MILITARY HEALTH CARE REFORM DETAILS RELEASED BY SENATE

Now that the Senate Armed Services Committee has approved its version of the defense authorization bill for fiscal 2017, we have a clearer picture of what direction they are taking with respect to military health care reform. 

A press release from the committee said that their version of the NDAA “initiates a comprehensive reform to modernize the military health system and provide beneficiaries with higher quality care, better access to care, and a better experience of care.  Critically, the NDAA’s reform initiatives adhere to a simple guiding principle: that beneficiaries should only be asked to pay more into a military system that delivers greater value.”

The Senate’s bill would consolidate TRICARE into two plans:  TRICARE Prime which would remain the MTF-centered managed care plan and TRICARE Choice, a combination of Standard and Extra that would utilize a network of civilian providers.  The Senate also adds a TRICARE supplement for beneficiaries who have other health insurance.

Unlike the House bill, the Senate’s version does not include any enrollment fees for active duty personnel.  It does, however, institute increases in health care fees for military retirees not eligible for Medicare.

Fees for retirees choosing TRICARE Prime would increase $68 annually from $282.60 to $350.60 for singles and $135 from $565.20 to $700.20 for family coverage. 

Retirees electing TRICARE Choice would pay $150/$300 (single/family) increasing over five years to $450/$900 (single/family). 

The bill would eliminate existing cost-shares for services provided under TRICARE Choice and replace them with fixed co-payments. 

Pharmacy costs would also rise.  The Senate committee supported the Pentagon’s plan to incrementally increase co-pays for prescriptions obtained at retail pharmacies and brand-name medication ordered by mail.  However, prescriptions would still be available at military treatment facilities at no cost and generic medication would be available at no cost if ordered through the mail.

The Senate’s bill would also: 

·       Expand the full range of telehealth services available to beneficiaries.

·       Initiate a fine for beneficiaries who miss their medical appointments.

·       Authorize lower co-payments for high-value pharmaceuticals and medical services.

·       Eliminate the requirement for pre-authorization for specialty care referrals.

·       Require a plan to improve pediatric care and related services.

·       Incentivize participation in disease management programs.

·       Authorize enrollment of eligible beneficiaries in federal dental and vision insurance programs managed by the Office of Personnel Management.

·       Expand and improve access to care by requiring a standardized appointment system in military treatment facilities.

·       Create local high-performing military-civilian integrated health delivery systems in which military treatment facilities would form strong partnerships with civilian health systems and the Department of Veterans’ Affairs to provide integrated health services for beneficiaries.

·       Create specialized care centers of excellence at major military medical centers to model specialized care delivery in high-performing health systems like the Cleveland Clinic.

·       Authorize a pilot program to give commercial health insurance coverage to reserve component members and their families.

·       Expand eligibility for care in military treatment facilities to veterans and certain civilians. Establish performance accountability for military healthcare leaders throughout the military health system.

·       Establish rigorous criteria for selection of military treatment facility commanders and minimum lengths of tours of duty for military treatment facility commanders.

·       Realign the medical command structure of the Department of Defense and shrink headquarters staffing.

Other non-health care related items in the Senate bill include:

·       A 1.6 percent pay raise instead of the 2.1 percent approved by the House.

·       End strength levels requested in the DoD budget.  The House voted to increase troop levels.

·       A requirement that both males and females to register for the draft.

·       A 25 percent cut in 4-stars and other flag and general officers.

·       Permanent authority to pay the Special Survivor Indemnity Allowance for SBP-DIC survivors. 

·       A 25 percent reduction in Senior Executive Service civilians.

·       Authorization for an increase of $40 million for reimbursement rates for the TRICARE Comprehensive Autism Care Demonstration program.

·       Authorization of $25 million in supplemental impact aid to local educational agencies with military dependent children and $5 million in impact aid for schools with military dependent children with severe disabilities.

·       Numerous enhancements to military whistleblower protections.

·       Authorization for $2.6 billion for the procurement of Army aircraft including 52 AH-64 Apaches, 36 UH-60 Blackhawks, and 22 CH-47 Chinooks.

·       Authorization for $1.2 billion for upgrades to M1 Abrams tanks, M2 Bradley infantry fighting vehicles, and Stryker armored combat vehicles.

The Senate’s defense policy bill authorizes funding at the level of the president’s fiscal year 2017 budget request, and includes $602 billion of discretionary spending for national defense – $543 billion for base functions in the Department of Defense and for nuclear functions within the Department of Energy and $59 billion for Overseas Contingency Operations funding for the Defense Department.  Similar to the president’s budget submission, $5 billion of the Overseas Contingency Operations (OCO) funding supports functions traditionally supported through the base budget.

The one major area that the Senate’s bill differs from the House version is the House plan to shift funds from the OCO account to pay for items they added in the defense authorization bill’s base budget. 

Use of OCO money means that the OCO account, which is exempt from budget caps, would only have enough money to fund overseas operations for half a year, requiring the next president to come back to Congress seeking additional funds for the remainder of fiscal 2017.

The budgetary maneuver has drawn a veto threat from the White House.

Senate Armed Services Committee Chairman John McCain, R-Ariz., said that he plans to seek a boost in overall defense spending when the measure goes to the Senate floor rather than shift the funds from the OCO account.

What’s next:  After two full days of debate, the $602.2 billion House version of the fiscal 2017 National Defense Authorization Act passed Wednesday night by a vote of 277-147. 

Senate Majority Leader Mitch McConnell indicated that the Senate’s defense policy bill would be on the floor for debate and passage next week.  Once that happens, a conference committee will be appointed to hammer out the differences. 

See more at: http://www1.ausa.org/legislation/newsletter/Pages/19may16legupdate.aspx#sthash.B9whGDRi.dpuf

DEFENSE SPENDING BILL DETAILS RELEASED

Details of the draft House defense spending bill for fiscal 2017 were released this week by the Defense Appropriations Subcommittee. 

Following the lead of the House Armed Services Committee, the subcommittee leaders would take money from the Overseas Contingency Operations (OCO) account to pay for items in the base budget.  The $517.1 billion bill is $3 billion above the current level and $587 million below the administration’s budget request. 

The OCO account would receive $58.6 billion.  Included in this is $43 billion to support the requirements of overseas operations through the end of April 2017

A summary released by the subcommittee provides details of the measure:

Military End Strength  The legislation includes $132.6 billion to provide funding for an additional 5,000 troops for the Active Army, 8,000 troops for the Army National Guard, and 7,000 troops for the Army Reserve.  

Pay The bill fully funds the authorized 2.1 percent pay raise for military personnel.

Defense Health Care The bill contains $34 billion for base requirements – $1.7 billion above the fiscal 2016 enacted level and $559 million above the request – for the Defense Health Program to provide care for troops, military families, and retirees.

Operation and Maintenance  Included in the legislation is $209.2 for operations and maintenance to support key readiness programs to prepare troops for combat and peacetime missions, including flight time and battle training, equipment and facility maintenance, and base operations.

Within this amount, the bill includes an additional $6.4 billion above the administration’s request to fill readiness shortfalls, $1.6 billion to invest in facility sustainment, restoration, and modernization programs, and $753 million for additional depot maintenance.  

Research and Development The bill contains $70.8 billion for research, development, testing, and evaluation of new defense technologies.

Equipment Procurement  The legislation provides a total of $120.8 billion for equipment and upgrades.  Funding for base requirements is $9.6 billion above the request and $644 million above fiscal year 2016.  These funds support military readiness by providing the necessary platforms, weapons, and other equipment the military needs to train, maintain the force, and conduct successful operations.

The Army would receive $1.2 billion for 72 UH-60 Blackhawk helicopters; $881 million for 52 remanufactured AH-64 helicopters; $374 million for 10 new aircraft; $689 million for 27 CH-47 Chinook helicopters; and $440 million for 123 Stryker Double V-Hull upgrades. 

Additionally, to maintain four Apache battalions in the Army National Guard, the bill provides $374 million for 10 new Apaches and $46 million to support the annual operating costs of the four battalions.  Also included is $131 million for 20 Lakotas for increased flight training requirements, and $242 million for an additional 36 Blackhawks to accelerate modernization of the fleet.  The bill also provides funds to maintain a Combat Aviation Brigade in Korea.

