July Washington Update

July 18,2018      Volume24,  Number 7

Senate Veterans’ Affairs Committee Holds Nomination Hearing for Robert Wilkie

On June 27th, Robert Wilkie, President Trump’s nominee to serve as head of the Department of Veterans Affairs (VA), testified at his nomination hearing before the Senate Veterans’ Affairs Committee. Mr. Wilkie was nominated to the position following a recent stint serving as Acting VA Secretary in the wake of the departure of Dr. David Shulkin.

During the hearing, Democratic Senators pressed Mr. Wilkie on his views concerning privatization of VA health care. Mr. Wilkie consistently stated his opposition to any privatization efforts. He also asserted his intent to be transparent and, if needed, to stand with veterans over the views of the President. Importantly, he also highlighted VA’s SCI care on two occasions, noting the importance of VA continuing to provide such specialty care.

The Senate Veterans’ Affairs Committee voted on July 10th to send his nomination to the full Senate. Based on support expressed by the committee, it appears that Mr. Wilkie is headed for confirmation. With congressional leaders anxious to have permanent leadership in place at VA as implementation of the VA MISSION Act begins it is likely that a floor vote will take place soon.

House VA Subcommittee on Health Advances Legislation

On June 27th, the House Veterans’ Affairs Health Subcommittee held a markup and advanced seven bills by voice vote to the full committee. These provisions were considered in a subcommittee hearing in early June where PVA offered a statement for the record. Committee members modified the bills based on that feedback. Of particular interest to PVA, was H.R. 5693, the Long-Term Care Veterans Choice Act. This bill would allow VA to contract with non-VA adult foster homes for certain veterans who would otherwise require institutional care. Sponsored by Congressman Clay Higgins (R-LA) and co-sponsored by Congresswoman Julia Brownley (D-CA) the bill received praise and swift support.

Another bill of note was H.R. 5974, the Department of Veterans Affairs Creation of On-Site Treatment Systems Affording Veterans Improvements and Numerous General Safety (VA COST SAVINGS) Enhancements Act. This legislation would require VA to use on-site regulated medical waste treatment systems at VA facilities. Currently, most VA facilities dispose of hazardous waste by contracting for removal by truck. This is both costly and potentially dangerous. On-site systems would mitigate such factors.

Subsequent to the subcommittee’s action, on July 12th, the full committee approved and sent to the House floor several bills for further action, including H.R. 5693 and H.R. 5974. Other bills from the June 27th markup that were approved by the full committee include H.R. 2787, the Veterans-Specific Education for Tomorrow’s Medical Doctors (VET MD Act); H.R. 5938, the Veterans Serving Veterans Act of 2018; H.R. 6066, to improve the productivity of the management of Department of Veterans Affairs health care; and H.R. 5864, the VA Hospitals Establishing Leadership Performance (VA HELP) Act.

Hiring and Retaining Veterans for the Modern Day Workforce

The House Veterans’ Affairs Economic Opportunity Subcommittee held a hearing on June 26th titled, “Hiring and Retaining Veterans for the Modern Day Workforce.” There was a single panel that included representatives from Hiring Our Heroes, U.S. Chamber of Commerce Foundation; Walmart; Starbucks; Prudential Financial; and Dell EMC. All panelists agreed that veterans bring a work ethic and leadership skills that are valued by employers. They also agreed that gaps between discharge and the time a service member becomes employed must be identified.

At the hearing, Mr. Matt Kress, Manager, Veterans and Military Affairs, Starbucks, stated that his company has committed to hiring 25,000 veterans and spouses by 2025. Mr. Robert Douthit, Senior Director, Dell EMC, emphasized that his company has a long history of identifying with and working with the military and will continue to do so by focusing on employing veterans and their spouses. It was also noted by panelists that some corporations actually have a difficult time finding qualified veterans for specific leadership positions.

Chairman Jodey Arrington (R-TX) requested that panelists review H.R. 5649 and provide the committee with feedback on how to improve its provisions. This legislation would make improvements to facilitate separating service members’ transition. PVA submitted a statement in May in support of the legislation.

H.R. 299 Update

On June 25th, the House suspended the rules and passed the Blue Water Navy Vietnam Veterans Act, as amended, 382-0. Once referred to the Senate, the Senate Veterans Affairs’ Committee decided not to send the bill to the floor, but to instead hold a hearing. The committee has since announced that it will review the measure during a hearing scheduled for August 1st.

PVA Advocacy Staff Go to Pittsburgh for ADA Training

During the week of June 18th, PVA national advocacy staff attended the annual Americans with Disabilities Act (ADA) National Symposium in Pittsburgh, PA. The Symposium was sponsored by the ADA National Network and hosted by the Great Plains ADA center. The event included three days of educational breakout sessions providing updates on the many facets of the ADA. Breakout sessions were presented on topics such as service animals, mapping and way finding, and the most recent ADA court decisions. Representatives from the Department of Justice also gave an update on Project Civic Access and how city and county administrators can comply with Title II public services requirements.

Another major area of focus was access to health care under the ADA. Sessions included: medical diagnostic equipment in health care, accessible personal health care records, enhancing patient experience in health care, and effective communication in the health care setting. All sessions at the Symposium are eligible for elective credit towards the ADA Coordinator Training Certificate Program (ACTCP), a professional certificate of expertise in ADA compliance.

The 2019 Symposium will be held in Dallas-Grapevine, Texas. For more information about the Symposium go to www.adasymposium.org.

PVA Advocates for the “Complete the MISSION” Amendment to the

MilCon-VA Appropriations Bill

On June 19th, PVA joined with more than 30 other veterans and military service organizations in support of the “Complete the MISSION” funding amendment. The amendment, which was spearheaded by Senate Appropriations Chairman Richard Shelby (R-AL) and Vice-Chairman Patrick Leahy (D-VT), would allow Congress to provide VA with sufficient resources to implement the provisions of the recently passed VA MISSION Act without triggering sequestration or requiring cuts to other programs. Shelby and Leahy sought to include the amendment on a “minibus” of appropriations bills, which included the MilCon-VA bill that the Senate passed the last week of June.

The need for the amendment is based on concerns about budgetary pressure resulting from provisions in the VA MISSION Act that would effectively move funding responsibility for care currently provided through the Veterans Choice Program from mandatory appropriations to a new discretionary program. The current domestic budgetary cap for FY 2019, and the anticipated caps for FY 2020 and FY 2021, did not contemplate the new and increased costs associated with the VA MISSION Act. The amendment would allow Congress to appropriate additional discretionary funding to meet the new requirements of the act: $1.6 billion for FY 2018, $8.67 billion for FY 2019 and $9.5 billion for FY 2020.

Despite bi-partisan support for the amendment, concerns about pitting the need for overall fiscal restraint against support for veterans resulted in a decision not to force a vote on the Senate floor. Now that the minibus has passed both the House and Senate, a conference committee is attempting to work out a compromise between the bills. According to the amendment’s supporters it is still in play and could still be included in a final bill.

PVA Participates in Canadian Forum on Wheelchair Damage in Air Travel

Heather Ansley, Acting Associate Executive Director of Government Relations, and Lee Page, Senior Associate Advocacy Director, participated in the Mobility Devices and Air Travel Forum sponsored by the Canadian Transportation Agency in Toronto, June 12th -13th. The forum served as a kick-off meeting for efforts by the Canadian government to address damage to large powered mobility devices in air travel. The effort is led by Oregon State University engineering professor Dr. Katharine Hunter-Zaworski, who has decades of experience in accessible travel.

The forum brought together a broad range of stakeholders, including Canadian and U.S. disability advocacy groups, Canadian and U.S. airlines, U.S. and Canadian government officials, aircraft and wheelchair manufacturers, airline trade associations, and international air travel policymakers. PVA, the only U.S. disability advocacy group, was invited to give a presentation during the forum regarding our many years of air travel advocacy and our current efforts working with the RESNA Standards Committee on Air Travel. The efforts by the Canadian government are more focused than those of the RESNA committee, which should produce important synergy between these initiatives.

Changes to Access for Service Animals and Emotional Support Animals

in Air Travel

PVA along with other members of our Air Carrier Access Act Working Group, submitted comments on July 9th, in response to an advance notice of proposed rulemaking (ANPRM) published by the U.S. Department of Transportation regarding access for service animals and emotional support animals in air travel. The Department requested public comment on 10 areas, including documentation for psychiatric service animals, conditions of access for emotional support animals, species limitations, and training requirements. The ANPRM is the Department’s first effort to revise its regulations since the failed attempt of the Department’s Accessible Air Transportation (ACCESS) Advisory Committee in 2016. PVA served as a member of that committee and led the disability community in the negotiation efforts.

In the intervening years, airlines have continued to push for revision of the rules based on concerns primarily about fraud and poorly trained animals that cause safety issues. Earlier this year, these concerns resulted in some airlines moving forward with their own restrictions on emotional support animals and psychiatric service animals. PVA provided comments to the Department in June asserting our belief that in many cases these restrictions go beyond those allowed under the Air Carrier Access Act and cause confusion for not only passengers but also airline personnel. On June 21st, Heather Ansley, Acting Associate Executive Director of Government Relations, also presented on this issue to disability protection and advocacy lawyers from around the country at a national conference in Baltimore.

The Department’s ANPRM will likely be followed by a notice of proposed rulemaking that will lay out a new rule for public comment. PVA has three main goals for a revised regulation: continued access for emotional support animals, equal treatment for psychiatric service animals, and improved training for airline personnel and their contractors. In addition, we will oppose any new restrictions on service animals that the Department might propose.

Some Veterans Can Now Claim Refund of Taxes Paid on

Disability Severance Payments

The Internal Revenue Service announced on July 9th, that certain veterans who received disability severance payments after January 17, 1991, and included that payment as income should file Form 1040X, Amended U.S. Individual Income Tax Return, to claim a credit or refund of the overpayment attributable to the disability severance payment. This is a result of the Combat-Injured Veterans Tax Fairness Act passed in 2016.

Most veterans who received a one-time lump-sum disability severance payment when they separated from their military service will receive a letter from the Department of Defense (DoD) with information explaining how to claim these tax refunds. The letters will include an explanation of a simplified method for making the claim. Veterans eligible for a refund who did not get a letter from DoD should visit the Defense Finance and Accounting Service (DFAS) and IRS websites for more information.

Statute of Limitations

The amount of time for claiming these tax refunds is limited. However, the law grants veterans an alternative timeframe – one year from the date of the letter from DoD. Veterans making these claims have the normal limitations period for claiming a refund or one year from the date of their letter from the DoD, whichever expires later. As taxpayers can usually only claim tax refunds within three years from the due date of the return, this alternative time frame is especially important since some of the claims may be for refunds of taxes paid as far back as 1991.

Amount to Claim

Veterans can submit a claim based on the actual amount of their disability severance payment by completing Form 1040X, carefully following the instructions. However, there is a simplified method. Veterans can choose instead to claim a standard refund amount based on the calendar year (an individual’s tax year) in which they received the severance payment. Write “Disability Severance Payment” on line 15 of Form 1040X and enter on lines 15 and 22 the standard refund amount listed below that applies:

  • $1,750 for tax years 1991 – 2005
  • $2,400 for tax years 2006 – 2010
  • $3,200 for tax years 2011 – 2016

Claiming the standard refund amount is the easiest way for veterans to claim a refund, because they do not need to access the original tax return from the year of their lump-sum disability severance payment.

Special Instructions

All veterans claiming refunds for overpayments attributable to their lump-sum disability severance payments should write either “Veteran Disability Severance” or “St. Clair Claim” across the top of the front page of the Form 1040X that they file. Because all amended returns are filed on paper, veterans should mail their completed Form 1040X, with a copy of the DoD letter, to:

Internal Revenue Service
333 W. Pershing Street, Stop 6503, P5
Kansas City, MO 64108

Veterans eligible for a refund who did not receive a letter from DoD may still file Form 1040X to claim a refund but must include both of the following to verify the disability severance payment:

  • A copy of documentation showing the exact amount of and reason for the disability severance payment, such as a letter from the DFAS explaining the severance payment at the time of the payment or a Form DD-214, and
  • A copy of either the VA determination letter confirming the veteran’s disability or a determination that the veteran’s injury or sickness was either incurred as a direct result of armed conflict, while in extra-hazardous service, or in simulated war exercises, or was caused by an instrumentality of war.

