Veterans Mental Health Bill Now Law (S. 2162)

From the US Senate Committee on Veterans Affairs:

WASHINGTON, D.C. - U.S. Senator Daniel K. Akaka (D-HI), Chairman of the Veterans’ Affairs Committee, issued the following statement today regarding enactment of S. 2162, the Veterans Mental Health and Other Care Improvements Act of 2008. S. 2162, introduced by Senator Akaka and cosponsored by a bipartisan group of Senators, makes various improvements to veterans’ mental health and other forms of care. The bill pays tribute to Justin Bailey, an Iraq war veteran who returned from combat only to lose his life to PTSD and an accidental overdose of prescription medications.

“Now that S. 2162 has been enacted, VA can incorporate these provisions to improve its strategy against the injury and enemy of PTSD and other invisible wounds,” said Akaka.

In his floor statement urging passage of S. 2162, Akaka detailed the origins of his legislation: “The legislation did not stem from a lobbyist or an interest group. It came about because of one letter - a letter to me from the parents of Justin Bailey - Mary Kaye and Tony Bailey.

“Justin Bailey was a war veteran who survived Iraq only to die while receiving care from VA for PTSD and substance use disorder. A week after his death last year, Justin’s parents were naturally heartbroken by the death of their only son, but even more than that, they were concerned that other veterans might share his fate if VA mental health care did not improve,” said Akaka.

The Bailey family has worked actively to improve veterans’ mental health, testifying before the Veterans’ Affairs Committee and supporting S. 2162.

S. 2162’s improvements to veterans’ mental health care include:

• Setting a standard minimum level of care for substance use disorder, and creating innovative enhancements to treatment
• Improving treatment to veterans with multiple disorders, such as PTSD and substance use disorder
• Mandating a review of VA’s residential mental health care facilities, to ensure that they are adequately staffed
• Creating a research program on PTSD and substance use disorder, in cooperation with the National Center for PTSD
• Enabling VA to provide mental health services to veterans’ families, and setting up a program to aid the families of returning servicemembers

S. 2162 also makes significant improvements in other areas of veterans’ health care:

Rural Veterans: More than doubles the beneficiary travel mileage reimbursement (from 11 to 28.5 cents per mile) eligible veterans can receive for travel to receive VA care, permanently sets the deductible to $3 each way for such travel, creates a pilot program on the use of peers to enhance outreach to rural veterans, and encourages coordination between VA and rural community-based resources.

Emergency Care for Veterans: Corrects current procedures used by VA to reimburse community hospitals for emergency care provided to eligible veterans.

VA Epilepsy Centers of Excellence: In recognition of the link between traumatic brain injury, a signature wound of the current conflicts, and epilepsy, establishes up to six VA Epilepsy Centers of Excellence focused on research, education, and clinical care for epilepsy.

Veterans’ Pain Care: Requires a pain care program, including care for acute pain, for all VA inpatient facilities for long-term mental health and substance abuse care and to prevent long-term chronic pain disability, expands VA health care staff education on pain assessment and treatment, and increases VA research on pain care.

Veterans’ Caregivers: Extends authority for VA to provide institutional and non-institutional long-term care and caregiver assistance services.

Medical Construction: Authorizes a series of major medical facility construction projects and outpatient clinic leases.

Homelessness: Creates targeted programs to assist low-income veterans, and increases funding capacity for the successful VA Grant and Per Diem program, which assists community-based organizations that serve homeless veterans.

Rehabilitating Veterans: Expands a program to help formerly incarcerated veterans reintegrate into society through employment counseling and other services.

S. 2162, introduced by Chairman Akaka, was reported by the Senate Committee, then passed the full Senate unanimously before being amended and passed in the House, then passed again in the Senate. President Bush signed the bill into law on October 10, 2008.

Thanks for the Head's-Up! from Swords To Plowshares!

Blue Water Navy & Agent Orange: Appeal Denied in Haas vs. Peake

The legacy of Agent Orange (AO) lives on.

Per 38 U.S.C. § 1116(a)(1)(A), if a veteran who has certain diseases can prove service “in the Republic of Vietnam” between January 9, 1962, and May 7, 1975, the disease will ordinarily “be considered to have been incurred in or aggravated by such service.”

