Fact Sheet: Hillary Clinton's Plan to Overhaul the VA
International
troops listen to a speech by U.S. State Secretary Hillary Clinton
during a meeting at Kabul airport before her departure from Afghanistan
November 19, 2009. REUTERS/Jerry Lampen (AFGHANISTAN POLITICS CONFLICT
MILITARY)
U.S.
State Secretary Hillary Clinton speaks during a meeting with
International troops at Kabul airport before her departure from
Afghanistan November 19, 2009. REUTERS/Jerry Lampen (AFGHANISTAN
MILITARY POLITICS CONFLICT)
U.S.
State Secretary Hillary Clinton meets with International troops at
Kabul airport before leaving Afghanistan November 19, 2009.
REUTERS/Jerry Lampen (AFGHANISTAN)
Hillary
Clinton believes that supporting our veterans is a sacred
responsibility. By fulfilling that responsibility, we not only ensure
that veterans receive the opportunity, care, and support they earned by
serving our country. Prioritizing their reintegration also ensures that
they bring their unique skills and experience to the success of their
communities and our nation after their service is over. Yet too often,
we as a nation failed to uphold our end of the bargain. As
Commander-in-Chief, she will personally commit to fulfilling America’s
promise to our veterans, our troops, and their families – a commitment
driven by her recognition not just of the extraordinary sacrifices they
make, but also of how essential that promise is to our long-term
national security and our vitality and prosperity at home.
Secretary
Clinton has fought for our veterans throughout her career. This issue
is deeply personal for her, and her approach is rooted in her upbringing
as the daughter of a World War II veteran and decades of experience
working with military members and their families. As First Lady, she
fought to have Gulf War Syndrome recognized. As Senator on the Armed
Services Committee, she fought to establish new services for military
members and veterans suffering from post-traumatic stress (PTS) and
traumatic brain injuries (TBI). She regularly worked across the aisle
to expand military benefits, including to ensure that all members of the
Reserves and National Guard and their families had access to health
benefits; to expand benefits afforded to surviving spouses; and to
broaden protections afforded by the Family and Medical Leave Act to the
family members of wounded service members. And as Secretary of State,
she was at the table in the Situation Room, providing advice to the
President on the most grave decision a Commander-in-Chief makes: whether
and how to send our military personnel in to harm’s way.
Secretary
Clinton is committed to a strong and resilient military, built by the
extraordinary men and women who volunteer to serve and the families who
serve alongside them. And she believes that issues affecting current
service members and veterans are inseparable. As President, she’ll
continue to support the needs and talents of all who have served and who
serve us still, whether Soldiers, Sailors, Marines, Airmen and Coast
Guardsmen, including active duty, reserve, and National Guard, and every
race, creed, gender, and sexual orientation. And she will have no
tolerance for failure to put veterans first.
Secretary Clinton’s comprehensive plan will:
Fundamentally
reform veterans’ health care to ensure veterans’ access to timely and
high quality health care and block efforts to privatize the VHA
Modernize and refocus the full spectrum of veterans’ benefits across the federal government
Overhaul VA governance to create a new veteran-centric model of excellence
Empower veterans and strengthen our economy and communities by connecting their unique skills to the jobs of the future
Sustain and strengthen the all-volunteer force
Strengthen services and support for military families
Veterans Agenda
The
systemic failures of the VA to uphold its core mission underscore the
need for fundamental reforms and focused leadership. Long wait times
for health care, crippling claims backlogs, and lack of coordination
among agencies represent government at its worst. Secretary Clinton
recognizes the gravity of these challenges, and as President will pursue
a veteran-centric reform agenda that tackles problems head-on and
revitalizes the VA. She will end the excuses and ensure our veterans
receive the timely health care they deserve. She will oppose the
privatization of the VA system, which would undermine our veterans’
ability to get the unique care that only the VA can provide while
leaving them vulnerable to a health care market poorly suited to their
needs. And she will lead a national effort to invest in and empower
veterans to apply their considerable skills in their communities.