Veterans who did not receive the DoD letter and who do not have the required documentation showing the exact amount of and reason for their disability severance payment will need to obtain the necessary proof by contacting the DFAS.

ACAA Working Group Meets with American Airlines

PVA national advocacy staff and other disability groups that are part of our Air Carrier Access Act Working Group met with Suzanne Boda, Senior Vice President, American Airlines (AA), and two other AA representatives on July 12th, to discuss the airline’s “disability improvement project” and other pending issues. The disability improvement project is an improved accountability program ensuring that AA employees and contract services personnel are trained to proficient standard of knowledge in how to assist passengers with disabilities. Areas of training focus on passenger assistance, from curb to gate, in an airport wheelchair; boarding passengers with disabilities via an aisle chair; and stowage of assistive devices. Also, there is a focus on training of personnel that load and unload wheelchairs into the belly of the plane.

With this improvement project, AA hopes to increase its customer service to people with disabilities. This includes minimizing wait times and ensuring connections. It also includes protecting assistive devices that are stored in the cargo hold of the plane so that they will be returned undamaged to their users.

Ms. Boda also discussed emotional support animal policy changes implemented on July 1st. In addition to the 48 hour notice, passengers who use emotional support animals must attest that their animal has been trained to behave in a public setting. All front line employees, such as gate agents, ticket agents, and flight attendants have been trained on the requirements of the Air Carrier Access Act. AA has also implemented an accountability rating system under which employees will be rated on their performance through survey scorecard responses by passengers with disabilities.

CCD Veterans Task Force Receives Briefing on Employment Among Veterans with Service-Connected Disabilities

On July 12th, the Consortium for Citizens with Disabilities (CCD) Veterans Task Force, of which PVA is a member, hosted James Borbely with the Bureau of Labor Statistics (BLS) for a briefing on that agency’s collection of data concerning unemployment and labor force participation among veterans with service-connected disabilities. Approximately 60,000 households and 100,000 individuals aged 16 and older are interviewed each month under the Current Population Survey (CPS) conducted by BLS. Of those numbers, between 8,000 and 9,000 respondents are veterans aged 18 and over.

Each year, in August, additional information is collected by BLS about veterans with service-connected disabilities which is compiled into an annual supplement that is released in March of the following year.

According to the data collected in August 2017, 4.9 million veterans had a service-connected disability, with 28 percent reporting a disability rating of less than 30 percent and 41 percent reporting a rating of 60 percent or higher. Veterans with a rating less than 30 percent were more likely to be in the labor force than those with a rating of 60 percent or higher [53.5 percent and 37.7 percent respectively]. Among the most recent cohort of veterans, those of Gulf War II era, 75.8 percent were in the labor force. However, broken down by disability rating, the data reveals a similar pattern to the broader population of veterans. Those with a VA disability rating less than 30% had the highest workforce participation rate at 91.6 percent, while those with a rating of 60 percent and higher had the lowest workforce participation rate at 61.7 percent. Veterans with a service-connected disability were far more likely to work for the federal government (19%) than veterans without a service-connected disability (7%) or nonveterans (2%). Only 59% of veterans with a service-connected disability worked in the private sector compared to 73% of veterans with no service-connected disability and 80% of nonveterans.

The 2017 BLS report, the Employment Situation of Veterans, can be found at https://www.bls.gov/news.release/pdf/vet.pdf.

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May’s Washington Update

May 16, 2018​​​​​​​​ Volume 24, Number 5

Historic Caregiver Expansion Passed by

the House of Representatives

On May 16th, the House of Representatives passed the “VA MISSION Act of 2018” by a vote of 347-70. The legislation now heads to the Senate.

This historic, bipartisan legislation would reform the Department of Veterans Affairs (VA) community care programs by consolidating them into a single program with enough funding to get through May of 2019. Second, it would review and realign VA’s health care infrastructure and strengthen VA’s ability to hire and train medical personnel. And of highest importance to PVA, it would make caregiver services available to those veterans with service-connected injuries that were incurred before September 11, 2001. By ending this inequity, roughly 70,000 veterans would be able to receive care and remain in their homes. At the same time, their caregivers, having sacrificed their own health and employment opportunities, some for half a century, would finally have desperately needed supports, and be acknowledged for the decades of service given, and billions of taxpayer dollars saved.

On May 8th, the House Committee on Veterans’ Affairs acted to advance the bill with a vote of 20-2. Prior to the House Committee vote, PVA, alongside 37 other veteran and military service organizations signed a joint letter to Congress expressing our strong support of the bill and asking Congress make progress before Memorial Day, as the VA MISSION Act is an “historic opportunity to improve the lives of veterans, their families and caregivers.”

Since the access crisis, illustrated by wait times in Phoenix in 2014, Congress, VA, and VSOs have worked to create a system to ensure it never happens again. While the VA MISSION Act is not a perfect solution it is a monumental step forward to ensure veterans are never without options.

Also included in the markup hearing on May 8th were 15 other bills, which were favorably reported. These bills included H.R. 299, the Blue Water Navy Vietnam Veterans Act of 2017; H.R. 5520, the Veterans Affairs Medicinal Cannabis Research Act of 2018; H.R. 4245, the Veterans’ Electronic Health Record Modernization Oversight Act of 2017; and H.R. 4334, the Improving Oversight of Women Veterans’ Care Act of 2017.


If the VA MISSON Act is not signed into law by Memorial Day, the Choice Program is set to run out of funding on June 1st. This would result in private providers unable to provide care to veterans and increased wait times at VA.

Please call your Senators and tell them to vote “Yes” on the “VA MISSION Act.”

PVA Participates in Event Highlighting the Need for a

Fourth VA Administration

On May 15th, Heather Ansley, Acting Associate Executive Director of Government Relations, participated in an event sponsored by the American Enterprise Institute (AEI) titled, “Reforming the VA by Empowering Veterans: A Conversation with Rep. Brad Wenstrup (R-OH).” The purpose of the event was to highlight the need for the creation of a fourth administration at VA that would focus on VA’s economic opportunity and transition programs.

The event, which was moderated by Leo Shane, Deputy Editor of Military Times, featured Rep. Brad Wenstrup (R-OH). On April 26th, Rep. Wenstrup introduced the Veterans’ Education, Transition, and Opportunity Prioritization Plan (VET OPP) Act of 2018, H.R. 5644. This legislation would establish the Veterans Economic Opportunity and Transition Administration within VA to be overseen by an Under Secretary of Veterans Economic Opportunity and Transition. VA programs and benefits to be moved to this new administration include the vocational rehabilitation and employment (VR&E) program, educational assistance programs, and the veterans’ housing loan and related programs.

Ms. Ansley participated in a panel discussion at the event with representatives from Student Veterans of America, AEI, and the Rand Corporation. During the panel discussion, Ms. Ansley discussed the importance of VA’s economic opportunity programs to assist veterans who acquire disabilities as the result of their military service and the need for VA to place more emphasis on the administration of these programs. The full event is available for viewing here: http://www.aei.org/events/reshaping-the-veteran-narrative-with-the-department-of-veterans-affairs-a-conversation-with-rep-brad-wenstrup-r-oh/.

Rep. Wenstrup’s legislation will be the subject of a legislative hearing on May 23rd, before the House Veterans’ Affairs Committee, Subcommittee on Economic Opportunity. PVA strongly supports this legislation. We believe that the creation of a new administration within VA focused on veterans’ economic opportunity and transition would elevate programs like VR&E and Specially Adapted Housing and result in increased attention from VA leaders and stakeholders. Also, the removal of these programs from the Veterans Benefits Administration will allow the Under Secretary for Benefits to focus fully on disability compensation and pension.

New Under Secretary for Benefits Begins Work at VA

Paul R. Lawrence assumed the role as head of the Veterans Benefits Administration on May 15th. Under Secretary Lawrence arrives at VA following a career in the accounting industry, where he focused mainly on federal government practice. He has a Ph.D. in Economics from Virginia Tech and served as a captain in the United States Army.

Under Secretary Lawrence joins Acting VA Secretary Robert Wilkie and Under Secretary for Memorial Affairs Randy C. Reeves in leading VA. At this time, Dr. Carolyn Clancy is serving as the Executive in Charge for the Veterans Health Administration. A permanent Under Secretary for Health has not been nominated.

Rumors continue to swirl about possible nominees for a permanent VA Secretary. Potential nominees include Rep. Brian Mast (R-FL), a veteran who lost both legs due to an IED while deployed to Afghanistan, and former House Veterans’ Affairs Committee Chairman Jeff Miller. VSOs have been informed that a new nominee may not be immediately identified. In the meantime, PVA’s Executive Director Carl Blake recently met with Acting Secretary Wilkie and pledged our support to work with the Department during this time of transition.

Provisions to Improve the Air Travel Experience of People with Disabilities Included in the FAA Reauthorization

On April 27th, the House passed the FAA Reauthorization Act of 2018 (H.R. 4) overwhelmingly by a vote of 393-13. This legislation includes many amendments from the Air Carriers Access Amendment Act (H.R. 5004) as introduced by Congressman Jim Langevin (D-RI).

PVA supports the following provisions included H.R.4:

Development of an airline passengers with disabilities bill of rights.
Increased civil penalties for harm towards passengers with disabilities or their wheelchairs.
Establishment of a Select Subcommittee on Aviation Consumers with Disabilities to the Advisory Committee for Aviation Consumer Protection.
Evaluation of areas for improvement to increase airport accessibility and training of air carrier and contract personnel.
Requirements for the U.S. Access Board and the DOT to investigate the feasibility of in-cabin wheelchair restraint systems for people with disabilities.
Directions to DOT to revise its service animal regulation.
Requirements for passengers with disabilities to receive timely and effective assistance at the airport and on the aircraft, including personnel providing hands on assistance possibly beingrequired to receive hands on training to perform that assistance and on the use of any needed equipment.

The Senate’s FAA reauthorization legislation is still pending and will likely come to the floor in June. The Senate legislation, S.1405, passed out of Committee on June 29, 2017, and has many of the same provisions affecting passengers with disabilities as the House version (H.R. 4). Of note, the Senate bill does not include specific direction for DOT to revise policies regarding service animals.

Other parts of the ACAAA (H.R. 5004 / S. 1318) that could possibly be added as amendments when the Senate bill goes to the floor are a private right of action, the referral to the Department of Justice (DOJ)
of alleged violations, and a requirement for airlines to use aircraft that meet accessibility standards as defined by the ACCESS Board and the DOT.

After the Senate passes its version of FAA Reauthorization, the two measures will be conferenced to work out the differences with the goal of having legislation for the President’s signature before the current FAA authorization expires at the end of September.

Important Disability Disaster Recovery Provisions Were

Added to the FAA Reauthorization

Included in H.R. 4, the House FAA reauthorization measure, were a number of disaster recovery related measures concerning temporary housing assistance, data reporting, duplication of benefits, and transparency in contracting. Of particular interest to people with disabilities are provisions of the bill that would increase funding for disaster mitigation and raise the ceiling on certain costs that can be excluded from maximum financial assistance that can be provided to survivors. Because funding for pre-disaster planning and development as well as post-disaster recovery is considered federal financial assistance, any construction undertaken for these purposes must comply with Section 504 accessibility guidelines. Thus, the monies in the House bill offer the potential for enhancing accessibility in post-disaster rebuilding efforts. In addition, the bill would exclude costs associated with repairing or replacing accessibility-related improvements or personal property from counting against a household’s maximum allowable disaster financial assistance. The Senate has not yet determined whether it will include these House disaster relief provisions in its version of the FAA bill but advocates remain cautiously optimistic that they will be included in any final agreement.

More Airlines Announce Changes to Their Service Animal Policies

American Airlines is the latest to announce that it will make changes to its service animal policy. Starting July 1, American will require travelers with emotional support animals to attest to their animal’s behavior via an airline provided form. The airline also announced additional changes including restrictions on types of animals and enforcement of the requirement to complete medical and the now animal behavior documentation 48 hours before takeoff.

