[Joint House and Senate Hearing, 117 Congress]
[From the U.S. Government Publishing Office]


                                                     S. Hrg. 117-746
                                                        
                                                        
                    LEGISLATIVE PRESENTATION OF THE
               AMERICAN LEGION AND MULTI VSOs: PVA, SVA,
                 MOAA, GSW, NGAUS, TAPS, MMAA, ADBC-MS

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                               JOINT HEARING

                                 OF THE

                     COMMITTEE ON VETERANS' AFFAIRS

                               BEFORE THE

                     U.S. HOUSE OF REPRESENTATIVES

                                AND THE

                              U.S. SENATE

                    ONE HUNDRED SEVENTEENTH CONGRESS

                             SECOND SESSION

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                             MARCH 8, 2022

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      Formatted for the use of the Committee on Veterans' Affairs
      
 [GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
 
 
        Available via the World Wide Web: http://www.govinfo.gov
        
        
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                    U.S. GOVERNMENT PUBLISHING OFFICE                    
53-631                       WASHINGTON : 2023                    
          
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                 SENATE COMMITTEE ON VETERANS' AFFAIRS

                     Jon Tester, Montana, Chairman

Patty Murray, Washington             Jerry Moran, Kansas, Ranking 
Bernard Sanders, Vermont                 Member
Sherrod Brown, Ohio                  John Boozman, Arkansas
Richard Blumenthal, Connecticut      Bill Cassidy, Louisiana
Mazie K. Hirono, Hawaii              Mike Rounds, South Dakota
Joe Manchin III, West Virginia       Thom Tillis, North Carolina
Kyrsten Sinema, Arizona              Dan Sullivan, Alaska
Margaret Wood Hassan, New Hampshire  Marsha Blackburn, Tennessee
                                     Kevin Cramer, North Dakota
                                     Tommy Tuberville, Alabama

                      Tony McClain, Staff Director
                 Jon Towers, Republican Staff Director

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        HOUSE OF REPRESENTATIVES COMMITTEE ON VETERANS' AFFAIRS

                   Mark Takano, California, Chairman

Julia Brownley, California           Mike Bost, Illinois, Ranking 
Conor Lamb, Pennsylvania                 Member
Mike Levin, California               Aumua Amata Coleman Radewagen, 
Chris Pappas, New Hampshire              American Samoa
Elaine G. Luria, Virginia            Jack Bergman, Michigan
Frank J. Mrvan, Indiana              Jim Banks, Indiana
Gregorio Kilili Camacho Sablan,      Chip Roy, Texas
    Northern Mariana Islands         Gregory F. Murphy, North Carolina
Lauren Underwood, Illinois           Tracey Mann, Kansas
Colin Z. Allred, Texas               Barry Moore, Alabama
Lois Frankel, Florida                Nancy Mace, South Carolina
Anthony G. Brown, Maryland           Madison Cawthorn, North Carolina
Elissa Slotkin, Michigan             Troy E. Nehls, Texas
David J. Trone, Maryland             Matthew M. Rosendale, Montana
Marcy Kaptur, Ohio                   Mariannette Miller-Meeks, Iowa
Raul Ruiz, California
Ruben Gallego, Arizona

                       Matt Reel, Staff Director
               Maria Tripplaar, Republican Staff Director
                            
                            
                            C O N T E N T S

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                             March 8, 2022

                            REPRESENTATIVES

                                                                   Page
Takano, Hon. Mark, Chairman, U.S. Representative from California.     1
Bost, Hon. Mike, Ranking Member, U.S. Representative from 
  Illinois.......................................................     5
Roy, Hon. Chip, U.S. Representative from Texas...................    16
Brownley, Hon. Julia, U.S. Representative from California........    19
Banks, Hon. Jim, U.S. Representative from Indiana................    21
Mrvan, Hon. Frank, U.S. Representative from Indiana..............    23
Rosendale, Hon. Matthew, U.S. Representative from Montana........    24
Slotkin, Hon. Elissa, U.S. Representative from Michigan..........    26
Miller-Meeks, Hon. Mariannette, U.S. Representative from Iowa....    27
Moore, Hon. Barry, U.S. Representative from Alabama..............    30
Pappas, Hon. Chris, U.S. Representative from New Hampshire.......    54
Ruiz, Hon. Raul, U.S. Representative from California.............    55

                                SENATORS

Tester, Hon. Jon, Chairman, U.S. Senator from Montana............     3
Moran, Hon. Jerry, Ranking Member, U.S. Senator from Kansas......     6
Boozman, Hon. John, U.S. Senator from Arkansas...................    17
Sinema, Hon. Kyrsten, U.S. Senator from Arizona..................    19
Tillis, Hon. Thom, U.S. Senator from North Carolina..............    22
Hassan, Hon. Margaret Wood, U.S. Senator from New Hampshire......    29
Blumenthal, Hon. Richard, U.S. Senator from Connecticut..........    49

                    INTRODUCTION OF PAUL E. DILLARD

The Honorable Ted Cruz, U.S. Senator from the State of Texas.....     4

                               WITNESSES
                                Panel I

Paul E. Dillard, National Commander, The American Legion.........     8

  accompanied by

  Lawrence Montreuil, National Legislative Director, The American 
    Legion

  Ralph Bozella, Chairman of the Veterans Affairs and 
    Rehabilitation Commission, The American Legion

  James LaCoursiere, Chairman of the Veterans Employment and 
    Education Commission, The American Legion

  Joe Sharpe, Director of Veterans Employment and Education 
    Commission, The American Legion

  Katie Purswell, Director of Veterans Affairs and Rehabilitation 
    Commission, The American Legion

                                Panel II

Jan Thompson, President, American Defenders of Bataan and 
  Corregidor Memorial Society....................................    32
Charles ``Charlie'' Brown, National President, Paralyzed Veterans 
  of America.....................................................    34
Jared Lyon, National President and Chief Executive Officer, 
  Student Veterans of America....................................    36
Rene Campos, CDR, U.S. Navy (Ret.), Senior Director, Government 
  Relations for Veterans-Wounded Warrior Care, Military Officers 
  Association of America.........................................    38
Claire Manning-Dick, National Vice President, Gold Star Wives of 
  America, Inc...................................................    40
Brig. Gen. J. Roy Robinson (Ret.), President, National Guard 
  Association of the United States...............................    41
Bonnie Carroll, President and Founder, Tragedy Assistance Program 
  for Survivors..................................................    43
Jennifer Dane, Chief Executive Officer and Executive Director, 
  Modern Military Association of America.........................    45

                                APPENDIX
                          Prepared Statements

Paul E. Dillard, National Commander, The American Legion.........    63
Jan Thompson, President, American Defenders of Bataan and 
  Corregidor Memorial Society....................................    98

    Attachment--Reference Points for American POWs of Japan......   107

Charles ``Charlie'' Brown, National President, Paralyzed Veterans 
  of America.....................................................   138

    Attachment--2022 Legislative Priorities......................   157

Jared Lyon, National President and Chief Executive Officer, 
  Student Veterans of America....................................   159
Rene Campos, CDR, U.S. Navy (Ret.), Senior Director, Government 
  Relations for Veterans-Wounded Warrior Care, Military Officers 
  Association of America.........................................   185
Claire Manning-Dick, National Vice President, Gold Star Wives of 
  America, Inc...................................................   206

    Attachment--Dependency and Indemnity Compensation Fact Sheet-
      December 2021..............................................   219

Brig. Gen. J. Roy Robinson (Ret.), President, National Guard 
  Association of the United States...............................   220
Bonnie Carroll, President and Founder, Tragedy Assistance Program 
  for Survivors..................................................   227
Jennifer Dane, Chief Executive Officer and Executive Director, 
  Modern Military Association of America.........................   244

                       Statements for the Record

Enlisted Association of the National Guard of the United States 
  (EANGUS).......................................................   273
Federal Bar Association..........................................   280
Fleet Reserve Association........................................   284
Jewish War Veterans of the United States of America (JWV)........   296
Military-Veterans Advocacy.......................................   305
National Association of Mortgage Brokers (NAMB)..................   319
Veterans Education Success.......................................   320
Veterans and Military Families for Progress (VMFP)...............   327

 
 LEGISLATIVE PRESENTATION OF THE AMERICAN LEGION AND MULTI VSOs: PVA, 
               SVA, MOAA, GSW, NGAUS, TAPS, MMAA, ADBC-MS

                              ----------                              


                         TUESDAY, MARCH 8, 2022

             U.S. House of Representatives,
                                   and U.S. Senate,
                            Committee on Veterans' Affairs,
                                                    Washington, DC.
    The Committees met, pursuant to notice, at 10 a.m., in Room 
210, House Visitors Center, Hon. Mark Takano, Chairman of the 
House Committee on Veterans' Affairs, presiding.

    Present:

    Representatives Takano, Brownley, Lamb, Pappas, Mrvan, 
Cherfilus-McCormick, Sablan, Underwood, Slotkin, Ruiz, Bost, 
Banks, Roy, Mann, Moore, Mace, Rosendale, and Miller-Meeks.

    Senators Tester, Brown, Blumenthal, Sinema, Hassan, Moran, 
Boozman, Cassidy, and Tillis.

    Also Present: Senator Cruz.

        OPENING STATEMENT OF HON. MARK TAKANO, CHAIRMAN,
              U.S. REPRESENTATIVE FROM CALIFORNIA

    Chairman Takano. Good morning. I call this hearing to 
order. A quorum is present. Without objection, the chair is 
authorized to call a recess at any time.
    Before we proceed, I would like to go over some items for 
our hybrid hearing.
    First, if you are experiencing connectivity issues, please 
make sure you or your staff contact our designated technical 
support so those issues can be resolved immediately.
    Members participating remotely must continue to remain 
visible on camera for the duration of their participation in 
the hearing, unless they experience connectivity issues or 
other technical problems that render the member unable to fully 
participate on camera.
    It is committee policy that members participating remotely 
will remain muted when not recognized, just like your turning 
your microphone on and off during an in-person hearing. This is 
out of courtesy to all members on the committee and so that 
background noise does not interfere with another member who is 
recognized to speak.
    When you are recognized, you will need to un-mute your 
microphone and pause for 2 or 3 seconds before speaking, so 
that your words are captured on the live stream.
    If you wish to have a document inserted into the record, 
please ask for unanimous consent and have your staff email the 
document to [email protected]. It will be 
uploaded to the committee document repository.
    Without objection, members will be recognized in order of 
seniority for questioning witnesses today. This will make it 
easier for me to ensure all members participating have an 
opportunity to be recognized.
    Does any member have a question about the procedures for 
this hearing?
    Seeing none, we will move forward.
    I now recognize myself for an opening statement.
    It is an honor to join all the members of the House and 
Senate Committees on Veterans' Affairs, virtual and in person, 
to hear directly from our veterans service organizations. This 
is our third and final hearing this year to hear testimony from 
the VSOs, which is invaluable as we work to support our 
Nation's veterans.
    During today's first panel, we will hear from The American 
Legion Commander and as well as other leaders from Legion.
    For our second panel, we will hear from representatives of 
seven additional VSOs, including Paralyzed Veterans of America, 
Student Veterans of America, Military Officers Association of 
America, Gold Star Wives of America, National Guard Association 
of the United States, Tragedy Assistance Program for Survivors, 
Modern Military Association of America, the American Defenders 
of Bataan and Corregidor Memorial Society will also be 
recognized.
    Welcome, everyone. And I would like to welcome all of the 
VSO members and supporters who have joined us online today as 
well.
    The opportunity to hear from our veterans service 
organization partners is incredibly important to me and I am 
grateful you all could participate today.
    This is a very exciting and busy month. Last week, the 
House debated and passed the critically important Honoring Our 
PACT Act. I want to personally thank the VSO community for the 
tremendous support you have provided during this successful 
legislative process.
    The work is not over, but I was encouraged to see 42 VSOs 
send a very strong letter to the House leadership supporting 
the PACT Act and, with your help, I know we can get this done.
    I would also like to express my thanks to Senator Tester 
for his continued efforts to work with me to pass comprehensive 
legislation to address toxic exposure in the Senate.
    Our bipartisan Honoring Our PACT Act finally provides much-
needed access to VA health care and disability benefits to over 
3.5 million veterans exposed to toxic substances. It requires 
that VA presumes veterans who were exposed to toxic substances 
rather than placing the burden on veterans to prove this link 
themselves. And, critically, it reforms VA's presumption 
decision-making process so Congress doesn't have to keep 
intervening.
    Vietnam veterans waited for more than 40 years for benefits 
related to Agent Orange exposure because of Congress' piecemeal 
solutions. Toxic-exposed veterans have held up their part of 
the pact and they deserve our action.
    Last week, the House kept its promise to these veterans and 
I look forward to continuing to work with the Senate to make 
this law.
    In last Congress, we secured several important wins for our 
veterans with the help of our VSOs, including passing the Blue 
Water Navy Vietnam Veterans Act, the Deborah Sampson Act, and 
the Veterans COMPACT Act, and the Commander Scott Hannon Act. I 
am very proud of these accomplishments, but they are only the 
beginning. We need to build on these achievements together and 
continue our fight for better health care and benefits in this 
Congress and beyond.
    Reading today's testimony, it is clear that VSO priorities 
greatly align with my own.
    My committee's top priorities for this Congress include 
creating a more inclusive and welcoming VA; building equity for 
an increasingly diverse veteran community; reducing veteran 
suicide; addressing toxic exposure; ensuring student veterans 
receive quality education; advocating for women veterans; 
modernizing VA; supporting VA's long-term care facilities; 
improving VA's management and oversight; and ensuring our 
legislative accomplishments are implemented effectively.
    Our diverse veteran community includes higher numbers of 
women, LGBTQ+, Black, Asian, Hispanic, and Native veterans than 
ever before. It is our country's diversity that strengthens our 
Armed Forces and veteran communities, and minority veterans 
deserve to feel safe and welcome when they enter through its 
doors, with outreach, programming, and solutions that address 
their unique needs.
    Additionally, VA must acknowledge the diversity of its 
workforce to address systemic discrimination in the workplace. 
We must ensure that health care and benefits are fairly and 
equitably distributed to all eligible veterans and, to do that, 
we must also ensure a safe and equitable workplace for VA 
employees.
    Our work to prevent veteran suicide continues. We must 
relentlessly pursue well-researched and scientifically sound 
policies that are proven to prevent suicide.
    We have big goals, but I know that with your support and 
insight here today, along with the support of the 
Administration, we will be able to deliver on them and fulfill 
the promises we have made to our Nation's veterans.
    I look forward to hearing today's testimony and thank you 
all for your continued advocacy and support for our veteran 
community.
    Chairman Tester, I now recognize you for your opening 
remarks.

        OPENING STATEMENT OF HON. JON TESTER, CHAIRMAN,
                   U.S. SENATOR FROM MONTANA

    Senator Tester. Thank you, Chairman Takano. I want to 
welcome all nine VSOs that are here today, with a special 
welcome to The American Legion, as you are up first. Commander 
Dillard, thank you for being here today, and I want to thank 
you for your advocacy on behalf of our Nation's veterans and 
their families.
    I also want to congratulate Chairman Takano and the entire 
House for passing the Honoring Our PACT Act. That was 
incredibly impressive.
    Simply put, our job is to do absolutely everything in our 
power to ensure veterans are connected to the care, the 
benefits, and the service they deserve in a timely manner.
    VA was facing staff shortages prior to COVID-19 and those 
have only gotten worse. We need to work on recruiting and 
retaining more folks to care for our veterans and help process 
their disability claims.
    We must also address mental health and continue to work to 
end veteran suicide nationwide. It is also past time that we 
finally pass comprehensive reform for toxic exposure.
    Since I introduced the Cost of War Act last year, we have 
seen a lot of progress. VA has created a new presumptive 
process that has added a dozen new presumptions, including the 
nine announced last week by the President, but we can't just 
rely on the executive branch. Congress has to take action and 
it has a constitutional responsibility to do its job on behalf 
of veterans. If we are going to fulfill our obligation to 
veterans, we need to roll up our sleeves and we need to do our 
jobs, and we need to work together in a bipartisan and 
bicameral way to deliver the results you need and that you have 
earned.
    Today, I want to give a special welcome to Jan Thompson, 
who is President of the American Defenders of Bataan and 
Corregidor Memorial Society.
    April 9th of this year marks the 80th anniversary of the 
Bataan Death March. I would particularly like to remember Ben 
Steele from Billings, Montana, a survivor of the Bataan Death 
March who contributed a great deal to our State and to our 
country. He survived the Battle of Bataan, the Bataan Death 
March, and a hellship to Japan, what we used to call the 
Japanese ships transporting American POWs, and forced labor in 
a coal mine. During his 42-months of imprisonment, he kept his 
sanity by sketching Montana scenes of cowboys and horses and 
barns. He came back home to Montana and spent the rest of his 
life teaching art and supporting students in his community.
    They don't make them like Ben Steele anymore and we 
certainly do miss him. I send my thoughts to his family and all 
other survivors and family members on this important 
anniversary.
    For the veterans here today, I want to thank you for your 
service and thank you for your work on behalf of your fellow 
veterans. We look forward to hearing from each one of you.
    Now I will turn it back to Chairman Takano.
    Chairman Takano. Thank you, Senator Tester. I appreciate 
the courtesy of all the chairs and ranking members up here 
today, and I want to extend the courtesy to Senator Cruz, who 
is with us here today, to introduce our guests.

             INTRODUCTION BY THE HONORABLE TED CRUZ

    Senator Cruz. Thank you, Mr. Chairman. It is great to join 
you.
    Chairman Tester, Chairman Takano, Ranking Member Moran, 
Ranking Member Bost, members of the committee, it is my honor 
and my privilege to introduce American Legion National 
Commander Paul Dillard to your committees.
    Commander Dillard is a proud Texan and a veteran who has 
dedicated his life to serving our country and serving our 
veterans. When he graduated from Whitesboro High School in 
1965, he joined the Navy, and ended up serving four tours in 
Vietnam.
    Upon coming home to Texas, Commander Dillard went to 
college, first at Grayson County Junior College, then East 
Texas State University. He got married to his wife, Donna, 
started a family, and eventually went on to start his own 
business, Dillard & Gand Insurance.
    Commander Dillard has been a member of The American Legion 
for 53 years, since 1969. He has served in many leadership 
roles in The American Legion over the years, including as Post 
Commander, Vice Commander, the chairman of many committees, the 
Commander of the Department of Texas, the National Vice 
Commander, just to name a few.
    He was elected as National Commander last September and is 
focusing his efforts on the theme ``No Veteran Left Behind.''
    Commander Dillard and his wife, Donna, have been married 
for 39 years. They have two sons, William and Jonathan, and two 
grandsons who are members of The American Legion family as 
well.
    It is my great pleasure that I introduce to you a fellow 
Texan, Commander Dillard, as he gives this Joint Session a 
report on The American Legion.
    Thank you.
    Chairman Takano. Commander, I am going to give the opening 
statements to the ranking members.
    I will now recognize Ranking Member Bost and then Senator 
Moran, and then we will have the opening statements from you.
    Ranking Member Bost.

