Retiree & Veteran Affairs News 28 September 2016
DEFENSE SPENDING STALLED AGAIN
It’s a 99.9% probability that Congress will pass a continuing resolution (CR) to keep the government running past the Oct. 1 deadline. How they reach their goal is the billion dollar question.
Any optimism the Senate had that they would be able to pass the defense spending bill was dashed Tuesday when the legislation failed to garner the 60 votes needed to proceed. This is the third time Democrats have blocked the measure.
Democrats are not necessarily opposed to the language in the bill, rather it is a tactical maneuver. They believe they will have more leverage over Republicans to secure additional domestic spending in the final FY17 spending package that presumably will be passed after the November elections.
There is nothing to suggest the path to passing a CR will be any easier.
The Senate leadership is in discussions with the minority leaders and the White House to move a continuing resolution to the floor next week. The stop-gap measure would expire Dec. 9.
There is some speculation that if the Senate can actually pass the measure next week, they would adjourn early, thus tying the House’s hands - either pass the Senate’s version or allow the government to shut-down, not a pleasing prospect any time much less in an election year.
House Republicans are divided on the duration of the measure with some agreeing to the shorter CR and, others, namely the House Freedom Caucus who do not favor lame-duck sessions and want the CR to last until March 2017.
Members of the House Freedom Caucus have indicated that they will support the short term continuing resolution if the leadership includes language dealing with Syrian refugees, an idea that will certainly be rejected by Democrats.
Round and round it goes!
AUSA prefers passage of routine spending bills in a timely manner. However, since that is unlikely, we strongly favor a short-term continuing resolution.
There hasn't been a full year's appropriation, adopted on time since 2007. While CRs are far better than government shut-downs, they are not a substitute for actual appropriations.
Under CR funding, the Army cannot move money around where it's actually needed or start new contracts. Budget dollars are placed against needs and priorities of previous years, leaving the priorities and needs of the current year unfunded. The end result of all this is, at a minimum, things cost more and they take longer to get.
Congress is demanding that the Army spend less money but they are making it more difficult to achieve that goal. It’s no way to do business and unfortunately, we don’t see any return to regular order on the horizon.
Will There be a COLA Next Year? Not Much, if Any
It’s not looking good for a Cost of Living Adjustment (COLA) for 2017. We won’t know for sure until October 18th but so far, it would only amount to .23 percent.
The COLA is determined by a formula each year that is based on the measure for inflation used by the Department of Labor. In 2014 retirees got a 1.5 percent COLA, in 2015 it was 1.7 percent, and this year it was 0 percent. Since the price of oil has fallen this year, and that makes up a significant part of the formula that determines the inflation rate, chances of a healthy COLA don’t look good.
This is in spite of the increases in the cost of Medicare for many seniors, as well as other increases for things that don’t outweigh the drop in oil prices.
"The Rural Connection" Quarterly NewsletterContact ORH to request a subscription.
The “The Rural Connection” Fall 2016 issue highlights some of the many efforts underway to inform health care policy that impacts rural Veterans and rural health care delivery. This issue is the last in a four-part series on the U.S. Department of Veterans Affairs’ rural health strategic goals.
- The Veterans Choice Program, From 2014 to Present
- The Commission on Care Final Report’s Impact on Rural Veterans
- New Website Offers Providers, Researchers and Partners Centralized Rural Veteran Information to Help Increase Veterans’ Access to Care
- White House Rural Council Focused on Rural Communities’ Health
- Tribal Tradition Meets Telemental Health Technology
- Connecting Mississippi’s Rural Veterans to Mental Health Care via Telehealth
- Rural Veterans Snapshot
- Rural Veterans Supported through USDA-funded Community Facilities Projects
- Electronic Sharing of Health Information Connects Maine’s Veterans, VA and Community Providers
- VA and Walgreens Partner to Provide Free Flu Shots to Veterans
- Unleashing Affordable Broadband Access to Empower Our Nation’s Veterans
- VA Resources to Support Veteran Caregivers
- New Mapping Platform Offers Users Opportunity to Explore Intersection of Broadband and Rural Health
- Request for Veterans Rural Health Advisory Committee Nominations
VA Awards $6.8 Billion for Medical Disability Examinations
Last week the VA awarded 12 contracts totaling $6.8 billion among 5 firms 12 contracts to provide medical disability examinations for Compensation and Pension qualification. This should reduce the wait times for veterans who are filing for service-connected benefits.
Department of Veterans Affairs Secretary Robert A. McDonald commented: “This is good news for Veterans who are waiting for VA to determine whether a condition can be considered service-connected. For these Veterans, we want the process to be smoother – from beginning to end. When we announced the MyVA initiative in 2014 to improve Veterans’ experience with VA, which meant looking at every process and every product. These awards represent a way for us to improve a significant process for Veterans.”
The Contracts were awarded to the following firms:
- VetFed Resources, Inc., Alexandria, Virginia;
- Logistics Health, Inc., La Crosse, Wisconsin;
- Medical Support Los Angeles, A Medical Corporation, Pasadena, CA;
- QTC Medical Services, Inc., Diamond Bar, California; and
- Veterans Evaluation Services, Inc., Houston, Texas.
We hope and think that this should speed up the process to initially qualify or increase service connected disability payments.
VA enrolled patients can get free flu shots at the VA and at Walgreens
Whenever Fall approaches (in fact it arrived last week) we are told to get the latest flu shot. The VA orders 2,000,000 doses of flu vaccine every year to give to its patients (and employees) at their hospitals and clinics.
But don’t have to travel to the VA if you don’t want to. Enrolled veterans can also get a free flu shot at your local Walgreens. This program runs through March 31st 2017.
For-Profit Schools Accreditor Stripped of Authority by Department of Education
Last week the Department of Education officially stripped the Accrediting Council for Independent Colleges and Schools (ACICS) of its authority to accredit schools and universities, and thus the eligibility of those institutions for federal funding. ACICS, the largest accrediting agency of for-profit colleges and universities in the country, has been dogged by criticism of its ability to be an effective watchdog for students as well as billions of taxpayer dollars.
We warned readers that this was possible several months ago.
We told you that a federal panel had voted to shut ACICS down in June amid intense criticism of the council for its loose oversight of educational institutions. ACICS was the accrediting agency for Corinthian Colleges and ITT Technical Institute campuses, which have both closed.
