Veterans for Common Sense Leaders Provide Testimony for Congressional Hearing on Toxic Exposure Research

(Washington – September 23, 2020) – The leaders of Veterans for Common Sense co-authored written testimony for today’s Congressional hearing on the military toxic exposure research.

The House Committee on Veterans’ Affairs, Subcommittee on Disability Assistance and Memorial Affairs held today’s oversight hearing entitled: “Toxic Exposures: Examining Airborne Hazards in the Southwest Asia Theater of Military Operations.”

The testimony was co-authored by James H. Binns, longtime former Chair of the congressionally chartered Research Advisory Committee on Gulf War Veterans’ Illnesses (RAC-GWVI; Dr. Roberta White, past scientific director of the RAC; Paul Sullivan, Veterans for Common Sense National Vice Chair and who helped author the first RAC charter following successful enactment of the 1998 legislation directing its creation; and Anthony Hardie, National Chair and Director of Veterans for Common Sense.

The full text is below, or available in PDF download: Statement for the Record – BINNS, WHITE, HARDIE, SULLIVAN – September 23, 2020 Toxic Exposures HVAC-DAMA

*****

STATEMENT FOR THE RECORD
OF
JAMES BINNS, ROBERTA WHITE, ANTHONY HARDIE, & PAUL SULLIVAN

FOR A SEPTEMBER 23, 2020 HEARING
OF THE
COMMITTEE ON VETERANS’ AFFAIRS,
SUBCOMMITTEE ON DISABILITY ASSISTANCE AND MEMORIAL AFFAIRS
ENTITLED:
“TOXIC EXPOSURES: EXAMINING AIRBORNE HAZARDS IN THE SOUTHWEST ASIA THEATER OF MILITARY OPERATIONS”

 

Chairwoman Luria, Ranking Member Bost, and Members of the Subcommittee, thank you for your leadership in introducing the Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act of 2020.  We are grateful to the bill’s authors for including presumptions for service-connection for any cancer and a list of specified respiratory conditions.  We are also grateful that the definition of who is covered by these presumptions includes: post-9/11 veterans exposed to open air burn pits and airborne hazards; veterans with Persian Gulf service since August 2, 1990 (including veterans awarded the Southwest Asia Service Medal for their Persian Gulf War service); and veterans with special operations and other contingency service in a long list of countries since that date.

Collectively in our individual roles, we led the passage of the 1998 legislation creating the congressionally-mandated Research Advisory Committee on Gulf War Veterans’ Illnesses (RAC-GWVI); authored its charter; served as its chair, scientific director, and advocates for affected veterans; co-authored its groundbreaking reports.  From these deeply engaged leadership perspectives, we feel an obligation to point out near-certain outcomes should the bill proceed without ensuring that future reviews directed under the legislation also include both human and animal studies of toxic exposures.

This gravely serious problem has been made apparent by the many reports released by the National Academies in these regards, including the recent report[i] and related news release of a National Academy of Medicine (NAM) committee on respiratory health effects among veterans who served in Southwest Asia. “The current uncertainty should not be interpreted as meaning that there is no association — rather, the issue is that the available data are of insufficient quality to draw definitive conclusions,” said the committee chair in a news release about the report.[ii]  Similarly, a 2011 National Academies (Institute of Medicine (IOM)) committee concluded there is, “[i]nsufficient data on service members’ exposures to emissions from open-air burn pits,” and that this, “is one of the reasons why it is not possible to say whether these emissions could cause long-term health effects.”  However, “the committee pointed out shortcomings in research and gaps in evidence that prevented them from drawing firm conclusions…”.[iii]

The major problem with this recent NAM report on veterans’ respiratory health issues, and with the related 2011 IOM burn pits report,[iv] and with the entire compendium of NAM/IOM reports related to burn pits exposure and Gulf War exposures and health is not that there are no good human studies – though that is indeed a true statement.  Instead, the real problem is that VA has failed to follow the law by failing to require that NAS reports consider scientific evidence in humans and animals.

Congress in 1998 established the standard for finding an association between toxic exposures and illness in veterans of the 1991 Gulf War.  Congress directed that VA and the National Academy of Sciences consider the exposure of humans and animals to specified toxins, the occurrence of illness in both humans and animals, and the associations between occurrence of illness in both humans and animals [38 U.S.C. 1118].[v]  Congress repetitively specified this explicit directive of both human and animal studies because its Members and staff knew that most studies of toxic substances are necessarily done in animals.

However, VA (and, by consequence, the VA-contracted NAM/IOM) did just the opposite, using a standard that limited consideration of associations between illness and exposure to solely human studies This deeply corrupted standard has been used in all subsequent NAS reports on Gulf War exposures and burn pits, and in effect ensures no association can ever be found. 

If the VA-contracted NAM were to follow the law requiring equal consideration of human and animal studies of toxic exposure, they would reach dramatically different conclusions about the serious and lasting effects of these toxins on veterans’ health.  The recent NAM respiratory health committee noted that the reason for its negative conclusion is that there are no good human studies: “The current uncertainty should not be interpreted as meaning that there is no association — rather, the issue is that the available data are of insufficient quality to draw definitive conclusions.”[vi]

Even more dramatically, the 2011 IOM burn pits report found: “Chemicals in all three major classes of chemicals detected [from burn pits at Joint Base Balad, Iraq] … have been associated with long-term health effects.  A wide array of health effects have been observed in humans and animals after exposure to the specific pollutants detected ….  The health-effects data on the other pollutants detected include: neurological effects, liver toxicity and reduced liver function, cancer, respiratory toxicity and morbidity, kidney toxicity and reduced kidney function, blood effects, cardiovascular toxicity and morbidity, reproductive and developmental toxicity.”[vii] However, the report’s conclusion considered only the sharply limited human studies, excluding this evidence and finding no association relevant to exposed veterans’ health.

In short, the problem is not the science.  The problem is the corruption of science through the application of impossible and unlawful standards.  The result is a large stack of expensive NAM and IOM reports that do little to nothing to improve the health and lives of veterans suffering the ill effects of toxic exposures from their exposures to burn pits and during the Gulf War.

Past performance seems likely to be a predictor of future performance.  Unless animal studies of toxic exposure are explicitly directed in all legislation that directs NAM studies related to toxic exposures and veterans’ health, it is unclear how future NAM considerations of strength-of-association determinations will result in any outcomes more favorable to veterans than NAM to date.  And, unless the use of the corrupted standard described above is changed, future NAM reports will be similarly unhelpful to the veterans suffering these adverse health outcomes resulting from their military toxic exposures.