ENSURE VETERANS’ ACCESS TO TIMELY AND HIGH QUALITY HEALTH CARE
Veterans
must have access to a system that puts their needs first. But in order
to build such a system, prepared for the unique and growing needs of the
twenty-first century, we cannot simply throw more money at the problem
or tell veterans to go get private care, as the VA’s implementation of
the Veterans’ Choice Act has shown. We also cannot throw our veterans
at the mercy of the private insurance system without any care
coordination, or leave them to fend for themselves with health care
providers who have no expertise in the unique challenges facing
veterans. The Veterans Health Administration (VHA) must embrace
comprehensive process and systems integration across its health care
enterprise to ensure a fully-networked and financially-sustainable
organization that is dedicated to best practices and continual
improvement in everything it does. Specifically, Secretary Clinton will: Create a new framework for VHA health care deliveryby refocusing, reorganizing, and streamlining the VHA to best serve veterans in the 21st
century. The VHA must be transformed from primarily a provider of
services into an integrated health care system that responsibly balances
its role as health care provider, partner, and payer for
veteran-directed care. And it must have the health care providers
necessary to ensure it is able to provide quality and timely care. At
the same time, the VA must maintain the ultimate responsibility of
coordinating and ensuring comprehensive and quality health care for
every veteran and the specialized services that they deserve – critical
functions that would disappear if the VA were privatized. The VHA must:
Refocus as a veteran-centric provider of service-connected care.
The VHA should focus its resources on what it can do best, particularly
health care for service-connected conditions. This is especially
important in areas where veterans lack access to the necessary care
outside of the VHA, such as prosthetics and traumatic brain injury.
Synchronize and coordinate VHA care with other available programs,
including coverage already provided to veterans, such as private or
employer-provided insurance, TRICARE, Medicare, federally-qualified
health centers, Indian Health Service, and the Affordable Care Act, to
ensure the most responsible use of taxpayer dollars;
Strategically purchase private-sector care
when it makes sense to do so, such as for some specialty inpatient or
surgical procedures, expanded access to mental health and substance
abuse treatment, or when the VA cannot provide timely access to
necessary care. Secretary Clinton would present and advocate for
legislation that allows the VA to pursue provider agreements to do this
in the most effective and efficient manner;
Establish a VHA Strategic Oversight and Governance Board
of health care and management leaders. In line with the best practices
of modern hospital systems across the country, the board will be
empowered to provide oversight of VHA management processes, monitor
accountability, promulgate best practices, and ensure the VHA remains
true to its mission of putting veterans first. This Board would include
strong veterans representation.
Personally convene the Secretaries of Veterans Affairs and Defenseregularly
in the Oval Office and direct them to develop, execute, and report on
an effort that integrates their health care operations to create a more
efficient and a sustainable system. She will direct them to:
Streamline the DoD-VA health care footprint
by identifying opportunities to co-locate and better coordinate
inpatient services across federal health delivery programs, while
stripping out costly and redundant bureaucratic functions, and
developing a plan to ensure the VA has the facilities needed to provide
21st century care;
Synchronize procurement to find cost
savings by negotiating and procuring a single formulary of
pharmaceuticals along with medical and office supplies and information
systems to ensure compatibility and eliminate waste and redundancy;
Streamline VA and DoD IT,
ending the years of delay in developing an electronic health record
(EHR) system that is fully interoperable. The VA has over 100 different
versions of its own EHR system, making it difficult enough to
communicate between different VA clinics, let alone with DoD. DoD and
VA must also eliminate bureaucratic barriers to seamless coordination
and information-sharing. And the new system must also link to private
sector providers to enable full information sharing, care coordination,
and integrated billing and payments.
Improve health care for women at the VHA
to ensure all veterans are fully and equally supported after serving
our nation. Women veterans are the fastest growing population served by
the VA, highlighting the importance of proactively addressing the VHA’s
ability to meet their needs. Secretary Clinton would work to pass
bipartisan legislation that requires VA medical facilities to meet the
health care needs of women veterans. In addition, Secretary Clinton
calls for:
New funding to ensure women equal and respectful access to health care,
going beyond simply modifying facilities and increasing the number of
OBGYNs employed by the VHA, to include expanding provider training,
ensuring culturally-competent VHA staff and policies, and providing
other gender-specific health services – including mental health
services;
Requiring the provision of reproductive services across the VHA to ensure women have access to the full spectrum of medical services they need;
Broadening initiatives to provide childcare at VA medical facilities
so that parents, particularly single mothers, don’t have to choose
between taking care of their child and taking care of their health.
