Defense Media Network

Interview with U.S. Rep. Gus M. Bilirakis, R-Fla.

Vice Chairman of the Veterans’ Affairs Committee and Co-chairman of the Military Veterans Caucus

Congressman Gus M. Bilirakis represents Florida’s 12th Congressional District. He is currently serving his sixth term in the U.S. House of Representatives.

Bilirakis serves on the Energy and Commerce Committee and is vice chairman of the Veterans’ Affairs Committee. He is co-chairman of the Military Veterans Caucus and a member of the Congressional Veterans Jobs Caucus.

He requested a seat on the House Committee on Veterans’ Affairs, because of his commitment to advocate on behalf of veterans and their families in the U.S. Congress. In his role as vice chairman of the Veterans’ Affairs Committee and member of the Health Subcommittee, Bilirakis continues to ensure the nation’s heroes remain a top priority.

Prior to being elected to Congress, Bilirakis served four terms in the Florida House of Representatives (1998-2006), where he chaired several panels, including Crime Prevention, Public Safety Appropriations, and the Economic Development, Trade, and Banking Committee.

Bilirakis earned a Bachelor of Arts degree from the University of Florida in 1986 and a J.D. from Stetson University in 1989. He interned for President Ronald Reagan and the National Republican Congressional Committee, and worked for former U.S. Rep. Don Sundquist, R-Tenn. He also currently teaches government classes at St. Petersburg College.

Veterans Affairs & Military Medicine Outlook: Could you briefly explain what the “Forever GI Bill” is? Also, could you highlight one or two of its most popular provisions that help veterans utilize their educational benefits?

U.S. Rep. Gus M. Bilirakis: This important new law will improve and extend GI Bill benefits while maximizing flexibility for the veteran and their family. Most importantly, the bill removes the expiration date by which a veteran previously had to use his or her GI Bill benefits. Future recipients will be able to use their GI Bill benefits their entire lives. The Forever GI Bill also increases GI Bill funding for reservists and guardsmen, dependents, surviving spouses, and surviving dependents; provides full eligibility to Post-9/11 Purple Heart recipients; restores eligibility for service members whose school closes in the middle of a semester; and creates a pilot program to use the GI Bill for certain high-technology courses. Additionally, the bill contained a provision I sponsored that will modernize the VA’s [Department of Veterans Affairs] information technology systems. We recently obtained an update from the VA regarding the law’s implementation. Based upon that report, I believe we are making progress in assisting veterans, but there is still more work to be done.

Are there educational institutions that prey upon veterans, knowing they can reap profit from their GI Bill benefits?

I believe the vast majority of educational institutions have our veterans’ best interests at heart and provide incredible opportunities to student veterans looking to learn and invest in their future through education. However, I have heard from stakeholders that there are bad actors in the industry who shamefully take advantage of veterans for their own benefit. One example of this is the implementation of the 90-10 rule, which states that for-profit institutions can receive a maximum of 90 percent of their revenue from federal financial aid sources. Unfortunately, GI Bill benefits are exempted from this rule, leading [to] the potential for bad actors to target veterans for their own purposes rather than for the educational benefit of the student veteran. I support closing this loophole and ensuring that VA benefits are treated on an equal playing field as other federal financial aid sources.

You co-sponsored the SIT-REP Act – the Servicemembers Improved Transition through Reforms for Ensuring Progress Act – that would protect veterans from educational institutions charging penalties due to potential delays in the processing of their tuition payments. How common had the practice of billing punitive fees become? In order to correct the erroneous fees, is the burden to report inappropriate charges on the institution or the veteran?

My legislation, the SIT-REP Act, was formed as a result of an implementation hearing held by my colleagues and I on the House Veterans’ Affairs Committee. At the hearing, stakeholders highlighted that because of delays in the processing of GI Bill benefits, some schools had imposed these burdensome penalties on student veterans. Again, while the majority of educational institutions are doing the right thing and ensuring veterans are not unfairly penalized for bureaucratic delays, there are still bad actors that have restricted access to education. In our legislative hearing on the bill, we heard of at least 15 cases where this practice occurs, and many believe the practice to be more widespread than advertised. I believe it is important to stop this practice across the board. To accomplish this, prior to and in order to receive GI Bill benefits approval, the burden falls on the schools to specifically adopt a new policy disallowing them from imposing a fee or denying access to education for student veterans.

Too often we see bureaucracy get in the way of doing the right thing for our heroes.

The newly formed Subcommittee on Technology Modernization will oversee the VA’s transition from VistA, short for the Veterans Health Information Systems and Technology Architecture, to the Cerner Millennium Electronic Health Record (EHR) System, among other projects. Committee Chairman Rep. Phil Roe, M.D., R-Tenn., stated in remarks on June 26 that “… we are at the beginning of the beginning.” What did the chairman mean by that?

