• ‘Fantasy budget’: House Democrats push back on VA spending request

    House Democrats Push

     

    WASHINGTON — House Democrats on Wednesday blasted the Department of Veterans Affairs for requesting a large budget increase for 2021, calling the proposed boost in spending at the expense of cutting other agencies a political stunt.

    “It’s not a good faith proposal,” said Rep. Debbie Wasserman Schultz, D-Fla., chairwoman of the House Committee on Appropriations subpanel on military construction, Veterans affairs and related agencies. “I know it is an election year and it is a fun and easy thing to ask for the sun and moon and the stars to help a population like our nation’s Veterans who deserve every bit of it. And we would be right there, if possible.”

    Other Democrats on the committee also attacked the proposed increase, comparing it to President Donald Trump’s proposal for deep cuts to other federal agencies, including a 9% cut to the Centers for Disease Control and Prevention amid a possible outbreak of coronavirus.

    “This size of an increase... it just really looks like the presentation of an unrealistic and political budget,” said Rep. Ed Case, D-Hawaii.

    The VA is requesting a 14% increase in its 2020 budget to $243.3 billion for 2021 and is the only federal agency seeking a double-digit funding boost. The VA is the second-largest federal agency, second only to the Defense Department in size and budget.

    The proposed budget is Trump’s fourth time requesting an increase for the VA, continuing a pattern set by previous administrations. The agency’s budget has increased consistently since the beginning of the Iraq and Afghanistan wars.

    “In a perfect world, this essentially fantasy budget is a wonderful request. We would love to provide Veterans with the best care and benefits money can buy,” Wasserman Schultz said during the hearing on the VA’s budget. “However, the reality is we live in a world with budget caps. What is frustrating is the administration knows this, and they are essentially using our Veterans as pawns in a political game.”

    VA Secretary Robert Wilkie pushed back, noting the gains that the department has made in shortening wait times for medical appointments and hiring health care providers and administrative staff as well as technological innovations such as a 5G hospital in Palo Alto, Texas.

    “VA is no longer a place where excuses and systemic failures rule the day,” Wilkie said. "[I was] asked to provide a budget to indicate to the country that Veterans are a priority."

    Source

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  • COVID-19 Information and Recent Legislation

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    As our nation is responding to the novel coronavirus health crisis, DAV's professional staff in Washington D.C., are engaging and advocating for veterans and their families with Congress, the Administration and VA. In light of our efforts, we are pleased to provide the following updates:

    On March 27, Public Law 116-136, the Coronavirus Aid, Relief, and Economic Security (CARES) Act was enacted. The CARES Act provided nearly $20 billion to VA to protect veterans and their families during this crisis. Below is a summary of provisions in the bill:

    • $14.4 billion for essential medical and protective equipment including the purchase of testing kits, personal protective equipment (PPE), and medical supplies to support growing demand for health care services at VA facilities and through telehealth services.
    • $2.1 billion to support increased demand for care in the community, especially at emergency rooms and urgent care facilities.
    • $2.15 billion to bolster telehealth capabilities through increased telework and call center capabilities to deliver health care services directly related to coronavirus and mitigate the risk of virus transmission.
    • $13 million to ensure VA can provide earned benefits by enhancing telework capabilities for the Veterans Benefits Administration.
    • $150 million to assist State Veterans Homes in their response to prevent, prepare for, and respond to coronavirus.
    • Authorizes temporarily waiver of in-person home visit requirement to enroll and permits telephone and telehealth visits as an alternative. Prohibits suspension or disenrollment from the certain VA programs during a public health emergency.
    • Requires VA to provide personal protective equipment to VA and community-based workers that provide care to veterans in their home.
    • Ensures the 2020 Recovery Rebate veterans receive under the CARES Act shall not be treated as income to avoid a loss or reduction of any VA benefits.
    • Increases flexibility for vulnerable veterans with limb loss, allowing them to seek prosthetic assistance at community providers instead of VA.
    • Expands telemental health services for veterans and gives VA the ability to enter into agreements with telecommunications companies to provide temporary, complimentary fixed and mobile broadband services.

