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Dynamic Chiropractic – April 9, 2009, Vol. 27, Issue 08

Another Year, Another VA Bill

Time for Congress to make full inclusion a reality.

By Editorial Staff

In what has become a near-annual tradition of sorts, Rep. Bob Filner (R-Calif.) has introduced legislation designed to expand the chiropractic benefit throughout the Veterans Administration (VA) health care system. H.R. 1017, introduced in the House on Feb. 12, requires the VA to staff a doctor of chiropractic at every VA medical facility no later than Dec. 31, 2012.

H.R. 1017 is similar to previous legislation aimed at providing chiropractic care to veterans, including H.R. 1470, introduced by Rep. Filner in 2007, and H.R. 5202, introduced in 2006 by Reps. Filner and Jeb Bradley (R-N.H.). On both occasions, Congress adjourned with the legislation still under deliberation, meaning no further action could be taken.

The current bill, as with previous versions, would "amend the Department of Veterans Affairs Health Care Programs Enhancement Act of 2001 [Public Law 107-135] ... to require the provision of chiropractic care and services to veterans at all Department of Veterans Affairs medical centers." This would mean at least 75 VA medical centers would offer chiropractic services on or before Dec. 31, 2010, and all VA medical facilities would offer services by the end of 2012. According to Dr. Anthony Lisi, VHA director of chiropractic services, as of December 2008, only 33 sites provide chiropractic care.

The American Chiropractic Association and the Association of Chiropractic Colleges were among the first to hail the latest legislation. "The ACA and ACC applaud the work of Rep. Filner as he continues to advocate for both chiropractic and our nation's veterans," said ACA President Glenn Manceaux, DC. "Veterans want, need and deserve access to chiropractic care, and it is our goal to ensure that chiropractic is ultimately available and accessible at every major VA health care facility."

Added ACC President Carl Cleveland III, DC: "The chiropractic educational community welcomes the opportunity to position its graduates and the profession to serve our nation's veterans, and this legislation allows veterans' easier access to chiropractic care. With a reported 49 percent of eligible veterans returning with neuromusculoskeletal issues, the need for expanded access to chiropractic services has never been more crucial."

Efforts to give veterans access to chiropractic services first took shape in 1999, when Public Law 106-117, the Veterans Millennium Health Care and Benefits Act, required the VA to establish a policy regarding chiropractic treatment. Two years later, Public Law 107-135 mandated that the VA introduce chiropractic clinics at a minimum of one site in each of its 21 geographic regions or Veterans Integrated Service Networks (VISNs). Public Law 107-135 also established an advisory committee  to oversee development and implementation of the chiropractic benefit.

In 2004, the VHA issued Directive 2004-35, establishing guidelines for the provision of chiropractic services, and in June of that year announced chiropractic openings at 26 medical centers. By late 2005, chiropractors were on staff at all 26 sites. In September 2007, the VHA established chiropractic services as an official program and named Dr. Lisi as the program's national director.

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