The clear intent of the statute is to treat medical problems from exposure to AO in the line of duty. However, the English language is always subject to interpretation. The VA argues that personnel on board shipveterans who had served in the waters off Vietnam ( generally known as “blue water” veterans, in distinction to "brown water" veterans who sailed up rivers) , even if operating close enough to the coastline to be exposed to AO on the wind or in the water, did not incur service "in" Vietnam.

This idiotic notion was rejected by the Veterans Court. Mr. Haas, a bluewater veteran who had served on an ammunition ship off Vietnam, sought disability compensation for type 2 diabetes and other problems within 38 U.S.C. § 1116. While the VA's regional office and its Board of Veterans’ Appeals denied the claim, on appel the Veterans' Court reasoned 38 C.F.R. § 3.307(a)(6)(iii) defined “service in the Republic of Vietnam” as including “service in the waters offshore, and that the DVA regulation ruling otherwise was unreasonable:

"...given the spraying of Agent Orange along the coastline and the wind borne effects of such spraying, it appears that these veterans serving on vessels in close proximity to land would have the same risk of exposure to the herbicide Agent Orange as veterans serving on adjacent land, or an even greater risk than that borne by those veterans who may have visited and set foot on the land of the Republic of Vietnam only briefly...."

However, the VA appealed this ruling and succeeded in having it overturned, in Haas vs. Peake.

Haas appealed to the United States Court of Appeals for the Federal Circuit for a rehearing, but on October 9, 2008 a panel upheld the VA 2-1.

There are two reasons for hope. First, Judge Fogel on the panel recommended that the full court grant rehearing en banc. Second, Bob Filner, Chairman of the House Committee on Veterans’ Affairs, introduced the Agent Orange Equity Act (HR 6562) to overturn the VA's position.

More information

• Federal Court Denies Petition at VA Watchdog
• The Haas Case at Blue Water Navy

Joint Chiefs chairman wants PTSD screenings

From USA Today:

"WASHINGTON — The Pentagon's top uniformed officer is calling for all returning combat troops, from privates to generals, to undergo screening for post-traumatic stress with a mental health professional, a move aimed at stemming an epidemic of psychological issues among veterans.

Adm. Michael Mullen, chairman of the Joint Chiefs of Staff, said there's a reluctance to acknowledge psychological problems for fear of showing weakness. Troops now fill out questionnaires after combat tours that help determine if they have suffered psychological damage. They're examined by medical professionals for physical injuries, but not by mental health experts.

"I'm at a point where I believe we have to give a (mental health) screening to everybody to help remove the stigma of raising your hand," Mullen said. "Leaders must lead on this issue or it will affect us dramatically down the road."

About one in five combat veterans from Iraq and Afghanistan suffer from post-traumatic stress or depression, according to a study by the RAND Corp. In all, RAND estimates that 300,000 veterans have been affected and it could cost more than $6.2 billion to treat them.

Half of the troops RAND surveyed reported that they had a friend who was seriously wounded or killed. Rates of post-traumatic stress disorder (PTSD) and depression were highest among soldiers and Marines, the study said.

"The PTS issue is something we just all have to focus on," Mullen said. "I think it's a bigger problem than we know."

Mullen's proposal is in its infancy, and there are no estimates about its potential costs or when it would start. Another potential complication is the number of available mental health professionals, such as psychiatrists, psychologists and social workers. Pentagon budget records show the military has increased signing and retention bonuses for these professionals in recent years to make up for shortages.

Troops also know how to evade certain mental health questions to avoid treatment. Mullen said the Pentagon still has not addressed the negativity surrounding mental health care, which has kept many troops from seeking help.

A trained mental health professional who meets one-on-one with a service member can detect signs of post-traumatic stress in as few as five minutes.

Troops worry their careers will suffer if they seek mental health care, said Terri Tanielian, co-director of RAND's Center for Military Health Policy Research. If Mullen's plan increases access to confidential care, she said, "we will go a long way to removing the stigma associated with getting mental health care."

