April’s Washington Update

April 18, 2017                                                                  Volume 23, No. 4

***PRIORITY***

The Government Relations staff is still looking for stories about problems that our members have experienced during air travel. Please visit www.AirAccess30.org and share your story.

House VA Health Subcommittee Considers Pending Legislation

On March 29, 2017, the House Committee on Veterans’ Affairs, Subcommittee on Health, held a hearing on pending legislation. Sarah Dean, Associate Legislative Director, testified on behalf of PVA. This testimony was Sarah’s first opportunity to testify before Congress.

Of particular importance to PVA was H.R. 95, the “Veterans’ Access to Child Care Act.” This legislation, introduced by Rep. Julia Brownley (D-CA), would make permanent the provision of child care for a veteran receiving covered health services at VA. PVA knows child-care is critical to expanding access to care. When veterans have reliable child care their participation in their own health increases, no-shows and cancelations decrease. Women veterans particularly report the inability to obtain child-care as one of their greatest barriers to VA.

PVA also supported H.R. 907, the “Newborn Improvement Act,” introduced by Rep. Doug Collins (R-GA). This bill would authorize hospital stays of up to 42 days for newborns under VA care. Currently, only seven days after birth is covered, after which the veteran takes on the cost. As the average hospital stay for a health newborn is two day, any newborn needing additional coverage is likely to be facing serious complications. PVA is specifically concerned about veterans with catastrophic injuries that can cause or exacerbate high-risk pregnancies or pre-term deliveries. A seven day limit arguably impacts veterans with disabilities at a greater rate than other veterans.

PVA also offered support for H.R. 1545, the “VA Prescription Data Accountability Act of 2017,” introduced by Rep. Ann Kuster (D-NH). All VA facilities now share prescription information of veterans and their dependents with state Prescription Database Monitoring Program (PDMP). However, due to technical oversight in the law the information of non-dependent, non-veteran, VA beneficiaries is not shared. This bill would rectify the flaw. While PVA strongly supports the bill, we expressed concern that the PDMPs may not be capturing those veterans who travel across multiple states to receive care from the SCI/D Centers. PVA encouraged Congress to ensure state PDMPs are able to share information across multiple state lines to offer all veterans the benefits that will come from these opioid safety measures.

All of the bills considered in this hearing were later passed by the subcommittee and sent to the full committee for consideration.

To read PVA’s full written testimony, please visit www.pva.org.

House VA Subcommittee on Disability Assistance and Memorial Affairs Holds Legislative Hearing

On April 5, 2017, the House Veterans Affairs’ Subcommittee on Disability Assistance and Memorial Affairs held a legislative hearing to consider a number of bills. Among them were two provisions affecting the annual cost-of-living allowance (COLA). PVA supported both measures. The first bill would authorize a cost of living adjustment effective December 1, 2017 equal to the percentage increase implemented by Social Security. The second provision being considered would make the annual adjustment automatic, not requiring Congressional action. Historically, the annual COLA bill has been important legislation that must pass each year. During times of particularly contentious relations in Congress, this legislation has been used as a vehicle to pass other important veterans legislation. While we have voiced this concern in the past, PVA did not object to making the COLA adjustment automatic going forward, as it would add a level of certainty for veterans expecting annual increases.

PVA also supported Ranking Member Tim Walz’s (D-MN) legislation which would prevent VA from demanding redundant compensation and pension (C&P) exams when veterans provide private medical evidence. While VA has the legal authority to rely on private medical evidence, too often it seems that VA requires a second medical exam from the veteran with a VA doctor despite having quality evidence already in hand. The pattern suggests a prejudice toward private medical evidence and the possibility that VA is seeking further evidence solely to avoid granting a claim.

Rep. Brownley (D-CA) offered a bill, H.R. 105 that would add greater protections to veterans who are fraudulently deprived of benefits being administered by a fiduciary. Currently, VA may only reissue lost benefits to veterans who are harmed by fiduciaries who administer benefits to more than ten veterans or if the fiduciary is an institution. If the veteran is not served by a qualifying fiduciary, VA can only reissue benefits to the extent that it recoups money from the bad actor. PVA supported this measure because it would allow VA to reissue benefits under all circumstances, regardless of whether it recoups the funds.

PVA also continues to support a service-connected presumption for Blue Water Navy Veterans who are claiming exposure to herbicides containing dioxin, including Agent Orange. We stressed that as more evidence and information becomes available on the connection that Congress take appropriate steps to ensure these veterans receive the appropriate care and compensation.

Finally, PVA supported H.R. 1390. Currently, VA is only authorized to transport veterans’ remains to the nearest national cemetery with available burial space. This proposal, though, would extend the options to state and tribal cemeteries. It would limit, however, the amount of reimbursement to the cost of the nearest national cemetery so as not to increase the financial burden on VA.

To view PVA’s full statement, please visit www.pva.org.

Congress Passes Choice Program Extension

With the Choice program set to expire on August 7, 2017, Congress recently passed a law eliminating the mandatory expiration date for the program, allowing it to continue to deliver health care services to veterans in the community and use up the remaining funds in the program. Without the extension, the projected remaining funds would be returned to the Treasury. This extension now provides extra time for Congress to address the shortfalls of the current program and move toward a wider and more permanent health care reform in VA. The bill now awaits the President’s signature.

Subcommittee on Disability Assistance and Memorial Affairs Leadership Holds Round Table on Appeals Reform

On March 28, 2017, PVA participated in a widely attended round table sponsored by Disability Assistance and Memorial Affairs Subcommittee Chairman Mike Bost (R-IL) and Ranking Member Elizabeth Esty (D-CT) to discuss moving forward with plans developed over the last year to modernize the disability claims and appeals process. The legislation proposed during the last Congress reflected the work product of numerous veterans’ service organizations, organizations representing private attorneys practicing veterans’ law, and leadership from the Board of Veterans Appeals and the Veterans Benefits Administration. The legislation ultimately failed to secure passage due to a number of concerns, primarily related to the necessity of further discussions on how the new system would be implemented without hurting veterans who have current claims pending. A renewed effort by stakeholders to push the legislation forward during this Congress is gaining traction, and a hearing on an updated version of the legislation is expected to take place in the coming months.

ACA Repeal and Replace Health Care Reform Effort Fails

In early March, the House of Representatives took up legislation to repeal the Affordable Care Act (ACA) and replace it with the American Health Care Act (AHCA). While portrayed as an effort to reduce health care costs for American consumers, the bill also proposed major changes to the Medicaid program through per capita caps and block grants and to repeal many provisions of the ACA that are critical to people with disabilities. In addition, the AHCA continued several problematic policies for veterans left over from the last effort to reform the health care system and created a potential roadblock for veterans to take advantage of tax credits offered in that measure.

The AHCA included cuts in Medicaid of some $880 billion along with caps on federal spending for the program. In return for greater flexibility for designing their own Medicaid programs, states would have received a lump sum—either in the form of block grants or a per capita spending formula—to provide services to their residents. Under the cap and cut proposal, the federal government would no longer share in the costs of providing health care services and community services beyond the capped amount. This would eliminate the enhanced federal match for the Community First Choice Option under Medicaid that provides attendant care services in the community. Thanks to this program, many poor veterans with serious nonservice-connected disabilities have been able to move from nursing homes into their communities. The AHCA would also have ended the ACA Medicaid expansion at a date earlier than current law. Data from the Robert Wood Johnson Foundation shows that the Medicaid expansion has helped thousands of veterans and caregivers obtain affordable health insurance coverage.

During its time under consideration in the House, the AHCA went through a number of changes in an effort by the leadership to garner sufficient votes to ensure its passage. However, each successive version made the bill even more challenging for people with pre-existing health conditions.

  • Loss of essential health benefits: One proposed change was to give states the option to waive important consumer protections in current law. For example, states could choose to ignore the essential health benefits rules that ensure that health plans cover basic services, many of which are particularly important to people with disabilities. Without a requirement that basic services be included in health insurance plans, insurers are likely to drop coverage of therapies or medications that support people with more health care needs.
  • No more protections for pre-existing conditions: Another troubling change being discussed was to let states waive the requirement for community rating. This would allow insurance companies to charge people with pre-existing conditions – including people with disabilities — whatever they wanted, essentially making any pre-existing condition protections meaningless. The combination of these changes would make it nearly impossible for people with pre-existing conditions to find affordable plans that cover basic health care services.

For veterans and PVA members in particular, the AHCA would have continued several problematic policies of the ACA as well as troubling new provisions that could affect the ability of many veterans to afford health insurance in the private market. The AHCA:

  • Continued to exclude CHAMPVA beneficiaries—dependents of the most catastrophically disabled veterans—from the dependents’ coverage policy up to age 26.
  • Failed to remove the prohibition on enrollment into the VA health care system for Priority Group 8 veterans, thus denying these veterans access to the principal health care system for veterans.
  • Denied access to tax credits making health insurance affordable to anyone eligible for a host of other federal health programs, including those “eligible” for coverage under Title 38 health care programs. This would prevent many veterans who may be “eligible for” but not enrolled in the VA health care system from accessing these tax credits intended to help people buy insurance.

On March 24, 2017, House Speaker Paul Ryan declared that there were not enough votes for the bill to pass the House of Representatives and the bill was pulled from the calendar. Nevertheless, discussions have continued between the Congressional leadership and the White House to craft a version of the AHCA that will be acceptable to a majority of Republicans in the House and Senate. PVA plans to continue monitoring developments in the health care reform debate to ensure that veterans and people with disabilities are not harmed by changes to vital health care programs on which they depend.

Update on the ADA Education and Reform Act of 2017

The “ADA Education and Reform Act of 2017,” H.R. 620, continues to gain co-sponsors. PVA opposes this legislation because it would limit the ability of people with disabilities to enforce their rights under Title III of the ADA. It was introduced by Rep. Ted Poe (R-TX). Original co-sponsors include Rep. Scott Peters (D-CA), Rep. Ken Calvert (R-CA), Rep. Ami Bera (D-CA), Rep. Jackie Speier (D-CA), and Rep. Michael Conaway (R-TX).

H.R. 620 has gained nine additional co-sponsors since it was introduced on January 24th:

  • Representative Pete Aguilar (D-CA)
  • Representative Ralph Lee Abraham (R-LA)
  • Representative J. Luis Correa (D-CA)
  • Representative Doug Collins (R-GA)
  • Representative Bill Foster (D-IL)
  • Representative Jeff Denham (R-CA)
  • Representative Krysten Sinema (D-AZ)
  • Representative Paul Mitchell (R-MI)
  • Representative Darrell E. Issa (R-CA)

Please contact your Representatives to let them know that PVA opposes this legislation because it would require a person with a disability to send a letter of notification to the business that it was out of compliance with the law giving it a grace period before one could file suit. Instead of complying with the law now, businesses (large and small) could employ a “wait and see” approach, continuing to violate the law with impunity. Instead, businesses should be proactive in complying with the ADA and work with the ADA National Network and other entities for any needed technical assistance.

The bill is pending before the House Judiciary Committee and may be marked up by the full committee in the coming weeks.

