Tag Archives: veterans affairs

Biden Administration Announces Actions to Address the Health Effects of Military Exposures

On Veterans Day 2021, the Biden Administration announced new actions to address health effects of military exposures on veterans © Karen Rubin/news-photos-features.com

On Veterans Day 2021, the Biden Administration announced new actions to address health effects of military exposures on veterans. The White House provided a fact sheet outlining new initiatives to address health impacts of military service:

Exposure to contaminants and environmental hazards poses a major health concern for veterans of all generations. There are also gaps and delays in the scientific evidence demonstrating conclusive links between known exposures and health impacts, leaving many veterans without access to Department of Veterans Affairs (VA) benefits and high-quality treatment to address significant health conditions. For example, it took decades to provide access to compensatory benefits and health care to many Vietnam era veterans for conditions presumed to be related to Agent Orange exposure. For the newest generation of veterans, concerns about burn pits and other exposures continue to mount. While the federal government has taken some steps to address these issues, including implementing registries to track veterans exposed to potentially hazardous substances, the Biden-Harris Administration is committed to doing more to enable timely access to services and benefits for those potentially exposed to hazardous materials.

As we mark Veterans Day and honor those who have worn the uniform of the United States, the Administration is moving forward to support our service members and veterans who may have encountered environmental hazards by:

Developing and testing a model for establishing service connection. It can be difficult for veterans to prove connection for disabilities resulting from environmental hazards. To mitigate this difficulty, VA may create presumptions of exposure in order to establish service connection for various chronic conditions when the evidence of an environmental exposure and the associated health risks are strong in the aggregate but hard to prove on an individual basis. In order to deliver benefits more quickly to veterans who developed disabilities due to exposure to environmental hazards and to lower the evidentiary burden on such veterans, VA developed a new model to accelerate the decision-making process to consider adding new presumptive conditions. This new model takes into consideration not only consensus reports from the National Academy of Sciences, Engineering, and Medicine, but also includes analyses of data from other sources as well, including data from the Veterans Benefits Administration and the Veterans Health Administration. The new model relies upon a multi-faceted scale to evaluate the strength of scientific and other evidence and allow VA to make faster policy decisions on key exposures. VA successfully applied this model to examine the association between exposures to particulate matter and three respiratory conditions, as announced last May.

Adding new presumptive conditions. In August, VA began processing disability claims for asthma, rhinitis, and sinusitis based on presumed exposure to particulate matter. Veterans who served in the Southwest Asia theater of operations and other areas and who developed these conditions within 10 years of military service are now eligible to apply for disability benefits and access to VA health care. This rulemaking was based upon application of the new presumptive model and involved careful review of a study conducted by the National Academies of Science, Engineering, and Medicine, as well as other evidence assessed by VA subject matter experts.

Applying new model to review evidence of service connection for rare respiratory cancers and constrictive bronchiolitis. VA will further test the new presumptive model to assess potential associations between military environmental exposures and constrictive bronchiolitis, lung cancers, and rare respiratory cancers such as squamous cell carcinoma of the larynx or trachea and salivary gland-type tumors of the trachea. The President has directed VA to complete the review of rare cancers and provide recommendations about new presumptions of service connection within 90 days. Based on the results of this review, the Administration will consider initiating additional rulemaking. Once the process is complete, the Administration will continue to test this model on additional health conditions and exposures to ensure more timely review and consideration of potential service connection.

Improving data on individual exposures. The Individual Longitudinal Exposure Record (ILER) is the primary Department of Defense and VA application to track, record, and assess environmental and occupational exposure to potentially hazardous substances. Currently, ILER is not scheduled to reach full operating capability until September 2023. To ensure full capability of the ILER, DoD plans to expand and accelerate the development schedule—and add additional data—enabling more comprehensive information on health risks of potential exposures to be more rapidly incorporated into service member and veterans medical care and benefit decisions.

Raising awareness of VA benefits related to military exposures. Many veterans are unaware of their eligibility for benefits and services related to potential military exposures. In addition, some claims adjudicators may not have up-to-date awareness of recent policies related to conditions newly presumed to be service-connected. In October 2021, VA launched an outreach campaign to inform service members and veterans about eligibility and benefits related to chronic disabilities that may be due to military exposures while in service. This includes efforts to embed educational and outreach materials into the Transition Assistance Programs (TAP) and as part of the Solid Start program, which reaches out to transitioning service members at regular intervals during the first year following their military separation. VA will also initiate new public service announcements and live events to encourage early and regular engagement with VA and other federal agencies for benefits, health care, and other services. VA also plans to provide refresher trainings for all claims processors, share information related to military exposures, and host a series of Q&A sessions related to implementation of the new presumptive disabilities that were implemented this summer. VA will also revise Frequently Asked Question materials and call scripts to ensure that front line employees are able to better assist veterans through the claims process. 