End the veteran suicide epidemic andensure
that every veteran has access to world-class medical and counseling
services whenever and wherever they are needed. To do this, Secretary
Clinton will:
Increase funding for mental health providers and training
to ensure timely and ongoing identification and triage of mental health
issues, and ongoing access to quality mental health care and substance
abuse treatment, particularly for alcohol and opiate abuse, including
private-sector care when necessary.
Expand programs targeted at providing effective mental health treatment for veterans that have participated in classified or sensitive missions without compromising non-disclosure requirements,working with Congress to pass needed legislation;
Promote better prescriber and treatment practices
by promulgating guidelines that recommend treatments for pain
management other than opioids, so that prescribers can consider those
alternatives, particularly for patients without chronic physical pain;
Ensure that Military Sexual Trauma (MST) is acknowledged as a valid form of PTS,
setting a burden of proof for MST that is no higher than for any form
of trauma, and that men and women who suffer from it are uniformly
eligible for disability compensation and treatment;
Educate and encourage state veterans affairs departments
to include veteran mental health programs in state requests for federal
grants as part of Secretary Clinton’s initiative to combat drug and
alcohol addiction;
Provide proper legal assistance to review and upgrade
other-than-honorable discharge categorizations for service members who
were improperly separated from service due to service-connected mental
health and cognitive issues, such as TBI, PTS, and addiction.
Continue efforts to identify and treat invisible, latent, and toxic wounds of warthat
continue to affect veterans, family members, and caregivers long after
their service. This includes Agent Orange, Gulf War syndrome, burn
pits, and – two issues that Secretary Clinton has long worked to better
address – PTS and TBI. Secretary Clinton will:**
Maintain presumptions of service-connection
for latent and invisible wounds from the Vietnam War, Gulf War, Iraq
war, and Afghanistan war while directing the VA to consider additional
presumptions of service connection for disabilities arising from toxic
exposure;
Expand the current VA burn pit registry to
become a comprehensive registry for all post-9/11 deployment veterans
exposed to environmental dangers, toxic hazards, and other conditions.
Dedicate research funding and provide mechanisms for collaborative efforts
to facilitate the development and expansion of evidence-based
diagnostic tools and treatments for veteran-centric conditions,
including mental health issues and other invisible, latent, and toxic
wounds of war, and direct the VA, HHS, and DoD to collaborate and
integrate portfolios when it makes sense to do so.
MODERNIZE
AND REFOCUS THE FULL SPECTRUM OF VETERANS BENEFITS ACROSS THE FEDERAL
GOVERNMENT SYSTEM BY IMPLEMENTING A “NEW BRADLEY PLAN”
In
the years following World War II, 16 million returning service members
were able to rely on the health care and educational opportunities
afforded by an adaptable VA organization, headed at the time by General
Omar Bradley. General Bradley worked effectively with Congress and
stakeholders to build the system that cared for those returning troops.
In a similar spirit, aimed at address the VA’s current limitations,
Secretary Clinton will direct a national, multi-sector effort to
streamline and modernize the veterans’ benefits system. The “New
Bradley Plan” will address the shortcomings of today, while ensuring the
nation can meet the needs of tomorrow’s veterans. To implement this
plan, Secretary Clinton will: End the disability benefits and appeals backlog through overtime work, productivity improvements, and new initiatives. Secretary Clinton will:
Streamline and simplify the claims process
by integrating DoD and VA medical evaluations, using “fully developed
claims” from private providers, allowing rules-based automatic
adjudication for the simplest of applications, and by ensuring veterans
have an effective appeals process to make sure the VA gets it right.
Improve the VA’s partnership with DOD to
anticipate and prepare for future waves of VA claims across the
government, and surge resources to the system before claims backlogs
grow out of control.