    For more information on the specifics of the CARES Act, please read the press statements issued from House and Senate Veterans' Affairs Committee leadership in the following links:

    On April 2, we issued an Action Alert through DAV CAN, referencing a joint letter sent to the Secretaries of Treasury and VA and advising you of the issue concerning Recovery Rebate checks specifically affecting veterans and survivors who have no income other than VA disability compensation or a related benefit and are not required to file income taxes. We thank you for your resounding response of almost 10,000 emails sent to Congress. As of this date, we are informed, the Department of Treasury and VA are currently working together to resolve this issue. We will continue to update you on this vital concern as we receive additional information.

    Source: DAV

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  • House passes largest VA budget ever, but partisan fights threaten its future

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    House lawmakers advanced the largest budget in Veterans Affairs history on Friday, but the spending package faces an uncertain future in the Senate and even tougher odds if it reaches the White House.

    That’s because the $241 billion VA funding measure — which also includes about $10 billion more in appropriations for military construction projects — includes language blocking President Donald Trump from transferring certain funds to his controversial military wall project, and money to begin renaming military bases currently honoring confederate leaders.

    Both of those topics have prompted presidential Veto threats in the past, and are likely to bog down negotiations to move the appropriations bills ahead in coming weeks.

    Ahead of Friday’s 224-189 largely partisan vote on the spending package, House Majority Leader Steny Hoyer, D-Md., urged his Republican colleagues to find a way to work through the differences and avoid the possibility of a partial government shutdown at the start of the new fiscal year, Oct. 1.

    “The bill ensures we provide resources to support our Veterans, so critical and across the board, thought to be a moral responsibility,” he said. “Sadly, it will in all likelihood join the more than 275 other House bills languishing in the Republican-controlled Senate.”

    The $241 billion in funds for VA roughly matches what White House officials requested in their budget request in February and includes about $105 billion in discretionary spending in fiscal 2021, an increase of about 13 percent from current levels.

    While other federal agencies have drastic cuts or limited growth in recent years, the Department of Veterans Affairs has enjoyed substantial yearly increases.

    VA was the only cabinet department to have a double-digit percentage spending increase under the president’s fiscal 2021 plan, and would become the second largest federal agency by discretionary spending under that budget outline, behind only the Department of Defense (which boasts nearly six times the VA proposed level of program funding and three times the total level of VA spending.)

    In fiscal 2001, the VA budget totaled $45 billion. Ten years ago, it was about $125 billion, a little more than half of the House-passed plan for fiscal 2021.

    “Amid a global pandemic, we also made unprecedented VA medical system investments to ensure that every Veteran has access to the top-notch health care that they deserve, including historic spending for women Veterans, mental health, suicide prevention, research, and homeless prevention,” said Rep. Debbie Wasserman Schultz, D-Fla., head of the Veterans panel for the House Appropriations Committee.

    “This bill ensures our Veterans and military families are protected, respected, supported and get the highest quality healthcare they deserve.”

    To avoid conflicts with federal budget caps, the discretionary funding increases — which cover a host of medical, transition and ongoing support programs — are designated under the plan as emergency funding.

    Of the $105 billion in discretionary funding, about $90 billion is set aside for VA medical care. That includes $10.3 billion in funding for mental health care, an increase of more than 9 percent from fiscal 2020, and $661 million for women’s health programs, an increase of 11 percent from the current year.

    Lawmakers also included $1.9 billion for homelessness assistance programs targeting Veterans, about $40 million above what the president requested.

    The military construction portion of the bill includes nearly $1.5 billion for family housing projects, an increase of about 9 percent from the president’s budget request, and $596 million for Guard and Reserve installation projects, about 5 percent above the president’s request.

    The measure also includes about $200 million for perfluorooctane sulfanate and perfluorooctanoic acid cleanup work at various military sites.

    Source

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  • Lack of a federal budget deal endangers Veterans, VA secretary warns

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    Congress won’t start dealing with the federal budget again in earnest until after the holidays, but Veterans Affairs Secretary Denis McDonough isn’t waiting until then to sound the alarm on the issue.

    In a press call with reporters last week, McDonough called reports of a possible full-year budget extension for federal agencies a looming disaster for Veterans care, Veterans benefits and department operations.

    “It would have a significant negative impact,” he said.

    “The Veterans Health Administration budget would be shorted $941 million in community care funds. … The construction account would be $458 million below the president’s request, causing delays and cost increases. And the Veterans Benefits Administration would be $259 million lower, which would prevent us from hiring and training staff.”

    The new fiscal year for the federal government began Oct. 1 without a new budget adopted by Congress. Lawmakers twice have extended fiscal 2021 spending levels into the new fiscal year, with those authorities set to end in mid-February.

