After a long delay, Congress approves a bill to provide care for more vets, expand the VA workforce, and create new facilities

A measure to expand benefits for veterans who become ill from exposure to burning fireplaces while on active duty is set to become law after the Senate approved the bill on Tuesday, which will also authorize new radical authorities to hire and retain employees to manage the outcome. increased use of the public health system.

The Honoring our Promise to Address Comprehensive Toxics (Honoring Our PACT) Act (S. 3373), which will deem, for the purposes of eligibility for care at the Department of Veterans Affairs, that 23 respiratory illnesses contracted by veterans are related to fire pits used in the military, is now heading to President Biden for his signature. The measure won, nearly lost, then regained bipartisan support after Senate leaders struck a landmark deal earlier this year. Veterans’ advocates believe millions of veterans could potentially become newly eligible for VA care under the legislation, leading lawmakers to include provisions in the measure to boost hiring, recruitment, compensation and bonuses for the department.

The bill took years to draft, as advocates and some lawmakers pushed for recognition that exposure to fires the military used to dispose of toxic and other waste causes cancer and other diseases. All veterans claiming related illnesses will have access to new exams at VA, which will establish a task force on how the department handles toxic exposure claims in the future.

The legislation survived several near-defeats, despite lawmakers’ overwhelming support for the bill. In June, the Senate passed the measure with all Democrats and a majority of Republicans supporting it. Due to a procedural issue, the Senate was forced to vote on the bill again. Twenty-six Republicans reversed their vote, leading the measure to fall short of the 60 votes required for passage. These lawmakers cited a provision that moved $400 billion in VA funding from the “discretionary” part of the budget that is newly allocated each year to the “mandatory” side, saying it would free up more funds in the future for Democrats can advance unrelated priorities. . The provision was not new, leading some Democrats to question whether Republicans were demanding a rematch after the majority party unveiled its highly anticipated tax reform and climate spending bill.

Senate Majority Leader Chuck Schumer, DN.Y., allowed a vote on an amendment introduced by Sen. Pat Toomey, R-Pa., that would have reallocated funds to the discretionary portion of the budget, but the measure was rejected. . VA Secretary Denis McDonough had warned that the amendment, which capped healthcare spending related to burn outbreaks, would lead to rationing of care for veterans.

The larger bill authorizes leases for 31 new VA medical facilities to help meet an expected surge in patients, which is expected to cost nearly $1 billion. The Congressional Budget Office found that the payroll and other human resource changes would cost $5.7 billion over the next decade.

The bill will authorize the department to buy out medical professionals’ contract to recruit them to VA, as long as they commit to the department for four years. VA will have $40 million per year available for buyouts. VA healthcare employees will be eligible for pay raises worth 50% of their base salary, up from the current cap of 30%. The overall salary would be capped at level two of the executive service pay scale, which is currently $203,000 per year. McDonough called lifting salary caps essential to VA recruitment and retention efforts and aggressively pushed Congress to pass the reform.

Buyouts to hire private sector staff caused a first sticking point earlier this summer, as the provision makes the benefit non-taxable and any changes to the tax law must come from the House. While the House previously passed its own version in the PACT Act, this benefit was added on the Senate side. Ultimately, the House passed a revised version of the bill that removed the tax portion of the new benefit and returned it to the Senate, where it was to pass. Instead, dozens of Republicans who voted to approve the bill weeks earlier decided to vote against it.

The measure would remove salary caps for all employees whose facility is closing, potentially creating widespread use of retention incentives as VA tries to close or consolidate hundreds of medical centers and clinics across the country. It would also remove caps for employees providing care to victims of combustion fireplaces. McDonough has implemented initiatives to strengthen child care subsidy eligibility, increase retention incentives, and create new career paths that will lead to more opportunities for promotions and raises.

The bill will remove the $360 million aggregate bonus cap currently set for VA for the next two years. This will facilitate the process of distributing recruitment and retention incentives and allow for salary increases for employees with critical skills. It will also allow VA to pay up to $100,000 for an employee’s student loan repayments and hire recent graduates on an accelerated basis.

VA will now create a rural recruitment strategy in consultation with each medical center and outpatient clinic. The department will work with the Office of Personnel Management to establish the qualifications of each human resources professional and standardize performance measures for them. It will also limit enforcement requirements for veterans’ preference for housekeepers, which House lawmakers have called “one of the most understaffed and hardest-to-hire positions at VA facilities in the world.” across the country”.

President Biden has already welcomed the bill and encouraged lawmakers to move quickly to pass it. Biden has speculated that his son Beau, who died of brain cancer after serving overseas near burning fireplaces, was affected by toxic exposures.

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