On March 1, Delta Airlines and United Airlines made similar changes to their service animal policies. Alaska Airlines also made changes to its policy that went into effect on May 1. Additional airlines are considering revisions to their policies.

Prior to making its announcement, American met with members of the disability community to discuss our concerns. During our discussions, PVA made it clear that we do not believe that airlines have the authority to place additional requirements on passengers traveling with emotional support animals, beyond those listed in the Air Carrier Access Act (ACAA) regulations. One positive aspect of American’s policy change, that is a direct result of our conversations, is the implementation of additional training for American personnel and contractors regarding service animals and emotional support animals.

PVA and nine other disability organizations sent a letter to U.S. Department of Transportation (DOT) Secretary Elaine Chao on February 6th asking the Department to deem Delta and United’s policies to be in violation of the Air Carrier Access Act (ACAA). On May 16th, DOT issued an Interim Statement of Enforcement Priorities Regarding Service Animals. DOT also released an ANRRM to begin the process for revising the ACAA’s service animal regulations.

In the meantime, Senator Richard Burr (R-NC) introduced legislation in the Senate, S. 2738, which would eliminate access for emotional support animals under the ACAA. PVA does not support this legislation. We believe that DOT should continue to move forward with its regulations to allow all stakeholders to engage in the process of determining access for service animals and emotional support animals.

PVA Participating in “Dry Run” of Appeals Modernization

In response to the growing backlog at the Board of Veterans Appeals (BVA), the President signed into law the Veterans Appeals Improvement and Modernization Act, also known as the Appeals Modernization Act (AMA). Along with AMA, the Department of Veterans Affairs (VA) implemented the Rapid Appeals Modernization Program (RAMP), a program that provides veterans with more appeals options.

This law, which is expected to go into effect in February 2019, creates a new framework for veterans who are dissatisfied with decisions rendered on their claims. Progress has been made in implementing the law; however, many questions remain unanswered, including:

What choices will veterans make under the AMA framework, and what factors will influence those choices?
What resources and information will veterans and their representatives need to effectively navigate the available options?
How easy or difficult is it to understand and use AMA forms, and how can they help avoid errors and confusion?
Will VA have all processes in place to smoothly implement AMA in February 2019?

To answer these questions and assist with the implementation of the AMA at the Board of VeteransAppeals, VA has implemented the Board Early Applicability Appeals Modernization program (BEAAM). This program allows up to 50 veterans and their representatives to participate in a “dry run” of AMA, including all appeal options, culminating in decisions by December 2018.

VA partnered with PVA, CalVet and the National Organization of Veterans Advocates (NOVA) and veterans they are representing to take part in the BEAAM program.

BEAAM offers veterans three “lanes”, or choices; veterans may choose one of the following options:

Direct Review: Judges will review the appeal using the same evidence that was considered in the original decision. The record is closed, so there is no submission of additional evidence.

Evidence Submission: Veterans may submit additional evidence with their appeal, or within 90 days of filing their appeal.

Hearing: Veterans may request a hearing before a Veterans Law Judge (VLJ); additional evidence may be submitted at the hearing or 90 days thereafter.

Currently, PVA has chosen 20 veterans who will participate in the BEAAM program.

April Washington Update

 

ACTING HEAD OF VA INSTALLED FOLLOWING THE DISMISSAL OF SECRETARY SHULKIN
On March 28th, President Trump announced the removal of Dr. David Shulkin as Secretary of Veterans Affairs. In his place, the President stated his intent to nominate Rear Admiral Ronny L. Jackson, MD. In the interim, he appointed Robert Wilkie, Under Secretary of Defense for Personnel and Readiness, to serve as Acting Secretary.
Following the announcement, PVA Executive Director Carl Blake released the following statement:
“We look forward to understanding more about the qualifications of Admiral Ronny L. Jackson, MD to helm the VA during this critical time. The VA has a broad mission and the Secretary must be someone who is eminently qualified to lead the nation’s second largest cabinet agency. In particular, reforming VA’s health care system to better serve the needs of veterans and their families is of great importance. We encourage the Senate Committee on Veterans’ Affairs to take these concerns very seriously as it considers Admiral Jackson’s nomination.”
Much has been made of Dr. Shulkin’s departure from VA and in particular what it means for the future of the VA’s health care system. The struggle to define the role of community care in serving the health care needs of veterans has torn open the debate on what some see as efforts by the Administration to privatize the provision of VA health care. Thus, we were pleased to see that Acting Secretary Wilkie has given his support to an existing bi-partisan, bi-cameral proposal with broad VSO support pending in Congress that would reform community care, expand eligibility for the program of comprehensive caregiver benefits, and launch a review of VA’s assets and infrastructure.
Rear Admiral Jackson’s confirmation hearing is currently scheduled for April 25th. In the meantime, PVA is anxious to learn more about him and hear his views on the issues that impact the services and benefits that PVA’s members depend on. During this time of change, VA needs a strong, capable leader who will focus on the needs of veterans in receiving the care they have earned.

OMNIBUS NEGOTIATIONS BREAKDOWN

In November 2017, the Senate VA Committee passed, 14-1, S. 2193, a bill that would reform the current VA Choice Program and all care in the community programs by consolidating them into one program. It also included the full expansion of the caregiver program to veterans injured in service in any era.

 

Amidst budget hearings in March 2018, there was speculation parts of S. 2193 would be included in the omnibus spending deal. Within a week, House and Senate committee leadership had crafted a deal, supported by the VSOs that included care in the community reform, asset review, and full expansion of the caregiver program.

Ultimately, these provisions were removed last minute in a round of political tradeoffs between House and Senate leadership. While a disappointing loss, we are pleased that members of Congress who were once opposed to expansion are now supportive. In the months to come, we hope to see such momentum push forward on behalf of caregivers.

FORTY-TWO SENATORS JOIN WITH SENATOR DUCKWORTH IN OPPOSITION TO THE ADA EDUCATION AND REFORM ACT
On March 29th, Senator Tammy Duckworth (D-IL) and 42 of her colleagues sent a letter to Majority Leader Mitch McConnell (R-KY) expressing opposition to the ADA Education and Reform Act (H.R. 620). Signatories to the letter include Minority Leader Chuck Schumer (D-NY) and Senate Judiciary Ranking Member Diane Feinstein (D-CA). In the letter, the Senators noted their strong opposition to not only H.R. 620, but also to “any legislation that would repeal or weaken rights under title III of the Americans with Disabilities Act.” The letter further requests that Leader McConnell join with them in ensuring that either H.R. 620 or any notification legislation “will never receive a vote in the United States Senate during the 115th Congress.”
PVA and other disability and civil rights organizations joined with Senator Duckworth to encourage Senators to sign on to the letter. In releasing the letter, Senator Duckworth specifically noted the opposition of PVA to H.R. 620. PVA Executive Director Carl Blake stated in a March 2nd letter to Senator Duckworth that, “Passing H.R. 620 would be devastating to the promise of the ADA to increase opportunities for people with disabilities.”
The formal opposition of 43 Senators means that any efforts to move ADA legislation that includes a notification requirement and cure period in the Senate would be up against very difficult odds. Nonetheless, to guard against the possibility of this or similar legislation moving this year, PVA staff recently participated in a briefing for Senate staff to educate them about the dangers of limiting the opportunity for people with disabilities to enforce their rights under the ADA. Moving forward, PVA will continue to strongly oppose the ADA Education and Reform Act, or any other legislation that rolls back the obligations of businesses under the ADA to accommodate people with disabilities.
For more information about Senator Duckworth’s efforts to stop ADA notification, please visit: https://www.duckworth.senate.gov/news/press-releases/duckworth-and-senate-democrats-vow-to-defeat-house-gop-led-effort-to-curtail-civil-rights-of-americans-with-disabilities.

FAA REAUTHORIZATION HAS TO MOVE
The Federal Aviation Administration Re-Authorization Act of 2017–S.1405, introduced by John Thune (R-SD) Chairman of the Senate Commerce, Science, and Transportation Committee and Ranking Member Bill Nelson (D-FL) along with Aviation Subcommittee Chair Roy Blunt (R-MO) and Ranking Member Maria Cantwell (D-WA) is must pass legislation in order to keep airports and general / commercial aviation in operation. The Senate is expected to take up debate in June after the House of Representatives finishes its business on H.R. 4–The FAA Reauthorization Act of 2018.
The House version is scheduled for debate at the end of April. Both versions of the legislation have amendments affecting passengers with disabilities as originally drafted in the Air Carrier Access Amendments Act (S.1318/H.R. 5004). Committee staff report that they would like to be through a conference committee by the end of July and have the legislation ready to go to the President, prior to September’s expiration of the current FAA authorization.

HOUSE ADDS COSPONSORS TO THE ACAAA
Representative Jim Langevin (D-RI-2) introduced the Air Carrier Access Amendments Act (H.R. 5004) in the House on February 13th. This is the companion piece to S.1318 introduced by Senator Tammy Baldwin (D-WI) last year. H.R. 5004 has been referred to the House Subcommittee on Aviation for further action. To date, the bill has added four cosponsors: Robert Brady (D-PA-1), Richard Neal (D-MA-1), Gwen Moore (D-WI-4), and David Young (R-IA-3), making the legislation bipartisan. This legislation would provide many improvements affecting passengers with disabilities including:
• Strengthening ACAA enforcement through referral of certain complaints to the U.S. Attorney General, increased civil penalties for damaged wheelchairs, and a private right of action.
• Ensuring airlines acquire airplanes that meet broad accessibility standards. Improved structural access includes safe and effective boarding and deplaning processes, procedures, and equipment along with better stowage options for assistive devices.
• Improving training for air carrier personnel and their contractors, including requiring heightened training for personnel who assist with the boarding and deplaning process.
• Requiring the Secretary of Transportation to work with stakeholders to develop an Airline Passengers with Disabilities Bill of Rights.
• Creating a U.S. Department of Transportation Advisory Committee on the Air Travel Needs of Passengers with Disabilities.

DOL VETS VSO MEETING
Advocacy staff attended the Department of Labor Veterans’ Employment and Training Service (DOL VETS) monthly briefing with veterans service organizations (VSOs) on March 30th. Senior Advisor for DOL, Matt Miller, gave an update on the omnibus appropriation that had just been enacted, noting the increases that were included for VETS.
The Jobs for Veterans State Grants program received an additional $5 million, as did the Transition Assistance Program (TAP) program and the Homeless Veterans Reintegration Program (HVRP).
HVRP is now funded at its authorized level. Miller also reported that 230 companies have signed up for the pilot run of the HIRE Vets Medallion program that seeks to recognize businesses that undertake special efforts to recruit and hire veterans.
The main focus of the meeting was a presentation by James Borbely with the Bureau of Labor Statistics (BLS) on the release of that agency’s annual report on the employment situation of veterans. The jobless rate for all veterans declined from 4.3 percent in 2016 to 3.7 percent in 2017. Veterans with a service-connected disability had an unemployment rate of 4.3 percent in 2017, which was little different from the rate for veterans with no disability. The unemployment rate measures those persons that are out of work but actively seeking employment.

 

Labor force participation rates are another measure and tell a somewhat different story when looking at the most recent cohort of veterans and their employment experiences.

The labor force participation rate of Gulf War-era II veterans with no service-connected disability is 85.5 percent. Among veterans with a service-connected disability, 75.8 percent are in the labor force. However, among veterans rated 60% or higher, only 61.7 percent are working. Detailed information from BLS on veteran employment can be found at: https://www.bls.gov/news.release/vet.toc.htm.

