 All right. Hello, everybody. As you are joining us this afternoon, we are asking that everybody keep their microphones on mute. That way we can get through as many of the questions as we can as possible without any background noise. And what we're also going to ask you to do is all the questions that you have, we're going to ask that you put in the chat function. And we will get to each of those questions. So we're going to start out with about 20 minutes on VA benefits, claims and appeals, then about 20 minutes on VA healthcare and healthcare related issues. And then we'll spend the last 20 minutes on whatever else we have that comes our way or any additional comments that we need. So I want to thank you first for all joining us this afternoon. And if we were at midwinter like we would normally be, we would be having conversations with all of you throughout the hotel in the hallways in between meetings. Maybe in the bar, I mean the restaurant, maybe in the restaurant, we'd be having conversations when we run into each other, or even on Capitol Hill. Since we're kind of missing that interaction with all of you, this was a great idea by Peter, that we have this little time during our normal midwinter weekend to invite questions from all of you that you may have on our critical policy goals, any other issues or questions that you may have. So it's just an opportunity for all of us to get together, share information, answer your questions, and make it almost feel like that we're together in DC. And before we get rolling, I want to thank everybody for their BPTL contributions and recognize those winners that are with us from the Outstanding Advocacy Awards. And I believe that is Mr. Jim Shuey in Nebraska is with us. Mr. Wilner in South Carolina is with us. And I'm not sure if I see anybody of the other departments with us, but Al is here. Alabel, I saw him. Oh, well, we just always know Al, and we don't even bother of recognizing Alabel in Wisconsin. I mean, just kind of like an algebraic given. So why don't we go ahead and get this show rolling. So, again, please put your questions in the chat function and we are going to get to them. And before we do, let me just make sure everybody knows who's who with us today. As you know, Joy Elam, our legislative director for DAV. Jeremy Viannaueva, assistant legislative director. Ashley Burns, deputy communications director she's helped us on women veterans issues as well as caregiver. And with us is Peter Dickinson senior executive advisor. Unfortunately, a member of our staff is not with us this afternoon and that is Marky Bearfield. He had no family emergency and wasn't able to be with us this weekend. So, we can go ahead and get this show on the road and start by answering any questions that you may have in reference to benefits related to issues or any of our critical policy goals, and I've already got a few questions. Let me make sure I find them. So once again if you have questions throw them in the chat box we're going to keep the microphones turned off but it looks like one of the first questions. We have is a benefits related question and Jeremy I believe this question is for you. And this is how can Congress and DAV address the spike of veteran unemployment that our nation has currently seen caused by the coven 19 pandemic journey. Hey, more than every afternoon everybody usually used to doing these in the morning. Thank you that's actually a really good question. First, you know let me say, you know hello to everybody that's here. Hey, I know I didn't do this last time but there you go. Okay, it's no ginger ale because it's lent but you get the idea so well that is that is actually a good question and there's a couple things. I'll go with Congress. Since we've seen this, this COVID this pandemic related spike in veteran unemployment there's been a few things that have gone on. There's been of course, you know when it comes to some of the real the employment training and employment services that VA has like the irony there's been a whole place on it. But there's also if anybody's reacted and I hope everybody's signed up to the commanders action network, there's anybody reacted anybody's reacting to the latest alert that we sent out, which was about essentially the rapid retraining program that Congress is trying to get started. Now we have high hopes for our last Congress got really close to passing and be put out there with the retraining program. I'm not eligible for any other either education or employment services. And we're unemployed because of the coronavirus pandemic that that would get them back to work so that's something that Congress has been working on. As for DAV, you know, immediately and I can't say and I know I'm biased but I've been having been more proud with how quickly DAV started up the the COVID relief program the COVID the unemployment COVID relief program that we did do. And I wish I could give you better numbers that's for the service department but on the legislative side of the many things that we've been pushing for is that a permanent removal for the state for the RNA services for those service disabled veterans. And the reason for that is that a lot of these veterans who, you know, are going to be unemployed are going to be seriously disabled. And a lot of those employers that are going to be shuttered are going to be ones that have provided what we would call, you know, sheltered employment for these seriously disabled veterans. And they're going to need help not just any retraining but retraining that focuses and takes an account their service connected disabilities. And we believe that if they just remove the delivery date and open up what is already stood up a program that's already set up and has shown success that we could help more specifically services disabled veterans and immediately. So, some of the things that we've been looking at. That's awesome Jeremy thank you and actually I have we've got another question for you. And the question is what can we do to help spouses for entitlement to their data to the DIC benefits. If the death certificates only list the cause of death as COVID-19. Is there any anything going on in reference to that issue. You know that's, that's a really good question and something that we've been focusing in on. And really, you know, trying to point out to Congress from the beginning is that, you know, one of the, the issues that will arise and that they should have looked for. Is that a lot of these harried doctors who, you know these hospitals are overwhelmed. But when someone passes away from coronavirus they're just going to put on their coronavirus and not have