Expanding training for VA and non-VA providers. Veterans often find that their providers and compensation and pension examiners are not well-trained to understand or treat veterans’ exposure concerns. To address this issue, VA has completed a contract with the American College of Preventive Medicine (ACPM) to provide a five-module certificate training program in military environmental exposures. This will provide a basic level of competence for all VA- and non-VA providers across the nation that will help better treat veterans with concerns about toxic exposures. VA will require all providers to complete the first module of this training for an entry-level understanding of the health outcomes of military exposures and encourage the remaining four modules for certification.

Establishing network of specialized providers and call center. Veterans with concerns about the health outcomes of military exposures experience inconsistent care to address these specific issues, especially outside of VA. Beginning in 2022, VA will launch VET-HOME, The Veterans Exposure Team-Health Outcomes of Military Exposures. VET-HOME will consist of two interconnected parts: a call center for veterans and providers, and a nationwide network of specialists. Veterans with questions about environmental exposures will call into a central location and be guided through the registry exam or environmental exposure process. They would then be referred to one of 40 environmental health providers across the United States who would use a telemedicine platform to assess and if necessary refer the veteran to a VA facility to complete any specialty testing, like a pulmonary function test or other lab work. Providers with questions on military exposures would be referred to one the 40 military environmental heath subject matter experts. The results of the consultation would be shared with the veteran’s primary care doctor, helping to deliver better care to the veteran.

Extending Eligibility Period for VA Health Care. Some Veterans do not have concerns about their health until several years after deployment or leaving service. At present, VA allows veterans to receive free VA health care for up to 5 years after discharge or release for any condition related to service in Operation Enduring Freedom (OEF) in Afghanistan or Operation Iraqi Freedom (OIF) or Operation New Dawn (OND) in Iraq. This is called an “enhanced eligibility period.” To ensure that veterans who served in these conflicts have access to health care from VA, the Administration will call upon Congress to implement a change to the statute to enable a longer enhanced enrollment period for the 3 million veterans who deployed to support recent combat operations.

Taken together, these actions will improve our understanding of the health effects of military-related exposures, educate providers and veterans about these exposures, and provide timelier access to health services and benefits for individuals who were exposed. The Administration will continue to prioritize efforts to support veterans who were exposed to environmental hazards during their military service. At the same time, the Administration will work with Congress on its encouraging ongoing efforts to ensure we are able to quickly and fairly recognize additional presumptions of service-connected disabilities, in order to live up to our sacred obligation to provide veterans the care they have earned.

Democratic Candidates for 2020: On Veterans Day, Biden Releases Personal Reflection, Detailed Agenda

Vice President Joe Biden released a detail plan for veterans © Karen Rubin/news-photos-features.com

Vice President Joe Biden, candidate for president, with Dr. Jill Biden, issued a statement on Veterans Day, and his campaign issued a detailed plan about what a Biden Administration would do for veterans. Here are is the statement and fact sheet from the campaign:

John Steinbeck memorably wrote that, “A soldier is the most holy of all humans, because [they are] the most tested.” From Fort McHenry to San Juan Hill, from the Argonne Forest to Midway, from the Mekong Delta to Fallujah, and on every battlefield between, America’s veterans have always been the most tested among us — and they have never failed in their duty.
 
In each generation, a small fraction of Americans serve and sacrifice on behalf of us all. Less than one percent of our population risks everything to protect our country, incurring in the rest of us a debt far greater than our nation could ever repay. We have always believed that the most sacred obligation of our government is to do right by the men and women who defend our nation at war — to care for them and their families, both while they are deployed and after they come home. It’s an obligation we are honor-bound to keep.
 
Veterans Day offers us a moment to reflect on that obligation, and to recommit ourselves to all that it truly means. Every one of our veterans deserves timely, world-class health care — the very best of what our country has to offer. They deserve comprehensive mental health support, and a thoughtful, well-funded plan to address the ongoing tragedy of veteran suicides. They deserve a serious approach to ending veteran homelessness, and greater resources to help them readjust to life at home once their service concludes. Not only do they deserve these things — their families and caregivers do, too.
 