NEXT GENERATION AMTRAK CARS TO REPLACE ACELA

On April 3rd, Senior Associate Advocacy Director, Lee Page went to Wilmington, DE to view a “mockup” of the next generation high speed trainset business car. The new design by Alstom, a French manufacturer, has an extendable bridge plate that deploys from the train car to accommodate the gap. Upon entering the train car you will notice a wide open vestibule with a wider turning radius connecting two cars (business and café) with an accessible path to go between the cars. Immediately entering the business car, you will see the accessible restroom with a circular door operated by electronic push button. The restroom is large enough to accommodate a person in a power chair or 3 wheeled scooter. After the restroom, you pass through an automatic glass partition into the seating area where on your left is a cut out for wheelchair space adjacent to a table that is accessible for the passenger to use for work or eating. Across from the wheelchair cut out space is an accessible passenger seat that a passenger could transfer into and his wheelchair would be placed behind his seat in a designated space for wheelchair stowage on the car.

The train ordered by Amtrak is Avelia Liberty, the latest development of Alstom’s high-speed train range Avelia. The new trainset will be able to carry up to 33% more passengers than the current Acela trains. The trainset configuration includes an innovative compact power car and nine passenger cars, with the possibility of three more being added if demand grows. The train is capable of travelling at speeds up to 186 mph, but will initially operate at a maximum speed of 160 mph based on Northeast Corridor (NEC) track speed limits.
Alstom is contracted to design and build 28 new high-speed trains, which will run on the NEC between Boston and Washington D.C. eventually replacing the Acela.
Amtrak and Alstom also signed a long-term contract under which Alstom will provide Amtrak with long-term technical support and supply spare components and parts for the maintenance of the new trainsets. Together, these contracts are worth $2 billion.
LIMITED CAREGIVER EXPANSION DISCUSSED
On April 5th the Republican staff of the House Veterans’ Affairs Committee held a roundtable to further discuss their proposed legislation to both expand and limit the caregiver program to veterans of any era who require assistance with three Activities of Daily Living (ADLs). At the same time, this draft is being considered, PVA, along with other VSOs, are working to advance a deal negotiated last month that would expand the caregiver program to all eras with the current eligibility criteria of one ADL. As this approach is most ideal, and would serve most of PVA’s members, we continue to advocate the Congress pursue it without hesitation. We hope to see a vote before Memorial Day recess.

If the effort of full expansion does not succeed, PVA will continue to support any legislative measure that opens any access to the caregiver program.
PVA has been clear, incremental expansion is not success, only a first step. Our priority remains equal access to the caregiver program for all veterans regardless of era served.

MILITARY TO CIVILIAN TRANSITION SUMMIT

On April 10th, Associate Legislative Director Steven Henry attended the Military to Civilian transition summit that convened leaders from public and private sector organizations who are committed to the seamless transition of military service members, veterans, families, and caregivers.
During the summit, multiple presentations were conducted regarding transition of service members and personal stories were provided by the families of veterans who had committed suicide. During breakout sessions, it was determined that the greatest barriers to a seamless transition are: gender; lack of a support network, to include family support; financial difficulties; and a lack of job prospects. Everyone in attendance agreed that for a seamless transition, all of these factors must be addressed.

HOUSE AND SENATE VETERANS’ AFFAIRS COMMITTEE UPDATES

On April 11th, a markup of pending legislation was scheduled with the House Disability Assistance and Memorial Affairs subcommittee; however, that markup was cancelled.
That same day, the House Economic Opportunity subcommittee marked up the following bills that PVA currently supports:
• H.R. 1206, Reducing Barriers for Veterans Education Act of 2017: This bill makes an individual who is eligible for educational assistance under the Post 9/11 Educational Assistance program eligible for assistance with the fees for applying to Institutions of Higher Education (IHEs)

• H.R. 3023, To Amend Title 38, United States Code, to eliminate the Authority of the Secretary of Veterans Affairs to pay reporting fees to educational institutions: This bill eliminates the authority of the Department of Veterans Affairs to pay reporting fees to educational institutions.

• H.R. 3940, Veterans Education Disaster Assistance Act: This bill provides housing stipends and supply fee payments under the Post-9/11 Educational Assistance Program for individuals affected by extended school closures due to natural disasters.

• H.R. 4451, Homeless Veterans’ Reintegration Programs Reauthorization Act of 2017: This bill reauthorizes Department of Veterans Affairs (VA) homeless veterans’ reintegration programs through FY2022. The bill includes among those for whom job training, counseling, and placement services are to be provided to expedite their reintegration into the labor force:

(1) veterans participating in the VA supported housing program for which rental assistance is provided under the United States Housing Act of 1937, (2) Indians who are veterans receiving assistance under the Native American Housing Assistance and Self Determination Act of 1996, (3) veterans who are transitioning from being incarcerated, and (4) veterans participating in the VA’s rapid re-housing and homelessness prevention program.

 

• H.R. 4830, SIT-REP Act: This bill provides for the disapproval of any course of education for purposes of the educational assistance programs of the Department of Veterans Affairs unless the educational institution providing the course permits individuals to attend or participate in courses pending payment by Department, and for other purposes.

• H.R. 4835, Job TOOLS for Veterans Act: This bill extends the pilot program on off-base transition training for veterans and spouses.

• H.R. 5044, Service-Disabled Veterans Small Business Continuation Act: This bill clarifies the treatment of certain surviving spouses under the contracting goals and preferences of the Department of Veterans Affairs.

Additionally on April 11th, the Senate Veterans’ Affairs Committee held a hearing on the nominations of Paul R. Lawrence to be VA Undersecretary for Benefits; and Joseph L. Falvey Jr., to be a judge for the U.S. Court of Appeals for Veterans Claims (CAVC).
During the hearing, both gentleman were allowed five minutes to provide opening remarks where each gave a brief description of his background, experience, and veteran status.
Mr. Lawrence, a graduate of West Point, thanked his family and explained that one of his priorities is to address over payments within the Department of Veterans Affairs. He also stated that he had not been interviewed by the White House, has no intention of privatizing the Department of Veterans Affairs, and is committed to ensuring all veterans receive the benefits they have earned, timely and accurately.
Mr. Falvey is a 30-year veteran of the United States Marines who has vast experience as a Judge Advocate but very limited experience in veterans law. Mr. Falvey did state that in the past few months he has been reading up on precedential decisions made by the CAVC and that his lack of VA experience does not hamper his ability to be an effective judge; instead, he will effectively apply the law without allowing outside influences to affect his decisions.

 

December Washington Update

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.

December 18, 2017                                                         Volume 23, Number 12

Tax Cut Bill Moves Ahead But Preserves Disability Provisions

As the Washington Update went to press, Congress was preparing to vote on the Tax Cuts and Jobs Act of 2017, the major tax initiative of the Trump Administration and Congress.  While taking no position on the overall issue of tax reform, PVA had expressed strong objections to provisions in the House bill that would have eliminated the deduction for significant medical expenses, the Work Opportunity Tax Credit (WOTC) that offers incentives for companies to hire veterans, people with disabilities and others with barriers to employment and the Disabled Access Tax Credit (DAC) which assists small businesses in making their establishments accessible to people with disabilities.  PVA had also expressed concern about the impact on programs such as Medicare, Medicaid and Social Security of the tax bill’s $1.5 trillion addition to the federal deficit.  While the final conference agreement to be voted on does not eliminate the medical expense deduction, WOTC or DAC, it will still add at least $1.5 trillion to the deficit and debt which is likely to play out in 2018 in proposals to cut Medicare, Medicaid and Social Security.  PVA expects to be involved in efforts to combat any dramatic reductions in these safety net programs that are vital to so many members

Senate VA Committee Advances Reform Bil

On November 29, 2017 the Senate Committee on Veteran’s Affairs voted to advance the “Caring for our Veterans Act of 2017.”  This legislation would consolidate the Department of Veterans Affairs (VA) community care programs into a singular program and provide additional resources to enable VA to meet the ever-increasing healthcare needs of veterans.  Since the establishment of the Veterans Choice program in 2014, VA has struggled with ever-changing program requirements enacted by Congress.  The proposed legislation is the logical next step to finally solidify the ways in which VA provides care in the community and provide the necessary tools to keep pace with the needs of our nation’s heroes.

Of great significance to Paralyzed Veterans of America, and the major VSOs, is expansion of eligibility to VA’s Comprehensive Family Caregiver Program.  Currently, the program is restricted to veterans injured on or after September 11, 2001.  This legislation would make eligible those veterans severely injured during and prior to the Vietnam War.  Two years later the program would expand to include veterans of all eras.  This will correct a shameful inequity that has gone on for too long, and asked caregivers and veterans to endure far too much

Press Conference on Expansion of VA Caregiver Progra

On December 6, 2017, PVA, DAV (Disabled American Veterans), The American Legion, and Veterans of Foreign Wars (VFW) presented nearly 200,000 petition signatures to House and Senate leaders urging passage of the “Caring for our Veterans Act of 2017” to expand access to the caregiver program.  At a press conference highlighting the issue, longtime champion and architect of the bill, Senator Patty Murray, and Ranking Member Tester spoke of the bipartisan commitment among members of the Veterans Affairs Committee to see caregiver expansion is accomplished by the end of the 115th Congress.  A similar commitment was offered by House of Representatives members Ranking Member Walz, and Congressmen Langevin and Costello.  The bill now awaits passage in the full Senate and would then require passage in the House

PVA Submits Comments on VA Claim Appeals Program

In November, PVA submitted comments on VA’s changes to its claims and appeals system, including RAMP, directed in the Veterans Appeals and Modernization Act of 2017.  It was PVA’s intent to provide observations on the process to date, provide comments on the information presented at a November meeting on the proposed CFR changes, as well as comments on the draft proposed regulations released on November 20

Our general observations included that we believed continued open and transparent communication from the VA was the best way to ensure veterans organizations are able to work within the new framework and best represent our members.  The meetings and contact with staff are very helpful, but we urged VA to promptly make available any internal training materials the agency is using so that we can train our staff in both the transitional phases, including RAMP, and the new appeals framework.

We also indicated that to be successful in rolling out the new framework, we needed to see where RAMP was working and where it was not.  Throughout the discussions leading up to the passage of the Veterans Appeals and Modernization Act of 2017, VA emphasized the importance of creating a feedback loop to identify and correct RO-specific errors.  We expected that the RAMP analysis would begin to provide this information and looked forward to seeing what VA had to report.

There were several areas of concern such as the agency sometimes using the term “dissatisfied” to describe when veterans might make a choice within the new framework.  “Dissatisfied” is not a statutory term, so it should not appear in any regulations or other binding guidance.  We expressed concerns about what happens after a case is remanded by the Board because if the case is not returned to the Board following continued denial, and it is not tracked in some way, then there is no way to ensure compliance with the remand order. This puts a huge burden on veterans and NSO representatives.  PVA also had specific concerns with the RAMP draft Standard Operating Procedure and about notice being provided to representatives simultaneously with claimants, whether by letter, email, text, or phone.

PVA will continue to monitor this critical change to VA’s appeals process to ensure all veterans receive the compensation they are due and have earned.

PVA Raises Concerns on VA Automobile Adaptive Equipment Program

PVA is very concerned about VA will no longer reimburse qualifying veterans with disabilities for standard Automobile Adaptive Equipment (AAE).  VA argues that many items such as air-conditioning and power brakes or steering are now standard equipment and not eligible if the veteran does not have an invoice reflecting the specific cost.  Unfortunately, many manufacturers now include these components as “equipment packages” without an itemized listing.

Interim Executive Director Carl Blake has met with VA Under Secretary of Health Dr. Clancy to express PVA’s displeasure with the number of denials of reimbursement.  He has also informed her that there has been no action in rewriting the AAE Handbook, but that when VA does decide to take action, they must involve the PVA and other VSOs in the development and writing of the new Directives.  He has also told VA Secretary Shulkin that AAE is one of the top priorities for PVA.

PVA requested that the Veterans Health Administration (VHA) provide an AAE briefing to the Veteran Service Organization (VSO) Prosthetic Workgroup in November.  During the briefing PVA and other VSOs expressed their dissatisfaction with the AAE program’s failure to allow for changes in the automobile industry technological advances to provide reimbursement for new technology in addition to the continuing failure of VA to reimburse vets for standard AAE.