some of the, the, some of the other factors being their service connected disability so that is a good call. And that is something that we brought forward to Congress. The senator senator cinema's office was pretty proactive in this and they released and I wish I had the bill number for me but also one of the alerts that we sent out, which was ensuring veterans survivors benefits act. What we're going to do is essentially that will, you know, make the VA provide a medical opinion to every service disabled veteran who passes away due to the coronavirus to list whether or not any of their service connected disabilities. In fact, we're contributory to their, to their cause of death cause of death we're really hopeful there's been a couple packages that that might have been a part of, and we're still hopeful that'll get passed sometime during this. Now, I would always say if you haven't done it already please share it like share that alert react to that alert send it around and understand how important this is. Now, that's to get that past if there's somebody that you know of that has a member of the family has passed away due to the coronavirus. And they were they did have service kind of disabilities, especially Vietnam veteran era, you know, veterans who were exposed to Asian orange, I would definitely have them and have them talk to DAB NSO or any NSO to see and talk them through their options, and seeing whether or not they can get their, their doctor to amend that death certificate to list whether they had diabetes or high blood pressure, or any lung condition that was caused by Asian orange. So that that would be my rambling, you know, opinion. And thanks, Jeremy. And that's one thing to remember if it's just COVID-19 on the death certificate. I can't stress this enough, the death certificate does not need to say the service connected disability cause of death, you can get a medical opinion from the physician so don't think we have to change the death certificate, because those are a little bit more complicated to get amended. So these are some of the other things that you can try to do until we get this piece of legislation hopefully passed that will automatically make them look at a medical opinion for cause of death with COVID-19 is to work with their physicians with driving spots to see if we can get a medical opinion that their service connected conditions cause or aggravated death. And those are kind of the key phrases we're going to look for so for those of you who have just joined us over the last few minutes. What we're doing is just a little Q&A we're asking you that you put your questions in the chat box we're going to spend the first 20 minutes or so on claims and benefits and then we're going to switch over to healthcare so I'm just going to be addressing specific to service connection and claims and appeals for the first few minutes and then we'll work on the other ones. Somebody asked if there is still money left in the COVID-19 relief fund and I just want to get that out there right away because I'm not exactly sure what that means. So let me just explain it in two ways. There's the DAV COVID relief fund for unemployed veterans. There's still money available for veterans to apply for the $250 grant through DAV's COVID relief for unemployment go right to the DAV website and there's a link on there for you to access that. Now the other COVID relief packages that DHA received there's still money there but we'll talk about that secondarily I want to focus on benefits real quick. And that is the toxic exposure space. We got a question in reference to what is currently going on with everything. Now, I hope everybody saw our critical policy goals that were posted to the website as well as watch the videos. So I'm not going to get into a lot of detail but somebody asked what about all current pending legislation or is there any new legislation for toxic exposures. And here's one of the great things that is coming up in reference to the burn pits exposure DAV's unique bill Veterans Burn Pit Exposure Recognition Act will be introduced in this Congress within the next two weeks from Senator's mansion and Senator Sullivan. So that's forthcoming and reference to K2 veterans, veterans who served at Kashi can canabad in Uzbekistan between 2001 and 2005, they were exposed to toxins as well. Senator Blumenthal is reintroducing a bill very soon we just saw a draft version of it. That is to point to presumptive service connection and healthcare benefits, specifically for K2 veterans. The Senate Veterans Affairs Committee also shared with us a draft piece of legislation to add hypertension as one of the presumptive diseases for Agent Orange. As you are aware, we did get a huge win. In the NDA last year, adding hyperthyroidism, bladder cancer, and Parkinson's ism related. We still have, in my opinion, two diseases left, hypertension and MGU, monoglomal, monoclonal gamopathy of unspecified origin. But those are two that we're working on. There is legislation that's going to be coming on that, as well as Senator Tillis will be introducing the team bill again this year. Senator Gillibrand will be introducing a presumptive benefits and diseases for burn pits as well. So there's a lot of movement of things coming and will be introduced over the next several weeks. So I just want to make sure everybody is aware that all of this toxic exposure legislation is coming very soon for the new Congress. Just reading through some of the questions, bear with me here. I want to make sure I deal with the service connection issues. And one is, I believe, we've got what is DAB and Congress doing to improve tribal and rural veterans with their submission of their benefits claims to VA. Actually, there has been in the works legislation for a very long time as well as several organizations are recognizing tribal service officers. Very similar to DAB chapter service officers. They are trying to get tribal service officers as a whole, as basically their own recognized POA entity across the board to help assist tribal service officers. And also they're looking into cross accrediting them with other major organizations to make it easier access for them to get claims training and access to assist those with those benefits. I didn't see anything else very specific to service connection claims and benefits. So we're going to switch a little bit over to healthcare real quick. And this is a big one and Peter, I believe this one is going to be you. And that is, what is DAB doing in reference to all of the deaths at VA nursing homes due to COVID-19. Thanks. That's obviously an important question. VA, which provides