---by Tom Vanden Brook, USA TODAY

Appeal with Representation at Court of Appeals for Veterans Claims

Beginners in the area of Veterans Claims may wish to consult the "Appeal with Representation" page of the United States Court of Appeals for Veterans Claims.

In addition to useful topics such as Rules of Practice and Procedure, Time Limits (very important!) and Forms and Fees, there is a link to a page blandly entitle Representation, which states:

"If you think this Court can consider your appeal, you should get advice from an attorney or from a service officer in a veterans organization or a state or county veterans affairs office.

You may represent yourself, but VA will be represented by its attorneys. Your case may be better presented if you are represented.

The Public List of Practitioners at this website may help you. It shows people who are allowed to represent appellants in this Court and have said that they are available to do that. Most charge a fee. The Court does not recommend or appoint them, or anyone else, to represent you.

You can also request assistance from The Veterans Consortium Pro Bono Program. The Pro Bono Program offers free representation by a qualified lawyer if you meet their eligibility requirements. To learn more about this Program, go to www.vetsprobono.org or call the Pro Bono Program at their toll free number: (888) 838-7727."

The site has a host of other useful information: http://www.vetapp.uscourts.gov

Employer Resource Guide

Employer Support for the Guard and Reserve (ESGR) publishes a 26-page Employer Resource Guide.

This can be helpful for employers who want to understand their rights and duties when an employee is called into uniformed service, and for employees concerned about keeping their job after the return from deployment.

The more people know, the more problems we can avoid. Download the free Employer Resource Guide and solve problems before they start!

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More information: http://www.esgr.org

The List Project: Helping Our Iraq Allies

Many Iraqis who helped us in Iraq are in danger; the List Project is a way to help them.

From "About The List Project":

"The List Project is a non-profit operating in the U.S., founded with the belief that the United States Government has a clear and urgent moral obligation to resettle to safety Iraqis who are imperiled due to their affiliation with the United States of America.

The List Project is the first comprehensive organizational effort to honor the sacrifice of these Iraqis. It has two pillars:

1. Help as many of the hundreds of Iraqis on our constantly-expanding List make it to the United States through a groundbreaking partnership with two top law firms and over 150 attorneys.

2. Provide a "cushion" for resettled Iraqis upon their arrival to America by:

• building an integration support fund to help defray emergency expenses, and
  
• helping them find meaningful employment through our expanding network of partnerships with the innovative NGOs like Upwardly Global.

Never before has there been such a vast group of refugees with access to their own pro bono representation by top U.S. law firms. Our partnership with domestic NGOs will maximize their integration so that they can be productive and successful in their new lives here in the U.S. The project hopes to contribute to a fundamental paradigm-shift in the way at-risk refugees can be assisted.

There is reason for optimism. We have succeeded in resettling dozens of Iraqis who fled their country because they helped us. Many more are on their way in the coming weeks and months. More and more law firms are approaching the List Project to contribute attorneys to the cause. American citizens write each day to offer rooms in their homes for the Iraqis we resettle, and contribute what small amounts they can.

But the List continues to grow at a frightening pace. An average of twelve new Iraqis are referred or write to the List Project each week. Because of the absurdly lengthy resettlement process, our allies who have fled to neighboring countries are losing hope of a life in peace in America, and with increasing regularity, giving up and submitting to whatever deadly fate awaits them back in Iraq.

The List Project is a U.S. 501(c)3 non-profit organization under the Tides Foundation."

Thanks for the information from Iraq and Afghanistan Veterans of America

Military Voting Protection Act of 2008 (S 3073)

The Senate has just passed the Military Voting Protection Act of 2008 to amend the Uniformed and Overseas Citizens Absentee Voting Act to improve procedures for the collection and delivery of absentee ballots of absent overseas uniformed services voters.

Tom Tarantino, of Iraq and Afghanistan Veterans of America, explains why this bill is important, and its limit:

"Military Overseas Voting: Help may be on the way
Our most basic charge as service member is to defend the country and its way of life. No action exemplifies the core principles of freedom more than the simple act of voting. It is our most basic right and one that we have had to fight for throughout our history. One would think that for those charged with its defense, casting a vote would be simple. Sadly, this is not the case. Many service members vote not in the district in which they are stationed, but in their home of record. The transitory lifestyle of the military makes this a common and necessary practice, and local municipalities generally have effective procedures in place to accommodate its constituents serving around the country. However, for those serving overseas the process is difficult, and for those deployed overseas, the process is practically impossible to navigate without the help and support of the DOD.

