S. HRG. 115–616 HEARING ON PENDING LEGISLATION HEARING BEFORE THE COMMITTEE ON VETERANS’ AFFAIRS UNITED STATES SENATE ONE HUNDRED FIFTEENTH CONGRESS SECOND SESSION AUGUST 1, 2018 Printed for the use of the Committee on Veterans’ Affairs ( Available via the World Wide Web: http://www.govinfo.gov U.S. GOVERNMENT PUBLISHING OFFICE 34–881 PDF WASHINGTON : 2019 COMMITTEE ON VETERANS’ AFFAIRS JOHNNY ISAKSON, Georgia, Chairman JERRY MORAN, Kansas JON TESTER, Montana, Ranking Member JOHN BOOZMAN, Arkansas PATTY MURRAY, Washington DEAN HELLER, Nevada BERNARD SANDERS, (I) Vermont BILL CASSIDY, Louisiana SHERROD BROWN, Ohio MIKE ROUNDS, South Dakota RICHARD BLUMENTHAL, Connecticut THOM TILLIS, North Carolina MAZIE K. HIRONO, Hawaii DAN SULLIVAN, Alaska JOE MANCHIN III, West Virginia ROBERT J. HENKE, Staff Director TONY MCCLAIN, Democratic Staff Director Majority Professional Staff Adam Reece Gretchan Blum Leslie Campbell Patrick McGuigan Maureen O’Neill David Shearman Jillian Workman Minority Professional Staff Dahlia Melendrez Cassandra Byerly Jon Coen Steve Colley Simon Coon Michelle Dominguez Amy Smith (II) CONTENTS AUGUST 1, 2018 SENATORS Page Isakson, Hon. Johnny, Chairman, U.S. Senator from Georgia ............................ 1 Brown, Hon. Sherrod, acting Ranking Member, U.S. Senator from Ohio .......... 2 Boozman, Hon. John, U.S. Senator from Arkansas .............................................. 20 Sanders, Hon. Bernard, U.S. Senator from Vermont ........................................... 29 Manchin, Hon. Joe, III, U.S. Senator from West Virginia ................................... 31 Cassidy, Hon. Bill, U.S. Senator from Louisianna ................................................ 36 Hirono, Hon. Mazie K., U.S. Senator from Hawaii ............................................... 38 Sullivan, Hon. Dan, U.S. Senator from Alaska ..................................................... 40 Tillis, Hon. Thom, U.S. Senator from North Carolina .......................................... 45 WITNESSES Peters, Hon. Gary C., U.S. Senator from Michigan .............................................. 3 Gillibrand, Hon. Kirsten E., U.S. Senator from New York .................................. 4 Prepared statement .......................................................................................... 5 Daines, Hon. Steve, U.S. Senator from Montana .................................................. 6 Lawrence, Paul R., Ph.D., Under Secretary for Benefits, Veterans Benefits Administration, U.S. Department of Veterans Affairs; accompanied by Ralph Erickson, M.D., M.P.H., Dr. PH, Chief Consultant, Post-Deployment Health, Veterans Health Administration, Tammy Czarnecki, Assistant Dep- uty Under Secretary for Health/Administrative Operations, Veterans Health Administration; and Jessica Bonjorni, Acting Assistant Deputy Under Secretary for Health for Workforce Services, Veterans Health Ad- ministration .......................................................................................................... 8 Prepared statement .......................................................................................... 10 Additional views ............................................................................................... 26 Response to request arising during the hearing by: Hon. Johnny Isakson .................................................................................... 27 Hon. Mazie K. Hirono ................................................................................... 40 Response to posthearing questions submitted by: Hon. John Boozman ...................................................................................... 47 Hon. Sherrod Brown ..................................................................................... 47,50 Hon. Joe Manchin III ................................................................................... 48 Hon. Mazie K. Hirono ................................................................................... 49 Nuntavong, Chanin, Director, National Veterans Affairs & Rehabilitation Di- vision, The American Legion ............................................................................... 54 Prepared statement .......................................................................................... 56 Manar, Gerald T., Blue Water Navy Veteran, Former Director, National Veterans Service, Veterans of Foreign Wars of the United States .................. 69 Prepared statement .......................................................................................... 71 Snee, Thomas J., National Executive Director, Fleet Reserve Association ........ 77 Prepared statement .......................................................................................... 