The Senate Veterans Affairs Committee met Wednesday afternoon to review the Department of Veterans Affairs’ (VA) implementation of the Honoring Our PACT Act. That legislation, which greatly expands veterans’ access to care and benefits for health conditions related to toxic exposures during their military service, was signed into law almost a year ago.
Earlier this week, the VA announced the start of a scientific review into links between acute leukemias, chronic leukemias, and multiple myeloma and toxic exposures experienced in the Southwest Asia theater of operations. If a link is proven, the VA will be able to declare a service presumption related to these conditions, eliminating a veteran’s need to prove service connection when claiming care and benefits. Since the PACT Act already declared cancers of the head and neck to be presumptive, this research will focus on conditions originating in other parts of the body. These are the first conditions chosen for scientific review under the PACT Act’s requirement that the Department more aggressively identify presumptive conditions related to toxic exposures.
Of the more than four million veterans screened for toxic exposures so far, over 40% reveal at least one area of concern. This creates a permanent record of exposure within the Veterans Health Administration (VHA). Going forward, clinicians might use that information to lower the threshold for some cancer screenings or to order laboratory tests to monitor potential health issues. In addition, every veteran reporting a concern is referred to the Veterans Benefits Administration (VBA) to see if they are eligible for more benefits. For example, a Vietnam era veteran’s hypertension could now be considered service connected under the PACT Act’s increased number of service presumptions.
Under Secretary of Veterans Affairs for Health Dr. Shereef Elnahal said the landmark legislation has already empowered the VA to provide care to more veterans and survivors than ever before. He related the experience of a veteran who now has several conditions, including diabetes, covered by the VA. This has not only improved the veteran’s health, but having VA coverage has provided the family with much-needed financial relief.
He described the various outreach efforts underway, including the “Summer VetFest”. VA employees have been trained in toxic exposure issues and the PACT Act. A wide spectrum of providers has trained to administer the toxic exposure screening. The VA has screened over four million veterans for toxic exposures.
The Veterans Health Administration (VHA) is also increasing its capacity to treat more veterans. Thanks to the law’s new hiring authorities, the VHA workforce has grown by 4.9% this fiscal year. They have reduced the time it takes to bring someone on board to fill vacant positions. He boasted that they have outpaced goals in hiring administrative staff, and they are improving scheduling systems. This includes implementing systems that allow veterans to book their own community care appointments.
The VHA is also using PACT Act authorities to expand infrastructure. They have signed several memoranda of understanding (MOUs) with academic medical centers to share clinical space. Elnahal pointed out that, this week, the Centers for Medicare and Medicaid Services (CMS) included VA hospitals in its national star rating system.
Under of Veterans Affairs for Benefits Joshua Jacobs said an increasing number of veterans are pursuing their earned services. Since August 10, 2022, the VA has received more than 772,000 PACT Act claims. Of those, 425,000 have been completed, with an almost 79% approval rate.
Jacobs talked about the same veteran Dr. Elnahal had mentioned. He said the veteran had first applied in 2016 for his conditions due to Agent Orange exposure. However, at that time, the VA could not approve the claims. Today, he has been awarded long overdue benefits, effective the day the bill was signed into law. He pointed out the VA decided to allow all presumptives under the law from the date of enactment, rather than phasing it in over several years.
The Veterans Benefits Administration (VBA) has been aggressively scaling up operations. Over the last 18 months, VBA has grown by 22%, with a workforce of more than 30,000 people. Through the end of June, they completed 1.9 million exams. This is almost 22% more than at the same time last year.
He acknowledged they have had challenges in implementation. He mentioned the need to improve training for claims processing, and the strain faced by processors. The VBA is improving its training, and providing new tools to help the processors. This includes more automated tools to streamline the process. Finally, he encouraged all veterans who think they may qualify under the PACT Act to submit an intent to file in order to preserve the ability for benefits to be backdated to last August.