Our veterans also deserve a leg up when it comes to educational and economic opportunities — everything from tuition assistance to skills training to entrepreneurship programs. That isn’t just for their benefit; America benefits enormously from the leadership, talent, and experience of veterans who gird every sector of our economy with sinew and smarts. The GI Bill was one of the greatest engines of widespread prosperity our country has ever conceived, helping to cement the most resilient middle class in the history of the world in the wake of World War II. Our veterans and our country deserve that commitment to be upheld and advanced.
 
Most of all, our veterans deserve leaders who will fight for them as ardently and as forcefully as they have fought for us.
 
That’s why, on this Veterans Day, we are proud to release a detailed and comprehensive plan to honor the full breadth of our obligation to veterans and their families — and to restore the sacred commitments that this White House has seen fit to ignore.
 
This plan and this cause are personal to us. Over the course of many years, it has been our honor to visit our troops in Bosnia, Kosovo, Iraq, and Afghanistan, and to witness their incredible strength of character firsthand. We have been blessed to visit with wounded veterans in Landstuhl, Germany, and at the Brooke Army Medical Center in San Antonio, and to welcome troops to our home for Thanksgiving dinners and spend many Christmas Days with the heroes at Walter Reed. When our son Beau was deployed to Iraq for a year, we whispered prayers, and learned a small portion of what sacrifice means to the families of those who serve.
 
Every one of the more than 18 million veterans in our country has earned our admiration and our gratitude — but it is our duty to repay them with something more than that. We must honor their service with bold policies that meet our sacred obligation, with opportunities commensurate to the sacrifices they and their families have made, and with trustworthy national leadership.

FACT SHEET:
The Biden Plan to Keep Our Sacred Obligation to Our Veterans
  

Joe Biden believes that as a nation, we have many obligations, but we have only one truly sacred obligation: to properly prepare and equip our troops when we send them into harm’s way, and to care for them and their families–both while they are deployed and after they return home. As the parents of a son who deployed to Iraq, Joe and Jill Biden understand the gravity of this promise. Our service members ensure our freedoms, our security, and the very future of our country. They are willing to sacrifice everything. Many do. And each of them deserves our respect and enduring gratitude, both while on active duty and after separating from service. 
 
President Trump has repeatedly failed our veterans and ignored this sacred obligation. From the outrage of deporting undocumented veterans without checking their record of military service, to allowing his wealthy Mar-a-Lago friends to drive veterans policy, to pursuing policies designed to privatize and dismantle the Department of Veterans Affairs (VA), Trump neither understands nor respects the idea of “duty, honor, country” that inspires our brave military members to serve and imbues our veterans with pride. 
 
Less than one percent of Americans currently serve in the military, and the other 99 percent of us owe them the secure futures they have earned. As president, Joe Biden will keep faith with our veterans and their families. He will meet our sacred obligation.


The Biden Record of Delivering for Our Veterans  
Joe Biden has fought aggressively for our service members and veterans throughout his career in public service. His record speaks for itself. On the broad range of issues that matter to our brave military members and our veterans, Joe Biden has always had their back.
 
As a senator, Joe Biden was an early advocate for Vietnam veterans who were exposed to Agent Orange and other toxins to be able to access the care and benefits they deserve.
He championed funding for prosthetics for veterans and mammogram coverage for female veterans, fought for proper burial allowances, and supported the concurrent receipt of retirement and disability pay for veterans. He co-sponsored the legislation to establish the Vietnam, Korean, and WWII memorials in Washington, D.C., as well as the post-9/11 GI Bill to provide educational benefits to a new generation of heroes.
 
Biden also led the way in the Senate on critical issues to protect the health of our military, most notably driving the fight to increase funding for up-armored Mine-Resistant Ambush Protected vehicles (MRAPs) by $23.6 billion, which saved thousands of lives and limbs of U.S. service members in Iraq and Afghanistan. And he introduced legislation to prohibit cuts to military medical care during times of war.
 
In the White House, Biden continued to be a clarion voice advocating for our veterans. The Obama-Biden Administration accomplished major milestones, including cutting the population of homeless veterans by almost half and reducing the unemployment rate for veterans by more than half. In 2013, when an unacceptable backlog of veterans’ disability claims was uncovered at the VA, the Obama-Biden Administration took aggressive action to rectify the failures and ultimately reduced the backlog by nearly 90 percent in just over three years. The Obama-Biden Administration also increased the overall funding request for the VA by more than 85 percent during its years in office, including a 76 percent increase in funding devoted to the critical issue of veterans’ mental health. It successfully implemented the new GI Bill and approved the long overdue expansion of benefits to those suffering from Agent Orange-related conditions.
 