Launch an Innovation Initiative led
by a team with diverse backgrounds and expertise to connect the VA with
leaders in the nation’s leading businesses, universities, and
non-profits to develop innovative solutions for sustainably managing the
claims and appeals process and to address unforeseen challenges.**
Bring Sustained and Focused White House Leadership and Attentionto
coordinate the programs supporting our veterans across the U.S.
government, ensure continued consultation and engagement with the
veteran community, and leverage the private sector to ensure the entire
nation is mobilized to meet this challenge. To do so she will:
Create a standing President’s Council on Veterans,
coordinated by a Senior White House official responsible for Veterans
Integration. The council will be an all-of-government approach to
supporting veterans, comprised of the heads of all 17 agencies involved
in this mission to synchronize and integrate the patchwork of programs
and benefits.
Conduct an end-to-end evaluation to optimize the full scope of benefits
afforded to our veterans and provide recommendations to ensure that
greater investments in services and support for veterans are smart,
effective, and will best meet the needs of veterans today and for
generations to come;
Convene a White House Summit on Veterans
to personally address progress on veterans’ issues with all
stakeholders directly, meet early and regularly with a cross-section of
veterans to understand their needs and ensure we meets our promises, and
work with state governors to ensure that veterans and National Guard
issues are addressed at the state level given their important role;
Continue to engage private and philanthropic sectors
with this effort by ensuring that companies know the value of hiring
veterans and by amending federal ethics and acquisition regulations to
allow VA, DoD, and other federal agencies to effectively partner with
the private and nonprofit sectors, including better data sharing, more
open access to federal facilities, and sharing of resources.
EMPOWER VETERANS BY CONNECTING THEIR UNIQUE SKILLS TO THE JOBS OF THE FUTURE
Secretary
Clinton recognizes that America’s veterans are an enormous asset for
the future of the country and our economic growth. Veterans bring
unique skills from their time in the military that can move America’s
economy forward. From their commitment to service and teamwork to
specific job skills from computer science to welding, investment in our
veterans can power a workforce for the future. Secretary Clinton is
committed to the programs and supports that will strengthen pipelines of
veterans and service members into higher education and industry.
Specifically, Secretary Clinton will: Support and broaden initiatives that provide educational benefits, job training, and support for veteran entrepreneurs.
Secretary Clinton will build on First Lady Michelle Obama’s Joining
Forces Initiative with a national push to improve the pipeline of our
nation’s veterans into the workforce. To do this, she will:
Make the Post-9/11 GI Bill a lasting part of the nation’s social contract with those who serve,
working with Congress to pass legislation that solidified existing
benefits, preserves and extends family transferability (including to
non-traditional families), and expands qualified uses for use in the 21st
century economy, such as at approved coding academies, entrepreneurship
programs, and apprenticeship programs with America’s leading companies
and labor organizations;
Expand tax credits for veterans’ employment
through reauthorizing and making permanent the Work Opportunity Tax
Credit for veterans and expanding it to provide credits to businesses
that hire disabled veterans.
Improve concurrent certification and credentialing programs
by increasing funds available to state and local governments to process
military certificates, and by expanding the concurrent credentialing
program to all appropriate military career fields, to ensure that our
veterans can seamlessly transfer their skills from the military to the
community;
Strengthen veteran entrepreneurship programs,
including expanding the efforts of the Interagency Task Force on
Veterans Small Business Development to provide entrepreneurship training
and counseling and small business loan guarantees;
Create pathways and platforms for service members to enter growing career fields,
including jobs in clean energy, cyber, and information technology, and
areas of critical need by improving integration between these
opportunities and the military’s Transition Assistance Program;
Protect veteransfrom
discrimination and predatory companies that unfairly target veterans
and their families, in the spirit of Secretary Clinton’s broader efforts
to protect consumers and bolster the middle class, she will:
Fight back against schools that prey on veterans,
including through legislation that closes the 90-10 loophole exploited
by for-profit schools, and by banning schools from receiving federal
student aid (including DoD tuition assistance and VA GI Bill funding) if
they are found guilty of fraudulently recruiting students;
Enforce zero tolerance
for firms that overcharge service members and veterans by banning bill
collectors and loan servicers from contracts to service federal loans,
and help defrauded students discharge debt from fraudulent schools;
Strengthen non-discrimination laws
protecting veterans and military families by expanding the Uniformed
Services Reemployment and Readjustment Act (USERRA) and Servicemembers
Civil Relief Act (SCRA), adding veteran status to the Fair Housing Act
of 1968 to protect veterans from discrimination in the housing market.