The Department of Education also issued a formal recommendation to eliminate the accrediting agency, which currently oversees about 725 institutions, oversaw $3.3 billion in federal financial aid last year, and affects roughly 800,000 students. Approximately 35,000 of those students are veterans.
ACICS plans to appeal the decision, the company said in a statement. It will have 30 days to file the appeal, during which it would retain its federal status. The appeal will be considered by Education Secretary John King.
For more information, check out the VA’s GI Bill comparator tool: http://www.benefits.va.gov/gibill/comparison_tool/about_this_tool.asp
Military Drug Take Back Program offers safe drug disposal
TRICARE Press Release:
Excess prescription and over-the-counter drugs can pose a serious risk in your home. The Military Health System (MHS) is helping the military community fight back against the dangers of unneeded, unused and expired drugs by offering Drug Take Back at military pharmacies in the U.S.
“Proper disposal of unneeded, unused and expired drugs lowers the risk of misuse and environmental contamination,” said Dr. George Jones, chief of Pharmacy Operations at the DHA. “The MHS Drug Take Back program accepts both prescription and over-the-counter drugs, so this is the time to clean out your medicine cabinet.”
Military pharmacies in the U.S. offer two Drug Take Back options. Most pharmacies have fixed containers in place where you can drop off your excess drugs. Others offer envelopes you can take home, fill with your drugs, and then mail in. Some have both. You can’t dispose of illegal drugs at MHS Drug Take Back locations.
Check to see if your local military pharmacy offers drug takeback at www.tricare.mil/mtf.
“Holding onto drugs past their useful life is a bad idea,” said Jones. “It could be a child accidently ingesting an over-the-counter sleep aid, or an addict finding expired pain killers. Don’t take the risk of having these drugs in your home once you don’t need them anymore.”
For more information on the Military Health System’s Drug Take Back efforts, visit the Drug Take Back Spotlight.
Nurse Advice Line serves as important tool for suicide prevention
TRICARE Press Release:
A panicked wife made a call and said that her active-duty military husband had a gun to his head and was threatening suicide. The nurse on the line calmly went through an established procedure to try and save a life.
“The first thing we did was get as much information as we could and calm the wife,” said Regina Julian, chief of Primary Care, Access and Patient Experience at the Defense Health Agency and the Nurse Advice Line, a 24-hour-a-day, seven-days-a-week, toll-free number for Military Health System beneficiaries. “Then the nurse told the wife, ‘Put him on the phone, and I’ll talk to him about the medical problems he’s having, while you get the gun when he puts it down. When he does that, unload the gun and throw the bullets as far away as you can, while I message first responders.’”
Julian said the nurse was able to talk to the service member and find out he had back problems from carrying heavy packs during multiple deployments. The combination of pain and the medications to treat that pain were making him depressed and unable to cope with life, making him feel he was at the end of his rope. The nurse leant a sympathetic ear, while the wife unloaded the gun and first responders arrived. “It was incredible. The nurse just kept her composure, we are so pleased we had a resource to provide this active-duty member and his wife because we were able to save a life through the Nurse Advice Line,” said Julian.
The calm actions were a result of the training all nurses get at the Nurse Advice Line. When beneficiaries call 1-800-TRICARE (874-2273), option 1, they are connected with a professional who has been trained to use a clinically proven process to work through issues and find the best solution. According to Julian, the nurse line receives up to nine suicide threats a day.
U.S. Public Health Service Capt. Christopher Hunter is the Department of Defense’s program manager for Behavioral Health in Primary Care and a clinical psychologist. He said there are a variety of issues that can lead people to want to kill themselves. But the factors that might increase suicide risk can affect people differently, based on other coping measures and support systems they might have, for example family and community support.
“Even when we know someone is at high risk, we don’t really have a good way of predicting who in that group of high-risk individuals will try to kill themselves,” said Hunter. “Our best path is to make sure people are aware there are a variety of avenues where they can get support.”
A key to raising that awareness is to stay on message.
“The more ways we let people know they aren’t alone and there is help for them in variety of ways, the more likely they are to use those services,” he said.
The Nurse Advice Line is one tool the military offers to help prevent suicide. It’s a first step that needs to be followed up with physical and mental health treatments. “It’s one avenue that helps us identify and protect those at risk so we can get them the help they need,” said Hunter.
Other numbers military families can call when experiencing emotional distress or thoughts of suicide are:
- The Military Crisis Line (visit the Military Crisis Line Chat or call 800-273-TALK to talk with a crisis counselor)
- The DCoE Outreach Center (visit Real Warriors Live Chat or call 866-966-1020 to talk with a health resource consultant)
- Military OneSource (call 800-342-9647 for one-on-one counseling)
Julian stressed it is important to seek professional assistance if any member of the family is experiencing the following feelings or behaviors:
- Thinking about hurting or killing himself or herself
- Talking or writing about death, dying or suicide
- Unable to sleep or oversleeping
- Withdrawing from friends, family or society
- Increasing alcohol or drug use
- Engaging in reckless or risky behavior
- Experiencing excessive rage, anger or desire for revenge
- Having feelings of anxiety, agitation or hopelessness
- Reliving past stressful experiences
- Experiencing dramatic changes in mood
“There are people out there in crisis, and you never know who they’re going to call,” said Julian. “We want to make sure we’re one more source they can turn to.”
DoD Vows to Bring Home Missing Warriors, Carter Says
By Terri Moon CronkDoD News, Defense Media Activity
WASHINGTON, Sept. 16, 2016 — The Defense Department today recommitted itself to its solemn pledge to make every effort to bring home all of its missing men and women to their families, Defense Secretary Carter said at the National Prisoner Of War and Missing in Action Recognition Day ceremony on the Pentagon’s River Terrace Parade Grounds this morning.
“We’re honored to be joined today by former POWs, individuals who endured captivity courageously and honorably during World War II, the Korean War and Vietnam,” the secretary said.
“To the families attending today and around the world -- whether you’ve been reunited or are still waiting for your loved one -- thank you for your patriotism and courage in the face of uncertainty, and thank you for all you’ve given to this country,” Carter said.
DoD works hard to meet its commitment to yesterday’s personnel to honor their service and their families, Carter said, adding a second reason exists. “We know what it means to the men and women serving today -- those who will serve in the future and their families as they see everything we’re doing to provide the fullest possible accounting of those who served before. They know we’ll do the same for them.”