 

Recommendations

  1. Amend the legislation to ensure the inclusion of animal studies. It is worth noting that in most cases, the animal studies of relevance have already been conducted, and such inclusion would not explicitly authorize nor require additional studies; indeed, these NAM committee do not actually do conduct research – they merely review already-conducted research.   Specifically, we recommend the inclusion of “or animals” in each of the six places solely “human” currently appears (additions are underscored; deletions are struck-through), as follows:
    1. Amend Section 2(b), “Process to Add Diseases Through Written Petition,” as follows: (b)(1)(A) – “the exposure of humans or animals to one or more covered toxins; and”; and, (b)(1)(B) – “the occurrence of the disease in humans or animals.”
    2. Amend Section 2(c), “Determinations by National Academies,” as follows: (c)(2)(A)(i) – “the exposure of humans or animals to one or 11 more covered toxins; and”
    3. Amend Section 3, title, as follows: “SEC. 3. AGREEMENT WITH THE NATIONAL ACADEMIES OF SCIENCES, ENGINEERING, AND MEDICINE CONCERNING THE EXPOSURE OF HUMANS TO BURN PITS AND OTHER TOXINS.”
    4. Amend Section 3 as follows:(b)(1) – “Under an agreement between the Secretary and the National Academies, the National Academies shall review and summarize the scientific evidence, and assess the strength thereof, concerning the association between the exposure of humans or animals to covered toxins and each disease suspected to be associated with such exposure.”
    5. Amend Section 3 as follows:(c)(1) – “For each disease reviewed under subsection (b), the National Academies shall determine (to the extent that available scientific data permit meaningful determinations) whether there is a positive association between the exposure of humans or animals to one or more covered toxins and the occurrence of the disease in humans or animals, taking into account the strength of the scientific evidence and the appropriateness of the statistical and epidemiological methods used to detect the association.
  1. Direct prior NAM/IOM reports be redone to include equal consideration of animal studies. These should be reconsidered to include animal studies of association between toxic exposures and health outcomes, including each NAM and IOM report on respiratory health, burn pits, and Gulf War veterans as has been broadly defined as beginning August 2, 1990 and to a date to be determined.
  1. Transparency in VA contracts with NAM. Past VA contracts with NAM for statutorily-mandated NAM reports on toxic exposures have been kept secret by VA.  These contracts should be made public in a timely fashion, perhaps by an explicit requirement that they be published in the Federal Register prior to their execution and allowing for public comment, including by veterans service organization and advocates.

We deeply appreciate your consideration and your interest in this critical matter.  For at least 20 years, VA has willfully subverted the explicit intent of Congress regarding the appropriate standard to be used in establishing associations – key to VA creating presumptions for VA claims determinations and the gateway to VA healthcare – where veterans were subjected to toxic exposures during their service.

This is a rare opportunity to give affected veterans the justice they deserve and to ensure that the results of this intentional misuse and manipulation of science are not inflicted on future generations of American veterans.  We would be pleased to provide further detail on these topics and to meet with you virtually.

Respectfully,

James Binns

Former Chair (2002-2014), Research Advisory Committee on Gulf War Veterans’ Illnesses (RAC-GWVI), U.S. Department of Veterans Affairs (VA); former Principal Deputy Assistant Secretary of Defense for International Security Policy, U.S. Department of Defense

Roberta White, PhD

Former Chair, Department of Environmental Health at Boston University; Former Scientific Director (2008-15) and Member, RAC-GWVI

Anthony Hardie

Gulf War Veteran, U.S. Army; Chair Emeritus, Programmatic Panel, Gulf War Illness Research Program, Congressionally Directed Medical Research Program, U.S. Department of Defense; National Chair and Director, Veterans for Common Sense; former Member (2005-2013), RAC-GWVI; former Executive Assistant for Legislative, Public, & Intergovernmental Affairs, Wisconsin Department of Veterans Affairs; former National Vice-Chair, National Gulf War Resource Center

Paul Sullivan

Gulf War Veteran, U.S. Army; Former Deputy Secretary, California Department of Veterans Affairs; Director of Veteran Outreach, Bergmann & Moore, LLC; National Vice Chair, Veterans for Common Sense; former Project Manager, U.S. Department of Veterans Affairs; past Executive Director, National Gulf War Resource Center; Advocate for both 1994 and 1998 Persian Gulf War Veteran research and benefits laws that created the RAC-GWVI and the mandated NAM reviews.”

 

END NOTES:

[i] National Research Council 2020. Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations. Washington, DC: The National Academies Press. https://doi.org/10.17226/25837

[ii] National Academy of Medicine.  September 11, 2020.  New Approaches Are Needed to Determine Whether Respiratory Health Problems Are Associated With Military Deployment to the Persian Gulf Regionhttps://www.nationalacademies.org/news/2020/09/new-approaches-are-needed-to-determine-whether-respiratory-health-problems-are-associated-with-military-deployment-to-the-persian-gulf-region

[iii] Institute of Medicine, Board on the Health of Select Population, Committee on the Long-Term Health Consequences of Exposure to Burn Pits in Iraq and Afghanistan.  October 31, 2011.  News Release: Evidence Inconclusive About Long-Term Health Effects of Exposure to Military Burn Pitshttps://www.nationalacademies.org/news/2011/10/evidence-inconclusive-about-long-term-health-effects-of-exposure-to-military-burn-pits

[iv] IOM 2011. Long-term health consequences of exposure to burn pits in Iraq and Afghanistan. Washington, DC: The National Academies Press.  https://www.nap.edu/catalog/13209/long-term-health-consequences-of-exposure-to-burn-pits-in-iraq-and-afghanistan

[v] 38 U.S.C. 1118:  “(b)(1)(A) Whenever the Secretary makes a determination described in subparagraph (B), the Secretary shall prescribe regulations providing that a presumption of service connection is warranted for the illness covered by that determination for purposes of this section.

(B) A determination referred to in subparagraph (A) is a determination based on sound medical and scientific evidence that a positive association exists between—

(i) the exposure of humans or animals to a biological, chemical, or other toxic agent, environmental or wartime hazard, or preventive medicine or vaccine known or presumed to be associated with service in the Southwest Asia theater of operations during the Persian Gulf War; and

(ii) the occurrence of a diagnosed or undiagnosed illness in humans or animals.