During the Obama-Biden Administration, the VA also led in creating the Blue Button app to help veterans access their health data and medical records more easily. Today, Blue Button is used by more than million veterans.
 
Additionally, Dr. Jill Biden and First Lady Michelle Obama created and led the Joining Forces initiative to build support for our veterans and military families, including a focus on increasing employment opportunities. Between April 2011 and the end of the Administration, Joining Forces supported programs and secured commitments from employers that led to the hiring or training of more than 1.5 million veterans and military spouses.
 

 
Our longest wars have taken their toll, both on our newest generation of veterans and on the system built to support them and previous generations of veterans. According to the most recent census data, there are more than 18 million veterans in the United States, and today’s veterans population has needs that the VA has never before addressed. This is reflected both in the growing interest for “anywhere, anytime” health care service models and in our growing understanding of behavioral health challenges, the harmful impacts of burn pits, environmental toxins, traumatic brain injury, and the devastating epidemic of opioid addiction and suicide. The VA must adapt to meet the ever-evolving needs of the veteran community. 
 
At the same time, the VA continues to struggle with poor organizational performance, staff shortfalls, leadership gaps, and IT systems failures. The integration of a new generation of veterans into the VA system has added a substantial number of veterans eligible for health care and other benefits as overall demand for services has surged, with the combination creating capacity challenges across the system. Too often, the VA’s performance in terms of access, outcomes, cost, and accountability is mixed. There have been both important successes and intolerable failures or gaps in service. Solving these challenges will require a substantial investment in talent, leadership time, budget, and public attention. It’s what we owe our veterans. It is past time to rethink and reinvent a better VA.
 
There is nothing partisan about improving support for service members, veterans, their families, caregivers, and survivors. As president, Joe Biden will unite the country and restore the VA as the premier agency for ensuring our veterans’ overall well-being by:

Providing Veterans World Class Health Care to Meet Their Specific Needs

Driving Progress to Eliminate Veterans Homelessness and Bring Down Suicide Rates

Creating Meaningful Employment and Educational Opportunities

Improving VA Management and Accountability. 

To support the VA mission, a Biden Administration will ensure coordination with the Department of Defense (DoD), Department of Housing and Urban Development (HUD), state agencies, and the thousands of non-governmental organizations that support this vital community. It will work faithfully to restore public trust in the VA so that no one in the military community or beyond will ever again question whether the United States of America keeps its promises to those who serve our country.
 
Providing Veterans World Class Health Care to Meet Their Specific Needs
The Veterans Health Administration serves upwards of 9 million veterans and is responsible for their whole health, physical and mental. Studies have found that health outcomes at VA hospitals are often better than their non-VA counterpart, and more than 90 percent of those who receive their health services through the VA report that they would recommend it to a fellow veteran. As president, Joe Biden will work to ensure that the VA provides the world class health care that our veterans have earned and deserve and sets the example for private sector care.
 
In the area of mental health, the VA and DoD have done pioneering work to address the specific needs of veterans, deploying innovative treatment solutions such as telehealth and other platforms to address a variety of conditions. The private sector trails the VA in its ability to provide behavioral health services to the nation as a whole, much less to understand the unique needs of veterans.
 
At the same time, the VA is also struggling with a rapidly deteriorating infrastructure, and many VA facilities are more than 60 years old. Further, across the system, the variance in quality of — and access to — care is unacceptable. As the demand for treatment has increased, the VA must continually strive to improve services and outcomes for veterans, especially in the areas of pain, polytrauma recovery, substance-use disorder (SUD), post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), and general behavioral health, in the most effective and cost-efficient way possible.
 
In addition to protecting and building on the Affordable Care Act with a public option to expand access to quality, affordable health care and lower costs, and commitments to keep rural hospitals open and expand health care delivery models for rural areas, a Biden Administration will:

Rebuild trust in the Department of Veterans Affairs. During the Obama-Biden Administration, we improved access to health care offerings for veterans in their communities, but there is still more work to do. Private sector points of care were designed to provide care to veterans when it was faster, closer, or offered superior services for a particular veteran’s needs. We must ensure that health care purchased in the community actually improves access and convenience and does not compromise the health of our veterans. President Biden will establish the right balance of VA care and purchased care, region by region, based on veteran needs, existing VA capacity, and availability of market alternatives.

