Wednesday, February 1, 2017

Veteran’s Perspective and Partial Breakdown on the Veteran’s Health Care and Benefits Improvement Act

By: Lois Matteis
January 11, 2017

           Being a veteran and sifting through what is and is not available to us through the Veteran Administration can be a very daunting task, especially considering all the new laws coming out and the current reputation the VA has among the military population. We have all heard the horror stories regarding the VA and how some of their more vile practices have cast a very dark spotlight over the organization (Why hello, Phoenix Scandal). It has been covered extensively in the media, and the trust for the organization is just become nearly nonexistent.
     This, on top of trying to translate 20 or more pages on what Congress wants to currently change can be incredibly confusing and time consuming. Reading the Veterans’ Health Care and Benefits Improvement Act required an entire day in the office reading and translating several existing laws and how they were to be amended. Overall, however, this enactment appears to be a set in the right direction for veterans and their families. Time will tell, as always, how well the new law will be implemented, but the law itself is a step in the right direction for veteran’s rights. Most importantly are the laws and reports being implemented in order to improve the accountability of the Veterans’ Administration, veteran’s Health Care, and homeless veterans’ policies in the future. In the following paragraphs, there will be a breakdown of highlighted sections involving these categories and what the pros/cons of each section are. A link to the full text of the act will also be displayed at the end of this post.

“SECTION 104: COMPTROLLER GENERAL REVIEW OF CLAIMS PROCESSING PERFORMANCE OF REGIONAL OFFICES OF VETERANS BENEFITS ADMINISTRATION”

What it is: This section is the first to start to address accountability issues within the Veterans’ Administration.  This has to do with reporting on regional offices to determine what separates the outstanding from the subpar and work from there on how to make what the outstanding offices do the norm around all regional offices.

Why I love it: Getting input from successful regional offices who seem to have figured out how to make the system work is incredibly beneficial to helping veterans in every region. They are identifying some key factors in the report like management and employee practices, effectiveness of communication, and processing of claims for disability compensation. If this report can help translate these stellar performance practices to those who need to work on performance, then veterans across the country will see a dramatic improvement in when they receive benefits and how they can receive further assistance after they have left the military.

What could have been better: This section covers some good points, but the time frame involved is arguably longer than it should be. Directly stated in the law is “No later than 15 months after the effective date specified in subsection (e)… EFFECTIVE DATE. - This section shall take effect on the date that is 270 days after the date of the enactment of this Act.” This, it seems, is their very long winded way of stating that no one will see any reports until around December 2019 at the earliest. It is important to understand that change and writing reports takes time. Waiting two years to report on existing practices, however, could translate this section to be for bureaucratic and political reasons more so than making veterans a priority. The time frame is also concerning because it could cause this law to lose momentum and significance as time goes on, especially through ever changing leadership and opinions on how to solve this problem.

“SECTION 105: REPORT ON STAFFING LEVELS AT REGIONAL OFFICES OF DEPARTMENT OF VETERANS AFFAIRS UNDER NATIONAL WORK QUEUE”

What it is: This section requires the Secretary of Veterans Affairs to submit a report to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives “on the procedures the Secretary will use to determine appropriate staffing levels at the regional offices of the Department under the National Work Queue for the distribution of claims processing workload.”

Why I love it:  Back in the beginning of 2016, the Veterans’ Administration made the much needed switch from all paper records to the electronic system called the National Work Queue in order to process claims. While this system has come with some of its own unique set of problems, implementing this law to report on it will be a great step in ensuring the efficiency of the website and breaking the bad habits which might have formed with trying to understand navigating the system early on. Also, they plan on submitting this report in a little over a year, so the wait for a report will not be nearly as long as the previously mentioned section.

What could have been better: The law is incredibly vague on what they will be required to report about the system, and literally only state “a report on the criteria and procedures.” One could assume they mean to report on the existing procedures in place, but changes in procedures down the line may make reporting more complicated then intended. The law also does not specify whether or not they even can change the current procedures, so again, this could skew the results of the report if the requirements of the report are not more directly specified.