(2)(A) In making determinations for purposes of paragraph (1), the Secretary shall take into account—

(i) the reports submitted to the Secretary by the National Academy of Sciences under section 1603 of the Persian Gulf War Veterans Act of 1998; and

(ii) all other sound medical and scientific information and analyses available to the Secretary.

(B) In evaluating any report, information, or analysis for purposes of making such determinations, the Secretary shall take into consideration whether the results are statistically significant, are capable of replication, and withstand peer review.

(3) An association between the occurrence of an illness in humans or animals and exposure to an agent, hazard, or medicine or vaccine shall be considered to be positive for purposes of this subsection if the credible evidence for the association is equal to or outweighs the credible evidence against the association.” [emphasis added] https://www.govinfo.gov/app/details/USCODE-2011-title38/USCODE-2011-title38-partII-chap11-subchapII-sec1118

[vi] IOM News Release, October 30, 2020.

[vii] IOM 2011, p. 5:  http://books.nap.edu/openbook.php?record_id=13209&page=5

Posted in Burn Pits, Gulf War Updates, Legislative News, Research, Toxic Wounds, VCS Congressional Testimony, VCS In The News, Veterans for Common Sense News | Comments Off on Veterans for Common Sense Leaders Provide Testimony for Congressional Hearing on Toxic Exposure Research

Veterans for Common Sense among 104 organizations calling for Congress to complete annual Appropriations bills stalled in the Senate

Failure to soon enact the fiscal year 2021 Defense Appropriations Act will result in cessation of critical Servicemembers and veteran medical research programs affecting veterans with Gulf War Illness and Burn Pits exposure

(Washington – September 10, 2020) – Today, 104 health and veteran advocacy organizations, including Veterans for Common Sense, joined in calling on Congressional leadership to work to enact the annual Defense spending bill that is currently stalled in the U.S. Senate.

Currently, a short-term continuing resolution has been proposed to prevent a government shutdown, which would result if the various annual spending bills already passed by the U.S. House are not enacted.  A full-year continuing resolution would result in defunding, and cessation, of the critically important Congressionally Directed Medical Research Program (CDMRP).

Veterans for Common Sense annually fights for annual renewal of the treatment-focused Gulf War Illness Research Program (GWIRP) and pushed for restoration of the Burn Pits Exposure topic area within the CDMRP’s Peer Reviewed Medical Research Program.

Earlier this year, Veterans for Common Sense and Vietnam Veterans of America (VVA) also pushed for the inclusion of medical research regarding peripheral neuropathy, a debilitating condition that affects 30 million Americans including countless thousands of veterans.  Vietnam War veterans appear to be significantly affected, and recent research has connected at least one form of peripheral neuropathy to service in the 1991 Gulf War.

Joining the The Quinism Foundation, Veterans for Common Sense also pushed for the U.S. Senate earlier this year to fund critical research into the chronic adverse neurological and psychiatric effects of mefloquine and related quinoline antimalarial drugs, following release of a report by a committee of the National Academy of Medicine (NAM).  The NAM committee was charged with looking at “long-term health effects” of antimalarial medication, with “special attention” “to possible long-term neurologic effects,” and “long-term psychiatric effects” — prevalent concerns among current and former military service members who took the drugs during military service in malaria-endemic regions.  These advocacy efforts were overcome by the COVID-19 pandemic and the politicization of one antimalarial drug later found to be ineffective for the treatment of COVID-19, and the Senate did not include the request.

The letter joined by Veterans for Common Sense calls for Congress to work to enact the Fiscal Year 2021 Defense Appropriations Act, to ensure that the Defense Health Research Programs, including the CDMRP, are fully funded next year.

The full text is below.

*****

September 10, 2020

The Honorable Nancy Pelosi                    The Honorable Mitch McConnell
Speaker of the House                                 Majority Leader, U.S. Senate
Washington, DC 20515                              Washington, DC 20510

The Honorable Kevin McCarthy                The Honorable Chuck Schumer
Minority Leader                                            Minority Leader
U.S. House of Representatives                  U.S. Senate
Washington, DC 20515                               Washington, DC 20510

Dear Speaker Pelosi, Majority Leader McConnell, Minority Leader McCarthy, and Minority Leader Schumer:

We, the undersigned organizations urge you to work toward the enactment of the fiscal year 2021 Defense Appropriations Act, to ensure that the Defense Health Research Programs, including the Congressionally Directed Medical Research Programs (CDMRP), are fully funded in fiscal year 2021.

Our organizations understand that Congress may need to pass a short-term continuing resolution to prevent a government shutdown on October 1. However, we are particularly concerned about the possibility of Congress enacting a year-long continuing resolution in lieu of completing the fiscal year 2021 Defense Appropriations Act. Under a year-long continuing resolution the CDMRP would receive no funding in fiscal year 2021. Failure to enact the Defense Appropriations Act will have major negative health implications for the millions of Americans – especially veterans, military service members and their families – who live with chronic and debilitating disorders. This will delay important new discoveries and translation of medical innovation into new treatments and cures for many disorders.

We collectively represent millions of American veterans, military retirees, military families, and civilians who benefit from the ongoing research funded by the Defense Health Research Programs at the Department of Defense (DoD).  We have worked tirelessly to advocate for continued funding for the programs, and we were pleased to see that the House version of the fiscal year 2021 Defense Appropriations Act includes strong funding levels for medical research.

The Defense Health Research Programs will be unable to fully prepare for the fiscal year 2021 grant solicitation process until they receive a fully-enacted fiscal year 2021 budget. The CDMRP annually receives more than 12,000 pre-applications and 7,000 full applications for grants and undergoes a rigorous process to evaluate and fund the best of these applications. Further delay in enacting the fiscal year 2021 appropriations bill will create unnecessary disruption with internal processes at DoD.

These delays will have systemic impacts on the way the DoD convenes programmatic panels to identify and implement programmatic changes and peer-review panels to provide thorough review of grant applications, and ultimately impact the ability of the DoD to conduct appropriate negotiations to award fiscal year 2021 grants. Further, failure to enact a fully-funded fiscal year 2021 budget will compromise the ability of scientific laboratories across the U.S to effectively plan and prepare the highest quality grant applications, potentially diminishing opportunities to maintain discovery-based research programs and disrupting critical scientific workforces.

