Veteran Care Improvement Act of 2023

Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; S. 1315, HEALTH Act of 2023; Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 762, HCBS Access Act; S. 100, Better Care Better Jobs Act; H.R. 547, Better Care Better Jobs Act; Tax credits for long term care expenses; H.R. 1795, Homecare for Seniors Act; S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; Veteran Care Improvement Act of 2023 (H.R. 3520); Veterans' Health Empowerment, Access, Leadership, and Transparency for our Heroes (HEALTH) Act of 2023 (S.1315); Credit for Caring Act of 2024 (S.3702; H.R. 7165)

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 762, HCBS Access Act; S. 100, Better Care Better Jobs Act; H.R. 547, Better Care Better Jobs Act; Tax credits for long term care expenses; H.R. 1795, Homecare for Seniors Act; S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; CMS Proposed Rule (CMS-2442-P), Ensuring Access to Medicaid Services; Veteran Care Improvement Act of 2023 (H.R. 3520); Veterans' Health Empowerment, Access, Leadership, and Transparency for our Heroes (HEALTH) Act of 2023 (S.1315); Credit for Caring Act of 2024 (S.3702; H.R. 7165); S. 2513 Veterans Improvement Act of 2025

Client expense: Not reported · Firm income: $30,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 762, HCBS Access Act; S. 100, Better Care Better Jobs Act; H.R. 547, Better Care Better Jobs Act; Tax credits for long term care expenses; H.R. 1795, Homecare for Seniors Act; S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; Veteran Care Improvement Act of 2023 (H.R. 3520); Veterans' Health Empowerment, Access, Leadership, and Transparency for our Heroes (HEALTH) Act of 2023 (S.1315); Credit for Caring Act of 2024 (S.3702; H.R. 7165)

Client expense: Not reported · Firm income: $30,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 762, HCBS Access Act; S. 100, Better Care Better Jobs Act; H.R. 547, Better Care Better Jobs Act; Tax credits for long term care expenses; H.R. 1795, Homecare for Seniors Act; S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; CMS Proposed Rule (CMS-2442-P), Ensuring Access to Medicaid Services; Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 762, HCBS Access Act; S. 100, Better Care Better Jobs Act; H.R. 547, Better Care Better Jobs Act; Tax credits for long term care expenses; H.R. 1795, Homecare for Seniors Act; S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; Veteran Care Improvement Act of 2023 (H.R. 3520); Veterans' Health Empowerment, Access, Leadership, and Transparency for our Heroes (HEALTH) Act of 2023 (S.1315); Credit for Caring Act of 2024 (S.3702; H.R. 7165)