    House and Senate leaders will have to reach a new budget extension or negotiate a full-year budget plan by then in order to avoid a partial government shutdown.

    But McDonough — along with other administration officials — are warning that another budget extension will hurt federal operations and that lawmakers should finalize plans for a full-year spending deal instead.

    “It’s a source of concern for me and it is occupying a good amount of my time right now,” McDonough said. “This is a natural time, as we come to the end of the calendar year, to be thinking ahead about the kinds of things that will be major priorities for us when we flip the calendar, and this [budget problem] is on my mind.”

    The White House has proposed $270 billion for VA operations and benefits in fiscal 2022, up about 12 percent from last year. Plans call for a 13.5% raise in mental health care spending (to $10.7 billion), a 14.5% boost in homelessness prevention ($2.6 billion), and a 12% boost in gender-specific care programs (over $700 million).

    All of those increases have been on hold for the last three months as department officials await a new budget. The budget extensions have locked them in at fiscal 2021 spending levels, without the planned plus-ups for those programs.

    Without those increases “I can’t rule out impacts on individual Veterans’ lives,” McDonough said.

    “We’ll obviously work really hard to mitigate that,” he said. “But, especially in the context of the ongoing pandemic, I’d hate to have to make these sets of balancing decisions.”

    The VA budget proposal has not faced specific opposition from either party on Capitol Hill, but has been stalled because of broader budget fights among Democrats and Republicans.

    Earlier this month, Defense Secretary Lloyd Austin issued a similar statement on the potential danger of a full year continuing resolution, saying it could hurt personnel support services and readiness initiatives.

    Lawmakers are expected to resume their budget deliberations when they return to Capitol Hill in January.

    Source

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  • Largest budget in VA history gets backing from House appropriators

    Denver VAMC 003

     

    House appropriators on Thursday backed the White House plan for a Department of Veterans Affairs budget of more than $300 billion in fiscal 2023, but with more transparency as to how medical costs are driving up that total annually.

    Members of the House Appropriations Committee approved the spending plan by a party-line vote of 32-26. The measure also includes $15.1 billion for military construction projects, $2.9 billion above President Joe Biden’s budget request.

    “Our Veterans, servicemembers, and their families have made immense sacrifices to protect and serve our nation, and it is our duty to make sure they have the support they need and deserve,” Appropriations Committee Chairwoman Rosa DeLauro, D-Conn., said in a statement.

    “This critical legislation builds on our commitment to our Veterans with targeted funding to enhance mental health care, suicide prevention, and substance use disorder programs, advance women’s health and whole health initiatives, and provide homelessness assistance to our Veterans most in need.”

    The measure also separates VA medical care spending into its own budget category, apart from other defense and non-defense discretionary spending. The move has been requested by Veterans Affairs officials.

    “The way it helps is that you can see tangibly the escalating cost of VA health care, which helps us consider those expenses more specifically and clearly,” said Rep. Debbie Wasserman Schultz, D-Fla., chairwoman of the committee’s panel on Veterans issues.

    “We’re getting a significant rise in VA medical care costs and that’s expected to continue to go up exponentially. So we’re making sure that we can find a way to address the rising costs of the VA funding without it eclipsing all of the other funding for discretionary programs across all the [federal appropriations] bills.”

    The VA budget proposal — the largest in department history — has nearly $119 billion for Veterans medical care in fiscal 2023, up 22% from current year levels.

    That includes $13.9 billion for mental health care (up 6% from this year), $911 million for gender specific health care programs (up 8%) and $183 million for substance abuse disorder programs (up 17%).

    Homeless assistance programs would be boosted to $2.7 billion, up 24% from current year levels.

    The full House chamber will likely vote on the spending plan next month, but the fate of the appropriations bill is uncertain after that. Senate appropriators have not yet released their plans for the VA or military construction budgets yet.

    The two chambers hope to agree on a compromise spending plan before the start of the new fiscal year, which starts on Oct. 1.

    Source

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  • New White House budget threatens access to Veteran benefits

    Access to Vet Benefits

     

    To use their healthcare benefits, Veterans are required to successfully navigate one of the most complex and least user-friendly bureaucracies around. The Veterans’ Administration (VA) has been underfunded for years as it continues to suffer from insufficient hospitals and a broken, backlogged benefits system.

