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Congressman Tim Ryan Applauds Passage of Military Construction and VA Appropriations Bill

May 10, 2019
Press Release

Washington, DC – Congressman Tim Ryan (OH-13) applauded the Appropriations Committee for passing the Military Construction, Veterans Affairs and Related Agencies funding bill on Thursday. As a member of the MilCon-VA Subcommittee, Congressman Ryan secured funding for a veteran suicide prevention grant program, to address and treat Adverse Childhood Experiences (ACEs) within the veteran population, and for other initiatives aimed at expanding and improving physical and mental health treatment for our veterans.

“As a member of the Military Construction and Veterans Affairs Subcommittee, I understand the importance of taking care of our veterans when they come home. This funding bill not only ensures they have the proper resources and tools to heal, but honors the commitments we made to them for their service,” said Congressman Ryan. “Whether it’s expanding veteran outreach to critical programs and services, increasing funding for suicide prevention efforts and mental health treatment, or upgrading health and wellness centers, we have a responsibility to provide our veterans with the care they deserve.”

The following is a list of provisions that Congressman Ryan championed and which were included in the FY2020 MilCon-Va Appropriations Bill:

1. Veterans Service Organization (VSO) Wellness Pilot Program
The bill extends the VSO Wellness Pilot Program for another 2 years.  This permits the VA to make grants to nonprofit Veterans Services Organizations recognized by the Secretary in accordance with section 5902 of title 38, United States Code, to upgrade, through construction and repair, VSO community facilities into health and wellness centers and to promote and expand complementary and integrative wellness programs.  It expands veteran access to wellness programs and expands complementary and integrative health promotion.

2. VetsCorps Pilot Program, $5,000,000
It is well known that an average of 20 veterans die from suicide every day.  14 of the approximately 20 veterans who die by suicide daily have not received care through the Department, which shows that existing prevention efforts will fail to reach the majority of those in need.  The report directs the Department to create a pilot program, carried out over a 2-year period, establishing a VetsCorps.  This Corps will be designed to reach veterans wherever they are and provide a personal connection to the VA. The pilot program shall be carried out at no fewer than six sites, targeted to regions with low rates of VA utilization and including at least one rural and one urban site.  At the conclusion of the pilot program, the Department shall report to Congress on the effectiveness of the pilot program at reaching veterans, particularly those in need, and increasing utilization of VA services and evaluate the cost-effectiveness of the program compared to existing outreach efforts.

3. Whole Health Expansion
The report recognizes the remarkable work that the Office of Patient Centered Care and Cultural Transformation is doing to approach veteran health with an integrative effort. Yet, only 18 Flagship Whole Health facilities exist that are implementing the Whole Health System. Early data indicates that veterans who are using Whole Health are using less opioids and derive greater satisfaction and meaning in their lives. The report directs the Department to submit a report to Congress on the outcomes derived from the Whole Health System and the resources needed to expand the Whole Health System across the Department.

4. Posttraumatic Growth Pilot Program
The report encourages the establishment of a pilot program to study the effectiveness and benefits of non-profit posttraumatic growth programs to determine the outcomes of such programs in contrast to traditional models of mental health care, the possible integration of such nonprofit programs into the mental health care programs provided by the Secretary, and the budgetary impacts of such integration. 

5. Art Therapies, $5,000,000
The report acknowledges the effective use of the creative arts therapies in treating veterans with traumatic brain injuries and psychological health conditions.  It supports the integration of the arts and creative arts therapies done by the VA’s Office of Patient Care and Cultural Transformation through the Whole Health initiative and encourages VA’s continued partnerships with healing arts providers.  The report supports the Secretary in continuing to expand these innovative programs throughout the Veterans Healthcare Networks and provides an additional $5,000,000 to do so.