PVA has met with VHA three times in the last two years to provide recommendations to improve the new Directive whenever VA takes action to rewrite it.  PVA will consider to work on this issue and has included AAE as a policy priority for 2018

Senate Briefing on Employment of Veterans with Disabilities

Senators Bob Casey (D-PA), Tammy Duckworth (D-IL), and Jack Reed (D-RI) sponsored a briefing for Senate staff on December 7th about supports and strategies for increasing employment of veterans with disabilities.  Bill Metheny, Director of Field Operations, Veterans’ Employment and Training Service (DOL VETS), for the U.S. Department of Labor (DOL) described DOL VETS role in promoting veterans’ employment among the various workforce development programs at the agency.  Carol Glazer, Executive Director for the National Organization on Disability (NOD) outlined that organization’s employment programs for wounded warriors.  Susan Prokop, Senior Associate Director of Advocacy spoke about Paralyzed Veterans of America’s (PVA) successful vocational rehabilitation program, Paving Access to Veterans Employment (PAVE) that now operates in seven regional offices around the country offering services to veterans as well as their caregivers.  Information about PAVE can be found at http://www.pva.org/veterans-employment.

PVA Serves as Panelist for Congressional Briefing on the Dangers of ADA Notification Legislation

On November 29, 2017, PVA participated in a congressional briefing sponsored by the National Federation of the Blind in opposition to the ADA (Americans with Disabilities Act) Education and Reform Act (H.R. 620).  This PVA-opposed legislation would require a person with a disability to give notice to a public accommodation of an architectural barrier under the ADA and provide the business with an opportunity to “cure” the violation prior to filing a lawsuit.

The purpose of the briefing was to educate congressional staff about the ADA and why the notification requirements proposed by H.R. 620 would be devastating to public access for people with disabilities.

Heather Ansley, Associate General Counsel for Corporate and Government Relations, served as PVA’s representative to the panel.  Other participants in the briefing were Scott LaBarre, Chairman of the Disability Rights Bar Association Board of Directors and President of the National Association of Blind Lawyers; Andy Levy, Partner, Brown Goldstein and Levy; and Andraea LaVant, Self-Advocate, Girl Scouts of America.  Former Congressman Tony Coelho, principle author of the ADA, served as the moderator.

In her comments, Ms. Ansley noted that implementing a notice requirement would effectively remove all incentive for businesses to fully comply with the ADA prior to being notified by a person with a disability about a violation.  This is against the goal of Title III which is to prevent denials of access by ensuring that barriers are removed so that when a person with a disability arrives at a business it is accessible to them.  She also noted that compliance with the ADA is not burdensome as there are free resources available to help businesses comply with the law.  For example, the federally funded ADA National Network provides free technical assistance through 10 regional centers located around the country.  Businesses needing assistance can call 1-800-949-4232 to reach the center nearest them.

At this time, we still do not know when, or if, this legislation will move to the House floor.  It was passed on a party-line vote by the House Judiciary Committee in September.  In the meantime, please continue to contact your House Member to let him or her know that you oppose H.R. 620.

House Task Force Hosts Forum on Veterans Entrepreneurship

On November 30th, the House of Representatives Democratic Caucus’ Task Force on Reinvesting in our Returning Heroes held a Member briefing about challenges facing veterans in starting their own businesses.  Attending the forum were House Democratic Caucus Chairman Joseph Crowley (NY-14), Vice Chair Loretta Sánchez (CA-38), task force co-chairs Representatives Julia Brownley (CA-26), Ruben Gallego (AZ-7), Donald McEachin (VA-4) and Brad Schneider (IL-10) along with Representative Marcy Kaptur (OH-9).  Speakers included Sue Hoppin, President of the National Military Spouse Network,

LeRoy Acosta, Assistant National Service Director for Disabled American Veterans, Susan Prokop, Senior Associate Advocacy Director for Paralyzed Veterans of America, and Ed Vargas, veteran and owner of a small business in Maryland.  The panelists discussed many of the problems veterans and military spouses encounter in starting a business when they return home and seek to begin their post-military professional careers.  Prokop focused on the appeal of self-employment for veterans with disabilities and efforts in past sessions of Congress to overcome some of the unique barriers to entrepreneurship that these veterans often face.  Mr. Vargas, owner of a Mr. Appliance franchise, spoke about the difficulties that high franchise fees pose to many veterans who wish to establish a business, noting the introduction by Rep. Brownley of HR 4473, the Veteran Entrepreneurs Act of 2017 that would provide a tax credit worth up to 25 percent of initial franchise fees for eligible veterans.

PVA Leadership and Staff Visit Puerto Rico Chapter in Aftermath of Hurricane

PVA President David Zurfluh and Vice President Hack Albertson led a delegation of national staff to Puerto Rico on December 4 through 6 to meet with chapter leadership, check on PVA members and meet with federal officials for an update on recovery efforts in the wake of hurricanes Irma and Maria which devastated the island in September.  Meeting at the chapter office on the day of their arrival, the group heard a presentation about the Puerto Rico Recovery Fund (PRRF) recently established by the Center for a New Economy (CNE).  CNE is a non-partisan think-tank that advocates for the development of a new economy for Puerto Rico and created the PRRF to draw in nonprofit and corporate support for rebuilding the island.  Jose Oramas with UPS [a PVA corporate supporter], another CNE PRRF partner described some of the work UPS has been doing through PRRF to activate charter flights moving supplies to Puerto Rico.  PRRF has set up 11 distribution centers around the island for water, food, hygiene kits, and other material and have delivered 1.4 million pounds of supplies thus far.

December 5th the delegation visited several PVA members in the outskirts of San Juan and mountain areas in the middle of the island.  Most of the members with whom the group spoke had power to their homes supplied by generators, but getting water continued to be an issue for almost all with whom they met.  The VA Medical Center had established contact with some PVA members, but not others, and only one veteran reported contact with the Federal Emergency Management Administration (FEMA).  In the meeting the day before, several chapter members had expressed varying degrees of frustration in their encounters with the FEMA bureaucracy.

December 6th was devoted to meetings with VA and FEMA officials from the Joint Field Operations center, which is the main office for federal agencies coordinating in Puerto Rico.  Dr. Antonio Sanchez, the acting director of the VAMC outlined numerous challenges the hospital confronted in trying to contact and assist veterans after the storm because of the destruction of internet, phone and satellite capacity.  Lack of street addresses in the medical center’s patient registry made it difficult, if not impossible, to find many veterans in the more remote areas of the island.  Dr. Sanchez observed that the center needs to do better at identifying patients who live alone and include plans for these people in their emergency preparation plans.

Dr. Nadal, the acting chief of the spinal cord injury unit, reported on the efforts VA has undertaken to offer training to other agencies involved in emergency preparation and response.  One of the problems mentioned by several members in the visits the day before was difficulty in obtaining vital prescriptions in the immediate aftermath of the storms.  The VA had implemented a pharmacy emergency system whereby veterans in rural and hard to reach areas were authorized to obtain prescription drugs from local drug stores.   However, many local pharmacies were unfamiliar with this emergency program and were charging the veterans copays and other expenses.  Dr. Nadal acknowledged that the VA needed to be more proactive in advertising its resources such as this.

The VA hospital had an open door policy during the emergency to anyone with a spinal cord injury, but the patients they received were considerably sicker than they expected.  In addition, many of the 350 veterans with SCI on the VAMC registry were medically stable but most of the emergency shelters were a challenge for patients with spinal cord injury.  Dr. Nadal said they ended up sending 15 patients to the mainland because they couldn’t manage patients at all the shelters on the island and felt that more work is needed to develop better shelters for medically stable people with disabilities.

The meeting with FEMA representatives included Madeleine Goldfarb the FEMA Disability Integration Advisor in San Juan, Philip Shaw with the FEMA Volunteer Agencies Liaison (VAL) office and Josephine Carmona whose office is responsible for handling immediate needs of storm survivors.  In discussing the apparent lack of contact among PVA members by FEMA, Ms. Goldfarb noted that a FEMA survivor registration number is needed in order for them to send out disaster assistance teams and Ms. Carmona added that they have to depend on local governments to inform them of the locations of people with disabilities, but once that information is provided, FEMA will then send in aid.

The FEMA officials expressed a desire to work more closely with PVA’s chapter to resolve some of the problems that had been raised in the previous days and in the meetings.  There also seems to be a need for improvements in the integration of the VA with the overall emergency management system and in its communication with veterans and the community about the resources it has to offer in disasters.  At the same time, agencies like FEMA and voluntary organizations need to understand that the VA does not serve all of the needs of veterans with disabilities and, like other people with disabilities, their circumstances need to be taken into account in emergency preparation and response.  In the months ahead, PVA plans to map out a set of recommendations for improving emergency preparation and response for its membership as well as the broader community of people with disabilities.

 

November Washington Update

November 15, 2017​​​​​​​​            Volume 23, Number 11
***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.

House VA Committee Conducts Hearing to Review Choice Reform Legislation

On October 24, 2017, the House Committee on Veterans’ Affairs conducted a legislative hearing to examine a number of important proposals. The hearing included two very important draft bills that offered direction for the reform of the Choice program administered by the Department of Veterans Affairs (VA). Paralyzed Veterans of America submitted a statement for the record for the hearing.

The focus of our testimony was on the draft bill presented by the House VA Committee—a bill that would eventually become H.R. 4242, the “VA Care in the Community Act”—and on the draft bill presented by the VA—the “Veteran Coordinated Access & Rewarding Experiences (CARE) Act.’’ PVA did not explicitly oppose either draft bill as presented.

We also emphasized in our testimony that before the Committee takes steps to reform the delivery of veterans’ health care in the community, it is important to affirm that specialized services are part of the core mission and responsibility of VA. In recent months, VA has indicated that, along with improving the delivery of care in the community to veterans, it plans to concentrate on expanding and improving what it considers “foundational services.” The Secretary has indicated that it considers spinal cord injury and disease (SCI/D) care and blinded care foundational services. However, he must make that policy unequivocally clear to all networks and all facilities. Additionally, we do not believe foundational services end with just those areas; there are many areas of service within VA that inform the principle of veteran-centric care. We appreciate the fact that the Secretary has committed to expanding SCI/D nurse staffing by approximately 1,000 new positions. These concerns about foundational services cannot be dismissed simply in the interest of focusing attention on more community care.

Congress should examine more closely how VA will monitor the quality of care veterans are receiving in the community. This question goes beyond a plan for care coordination. If VA is unprepared to retain ownership of responsibility for care delivered in the private sector, Congress will be helpless in conducting adequate oversight. PVA believes that the Committee and VA need to seriously consider the consequences for veterans when they are injured during the course of their treatment in the community. When veterans receive treatment at a VA medical center, they are protected in the event that some additional disability or health problem is incurred. Under 38 U.S.C. § 1151, veterans can file claims for disability as a result of medical malpractice that occurs in a VA facility or as a result of care delivered by a VA provider.

When PVA questioned VA as to whether these protections are conferred to veterans being treated in the community, VA officials confirmed in writing that this protection, as a matter of law, does not attach to the veteran in such circumstances. We continue to advocate for the inclusion of this protection in any final bill considered by the Committee. Unfortunately, the bill being considered in the House does not include these provisions.

PVA strongly supports the concept of developing a high-performing integrated health care network that would seamlessly combine the capabilities of the VA health care system with both public and private health care providers in the community. We believe that the design and development of VA’s network must be locally driven using national guidance, and it must reflect the demographics and availability of resources within that area. VA has taken the first steps toward this goal by conducting its pilot market assessments using three individual VHA facilities and their surrounding health care markets.

PVA also supports the Secretary’s plan to move the Department away from the current 30-day/40-mile eligibility standards in favor of a case-by-case clinical determination. The Committee’s draft bill targets the same desired end goal. Access decisions dictated by arbitrary wait times and geographic distances have no comparable industry practices in the private sector. This change would shift the organizational mindset and focus of VA to clinical outcomes instead of catering to arbitrary metrics governing access to care in the community. We have consistently advocated for this proposition before Congress and the administration, stating that eligibility and access to care in the community should be a clinically-based decision made between a veteran and his or her doctor. Establishing appropriate eligibility standards will be an integral part of a sustainable network.