long term care support to veterans through three different ways, I think, as most of you know, VA runs itself nursing homes, they're called Community Living Centers or CLCs. VA supports state veteran homes, which actually provide most of the institutional long term care that they provide by providing partial support and the state provides partial support. And VA provides support to veterans who are able to go to contract community nursing homes. We shouldn't be surprised when we look at the pandemic, particularly early on, that most of the deaths were aware from COVID come to elderly people with underlying and chronic conditions, and that they more frequently have negative outcomes for men than women. So essentially you've described the population in nursing homes for veterans, which are predominantly men, very aged and have significant comorbid conditions. So early on, of course, there was a lot of deaths that occurred in a number of places, both in community nursing homes as well as state veteran homes. The VA's Community Living Center is fared better in large part because they're often attached to VA medical centers. They actually have a much higher standard of care because of that. For example, they have oxygen lines very often running right into their rooms are able to do a lot of things. So the CLCs have been a much done fared much better throughout. The problem with other nursing homes, whether they're state veteran homes or community homes is it is impossible to keep COVID essentially out of any place. And a lot of those facilities, particularly the older ones are built with multiple people in a room. Many of them also have dementia wards, and it's very hard to try to get people to stay within a room. So there's a couple of things that have gone on. They all have, of course, followed the guidelines both from CDC from CMS from VA, all of the facilities. There has been a greater look at reporting requirements from particularly state veteran homes to get the data. Congress has provided some significant support. They provided $150 million to help with emergency COVID grants last year, something we supported. Some facilities were able to apply for those grants to use them for things like negative pressure rooms again running as I mentioned oxygen lines, and other ways. Congress also at the end of last year, provided $100 million to support the operations. And the state veteran homes in particular, as they were frozen from admitting new veterans during COVID. They not only had their numbers going down as their people did pass away, both from COVID and other causes because of course that is what happens in long term care facilities they're often people's final resting places where they go. They had increased costs of COVID protection they had to address but they also had a loss of the federal support that comes based on a per diem basis. So Congress in the new COVID relief bill that they're now considering, and you've heard about this one this is the large package they talked about $1.9 trillion $2 trillion. It does have within it an effort to provide greater support to state veteran homes in particular $500 million for the grant program that helps support state home construction and $250 million to again make sure that the state homes don't suffer financially and therefore have to cut back on the number of veterans that they're willing to help. So DAV has been in contact regularly with VA in the long term care programs with the state veteran homes directly themselves. And we've certainly talked to the VHA about the community living centers. I think what's important to remember is, you are going to see more deaths in a location where the most vulnerable population is now there were some extreme examples obviously Holy Oak and Massachusetts is the one that's out there there's a broad investigation going on there. So that we do need to understand that what the situation is it's impossible to keep it out we couldn't keep it out of the most secure facilities in the country from the White House or anywhere else. You can't keep it out of any facility but in the long term one of the lessons we'll have to learn is how to build long term care facilities. I don't think they're going to build any facilities with four people to a room in the future. So, there's a lot of that type of thinking going on. Before we get into another healthcare question. I know there's a little bit of this in the chat box I'm going to clear it up about resolutions. I'm going to make this as clear as I can all the resolutions we currently use our resolutions that were passed at the last national convention we have upcoming for the upcoming convention, hopefully that we're going to be having in Reno in 2021 will only be able to consider resolutions that were passed by your department. So, long short answer is if your department does not have a department convention to approve resolutions, they cannot be considered at the national convention. So if your department does have a convention and does approve resolutions to go to the national convention, they will be considered for the upcoming year but again if your department does not have a convention, it cannot approve resolutions to be considered at national convention so I hope I cleared that up a little bit for everybody enjoy. We got a question I believe specific for you. And that is what is the, what is being done to get community care doctors access to veterans medical records from the VA medical sector. I think Shane. So, one of the issues as you know that VA is dealing with right now during this transition period with their electronic health record. The scheduling package all of the it changes that they're working on is to make sure that there's that interface with community care providers, some facilities right now, you know still are not able to do that electronically. In most cases, for example, if you get referred out, most facilities now have a community care office that handles all, you know, making those appointments getting your medical records to the clinical person who you're going to see in their network or community and getting those back. They're doing it in a variety of ways and it is different in various facilities, but the goal is through the it is to have that ability to do that electronically. I don't think that's going to be, you know, in the near future. You know, as they're just starting to roll out some of the electronic health record. You know, in one part of the, you know, the in the business in the north west. But we don't know yet how that rollouts exactly going to go there was just a GAO report there's been some, you know, issues but