WASHINGTON, D.C. - On March 30, Department of Veterans Affairs (DVA) Secretary Anthony Principi announced an historic and far-reaching blueprint for formalizing the full inclusion of chiropractic care into the massive veterans health care system in the United States.
"This is a great victory for veterans and an historic new opportunity for doctors of chiropractic across America," said Donald Krippendorf, DC, president of the American Chiropractic Association (ACA) and a U.S. Navy veteran. "Secretary Principi always makes certain that veterans come first. He's done so today by acting decisively to bring chiropractic care into veterans hospitals from coast-to-coast and to make doctors of chiropractic full partners in providing care to all those who answered our country's call to serve."
Since the creation of the DVA health system, the nation's doctors of chiropractic have been kept outside the system and all but prevented from providing proven, cost-effective and much-needed care to veterans, including those among the most vulnerable and in need of the range of health care services DCs are licensed to provide.
In 2002, 4.5 million patients received care in DVA health facilities, including 75% of all disabled and low-income veterans. Although the DVA health care budget is roughly $26 billion, in 2002, less than $370,000 (.0014%) went toward chiropractic services for veterans.
In issuing the order to his department to begin inclusion of chiropractic care, Secretary Principi specifically acknowledged that the goal is "to ensure that chiropractic care is ultimately available and accessible to veterans who need it throughout the DVA system."
Key elements include:
- the DVA's endorsement of the integration of full-scope chiropractic care (under applicable state law) into all missions of the DVA health care system - including patient care, education, research and response to disasters and national emergencies- and DVA facilities across the country;
- the DVA's endorsement of a successful and patient-friendly model - essentially based on the operations of Bethesda National Naval Medical Center - of full integration of doctors of chiropractic as partners in health care teams;
- the inclusion of chiropractic care into the VA's funding of research into treatment of service-connected conditions;
- the inclusion of chiropractic colleges and students in training programs at VA facilities; and
- the establishment of a goal to ensure continuity of chiropractic care for newly discharged veterans who have been receiving chiropractic care through the Defense Department health care system.
Direct Access Bill Introduced in Congress
On March 31, only a day after Secretary Principi's historic announcement, Congressman Bob Filner (D-CA) introduced HR 4051 - legislation to provide veterans with direct access to doctors of chiropractic through the DVA health care system. The ACA worked closely with Congressman Filner on the direct access bill now before Congress, and on other ongoing efforts to ensure unimpeded access to chiropractic care.
In the past, segments of the federal bureaucracy have been reluctant to implement directives from Congress regarding chiropractic care. This new bill seeks to send a message to opponents of chiropractic inside and outside of the government that America's veterans will not be denied the chiropractic care they need and deserve.
The Filner bill seeks to amend Title 38 of the United States Code to permit eligible veterans to receive direct access to chiropractic care at DVA hospitals and clinics. Section 3 of HR 4051 states: "The Secretary [of Veterans Affairs] shall permit eligible veterans to receive needed [health care] services, rehabilitative services, and preventative health services 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." The measure goes on to directly prohibit discrimination among licensed health care providers by the DVA when determining which services a patient needs.
Congressman Filner is a senior member of the Committee on Veterans Affairs. He represents California's 51st Congressional District, including Imperial County and a portion of San Diego County. In 2004, the ACA presented Congressman Filner with its Veterans Health Care Leadership Award.
ICA Quick to Support Filner Bill
The same day the Filner bill was introduced, the International Chiropractors Association (ICA) urged "all in chiropractic to contact their U.S. Congressional Representatives and urge them to co-sponsor this important bill."
"ICA enthusiastically supports this initiative," said ICA Legislative Committee Chairman Dr. Michael S. McLean. "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." Dr. McLean serves on the Chiropractic Advisory Committee and has participated in every aspect of the development of the legislation that established the VA chiropractic program, including the efforts of the committee to advise Secretary Principi on the details of the program.2,3
- VA Chiropractic Advisory Committee finalizes recommendations; Secretary Principi expected to review soon. Dynamic Chiropractic, Nov. 17, 2003. www.chiroweb.com/archives/21/24/17.html.
- Chiropractic celebrates - Bush signs VA bill. Dynamic Chiropractic, Feb. 25, 2002. www.chiroweb.com/archives/20/05/18.html.
- Vaughn CS. VA Chiropractic Advisory Committee update. Dynamic Chiropractic, Sept. 1, 2003. www.chiroweb.com/archives/21/18/21.html.