Conduct a thorough assessment of the staffing needs and requirements across the VA to inform specific hiring initiatives and programs for attracting and retaining medical professionals. This includes ensuring that professionals are working to the full scope of their license and creating incentives to support health care professionals joining the VA workforce.

Refine and update Community Care Guidelines, ensuring that if a veteran is referred to a community care provider that does not meet the same level of access and quality as the VA, the veteran will be referred back to the VA. This full-circle referral process will better ensure that veterans are seen in a timely manner and receive the best possible quality of care.

Establish cultural competency training protocols to ensure that providers in VA facilities and in community care settings understand and are equipped to support the needs of LGBTQ veterans in the health care setting.

Work with Congress to improve health services for women veterans. Biden will ensure that each VA Medical Center has at least one full-time women’s primary care physician; and, within 200 days of taking office, make available a women veterans training module for community health care providers. And, Biden will work with Congress to enact the Deborah Sampson Act and ensure that the safety and privacy concerns of women veterans are addressed throughout his Administration.

Provide funding to ensure there is safe, reliable child care at all VA Medical Centers.

Work with Congress to eliminate co-pays for preventive health care for veterans, which can create unnecessary barriers to seeking basic preventive care. 

Expand the list of presumptive conditions to ensure no veteran who experienced a TBI or had exposure to burn pits or other environmental toxins goes without access to VA health care and benefits. We cannot ask our veterans who are suffering to wait decades, as we did with Agent Orange. President Biden will also increase access to VA care beyond the 5-year eligibility window for combat veterans, as conditions related to toxic exposure may take many years to manifest.

Increase research dollars by $300 million to invest in better understanding the impact of TBI and toxic exposures (including burn pits) on long-term health outcomes, and continue to drive research focused on the needs of disabled veterans.

Ensure that disabled veterans that require a prosthesis are able to access the most modern prosthetics technology available, and that they are able to upgrade their equipment at no cost as new developments occur.

Expand funding for direct and purchase-care treatment for disorders related to the misuse of alcohol and opioids in order to reduce unacceptably long wait-times for treatment.

A Biden Administration will support the legalization of cannabis for medical purposes and reschedule cannabis as a schedule II drug so researchers can study its positive and negative impacts. This will include allowing the VA to research the use of medical cannabis to treat veteran-specific health needs.

Ensure the full integration of veteran caregivers as members of the health care team for veterans. The VA offers a diverse array of programs and supports for caregivers, however, we must ensure that the VA remains a caregiver-friendly environment and respects their role in ensuring the recovery and rehabilitation of their loved one. 

Increase funding for and expand access to telehealth through the VA, particularly in rural areas not able to access timely care.

Modernize VA hospitals and clinics to serve our veterans better through a nationwide infrastructure plan that provides a comprehensive refresh of VA health facilities. Biden will retrofit VA’s existing brick and mortar physical locations, where patient volume warrants, and repurpose older facilities to meet new needs such as assisted-living facilities and long-term care alternatives. Biden will improve both the buildings and equipment, so the VA continues to lead in providing 21st century care.  

Create safe, modern, clean, and recovery-oriented housing for veterans being treated for SUDs and those who are homeless by refurbishing buildings condemned or not in use, such as the massive VA Los Angeles campus.

 
Driving Progress to Promote Veterans’ Mental Health and Well-Being
Suicide is a public health crisis–the 10th leading cause of death in the United States. As a society, we need to work together to eliminate the stigma felt by those who are suffering and struggling with their mental health. There is no shame in asking for help. As president, Joe Biden will increase access to mental health treatment by enforcing full mental health parity and ensuring all Americans have access to high-quality mental health care, regardless of their insurance coverage status. Service members and veterans are at an elevated risk of dying by suicide. Recent data show that, on average, 20 veterans and service members die by suicide every day, and among some groups, the rate of suicide is rising alarmingly. Even one death by suicide is devastating, and we must do more to stem the tide. The Trump administration has grossly mismanaged this crisis, at one point leaving millions of VA dollars dedicated to suicide prevention efforts unused, and that’s just not right. This is a serious challenge, and our goal must be to remove the stigma in military communities to seek help, ensure that every veteran that reaches out is immediately connected to support and services, and to ultimately end the suicide crisis among veterans. As president, Biden will ensure a multi-faceted, substantive, and sustained commitment that addresses this as the public health emergency that it is.
 
