July’s Washington Update

July 18, 2017 Volume 23, No. 7

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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”

May Washington Update

May 16, 2017 Volume 23, No. 5

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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.

Bi-Partisan Accountability Bill Introduced

On May 11, 2017, Senate VA Committee Chairman Johnny Isakson (R-GA) and Ranking Member Jon Tester (D-MT) introduced the “VA Accountability and Whistleblower Protection Act.” The legislation was also co-sponsored by Senator Marco Rubio (R-FL). PVA offered our strong support for this critical piece of legislation. The principle goal of the legislation is to allow the Department of Veterans Affairs (VA) to terminate bad employees faster while also strengthening protections for whistleblowers. The bill streamlines the VA’s process for reviewing and firing employees who engage in misconduct or perform poorly without sacrificing their due process rights.

The “VA Accountability and Whistleblower Protection Act” has three major provisions:

1. Increase accountability within the VA by:

a. Giving the VA Secretary the authority to expedite the removal, demotion or suspension of employees at the VA based on performance or misconduct.

b. Shortening the process to remove employees at all levels of the department when evidence proves that they have engaged in misconduct or are performing poorly.

c. Incentivizing managers to address poor performance and misconduct among employees by including these issues in the annual performance plan.

d. Prohibiting bonuses for employees who have been found guilty of wrongdoing.

e. Prohibiting relocation expenses for employees who abuse the system.

2. Protect whistleblowers by:

a. Codifying the Office of Accountability and Whistleblower Protection at the VA and mandating that the head of the office be selected by the President with the advice and consent of the Senate, giving Congress more oversight over the department.

b. Requiring the VA to evaluate supervisors based on their handling of whistleblowers.

c. Requiring the VA to provide department-wide training regarding whistleblower complaints once a year.

3. Strengthen VA leadership by:

a. Giving the VA Secretary additional flexibility in hiring and firing senior executives.

b. Removing bureaucratic barriers to holding senior executive accountable by expediting executive appeals and sending them directly to the VA Secretary.

c. Reducing benefits for employees who are disciplined or removed for misconduct.

Along with PVA, this legislation is supported by the American Legion, Veterans of Foreign Wars, Iraq and Afghanistan Veterans of America, Military Order of the Purple Heart, the Project on Government Oversight, AMVETS, and Got Your 6.

PVA Executive Director Sherman Gillums offered the following statement in support of the bill:

Paralyzed Veterans of America has long called for measures that bring greater accountability and protects those employees who have the courage to call out fraud, waste, and abuse in the Department of Veterans Affairs. We firmly believe that the culture of a company, organization, or federal agency is shaped by the worst behaviors its leader is willing to tolerate. The “VA Accountability & Whistleblower Protection Act” is the first major step toward reshaping behavior in VA by tolerating bad behavior and poor performance no more. Our veterans deserve it; and so do the hardworking public servants of VA who are tired of being overshadowed by the performance of substandard managers and employees.

The focus will now turn to the House VA Committee to bring companion legislation forward. During the last Congress, the House and Senate VA Committees were unable to come to a compromise on accountability legislation; however, House VA Committee Chairman Phil Roe (R-TN) and Ranking Member Tim Walz (D-MN) have both offered support for the Senate bill.

House Subcommittee Holds Roundtable on Caregiver Support Programs

On April 27, 2017, the House Veterans’ Affairs Subcommittee on Health held a roundtable to examine how the Department of Veterans Affairs (VA) can improve the Caregiver Support Program, available to veterans of all eras, and the Comprehensive Family Caregiver Support Program, limited to veterans who were catastrophically injured after September 11, 2001. Members of the subcommittee and their staffs engaged representatives from the veterans’ service organization (VSO) community, the Veterans Health Administration (VHA), and the Department of Health and Human Services (DHHS).

At the forefront of the discussion was the date of injury eligibility requirement of the Comprehensive Family Caregiver Program. Members of Congress generally support expanding the program, but are deeply hesitant to approving this necessary change due to cost considerations. Some veterans groups support the idea of delaying expansion until the current program is made essentially perfect. This is a position that PVA strongly opposes. Representatives of the VA welcome the program’s expansion but expressed concern Congress would not provide them the support and resources needed to meet such an overwhelming need. PVA, DAV, VFW, and the American Legion continue to advocate expansion without hesitation.