The process:  The full Appropriations Committee will now consider the measure.  Later, it will be sent to the House floor for a vote.

- See more at: http://www1.ausa.org/legislation/newsletter/Pages/12May2016.aspx#sthash.xMMb1OQn.dpuf

WAR OF WORDS ERUPTS OVER OCO SPENDING

Secretary of Defense Ash Carter has taken a negative position on the House Armed Services Committee’s plan to shift funds from the Overseas Contingency Operations (OCO) account to pay for the unrequested items in the defense authorization bill’s base budget.

The Committee’s plan means that the OCO account, which is exempt from budget caps, would only have enough money to fund overseas operations for half a year, requiring the next president to come back to Congress seeking additional funds for the remainder of fiscal 2017.

Carter said in a hearing before the Senate last week that the move amounts to “gambling” with troops' funding at a time of war and called it “deeply troubling” and “flawed.”

“It would spend money on things that are not DoD’s highest unfunded priorities across the joint force.  It buys force structure without the money to sustain it and keep it ready, effectively creating hollow force structure, and working against our efforts to restore readiness,” Carter said. 

Carter added that the House committee’s plan is a “step in the direction of unraveling the Bipartisan Budget Act,” which the secretary cited as giving the department much-needed budget stability.

“It’s another road to nowhere, with uncertain chances of ever becoming law, and a high probability of leading to more gridlock and another continuing resolution — exactly the kind of terrible distraction we’ve seen for years, that undercuts stable planning and efficient use of taxpayer dollars, dispirits troops and their families, baffles friends, and emboldens foes,” Carter said.  “I cannot support such maneuvers.

Carter reiterated his position again this week telling reporters that he considers the move “objectionable on the face of it.”

Now, Chairman of the House Armed Services Committee Mac Thornberry, R-Texas has fired back at the Secretary.

In a statement Thornberry said, “What’s objectionable is deploying troops who aren’t fully trained, whose equipment is worn out, and who didn’t get the resources they needed back home to be ready to face our enemies overseas.  What’s objectionable is cutting the military well below levels anyone thinks is wise, denying our troops their pay raise for three years in a row, forcing them to live in crumbling barracks or work in hangars that have literally been condemned.  I am determined to turn our readiness crisis around, even if I have to do it over the Secretary’s objections.”

The full House is expected to vote on the defense authorization bill for fiscal 2017 in mid-May.  The Senate Armed Services Committee will start writing their version of the bill next week. 

- See more at: http://www1.ausa.org/legislation/newsletter/Pages/5May2016LegislativeNewsUpdate.aspx#sthash.p3cxpjSU.dpuf

VA selects new Director of the Center for Women Veterans

May 3, 2016, 02:29:00 PM

 VA selects new

Director of the Center for Women Veterans

WASHINGTON - The Department of Veterans Affairs announced the appointment of a new director of the Center for Women Veterans.

Kayla M. Williams assumed duties this week as Director, serving as primary advisor to the Secretary on Department policies, programs and legislation that affect women Veterans.

“Kayla embodies everything it means to be a true advocate for women Veterans and I am proud to welcome her to VA in this leadership role,” said Secretary of Veterans Affairs Robert A. McDonald. “This is an important time for VA as we prepare for the growing number of women we expect to take advantage of the VA services they have earned. I know Kayla will be tremendously helpful in improving services for female Veterans now and in future.”

Williams is a member of the Army Education Advisory Committee, a former member of the VA Advisory Committee on Women Veterans, a 2013 White House Woman Veteran Champion of Change, and a 2015 Lincoln Award recipient.

She worked eight years at the RAND Corporation conducting research on servicemember and Veteran health needs and benefits, international security, and intelligence policy.

Williams graduated cum laude with a BA in English Literature from Bowling Green State University and earned an MA in International Affairs with a focus on the Middle East from American University.

She is author of two books.  Love My Rifle More Than You: Young and Female in the U.S. Army, is a memoir about her deployment to Iraq. Her second book is, Plenty of Time When We Get Home: Love and Recovery in the Aftermath of War, about her family's journey from trauma to healing.

Williams is coming from Pittsburgh, PA with her husband, a combat-wounded veteran, and their two children.

The Center for Women Veterans was established by Congress in November 1994 by Public Law (P.L.) 103-446 and monitors and coordinates VA’s administration of health care and benefits services and programs for women Veterans. The Center serves as an advocate for a cultural transformation in recognizing the service and contributions of women Veterans and women in the military.

STATEMENT FROM VA SECRETARY ROBERT A. MCDONALD

On Monday, I made some remarks on how we’re working to improve Veterans' satisfaction with the care they receive from VA. It was never my intention to suggest that I don't take our mission of serving Veterans very seriously. 

In fact, improving access to care is my number one priority and the priority I have set for the entire department.  For the last two years, the huge majority of VA employees have worked tirelessly to improve the timeliness of the care and benefits we provide to Veterans. 

As I've told Veterans Service Organizations, Members of Congress, and myriad other groups of Veterans stakeholders, our goal is to ensure VA becomes the Number 1 customer-service organization in government. 

To do that, we are following many of the best practices of private sector health care providers and exceptional customer-service organizations.

At VA we take our mission of caring for those who "shall have borne the battle" very seriously; we have the best and most noble mission in government. 

If my comments Monday led any Veterans to believe that I, or the dedicated workforce I am privileged to lead, don't take that noble mission seriously, I deeply regret that. Nothing could be further from the truth. 

As we approach the Memorial Day holiday and pay tribute to the sacrifices of courageous men and women who placed the interests of others above their own, we at the VA remain focused on our mission to care for those who bravely served our Nation.

Senate moves forward with its version of the National Defense Authorization Act (S. 2943)

Last week the SASC approved its version of next year’s NDAA (S.2943) and sent it on to the full Senate to consider its amendments and approval. In a great many ways it is different from the House’s version. It may be brought to the floor at any time so it is extremely important for you to know how the Senate’s proposals may affect you. 
 

On TRICARE and healthcare issues it is important to note that the Senate (like the House) proposes no changes in the TRICARE for Life program (TFL).  
 

But there are a great many healthcare program changes in the bill including:

• creating a new annual enrollment fee for TRICARE Standard that would start at $150/$300 (single/family) as of Jan. 1, 2018, and rise to $450/$900 over the next five years. Please note that this includes all TRICARE Standard beneficiaries including the service member and his or her family ; 
   
• raising the TRICARE Prime annual enrollment fee 24 percent to $350/$700 (single/family). Again, there is a yearly enrollment fee for the Service member him or herself;
• raising the annual cap on out-of-pocket expenses to $1,500 for currently serving families and $4,000 for retired families (vs. current $1,000/$3,000); 
•  
• giving DoD discretion to implement a pilot program authorizing Guard and Reserve members to elect coverage under the auspices of the federal employees health insurance program; If implemented it will be interesting to see if DoD will be willing to pay 70-72% of the healthcare premiums that the civilian departments of the federal government pay.  
   
• eliminating TRICARE Standard deductibles for care from DoD network providers, but doubling the deductible to $300/$600 (single/family) for out-of-network care;  
   
• changing TRICARE Standard co-pays for various provider visits to a flat fee vs. a percentage of TRICARE-approved charges;
   
• adjusting annual enrollment fees by the Consumer Price Index for Health Care Services established by the Bureau of Labor Statistics; This index is much higher than the regular Consumer Price Index that is used to determine your yearly COLA.
   
• adjusting co-pays, doctor visit cost shares, the catastrophic cap, and other flat fees by the same percentage as the retired pay COLA;
   
• roughly doubling pharmacy copays over a 9-year period, including raising the mail-order copay for generic drugs from the current zero to $11, effective in 2020; and
   
• authorizing DoD to collect a “no-show” fee for missed appointments at military medical facilities.

For other issues the Senate:

• approved force levels recommended in the president's budget rather than increases like the House bill recommended;
   
• created a 5 location test of “privatizing” commissaries.
   
