker, if the past is any guide to the future, then I must remain concerned until I see these new policies firmly in place and working well in all VA treatment facilities.

"To help ensure that, in the future, barriers to veterans who want and need chiropractic care are fully removed, I am pleased to introduce legislation that would require the VA to make chiropractic care available on a direct access basis to our veterans. Perhaps my legislation will prove not to be necessary ‑‑ because referrals to doctors of chiropractic will actually take place with the encouragement and support of the leadership of the VA. But as insurance the enactment of the legislation I propose would guarantee the right of a veteran to obtain this important service without the cost and stumbling blocks of going through potentially hostile gatekeepers.

"Accordingly, I urge my colleagues to join me in supporting unimpeded access to chiropractic care throughout the veterans health care system and help enact this measure..."

All three members of the Chiropractic Coalition endorsed Filner's earlier direct access bills. In applauding Filner's efforts in 2005, Dr. McLean noted that the "ICA enthusiastically supports this initiative. There is no question that veterans should have the minimum amount of bureaucracy standing between them and the care they want, and that the current status of the chiropractic program within the VA, requiring primary care referral is unacceptable to the ICA, to the profession at large, and to the veteran beneficiary."

The FSCO, a member of the Chiropractic Coalition with the WCA and ICA, favored the bill as well. "(The bill) will go a long way to right an injustice to our veterans," said Richard Plummer, DC, then‑FSCO Board chairman. "Our veterans (of which I am one) should have the right and freedom to go to the health care provider they choose and not have to go through a gatekeeper. The FSCO firmly supports direct access for all American veterans to receive chiropractic care and will work to support Rep. Filner's Bill."

Filner has had a long‑standing relationship with the Chiropractic Coalition and has been a special guest at the Coalition's Legislative Day. His position as chair of the Veterans Affair's committee has made him a powerful ally in the fight for veteran's health care rights.

All chiropractors are asked to contact their representatives and urge them to co‑sponsor and/or support Rep. Filner's bills.