Our position remains clear—it is unjust to provide critically needed support services to one group of veterans, and deny it to another, for no other reason than cost. PVA will continue to advocate for the Caregiver Support program to be properly resourced and the Comprehensive Family Caregiver Support Program to be opened to those who would otherwise be eligible, and are in critical need.

HVAC Pushes Forward with Appeals Modernization in the 115th Congress

On May 2, 2017, the House Committee on Veterans’ Affairs held a hearing on H.R. 2288, the “Veterans Appeals Improvement and Modernization Act of 2017.” The bill’s introduction follows on the heels of the recent Congressional round table hosted by the Chairman of the Subcommittee on Disability Assistance and Memorial Affairs, Mike Bost (R-IL). He and Ranking Member Elizabeth Esty (D-CT) are the original co-sponsors of the legislation.

The bill is an evolution from efforts throughout last year to present Congress with a new framework for processing disability claims and appeals. Much of the criticism last year dealt with the lack of a plan for implementation, a comprehensive risk assessment, and an understanding of what resources would be needed. There must be enough resources to ensure that VA does not leave behind veterans already who are already waiting while it starts a new program. PVA supports the new framework, and we also support this legislation’s requirements for extensive reporting by VA as it moves forward with implementation.

It is notable that the House and Senate have been working closely on this legislation, and shortly after the hearing it was announced that the Senate would be introducing a companion version of the House bill that has bipartisan and bicameral support.

PVA’s full statement for the record can be viewed at: http://docs.house.gov/Committee/Calendar/ByEvent.aspx?EventID=105902

VA Adopts New Standards for Medical Diagnostic Equipment

The U.S. Department of Veterans Affairs (VA) will adopt new accessibility standards issued by the U.S. Access Board to ensure access to medical diagnostic equipment (MDE) at its health care facilities. Under an agreement governing acquisition, the VA will require that new equipment meet the MDE standards which were published in January of this year. The VA’s health care network, the largest integrated health care system in the U.S., includes 152 medical centers, nearly 800 community-based outpatient clinics, and over 125 nursing home care units.

Access to MDE has been problematic for people with disabilities, including those who use wheelchairs and other mobility aids. The Board’s standards provide design criteria for examination tables and chairs, including those used for dental or optical exams, weight scales, radiological equipment, mammography equipment and other equipment used for diagnostic purposes by health professionals.

The MDE standards, as issued by the Board, are not mandatory unless adopted by a federal agency. The VA’s use of these standards will help it meet responsibilities under section 504 of the Rehabilitation Act which requires access to federally funded programs and services. Other entities, including health care providers and state and local governments, can voluntarily adopt and apply the standards as well.

For further information on the MDE standards, visit the Board’s website or contact Earlene Sesker at sesker@access-board.gov, (202) 272-0022 (v), or (202) 272-0091 (TTY). Questions about the new VA acquisition policy should be directed to Laurence Meyer at Laurence.Meyer@va.gov.

House Passes American Health Care Act

On May 4, 2017, the U. S. House of Representatives passed H. R. 1628, the American Health Care Act (AHCA), by a vote of 217 to 213. The bill would significantly modify the Patient Protection and Affordable Care Act (ACA), also known as Obamacare. Twenty Republicans joined all of the Democrats in the House in voting against the measure. The bill is not a complete repeal of the ACA, as has been promised by Republicans for seven years, but deals only with those parts of the ACA with budgetary implications in order for the Senate to pass it with a simple majority vote, a process none as reconciliation.

The AHCA reduces funding for subsidies provided under the ACA to make health insurance coverage purchased through the health exchanges more affordable and tilts the benefits of those subsidies toward younger people. However, it also creates tax credits that would be available to people to purchase health plans outside the exchanges. The measure eliminates a number of taxes, including those on health insurers, under the ACA that were designed to pay for its provisions. Instead of a mandate that individuals carry health insurance, H.R. 1628 would allow insurers to charge those with coverage gaps longer than 63 days a one-year, 30 percent surcharge on their insurance premiums. In addition, the House bill cuts over $800 billion from Medicaid over ten years and, in 2020, would end the ACA’s expansion of Medicaid through which some 11 million Americans have gained health care coverage. The bill also eliminates funding for several public health programs aimed at preventing bioterrorism and disease outbreaks.