SECTION 106: INCLUSION IN ANNUAL BUDGET SUBMISSION OF INFORMATION ON CAPACITY OF VETERANS BENEFITS ADMINISTRATION TO PROCESS BENEFITS CLAIMS

What it is: This section goes on to announce how it will be analyzing each employee and on average, how many claims each can process in a given year. The section goes into further detail explaining how this will be a “time and motion study” and how the Secretary himself will provide a description of how he plans to improve the processing of claims.

Why I love it: Processing claims has been a big issue within the Veterans Administration and wait times can be astronomical when waiting for benefits, depending on when the claim was submitted. Measuring the average number of claims a single employee can do in a year will be a productive step in determining whether this problem stems from an employment shortage or a work ethic shortage. This report would allow those who write policies and procedures to curtail a very detailed and thorough mandate to the problem that would actually address the roots of the issue, not just surface issues.

What could have been better: Again, the time frame of this section leaves much to be desired. This section states that this will apply after fiscal year 2018, which means, at the earliest, we will not even see any potential solutions until fiscal year 2019, and that is at the earliest time frame.
      If this was the first time the Veterans’ Administration was being spoken about, this time frame would be understandable. When, however, you have had multiple issues and instances regarding mishandling claims over several years, the time frame should implicate some hustle to get this solved, or at least establish shorter checkpoints to guarantee they are actually making an effort to ensure this section actually comes to pass.
     As stated before, the VA has lost trust with millions. In order to re-establish this trust, quicker time frames would have been an essential way to illustrate an effort. As this section stands now, it seems this act is asking us to put a lot of trust into this administration doing what it needs to do without them making sure it gets done. Honestly, if they were doing what they needed to do from the beginning this law would not be necessary in the first place.

SECTION 612: ANNUAL REPORT ON VETERANS HEALTH ADMINISTRATION AND FURNISHING OF HOSPITIAL CARE, MEDICAL SERVICES, AND NURSING HOME CARE

What it is: This section states an annual report will be submitted from March 1st, 2018 and every year after until 2022 to the Committee on Veterans’ Affairs of the Senate and House of Representatives concerning:
1)      The furnishing of hospital care, medical services, and nursing home care under the laws administered by the Secretary; and
2)      The administration of the furnishing of such care and services by the Veterans Health Administration.
This report will include an evaluation of the effectiveness of increasing and improving the access of hospital care, medical services and nursing home care to eligible veterans, without increasing the costs incurred for such health care by the Federal Government.

Why I love it: The assessment is incredibly detailed on what they will be evaluating for this report. Everything including: the workload of physicians, patient demographics, physician compensation and productivity, pharmaceutical prices, percentage of care provided to veterans within facilities and third-party health billings owed to the Department.
     This will look at everything. It will give a descriptive look at how doctors spend their time and how much they get paid in correlation. This is a badly needed report to get a good idea on where the Department can actually cut funding and what needs to be worked on. Also, the time frame is very reasonable and gives the Veterans’ Health Administration the time they need to supply all needed information.

What could have been better: Having a third party corporation or nonprofit might have been a better option when it comes to who should submit the report. Granted, the Secretary was just announced recently, so being cautiously optimistic about the finding is not unwarranted, but it does leave a lot in the air. An established consulting firm, however, might have been a better option considering how low the approval is towards the Veterans’ Administration in general.

“SECTION 711: INCREASED PER DIEM PAYMENTS FOR TRANSTIONAL HOUSING ASSISTANCE THAT BECOMES PERMANENT HOUSING FOR HOMELESS VETERANS.”

What it is:  This increases the per diem payments for transitional housing which eventually becomes permanent housing for homeless veterans. The maximum rate offered will now be 150 percent of the rate authorized for State homes for domiciliary care. Along with this, the Secretary of Veteran Affairs also has the ability to increase this amount, depending on the needs of the veteran in question.
Why I love it: The problem of homeless veterans has been a very well-known issue for a significant period of time and has concerned a major portion of the population over time. This not only further addresses the issue, but also rewards the States who make the effort to care for their local homeless veterans.

What could have been better:  While the per diem increase is by far a major improvement, it still is restrictive when it comes to a veteran receiving care, especially for those who live in nursing homes or other special situations related to this one. While the i Veterans’ Administration budget is as limited as it is complicated, some more focus should be dedicated to those who can no longer live on their own or who are homeless. 

“SECTION 712: PROGRAM TO IMPROVE RETENTION OF HOUSING BY FORMERLY HOMELESS VETERANS AND VETERANS AT RISK OF BECOMING HOMELESS.”

