Veterans Committee Goals

- 2023 TMC Veterans Committee Legislative Goals
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
- Service-Connected Conditions and Toxic Exposure
- Caregivers and Aging Veterans
- Education, Training, Employment, and Protections
- Suicide Prevention and Mental Health
- Underserved Veterans
Service-Connected Conditions and Toxic Exposure
Claims and Appeals Backlog
Issue: Currently veterans would have to fill out a FOIA request to obtain their Claims File (C-File) which takes months for the veteran to receive a digital file. In some cases where the claims are time sensitive, it’s very crucial for the veteran to receive this file in a timely manner.
- TMC Position: Congress and VA should work out a detailed plan to make this file conveniently available to the veteran at all times as it is with the blue button on the Vet Health website.
Issue: Due to the COVID-19 pandemic and the Veterans Benefit Administration’s (VBA) halting of Compensation and Pension (C&P) exams across the country, the implementation of PL-115-55, The Veterans Appeals Improvement and Modernization Act of 2017, has become ever more critical.
- TMC Position: Continue engaging 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.
Service-Connected Occupational Health and Environmental Hazard Exposures
Issue: Toxic exposure-related illnesses are a growing health concern among the veteran and the military community. For the current generation, burn pits are the most common form of exposure to toxicants. The passage of the Honoring Our PACT Act made significant strides forward for our toxic-exposed veterans and survivors. We must support implementation of this monumental bill and ensure other toxic exposures are not forgotten.
- TMC Position:
- Monitor VA’s implementation of the Honoring Our PACT Act to include expanded healthcare eligibility and recently established presumptive conditions.
- Support VA staffing needs to effectively implement the Honoring Our PACT Act.
- Support the addition of illnesses as new presumptive conditions when the scientific burden has been met.
Caregivers and Aging Veterans
Issue: VA faces many challenges in providing care and services to the increasingly aging veteran population. The pandemic continues to strain VA resources in both staffing and funding of services for older veterans. COVID-19 also exposed vulnerabilities of veterans receiving home-based community services (HBCS) and in long-term care (LTC) facilities and nursing homes. While VA has a plan in place to expand HBCS and LTC by 2026, TMC is concerned these programs will continue to be difficult for veterans and their caregivers to access and will not be uniformly administered across the system.
VA also implemented its final expansion of the Program of Comprehensive Assistance for Family Caregivers (PCAFC) to eligible veterans of all eras on October 1, 2022. TMC commends VA for collaborating with various stakeholder groups to make essential improvements to the program to streamline the program and make it easier for caregivers and veterans to navigate. We do urge the VA and Congress to resolve eligibility and system issues as early as possible in this Congress.
- TMC Position: Expand access to caregiving, palliative, geriatric, and extended care programs and services for veterans and wounded warriors and their caregivers.
- Increase telehealth services to offset the lack of in-person visits and care due to pandemic restrictions for older veterans needing care.
- Require VHA to develop measurable goals for its efforts to address key challenges in meeting the demand for long-term care such as workforce shortages, geographic alignment of care particularly for rural veterans, and limitations in providing specialty care.
- Expand long-term residential or home health care program options through community partnerships and assure community partners have capacity to meet need.
- Strengthen VHA’s engagement in monitoring and assessing State Veterans Homes through documentation of failures in meeting quality standards during facility inspections and reporting resolution of documented discrepancies.
- Assure VA and Congress are actively providing oversight and guidance to address existing PCAFC eligibility and program issues. Continue to assist the VA and Congress to identify and implement program improvements either through policy, regulatory, or legislative means.
- Establish organization-wide guidance on caregiver assessments and reassessments.
- To reduce subjectivity in eligibility determinations for blinded veterans, the Secretary should exercise the authority in 38 USC 1720G(a)(2)(C)(iv) to establish PFAFC eligibility for veterans who are either 5/200 or worse in both eyes, or have a field of vision of 5 degrees or less in both eyes.