U.S. service members will stop at nothing to accomplish their missions -- standing with allies and standing up to Russia’s aggression in Europe, managing change in the vital Asia-Pacific region, deterring North Korea’s provocations, countering Iran’s malign activities, and helping accelerate the lasting defeat of the Islamic State of Iraq and The Levant -- because “They know we’ll stop at nothing, and make every effort to bring them home to their families,” the secretary said.
“Together,” the secretary said, “we can meet our sacred commitment -- to the force of yesterday, today and tomorrow.”
Saluting Patriotism, Courage, Bravery
Air Force Gen. Paul J. Selva, the vice chairman of the Joint Chiefs of Staff, said to the audience on behalf of Marine Corps Gen. Joe Dunford, the chairman of the Joint Chiefs of Staff, and every service member, “We salute you for your patriotism, courage and bravery. Thank you for your being here today.”
“It is truly an honor to be here today as we pay homage to often unsung heroes,” Selva said, noting that former POWs and their families taught today’s military the meaning of legacy of honor and duty “[which] we strive to carry out every single day.”
To the families of those still missing in action, Selva said their sacrifice is humbling, “and we thank you for your faith and perseverance. You are for us a beacon of hope.”
Selva Recognize Families’ Sacrifices
The vice chairman said it’s important to recognize the significance of the sacrifices every family of prisoners of war and those missing in action have made through rebuilding their lives, their hardships of not knowing, and the difficulty of holding out hope.
“The motto that flies on the POW and MIA flag is one that we’ve internalized to our very core,” Selva said of the words, “You Are Not Forgotten” that appear on the flag.
“We will never forget. It is emblazoned on our hearts as is the memory of every member that we have lost in battle, and remains missing in action,” the vice chairman said.
Army could upgrade dozens of discharges for soldiers with PTSD, TBI
The Army will consider upgrading the other-than-honorable discharges of 73 soldiers diagnosed with post-traumatic stress disorder or traumatic brain injury after a servicewide review found they may not have undergone a required medical examination.
Army Secretary Eric Fanning outlined the results of the review in an Aug. 25 letter to Sen. Chris Murphy, D-Conn., which Murphy's office posted online Thursday. The review came after a Nov. 4 letter from Murphy and 11 other Democratic senators to senior Army leaders citing a National Public Radio investigation that reported more than 20,000 soldiers with PTSD or TBI diagnoses had been separated for misconduct since 2009.
Fanning's letter offered discharge figures from January 2009 through July 2015:
- The Army separated 469,294 soldiers, 67,697 of whom "had a behavioral health diagnosis in their record and were separated for misconduct."
- Of those, 3,327 soldiers had deployed within 24 months of separation and had a PTSD or TBI diagnosis, meaning they should have undergone a pre-separation medical exam to evaluate that diagnosis.
- The vast majority of those soldiers received honorable discharges. Of the 394 who didn't, 221 received "appropriate behavioral health evaluations" that were available to their commanders when their discharge status was determined.
However, the remaining 73 cases had "insufficient documentation" and will be sent to the Army Review Boards Agency "to determine if the Soldier's discharge should be upgraded based on evidence of record," Fanning wrote.
"The Army remains confident in the administrative processes that define misconduct separation procedures," he added.
Fanning also pointed to a recent All-Army Activities message that requires officials to record the reception and review of the required exams.
Murphy praised the Army's response in a news release that accompanied the letter.
"I’m grateful the Army took our concerns seriously and has made internal improvements to ensure that returning soldiers with brain injuries or PTSD receive the health care, benefits and respect they deserve," he said. "I will continue to work to make sure that all veterans are treated fairly and honorably by our government.”
Eight other senators wrote to Defense Secretary Ash Carter last week asking him to consider a militarywide policy that would require a review before the issuance of an involuntary other-than-honorable discharge to determine whether the misconduct stemmed from physical or mental trauma, such as TBI or sexual assault.
Navy Secretary Ray Mabus added a layer to his department's involuntary separation process June 1, requiring a review similar to what the eight senators proposed. Sailors and Marines facing separation who have been diagnosed with a mental health condition can be referred to the service's Disability Evaluation System, and any other-than-honorable cases must be reviewed by a flag or general officer.
DeVry Adopts Reform Favored by For-Profit Critics
By tackling the controversial 90-10 rule -- and lowering it for its institutions -- DeVry Education Group is looking to assert its place as a leader in the for-profit sector.
The for-profit college sector is under intense regulatory scrutiny and several major players are shutting down, so some providers are embracing reforms to differentiate themselves.
DeVry Education Group is the latest to do so: it announced today that it will voluntarily limit the amount of federal revenue, including from veterans and military tuition assistance, it receives by lowering the so-called federal 90-10 rule at each of its institutions.
That rule requires for-profit institutions to receive at least 10 percent of their revenue from nonfederal sources. DeVry plans to change the ratio to 85-15, which is what the federal ratio was from 1992 to 1998.
"This is a significant pledge that DeVry Group is voluntarily making for the long term, and it underscores our commitment to finding solutions to the issues facing higher education today," said Lisa Wardell, president and chief executive officer of DeVry Education Group, in an interview with Inside Higher Ed. "This is part of a broader effort to improve our policies and demonstrate the quality and value of our programs."
The controversial 90-10 rule has been criticized by congressional Democrats and the Democratic presidential nominee, Hillary Clinton, because it currently doesn't count veterans' educational benefits toward the 90 percent limit. That loophole, they argue, increases the likelihood that for-profits will aggressively recruit military veterans.
Wardell said that the for-profit sector is at a turning point, and DeVry wanted to be the first to make this change. The company is expecting all of its institutions to reach the new threshold -- and stay beneath it -- by July 2017. After that, the company is planning to publish the ratio for all its campuses annually, she said.
"There is growing and bipartisan support for returning to the 85 percent limit on federal funds and for closing the veterans and military funds loophole," Jennifer Wang, D.C. office director for the Institute for College Access and Success, said in an email. "DeVry recently did the same thing [by] voluntarily announcing it would stop forcing students into arbitration, in advance of anticipated final regulations banning schools from requiring arbitration."
DeVry isn't planning to change its access or financial aid process, Wardell said, adding that one way it is planning to meet the new threshold is through DeVry Works, its initiative that connects students to employers. Those employers would hire students and provide tuition assistance.