              OPENING STATEMENT OF HON. MIKE BOST,
       RANKING MEMBER, U.S. REPRESENTATIVE FROM ILLINOIS

    Mr. Bost. Thank you, Mr. Chairman, and good morning.
    Many of you who know me know that in my life here and in my 
life before I got here, I wore many hats. So, whenever I give 
this testimony this morning, I hope that you can allow me to 
wear one of the hats I am kind of proud of.
    And, you know, it is an honor to be with Chairman Takano, 
Chairman Tester, Ranking Member Moran in welcoming you here 
today.
    My name is Mike Bost and I am the leading Republican for 
the House Republican VA committee. I am also a veteran, the son 
of a Korean War veteran and the grandson of a Korean War 
veteran; the nephew of a Vietnam veteran, who suffered from the 
ultimate oxymoron, friendly fire, and has 100 percent 
disability, but also has had a very successful life after 
coming home from Vietnam; but I am also the father of a Marine 
veteran--active Marine--and a grandfather of an active Marine.
    Like you, I know what it is like to serve and I know what 
it is like to stop serving. It is a tough transition, but I 
have done it, as I know all of you have as well. I still apply 
the lessons I learned during my active service to my daily 
life. That is especially true of my work on this committee and 
why I think these joint hearings are such valuable traditions. 
You understand the problems facing--what we face because they 
are your problems too. Your service here in Washington and 
throughout the country makes a difference, and I appreciate it.
    It has been a difficult couple of years for all of us and 
veterans have not been immune from it. The American Legion and 
the other VSOs represented here today are needed now more than 
ever to help our veterans get the care, benefits, and services 
they need. I am grateful for each one of you, for your work 
both in your active service time and now beyond.
    I am proud of what we have accomplished together so far 
this Congress and I am excited for the accomplishments that lie 
ahead. What is top for me, and I know for many of us as well, 
is the veterans who are suffering from toxic exposure. Helping 
them is our number one priority this Congress. We still have a 
long way to go to get there and this Congress is not getting 
any longer.
    I have heard loud and clear the call of the VSOs community 
for a comprehensive bill that addresses both care and benefits 
for toxic-exposed veterans. The time to work across the aisle 
and across the Capitol to get one for you is now.
    We must also work hand-in-hand with Secretary McDonough. He 
actually, last week, added nine new respiratory cancers to the 
VA list of presumptive conditions, and I appreciate his 
leadership and using the authority that Congress has given to 
the VA and his actions to ensure that veterans can get the 
benefits they have earned. I encourage the Secretary to 
continue to act where appropriate on behalf of toxic-exposed 
veterans.
    And I also encourage Chairman Takano and my colleagues in 
the House to act to pass Chairman Tester's and Ranking Member 
Moran's Health Care for Burn Pit Veterans Act. The Senate sent 
that bill our way 3 weeks ago. This is an important first step 
to fulfill our promises to toxic-exposed veterans and every day 
the House fails to send it to the President is another day that 
toxic-exposed veterans cannot get care that they need from the 
VA. However, I want to underscore my commitment that it is only 
the first step and additional steps will be needed to address 
other benefits.
    VSOs have been a critical advocate on toxic exposure and I 
know that you will all continue to be so. I want to thank you 
for the work that you have been doing and I am proud to be in 
the fight with you at all times.
    And, with that, I yield back.
    Chairman Takano. Thank you, Ranking Member Bost.
    Now, Ranking Member Moran, Senator Moran, I recognize you.

             OPENING STATEMENT OF HON. JERRY MORAN,
            RANKING MEMBER, U.S. SENATOR FROM KANSAS

    Senator Moran. Chairman Takano, thank you very much for 
hosting us today, and it is good to be back in this room and 
hear from our veterans service organizations.
    Commander Dillard, welcome. I too can't wear the hat that 
Ranking Member Bost does, but I am a member of the Sons of the 
American Legion, and I am an honorary member of the post in 
Mulvane, Kansas, The American Legion Riders, and I appreciate 
my relationship with your organization so much. I appreciate it 
because you speak so well for the veterans that are your 
members and even veterans who are not.
    Thank you to our other VSOs partners for joining us today 
to share with us your membership's top priorities for the 
remainder of this Congress, and I look forward to hearing from 
all of you. I hope that when we join each other together in 
2023 that we are all together in person. And, in that regard, I 
wanted to recognize all the Kansans, American Legion members 
and others, who are joining us today by technology.
    To start with, I want to extend my sincere gratitude to The 
American Legion for your strong and early support of a bill I 
introduced, Guaranteeing Healthcare Access to Personnel who 
Served, called GHAPS, which would work to close the gaps in VA 
care by ensuring certain and consistent coverage to veterans 
who get their care through the VA, including often hard-to-
reach veterans such as those in rural and highly rural areas, 
tribal veterans, and those living overseas. I look forward to 
continuing to partner with you to get this, what I consider to 
be a very important piece of legislation, across the finish 
line.
    Additionally, I want to commend and thank The American 
Legion for your continued partnership with the VA to bring 
telehealth access to rural communities through ATLAS 
initiative. I look forward to seeing soon the ATLAS pod that is 
set to come online in Emporia, Kansas later this month, and I 
am pleased that Kansas veterans in that area of my State will 
now have better access to VA telemedicine.
    I want to thank The American Legion also, and the Military 
Officers Association, for your support of the Health Care for 
Burn Pit Veterans Act, which was cosponsored by every single 
member of the Senate Veterans' Affairs Committee and passed out 
of the Senate by unanimous consent last month.
    I thank Chairman Tester and Ranking Member Bost for their 
work, and I look forward to continuing our efforts to cooperate 
with Chairman Takano to get all four corners to a solution that 
is in the best interests of all veterans.
    We share a number of priorities, from meeting the 
challenges for caring for our toxic-exposed veterans and 
addressing the disability claims backlog, to continue to 
enhance suicide prevention and mental health care, and 
improving access and choice in health care, as well as working 
toward improved educational benefits, and expansion and 
flexibility to assist veterans through the COVID-19 pandemic.
    You have my commitment that the Senate Veterans' Affairs 
Committee will continue to partner with you and the larger 
veteran community on addressing these and other priorities.
    I look forward to your presentations today, but before 
yielding back I want to thank all members of the United States 
military currently serving in NATO countries, including those 
with the 1st Infantry Division from Fort Riley, Kansas. They 
and the people of Ukraine are in our thoughts and prayers. And 
having confirmed what everyone who served in our military over 
a long period of time knows, the price of freedom is not easy 
to attain. And the people of Ukraine and their leaders not only 
are in our thoughts and prayers, but they provide us with 
inspiration and a reminder of the sacrifice that is often 
necessary.
    Thank you again for your testimony today, and I yield back.
    Chairman Takano. I thank the ranking member for his 
comments. I associate myself with his last comments regarding 
our service members who are currently serving and our situation 
in Ukraine.
    Let me point out to the Commander before I recognize him 
for his 5 minutes of my own--I do not wear the hat that my 
colleague does from the State of Illinois, but I did benefit 
from American Legion Program Boys State, I can't remember if it 
was '78 or '79, it was a long time ago, but I certainly 
appreciated that opportunity and I think it is a great program 
all across the country.
    So let me now introduce our witnesses, and I will now 
recognize our witnesses for our first panel for their opening 
statements. First, we have Mr. Paul E. Dillard, National 
Commander of The American Legion. He is accompanied by Lawrence 
Montreuil, the National Legislative Director; Ralph Bozella, 
Chairman of the Veterans Affairs and Rehabilitation Commission; 
James LaCoursiere, Chairman of the Veterans Employment and 
Education Commission; Joe Sharpe, Director of Veterans 
Employment and Education; and Katie Purswell, Director of 
Veterans Affairs and Rehabilitation at The American Legion.
    Commander Dillard, you are recognized for 5 minutes to 
present your testimony.

                            PANEL I

                              ----------                              


          STATEMENT OF PAUL E. DILLARD, ACCOMPANIED BY

               LAWRENCE MONTREUIL, RALPH BOZELLA,

       JAMES LACOURSIERE, JOE SHARPE; AND KATIE PURSWELL

    Mr. Dillard. First of all, I would like to make a comment 
in thanking Senator Cruz for his kind introduction for a fellow 
Texan.
    Chairman Takano, Chairman Tester, Ranking Members Bost and 
Moran, members of the House and Senate Committee on Veterans' 
Affairs, Russia's invasion of Ukraine is a stark reminder that 
peace is fragile. At any time, with or without notice, military 
personnel might be called upon to defend our freedom.
    An essential purpose of The American Legion is to ensure 
those personnel are not forgotten after the fighting is over. 
The American Legion was founded largely on that idea.
    As you see from our legislative priorities for the second 
session of the 117th Congress, peer support is a central theme. 
And, as veterans, we are all peers, no matter where we served, 
no matter when we served, or who we are.
    Peer support is the basis upon The American Legion's 
continued fight for government accountability to men and women 
exposed to dangerous toxins while in uniform.
    Peer support is why we led the fight to obtain health care 
benefits for bomb test veterans who were exposed to atomic 
radiation. The American Legion later proved to the world, with 
the help from Columbia University, that the defoliant Agent 
Orange poisoned tens of thousands of our peers, Vietnam 
veterans.
    And, today, on behalf of our comrades from the newest era, 
we implore Congress to deliver long-overdue relief, assistance 
and recognition for veterans who suffered due to the exposure 
to the toxic fumes of burn pits in the Middle East.
    Specifically, we call for a three-prong approach. One, 
concede that exposure occurred to all veterans deployed to 
identified locations during the Gulf War and the Global War on 
Terror. Two, establish a list of presumptive illnesses 
associated with exposure to burn pits and other toxic hazards 
where scientific evidence exists. And, three, create a 
framework for the VA to establish additional presumptive 
illnesses when scientific evidence shows an association.
    Veterans who are suffering now cannot wait decades to 
receive the care they need and rightfully deserve, as was the 
fate for so many veterans exposed to Agent Orange.
    Whether a veteran was exposed to toxins in the jungle of 
Vietnam or a combat outpost in Iraq, we in The American Legion 
all stand as peers who have been down this road before and know 
the government can do better to accept responsibility and help 
these veterans as they confront illnesses caused by preventable 
exposures.
    This value is written into our American Legion constitution 
preamble, ``To consecrate and sanctify our comradeship by our 
devotion to mutual helpfulness.'' That value, over a century 
old, guides our spirit and peer support today.
    There is perhaps no better example of the power of peer 
support than the Buddy Check program, which The American Legion 
launched in 2019. More than 3,600 American Legion posts 
performed Buddy Check outreach services for veterans in 2020, 
and nearly 3,800 did so again 2021. Approximately 500,000 
veterans have been assisted through this program.
    Some veterans have needed food, medicine, or household 
repairs, others needed to understand how VA could help them. 
The majority was simply glad to hear a fellow veteran's voice 
during a difficult time.
    Isolation is no friend to the veteran who may be 
confronting post-trauma stress disorder and possibly a risk of 
suicide, and in need of connection with others who understand. 
That is why we strongly support the expansion of Buddy Check 
into a national week outreach by VA. A National Buddy Check 
Week can help bridge that gap between veterans in need and VA 
services to help them. Connections like that is why we also 
strongly support the attachment of trained peer support 
specialists to posts of The American Legion and other veterans 
organizations around the country.
    American Legion peer support extends to the immigrant 
veterans who have always served in the United States Armed 
Forces. For most of our Nation's existence, that service opened 
a reliable pathway to U.S. citizenship. More than 760,000 
immigrants have become naturalized U.S. citizens this way. In 
the last few years, however, that pathway has been obstructed. 
Citizenship assistance programs have faded from our military 
bases. U.S. veterans from other nations are serving honorably 
and then discharging as resident alien non-citizens. They come 
out confused. Why did their service not bring them citizenship, 
let alone expedited citizenship they believe was promised to 
them. And then, in the worst case, they are deported and 
disconnected from the VA benefits they have earned.
    Thank you, Chairman Takano, for your leadership on behalf 
of our immigrant military peers who served honorably but were 
later deported because U.S. citizenship was next to impossible 
for them while they were in service, fighting on our behalf.
    The American Legion proudly supports the Veterans 
Deportation Prevention and Reform Act that addresses 
naturalization during service and protects non-citizen veterans 
and their families from unwarranted deportation.
    Peer support drives The American Legion's ongoing priority 
to improve VA health care service for women, the fastest-
growing demographic among our peers. The Protecting Moms Who 
Served Act was one step among many more that need to be taken 
before women feel comfortable and well served in all VA medical 
facilities.
    Peer support is why we continue to fight for fair GI Bill 
education benefits for Reserve and National Guard veterans who 
have served on the front line of America's dangerous battle 
against the COVID-19 pandemic, but have not accrued GI Bill 
points unless they receive Federal orders.
    Peer support stirred The American Legion outrage when we 
learned that barracks of Walter Reed National Military Medical 
Center had become so run down that showers and air conditioners 
did not work, locks were broken, sanitary conditions were 
nearly unlivable for years. Quality life for military personnel 
and publicity breakdowns like this have a definite impact on 
willingness of young people to enlist or stay in the service.
    Peer support is always why we demand that U.S. Coast Guard 
personnel are protected from pay interruptions in the event of 
government shutdowns, as are the other branches of the military 
service, they should be receiving their pay.
    And this brings me back to Ukraine. Today, as U.S. troops 
deploy to Eastern Europe to defend our allies in case the war 
expands, history reminds us again that we never know when or 
with what notice men and women will be called upon to fight. 
How we treat them now and in the years ahead when the effects 
of their sacrifice are upon them is certain to be more than a 
matter of compassion, but one of national security as well.
    With Russia's invasion of Ukraine, we are witnessing 
Europe's ground war since World War II. It is disheartening to 
know there are still World War II veterans who do not have 
access to VA health care and the benefits. The American Legion 
is fighting to correct this lapse with legislation pending in 
Congress.
    Our World War II veterans halted the spread of tyranny, 
securing our democracy for generations to come. As of last 
month, fewer than 240,000 World War II veterans remain, and 
hundreds pass away every day.
    And I want to thank both the House and the Senate Veterans' 
Affairs Committee for passing bills that would rectify this. 
Time is literally running out for these veterans. It is 
critically important that one of these bills is enacted into 
law as soon as possible.
    It is time that we do this now, while we still have some of 
the greatest generation still with us. We are losing them too 
quick, let's honor them. Thank you all for passing that bill, 
now we just need to get the work done.
    Chairman Takano, Chairman Tester, Ranking Members Bost and 
Moran, on behalf of more than 3 million members of The American 
Legion family, The American Legion, The American Legion 
Auxiliary, the Sons of The American Legion, I thank you for the 
opportunity to present just some of our American Legion's 
legislative priorities for this session of Congress, and we 
look forward to your questions and discussions.
    Thank you.

    [The prepared statement of Mr. Dillard appears on page 63 
of the Appendix.]