• made the Special Survivor Indemnity Allowance permanent at the $310 monthly rate; The House NDAA only extended the SSIA program 1 year.
   
• provided a 1.6% military pay raise. While the House included the full 2.1% COLA.
   
• requires women to register for the draft. The House deleted a similar provision and required a study instead.
• These are huge changes that we and our brothers and sisters are working hard to stop and/or slow down. It is important that you contact your Senators about the proposals that would specifically harm you, your families and colleagues and urge that they not be accepted. 

Senate Version of VA Accountability Legislation Concerns Federal Employee Groups, But Moves Forward Anyway

Last week a key federal employee organization, the American Federation of Government Employees (AFGE), failed to sign a letter from twelve other federal employee groups that accused Senate legislation of ripping due process rights for Department of Veterans Affairs employees.

The letter points to ways the bill would “undermine constitutionally-guaranteed protections” and allow “the VA’s workforce to become vulnerable to undue political influence.” Most groups in the employee organization coalition don’t represent VA staffers – but the AFGE does. AFGE's failure to sign on signifies that while they are worried that approval of the bill could establish a precedent undermining civil service protections across government, failing to address this critical problem could lead to a stronger push over time to further erode the benefits that come with federal employment.

Basically, the legislation would leave VA senior executives without the ability to appeal disciplinary actions to the Merit Systems Protection Board (MSPB). Section 113 says the secretary may “reprimand or suspend, involuntarily reassign, demote, or remove” the employees. Any appeal would be limited to “an internal grievance process that the Secretary…shall establish.” Furthermore, the decision of this in-house process “shall be final and conclusive.”

While it is entirely possible that this precedent (making top federal employees “at will” and thus subject to political pressures from which they have traditionally been sheltered) could turn out to be a monumental mistake, TREA believes that the culture of the VA is such that this kind of radical reform might be enough to instill a sense of pride and frankly, an urgency to VA employment that currently seems to be missing. As long as this legislation is not expanded any further to other departments, TREA is on board with it. VA's ineptitude and complete unwillingness to mete out punishment for bad work performance has forced Congress to act in a way that would have been unthinkable only a few short years ago.

Isakson Op-Ed: We’re Taking on VA’s Corrupt Culture

Below is an Op-Ed written by SVAC Chairman Johnny Isakson (R-GA) explaining his reason for introducing the Veterans First Act which would institute the changes discussed in the previous article. 
 

Monday, May 23, 2016

WASHINGTON – U.S. Senator Johnny Isakson, R-Ga., chairman of the Senate Committee on Veterans’ Affairs, authored the following opinion piece on the Veterans First Act, a comprehensive bill he introduced to help change the culture of corruption at the Department of Veterans Affairs (VA). The bill includes improved accountability measures to give the VA the tools to fire bad actors, to prohibit bonuses for employees accused of wrongdoing and to institute protections for whistleblowers.

Op-Ed: We’re taking on VA’s corrupt culture

As published in the Atlanta Journal-Constitution

May 21, 2016

By U.S. Senator Johnny Isakson, R-Ga., chairman of the Senate Committee on Veterans’ Affairs 

Two years ago, the nation watched in horror as the Department of Veterans Affairs (VA) wait-time scandal unfolded at the Phoenix VA Medical Center. VA employees were making veterans wait so long for appointments that some veterans were dying because of it.

As the VA and Congress worked in tandem to clean up that mess, other scandals have continued to make headlines around the country: VA executives fraudulently collecting hundreds of thousands of dollars in relocation expenses; VA health care workers over-prescribing opiate drugs; VA managers allowing a hospital construction project to go $1 billion over budget.

With each new scandal, what became abundantly clear is that the VA lacks the tools to discipline or remove its bad actors. VA Secretary Robert McDonald himself has admitted that there is a serious lack of accountability among his 335,000 employees.

When the VA cannot hold negligent employees accountable, everyone loses. Taxpayer dollars are wasted on employees who are not fully committed to helping our veterans. Other employees at the VA suffer because they are forced to work with delinquent supervisors or coworkers. Most egregiously, our veterans suffer because the people responsible for caring for them are putting themselves first – not our veterans.

Since taking over as chairman of the Senate Committee on Veterans’ Affairs, I’ve been working to change the culture of corruption at the VA. I’m proud to say that we now have a bill that will give the VA the tools it needs to properly hold all of its employees accountable. The Veterans First Act will force the VA to put veterans first and ensure that no ineffective, incompetent employees get in the way of the delivery of care and benefits to our veterans. 

The Veterans First Act takes accountability further than any previous reforms. It increases the VA’s authority to remove all employees at all levels of the department. It expedites the appeal process to ensure that employees will not be able to just remain on the VA payroll indefinitely waiting for their disciplinary appeal that, until now, could take hundreds of days.

The Veterans First Act also specifically focuses on VA senior executives, many of whom have been at the center of the VA’s scandals. Our bill will make it easier for the VA to remove poor performing senior executives and replace them with qualified candidates. Any appeals by senior VA executives would no longer go to the Merit Systems Protection Board, but instead would be handled directly by the VA secretary.

The Veterans First Act also includes a number of other provisions to hold employees accountable, such as prohibiting the VA from awarding bonuses to bad actors and protecting whistleblowers so that VA employees are not afraid to speak up when they see something or someone getting in the way of our veterans receiving the care they deserve.

Holding VA employees accountable is critical, but we have gone even further to make improvements to the care and benefits we give our veterans. The Veterans First Act includes measures to expand the VA program that allows seriously ill veterans to receive care in their own homes. The bill builds on the Clay Hunt Suicide Prevention for American Veterans Act to address veterans’ mental health care needs. It includes a pilot program to address the massive backlog of veterans’ appeals, which right now stands at 445,000 disability claims appeals. It expands Post-9/11 GI Bill eligibility to thousands of Reservists and National Guardsmen. It addresses the national epidemic of opioid over-prescription among veterans, and it clarifies eligibility for interment at Arlington National Cemetery, among many other reforms.

When the wait-time scandal erupted at the Phoenix VA Medical Center almost two years ago, it became clear that some at the VA had lost sight of the agency’s core mission – to put our veterans first. The Veterans First Act will go a long way to ensure the VA gets back on track and to change the culture of corruption at VA. As chairman of the Senate Committee on Veterans’ Affairs, I will do everything I can to get this key reform legislation to the president’s desk.

House, Senate Advance Legislation to Let VA Docs Talk to Vets about Medical Marijuana

Last week the U.S. House of Representatives voted to let doctors at the Veterans Affairs Department talk to patients about using medical marijuana. This was part of the the Military Construction and Veterans Affairs Appropriations bill, and it passed by a vote of 295-129. The Senate approved a similar provision later in the day.

If President Barack Obama ends up signing the law, veterans in states where medical or recreational marijuana are legal will be able to receive feedback from doctors at the Department of Veteran Affairs on how the drug may be used as part of their treatment for conditions such as post-traumatic stress disorder (PTSD).

According to military.com, VA doctors are currently prohibited from filling out forms required for a veteran to seek the drug, even in places where purchasing it is legal. The new measure blocks the VA from spending any funds to enforce that rule -- effectively lifting the restriction and clearing the way for veterans to receive help.

Former Head of Phoenix VA Medical Center Pleads Guilty to Accepting Bribes; Gets No Jail Time

Sharon Helman, former head of the Phoenix VA health system at the time of the wait list scandal that broke roughly two years ago, has been sentenced to two years' probation for failing to disclose gifts received while performing her duties.

Helman was sentenced last week for making a false statement to a government agency by not including more than $19,000 in gifts — including a car, concert tickets and round-trip airfare — on a financial disclosure report.

House Advances Bills

On Wednesday, the House Veterans’ Affairs Committee held a markup to advance several pieces of legislation. These included bills that would permanently authorize the Veterans’ Success on Campus program, which provides counseling and benefits assistance to student veterans; the VA Health Center Management Stability and Improvement Act, which would require the VA to develop and carry out a plan to hire permanent directors at each VA Medical Center; and a bill that would allow the VA to recoup relocation expenses paid to employees when it is found that they did not deserve them. These bills were advanced to the full House for consideration. Stay tuned to the Action Corps Weekly for updates.