The “Social Security 2100 Act” Reintroduced

On April 5, 2017, PVA Senior Associate Advocacy Director Susan Prokop joined Members of Congress, disability advocates and representatives of the aging community at a Capitol Hill roll out of H.R. 1920, the “Social Security 2100 Act,” introduced by Rep. John Larson (D-CT). Rep. Larson is Ranking Minority Member on the House Ways and Means Social Security Subcommittee. Citing polling data that shows 72 percent of Americans believe that Social Security benefits should be increased, not cut, Rep. Larson described provisions in his bill favored by 7 out of 10 Americans. Among those provisions are:

  • Adoption of the CPI-E for inflation increases: Using the CPI-E for the annual Social Security cost of living adjustment (COLA) would better reflect the costs incurred by seniors and people with disabilities who spend a greater portion of their income on health care, utilities and other necessities.
  • Protections for low income workers: To ensure that low income working people who pay into the system over a lifetime don’t retire into poverty, the bill establishes a new minimum benefit set at 25 percent above the poverty line.
  • Adjustments in the payroll tax wage base to help finance the system: Presently, payroll taxes are not collected on annual wages over $127,000. H.R. 1902 would apply the payroll tax to wages above $400,000 which would affect the top 0.4 percent of wage earners.
  • A gradual increase over 20 years in the payroll contribution rate to keep the system solvent: Beginning in 2018, FICA taxes would rise 0.05 percent annually so that workers and employers would pay an additional 1.2 percent by 2041. For the average worker this would mean paying an additional 50 cents per week to ensure the system’s longevity.

In addition, HR 1902 would provide a modest increase in benefits for all beneficiaries equivalent to 2 percent of the average benefit, cut taxes for upper income beneficiaries by raising the thresholds at which benefits are taxed to $50,000 for individuals and $100,000 for couples and combine the old age and survivors and disability insurance trust funds to foreclose future arguments over the disability insurance program by eliminating the artificial separation of the trust funds.

PVA supports H.R. 1902 because of its more realistic cost-of-living-adjustment for beneficiaries, enhanced protections for low income workers, and long overdue adjustments in the financing mechanisms for the system. Indeed, an independent analysis by the Social Security Administration’s Chief Actuary indicates that this legislation will extend the financial health of the system beyond the next 75 years. PVA believes this legislation demonstrates that preserving and strengthening Social Security can be done without causing harm to beneficiaries.

U.S. Access Board Issues Guidance on the International Symbol

of Accessibility

The U.S. Access Board has released guidance on the International Symbol of Accessibility (ISA) to address questions that have arisen on the use of alternative symbols. Some cities and states have adopted a different symbol that was created to be more dynamic and suggestive of movement. The Board’s guidance explains how use of a symbol other than the ISA impacts compliance with the Americans with Disabilities Act (ADA).

Standards issued under the ADA require that the ISA label certain accessible elements, spaces, and vehicles, including parking spaces, entrances, restrooms, and rail cars. Similar requirements are contained in standards issued under the Architectural Barriers Act (ABA) for federally funded facilities. The ISA, which is maintained by the International Organization for Standardization (ISO), has served as a world-wide accessibility icon for almost 50 years.

“Consistency in the use of universal symbols is important, especially for persons with limited vision or cognitive disabilities,” states Marsha Mazz, Director of the Board’s Office of Technical and Information Services. “In addition to the ADA and ABA Standards, many codes and regulations in the U.S. and abroad also require display of the ISA.”

While the ADA Standards do not recognize specific substitutes for the ISA, they do generally allow alternatives to prescribed requirements that provide substantially equivalent or greater accessibility and usability under a provision known as “equivalent facilitation.” However, in the event of a legal challenge, the entity pursuing an alternative has the burden of proof in demonstrating equivalent facilitation. Under the ABA Standards, use of a symbol other than the ISA requires issuance of a modification or waiver by the appropriate standard-setting agency.

The ISA bulletin is posted on the Board’s website along with other issued guidance on the ADA Standards and the ABA Standards.

 

 

March Washington Update

March 17, 2017                                                                Volume 23, No. 3

***PRIORITY***

The Government Relations staff is still looking for stories about problems that our members have experienced during air travel. Please visit www.AirAccess30.org and share your story.

PVA Annual Advocacy and Legislation Seminar

The PVA Government Relations Department held its annual Advocacy and Legislation Seminar, from March 6-9, 2017, in Washington, D.C. The seminar serves as an opportunity to bring in representatives from every PVA chapter to Washington to learn about the policy priorities of the organization and then to carry that message to their representatives and senators in Congress.

This year’s seminar focused on two main areas. The Advocacy portion discussed in great detail our continued efforts, and the work we have ahead of us, on the Air Carrier Access Act, and efforts to improve air travel for people with disabilities. A panel of experts we have worked with on this issue included representatives from the Department of Transportation, Virgin America Airlines, and the Flight Attendants Association. Government Relations’ Advocacy staff also discussed entitlement reform, specifically Social Security, Medicare and Medicaid, as well efforts to undermine the Americans with Disabilities Act (ADA) known as ADA notification.

The Legislative portion of the seminar focused significant attention on the delivery of veterans’ health care, particularly in the area of specialized services such as spinal cord injury and disease (SCI/D) care. Attendees had the opportunity to hear from Dr. Manosha Wickremasinghe, the incoming Executive Director of the Spinal Cord Injury/Disease Service at the Department of Veterans Affairs (VA). There were several discussions about the many ideas being proposed for VA health care in the future and how that might impact SCI/D care. Government Relations’ Legislative staff also discussed appeals reform as well as the expansion of the Comprehensive Family Caregiver Program at VA.

PVA members then spent two days storming the halls of Congress to discuss our policy priorities. In addition to our members meeting with members of the House and Senate, on March 9, PVA National President Al Kovach, Jr. presented his annual testimony before a joint hearing of the House and Senate Committees on Veterans’ Affairs.

He emphasized the importance of VA health care to him personally following his injury. The seminar wrapped up with a Congressional reception that evening to allow PVA members to continue to interact with congressional staff from both the House and Senate.

This year’s seminar was a major success. National staff has already begun outreach to offices that have expressed an interest in advancing our priorities. We were also able to increase digital engagement with the organization and we leveraged the PVA app to communicate much of our information quickly and effectively. The inclusion of state-specific information on the VA’s SCI/D service proved very useful in our members’ meetings with their representatives and senators. We are already beginning our planning for the 2018 Advocacy and Legislation Seminar.

House Committee on Veterans’ Affairs Holds Hearing on

Community Care

On March 7, 2017, the House Committee on Veterans’ Affairs (HVAC) held a hearing entitled, “Shaping the Future: Consolidating and Improving VA Community Care.” With the Choice program set to expire on August 7, 2017, HVAC Chairman Phil Roe (R-TN) sponsored a bill, H.R. 369, which would eliminate the mandatory expiration date for the program, allowing it to continue to deliver health care services to veterans in the community and use up the remaining funds in the program. New funds will eventually be needed, though, and with that request a much-needed revamp of the Choice program – Choice 2.0 as Secretary Shulkin called it during the hearing.

During the hearing, Secretary Shulkin made a number of commitments indicating a continued preference of strengthening the VA health care system’s ability to deliver direct care and developing an integrated network of providers to help fill gaps in service throughout the country. Over the last two years, much controversy has surrounded the issue of granting veterans unfettered choice of where they receive care. This proposal has proven cost-prohibitive. As a result, the administration, VA and other stakeholders are coalescing around the idea of fitting greater expansion of veterans’ choice into a consolidated community care program that utilizes an integrated network of providers.

In a markup the day after the Choice hearing, the Committee added two provisions to H.R. 369 that would give VA the ability to become the primary payer as well as share certain limited patient information with community care doctors treating veterans without seeking the veteran’s affirmative consent. VA has long asked for these provisions since putting forth its community care consolidation plan back in October 2015. VA serving as primary payer will hopefully alleviate the many instances where community care providers turn medical bills over to the veteran when VA takes too long to pay for services.

The hearing also drew two major announcements from the Secretary, one of which received a standing ovation. The first is that VA plans to get away from developing its own IT solutions and start purchasing more commercial off-the-shelf products. The second, and perhaps even more substantial announcement, was that VA will begin offering mental health care services to veterans who received an other-than-honorable discharge from the military. The logistics, timeframe and other eligibility details were not discussed, but VA’s decision to not wait for Congress to force the issue through legislation drew significant praise from the Committee.

PVA Presents Senator Patty Murray (D-WA) the 2017 Gordon H. Mansfield Congressional Leadership Award

On March 9, 2016, Paralyzed Veterans of America honored Senator Patty Murray (D-WA) with the 2017 Gordon H. Mansfield Congressional Leadership Award. Senator Murray and her staff have worked tirelessly with PVA’s Government Relations staff to advance and see implemented the legislation that enables VA to provide in vitro fertilization (IVF) to eligible veterans and their spouses. These long-awaited procreative services finally became available to veterans on January 19 of this year, and are approved through September 30, 2018.

Senator Murray has been a champion of IVF for veterans for years. Yet her persistence that Congress do the right thing never wavered. She continues to lead the effort to see that IVF become a permanent benefit.

The Gordon H. Mansfield Congressional Leadership Award is named for the Honorable Gordon Mansfield, former Acting Secretary of the Department of Veterans Affairs and Executive Director of Paralyzed Veterans. The award reflects upon his services as the former Assistant Secretary for Congressional and Legislative Affairs at the VA, and Paralyzed Veterans’ first associate executive director of government relations. The late Mr. Mansfield was a combat-injured Vietnam veteran who was awarded the Distinguished Service Cross.

Senator Murray was notified of the award earlier this year, and was presented with it March 9th at a private meeting during Paralyzed Veterans of America’s annual Advocacy/Legislation Week. The Senator issued the following statement of recognition: “Military families sacrifice so much on our behalf, and they deserve to know their country will be there for them, no matter what. Making sure veterans and their spouses have access to reproductive assistance is just one way we can fulfill that promise, and I couldn’t be more proud to have Paralyzed Veterans of America by my side as we work together to make sure we are doing everything we can for the men and women who sacrifice so much in their service to our country.”

Caregiver Expansion Bill Introduced

On March 9, 2016, Senator Patty Murray (D-WA) introduced S. 591 and Rep. Jim Langevin (D-RI) introduced the house companion bill, H.R. 1472, the “Military and Veteran Caregiver Services Improvement Act.” This bipartisan legislation would expand VA’s Comprehensive Family Caregiver Program to veterans of all eras. Currently, a veteran has to have been severely injured on or after September 11, 2001 in order to be eligible. Expansion would make available the resources that caregivers need to provide quality care to veterans. These resources include a monthly stipend based on the hours of care provided, healthcare through CHAMPVA, respite care, and additional training among other services.

Caregivers play the most critical role in the wellbeing of a catastrophically disabled veteran. From activities of daily living, to psycho-social interaction, to maintaining good health that prevents institutional care- these caregivers have been sacrificing their own financial and physical wellbeing to care for veterans, with little to no support from VA. Congress has no justification for denying access to pre-9/11 veterans. This legislation would rectify this inequity.

Among other things, the Military and Veteran Caregiver Services Improvement Act would:

  • Make the program more inclusive of mental health injuries.
  • Reauthorize the Lifespan Respite Care Act and expand essential respite options for caregivers.
  • Give veterans the opportunity to transfer GI Bill benefits to a dependent, to help unemployed or underemployed spouses of injured veterans prepare to become the primary income for the family.
  • Make caregivers who work in the federal government eligible for flexible work schedules.
  • Provide assistance with childcare, financial advice and legal counseling, which are all top, and currently unmet, needs.

We urge all PVA members to contact their senators and ask them to support S. 591 and contact their representatives and ask them to support H.R. 1472. These bills will have a significant impact on our members, many of whom rely upon caregivers on a daily basis.