    Chairman Takano. Thank you, Commander, for your testimony 
and, without objection, your written testimony in full will be 
included in the hearing record.
    I now [audio malfunction] you know, your priorities are 
fully mine. I want you to know that. And, you know, it strikes 
me that--well, I am proud of the fact that Democrats and 
Republicans have come together to act immediately on $12 
billion in emergency aid to Ukraine. There is an urgency that 
we see.
    Commander, do you believe, as I do, that there is also an 
urgency to attend to the unfinished business of our toxic-
exposed veterans to make sure that we do concede exposure for 
the purpose of giving health care to 3.5 million veterans who 
were probably exposed, the framework for future presumptions, 
and ensuring that we actually approve a list of presumptions? 
Although the VA has made progress on nine more, we have a more 
extensive list of 23 in the bill. Do you believe, as I do, that 
getting this unfinished business done deserves the same sort of 
bipartisan sense of urgency? Because I believe these veterans 
are still in the heat of battle with the things that they are 
continuing to fight as a result of their service.
    Mr. Dillard. Yes, sir, Chairman Takano. As a Vietnam 
veteran, Agent Orange, we can't wait 40 years. They need the VA 
health care that they are entitled to and they have earned. 
Yes, we wholehearted, The American Legion would like Congress 
to take actions on a toxic bill and get those to the first 
step, and then we can keep improving as scientific evidence 
brings other to the forefront. Yes, sir.
    Chairman Takano. You spoke a lot about peers and peer--and 
how you have a wonderful program of--you have advocated for the 
inclusion of Buddy Check Week as a way to strengthen VA's Peer 
Support Specialists program, and I included the Buddy Check 
program as well as other helpful ideas in H.R. 6411, the 
bipartisan, bicameral STRONG Veterans Act.
    Can you say more about how vital peer support is in helping 
veterans with mental health and substance use challenges?
    Mr. Dillard. Yes, Chairman Takano. A veteran talking to 
another veteran is so much different than talking to someone 
that don't understand where you have been and how you got 
there. I have traveled the last 6 months throughout the United 
States as National Commander. There is stories after stories I 
have heard on the success. I have heard from other veterans 
saying I saved a life, they got him help. We know Buddy Check 
works and for them to talk to a veteran, there is no doubt 
about it that it is a very strong program, because over 500,000 
we got to visit and talk with and some of them, like I said, 
they just--it is nice--isolation, isolation, loneliness, that 
is when things creep back, that is when we can help them most 
with that phone call.
    So, yes.
    Chairman Takano. Well, thank you, sir.
    I now want to recognize Senator Tester for 3 minutes.
    Senator Tester. Thank you, Chairman Takano.
    And, Commander Dillard, thank you for being here today.
    I want to thank you back a few years when you served in 
Vietnam and were exposed to Agent Orange. I think somebody said 
four tours, it might have been you. We certainly appreciate 
that service.
    As we talk about Agent Orange, 49 years after the U.S. 
presence ended in Vietnam, we still haven't dealt with that 
issue totally from a presumptive standpoint. Hypertension, for 
example, otherwise known as high blood pressure, which there is 
direct scientific evidence that if you were exposed to Agent 
Orange you could get hypertension, it was directly connected, 
still is not covered. What would you tell somebody in my 
position if they said, you know, we can't cover hypertension 
because it costs too much money?
    Mr. Dillard. I would say you wrote the check for the war to 
send our veterans in harm's way, it is time to cash that check.
    Senator Tester. So your organization has a number of 
veterans that served in the Gulf that were exposed to burn pits 
and oil well fires and those kind of toxins, what are you 
hearing from them?
    Mr. Dillard. Of course, many of those remember and know 
Agent Orange, the toxin, this is what they think about more 
than anything. And they do, they do worry about what may be on 
the horizon for tomorrow. Will the VA be there? Will the 
presumptive be there to take care of me?
    Senator Tester. So I want to move to another issue, albeit 
that I think toxic exposure is--we haven't dealt with well in 
the past and we need to start dealing with it better today, and 
that is why we have a number of bills dealing with that issue 
and we need to get them done this Congress. But VA recently 
narrowed eligibility for the caregivers program, a program that 
I know you are aware of.
    I am disturbed by reports that veterans and caregivers in 
Montana are being rejected at very, very, very high rates, 
including caregivers who have been a part of the program for 
years and years.
    What is your membership experiencing with the caregivers 
program, and the application and appeals process?
    Mr. Dillard. Yes, Chairman Tester, we are very disturbed 
because of the hardship it puts on our caregivers, but I would 
like to ask my Director of Veterans Affairs and Rehabilitation, 
Ms. Purswell.
    Mr. Bozella. Commander, if you don't mind, I would like 
to----
    Mr. Dillard. Ralph?
    Mr. Bozella [continuing]. Talk, yes. Commander, I would 
like to handle that. Thank you.
    Ralph Bozella, Chairman of the Veterans Affairs 
Rehabilitation Commission.
    We are finding out that the caregivers applying for those 
claims are being rejected at 86 to 87 percent, and we don't 
know why those caregivers cannot appeal those claims through 
the VBA system, and that needs to be fixed. We have to care for 
those who care for our veterans.
    Thank you.
    Senator Tester. Thank you very much for that comment. And, 
Commander Dillard, thank you very much for your testimony. I 
appreciate you guys being here.
    Chairman Takano. Thank you, Chairman Tester.
    Ranking Member Bost.
    Mr. Bost. Thank you, Mr. Chairman.
    Commander, you know, right now, law-abiding veterans are 
losing their Second Amendment rights simply because the VA 
appoints them a fiduciary to manage their VA financial 
benefits. My bill is H.R. 1217, the Veterans Second Amendment 
Protection Act, would prevent these veterans from losing their 
right to bear arms unless--and this is an important unless--
unless a court has found them to be a danger to themselves or 
others, just like any other citizen of this United States, not 
because of the fact that they are a veteran, but because they 
are a citizen of the United States.
    Can I get your organization to support the bill that would 
stop that from occurring and recommending anybody that has a 
fiduciary to the NICS system.
    Mr. Dillard. Yes, sir, Ranking Member. We will, The 
American Legion will support that and we do support that, 
because no bureaucrat should be able to determine, to ruin or 
take away your Second Amendment rights to bear arms.
    Mr. Bost. Yes. And I think it is a vitally important issue 
for us to deal with because, when we are dealing with the 
amount of suicides that our veterans are having every day, many 
veterans of the 20 a day, even though the 2019 study showed 
that we reduced that by a small amount, that only six of those 
have ever been inside a VA or ever sought VA help.
    And I believe that there are a lot of communities where our 
veterans are that they are choosing not to seek that help 
because of this particular thing that has been--because 
veterans talk among themselves of things that are out there. 
And so I am hoping that we can get that moved through.
    You know, also, if the PACT Act as passed by the House last 
week was signed into law, VA expects its claims backlogs to be 
more than double and VA health care wait times to significantly 
increase. In recent years, we have brought down wait times for 
VA significantly through our collective hard work; the PACT Act 
could single-handedly destroy that progress.
    Do you agree that understanding the impacts are important 
considerations prior to proceeding with what could be an 
extensive expansion of eligibility?
    Mr. Dillard. Ranking Member, I would like for my colleague 
here, Mr. Montreuil, to elaborate on that, please.
    Mr. Montreuil. Ranking Member Bost, we absolutely agree 
that how a piece of legislation is going to impact the VA, 
especially when it is so large, needs to be understood. But we 
certainly would like to reiterate our call for the need for 
comprehensive action and the need for a bill that has a 
concession of exposure, has a list of presumptives and has a 
presumptive framework, but we should absolutely understand the 
impact at VA.
    Mr. Bost. Yes, I think it is vitally important that 
everyone understands that everybody sitting up here on this 
dais and everybody in the committee knows how important because 
the first two questions--our first group of questions, you are 
going to continue to hear that today is about toxic exposure 
and how important it is, but we have got to make sure that as 
we move forward it is something that we can do. We can 
provide--not that it is something we can come out and do a 
press pop with, but it is something that we can get across the 
finish line and signed by the President, so that our veterans 
can quickly receive the health care that they need.
    And, with that, my time has run out and I yield back.
    Chairman Takano. Thank you, Ranking Member Bost.
    Ranking Member Moran, Senator Moran.
    Senator Moran. Thank you, Chairman Takano.
    Again, Commander, thank you. I appreciate your presence 
here today, but I also greatly enjoyed our conversation in my 
office. And we like Texans generally in Kansas, except during 
football season and basketball season, but we may even like you 
during those times.
    I want to highlight again a project that The American 
Legion is significantly involved in, and I am excited that a 
pod is arriving in Emporia, Kansas, it has a great history in 
regard to veterans, The American Legion--and Emporia, Kansas 
does, it is a very significant place in the history of caring 
for veterans--and you have partnered to provide that 
opportunity for an ATLAS pilot program to include Emporia.
    I just want to give The American Legion, you and your 
colleagues, a chance to talk about that partnership with 
Philips, tell me what you hope it will achieve, tell me and the 
committee how we can help that be achieved, and what we can do 
once the pilot program is completed, assuming that it assures 
us of the things that we are looking for, and how do we make 
sure it is expanded elsewhere.
    Mr. Dillard. Yes, sir, Ranking Member Moran. The best 
person that I can think of would be Ms. Purswell to address 
this.
    Senator Moran. Thank you, ma'am.
    Ms. Purswell. Thank you very much, Senator. We are so happy 
to have the ATLAS pod in Kansas. We really want to thank 
Philips for facilitating this pilot program and bringing us 
into the fold. Anything that we can do to help support our 
veterans in especially mental health care at this time we are 
happy to be involved with.
    The Kansas pod, as I am sure you know, is now complete, and 
they are hoping to do a soft opening here in the next week or 
two and start seeing patients right away. It is critical things 
like the ATLAS pod go through because there are rural veterans 
and veterans that have trouble with access to internet to be 
able to go to their appointments. They need a safe place that 
is clinical, that is clean, that there is someone there to help 
them with the technology that they may not have access to in 
rural areas.
    It is also vitally important that this pilot succeed. We 
need to have more pods like this in other rural communities for 
veterans to access.
    Senator Moran. I thank you. And, again, I look forward to 
being there. We are talking about having a ribbon cutting and I 
look forward to being with Kansas American Legions. I am going 
to invite you and the Commander to join us as well as we 
celebrate one more advancement toward providing, in this case, 
mental health services to veterans who live in rural and highly 
rural areas.
    Nineteen seconds. I would just highlight that we know that 
President Biden is supportive of the PACT Act, we know that the 
Secretary has testified it has challenges in being implemented 
prior to the President's endorsement, but we have given the 
Secretary of Veterans Affairs the authority to do something he 
or his successors could not do, provide health care to every 
veteran post-9/11 who is experiencing or will experience 
consequences due to toxic exposure.
    The Department of Veterans Affairs has the authority to 
provide additional presumptions. We are working in the Senate 
to provide the framework, but we are anxious for the Secretary 
to by April 1 provide us with the information that he has 
garnered.
    Why would you think, if the Secretary has the authority to 
provide more presumptions to toxic exposure, that he hasn't 
utilized that authority to do so?
    Mr. Dillard. Once again, I will let Lawrence Montreuil 
answer that.
    Senator Moran. Thank you. Sir?
    Mr. Montreuil. Thank you for that question, Senator Moran.
    The VA has certainly been proactive as it pertains to 
presumptives for toxic exposure, we have seen that with 12 
presumptives within the past 8 months, but we would certainly 
like to see them move forward expeditiously and look at some of 
the other cancers that we all know there is scientific evidence 
for.
    Senator Moran. I wanted to live up to Congressman Bost's 
suggestion that all of us were going to talk about toxic 
exposure and I didn't want to be the one who didn't.
    It is hugely important to each and every one of us in this 
committee and certainly to those we serve. Thank you.
    Chairman Takano. Representative Brownley, Chairwoman 
Brownley, you are recognized for 3 minutes.
    [Audio malfunction.]
    Chairman Takano. Chairwoman Brownley, your microphone--are 
you muted still or is it a technical problem with us?
    [Audio malfunction.]
    Chairman Takano. Are you un-muted?
    What does our technical team say?
    [Pause.]
    Chairman Takano. All right, Chairwoman Brownley, let's go 
to Senator Sinema and we will come back to you.
    Senator Sinema?
    [Audio malfunction.]
    Chairman Takano. I can't hear Senator Sinema either.
    [Pause.]
    Chairman Takano. Okay. Congressman Roy, I will call on you 
next. Yes, until we can get the audio fixed with the people on 
Zoom so we can hear it. We will go to you.

                         HON. CHIP ROY,
                 U.S. REPRESENTATIVE FROM TEXAS

    Mr. Roy. Thank you, Mr. Chairman. I appreciate it.
    I appreciate each and every one of you for being here 
today. Commander Dillard, I appreciate having a Texan here in 
the room. I echo Senator Cruz's remarks in introducing you 
here, and thank you for your service and all of you for your 
service. It is an honor to be here with you all.
    There are so many--we have got 3 minutes, obviously, we 
have so many members that want to talk to you, so it is hard to 
go through all the issues that are so important. Obviously, we 
talk on a regular basis with those who are in our districts and 
our communities, but I appreciate the opportunity here with 
testimony.
    You know, I would love to talk about Second Amendment 
rights and protecting veterans' Second Amendment rights, we 
have got legislation, Ranking Member Bost and I both have bills 
ensuring that our veteran community is not losing their ability 
to defend themselves because of PTSD and other issues, and I 
would love to talk with you all about that and I am happy to. 
Independently, I have talked to a lot of folks in Texas 21, 
where I represent Fort Sam Houston, I represent Army Futures, 
represent thousands of veterans in and around San Antonio and 
Austin. As you all know, that area is highly populated with 
veterans because, you know, it is the best district in the best 
State in America, so it attracts a lot of veterans.
    But I did want to just throw to you all one just general 
question, something that I think probably drives me the most in 
terms of my service on Veterans' Affairs is wait times and 
quality of service with respect to health care access. You 
know, we all want to deal with the burn pit issues and we are 
trying to work through that, and there are some differences of 
opinion on how to do that and we are going to work through 
that. We have got to do it responsibly and we need to work hard 
to do that.
    But in general, just a general question for you all about 
your experience with wait times. I get updates and I ask my 
constituents to advise me every time they hit an issue and I 
just keep trying to--give me examples, and then I go feed it to 
the VA head in South Texas and to try to improve it. But if you 
could speak a little bit to that, whichever one of you is 
appropriate, about your experience with wait times, what you 
are seeing with wait times, what you are seeing with the 
quality of care, and do you think it is where it needs to be 
and do you have--you know, do you know any of your fellow 
veterans and people that have run into snags and run into 
bureaucracy that can't get in and out of the MISSION Act 
private care into the VA, running into, you know, data base 
issues, running into slowdowns. Try to get an MRI, can't get an 
MRI, tried to get--because I get a lot of those. So I just 
wanted to hear from you all what you are hearing and your 
experience there.
    Mr. Dillard. Yes, Congressman, and I understand where you 
are coming from and I do hear that also. I have been fortunate, 
I haven't had that problem per se, and the VA health care is 
all I use. And so it has been good. But Ralph Bozella, our 
Chairman of Veterans Affairs and Rehabilitation, can probably 
shed more light.
    Mr. Bozella. Thank you, Commander.
    Thank you, Congressman Roy.
    Access is the number one thing for any veteran and I think 
whether we have care on a VA campus or care through care in the 
community through the MISSION Act, we have to always remember 
that any care that we get through VA is still VA care. VA is 
still the primary provider. There are access issues because of 
many barriers, the recruitment and retention of providers, 
particularly in rural areas. I think the rural health care 
system really needs a strong look from VA.
    If a VA Under Secretary is nominated for VHA and we get 
that kind of leadership in there, I would hope that rural 
health is a primary target for fixing those exact kind of 
issues. I think that we need to recruit more community care 
providers, people who want to work with VA. There is 
contractual issues with that. And the number one thing that has 
to happen when a veteran goes to community care is the records 
must be transferred back to VA in a timely fashion, and also 
that bill must be paid or the veterans get stuck with a bill 
payment.
    So I can go on about this, but the time is up and I think 
you get the message.
    Mr. Roy. Thank you, sir.
    Chairman Takano. Thank you, Congressman Roy.
    The situation is that we can't hear what our online 
participants are saying, so when they ask questions of our 
witnesses, our witnesses can't hear them.
    So we are going to test this again. Chairwoman Brownley, I 
am going to ask you to try to ask your questions and see if it 
works, so that our witnesses can hear what your questions are. 
So, Chairwoman Brownley, give it another try.
    [Audio malfunction.]
    Chairman Takano. I am afraid we can't hear Chairwoman 
Brownley.
    We are going to keep trying to fix it and, while we are 
fixing it, I am going to go on to Senator--actually, Mr. Mann--
Mr. Mann is online, right? So he is not--so we are going to 
prioritize people here in the room.
    So, Senator Boozman, Senator, we are going to go to you 
next because the next person online, we can't hear them. So, 
Senator Boozman, go ahead.

                       HON. JOHN BOOZMAN,
                   U.S. SENATOR FROM ARKANSAS

    Senator Boozman. Thank you. We were just--I was asking you 
about San Antonio. My dad was at [inaudible] on B17s and got 
his training there. He met my mom. And it was one of those 
deals like, you know, you meet, 3 months later you are engaged 
and married and all of that, and were married for, you know, 
until he passed away in his late 60s. So lots of good memories 
of the old days going down there through the years.
    But I wanted--first of all, I want to thank you all. I have 
had the opportunity to serve now in the Senate VA Committee and 
then in the House, and I can tell you, you know, 99 percent of 
the things we get done is because of the advocacy of our 
veterans service organizations. You all do a tremendous job.
    And a big shout-out, as always, to the Auxiliaries. Nobody 
does a better job. They certainly are the backbone. My wife 
reminds me, most of the time they are also the brains of the 
organization. So we appreciate them very, very much.
    But I wanted to just ask about something that is a little 
bit different. And burn pits are so important, but we have got 
a lot of other stuff going on at the same time. The CDC 
estimates that between the years 2000 and 2020 more than 
437,000 U.S. service members were diagnosed with a traumatic 
brain injury, TBI, and other traumas, including military sexual 
trauma, are major health concerns for service members and 
veterans due to their direct link to PTSD, in addition to 
putting these members at high risk of suicide.
    The Post-9/11 Veterans Mental Health Care Improvement Act, 
which was passed out of this committee unanimously, calls on 
the VA to conduct a study on the efficacy of clinical and at-
home resources for PTSD, to include the use of mobile 
applications, family members, as well as other veterans, when 
dealing with stressors.
    Commander, can you discuss the challenges of service 
members and veterans suffering from TBI, PTSD, and mental 
health issues, and why is it so important for service members 
and veterans to be able to choose treatments that work best for 
them?
    Mr. Dillard. Yes, Congressman. I am going to ask Ms. 
Purswell to address that. She is really on top of it.
    Senator Boozman. I know she is. We appreciate you.
    Ms. Purswell. Thank you so much for that question.
    As someone who suffers from TBI and PTSD, I have found a 
lot of challenges. It is really important for us to understand 
that people who suffer from things like TBI and PTSD sometimes 
have difficulties with a lot of different tasks. One of the 
biggest challenges is getting to appointments. The distances 
that you have to drive and all of the steps that you have to 
take to get those appointments taken care of and to get care, 
it really bogs down the veteran's ability to seek care.
    Anything that you do that makes it more difficult to seek 
care creates a barrier. So, things that you were saying, 
clinical and at-home services, that is critical. It is critical 
for people with TBI, PTSD. Sometimes we can't get out of the 
house. Sometimes we are taking so many medications we can't 
drive or there is no one to drive us.
    So, being able to seek care in your home is a game changer 
that would be wonderful.
    Senator Boozman. Very good. Thank you.
    I appreciate you guys.
    Thank you, Mr. Chairman.
    Chairman Takano. Thank you, Senator.
    We are going to try again with Chairwoman Brownley.
    Chairwoman Brownley, can you try again to ask your 
questions.
    Ms. Brownley. Thank you, Mr. Chairman.
    Can you hear me?
    Chairman Takano. Breakthrough.
    OK. So, Chairwoman, continue.

                      HON. JULIA BROWNLEY,
              U.S. REPRESENTATIVE FROM CALIFORNIA

    Ms. Brownley. Thank you, Commander, for being here and 
thank you to you and all your members and your families for 
your service to our country.
    Senator Tester talked about, in his questioning, the 
Caregiver Program and I certainly support his concerns with 
regard to the Caregiver Program. I am trying to enhance in-home 
care for our veterans, for all veterans who need it, whether 
they be disabled or elderly.
    And I introduced a bill last week, and we are calling it 
the Elizabeth Dole Home and Community Based Services for 
Veterans and Caregivers Act of 2022. We wanted to name it after 
Elizabeth Dole because of all of her good work, particularly 
around caregivers.
    But the objective of this bill is really to really change 
the paradigm within the VA for disabled and our elderly. More 
than half of our veteran population are over the age of 65. To 
change the paradigm from institutionalized care to home care.
    And I think it is an important bill. I think it is what 
veterans want. I think it is win-win. It is a win-win program 
because I think it is less expensive, actually, to take care at 
a high-quality level of veterans at home versus 
institutionalized care. And I know from all the veterans that I 
speak to, everyone wants to stay at home if they are able to 
stay at home.
    So, I am not sure whether you are familiar with the bill. I 
know in your written testimony, you talked about long-term 
care. It sort of sounded like my bill. I was wondering if you 
have had a chance to review it and, if so, if you support it.
    Mr. Dillard. Yes, Congresswoman, we have reviewed it and we 
definitely support it because we believe that veteran, if 
possible, care at home would be much better for them during 
that hard time. So, yes, we support your bill.
    Ms. Brownley. Well, I look forward to working with you and 
all the other VSOs to, you know, get this over the finish line. 
I think it is, we are talking about a lot of important bills. 
The caregiver bill, the toxins, the PACT Act, and I think this 
stands up there in importance and I look forward to working 
with you on it.
    And, again, thank you for your service and thank you for 
being here.
    With that, I yield back.
    Chairman Takano. Thank you, Chairwoman Brownley.
    I agree with you, the long-term care is truly a priority 
that we need to address and especially in light of what we have 
experienced during this pandemic, I think it has brought those 
issues to the forefront.
    Let us turn now to Senator Sinema. Senator Sinema?