we're getting briefings on that but certainly it's an issue that, you know, we're keeping an eye on that's the goal to make it as seamless as possible when someone does have to go out in the to get care in the community, and that those records can, you know, go back and forth between VA and the community. Thank you very much, Joy. I have another question. This may be you or maybe Ashley or Peter, which I'll give you first crack at this one. Has the be looked into adult daycare being available to veterans, or is this something that should be considered as a resolution at an apartment level. Let me start that and see if they want to jump in. So, when you look at the long term care options, they range all the way from the institutional care at the facilities I talked about. Down to home based models of care, and there's a number of programs in there. One of those is adult day health care, which is essentially a way to provide in home care to a veteran on a day basis. They can get into a VA facility or a stay home facility, for example, so that the care caregiver can have the day essentially freed up and they can get care for the day inside a facility. There are. It is they don't sleep overnight but they're basically there during the day and they can be there, depending on their need from 123 up to five times a week. They do provide support for this they do provide it in state veteran homes. We do support more and more models of non institutional care for those veterans who have options to be able to stay in home if they can get support, whether it's this option to be able to bring in their loved one for example a couple times a week. So they can get sometimes it's just a matter of getting them bathed, you know, that is very difficult to do at home. Sometimes while they're there they can get their medications checked they can get various therapies and so forth so we are supporting that and we're supporting some other models in between one of those we call medical foster homes. So this is a model that rather than a large institutional facility. There are people who want to provide care with smaller facilities sometimes in a home, where they can take care of three to five to seven veterans and give them that support. They also get licensed in the same way and are subject to all the same inspections. And I will take this opportunity just to comment on something I did see I saw Joe put did put in a comment, and there is concern about what's being done to control state VA and state home nursing care, in regard to infection control, for example. And while there are individual instances where there are problems, understand that infection control is a regular part of what VA inspects what CMS inspects for those state homes that are also Medicaid supported what VA CLC does and what the community homes do. Remember every year they've got to fight the flu. Again, while the flu for a lot of people is not a major problem in a nursing home with elderly people with with a lot of conditions flu season is a regular battle each year. So there are certainly significant protocols in VA facilities and state home facilities, and if they were doing them in medical foster homes they would have to meet the same infection control. Can there be improvement, of course, or their instances where there are problems, undoubtedly, but by and large these facilities do do a pretty good job. Thank you very much Peter and actually actually we have a question. That's in your space, as they say, what is the current update on phase two for the caregiver expansion. All right, thanks Shane and I might look to Peter to back me up on some of this if I don't cover it all, but it's a good question. And there has been some movement Peter and I have been deep in discussions on on this issue so even just in the past week we've held some meetings with a few of the other VSOs to start gauging support for a push to expedite that second phase which again is May 7 1975 through September 11. So, we've gotten some good feedback so far it seems like there's definitely support within that community to make that push. So we have kind of a couple next steps. First we need to get a feel for how the program is currently working under the phase one expansion. So that's looking to see if we can have a you know if there can be a hearing to get that feedback from VA what's working and what's not. What do they still need as far as staffing and funding etc. And then from there we can start to address those things and determine the feasibility of initiating phase two. We also had, like I said, held a couple meetings last week with the staffs for Senator Patty Murray who, as you know was was a champion for the caregiver issue. And for with the staff from Senator Gary Peters office who actually introduced the team caregiver act, which among other things called for VA to to choose whether they would opt in or opt out of sending decision notification letters for that comprehensive caregiver program after a veteran had applied. And Peter you can correct me on the on the time frame there and it was 60 days from the implementation. And we're coming up on on that deadline for VA to make that determination of whether they will opt in or opt out so we're going to be engaging with them to see if they've made a decision as of yet. And if they have not made that decision. Certainly we will encourage them not to opt out of sending those notifications so long story short. You know, while we were very happy to see that severely ill veterans would now be included in the eligibility for that program, which is a change from what it was before was just severely injured veterans. So today's one expansion did begin this past October, albeit a year late. This issue isn't over for us so implementation of the provisions within the team act. And certainly, you know, if at all possible expansion of that phase two. We want to see that expedited, which would be October 1 of this year which was the original date that we anticipated it would happen again because VA did not certified their IT system. In a timely manner that we believed it which should have been done which would have put the initial expansion of phase one on October 1 2019. As we said it was a full year late so October 1 2020 was when it did open up to World War two Korean era and in Vietnam era veterans. So that two year gap is what they had originally set so that phase two should begin this October. And as it currently stands, it's it's looking like it will be October 1 2022. So that's, that's what we're trying to do is look to get that expedited up to this October. Awesome. Thank you very much, Ashley. Shane you're on