Hearing on Innovative Careers in Technology

On Tuesday, the House Veterans’ Affairs Committee held a hearing regarding innovative careers for veterans in technology based fields. During the hearing committee members made sure to focus on discussing not just tech-savvy, younger veterans, but also older generations of veterans interested in technology based careers. In attendance were leaders and policy makers from Microsoft, Amazon, NS2 Serves and Uber, whose companies have been making great efforts to hire more veterans. The VFW praises companies who offer innovative technology employment opportunities for veterans. Learn more.

House Passes Amendment for Blue Water Navy Benefits

An amendment to the House-passed version of the Military Construction and Veterans Affairs appropriations bill would extend presumptive service connection for conditions associated with Agent Orange exposure to Blue Water Navy Vietnam veterans. Currently, only those Vietnam veterans who were “boots on the ground” or served on the inland waterways are eligible for the presumption. This would mean eligibility for health care and compensation for thousands of veterans. The inclusion of the amendment came on the heels of a Washington, D.C., press conference organized by its sponsor, Representative Chris Gibson (R-NY), and attended by the VFW. The passage of this amendment is a major victory, as the VFW has long advocated that Blue Water Navy v eterans should be eligible for presumptive exposure to Agent Orange. Still, the amendment must pass the Senate. Be on the lookout for an Action Alert on this issue next week, and feel free to begin contacting your Senators today to let them know that this is a top priority! Read the Military Times article about the amendment. 

Congress Advances VA Appropriations Bills

On Thursday, the House of Representatives and the Senate advanced their respective Military Construction and Veterans Affairs appropriations bills for fiscal year (FY) 2017. Both bills fall short of the Administration and the Independent Budget’s request for veterans programs, specifically for the VA’s FY2017 construction accounts and advance appropriations for FY2018. Both bills increase funding from FY2016 levels and the Senate’s version nearly matches the Administration’s request, but the House bill falls $1.5 billion short of the $75 billion the VA said it needs for health care, benefits, cemetery operations, construction and other discretionary spending programs. Both bills include language to authorize VA providers to discuss the use of medical marijuana with VA patients. The Senate bill includes a provision that would expand fertility treatments the VA provides veterans who have lost their ability to reproduce due to severe injuries they suffered during military service. However, the Senate failed to adopt an amendment introduced by Senator Grassley (R-IA) to end the wrongful p ractice of denying veterans who require a fiduciary their second amendment rights. The House bill does include a provision that would expand disability compensation benefits to Blue Water Navy veterans. It is unclear when Congress will discuss or consider a compromise bill, but the VFW urges its members and supporters to contact their members of Congress to ensure these three important provisions are included in a final compromise bill. 

New Army Secretary Sworn In

On Wednesday, Eric Fanning was sworn in as the 22nd secretary of the Army during a small Pentagon ceremony after being confirmed by the Senate a day earlier. Fanning’s previous Pentagon positions include being deputy undersecretary of the Navy, acting secretary of the Air Force, and chief of staff to Defense Secretary Ash Carter. He defines his new job as making sure the Army recruits the best, trains them properly, equips them with what they need to do the job right, and to get them home. Read more. 

MIA Update

The Defense POW/MIA Accounting Agency has announced the identification of remains of five American service members who had been missing in action since World War II. Being returned home for burial with full military honors are:

• Navy Chief Storekeeper Herbert J. Hoard, 36, and Seaman 2nd Class Dale F. Pearce, 21, had been missing since Dec. 7, 1941, when the battleship USS Oklahoma they were aboard suffered multiple torpedo hits and capsized as it was moored off Ford Island in Pearl Harbor, Hawaii. Hoard will be buried May 21 in his hometown of DeSoto, Mo., and Pearce will be buried May 26 in his hometown of Dennis, Kan. 
• Marine Pfc. Elmer L. Mathies Jr., 21, will be buried May 28 in his hometown of Hereford, Texas. Mathies died Nov. 20, 1943, while fighting the Japanese on the small island of Betio in the Tarawa Atoll of the Gilbert Islands. He was assigned to Headquarters Company, 2nd Battalion, 8th Marines, 2nd Marine Division.
• Army Capt. Elwood J. Euart, 38, of Pawtucket, R.I., died Oct. 26, 1942, trying to rescue some soldiers who were trapped in a transport ship that struck two mines as it was entering Espiritu Santo in the New Hebrides. He was assigned to the 103rd Field Artillery Battalion, 43rd Infantry Division. Burial details have yet to be announced.
• Army Air Forces 1st Lt. Donald L. Beals, 21, of Brookings, S.D., was a P-47 Thunderbolt pilot who died April 17, 1945, while on a combat mission near Dresden, Germany. He was assigned to the 494th Fighter Squadron, 48th Fighter Group, 9th Air Force. Burial details have yet to be announced.  

Bill Would Return Taxes to Some Vets

Similar measures pending before the House and Senate would repay more than $78 million in taxes that were collected wrongly from veterans. The bills, H.R. 5015 and S. 2712, would direct the Defense Finance and Accounting Service (DFAS) to identify the roughly 14,000 veterans who received severance packages from the Defense Department after they sustained combat-related injuries that effectively ended their military careers. The accounting service then would reimburse those veterans for the taxes they paid. If the measures become law, affected veterans would not have to worry about filing amended tax returns to recoup the money they are owed. Also, veterans who were taxed more than three years ago still would be reimbursed, even though the window for filing an amended return normally would be closed.

Stars and Stripes 
Secretary of Defense Ash Carter is waiting to see whether Congress uses war funds in the 2017 defense budget before he decides to recommend that the president veto it, Pentagon Press Secretary Peter Cook said May 16. During the last month, the House and Senate have passed their versions of the annual National Defense Authorization Act. Though each chamber has passed an overall budget of $610 billion, the House version shifts $18 billion from a fund dedicated to war spending to pay for increased troops, aircraft and shipbuilding, a maneuver that Carter criticized as "gambling with funding for our troops."  READ MORE 
 

 Senate Releases its Version of the FY2017 National Defense Authorization Act

Each year we await Congressional action on the National Defense Authorization Act (NDAA) because that is the legislation through which Congress makes changes in policies within the Department of Defense. Of course, DoD has the ability to make certain administrative changes, as do each of the services. But on things like military health care, pay raises, commissaries, or other benefit increases or decreases, Congress takes action through the NDAA. Each chamber of Congress passes its own version, and then they meet in conference committee to work out the differences and come up with one bill.

We have already told you about the version of the NDAA that has passed out of the House Armed Services Committee and will very soon be debated on the floor of the House as they seek final passage of their version. The Senate Armed Services Committee has now released the highlights of its version of the NDAA.

Here are some of the highlights.

The House has passed a 2.1 percent active duty military pay raise, equal to the expected rise in civilian wages in 2017. The Senate passed a 1.6 percent pay raise, which matches the White House’s request for 2017 and translates into $30 to $60 more a month for most enlisted personnel, and $60 to $120 for most officers

The House plan would include reorganizing multiple Tricare programs into two options: the existing Tricare Prime program and Tricare Preferred, a new network care option similar to Tricare Standard and Extra.

The Senate plan calls for three new Tricare health plans: Tricare Prime, Tricare Choice and Tricare Supplemental, with different fee structures and parameters than the House proposal.