The same is true when it comes to veterans experiencing homelessness. The Obama-Biden Administration proved that we can make huge inroads to address this persistent challenge with sustained attention and cross-coordination among government departments. But with just over 23,000 veterans without shelter on any given night, we have much more work to do.
 
A Biden Administration will:

Publish within the first 200 days in office a comprehensive public health and cross-sector approach to addressing suicide in veterans, service members, and their families.

Work aggressively to facilitate immediate access to mental health services for veterans in crisis, to include standardizing performance expectations around same day, walk-in and urgent mental health services; hiring more ER psychiatric staff and peer specialists; expanding crisis line capacity to ensure all calls are answered and appropriate referrals occur within hours; and implementing specific programs to encourage veterans to prioritize their mental health by reaching out to the VA when they need support. Within the first year in office, President Biden will have a goal of completely eliminating wait times for veterans who reach out with suicidal ideation so that they are immediately taken into treatment.

Together with states, community-based organizations, and employers, implement public education and outreach initiatives to help veterans understand that care is available and effective. We must work to end the culture of silence around mental health issues and remove the stigma associated with getting mental health treatment, particularly among service members who are more used to helping others than asking for it themselves.

Ensure the DoD’s Suicide Prevention Office and the VA have the resources and staff they need to make smart investments with allocated funds–and that money dedicated to suicide prevention efforts never goes unused.

Create a national center of excellence for reducing veteran suicide, similar to the National Center on Homelessness among Veterans. Biden will recruit top-level leadership to build strategic partnerships and solutions that extend beyond the VA’s health care system.

Require all providers of veterans services funded by the VA to receive training on suicide risk identification and safety planning, to include lethal means restriction and appropriate response and reporting about suicide. 

Enact policies that promote the value and dignity of life by supporting programs that increase economic stability; promote connectedness through structured social support; and reduce risky behaviors, such as substance use, poor sleep, and improper firearm storage.

Expand capacity at Vet Centers to ensure veterans in communities can access readjustment counseling services and resources, including financial and long-term planning. President Biden will specifically expand outreach and resources for veterans as they experience periods of transition, not just out of the military, but throughout their life, including into post-career retirement.

Tackle issues that contribute to higher suicide risk. This includes implementing programs to disseminate high-quality treatments for PTSD, ensuring that veterans have access to the best treatments available no matter where they receive care, and instituting policies that seek to eliminate discrimination, end harassment and hold perpetuators of sexual assault in the military accountable. A Biden Administration will not tolerate the sexual assault culture that has become all too common in the military and veteran sector.

Work with Congress to continue to drive down veteran homelessness by permanently authorizing the Supportive Services for Veterans Families (SSVF) program, which provides critical funding for wrap-around services for those facing homelessness. President Biden will also work to ensure that we better understand the unique needs of women and LGBTQ veterans experiencing homelessness.

Reform the policy and review processes for veterans so that less-than-honorable discharges will not be unjustly awarded for conduct directly linked to the behavioral health effects of PTSD, TBI, or other trauma experienced while serving.

 
Creating Civilian Lives of Meaning and Opportunity
The Obama-Biden Administration worked tirelessly to bring down high unemployment levels among our veterans. Over the course of 8 years, the Obama-Biden administration cut the veteran unemployment rate by more than half. That is vitally important progress, but now, we have to think about empowering our veterans and their future employers with the tools they need to build pathways to successful, long-term careers. Recent data indicate that veterans are more likely than their civilian counterparts to take a job at lower skill-level. As president, Biden will keep his foot on the gas to ensure that service members transitioning back to civilian lives have the best opportunities to succeed and build fulfilling futures.
 
A Biden Administration will:

Work closely with DoD to ensure that the Transition Assistance Program (TAP) is implemented effectively and that outcomes are regularly reported.

Ensure that more transitioning service members are able to access job training and placement services prior to their end of active duty service. By expanding private sector relationships through programs like the SkillBridge program, Biden will give qualified transitioning service members the opportunity to start building a meaningful civilian career as early as possible.

Work with the Department of Labor to enforce the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA) hiring benchmark among federal contractors and subcontractors, and provide preferences and incentives to corporations that meet the benchmark.

Promote corporate mentorship programs between veteran-owned businesses and existing contractors to support veteran entrepreneurship.

Ensure careful implementation of the Forever GI Bill so that veterans receive the educational benefits they have earned on time.

Implement annual reporting to be led by the VA in partnership with the Department of Education and promote interagency cooperation and data sharing to better understand academic outcomes for all GI Bill users.

