Forward Observer — ‘Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012’ Enacted!

NEW VETERANS OMINBUS BILL SIGNED INTO LAW ON 6 AUGUST

LVMAC Poster Art 2005Surprisingly, nothing has been mentioned in the local media on the recent passage of H.R. 1627 (now known as Public Law 112-154), Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012, despite its importance to the veterans community. It is an omnibus bill affecting many; and it finally brings some, though not total, resolution to the Camp Lejeune water contamination situation which has been previously written about.

Several veterans organizations withheld their support because the Lejeune provision set a dangerous precedent in their opinion. In their minds, the bill unfairly levies requirements on the VA to take care of an essentially Department of Defense (DoD) or TRICARE problem.  While we might agree with them from one perspective, the larger issue is the government taking responsibility to care for those in need of it, no matter whence it comes. We are more concerned about the fact that no one currently knows when the VA will implement the Lejeune actions required, since no deadline has been set.

Below is a summary of most of the key provisions of the new law:

Camp LeJeune Hospital Care and Medical Services: A veteran who served on active duty in the Armed Forces at Camp Lejeune, North Carolina, for not fewer than 30 days during the period beginning on January 1, 1957, and ending on December 31, 1987, is eligible for hospital care and medical services for any of the following illnesses or conditions, notwithstanding that there is insufficient medical evidence to conclude that such illnesses or conditions are attributable to such service:

­  – Esophageal cancer
­   – Lung cancer
­   – Breast cancer
­   – Bladder cancer
­   – Kidney cancer
­   – Leukemia
­   – Multiple myeloma
­   – Myleodysplasic syndromes
­   – Renal toxicity
­   – Hepatic steatosis
­   – Female infertility
­   – Miscarriage
­   – Scleroderma
­   – Neurobehavioral effects
­   – Non-Hodgkin’s lymphoma

A family member of a veteran who resided at Camp Lejeune, North Carolina, for not fewer than 30 days during the period described or who was in utero during such period while the mother of such family member resided at such location shall be eligible for hospital care and medical services furnished by the Secretary for any of the illnesses or conditions described, notwithstanding that there is insufficient medical evidence to conclude that such illnesses or conditions are attributable to such residence.

Unfortunately there are some limitations written into the law which may have unforeseen consequences. The Secretary may only furnish hospital care and medical services under to the extent and in the amount provided in advance in appropriations acts for such purpose. Hospital care and medical services may not be furnished for an illness or condition of a family member that is found, in accordance with guidelines issued by the Under Secretary for Health, to have resulted from a cause other than the residence of the family member as described above.

The Secretary may provide reimbursement for hospital care or medical services provided to a family member only after the family member or the provider of such care or services has exhausted without success all claims and remedies reasonably available to the family member or provider against a third party for payment.

The Secretary has until 31 December 2013 before he must start reporting on the VA’s progress on this provision of law. Nevertheless the law does specify he must report on the number of veterans and family members provided hospital care and medical services during the period beginning on October 1, 2012, and ending on the date of such report. The report will identify the illnesses, conditions, and disabilities for which care and services have been provided such veterans and family members under such provisions of law during that period;  the number of veterans and family members who applied for care and services under such provisions of law during that period but were denied, including information on the reasons for such denials; and the number of veterans and family members who applied for care and services under such provisions of law and are awaiting a decision from the Secretary on eligibility for such care and services as of the date of such report.

However, the new law does not apply to VA disability compensation.  While it continues to monitor the above DoD research, the VA states, “At this time  there is insufficient scientific and clinical evidence to establish a presumptive association between service at Camp Lejeune during the period of water contamination and the development of certain diseases.”  That does not mean one cannot apply for compensation, however.  See Hazardous Exposures in the Answers Desk for more information on this subject.

The bill also addresses other areas of concern.  We have highlighted and grouped most of them according to the agency and topic area:

Homelessness – Veterans Health Administration (VHA) and Department of Labor: The new act provides funding for new construction of transitional housing for homeless veterans, and an increase in funding from $100 million to $300 million for the Supportive Services for Veteran Families program – the only federal, veteran-specific program that offers rapid re-housing and prevention resources to community providers. It also reauthorizes Department of Labor’s Homeless Veterans Reintegration Program ($50 million in funding) and the VHA’s Homeless Providers Grant and Per Diem Program ($250 million in funding), plus expands the VA’s Special Needs Grant Program to include male homeless veterans with minor dependents. Finally, it requires the VA to provide treatment and rehabilitation services to homeless veterans who do not suffer from serious mental illness.

It also increases the prohibition of banks from foreclosing on the homes of military families from nine months to one full year after military service is completed.

Claims Processing – Veterans Benefits Administration (VBA): It potentially streamlines the VA’s disabilities claims process by waiving the review of new evidence presented to the Board of Veterans’ Appeals, allows signatories for veterans to sign and file claims, and requires claims processors to make at least two attempts to assist veterans in obtaining relevant records, including private medical records. It also requires the VA to review and revise its skills and competency thresholds for Veterans Benefits Administration employees, ensuring that claims for compensation and pensions are not affected by incompetent workers, and that appropriate personnel actions are enforced.

Hiring of Veterans by Contractors – Department of Labor:  The new act requires the Department of Labor to publish the records of government contractors in their hiring veterans. In addition, VA would establish a “VetStar” program recognizing companies that have made significant contributions to veterans employment. Perhaps this measure may prove beneficial in revealing the truth in veterans hiring practices – an underlying problem in the US VETS program has been the lack of tracking of the success of veterans preference policies.

Patient Care – VHA:  While the act encourages improving healthcare access for veterans through the use of more tele-consultation capabilities, it also aims at improving VA health care for rural veterans by waiving co-payments for those who use telehealth care – a double-edged sword?  Additionally, it presses for the establishing of VA rural health resource centers to better accommodate the health-care needs of rural veterans. Traumatic brain injury patients will receive increased attention through the expansion of rehabilitation and reintegration services to increase their independence and quality of life. Although we have never noticed the problem, having seen service dogs in VA facilities locally, the law now forbids the VA from banning them from their facilities. And finally, it creates new measures to prevent sexual assaults at VA facilities from going unreported and unpunished (A 2011 GAO report determined the VA had inadequate tracking and reporting procedures in place for such assaults.).

Burial – Department of Defense and National Cemetery Administration (NCA, VA):  The original and sole purpose of the H.R. 1627, until it was amended with ‘riders’, now limits grave site reservations at Arlington National Cemetery to one, because the cemetery is running out of space. Also, protesters at military funerals will be punished by criminal or civil action under federal law (some states like Pennsylvania have passed their own laws) if they violate restrictions placed on their activities.

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RJH

28 August 2012

Updated: 9 September 2012 (to include information on Camp Lejeune disability compensation)

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