    The VA consists of over 412,000 employees (plus contractors), 6,000 buildings, including 1,600 health care facilities, 144 medical centers and more than 1,200 outpatient sites. The last two decades of war have produced the greatest number of Veterans since the Vietnam era, putting additional stress on an increasingly complex system that has also been plagued with scandal, overwork and disappointment.

    For example, of the roughly 520,000 pending VA claims for disability compensation and benefits, 191,000 are considered to be backlogged (defined as older than 125 days). Exacerbated during the pandemic, much of the important work at the National Personnel Records Center at the National Archives and Records Administration (the team that helps with processing disability claims) was stopped and 90% its staff were sent home.

    Historically assistance and instruction for the individual Veteran has been provided by VA intake officers, Veteran Service Organizations (VSOs) and internet instruction for self-help. Unfortunately, all of these avenues have proven inadequate to the challenge.

    The VA continues to fight an increasing backlog making their direct assistance all but entirely a thing of the past. The on-line instructions are wholly inadequate for the average Veteran because of the innate complexity of the system on a par with the IRS. The VSOs have always been the long pole in this tent but their shrinking membership, service disparities given the state you live in, and ever-lowering visibility in the community makes their assistance less and less the effective stopgap they once were.

    Over that last decade, private consulting agents who work on a contingency basis have become an effective private sector solution to this lack of this assistance for Veterans. These are non-government actors that, similar to VSOs, can help Veterans work through benefits claims and assist in each step of the process. They typically work on a contingency model which means they do not get paid unless there is a benefit increase for the Veteran. As is the case with a most private enterprise, these consultants have extensive staff expertise and systems in place to be as efficient as possible.

    Much like hiring an attorney to assist in the process, the Veteran gets the same help from these consultants at a fraction of the cost of lawyers and on a success-fee basis. To safeguard against fraud or incompetence, these consultants must be accredited by the VA to provide these services.

    Government bureaucrats preparing the Biden Administration’s VA budget request have included a prohibition of these consultants from being able to be accredited. This prohibition is a revival of a failed attempt by Montana Senator Steve Daines in the last Congress to eliminate the consultants from the process of providing individual assistance to Veterans.

    Whether this proposal is rooted in a desire to protect attorneys and their hourly fees (attorneys are not similarly prohibited by the VAs proposal), punish private enterprise looking to supplant a bloated and inefficient government bureaucracy or just a desire to stop being showed-up by an efficient and helpful organization; the proposal is misguided and completely without any consideration for the long-suffering Veteran.

    These types of consultants are all but essential in other interactions citizens have with our government. From private tax preparation to private ambulance services and a host of others; private companies providing direct services to citizens to assist in their interactions with government are as common as they are often indispensable.

    Considering the backlogs to initial intake for new claims alone, the VA should be looking to streamline and expand the levels of private assistance to its own inability to do this important task. There are ways to ensure that these consultants remain reliable, capable and effective. Simply eliminating them is a lazy, non-solution to what is largely a non-problem.

    In proposing this legislative change, the Biden VA and others in Congress cite the high costs and challenges to accrediting, overseeing and occasionally policing private consultants. Basically, the VA says they can’t advise and assist the Veteran on their own but allowing private help is too difficult to accept. Congress should reject the tired bureaucratic whine of “too hard” and insist that they continue to accept this private help, get over themselves and get better at integrating it successfully.

    In Congress, I sat on the Veterans’ Affairs Committee, previously I served in the Army, and I am a member of the American Legion – one of the main VSOs providing this non-government assistance to the Veterans. In my opinion, the need for private consultants supplementing an inadequate bureaucracy, over stressed VSOs and expensive attorneys is not only preferable but necessary.

    The VA can and should do better and needs to drop this budgetary request and embrace private help to its government mission.

    Source

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  • President Signs NDAA: What the Law Includes, and What's Next

    Donald Trump 032

     

    President Donald Trump signed the FY 2020 National Defense Authorization Act (NDAA) on Dec. 20 in a ceremony at Joint Base Andrews, Md. This landmark legislation culminates the many efforts ranging from grassroots visits at home to coordinated campaigns on Capitol Hill over a period of time ranging from months to decades.

    MOAA’s Storming the Hill in April, and the Summer Storm in August, were instrumental in increasing awareness and support for the military pay raise, repeal of the “widows tax,” and protecting TRICARE and military medicine. The NDAA represented success in all of these advocacy priorities.