A corporate filing from the company reveals that all DeVry institutions are below the federal 90-10 threshold as of 2015, but those ratios don't include veterans or military benefits. For instance, Ross University School of Veterinary Medicine receives 84 percent of its revenue from federal sources. Chamberlain College of Nursing receives 65 percent, while DeVry University's undergraduate and graduate programs were at 68 percent and 67 percent of revenue from federal sources, respectively.
DeVry's other holdings -- Becker Professional Education and DeVry Brasil -- do not receive any federal student aid.
"In all due respect to DeVry's proposal, how does this affect the school and your programs, because most of their four-year liberal arts and medical programs are nowhere close to 90-10 threshold, so doing something that doesn't cost you isn't really courageous," said Steve Gunderson, president and chief executive officer of Career Education Colleges and Universities, which represents many institutions in the for-profit sector. (DeVry is not a CECU member.) "When you look at all postsecondary education, look at the two-year career programs because they tend to serve a demographic that is much more low income. Of all of the DeVry programs, the one that comes close is Carrington College, but all their other programs wouldn't be impacted."
Carrington's Phoenix location, for instance, receives 80 percent of its revenue from federal sources.
Gunderson said the focus shouldn't be on the ratio of federal dollars going to for-profits, but instead on how for-profits can serve the increasing number of low-income students and veterans who depend on government resources.
"When you look at a school in the inner city serving low-income, minority students and they're at that threshold of 85-15 … you have to ask, 'Who did they deny enrollment to?'" Gunderson said. "Is it the low-income single mother or the veteran, because if they accept them they'll go over that threshold?"
Instead, Gunderson said he would prefer to see more "skin in the game" solutions that look at the total public resources invested across all sectors and the student outcomes that every institution produces.
But similar to the decision by DeVry and Apollo Education Group, which owns the University of Phoenix, to end arbitration clauses, at least confronting issues like the 90-10 rule implies that other changes may be coming down the line.
"This strikes me as one of the more meaningful attempts at self-regulation that I've heard from a major player in this sector," said Ben Miller, senior director for postsecondary education at the Center for American Progress. "It's a sign that there's a recognition that the existing 90-10 rule doesn't work and needs to be updated, and in terms of improving the view of DeVry -- it doesn't hurt."
DeVry is still facing a lawsuit from the Federal Trade Commission for allegedly making deceptive claims about job placement rates and graduates' wages.
Wardell said the company is working with the FTC and the U.S. Department of Education to resolve the issue, but that the decision to alter the 90-10 threshold was unrelated to those dealings. Rather, she said, the company is looking to confront the issues that plague the for-profit sector.
"This will show, for us, a shift in focus to a resolution of issues," she said. "We don't disagree students come first and changes have to be made."
Institutions that exceed the 90-10 rule for two consecutive years lose the ability to participate in federal financial aid programs for at least two years. DeVry didn't explain what would happen if campuses don't reach or maintain the 85 percent threshold, but Wardell was assertive that the institutions will achieve the new threshold.
"DeVry is in the business of democratizing access to education, helping students achieve career goals and being a part of the solution to the workforce skills gap," Wardell said, adding that lowering the ratio is just one of a number of institutional reforms DeVry is developing.
Department of Labor
Strengthening Vets Newletter
September is National Preparedness Month and just as families across the country learn how best to prepare themselves for the unexpected, the Veterans' Employment and Training Service (VETS) is dedicated to helping prepare America's veterans, servicemembers, and their spouses for rewarding careers by providing the employment resources that make a difference.
During the peak of the veteran unemployment crisis in 2011, the President established the Veterans’ Employment Initiative (VEI) Task Force to ensure the career readiness of transitioning Service members. Together, with our Federal partners, the VEI built a plan to strengthen and enhance the existing Transition Assistance Program (TAP) aimed at providing separating servicemembers and their spouses with the training and support they need to transition successfully to the civilian workforce.
We also implemented a new, Military Life Cycle (MLC) model. The MLC strengthens emphasis on early preparation, from the beginning stages of a servicemember’s military career. It outlines key points in time, or “touch points,” that align a servicemember’s current military career track with their future civilian career goals. It also promotes awareness of the Career Readiness Standards (CRS) that servicemembers must meet long before separating from Active Duty and makes transition a well-planned, organized progression of skill building and career readiness preparation.
Our part in supporting a successful transition includes the DOL Employment Workshop and much, much more. As we prepare servicemembers and their families for successful employment outside of the military, we also offer intensive one-on-one assistance from our employment specialists for certain eligible populations that include:
• ALL transitioning servicemembers 18-24 years old;
• Active Duty servicemembers who are involuntary separated through a service reduction-in-force;
• Servicemembers who are referred via a Capstone “warm handover” or those who have not met Career Readiness Standards;
• Servicemembers who are wounded ill, or injured and receiving treatment in military treatment facilities or warrior transition units as well as their eligible spouses or other family caregivers.
Additionally, military spouses who are unable to remain employed due to permanent change of station orders or as the result of military deployment, along with transitioning servicemembers who are within six months of separation are eligible to receive employment and training assistance at any time, under the Department of Labor's National Dislocated Worker Program at any American Job Center (AJC).
To find out more about employment resources available to you and your family, be sure to visit your local AJC located in 2400+ communities across the country--- even before your transition out of uniform. You’ll learn about the employment services and training you can access to help make your transition to civilian life a successful one.
Preparation is key to any successful mission—and DOL VETS is committed to helping prepare you and your family along the way.
Chrysler Liquidating Trust Commits $750,000 to Support Homeless Veterans
Donation is Part of VA’s Partnership Efforts Resulting in 220 grants to Veterans and Families
WASHINGTON – The Department of Veterans Affairs (VA) is partnering with Chrysler Liquidating Trust to provide funds to support VA efforts to end Veteran homelessness. The partnership is part of the MyVA Strategic Partnership Initiative, which works with external organizations to improve the delivery and access of care for Veterans.
Earlier this year, the Chrysler Liquidating Trust committed $750,000 to support VA’s efforts to prevent homelessness in Detroit, Philadelphia and Los Angeles. Leveraging VA’s existing partnership with the Pentagon Federal Credit Union Foundation, more than $233,000 of these funds have been awarded to cover rent and utility deposits for Veterans. As of July 2016, approximately 220 grants were distributed to support Veterans and their families.
The Chrysler Liquidating Trust partnership grew out of discussions between Secretary McDonald and Bob Manzo, Trustee for the Trust on the importance of forging strategic partnerships and the ongoing work to end Veteran homelessness.