PVA Prosthetics Consultant Participates in Brain Awareness

Week Program

The National Museum of Health and Medicine hosted its 18th annual Brain Awareness Week (BAW) program March 13 -17, 2017. The museum wanted to showcase the DEKA Robotic Arm in an exhibit called “Advances in Military Medicine”. Fred Downs, PVA Prosthetics Consultant, provided live demonstrations of the DEKA Robotic Arm to the students. Mr. Downs described how he dons the arm, and demonstrated how he controlled the arm and hand with movements of his feet to which inertial measurement units (IMU) are attached. The IMUs send wireless signals to 10 computers in the arm that move the elbow and hand into different positions and grips. He uses the various functions they perform to increase his independence.

During BAW, the Museum invites middle school students to visit the museum to learn about neuroscience from a variety of professionals through hands-on interactions. The museum will host about 120 students per day (60 in a morning session and 60 in an afternoon session) who rotate through 5-6 activity stations for about 15 minutes per station. The goal is to provide an opportunity to use STEAM (science, technology, engineering, art and math) to inspire students to pursue studies and careers in the sciences.

The museum has both DOD and civilian partners who help share excitement about the neurosciences with the students to include the Walter Reed National Military Medical Center Speech and Audiology Clinics, Defense and Veterans Brain Injury Center, Uniformed Services University, Society for Neuroscience, Howard University, Rutgers, Congressionally Directed Medical Research Programs, and NIH. These BAW partners are engaged in some of the most cutting edge brain science research in the country. Brain Awareness Week at the National Museum of Health and Medicine highlights that research and promotes the field as a career option.

DOT Delays Implementation of Final Rule Requiring US Airlines

to Report Wheelchair Data

On March 2, 2017, the Department of Transportation (DOT) announced that it will delay the implementation by one-year of the final rule requiring large domestic airlines to track and report information about wheelchairs and scooters. The rule was published on November 2, 2016, and went into effect on December 2, 2016.

As originally published, airlines would be required to provide DOT with information on the total number of wheelchairs and scooters they enplane on a monthly basis for flights taking place on or after January 1, 2018. Airlines would also need to report how many of those wheelchairs and scooters were “mishandled.” The new date for implementation announced by DOT is January 1, 2019.

DOT took this action in response to a request from airlines to delay the implementation of the regulation in the spirit of a memorandum issued by the White House Chief of Staff on January 20. In part, the memorandum directed agencies to delay for 60 days the effective date of published regulations that had not yet taken effect.

PVA believes that delaying the reporting requirement for wheelchair and scooter data in the spirit of this memorandum was an overly broad interpretation of its application. The regulation had already been in effect for nearly 90 days when DOT announced its intent to delay implementation. Furthermore, DOT took this action without providing all stakeholders with a formal opportunity to comment.

PVA has communicated our concerns about the delay publicly and directly to DOT. We will continue to closely follow this matter. At this time, the delay has not been published in the Federal Register.

PVA Trains Wheelchair Attendants for Virgin America Airlines

On March 8, 2017, Senior Associate Advocacy Director Lee Page and Heather Ansley, Associate General Counsel for Corporate and Government Relations, met with representatives from Virgin America Airlines at Reagan National Airport (DCA) in Washington, D.C. The meeting was at Virgin’s request so we could facilitate a discussion around the boarding process and demonstrate proper technics for transfers in and out of an aisle chair. Virgin America contracts with Huntleigh USA Corp. at Reagan National for wheelchair assistance to assist passengers with disabilities in boarding and deplaning as part of their responsibility under the Air Carrier Access Act (ACAA).

After introductions, Mr. Page and Ms. Ansley thoroughly explained the ACAA as well as the legal responsibilities of the airline, Virgin America and their contractor Huntleigh, for what services are required to be provided to qualified passengers with disabilities. Mr. Page with the assistance of Huntleigh personnel demonstrated proper transfer technics on and off an aisle chair that was provided. Whereas Huntleigh personnel knew what to do in the transfers, Mr. Page emphasized that they need to take direction from the passenger with the disability;

The discussion lasted about two hours and there were around 25 participants from Virgin America, Huntleigh and a few representatives of Alaska Airlines, which is buying Virgin America. PVA will continue to work with Virgin America and Alaska Airlines to create future opportunities to educate personnel on the specific needs of passengers with disabilities.

February Washington Update

February 16, 2017 Volume 23, No. 2

***PRIORITY***

The Government Relations staff is still looking for stories about problems that our members have experienced during air travel. Please visit http://www.AirAccess30.org and share your story.

Senate Unanimously Confirms Dr. David Shulkin as Secretary of Veterans of Affairs

On February 13, 2017, the Senate unanimously confirmed Dr. David Shulkin as the next Secretary to lead the Department of Veterans Affairs. Despite a week of all-night debates as part of efforts to delay more controversial Cabinet Appointees, debate on Secretary Shulkin lasted a mere ten minutes. His confirmation is historic in that he will be the first person to lead the Department never having served in uniform. A strong compensating factor, though, is that for the past two years, he has served as the Under Secretary of the Veterans Health Administration (VHA), specifically leading the efforts to reform veterans’ health care.

His successful private sector career in health care coupled with experience working at the highest level of VA suggests he is uniquely suited to hit the ground running. With this favorable blend of experience, though, comes added scrutiny. While Secretary Shulkin has publicly committed to not “privatizing the VA,” PVA will continue to stress with Secretary Shulkin, as we have in the past, the importance of protecting specialized services and appropriate staffing levels in providing high-quality care to veterans with a spinal cord injury or disease.

One specific challenge he is expected to face is the requirement to broaden his view beyond VHA and lead the Department as a whole. As he already acknowledged during his confirmation hearing before the Senate Committee on Veterans’ Affairs, there is an intersection between VHA and the Veterans Benefits Administration (VBA) in the world of disability claims adjudication that cannot be ignored. Put simply, in most instances, veterans cannot receive health care from VA until they receive a rating from VBA. It is imperative the claims and appeals are adjudicated swiftly, efficiently, and, most of all, accurately.

The Independent Budget Policy Agenda for the 115th Congress Released

In February, the co-authors of The Independent Budget (IB)—DAV, Paralyzed Veterans of America, and Veterans of Foreign Wars—released the IB Policy Agenda for the 115th Congress. This year marks the 30th edition of this important endeavor. Since the release of our last policy agenda at the start of the 114th Congress in January 2015, we have seen significant attention on reforming key elements of the delivery of veterans’ health care and benefits. Our focus remains on informing and influencing key policy decisions directed by the administration and Congress that will have a direct impact on veterans and their families.

This year’s document highlights six critical issues that we believe require the greatest attention for the 115th Congress. The critical issues include:

1. Strengthen, Reform, and Sustain the VA Health Care System—The IB focuses on the framework for veterans’ health care delivery reform proposed in 2015. Inherent in this framework is the preservation and strengthening of a robust Department of Veterans Affairs (VA) health care system, particularly specialized services such as spinal cord injury and disease care, blind and vision impaired care, polytrauma care, traumatic brain injury care, and mental health care services. Our recommendations are also meant to frame the debate in the context of the VA’s community care consolidation plan, the Commission on Care recommendations, and recommendations from the Independent Assessment conducted by the MITRE and RAND corporations.

2. Remove Budget Constraints that Negatively Impact Veterans Programs—This edition focuses on the structural impediments that lead to insufficient resources being provided to ensure VA has adequate capacity to meet the needs of veterans. It addresses ongoing budget caps, sequestration, PAYGO and other budget and appropriations rules as well as the need to complete appropriations reform providing all VA programs advance appropriations.

3. Reform the Claims and Appeals Process—Appeals modernization and reform has been a primary objective of VA leadership and has been widely discussed in the House and Senate. The IB focuses on the issues that must be addressed in the course of implementation of claims and appeals reform irrespective of the final outcome of appeals reform legislation.

4. Realign and Modernize Capital Infrastructure—The misalignment and deterioration of much of VA’s capital infrastructure is a commonly discussed problem that continues to negatively impact the delivery of care to veterans. The Commission on Care and the MITRE-RAND Independent Assessment recognized the significant funding gap for VA’s infrastructure and the need to realign and right-size that infrastructure to best serve veterans, efficiently deploy resources and remain viable in the future

5. Improvements Needed in the Program of Comprehensive Assistance for Family Caregivers (PCAFC) of Severely Injured Veterans—Expansion of the comprehensive family caregiver program administered by the VA to veterans of all eras remains a high priority for the IB. Additionally, key facets of that program must be improved to ensure efficient implementation and effective delivery of services. At the same time, other programs that offer similar support services for catastrophically disabled veterans must be enhanced.

6. Ensure that VA Provides High-Quality, Effective Programs and Services to Meet the Unique Needs of Women Veterans—Much work remains to ensure that women veterans are able to access the full range of health care services that are appropriate to their unique needs. Additionally, benefits and service support programs must be enhanced to ensure that women veterans receive equitable treatment in the delivery of their earned benefits and services.

The IB serves as a guide for our legislative work in Congress and as a resource for both the Department of Veterans Affairs (VA). This policy agenda will soon be followed by the budget report for FY 2018 and FY 2019, scheduled to be released before the end of February.

To view the full IB Policy Agenda for the 115th Congress, visit http://www.independentbudget.org.

HVAC Subcommittee on Disability Assistance and Memorial Affairs Examines Impact of National Work Queue

The Subcommittee on Disability Assistance and Memorial Affairs kicked off the 115th Congress with a hearing examining the progress of VBA’s new method of allocating disability claims among its processors, the National Work Queue (NWQ). Historically, claims were processed by the local Regional Office (RO) where it was submitted. Naturally, some offices experience a relatively light workload or exceptional productivity while others are inundated with an overwhelming number of claims or, for any number of reasons, are plagued with low productivity and slow processing times. In an attempt to move into the 21st Century, VBA developed and began using a digital system designed to gather all disability claims submitted by veterans throughout the United States and distribute them to RO’s based on capacity. The practical effect for veterans is that if your local RO is handling claims in a timely manner, your claim will likely be adjudicated locally. But if your local RO is struggling to process claims within a standard of 125 days, the NWQ will take the excess claims that the local office cannot handle and move them to an RO that can.

Moving to a digital system and changing the landscape of where claims are normally processed brought both increased efficiency and accuracy. But it is also still facing certain challenges. Chairman Mike Bost (R-IL) touched on one of these challenges, the paradox of VBA increasing efficiency in processing claims and yet the backlog continues to rise. The Veterans Health Administration faces the same issue – as access to care improves, more veterans want in to use VA health care. Likewise with claims – as processing times and accuracy improve, more veterans find it worth it to submit a claim. In essence, the efficiency is offset by increased demand, and it ultimately looks like VA is making no progress.

New Ranking Member Elizabeth Esty (D-CT) and Chairman Bost both attempted to flesh out the VSOs’ collective concerns, though, with claims that are no longer local. Under the old system, the VSO service officers would be able to review the RO’s decision prior to it being issued, mostly to correct any clerical or blatant errors before the decision was made final. VFW noted that, by its calculations, 1 in 10 claims experience errors that were easily correctable. Being able to inform the RO of a mistake before the decision is finalized prevents a large number of veterans from being unnecessarily forced into the arduous and lengthy appeals process. It similarly prevents VA from having to do unnecessary work. Under the new digital system, VA’s attempt to re-create this feature just is not working. Service officers are struggling to track down claims that have been distributed to other RO’s and they are not able to prevent final decisions from being made with mistakes. VBA officials have yet to produce an acceptable remedy, and this hearing was a chance for Congress and VSO’s to apply more pressure to VBA for a fix.