                      HON. KYRSTEN SINEMA,
                   U.S. SENATOR FROM ARIZONA

    Senator Sinema. Thank you, Chairman Takano.
    Commander Dillard, thank you for your service to this 
Nation and for the service your organization does for America's 
veterans. I appreciate The American Legion's support for 
expanding telehealth, especially for veterans in rural areas. 
The American Legion was instrumental in placing an ATLAS pod in 
Wickenburg, Arizona, saving veterans hours of transportation to 
the nearest VA clinic.
    We look forward to continuing the work with The American 
Legion to support and promote that site so it can serve Arizona 
veterans to the fullest extent possible.
    To my question. Commander Dillard, homeownership can lead 
to more stable family lives, better health outcomes and 
personal economic benefits, yet this dream remains out of reach 
for many Americans and Arizonans, including our veterans.
    I have heard that when applying for a residential mortgage, 
less than 12 percent of qualified veterans take advantage of 
their earned benefit of the VA loan. Why do you think so few 
veterans utilize the VA loan and do you believe that veterans 
don't know they may qualify for a VA home loan or that a VA 
mortgage may lead to overall lower cost to the borrower?
    Mr. Dillard. Yes, Congresswoman. I would like to ask my 
chairman, James LaCoursiere, to respond to that, please, or the 
director--fine, Joe, you can handle it.
    Mr. Sharpe. Thank you very much for that question. There 
are currently some issues with the Home Loan Program. It is 
currently not as competitive as many of the other private 
sector Home Loan Programs and we have testified in the past 
about doing whatever we can to increase the competitiveness of 
the Home Loan Program.
    One of the biggest barriers to veterans being able to take 
out a home loan is they really don't know all the ins and outs 
of the program, itself. And we have stated that we would like 
to see VA do a better job of outreach as far as making sure the 
veterans are aware of the program and their other benefits. And 
the other thing is to make sure that veterans are prepared to 
be competitive with the private sector, themselves. Financial 
[inaudible] is a huge issue and even though it is a great 
program where you don't have to pay any money down, it will 
still make veterans more competitive if they are taught how to 
be sure to, you know, save enough money where they can compete 
with the private sector and putting money down, as well.
    So, those are some of the issues with the Home Loan Program 
and we definitely feel like veterans, especially in high-cost 
areas, need greater assistance. Thank you.
    Senator Sinema. And a follow-up question. Loan officers may 
not be steering buyers away from VA loans, but they are not 
required to disclose the VA mortgage option.
    Do you think that more widespread disclosure would help 
protect veterans and ensure that they can access that earned 
benefit?
    Mr. Sharpe. We definitely believe that that should happen. 
Again, many veterans aren't aware of their benefits and the 
Home Loan Program is one of the benefits that veterans aren't 
really briefed on. And with that, that would make us much more 
competitive as far as purchasing a home loan.
    Senator Sinema. Thank you.
    Thank you, Mr. Chairman.
    Chairman Takano. Thank you, Senator Sinema.
    Representative Banks, you are recognized for 3 minutes.

                        HON. JIM BANKS,
                U.S. REPRESENTATIVE FROM INDIANA

    Mr. Banks. Thank you, Mr. Chairman.
    And thank you to the guests we have here today. It is such 
an important topic. We appreciate your leadership.
    As I reached out to my local county veteran service 
officers about the hearing today, I asked them, what do you 
want me to ask about when we speak with all of you?
    And, Mr. Dillard, one of the concerns that I heard among 
many of my VSOs, as well as the many aging veterans throughout 
the counties that I represent, is about the incessant amount of 
paperwork that it takes to file for VA pension benefits. In my 
district, we have many people who are filing for their pensions 
and they have had their claims denied and then reinstated after 
appeal, and I hear this story over and over again. It is 
obviously unacceptable.
    Mr. Dillard, why is pension paperwork so large of an 
obstacle and what can we do about it?
    Mr. Dillard. You are correct, Congressman.
    And that is a problem and it is a stigma that runs rampant 
through our veterans, but I would like--Ralph Bozella works 
with this daily and I would like Ralph Bozella to comment on 
it.
    Mr. Bozella. Thank you, Commander.
    Thank you, Congressman Banks.
    You know, the pension process, sometimes gets lost in the 
overall claims process because veterans are typically filing 
claims for service-connected disabilities. That service is 
moving beyond with the ideas for automation in that system. I 
am not sure how that automation may affect the pension.
    But even in the claims process for disabilities, we think 
VA needs to hire more claims adjudicators and I would think the 
same thing needs to happen in the pension process, as well.
    And as to why the paperwork is more, because once the 
claims process went to the VBS management system and everything 
was scanned, that system became more manageable. So, that is 
what I know about it. Thank you.
    Mr. Banks. And I appreciate that feedback. You know, again, 
as I talk to my local veteran service officers at the counsel 
level--I serve 12 counties--I am always struck by how hard they 
work to serve veterans at the local level, often, and many of 
the rural communities that I represent in Northeast Indiana. 
These selfless men and women who serve in this role as the 
local level, they often volunteer their time to help veterans 
navigate the complex bureaucracy of the VA.
    However, I have been told that inconsistent accountability 
standards means that the quality the veterans receive might 
vary from vascular service offer to veteran service officer. 
And I wonder, Mr. Dillard, if you have any comments about is 
The American Legion satisfied with the performance of our 
veteran service officers at the local level and what can 
Congress do to streamline some of the process or performance-
related issues that our VSOs deal with.
    Mr. Dillard. Yes, Congressman. Accrediting service officers 
is a big key so they can get through the process. And we 
understand there are some still working on it, so that is 
difficult times for our veterans to do that and some of them 
actually get discouraged and disgusted and they don't come 
back. And so, that is a problem that we will be working 
through.
    And we need to communicate to our veterans more. We have 
service officers that do all this work for free, also, through 
The American Legion at different departments, fully accredited.
    Mr. Banks. Thank you very much.
    My time is expired.
    Chairman Takano. Thank you, Mr. Banks.
    Senator Tillis, 3 minutes.

                       HON. THOM TILLIS,
                U.S. SENATOR FROM NORTH CAROLINA

    Senator Tillis. Thank you, Mr. Chairman.
    Commander Dillard, thank you for being here. Thank you for 
your continued service and that of the team that you have with 
you there today.
    A quick question or advice from you. I think that you are 
aware that we passed the Health Care for Burn Pit Veterans bill 
unanimously just a little while back out of the Senate. We now 
have the PACT Act lying in the Senate. We are going to have to 
reconcile some of the differences; our three-phase approach 
versus some of what has been proposed in the PACT Act.
    What advice would you give us as we try to reconcile those 
differences and move forward to make sure that we produce 
something that goes to the President's desk?
    Mr. Dillard. Yes, sir, Congressman. Once again, I would 
like Lawrence Montreuil to address that issue.
    Mr. Montreuil. Thank you for that question, Senator.
    As the Commander mentioned in his opening comments, we 
really feel that comprehensive action is necessary and I think 
we have heard that throughout the veteran community and the 
members of this committee. I am certainly aware of the Health 
Care for Burn Pit Veterans and allowing veterans access now to 
healthcare, those who are suffering now; that is an important 
element and that should be a part of any comprehensive approach 
that we take to address this issue. But I can't urge you enough 
that a concession of exposure and a presumptive framework are 
essential elements, as well, and really need to be included in 
any final legislative package, as those bills are reconciled.
    Senator Tillis. Thank you for that.
    Do you agree that we have to take care in the way that we 
go about in coming up with consensus to make absolutely certain 
that our current promises made to veterans are kept and that 
this is an additional installment on the debt that we owe them; 
in other words, we don't want to simply move forward and not be 
concerned with the potential resource impacts that it could 
have on current obligations?
    Mr. Montreuil. That is certainly something to always be 
mindful of, but I think another thing to be mindful of the fact 
is that when we wrote this check, when we sent those veterans 
into combat and exposed them to these conditions and illness 
and diseases and we need to ensure that they are taken care of 
and provided that healthcare.
    Senator Tillis. I agree with that.
    Just briefly, I only have 45 seconds, something that I 
asked in the prior panels last week, what have we learned from 
COVID and the expansion of telehealth that should just become 
standard operating procedure within the VA?
    Mr. Dillard. Telehealth has helped tremendously and 
especially in our rural areas, but we have--we have grown and 
many veterans are getting used to it and they do like it, 
instead of driving that distance. So, telehealth is very 
important into our VA healthcare system and we appreciate it.
    Senator Tillis. Thank you all. Thank you, again, for your 
continued service.
    Thank you, Mr. Chair.
    Chairman Takano. Thank you, Senator Tillis.
    Representative Mrvan?

                       HON. FRANK MRVAN,
                U.S. REPRESENTATIVE FROM INDIANA

    Mr. Mrvan. Thank you, Chairman Takano.
    Thank you all from The American Legion who are here today. 
Commander Dillard, thank you very much.
    Yesterday, I was proud to introduce H.R. 6961, the Dignity 
for MST Survivors Act in an effort to reduce the potential for 
re-traumatization in MST claims appeal process, as identified 
by our VSO partners. This legislation would require VA to 
ensure that members of the Board of Veterans' Appeals complete 
annual MST training. This legislation would also require VA to 
review the language used in claim denial letters to ensure such 
language is carefully worded in order to avoid any re-
traumatization of any of our veterans.
    Commander Dillard, I appreciate the attention to MST in 
your written testimony, as well as The American Legion's 
efforts to address this issue. In your view, what other steps 
must VA take in order to prevent the re-traumatization of MST 
survivors in a claim-appeal process?
    Mr. Dillard. Thank you for that question, Congressman. And 
Ms. Purswell, our director of Veterans Affairs and 
Rehabilitation, will address that.
    Ms. Purswell. Thank you for that question.
    Just to start with, that bill sounds amazing. It sounds 
great. Making sure that MST survivors are not re-traumatized by 
reading through documents when they are being told that they 
are being denied is really important. We at the Legion, our 
appeals representatives have a special person who is trained to 
deal with those sensitive cases. So, I think that is something 
that could be, in addition to this bill, would be to make sure 
that you have someone who is trained to understand that there 
are sensitive issues, sensitive topics, sensitive phrases that 
should not be used when they are writing appeals letters.
    It takes a special person to be able to handle those kinds 
of claims and appeals and not everybody is cut out for that, 
and we need to make sure that we are putting the right people 
in the right places.
    Mr. Mrvan. Well, thank you very much.
    Additionally, I have a separate question. We know from the 
Independent Budget recommendations for VA that modernization of 
the veterans benefit management system is a priority for 
several VSOs.
    Commander Dillard, do you have any perspective to share 
regarding the current state of the system and do you believe 
that the VBMS is equipped to handle the anticipated influx of 
toxic exposure claims following congressional action on the 
toxic exposure?
    Mr. Dillard. A very important question and thank you for 
that. And Ralph Bozella, our chairman, will address that.
    Mr. Bozella. Thank you, Commander, yes.
    Congressman, the system with the VBMS works and it is now 
about 10, 12-years-old because they took all that paperwork and 
scanned it, and from that moment on, everything then was filed 
electronically.
    How long will that system last? Well, there is no doubt it 
has to be improved and updated like all electronic systems. We 
have heard from a VA employee the other day at one of our 
meetings that their new management system is working to upgrade 
that, but you still need to hire more claims adjudicators 
through the process in order to make it work.
    Mr. Mrvan. I thank you.
    And with that, I yield back my time.
    Chairman Takano. Thank you, Representative Mrvan.
    We have a few members left and I am going to ask if you 
would like to participate, if the members would like to 
participate in another round of questioning with our American 
Legion, so go ahead, Mr. Rosendale, 3 more minutes if you would 
like to take 3 more minutes.

                    HON. MATTHEW ROSENDALE,
                U.S. REPRESENTATIVE FROM MONTANA

    Mr. Rosendale. Thank you, Mr. Chair. I appreciate that.
    As with everyone else here making their comments about the 
toxic exposures, I want to make sure that I mention it as well, 
and thank you all for being here.
    I have had some cancer ravage my family; I lost a brother 
and a sister to cancer. So, I am very, very well aware and have 
seen firsthand, the financial and emotional hardship that it 
causes families, and so I am hypersensitive to it. I want to 
make sure that we get that assistance out immediately. I would 
love to pass the Senate legislation so that we can get that 
treatment out there.
    And I was really glad to hear today that we are not only 
looking at defining the exposure, where and how it took place, 
the conditions, but also to have this framework with which we 
don't have to go back out and figure out how are we going to 
identify other conditions that arise, that that framework is 
going to be there so we condition just pull the trigger on it 
and start getting that assistance right away.
    Additionally, I was glad to hear the conversations about 
the red flag laws and our Second Amendment rights for our 
veterans. I have hosted the Wounded Warriors out at my ranch to 
go hunting. I have seen the Warriors & Quiet Waters programs in 
Montana, the veteran SCUBA program that we have there in 
Montana. And it is good to see all these additional programs 
that are being utilized for vent, an area to vent, if you will, 
for the veterans to deal with some complexities they have in 
their life, without subjecting them to the loss of their Second 
Amendment rights, because that is a really big problem.
    But we also have to recognize that we have a lot of 
veterans that are taking their lives and they do use a firearm. 
And like the Buddy Check program that you were talking about, I 
think that is good. There is a program that I attended with 
veterans just to listen in and it was called the Overwatch 
Project and the Overwatch Project is dedicated toward getting 
time and distance between the veterans and their firearms, 
without violating their Second Amendment rights, without 
passing red flag laws.
    And I think that it would be great for everybody to take a 
look at that and see if they could spread the word around their 
community, because they have been very successful at helping 
the veterans with violating their rights.
    Commander, if I could, I would like to direct this question 
to Mr. Sharpe, because it is about education. Have you heard 
about the new interpretation that has been given to the 8515 
Rule, which is going to change from 15 percent of the veterans 
who receive support from the VA to 15 percent of the veterans 
who receive support from any financial institution in order to 
identify that eligibility, because we have got college and 
universities and veterans on a mass scale that are going to be 
disqualified from utilizing that benefit because the 
interpretation is changing.
    Mr. Sharpe. Thank you for that question.
    The American Legion is aware that there is an issue with 
8515 Rule and we are very concerned that any new interpretation 
that may disqualify a veteran from receiving a quality 
education that leads to gainful employment, we would not be 
for.
    Mr. Rosendale. Exactly.
    So, I would ask--I see that my time is up--but I would ask 
for your support to work with you on that to make sure that 
that interpretation is not changed.
    Mr. Sharpe. Yes, sir.
    Mr. Rosendale. Thank you so much.
    And, Mr. Chair, I would yield back. Thank you.
    Chairman Takano. Thank you, Representative Rosendale.
    I see that Representative Slotkin has joined us and 
Representative Slotkin, I am going to recognize you for the 
first round of questioning.
    Mr. Mrvan, are you intending to question for a second 
round?
    Mr. Mrvan. Not at this time.
    Chairman Takano. Okay. So go ahead, Representative Slotkin.
    Ms. Slotkin. I'm sorry, Chairman. Give me 2 seconds. I 
wasn't expecting to get a question so quickly. Just give me 2 
minutes. So, you can go on to someone else. I apologize.
    Chairman Takano. Well, I can go ahead with my questioning 
then, and then I will call on you. So, I am going to do my, I 
will take my second question and then I will call on 
Representative Slotkin to do her first round.
    Commander, much concern has been expressed about 
overloading the VA with new eligibilities through the, you 
know, I think rather, it is through the PACT Act's title, first 
title, which deals with the concessions, which would enable, or 
make eligible, 3.5 million veterans who were exposed are our 
War on Terror veterans and all of our overseas contingency 
veterans.
    But did the Legion take notice of the revisions that were 
made by the committee regarding the phasing in of eligibility 
over a 10-year period through, I think, five separate cohorts, 
so that the VA would not suddenly be deluged with 3.5 million 
eligibilities all at once. Could you comment on, you know, what 
you might think the feasibility, that we improve the 
feasibility. We also definitely improved the cost outlook. We 
reduced spending, we reduced the cost to implement the bill by 
about $74 billion.
    Your response?
    Mr. Dillard. Thank you, Mr. Chairman.
    I believe Lawrence Montreuil can answer that on a better 
note than me, but that is a concern.
    Lawrence?
    Mr. Montreuil. Thank you for that, Chairman.
    And we actually took a note of that and I think the changes 
made certainly makes it more executable by VA and it seems they 
have absolutely been supportive. I think the PACT Act is one of 
the most comprehensive bills that we have seen and if that were 
to make it to the Senate floor, we would absolutely urge 
members to vote for that bill.
    It includes everything that we think should be in the 
final, comprehensive package, which includes concession of 
exposure, presumption of framework, and a list of presumptive 
conditions. Additionally, it goes further to take care of our 
Vietnam veterans and it has the presumption for hypertension, 
which we think is essential. But, certainly, those changes in 
Title 1, we would assess, would make it more executable by the 
VA.
    Chairman Takano. I appreciate that.
    And I also appreciate the comments of many of my colleagues 
on the Senate, and our Republican colleagues on the Senate, who 
seem ostensibly, to be open, you know, they are open to further 
discussions and I appreciate your feedback on that.
    Just so that it is understood, that there were technical 
questions raised by VA before we made these changes and I do 
think that VA was made a lot more comfortable by the phase-in 
approach, so that they were not deluged with, you know, 3.5 
million eligibilities all at once.
    I now would like to call on Representative Slotkin for 3 
minutes much.
    Go ahead, Representative Slotkin.

                      HON. ELISSA SLOTKIN,
               U.S. REPRESENTATIVE FROM MICHIGAN

    Ms. Slotkin. Great. Thank you. Sorry about that and sorry 
that I am not in the room with you there.
    You know, I represent Michigan. We were thrilled to have 
the PACT Act pass the House last week and I really urge 
everybody to heed what we have been hearing from our panelists 
over the past week, of just to get it done. Get something done.
    But I guess my question is, is there, to our witnesses, you 
know, we all know Agent Orange. We all know what that meant for 
the Vietnam-era. That is something that is well-known, even in 
sort common parlance if you weren't a veteran. People know what 
Agent Orange is. We know that it created major health problems 
for a whole generation of veterans.
    What can we do to expose people more to understanding what 
burn pits do to their health? Because I think it is a post-9/11 
generation, you know, set of ailments. It is someone like me 
who watched how many generations of young soldiers lived next 
to burn pits in Iraq.
    So, what can we do to educate people? What can we do to get 
exposure out there for this set of issues as this generation's 
Agent Orange?
    Mr. Dillard. Thank you for that question.
    First of all, we have got to get a bill passed. We have to 
get it in law and then it is up to a lot of us VSOs to ensure 
we alert our members, what is there, what is available, and we 
will do that. And so, that is the key.
    And then after that, it is communication, because they need 
it. It is something that we have got to, as you said, get her 
done. You know, we have to get her done because our veterans, 
they deserve the benefits from the VA for their health and we 
appreciate it.
    Ms. Slotkin. Great. Thank you.
    I think, for me, as a pragmatist, just understanding how 
the Legislature works, making sure we get something done, Mr. 
Chairman, before the summer, and before, certainly, this body 
breaks on August 1st, I think, is extremely important.
    And the PACT Act, the version of the bill that we sent over 
to the Senate, I think, should be the basis of the conversation 
and the negotiation. We all want to help our veterans on a 
bipartisan basis and I appreciate anything you all can do to 
support the energy to push our Senate friends to get to it.
    Thanks very much, Mr. Chairman. I yield back.
    Chairman Takano. Thank you, Representative Slotkin. I take 
your words to heart. I was heartened to hear Ranking Member 
Moran say that he would like to see a four-corners agreement on 
toxic exposure.
    So I believe the spirit of comity, with regard to getting 
agreement on this issue, I think is very much in the air and so 
I do take your comments to heart, so thank you.
    I see that Representative Miller-Meeks has joined us. I am 
going to recognize you for 3 minutes for this panel and then I 
am going to call a recess until we get our next panel 
empaneled.
    But, go ahead, Representative Miller-Meeks.