The CDMRP is a critical component of the Defense Appropriations Act, and failure to enact this legislation will have a devastating impact on the program.  Aside from the obvious biomedical and economic consequences of such actions, such as stalling or eliminating the critical development of new and more effective therapies that lower costs and save lives, failure to enact will interrupt important pipelines that have allowed investigators at U.S. medical research institutions to build careers and act on new and innovative medical research ideas.

We therefore urge you to work together in a bipartisan, bicameral spirit and enact the fiscal year 2021 Defense Appropriations Act.

Sincerely,

Action to Cure Kidney Cancer

ALS Association

American Academy of Allergy, Asthma & Immunology

American Academy of Dermatology Association

American Academy of Neurology

American Association for Cancer Research

American Association for Dental Research

American Autoimmune Related Diseases Association

American Brain Tumor Association

American College of Rheumatology

American Gastroenterological Association

American Psychological Association

American Society for Gastrointestinal Endoscopy

American Society for Microbiology

American Urological Association

Aplastic Anemia and MDS International Foundation

APS Foundation of America, Inc

Arthritis Foundation

Asbestos Disease Awareness Organization

Association of American Cancer Institutes

Asthma and Allergy Foundation of America

Batten Disease Support and Research Association

Bladder Cancer Advocacy Network

Bridge the Gap – Syngap Education and Research Foundation

Buoniconti Fund to Cure Paralysis

Burn Pits 360 Veterans Organization

Cancer ABCs

Charlie Foundation

Child Neurology Foundation

Children’s Tumor Foundation

Christopher & Dana Reeve Foundation

Citizens United for Research in Epilepsy (CURE)

Coalition for National Security Research

Colorectal Cancer Alliance

Cure HHT

Danny Did Foundation

Deadliest Cancers Coalition

Debbie’s Dream Foundation: Curing Stomach Cancer

debra of America

Duke Health

Duke University

Epilepsy Foundation

Epilepsy Leadership Council

Fight Colorectal Cancer

Foundation to Eradicate Duchenne

George Mason University

Global Health Technologies Coalition

GO2 Foundation for Lung Cancer

Harvard University

Hepatitis B Foundation

HIV Medicine Association

Indiana University

Infectious Diseases Society of America

International Myeloma Foundation

International Pemphigus Pemphigoid Foundation

KidneyCAN

Kidney Cancer Association

LAM Foundation

LGS Foundation

Littlest Tumor Foundation

Living Beyond Breast Cancer

Lupus and Allied Diseases Association, Inc.

Lupus Foundation of America

Lymphoma Research Foundation

Melanoma Research Foundation

Miami Project to Cure Paralysis

Michigan State University

National Alliance for Eye and Vision Research

National Alliance of State Prostate Cancer Coalitions

National Association of Nurse Practitioners in Women’s Health (NPWH)

National Autism Association

National Brain Tumor Society

National Fragile X Foundation

National Multiple Sclerosis Society

National Pancreas Foundation

National Vietnam and Gulf War Veterans Coalition

Neurofibromatosis Midwest

Neurofibromatosis Network

Neurofibromatosis Northeast

Ovarian Cancer Research Alliance

Pancreatic Cancer Action Network

Parent Project Muscular Dystrophy

PKD Foundation

Prostate Cancer Clinical Trials Consortium

Prostate Cancer Foundation

Prostate Conditions Education Council

Pulmonary Fibrosis Foundation

Research!America

Scleroderma Foundation

Sergeant Sullivan Circle

SHEPHERD Foundation

Sjögren’s Foundation

SLC6A1 Connect

St. Baldrick’s Foundation

Susan G. Komen

Texas NF Foundation

Tuberous Sclerosis Alliance

University of Central Florida

University of Iowa

Veterans for Common Sense

VHL Alliance

Wayne State University

Weill Cornell Medicine

ZERO-The End of Prostate Cancer

 

cc:  House and Senate Committee on Appropriations

###

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Veterans for Common Sense Letter to VA Regarding Predatory Corporate Schools

SUBJECT: Commonsense Suggestions re: 38 USC 3696

June 18, 2020

Dear Under Secretary Lawrence,

On April 9, Veterans for Common Sense was among 33 veterans organizations that co-signed the attached letter to Secretary Wilkie regarding improper GI Bill payments to ineligible colleges, especially those that should not be approved for GI Bill under 38 U.S.C. 3696.

In that letter, we collectively provided the following commonsense recommendations to the Secretary to help determine whether schools in violation of 38 U.S.C. 3696 have demonstrated sufficient “corrective action” to restore GI Bill eligibility:

  • Faced sufficient deterrence commensurate with the harm against veterans;
  • Is a repeat law-offender;
  • Put in place an independent auditor to verify future recruiting and advertising practices;
  • Replaced the executives responsible for the illegal conduct;
  • Removed pressure on recruiters to enroll students at all costs; and
  • Undergone a risk-based review by the State Approving Agency.

Also attached is a fact sheet entitled, “Many Corporate School Chains Repeatedly Settled Lawsuits for Misleading Advertising, High-Pressure Recruiting, and False Certifications.”  This fact sheet was developed by Veterans Education Success, which we have been proud to closely partner with since its inception and continue to very strongly support in collaborative efforts to preserve and enhance veterans’ federally-funded education programs and to protect veterans from predatory entities and practices.  As the title of the fact sheet implies, it shows that many of these schools under consideration are repeat offenders in these regards.

As the Department of Veterans Affairs makes these crucial determinations relative to protecting veterans from these predatory institutions, we want to take this opportunity to again highlight these recommendations and the attached documents.

Thank you for your reasoned consideration of these matters, which stand to impact countless veterans.

On behalf of Veterans for Common Sense and with appreciation for your efforts on behalf of veterans,

-Anthony

Anthony Hardie,
National Chair & Director
Veterans for Common Sense
1140 3rd St. NE, Spc 2138
Washington, DC 20002-6274
www.VeteransforCommonSense.org

 

 

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Open Letter from Veterans for Common Sense

Veterans for Common Sense, a national veterans organization, has issue an open letter in the wake of the George Floyd murder and the threatened invocation of the Insurrection Act. We invite all who have served in the U.S. military and agree to sign on to this letter.

Read the letter and add your signature.

The final letter will be published listing all those who have joined in signing it.