Other features of the Senate NDAA with regard to health care are:

• Authorizes lower co-payments for high-value pharmaceuticals and medical services.
• Eliminates the requirement for pre-authorization for specialty care referrals.
• Authorizes enrollment of eligible beneficiaries in federal dental and vision insurance programs managed by the Office of Personnel Management.
• Eliminates existing cost-shares for services provided under the current TRICARE Standard plan and replaces them with fixed co-payments to lower overall costs for beneficiaries.
• Authorizes a pilot program to give commercial health insurance coverage to reserve component members and their families.
• Authorizes conversion of military healthcare provider positions to civilian or contractor positions.
• Authorizes increases in existing single and family annual enrollment fees for working-age military retirees.
• Authorizes changes to co-payments for medical services, including allowing DOD to lower co-payments for high-value services and raise co-payments for low-value services.
• Increases pharmacy co-payments incrementally over a 9-year window. Pharmaceuticals at military hospitals and clinics will remain free of charge. Generic pharmaceuticals will remain free of charge through the mail order pharmacy through fiscal year 2019.
• Authorizes DOD to give preferential status to any non-generic pharmaceutical agent on the uniform formulary by establishing the same co-payment as the co-payment of a generic product under the retail and mail order programs.
• Authorizes appointment no-show fees in military treatment facilities.
• Incentivizes participation in disease management programs.

In short, the Senate wants more pharmacy co-pay increases, commercially health insurance for reserve component members, certain higher annual enrollment fees, civilianization of some military health care providers, and changes in co-payments for some medical services, among other things.

Unfortunately, there are no specific details beyond what is above. We expect to have those next week and will advise you of them in our next update.

We also have not yet seen what the Senate may do with regard to commissaries, but the House version of the NDAA makes changes in the commissary system and we expect the Senate will also. It is our belief that the commissary benefit is in real danger but we must wait and see what the Senate may be proposing.

The Senate NDAA also contains a provision to make young women register for the draft, as does the House version. However, there will be an effort in the House to strip the provision from its bill when it is debated by the full House.

We are watching all of this closely and we’ll keep you informed. We will also continue lobbying vigorously to protect your promised and earned military benefits.

Centennial World War I Commemoration Effort Gears Up

It was called The Great War even as it was going on. It engulfed the world, and the world is still feeling its effects.

 2014 marked  the 100^th anniversary of the start of World War I, and as visitors to England, France or several other European countries can attest, they began commemorating the occasion a couple of years ago.  At the same time U.S. officials began gearing up to mark the centennial of the U.S. entry into the war in 1917.

  The Great War began in July 1914 with the assassination of Austrian Archduke Franz Ferdinand. This triggered an interconnecting network of alliances to spark mobilization, bringing in the empires of Europe. England, France and Russia lined up against Germany, the Austro-Hungarian Empire and the Ottoman Empire.

A generation of men died in battle on the fields of France. The Somme, Verdun, Ypres and Meuse-Argonne became killing grounds. On the Eastern Front, millions of Germans, Austrians and Russians battled. Overall, about 16.5 million people were killed in the war.

At first, the United States stayed out of it. In fact, when President Woodrow Wilson ran for re-election in 1916, his campaign slogan was “He kept us out of war.”

But on April 7, 1917, the United States declared war on Germany and the other Central Powers and raised a military force of more than 4 million men. The United States lost 116,516 service members in World War I. Another 205,690 were wounded.

While the United States didn’t enter the war until 1917, the World War I Centennial Commission is beginning its mission of education now to provide Americans some context for the epochal war. Robert J. Dalessandro is the director of the U.S. Army Center of Military History at Fort Lesley J. McNair, Va. He also is the acting chairman of the U.S. commemoration commission.

“You can’t just drop into World War I in April of ’17 without understanding the road to war,” Dalessandro said in an interview. “It was complex politically and internationally, and Americans today need to know what Americans then thought about the war.”

Congress chartered the WW1 commission to encourage private organizations and state and local governments to organize activities commemorating the centennial. The panel will coordinate activities throughout the United States tied to the centennial and will serve as a clearinghouse for the dissemination of plans and events, he said.

While its charter covers the United States, the commission also is looking at international events, and will mark those appropriately, he added. “We want to lead efforts that raise awareness, that encourage a spectrum of organizations to plan programs and develop an education program targeting America’s youth,” Dalessandro said.

The education aspect may be the commission’s most important challenge, he added. “We need to wake up the interest of a new generation of Americans on the effects of World War I,” he said.

Americans today need to know that World War I changed everything for America, Dalessandro said.

While the Civil War saw a draft, Dalessandro said, World War I saw the first universal draft.

“The first question is if you have a universal draft for men, what do you do with African-American men?” he said. African-American leaders were determined that black men fight as combat soldiers and fight in integrated units. They also pushed for black officers, Dalessandro said. “Part of that happened,” he added.

For many African-Americans, he noted, the experience in France was their first taste of an environment without Jim Crow laws. “There, they are looked on as equals and that is a revelatory experience,” he said.

World War I was the first time masses of American women entered the workforce, Dalessandro said. There were nurses, “yeomanettes,” telephone operators, Red Cross workers, “Doughnut Dollies” and women working in factories. And at the end of the war, women had the vote.

“In the Civil War, you have Irish and German immigrants in great numbers in the Army,” Dalessandro said. “But in World War I, you have Italian-Americans, Eastern Europeans, Jews, large numbers of Russians, Poles, Czechs, Slovaks -- soldiers from ethnic groups that have emigrated, and it’s a quick road to citizenship.”

The question was whether these men would fight together -- whether they would consider themselves Americans, he added. And the answer was yes, he said.

Some historians call The Great War just Act 1 of a greater war that includes World War II and the Cold War. Fascism grew out of the experiences in the war. Revolution took hold in Russia, and the Soviet Union was born. The Versailles Peace Treaty set the stage for Act 2 in 1939.

The Battle of Meuse-Argonne was the largest American battle up to that point. More than 500,000 doughboys and Marines fought, and many died, on the fields and forests of France. They faced not only bullets and artillery, but also poison gas, tanks and planes. And yet, the American impression of the war is “Snoopy vs. the Red Baron” or movies such as “All Quiet on the Western Front,” “Paths of Glory” or “Wings,” Dalessandro said.

World War I set the stage for the rest of the 20th century. It destroyed four empires: the German Empire, the Austro-Hungarian Empire, the Russian Empire and the Ottoman Empire. It also set the stage for current conditions in the Middle East by the Balfour Declaration, which called for a Jewish homeland in the region and by the victors drawing the borders of new countries.

One hundred years on, World War I continues to cast a shadow, Dalessandro said. The nation needs to learn from it, he added, and the commemoration is a place to start.

 Tobacco prices going to rise in Commissaries and Exchanges

Sometime in the near future the price of cigarettes, cigars etc. will be the same in military stores as it is in civilian states. Secretary of Defense Ash Carter issued a memo on April directing that tobacco prices in commissaries and exchanges will match civilian stores in the states when taxes are included.

The memo read that tobacco prices “shall match the prevailing local price in the community, including the effect of all applicable taxes that local consumers pay when purchasing tobacco.”

OCONUS, prices will be set “within the range of prevailing prices for that same product” established in outlets of the defense retail systems in the U.S.

Presently federal taxes of $1.01 a pack is already included in the manufactures price but state and local taxes are not. The new policy will mean an average price increase of 25%-33% however some states will be higher.

The policy is intended to try and stop tobacco use.

It has not been announced when this policy will go into effect. DoD says they are still working out the details.

SVAC Passes Huge Veterans First Act, HVAC Attacks It As Betrayal to Party

Last week the Senate Veterans' Affairs Committee passed the huge veterans omnibus bill, called the Veterans First Act, in a unanimous vote. Oddly, the House Veterans' Affairs Committee issued a press release which, quoting an article in the Daily Caller, called it “Democratic” bill that was “weak” and that the American Federation of Government Employees union had promised to help the ranking Democrat on the committee, Richard Blumenthal of Connecticut, because of his efforts to preserve job security for VA employees.

The fact that the vote was announced only hours before it was taken, and that it took place in the Capitol, instead of in the Veterans' Committee room in the Russell Senate Office building (and away from the live cameras there) only added ammo to the HVAC's broadside. Needless to say, it is going to be very interesting watching the Republican-dominated House and Senate duke it out in the next few weeks over this important legislation.

SVAC Chairman Senator Johnny Isakson, (R-GA) called the unanimous vote as a sign of strong support for the measure and downplayed growing criticism about the provisions.

We are very supportive of certain aspects of the legislation, including an expansion of the Caregivers Program to the caregivers of injured veterans from all eras. The program offers stipends, health benefits and other support for those who provide full-time care. The caregivers expansion is only one provision in the 400-page bill, along with new assistance for homeless veterans, expansion of veterans and survivors eligible for education benefits, and improvements to health care programs.