PVA has observed a particular concern with the NWQ as it relates to special issues, specifically Amyotrophic Lateral Sclerosis (ALS) claims, homelessness, and terminal issues. When these claims are arriving in the NWQ, they are not being flagged appropriately and worked by the appropriate team. Instead they are being worked in the order of the date of claim. This creates a delay in these claims which could cause the veteran to die before seeing benefits. PVA hopes to work with VBA to alleviate this problem.

ADA Education and Reform Act of 2017 Reintroduced in the House

On January 24, 2017, Representative Ted Poe (R-TX) reintroduced the “ADA Education and Reform Act of 2017.” This legislation would limit the ability of people with disabilities to enforce their rights under the ADA by requiring a person with a disability to send a letter of notification to a business alerting the owner that it is out of compliance due to an architectural barrier prior to being able to file a lawsuit. Other co-sponsors include Representatives Scott Peters (D-CA), Ken Calvert (R-CA), Ami Bera (D-CA), Jackie Speier (D-CA), and Michael Conaway (R-TX).

PVA opposes this legislation. We believe that it would remove the incentive for businesses, social service establishments, and other places of public accommodation to comply with the ADA’s accessibility requirements. Businesses could employ a “wait and see” approach, continuing to violate the law with impunity. Instead, businesses should be proactive in complying with the ADA and work with the ADA National Network and other entities for any needed educational resources.

DOT Releases Annual Report on Disability-Related Complaints for 2015

In February 2017, DOT released the latest figures on complaints filed directly with airlines. In 2015, passengers filed 30,830 disability-related complaints as reported by 176 domestic and foreign air carriers, which represents a nearly twelve percent increase over 2014. Top complaints with U.S. carriers for passengers with paraplegia or quadriplegia include failure to provide assistance and seating accommodation. In 2015, passengers also filed 939 disability-related complaints directly with DOT.

 

January 2017 Washington Update

January 17, 2017                                                   Volume 23, No. 1

***PRIORITY***

The Government Relations staff is still looking for stories about problems that our members have experienced during air travel.  Please visit www.AirAccess30.org and share your story. 

PVA Outlines Policy Priorities for the 1st Session of the 115th Congress

Prior to the Christmas holiday, the Government Relations Department finalized our primary policy priorities for 2017. A brief outline of those issues that will comprise our point papers for the Advocacy and Legislative Seminar in March is below:

  1. Protection of Specialized Services: The highest priority is to strengthen and sustain VA’s specialized services, such as spinal cord injury/disease care, blinded care, poly-trauma care, and mental health care, which are not duplicated in the private sector. This will include advocating for sufficient funding to hire additional physicians, nurses, psychologists, social workers and rehab therapists. We will also focus on the need to retain title 38 U.S.C. protections for veterans getting care in the community.
  2. Expand Eligibility for VA’s Comprehensive Family Caregiver Program: Congress must expand eligibility for caregiver services provided through the VA’s Comprehensive Family Caregiver Program veterans with service-connected injuries or illnesses incurred prior to September 11, 2001.
  3. Comprehensive Reform of the Claims Appeals Process Needed: Support comprehensive reform of the benefit claims and appeals process to modernize and streamline the process, in accordance with the legislation developed and agreed to in 2016 by senior leaders of VA, VBA, the Board of Veterans Appeals, VSOs and other stakeholders.
  4. Improve Benefits for Catastrophically Disabled Veterans: Improve benefits for veterans with the most severe disabilities, to include increasing the rates of Special Monthly Compensation as well as Aid and Attendance benefits.
  5. Air Carrier Access Act (ACAA) Problems for People with Disabilities: Improve access to air travel for people with disabilities by strengthening protections in the ACAA to ensure safe and efficient assistance and accommodations in air travel and increasing enforcement of these protections.
  6. Americans with Disabilities Act (ADA) Notification: Protect the rights of people with disabilities to seek redress of discriminatory barriers in public accommodations under the ADA by refusing to enact notification requirements under the ADA.
  7. Protect and Strengthen Social Security and Medicare (Entitlement Reform): Social Security and Medicare should be strengthened and efforts to undermine these programs through benefit cuts or privatization must be rejected.

Members of House VA Committee Chosen

The House Committee on Veterans’ Affairs recently announced the members who will sit on the Committee for the 115th Congress. As previously discussed, Rep. Phil Roe (R-TN), will serve as the Committee Chairman. The following Republicans were also chosen to serve on the Committee:

Doug Lamborn (R-CO)

Gus M. Bilirakis (R-FL)

Mike Coffman (R-CO)

Brad Wenstrup (R-OH)

Amata Coleman Radewagen (R-American Samoa)

Mike Bost (R-IL)

Jodey Arrington (R-TX)

Jim Banks (R-IN)

Jack Bergman (R-MI)

Neal Dunn (R-FL)

Clay Higgins (R-LA)

John Rutherford (R-FL)

Additionally, the following assignments for Subcommittee leadership were made:

Rep. Mike Bost (R-IL): Chairman, Subcommittee on Disability Assistance and Memorial Affairs

Rep. Jodey Arrington (R-TX): Chairman, Subcommittee on Economic Opportunity

Rep. Brad Wenstrup (R-OH): Chairman, Subcommittee on Health

Rep. Jack Bergman (R-MI): Chairman, Subcommittee on Oversight and Investigations

Announcements for the Democratic membership of the Committee have yet to be made. However, we anticipate a number of previous members of the Committee to be moving on to other House Committee assignments.

Meanwhile, as previously reported, the Senate Committee on Veterans’ Affairs will be chaired by Senator Johnny Isakson (R-GA), and the new Ranking Member will be Senator Jon Tester (D-MT). While it has not been formally announced, the Committee membership is not expected to change significantly.

Camp Lejeune Presumption of Service-Connection Granted for Eight Conditions

On January 13, 2017, the Department of Veterans Affairs published a Final Rule granting presumptive service connection to certain diseases associated with contaminants present in the base water supply at U.S. Marine Corps Base Camp Lejeune, North Carolina. The presumption is rebuttable. The rule covers veterans who served a minimum of 30 days at Camp Lejeune during the period of August 1, 1953 through December 31, 1987. Reservists and members of the National Guard meeting the 30-day requirement will be considered veterans for purposes of this presumption. The rule is expected to become effective on approximately March 15, 2017.

The presumption of service-connection applies to the following eight diseases: 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; 8. Bladder cancer. This list of diseases now receiving a presumption of service-connection does not affect the list of fifteen diseases which qualify for free medical care through the VA as provided in the “Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012.”

Affordable Care Act Repeal Begins But Raises Many Questions

Congress has begun taking the first steps toward repealing the Patient Protection and Affordable Care Act (ACA) with a Senate vote on January 12. The vote was on a fiscal year 2017 budget reconciliation measure and followed party lines with 51 Republicans voting in favor to 47 Democrats opposed. Sen. Rand Paul (R-Ky.) also voted no, in part over concerns that GOP leaders have not committed to a plan to replace the Affordable Care Act after it is repealed. The bill was expected to go to the House of Representatives for a vote on Friday January 13 and be passed easily. The reconciliation bill contains instructions to several House and Senate Committees to work out the details of repeal and report back with legislation to implement repeal by the end of January.

A large part of the ACA can be repealed through reconciliation, which only needs the support of 51 senators – an easier threshold to achieve than the 60 votes required by most other pieces of legislation in the Senate. Among the elements of the ACA that are targeted for removal are the individual penalties for non-coverage, premium supports and tax credits making coverage affordable, the Medicaid expansions with federal matching funds that have been adopted by over 30 states and taxes on high-income households and the health care industry that helped pay for the ACA’s coverage expansions.

The dilemma facing the Republican leadership is that they and President-elect Trump have promised to offer a replacement health care proposal in conjunction with ACA repeal. They have also offered assurances that many of the popular provisions in ACA will be retained, including the protections against discriminatory health insurance policies and coverage of dependents up to age 26. Some in the leadership have suggested that the effective date of repeal could be delayed for several years while a replacement plan was developed and put in place. Aides to House leaders have cautioned that any replacement legislation will only be partial because of the need to get changes through the Senate with 51 votes and the reconciliation rules that require measures to have a budgetary impact. Developing a more comprehensive replacement to the ACA would need 60 Senate votes and significant Democratic support.

According to some analyses, removing the coverage mandates and premium subsidies could cause turmoil in the individual insurance market as some companies that had expected more customers pull out and those companies that remain are forced to raise premiums to account for uncertainty. The Congressional Budget Office has estimated that eliminating the individual mandate would cause premiums in the individual market to rise by 20 percent. This in turn would likely cause large numbers of younger, healthier individuals to drop their insurance, leaving people with serious health conditions to remain in the individual market facing ever increasing premiums.

Other effects of passage of the reconciliation bill as outlined by the Urban Institute include:

  • An increase in the number of uninsured people from 28.9 million to 58.7 million in 2019, an increase of 103 percent. The share of nonelderly people without insurance would increase from 11 percent to 21 percent, a higher rate of un-insured than before the ACA because of the disruption to the non-group insurance market. Of the 29.8 million newly uninsured, 22.5 million people become uninsured as a result of eliminating the premium tax credits, the Medicaid expansion, and the individual mandate. The additional 7.3 million people become uninsured because of the near collapse of the non-group or individual insurance market.
  • A reduction in numbers of those covered by Medicaid or the Childrens’ Health Insurance Program by 12.9 million people.
  • A reduction in Federal government spending on health care for the non-elderly [including many people with disabilities under age 65] by $109 billion in 2019 and by $1.3 trillion from 2019 to 2028 because the Medicaid expansion, premium tax credits, and cost-sharing assistance would be eliminated.

Several amendments were offered during the Senate budget reconciliation debate by Senators Bernie Sanders (I-VT) and Bob Casey (D-PA) to protect Medicaid, Medicare and other safety net programs. They were all defeated on partisan votes with only one or two Republicans voting in their favor. Once the committees return with their plans at the end of January, a clearer picture of any replacement legislation will emerge. Subsequent actions on health reform are likely to arise in the context of tax reform proposals and possibly reauthorization of the Childrens’ Health Insurance Program. As deliberations on the fate of ACA continue, PVA will continue working with its allies in the disability community and in Congress to raise with policymakers the severe, adverse impact on people with disabilities that will attend repeal of the ACA.

DOT Releases New Air Carrier Access Act Training Materials

The U.S. Department of Transportation (DOT) has released new training materials targeted at the top areas in which passengers with disabilities encounter difficulties in air travel.

In December 2015, DOT originally announced its intent to develop new materials that airlines and their contractors can use to supplement their current training programs addressing the four issues on which DOT receives the largest number of disability-related complaints. The materials cover (1) wheelchair and guide assistance; (2) stowage, loss, delay, and damage of wheelchairs and other mobility assistive devices; (3) aircraft seating accommodations; and (4) travel with service animals. PVA participated in DOT-led focus groups along with other members of the disability community and the airlines in the development of the materials.

The training materials, which are available online, include videos, brochures, digital content designed for viewing on a mobile device, and a tip sheet and are organized by topic. DOT will also be posting two interactive guides in the near future. In addition to developing materials for airline personnel and their contractors, companion pieces for passengers with disabilities are also available.