    These engagements and achievements led to MOAA being recognized for the 13th year in a row as a top lobbyist by The Hill, a news outlet based in Washington D.C.

    Here’s what’s included in the NDAA, and a look at these critical issues moving forward:

    Pay Raise

    What’s In: A 3.1% raise effective Jan. 1, 2020. The raise matches the administration’s request and is the largest pay increase for troops in 10 years. A 3.1% increase equates to an annual raise of $1,200 for an O-3 with 10 years of service.

    What’s Next: MOAA will again start working to ensure the president’s budget for the next fiscal year includes a pay raise based on the Employment Cost Index (ECI) report from October 2019. Based on that figure, next year’s raise should be 3.0%.

    TRICARE

    What’s In: Congress approved no new fees or pharmacy increases in 2020. Previously agreed upon increases for medical and pharmacy copays will take effect in January 2020.

    What’s Next: MOAA will continue to lobby against any disproportional fee increases that may exceed cost-of-living adjustments.

    Medical Billets

    What’s In: MOAA’s extensive efforts on the medical billet reduction issue paid off with a provision that addresses concerns regarding both medical readiness and beneficiary access to high quality care.

    What’s Next: The provision prohibits DoD and the services from reducing medical end strength authorizations until they complete a series of steps. MOAA will monitor and ensure DoD performs the following:

    • A review of medical manpower requirements of each military department under all national defense strategy scenarios.
    • An analysis of affected billets together with mitigation plans to address potential gaps in health care services.
    • The creation of metrics to determine TRICARE network adequacy.
    • The establishment of outreach plans for affected beneficiaries, including transition plans for continuity of health care services.

    Survivor Benefits

    What’s In: After nearly 50 years, MOAA’s efforts and the efforts of others finally paid off with the elimination of a financial penalty more than 65,000 military survivors face, known as the “widows tax.” Eliminating the widows tax has been a top legislative priority for MOAA for decades.

    Earlier this year, more than 150 members from around the country came to Washington, D.C. to participate in MOAA’s annual Storming the Hill event. One of the main topics MOAA members raised with their elected officials was eliminating the widows tax.

    What’s Next: According to the legislation, the offset will be phased out over a three-year period in this fashion:

    2020: No changes. Current Special Survivor Indemnity Allowance (SSIA) and all current Survivor Benefit Plan-Dependency and Indemnity Compensation (SBP-DIC) offsets remain in place. MOAA will continue to follow the evolution of directives which will support the implementation and ultimate completion of this repeal.

    2021: The SBP-DIC offset is reduced by one third. Annuitants will receive the amount that would exceed two-thirds of the Dependency and Indemnity Compensation.

    2022: The SBP-DIC offset is reduced by two-thirds. Annuitants will receive the amount that would exceed one-third of the Dependency and Indemnity Compensation.

    2023: The SBP-DIC offset is eliminated. Annuitants will receive the full amounts of both SBP and DIC. Further, on Jan. 1, 2023, survivor benefit eligibility is restored to those who previously elected to transfer payment of their annuity to a surviving child or children.

    Guard and Reserve

    What’s In: For those National Guard and Reserve servicemembers who served on 12304B orders, such service will now count toward their active duty time to lower the age when they receive their retirement pay.

    What’s Next: MOAA will continue to work to identify and correct inequities in service and benefits borne by servicemembers and their families in the Guard and Reserve. MOAA recently engaged the Defense Finance and Accounting Service (DFAS) to address the inordinate delay for retiring reservists – many routinely having to wait over 6 months to receive their retirement pay. Additionally, MOAA will continue to seek a standardized service record for members of the reserve component.

    Medical Malpractice

    What’s In: To address non-combat related military medical malpractice, the NDAA directs DoD to develop a regulation for negligent malpractice to be addressed through the military legal system. Although this is not a repeal of the 1950s era “Feres Doctrine,” it provides a framework of redress for servicemembers who have suffered from medical malpractice. The NDAA authorizes a payment up to $100,000 by DoD judges and higher amounts by the Department of the Treasury.

    What’s Next: MOAA will monitor implementation and ensure our members and prospects understand the procedures and policies to be written in support of this legislation.

    Spouse and Family

    What’s In: After identifying significant health and safety concerns in military housing, MOAA elevated these issues to DoD and Congress, culminating with congressional hearing that built the foundation of legislation to direct improvements. This bill underwrites the most comprehensive military housing reform since 1996.