Client expense: Not reported · Firm income: $30,000

VA budget: Lobbied for Congress to provide funding to plug a $15 billion budget shortfall for FY 2024 and FY 2025. Veterans Benefits Administration: Lobbied for changes to and oversight of Veterans Benefits Administration's (VBA) employee performance standards. Lobbied for increased oversight and changes to performance standards for Legal Administrative Assistants in the VBA National Call Centers. Lobbied for comprehensive changes to internal VBA processes for claims, including changes to the VBA National Work Queue. Lobbied to require the VA to include VA employee input when making changes to the claims process, employee performance standards, and training for claims processors. Lobbied on the processing of complex claims within the Veterans Benefits Administration, including how it relates to Military Sexual Trauma, Traumatic Brain Injury, and catastrophic injury claims. Lobbied on the specialization of claims processing for highly complex cases. Lobbied to prevent compassion fatigue for certain claims processors. Lobbied for reforms to the VBA National Work Queue. Lobbied for oversight and improvements into VBA employee training. Lobbied on VBAs use of Performance Improvement Plans. Board of Veterans Appeals: Lobbied for the introduction and in support of H.R. 9046, the Board of Veterans Appeals Attorney Retention and Backlog Reduction Act including the re-instatement of GS-14 career ladder position and the career path to a journeyman GS-15 position. Lobbied for the re-instatement of experience requirements for Board of Veterans Appeals Members (Veterans Law Judgements). Lobbied in support of and for changes to H.R. 1378, the Veterans Appeals Backlog Improvement Act. Lobbied for additional oversight at the Board of Veterans Appeals. Lobbied for additional training for Board of Veterans Appeals Attorneys. Lobbied in support of ANS to H.R. 1530, the Veterans Benefits Improvement Act of 2023. C&P Exams: Lobbied against contracting out of Compensation and Pension (C&P) Exams and bringing those exams back into the VA. Lobbied to keep all specialty C&P Exams including but not limited to Traumatic Brain Injury (TBI), Post Traumatic Stress Disorder (PTSD), Military Sexual Trauma (MST), veterans who served as Prisoners of War (POWs), veterans who suffered catastrophic injuries, and veterans who are currently eligible to pursue toxic exposure claims. Lobbied for the VA to utilize more internal C&P Providers by hiring more staff and returning staff to C&P positions who had previously been reassigned. Lobbied to keep Integrated Disability Evaluation System (IDES) Exams within the VA. Lobbied for the continued oversight of contract C&P Exams. Lobbied to make C&P Exams available in every VA Medical Center. Lobbied to make sure the VA is in compliance with Section 2002 of the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020. Lobbied in support of S. 2718, the Medical Disability Exam Improvement Act of 2023. Lobbied for technical changes to S. 3979, to make permanent and codify the pilot program for use of contract physicians for disability examinations, and for other purposes. Collective Bargaining Rights: Lobbied in support of H.R. 4906 "Protecting VA Employees Act" to repeal parts of the VA Accountability Act. Lobbied in support of H.R. 6538, the VA Correct Compensation Act of 2023 and for its introduction in the Senate. Lobbied in support of S. 4046/H.R. 9855, the "VA Employee Fairness Act. Lobbied in support of and for changes to S. 2679, the Leadership, Engagement, Accountability, and Development (LEAD) Act of 2023. Lobbied in opposition to H.R. 4278 / S.2158, the "Restore Department of Veterans Affairs Accountability Act." Lobbied in support of and for changes to H.R. 6531, the TRAIN VA Employees Act. HR modernization: Lobbied to address problems created by VA reorganization of its human resources processes including centralization and implementation of new information technology systems, and practices and policies related to filling and posting unfilled positions. Lobbied to have Congress require the VA to return the HR functions back to VA facilities and to appropriate funding for it. VA Compensation: Lobbied in support of H.R. 7127/S. 3688, the "FAIR Act" to raise pay for federal employees at the VA. Lobbied in support of H.R. 866/S. 3194, the "Equal COLA Act" to protect VA employees in FERS. Lobbied in support of H.R. 82/S. 597, the Social Security Fairness Act" to protect VA employees affected by the Windfall Elimination Provision (WEP) and the Government Pension Offset (GPO). Lobbied in support of H.R. 543, the "VA CPE Modernization Act." Lobbied in support of H.R. 1322 the "Law Enforcement Officers Equity Act" and S. 1658, the "Law Enforcement Officers Parity Act" as it pertains to VA Police Officers. VA Infrastructure: Lobbied for restriction on VA's authority to close or reduce services at rural healthcare facilities in the 2024 and 2025 VA Military Construction appropriations bill. VA Quality: Lobbied to amend H.R. 6330, the Veterans Sentinel Act to include data collection and analysis for suicides that happen when veterans are served at non-VA facilities. Privatization: Lobbied against continued increased spending on community care at the expense of VA's own staffing and infrastructure. Lobbied against an amendment to H.R. 8580, the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2025 forcing VA to apply the same access standards for Mental Health Residential Rehabilitation Treatment Program (MH RRTP) as for primary care, specialty care, and non-institutional extended care services. Lobbied against amendments to H.R. 8070, the Servicemember Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025 that would codify Trump-Era access standards responsible for rapid privatization of the VA, prohibit VA from modifying access standards to allow telehealth to satisfy these access standards and require VA to meet strict timeframes evaluating high-risk veterans for referral to residential treatment and rehabilitative programs without providing any additional funding to staff these new obligations. Lobbied against amendments to H.R. 