This massive project undertaken by the VA and DOD [Department of Defense] has been a long time coming. While then-Secretary [David] Shulkin announced his decision in the summer of last year, the goal of achieving continuous interoperability between the two agencies is well overdue. I believe the chairman is saying that despite the progress that we have made, we still have a long way to go to achieve this goal. We must ensure that the planning activities and critical workflows are standardized across the board before beginning with implementation in any initial sites. I am confident the VA committee, under the leadership of Chairman Roe, as well as the new Subcommittee on Technology Modernization, will work to ensure proper oversight of this critical mission.

Has the Cerner EHR System been deployed to the three initial sites as planned? If so, what is your impression of the success of the system? What progress has been made in implementing it?

My understanding is the new system has been deployed in their initial sites in the Pacific Northwest, but that there is still a significant amount of work to be done in ensuring better workflows, training, and full functionality. As a result of poor initial implementation and dissatisfaction amongst its users, the Defense Health Agency has been strategically evaluating its next steps by collecting feedback and addressing areas that need improvement. This is a significant change of system across the board. I look forward to hearing more about the progress of these improvements in committee hearings in the coming months.

official photo Bilirakis

Rep. Gus M. Bilirakis, R-Fla.

As of today, more than 150,000 service members and veterans have registered with the VA’s Airborne Hazards and Open Burn Pit Registry. Are committee and caucus members able to access and use the data available in the registry?

I have not been able to access or use the specific data that has been submitted into the VA’s Burn Pit Registry.

Furthermore, the VA’s registry plan does little to help veterans who are suffering now, which is unacceptable. Recently, the VA committee held a hearing assessing the health effects of burn pit exposure. We had an opportunity to question the VA on the shortcomings of the registry and its lack of implementation. I believe the VA should be doing more to prioritize toxic exposure and involve other federal scientific and medical research agencies, such as NIH [National Institutes of Health], CDC [Centers for Disease Control and Prevention], and EPA [Environmental Protection Agency].

It is a widely known fact that veterans serving in Operation Enduring Freedom and Operation Iraqi Freedom were exposed to toxic chemicals in burn pits during their deployments. Many of these veterans are now battling a wide range of diseases, some of which have proven fatal. I partnered with Rep. Raul Ruiz [D-Calif.], a physician and public health expert by trade, to craft legislation to address this issue. My bill, the Protection for Veterans’ Burn Pit Exposure Act, seeks to remedy an injustice that is preventing veterans from being able to access the medical care and disability compensation benefits to which they should be entitled. Specifically, this critical legislation will provide a presumption of service connection for exposure to toxic burn pits, which will enable the veterans battling illness to immediately access VA medical care and disability benefits. To accomplish this, my bill establishes an Open Burn Pit Advisory Commission, an independent body that would be tasked with gathering the medical and scientific data necessary to make recommendations on the association of diseases connected to toxic burn pit exposure. The commission, comprised of 15 members with distinguished backgrounds in medical, scientific, and epidemiological research, as well as expertise in military and veteran health care, would be able to access data from all federal agencies and award grants for original research for the purposes of determining this scientific connection. We can’t change the fact that they were exposed and are sick, but we have the power to get them the help they need. I will not stop fighting on their behalf until they get the benefits and medical treatment they deserve. 

You co-authored, with Rep. Peter Welch, D-Vt., as part of the final DOD spending bill, a measure to include $1 million to improve interagency coordination between the DOD and the VA to study the effects of toxic exposure to burn pits. Could you talk about this briefly?

The final Defense Appropriations bill contained language I co-sponsored with Rep. Welch to allocate $1 million to improve interagency coordination between the DOD and the VA as both agencies study the effects of toxic exposure to burn pits. We must expedite the process of ensuring that our men and women who are experiencing hardship due to exposure to these toxins during their service get the medical treatment and benefits they need. Coordination between these two agencies is necessary and these funds are key to making that happen. Too often we see bureaucracy get in the way of doing the right thing for our heroes. I’ve met with many of these veterans. They are suffering and their stories are heartbreaking. They don’t have time to wait any longer. As I stated [earlier], I will not stop fighting for them.

Additionally, what is being done by Congress to reduce the danger of burn pit exposure to those who are currently serving in uniform?

While the practice of utilizing burn pits has largely been discontinued, hearing reports that some burn pits are still in use in Iraq and Afghanistan is certainly troubling. The VA committee has conducted their hearing on this issue, and I support the movement of legislation to continue to bring burn pit exposure to national attention. My bill, the Protection for Veterans’ Burn Pit Exposure Act, focuses on the VA’s role in addressing benefits and health care for those who have returned home. However, I am hopeful the House and Senate Armed Services committees can address this by calling DOD in to testify on their practices and on these reports.

Funding for veterans wishing to see a private health care provider has moved from mandatory to discretionary spending. What are your thoughts on this?