The hearing agenda also included several other bills. PVA supported H.R. 1133, the “Veterans Transplant Coverage Act;” H.R. 2123, the “Veterans E-Health and Telemedicine Support (VETS) Act of 2017;” and H.R. 2601, the “Veterans Increased Choice for Transplanted Organs and Recover Act of 2017.” While we also supported the intent of H.R. 3642, the “Military Sexual Assault Victims Empowerment (SAVE) Act,” we expressed reservations about some of the underlying assumptions of the bill. Similarly, we expressed concerns about a draft bill that would require the Veterans Crisis Line to collect certain data from veterans who contact the line in crisis.

Subsequent to the hearing, the Committee attempted to mark-up H.R. 4242; however, a recent cost estimate provided by the Congressional Budget Office forced the Committee to withdraw the bill from consideration at this time.

PVA’s full written statement can be viewed at http://www.pva.org.

House of Representatives Passes Veterans Legislation

During the week of Veterans’ Day, the House of Representatives passed a long list of bills targeted at improving various services in the Department of Veterans Affairs (VA). That list includes:

• H.R. 918, the “Veteran Urgent Access to Mental Healthcare Act.” This bill would require VA to provide an initial mental health assessment and any subsequent mental health services required to meet urgent mental health care needs to former service members who would otherwise be ineligible for
such services because they were discharged from military service under other than honorable (OTH) conditions.
• H.R. 1066, the “VA Management Alignment Act of 2017.” This bill would require VA to submit a report regarding the roles, responsibility, and accountability of elements and individuals of VA, using the findings of the Independent Assessment, the Commission on Care, and relevant GAO reports as resources.
• H.R. 1133, the “Veterans Transplant Coverage Act.” This bill would authorize VA to provide all care and services needed for a veteran to receive an organ transplant from a live donor, regardless of whether the donor is eligible for VA health care or whether the health care facility is part of the VA.
• H.R. 1900, the “National Veterans Memorial and Museum Act.” This bill would designate the Veterans Memorial and Museum in Columbus, Ohio, as the National Veterans Memorial and Museum.
• H.R. 2123, the “Veterans E-Health and Telemedicine Support Act (VETS) Act of 2017.” This bill would give the VA Secretary the legislative authority to allow VA providers to practice telemedicine across state lines.
• H.R. 2601, the “Veterans Increased Choice for Transplanted Organs and Recovery (VICTOR) Act.”
• H.R. 3122, the “Veterans Care Financial Protection Act of 2017.” This bill directs VA to work with federal agencies and states to develop and implement standards that protect individuals who are eligible for increased pension from dishonest, predatory or otherwise unlawful practices.
• H.R. 3562, a bill to authorize the Secretary of Veterans Affairs to furnish assistance for adaptations of residences of veterans in rehabilitation programs.
• H.R. 3634, “the Securing Electronic Records for Veterans Ease (SERVE) Act of 2017.” This bill would make BAH documentation available online to all veterans, which would help confirm a veteran’s monthly housing stipend and simplify their home or apartment rental process.
• H.R. 3656, a bill that would provide a headstone or marker for all eligible non-veterans who die on or after November 11, 1998.
• H.R. 3657, a bill that would authorize VA to provide headstones and markers to eligible spouses and dependents who are buried or interred at tribal veterans cemeteries.
• H.R. 3705, the “Veterans Fair Debt Notice Act.” This bill instructs VA to use plain language in its debt notices to provide a clear explanation of why VA is alleging that the veteran owes such a debt.
• H.R. 3949, the “Veteran Apprenticeship and Labor Opportunity Reform (VALOR) Act.” This bill would simplify an approval process by allowing companies to register their apprenticeship programs with one central approval agency.
• H.R. 4173, the “Veterans Crisis Line Study Act of 2017.” This bill would require VA to conduct a study on the outcomes and efficacy of the Veterans Crisis Line based on an analysis of national suicide data and data collected from the VCL.

PVA generally supported all of the bills that were considered and approved by the House. In testimony earlier this year, we did express concerns about the data collection process that would occur to support H.R. 4173, particularly what the impact might be of trying to obtain this type of information from veterans who are in crisis.

VA Considering Proposed Cuts to VA Special Purpose Funds

In October, PVA became aware of VA’s plan to move nearly $1 billion dedicated to programs such as Women’s Health, Mental Health, Research, and Suicide Prevention, to a general purpose fund for an unclear purpose. While the VA has claimed that it will be used to reinvest in “foundational services”—which includes spinal cord injury/disease care, there has been no guarantee that will actually occur at this point. It seems the real impact of this dramatic shift of funds from special purpose to general purpose is to provide more resources and flexibility to Veterans Integrated Service Networks (VISNs) and Medical Center Directors. PVA has long argued for the need for medical centers to be fully equipped to meet the needs of their patients. And while we understand the ultimate goal of this shift of resources we are deeply concerned by such a dramatic realignment of resources and the potential impact on veterans.

VA has not provided VSOs or Congress any detailed explanation for how the proposed cuts to critical programs will better serve veterans. Given the magnitude of the proposed repurposing and the potential to devastate critical programs, PVA and others in the VSO community have been diligently engaging with VA to pause the move until the extent of the impact is understood. Several members of Congress, including the Senate Appropriations Subcommittee on Military Construction, Veterans Affairs, and Related Agencies have reached out to Secretary Shulkin as well to get clarification.

We will continue to monitor this action as the consequences for some key programs in VA could be severe. While VA has promised that “foundational services” will benefit from this shift, we do not believe that it should be at the expense of other critical services within VA.

PVA Hosts Roundtable with Senate Commerce Leaders on Air Travel Accessibility

On November 8, 2017, PVA hosted a roundtable with the Senate Commerce, Science, and Transportation Committee on improving access to air travel for veterans with disabilities. The purpose of the roundtable discussion was to focus on how disability-related provisions in S. 1872, the “TSA Modernization Act,” and S. 1405, the “FAA Reauthorization Act of 2017,” would lay the ground work for ensuring safe and effective access to air travel for all people with disabilities. The roundtable provided an opportunity for PVA leaders to share their travel experiences and for Senators and staff to learn more about their concerns. Senators engaged leaders about the frequency of wheelchair damage, service animals, and the general accessibility of air travel.

PVA National President David L. Zurfluh, PVA National Secretary Larry Dodson, PVA National Vice President Charles Brown, and Interim Executive Director Carl Blake were joined at the event by Senate
Commerce Committee Chairman John Thune (R-SD), Ranking Member Bill Nelson (D-FL), and Senator Tammy Duckworth (D-IL). Heather Ansley, Associate General Counsel for Corporate and Government Relations and Lee Page, Senior Associate Advocacy Director, served as moderators for the event. Representatives for Wounded Warrior Project, the American Legion, and VetsFirst also participated.

PVA Hosts First Meeting of the RESNA Standards Committee on Air Travel

On November 7, 2017, PVA hosted the first meeting of the RESNA Standards Committee on Air Travel. The goal of the committee is to create air travel standards and guidelines for mobility devices, to include design, labeling, information cards, and airport personnel handling and training procedures. RESNA is a standards developing organization accredited by the American National Standards Institute (ANSI). The RESNA Assistive Technology Standards Board is the U.S. Technical Advisory Group to ANSI for the development of ISO (International Organization for Standardization) standards pertaining to assistive technology and other products for persons with disabilities.

PVA is an official member of the committee and works closely with the committee’s leadership. Moving forward, the committee plans to meet quarterly over the next year to work toward the goal of reducing damage to wheelchairs in air travel. PVA is joined by airlines, wheelchair manufactures, and other key stakeholders in these efforts.

Congress Prepares to Tackle Tax Reform by End of November

Efforts to make major changes in the tax code for the first time in 30 years recently moved forward in the House and Senate. As of press time for this newsletter, the House was preparing to vote on H.R. 1, the “Tax Cuts and Jobs Act,” while the Senate Finance Committee had begun working on its own version of the legislation with a vote expected in the full Senate after Thanksgiving. Proponents of these measures point to the anticipated economic growth that will ensue from reductions in corporate and individual tax rates and simplification of the tax code. Meanwhile, the nonpartisan Congressional Joint Committee on Taxation has produced analyses of the legislation showing almost 60 percent of U.S. households would see meaningful tax cuts in 2019. However, by 2027, because of changes to deductions and credits in the current tax code, less than half of Americans would experience a tax cut worth $100 or more, while about 1 in 5 would see their taxes go up compared with current law.

In a letter to the House Ways and Means Committee, PVA expressed strong opposition to provisions in the House bill that would eliminate several credits and deductions in the tax code of particular importance to veterans and people with disabilities. H.R. 1 would repeal the Work Opportunity Tax Credit that has helped companies hire almost 300,000 veterans with barriers to employment from 2013 to 2015.

The bill also would repeal the Disabled Access Tax Credit that was created in 1990 to help small businesses comply with the Americans with Disabilities Act. In addition, the House measure would eliminate the medical expense deduction which has softened the burden of over 9 million households facing high costs associated with long term disabilities and illnesses.

The initial Senate Finance Committee chairman’s mark of the tax measure did not include repeal of these credits and deductions. However, Congress must ensure that the final tax bill adds no more than $1.5 trillion to the deficit, which was the limit fixed in the House and Senate budget resolutions.

As a result, the conference committee that will be appointed to reconcile the House and Senate tax bills will be under considerable pressure to eliminate deductions and credits that add to the measure’s costs. Nevertheless, PVA will continue to press its support for these tax credits and deductions that advance the economic independence and community integration of veterans and people with disabilities.

FAIR Heroes Act Introduced

On November 9, 2017, Senator Bill Nelson (D-FL) and Senator Richard Blumenthal (D-CT) introduced S. 2117, the “FAIR Heroes Act,” that would make veterans who were medically retired from the military eligible for both Medicare Part B and TRICARE, a health care program for retired veterans and their families, and allow them to choose which health plan works best for them. Under current law, veterans who receive Social Security Disability Insurance (SSDI) benefits are required, by law, to purchase Medicare Part B coverage. In some cases, they must maintain that coverage even if they return to work. S. 2117 would give these veterans the choice to enroll in TRICARE instead of Medicare Part B. According to a press statement accompanying the bill’s introduction, this legislation could save many veterans up to $1,300 a year.

Currently, medically retired veterans who fail to purchase Medicare Part B coverage immediately upon becoming eligible, or who fail to maintain that coverage for at least eight years after returning to work, are forced to pay a late enrollment fee and higher premiums if they enroll in Medicare later in life. The late-enrollment penalty and higher premiums make Medicare coverage unaffordable for many of these veterans. The legislation seeks to change that, not only by giving these disabled veterans the option to enroll in TRICARE instead, but also by eliminating the eight-year Medicare requirement and late-enrollment penalties for those who were medically retired from the military.

PVA has endorsed this legislation because of many of our members are affected by this issue.

August Washington Update

August 14, 2017                                                                Volume 23, No. 8

***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. 

Congress Approves Choice Funding Extension

Prior to leaving for the August recess, the House of Representatives and Senate approved legislation that would provide additional funding to keep the Department of Veterans Affairs (VA) Choice program operating. Due to significant increases in utilization of the Choice program over the last 6 months, the VA faced the prospect of the program running out of funding by August 15th. In an effort to relieve that problem, Congress approved a bill that provides approximately $2.1 billion to keep the Choice program running for an additional six months. The bill also includes funding to open 28 capital leases that have been held up for budget reasons for nearly two years, as well as provisions to improve workforce innovation, recruitment and retention of providers in the VA health care system.

Unfortunately, Congress will be forced to deal with this issue again six months from now. A long term solution for how VA will manage its community care programs, which includes the current Choice program, has not been finalized. Meanwhile, the House and Senate Committees on Veterans’ Affairs are already developing their own legislative solutions to community care. They range from VA coordinating all community care decisions to veterans having unfettered choice to decide when and where they will seek care.

PVA has already testified on a couple of occasions this year on the future of the Choice program. In the spring, the VA unveiled its own C.A.R.E. program that it hopes to make the basis of all of its community care going forward. However, much work remains to reach a consensus on the final program, to include how VA will invest in and sustain its “foundational commitments” (spinal cord injury/disease care, blinded rehabilitation, prosthetics, etc).