8070, the Servicemember Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025 that would require VA to meet 72-hour evaluation timeframe for evaluating high-risk veterans for residential treatment centers without providing adequate funding or putting equivalent credentialing and quality requirements on private programs. Lobbied against a proposal to create a pilot program under which the Secretary would contract out to fill vacancies at a medical facility with non-department health care providers. Lobbied against a provision in H.R. 9438, the No Wrong Door for Veterans Act, reduces the wait time for VA mental health care from the current 20 day to just 3 days. Lobbied in opposition to H.R. 9146, Ensuring Continuity in Veterans Health Act, which would require the Secretary to include continuity of care as one of the criteria used to determine when private care would be in the best medical interest (BMI) of a veteran undermining VAs ability to decide when returning a veteran to the VA is the in the best interest of the veteran. Lobbied against the Veterans Mental Health Access Act, which would create a parallel private mental health program that supplants VAs direct care system rather than supplement it when veterans cannot reasonably access VA care. Lobbied in opposition to H.R. 3520, the Veteran Care Improvement Act of 2023, H.R. 1315, the Health Act and S. 2649, Making Community Care Work for Veterans Act. Lobbied in opposition to H.R. 3146, the Veterans Health Care Freedom Act, which would codify community care access standards that create a bias toward referral to community care over VA's own healthcare. Lobbied for oversight of new VA private contracting program, the Integrated Critical Staffing Program. Lobbied for oversight of VA staffing reductions. Lobbied against potential closure or privatization of services at VA Medical Centers in Philadelphia and Coatesville, PA. Testimony, Statements for the Record, and Letters. Lobbied for better information on scheduling and appointment times for both in-house VA and private care. Lobbied for more information about the costs of VA care. Lobbied against VA raising the ceiling for payment to third party private, Community Care contractors. Lobbied against prohibiting public health care programs from using QALYs to determine price. Lobbied in opposition to H.R. 485, the Protecting Health Care for All Patients Act, and urge that it be defeated on the House floor. H.R. 485 would increase already high healthcare costs for the Federal Employees Health Benefits Program (FEHBP), which covers the vast majority of AFGE members and their families. In additional to FEHBP, the bill would prohibit Medicaid, Medicare Advantage (MA) plans, Medicare Part D Plans (PDPs), the VA, and the Defense Health Agency from using Quality Adjusted Life Years (QALYs) - a measure that ascertains the value of a drug - to make decisions about a drugs price. Medicare already prohibits the use of QALYs in ways that discriminate against the elderly (such as by valuing the extension of life of an older person as less than extending the life of a younger person). Lobbied against amendments to H.R. 8070, the Servicemember Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025 that would: 1) codify Trump-Era access standards responsible for rapid privatization of the VA, prohibits VA from modifying access standards to allow telehealth to satisfy these access standards and requires VA to meet strict timeframes evaluating high-risk veterans for referral to residential treatment and rehabilitative programs without providing any additional funding to staff these new obligations and 2) require VA to meet 72-hour evaluation timeframe for evaluating high-risk veterans for residential treatment centers without providing adequate funding or putting equivalent credentialing and quality requirements on private programs. Lobbied against Amendment to H.R. 8580, the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2025 forcing VA to apply the same access standards for Mental Health Residential Rehabilitation Treatment Program (MH RRTP) as for primary care, specialty care, and non-institutional extended care services that would not apply to private RRTP facilities, promoting privatization. Lobbied against provisions in H.R. 8371, the Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act that would allow decisions between a veteran and a doctor to remain final without VA authorization and provisions that would require strict timeframes for placement of high-risk veterans in mental health treatment programs for VA programs but not private programs. Lobbied in support of final passage of S. 141, the Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act. Statements and Correspondence: Testified before the House Veterans Affairs Subcommittee on Health on December 17, 2024 legislative hearing. Specific Legislation: Lobbied in support of H.R. 6538, the "VA Correct Compensation Act of 2023." Lobbied in support of S. 4046/H.R. 9855, the VA Employee Fairness Act. Lobbied in support of H.R. 536/S. 124, the "FAIR Act" to raise pay for federal employees at the VA. Lobbied in support of H.R. 866/S. 3194, the "Equal COLA Act" to protect VA employees in FERS. Lobbied in support of H.R. 82/S. 597, the "Social Security Fairness Act" to protect VA employees affected by the Windfall Elimination Provision (WEP) and the Government Pension Offset (GPO). Lobbied in support of H.R. 543, the "VA CPE Modernization Act." Lobbied in support of H.R. 1322 the "Law Enforcement Officers Equity Act" and S. 1658, the Law Enforcement Officers Parity Act" as it pertains to VA Police Officers. Lobbied in support of and for changes to H.R. 1378, the "Veterans' Appeals Backlog Improvement Act." Lobbied for changes to S. 10 the "VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support (CAREERS) Act of 2023." Lobbied for changes to S. 10, the "VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support" (CAREERS) Act related to market pay, performance pay, cost of living adjustments, licensure, and certification reimbursement, covid leave flexibility, and recruitment and retention at VA community living centers. Also lobbied for