Move decisively to end veteran homelessness by building on successful initiatives and expanding programs that help ensure long-term success.
Increase funding for reducing homelessness while expanding public-private partnerships,
with an emphasis on regions with the greatest need. Leverage federal
resources to support community-based organizations, including by
reallocating excess and unused federal property for use by
veteran-focused non-profit organizations;
Expand complementary programs and services
including outreach, especially in locations involving high densities of
homeless veterans, and programs that prepare veterans for independent
living to prevent recidivism, such as counseling, job training,
disability benefits, and transportation;
Address the needs of homeless women veterans and homeless veteran families by
clarifying language in the Fair Housing Act that removes ambiguities in
the law regarding gender and family-specific housing, and providing
shelter options that account for local demographic conditions.
Support Veterans Treatment Courts nationally
using block grants to state and local governments while also directing
the VA to expand its current pilot programs for “medical legal
partnerships” to offer space to community legal organizations in VHA
clinics. Veterans Treatment Courts provide an alternate to the
traditional criminal justice system for veterans with minor offenses
aggravated by mental health or substance abuse issues, ensuring these
veterans are rehabilitated while getting the treatment they need. Recognize the honorable service of LGBT veterans
by proactively reviewing and upgrading discharge records for veterans
who were discharged because of their sexual orientation; and honoring
their service by continuing efforts to improve the support and care they
receive at the VHA to ensure respectful and responsive health care.
OVERHAUL VA GOVERNANCE TO CREATE NEW VETERAN-CENTRIC MODEL OF EXCELLENCE
Fulfilling
the nation’s duty of taking care of our veterans requires effective
performance by the VA and other federal agencies that support veterans.
As part of a broader effort to promote good governance, Secretary
Clinton will reform management within the Department of Veterans
Affairs, ensure fair and transparent accountability, and set us on a
path to excellence for our nation’s veterans for generations to come.
Secretary Clinton will: Create a culture of accountability, service, and excellence at the VA.Secretary
McDonald has done a commendable job of refocusing the VA on its core
mission: putting veterans first. But Secretary Clinton believes more
must be done to reform and improve the VA from the top-down, and from
the bottom-up. Secretary Clinton supports legislation that will:**
Hold every employee accountable for their performance and conduct.
From the top leadership to mid-level managers to entry-level employees,
everyone at the VA must embody the highest workplace standards.
Supervisors must be empowered to suspend or remove underperforming
employees in accordance with due process not only for the good of the
organization, but in service of our nation’s veterans.
Revamp the performance evaluation system
to recognize and advance high-performing employees to create a
thriving, effective, and sustainable organizational culture, while also
establishing processes to ensure managers are held accountable for
taking action to deal with poorly performing employees.
Bolster critical whistleblower protections.
Individuals who sound the alarm over wasteful programs or question
inefficient practices embody the spirit of reform and management
excellence that the VA must champion. Whistleblower protections are key
to ensuring these employees are empowered and their voices heard, not
silenced.
Provide budgetary certainty to
facilitate reforms and enable long-term planning. The recent budget deal
reached between the Congress and the White House is a promising first
step in providing government agencies with much needed fiscal stability.
But we must go further by ending the sequester for both defense and
non-defense spending in a balanced way, and prioritizing full-funding
and advance appropriations for the entire Department of Veterans
Affairs. Ensure our veterans are buried with the honor, distinction, and integrity they deserve, directing the VA to clean up problems that have led to unacceptable indignities for our veterans and their families.
Military Personnel and Families Agenda :
Our
obligation to our veterans cannot be separated from our broader
commitment to take care of our soldiers, sailors, airmen, marines, coast
guardsmen –active duty, reserve, and National Guard – and their
families. Our men and women in uniform have volunteered to put their
lives on the line to serve our country in operations that keep our
people safe and ensure peace and security across the globe. As
President, Secretary Clinton will make sure the United States supports
the men and women who make the US military the best-trained,
best-equipped, and strongest military the world has ever known.
Secretary
Clinton believes that no individual should have to choose between
serving their country and taking care of their family, while on active
duty or afterward. She will continue to work with civilian and military
national security leaders to ensure that our nation’s armed forces are
trained, equipped, and ready for the full spectrum of challenges they
will face, including those still over the horizon.