Congress Approves Permanent Change to the Post-9/11 GI Bill

The latest update to the Post-9/11 GI Bill made its way through Congress prior to the August recess and now awaits the President’s signature. The “Harry W. Colmery Veterans Education Assistance Act of 2017,” wielded strong bipartisan support throughout both chambers of Congress allowing the bill to be fast-tracked to the President’s desk. After a unanimous vote in the House, the Senate followed suit by passing the bill by voice vote.

The bill’s namesake, the Forever GI Bill, comes from the elimination of the “use it or lose it rule” that requires the benefit to be used within fifteen years. In today’s world, it is common for veterans to make career changes later in life. This makes it all the more important to retain education benefits that can help facilitate successful transitions. One significant change makes all Purple Heart recipients eligible for 100 percent of the benefit. Because the benefit percentages are based on time in service, veterans removed from service due to wounds sustained in combat were often unable to reach the full 100 percent rating.

The bill addresses a number of other inadvertent inequities as well. One deals with the Fry Scholarship. Surviving spouses and children of service members who die in the line of duty after September 10, 2001, who are utilizing the GI Bill to attend school are currently ineligible for the Yellow Ribbon Program which fills the gap between the GI Bill benefit amount and full tuition at private institutions. Another oversight in the original law precluded reservists mobilized in support of a Department of Defense (DOD) combatant command and when Governors’ request federal assistance in responding to major disasters or emergencies from counting that service time for eligibility.

Other changes include a long-overdue increase in monthly payments for Dependents’ Education Assistance (DEA) by approximately $200. However, the eligibility time period will be reduced from 45 months to 36 months. Most, if not all, GI Bill benefits now cover 36 months of education time, which equates to approximately four school calendar years. The bill also encourages more students to enter into science, technology, engineering and math (STEM) programs, and it restores benefits to students whose schools closed or lost accreditation in the middle of a semester, costing the veteran a semester of eligibility without actually earning any credits.

While the provisions in the bill were far from controversial, the bill got off to a rocky start as VSOs battled over how it would be funded. The original proposal that had widespread support would have mimicked the Montgomery GI Bill, which required active duty service members to pay a nominal amount of their salary into the program to become eligible. Some groups, however, balked at forcing service members to pay for this benefit. The visceral backlash sunk the bill initially. It regained momentum, however, and was ultimately successful using a different funding mechanism which aligns Basic Allowance for Housing (BAH) rates for GI Bill users with current DOD rates for active duty service members. The GI Bill’s current rates were higher than DOD rates, and the reduction in amount will ultimately cover the cost of expanding the GI Bill.

Senate Approves Appeals Modernization Act

On August 2, 2017, the Senate moved appeals modernization one step closer to becoming a reality. H.R. 2288, the “Veterans Appeals Improvement and Modernization Act of 2017,” was introduced and overwhelmingly passed in the House earlier this year. The Senate tacked on a few more technical refinements and passed the bill under voice vote just before the August recess. Despite being in recess, the House passed the appeals modernization bill by unanimous consent (meaning there were no objections to the minor technical changes) on August 11, 2017.

Once the bill is enacted into law, the earliest changes are expected to be seen approximately eighteen months after enactment. The massive overhaul of the disability claims and appeals process has long been in the works, but the new law will require extensive efforts to implement and widespread changes to the regulations that govern the process.

PVA Files Lawsuit over Wheelchair Damage Rule

At the end of July, PVA filed suit against the Department of Transportation (DOT) for abruptly rolling back a rule intended to make airline travel safer and easier for passengers with disabilities. The rule, which requires domestic airlines to track and report data on lost and damaged wheelchairs and scooters, was delayed by the Administration without seeking input from people with disabilities. DOT originally published the rule in November 2016, following a five-year rulemaking process that included input from air travelers, consumer and disability advocacy groups, and airlines.

The rule was scheduled for implementation in January 2018. In March 2017, DOT abruptly delayed the rule’s implementation date by one year, until January 2019, without providing the public any notice or opportunity to comment, in violation of the Administrative Procedure Act. DOT claimed the delay was necessary due to implementation “challenges” faced by the airline industry. However, the only evidence of these challenges DOT presented was a single email the agency received from the airline industry.

Since DOT’s decision, PVA has informed Administration officials and members of Congress about how the rule’s delay will hurt people with disabilities and asked that DOT allow these critical protections to move forward. Together with the complaint, PVA filed a motion to reinstate the rule’s original effective date. The case was filed in the United States District Court for the District of Columbia.

Senate Effort to Repeal and Replace Affordable Care Act Fails

In a series of votes over the course of a week in late July, the Senate rejected a variety of proposals intended to repeal all or parts of the Affordable Care Act (ACA) and replace the 2010, health care law with dramatically different provisions that would have resulted in increased numbers of uninsured Americans and millions more exposed to insurance discrimination due to pre-existing health conditions and disabilities. Senators were first presented with an amendment to the bill that passed the House of Representatives in May that would have capped and cut Medicaid by over $700 billion, eliminated most home and community based services programs in Medicaid, adjusted downward the ACA’s affordability tax credits and allowed insurers to sell health plans that imposed lifetime caps on benefits and excluded from coverage many services vital to people with disabilities. That bill—the “Better Care Reconciliation Act (BCRA)”—failed on a vote of 43 to 57.

The Senate then considered a motion to repeal the entire ACA with nothing to replace it. The effective date of the repeal would have been delayed for two years under the assumption that Republicans would draft a replacement plan during that period. The Congressional Budget Office (CBO) estimated that this proposal would have resulted in 32 million more uninsured over the next decade. That proposal also failed with all Democrats and seven Republicans voting against the measure.

During the course of the week, numerous motions were made to send the bill to the appropriate committees with instructions to conduct hearings on the proposals to amend the ACA, obtain CBO scores and receive input from stakeholders affected by suggested changes to the law. All of these efforts failed along with other motions designed largely for political messaging purposes

In a final effort to pass something that could ostensibly go to conference with the House-passed bill, the Senate GOP leadership put forward what was called “Skinny Repeal and Replace.” This amendment would have eliminated both the individual and employer mandates of the ACA as well as the medical device tax but left the remainder of the ACA intact. Even so, this measure would have destabilized insurance markets, added 16 million Americans to the ranks of the uninsured and still have cut Medicaid by over $200 billion. Moreover, there were serious concerns among Senators on both sides of the aisle that a conference report would be drafted in secret and return with provisions reinstating insurance discrimination, making steep reductions in financial assistance to make insurance affordable and even more damaging cuts to Medicaid. These were the concerns that had compelled the opposition of Senators Collins and Murkowski throughout the debate and which led them to vote “No” on this final package. Their votes, coupled with the 48 Democratic votes against the amendment, set the stage for one of the most dramatic scenes witnessed in the Senate in years.

Earlier in the week, Sen. John McCain (R-AZ) returned to the Senate after being diagnosed with an aggressive form of brain cancer to vote in favor of advancing the debate on health care reform. Sen. McCain made a very eloquent statement about the failure of the Senate to pursue bipartisan solutions to health care reform and to follow “regular order” on this very important legislation. Regular order is a Senate term of art which means that the health care bill or bills would have been considered in committee hearings, been open to amendment, received full vetting by the CBO and provided opportunities for those affected by the proposals to testify. In the early morning hours of July 28, the vote on the “skinny repeal” was defeated when Sen. McCain shockingly voted against the measure.

At the beginning of debate, PVA sent a letter to all Senators echoing the concerns expressed by Sen. McCain. Lack of transparency in the development of the Senate bill and the method under which the legislation was put forward meant that many of PVA’s objections to the legislation could not be addressed. As written, the Senate bill would continue to exclude the children of catastrophically disabled veterans covered by CHAMPVA from its provisions ensuring dependent insurance coverage up to age 26. Unanswered questions remained regarding the availability of affordability tax credits for veterans who are not enrolled in the VA health care system if the Senate bill had become law. Perhaps most significantly, little attention was paid to the impact of Medicaid cuts to over 2 million veterans that rely on that program and what that might mean for increased demand on the VA health care system. The VA Secretary himself had expressed concern about potential new demand on the VA health care system if these veterans lose Medicaid coverage but without hearings on the bill there was no chance to examine this issue.

There is increasing bipartisan consensus that something must be done to help those in the small employer and individual insurance markets who face increasing premiums, excessive deductibles and loss of health plan choices. Perhaps most urgent is an impending need to fund the ACA’s cost sharing subsidies for lower income health plan customers. Insurers will soon be making decisions for 2018, about their participation in the health insurance exchanges based on these subsidies.

Senators Lamar Alexander (R-TN) and Patty Murray (D-WA), the chairman and ranking member of the Health, Education and Labor Committee, plan to hold hearings in September to explore options for shoring up the financing of health insurance exchanges and other fixes to the ACA that have bipartisan support. Meanwhile, in the House, a Problem Solvers Caucus that is almost evenly comprised of Republicans and Democrats has begun putting together proposals that would increase the number of workers from 50 to 500 for companies subject to the ACA employer mandate and create a federal stability fund to help states reduce premiums and other costs for those with expensive medical needs.

It remains to be seen how far these discussions will progress after the August recess in light of other demands on Congressional time, such as completion of the budget and the need to increase the debt limit. PVA will nonetheless be encouraging Congress to pursue a more open and bipartisan approach to health system reforms that respond to the needs of all Americans, including veterans and people with disabilities.

 

July’s Washington Update

July 18, 2017 Volume 23, No. 7

***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.

Senate Committee on Aging Considers Military Caregivers

On June 14, 2017, Senator Elizabeth Dole testified before the Senate Special Committee on Aging regarding the needs of military caregivers. Joining the Senator’s remarks with his own testimony was Hidden Heroes ambassador and actor, Ryan Phillipe. A second panel included veterans, their caregivers, and researchers from the RAND Corporation who shared the findings of a report commissioned by the Elizabeth Dole Foundation outlining the critical needs of caregivers.

There are currently 5.5 million veteran and military caregivers. Many post-9/11 service connected veterans have found support through the VA Comprehensive Family Caregiver Program. However, the majority of veterans with service-connected disabilities are remain ineligible. Senator Dole extolled the moral urgency of correcting this inequality. And while most members of the committee ardently agreed to expansion in principle, the cost of the effort remains a concern not yet alleviated.

Additionally, Senator Dole illustrated the toll of the duties of caregiving on those providing it. The wellbeing of the caregiver is directly linked to the wellbeing of the veteran. As a caregiver’s health declines or is interrupted so too does the quality of assistance. Other deleterious factors in providing care are the loss or insecurity of income. Caregivers often decrease the hours they can work or quit their jobs altogether to care for a veteran. Caregivers, similar to their veterans, often experience devastating isolation in their roles that can take them out of their communities and social interactions necessary to maintaining emotional wellbeing.

The Elizabeth Dole Foundation works to raise awareness of the role of caregivers in our society. Last September, the Foundation launched Hidden Heroes to push forward solutions to the daily challenges caregivers face. PVA has developed a relationship with the Foundation to advance legislation that will expand eligibility for the Comprehensive Family Caregiver Program permanently.

PVA Testifies Before Subcommittee on Economic Opportunity

On June 29, 2017, Gabe Stultz, Legislative Counsel for PVA, testified before the House Veterans’ Affairs Committee, Subcommittee on Economic Opportunity. The Subcommittee considered a number of bills, including efforts to better track bonuses and the reasons behind transfers of VA employees. PVA testified specifically on a draft proposal that would restructure the way home adaptations are delivered as part of the Independent Living Services in the Vocational Rehabilitation and Employment (VR&E) program. For anyone qualifying for home adaptations under the VR&E program, the draft bill would have the VA’s Specially Adapted Housing (SAH) office carry out the actual delivery of services.

Because the Loan Guaranty office currently administers both the SAH and SHA grants, the effect would be to consolidate all administrative authorities for home modifications under one office within VA. The HISA grant would remain separate and continue to be administered by the Prosthetics and Sensory Aids department within the Veterans Health Administration (VHA). PVA called for oversight to ensure that as VA consolidates the administrative functions that it does not suddenly increase the workload in the SAH program without a corresponding increase in staff.