                 HON. MARIANNETTE MILLER-MEEKS,
                 U.S. REPRESENTATIVE FROM IOWA

    Mrs. Miller-Meeks. Thank you so much, Chairman Takano, and 
thank you to all the witnesses.
    Last year, Congress increased funding for the VET TEC pilot 
program from $15 million a year to $45 million a year to allow 
for more eligible veterans to participate. This is a program 
that provides veterans with an opportunity to use GI-style 
benefits to participate in short-term training jobs in the IT 
industry.
    The program has been extremely successful. We know that our 
most recent data, as of March 1, 2022, that total applications 
received were 60,527. Certificates of eligibility: 40,412. 
Total participants from fiscal year 2019 to the present have 
been 5,566. Total graduated: 3,721 for an 87 percent graduation 
rate. There were 569 who withdrew after the start of the term. 
Presently attending: 1276. Meaningful employment not obtained 
is 739, but meaningful employment attained, 19,002, for a 72 
percent employment rate, which to me, is outstanding, with an 
average salary of $60,000 and change.
    This has been an extremely successful program in my eyes. I 
know that veterans in my community appreciate the opportunity 
to participate and I am just wondering what feedback have you 
all received on the pilot program and can you please identify 
any improvements that you think are needed to help more 
veterans access this program.
    Mr. Dillard. Thank you very much for that question, because 
it is an important program, but I would like to give this 
opportunity to my chairman of Veterans Employment and Education 
Commission, Jim LaCoursiere.
    Mr. LaCoursiere. Thank you, Commander.
    And, also, thank you, Congresswoman, for that question, 
also for your leadership on this particular issue.
    We in The American Legion are encouraging and believe in 
expanding the training and education with VA programs such as 
the VET TEC and the VRAP, also pushing the VetsFirst, and job 
employment through the Federal Government.
    The best thing we can do is actually make the programs more 
visible with our servicemembers. A lot of our servicemembers 
are not aware of their benefits and entitlements. We need to do 
a better job, and when I say, ``we,'' I am talking the veteran 
service organizations, but also reaching out to the schools. We 
need to let them know what their benefits are. So, expanding 
the programs, the sooner we can get them marketed, where we can 
get them educated, which gives them decent employment, which 
also makes them worthy tax-paying citizens, donating money into 
the communities and also into the national economy.
    The other piece of assistance that we are looking at is the 
extension of the sunset date, which is scheduled to expire 
December of this year. Thank you.
    Mrs. Miller-Meeks. Thank you for that.
    And I want to also thank Representative Kai Kahele, who was 
instrumental in helping us push forward legislation to increase 
funding. We will take it to heart about the marketing and the 
sunset dates, as well.
    And I am over time, so with that, Chairman Takano, I yield 
back. Thank you so much.
    Chairman Takano. Thank you, Representative Miller-Meeks.
    I am going to have to go back on what I said about moving 
to the next panel. We have got three more members. I am 
delighted to recognize Senator Hassan for 3 minutes.

                   HON. MARGARET WOOD HASSAN,
                U.S. SENATOR FROM NEW HAMPSHIRE

    Senator Hassan. Thank you so much, Mr. Chair, and thanks 
for your flexibility.
    And good morning, everybody. Thank you all so much for your 
service and for what you do for our veterans.
    Commander Dillard, I wanted to start with a question to 
you. As you mentioned in your testimony, The American Legion's 
Buddy Check initiative is an important peer-to-peer effort in 
which volunteer veterans check in on their buddies who may need 
help, whether it be mental health resources or just the comfort 
of a phone call, knowing that there is another veteran thinking 
about them and to connect to.
    I was glad to see the Senate pass bipartisan legislation 
that Senator Ernst and I sponsored together, to build on these 
efforts by directing the VA to designate a national Buddy Check 
Week.
    Commander, can you please speak to how buddy checks, which 
are volunteer-led, would complement the VA's efforts to support 
veterans' mental health.
    Mr. Dillard. First of all, thank you for the question, but 
Senator Hassan, I do want to thank you for your leadership in 
getting that Buddy Check bill passed through the Senate. It is 
very important to us.
    Senator Hassan. Thank you.
    Mr. Dillard. We are veterans and we will call veterans. 
They don't have to be legionnaires. They don't have to be a 
dues-paying legionnaire. We don't care: A veteran is a veteran 
and our brothers and sisters in arms.
    This can help the VA in many ways on the health of those 
veterans that we have talked. I have heard so many. We don't 
have the time to talk about some of the good things I have 
heard as I have traveled the States.
    But when a veteran talks to a veteran, they open up more--
--
    Senator Hassan. Yes.
    Mr. Dillard [continuing]. And we can promise them that we 
will always fight for those Second Amendments. There won't be a 
stigmatism about, I am not going for mental health, and that is 
the key. So, we need to be there and that helps the VA whenever 
they start working with that veteran, and we can detect if we 
sense some problems.
    Senator Hassan. Right.
    Mr. Dillard. And so----
    Senator Hassan. Well, thank you for that.
    And I wanted to follow up with one other question, because 
every year, 200,000 servicemembers transition from military to 
civilian life. The majority are 18 to 34-years-old in that age 
range, which is also the age range for the highest veteran 
suicide rate.
    That is why I introduced bipartisan legislation to 
strengthen and make permanent Solid Start, which, as you know, 
is a VA initiative that aims to contact every veteran multiple 
times by phone in the first year after they leave active-duty 
to check in and help connect them to the VA programs and 
benefits. I am glad to have the continued support of the Legion 
for this bill.
    Can you speak to how early and consistent contact with 
veterans transitioning from military to civilian life is 
critical to their mental health and well-being.
    Mr. Dillard. Yes, Senator.
    It is very critical and the first part of coming out of 
transition, you are in a different place. And so, the Solid 
Start program was a big step in contacting these veterans at 
their early stage of transitioning or out of the service 
because now the VA can tell them of the health and benefits, 
the possibilities that they may be able to get.
    I think that was a very, very good move on the VA in order 
to do the Solid Start and I think it is three times within the 
first year. If we had people, we could do it more.
    Senator Hassan. Well, thank you. I am over time. I 
appreciate the chair's flexibility. I just really appreciate 
the Legion's leadership on all of these issues. Thank you so 
much.
    Chairman Takano. Thank you, Senator Hassan.
    I now would like to turn to Representative Mace for 3 
minutes.
    Representative Mace? Can you hear me, Representative Mace? 
Nancy? Can you unmute?
    Representative Mace? We can't hear Representative Mace.
    Nancy, we can't hear you.
    Ms. Mace. I am having--give me 1 minute, Mr. Chairman. I am 
having some technical difficulties with my computer.
    Chairman Takano. Representative Mace, we can hear you now. 
Representative, we can hear you.
    Oh, she's going to reboot. Okay. She will probably reboot.
    Representative Moore, are you prepared to----
    Mr. Moore. Yes, Chairman Takano.
    Can you hear me Okay?
    Chairman Takano. We can hear you.
    Go ahead, Representative Moore.

                       HON. BARRY MOORE,
                U.S. REPRESENTATIVE FROM ALABAMA

    Mr. Moore. First, let me say, thank you, Mr. Chairman and, 
certainly, Commander Dillard, for being here. And I appreciate 
everyone participating in these hearings.
    First question would be, you know, women veterans are some 
of the fastest growing segment of homeless veteran population 
that we have. What steps should Congress take to ensure that 
the needs of our homeless women veterans are being met?
    Mr. Dillard. Thank you very much for that question and my 
director, Joe Sharpe, of Veterans Employment and Education, he 
can answer that much better than myself.
    Joe?
    Mr. Sharpe. I would like to say we have been--thank you for 
that question--we have been very successful as far as bringing 
down the homeless problem. At one time, we had about 250,000 
homeless veterans at any time and now it is down to about 30 to 
40, and a lot of that has been done by legislation that was 
passed by Congress and also the VA HUD-VASH Program has been 
highly successful. We definitely believe that that program 
should be expanded.
    It should definitely have some provisions for women 
veterans, since they are the highest group that is experiencing 
homelessness. And we would definitely like to have permanent 
authorization of support and services for veterans and families 
program. Thank you.
    Mr. Moore. Thank you.
    And kind of a follow-up, how can we in Congress improve the 
Transition Assistance Program to better serve disabled veteran 
members and their transition from active to civil service?
    Mr. Moore. The American Legion has always been for 
improving the TAP program. One of the things we wanted to do is 
to ensure that before a veteran leaves the military, that they 
are gainfully employed, that there is a revenue source coming 
into that family before they leave and have to be on 
unemployment.
    Many of the programs that we currently have actually do 
what we have been looking for. The SkillBridge program that DoD 
does that actually trains individuals, the program for 
licensing certification really helps veterans find employment 
prior to their departure. The VET TEC program is another 
program, again, that we are very proud of. We have about 10 
million jobs that we can't fill because of high-skill type 
employment and jobs like the SkillBridge program that we would 
like to see expanded, and the VET TEC, we also want to see 
expanded, do exactly that.
    We have always been for gainful employment and when you 
start seeing servicemembers being employed with salaries from 
60 to $140,000, that is the perfect thing for individuals who 
are gainfully employed. They are able to take care of 
themselves, their families, and contribute to their 
communities. Thank you.
    Mr. Moore. Thank you.
    And with that, Mr. Chairman, I am out of time. I will yield 
back.
    Chairman Takano. Thank you, Representative Moore.
    I am going to call an end to this first panel and excuse 
our panelists.
    Thank you so much to The American Legion for all you do for 
our veterans, the voice that you provide. It is, indeed, a 
pleasure to see you all again. I know I spent some time with 
you all in Phoenix and I very much appreciate all that you do 
for veterans.
    You are a very special voice, a very special voice that is 
instrumental and essential in moving this place, the Capitol, 
to do the right thing and to keep our promises.
    So, with that, I am going to excuse this panel and before I 
come down, I want to make sure I shake all your hands before 
you go and then we will reset the table for the next panel.
    A 5 minute recess.
    [Recess.]
    Chairman Takano. I now reconvene the joint committee for 
the testimony of our second panel, the testimony and our 
questioning. But before I recognize our second panel, I would 
like to recognize Jan Thompson, who is the President of the 
American Defenders of Bataan and Corregidor Memorial Society, 
the ADBC-MS. This year is the 80th anniversary of the U.S. 
battles of World War II.
    The American Defenders of Bataan and Corregidor Memorial 
Society represent an important voice for this history and the 
ongoing struggles to recognize those who sacrificed so much, 
including the POWs of these battles.
    So, Ms. Thompson, if you are--you will be joining us, I 
think, through--there you are, Ms. Thompson.
    Ms. Thompson, I would like to recognize you. I know you 
were a guest of Senator Tester, who is not here with us, but I 
wanted to make sure you had an opportunity to provide some 
testimony to us. You are welcome.
    Can we hear--Ms. Thompson, can you say something, because I 
want to test the testimony.
    Ms. Thompson. Yes, good morning, everyone.
    Chairman Takano. We do hear you, so go ahead.
    Ms. Thompson. Thank you.

                            PANEL II

                              ----------                              


                   STATEMENT OF JAN THOMPSON,

          PRESIDENT, AMERICAN DEFENDERS OF BATAAN AND

                  CORREGIDOR MEMORIAL SOCIETY

    Ms. Thompson. So, this is--so, Chairman Tester and Takano, 
Ranking Members Moran and Bost, and members of the Senate and 
House Veterans Affairs Committee, thank you for inviting me to 
speak about the American POWs of the Empire of Japan during 
World War II. We honor these American men and women as the 
heroes who deserve recognition by Congress and America, as a 
whole. They have largely been forgotten and we must remedy 
this.
    I represent the American Defenders of Bataan and Corregidor 
Memorial Society and I am the daughter of one of those POWs. 
The ADBCM Society represents men and women who defended 
American territories and allies in the Pacific, such as Guam, 
Wake, Midway, Java, the Philippines, and the Marianas.
    Within the first 6 months of the war, by June 1942, the 
majority became prisoners of war. Our mission is to preserve 
the history of the American POW experience in the Pacific and 
to teach future generations of the POW's sacrifice, courage, 
determination, and faith, as this is the essence of the 
American Spirit.
    Like today's Ukrainians, the Americans in the Pacific were 
fighting a formidable invader. The Empire of Japan also had far 
superior equipment and armed forces. Although Guam fell within 
days of Pearl Harbor, the Marines and civilians on Wake Island 
held out for a legendary 2 weeks and the American and Filipino 
defenders in the Philippines repelled the Japanese Army for 
nearly 5 months. They fought with outdated weapons, lack of 
medicines, ammunition, and supplies. Help did not come from the 
United States.
    The men on the Bataan Peninsula will have surrendered 80 
years ago next month. Those surrendered on Bataan endured what 
is now known as the Bataan Death March and as Senator Tester 
said in his opening remarks, this April 9, marks the 80th 
anniversary of the Bataan Death March.
    Less than 1 month later, on May 6, the island of Corregidor 
was surrendered and the rest of the American and Filipino units 
scattered throughout the 7,000 islands of the Philippines soon 
followed.
    Some of you know about the wars of the Bataan Death March, 
but few of you know about the beheading of Wake Island Marines 
or the machine gunning of American sailors who survived the 
sinking of the USS Houston or the deadly imprisonment in Japan 
of the indigenous people of Attu from Alaska.
    To survive the surrender was just one hurdle, because each 
day of the POW's captivity, three and a half years, was a 
constant struggle for survival. All the POWs, American and 
ally, were starved, denied medical care, refused clothing, 
routinely beaten, and murdered. Some POWs became human 
experiments. Some aviators were executed, followed by a 
ritualistic eating of their livers. And others, without reason, 
such as on Wake and Palawan, were simply massacred.
    As the war progressed, the majority of the POWs were 
shipped throughout the Empire on what were called ``hellships'' 
to be slave laborers for private Japanese companies. All of 
these hellships were unmarked. Many were sunk by American 
bombers or submarines.
    Thousands of American POWs died by friendly fire. For those 
who survived captivity, returning home presented another 
battle. Some POWs were forced to sign gag orders about the 
horrors they experienced. Many of them could not articulate 
what had happened to them or what they had witnessed and it 
took a very long time for the Veterans Administration to 
recognize they all had returned home with a disability.
    The sacrifice and resilience of the American POWs of Japan, 
especially in light of today's events, should not be forgotten. 
Their courage continues to inspire.
    To this end, in this year of the 80th anniversaries, I 
request that Congress immediately approve an accurate and 
inclusive Congressional Gold Medal for America's early 
defenders of the Pacific who fell to Japan. They are the most 
diverse World War II cohorts to be considered for the 
Congressional Gold Medal.
    The U.S.-Japan alliance is very strong today and we ask 
Congress to encourage the Japanese in the following: to 
institutionalize the reconciliation program that was started in 
2010 with the ADBC Memorial Society. The current POW Japan 
Friendship Program should be expanded. Japan's UNESCO sites 
need to acknowledge POW slave labor and a world-class memorial 
should be installed at the Port of Moji, where most POWs 
entered Japan on the hellships.
    The epic battles of Bataan and Corregidor were a symbol of 
hope and a beacon of our future success. They should not be 
forgotten. It is time to honor these men and women.
    And thank you for listening and inviting me today.

    [The prepared statement of Ms. Thompson appears on page 98 
of the Appendix.]

    Chairman Takano. Thank you, Ms. Thompson, for your 
testimony. I will ask my staff to brief me on the status of the 
legislation that you have brought up.
    Let me just say that I, too, believe this history is so 
important. The sacrifice of our World War II veterans in the 
Pacific and, specifically, those that served, those that 
endured the hellships and those that endured the Bataan Death 
March. We must remember their sacrifice. We must face up to 
history, no matter how terrible it is. We must encourage our 
ally Japan, to do that. We must live up to those ideals for 
ourselves, as well, to face our own history.
    So, thank you so much for your testimony and thank you so 
much for the work that you do.
    I will now recognize our witnesses for our second panel for 
their opening statements. First, we have Charles ``Charlie'' 
Brown, National President of the Paralyzed Veterans of America, 
or PVA. You are recognized for 5 minutes for your testimony.

            STATEMENT OF CHARLES ``CHARLIE'' BROWN,
       NATIONAL PRESIDENT, PARALYZED VETERANS OF AMERICA

    Mr. Brown. Chairman Tester, Chairman Takano, and members of 
the committee, I am honored to have this opportunity to speak 
with you today on behalf of tens of thousands of veterans with 
spinal cord injuries and disorders who depend heavily on the 
benefits and healthcare available through the Department of 
Veterans Affairs.
    This week, PVA members from our 33 chapters will be meeting 
virtually with Members of Congress to strongly advocate for the 
legislation that is crucial to their ongoing health and 
independence.
    My written testimony includes a full list of PVA's 2022 
priorities. In the interests of time, I would like to focus on 
three critically important issues that Congress must address: 
improved access to specialty systems of care; expanded access 
to the Home and Community Based Services, or HCBS; and 
increased access to benefits that promote the health, safety, 
and independence of catastrophically disabled veterans.
    First, PVA firmly believes that VA is the best care for 
veterans with catastrophic disabilities. Their spinal cord 
injury and disorder, or SCI/D, system of care provides a 
coordinated, lifelong continuum of services for paralyzed 
veterans. There is no comparable private system.
    As a result, we are deeply concerned by the reports 
recently that the VA intends to recommend a part of the Asset 
and Infrastructure Review process, the closure, or the 
consolidation of some of the SCI/D centers. We believe that 
services must be maintained in line with the accurate 
assessment of available resources and the true needs of 
veterans with SCI/D.
    In the meantime, we are concerned about VA's current 
workforce crisis. Although, ongoing has been made more 
difficult by the pandemic, PVA estimates there is a shortage of 
several hundred nurses in the SCI/D system of care, which 
limits bed availability for admission into the SCI/D centers, 
reducing access for specialty-care delivery.
    We urge Congress to pass the RAISE Act to help VA address 
staffing concerns and fulfill its mission to care for veterans.
    We also want Congress to pass the MAMMO Act. Mammography 
services are critical to ensuring the health of our women 
veterans who see an increased prevalence of breast cancer 
compared to their civilian counterparts; however, as many PVA 
women can attest, not all screening devices, whether in the VA 
or in the community, are accessible for wheelchair-users. No 
woman veteran should have less than full access to care, 
especially simply because they are in a wheelchair or have a 
disability.
    The second issue I would like to address is the improved 
access to the HCBS. I, along with many of my fellow PVA 
members, live independently, but depend upon the services of a 
caregiver to help us live our basic activities of daily living, 
such as getting out of bed, dressing, and taking care of our 
basic bodily needs.
    One Saturday morning, this past fall, I was informed late 
that I would not be receiving the home care that I desperately 
needed. At that point in time, I realized it would be between 
25 or more hours before I would receive my next nursing 
services. I wouldn't be able to eat. I wouldn't be able to 
drink. I wouldn't be able to take medications. I would be stuck 
in bed without any services.
    Thankfully, through the process of making many phone calls, 
I was able to regain some help and somebody was able to come 
out to my home and help me. When I contacted my social worker 
at the VA offices on the next available opportunity, I was 
informed that it was my duty to have backup; it wasn't the duty 
of the services.
    For me, when I sustained my SCI/D during my military 
service, I knew that there would be significant barriers and 
challenges, but I never dreamed that I would literally be 
abandoned by the system that was supposed to support me and my 
fellow veterans. No veteran should ever be able to face this 
situation.
    That is why PVA gives its strongest endorsement for the 
recently introduced Elizabeth Dole Home and Community Based 
Services for Veterans and Caregivers Act. This critically 
important legislation would make urgently needed improvements 
to the VA HCBS, including expanding the Veterans Directed Care 
Program to all VA medical centers; creating pilot programs to 
address direct-care worker shortages; and increasing access to 
respite care. We urge Congress to pass this bipartisan 
legislation.
    Finally, we need Congress to pass pending legislation that 
would increase access to the benefits that promote the health, 
safety, and independence of paralyzed veterans. And with the 
[inaudible] legislation, that would increase access to adaptive 
vehicles for catastrophically disabled veterans. VA provides 
one Automobile Grant during a lifetime. The current grant pays 
for almost one-half or to one-third of the cost of the vehicle 
to be adapted.
    A safe, accessible vehicle is not a luxury to wheelchair 
users, who often encounter barriers in accessing 
transportation, including air travel, on other Americans. We 
urge you to pass either the AUTO for Veterans Act or the Cars 
for Veterans Act this year.
    Thank you, again, for the opportunity to share our views 
and our ongoing commitment to paralyzed veterans and their 
caregivers. I would be happy to answer any questions you may 
have.