“It gives me great pleasure to announce another VA partnership,” said VA Secretary Robert A. McDonald. “VA’s new strategic partnership with the Chrysler Liquidating Trust is a great example of ways VA is opening its doors to new kinds of partners to better serve Veterans. Just this summer, President Obama announced a nearly 50-percent decline in Veteran homelessness. It’s these kinds of collaborations that are helping us achieve results. Caring for Veterans is a shared responsibility and opportunity.”
“After speaking with Secretary Bob and hearing about VA’s newly invigorated effort to work with external partners, I wanted to find a way to use these funds to support Veterans,” said Trusts’ Manzo. “There’s no reason VA has to take on issues like homelessness by itself. There are ways that all organizations can step up to the plate to support this important national issue.”
The Chrysler Liquidating Trust was established as part of the Troubled Asset Relief Program (TARP). During its creation, it was pre-determined any surplus funds would be allocated to a national cause benefiting Americans. Trust officials chose to allocate those surplus funds to Veterans’ issues.
Since the launch of the MyVA, the largest transformation in the history of VA, the Department has entered into new collaborations with dozens of external organizations to combat issues of homelessness, suicide and Veteran unemployment.
For more information about VA’s Homeless Programs, visit http://www.va.gov/homeless. Information about MyVA transformation efforts may be found at http://www.va.gov/opa/publications/myva_transformation_update_2_2016.asp.
Contested VA reform bill going up for debate in House
WASHINGTON – The House is set to debate veterans legislation Tuesday containing contentious reform on how Department of Veterans Affairs employees are demoted and fired.
In the bill, called the VA Accountability First and Appeals Modernization Act, are measures to do away with a lengthy appeals process, allowing the VA to fire employees more quickly. Also packaged in the bill is a set of new rules intending to shorten veterans’ waits to appeal a denial of disability benefits.
Lawmakers will vote Wednesday on the bill, said Drew Florio, a staff member for Rep. Kevin McCarthy, R-Calif., the House majority leader.
Rep. Jeff Miller, R-Fla., introduced the bill in July in response to a federal appeals board reversing a series of disciplinary actions against VA executives in malfeasance cases.
“The biggest obstacle standing in the way of VA reform is the department’s pervasive lack of accountability among employees at all levels,” Miller said when introducing the bill. “Until this problem is fixed once and for all, long-term efforts to reform VA are doomed to fail.”
In February, the Merit Systems Protection Board, which hears appeals from federal employees when they’re demoted or fired, reversed the VA’s attempt to fire Linda Weiss, the director of the Albany Stratton VA Medical Center, after revelations of mismanagement of patient care. Earlier board decisions reversed disciplinary actions against two executives, Diana Rubens and Kimberly Graves, who collected hundreds of thousands of dollars in relocation incentives.
The actions frustrated veterans service organizations and Deputy VA Secretary Sloan Gibson, who has said the board took away his ability to hold senior executives accountable.
While VA leaders have agreed the process to dole out disciplinary action needs altered, the agency on Monday called some of the changes in Miller’s bill unconstitutional.
“VA is committed to ensuring that employees are held accountable, but a number of the accountability provisions included in this legislation may be unconstitutional and may hinder VA’s ability to attract and retain the top talent necessary to ensure that our veterans are given the treatment and attention they have earned,” according to a VA statement.
nder the bill, the MSPB would be removed from the process of disciplinary action against executives. Instead, the act would establish a new, three-member Senior Executive Disciplinary Appeals Board that would have 21 days to make a final decision on the termination or demotion of executives.
The American Federation of Government Employees, which represents about 230,000 VA employees, sent a letter to the House on Friday also opposing Miller’s bill.
Marilyn Park, with the AFGE, said it does away with employees’ due process rights.
The bill would shorten the length of notice that employees receive before they’re fired or demoted, meaning they would have less time to build a case in their defense, Park said.
The bill would also require the MSPB to issue a decision on a demotion or termination in 60 days. If the board failed to get to a case in that time, the VA’s decision would automatically be final.
The latest data from the board shows it takes an average of 281 days to issue a decision.
“It’s terrible for people to wait,” Park said. “But the reality is, if it takes 281 days now to get to most peoples’ cases, and you say 60 days, most people are going to get cut out.”
In response to AFGE’s ongoing critique of the bill, Miller wrote an opinion piece for Military.com last week, saying the organization was demanding “to preserve the dysfunctional status quo of our federal personnel system.”
McCarthy, in a written statement Friday, said the bill “represents the continued problem-solving needed to help transform and modernize the VA into a more responsive, effective and accountable institution.”
In the statement Monday, the VA said it supports the part of the bill altering an “antiquated” system for appealing decisions on veterans’ benefits claims. Without reform to the appeals process, the number of cases pending would jump to 2.17 million by the end of 2027, and veterans would wait an average of three years to hear the outcome of their claims, according to the statement.
For months, the VA has thrown its weight behind competing legislation, the Veterans First Act. That bill has been stalled in the Senate since it passed the Senate Veterans’ Affairs Committee in May with unanimous support.
The Veterans First Act contains dozens of changes. Like Miller’s bill, some of the proposals are intended to streamline the appeals process for disability compensation and shorten the length of time – though less drastically — that a federal board has to decide whether an employee was rightly fired.
Under the Veterans First Act, the MSPB would have a deadline of 90 days to issue a decision.
VA Secretary Bob McDonald has said the VA “can’t fire our way to excellence.”
In interviews and speeches to veterans service organizations the past few months, McDonald pushed Congress to pass a VA budget and stressed the importance of other reform measures.
“We created a new law. It’s ready to go,” McDonald said of the Veterans First Act in a C-SPAN interview last week. “We simply have to get it passed. We can’t get it to the floor to get voted on.”
ITT Has Closed Its Doors Permanently – Here’s What The VA Says Veterans Should Do
The Department of Education will be holding informational webinars regarding the ITT closure and the way forward.
Effective Sep 6, 2016, ITT Technical Institute has discontinued operations at ALL campuses.
What does this mean for your GI Bill benefits?
This means you can no longer receive GI Bill benefits, including the monthly housing allowance, for any future classes at ITT. Even if your enrollment for the upcoming term was already submitted to VA for classes at ITT beginning after the end of the summer quarter, VA cannot pay for it. This includes payments under any GI Bill benefit program including the Post-9/11 GI Bill and the Survivors’ and Dependents’ Educational Assistance Program. VA does not have the legal authority to restore any GI Bill benefits you have used to attend ITT, even if you are not finished with the classes this term. You are, however, free to pursue your education goals at another school or training facility.