    What’s Next: MOAA will watch closely the implementation of this housing reform to ensure the results follow the rigorous efforts leading to the bill, ensuring compliance with the following legislated actions:

    • Establish a tenant bill of rights and responsibilities.
    • Ensure medical costs and relocation expenses are covered by landlords.
    • Formalize a dispute resolution process.
    • Ensures a proper work order system and complaint database are in place along with a number of other provisions correcting gaps and negligence in the Military Housing Privatization Initiative (MHPI) system.
    • Expand direct hire authority for DoD for child care providers. Additionally, take a closer look at the capacity of child care centers on post and streamline hiring to ensure they are properly staffed.

    The bill also expands spouse employment resources, such as an increase to $1,000 for licensure reimbursement as well as expansions to the My Career Advancement Account (MyCAA) program for any degree area and to include Coast Guard spouses.

    This defense bill is a big win for servicemembers and their families. MOAA thanks Congress for its bipartisan work, and President Trump for endorsing the legislation and extending our nation’s streak of producing a defense bill to 59 years.

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  • Proposed VA Budget Would Increase Funding for Cancer Treatment

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    The Department of Veterans Affairs' $243.3 billion budget request for next fiscal year includes a $75 million increase for cancer treatment so the VA can "deliver the most up-to-date care as close to the patient's residence as possible."

    The investment would go toward the VA's precision oncology program, which moves away from one-size-fits-all cancer treatments to personalized care that focuses on the patient's and cancer's DNA mutations to figure out the best treatment.

    Retired 1st Sgt. Jeremy Kitzhaber, 49, considers it a great improvement.

    "I'm all for it because I had to go outside of the VA to get it," he said.

    Kitzhaber spent 22 years in the Air Force, where he worked in civil engineering. Before retiring in 2012, he deployed several times, including Incirlik Air Base, Turkey, for earthquake relief and Al Dhafra Air Base, United Arab Emirates, in support of Operation Iraqi Freedom.

    While he prefers to receive care from the VA, it wasn't possible in 2014 when he was diagnosed with Pseudomyxoma Peritonei, or appendix cancer, which "leaks everywhere."

    It was caused by exposure during his duties to radiation and chemical and biological hazards, he said.

    Since there were no VA oncology physicians who specialized in his cancer, Kitzhaber went to a private provider in Omaha, Nebraska. The surgeon lifted Kitzhaber's organs out of a 13-inch incision in his abdomen and "washed his inner belly with chemo," he said.

    When he returned to the VA, his medical team started him on traditional chemotherapy that was so severe he almost died. The cancer returned a few months later.

    "Cancer care is changing rapidly and becoming increasingly complex," a VA spokeswoman said via email Thursday. "The overall mission of the Precision Oncology initiative is to improve the lives of Veterans with cancer through Precision Medicine by implementing a learning health care model to quickly transition new knowledge into clinical practice and to maximize learning from clinical practice."

    Precision medicine is what ultimately saved Kitzhaber's life. The first genetic test he received from the Omaha physician showed nothing more could be done for his stage 4 cancer. But a second opinion and blood test from an oncologist in San Diego proved a breast cancer drug would drastically slow the cancer's progress.

    "I tell people it was 60 miles an hour with no treatment; now it's 1 mile an hour," he said, adding that the drug has had few side effects: a little fatigue, slightly thinner hair and more brittle nails.

    That's compared to 20 rounds of chemotherapy, which caused him to black out four times due to his heart going into atrial fibrillation.

    Among the initiatives to be funded by the VA's budget request will be the National Precision Oncology Program (NPOP), which gives access to a tumor DNA sequencing database and a national molecular oncology tumor board. It will also fund "TeleOncology," a service to let patients access oncology specialists remotely through the internet.

    There are about 40,000 cancer cases reported to the VA's Central Cancer Registry annually, according to a 2012 study. Though the database is not available to the public, the VA reports that the five most frequently diagnosed cancers among Veterans are prostate; lung and bronchial; urinary and bladder; colon; and skin.

    Terrence Hayes from Veterans of Foreign Wars said in an email that his organization has heard from several Vets who have struggled to find the right care for their specific need and have had to undergo "rigorous" cancer treatments like Kitzhaber.