What it is: This law allows the Secretary to provide case management services to veterans who have been homeless or who are about to be homeless in order to improve retention rates. In order to fund this program the Secretary will award grants to organizations, which demonstrate the ability to provide case management services.
    Organizations that take priority are those who demonstrate the ability to provide permanent housing that meet quality house standards and those who voluntarily cease receiving grants for homeless veterans with special needs.
    Along with this, no later than June 2020, the Secretary must submit a report on the program to the Committee on Veterans’ Affairs of the Senate and House of Representatives. This report will contain information such as: 
1)      Percentage of veterans who used the case management services who were able to receive permanent housing.
2)      Percentage of veterans who used the case management services who were not able to receive permanent housing.
3)      Comparison of the case management services before and after the services from veterans who have utilized the program
4)      An assessment of the employment status of veterans who received case management services under the program before and after receiving the case management services.

Why I love it: This not only has implemented a possible solution to the problem, but has already also established a detailed report for receiving feedback for the program. They also have established a section getting direct feedback from the veterans themselves, which will provide an in-depth first hand understanding of how effective this program will be.

What could have been better: Again, the period of time does run a little long until the results of this program are confirmed. This, however, is an understandable time frame considering the construction, grant requests and approval will need considerable time to get established.
   An issue somewhat perplexing, however, is organizations must volunteer to cease receiving grants for homeless veterans with special needs.   It is not mandatory to cease receiving the grant, but a higher priority will be given to those who do. Taking care of those with special needs is costly, and may discourage many organizations from trying to receive more grants in order to try and take care of those who need it. It is unclear at this point how long this new grant process will take and asking an organization to stop receiving grants for special needs veterans may not be possible if they have to wait a significant amount of time to receive those funds as replacements.

This is not nearly everything stated within the law, as it also goes over educational benefits, burial benefits, and other matters related to the VA. The link to analyze everything within this law is https://www.congress.gov/bill/114th-congress/house-bill/6416/text#toc-H189A88B1643645908EA229409DBDD3AD





    

Friday, January 6, 2017

Jeff Miller as Trump's Pick for the VA

Jeff Miller as Trump’s Next Pick:

How Miller’s 6 Years of Ground Work will Make
 Trump’s 10 Point Plan for the VA Achievable

By Brittney, 1/6/2017
“Veterans should come first in the country they fought to protect,” President-Elect Donald J. Trump said in a July 11th speech on veteran affairs in Virginia Beach, a major naval base town in Virginia. “Under a Trump Administration they will -- America First, Veterans First.”

Trump in the same speech said that one of his top priorities would be to “Ensure our veterans get the care they need wherever and whenever they need it. No more long drives. No more waiting backlogs. No more excessive red tape. Just the care and support they earned with their service to our country.”

With Trump’s overwhelming win of the military vote the impending selection of the head of the Department of Veteran Affairs is widely being anticipated. House Committee on Veterans Affairs (HVAC) Chairman Jeff Miller has long been favored to head the VA. Miller has remained as an anticipated candidate throughout the selection process and recently received our endorsement for the position.

Miller distinctly mirrors Trump’s outspoken withdrawal from the fatally ineffective department that has afflicted our vets for almost a decade and he is confident in his ability to change the failed department when two others before him could not. In a December interview on the topic Miller told USA Today that a part of his anticipated success would be contributed to the Trump Leadership saying that “the difference between Shinseki and McDonald is the fact that they both work for President Barack Obama.” He added that “Trump will be able to take on many of the very people that want to keep the VA the same.”

Trump and Miller are not only aligned in their publically candid criticism of the department. In Miller’s six years as Chairman he has worked diligently on legislation chipping away at the bureaucratic rules that hold the VA stagnant in its failures. In fact, 12 of Miller’s 25 sponsored bills have been in support of Veterans or Service members and 30 bills cosponsored by Miller have been in support of veterans, service members or military families. Trump’s ten point plan to reform the VA may be achievable because of the groundwork already laid by Miller. This is why at the Center for American Homeless Veterans we consider Miller as the most capable appointment to finally lead the VA to welcomed change.