Posted in Legislative News | Comments Off on Open Letter from Veterans for Common Sense

Veterans for Common Sense Among 7 Organizations Calling for Improved VA Testing for COVID-19

WASHINGTON, DC — Veterans for Common Sense is among seven veterans advocacy and service organizations that this week wrote Department of Veterans Affairs (VA) Secretary Robert Wilkie regarding testing, screening, and communications related to the COVID-19 virus.

In the letter, the organizations wrote,

“While we recognize the unique challenges VA faces with this pandemic, these and related issues are deeply concerning given that millions of our nation’s veterans rely on VA medical care – including and even more so during these difficult times.  We therefore encourage you to take the steps necessary to quickly ensure a more unified national approach by VA that addresses these and related issues.  Most especially, we encourage you to quickly take the necessary steps to ensure VA provides a clearly articulated and viable path for every veteran who needs testing for the COVID-19 virus, a clear response regarding those veterans who are turned away, and what specific actions VA will take to ensure that veterans who present with symptoms are immediately tested rather than turned away.  We appreciate your leadership during these difficult times and look forward to hearing the results of these necessary changes from the veterans we represent.

The letter came after a report released last week by the VA Inspector General that found only one VA facility in the U.S. had the capacity to process COVID-19 tests and that expanding that capacity would help flatten VA’s curve. COVID-19 has been a wrecking ball. It’s taken lives, broken families, and disrupted every facet of our lives. But we can’t allow ourselves to give into desperation. We need to face these challenges head on, and part of doing that is appreciating the things we do have rather than wallow in what we’ve lost. In the case of this disease, and any other major crisis, you should always be looking for things to appreciate. Yes, social distancing has been hard, but for many of us it’s also been an opportunity to bond with family members in new ways. We’ve had to rely on each other to get through this and forge even stronger bonds than ever. Some of us have been helping our neighbours who can’t get out for one reason or another or have been on the receiving end of that help. This is a beautiful thing, this crisis has shown who we are as Christians. Many of us have also had the chance to catch up on projects around the house, to start new hobbies, or even just gain a new perspective on what we appreciate and enjoy in life. As many of our typical distractions and chores fall away, we’ve been able to focus in on what matters, what really makes us happy. No matter how terrible the situation, there are always traces of God’s grace and goodness to be found. Every day is a gift, no matter what obstacles face us, so focus on the things that make you happy, that show you God’s love for us, and treasure them. Find joy wherever you can and take that attitude forward as we move out of this crisis and back towards normality. You can get more detail about C4i Blog to visit here.

A story published today by Fox News (“VA hospitals lack adequate coronavirus testing, protocol…“) reported:

The specialized division within the Department of Veterans Affairs launched an investigation at the start of the coronavirus outbreak in the U.S. in which their officials went undercover as they looked into the preparedness throughout hundreds of VA hospitals and other health care facilities.

They alleged in their report, “OIG Inspection of Veterans Health Administration’s COVID-19 Screening Processes and Pandemic Readiness”, that while a majority of the facilities were able to conduct swab tests for the virus, they were not able to screen the samples on-site. In fact, only one facility, VA Palo Alto in California, is able to get test results processed on the premises.

One facility leader told OIG investigators that having the ability to test samples on-site would shorten result times. It’s believed that the short turn around in time would help in flattening the curve of infected veterans.

“One Facility estimated that specimen processing time could be reduced from several days down to four hours by processing at an on-site laboratory,” reads a line from the report.

Out of the 125 outpatient facilities visited by investigators, a robust 97 percent were able to screen for COVID-19, but only 71 percent were found to be adequate. Four facilities were found to have no readiness plan in place and did not screen patients or ask them if they were feeling any of the symptoms associated with the coronavirus. ….

Our concern is the lack of action, these are procedural concerns that can save the lives of our Veterans,” Rosie Torres, founder of veteran advocacy group Burn Pits 360 said to Fox News. “Our overarching concern is that actual testing was given short shrift coverage in this report.” ….

Burn Pits 360 along with several other veterans’ organizations like Veterans for Common Sense, recently sent a letter to VA Secretary Robert Wilkie in which they addressed their concerns regarding the OIG’s findings. They also underscored how the lack of preparedness has already affected veterans across the country, including a former drill sergeant in Oklahoma City who verbally screened positive on his phone call with VA but was unable to get tested for three days. He remains ill and is self-treating with a wife at home who is battling cancer. He fears that he could infect her due to her compromised immune system.

It also includes one veteran in Gainesville, Fla., who was screened and to date, has been refused treatment; and a Gulf War veteran in Portland, Oregon who was refused entry to the VA emergency room due to having ADI-trained service dog.

“The report indicates an inadequate communication system, a lack of a unified national VA outreach guidance campaign addressing symptoms, concerns, and screening procedures such as how to get tested,” Torres says adding that the OIG report does not address the VA’s outmoded screening questions.

“They have been asking, ‘Have you traveled to China or Iran,’ rather than, ‘Have you traveled to a U.S. city that’s a known coronavirus hotspot,’” she said.

“They are only adapting it now that it widespread across the U.S.”

The full text of the letter is below:

(Download PDF) – SecVA CV-19 Letter


March 31, 2020

The Honorable Robert Wilkie
Secretary of Veterans Affairs
U.S. Department of Veterans Affairs
810 Vermont Avenue, N.W.
Washington, D.C. 20420

SUBJECT:  COVID-19 Testing, Screening, and Communications

Dear Secretary Wilkie,

We are writing to express our grave concerns regarding what appear to be continued inadequate testing and communications related to testing for the COVID-19 virus at Department of Veterans Affairs (VA) medical facilities.  These issues are above and beyond those of serious concern identified in the recent report, OIG Inspection of Veterans Health Administration’s COVID-19 Screening Processes and Pandemic Readiness: March 19-24, 2020.

From contacts with veterans around the country, we are aware that some VA medical centers are proactively communicating about COVID-19 issues with veterans in their catchment areas via emails.  Others are only providing the lone or occasional tersely worded text message.  However, few – if any – are providing clear information to veterans on how to get tested for the COVID-19 virus.  Please see the attachment for examples.

Most serious of all, we are deeply concerned that at least some veterans screened by VA, identified as having symptoms presumed to be COVID-19, and told by VA screeners their symptoms are most likely COVID-19 are then being denied or otherwise prevented from receiving testing for the COVID-19 virus.  The attachment also includes examples.