79 Weidman, Rick, Executive Director for Policy and Government Affairs, Viet- nam Veterans of America .................................................................................... 81 Prepared statement .......................................................................................... 83 APPENDIX Cantwell, Hon. Maria, U.S. Senator from Washington; prepared statement ..... 91 Feinstein, Hon. Dianne, U.S. Senator from California; prepared statement ...... 91 Advanced Medical Technology Association (AdvaMed); prepared statement ..... 92 (III) IV Page Appraisal Institute (AI); letter ............................................................................... 94 Webb, Amy, National Legislative Policy Advisor, American Veterans (AMVETS); prepared statement ......................................................................... 95 McClain, Hon. Tim S., Chairman, Board of Directors and James Lorraine, President & CEO, America’s Warrior Partnership (AWP), Augusta, GA; prepared statement .............................................................................................. 100 Johnson, Cinthia, Interim Executive Director, Connecticut Veterans Legal Center (CVLC); prepared statement ................................................................... 103 Villanueva, Jeremy M., Associate National Legislative Director, Disabled American Veterans (DAV); prepared statement ................................................ 109 U.S. Department of Defense (DOD); prepared statement .................................... 119 Denton, Ivan, Director, Office of National Programs, Veterans’ Employment and Training Service, U.S. Department of Labor (DOL); prepared statement .............................................................................................................. 123 Mortgage Bankers Association (MBA); prepared statement ................................ 129 Military Officers Association of America (MOAA); prepared statement ............. 133 Military Order of the Purple Heart (MOPH); prepared statement ..................... 138 Wells, CDR John B., USN (Ret.), Executive Director, Military-Veterans Advo- cacy (MVA); prepared statement ........................................................................ 139 Mendenhall, Elizabeth J., 2018 President, National Association of REAL- TORS® (NAR); letter ........................................................................................... 145 Murphy, Sharon L., President, National Association of State Veterans Homes (NASVH); prepared statement ............................................................................ 146 Stewart, Joshua, Director of Policy, National Coalition for Homeless Veterans (NCHV); letter ...................................................................................................... 147 Co-Directors, National Military and Veterans Alliance (NMVA); letter ............. 149 Paralyzed Veterans of America (PVA); prepared statement ................................ 150 Augustine, Ms. Lauren, Vice President of Government Affairs, Student Vet- erans of America (SVA); prepared statement .................................................... 155 Tragedy Assistance Program for Survivors (TAPS); prepared statement ........... 159 Bandzul, Thomas, Esq. Legislative Counsel, Veterans & Military Families for Progress (VMFP); prepared statement ......................................................... 161 Bardorf, Rene´ C., Senior Vice President of Government and Community Rela- tions, Wounded Warrior Project (WWP); prepared statement ......................... 164 HEARING ON PENDING LEGISLATION WEDNESDAY, AUGUST 1, 2018 U.S. SENATE, COMMITTEE ON VETERANS’ AFFAIRS, Washington, DC. The Committee met, pursuant to notice, at 2:32 p.m., in room 418, Russell Senate Office Building, Hon. Johnny Isakson, Chair- man of the Committee, presiding. Present: Senators Isakson, Boozman, Heller, Cassidy, Tillis, Sul- livan, Sanders, Brown, Blumenthal, Hirono, and Manchin. OPENING STATEMENT OF HON. JOHNNY ISAKSON, CHAIRMAN, U.S. SENATOR FROM GEORGIA Chairman ISAKSON. Good afternoon. I call this meeting of the Senate Veterans’ Affairs Committee to order. This is a hearing on legislation that will be pending before the U.S. Senate at some point in time in the future, in some cases the near future. I have had conversations with the authors before and told them that we would have a hearing as early as I could have one so we could get the preliminary information out there. I appre- ciate everybody who is here today from both the Senate and the members of the VA, plus VA staff and the advisory committees. We have a full agenda. We have 15 pieces of legislation to ad- dress. We have two panels with four speakers each. We have a number of big issues, but probably no bigger