In 2000, I was deployed to Bosnia during the Presidential Primary Elections. Knowing beforehand that I would be deployed, I applied for an absentee ballot. As I did not know where I would be stationed, I had it sent to my parents thinking that they would be able to send it to me, and I could return it in time. As you can imagine, this was not the case. The ballot took two weeks to get to me at Camp Tuzla, another two weeks for it to return to California, and it missed the deadline. For all of us who have been deployed, we all know and accept the realities of the Military postal system. By and large, the system works pretty well, but it is near impossible to deal with anything time sensitive. In Bosnia, the system was unpredictable. In Iraq and Afghanistan, the system is functional, but chaotic. Clearly, there needs to be a special emphasis and assistance from the DOD in order to ensure that those who are fighting for our freedoms are able to cast their vote and be counted.

Currently the DOD uses the Federal Voter Assistance Program (FVAP), which provides a 460 page instruction manual detailing the step by step procedures for completing and sending the Federal Post Card Application (FPCA). The FPCA is a combined voter registration and absentee ballot application that was created from the Uniformed and Overseas Citizen Absentee Voter Act of 1986. As states have a variety of different requirements, the “catch all” FPCA is difficult to fill out and a significant portion end up getting rejected by the states. According to a Pew Research study, 40,000 military FPCAs were rejected in 2006 due to some error in filling out state requirements. Furthermore, units Voter Assistance Officers are not given proper training on the difference between local registration and the FPCA.

In 2004 I was appointed as the Voter Assistance Officer (VAO) for my Troop. The only information or guidance I received was the memo assigning me the extra duty. Being responsible, I set out on my own to find resources and pathways to get my soldiers registered either locally or in their home state. I did locate the FVAP, and made attempts to get every soldier that was interested properly registered. In 2004 this was not as easy of a task as it is today. In garrison, this program works, as it relies on the predictability of the US. Mail. However, the Pew study shows that in 2004 VAOs reached only 50%of military voters. Furthermore, states require a myriad of different requirements that lead to confusion and error when filling out the FPCA. The Federal Voter Assistance Program is assigned the responsibility to register overseas voters, yet does not have the authority to affect and change the systems needed to make registration happen.

On October 1, the Senate passed S 3073, the Uniformed and Overseas Citizens Absentee Voting Act. This act requires the Secretary of Defense to establish procedures for collecting absentee ballots of military overseas voters in elections for federal office; and delivering such ballots to the appropriate state election officials. Additionally, it mandates that the delivery must take place prior to the polls closing and authorized the DOD to use express mail and contract delivery services to ensure local receipt of ballots.

This Act takes care of the biggest and most obvious flaw with Federal Voter Assistance Program. As anyone who has been deployed will tell you, it is impossible to plan for anything time sensitive through the mail from a combat zone. In 2006 86% of the FPCAs were sent via the mail, and with the military postal system average round trip being 24-36 days to and from Iraq and Afghanistan there is little to no room for error. Given that most service members transfer units every two to three years, and are deployed every 18- 24 months; most addresses are obsolete by the next election cycle. In 2006 this resulted in 35,000 military and overseas citizen absentee ballots being returned to local election officials as undeliverable. By requiring the DOD to ensure the safe and timely passage of military ballots to their home districts each election cycle, service members are one step closer toward ensuring that the vote that they fight to defend gets counted. Additionally, by not distinguishing between FPCAs and locally obtained election materials, the DOD allows for a much smoother process in requesting and returning the service member’s absentee ballot.

S 3073 is not a complete solution. While it does provide a greater level of assistance to the service members in ensuring timely delivery of election materials, it does not directly address the variance in state registration requirements, nor does it provide the FVAP broader authorities in reducing barriers for military voters. S3073 is a good first step, and one that I feel is long since overdue." ... Tom Tarantino.