Develop best-practice guidelines for supporting veterans in higher education to assist higher education institutions to improve graduation rates among GI Bill recipients and provide financial incentivizes for campuses that follow guidelines and transparently report their outcomes.

Work aggressively to close the 90/10 loophole on GI Bill and Tuition Assistance dollars to keep for-profit bad actors from raiding the benefits service members and veterans have earned.

Support and protect post-9/11 GI benefits for veterans and qualified family members by strengthening the GI Bill Comparison Tool and School Feedback Tool to put an end to post-secondary institutions’ predatory practices.

Protect undocumented members of our armed services, veterans, and their spouses from deportation, because if you are willing to risk your life for this country, you and your family have earned the chance to live safe, healthy, and productive lives in America.

Work with DoD and the Department of Homeland Security to provide timely naturalization for those who have served honorably in our military, with an earned path to citizenship prior to discharge or retirement.

 
Improving VA Management and Accountability
The agency charged with meeting the needs of our veterans–not only their health care needs, but administering their full range of benefits and overseeing the cemeteries that guard their honor in death–should not be limited by outdated management tools and practices. Our veterans deserve the best services available. As president, Biden will enhance the capacity of the VA to serve our veterans as efficiently as possible by overseeing a generational upgrade to clinical and management systems, by leveraging commercial best-practices and modern technologies to meet the unique demands of public sector mission.
 
A Biden Administration will:

Improve health care access, quality, and customer experience by seamlessly augmenting direct care with purchase care enabled under the Mission Act. Enhance the administrative, financial, and operational systems that underpin the provision of care in the network model by improving vital case management systems, quality oversight, integrative health treatments and supporting administrative, financial and IT systems. These reforms will help ensure access to high-quality care and a first-rate customer experience that satisfies all veterans, regardless of where they receive care.

Create standards of health record interoperability that ensure a comprehensive health record is provided by community care organizations back to the VA.

Invest in improving human resource and management practices across the VA to strengthen the customer experience for our veterans and deliver services more efficiently. This will include a focus on workforce training and cultivating a culture across the VA that places a premium on quality and service.

Leverage options under the Mission Act to pilot alternative payment models and prioritize care models that improve the quality of care, not just the volume of services. Veterans should be able to access care in a way that works best for them, not the way that is most convenient for the system, in particular when it comes to meeting specific needs such as rehabilitation services, SUD, and behavioral health.  

Reduce delays and errors in claims processing and in scheduling the medical exams necessary for veterans to complete their disability claims. This has been a constant source of frustration for veterans. The long delays in the system, and rates of error — in both Regional Offices and the Board of Veterans’ Appeals — are too long and too high, and unfairly delay adjudication of veterans claims. A Biden VA will identify the sources of the problem and undertake the investments in personnel and training needed to ensure that veterans receive accurate decisions in a more timely manner. 

Help more veterans gain access to their own health data and medical records through the Blue Button app. Blue Button has been downloaded by more than 2 million veterans and is increasingly being used by Medicare beneficiaries and the private sector. By making Blue Button easier to use, the VA will continue to lead the movement of patient-centered models of care.

Implement a VA-hosted health record that can serve any and every American who wants one. We can leverage Blue Button to access health information no matter where it is, to allow veterans and citizens to manage and use it as they see fit. By putting our veterans first, we can make the VA the nexus of the best care everywhere.

Create a national health database for non-profit research scientists and the commercial sector that would accelerate discovery of the best therapies against the devastating diseases of our time: cancer, heart disease, and Alzheimer’s, and dementia. Biden will direct the VA to support the database using its infrastructure, making access available to all. Veterans will be able to choose, on an individual basis, whether or not to contribute their data. This national repository for longitudinal health data will enable us to use technological innovations to see patterns that people don’t easily recognize and make connections we don’t normally make for the U.S. population as a whole.