Education, Training, Employment, and Protections
Education
Issue: Student veterans tend to be older, are more likely to have children, and have a disability. Since its inception, the GI Bill has been a vital tool for recruitment and retention by the uniformed services and essential for helping make the transition to civilian life. Research shows education benefits continue to be one of the top reasons for joining the military.
- TMC Position:
- Urge proportional upgrades to the Title 10 Montgomery GI Bill program to keep pace with the cost of education, and to transfer 10 USC 1606 into Title 38 as sub-chapter of Forever GI Bill to finalize sunsetting the Montgomery GI Bill.
- Ensure sufficient funding and oversight to modernize VA’s GI Bill information technology system.
- Increase VA flexibility for out-of-cycle housing allowance adjustments.
Training
Issue: Transitioning service members are often looking for training certifications and credentials in a professional field. The Veterans Readiness and Employment (VR&E) program can provide for their unique needs and translate their skills to the civilian sector.
- TMC Position:
- Strengthen the VR&E program to provide consistent and predictable benefits for veterans with disabilities.
- Establish a Monthly Housing Allowance (MHA) for VR&E students similar to the Post-9/11 GI Bill.
- Promote entrepreneurship within VR&E and outreach to other federal entities to advance training opportunities to increase success rates.
- Continue to improve and modernize the case management system. Increase staffing of and comprehensive training for VR&E counselors.
- Expand VET-TEC offerings and participation for in demand jobs to high quality providers.
Employment
Issue: Veteran unemployment has recovered to near record lows and is currently lower than the non-veteran population. This is a testament to the effective policies to help reintegration after service. TMC must continue to support these employment programs to help all veterans.
- TMC Position:
- 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.
- Preserve and expand Public Service Loan Forgiveness which supports military recruitment and veteran hiring in public service.
- Re-enact employer tax incentives under the VOW to Hire Heroes Act and pursue provisions to increase the utilization rate.
Protections
Issue: Veterans are often targeted by predatory corporations and institutions. Schools offer students valuable education options, but reforms are needed to prevent schools from aggressively targeting veterans, service members, families, and survivors for their earned educational benefits. Additionally, reports show veterans use high-cost loans at four times the rate of civilians. Protections need to be enacted and strengthened to ensure the veterans are supported after leaving service.
- TMC Position:
- Protect VA and DoD education program benefits from abuses and fraudulent practices targeting veterans and service members.
- 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.
- Support continuous review and upgrades of the Servicemembers’ Civil Relief Act (SCRA) and Uniformed Services Employment and Reemployment Rights Act (USERRA), including elimination of “forced arbitration” clauses in contracts that nullify their protections.
- Increase lending protections for uniformed service members, veterans, families, caregivers, and survivors while maintaining access to quality credit.
- Strengthen re-employment rights for operational reservists who support military missions on Title 10 orders.
- Exempt GI Bill from being considered income in any need-based federal student aid calculations.
Suicide Prevention and Mental Health
High Veteran Suicide Rates
Issue: The suicide rate among veterans is much higher compared to civilians, and even higher for female veterans. For younger veterans, the rates are even more disproportionate, and climbing even higher. For example, while the overall veteran suicide rate rose 30% from 2005 to 2017, the 18-34-year-old veteran suicide rate rose by 2.5 times. While 18-34-year-old veterans make up only 10% of the veteran population, they represent 94% of the increase in veteran deaths. In addition, the suicide rate for active duty servicemembers is at an all-time high, with the U.S. Army experiencing its highest rate since before World War II.
- TMC Position: Expand research into core causes, risk factors, and protective factors for service member, veterans, families, caregivers, and survivors:
- Expand government and non-government funding around service members, veterans, families, caregivers, and survivors suicide rates, their possible causes, and the most significant risk and protective factors for each of these populations.
- Ensure the VA and DoD release the underlying raw data from their annual suicide reports (properly redacted to protect individual identities).
- Ensure DoD resumes reporting veteran combat deployment data to VA and for VA to resume reporting on combat deployment data for suicides.
- Explore the expansion of alternative therapies including complimentary treatment modalities such as highly trained service dogs, equine therapy, outdoor and sports-related programs, and other innovative treatments.
