Veterans Committee Goals

Legislative Goals for 2020
The primary focus of these goals reflects recommendations to the Department of Veterans Affairs (VA) on disability compensation, health care, and other benefits administered through the VA Benefits Administration (VBA), the Veterans Health Administration (VHA) and the National Cemetery Administration (NCA) authorized under Title 38 of the U.S. Code.

GUIDING PRINCIPLES FOR VETERANS' HEALTH CARE AND BENEFITS

Promote national recognition and understanding of military service and how health care and benefits are earned through service in uniform in defense of the Nation and are qualitatively different from “entitlement” or “social welfare” programs.
Oppose deficit-driven or political decisions that would erode foundational services and benefits delivered through the VA or decisions which would align earned veterans’ medical or other benefits with unrelated federal or civilian benefit programs.
Oppose proposals that would eliminate or diminish veterans’ health care and other benefits to alleviate national economic or federal agency woes.

TOP AREAS OF FOCUS

Suicide Prevention and Behavioral Health Care
Service-Connected Health Conditions and Environmental-Toxic Exposures
Women Veterans Health Care and Benefits
VA MISSION Act Implementation and Legislative Improvements

HEALTH CARE

Health Care System Modernization. Continue to support investing in the modernization of VHA clinical, technology and electronic health records, financial, infrastructure, and human resource systems.

Veterans Access to Foundational Health Care Services. Support policies and initiatives that result in timely access to high quality services and preserve core health system mission functions—Clinical, Education, Research, and National Emergency Response.
Implementation of the VA MISSION Act (John S. McCain III, Daniel K. Akaka and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Outside Networks Act, Public Law 115-182).

Actively engage with VA, Congress and the Administration as necessary to refine the measure to ensure the following four main pillars of the Act are implemented as intended by Congress:

Consolidating VA’s community care programs and assuring implementation is consistent at all VA locations. Urgent care providers within VA networks must clearly be identified and accessible.
Expanding the VA Program of Comprehensive Assistance for Family Caregivers (PCAFC) to eligible veterans of all eras. Assuring VA implements the provisions in a timely manner and the expanded program does not restrict eligibility to the full array of potential benefits.
Providing VA the necessary flexibility to align its infrastructure footprint with the needs of our nation’s veterans.
Strengthening VA’s ability to recruit and retain quality health care professionals.

Expand the PCAFC to include “illness” as a condition for defining serious injury for purposes of program eligibility.

FY 2021/2022 President’s-VA Budget Request

Assess the Administration’s budget proposal against current and projected health care system requirements as proposed by stakeholders such as the veterans service organizations like the Independent Budget (IB) and Friends of VA Medical Care and Health Research (FOVA).
Secure and sustain timely and continuous VA funding through two-year appropriations cycles.
Reject proposals to cut or erode VA foundational health care services.
Oppose efforts to use veterans’ disability compensation or other benefits to pay for VA health care requirements.

VHA Health Care Workforce. Pursue health system workforce improvements and seek opportunities to eliminate the reported over 49,000 employee vacancies in VA by:

Supporting VA Inspector General (IG) recommendations for significant and sustained improvement in such areas as accurately tracking VHA’s vacancy numbers; considering the implications for support staff and other team members in staffing models for particular positions; reliable and transparent reporting; recruiting and retention oversight that includes consideration of both individual facility and veterans’ needs within a community; and, strong and consistent leadership to create a stable and welcoming environment (Statement IG before the House Committee on Veterans’ Affairs hearing on Critical Impact: How Barriers to Hiring at VA Affect Patient Care and Access, September 18, 2019).
Establishing national operational predictive staffing models that cover all critical health care occupations to address chronic shortages, especially in high vacancy areas (e.g., physicians, physician assistants, mental health providers, and nurses) so that VHA is better equipped to assess and implement effective measures to address staffing needs at the national level while supporting flexibility at the facility level.
Implementing independent practice authority for advance practice nurses ensuring health care professionals are practicing at the full-scope of their field of practice.
Expanding outreach to DoD and other federal health agencies to recruit transitioning health care professionals, reducing hiring, credentialing and onboarding barriers, and investing in workforce development programs to retain clinicians and support staff.
Tracking DoD’s planned medical billet reductions as directed by the FY 2017 National Defense Authorization Act and the President’s FY 2020 budget request authorizing the reorganization and transfer of approximately 18,000 military-civilian health care positions to support force readiness requirements—assessing these reductions on VHA’s community care network expansion as well as DoD and VA joint efforts to link to defense system resources and provider networks through sharing agreements and other collaborative initiatives.
Growing the existing Memorandum of Understanding between the VHA and the Department of Health and Human Services from 30 to more than 100 billets for members of the U.S. Public Health Service (USPHS) to serve in clinical and non-clinical roles.
Establishing an MOU between VHA and USPHS to create and fund 10 slots per year at the Uniformed Services University of the Health Sciences (USUHS) for medical students who agree to join USPHS and then serve in VHA clinics and hospitals to repay their medical education; supporting VHA’s efforts to educate, train and grow the field of health care professionals through cooperative partnerships with USUHS and the Defense Health Agency.

Behavioral Health and Well-Being. Fully implement and sustain an integrated, multidisciplinary, biopsychosocial, comprehensive behavioral health system, incorporating traditional and nontraditional prevention and treatment protocols to address the epidemic of suicides and growing numbers of service members, veterans and family members suffering from pain, mental health conditions and traumatic injuries.

Invest in innovative programs and tools like the VA’s Recovery Engagement and Coordination for Health – Veterans Enhanced Treatment (REACH VET), a predictive model that analyzes existing data from veteran’s health records to identify those patients VA considers at high risk for suicide, hospitalization, illness or other adverse outcomes in order to provide pre-emptive support and care. Expand funding and accelerate research strategies to identify and treat at-risk populations, leveraging VA-DoD electronic health records to complement data collection, prevention and treatment strategies to promote mental health and well-being and eradicate suicides.

Accelerate effective prevention, treatment, and training programs to address military sexual trauma (MST) experienced by women and men during and post service, and seek joint congressional oversight hearings to improve DoD and VA policies and procedures to care and compensate veterans suffering from MST.
Prioritize the appointment of a director and fill existing vacancies in the in VA’s Suicide Prevention Office. Ensure the department aggressively pursues efforts to increase behavioral health staff, resources, and crisis line capacity, ensure outreach efforts are expanded and synchronized with the DoD Suicide Prevention Office and activities are aligned with the President’s Roadmap to Empower Veterans and End a National Tragedy of Suicides (PREVENTS) executive order.
Expand VA-DoD outreach and policy efforts to address mental health needs of veterans with an other-than-honorable discharge.
Support expansion of evidence-based and complementary integrative medical treatment approaches to improve delivery of care and veteran’s health outcomes.
Invest in resources and programs to aggressively promote prevention before crisis, incorporating self-help tools and services for empowering, educating and engaging veterans’ involvement in managing their individual health care.
Support implementation of the Department of Health and Human Services Pain Management Best Practices Inter-Agency Task Force Report, May 9, 2019, outlining recommendations to eliminate gaps and improve VA-DoD pain management programs and medication-assisted treatments, including opioid treatment, mental health, and suicide prevention programs for servicemembers and veterans such as:

Physicians and clinical health care providers caring for service members and veterans, regardless of practice setting, should consider in their pain care plan prior military history and service-related health factors that may contribute to acute or chronic pain.
The integration of the DoD and VHA health systems is important for effective and timely pain care, and should include coordination of the transition from active duty to veteran status and care coordination across the health care spectrum that includes a smooth transition to primary care, mental health and pain specialty physicians, and other health care providers.

Women Veterans. Aggressively invest and implement VA’s Strategic Priorities to meet the growing population of women veterans. Reduce barriers to enrollment in VHA and increase access to comprehensive primary care, health education, and reproductive health services; enhance communication and leverage partnerships; and, improve gender-specific medical and mental health care services to meet the unique needs of women service members and transitioning women veterans.