5 Years of Joining Forces: A Progress Report and Call to Action to Support Military, Veterans and their Families

Veterans salute flag during Memorial Day event in North Hempstead, Long Island, NY.  In five years, Joining Forces, a signature issue for First Lady Michelle Obama, has led to the hiring or training of more than 1.4 million veterans and military spouses, ended veteran homelessness in states across the country, and provided 60,000 military-connected students with support and educational opportunities © 2016 Karen Rubin/news-photos-features.com
Veterans salute flag during Memorial Day event in North Hempstead, Long Island, NY. In five years, Joining Forces, a signature issue for First Lady Michelle Obama, has led to the hiring or training of more than 1.4 million veterans and military spouses, ended veteran homelessness in states across the country, and provided 60,000 military-connected students with support and educational opportunities © 2016 Karen Rubin/news-photos-features.com

Since April 2011, Joining Forces, a signature initiative of First Lady Michelle Obama and Dr. Jill Biden, has led to the hiring or training of more than 1.4 million veterans and military spouses, ended veteran homelessness in states across the country, and provided 60,000 military-connected students with support and educational opportunities. On the final Veterans Day of the Obama Administration, the White House offered a progress report:

Joining Forces is a nationwide initiative launched by First Lady Michelle Obama and Dr. Jill Biden in April 2011 to call upon all Americans to support service members, veterans, and their families through wellness, education, and employment opportunities. Joining Forces works to inspire, educate and encourage action from both the public and private sectors to ensure that service members, veterans, and their families have the tools they need to succeed throughout their lives.

The last Veteran’s Day of this Administration provides an opportunity to celebrate the progress Joining Forces has made in bringing attention to the unique strengths and needs of America’s military families, while highlighting their skills, experience and dedication—encouraging greater connections between the American public and the military that will continue into the future. 

Employment

Since the launch of Joining Forces, the unemployment rate for our 9/11 generation of veterans has been reduced from more than 12 percent to lower than the national average today. Employers ranging from smaller start-ups to some of the largest corporations in the world have hired or trained more than 1.5 million veterans and military spouses. In May 2016, the First Lady announced commitments to hire and train 170,000 new veteran and military spouse in high-growth sectors, including aerospace, telecommunications and technology. In addition, 15 companies and organizations have committed to lead training programs, sponsor scholarships, and support certification courses for more than 60,000 veterans and military spouses over the next five years.

In addition, the creation of the Military Spouse Employment Partnership, a network that now includes more than 335 companies, has led to the hiring of 100,000 military spouses through postings on the Military Spouse Employment Partnership Career Portal and mentoring of military spouses. The Partnership also provides employment data on military spouses hired.

Joining Forces also issued a call to action to all 50 U.S. governors to take executive and/or legislative action to streamline state licensing for the military community, and today, all 50 states have taken action to support the military community by making it easier for military spouses to overcome barriers to employment. In collaboration with state legislators and regulators, Joining Forces and the U.S. Department of Defense have helped states adopt simple measures to accommodate the demands of the military and support military spouses as they seek to continue their careers. 

Education

Since 2011, more than 100 colleges and universities have signed the “Educate the Educators” commitment, which prepares educators to lead classrooms and develop cultures that are more responsive to the social, emotional, and academic needs of military-connected children. In addition, all 50 states have signed on to the Military Child Education Compact, which focuses on the inequities facing school children of military parents when they are required to relocate across state lines.

In April 2014, Dr. Biden helped launch the VA GI Bill Comparison Tool, a website that allows service members and dependents using the GI Bill to research tuition and fees, housing allowances and book stipends, as well as graduation rates and loan default rates for each school so that they may make an informed decision on next steps.

In April of 2016, the National Math and Science Initiative’s (NMSI) College Readiness Program fulfilled a commitment made during the launch of Joining Forces in 2011 to expand into 200 military-connected schools, providing more than 60,000 military-connected students with the support and educational opportunities they deserve.Through its College Readiness Program, NMSI is broadening access to rigorous AP coursework in math, science, and English and equipping students with the knowledge and skills they need to graduate from high school ready for college and the STEM-intensive careers of the 21st century.

Wellness

To call upon cities, counties and states to commit to ending and preventing homelessness among veterans in their communities, the First Lady issued The Mayors Challenge to End Veteran Homelessness in June 2014. As a result, 35 communities and the states of Connecticut and Virginia have effectively ended veteran homelessness.

The First Lady also launched the Campaign to Change Direction in March 2015—a nationwide mental health public awareness campaign to promote education and awareness of mental health issues affecting the military community. The Change Direction initiative is a collection of concerned citizens, nonprofit leaders, and leaders from the private sector who have come together to change America’s perception of mental health, mental illness, and wellness. More than 230 partner organizations have joined the campaign.

In addition, more than 100 Association of American Medical College (AAMC)-member medical schools across the country signed a pledge recognizing the sacrifice and commitment of current and returning military service members. AAMC and the Center for Deployment Psychology now produce Joining Forces Wellness Week, a week-long series of interactive trainings for clinical and non-clinical wellness professionals focused on specific health and wellness issues of veterans, service members, and their families.