Here is a list of Trump’s 10 point plan to reform the Department of Veterans Affairs and what Miller has already done to align with each of Trump’s points:

1)     Appoint a VA Secretary whose sole purpose will be to serve veterans. Under a Trump Administration, the needs of D.C. bureaucrats will no longer be placed above those of our veterans.

a)     After 6 years being intimately involved with the VA Miller likely already has a full grasp of the immediate reform needed and individuals in need of removal.
b)    In response to justifications made by the VA after news broke of Veteran deaths directly caused from a delay in care from VA medical centers, Miller pleaded with the department to refrain from empty apologies and defenses saying the following in an tense hearing on the matter:

What our Veterans have truly “earned and deserve” is not more platitudes and, yes, one adverse incident is indeed one too many.  We all recognize that no medical system is infallible, no matter how high the quality standards might be.  But I think we all also recognize that the VA health care system is unique because it has a special obligation not only to its patients – the men and women who honorably serve our nation in uniform – but also to its financers – the hard-working American taxpayers.

2)    Use the powers of the presidency to remove and discipline the federal employees and managers who have violated the public's trust and failed to carry out the duties on behalf of our veterans.

a)     In 2016 Miller sponsored the VA Accountability First and Appeals Modernization Act of 2016 (H.R. 5620) “which authorizes the Department of Veterans Affairs (VA) to remove or demote a VA employee based on performance or misconduct and provides that specified federal employee performance appraisal provisions shall not apply to such removals or demotions.” This bill is pending in the Senate (House Passed 9/14/2016).

3)    Ask that Congress pass legislation that empowers the Secretary of the VA to discipline or terminate any employee who has jeopardized the health, safety or well-being of a veteran.

a)      In 2014 Miller sponsored Department of Veterans Affairs Management Accountability Act of 2014 (H.R. 4031; 113th Congress) , a bill that “would give the Secretary of VA the authority to remove or demote any individual from the Senior Executive Service upon determining that such individual's performance warrants removal or demotion.”

b)    Miller sponsored VA Accountability Act of 2015 (H.R. 1994), a bill that “amends title 38, United States Code, to provide for the removal or demotion of employees of the Department of Veterans Affairs based on performance or misconduct, and for other purposes.” This bill is pending in Senate. (House Passed 7/29/2015)

4)    Create a commission to investigate all the fraud, cover-ups, and wrong-doing that has taken place in the VA, and present these findings to Congress to spur legislative reform.

a)     Miller has supported the creation of the commission on care to “examine veterans’ access to Department of Veterans Affairs health care and to examine  how best to organize the Veterans Health Administration, locate health resources, and deliver health care to veterans during the next 20 years.” In a statement in response to the first Commission report Miller noted that “the document makes it abundantly clear that the problems plaguing Department of Veterans Affairs medical care are severe. Fixing them will require dramatic changes in how VA does business, to include expanding partnerships with community providers in order to give veterans more health care choices”

5)    Protect and promote honest employees at the VA who highlight wrongdoing, and guarantee their jobs will be protected.

a)     Miller and Trump alignment is evidenced when Miller was asked by USA Today if VA workers were the problem with the VA. Miller responded by saying that “There are thousands of good employees who work at the VA every day. I don’t want to be remembered as the chairman who was only focused on the negative at the department. Unfortunately, there has been a considerable amount of negative that needed to be highlighted and we did our job.”

6)    Create a private White House hotline, which will be active 24 hours a day answered by a real person. It will be devoted to answering veteran's complaints of wrongdoing at the VA and ensure no complaints fall through the cracks.
a)      Awaiting comment from the House Committee on Veterans’ Affairs on stance of committee previously led by Miller.

7)    Stop giving bonuses to any VA employees who are wasting money, and start rewarding employees who seek to improve the VA's service, cut waste, and save lives.

a)     In 2015 Miller sponsored a bill to authorize the Secretary of Veteran Affairs to recoup bonuses and awards paid to employee of the Department of Veterans’ Affairs (H.R. 280). This bill  “authorizes the Secretary of the VA to issue an order directing a VA employee to repay the amount, or a portion of the amount, of an award or bonus paid to the employee if: (1) the Secretary determines that such repayment is appropriate, and (2) the employee is afforded notice and an opportunity for a hearing. Makes the Secretary's repayment decisions final and unreviewable by any other agency or any court. The bill is still pending in the Senate. (House Passed 3/2/2015)

8)    Reform the visa system to ensure veterans are at the front of the line for health services, not the back.

a)     While Miller has not publically made any statement on Trump’s indication to require businesses hiring foreign workers to first give favor to veterans, he has worked to understand the current accumulation of veterans waiting for much needed help .In 2013 Miller sponsored bill H.R. 2189 to establish a task forces to evaluate the backlog of disability claims of the department. It would also analyze potential solutions to the claims process issues and submit the solutions to the Secretary. This bill would then require the Secretary to implement the suggested solutions or submit justification to Congress regarding suggestions not implemented.

