Veterans Affairs Secretary Denis McDonough is encouraging eligible veterans to submit claims for new benefits and treatment opportunities available under the newly passed “Honoring Our Promise to Address Comprehensive Toxics” legislation — better known as the PACT Act.
“This is (the) largest expansion of access to care and to benefits, at least since the Agent Orange Act and arguably ever,” McDonough said this week during an interview with the Honolulu Star-Advertiser. “Concretely, what that means in Hawaii is there are at least 53,000 vets, we assess, (who) will have access to a greater amount of care and greater benefits as a result of the PACT Act,” he said, adding that at least 22,000 of those are vets who have yet to enroll in VA services.
McDonough was in Hawaii to testify at a congressional field hearing at the Oahu Veterans Center chaired by Hawaii’s U.S. Sen. Mazie Hirono on Wednesday where he discussed the new law as well as the VA’s efforts to address staffing shortages and expand treatment. He also toured island facilities and met with veterans and care providers.
Among other things, the PACT Act, which became law in August, expands and extends VA health care eligibility for veterans who sustained ailments tied to toxic exposures during the Vietnam War, Gulf War and in post-Sept. 11, 2001, military conflicts.
The law adds more than 20 new presumptive conditions related to burn pits and other toxic exposures and more presumptive- exposure locations for Agent Orange and radiation. Burn pits were used used in Iraq and Afghanistan to dispose of chemicals, tires, plastics, medical equipment and human waste on military bases. Estimates of affected troops run to 3.5 million. However, 70% of disability claims involving exposure to the pits were denied by the Department of Veterans Affairs, according to reporting by The Associated Press.
Also, the PACT Act requires the VA to provide a toxic-exposure screening to every veteran enrolled in VA health care.
McDonough said that statistically, veterans who receive care from VA have better health care outcomes than those who opt out of the services. But in Hawaii many veterans complain that accessing that care has proved difficult as they battle both bureaucracy and geography. Some veterans residing here travel long distances to get services, sometimes traveling interisland for appointments, and have contended with long wait times.
“Some people feel distrustful of us … and some people don’t want to have to go through that hassle. I don’t blame them,” said McDonough. “But I really want them to come in and give it a go.”
Hawaii veterans are served by the VA Pacific Islands Healthcare System, headquartered at Tripler Army Medical Center. The system is also responsible for providing care to all veterans across the U.S. Pacific island territories of American Samoa, Guam and the Commonwealth of the Northern Mariana Islands.
The Pacific island system has long been short on facilities of its own and has had to turn to forging partnerships with military installations and various hospitals and community clinics spread across the islands of the Pacific.
“We know that there’s unmet demand now. In as much as (the PACT Act) opens another door to care, it means that there are increased requirements on the system,” said McDonough.
In December the VA broke ground on a new $120 million clinic in Kalaeloa named for Hawaii’s late U.S. Sen. and World War II veteran Daniel Akaka. It will be the first new major VA project of its size in Hawaii since the Spark M. Matsunaga VA Medical Center opened at Tripler in 2000.
Expected to begin operations in late 2023, the roughly 66,000-square-foot clinic will provide primary care, mental health services, audiology, women’s care, physical therapy, dental services, prosthetics and other specialty care for veterans on Oahu’s Leeward Coast.
“Something like the Akaka (clinic) will have to be repeated in other places to manage the increased access that’s going to be required,” said McDonough.
Pacific Islanders served in particularly high numbers during the post-9/11 wars in places like Iraq and Afghanistan. A study of 2003 re- cruiting data found Pacific Islanders joined the Army at a rate 249% higher than that of other ethnic groups.
During the Wednesday hearing, Hirono raised concerns about demographic data showing that Pacific Islander and Asian American vets have higher suicide rates than other veteran groupings.
“That’s why we want to make sure that we meet that demand out here and that we underscore to communities that maybe … in the past felt underrecognized and underappreciated that we’re here for them,” said McDonough.
In August, Deputy Secretary of Veterans Affairs Donald Remy went on a fact- finding tour of the Pacific that included stops in Honolulu and Hilo as well as Saipan, Guam and the Philippines. Among the items on Remy’s agenda was seeking ways to serve U.S. military veterans living in the island countries signed onto the Compacts of Free Association.
The U.S. military actively recruits citizens of the republics of Palau and the Marshall Islands and the Federated States of Micronesia. The U.S. military can operate in COFA-designated countries freely in return for providing aid programs and largely visa-free travel to the U.S. for citizens. However, the VA has no facilities in those countries, and veterans who return after their service have struggled to access their benefits.
McDonough said the VA is looking at building relationships with existing medical facilities as well as partnering with the Department of Defense to expand access to care for vets residing in COFA countries.
Among recent steps taken to expand care is delivery of virtual audiology boxes into the COFA countries to provide remote audiology services for veterans. So far this year, the VA Pacific island system has provided some 3,600 remote telehealth audiology appointments.
Veterans fought for decades to force the U.S. government to acknowledge the effects of toxic exposure in many places. The PACT Act includes provisions originally introduced in 2015 by Hawaii’s late U.S. Rep. Mark Takai to provide health care and disability compensation for veterans exposed to radioactive waste while cleaning up a nuclear testing site on Enewetak Atoll in the Marshall Islands.
McDonough said that any service member who suspects exposure to toxic substances at any point during their service should report it and file a claim.
In Hawaii the community is approaching the first anniversary of the November contamination of the Navy’s water system, which serves 93,000 people on Oahu, by jet fuel from the service’s underground Red Hill facility. The water crisis affected thousands of service members and military families, and many reported becoming ill from consuming the water or suffered burns and rashes after using it to bathe.
The Navy dispatched divers into the Red Hill water well itself to investigate the contamination and later to participate in efforts to flush contaminated water. Some sailors who participated in response efforts have reported symptoms they suspect are related to working in or around the contaminated well.
“Don’t wait for there to be some finding that says, ‘Hey, this is now service- connected.’ Come in and file the claim,” said McDonough. “That claim may be one of the claims that helps us get a piece of data.”
For information about the PACT Act, go to va.gov/pact.