    "It is encouraging to see VA institute this program and focus more on a personalized approach to cancer treatment for our Veterans," he said. "A one-size-fits-all approach to cancer treatment cannot be the way we look at treating our Veterans, especially many who developed these cancers due to the environmental hazards they have come in contact with during their service."

    Hayes added the VFW hopes this means the VA will have quicker diagnoses and more thorough treatment measures to extend Veterans' lives.

    William Goeren, CancerCare director of clinical programs, said he's found that, while precision oncology has fragmented care, it gives a lot more hope for patients.

    "I will say that precision medicine does provide a patient with a greater sense of hope and individualized attention versus a one size fits all," he said. "[But] there are often so many [medical doctors] involved in a case that patients often don't know who is leading their treatment, especially if a patient has co-morbidities."

    CancerCare is a national organization that provides free counseling and emotional support services to cancer patients. It's been studying how to work with Veterans with cancer as it tries to create a support group for them.

    Goeren said he's found that, while Veterans have similar challenges as other cancer patients -- including financial strain and transportation difficulties, they have trust issues when it comes to getting care.

    "In some ways, they feel betrayed by their own government. It was through their work that they have now come down with cancer," he said. "There's a sense of 'I've been burned once -- by an organization, the federal government -- so I'm not trusting of anything.'"

    Goeren said this is similar to what black or LGBT patients feel when it comes to receiving health care treatment when they have historically been shunned.

    Currently, the VA's options for cancer treatment include surgery, chemotherapy, immunotherapy, targeted therapy and hormonal therapy, among others, the VA spokeswoman said. A VA patient is tested for cancer when he or she has symptoms or abnormal test results. If the test shows cancer, the treatment approach will vary based on the patient and cancer.

    "Cancer diagnosed at any age is scary," Kitzhaber said. "We have these life plans all that kind of go away."

    Before his diagnosis at 43, he said he had his life planned out until the age of 80, looking forward to celebrating his 50th wedding anniversary and taking care of grandchildren. Now, his outlook is much shorter.

    "It's not always easy to go outside the system," he said. "Seventy-five million dollars, to me, for people to have a better quality of life, live longer, is money well spent."

    Source

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  • VA budget plan includes new office focused on preventing harassment, promoting diversity

    Denis McDonough 002

     

    Veterans Affairs officials will create a new office focused on diversity and harassment prevention under the White House’s fiscal 2022 budget plan unveiled Friday, which also includes significant funding boosts for improving mental health care and ending homelessness.

    The total budget request of nearly $270 billion would be an increase of more than 10 percent over current year spending levels and an 9 percent increase in discretionary funding ($117.2 billion) for the department.

    It represents another significant boost for a department which has seen steady budget growth over the last two decades. In fiscal 2001, the VA budget totaled about $45 billion. By fiscal 2011, it was about $125 billion, almost triple that total. Ten years later, in 2021, the department’s budget was nearly double that again, at $245 billion.

    That total does not include an additional proposed $18 billion under President Joe Biden’s American Jobs Plan, much of that for infrastructure improvements at VA medical centers throughout the country.

    In a statement, White House officials said the spending plan “will ensure VA is moving swiftly and smartly into the future, with much-needed monetary investments in our most successful and vital programs.”

    It also includes the creation of a new Office of Resolution Management, Diversity, and Inclusion.

    Both Biden and VA Secretary Denis McDonough have vowed to make VA programs more inclusive to minority and women Veterans. Officials said that the new agency would oversee department diversity programs and create “a robust harassment prevention program” in response to concerns about sexual misconduct policies for the department.

    The department has come under intense criticism in recent years for a series of sexual misconduct scandals. In 2018, a report from the Government Accountability Office found that about one on four women working at VA reported experiencing sexual harassment or abuse, and one in three employees said they witnessed an act of sexual misconduct.

    Last year, dozens of Democratic lawmakers and Veterans advocates demanded the resignation of then VA Secretary Robert Wilkie over his mishandling of a sexual abuse complaint from a congressional staffer while she visited the Washington, D.C. VA Medical Center.

    Biden and McDonough have promised “zero tolerance” for such incidents. The new office would also oversee the implementation of several new diversity and anti-harassment initiatives approved by Congress in recent months.

    On the medical side, the budget plan calls for mental health care spending to rise significantly next year, up about 13.5 percent to more than $10.7 billion. Suicide prevention outreach specifically would almost double, from about $287 million this year to a proposed $598 million in fiscal 2021.