mute. I know somebody else muted me. I know I'm a talker. I know I'm a little loud. I get that. But if you mute me I'm just going to log off and call it a day. But joy, we have another question for you and then I got a few more for Peter. Joy, what, what is the House and Senate Veterans Affairs plans this year on improving mental health and suicide prevention efforts. So, as most of you probably are aware, there were two major pieces of legislation passed last just at the very end of the 116th Congress, the compact act and the john Scott Hansen bill and coming out of the Senate. So, both of those are going to be from what we understand a focus on making sure that those provisions in there get implemented. There were a lot of things related both to suicide prevention efforts and VA's mental health services in general just improving access improving staffing timeliness to getting mental health services. One of the things that both the House and Senate Veterans Affairs Committee worked on that was included in that legislation is access to care through community partnerships. So trying to prevent suicide and veterans crisis that are related to other issues like maybe, you know, divorce loss of their home loss of their employment and loss of their home and other things. So they're going to be working with, there's going to be grants that will be authorized for some community partners who also going to do some work in the community so that veterans who are not using the VA health care system to see if they can capture them there, to the VA if needed, or provide services in the community so that will be they have told us, you know, a bulk of their time will be spent on just looking at that. You know, it will continue to be a priority issue though I mean they want to see these rates of suicide among veteran population start to decrease and they're looking for these other ways that that they can be addressed. So, I'll leave it at that. Thank you joy we did have a question about one those we're going to be implemented and I think that kind of takes care of both of those based on your comments so thank you very much. Peter I got a question for you. Understanding that we're still waiting on the market assessment. And that they have called for comments in section 203 of the mission actor the air act cyber security and the federal government has had a number of issues with agencies being attacked due to a third party. Is there an attempt to address this with respect to community care providers in the network will be exchanging veterans health record information, and will this have an impact on air commission as well. I got a question Richard. It's actually an extremely interesting question and one that I think is well time we actually have. Next week we'll be having a consultation with Dr stone who's continuing as the acting under secretary for health. There might be an opportunity to ask this question. Your point is, is well made. We've, you know, we've seen the big cyber hack, you know that occurred several months ago or we discovered several months ago. Parts of the parts of the federal government we've heard about potential cyber hacks to our utilities and our power grids and all sorts of things so the question becomes, what is the, what is the level of safety that VA is requiring of partners in the community, in terms of cyber security. And that will matter, not just exchanging personal information but also you know for veterans, make sure that they're as well protected internally through hippies they are when they go outside the VA firewall. So I don't have a good answer to are they protected I think it's a good issue to bring forward to look at it. And we'll just add a small comment to the, again, as you're aware Richard, others talking about that the part of the mission act which was to strengthen the VA health care system was also to perform an asset and infrastructure review to look at where all of the VA hospitals, you know, 172 medical centers 1240 odd outpatient clinics and a number of other facilities. What is their current condition. What needs to be done in terms of repairing rehabilitating them. What are the proper locations of the facilities for the next 1020 years. Do they need to be realigned. And how will this work, both with community care, but the question we've started putting forward is, what should health care delivery look like in a post pandemic world, assuming we ever get there. These are all part of what's an asset infrastructure review that started and under that law will take place over the next couple of years. The first step is federal register comments do back on May 1, looking at criteria by which VA will measure, in their opinion, what facilities need to be expanded, repaired replaced or potentially realigned or even potentially closed. So in the first step we do have concerns as part of what we put forward in our, if you've been able to see the videos online that we have on the critical issues. If you haven't certainly commend you to them on our midwinter 2021 webpage and maybe Ashley or Shane could put that in the chat. So everybody could have just a quick, quick, direct access to it. So we have concerns about the asset infrastructure infrastructure review that it's done properly, and we're concerned there, they may be rushing it now not taking into account the delays that covert is caused, and the delay in rolling out the mission act as someone asked a question how long as it takes to roll out a law. So given that we are looking to make certain that the timeline on that is proper we think it needs to be pushed back a year. And if you get that right if you don't have bad data and bad. If you have bad data bad analysis going in you're going to come out with bad results so we want to do that right, and it is important if we're going to properly fund VA, wherever we're going to get the right funding for construction and for via infrastructure. It'll be because we have a long term plan that was adopted with real input from all the stakeholders so so great question Richard. So maybe let's let's have the same conversation a couple months from now hopefully that'll be some more information we can dig out on that thanks. Thanks Peter appreciate it Richard thanks again for the question. Jeremy, I got a question for you as we've kind of gone through all the benefits and health care questions up to this point we've got a few more in and this one is for you sir. SPP DIC offset has been eliminated, and the DIC remarriage age has been lowered from 57 to 55. Will DAV continue to focus on these benefits, or will we be shifting our attention to other survivors benefits. You