What resources are available to you today?
Our GI Bill Comparison Tool can help you review and compare alternatives to ITT Tech to continue your education goals. You must transfer to a new school approved for the GI Bill to continue receiving VA education benefits, including the monthly housing allowance under the Post-9/11 GI Bill.
What can I do if I have additional questions?
Our Education Call Center is available at 1-888-442-4551 (Monday – Friday, 7 a.m. – 6 p.m. CST) for any questions about your GI Bill benefits and remaining entitlement. You can also join the conversation on our Facebook page or follow us on Twitter. The Department of Education has more information about ITT’s closure and as Secretary King states, we will do all we can to continue to provide information to you on your options.
Be sure to pass this information on to anyone you know who might be affected.
We Support Duckworth/Zeldin Bill to Make Sure Veterans Get Equal Healthcare
Representatives Tammy Duckworth (D-IL) and Lee Zeldin (R-NY) introduced a bipartisan bill last week that would ensure veterans receive the same preventive health benefits as all insured Americans. Currently, veterans are the only insured Americans required to pay out-of-pocket copayments for essential preventive healthcare services.
Duckworth and Zeldin’s new Veterans Preventive Health Coverage Fairness Act would address this disparity and improve veteran care, helping reduce deaths from chronic illnesses while saving taxpayers from footing the bill for costlier, but largely preventable, treatments through the Department of Veterans Affairs (VA).
According to the U.S. Centers for Disease Control and Prevention (CDC), 7 of 10 deaths in this country are caused by chronic illnesses like cardiovascular disease and breast cancer that nearly half of all adults suffer from, and many of those illnesses are preventable with early and effective treatment. Catching these potentially fatal illnesses early may avoid costly and complex treatments down the line and, more importantly, increases patient survival odds. That’s one reason current law requires every insurer except the VA to cover important preventive services and medications at no additional cost to insured individuals.
Given the costs, in both dollars and in lives, associated with chronic disease, investing in preventive healthcare strategies is both sensible, cost-effective and a more humane path forward. The bipartisan veterans Preventive Health Coverage Fairness Act would provide veterans preventive medication and services cost-free, the same benefit that all other insured Americans receive, and enhances continuity of care for servicemembers transitioning from military healthcare coverage. This will ensure the health benefits provided to military personnel, veterans, military retirees and civilians are subject to consistent copay standards for preventative health services.
Vet Centers May Have the Help You, or Someone You Know, Needs
Vet Centers, part of the Department of Veterans Affairs, provide community-based counseling, outreach, and referral services to eligible Veterans who served in any combat zone, and their families. Services include counseling for transitioning and readjustment, military sexual trauma, and issues related to marriage, family, and bereavement. Referrals to VA mental health care, employment, education, and other services and benefits are also provided.
More than 300 Vet Centers are located throughout the U.S. Veterans living in rural areas may also access these services through Mobile Vet Centers, which travel from county to county to reach as many Veterans as possible.
Eligibility to use the services of Vet Centers includes any Veterans and active duty Service members, and members of the National Guard and Reserve components, who:
· Have served on active military duty in any combat theater or area of hostility*
· Experienced a military sexual trauma;
· Provided direct emergent medical care or mortuary services, while serving on active military duty, to the casualties of war, or;
· Served as a member of an unmanned aerial vehicle crew that provided direct support to operations in a combat zone or area of hostility.
· Vietnam Era veterans who have accessed care at a Vet Center prior to January 1, 2004
Vet Center services are also provided to family members of Veterans and Service members for military related issues when it is found aid in the readjustment of those that have served. This includes bereavement counseling for families who experience an active duty death.
The kinds of help available include:
Readjustment counseling -- a wide range of psycho social services offered to eligible Veterans, Service members, and their families in the effort to make a successful transition from military to civilian life. They include:
· Individual and group counseling for Veterans, Service members, and their families
· Family counseling for military related issues
· Bereavement counseling for families who experience an active duty death
· Military sexual trauma counseling and referral
· Outreach and education including PDHRA, community events, etc.
· Substance abuse assessment and referral
· Employment assessment & referral
· VBA benefits explanation and referral
· Screening & referral for medical issues including TBI, depression, etc.
VA's readjustment counseling is provided at community-based Vet Centers located in easily accessible neighborhoods near Veterans, Service members, and their families, yet separate from VA organizational sites to ensure confidential counseling and reduce barriers to care. All Vet Center services are prepaid through military service. Contact your nearest Vet Center through information provided in the Vet Center Directory or listings in your local blue pages. Vet Center staff are available toll free and around the clock at 877-WAR-VETS (927-8387).
All Vet Centers maintain non-traditional appointment schedules, after normal business hours, to accommodate the schedules of Veterans, Service members, and their family members.
VA publishes proposed rules for Camp Lejeune exposure
Last week the Department of Veterans Affairs published in the Federal Register a proposed rule creating a presumptive service connection for 8 conditions ((1) kidney cancer; (2) liver cancer; (3) Non-Hodgkin's lymphoma; (4) adult leukemia; (5) multiple myeloma; (6) Parkinson's disease; (7) aplastic anemia and other myelodysplastic syndromes; and (8) bladder cancer) for all those who served for at least 30 days at Camp Lejeune from August 1st 1953 through December 31st 1987.
Interestingly this includes the statement: “In addition, VA proposes to establish a presumption that these individuals were disabled during the relevant period of service, thus establishing active military service for benefit purposes. Under this proposed presumption, affected former reservists and National Guard members would have veteran status for purposes of entitlement to some VA benefits."
This may finally be the end of the long term controversy concerning contaminated water at Camp Lejeune. To read the full proposed rule and to make a formal comment please go to:
There is a 30 day comment period from September 9th 2016
Almost a million current military personnel are expected to opt for ‘blended’ retirement system
By TOM PHILPOTT | STARS AND STRIPES
Published: September 4, 2016
More than 740,000 currently serving active-duty members and 176,000 drilling Reserve and National Guard personnel are expected to opt in to the new Blended Retirement System when the choice becomes available in 2018 to military members with fewer than 12 years of service.
The opt-in estimates are the product of a “dynamic retention” computer model developed by RAND Corp. and used to predict how personnel will react to a new retirement choice. The BRS was designed by the Military Compensation and Retirement Modernization Commission and approved by Congress last year after lawmakers tweaked a few features.