    Suicide prevention has been a top priority at the department in each of the last three presidential administrations, but the rate of suicide (about 17 Veterans a day) has remained frustratingly steady over the last decade despite increased financial resources.

    Homelessness prevention and support programs would grow 14.5 percent under the plan, topping $2.6 billion. Federal officials estimated about 37,000 Veterans are experiencing homelessness on any given night, a figure that is half the level of a decade ago but up slightly in recent years.

    Gender specific care spending would also rise in the budget proposal, about 12 percent to over $700 million.

    Caregiver stipend payment costs are expected to up by nearly a third next year, as more Veterans are added to the program.

    In fiscal 2020, when the program was open only to Veterans who served after Sept. 11, spending on the program was about $500 million. Now that the program has been expanded to include Veterans who served before 1973, spending is expected to surpass $1.5 billion in fiscal 2022.

    Lawmakers are expected to debate the budget proposal over coming months, with a goal of passing a final version by the start of the new fiscal year on Oct. 1. However, this White House budget plan is the latest arriving in history, likely pushing final passage of the spending plan to later in the year.

    The VA budget is not seen as a highly controversial topic in Congress, even with the significant funding increases in recent years. But approval of the department’s budget has been stalled several times in recent years because of unrelated spending fights among lawmakers.

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  • Veteran Affairs to Get a Budget Hike…But the Numbers Don’t Add Up

    Budget

     

    The Biden administration really does struggle with math. And as they look to boost the budget of the Veteran Affairs, it’s becoming quite obvious.

    The budget for the VA has been suffering for years. Ask any Veteran if they’re happy with the quality of care they are receiving or if they think they’re being properly compensated for their injuries. The answer will be a resounding “no.”

    VA officials are asking for $270 billion for the next fiscal year. It’s a lot more than what has been spent in the past, but it’s desperately needed to get the Veteran Affairs budget to the level that it needs to be.

    Mike Bost, a Republican Representative out of Illinois, has said “the time has come to ask when VA will be adequately funded.” As a ranking member of the House Veterans’ Affairs Committee, he believes that Congress must work to prioritize Veterans.

    When you look at the way that Congress has been spending money lately, $270 billion is a small request. After all, shouldn’t we be taking care of our Veterans before we take care of many of the other things that Congress wants to spend money on – like gender studies in foreign countries?

    For the fiscal 2022 year, there’s an ask for a 10 percent increase in VA spending. The problem is that there are many Democrats that don’t understand the math.

    If the budget goes up by 10%, that means that demand for VA services should go up by 10%, too…right?

    Wrong. The VA has been significantly underfunded for years.

    Proof of that is to show that in 2001, the VA budget was only at $45 billion. That’s not a lot of money to care for the number of Veterans in the system. This includes not only their disability compensation but also the care that’s provided at VA facilities around the country.

    Over the years, the VA budget has grown – but it’s still not where it needs to be.

    Many want to look at the VA budget in comparison to prior years. The budget in 2001 was six times smaller than the budget that’s being requested for 2022.

    Rather than comparing it to prior years, Congress needs to look at the realistic number that’s needed to process VA claims and take care of Veterans properly.

    If the Democrats can focus on infrastructure, Republicans can focus on VA benefits. And speaking of infrastructure, there’s another demand for the VA. Administration officials also want to see $18 billion from the $2 trillion infrastructure plan so that upgrades can be made to VA hospitals.

    Veterans have had to sacrifice a lot so that Americans can enjoy life, liberty, and the pursuit of happiness. And as VA Secretary Denis McDonough points out, there are toxic exposure bills sitting before Congress that could end up adding tens of billions more to the VA spending in the next few years.

    Bost has concerns that the VA Veterans being enrolled is actually dropping. This means that some spending will go down. He’s eager to grow the VA budget, but wants to ensure that it is in line with demand.

    Meanwhile, there are Democrats who would love nothing more than to cut from the VA so that the money can go to frivolous other things.

    We have to take care of our Veterans. Without them, we would not be the country that we are today.

    It does appear that there are enough people in Congress who want to fight for our Veterans. Caregiver benefits and funding for homeless Veterans are both being boosted.

    Finally, we can finally see some sensible spending within the budget. Luckily, some money is actually going toward Americans. It’s nice to see that we’re not cutting from everywhere to give to migrants. Now, if we can just boost the budget a bit more for Veterans, we might actually save the country.

    Source

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