An official Congressional Budget Office (CBO) scoring of the bill has not been released yet, but is expected soon.

While the inclusion of a cut in GI Bill housing stipend growth is causing some VSOs, to have trouble completely supporting the bill, it is the VA accountability portions of the bill that are giving the House indigestion.

Senators included in the omnibus VA leaders’ plans to reclassify department senior executives to allow for faster hiring and firing of those positions, and give supervisors more flexibility on pay and work hours.

But the measure goes further on accountability issues, limiting the amount of time any VA employee can be placed on administrative leave and blocking bonuses for some workers.

It also gives broad power to VA leaders dismiss almost any employee. That’s an effort to address past cases where workers who committed off-duty criminal acts stayed on the VA payroll, due to complicated firing rules.

Union leaders and the White House have objected to similar plans in the past, calling it an erosion of workers’ rights. House lawmakers have indicated the Senate plan does not go far enough. Whereas under the Senate plan disciplinary decisions which today can take more than 400 days to complete would be reduced to 110, the House plan trims that even further, to 52 days for appeals and rulings.

It is important to note that the cut in BAH brings the GI Bill BAH payment in line with what DOD is going to be paying the active duty going forward; that 5% (overall) cut was passed in last year's NDAA. This fact makes it much harder to argue that Congress is betraying veterans, when the active duty is already facing such a cut.

VA Re-Analyzing Suicide Statistics; New Ones Due Out In Summer

The Department of Veterans Affairs(VA) told the House Veterans' Affairs Committee (HVAC) last week that is is currently analyzing data that it has received from the Centers for Disease Control (CDC) that could erase the widely-heard statistic that 22 veterans die by suicide each day.

The Washington Post's “Factchecker” had found years ago that this number was unreliable at best.

VA analysts are currently analyzing death records for all personnel who served from 1979 to 2015.

In the past data came from the states, which led to questionable conclusions.

The “22 veterans a day” takeaway from a 2012 study did not include a number of states with high veteran populations like California, Texas, Arizona and North Carolina, and did not account for deaths that may have been suicides but were not indicated on death certificates.

A more recent VA study of post-9/11 combat veterans found that 1,868 veterans died by suicide, from 2001 to 2009, fewer than one a day. Regardless of the actual number, any veteran committing suicide is one too many.

Suicidal servicemembers and veterans can call the Veterans Crisis Line, 800-273-8255, press 1, for assistance. Help also is available online at www.militarycrisisline.net or by text, 838255

House Hearing on Veteran Suicide

The House Veterans’ Affairs Committee held a hearing on Thursday to discuss veteran suicide. Topics highlighted during the hearing were data gathering and analysis, better staffing of mental health providers, expansion of peer support programs, timeliness of patient care and outreach. The committee strongly highlighted the need to increase mental health staff within the VA, as well as shorten the amount of time required to hire these health care providers. The VA representatives discussed what they are doing to improve the Veterans Crisis Hotline as well as expand peer support specialist programs. The VA also explained that they have been conducting research to better understand veteran suicide, not just as whole, but within subpopulations based on gender and age. The epidemiology department of the VA has been working with the Centers for Disease Control and Prevention as well as DOD to analyze data for all vet erans dating back to 1979. Results should be published mid-summer, which should help not only the VA, but the House and Senate Veterans’ Affairs Committees make forward-moving decisions on how to better prevent veteran suicide and improve mental health treatments. View a video of the hearing.

Senate Hearing on Tribal Veterans Health Care Bill

On Wednesday, the Senate Indian Affairs Committee held a hearing to discuss the Tribal Veterans Health Care Enhancement Act, which would require the Indian Health Service (IHS) to cover the copayments VA charges Native American veterans who have been referred to VA medical facilities by the IHS for non-service connected conditions. The bill’s sponsor, Senator Thune, explained that IHS covers the copayments of Native American veterans who are referred to private sector providers, but not VA providers. This bill would correct this inequity. Santee Sioux Nation Chairman Roger Trudell discussed the barriers Native American veterans are required to overcome when receiving the health care and benefits they have earned. View a video of the hearing.

House Passes Veterans Bills

This week, the House passed two veterans bills which would curb the VA’s use of opioid prescriptions to treat and manage chronic pain, and would enable service members with military emergency medical technician (EMT) training to leverage their military training to streamline the process for state certification and licensure as an EMT. The bills now await consideration by the Senate. While the Senate Veterans’ Affairs Committee has advanced its version of the Jason Simcakoski PROMISE Act, the Senate Health, Education, Labor, and Pensions Committee has yet to consider the Veteran Emergency Medical Technician Support Act of 2015. Stay tuned to the Action Corps Weekly for updates.

Senate Advances Veterans Omnibus

On Thursday, the Senate Veterans’ Affairs Committee advanced a veterans omnibus bill, the Veterans First Act, which includes a number of important provisions the VFW strongly supports, including expansion of the Caregivers Program to pre-9/11 veterans, expansion of the Yellow Ribbon Program to Fry Scholarship beneficiaries and authorization for research on the health effects toxic exposures may have on the descendants of exposed veterans. This bill would also curb the VA’s use of high-dose opioids to treat and manage chronic pain and improve accountability of VA employees who put veterans’ lives at risk. The VFW looks forward to working with the Senate to secure the swift passage of this important bill. For a summary of the bill, click here.

House Advances Key Bills

On Wednesday, the House Veterans’ Affairs Subcommittees on Economic Opportunity and Disability Assistance & Memorials Affairs each held markups to advance several pieces of legislation to the full committee. They included bills that would increase accountability for VA employee relocation and travel, encourage veteran hiring in the private sector, improve oversight of the GI Bill, authorize a cost of living allowance for 2017, provide an extra month of benefits to families following a veteran’s death, and provide special compensation for veterans who lose or lose the use of creative organs in the line of duty. The VFW supports each of these measures. Stay tuned to the Action Corps Weekly for updates as they continue to move through the House.

Changes to Spina Bifida Program

This week, the VA implemented changes to health care and services it covers for certain children of Vietnam War and Korean DMZ veterans born with spina bifida. Starting this week, Spina Bifida Program beneficiaries are eligible to receive homemaker or home health aide services that provide assistance with daily living activities or instrumental activities of daily living that have therapeutic value. The VA has also made changes to the list of health care services that require preauthorization. For more information on these changes, contact the Spina Bifida Health Care Benefits Program General Information at 888-820-1756. You can also read more here.

Take the Military Family Survey

Blue Star Families has asked the VFW to help distribute their 2016 Military Family Lifestyle Survey to active duty, Guard, Reserve and veteran families. The data collected provides real-time feedback from military members and families on issues ranging from operations tempo to pay and benefits, stress, caregiving and employment. The survey closes on May 31. Take the survey online now.

MIA Update

The Defense POW/MIA Accounting Agency announced the identification of remains of four American servicemen who had been missing in action since World War II and Korea. All will be buried with full military honors. Returned home are:

·         Navy Ensign William M. Finnegan, 44, of Bessemer, Mich., Ensign John C. England, 20, of Alhambra, Calif., and Chief Petty Officer Albert E. Hayden, 44, of Mechanicsville, Md., had been missing since Dec. 7, 1941, when the battleship USS Oklahoma they were aboard suffered multiple torpedo hits and capsized as it was moored off Ford Island in Pearl Harbor, Hawaii. Hayden will be buried May 18 in Morganza, Md.

·         Army Sgt. Billy J. Williams, 20, of Madisonville, Texas, will be buried May 17 in Madison County, Texas. On Feb. 14, 1951, Williams was assigned to 2nd Reconnaissance Company, 2nd Infantry Division, when his company was attacked by Chinese forces in the vicinity of Chuam-ni, North Korea. He was declared missing in action after the battle. It would be later learned he had been captured, but died in captivity in April 1951.