The number of current members who will opt to leave their “High-3” retirement plan with its higher lifetime value for the near-term rewards and flexible features of the BRS is important to Department of Defense Board of Actuaries.
The three-member board is responsible for ensuring the Defense Department’s Military Retirement Fund is properly valued and actuarially sound. It held its annual meeting July 15 and accepted RAND’s estimate that a total of 916,754 active and reserve component members will opt into the BRS starting 16 months from now. That estimate is roughly half of the 1.8 million active-duty, Guard and Reserve members eligible to make the choice.
A transcript of that July meeting, however, shows the board and department actuaries embraced RAND’s numbers only reluctantly, as flawed approximations but also the best available. To understand why the number experts grumbled, we first need to review major features of the BRS.
The new plan is called blended because it combines an immediate but also smaller annuity after 20 or more years of service with a Thrift Savings Plan enhanced by government matching of member contributions of up to 4 percent of basic pay plus an automatic 1 percent government contribution for all BRS participants, whether they contribute or not to a TSP.
This 401(k)-like nest egg toward retirement is a portable benefit on leaving service. Veterans can roll the account into an employer 401(k) or continue to make contributions whether they served two years or 40 years in the military. Because this feature will benefit the great majority of members who leave service short of retirement eligibility at 20 years, the blended plan is expected to be a popular option, particularly with younger folks on their first or second enlistment and officers completing initial service obligation.
Committed careerists, however, are likely to stick with High-3 retirement, which will pay 20 percent more in lifetime annuities if full careers are a realistic goal.
The blended plan has two other features High-3 doesn’t.
By current law, BRS participants are to receive a one-time “continuation payment” at the 12-year mark that, at a minimum, must equal 2½ months of basic pay for active-duty members who agree to serve four more years or one-half month of active pay for reserve component personnel who make the same deal.
DOD pay officials wanted the continuation payment to be used solely as a retention tool. So they asked Congress this year to lift all restrictions on amounts paid, when paid and to whom. Both the House and Senate declined to grant such flexibility in their separate versions of the fiscal 2017 defense authorization bill. But both chambers did vote to relax the timing of this feature so continuation pay can be offered from the eighth to 12th year of service in exchange for serving a minimum of three more years.
The last key feature of the BRS allows those who reach retirement to receive in a lump sum 25 percent or 50 percent of their pre-old-age retirement annuities. In other words, here would be cash to help buy a home, start a business or pay off debts in return for reducing military annuities by one-quarter or one-half until age 67.
What bothered the Board of Actuaries about the RAND forecasts for number of members who will opt for the BRS is that no one has calculated yet how attractive the lump-sum feature will be. Another term for the missing ingredient is “personal discount rate.” Without that rate, which the board characterizes as a policy decision, RAND was forced to assume that no BRS member would elect the lump-sum distribution.
Because many will, however, the actuaries know the BRS opt-in estimates and therefore, projected costs to properly fund the new military retirement option are not precise enough to be acceptable. The board so advised Defense Secretary Ash Carter in a mid-July letter providing the board’s annual status report on the Military Retirement Fund.
“Although we are unable to opine on the analytical model used to produce RAND’s opt-in assumptions, we have approved [the Office of Actuary’s] reliance on these assumptions, produced by that model, because we have no better basis for projecting opt-in behavior,” the board advised.
“However, the significant uncertainty surrounding the opt-in process (for example with respect to the financial training to be provided to servicemembers) and other aspects of the BRS means the opt-in and other assumptions are likely to change as more experience and information about the new system (e.g., the discount rate to be used for lump sums) become available.”
Members who enter service on or after Jan. 1, 2018, have no choice; the BRS will be their retirement plan. Another group with no choice is members with 12 or more years of service by Dec. 31, 2017. They will be grandfathered under current High-3 retirement.
Congress rejected not only the department’s idea to eliminate the minimum continuation payment but three other changes sought to the BRS to save an estimated $5.4 billion on retirement through fiscal 2021. DOD officials wanted TSP matching to start in the fifth year of service rather than the third year. That would have dampened the value of the plan substantially for participants after their first enlistment.
Officials also wanted TSP matching to continue until retirement rather than end at 26 years of service, as the law now requires. Lawmakers decided that change would have benefited primarily senior officers, and rejected it.
The DOD also asked to raise maximum government contributions to TSP under the blended plan from 5 percent basic pay to 6 percent. Congress balked at the added cost and also reasoned the match should stay at 5 percent for parity with federal civilian TSP participants. DOD officials argued it’s not parity to match 5 percent of federal salaries against 5 percent of basic pay, ignoring that military folks get a large portion of pay as allowances.
Veterans Affairs official moves to rebuild trust with Phoenix veterans
PHOENIX – Sloan Gibson, deputy secretary of Veterans Affairs, delivered a message Thursday of change for veteran’s health care after months of roiling problems that reached from Arizona to around the country, including months-long wait times for medical treatment.
The Carl T. Hayden VA Medical Center, which will have its fifth administrator in two years, continues to face challenges, such as low number of staff and facilities, Gibson said.
He said wait times at the Phoenix hospital have improved since 2014, when massive problems with the system were exposed. About 95 percent of veterans are seen within 30 days of making their appointments, he said.
Clinics also have been built. Two years ago, a clinic opened in Gilbert in the southeast Valley, serving more than 20,000 veterans. Another clinic opened in Scottsdale about a year ago to provide primary and mental healthcare to more than 3,000 veterans.
Gibson praised Deborah Amdur, who retired as director after nine months on the job, according to azcentral.com. She is being replaced by Barbara Fallen, who will serve as interim director.
Since the VA scandal erupted in 2014, according to azcentral.com, four administrators at the medical center in Phoenix were suspended and eventually fired. Others retired, resigned or transferred.
Spokeswoman Jean M. Schaefer did not know how long it will take find a permanent director.
“We will not be rushed by the calendar,” Schaefer said.
DoD’s New Electronic Health Record Rollout Delayed
The Pentagon announced last week that the rollout of its new electronic health record system will be delayed because of newly-discovered technical problems.
The system, known as MHS Genesis, encountered problems integrating its commercial software with the old system DoD has been using for patient data. As a result, instead of introducing the system at a few hospitals and clinics in early December, it will be delayed for an undetermined amount of time, perhaps only a few months.