SUSTAIN AND STRENGTHEN THE ALL-VOLUNTEER FORCE
The
All-Volunteer Force (AVF) has been stressed by fourteen years of
continuous combat and is endeavoring to rebuild and reset, while facing
growing instability and complexity around the world, reduced
end-strength, and an uncertain fiscal environment. Secretary Clinton is
developing a broad strategy on DOD budget and reform measures grounded
in permanently ending the damaging sequester while making smart reforms
in both defense and non-defense spending. Included in that plan will be
military personnel policies that support and promote total force
readiness by: Supporting smart compensation and benefits reformthat
attracts the best and brightest new recruits to the AVF. Secretary
Clinton’s unwavering commitment to our military men and women includes
policies that will:**
Ensure reforms to military compensation and retirement benefits improve readiness and quality-of-life,
and working with Congress and the services to ensure that ongoing
improvements to the system, such as plans to modernize the commissary
system, are accomplished in a smart and comprehensive manner,
guaranteeing the strength and sustainability of the force for
generations to come.
Modernize the military health system
by ensuring service members, military retirees, and their families
robust access to health care by changing the incentive structure of the
TRICARE contracts to produce better health outcomes with better patient
satisfaction, expanding access to mental health care through
telemedicine and non-traditional treatments, and ensuring the health
needs of military women – including reproductive health care – are fully
supported.**
Adopting modern and inclusive personnel policies
that serve to bolster and enhance the finest fighting force the world
has ever seen. Secretary Clinton’s plan will both take advantage of
America’s strengths while embodying its values. This includes:
Attracting millennials to military service
by building on ‘force of the future’ initiatives, to include
emphasizing military opportunities in science and technology and
promoting smarter and more flexible DoD policies on tour lengths and
assignments, which give military families greater stability and increase
retention.
Zero-tolerance for Military Sexual Assault and Harassment
by strengthening protections to ensure that our women and men in
uniform can serve without fear of sexual assault or harassment, and
without fear of retaliation for reporting.**
Welcoming women to compete for all military positions
provided they meet the requisite standards, in line with the ongoing
DoD policy review. From piloting fighter jets to serving on submarines
to earning respect as an Army Ranger, merit and performance should
determine who serves in the military’s combat specialties and units, not
gender.
Supporting the DoD policy review on transgender service,
anticipating that transgender people will soon be allowed to serve
openly alongside their comrades in arms in a military where everyone is
respected enough to let them serve with dignity.
STRENGTHEN MILITARY FAMILY SERVICES AND SUPPORT
Secretary
Clinton recognizes that military family readiness is a critical part of
total force readiness, and she understands that military families face
unique concerns and challenges, especially after fourteen years of
continuous deployments. To tackle these challenges, Secretary Clinton
will: Promote family policies that provide
military families with additional opportunities and much-needed
flexibility in juggling multiple challenges. This includes:
Increasing access to child care
both on- and off-base, including options for drop-in services,
part-time child care, and the provision of extended-hours care,
especially at Child Development Centers, while streamlining the process
for re-registering children following a permanent change of station
(PCS);
Creating flexibility around military moves by
allowing families to continue receiving their housing allowance for up
to six months after a military member’s PCS move under common-sense
circumstances; for example, when the service member has a spouse
enrolled in a degree-granting program or one or more children enrolled
in a local school;
Expand military spouse employment initiatives
by developing resources and high quality portable or work-from-home
positions for spouses while expanding public hiring preferences and
credentialing programs to assist military spouses.
Champion efforts to care for our military members and families, and ensure that our nation honors and respects them throughout their service and beyond. Secretary Clinton will:
Ensure continued focus on mental health for military members and families
by enhancing DoD programs to help remove the stigma of mental health
issues and by developing a comprehensive whole-of-life approach with the
DoD Suicide Prevention Office that includes education, training,
counseling resources, and family outreach;
Remain committed to extended leave policies
that are critical to military families, whether preparing for a service
member’s deployment or caring for a wounded warrior, and expanding paid
maternity and paternity policies across all of the services;
Continue to support Gold Star Families
and recognize their sacrifice through enhanced gratuity payments to
surviving spouses and ongoing access to benefits in recognition of their
sacrifice.