Secure additional funding in the FY 2021/2022 MilCon-VA Appropriations to meet requirements to provide gender-specific care and redesign the health care delivery system and facilities, including emphasis on programs for women veterans with special needs (e.g., rural, homebound, aging, and amputee veterans).
Hire additional physicians and other medical staff designated as women’s health providers and clinical support team members.

Assess current research, studies and treatments being used to address higher rates of mental health conditions and suicidal ideation among women who have served and require VA to establish a comprehensive strategy and prevention plan for incorporating evidence-based approaches and practical wrap-around gender-specific health care programs and services.

Rural Veterans. Increase funding for the VA Office of Rural Health and ensure mandated outreach efforts in rural and remote areas are implemented, to include expansion of telehealth/telemental health to mitigate rural health provider gaps.
Service-Connected Occupational Health and Environmental Hazard Exposures. Support research to determine the impact on service members exposed to occupational or environmental toxins or hazardous substances resulting from their military service in or outside of the U.S. Support legislation that assures health care and benefits are established to appropriately compensate and support veterans, family members, and survivors, particularly veterans who experience catastrophic and devastating cancers, diseases, and other health conditions, or death.

Implement the September 2016, Government Accountability Office Report (GAO-16-781) recommendation for DoD and VA to examine the relationship between direct burn pit exposure, and potential long-term health-related issues as well as the National Academies of Sciences, Engineering, and Medicine’s Report of 2011, which suggested the need to evaluate the health status of service members from their time of deployment over many years.
Allow surviving family members to add deceased veterans to established registries.
Monitor implementation of toxic exposure assessment and research provisions in the Jeff Miller and Richard Blumenthal Veterans Health Care and Benefits Improvement Act of 2016 (P.L. 114-315) and the FY 2019 MilCon-VA Appropriations bill requiring VA to provide clinical proposals focused on post-deployment health for veterans exposed to airborne hazards and open burn pits.
Require DoD to implement a plan to establish baseline health assessments, collecting military service assignment, deployment, military history, and other medical-personnel data at the point of entry into the military and at regular intervals throughout military service.
Require VA-DoD to establish standard data elements and procedures, leveraging the departments’ electronic health record platform as the official data management system for collecting, retrieving and managing military assignment, deployment, military history, and other medical-personnel data to provide health care and benefits to service members, veterans and their families.

Wounded, Ill and Injured (WII) Warrior Care. Advocate for timely access to VA-DoD health care and benefits, caregiver support and other services, and strengthen VA-DoD-Service WII programs. Identify gaps in health care, benefits and services and make recommendations for improvements.

CHAMPVA Young Adult. Expand CHAMPVA to adult children of eligible veterans, family members and survivors until age 26 to align eligibility with TRICARE and private sector health insurance plans.

VHA Access and Fees. Oppose enrollment or access fees for current and future veterans enrolled in VA health care in all priority groups. Preserve integrity and access to both VA and DoD health systems for dually eligible members.

CLAIMS PROCESSING AND APPEALS SYSTEMS

Integrated Disability Evaluation Benefit Systems. Improve legacy and integrate disability evaluation systems and benefits delivery at discharge efficiency and effectiveness. Continue to press DoD and VA to achieve true interoperability of electronic medical, personnel and benefit records.
Claims and Appeals Backlog. Engage with VA in the implementation of the Veterans Appeals Improvement and Modernization Act of 2017 (P.L. 115-55) to improve the claims and appeals process. Support investment in software and hardware upgrades for claims management. Preclude ‘unlicensed’ individuals from taking fees for representing veterans’ claims.
Agent Orange Presumptive Service Connections. Ensure fair and consistent application of standards and procedures for adjudicating Agent Orange claims.
Camp Lejeune Water Contamination. Encourage expansion of Camp Lejeune water contamination conditions to include all those recognized by DoD in 2012 and provide fair effective dates. Promote the inclusion of affected family members.
Mental Health Discharge Board of Review. Support creation of a Mental Health Discharge Board of Review to redress ‘low-ball’ service member ratings for PTSD, TBI, and MST, including Vietnam War and Gulf War I periods. Support efforts to ensure review boards take circumstances of in-service trauma into consideration.
VA Schedule of Rating for Disabilities (VASRD). Support the continual modernization of the VASRD based on current medical science.
Service-Disabled Veterans Insurance (S-DVI) Rate Increase. Modernize
S-DVI program so it is in line with current group life insurance rates.