6. Adverse Childhood Experiences
The report recognizes that Adverse Childhood Experiences (ACEs) exist within the veteran population at a substantially higher rate than in the general public. These experiences correlate with significant negative health outcomes, including on behavioral, mental and physical health. The report encourages the Department to track ACEs among veterans and target individualized treatment. To ensure appropriate treatment from the moment a veteran enters the VA, it is critical that the VA coordinate with the Department of Defense to obtain information on ACEs from service members and provide a seamless transition in care.

7. Collaboration to Address Rare Cancers
The report directs the Department to issue a report on the collaboration between the Department, the John P. Murtha Cancer Center at Walter Reed National Military Medical Center, and the National Cancer Institute and how it will address rare cancer, including molecular subtyping, systemic research and development gaps, and inadequacies in targeted treatment options.  There are 55 cancers that disproportionately affect those serving in the military and 67 percent of them are rare. Of the 396 total cancers, 374 are rare and few treatment options are available. Military personnel are uniquely exposed to carcinogens, including asbestos, industrial solvents, nuclear radiation, depleted uranium, lead, fuels, PCBs, and components of Chemical Agent Resistance Coating, all hazards that may increase the risk of cancer for military personnel and veterans.

8. Hospice Care for Vietnam Veterans
Public Law 115-244 directed VA to undertake a pilot program to develop techniques, best practices and support mechanisms to improve end-of-life care for combat veterans and Vietnam-era veterans. Additional progress is needed by the VA for the pilot program.  This report directs VA to contract with a non-profit hospice care provider with Vietnam veteran-centric programming for the purposes of improving care in the near term through a regional care project.  Organizations such as the non-profit National Partnership for Hospice Innovation and non-profit hospice centers are developing programs designed to meet the specific end-of-life care needs for Vietnam-era veterans today. Such an approach could be beneficial to Iraq, Afghanistan, and Syria combat veterans in the future.

9. Veteran Suicide Prevention Grant Program, $3,000,000
The report provides additional funding to continue and broaden efforts to coordinate veteran suicide prevention efforts under the PREVENTS Initiative.  A primary focus of these efforts is to engender collaboration across public and private sectors to end the national tragedy of suicide, including the use of public-private partnerships. This is a strategy that is vital to address critical mental health issues in our veteran population. The VA established a public-private pilot program in six states and the District of Columbia to address the causes and contributing factors that lead to suicides among our veteran populations. Because firearms were used in nearly 70 percent of all veteran suicide deaths, an important focus of the pilot program includes the safe storage of firearms.

10. Vietnam Era Veterans Hepatitis C Outreach Testing
The report notes that the prevalence of hepatitis C is higher among military personnel, but that prevalence data for the cohort at greatest risk, Vietnam Era Veterans, remain unknown. VA is encouraged to work with other stakeholders and veteran services organizations to conduct an outreach testing campaign that establishes the prevalence number for this cohort while evaluating point-of-care testing opportunities that can reach veterans outside of the VA system.

11. Interactive Patient Care
The report notes that a third of VA Medical Centers are implementing the Whole Health initiative through interactive patient care, a model that empowers patients and educates them on the care they receive. Interactive patient care implementation has shown increases in patient satisfaction and improvement in quality and safety outcomes.  VA is directed to expand use of interactive patient care through use of a national contract to ensure coordination and standardization of field implementation of the Whole Health initiative.

12. Interactive patient care beyond the inpatient setting
The report supports Whole Health as a model of care delivery at all points of care whether in VA facilities, in the community, or at home.  Several VA Medical Centers are implementing the Whole Health model through interactive patient care, but there is concern about how the Department will ensure the Whole Health model is sustained when the veteran is outside of the VA inpatient setting. To achieve success, the VA must facilitate the veteran’s care team’s ability to provide the same consistent and collaborative patient engagement and interactive patient care outside of VAMCs and enable the veteran and the veteran’s care team to be actively involved in the veteran’s Whole Health Plan.  The Department is directed to leverage technology to facilitate management and adaptations of the veteran’s Whole Health Plan, ongoing communication, and awareness of additional VA services to support fulfillment of the Whole Health Plan.