    [The prepared statement of Mr. Brown appears on page 138 of 
the Appendix.]

    Chairman Takano. Thank you, Mr. Brown.
    Without objection, your written testimony, in full, will be 
included in the hearing record.
    Next, we will hear from Jared Lyon, National President and 
CEO at the Student Veterans of America, or SVA.
    You are recognized for 5 minutes for your testimony, Mr. 
Lyon.

                    STATEMENT OF JARED LYON,

        NATIONAL PRESIDENT AND CHIEF EXECUTIVE OFFICER,

                  STUDENT VETERANS OF AMERICA

    Mr. Lyon. Thank you, sir.
    Chairmen Tester and Takano, Ranking Members Moran and Bost, 
and members of the committees, thank you for allowing the 
Student Veterans of America to testify on our legislative 
priorities for the 2022 legislative calendar.
    With more than 1500 on-campus chapters, Student Veterans of 
America is committed to the empowerment of yesterday's 
warriors. Through a supportive network of chapter leaders, SVA 
works to transform the skills and experience of student 
veterans to ensure that they achieve their greatest potential.
    In my statement today, I will briefly discuss some of the 
most pressing issues that we hear from student veterans and our 
chapters. We encourage the committees to review our written 
testimony for a comprehensive list of our policy priorities. In 
my remarks today and the ones that follow, I will focus on our 
four policy issues of special importance to VHA in 2022.
    First, is the permanent emergency protections for VA 
education benefits. As we look to a future beyond the pandemic, 
it is clear that VA needs broader, permanent authority to 
proactively protect student veterans' benefits during national 
emergencies. These committees saw firsthand, the gravity of the 
situation facing tens of thousands of student veterans and 
their families as the pandemic unfolded in earnest back in 
March 2020.
    The sheer amount of work that was involved to identify 
holes in VA's support system, craft legislative solutions, and 
push them through Congress cannot be overstated. While we are 
grateful for the committee's work in making this happen, let's 
ensure that we don't have to repeat this arduous task.
    We strongly encourage these committees to learn from our 
shared history and make the temporary protections a permanent 
authority at VA to ensure adequate protections are available 
for the next emergency.
    Second, access to VA healthcare for student veterans. 
Student veterans' access to VA education benefits is of 
critical importance. The needs of student veterans do extend 
beyond education benefits and one of those needs is healthcare.
    Military service, especially with the recent end to the 20-
year war in Afghanistan, could weigh heavily on the minds of 
student veterans. According to the Journal of American College 
Health, student veterans are more likely than their peers to 
experience mental health challenges. But these data demonstrate 
that if treatment is available to student veterans, they are 
more likely to seek out and receive treatment.
    SVA believes that Congress should take steps to ensure that 
mental health resources are available to student veterans where 
they are: on campus.
    An often overlooked program is VA's Veteran Integration To 
Academic Leadership, or VITAL program. VITAL is a joint effort 
between the Veterans Health Administration and the Veterans 
Benefits Administration that provides on-campus mental health 
and support services to student veterans when and where they 
need it, and coordinates with VHA, VBA, and Community Care 
providers.
    In addition, VITAL provides education and training on 
student veteran-specific needs to campus faculty and staff to 
further aid colleges in creating a more welcoming and inclusive 
community for veterans transitioning out of the military. When 
viewed in light of the VA's whole-health treatment objective, 
VITAL's broad portfolio of services stands out as a well-
designed, flexible and responsive to the day-to-day needs of 
student veterans. SVA supports expansion of the VITAL program 
and its capabilities on campuses across the country through 
increases in annual funding and proper prioritization within 
VA.
    SVA has received valuable feedback from student veterans in 
recent years about how VA can continue to modernize the VA work 
study program.
    One issue that is raised regularly is substantial disparity 
and opportunities available through VA work study compared to 
traditional work study currently available to non-veteran 
peers. VA work study students are largely required to work in 
roles directly related to VA. This limits greatly participants' 
ability to learn and develop in the skill sets they need to 
enter the broader workforce upon graduation.
    As part of our ongoing VFW SVA legislative fellowship, we 
are working with fellow PhD student and Air Force veteran John 
Randolph of Penn State University to recommend important 
changes to the VA work study system. Specifically, John 
proposes broadening the pool of qualifying work study 
opportunities and improving payment rate and structure.
    We hope to work with these committees to examine further 
expansion of the VA work study programs.
    Fourth is childcare. Childcare needs to be another area 
that we focus on, as it is a pressure point for many student 
veterans. Increasing access to childcare is a near universal 
conversation among SVA chapters. It is no surprise that given 
more than 50 percent of student veterans themselves are 
parents. Childcare challenges created added pressures for the 
veterans and post-traditional students that can complicate 
academic journeys.
    Finally, I would like to briefly address two additional 
issues. SVA remains committed to increasing certain monthly 
housing allowance rates, or MHA, including that of exclusively 
online learners, and we look forward to working with the 
committees to address this issue.
    Second, SVA strongly supports Garden Reserve G.I. Bill 
Parity. We thank Chairman Levin for championing the House 
passed Garden Reserve G.I. Bill Parity Act. And we encourage 
the Senate to pass this bill swiftly. And today, on 
International Women's Day, I would like to recognize and 
acknowledge our sisters in arms, who make up nearly half of all 
SVA chapter leaders nationwide.
    SVA appreciates the committee's commitment to acting on 
these issues, which directly support student veterans and their 
needs. And in doing so, you are ensuring we truly meet the need 
of all those who have borne the battle. By addressing them, you 
are ensuring our country delivers on the promise we made to 
every veteran the day they chose to serve. That service to our 
country will not just be rewarding on its own, but would leave 
veterans better off than when they joined.
    Thank you for your time, and attention, and devotion to the 
cause of veterans in higher education. I look forward to your 
questions.

    [The prepared statement of Mr. Lyon appears on page 159 of 
the Appendix.]

    Chairman Takano. Thank you, Mr. Lyon, for your testimony. 
Without objection, your full written testimony will be included 
in the hearing record.
    We will now hear next from--I am jumping a little bit out 
of order here, but Rene Campos--Commander Rene Campos, Senior 
Director, Government Relations for Wounded--for Veterans 
Wounded Warrior Care at Military Officers of America. You are 
recognized for 5 minutes.

    STATEMENT OF RENE CAMPOS, CDR, U.S. NAVY (RET.), SENIOR 
  DIRECTOR, GOVERNMENT RELATIONS FOR VETERANS-WOUNDED WARRIOR 
         CARE, MILITARY OFFICERS ASSOCIATION OF AMERICA

    Ms. Campos. Chairman Tester and Takano, Ranking Members 
Moran and Bost, and committee members, thank you for the 
opportunity to share MOAA's priorities.
    We commend the committees and VA for pressing hard in 2021 
to support veterans, service members, and their families during 
a difficult year in the fight against the pandemic.
    I would like to highlight two concerning trends. First is 
unpredictable funding. MOAA, like the IB VSOs is concerned 
about how ongoing crises and threats could dramatically alter 
VA's mission and funding. Congress must establish a path for 
predictable funding so VA can meet its modernization mandates.
    Equally concerning is VA's ability to execute the massive 
volume of legislation enacted in recent years while dealing 
with ongoing systemic problems. The Secretary is further 
challenged by not having an undersecretary for health and 
benefits. Congress--MOAA urges Congress and the administration 
to expedite the process to fill these critical positions.
    Turning to health care, stabilizing, modernizing VHA's 
workforce and support systems is crucial. One member wrote MOAA 
with thoughts of dropping his care a year being at the VA in 
Monterey California, saying, at first VA seemed like a good 
system, but I have since learned it is not user-friendly and 
difficult to navigate. I have tried working with a patient 
advocate, but she couldn't do much. Like so many VA employees, 
she left.
    We urge Congress to support the Secretary's human 
infrastructure plan to include permanent authority for 
expediting, hiring, and onboarding of staff and increasing pay. 
For long-term care and extended, VA recently announced its plan 
to establish more caregiving programs and geriatric and 
extended care facilities by 2026.
    However, we believe more immediate actions are needed. MOAA 
supports the Elizabeth Dole Home and Community Based Services 
for Veterans and Caregivers Act, and we urge funding and 
passage of this comprehensive legislation.
    There is also a need for dedicated funding to expand three 
newer and hugely popular programs. That is the medical foster 
homes and veterans directed care programs.
    Next, MOAA thanks VA for its commitment to supporting 
women, minority, and underserved veterans, but it is woefully 
behind in collecting quality data on race, ethnicity, and 
gender, and must take corrective action immediately across the 
enterprise.
    MOAA recommends VA and Congress accelerate its efforts to 
eliminate disparities to ensure equitable delivery of health 
care and benefits across all veteran populations. We also 
appreciate Congress and VA prioritizing mental health and 
suicide prevention. But veterans are still struggling to 
schedule appointments.
    MOAA's Texas council of chapter's experience sums up this 
challenge. Veterans are getting the runaround in obtaining 
referrals to community care providers. Many have PTSD and can't 
get timely access to a mental health counselor at the VA or in 
the community. Others waited months for routine procedures, 
like colonoscopies and shoulder surgeries. Congress must ensure 
VA continues executing enacted legislation and investing in 
mental health and suicide prevention services.
    In terms of benefits, the need for passing comprehensive 
toxic exposure reforms is urgent. Recognizing when toxic 
exposure has occurred allows veterans, health care providers 
and researchers to proactively detect, monitor and treat 
conditions earlier. MOAA recommends Congress pass comprehensive 
toxic exposure reform, which includes access to health care, 
reforms the presumptive process, and establishes presumptions 
for illnesses meeting the standard of positive association.
    Finally, in 2017, Congress took action to protect veterans 
with VA home loans. But signs of predatory behaviors are 
reemerging. MOAA believes Congress should mandate regular 
reporting of data and consumer protection concerns on this 
benefit, and with the assistance of other Federal agencies.
    In closing, we look forward to working with the committees 
and the VA to better the lives of those who served this country 
faithfully. I thank you, and I stand by for your questions.

    [The prepared statement of Ms. Campos appears on page 185 
of the Appendix.]

    Chairman Takano. Thank you, Ms. Campos. And I apologize for 
the technical difficulties you endured while under such stress, 
but I will say that you performed admirably. Without objection, 
your full written testimony will be included in the hearing 
record.
    I now--let's see. Something out of order here. Our next 
witness is Claire Manning-Dick, Vice President at the Gold Star 
Wives of America. You are now recognized for 5 minutes for your 
testimony, and you are doing it online. Ms. Manning-Dick.

               STATEMENT OF CLAIRE MANNING-DICK,

                    NATIONAL VICE PRESIDENT,

                GOLD STAR WIVES OF AMERICA, INC.

    Ms. Manning-Dick. Chairman Tester, Ranking Member Moran, 
Chairman Takano, and Ranking Member Bost, and distinguished 
committee members, we want to thank you for inviting us to 
testify this year. It has been our honor and privilege to work 
with legislators for over 77 years to better the lives of 
surviving spouses and families.
    [Spoken in foreign language]. My name is Claire Aca 
Manning-Dick. I am the surviving spouse of Sergeant Richard 
Charles Dick, who served in the U.S. Air Force from 1964 to 
1968. Richard continued his life of service as a dedicated 
leader as our vice chairman for our Shoshone-Paiute tribes on 
the Duck Valley Indian Reservation. He fought during the Tet 
Offensive in South Vietnam, and he died in 2010 due to Agent 
Orange exposure.
    After being his caregiver, I am now the primary caregiver 
of his 98-year-old mother. I am the daughter of a World War II 
marine sergeant who fought several battles protecting the 
Navajo Code Talkers. Later, my father served as a Marine 
assistant to Ira Hayes, the well-known Iwo Jima flag raiser. I 
am the granddaughter of a World War I veteran, who served six 
campaigns in France.
    Native American veterans have a strong legacy of service to 
our country, and I am proud of my heritage and the dedication 
of our people to this great Nation. Native American veterans 
who live on isolated reservations like I do understand all too 
well the pain and suffering of high rates of suicide, opioid, 
and alcohol addictions, and limited health services.
    To receive services from a health specialist, we need to 
drive 300 miles round trip for the VA medical services or even 
civilian medical services.
    COVID was very devastating to our reservation, and many of 
our veterans were taken ill. Not having access to mental health 
services resulted in our reservation experiencing the highest 
rate of suicide we have seen in years.
    It is our hope that the VA will provide better outreach to 
veterans and their families on all reservations. Especially 
those in remote areas, and to increase funding to all veteran 
clinics.
    When mental health services are unavailable and no 
diagnosis is made, benefits are not afforded to the family left 
behind due to suicide.
    GSW supports any effort to reduce the rate of service-
connected deaths by suicide, and to expedite the process for 
survivors to obtain the benefits they desperately need. Of 
course, an increase in compensation to all surviving spouses is 
the number one goal for Gold Star Wives of America. Other than 
the cost of living raises, the DIC, dependent and indemnity 
compensation, has not had a raise since 1993, when the flat 
rate was created for all going forward. The flat rate is the 
equivalent of 43 percent of a 100 percent disabled veteran.
    We are asking for equity with surviving spouses of Federal 
employees who receive 55 percent. We are also asking to 
authorize survivors of retirees to draw the full month retired 
pay for the month in which the retiree dies. Many of our 
members have been widowed due to the effects of Agent Orange. 
We are now dealing with the effects of exposure to burn pits 
and other toxic exposures.
    When healthy young people are sent to war and subsequently 
exposed to toxins, they should not have to prove their exposure 
or to wait for the science. It has already been 30 years since 
the First Gulf War, and we are still waiting for a true 
definition or clinical case of Gulf War Syndrome.
    We hear from many of our survivor spouses under age 55, who 
are wanting to remarry and are hesitant, as they are fearful to 
lose the benefits which they have been awarded.
    For 77 years, we have come to remind you to follow the 
words of Abraham Lincoln. To care for him who have borne the 
battle, and for his widow, and his orphan. While our spouses 
paid the ultimate sacrifice for our country, we are the ones 
who proudly live out their sacrifice each and every day. 
[Spoken in foreign language]. Thank you again for your time and 
attention.

    [The prepared statement of Ms. Manning-Dick appears on page 
206 of the Appendix.]

    Chairman Takano. Thank you, Ms. Manning-Dick for your 
testimony. Without objection, your full written testimony will 
be included in the hearing record.
    I now recognize Brigadier General J. Roy Robinson, 
President of the National Guard Association of the United 
States. You are recognized for 5 minutes for your testimony, 
General.

  STATEMENT OF BRIG. GEN. J. ROY ROBINSON (RET.), PRESIDENT, 
        NATIONAL GUARD ASSOCIATION OF THE UNITED STATES

    Mr. Robinson. Thank you. Chairman Tester, Ranking Member 
Moran, Chairman Takano, Ranking Member Bost, and other 
distinguished members of the Senate and House Committees, on 
behalf of the almost 45,000 members of NGAUS and nearly 450,000 
soldiers and airmen of the National Guard, we greatly 
appreciate this opportunity to share with you our thoughts on 
today's hearing topics for the record.
    Thank you for the support you have provided to ensure 
accountability and improve our Nation's services to veterans 
and their families. Over the past several years, the combined 
efforts of your two committees have produced critical advances 
that have improved the lives of our National Guardsmen and 
women. And I would like to personally thank each and every one 
of you for that hard work. From increased USERRA protections to 
VA home loan eligibility for National Guard Title 32 service, 
we continue to make progress on multiple fronts towards true 
parity between the Active and Reserve components.
    Today I would like to focus on three specific issues 
impacting Guardsmen that fall under the jurisdiction of this 
Committee: The benefits of increased access to medical 
coverage, ensuring benefit parity for Guardsmen, and further 
strengthening the Total Force by finally creating a singular 
document of military service to replace the active-duty only 
DD-214.
    I would like to discuss with the committee today providing 
zero-cost TRICARE health coverage to the National Guard and 
Reserve. While this is not an effort that I expect will be 
concluded this year, I believe very strongly that the time is 
now to discuss if an Operational Reserve is better served 
through ensuring guaranteed medical coverage in lieu of the 
current disjointed system of third party health contractors and 
Periodic Health Assessments. This year, NGAUS will advocate for 
conducting a study at the Department of Defense into what the 
cost of such a change in policy would be.
    The benefits of zero-cost TRICARE coverage extend beyond 
medical readiness and well-being for reserve component military 
families. TRICARE, as one of our top retention policies, will 
help us keep a manned and ready force. In addition to building 
medical readiness today, providing preventive care throughout 
our servicemembers' careers will likely reduce medical 
expenditures when they transition from drilling guardsman to 
veteran. This will also become a significant employer benefit 
when a CEO or hiring manager knows a servicemember will not 
require health insurance coverage.
    As we ask more and more of our National Guard and Reserve 
units in peacetime training, I worry that companies will start 
to choose equally qualified non-military candidates over our 
servicemembers simply because they are concerned that the 
soldier or airman will be away too often. We must find a way to 
better incentivize these companies.
    I ask for each of your support on H.R. 3512, Healthcare for 
Our Troops Act. This groundbreaking bill will re-create how we 
provide preventive health care to the National Guard and I am 
convinced that it will not only provide better health results 
to our Servicemembers but will prove cost advantageous in the 
long run.
    One of the primary legislative goals of NGAUS is to address 
the benefit disparity for guardsmen under Federal activation 
authorities. For the past several years, I have addressed this 
committee and asked for your assistance in correcting numerous 
benefits not afforded to the thousands of Guard and Reserve 
servicemembers deploying under Title 10 U.S.C. Section 12304(b) 
status.
    With the passage of the Forever G.I. Bill and the fiscal 
year 2018 National Defense Authorization Act, guardsmen and 
Reservists are now eligible for nearly all of the same benefits 
as their active duty counterparts, including tuition 
assistance, transitional healthcare access, and post-9/11 G.I. 
Bill benefits.
    Of major concern for the National Guard is creating full 
parity for Guard service in relation to earning thepost-9/11 
G.I. Bill benefits. Guardsmen currently serve in a variety of 
statuses and missions that do not accrue the same G.I. Bill 
benefits as their active duty counterparts.
    Unlike our Active Component peers, a day in the National 
Guard or Reserve does not always equal one day of service: 
regular weekend training days and annual training do not count 
toward benefits.
    Federal deployments abroad have decreased making it much 
more difficult for Reserve component servicemembers to earn 
Federal benefits, including the G.I. Bill.
    Examples of this distortion in eligibility have been 
particularly acute in the past several years of increased 
domestic mobilization. Much of the COVID response, responses to 
civil disturbance, and disaster relief have not granted G.I. 
Bill eligibility.
    Lastly, I would like to discuss the need for a singular 
record of military service across all components and all 
services. If the Department of Defense truly wants to achieve 
its long-stated goal of the total force, then a cumulative 
document recording all military service, active duty, and 
reserve component is critical.
    The fact that the active duty, Guard, and Reserves all have 
different documents to describe military service is both 
unnecessary and cumbersome. Thank you.