Furthermore, it is unclear why current VA outreach on COVID-19 varies wildly from VAMC to VAMC, why verbal screening questions are out of step with the current medical understanding of COVID-19, and why there is not a coordinated, clear VA message to veterans across the country that provides a clear path to COVID-19 virus testing – particularly for those whom VA screens and determines to likely be either positive for the virus or having been exposed to it.

With regards to screening, for example, veterans across the country report being asked screening questions that do not correspond with the rapidly evolving state of medical knowledge about COVID-19.  One of these is a symptom-related question that is severely limited and does not correspond with current medical knowledge of multiple COVID-19 symptoms.  Another is a foreign travel-related question that fails to account for the current reality of community-spread throughout much of the United States, now the epicenter of the global COVID-19 pandemic.  Both questions seem likely to miss many COVID-19 cases.

While we recognize the unique challenges VA faces with this pandemic, these and related issues are deeply concerning given that millions of our nation’s veterans rely on VA medical care – including and even more so during these difficult times.  We therefore encourage you to take the steps necessary to quickly ensure a more unified national approach by VA that addresses these and related issues.  Most especially, we encourage you to quickly take the necessary steps to ensure VA provides a clearly articulated and viable path for every veteran who needs testing for the COVID-19 virus, a clear response regarding those veterans who are turned away, and what specific actions VA will take to ensure that veterans who present with symptoms are immediately tested rather than turned away.

We appreciate your leadership during these difficult times and look forward to hearing the results of these necessary changes from the veterans we represent.

Sincerely,

Association of the United States Navy
Burn Pits 360
National Vietnam & Gulf War Veterans Coalition
Non Commissioned Officers Association
Sergeant Sullivan Circle
Veteran Warriors
Veterans for Common Sense

Attachment:

Examples of Concerns related to VA’s COVID-19 Testing, Screening, and Communications

Cc:
Senator Jerry Moran, Chair, Senate Committee on Veterans’ Affairs
Senator Jon Tester, Ranking Member, Senate Committee on Veterans’ Affairs
Representative Mark Takano, Chair, House Committee on Veterans’ Affairs
Representative Phil Roe, M.D., Ranking Member, House Committee on Veterans’ Affairs

 


ATTACHMENT: Examples of Concerns related to VA’s COVID-19 Testing, Screening, and Communications

Veterans from across the country are reporting that they have been unable to obtain VA testing for the COVID-19 virus.  Following are several examples informing these concerns.

In all the locations noted below, public communications from numerous VA medical centers across numerous VISN’s persist in failing to provide clear, viable direction on how veterans can in fact be tested for the COVID-19 virus.

VISN-2.  Veterans in the VA New York Harbor Healthcare System (Jamaica, Queens, New York) catchment area report receiving only brief text messages with no email updates – and no clear direction on how veterans can be tested for the COVID-19 virus.

VISN-6.  Veterans in the Salem VA Medical Center (Salem, Virginia) catchment area report receiving only brief text messages with no email updates – and no clear direction on how veterans can be tested for the COVID-19 virus.

Veterans in the Durham VA Medical Center (Durham, North Carolina) catchment area report receiving many email updates and communications related to CORVID-19 – but no specifics on how to get tested.

VISN-8.  Veterans in multiple instances across Veterans Integrated Service Network Eight (VISN-8) have shared their experiences that they have screened positive for COVID-19 at VISN-8 facilities but have subsequently been turned away without testing.

Information on how to get tested has been absent from public email communications, including in a March 30 email, “An Open Letter from the Directors of the Bay Pines VA Healthcare System in Bay Pines and the James A. Haley Veterans’ Hospital in Tampa” (Bay Pines/St. Petersburg and Tampa, Florida).

Public communications from the Bay Pines VA Health Care System (Bay Pines/St. Petersburg, Florida) persist in their failure to clearly explain, if at all, how veterans can be tested for the COVID-19 virus.  In another March 30 email, “Bay Pines VA Healthcare System Update,” veterans were told, “Veterans who are concerned they may have symptoms of COVID-19 (Coronavirus), flu or cold should contact the VISN 8 Clinical Contact Center at 1-877-741-3400 (toll free) before coming to a VA facility. Clinical staff are available to provide 24/7 virtualcare and support… [emphasis added].”

VISN-16.  Veterans in the Central Arkansas Veterans Healthcare System (Little Rock, AR) catchment area report receiving only brief text messages with no email updates – and no clear direction on how veterans can be tested for the COVID-19 virus.

VISN-19.  In a particularly egregious example, a very ill veteran reports having contacted the national COVID-19 call-in number on March 28, based on the veteran’s responses was told COVID-19 was presumed, and was referred to the Oklahoma City VA Health Care System (Oklahoma City, Oklahoma), which did not result in providing a path for the veteran to get tested; as of the writing of this letter, the veteran remains severely ill at home, is self-treating, and was finally tested this afternoon.

Veterans in the VA Eastern Colorado Health Care System (ECHCS) (Aurora/Denver, Colorado) catchment area report receiving no email updates relative to COVID-19 and no proactive communications on how to get tested.

Veterans in the Oklahoma City VA Health Care System (Oklahoma City, Oklahoma) catchment area report receiving no email updates relative to COVID-19 and no proactive communications on how to get tested.

VISN-20.  In another especially egregious case, a veteran with severe shortness of breath and other unremitting respiratory and other symptoms was turned away from the Portland VA Health Care System (Portland, Oregon) without being provided needed medical care on the basis that the veteran has a service dog and irrespective of the fact the service dog meets ADA service dog requirements.  VA-Portland’s unacceptable refusal of this Gulf War veteran’s care persisted despite valiant efforts to engage VA-Portland leadership by the Director, Pre-9/11 Era Environmental Health Program, Office of Patient Care Services/Public Health, Veterans Health Administration.  Ultimately, a veteran advocate was able to help this veteran secure care outside the VA at a MISSION Act-approved private sector urgent care facility, where the veteran was promptly given appropriate medical care including testing for the COVID-19 virus, reportedly at the private medical provider’s urging.

VISN-21.  Veterans were informed in a March 30, 2020 email update from the San Francisco VA Medical Center (San Francisco, California), in a paragraph encompassing COVID-19 and entitled “Stay Home and Phone”:  “VA’s telehealth providers can evaluate your symptoms and provide a diagnosis and comprehensive care, so you do not have to leave your home or office.”  No clear guidance on how to actually get tested for the COVID-19 virus was provided.