Joining Forces Announces 1.2 Million Veteran & Spouse Hires, Aims for 100k More

First Lady Michelle Obama and Dr. Jill Biden announced last week that since 2011, when Joining Forces, the White House initiative created to help veterans and military spouses find jobs, companies have hired or trained more than 1.2 million veterans and military spouses.

Additionally, 40 companies have pledged to hire more than 110,000 veterans and military spouses over the next five years. Even more companies have committed to at least training veterans and military spouses, even if they are unable to commit to specific hiring goals.

Jeff Bezos, founder and CEO of Amazon, vowed to hire 25,000 veterans and military spouses in the next five years.

It is clear that these companies would not be going the extra mile to hire veterans if doing so wasn't helping their bottom line. According to Mrs. Obama, “they [the companies] saw for themselves that our veterans and military spouses are simply the best employees around.”

The aerospace-defense sector pledged to hire a combined total of 30,000 veterans, and the telecommunications sector committed to hiring a combined total of 25,000.

VA selects new Director of the Center for Women Veterans

Last week the VA announced that author and veteran Kayla M. Williams will be the Director of the VA’s Director of the Center of Women veterans and the VA Secretary’s primary advisor on projects, programs, legislation and policies that effect women veterans.

 Ms. Williams was an Arabic linguist and former intelligence specialist in the Army. She served in Iraq which served as the basis of her first book “Love my Rifle More than You: Young and Female in the U.S. Army (2006). Her second book is “Plenty of Time When we get Home: Love and Recovery in the Aftermath of War.” (2014)

“Kayla embodies everything it means to be a true advocate for women Veterans and I am proud to welcome her to VA in this leadership role,” said Secretary of Veterans Affairs Robert A. McDonald. “This is an important time for VA as we prepare for the growing number of women we expect to take advantage of the VA services they have earned. I know Kayla will be tremendously helpful in improving services for female Veterans now and in future.”

She is married to a wounded combat veteran and they have 2 children.

Unemployment Rate for Post 9/11 veterans is lowest ever

In April the unemployment rate for Post 9/11 veterans was 4.1%! The all-time low. The nation’s unemployment rate in March was 5.0% but that is seasonally adjusted while veterans’ unemployment rates are not seasonally adjusted. So it is a little like comparing apples and oranges.

This group “has seen an unprecedented run of employment success over the last 12 months. April 2016 marks the seventh time since May 2015 that the monthly unemployment rate was either the lowest or the second-lowest recorded at the time it came out.”

For all American veterans unemployment was 3.9% in April, down from 4.5% in March and 4.7% in April 2015.

Progress, Promise, and Challenges in U.S. Veterans' Health Policy

On Wednesday, the Center for Strategic and International Studies hosted Secretary of Veterans Affairs Robert McDonald to discuss his transformation of the VA into a high performing organization. McDonald detailed his 12 priorities for 2016, which include improving a veteran’s experience when receiving VA health care, staffing critical positions that are vacant, and transforming information technology and supply chain processes. View a video of his speech.

The VA Expands MyVA Communities

As part of Secretary McDonald’s MyVA transformation initiative, the VA has established local community engagement boards, called MyVA Communities, around the country. These boards provide a feedback and input mechanism for local veterans, and bring together the local VA leadership to meet the unique needs of veterans in each community and facilitate the development of local solutions. The VA has incorporated more than 50 community engagement boards into the MyVA Communities initiative and expects to have nearly 50 more by the end of the year. To learn about the MyVA Communities initiative or to find a local community engagement board, click here.

New Director of Center for Women Veterans

The Secretary of VA has appointed Kayla Williams as the Director of the Center for Women Veterans. In this role, Williams will be the primary advisor to the Secretary on programs, policies and legislation that affect women veterans. Williams is an OIF veteran and is a long-time advocate for women veterans who has experienced the road to recovery with her husband who suffered a TBI while deployed in Iraq. Learn more about Williams.

New Military Sexual Assault Report

Only 254, or four percent of nearly 6,100 sexual assaults reported by military service members last year resulted in court-martial convictions, according to the Pentagon’s latest report on military sexual assaults, which was released on Thursday. Although court-martial proceedings are still pending on 113 others, many reported assaults resulted in no punishment for an array of legal reasons that included lack of jurisdiction, lack of evidence, a commander's decision not to prosecute, or because the alleged perpetrator separated from the military. A full quarter of the complaints were filed as “restricted” reports, which meant the service member reporting the assault only sought health care or victims' support services, not a formal investigation. More than 500 cases were also resolved without a court-martial, which indicates non-judicial punishments and administrative discharges. About 20 percent of victims were men, whi ch along with the total reports filed was consistent with the 2014 report. Learn more. 

Invictus Games Begin This Weekend

The second Invictus Games, an Olympic-style international competition for wounded warriors, will be held May 8-12 in Orlando, Florida. Taking its name from the Latin word for “unconquered,” the mission of the Invictus Games is to use “the power of sport to inspire recovery, support rehabilitation and generate a wider understanding and respect for wounded, injured and sick servicemen and women.” This year, 500 competitors representing 15 nations will compete in 10 athletic events. Television coverage will begin with the opening ceremony on Sunday, and continue throughout the week on ESPN2 and ESPN3. Learn more. View the complete broadcast schedule.

V-E Day Commemoration

A public ceremony to commemorate the 71st anniversary of Victory in Europe Day will be held at the National World War II Memorial in Washington, D.C., on Mother’s Day, May 8, at 11 a.m. All WWII veterans are invited to attend and be recognized for their service and sacrifice. The WWII Memorial has very few disability parking spaces, and street parking could be limited since it’s the tourist season. Taxis to the memorial are plentiful and recommended. The two closest Metro stations, Federal Triangle and Smithsonian, are both about a half-mile away. Learn more about this and other events.

MIA Updates

The Defense POW/MIA Accounting Agency announced the identification of remains of four American servicemen who had been missing in action from World War II and Korea. Being returned for burial with full military honors on a date and location to be announced are:

• Fireman 2nd Class James B. Boring, 21, of Vinton County, Ohio, Navy Fireman 3rd Class Edwin C. Hopkins, 18, of Swanzey, N.H., and Ensign Lewis B. Pride Jr., 23, of Madisonville, Ky., had been missing since Dec. 7, 1941, when the battleship USS Oklahoma they were aboard suffered multiple torpedo hits and capsized as it was moored off Ford Island in Pearl Harbor, Hawaii.
• Army Sgt. 1st Class James P. Shunney, of Providence, R.I., was lost fighting in North Korea on Nov. 2, 1950. He was assigned to Company I, 3rd Battalion, 8th Cavalry Regiment, 1st Cavalry Division.

·         House of Representatives Armed Services Committee Reveals Proposed Health Care Changes

Two weeks ago the Personnel Subcommittee of the House Armed Services Committee (HASC) released its proposals for the FY2017 National Defense Authorization Act. The HASC is the committee in the House with jurisdiction over most military personnel matters and what comes out of that committee usually is passed by the entire House of Representatives.

The proposals of two weeks ago, however, did not contain any changes in the military health care system. We learned that it was because there was disagreement between the chairman of the Personnel subcommittee and the chairman of the entire Armed ServicesS Committee.

They managed to work out their differences and last week they revealed their proposals.

According to a statement from the two chairs, their proposals “Simplify TRICARE Options by providing two comprehensive options designed to better meet the health care needs of servicemembers, their families and retirees: a managed care option [Tricare Prime] and a no-referral network option [Tricare Preferred].

“Expand Access to Care by eliminating referrals for urgent care and ensuring urgent care access for military families through 11:00PM; extending care at Military Treatment Facilities (MTF) primary care clinics beyond normal business hours; expanding public-private partnerships to increase and complement MTF services provided to beneficiaries; and enabling retirees to purchase durable medical equipment at the DOD cost.

“Improve Beneficiaries Experience at Military Treatment Facilities by standardizing       appointment scheduling and first-call resolution when contacting clinics, increasing the number of available appointments, and maximizing the use of telehealth and secure messaging.”

An article in the Military Times explained it this way: 

·         “Those changes include reorganizing multiple Tricare programs into two options: the existing Tricare Prime program and Tricare Preferred — a network care option similar to Tricare Standard and Extra. The current fee structure would remain in place but could change in 2020 if the Defense Department meets certain standards for patient access and care. 