    [The prepared statement of Mr. Robinson appears on page 220 
of the Appendix.]

    Chairman Takano. Thank you, General Robinson. The--your 
written testimony in full will be included in the hearing 
record without objection.
    Our next witness is Major Bonnie Carroll, founder--
president and founder at the Tragedy Assistance Program for 
Survivors, Incorporated. You are recognized for 5 minutes for 
your testimony.

                  STATEMENT OF BONNIE CARROLL,

                     PRESIDENT AND FOUNDER,

            TRAGEDY ASSISTANCE PROGRAM FOR SURVIVORS

    Ms. Carroll. Chairmen Tester and Takano, Ranking Members 
Moran and Bost, and distinguished committee members, on behalf 
of the Tragedy Assistance Program for Survivors, thank you for 
allowing me to speak on behalf of the families of America's 
fallen heroes.
    Since TAPS was founded in 1994, we have provided care and 
support to more than 100,000 bereaved military family members 
of all ages, representing all services and all manners of 
death.
    In 2021 alone, 9,246 newly bereaved survivors came to TAPS 
for care. Of those, 27 percent were grieving the death of a 
military loved one to suicide, and 31 percent to illness loss. 
More than 16,500 surviving family members whose military loved 
ones due to an illness are now receiving support from TAPS. 
Sadly, we project this number to increase by more than 3,000 
this year.
    As a result of these increasing losses and the challenges 
they posed for grieving loved ones, many of whom were 
caregivers for their veteran, without recognition or government 
support, for years before their death, TAPS is committed to 
promoting a deeper understanding of the illnesses that may 
result from exposures to environmental toxins.
    As a leading voice for these impacted families, TAPS is 
grateful to the Chairman and ranking members for crafting 
comprehensive toxic exposure legislation. The Cost of War Act 
and the Honoring Our PACT Act will ensure 3.5 million veterans 
exposed to toxins received critical health care, and their 
surviving families will have access to all available benefits 
earned through the service of their loved one.
    We thank the House for passing the PACT Act last week and 
the Senate for passing the Health Care for Burn Pit Veterans 
Act, the first step in a three-phased approach for delivering 
health care and benefits to veterans exposed to environmental 
toxins and fulfilling our Nation's sacred obligation to care 
for our veterans and for their survivors.
    From our decades of experience, we have learned that 
families grieving a suicide loss often cope with symptoms of 
trauma and complicated grief, putting them at increased risk 
for suicide themselves, for post-traumatic stress, and other 
mental health concerns due to the traumatic nature of their 
loss, providing critical bereavement support to help mitigate 
suicide survivor's risk is imperative.
    We appreciate Representative Rouser and Senator Tillis, 
sponsoring the Expanding the Families of Veterans Access to 
Mental Health Services Act, which provides VA, vet center 
counseling, and mental health services to surviving families of 
veteran suicide loss who are currently ineligible to access 
these life saving services.
    We thank Chairman Takano for introducing the STRONG 
Veterans Act of 2022, which includes hiring an additional 100 
full time equivalent employees at VA vet centers to provide 
expanded mental health care to veterans, service members, their 
families, and their survivors.
    TAPS also proudly endorses the Gold Star Families Day Act 
and thanks Senators Warren and Ernst for their support. This 
important legislation, supported by 35 veteran service 
organizations, to include Gold Star Wives and American Gold 
Star Mothers, will create a Federal holiday to recognize and 
honor the sacrifices made by the families of all those who 
stepped forward to serve in defense of freedom and who died 
while serving or as a result of their service.
    TAPS remains committed to improving dependency and 
indemnity compensation for surviving families. We are grateful 
to Chairman Tester and Senator Boozman, for Congresswoman 
Hayes--and Congresswoman Hayes for introducing the Caring for 
Survivors Act of 2021, to strengthen DIC and provide equity 
with other Federal survivor benefits.
    TAPS is also working with Congress to introduce 
comprehensive legislation to allow surviving spouses to 
remain--retain their benefits upon remarriage. Under current 
law, typically young widows who tragically lose their spouse in 
the military lose survivor benefits if they remarry before the 
age of 55. Many survivors from illness loss, suicide, as well 
as combat are younger than 55, and often have children who they 
must now raise alone. These surviving spouses, therefore, do 
not remarry after the death of their servicemember because the 
loss of these financial benefits would negatively impact their 
family, an additional unfair burden on them.
    And I would be remiss if I did not express our support 
today for the surviving families in Ukraine and to our sister 
organization, TAPS Ukraine. Thank you for the opportunity to 
speak on behalf of our families today.

    [The prepared statement of Ms. Carroll appears on page 227 
of the Appendix.]

    Chairman Takano. Thank you, Major Carroll, for your 
testimony. Without objection, your written testimony in full 
will be included in the hearing record.
    Finally, we will hear from Jennifer Dane, Chief Executive 
Officer and Executive Director for the Modern Military 
Association of America. You are recognized for 5 minutes for 
your testimony.

                  STATEMENT OF JENNIFER DANE,

        CHIEF EXECUTIVE OFFICER AND EXECUTIVE DIRECTOR,

             MODERN MILITARY ASSOCIATION OF AMERICA

    Ms. Dane. Thank you, Chairman Tester, Chairman Takano, 
Ranking Member Moran, Ranking Member Bost, and the members of 
the committee. I am Jennifer Dane. I am an Air Force veteran. 
Founded in 1993, the Modern Military Association is the 
Nation's largest lesbian, gay, bisexual, transgender, and queer 
military and veteran non-profit, advocating for fairness and 
equality. And we appreciate the opportunity to be here today.
    Our community has served honorably since the Revolutionary 
War, but we have largely been left out of the narrative. 
However, over the course of American history, our past and our 
current existence, especially in Texas and Florida, is laden 
with discrimination and vast harm, most recently with the 
implementation of the transgender service ban and Don't Ask, 
Don't Tell, which was repealed in 2011.
    Those two harms harmed hundreds of thousands of veterans 
and family members indirectly and directly. I, personally, was 
investigated under Don't Ask, Don't Tell. And know that there 
isn't a day that goes by that I am not reminded that without 
equality and fairness, my service is seen lesser than my 
straight counterparts.
    Since then, the fight for equality and justice has never 
ceased. We are incredibly honored to support--to fully support 
Chairman Takano's commission on examining the harms of Don't 
Ask, Don't Tell. We also applaud VA's Secretary McDonough's 
taking steps to restore veteran benefits for other than 
honorable discharges, many of which were from Don't Ask, Don't 
Tell. And he also displayed the pride flag honorably.
    However, this is not enough. Currently, the VA, DOD, and 
DHS do not collect standardized data and research on our over 
one million veterans, even with the consent of these veterans. 
Without critical information, health disparities will continue 
and concerns will only be exacerbated.
    Instead of providing cost effective and timely preventative 
care for these veterans, informed by research and analysis, you 
all, Congress, are costing American taxpayers millions of 
dollars. Congress must eliminate the red tape that surrounds 
approval for research and analysis for our communities. And we 
know this capability does exist, and we have been working with 
Cerner to do--to make sure that the Electronic Health Records 
Management System is fully implemented. We know how critical it 
is to our communities.
    It is 20 years in the making, and it is critical that the 
success continues. We applaud VA for hiring executives from 
DHA, and ensuring the leadership that allows us--to make timely 
decisions, which we know saves lives. This platform will allow 
for the successful transition from the DOD to VA.
    Next, we urge Congress to establish an internal task force 
within the VA to--that is vital to meet the needs of our 
communities and provide funding to establish a full time LGBTQ 
care coordinator. To date, there is zero funded--fully funded 
LGBTQ care coordinators that exist. This includes providing--
also providing standardized cultural competency training to 
understand the vast differences and experiences of our LGBTQ 
military and veteran community, which our organization did 
create and is the only training program to do so, called 
Rainbow Shield. We did that to address these urgent needs to 
fill the gaps.
    Lastly, we urge Congress to examine--to fully examine the 
family building program that works and operates within the VA. 
For a veteran to receive this service, a service connection 
disability must be established for those wanting to conceive. 
If a veteran meets that criteria, they must be married and be 
able to provide sperm or an egg, which one could assume this 
means they--to receive that benefit, you must be in a married, 
heterosexual relationship. It leaves our veterans out that are 
single, partnered, and married to someone of the same sex.
    So with that, we want to really emphasize the fact that our 
LGBTQ veterans are left out of the narrative many times. We 
know that this implementation of this Electronic Health Records 
Management System will change the way that our veterans are 
seen by collecting data.
    So before we can address some of these issues like 
homelessness or burn pit exposure for our communities, we know 
that the data and research must exist. So unlike these other 
VSOs that are up here, that have done this for years, we are 
just asking for simple data to know what our community needs. 
Because if we really want to address all veterans, this 
community must be seen, heard, and known that they are existing 
in today's society. And with that, again, thank you, Chairman 
Tester, Chairman Takano, and Ranking members Moran and Bost, 
and the distinguished members of the committee. I heed for 
questions and comments.

    [The prepared statement of Ms. Dane appears on page 244 of 
the Appendix.]

    Chairman Takano. Thank you, Ms. Dane. Without objection, 
your written testimony in full will be included in the hearing 
record.
    I am going to--since we have only three members and no 
members--three members present and no members on the online 
platform, I am going to extend questioning time to 5 minutes 
each. I will begin with myself. I will recognize myself.
    I would like to start with a question for any of the 
panelists. As I mentioned earlier in the hearing, the PACT Act 
establishes a process for--at VA for consideration of new 
potential presumptions which with concrete decision-making 
timelines at each step of the process. The bill also creates 
greater opportunity for public input into which conditions VA 
is considering for inclusion.
    Could any of the panel, or a few of the panel describe the 
importance of VSO input into the presumptive determination 
process? So we have a--that is what we try to do in the bill.
    Major Carroll, I see you smiling. Do you want to begin?
    Ms. Carroll. No. Thank you, sir. I just appreciate this 
very much. We learn so much from our surviving families, the 
illnesses that their loved ones suffered, the journey that they 
took to get medical care, find that diagnosis, and then service 
connect it back to deployments and exposures. What you are 
doing to open this up and really understand what families are 
facing, and the burden this has placed on servicemembers is 
tremendous, and I am so very grateful to you. This is 
critically important.
    Chairman Takano. Any other panelists? Ms. Campos?
    Ms. Campos. Yes, sir. I appreciate that question. We have 
found over the years in our organization, like many of my 
colleagues here, that the best legislation is made when you 
have a collective inclusive group of people working together to 
craft the legislation as it moves forward.
    We have seen from history with--even with these committees 
in working appeals modernization, we have a collective 
coalition of people working on toxic exposure. And again, we 
have come so far that it is important to be inclusive in this 
process, and we ask that both the committees work together. I 
know we will work together to do whatever we can to get 
comprehensive legislation across the line this year.
    And we don't have any other choice. We need to do it now.
    Chairman Takano. Thank you, Ms. Campos. Mr. Brown, I see 
you nodding your head.
    Mr. Brown. Thank you, Chairman Takano. I will just say that 
no one works in a vacuum, and working with the VSOs together, I 
think we can make a strong impact in getting this passed now. 
It is beyond time. It has happened for a long time. So I thank 
you, sir, for that opportunity.
    Chairman Takano. Anybody else wish to weigh in on this 
question?
    Well, thank you for that testimony. One of the goals of the 
PACT Act is to shift the burden of proof of service connection 
in favor of the veteran. Can someone please describe for me the 
current difficulty that veterans face when filing disability 
claims at VA, particularly when the claim was contingent upon 
access to service records that are decades old and may not 
contain all of the relevant information about the veterans' 
service and potential exposure? Any comment about that? Ms. 
Campos?
    Ms. Campos. Well, I can speak from our members and also 
from those folks that, including myself, that have gone through 
the disability process. I am not sure it has changed a great 
deal. It is very complex. And if you--if the veteran doesn't 
get--before they are even leaving active duty, if they don't 
get the assistance, they are fighting a system all the way.
    So I think that it is--it is so important that the veteran 
have what they need. Some folks leaving service have to get 
their own medical records. In other words, we make it too hard 
for people to serve. And how we treat them on the other side of 
the DD-214 is important. And if we don't value their service on 
that side and help them through that process, which is not a 
simple process. It is time consuming and also very difficult to 
even talk to somebody through the process. So it is critical 
that we--veterans have somebody to help them navigate the 
system.
    Chairman Takano. [No Audio].
    Mr. Bost. Thank you, Mr. Chairman. My questions are also to 
anyone on the panel. The January veteran unemployment rates 
are, thank heaven, about 38.8 percent, which is actually better 
than the national average. However, this was down from an 11.8 
percent in April 2020 due to COVID-19 pandemic.
    What employment programs have you seen that have been most 
effective at getting our veterans back to work, and what can 
Congress do to keep these numbers as low as possible?
    Mr. Lyon. Sir, I am happy to take that question. So when we 
look at student veterans throughout the United States, and 
their family members who are in school, they are attending 
school with one of the best reemployment programs that exists. 
It is the G.I. Bill. One of the areas that the pandemic shed 
particular light on, even though the unemployment numbers are 
low at the moment, is the fact that just over half of all 
student veterans who are using the G.I. Bill and in school 
right now are working full or part time while they are in 
school.
    And so it can't be overstated enough that as we think 
through job programs that work, to encourage employers to 
actually reach out to today's student veterans on campuses in 
their communities where they have open jobs, and if we can try 
to match better the employment opportunities for student 
veterans with what they are actually majoring in.
    Unfortunately, while they are in school, they tend to work 
in retail or service jobs, yet their top three majors for this 
population are business; science, technology, engineering, and 
math; and health related fields. And often that second 
transition after graduating college and joining the workforce 
can be made more difficult when you don't have working 
experience in the industry that you have majored in.
    So encouraging folks to reach out from an employment 
perspective to those working adults who are back in school, 
today's student veterans. Thank you, sir.
    Mr. Bost. Any of you been watching closely our VET-TEC 
program and the success of the VET-TEC program, and comment on 
the success of it? I know that it is one of the highest 
actually placements ones that are out there.
    Then the next question, a follow up on that is, are you 
concerned--right now we are seeing that it is beginning to run 
out of funds, and do you feel that that is something that 
should be pushed to the front and taken care of very quickly to 
make sure a program like that continues?
    Mr. Lyon. Sir, I don't mind jumping in again here. VET-TEC 
came to being when Forever G.I. Bill became a reality in 2017. 
And each year that the pilot program has been available, it has 
run out of funds quicker than the demand for the program.
    When we think of education and training in the broadest 
sense, the majority of G.I. Bill users are actually attending 
post-secondary education. They are achieving their degrees. So 
programs like VET-TEC actually reach out to those veterans who 
potentially are not planning to go to college and are looking 
for education and training opportunities beyond the traditional 
degree.
    I think in an ever-shifting economy, as we look to make 
sure that veterans remain competitive as a workforce, programs 
like VET-TEC should be prioritized with their ability to make 
sure that they are properly funded to meet demand for today's 
veterans.
    Mr. Bost. So we are going to--I want to shift to a question 
here. One in four female veterans report sexual harassment by 
male veterans on the VA grounds. This is a horrible fact, but 
VSOs are uniquely placed in to be part of ending the sexual 
harassment at the VA. How can your organizations partner with 
the VA and other VSOs to educate veterans and staff on the role 
in ending sexual harassment at the VA. Anybody?
    Ms. Dane. I mean, I can speak to that as the person. I 
mean, I am a woman that uses the VA facilities. I am also an 
MST survivor in service. And I think this is a great question 
to ask. One we don't have an answer to. But I think as the time 
progresses, and more training, not only with the employees, but 
also our fellow veterans, I think especially our older VSOs 
need to strategically talk about what it really means to talk 
to younger veterans, especially our younger--well, any female 
veteran for that matter, because some would consider talking to 
me like, ``Hi, sweetheart,'' as sexual harassment, which isn't 
definitely the case sometimes. There is more of a case of that.
    But just really being--knowing that this isn't--that all VA 
needs to know, there is so many different diverse perspectives. 
And I think that the VA is doing a really good job with its 
staff and training, and I think the veterans are the ones that 
need to really come together and learn how to talk to one 
another in ways.
    And it is also a reason why that there is specialized--a 
women's veteran clinic. So there is safety. It is also for 
LGBTQ folks too. We also want to be protected too. So it is not 
just for women veterans. It is for those that are different 
from the veteran portfolio of a white male veteran. If we are 
different than that, I mean, I feel like there has got to be 
more education and training for VSOs that have that as their 
demographic. And maybe just exposure and bringing us together. 
Because I believe at the crux of it, we are stronger together. 
And exposing is--exposure to a certain perspective is the best 
way to solve those problems.
    Not directly, to your questions, but indirectly of how we 
can co-op that conversation and do it in a way that is more 
meaningful and has lasting impacts.
    Mr. Bost. Thank you for your answer. My time is expired, 
and I yield back, Mr. Chairman.
    Chairman Takano. Thank you, Ranking Member Bost. I 
recognize Senator Blumenthal for 5 minutes. Senator?