The program has a five-year cost ceiling of 4.6 billion, which DoD believes will not increase because of the delay. In addition, at this point it is believed there will be no delay in the overall schedule for a final rollout to all DoD medical facilities.
Statement From VA Secretary Robert A. McDonald On President Obama’s Final Assessment of the Commission on Care
WASHINGTON – Today, consistent with the Veterans Access, Choice, and Accountability Act of 2014, the President’s formal response to the Commission on Care was transmitted to Congress. As the President has said, “a sacred covenant exists between Veterans and this nation: servicemen and servicewomen take an oath to protect our country, and in turn, our nation pledges to take care of them when they leave the service. The Commission’s work to evaluate the Veterans Affairs health care system is important in ensuring we keep our promise to our Veterans.” Secretary of Veterans Affairs Robert A. McDonald released the following statement on the report: VA stands firmly behind the President’s final assessment of the Commission on Care report, and we thank the Commission for their hard work. With input from Congress, Veterans Service Organizations (VSOs), and government partners, VA has thoroughly reviewed each and every recommendation to determine whether they were feasible and advisable within the scope of the law.
The President and VA find 15 of the 18 recommendations in the Commission’s report feasible and advisable, and we have already accomplished or have been working on 12 out of the 18 through our ongoing MyVA transformation. The Department has already started implementing the Commission’s recommendations that the President and VA found feasible and advisable. Transforming VA into a Veteran-Centric Department Two years ago, the President charged me with transforming VA into the high-performing, Veteran-centric organization our Veterans deserve. I am thrilled to see that through our MyVA transformation initiative. Though there is certainly much more work to be done, VA has already made irrefutable progress in increasing Veterans’ access to quality health care and the benefits they have earned. Progress Made This past March, VA set a new record for completed appointments: 5.3 million inside VA, 730,000 more than in March 2014. VA increased access to Veterans through an integrated system of care. VHA staff and Choice contractors created over 3 million authorizations for Veterans to receive care in the private sector from October 2015 through July 2016. This is a 42 percent increase in authorizations when compared to the same time period last year. From FY 2014 to FY 2015, Community Care appointments increased about 20 percent from 17.7 million in FY14 to 21.3 Million. Clinical workload is up 11 percent in the past two years. Nearly 97 percent of appointments are now completed within 30 days of the Veteran’s preferred date; 22 percent are same-day appointments; average wait times are five days for primary care, six days for specialty care, and two days for mental health care. Nearly 90 percent of Veterans now say they are “satisfied or completely satisfied” with the timeliness of their appointments.
On Commission’s Recommendation to Establish VHA Board of Directors Overall, we found 15 of the 18 recommendations feasible and advisable, and are working to implement them. However, VA strongly disagrees with the Commission on its proposed “board of directors” to oversee the Veterans Health Administration (VHA). Such a board is neither feasible nor advisable for both constitutional and practical reasons. Most problematically, this proposal would seem to establish VHA as an independent agency, which would frustrate ongoing efforts to improve the Veteran’s experience by integrating Veterans health care and services across VA, making it more difficult for Veterans to receive the quality care where, when, and how they need it. Increasing Access to Health Care is a Shared Goal We do, however, strongly agree with the idea of external advice and counsel to ensure the VA operating with the greatest degree of efficiency and effectiveness for Veterans. VA is already advised by our new MyVA Advisory Committee, which has been hard at work since March 2015 applying the members’ extensive experience in customer service and organizational change to our transformational challenge. They are leaders in business, medicine, government, and in Veteran advocacy. Among them are eight Veterans like: Major General Joe Robles who after spending 30 years in the Army became President and CEO for USAA; Dr. Richard Carmona, a Special Forces Vietnam Veteran and the 17th Surgeon General of the United States; and Navy Veteran Dr. Connie Mariano, who was the first military woman to serve as White House Physician to the President, the first woman Director of the White House Medical Unit, and the first Filipino American in US History to become a Navy Rear Admiral. These are innovative, resourceful, respected leaders who are advising us on transformation. They know business. They know customer service. And, they know Veterans. I strongly support the Commission’s intent that creating a high-performing, integrated health care system that encompasses both VA and private care is critical to serving the needs of Veterans. In fact, VA has outlined our approach to achieve this same goal in our Plan to Consolidate Community Care, submitted to Congress in October 2015. This plan would provide Veterans with the full spectrum of healthcare services and more choice without sacrificing VA’s foundational health services on which many Veterans depend. At the same time, it is critical that we preserve and continue to improve the VA health care system and ensure that VA fulfills its mission. Veteran Service Organizations, having decades of experience advocating for generations of our Nation’s Veterans, have made it crystal clear that Veteran Service Organizations, having decades of experience advocating for generations of our Nation’s Veterans, have made it crystal clear that they believe VA is the best place for Veterans to receive care.
Many VSOs fear that the Commission’s vision would compromise VA’s ability to provide specialized care for spinal cord injury, prosthetics, traumatic brain injury, post-traumatic stress disorder, and other mental health needs, which the private sector is not as equipped to provide. We share their concern and therefore do not support any policies or legislation that will lead to privatization, which I am pleased the Commission did not recommend outright. Privatization is not transformational. It’s more along the lines of dereliction of duty. VA is well on its way towards realizing the integrated health care network envisioned by the Commission, but we cannot get there alone. Congress is our board of directors. If Veterans are to receive the care and services they deserve, Congress must do its job as our board. Abdicating leadership and constitutional responsibilities by creating more bureaucracy hurts Veterans and slows the progress of our MyVA transformation. Congress must act on key pieces of legislation like our Plan to Consolidate Community Care, our plan to reform the claims appeals process, and the President’s budget request for VA. We, along with VSOs, have worked hard with Republicans and Democrats in Congress to develop these critical pieces of legislation. We know that the vast majority in Congress understand how critical these issues are and are ready to take action. I call on leadership from both parties to put political expediency aside and do what is best for our Veterans and for taxpayers. Only then will we be able to truly transform VA into the 21st century organization Veterans deserve. A link to the Commission on Care Final Report may be found here. A link to the Secretary’s letter to the President in response to the report may be found here. Links to the President’s statement and letter may be found at https://www.whitehouse.gov/the-press-office/2016/09/01/statement-press-secretary-presidents-response-commission-care-report and https://www.whitehouse.gov/the-press-office/2016/09/01/letter-president-report-va-commission-care
Information on the Commission on Care and its Charter may be found at https://commissiononcare.sites.usa.gov/commissioners/.