know, especially since you know SPP DIC isn't technically gone completely away yet. You know it's just beginning we will still, you know press as much as we can if the opportunity ever rises to make that an immediate end to that offset. Well, let me just focus in on the lowering of the remarriage age from 57 to 55 and then you know the the slow removal of the SPP DIC offset. First of all, you know we are of course I like we've, we've said ad nauseam I think is you know we are resolutions based organization, and our resolution specifically states about the SPP DIC offset that you know one we, you know we urge Congress to remove it and if it ever removed that we will. We will then look to remove the six year limitation on signing up for SPP. There was a lot of people who were told. And at that time that it was either or there was going to be an offset and that if you didn't sign up for it at that time. At that six year period. Well, the circumstances have changed now, and we will continue to advocate that folks can resign up for the SPP program now that there is no longer an offset. So there's that the lowering of the remarriage age same thing. I'm extremely happy that now that there is, you know, parody between, you know, federal employee benefits and DIC that, you know, if you get married at below the age of 57, you know at 55 then you still would retain the DIC. You know that's a great win for us it's something that we've been going for for a long time, however our resolution doesn't give a time period, it doesn't give an age limit. We will continue to advocate, you know, for lower remarriage age, you know, and look for that, you know, maybe in the, and the near future that you know we will be advocating for, you know, different ways to to accomplish that. But of course yes I mean, you know, we're we're very happy but we're not going to rest on our laurels there's still, you know the the 10 year time period for DIC eligibility that we will continue to hammer down on. So, you know, the, the increasing of the DIC benefit. And, you know, we don't think that it is a survivable, you know, compensation benefit we think that that definitely needs to get fixed. So the other survivor benefits that we're going to be focusing on now that have to do with COVID and, you know, the medical opinions and seeking searching for those for those who service connected veterans who die of the Coronavirus, and then, you know, the dependence educational assistance, you know chapter 35 the assistance with that and taking away that delimited date permanently. So we still got a lot of things to to work on. I wouldn't say that we're going to be focusing on one more than the other, you know, but look forward to it in the, in the near future. You know, we're hoping that there's going to be some bills that are coming out really really soon that's going to address a lot of these issues so awesome thank you very much Jerry for taking care of that question. I'm going to address something really quick and then we'll get into a few more questions. I saw a little bit of this in the chat box and I know this is on everybody's mind. Well they passed a lot of writing the three presumptives for Agent Orange. Why haven't they started making decisions yet anybody have that question. Oh, our department of South Carolina cares. Russi you guys are sleeping. Jim surely I saw you. So this is what's going on and if anybody is familiar with what happened the last time in 2010 they added three presumptive diseases to Agent Orange. And I'm just going to tell you this up front. It took 10 months from the time they made the announcement to the time they got the regulations updated and the ability to start granting benefits. Now that was in 2010. VA has just said that what they're doing right now any claim for hypothyroidism bladder cancer or Parkinson's ism related to Agent Orange. They are being deferred. They are not denying those claims right now they are deferring them for more information about how they need to proceed with promulgation. If they can grant any of those three diseases on a direct basis, not as a presumptive to Agent Orange, they will. But they're deferring all of those decisions at this time and again I believe it's because they're going to have to wait until they get regulations or authority from the secretary to go ahead and give them the authority to start making those decisions because I'm with you. There are so many veterans with those three conditions and you look at bladder cancer, many veterans with it don't have a lot of time. So the quicker they can get to promulgating these decisions, the quicker it'll be for everybody to get access to benefits and health care. So I agree. So we've got that and that's the current state of play we just got that information actually Friday. Because we've been asking a lot over the last month and a half as you can imagine, we've even heard stories that VA were denying those three benefits, because a law wasn't enacted yet and put into regulation. Now I believe that was just a vicious rumor. We haven't seen any of that within DAB's represented veterans, but they are currently deferring those cases for the time being. So I'm going to go ahead and shift gears to another health care related question. And actually I believe this one is going to be for you and I see you've got somebody helping you answer the question right now which is probably good. And that is DAB's new critical policy goal just doesn't include women veterans but underserved veterans and minority groups. What is the DAB specifically doing for rural veterans and Native American veterans and tribal veterans as far as access to access to the internet access to telehealth and just access for benefits. Yeah, so that definitely as you mentioned the expansion of our critical policy goal to include not just women veterans but also those underserved populations, racial and ethnic minority veterans as well as LGBT veterans as well. So we're looking across the board at a number of different factors and asking VA to kind of dig in and take a look at some of the cultural barriers that may exist like you mentioned if there's locations there's access issues, things like that. We're asking VA to make sure that they're doing a better job collecting data. We actually did happen to unearth a report the other day that sort of goes through a number of those. It kind of breaks down by gender, by race, the different outcomes and disparities that may exist across the board within healthcare for VA and so we're taking a look at that we're encouraging as per the critical policy goal for VA to do a better job collecting that data, analyzing