9)    Increase the number of mental health care professionals, and allow veteran's to be able to seek mental health care outside of the VA.

a)     In 2016 Miller sponsored bill H.R. 4590 which “directs the Department of Veterans Affairs to study and report on programs to assist veterans in their transition to civilian life. This bill is still pending in the Senate. (House Passed 6/21/2016)

10)Ensure every veteran has the choice to seek care at the VA or at a private service provider of their own choice. Under a Trump Administration, no veteran will die waiting for service.

a)     In 2014 Miller sponsored Veteran Access to Care Act of 2014 (H.R. 4810, as amended), “a bill  that would require VA to offer non-VA care at the department’s expense to any enrolled veteran who cannot get an appointment within VA wait time goals or who lives more than 40 miles from a VA medical facility.” This bill was signed into law as part of the The Veterans Access, Choice and Accountability Act of 2014. (House Passed 6/10/2014)

b) In 2015 Miller sponsored the Long-Term Care Veterans Choice Act (H.R. 294), “authorizing the Secretary of Veterans Affairs (VA), during the three-year period beginning on October 1, 2015, to transfer a veteran for whom the Secretary is required to provide nursing home care to a medical foster home that meets VA standards pursuant to a contract or agreement with the VA, at such veteran's request. Requires such veteran to agree, as a transfer condition, to accept VA home health services.” This bill is still pending in Senate. (House Passed 3/2/2015)

Many of Miller’s attempts to reform VA with legislation have fallen flat in the Senate. A Trump-Miller team would need to move fast and aggressively to enact measureable change in the next four years. The VA is plagued with union like hiring structures and an inability for any parties to take accountability. An integrated Trump- Miller team combined with a unified House and Senate may be the only opportunity for VA reform that lasts.

Any other appointee will be faced with a huge learning curve and hit with the same bureaucratic road blocks Miller has been navigating for almost a decade. This will inevitably cause a delay in action. These are delays our Vets can’t afford, as proven by numerous reports of veteran’s deaths due to VA negligence. Their lives are literally on the line once more.

Take action today. Contact your local Congressional Representatives and ask them to make Veteran’s a top priority in the next four years.