To access the materials, please visit: https://www.transportation.gov/airconsumer/disability-training/. These materials should be circulated broadly to ensure that people with disabilities have a better understanding of their rights and responsibilities under the Air Carrier Access Act.

Consent Order Issued Against American Airlines In Response to ACAA Training Violation

The U.S. Department of Transportation (DOT) has issued its first consent order for 2017 under the Air Carrier Access Act (ACAA) in response to a formal complaint filed by Mr. Kevin Crowell, a veteran with a disability, against American Airlines.

Mr. Crowell, who uses a service animal for PTSD and mobility issues, encountered difficulties in securing a bulkhead seat on an American flight in April 2014. Under the ACAA, people who use service animals have priority access to bulkhead seats. Mr. Crowell contacted American prior to his travels to secure the accommodation. Once he arrived at the gate for a connecting flight, however, his wife was informed that pets are not allowed to sit in the bulkhead. Despite providing information to the agent showing that his animal was not a pet, he was directed to a non-bulkhead seat. His animal would not fit and he requested his original seating assignment. American allegedly asked him to take his assigned seat or deplane. Once he deplaned, he alleged that a Customer Care Manager was called to meet with him, and offered to accommodate him on the next flight to his destination, but he declined the offer.

In his formal complaint, Mr .Crowell alleged that American Airlines denied him transportation on the basis of his disability, failed to accommodate his service animal, and failed to train their staff to proficiency as required under the ACAA. DOT found that American did not deny transportation or fail to accommodate his service animal because American asserted in its response to the complaint that although there was initial confusion they offered to accommodate him on his originally scheduled flight. As a result of the errors that led to the confusion, DOT found that the airline failed to train its staff to proficiency regarding the ACAA rights of passengers using service animals.

The order requires American to provide supplemental training to reservations and gate agents and to ensure that supplemental materials are included in the training programs for new agents. The order is available here: https://www.transportation.gov/airconsumer/eo-2017-1-11

PVA Trains Wheelchair Attendants for Virgin America Airlines

In early December, Senior Associate Advocacy Director Lee Page and Heather Ansley, Associate General Counsel for Corporate and Government Relations, met with representatives from Virgin America Airlines at Dulles International Airport (DIA) in northern Virginia. The meeting was at Virgin’s request to facilitate a discussion around the boarding process and demonstrate proper technics for transfers in and out of an aisle chair. Virgin America contracts with Huntleigh USA Corp. at Dulles for wheelchair assistance to assist passengers with disabilities in boarding and deplaning as part of their responsibility under the Air Carrier Access Act (ACAA).

After introductions, Mr. Page and Ms. Ansley thoroughly explained the Air Carrier Access Act and the legal responsibilities of the airline–Virgin America—and its contractor—Huntleigh—in what services are required to be provided to qualified passengers with disabilities. Mr. Page with the assistance of Huntleigh personnel demonstrated proper transfer technics on and off two different aisle chairs that were provided. Whereas Huntleigh personnel knew what to do in the transfers, Mr. Page emphasized that they need to take direction from the passenger with the disability.

The discussion lasted about two hours and included approximately 25 participants from Virgin America, Huntleigh USA, and a few representatives from Alaska Airlines. PVA agreed to work with Virgin America and Alaska Airlines to develop future opportunities to educate personnel on the specific needs of passengers with disabilities.

U.S. Access Board Releases Accessibility Standards for Medical Diagnostic Equipment

The U.S. Access Board has issued new accessibility standards for medical diagnostic equipment (MDE) in response to a requirement in the Affordable Care Act. The standards provide design criteria for examination tables and chairs, weight scales, radiological and mammography equipment, and other diagnostic equipment that are accessible to people with disabilities. They include requirements for equipment that requires transfer from mobility aids and address transfer surfaces, support rails, armrests, and other features. PVA was a member of the MDE Accessibility Standards Advisory Committee that made recommendations to the Access Board.

Barriers to diagnostic equipment include equipment height and other dimensions, the lack of supports and features necessary for transfer, and the characteristics of contact surfaces. The standards address these as well as other features such as operable parts and patient instructions. The provisions are organized based on use position and whether transfer from wheelchairs is necessary.

As issued by the Board, the standards are not mandatory on health care providers and equipment manufacturers. The U.S. Department of Justice, which has issued guidance on access to medical care, may adopt them as mandatory requirements under the Americans with Disabilities Act. Other federal agencies may implement them as well under the Rehabilitation Act which requires access to federally funded programs and services.

The standards are available here: https://www.access-board.gov/guidelines-and-standards/health-care/about-this-rulemaking/final-standards.

An overview of the standards are available here: https://www.access-board.gov/guidelines-and-standards/health-care/about-this-rulemaking/background/overview-of-the-mde-standards.

 

December Washington Update

December 15, 2016                                                         Volume 22, No. 12

***PRIORITY***

The Government Relations staff is still looking for stories about problems that our members have experienced during air travel. Please visit www.AirAccess30.org and share your story.

Key Leaders Chosen for House and Senate Committees

During the lame duck session following the November election, the Republican and Democratic caucuses in the House or Representatives and Senate chose the members who will serve as the Chairmen and Ranking Members of Committees during the 115th Congress beginning in January 2017. In the House, Rep. Phil Roe (R-TN) was chosen as the next Chairman of the House Committee on Veterans’ Affairs. Rep. Roe is replacing Rep. Jeff Miller (R-FL) who is retiring at the end of this year. Rep. Roe is a doctor who has used his experience to inform his views on the reform of veterans’ health care delivery. He has supported greater choice for care in the community for veterans, but he has generally opposed outright privatization of the Department of Veterans Affairs (VA) health care system. The House VA Committee Ranking Minority Member position has not been decided yet; however, it is expected to be either Rep. Mark Takano (D-CA) or Rep. Tim Walz (D-MN). Leadership for the four Subcommittees is expected to be chosen in January.

In the Senate, Senator Johnny Isakson (R-GA) will continue as the Chairman of the Senate Committee on Veterans’ Affairs. Senator Isakson has previously expressed support for expansion of the Comprehensive Family Caregiver Program—a high priority for PVA—to veterans of all eras. He has also lead efforts to improve accountability without undermining employees’ rights. Importantly, he also supports greater choice for veterans seeking health care. Senator Jon Tester (D-MT) will be the new Ranking Minority Member of the Senate VA Committee.

The National Advocacy Program staff will continue to work with a number of key committees through our work on the Air Carrier Access Act, entitlement reform, and the Americans with Disabilities Act (ADA). The expected chairman of the Senate Commerce, Science and Transportation Committee is Senator John Thune (R-SD), who is the current chairman of the committee. Also returning will be Ranking Member Bill Nelson (D-FL). The returning chairman of the House Transportation and Infrastructure Committee is Rep. Bill Shuster (R-PA), while Rep. Peter DeFazio (D-OR) is expected to remain the ranking member of the committee.

PVA’s efforts to strengthen the Air Carrier Access Act (ACAA) must go through these committees. PVA worked with these committees in 2016 when we were successful in having PVA-drafted language included in the 2016 FAA Extension. This language required GAO to conduct a review of disability-related training for airline staff and their contractors. In 2017, we will be working to ensure that legislation to reauthorize the FAA, which must be completed by September, includes additional PVA-supported language that will increase enforcement of the ACAA and improve the travel experience for passengers with disabilities.

A number of committees will address potential entitlement reform, specifically the Social Security and Medicare programs. Senator Orrin Hatch (R-UT) is expected to remain the chairman of the Senate Finance Committee. Also returning will be ranking member Ron Wyden (D-OR). The new chairman of the House Energy and Commerce Committee is Rep. Greg Walden (R-OR), while the Ranking Member is expected to be Rep. Frank Pallone (D-NJ).

The returning chairman of the House Ways and Means Committee is Congressman Kevin Brady (R-TX), while Rep. Richard Neal (D-MA) is expected to become the ranking member. The outgoing chairman of the Social Security Subcommittee, Rep. Sam Johnson (R-TX), recently dropped a placeholder Social Security reform bill that focuses on benefit cuts. This legislation is expected to be the basis for reform during the 115th Congress beginning in January 2017. The expected new ranking member on the Social Security Subcommittee is Rep. John Larson (D-CT) who is the main sponsor of a bill to expand Social Security.

We also anticipate work that will have an impact on ongoing implementation of the ADA. With this in mind, the expected chairman of the Senate Judiciary Committee is current Chairman Charles Grassley (R-IA). Senator Dianne Feinstein (D-CA) will be the new ranking member of the Senate committee. The chairman of the House Judiciary Committee is current Chairman Robert Goodlatte (R-VA). Rep. John Conyers (D-MI), current ranking member of the Judiciary Committee, is expected to retain his position.

PVA’s efforts to protect the Americans with Disabilities Act (ADA) are under the purview of the Senate and House Judiciary Committees. PVA is concerned about efforts to require people with disabilities to notify businesses of architectural barriers prior to filing a lawsuit under the ADA. Legislation that would have required notification was introduced in the House and Senate in the 114th Congress and passed the House committee. We anticipate this issue to return in 2017.

There are also additional committees that the Government Relations Department will engage with during the 115th Congress. The expected chairman of the Senate Health, Education, Labor and Pensions Committee is Senator Lamar Alexander (R-TN), who is the current chairman of the committee. Also returning will be Ranking Member Patty Murray (D-WA). The new chairwoman of the House Education and the Workforce Committee is Rep. Virginia Fox (R-NC), while Rep. Robert Scott (D-VA) is expected tp be the ranking of that committee once again. The expected new chairman of the Senate Banking, Housing and Urban Affairs Committee is Senator Michael Crapo (R-ID), and the returning ranking member is Senator Sherrod Brown (D-OH). The returning chairman of the House Financial Services Committee is Rep. Jeb Hensarling (R-TX), and Rep. Maxine Waters (D-CA) is expected to remain the ranking member of the committee.

We will update PVA members as additional key leadership positions in the House and Senate are determined early in January.

“Veterans Mobility Safety Act” Approved by Congress”

On November 29, 2017, the House gave final approval to H.R. 3471, the “Veterans Mobility Safety Act.” The revised bill includes significant language changes to address concerns brought by outside equipment dealers to PVA leadership earlier this year. Gabe Stultz, Associate Legislative Director, deserves a great deal of credit for his relentless advocacy work on this issue. This bill was championed by Rep. Jackie Walorski (R-IN), who is a member of the House VA Committee, and it was pushed in the Senate by Senator Jerry Moran (R-KS).

PVA has spent the last year working to get this important piece of legislation enacted. Support for this legislation was compromised at various points by competing business interests that appeared to be more interested in getting an advantage over their competition, rather than focusing on the most important priority of the legislation—veterans being served. Fortunately, Congress managed to overcome a great deal of misinformation, and in some cases blatant falsehoods, to take this positive step.

Moving forward, PVA will work with the VA to ensure that we have a prominent role in the implementation of this requirement.

Large Veterans Omnibus Bill Approved by Congress

Prior to adjourning the 114th Congress, the House and Senate passed a large veterans omnibus bill that contained a wide array of provisions that had previously been considered throughout the course of the last two years, but not finally approved. On December 6, 2016, the House approved H.R. 6416, the “Jeff Miller and Richard Blumenthal Veterans Health Care and Benefits Improvement Act.” The Senate approved the bill by voice vote prior to adjourning for the year.