that data and identifying areas where they can improve. Joy may have a few other comments as well on on more specifics of what they're looking to do but I did want to mention too there was a bill that was just introduced. It's it's somewhat covering that ground but also I know we'll go to the basement a second something that I think it kind of talks a little bit about mental health care and suicide prevention and specifically looking at how we do outreach to those populations that are underserved that the outreach may not be as strong and looking at how we can facilitate that messaging better to those communities and make sure that they have access to the resources that they need when it comes to mental health care and suicide. So Joy do you have anything else you might want to add there too. I would just add that there was the coven. I mean, excuse me the genomic be a just put out a press release on their new within the million veterans program their genomic database they're going to do a special project now looking at because they have the most diverse genomic database. So we're going to be looking specifically at outcomes for minority veteran population. So, this is exciting. This is exactly what we've been asking for, and, you know, VA's been following these things and got a lot of raw data now it's sort of putting it all together, and what can be done in terms of like Ashley said communications, but for proving improving access where are those barriers whether it be how they communicate cultural barriers language barriers mean there's just a number of things that can cause. You know this disconnect and we found that the high rates of service connected to say disabled veterans that use VA in both minor and various minority populations they're high users of the healthcare. So that's why we think it's it is extremely important for VA to be a real leader on that so yeah, and I and just one last thing in the rural or underserved communities. We're trying to see these partnerships with various other businesses, and even veteran service organizations where they have locations where people can come if they don't have access in their rural area. Maybe just a little bit closer than going to VA, but you know, a Walmart or various locations where they're going to try to set up these access points for telehealth or, you know, other functions that if they're if they're have issues with broadband. Thank you joy and that is very good point several VSOs, veterans organizations across the country are setting up points for that telehealth, as well as Walmart's around the country are setting up and becoming available to so there are a lot of options because yes there are a lot of veterans and rural communities like where I come from in the great land of Hey John go big red and so there is always an access issue and then when you look at Native Americans, it sometimes becomes even harder when there aren't a lot of resources, and if they're farther away from the communities. So we're going to have time just for a couple of more questions. And Peter, I have one for you, sir. And that is, what is being done about doctors who are let go from the VA, but have gone out and now have contracts with the VA. Thanks. Good question very timely I suspect the person. I think as Joe asked it saw that there was a GAO report that just came out generated a couple stories about healthcare providers who were disqualified from providing Karen be a, but may be able to find their way through one of the community contracts or the community providers as part of the network with triwester optum. So that was something that was anticipated in the mission act when that was being brought to Congress and past was how to make certain that if someone is disqualified from practicing medicine and VA that we make sure that they don't then turn up inside a community providers office, which goes around it. And what the GAO report found was a couple things. One was that this is primarily a question of working through the two major, what they call third party administrators. That's triwest and optum, and they're required to make certain that every one of the providers that they credential to be part of the veteran care networks that they operate has a valid license and it's not been disqualified. What they found was that in some cases, while the clinician might apply to be part of the network and I think it might have been one or both of the two big optum and triwest. And they were licensed in the state of Nebraska, for example, since Big Red is out there to provide community care that they were only checking had they ever been lost their license or had other issues in Nebraska, rather than checking all 50 states. The GAO identified a vulnerability which was that they may have lost their license to practice in, again, Florida, but they showed up in California as part of a local community care network. So that's one issue the other issue was how often they were checking. So they would run essentially this report on all of their providers but then there could be a gap in between. The GAO report just came out. I actually haven't read the whole thing I had taken a look at the summary. It's something that we'll be looking at to see what else is needed clearly there is steps needed to tighten this up. So it is a good topical question is something we'll be following up on thanks. Thank you very much Peter I really appreciate it and I think we've got time just for a couple of more. And it looks like we've got the first one from the great state of Alabama. And that is joy I think this might be for you something that may be of help specifically on veteran suicide issues is all the work that is currently being done by I don't know what your acronym means Chad, maybe six six letters I don't know what that means so we'll call it the s a m h s a through the governor's challenge on veteran suicide. So I'm not really sure what the specific question is since we're not familiar with that program because it sounds like it's specific to Alabama, but joy. Is there anything that you can provide on other programs are looking at to help with that. Yes, and so that that stands for SAMHSA, the state and mental health services anyway. Specifically on veteran suicide issues is all the work can only be done. The governor's challenge, something that may be of help specifically. So I know with this outreach is far and wide so it's a really a public health model that the state is adopting on the suicide prevention efforts with grants and I know they're working with other federal partners, state partners, local entities. So I think the door is open to all comers, you