The AHCA would make a number of changes to the types of health insurance plans that would be available by changing the rules governing protections for those with pre-existing conditions and by eliminating requirements that health plans cover certain benefits. States would be allowed to seek a waiver from the Department of Health and Human Services (HHS) so that insurers could charge higher premiums to those with pre-existing conditions. If HHS does not respond to a state’s request within 60 days, those changes would automatically go into effect. As part of a waiver application, states would have to set up a high risk insurance pool or design a subsidy program of their own for residents with pre-existing conditions who might be priced out of the insurance market as a result of the waiver.

In a letter to the House, PVA expressed concern about a number of the provisions in H.R. 1628 that could have harmful effects on veterans and people with disabilities. Under the bill’s changes to financing of Medicaid, the federal government would no longer share in the costs of providing health care services and community services beyond a capped amount. This would eliminate the enhanced federal match for the Community First Choice Option under Medicaid that provides attendant care services in the community. Thanks to this program, many poor veterans with serious non-service connected disabilities have been able to move from nursing homes into their communities. Data from the Robert Wood Johnson Foundation shows that the Medicaid expansion that would be eliminated by the bill has helped thousands of veterans and their caregivers.

By allowing states to seek waivers that would permit insurers to charge higher premiums to people with pre-existing conditions, people with disabilities and expensive health conditions could again be exposed to significantly higher medical costs. The waivers would also relieve states of the ACA’s requirement that certain essential health benefits must be provided, including crucial services for people with disabilities such as prescription drugs, rehabilitative and habilitative services and devices, preventative and wellness services and chronic disease management. In combination, these changes would very likely make it difficult for people with pre-existing conditions to find affordable plans that cover basic health care services.

For veterans and PVA members in particular, the AHCA continues several problematic policies of the ACA as well as troubling new provisions that could affect the ability of many veterans and their family members to afford health insurance in the private market. Those provisions include:

• Retains coverage of adults up to age 26 on parents’ health policies but continues to exclude CHAMPVA beneficiaries—dependents of the most catastrophically disabled veterans—from this benefit.

• Fails to remove the prohibition on enrollment into the VA health care system for Priority Group 8 veterans, thus denying these veterans access to a viable option for health care.

• Offers tax credits meant to make health insurance affordable to anyone except those eligible for a host of other federal health programs, including those “eligible” for coverage under Title 38 health care programs. This would prevent many veterans who may be “eligible for” but not enrolled in the VA health care system from accessing these tax credits intended to help people buy insurance.

The Senate has begun to discuss parameters of a health care reform bill but is not expected to use H.R. 1628 as the basis for its efforts. Over the coming months, PVA plans to reach out to the Senate committee leadership involved in developing its legislation to ensure that veterans and people with disabilities are not disadvantaged in the process.

April’s Washington Update

April 18, 2017                                                                  Volume 23, No. 4

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

House VA Health Subcommittee Considers Pending Legislation

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

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

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

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

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

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

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

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

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

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

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

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

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

Congress Passes Choice Program Extension

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

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

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

ACA Repeal and Replace Health Care Reform Effort Fails

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

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

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

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

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

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

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

Update on the ADA Education and Reform Act of 2017

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

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

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

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

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

The “Social Security 2100 Act” Reintroduced

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

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

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

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

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

of Accessibility

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

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

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

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

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

 

 

March Washington Update

March 17, 2017                                                                Volume 23, No. 3