The VA Fiduciary Program and Veterans’ Constitutional Rights
Issue: The VA Fiduciary Program allows VA rating officials and health care providers, without any judicial oversight, to involuntarily refer a veteran to the fiduciary program. Once referred to the program, the veteran has 60 days to prove to VA they are, in fact, competent to handle their VA benefits – the burden of proof falls to the veteran to prove they are competent. Once placed in the fiduciary program, the veteran is then reported by VA to the Department of Justice to be placed on the National Instant Criminal Background Check System (NICS) as a “mental defective,” after which the veteran is informed, they are no longer allowed to purchase or possess firearms.
By setting up such disincentives for veterans to seek mental health care from VA, they are driving the very veterans who should be seeking mental health care away from the system.
- TMC Position: Reform the VA Fiduciary Program so that:
- Ensure the burden of proof for determining a veteran is incompetent to handle their own benefits is placed on VA and not on the veteran.
- De-link the fiduciary consideration or determination and reporting the veteran to the NICS database or any other law enforcement action.
Passage of S. 785, The Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019 (Public Law No: 116-171).
Issue: The legislation is a comprehensive law to address a wide variety of veteran suicide prevention measures, and will require extensive regulatory and policy action by VA to fully implement, including:
- Improvements to military to civilian transition programs,
- A $175 million grant program for community veteran suicide prevention programs,
- Study on complementary and integrative health treatments,
- Analysis of the impact of opioids on veteran suicide risks,
- GAO reviews of both VA mental health staffing and VA efforts to manage particularly at-risk veterans’ suicide program,
- Develop a clinical provider treatment toolkit and revise its Clinical Practice Guidelines,
- Develop precision medicine initiatives for brain and mental health biomarkers,
- Expand VA funding of academic research,
- Broaden the review and execution of the VA’s Readjustment Counseling Service,
- Expand VA support services to women veterans,
- Award grants for expanding telehealth capabilities, and
- Review the expanded use of HBOT treatments.
- TMC Position: Ensure the full implementation of S. 785, The Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019.
- TMC Position: Ensure the full implementation of S. 785, The Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019.
UNDERSERVED VETERANS
Issue: Women, minority and other underserved veterans transitioning out of uniform face unique challenges because of their experiences in service or other barriers. Women veterans are also the fastest growing population of veteran patients, according to the Department of Veterans Affairs (VA). VA expects women health care enrollees to grow from the current 10% to as high as 19% by 2025.
Additionally, according to GAO, VA has taken steps to reduce disparities in health care outcomes linked to race and ethnicity but lacks the mechanisms to measure progress and ensure accountability. VA funds research efforts that have identified disparities in health care outcomes involving minority veterans but rely on data that department officials and researchers noted have weaknesses in completeness and accuracy.
Despite recognizing weaknesses related to the quality of race and ethnicity data, VA has not implemented corrective actions to address them. COVID-19 has placed a spotlight on the barriers and disparities facing underserved veterans when seeking access to health care and services through VA.
TMC urges VA to expand its collaborative efforts with its federal partners and expedite efforts to remove these and other barriers to ensure all veterans receive the same care, services, and benefits they earned through service.
- TMC Position
- Eliminate health disparities for underserved veterans to ensure health equity in accessing timely, sensitive, and quality benefits through VA.
- Lessons learned during the COVID-19 national pandemic should be identified and applied to accelerate VA’s efforts to eliminate disparities and achieve health equity to meet the unique needs of high-risk veteran groups.
- Secure additional funding for research, treatment, data management, medical care, and staffing to provide gender-specific and culturally competent care.
- Redesign VHA delivery system and facilities to remove barriers to ensure privacy and a safe and inclusive environment for, including veterans with special needs such as: those living in rural areas; homebound; aging; amputee; cognitively and physically impaired, and veterans with cultural and language differences.
- Expand VA sexual assault/harassment prevention efforts to eliminate problems enterprise wide.
- Eliminate health disparities for underserved veterans to ensure health equity in accessing timely, sensitive, and quality benefits through VA.