Implementation of the Mission Act, suicide prevention and mental health care -- along with education, women veterans and environmental exposures -- top the lists of concerns veterans advocates have as they look toward the legislative year ahead.
For the past two weeks, in hearings before joint meetings of the Senate and Veterans Affairs Committees and meetings with lawmakers, veterans service organizations (VSOs) have discussed what is important to veterans from all eras this year.
The goal, as Iraq and Afghanistan Veterans of America CEO Jeremy Butler said during testimony Thursday, is to work with Congress to "deliver results, not just for IAVA veterans but for veterans of all organizations."
Topping the priorities for nearly all the VSOs is implementation of the Veterans Affairs Mission Act, the legislation that will provide health care services to veterans outside of Department of Veterans Affairs medical facilities. The legislation replaced a number of outsourced care programs at the VA, including Choice, which allowed veterans who live more than 40 miles from a VA facility or faced wait times of more than 30 days for an appointment to seek private care.
Rene Bardorf, senior vice president of government and community relations for the Wounded Warrior Project, said implementation of an integrated system of care at the VA will require "transparency, oversight and strict adherence to the belief that our veterans are best served by a health care system designed to amplify access and quality."
"Please ensure a streamlined process exists to enroll providers. ... And reimbursements must be paid on time," Bardorf said Thursday.
Suicide also is a topic that nearly all VSOs want to see addressed -- both within the administration and through legislation. In an emotional moment during a hearing Thursday, Army veteran Regis Riley, AMVETS national commander, discussed veteran suicides, which average 20 a day.
Particularly, he noted the uptick in those occurring in parking lots of VA facilities, such as the death of Marine Col. Jim Turner on Dec. 10 at the Bay Pines VA Medical Center in Petersburg, Florida. And, he added, this week, an AMVETS post commander in Annville, Pennsylvania, died by suicide in front of his AMVETS post. He was 35.
"VA continues to insinuate that veterans killing themselves have not participated in VA care. What we are doing is not working. To start fixing the problem, you have to own the problem," Riley said.
While the groups were varied -- from the largest, including the American Legion and Veterans of Foreign Wars, to the more obscure, the American Ex-Prisoners of War -- they presented a unified front to Congress, urging lawmakers to support those who have served the nation.
"We cannot stress enough the need to preserve and strengthen the VA health care system while more resources, including the community, are leveraged to expand access to care," said David Zurfluh, national president of the Paralyzed Veterans of America.
The following are among issues veterans service organizations want to see addressed:
Female Veterans' Health Care
As the number of female veterans increases, the VA must do more to accommodate their physical and mental health needs, to include expanding services for them at VA medical centers and ensuring that female veterans are apprised of their benefits, the groups said.
While the VA has said it has attempted to call 1.2 million female veterans, and has reached 600,000, the effort is not enough unless all VA medical facilities can provide them quality care, according to the VSOs.
The American Legion is encouraging Congress to provide child-care services at VA medical centers for appointments, ensure that all VA facilities have up-to-date diagnostic and treatment options, and meet the privacy needs of female veterans at all facilities.
IAVA has named "galvanizing support for women veterans" one of its top six initiatives for the year. "While the past few years have been encouraging in the display of growing interest in ensuring health care accessibility for women veterans at VA ... there is still much work to be done," Butler said.
Several organizations want to see increased protection for student veterans, to include ongoing oversight of the Forever GI Bill and ensuring that students can choose the schools that best meet their needs.
A number of groups also would like to see closure of what is known as the "90/10 loophole," which means that schools must have at least 10 percent of their funding from revenue sources that are not considered federal funds. Organizations say this loophole pushes less reputable schools to attract veterans -- at all costs, which allows them to prey on veterans through aggressive marketing campaigns.
A number of organizations, including the VFW, are calling for legislation requiring the Defense Department and VA to document environmental exposures and support research and disability compensation for affected veterans. From the Blue Water Navy veterans and those affected by burn pits, contaminated water and other environmental hazards, former service members deserve care, they say.
"Congress can't fail these veterans again," VFW Commander in Chief Vincent Lawrence said.
Traumatic Brain Injury Research and Awareness
Noting that veterans with traumatic brain injuries are at higher risk for developing Alzheimer's disease, Parkinson's, dementia and amyotrophic lateral sclerosis, the Wounded Warrior Project and American Legion called for more research and preparation for what could be a significant number of veterans needing assisted living services and rehabilitative care.
"While the number of veterans diagnosed with TBI and PTSD is increasing significantly, the types of treatments offered remain limited and inadequate," American Legion National Commander Brett Reistad said in his prepared statement.
Other items that the advocates would like to see more support for include medical marijuana, improved implementation of caregiver programs and better support for catastrophically ill veterans.