***PRIORITY***

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

PVA Annual Advocacy and Legislation Seminar

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

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

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

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

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

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

House Committee on Veterans’ Affairs Holds Hearing on

Community Care

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

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

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

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

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

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

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

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

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

Caregiver Expansion Bill Introduced

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

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

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

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

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

PVA Prosthetics Consultant Participates in Brain Awareness

Week Program

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

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

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

DOT Delays Implementation of Final Rule Requiring US Airlines

to Report Wheelchair Data

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

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

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

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

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

PVA Trains Wheelchair Attendants for Virgin America Airlines

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

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

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

January 2017 Washington Update

January 17, 2017                                                   Volume 23, No. 1

***PRIORITY***

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

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

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

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

Members of House VA Committee Chosen

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

Doug Lamborn (R-CO)

Gus M. Bilirakis (R-FL)

Mike Coffman (R-CO)

Brad Wenstrup (R-OH)

Amata Coleman Radewagen (R-American Samoa)

Mike Bost (R-IL)

Jodey Arrington (R-TX)

Jim Banks (R-IN)

Jack Bergman (R-MI)

Neal Dunn (R-FL)

Clay Higgins (R-LA)

John Rutherford (R-FL)

Additionally, the following assignments for Subcommittee leadership were made:

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

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

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

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

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

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

Camp Lejeune Presumption of Service-Connection Granted for Eight Conditions

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

The presumption of service-connection applies to the following eight diseases: 1. Kidney cancer; 2. Liver cancer; 3. Non-Hodgkin’s lymphoma; 4. Adult leukemia; 5. Multiple myeloma; 6. Parkinson’s disease; 7. Aplastic anemia and other myelodysplastic syndromes; 8. Bladder cancer. This list of diseases now receiving a presumption of service-connection does not affect the list of fifteen diseases which qualify for free medical care through the VA as provided in the “Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012.”

Affordable Care Act Repeal Begins But Raises Many Questions

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

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

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

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

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

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

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

DOT Releases New Air Carrier Access Act Training Materials

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

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

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

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

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

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

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

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

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

PVA Trains Wheelchair Attendants for Virgin America Airlines

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

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

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

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

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

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

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

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

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

 

The Ricky Raley Story

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

 

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

 

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

 

Back Home

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

September 16, 2016                                                        Volume 22, No. 9

***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. 

The Independent Budget Begins Development of Policy Agenda for the 115th Congress

During the August recess, PVA met with our partners in The Independent Budget (IB)—Disabled American Veterans and Veterans of Foreign Wars—to begin the planning process for the IB Policy Agenda for the 115th Congress.  Following the meeting, the organizations approved six critical issues that will lead the next IB.  Those issues are:

  1. Restructure the Delivery of Veterans Health Care—The Independent Budget will focus on the framework for veterans’ health care delivery reform proposed last year. Inherent in this framework is the preservation and strengthening of a robust Department of Veterans Affairs (VA) health care system, particularly specialized services such as spinal cord injury and disease care, blind and vision impaired care, polytrauma care, traumatic brain injury care, and mental health care services.
  2. Remove Budget Constraints that Negatively Impact Veterans Programs—This issue will focus on the structural impediments that lead to insufficient resources being provided to ensure VA has adequate capacity to meet the needs of veterans.
  3. Reform the Claims and Appeals Process—Appeals modernization and reform has been a primary objective of VA leadership this year and has been widely discussed in the House and Senate.
  4. Realign and Modernize Capital Infrastructure—The misalignment and deterioration of much of VA’s capital infrastructure is a commonly discussed problem that continues to negatively impact the delivery of care to veterans.
  5. Expand and Improve the Comprehensive Family Caregiver Program—Expansion of the comprehensive family caregiver program administered by the VA to veterans of all eras remains a high priority for The Independent Budget.
  6. Ensure that VA Provides High-Quality, Effective Programs and Services to Meet the Unique Needs of Women Veterans—Much work remains to ensure that women veterans are able to access the full range of health care services that are appropriate to their unique needs.

The document will also include a wide-array of issues addressing veterans’ benefits, health care, construction, education, employment and national cemeteries.  The IB Policy Agenda will be released in January 2017 in conjunction with the start of the 115th Congress.

House and Senate VA Committees Review Commission on Care Report

Following the long August recess, the House and Senate Committees on Veterans’ Affairs returned to work.  Their first order of business included hearings to review the Commission on Care report released in July.  The House VA Committee conducted its hearing on September 7 and the Senate VA Committee followed up with a hearing on September 14.  PVA submitted an official statement for the record for both of the hearings.