While the bill is a tapered version of the “Veterans First Act,” which passed the Senate unanimously in May, it does contain 76 provisions pertaining to veterans’ health care, disability benefits, and homelessness assistance. However the bill excludes two important concepts that were high priority issues with bipartisan support—expansion of the VA’s Comprehensive Family Caregiver Program to veterans of all eras and Appeals Reform.

The measure is named after Senator Richard Blumenthal (D-CT), former Ranking Member of the Senate VA Committee, and retiring Chairman of the House Committee on Veterans’ Affairs, Rep. Jeff Miller (R-FL). It temporarily increases the number of judges for the U.S. Court of Appeals for Veterans Claims from seven to nine to help address the large backlog of veterans’ appeals that may soon arrive at the court.

The act will allow for the hiring of more mental health providers and emergency room doctors and extends education benefits to surviving family members. It also begins the research needed to help descendants of veterans exposed to toxic substances.

PVA is ultimately disappointed that the House and Senate sacrificed some extremely important programs and legislative priorities in the interest of passing “some” legislation to improve benefits and services for veterans.

U.S. Access Board Updates ADA Guidelines for Buses and Vans

The U.S. Access Board has issued a final rule updating sections of its accessibility guidelines for transportation vehicles covered by the Americans with Disabilities Act (ADA). The rule revises provisions in the guidelines that apply to buses and vans to enhance accessibility and to address industry trends and improvements in design and technology. The guidelines, which the Board originally published in 1991, apply to new or remanufactured vehicles.

The guidelines for buses and vans address boarding access, fare devices, interior circulation, seating and securement, signs, lighting, and announcement systems. The rule reduces the maximum slope for vehicle ramps because low floor buses are now ubiquitous in fixed route systems. New provisions also address level boarding systems and incorporate updated standards for wheelchair securement systems. The rule improves communication access by requiring that buses in fixed route systems with at least 100 buses have automated stop and route announcements that are visual as well as audible. Further, access to over-the-road buses, which are typically used in commuter and long-distance bus lines and charter services, is more comprehensively addressed. In addition to these substantive changes, the rule features a new format and numbering system. An assessment of the costs and benefits is included with the rule.

The Board previously issued versions of the rule in draft and proposed forms for public comment and has finalized the rule based on the feedback received. At a later date, the Board will propose updates to sections of the guidelines covering vehicles in fixed guideway systems, including rapid, light, commuter, and intercity rail, according to recommendations from an advisory committee it chartered, the Rail Vehicles Access Advisory Committee, which submitted its report to the Board last year.

The Board’s vehicle guidelines serve as the basis for mandatory standards issued by the Department of Transportation (DOT) under the ADA. Compliance with the updated requirements for buses and vans will become mandatory once specified by DOT in a future update of its ADA standards.

PVA Trains Wheelchair Attendants for Virgin America Airlines

In early December, Senior Associate Advocacy Director Lee Page and Heather Ansley, Associate General Counsel for Corporate and Government Relations, met with representatives from Virgin America Airlines at Dulles International Airport (DIA) in northern Virginia. The meeting was at Virgin’s request to facilitate a discussion around the boarding process and demonstrate proper technics for transfers in and out of an aisle chair. Virgin America contracts with Huntleigh USA Corp. at Dulles for wheelchair assistance to assist passengers with disabilities in boarding and deplaning as part of their responsibility under the Air Carrier Access Act (ACAA).

After introductions, Mr. Page and Ms. Ansley thoroughly explained the Air Carrier Access Act and the legal responsibilities of the airline–Virgin America—and its contractor—Huntleigh—in what services are required to be provided to qualified passengers with disabilities. Mr. Page with the assistance of Huntleigh personnel demonstrated proper transfer technics on and off two different aisle chairs that were provided. Whereas Huntleigh personnel knew what to do in the transfers, Mr. Page emphasized that they need to take direction from the passenger with the disability.

The discussion lasted about two hours and included approximately 25 participants from Virgin America, Huntleigh USA, and a few representatives from Alaska Airlines. PVA agreed to work with Virgin America and Alaska Airlines to develop future opportunities to educate personnel on the specific needs of passengers with disabilities.

PVA Attends Universal Access in Airports Conference

From November 14 – 16, 2016, Senior Associate Advocacy Director, Lee Page and Heather Ansley, Associate General Counsel for Corporate and Government Relations attended the sixth Universal Access in Airports (UAIA) conference in San Francisco. The conference was hosted by the Open Doors Organization (ODO) of Chicago.

ODO is a 501(c)(3) non-profit organization based in Chicago, Illinois, was founded in 2000 for the purpose of creating a society in which all persons with disabilities have the same consumer opportunities as everyone else. They aspire to teach businesses how to succeed in the disability market, while simultaneously empowering the disability community.

The UAIA Conference focuses on what’s new in aviation, to include regulations, technology, and innovative best practices. The conference also addresses service gaps and barriers that still prevent air travel from being fully accessible to older adults and people with disabilities. Attendees to the conference included representatives of airlines, DOT and FAA regulators, Architects and ADA coordinators for airports, TSA, customer service senior management, product manufactures, contracted service management and persons with disability.

The two days of information sharing included a briefing from the Department of Transportation on the recently concluded ACCESS Committee that had consensus agreement for rulemaking around Lavatories on single aisle aircraft of a certain size, and inflight entertainment and communication for the deaf and hard of hearing and those who are blind or limited vision. Other panels focused on products of accessibility that could increase access at airports in the realm of seating design and website accessibility. A consumer panel focused on the experience of navigating through the airport and the problems of going through TSA security checks and the utilization of contract service employees who assist passengers with disabilities.

Overall, this conference is heavily attended by the airline industry and provides a good opportunity to network. The next conference will be in Minneapolis, MN in 2018.

ADA Transportation Survey

The ADA Participation Action Research Consortium (ADA_PARC), a collaborative research project of the ADA Regional Centers, is conducting a study on the accessibility of public transportation for people with disabilities. The purpose of the study is to increase the knowledge base about transportation access for people with disabilities with the hope of improving access to transportation at the regional and national levels

The survey is available at: https://unco.co1.qualtrics.com/jfe/form/SV_00wcGeTOzGL2lQ9. It will be open until mid-January 2017.

 

We encourage our members to participate in this important study.

The Ricky Raley Story

A veteran leads others out of the darkness
By: Brian
In: Chive Charities
In September 2008, Ricky Raley was nearing the end of his first deployment in Iraq with the Army National Guard. He had formed a close bond with the other members of his unit – a bond that can be difficult for us civilians to understand. The men and women you serve with in combat experience some of the most extreme moments of fear, sadness, joy, and camaraderie. In the moments when the mortars whistle in or the bullets whiz past, there is no one else in the world but the people to your left and right. There is a level of understanding and mutual appreciation for one another when you realize that the survival of your friends is essential to your own.
In September 2008, Ricky Raley was nearing the end of his first deployment in Iraq with the Army National Guard. He had formed a close bond with the other members of his unit – a bond that can be difficult for us civilians to understand. The men and women you serve with in combat experience some of the most extreme moments of fear, sadness, joy, and camaraderie. In the moments when the mortars whistle in or the bullets whiz past, there is no one else in the world but the people to your left and right. There is a level of understanding and mutual appreciation for one another when you realize that the survival of your friends is essential to your own.

 

With his unit, Ricky had taken to volunteering as the lead gun truck for every mission. Ricky always wanted to be in control of his own destiny and protect his friends following behind.
With his unit, Ricky had taken to volunteering as the lead gun truck for every mission. Ricky always wanted to be in control of his own destiny and protect his friends following behind.

 

During one mission, Ricky’s truck was leading the way when his mine roller tripped an IED (improvised explosive device). Once the dust settled and the ringing in his ears subsided, Ricky’s unit was able to patch up the truck and make the painstakingly slow, 2-hour trip to complete the mission with a hobbled truck. Ricky along with two others in the truck at the time of the explosion received purple hearts for their efforts. They also each sustained mTBI’s (mild traumatic brain injury) from the blast. Ricky would be returning home with non-visible scars but at least he was returning in one piece.

 

Back Home

 

For many returning soldiers, the transition back into civilian life can be tough. For Ricky, it was no different. What came naturally to him before seemed strange to him now. Mentally, something had changed in him. He longed to be back in Iraq on the line with his buddies where he felt comfortable. On April 17th 2009, everything changed.

 

Ricky and his friend were driving down a backcountry road in Westfield, Indiana. They were headed to a buddy’s garage to pick up powder for a motorcycle frame Ricky was powder coating. It was a drive they had made thousands of times. It had also been months since Ricky returned home from his deployment to Iraq and the dangers that come with carrying out his unit’s missions. There was no reason to believe that his life was in peril that particular day.

 

Before anyone knew what was happening, Ricky’s friend lost control of the truck and they tumbled, end over end, into a ditch.
During one mission, Ricky’s truck was leading the way when his mine roller tripped an IED (improvised explosive device). Once the dust settled and the ringing in his ears subsided, Ricky’s unit was able to patch up the truck and make the painstakingly slow, 2-hour trip to complete the mission with a hobbled truck. Ricky along with two others in the truck at the time of the explosion received purple hearts for their efforts. They also each sustained mTBI’s (mild traumatic brain injury) from the blast. Ricky would be returning home with non-visible scars but at least he was returning in one piece.
Back Home
For many returning soldiers, the transition back into civilian life can be tough. For Ricky, it was no different. What came naturally to him before seemed strange to him now. Mentally, something had changed in him. He longed to be back in Iraq on the line with his buddies where he felt comfortable. On April 17th 2009, everything changed.
Ricky and his friend were driving down a backcountry road in Westfield, Indiana. They were headed to a buddy’s garage to pick up powder for a motorcycle frame Ricky was powder coating. It was a drive they had made thousands of times. It had also been months since Ricky returned home from his deployment to Iraq and the dangers that come with carrying out his unit’s missions. There was no reason to believe that his life was in peril that particular day.
Before anyone knew what was happening, Ricky’s friend lost control of the truck and they tumbled, end over end, into a ditch.

 

Ricky awoke to an EMT hovering over him trying to figure out what happened. As if in a dream, it took a while for him to feel anything and process what had happened. Then, reality set in. Ricky’s arm was completely broken in half, and he was now paralyzed from the waist down.

 

In the days that followed, everyone around Ricky was devastated. His friends and family felt sorry for the hand he was dealt. He had every reason to give up. But that simply is not Ricky. He was in control of his own destiny. From his perspective, there was no reason to feel sad about something he could not change. He had a duty to his future wife and his unborn son to pick himself back up and be strong for them. So just 5 days after the accident and after multiple surgeries, Ricky was already in physical therapy.
Ricky awoke to an EMT hovering over him trying to figure out what happened. As if in a dream, it took a while for him to feel anything and process what had happened. Then, reality set in. Ricky’s arm was completely broken in half, and he was now paralyzed from the waist down.
In the days that followed, everyone around Ricky was devastated. His friends and family felt sorry for the hand he was dealt. He had every reason to give up. But that simply is not Ricky. He was in control of his own destiny. From his perspective, there was no reason to feel sad about something he could not change. He had a duty to his future wife and his unborn son to pick himself back up and be strong for them. So just 5 days after the accident and after multiple surgeries, Ricky was already in physical therapy.

 

Ricky and his wife Quynhmy, who was 4 months pregnant at the time of the accident.