Monday, May 2, 2016

Wedge Issues

     This presidential election has been the most interesting I have ever witnessed. We started this election with 29 candidates running for president and with over 1,700 candidates filing a Statement of Candidacy. On a national level there are only 7 candidates left across all the nationally recognized parties; Hillary Clinton, Bernie Sanders , Donald Trump, Ted Cruz, John Kasich, Gary Johnson, and Jill Stein.  Emails, hand size, genitalia size, Chipotle, eating habits, and who has the better concealer were all discussed.  This election started off talking about very serious issues such as the economy, conflicts in the Middle East, and healthcare. We have now reached the point in our election cycle where we are discussing issues that are meant to drive a wedge and ultimately divide us as a nation. We are currently discussing issues that are not issues for the vast majority of Americans.        
     North Carolina recently passed a law that makes it illegal for people of the opposite gender to use a different gender that they were not assigned at birth. Catlin Jenner, the former Olympian and father of six, recorded a video were she said, “Thank you, Donald. I really appreciate it,' Jenner told the camera after exiting the ladies’ room, 'And by the way Ted, nobody got molested." Though  Jenner, a Republican, claims to side with Cruz on most political and economic issues, the two stand on opposite sides of the debate over so-called “bathroom bills” that require individuals to use the public restrooms and changing facilities that correspond to their biological sex, regardless of how they identify. When asked earlier this week about the safety concerns that many, including Cruz, have voiced about sexual predators using the guise of transgenderism as a means of abusing women and children, Jenner explained that this matter should not be included in the debate. Ted Cruz has said that, "in my view, this is not a matter of right or left or Democratic/Republican. This is common sense,” he began. “It doesn’t make sense for grown adult men — strangers — to be alone in a restroom with a little girl [...] and this is the height of political correctness,” Cruz added. “ Frankly the concern is not the Caitlyn Jenner's of the world. But if the law is such that any man if he feels like it can go in a women’s restroom and you can’t ask him to leave, that opens the door for predators.” The Texas senator noted that he spent many years in law enforcement, during which he came across many instances of child predators. I am so thankful for bathroom signs because I did not know until now that they have stopped so many child rapists from committing terrible crimes. Another wedge issue is the economy, but more specifically manufacturing jobs, the auto bailout, and trade policy. Globally manufacturing jobs are in a decline. Countries that are thought to produce the most like India and China are in an economic slow down. The U.S. has lost more manufacturing jobs due to ever increasing productivity than to jobs being sent overseas. The Auto Bailout that came after 2008 was thought to be a terrible economic decision, but just five days ago it was made public that Ford has had its best first quarter report in over 113 years. Overall, the number of cars Ford sold worldwide last quarter rose nearly 10% to 1.7 million, which lifted revenue to $38 billion. Net income jumped to $2.5 billion from $1.2 billion a year earlier. Its automotive operating profit also more than doubled to nearly 10%. On the issue of trade policy, most Americans are upset with countries such as China who they believe have benefited unfairly from trade deals that they are not even a part of. America over the last 50 years has moved away from manufacturing jobs and moved to finance, services, and IT. No new trade deal can bring back manufacturing jobs that no longer exist.
      Another important wedge issue is the misconception that foreign countries and people with unfavorable views towards the United States are laughing at us.  Yes, the argument can be made that countries do not like the U.S. but they somehow respect us less is not true. Russian President Vladimir Putin is quoted as saying, "Obama is a decent, very responsible man". Russia and the U.S. are not on the best of terms, but there is still respect on both sides.
      The last wedge issue I would like to discuss is the current state of the U.S. Military. The U.S. Military is bigger than the next 11 countries combined. The U.S. accounts for 38% of total global defense spending. The U.S. currently has the world's first and second largest Air Force, Navy and Army. Sure we could increase the size of the military, but to what end?
        These are some issues that people should be generally upset about. On any given night there are 48,000 homeless veterans on the streets. There are children in this country that do not have access to clean water. But as a country, we are arguing about bathrooms and jobs that do not exist.

- John Felder

Monday, April 18, 2016

                                                     Coming Soon Vets Vision Podcast

Thursday, April 14, 2016

Outrageous Sentences for Marijuana




 Lee Carroll Brooker, a 75 year old disabled veteran suffering from chronic pain, was arrested in July 2011 for growing three dozen marijuana plants for his own medicial use behind is son's house in Dothan AL, where he lived. Mr. Brooker was sentenced to life in prison without the possibility of parole. Alabama law mandates that anyone with certain prior felony convictions must be given life with no parole for possessing more than 1 kilo of marijunana regardless of intent to sell. Mr. Brooker was convicted of armed robbery in Florida over 20 years ago. At Mr. Brooker's sentencing hearing the trial judge told him, "if I could sentence you to a term that is less tha life without parole I would". This case has made it all the way to the Supreme Court and on Friday the court will deciede if the case should be heard. Regardless of where one might stand on this issue of legalizing marijuana, no one should be sentenced to life in prison for simply growing it for medical use. Decisions such as these could deter veterans from using medical marijuana to help combat problems such as PTSD, chronic pain, and depression.
 

-John Felder


Check out the full article here

Monday, April 4, 2016

2 Vets, 2 legs, and 29,000 feet

In a dramatic demonstration to show that the injuries that they received in the line of duty won't keep them down, two veterans are attempting to become the first combat amputees to reach the summit of Mount Everest. Chad Jukes and Thomas Charles “Charlie” Linville both lost their right legs while serving in Iraq, and aim to tackle the world highest peak later this year. The duo are attempting this feat to show the world that the injuries that many veterans have suffered in combat do not define who they are, and they are just as capable as they were before their injuries. Best of luck to these two heroes, who may soon stand far taller than people with both legs.

-Matt