In July, the Commission on Care, established by P.L. 113-146, the “Veterans Access, Choice, and Accountability Act of 2014” (Choice Act), released its final report on the future of veterans’ health care.  The Commission was charged with examining access to care and strategically examining how best to organize the Veterans Health Administration, locate health care resources, and deliver health care to veterans during the next 20 years.  The report contains 18 major recommendations.  The most notable recommendations include establishment of an integrated health care network to expand access to care.  This recommendation mirrors in many ways previous recommendations of The Independent Budget—co-authored by PVA, DAV, and VFW—as well as the current community care consolidation plan that the Department of Veterans Affairs (VA) unveiled last fall.

The Commission also recommended a governance board to oversee the planning, policy and implementation of a new veterans’ health care system.  While this idea seems intriguing, it does not contemplate the biggest challenges of a new governance structure.  Specifically, this board would actually be more politically driven than current VA leadership due to the mechanism for selecting board members (appointed by House and Senate leadership).  Additionally, the Commission did not rationalize the interaction between the Veterans Health Administration and the Veterans Benefits Administration and how that would be impacted by this new governance structure.

The greatest concern PVA has with the Commission report is the recommendation regarding “choice.”  The report calls for allowing veterans the choice of primary provider within the new integrated health care networks.  However, it does not consider the impact that giving more veterans expanded choice will have on the current VA health care system and specifically specialized services, such as spinal cord injury and disease care.  The Commission analysis suggests that as much as 40 percent more care will move into the community under this proposal.

PVA also expressed other concerns with the Commission report.  We provided a detailed analysis to the Administration as well as the House and Senate Committees on Veterans’ Affairs.  PVA’s initial response and our in-depth statements for the record to this report can be found at www.pva.org.  The full report can be viewed at https://commissiononcare.sites.usa.gov/.

House Passes Important Legislation

As Congress returned after Labor Day from its annual summer recess, a few veterans-related bills passed through the House.  H.R. 5620, the “VA Accountability First and Appeals Modernization Act,” has two major components.  The first is a set of accountability measures which would institute reforms at the Department of Veterans Affairs (VA) and provide the Secretary increased flexibility to remove a VA employee for performance or misconduct.  It also strengthens whistleblower protections, including restricting bonus awards for supervisors who retaliate against whistleblowers

The second major component of H.R. 5620, is the proposed overhaul of the veterans’ disability claims and appeals process that PVA has been involved with since the plan’s inception.  The legislation is the work product of a collection of VSO’s who collaborated and negotiated for several months with VA.  While PVA supports the proposed system, we still insist there is further work to be done to deal with how that system is implemented.

With appeals now taking a minimum of three years on average to adjudicate, there is a strong consensus on the Hill that reform is needed now.  PVA participated in a press conference held at the Capitol Visitor Center promoting the issue.  Several members of Congress were present, including Senator Richard Blumenthal (D-CT), who introduced S. 3328, a bill that mirrors only the appeals provisions in H.R. 5620.  Because the accountability portion of H.R. 5620, is highly politicized, its fate in the Senate remains unclear.  However, PVA does support both components of H.R. 5620.

The House also passed H.R. 3471, the “Veterans Mobility Safety Act,” by voice vote with strong bipartisan support.  The bill will require VA to develop safety certification standards for vendors installing Adaptive Automobile Equipment (AAE).  Current law does not require individuals or businesses installing adaptive equipment to demonstrate any sort of qualifications or expertise to do so, sometimes leading to faulty and dangerous installations.  The process of developing those standards would include industry representatives, the National Highway Traffic Safety Administration, and most importantly, veterans’ service organizations.  Given the very high percentage of PVA members who rely upon AAE, we are well-positioned to represent the interests of veterans and ensure that the standards do not diminish the availability and delivery of these products.  We are now awaiting Senate consideration of a similar bill.  Senator Jerry Moran (R-KS) is preparing to introduce an amended version of H.R. 3471, which PVA supports, that should see this important legislation signed into law.