·         “Under the HASC proposal, all personnel now serving or who will retire before Jan 1, 2018, will elect to use Tricare Prime or Tricare Preferred and will pay the current fee structure, with enrollment fees adjusted to the cost of living. 

·         “The current fee structure would remain in place until 2020. Then, if DoD has shown to Congress that it has improved the overall quality and access to care for beneficiaries, retirees using Tricare Preferred would start paying an annual enrollment fee: $100 per an individual and $200 for a family. 

·         “Those on Tricare Prime would continue to pay the COLA-based enrollment fee.

 ·         “Active-duty families would continue to not pay any enrollment fees until their sponsor retires.

 ·         “Anyone enlisting after Jan. 1, 2018, would pay an annual fee, including the active-duty member, of either $180 for an individual and $360 for a family for Tricare Prime, or $300 for an individual or $600 for a family for Tricare Preferred.

 ·         “When they eventually retire, they would pay $325 for an individual and $650 for a family on Prime and $425 for an individual and $850 for a family for Tricare Preferred.

 ·         “Another change also would be implemented for new users in 2018: they would pay set amounts for primary and specialty care visits under Tricare Preferred, instead of the 20 percent or 25 percent rate currently used.”

It is probable that these proposed changes will pass the House of Representatives sometime in April. However, the Senate is expected to reveal its proposals sometime in early May. Both the chairman of the personnel subcommittee of the Senate Armed Services, Sen. Lindsey Graham (R-S.C.) and the chairman of the entire Senate Armed Services Committee, Sen. John McCain (R- Ariz.) have long advocated for major changes in the military health care system for making military personnel, especially retirees, pay more for their health care.

If the Senate and House pass radically different proposals, it will require a great deal of negotiation to reach an agreement on a final proposal. It is not likely that we will know the final result of all of this until at least this fall – and perhaps even later.

In addition to health care, the House proposal would give active duty troops a 2.1 percent pay raise in 2017. However, this is more than the Defense Department proposed so we have to again wait and see what the Senate will do.

There is another provision that would force young women to register for the draft when they reach the age of 18. This provision was inserted by Congressman Duncan Hunter (R-Calif.) who ended up voting against it. He said he is opposed to allowing women in combat but since they have been, they should now have to register for the draft, something he is also opposed to. He said he offered his provision as an effort to start a national discussion about the issue to see if this is what the American people really want.

Lawmakers also passed an amendment that would reform the way retirement pensions are given to service members who have gone through a divorce.

The amendment provides that someone who is divorced from a service member will only be able to receive a portion of the retirement pay consistent with the rank of the service member at the time of the divorce.

 In other words, if a person gets divorced as a major, but retires as a general, the portion of retirement pay the non-service member divorcee is eligible for is at a major pay grade.

While we are pleased that there is a certain amount of grandfathering in the health care proposal, and that they did not touch Tricare for Life, we are still evaluating the rest of the health care proposal before taking a position.

Finally, there is a provision dealing with the commissary system.

In past years DoD had proposed cutting the benefit and then looking for ways to reform it. This year, that has seemingly changed and they’ve said they want to reform the system before making cuts. Although there is widespread support in Congress for the commissary system, many key members want to eliminate the commissaries as we know them today, which means it would cost you more to shop at a commissary. We now know what the House of Representatives is proposing, although we still do not know what will come out of the Senate.

The idea in Congress is to have the commissaries start making a profit so that eventually they will no longer have to appropriate money for them. The issue is very detailed and difficult to summarize, but our concern is that present plans by DoD and Congress are setting up a situation whereby the commissaries and the exchanges will be combined. If that happens, you will still be able to shop at a commissary, but the savings you have today will be gone.

We continue to evaluate the commissary change proposal but we remain firm in opposition to any reduction in the commissary benefit. If DoD can actually maintain the benefit, even as the appropriated funds for the commissary system are reduced, we will support it. But that remains to be seen and right now we remain very skeptical.
 

Bill Help Combat-Wounded Vets Recoup Improperly Taxed Severance Payment
 

Last week the Senate Finance Committee approved the 2016 Taxpayer Protection Act. The bill contained an amendment that would require the Department of Defense (DOD) to pay back all of the improperly-withheld income taxes on severance payments made to medical retirees who were forced to retire because of combat related wounds going as far back as 1991
 

The amendment is based on a bill which was cosponsored in a bipartisan manner by Senators John Boozeman (R-Ark.) and Mark Warner (D-Va.) that directed DOD to identify affected veterans, notify them, and ensure the government pays them back while also extending the statute of limitations on amended tax returns so that those who were affected can still “still receive their full and proper payments,” according to Senator Warner. But the new, bigger bill still has to pass through the full Senate, and then it would have to go to the House of Representatives as well, so it is a long ways off from becoming law.
 

Some estimates put the number of Chapter 61 medical retirees affected by this improper taxation at over 14,000, and the dollar amount at nearly $78 million. DOD argues that the real numbers are not as high. Apparently DOD has known about the problem for years, but it is still up to the retiree to figure out that they have been improperly taxed and then to go to the Defense Finance Accounting Service (DFAS) and recoup the money on their own.

Senate VA Committee Unveil Massive New Omnibus Bill

Last week the leaders of the Senate Veterans' Affairs Committee released a huge new Department of Veterans' Affairs reform package that includes “sweeping new accountability rules for Department of Veterans Affairs employees, a dramatic expansion of the veterans caregiver program, and promises of changing the agency to a more veteran-friendly culture,” according to Military Times.

Additionally, the bill does away with the controversial cuts to the Post 9/11 GI Bill that had split the VSO community when the House passed HR 3016, as shown in this article on military.com.

According to TREA's Deputy Legislative Director Mike Saunders (as reported by the above military.com article): “We shouldn't be forced to rob Peter to pay Paul … I think that's what the rest of the veteran service organization community feels, as well."

The reference to robbing “Peter to pay Paul” is alluding to the fact that the Basic Allowance for Housing (BAH) cuts for the dependents of servicemembers who have the Post 9/11 GI Bill benefit transferred to them more than 180 days after the House bill is signed into law were being used to pay for many other things that the veterans community has long been pushing for, such as expanding Fry scholarship eligibility, provisions for improving postnatal care for female veterans, expanded K-9 therapy for veterans suffering with post-traumatic stress disorder, reauthorizing the VA work-study program and removing the cap on VA home loan guarantees.

While there is bipartisan support in the Senate, the measure faces an uncertain future with the House and White House. The House wants to know how much everything costs and doesn't think the employee accountability measures go far enough, and the White House thinks that the new employee firing rules will be too strict.

The omnibus, known as the Veterans First Act, gives VA leaders the ability to more easily hire and fire department senior executives, changing the employment policies to rules that mirror private-sector contracts.

But it also goes further, limiting the amount of time any VA employee can be placed on administrative leave, blocking bonuses for some workers, and allowing any VA employee to be fired for misconduct with more limited appeals and a quicker timeline. House Democrats and the White Houses have signaled that they will not go along with those changes.

The Senate omnibus also includes a new office charged with protecting whistleblowers, with more oversight and reporting to Congress on that recurring issue.

On health care, the bill includes a massive expansion of VA’s program for caregivers of seriously injured veterans, which provides financial support, health benefits and other services for family members offering care.

Under the plan, financial stipends would be extended to caregivers of veterans injured or wounded on active duty on or before May 7, 1975. Currently, that benefit is only available to veterans who served after Sept. 11, 2001.

The benefit would begin as soon as VA can establish the technology infrastructure needed to support the additional caregivers. Two years after that, it would be extended to all caregivers of veterans, regardless of the era they served.

The Congressional Budget Office in 2014 estimated that expansion of the caregiver program to all eligible veterans would cost VA $9.5 billion over four years. According to Military Times, Senate Veterans' Affairs staffers estimated the omnibus' cost at around $4 billion, with enough offsets to cover the spending. Congressional Budget Office scoring of the document is still pending.