PVA Participates in Public Hearing on Implementation of the Veterans Mobility Safety Act

In December 2016, Congress enacted the “Veterans Mobility Safety Act,” a bill that requires VA to ensure that vehicle adaptations are carried out by qualified individuals. While VA has standards for the specific equipment being installed on vehicles, it never had any standards for who was installing that equipment. Simply put, the safety of the equipment itself is irrelevant if the person installing it is incompetent.

The law called for VA to develop a policy related to safety certification for installers. VA began the process by soliciting comments from stakeholders in writing back in February of this year. On June 13, 2017, VA continued this process by hosting an in-person hearing where stakeholders could voice their opinions. Fred Downs, Prosthetics Consultant for PVA, provided an oral statement on our organization’s behalf. The following is an excerpt from the oral statement and highlights our main position on the matter:

When PVA first involved itself in the passage of the Veterans Mobility Safety Act, our biggest concern was ensuring that as safety standards for installing automotive adaptive equipment were implemented, the end user would not be negatively impacted. The risks as we saw them were that, either by design or by poor implementation of this law, veterans might begin to lose access to vendors who have long provided disabled veterans with safe products.

VA is charged with developing safety standards, but these standards were not intended to govern the entire industry. They are only supposed to serve as a benchmark by which others are judged. VA’s standards should only be directly employed when a provider fails to present certification from the product manufacturer or a trade association that incorporates adherence to stringent safety standards as part of its membership.

This law should not be viewed as an opportunity for VA to expand regulations on the industry. The goal is to identify providers who are offering substandard installations and unwilling to adhere to basic industry safety standards. When those providers are identified, they should face a choice: become certified under VA’s standards or stop doing business with VA.”

We remain concerned that VA has not developed a sound policy yet to ensure proper implementation of these requirements. We will continue to work with VA staff to ensure that this necessary change is not haphazardly carried out.

House and Senate FAA Reauthorization Bills Include Provisions to Improve Air Travel for Passengers with Disabilities

PVA’s efforts to improve air travel for passengers with disabilities have led to the inclusion of disability-related provisions in the House and Senate versions of the Federal Aviation Administration (FAA) Reauthorization bills currently pending on Capitol Hill. Many of these provisions are similar to those found in the S. 1318, the “Air Carrier Access Amendments Act,” that is strongly supported by PVA.

The “21st Century Aviation Innovation, Reform, and Reauthorization Act” (H.R. 2997), the House’s version of the FAA Reauthorization, includes four disability-related provisions as passed by the House Transportation and Infrastructure Committee on June 27. Sections 541, 542, and 543 would establish a select subcommittee on passengers with disabilities to advise the Secretary of Transportation, require a study concerning airport accessibility and air carrier training policies, and mandate research into the feasibility of allowing passengers with disabilities to fly from their wheelchairs. An amendment added during the committee’s markup would also require the Department of Transportation (DOT) to move forward in promulgating rules on service animals, lavatories on single-aisle aircraft, and in-flight entertainment.

As passed out of the Senate Commerce, Science, and Transportation Committee on June 29, S. 1405, the “FAA Reauthorization Act of 2017,” would require a study concerning airport accessibility, a determination on the feasibility of using in cabin wheelchair restraint systems, and the creation of an advisory committee on the air travel needs of passengers with disabilities to advise the Secretary of Transportation on implementation of the Air Carrier Access Act (ACAA). The Senate FAA Reauthorization also includes a requirement for airlines to provide wheelchair and scooter information to DOT beginning January 1, 2018. This requirement was delayed by the Department earlier this year. Other provisions added during the committee’s markup include an airline passengers with disabilities bill of rights, increased civil penalties for harm to assistive devices or passengers with disabilities due to ACAA violations, and a requirement for hands on training for those who provide that type of assistance to passengers with disabilities.

Both the House and Senate versions of the FAA Reauthorization are currently pending floor action. Each includes provisions unrelated to the disability sections that may make it difficult for either bill to pass. The current FAA authorization expires at the end of September. Congress must take action to either extend the current authorization or pass a reauthorization before that time.

In the meantime, PVA will continue to seek additional co-sponsors for S. 1318, and support for further amendments to the FAA Reauthorization bills to foster additional improvements in air travel for passengers with disabilities.

Senate Health Care Reform Bill Introduced

On June 22, 2017, Senate Majority Leader Mitch McConnell released the Better Care Reconciliation Act (BCRA), the Senate’s version of a bill to “repeal and replace” the Affordable Care Act (ACA). Developed largely in secret by a few allies of the Majority Leader, the bill was intended for a quick vote under simple majority rules prior to the July 4th Congressional recess. However, strong bipartisan opposition to the measure, including among moderate and conservative Republicans, arose and forced Leader McConnell to postpone the vote. A revised version of the bill was unveiled on July 13. The majority leader has been working to corral the necessary 50 votes (Vice President Pence would be the tie breaker) to proceed under reconciliation rules. Among the provisions of the bill in its latest form are:

Cuts to Medicaid – In addition to phasing out the ACA’s Medicaid expansion, which has covered roughly 340,000 veterans nationwide, according to FamiliesUSA, the Senate bill would, according to the Congressional Budget Office, reduce spending in the basic Medicaid program by 35 percent by 2036. Under the limits on Medicaid funding contained in the bill, states would likely be forced to severely restrict the populations covered and services provided by the program. This could put at risk approximately 1.75 million veterans currently covered by traditional Medicaid.

  • Pre-existing condition exclusions – The BCRA permits states to waive portions of the ACA’s essential health benefit (EHBs) requirements. The ACA requires that certain benefits be included in any insurance plan offered on the individual and small group market. These EHBs include outpatient services, emergency room care, hospitalization, maternity care, mental health and substance abuse services, prescription drugs, rehabilitative and habilitative services, lab tests, preventative care, and pediatric care. With a state waiver, insurers would be able to deny numerous services that people with disabilities, and others with pre-existing conditions rely upon. It would also mean that individuals living in one state may be able to access the services they need, while those in another state may not. People with pre-existing conditions could technically still be able to purchase insurance, just not the insurance that includes the services they need at a cost they can afford.

 

  • Lifetime and annual limits on benefits – The ACA limits the amount that insurers can charge annually to individuals and families for out-of-pocket payments. The Senate proposal would make it easier for states to apply to the federal government to waive these limits. Similarly, while there is language in the bill that continues the prohibition on lifetime coverage caps, these only apply to limits on essential health benefits. If a state changes or eliminates the essential benefit options, lifetime coverage caps could effectively be reinstated. This would have a disproportionate impact on individuals with disabilities who depend on many services now required to be offered under the EHB rules.
  • Creation of high risk pools – A state stability fund is proposed to help states bring down premiums and start programs that lower costs for insurers and consumers. The bill includes more than $180 billion for this fund. Prior to the ACA, 35 states had created high-risk pools to offer coverage to state residents with pre-existing conditions that made them uninsurable. Features adopted by the states to limit enrollment, and thus costs, included premiums set well above the standard non-group market rates, 6 to 12 month exclusion periods for pre-existing conditions, lifetime and annual dollar limits on coverage and deductibles between $1000 and $5000.

 

  • Other provisions – The revised bill retains several of the taxes included in the ACA such as the 3.8 percent investment income tax on people making over $200,000 a year, a tax on incomes of health insurance executives and the Medicare health insurance tax that was created to extend the life of the Hospital Insurance trust fund. The newest version of the BCRA includes $45 billion in funding to address the opioid crisis. Another new provision in the bill would allow funds in Health Savings Accounts to go toward insurance costs.
  • Cruz amendment – An amendment is expected to be offered by Sen. Ted Cruz (R-TX) allowing health plans with slimmer benefits packages to be sold on and off the health market exchanges under the assumption that this would make these insurance plans cheaper. However, insurers would also be required to sell at least one ACA-compliant plan. Critics of this amendment fear that segmenting the market in this fashion would drive younger, healthier people to the minimalist plans, leaving older, sicker constituents with the more expansive health plans. This would likely cause premiums for the more robust insurance plans to increase significantly. To protect insurers who attract a disproportionate share of “high risk” individuals, the bill will include a $70 billion fund to offset costs for these companies.

Since the 115th Congress began debating health care reform, PVA has expressed its strong desire that these deliberations be done in a bipartisan fashion under regular order with stakeholders given an opportunity to consider and weigh in on various policy options. By using reconciliation, which requires only a 50 vote margin to win passage, to advance the Senate’s legislation, several issues of particular concern to PVA will go unaddressed. For example, the children of catastrophically disabled veterans covered by CHAMPVA will continue to be excluded from current policies that provide for dependent insurance coverage up to age 26. There have been some questions whether the tax credits meant to make health insurance affordable would be available to veterans who are eligible but not enrolled in the VA health care system. PVA has been informed that reconciliation procedures preclude the opportunity to clarify this issue.

The new version of the BCRA retains almost $800 billion in Medicaid cuts over ten years. Between traditional Medicaid, the Medicaid expansion as well as the ACA premium tax credits, there has been a 40 percent decrease in uninsured non-elderly veterans between 2013 and 2015.1 Most of these veterans are older than 45, the age group most adversely affected by the Senate bill’s provisions allowing older individuals to be charged up to five times the standard premium amount.

Some of these veterans may be able to enroll in the VA health care system under current rules but others, because of policies that bar enrollment to certain veterans above modest income thresholds, will be denied access to the VA. Congress could act to open up the VA health care system to all veterans but it is unclear whether the VA has the budgetary and system capacities able to handle even half of the veterans now covered under Medicaid.

As of the deadline for the Update, the BCRA was tabled as several Republican senators have come out in opposition to the bill, including Sen. Rand Paul (R-KY), Sen. Susan Collins (R-ME), Sen. Jerry Moran (R-KS), and Sen. Mike Lee (R-UT). Sen. McConnell has indicated that he may bring a simple ACA repeal bill to the floor for consideration given the failing support for the BCRA. PVA staff will continue to monitor this effort and reach out to chapters as this debate continues.

Social Security Trustees Issue Annual Report on System’s Status

On July 13, 2017, the Social Security Trustees released their annual report on the current and projected financial status of the Social Security trust funds. The 2017 Trustees Report highlights that the Social Security system continues to operate well for the American people. The Social Security system’s financial outlook remains stable, and can continue to pay all scheduled old age, survivors, and disability benefits until 2034. With modest increases in revenue, Social Security will be able to pay full benefits throughout the century and beyond. The 2017 Trustees Report finds that Social Security is fully solvent until 2034, but faces a moderate long-term shortfall.

In 2016, Social Security took in roughly $35 billion more in total income, including interest, than it paid out. Its reserves were $2.85 trillion at the end of 2016. If Congress does not act before 2034, the reserves would be drawn down, and revenue coming into the Trust Funds would cover about 77 percent of scheduled benefits. The Trustees Report also projects that Social Security’s Disability Insurance (SSDI) trust fund by itself can pay all scheduled benefits until 2028—5 years longer than projected in the 2016 Trustees Report. If Congress takes no action before 2028, the Trustees project that thereafter the SSDI trust fund will be able to pay about 93 percent of scheduled benefits.

Royal Caribbean Disability Advisory Board Meets

In June, Susan Prokop, PVA Senior Associate Advocacy Director, attended the meeting of the Royal Caribbean (RCCL) Disability Advisory Board to receive updates on the company’s efforts to make its cruises accessible and to promote itself as an inclusive employer to people with disabilities. PVA was appointed as a member of the Advisory Board in 2016.

Members of the advisory board heard presentations on Royal Caribbean’s efforts to track special needs requests and training modules developed for customer contact center staff to assist guests with disabilities. The cruise line has also recently established an employee resource group (ERG) for staff with disabilities in three of its call center sites in South Florida, Wichita, Kansas and Springfield, OR. RCCL hopes to use this ERG to engage with local chapters of its three disability advisory boards.

1 Urban Institute, April 2017, “Veterans Saw Broad Coverage Gains Between 2013 and 2015”