The House also passed H.R. 5936, the “Veterans Care Agreement and West Los Angeles Leasing Act of 2016.”   While PVA supported the overall intent of the bill and particularly the provisions related to provider agreements, we expressed serious concerns about aspects of the legislation.  VA has long struggled to attract smaller provider organizations necessary to fill gaps in health care services found in rural areas due to the laborious FAR process that governs contracting.  This bill will streamline the process for providers, allowing greater access to care as smaller organizations find it feasible to join the VA’s health care network.  PVA objected, however, to the bill’s weakening of employment opportunities and protections available for veterans, veterans with disabilities, and individuals with disabilities. The bill ultimately permits Veterans Care Agreement providers to not comply with important nondiscrimination and affirmative hiring provisions.  PVA and our partners in the disability and veterans communities have long opposed efforts to minimize this compliance.

Work Continues on ACCESS Committee

The DOT ACCESS Committee that was established in May will meet for the 5th time in mid-September with one more face to face meeting scheduled for October before the Committee completes its work. The Committee appointees are working hard to come to a consensus point of agreement on the definition of a service animal, whether DOT should require new single aisle aircraft to have an accessible lavatory and should in-flight entertainment and communications be accessible for those who are deaf and hard of hearing and or blind.

Before the September meeting members of the lavatory working group traveled to Dallas to board and study four different American Airlines twin aisle aircraft to view configurations of the accessible lavatory.  Twin aisle aircraft are required to have one accessible lavatory that would allow a passenger on an on-board wheelchair to enter the lavatory and have the door closed.  The working group also reviewed a smaller commuter-style plane to better understand the challenges with accessibility on that model of aircraft.  The Committee members hope to garner information and ideas from the design of these lavatories that can be used on single aisle aircraft.

PVA Supports Fair Pay and Safe Workplaces Regulation

To ensure that federal contractors better comply with laws that protect their workers’ safety, wages and civil rights, the U.S. Department of Labor announced on August 25th final regulations and guidance implementing the Fair Pay and Safe Workplaces Executive Order.  Signed by President Obama in July 2014, the order requires prospective federal contractors to disclose labor law violations and gives agencies more guidance on how to consider labor violations when awarding federal contracts. It directs the department and the council to issue regulations and guidance to implement the new requirements.

In a statement coinciding with the regulations release, PVA Executive Director, Sherman Gillums stated, “Every American should be protected against discrimination of any kind in the workplace, and Paralyzed Veterans of America commends President Obama for taking this action. The American workforce is increasingly diverse. As a result, upholding an equal opportunity to work is vital. The executive order will help prevent discrimination against veterans and people with disabilities by requiring that violations of labor and employment rights laws-such as the Americans with Disabilities Act, Vietnam Era Veterans’ Readjustment Assistance Act and Section 503 of the Rehabilitation Act-be among the considerations taken into account by the federal government in its contracting process.”

Overall, the action will help protect taxpayers, law-abiding businesses, and the more than one-in-five Americans employed by companies that do business with the federal government.  These final regulations will allow contracting agencies to begin implementing the order and identify companies with egregious violations. They can then be held accountable for amending their procedures before they receive any future contracts.

In supporting this action by the President, Gillums also noted that there have been recent Congressional efforts to undermine the order with the inclusion of provisions in the House and Senate National Defense Authorization bills to exclude Department of Defense contracts-which account for approximately two thirds of government contracts-from coverage under the order. Lawmakers in both houses and the Obama Administration are now working to ensure that this language is removed from the final version of the legislation during conference committee. “For the sake of Paralyzed Veterans members who are seeking employment with federal contractors, I sincerely hope that this language will be struck from the defense bill,” Gillums concluded.

The final regulations will be effective on October 25, 2016, and be implemented in phases to give contractors time to understand their responsibilities. The final guidance is available at: https://www.federalregister.gov/articles/2016/08/25/2016-19678/guidance-fair-pay-and-safe-workplaces. The final regulations are available at: https://www.federalregister.gov/articles/2016/08/25/2016-19676/federal-acquisition-regulation-fair-pay-and-safe-workplaces