 

The first year after the accident was the most difficult for Ricky. While he was overjoyed when his wife, Quynhmy, gave birth to their son, the reality of the challenge ahead set in. Trying to raise a son while adjusting to life in a wheelchair and dealing with the mental scars of his time in Iraq took its toll. A cold and dark Midwestern winter confined Ricky inside for many days, which did nothing to help his mental state.
Ricky and his wife Quynhmy, who was 4 months pregnant at the time of the accident.
The first year after the accident was the most difficult for Ricky. While he was overjoyed when his wife, Quynhmy, gave birth to their son, the reality of the challenge ahead set in. Trying to raise a son while adjusting to life in a wheelchair and dealing with the mental scars of his time in Iraq took its toll. A cold and dark Midwestern winter confined Ricky inside for many days, which did nothing to help his mental state.

 

When spring came, Ricky found a passion that gave his life new purpose: adaptive sports. He got an adaptive bike and before long he was competing in marathons. He joined a wheelchair basketball team that won two national championships. “It pulled me out of the darkness I was in for some time after the injuries,” Ricky said about his new passion. “I found some freedom in being able to train hard and compete again” Perhaps just as important, competing on a team again helped fill a void left behind in Iraq. His teammates became his new brothers in arms.
When spring came, Ricky found a passion that gave his life new purpose: adaptive sports. He got an adaptive bike and before long he was competing in marathons. He joined a wheelchair basketball team that won two national championships. “It pulled me out of the darkness I was in for some time after the injuries,” Ricky said about his new passion. “I found some freedom in being able to train hard and compete again” Perhaps just as important, competing on a team again helped fill a void left behind in Iraq. His teammates became his new brothers in arms.

 

Over a thousand miles from Westfield and Ricky Raley, Chive Charities was outlining some of our goals for 2016. John, Leo and I had just tasked Angie Cone with helping more veterans than ever before in Chive Charities’ history. Angie knew a key component of reaching that goal would be to connect with a trustworthy network of nonprofits that also assist our veterans.

 

It did not take long to find The Boot Campaign, a nonprofit dedicated to raising awareness of the unique challenges service members face during and post-service as well as providing assistance to military personnel, past and present, and their families. At the time, the Boot Campaign was working on an exciting campaign called the Backyard Refresh. Boot Campaign & Mike’s Hard Lemonade were teaming up to show gratitude to our troops through performing backyard makeovers to deserving veterans and their families. Ricky Raley was one of those chosen for a refresh. Immediately, we knew that Chive Charities needed to be involved in some way.
Over a thousand miles from Westfield and Ricky Raley, Chive Charities was outlining some of our goals for 2016. John, Leo and I had just tasked Angie Cone with helping more veterans than ever before in Chive Charities’ history. Angie knew a key component of reaching that goal would be to connect with a trustworthy network of nonprofits that also assist our veterans.
It did not take long to find The Boot Campaign, a nonprofit dedicated to raising awareness of the unique challenges service members face during and post-service as well as providing assistance to military personnel, past and present, and their families. At the time, the Boot Campaign was working on an exciting campaign called the Backyard Refresh. Boot Campaign & Mike’s Hard Lemonade were teaming up to show gratitude to our troops through performing backyard makeovers to deserving veterans and their families. Ricky Raley was one of those chosen for a refresh. Immediately, we knew that Chive Charities needed to be involved in some way.

 

Ricky’s backyard refresh begins and he even gets in on the action!
Ricky’s backyard refresh begins and he even gets in on the action!

 

Ricky’s backyard refresh was almost complete. It was missing just one thing…

 

Since discovering adaptive sports, Ricky has chosen to use his unfortunate circumstance to inspire and help others as the director for the Paralyzed Veterans of America Indiana Chapter. When individuals in similar circumstances see all that Ricky has accomplished, they are inspired to push themselves to heights they never thought possible.

 

For Ricky, there is an unaccomplished goal still looming over him that he knows he can one day achieve. Ricky is determined to complete a triathlon. If you ask him what is holding him back, he will tell you it is the training required for the grueling swimming portion of the race. Getting to a public pool to train can be a challenge and embarrassing at times. Without the use of his legs, Ricky’s swimming motion and big body take up a large amount of space, disturbing the other swimmers.
Ricky’s backyard refresh was almost complete. It was missing just one thing…
Since discovering adaptive sports, Ricky has chosen to use his unfortunate circumstance to inspire and help others as the director for the Paralyzed Veterans of America Indiana Chapter. When individuals in similar circumstances see all that Ricky has accomplished, they are inspired to push themselves to heights they never thought possible.
For Ricky, there is an unaccomplished goal still looming over him that he knows he can one day achieve. Ricky is determined to complete a triathlon. If you ask him what is holding him back, he will tell you it is the training required for the grueling swimming portion of the race. Getting to a public pool to train can be a challenge and embarrassing at times. Without the use of his legs, Ricky’s swimming motion and big body take up a large amount of space, disturbing the other swimmers.

 

What he really needs is a therapy pool. That’s where Chive Charities and the Green Ribbon Fund donors come in. With a grant of $22,000, we were able to purchase and install a therapeutic swim / spa in conjunction with Boot Campaign’s Backyard Refresh. The spa’s quad swim jet system can now allow Ricky to swim in place against the the current of the jets. He will no longer need to spend the time going to the public pool where he feels all eyes are on him as he uses the lift to get in. The spa will also allow him to spend more time with his family who is his motivation to keep pushing forward.
What he really needs is a therapy pool. That’s where Chive Charities and the Green Ribbon Fund donors come in. With a grant of $22,000, we were able to purchase and install a therapeutic swim / spa in conjunction with Boot Campaign’s Backyard Refresh. The spa’s quad swim jet system can now allow Ricky to swim in place against the the current of the jets. He will no longer need to spend the time going to the public pool where he feels all eyes are on him as he uses the lift to get in. The spa will also allow him to spend more time with his family who is his motivation to keep pushing forward.

 

Ricky has always been a leader. He wants to be out in front when things get rough. Now he’s using his experiences to motivate others when they hit turbulent waters. “Being paralyzed does suck from time to time,” Ricky told me on the phone. “But I now have a platform to reach all kinds of people and change their lives. If it’s a person who is freshly injured and just wants to know what life is going to be like now or if it is a person who is able-bodied and just needs the knowledge of what it is like to be in a chair, I can do that now. I have amazing people in my life now and constantly meet truly inspiring people.” Thanks to a group of dedicated Chive Charities’ donors, Ricky will be completing triathlons in no time and inspiring thousands more to reach their potential.

 

“When life gets hard just roll on!” – Ricky Raley
Ricky has always been a leader. He wants to be out in front when things get rough. Now he’s using his experiences to motivate others when they hit turbulent waters. “Being paralyzed does suck from time to time,” Ricky told me on the phone. “But I now have a platform to reach all kinds of people and change their lives. If it’s a person who is freshly injured and just wants to know what life is going to be like now or if it is a person who is able-bodied and just needs the knowledge of what it is like to be in a chair, I can do that now. I have amazing people in my life now and constantly meet truly inspiring people.” Thanks to a group of dedicated Chive Charities’ donors, Ricky will be completing triathlons in no time and inspiring thousands more to reach their potential.
“When life gets hard just roll on!” – Ricky Raley
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October Washington Update

October 18, 2016 Volume 22, No. 10

***PRIORITY***

The Government Relations staff is still looking for stories about problems that our members have experienced during air travel. Please visit http://www.AirAccess30.org and share your story.

Congress Approves CR, Includes PVA Priorities

Prior to recessing for the November election at the end of September, Congress approved H.R. 5325, the “Continuing Appropriations and Military Construction and Veterans Affairs Appropriations Act for FY 2017,” that included full-year funding for the Department of Veterans Affairs (VA). The bill contains three very important priorities for PVA. These include:

1. Reinstatement of the annual capacity reporting requirement. While a date for implementation has not been established, this is an important accomplishment that will bolster the work done by the PVA Medical Services site visit teams.
2. Authorization of the provision of reproductive services through VA, to include in vitro fertilization (IVF). This has long been a high priority for PVA. For the first time, veterans with service-connected catastrophic disabilities that preclude them from having children will have access to reproductive services through the VA. Unfortunately, we will have to defeat an amendment included in the Labor/HHS Appropriations bill, introduced by Rep. Andy Harris (R-MD), that risks undermining the authority to provide IVF services both at VA as well as the Department of Defense.
3. Beneficiary travel for “some” non-service connected catastrophically disabled veterans, including those with SCI, blindness and amputation. The language in the bill states that it can be provided to those who travel to an inpatient rehabilitation facility, such as an SCI center, and are admitted for overnight stay or provided temporary lodging. Assuming appropriate interpretation, this should at least open the opportunity for beneficiary travel for PVA members receiving annual physicals; however, we do not believe it authorizes beneficiary travel for non-service connected veterans for same-day appointments. Additionally, it remains to be seen when this benefit will actually go into effect. We will obviously have to track implementation of this closely.

Sarah Dean, PVA Associate Legislative Director, deserves a great deal of credit for her tireless work on the capacity reporting issue and the IVF provisions specifically. Hard work remains to ensure that proper implementation of these important provisions occurs. This will be particularly true of the capacity report and the beneficiary travel provisions, which I anticipate VA will be resistant to acting on.

Legislation Stalled in the Senate

While key provisions were included in the CR, the lack of compromise generally led to a number of important pieces of legislation being left unfinished. Perhaps the biggest issue that has yet to be resolved is the appeals reform included in H.R. 5620, the “Accountability First and Appeals Reform Act,” introduced by House VA Committee Chairman Jeff Miller (R-FL). That legislation also included strong accountability measures for VA staff. The legislation passed the House in September with strong bipartisan support, but it is being held up in the Senate, primarily over disagreements on the accountability provisions.

Our work also continues on H.R. 3471, the “Veterans Mobility Safety Act.” While we were able to get it passed in the Senate, there has been continued resistance in the Senate. However, Gabe Stultz, Associate Legislative Director, has worked closely with Senator Jerry Moran’s (R-KS) office and they are prepared to move an amended version of H.R. 3471 that will satisfy all interested parties when Congress returns after the election.

Finally, the Senate has been unable to advance S. 2921, the “Veterans First Act.” Of highest importance to PVA in that legislation is provisions that will expand access to the Comprehensive Family Caregiver program to veterans of all eras, not just those injured after September 11, 2001. Unfortunately, cost remains a hurdle to advancing that effort. Additionally, provisions that are generally perceived to water down accountability, per the request of the government unions, have led a stalemate over the bill.

We anticipate a lot of focus on appeals reform and accountability when Congress returns for a lame duck session after the election in November.

DOT ACCESS Committee Completes Work

The U.S. Department of Transportation’s Advisory Committee on Accessible Air Transportation (ACCESS Committee) completed its business on Friday, October 14, 2016. The 25 member Committee was charged with negotiating in good faith to reach consensus on a proposed rule addressing inflight entertainment, service animals, and accessible lavatories on single aisle aircraft. The department intends to use the consensus agreement from the ACCESS Committee as the basis for a proposed rule. After six months’ worth of work, there were varying degrees of success. The Committee focused on three key areas—lavatories, service animals, and inflight entertainment. The following is a review of that work.

Lavatories

The Committee reached consensus that all new aircraft of a certain size shall have accessible lavatories by a certain date. Recognizing that a prior committee failed in this process in 1993 and that there is expense to the industry in complying, the Committee adopted a two tiered approach in providing accessible lavatories on new single aisle aircraft.