know, who are interested in trying to, support support that mission is going to be going through and looking at those the grants that, you know, request that come in. So it wouldn't surprise me that they would be, you know, working with SAMHSA who obviously is, you know, an established person in the community, you know, in the states in the communities. And I don't know that we're going to have an awful lot of time left, but there is one issue I wanted to address real quick there was a comment or a question in there, specific to proposals to reduce veterans benefits from a CBO score in 2018, Richard, not concerned about 2018. Well, why is that you're thinking, well Richard they came out with a new report in December of 2020. So CBO comes out with the report. CBO is the Congressional Budgetary Office. CBO is an agency within Congress. And every two years they come out with a new report. That's called deficit reduction measures. So these aren't laws, these aren't bills. These are options for the federal government to save money. And guess where they look. Oh my God, you're right. Veterans benefits. They look at veterans benefits. And in the recent report from 2020 and I'm just going to touch on some of those real quick. This is part of our critical policy goal for 2021. If you haven't checked out our critical policy goals, you should go to the link for midwinner. The critical policy goals are there as well as we talk about this in the video. One of the first recommendations CBO is making to save money is we need to eliminate IU for all veterans who reach age 67. That's right. It's time to get rid of all you freeloading veterans who don't want to work and just take money once you hit retirement age. Now of course, this is a horrible idea. And it's arbitrary and here's why it's a very arbitrary idea. But all they're saying is, if you meet the age of 67, which is Social Security retirement age, that means you have other options. Okay. How many veterans do you know are entitled to Social Security retirement benefits, because they've been on IU so long and haven't worked that there is nothing in there for them that they're eligible for. Anybody know veterans like that? I know a ton of them like that. Or they've never had a job in the civilian world long enough to get a pension or retirement from a civilian place, right? I know lots of veterans like that too. So this idea is purely, purely monetary savings. There's no other logic behind it. Now, ask me, Shane, what's the average age of members of Congress? I'm 67. So they're going to decide that veterans should stop getting benefits and work at 67, but some of them are in their 80s, just saying it doesn't quite sound right. One of the other ideas in that CBO report, are you ready? If a veteran's only 10 or 20%, they want to stop paying them benefits. Period. 30% higher or all those who should get a payment. Rest of you that are just getting your 10 and 20%, whatever, that was one of the recommendations in the CBO report. And the reason I bring these up is not because they're being introduced into law. We need to be aware of these things because these ideas do find their way in conversations on the Hill. The IU issue was a part of the former President Trump's budget proposal in 2018 to reduce IU on veterans at the age of 65. That's why we need to be mindful of these. One of the other ideas they have is how many retired veterans are out there right now on this call? Who's a retiree? Who are retired? Well, one of their ideas is once you hit retirement age, reduce all of your VA benefits by 30%. Period. And I'm sure you guys are okay with that. You don't need that extra 30%. Oh, you do. See, these are the horrible ideas that are out there. And one more that I'm going to share with you, and this is the cherry on top. They want to make all VA compensation and pension payments taxable, a proposal to remove tax-free status on VA compensation and pension, because it's more important that we save them a few bucks on veterans benefits on our backs than anywhere else. Richard, I know you asked about the 2018 report. We're talking about the 2020 report, because some of those proposals overlap, but some of them are even more disturbing, especially if you're only 10 or 20%, you're not going to get paid anymore. Or when you retire, we're automatically going to take 30% of your pay, your compensation, which one has nothing to do with the other, not even close. These are the things we're trying to make part of our agenda for 2021 in protecting veterans benefits and claims. So I'm not going to take any more questions at this point. If you have questions, remember our contact information is available on the website. For midwinter, there's a link in there for our information. So if there's additional questions you have, please let us know. I want to thank you all for coming. I know it wasn't quite the same banter we get at midwinter with us standing in the hallway or standing out in the smoke pit. For those of you who smoke and share a laugh and a joke and talk about benefits. Before we close out, I want to pass this over to our legislative director and let Joy close this out with any additional comments for everybody. And again, thank you all for attending. I hope you found this informative. Thanks. Thanks so much for moderating Shane. I hope everybody got at least one question answered but if not, please, as he noted, please check out the web page for midwinter. You're going to find all kinds of resources there we take videos of each critical priority goal. Our critical priority goals, legislatively for the 117th are up there you can print a copy. We've got our contact information so lots of information to and the presentations for our award winners are outstanding performance and advocacy. We've got a congressional award so far so far. So we thank Ashley and her team for helping coordinate that this year. And we hope you guys will take a look at it and remember we still need to make sure we're advocating for, you know, our legislative goals for this year and so although it's going to be done virtually, we know our members, all of you are going to be the lead on that and you're going to be able to get the departments and chapters. And I think Ashley and I were just going back and forth we're hoping to be able to post the video. So others can listen to the questions and answers but you all have a good evening thanks for joining us, and we will see you soon we'll be having our webinar calendar setup, shortly and putting those out so you can set some dates aside for additional times to the next team. Thanks everyone. Thanks. Thanks everybody appreciate it.