                    HON. RICHARD BLUMENTHAL,
                 U.S. SENATOR FROM CONNECTICUT

    Senator Blumenthal. Thank you so much, Mr. Chairman, and 
thank you for the focus on toxic burn pits, subject of intense 
interest to me, as well as other kinds of contaminants on the 
battlefield or here at home, Camp Lejeune, and Hawaii are good 
examples of how exposure to those contaminants can cause 
lasting severe injury and pain and infliction to our veterans.
    I want to focus on an issue where a number of you have been 
very supportive. I want to cite particularly the Paralyzed 
Veterans of America, the Disabled Veterans--Disabled American 
Veterans, and the Veterans of Foreign Wars, which have issued a 
statement in support of my work on emergency care 
reimbursements, and the comprehensive independent budget fiscal 
years, 2023 and 2024 for Department of Veterans Affairs, BVA 
compiled along with those other organizations, the DAV and the 
VFW a written statement on this issue, noting that you 
``continue to note that VA must begin fully implementing the 
Wolf v. Wilkie court ruling.''
    The statement in the budget comes as a reminder that the VA 
has work to do in light of your having shared nearly identical 
recommendation last year. That work is really overdue. The 
statement goes on to endorse the legislation that I have 
offered to ``mandate VA to begin processing reimbursing 
veterans for emergency care.''
    As you well know, the VA's wrongful denial and refusal to 
process many thousands of outstanding emergency care 
reimbursements owed to veterans who receive care at non-VA 
facilities, is continuing to occur despite two judicial 
decisions in telling the VA to pay veterans back, which the VA 
is again appealing in the courtroom.
    I was proud to introduce the Veterans Emergency Care 
Reimbursement Act of 2021. I introduced it last year. I am 
currently working on a letter to Secretary McDonough, who is 
very aware of my position on this issue again.
    Mr. Brown, would you please describe your feeling, and I 
presume it is a feeling of frustration, because of this ongoing 
legal battle, and what your expectation would be. What your 
message is to the VA today?
    Mr. Brown. Well, PVA strongly believes that the Wolf v. 
Wilkie court decision must be implemented. I can speak on 
behalf of specifically one of my friends and members of PVA was 
taken to an emergency hospital for an injury. Upon getting 
released from the hospital and going home, he submitted the 
bills to be paid. They are more than--I believe he is more 
than--over half a year now, and they still haven't been paid by 
the VA. That has severely affected his personal credit limits 
and things like that. And it is beyond uncomprehensible why the 
VA won't cover those things because there was no facility near 
him, and the emergency basis, he needed to be taken care of.
    And as the VA says before, that we will--this is what we 
cover. We will cover these bills. But now they don't. So we do 
expect the VA to move forward. We are encouraging them to do 
so. We just think they need to move faster than they already 
are. And it is harmful to veterans in just more than--it is a 
mental aspect also too. It just doesn't wear down your home, 
your value at home, but it also wears down your mental ability.
    So we strongly encourage the VA to move forward on this in 
a faster effort.
    Senator Blumenthal. Thank you. As you point out, its impact 
is devastating. Not only financially, possibly physically, but 
also emotionally. And I would just urge the VA to respond to 
your very eloquent call. Thank you. Thanks, Mr. Chairman.
    Chairman Takano. Thank you, Senator Blumenthal. I now 
recognize Health Subcommittee Chair Representative Brownley. 
Chairwoman Brownley?
    Ms. Brownley. Thank you. Thank you, Mr. Chairman. And thank 
you for all the panelists for being here, and what you do every 
single day for our Nation's veterans.
    Mr. Brown, I wanted to thank you too for recognizing two of 
my bills, the MAMMO Bill, which we continue to work on, and the 
currently--recently introduced bill, the Elizabeth Dole 
Community Based Services for Veterans and Caregivers Act of 
2022.
    So, Mr. Brown, if you could, just elaborate a little bit 
why you think expanding home and community based services for 
elderly and disabled veterans is important?
    Mr. Brown. Thank you for the question. This one actually 
hits home with me also. My sister was my caregiver for 22 
years. Unfortunately, about two years ago, I lost the ability 
for her to work for me because I couldn't pay her. She had to 
get a job outside. Which I fell back on the community care 
system. So it does hit home.
    It is important to keep our dignity, keep our family. You 
are healthier when you are home than you are in a community 
care system. So I will just say that is why it is important to 
me.
    Ms. Brownley. Well, thank you for that. And I really do--I 
really appreciate your support and your own personal story 
around that. And I think--I introduced this because I think so 
many of our veterans, both disabled veterans and veterans who 
are aging, all want to be taken care of at home if they are 
able to, and not be in any kind of institutionalized care.
    So I will look forward to working with you on that bill as 
we move forward. And, Commander Campos, thank you for 
mentioning the Elizabeth Dole bill as well. I think probably 
for the members that you represent, you are representing more 
of the elderly and less the disabled. So if you could speak a 
little bit to its importance.
    Ms. Campos. Well this--as I said in our testimony, this 
is--and I think COVID has kind of hit home a lot more the need 
for having this. Many of the veteran and military service 
organizations here, and those that we work with in the military 
coalition, we have been working to try to get VA to move 
forward quicker to meet the needs of an elderly population.
    But again, we also have people leaving service who have 
been wounded, ill, or injured. Not only because of wars but 
just in service as a whole. And these veterans want to live as 
independently as possible. And VA, while I recognize in our 
testimony, grateful that they are moving forward, expanding 
extended care and long-term care, and planning over the next 
few years, there are other things that need to happen more 
quickly that are popular, like the Veterans Directed Care 
Program I mentioned.
    I can speak personally, too, for my brother who I lost last 
year, and that foster home care would have been very good. It 
is something he wanted but he wasn't eligible for. So this bill 
is--we are very grateful that it is something that is timely 
and long overdue. So thank you.
    Ms. Brownley. Thank you very much, Commander. And thank you 
for sharing your story with regards to your brother.
    I only have a few seconds left, Commander Campos. You also 
mentioned in your written testimony the importance of the--of 
another bill that I introduced, the Dental Care for Veterans 
Act. Can you speak a little bit to that and kind of let us know 
how many of your veterans this seems to be a constant issue and 
problem for them?
    Ms. Campos. Thank you ma'am. I appreciate that question. I 
think like mental health, we have started the dialogue of 
saying that mental health is physical health, and that is 
together.
    I think you have to look at that in terms of dental health 
as well. We have supported your bill, as well as Senator 
Sanders, and we believe strongly that dental health and 
considering the comorbidities that so many veterans in the VA 
have, that you can't take care of the physical without also 
taking care of the mental as well as the dental side of their 
care.
    And again, that affects other parts of their quality of 
life and their well-being.
    Ms. Brownley. Thank you so much. And thank you, Mr. 
Chairman. I yield back.
    Chairman Takano. Thank you, Chairwoman Brownley. Ranking 
Member Rosendale, you are recognized for 5 minutes.
    Mr. Rosendale. Thank you, Mr. Chair. I appreciate that. And 
I really enjoy seeing all of our VSOs here in the meeting live. 
It is great to have you here joining us, really. And thank you 
so much for all of your advocacy for the veterans. We really do 
appreciate that.
    Mr. Brown, I don't have a question for you, but I really 
appreciate your statement on the--a number of benefits that the 
Veterans Administration seems to offer back out and declare 
that they will cover, and then to actually rescind that at the 
last moment when the veteran really relies upon it. And I for 
one sure recognize the--just the unpredictability and the havoc 
that that creates in a veteran's life, not to mention the other 
veterans that look at that circumstance and say well, why in 
the world would I want to get involved in an operation like 
that that can't run itself properly. So thank you very much for 
that input.
    Which brings me to the question that I want to go to Mr. 
Lyon about. The previous panel that we had here, I was talking 
to them about this change in interpretation. Not a change in 
law, not a change in statute, but a change in interpretation 
and the 8515 recognition for our students to be able to get 
education benefits from the VA. And I was wondering if you had 
any of your members already run into this, because apparently 
it is starting to roll out, or could you expound upon what we 
could anticipate this fall if this isn't sorted out.
    Mr. Lyon. Thank you for the question. I appreciate it. And 
generally speaking with the issue that you are bringing up, 
there are certainly big areas of concern. I think chief among 
them is certainly as it pertains to institutional compliance 
and the way in which VA is interpreting and presenting 
guidance.
    And I think ultimately, regardless of how many folks are 
impacted, and there certainly are, the VA guidance is kind of 
paramount. And just taking your interest, we would love to work 
with you and your team to have a better opportunity to have a 
greater sort of clarity and communication from VA relative to 
this new change in interpretation.
    Mr. Rosendale. I really appreciate that. And we are trying 
right now to apply pressure on the VA to clarify, and basically 
just to return to the interpretation that they had been using 
for 60 years. I mean, going back to the G.I. Bill. To make sure 
that the students were able to get that benefit that they were 
promised when they actually enlisted. That is where we are 
supposed to be.
    Which brings me to my next question, which is for you, 
General Roy. We talked to a lot of servicemembers, veterans and 
active, in regards to the recognition of duty, okay, to 
identify benefits. And I for one, we--ten percent of the 
population of Montana is veterans. So we are very, very 
concerned about these issues. And what I have also seen is the 
amount of reliance that the military has placed upon the 
National Guard to supplement all of their additional 
activities.
    Unfortunately, we have been involved in a lot of conflicts 
as of recent, and it has been very--placed a lot of pressure on 
the National Guard to help fill those voids. But the other 
conversation that everyone has is we have to be careful about 
the diminishing return on this investment, if you will, to make 
sure that we don't place the benefit level so high on the 
National Guard that we start drawing the enlistment, the 
incentive to enlist in the traditional or full active duty.
    And so I just would love to hear some feedback from you on 
this.
    Mr. Robinson. Yes, sir. That is a great question. But I 
would ask you to look at it from a little bit different 
perspective. If you look at the men and women who join the 
active component of any of the services, their average service 
is going to be between four and six years. Very few of those 
servicemembers are going to go on to receive a full retirement 
and stay in for 20 or 30 years.
    So what it does is, it makes the Guard and Reserve a very 
attractive option when they opt out of active service. When 
they leave active service, they want to move back to Montana, 
and they want to continue to serve in a uniform, we want to 
make it very attractive for the Guard and Reserve to be a great 
option for them to come in, and fill those ranks, and continue 
to serve.
    And if you think about everything that is involved, and the 
cost associated with training servicemembers throughout all the 
services, we want to retain that to the best extent possible. 
And the percent of those who come and serve in the Reserve 
components, National Guard and Reserve, they stay longer, and a 
much greater percentage of them actually qualify for retirement 
benefits, although at a reduced rate.
    So there is actually some goodness in trying to make the 
Guard and Reserve a more attractive place to go.
    Mr. Rosendale. And if, in fact, they had already served in 
full active military.
    Mr. Robinson. Correct.
    Mr. Rosendale. That makes sense. Thank you. Thank you very 
much. I appreciate that. Mr. Chair, my time is up. I would 
yield back. Thank you.
    Chairman Takano. Thank you. I learned something from that 
exchange, so thank you for that question.
    Representative Pappas, you are recognized for 5 minutes.

                       HON. CHRIS PAPPAS,
             U.S. REPRESENTATIVE FROM NEW HAMPSHIRE

    Mr. Pappas. Thank you very much, Mr. Chairman. And thank 
you to all of our panelists here today for some very compelling 
testimony, and for your service, and all of your advocacy work 
that I think is really important to our committee moving 
forward. So I appreciate that.
    I wanted to start with Brigadier General Robinson. And I 
appreciate your comments about zero cost TRICARE, about fully 
parity for members of the Guard and Reserve. I see this through 
the New Hampshire National Guard, that I come into contact 
with, who I know are continuously being called upon during 
times of national emergency and crises in New Hampshire. But we 
know they aren't always credited for those activations as they 
should be.
    I wanted to highlight a bill that I am introducing later 
this week. It is a companion bill to a bill that is in the 
Senate, the Record of Military Service for Members of the Armed 
Forces Act. It is going to ensure that all members of the 
Reserve components are provided the same DD-214 as other 
members of the Armed Forces following their retirement or 
completion of service.
    And so I know that you alluded to this in your testimony. I 
am wondering if you could talk a little bit more about the 
importance of a standardized form and what this would do for 
members of the Guard and Reserve.
    Mr. Robinson. Thank you for your question. We are working 
on this right now. So just think about the difficulty in those 
who have served, providing documentation to the VA for any type 
of service after they take the uniform off. If they have served 
in multiple services or multiple components, then it is a 
matter of going around and gathering up different documents to 
include the DD-214 from their active service, NGB Form 22 from 
their Reserve service or from the Guard Reserve--Service.
    So the idea that we could someday have one document that 
captured all the service of a servicemember, without regard to 
the service component or the actual component that they do the 
service in, or the geographic location where they do the 
service, either domestic or overseas, could be captured on one 
document that at some point in time could possibly be 
electronic, and it would be there for a very long period of 
time. As opposed to the servicemembers going around, or their 
families, when the need arises to prove that service, going 
around and trying to collect these documents from several 
different repositories across the country.
    So we think it would be a really good move for those in the 
National Guard who try to document their service with a form 
that all don't understand. But I also think it would be very 
positive for those who serve in multiple services and in 
multiple components, and the challenge of gathering and 
documenting that service. Thank you.
    Mr. Pappas. Well thank you for your comments and for 
highlighting why this is important. And I look forward to 
continuing to work with you on this issue, and hopefully 
building some significant momentum in the Congress to pass this 
really common sense piece of legislation.
    With my remaining time, I wanted to turn to Ms. Dane. I 
know that we are more than a decade now after the repeal of 
Don't Ask, Don't Tell, but we know that there are LGBTQ 
veterans who are still denied benefits and services, who have 
been caught up in everything--in the legacy, really, of that 
era.
    Last September, the VA took steps to remove barriers facing 
those veterans who are still unable to access benefits, but 
clearly we need to establish protections in law, which is why I 
have got a bill called the SERV Act that looks to make 
permanent access to VA benefits outlined by the Secretary.
    I want to thank your association and your leadership on 
this issue. And just wondering if you have any additional 
comments on steps we need to take to ensure that LGBTQ veterans 
are treated fairly and also feel comfortable receiving the care 
that they need through VA?
    Ms. Dane. Absolutely. And thank you for that question. We 
know that since World War II until the repeal of Don't Ask, 
Don't Tell in 2011, 144,000 servicemembers were discharged 
dishonorably or other than honorable, simply for being lesbian, 
gay, or bisexual.
    We know that less than 1 percent of those benefits have 
been restored. So it is critical that these veterans are seen 
and visible and get the honor and dignity that they deserve. 
And especially having their benefits restored.
    Our organization these past two years, I have worked with 
over--probably about 500 service members, trying to get those 
appeals and the benefits given back from them from the Board of 
Record Correction. To date, I have only seen one of those 
upgraded. One upgrade for petitioning the Board of Records 
Correction.
    We also--because of the pandemic, it exacerbated the wait 
time to actually get them. We saw members of our community die 
because they didn't have access to health care. And whenever 
they did die, they couldn't have access to their burial 
benefits.
    So what I--I have to tell families, I am so sorry, I--your 
family member served with dignity and respect, and we can 
appreciate that, but the VA says your duty, or your service is 
not valid. So we urge that the SERV Act be absolutely 
implemented. And we urge the VA to do this immediately without 
any hesitation, because we do need to restore dignity and honor 
to those servicemembers who served our country, and they are 
our American heroes.
    Thank you.
    Mr. Pappas. Well, thank you very much for those comments. I 
am over my time. But I do want to say that it is long past the 
time to right the wrongs of our history, especially when it 
comes to this group of veterans. So thank you for your 
comments. I yield back.
    Chairman Takano. Thank you, Representative Pappas. I now 
recognize Representative Ruiz for 5 minutes.

                        HON. RAUL RUIZ,
              U.S. REPRESENTATIVE FROM CALIFORNIA

    Mr. Ruiz. Thank you, Chairman. It took over two decades 
since our 9/11 veterans began to serve, but the House has 
finally passed a historic, comprehensive bill that will help 
veterans suffering from exposure to burn pits and other toxins.
    Last week, House members from both sides of the aisle came 
together and agreed that our veterans should not have to 
shoulder the burden to prove their illnesses are a result of 
their service to our country and exposure to toxic burn pit 
smoke.
    Now, it is the Senate's turn to act. While I understand the 
Senate has already passed a bill that would allow veterans an 
extra five years to apply for health care, it doesn't address 
the key problem, and it is missing an important--the most 
important key element in order to truly help veterans harmed 
from toxic exposures.
    Presumptions. Military studies based on the Gulf War on the 
health effects of open air waste burning can be traced back to 
the 1990s, when concerns about health risk began to rise from 
returning Gulf War veterans. Yet many continue to argue that 
more studies and reviews are needed before we can prove our 
veterans' illnesses are related to their service.
    As a physician and public health expert, I understand the 
necessities for studies and the importance of understanding the 
science behind an illness and disease, but that has been done 
here.
    The evidence has shown us time and time again that there is 
a connection between illnesses veterans are diagnosed with and 
their service near burn pits. Otherwise, healthy veterans with 
no increased risk factors are becoming delayed casualties of 
war, when years later they develop respiratory illnesses and 
cancers.
    We don't need more studies to understand why. Carcinogens 
cause cancer. Breathing noxious chemicals cause lung injury. 
Burn pits, toxic smoke contains toxic chemicals that harm lungs 
and carcinogens that cause cancer. We need to follow the 
evidence and presume service connection for all 23 illnesses 
listed in the Honoring Our PACT Act, which I call on my Senate 
colleagues to pass immediately.
    Our veterans cannot wait longer to get the health care that 
we owe them. My first question, Claire Manning-Dick, thank you 
so much and all the Gold Star Wives of America for your 
commitment to bring awareness to the inequities that exist and 
benefits for surviving spouses and children.
    As mentioned in your statement, the Gold Star Wives of 
America supports the Honoring Our PACT Act, which includes my 
bill, The Presumptive Benefits for Warfighters Exposed to Burn 
Pits and Other Toxins Act. Can you tell us why it is important 
to pass legislation that includes a presumption of service 
connection for illnesses and cancers?
    Ms. Manning-Dick. Yes. It is so important. This is just 
desperately needed. All of the--just going back to my husband, 
how hard it was for him to prove that he was exposed to toxic 
exposure.
    And it took years and years to--because we were denied 
several times. But now, you are looking at the burn pits and 
the things that the families are going through, especially--I 
can speak for the isolated areas, because we live so far out on 
the reservations, and we are not receiving a lot of the 
outreach and the services that we really need to get. And we 
need to have a better connection with the VA.
    The VA really needs to do a better outreach consistent of 
doing the paperwork and the studies and the science of the 
toxic exposure. And this is just something that is long time 
coming, and I am just so proud of you to have this 
encouragement. It is just a long time coming, and we are really 
supporting anything that you push----
    Mr. Ruiz. It seems to me, ma'am, that simply extending the 
time that veterans can apply for their health care doesn't 
solve the problem of the burden still on the veteran and having 
to fight the VA to prove that their service related cancer and 
chronic bronchiolitis and other lung injuries are due to burn 
pits; is that correct?
    Ms. Manning-Dick. Yes. Yes, definitely. That is correct. 
Yes.
    Mr. Ruiz. So would you say that the presumption and taking 
that burden off the shoulders of the veterans is the key 
element in addressing burn pits for our veterans today?
    Ms. Manning-Dick. Yes. Yes, definitely. We----
    Mr. Ruiz. Thank you.
    Ms. Manning-Dick. Thank you.
    Chairman Takano. Thank you, Dr. Ruiz.
    We are--I have got a hard stop at 1:30, but Ranking Member 
Bost, if you would like to take 5 minutes, please go ahead.
    Mr. Bost. Only to thank our witnesses for being here and 
thanking them for the hard work that they do every day for each 
one of their groups, organizations, and the veterans that they 
serve. And thank you so much for being here.
    Chairman Takano. Thank you, Ranking Member Bost. I, too, in 
my closing wish to thank all of the witnesses here today for, I 
know, the incredible work that you do. We have worked with each 
of you on legislation. Some of that legislation I know has 
already passed the 50 goal line.
    As I say, I think with respect to the Parity Act, we are 
within field goal range, but we are not going to settle for 
three points. We are going to go for the touchdown, and as I 
say, the two point conversion.
    So--and that is true also for the PACT Act and everything 
else, that we have got--that we put through the House, and we 
have got Ms. Brownley's legislation that is pending. I mean, we 
have got a lot of folks, a lot of people on both sides of the 
aisles that want to move stuff. It is going to be my ambition--
it is my ambition that we have a banner year for veterans under 
my watch. So but it is only going to happen--it only happens 
with you and your members, and your advocacy, and we take our 
priorities from you. So thank you for all the work you do.
    And with that, the joint committee hearing is now 
adjourned. Thank you.
    [Whereupon, at 1:24 p.m., the Joint Committee was 
adjourned.]

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