The first tier includes all new aircraft delivered three years after the effective date of the final rule. The second tier includes aircraft that are ordered 18 years and delivered 20 or more years after the effective date of the final rule; or are a new type design for which application is filed with the FAA or a foreign carrier civil aviation authority more than 1 year after the effective date of the final rule. Both tiers have multiple levels of access for passengers with disabilities. Access that begins in the first tier carries over into the second tier of accessibility.

Specifically, the first tier applies to all carriers operating aircraft that have FAA-certified maximum passenger capacity of 60 or more seats. This will include flight attendant training on an annual basis to proficiency in use of the new DOT onboard wheelchair and assembly or modifications to the accessible features of the lavatory. Carriers must also provide information upon request to passengers with disability concerning the accessible features of the lavatory including controls and dispensers and the information must be on the carrier’s website, in electronic or printed forms with picture diagrams, on the aircraft. Carrier will also remove the international symbol of accessibility (ISA) from all lavatories new and in service that cannot facilitate an independent seated transfer.

All first and second tier aircraft with FAA-certified maximum passenger capacity of 125 or more seats will have at least one lavatory that meets the following specifications. The aircraft shall have a standard toilet seat height ranging from 17-19 inches high, assist handles that support 250 pounds and an array of controls and dispensers that are tactilely accessible and measured for a performance specification that meets the definition of a person with a disability in a seated position. These interior lavatory components include: attendant call buttons, door lock, flush control, faucet controls, paper towel and soap dispensers, and trash and bio waste units. All components where reasonably available in supplier catalogs shall be operable with one hand and shall not require tight grasping, pinching, or twisting of the wrist.

Other features that will apply to a first tier aircraft include a visual barrier that shall be available upon request. It will provide passengers with disabilities using the lavatory (with the door possibly open) a level of privacy substantially equivalent to that provided to ambulatory users. Most importantly is a door sill or threshold that provides minimum obstruction to the passage of the on board wheelchair across the sill while preventing leakage of fluid or causing a tripping hazard during evacuation. The door sill threshold applies to both tiers of access.

New covered single aisle aircraft with FAA-certified maximum passenger capacity of 125 or more seats entering service three years after the effective date of the final rule must have onboard wheelchairs that meet new standards to be developed by DOT. DOT will consult with advocates, airlines, wheelchair manufacturers, flight attendants and other stake holders in developing these standards. The purpose of the onboard wheelchair standards is to improve the safety of traditional models of onboard wheelchairs and develop, if feasible, specifications for an over-the-toilet onboard wheelchair design. The target date to complete the onboard wheelchair standards is February 2017.
Second tier aircraft with FAA-certified maximum passenger capacity of 125 or more seats in which lavatories are provided will be required to have one lavatory of sufficient size / design to permit a passenger with a disability to perform a seated independent and dependent transfer from the onboard wheelchair to and from the toilet within a closed space that affords to persons using the onboard wheelchair privacy equal to that afforded by ambulatory passengers. To ensure these new lavatories meet the performance specifications they will be designed/modeled with the 95 percent male (6’2, 246lbs) and 5 percent female (4’11,125lbs) range to meet the required transfers, including the use of a 95 percent male to assist a dependent 95 percent male with a transfer from the onboard wheelchair to and from to toilet within the closed lavatory space.

The committee reached a consensus vote of 17 for the agreement, 1 no vote and 3 abstentions. PVA supported this agreement as first tier accessibility will provide increased access to lavatories in the short-term and ensure full-access at a time-certain in the future.

Service Animals

Despite good faith negotiations, the ACCESS Committee reached an impasse in its efforts to come to a consensus on revising the definition of a service animal and the requirements for access for those animals under the ACAA.

The impasse resulted due to an inability to find a suitable alternative to current regulations which allow airlines to request as a condition of access that users of psychiatric and emotional support animals provide current documentation from a mental health professional stating that they have a mental or emotional disability for which they need the animal. Airlines and advocates considered imposition of a requirement for all service animal and emotional support animal users to complete an attestation confirming that they were a person with a disability and that the animal was needed either in flight or at the destination due to the disability. The proposed attestation would also have alerted the individual to the possibility that attempting to pass a pet as a service animal or emotional support animal could result in penalties. Ultimately, we were unable to find a solution that would free psychiatric and emotional support animal users from the burdens of medical documentation without imposing new, unacceptable burdens on all service animal users.

Another issue that remains unresolved is the types of species of service animals that should be allowed under the ACAA. Currently, domestic carriers are never required to permit access for unusual service animals such as snakes, rodents, and spiders, but must otherwise permit access for service animals unless the carrier determines that there are factors that preclude the animal from traveling in the cabin. Foreign carriers do not have to provide access to service animal species other than dogs. Stakeholders generally agreed that dogs, miniature horses, and capuchin monkeys should be classified as service animals. An unresolved question remained whether cats should also be included.
In addition, stakeholders were unable to resolve whether emotional support animals should continue to have access. Under the ACAA, the definition of service animal includes emotional supports animals. Stakeholders considered removing emotional support animals from the definition and reclassifying those and other similar animals as “support animals.” Species considered for support animals included dogs, cats, and rabbits. Those animals would have had more limited access than service animals as in many cases they would have been required to travel in a pet-carrier but still able to perform disability mitigation, if needed.

In light of the failure of these negotiations to reach consensus, DOT will now be charged with developing a proposed rule on this issue. The efforts of disability advocates, including PVA, have provided DOT with significant insight. We look forward to weighing in with DOT to ensure that any proposed rule preserves the access rights of all service animal users.

Inflight Entertainment

The ACCESS Committee still has work to do in trying to reach consensus on the issue of accessible inflight entertainment and communication. Currently, airlines are not providing captioning for the deaf or audio description for the blind on movies or television shows packaged by the airlines for inflight entertainment. The problem revolves around technical hardware and software mechanical issues of the seatback display systems that in service airplanes use. The work group on inflight entertainment and communication will meet November 2, 2016 to finish their negotiation in hopes of reaching a consensus.

The DOT Facilitators’ report is due in early December. The report will reflect the entire work of the ACCESS Committee in the three areas they were charged to reach agreement on and all public documents that were sent to the Committee in support of the issues. The DOT onboard wheelchair standards are due in February 2017 and the Department hopes to publish a Notice of Proposed Rulemaking in the Federal Register by the end of June 2017.

PVA Participates in Suicide Roundtable Discussion
On September 23, 2016, VA gathered a large group of veterans’ service organizations (VSOs) to discuss opportunities for collaboration and some of the salient issues with regard to confronting veteran suicide. The primary issues discussed related to both identifying at risk veterans and getting those veterans to engage in VA-provided services. An additional challenge is that even if veterans are identified, not all are eligible for care.

VA discussed briefly the mental health summits that it is holding throughout all VAMCs. The American Legion mentioned that many of their NSOs were not made aware of these summits, and the opportunity for VSOs to reach out to their local members was lost. VA will reevaluate its communications with VSOs for the summits, and they provided the upcoming schedule of all summits so that VSOs can alert their field offices.

VA also explained briefly some of their efforts to assist families of veterans who are contemplating suicide and community providers handling veteran patients contemplating suicide.

Ultimately, the forum was a chance for VA to ask PVA and our fellow VSOs as individual organizations to decide how we can partner with VA to reach veterans who are struggling. Suicide prevention materials being shared publicly by the VA can be viewed at the video links below:

• Newest Suicide Prevention PSA “Be There: Help Save a Life”: https://youtube/MCSZ7FjTq5I
• Suicide Prevention PSA “I’m good. But are you ready to listen?”: https://youtu.be/YPFo9EvUUvA
• Suicide Prevention PSA “The Power of 1”: https://youtu.be/WSx11Kmnmrg
• Veterans Crisis Line – After the Call: https://youtu.be/l8cQHTzZTIs

Deadline for Claims in Department of Justice’s Historic Settlement with Greyhound for ADA Violations Approaching

On February 8, 2016, the Department of Justice announced a consent decree resolving a complaint against Greyhound for alleged violations under the Americans with Disabilities (ADA). Allegations against Greyhound included failing to maintain accessibility features on buses, failing to provide assistance to passengers with disabilities, and failing to allow passengers using wheelchairs to complete reservations online. As a result of the consent decree, Greyhound will be required to compensate travelers with disabilities who experienced disability discrimination while traveling or attempting to travel on Greyhound.

The deadline for passengers with disabilities who encountered disability-related discrimination on Greyhound to submit a claim for compensation is November 10, 2016.
To be eligible for compensation, an individual must have a disability; have traveled or attempted to travel on Greyhound between February 8, 2013, and February 8, 2016; and have experienced a disability-related incident during travel or while attempting to travel. Examples of incidents include lack of accessible transportation and failure to make disability-related accommodations.

Individuals who believe they meet these requirements must submit a claim online, by email, or mail to Greyhound’s appointed claims administrator by November 10, 2016. Instructions regarding the claims process are available at: http://www.dojvgreyhoundsettlement.com. To contact the Claims Administrator, please call 1-844-502-5953 or by email at GRYsettlement@classactionadmin.com.

ADA Notification Act Legislation Introduced in the Senate

On September 28, 2016, Sen. Jeff Flake (R-AZ) introduced S. 3446, the “ADA Education and Reform Act of 2016.” This legislation would require a person with a disability to give notice to a public accommodation of an architectural barrier under the Americans with Disabilities Act (ADA) prior to filing a lawsuit. Sen. Flake’s legislation is a companion bill to H.R. 3765, which was introduced by Rep. Ted Poe (R-TX) and passed by the House Judiciary Committee in July. Despite concerns that H.R. 3765 might be brought to the House floor for a vote in September, no further action on this legislation has occurred.
PVA strongly opposes proposed ADA notification requirements. Notification laws put the onus on the person with a disability to find ADA violations and notify a public accommodation of those violations. No other civil rights group is forced to shoulder the burden of triggering compliance with the law and, once they have done so, to wait to enforce their civil rights. Accessibility standards, such as those the ADA includes, are extremely important. Covered entities should continuously evaluate their businesses for appropriate access under the ADA and not wait to receive a notification before acting to make them fully accessible.

OFCCP Hosts Business Roundtable for National Disability Employment Awareness Month

On October 6, 2016, the Office of Federal Contract Compliance Programs (OFCCP) hosted a forum highlighting successful business strategies for outreach to and recruitment of people with disabilities into the nation’s workforce. OFCCP is the agency within the Department of Labor (DOL) responsible for enforcing government contractors’ compliance with Section 503 and VEVRAA. Those regulations require federal contractors to take affirmative steps to recruit and hire people with disabilities and certain targeted veterans, including those with disabilities. The roundtable was part of OFCCP’s observance of National Disability Employment Awareness Month and brought together representatives of companies that have excelled in making disability inclusion a vital part of their workforce diversity efforts.

In a keynote address, Robert J. O’Hara, Vice President with United Technologies Corp., expressed support for the regulations that require companies to document their progress in bringing more people with disabilities into their operations. He also described challenges they encountered in broadening their disability outreach including appropriate ways to encourage people to identify as someone with a disability and connecting with talent pipelines to find qualified applicants. Among the strategies that worked for UT and for others at the forum were participation in networking conferences sponsored by organizations such as U.S. Business Leadership Network and National Organization on Disability, creating partnerships with universities to reach students with disabilities, and involvement of top corporate leadership in disability inclusion efforts.

For more information about DOL initiatives undertaken for National Disability Employment Awareness Month go to https://www.dol.g