One of the many reforms of the recently enacted VA MISSION [Maintaining Systems and Strengthening Integrated Outside Networks] Act was to gradually move the VA’s community care programs from mandatory to discretionary spending. I believe this is a fiscally responsible effort to return budgetary authority back to congressional appropriators. Congress has always and consistently spent the money needed to fund our nation’s military and provide for our nation’s veterans. The VA has seen consistent budget increases over the past decade, and I am confident the Budget and Appropriations committees will continue to provide the funding needed for our nation’s heroes under regular order, much like we do on an annual basis with the NDAA [National Defense Authorization Act] and defense appropriations processes.

Specifically, this critical legislation will provide a presumption of service connection for exposure to toxic burn pits, which will enable the veterans battling illness to immediately access VA medical care and disability benefits.

Last fall, you and many of your colleagues sent a letter to then-VA Secretary David Shulkin to request coverage for health conditions related to Agent Orange exposure for “Blue Water” Navy Vietnam veterans. Could you explain the request and what it could mean for these veterans? What is the status of your request?

The VA has not complied with our request to grant presumptive status. I am personally offended by the commentary offered by a high-ranking VA official in a recent Senate hearing. Not only did his comments show a complete lack of understanding for the plight of those who were exposed to burn pit toxins, but also for the injustice that has been perpetuated against Blue Water Navy veterans. Our focus should be on the cost that has been incurred by these veterans, who are sick and, in some cases, dying, as well as the financial and emotional hardship that their families have endured – not the cost to the system. Congress has given the VA record increases in funding in recent years. These dollars are to be used to help our veterans. The brave men and women who have been exposed to these toxins risked their lives to defend our nation. Now it is our job to defend them against this bureaucratic way of thinking, to remove the red tape, and to ensure we honor our commitment to them by providing the medical care and benefits they have earned through their sacrifice and service. Therefore, the House passed the Blue Water Navy Vietnam Veterans Act of 2018, which extends the presumption of exposure to [that] group of veterans. The bill passed the House by a 382-0 vote. We are working with our Senate colleagues to get this bill to the president for enactment as soon as possible.

What do you consider the biggest challenges facing the VA today?

There is no doubt the VA has experienced an incredible amount of change and reform over the past few years, and implementing these reforms is no easy task. Nevertheless, the VA has the critical mission of providing care and benefits to our nation’s heroes, who have sacrificed so much. Beyond many changes in leadership, I believe one of the biggest challenges the VA faces is the morale and retention of its employees. We want to be able to attract the best and the brightest in to the Veterans Health Administration, for example, but the VA often has trouble recruiting and incentivizing these individuals to work and stay in the agency.

Additionally, while progress has been made, the VA still faces challenges in improving its efficiency and transparency. I am confident the reforms we are making in Congress are helping and not hindering this process, but the VA needs strong leadership to be able to see this through. I am hopeful the new secretary will be able to establish stability and vision as it moves forward under continual scrutiny.

What legislative accomplishments regarding veterans do you feel most proud of?

In 2016, I passed two critical pieces of legislation dealing with mental health and substance abuse as part of the Comprehensive Addiction and Recovery Act. The first was the Creating Options for Veterans’ Expedited Recovery [COVER] Act, which established a commission to examine VA’s current therapy model and the potential benefits in incorporating complementary, alternative therapies. The COVER Commission is currently undergoing its public meetings to study and make recommendations for integrative and alternative treatments at the VA, and I look forward to seeing these new therapies implemented into traditional care models.

The second is the Promoting Responsible Opioid Management and Incorporating Scientific Expertise [PROMISE] Act, which increased patient safety by ensuring that VA physicians are trained in and utilize best practices for prescribing opioids. It also required the VA to increase information-sharing with state licensing boards. This legislation ensures that the same safeguards are in place at the VA as exist in private settings. Both the PROMISE and COVER acts have provided for more personalized and individualized care options and alternatives to opioids.

Is there anything you’d like to add?

One additional measure that is very near and dear to my heart is the Transition Improvement Act, which passed the House [at] the end of July [2018]. We spend a minimum of six months preparing service personnel for their military assignments and a maximum of one week preparing them for successful reintegration into civilian society. We owe these brave [people] more than that, and local veterans in my community who were able to provide direct input into this bill tell me that this is one of the most serious challenges currently facing the men and women who are exiting the military. I am hopeful that the Senate will take action on this important issue.

Another priority of mine is expanding veterans’ access to dental care. Oral health is an important part of overall wellness and studies show that preventative dental treatment of patients with certain chronic illnesses provides long-term savings in health care costs for treating the medical illness. I filed the VET CARE bill to expand veterans’ access to dental care while saving the VA money. Many people do not realize that very few veterans receiving health care through the VA qualify for dental care. I hope to demonstrate those potential savings in a pilot project authorized by my legislation, which can be replicated for all veterans in the years to come.

Additionally, I also filed the VA Community Care Enhancement Act, a bipartisan bill that provides a pilot program to test integrative centers between the VA and community health centers. I believe we can improve veterans’ access to care by having local VA medical centers work together with community health centers to get veterans the care they deserve.

This article was originally published in the 2018 Fall edition of Veterans Affairs & Military Medicine Outlook By Faircount, LLC