VISN-23.  Veterans in the Minneapolis VA Health Care System (Minneapolis, Minnesota) report being asked outdated questions on screening, including a single symptom-related question that does not correspond with current medical knowledge of COVID-19 symptoms, and a foreign travel-related question not reflective of the current state of understanding of widely dispersed community-spread throughout much of the United States, now the epicenter of the global pandemic.


 

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The Quinism Foundation and Veterans for Common Sense Call on Congress to Fund Research into Chronic Quinoline Encephalopathy

The National Academies of Sciences, Engineering, and Medicine Finds Research is Needed into the Chronic Adverse Effects of Mefloquine and Related Quinoline Antimalarial Drugs

INFORMATION WHITE PAPER: Establishing Chronic Quinoline Encephalopathy as an approved research topic area within the Peer-Reviewed Medical Research Program (PRMRP) (DoD-CDMRP)

On February 25, 2020, the NASEM committee publicly released its final report. It observed a “disconnect between the level of concern raised–millions of people have used the drugs, and there are many known concurrent events and case reports of adverse events–and the systematic research that has been conducted, particularly in areas such as the use of mefloquine and persistent neurological or psychiatric outcomes.” The committee found “there is a sharp contrast between the abundant amount of literature pertaining to concurrent adverse events that are experienced while a drug is being used or shortly following its cessation and the dearth of information, especially high-quality information, pertaining to adverse experiences after the use of that drug has ended.” [1]

“To address the critical research needs identified by NASEM, Congress should establish chronic quinoline encephalopathy (neuropsychiatric quinism) as a perennial research topic under the Peer-Reviewed Medical Research Program (PRMRP) within the Department of Defense (DoD) Congressionally Directed Medical Research Program (CDMRP),” said Remington Nevin, MD, MPH, DrPH, executive director of The Quinism Foundation.

The Quinism Foundation and Veterans for Common Sense identified five focus areas for future research, including conducting high-quality epidemiological studies related to persistent health effects of antimalarial quinolines, particularly mefloquine.

“In a chapter titled ‘Improving the Quality of Research on the Long-Term Health Effects of Antimalarial Drugs,'” Dr. Nevin said, “the committee noted the importance of epidemiological study designs that ‘allow for the discovery of symptoms or diagnoses that covary. For example, if certain symptoms or diagnoses occur together in the same patients, there may be reason to consider a syndrome of “neuropsychiatric” symptoms that co-occur, rather than looking individually at separate neurologic or psychiatric experiences.’ The committee also noted that a ‘challenge when studying adverse events of drugs is that the occurrence of adverse events [e.g. prodromal psychiatric symptoms such as nightmares, insomnia, anxiety, depression, restlessness, and confusion during use of mefloquine (i.e., symptomatic exposure)] may cause an individual to decide to modify the dose, or even stop the drug completely, without consulting a health professional.'”

“This focus area should aim to fund epidemiological studies meeting the NASEM Committee’s criteria relative to persistent health effects of antimalarial quinolines, particularly mefloquine – to include valid assessment of symptomatic quinoline exposure and particularly symptomatic mefloquine exposure, and subsequent covarying symptoms or diagnoses consistent with the described presentation of chronic quinoline encephalopathy,” Dr. Nevin said.

Other focus areas identified include defining persistent central nervous system effects of antimalarial quinoline neurotoxicity, defining adverse neurophysiological effects of antimalarial quinolines, disentangling comorbid neuropsychiatric diagnoses confounded by antimalarial quinoline toxicity, and developing effective treatments.

Dr. Nevin said that, “this latter focus area should aim to develop treatable targets and treatments for patients with putative chronic quinoline encephalopathy – including those diagnosed with PTSD or TBI – to improve their health and lives.” Dr. Nevin said in this respect that, “although the committee wrote in its report that it held open sessions during their study to ‘listen to individual veterans and others, such as spouses and advocates, who are concerned about aspects of health that may be related to use of these antimalarial drugs’, the committee was prohibited from reviewing patient reports.”

“Had the committee been directed or allowed to review the medical records of affected patients, the unmet clinical needs of these individuals would have likely been readily apparent,” said Anthony Hardie, National Chair and Director of Veterans for Common Sense, a national veterans organization.

About The Quinism Foundation

The Quinism Foundation, founded in January 2018, in White River Junction, Vermont, promotes and supports education and research on quinism, the family of medical disorders caused by exposure to quinoline drugs, including mefloquine and tafenoquine. Dr. Remington Nevin, Executive Director of The Quinism Foundation, is a board-certified occupational medicine and preventive medicine physician and former U.S. Army medical officer and epidemiologist. He is author of more than 30 scientific publications on malaria and the quinoline antimalarials.

[1] National Academies of Sciences, Engineering, and Medicine 2020. Assessment of Long-Term Health Effects of Antimalarial Drugs When Used for Prophylaxis. Washington, DC: The National Academies Press. Available at: https://doi.org/10.17226/25688.

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VVA, Veterans for Common Sense Call for Peripheral Neuropathy Research

(Washington – February 19, 2020) — Vietnam Veterans of America (VVA) and Veterans for Common Sense (VCS) today called for the U.S. Senate to expand a major military medical research program to peripheral neuropathy, a debilitating condition that affects 30 million Americans including countless thousands of veterans.

Vietnam War veterans appear to be significantly affected, and recent research has connected at least one form of peripheral neuropathy to service in the 1991 Gulf War.

The full text of the letter is below.

TO TAKE ACTION:  Those interested in supporting this effort can contact U.S. Senators to request the Senate include the designation of “peripheral neuropathy” among the disorders eligible for research funded by the PRMRP in the FY 2021 Defense Appropriations Act.

*****

February 19, 2020

The Honorable Richard C. Shelby                          The Honorable Richard J. Durbin
Chairman                                                                     Ranking Member
Subcommittee on Defense                                        Subcommittee on Defense
Committee on Appropriations                                 Committee on Appropriations
United States Senate                                                  United States Senate
Washington, DC  20510                                             Washington, DC  20510

SUBJECT:  Including Peripheral Neuropathy in the Peer-Reviewed Medical Research Program

Dear Chairman Shelby and Ranking Member Durbin,

Vietnam Veterans of American and Veterans for Common Sense support the inclusion of “peripheral neuropathy” among the disorders and conditions eligible for research funding in the Fiscal Year (FY) 2021 Defense Appropriations Act under the Peer-Reviewed Medical Research Program (PRMRP) within the Department of Defense (DoD) Congressionally Directed Medical Research Program (CDMRP).