EMPLOYMENT, EDUCATION AND TRAINING PROGRAMS

Veterans Employment. Support initiatives for employers to recruit, hire and retain veterans, including veterans of the Guard and Reserve.
Veterans Hiring Incentives. Re-enact employer tax incentives under the Vow to Hire Heroes Act.
Vocational Rehabilitation and Employment (VRE) Benefits. Strengthen the VRE program to provide consistent and predictable benefits for veterans with disabilities. Establish a cost-of-living stipend for VRE participants. Promote entrepreneurship within VRE and outreach to other federal entities to advance training opportunities to increase success rates.
Veteran-Owned and Service-Disabled Veteran-Owned Businesses. Ensure veteran-owned and service-disabled veteran-owned businesses achieve parity with other federal contracting categories and ensure all federal departments at least meet established veteran contracting and hiring goals.
Basic Reserve GI Bill Benefits. Urge proportional upgrades to the Title 10 Montgomery GI Bill program to keep pace with the cost of education.
GI Bill Integration for 21st Century Force. Urge hearings for a unified architecture for all GI Bill programs for active duty, Guard and Reserve service members under the principle of awarding benefits according to the length and type of duty performed.
Student Veterans Protections. Support measures to foster positive student-veteran outcomes including:

Ensure sufficient funding for technical implementation of all provisions of the ‘Forever GI Bill’.
Preserve and expand Public Service Loan Forgiveness which supports military recruitment and veteran hiring in public service.
Align VA protections for student veterans with Departments of Education and Defense protections.
Extend the “90-10” ratio of federal aid to include VA and DoD education benefits.
Ensure schools spend VA and DoD education program funds on serving veterans and service members.
Protect VA and DoD education program benefits from abuses and fraudulent practices targeting veterans and service members.

ADDITIONAL ISSUES

Homeless Veterans. Support and expand VA initiatives to reduce and eliminate veteran homelessness.
Veterans’ Preference. Authorize veterans’ preference appeal rights for veterans employed by VA or other federal, state, and local government agencies. Oppose legislation restricting preference currently in law.
Financial and Legal Protections. Support continuous review and upgrades of the Servicemembers’ Civil Relief Act (SCRA), including elimination of “forced arbitration” clauses in contracts that nullify SCRA’s protections. Increase lending protections for uniformed service members, veterans and family members. Strengthen re-employment rights for operational reservists who support military missions on Title 10 orders. Allow military families to break a lease without penalty when on-post housing becomes available. Make mortgage protection coverage permanent.
Veterans Treatment Courts. Advocate for funding for further expansion of these courts and dockets in jurisdictions across the country. Support scaling of services for incarcerated veterans. Promote the establishment of specialized housing units for veterans in jails and prisons.
Cyber Protection. Encourage Congress, VA and DoD to investigate the online targeting of service members, veterans and their families for fraud and disinformation campaigns by foreign and domestic entities. Where warranted, provide information, training and tools on cyber-hygiene to provide stronger protections to help service members, veterans and their families from becoming targets for online threats to their financial, psychological and social well-being.
VA Debt Collection. Eliminate inaccurate debt reporting and collection by the VA and improve the department’s practices to be in line with the Federal Debt Collection Practices Act.
Veteran Mortgage Insurance Protection. Increase protections for veterans utilizing the VA Home Loan Program and increase investigation and oversight of organizations targeting veterans.
VA Technology Modernization. Support VA’s Artificial Intelligence efforts and other technological modernization advances across VA that contribute to improving the quality life for veterans and their families.