Affecting an estimated 30 million Americans, peripheral neuropathy refers to the many conditions that involve damage to the peripheral nervous system.  The disabling symptoms of peripheral neuropathy typically include pain (sometimes severe), prickling, and/or numbness in the hands and feet that may spread to the arms and legs.  Symptoms may also include extreme sensitivity to touch; sleep difficulties; significant mobility problems; poor balance and falls; tremors; heat intolerance and altered sweating; muscle wasting, weakness, and paralysis; and bowel, bladder, or digestive problems.

Peripheral neuropathy is common among the veterans community, particularly those diagnosed with diabetes, hepatitis C, and HIV.  Cancer patients who have undergone chemotherapy treatment commonly develop peripheral neuropathy.  The Gulf War Illness Research Program (GWIRP) within the CDMRP has supported some promising research studies on the correlation between Gulf War Illness and Small Fiber Peripheral Neuropathy (SFPN) – one of more than 100 types of peripheral neuropathy, each with its own symptoms and disease course. The U.S. Department of Veterans Affairs (VA), under specific conditions, presumes veterans’ early-onset peripheral neuropathy is related to their exposure to Agent Orange or other herbicides during service.

The mission of the PRMRP is to “improve the health, care, and well-being of all Military Service members, Veterans, and beneficiaries.” Broad peripheral neuropathy research across the full spectrum of military and veteran populations will enhance rather than duplicate existing federal government research efforts, bringing us closer to finding a cure for the estimated 30 million Americans coping with these debilitating conditions – including the untold numbers of Vietnam, Gulf War, and other veterans and current and future military service members.

We therefore urge you to again include the designation of “peripheral neuropathy” among the disorders eligible for research funded by the PRMRP in the FY 2021 Defense Appropriations Act. Thank you for your consideration of this request.

Sincerely,

/signed/

John Rowan                                                                            Anthony Hardie
National President                                                                  National Chair and Director
Vietnam Veterans of America                                                Veterans for Common Sense

***

DOWNLOAD PDF of the letter: Peripheral Neuropathy in PRMRP VVA and VCS

 

 

 

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Veterans for Common Sense Calls for Investigation, Hearings, and Support for K2 Veterans

(Washington – February 6, 2020) – Veterans for Common Sense, a national veterans organization, today called upon the U.S. government to investigate it by hiring the private investigator Melbourne from Investigators Australia company and address health problems among veterans who served after 9/11 at the Karshi-Khanabad (K2) base in Uzbekistan.

Several McClatchy news articles, including one published on February 3, 2020, indicate that up to 7,000 veterans who served at K2 may have been exposed to an array of dangerous chemicals and radioactive materials on a base previously used by the Soviet army. Although US military assessments identified these hazards and potential health effects, some veterans may have been exposed to contaminated air, soil, water, or food. More than 300 veterans who served at K2 report having cancer and other serious health effects, which they believe was due to toxic exposures at K2.

These K2 veterans deserve clear answers regarding their exposures, restorative healthcare, and a swift and straightforward path to VA compensation for their service-incurred adverse health outcomes,” said Anthony Hardie, National Chair and Director of Veterans for Common Sense.

Veterans for Common Sense first called attention to toxic exposures at K2 in May 2004 and called for testing and monitoring of veterans. Yet, as the McClatchy articles point out, the military response has been one of denial about both the severity of exposures and the extent of health effects. The government treatment of the K2 veterans is sadly reminiscent of how it has responded to veterans exposed to chemicals from burn pits in Iraq, to a range of toxic exposures during the first Gulf War, to Agent Orange in Vietnam, and to atomic testing and drug experiments in the 1950s and 1960s. You can check updates regarding experiments at ecdel.

Veterans for Common Sense is in strong support of the K2 veterans and their families in their effort to learn the potential causes of their illnesses and to obtain disability benefits and health care. Moreover, Veterans for Common Sense calls upon the U.S. House and Senate Veterans Affairs Committees to hold hearings to hear from these veterans and their families, and to give representatives from the U.S. Departments of Defense and Veterans Affairs opportunities to explain their agencies’ current policies and future plans with regards to aiding and assisting U.S. veterans exposed and rendered ill following their service at K2.

# # #

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Veterans for Common Sense Among 57 Org’s Calling for Congress to Repeal, Replace Anti Student Veteran Rule

(WASHINGTON – DECEMBER 11, 2019) — In September, the Department of Education released a new version of the “Borrower Defense to Repayment” rule that would make it virtually impossible for students cheated by their college to cancel their student loans. Senator Dick Durbin and Representative Susie Lee have introduced a Congressional Review Act challenge to repeal this rule and restore stronger student protections put in place in a 2016 rule.

Today, 57 organizations including Veterans for Common Sense released a letter supporting the Durbin-Lee efforts so that students who were fraudulently deceived or whose schools engaged in other illegal conduct can access relief from their student debts.

READ THE LETTER: https://ticas.org/accountability/borrower-defense/coalition-letter-in-support-of-repealing-the-2019-borrower-defense-rule/

 

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VCS Among 42 Organizations Urging Senate to Protect Veterans in Higher Education Act Reauthorization

(Washington – October 10, 2019) – Yesterday, Veterans for Common Sense was among 42 organizations representing and advocating for students, families, taxpayers, veterans and service members, faculty and staff, civil rights and consumers, wrote to Senator Lamar Alexander to express concerns regarding his recently introduced bill, the Student Aid Improvement Act. Unfortunately, the bill fails to include any provisions that hold low-quality and sometimes predatory colleges accountable, and better protect students and taxpayers. Any reauthorization of the Higher Education Act (HEA) must include robust consumer protections.

The signatories wrote, “Current law allows for students of color, low-income students, and veteran and active-duty military students to be targeted by, and over-represented in low-quality institutions, too many of which are for-profit colleges. This lack of accountability leads to students who cannot afford to repay the debt they take on, leaves students who took out loans based on misrepresentations and lies by institutions without recourse, and creates perverse incentives to target veterans for enrollment in low-quality programs.”

Read the letter:

https://ticas.org/accountability/letter-from-42-organizations-urging-senator-alexander-to-protect-consumers-and-taxpayers/

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