specific changes to the bill related to the inclusion of VA Police Pensions, Continuing Professional Education Benefits, and Collective Bargaining Rights for Title 38 Employees. Lobbied to renew a defunded corpsmen and medic vocational education and training program Grow Our Own. Lobbied in support of H.R. 4906 "Protecting VA Employees Act" to repeal parts of the VA Accountability Act. Lobbied for oversight of the "Honoring Our PACT Act." Lobbied in opposition to H.R. 4278 / S. 2158, the "Restore Department of Veterans Affairs Accountability Act." Lobbied in support of and for changes to H.R. 6531, the TRAIN VA Employees Act. Lobbied in support and for changes to S. 2679, the VA LEAD Act of 2023. Lobbied in opposition H.R. 3520, the Veteran Care Improvement Act of 2023. Lobbied in opposition to S. 2649, the Making Community Care Work for Veterans Act. Lobbied in opposition to S. 1315, the HEALTH Act. Lobbied in opposition to H.R. 485, the Protecting Health Care for All Patients Act. Lobbied for changes to H.R. 1089, the "VA Medical Center Facility Transparency Act." Lobbied in support of H.R. 1530, the "Veterans Benefits Improvement Act of 2023." Lobbied in support of H.R. 3504, the "VA Medical Center Security Report Act." Lobbied in support of, S. 1951, the "Department of Veterans Affairs Income Eligibility Standardization Act," which would eliminate subcategories of priority for enrollment to make more veterans eligible for enrollment in VA health care. Lobbied in support of the, S. 1954, the "Improving Whole Health for Veterans with Chronic Conditions Act," which would create a pilot to provide dental benefits to veterans with diabetes and ischemic heart disease. Lobbied in opposition to S. 1545, "Veterans Health Care Freedom Act," which would set up a pilot program to allow veterans to choose community providers at their preference without the need for referral by the VA. Lobbied in opposition to H.R. 754, Modernizing Veterans' Health Care Eligibility Act, which establishes the Commission on Eligibility (staffed with bipartisan congressional and presidential appointees) to examine veterans' eligibility for health care from the VA. Lobbied in opposition to H.R. 41, VA Same-Day Scheduling Act of 2023, which requires the VA to ensure that when a veteran enrolled in the VA health care system contacts the VA by telephone to schedule an appointment for care or services at a VA facility, the appointment must be scheduled on that same call. Lobbied in support of S. 1113, the "Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act," which would set minimum nurse‐ patient staffing requirements for public and private health care systems, including YA and Department of Defense medical facilities. Lobbied in support of H.R. 542, the "Elizabeth Dole Home-and Community-Based Services for Veterans and Caregivers Act." Lobbied in support of S. 2718, the Medical Disability Exam Improvement Act of 2023. Lobbied in opposition to H.R. 3176, Veterans Health Care Freedom Act, which creates a three-year pilot program allowing veterans to obtain hospital care, medical services, psychological services, and extended care bypassing VA authorization and the need to meet access standards. Lobbied in opposition to H.R.5287, the Veterans Access to Direct Primary Care Act, would establish Health Savings Accounts (HSAs) funded by the VA that veterans could use for private healthcare. Veterans electing these HSAs would be completely barred from accessing VA healthcare services. Lobbied in opposition to the Complete the Mission Act (No bill number). This proposal codifies the Community Care access standards, modifies 38 USC 1703(d)(2) to make veteran preference to go to a private provider a criterion for what constitutes best medical interest and creates a pilot three-year pilot program in at least five locations where veterans could access outpatient mental health and substance use services. AFGE opposes this provision as it would circumvent VAs ability to coordinate care and is unsustainable for the VA in the long term. Lobbied to preserve changes to H.R. 3738, a bill To amend title 38, United States Code, to establish in the Department of Veterans Affairs the Veterans Economic Opportunity and Transition Administration, and for other purposes. Lobbied for technical changes to S. 3979, to make permanent and codify the pilot program for use of contract physicians for disability examinations, and for other purposes. Lobbied in support of and for changes to H.R. 7765, the VA Security Screening Pilot Program Act Lobbied for the introduction and support of the Board of Veterans Appeals Attorney Retention and Backlog Reduction Act. Lobbied for changes to H.R. 7793 the Veterans Appeals Operations Expansion Act of 2024; Lobbied for changes to H.R. 7917, the Veterans Appeals Efficiency Act of 2024; Lobbied for changes to H.R. 7919, the Veterans Claims Quality Improvement Act of 2024. Lobbied or changes to H.R. 7883, the Toxic Exposures Examination Improvement Act Lobbied in opposition to H.R. 7734 the Personnel Integrity in Veterans Affairs Act of 2024 Lobbied in support of H.R. 9046, the Board of Veterans Appeals Attorney Retention and Backlog Reduction Act Lobbied in support of H.R. 2971, the Veterans Claims Education Act of 2023 Lobbied for changes to H.R. 8874, the Modernizing All Veterans and Survivors Claims Processing Act Lobbied in support of and for changes to H.R. 8879, the Improving VA Training for Military Sexual Trauma Claims Act Lobbied for changes to H.R. 8881, the Rural Veterans Improved Access to Benefits Act of 2024. Lobbied for passage of H.R. 9747, the Continuing Appropriations and Extensions Act, 2025 to continue to fund the federal government through December 20, 2024. Lobbied in support of final passage of S. 141, the Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act. Lobbied against expanding use of Schedule F for VA employees.

ACA Exchanges & Enrollment Prior Authorization Mental Health Parity Facilitating Accountability in Reimbursements Act (FAIR Act) (H.R. 3417) Site-based Invoicing and Transparency Enhancement (SITE) Act (S.1869) Lower Cost, More Transparency Act (H.R. 5378) AI Use in Healthcare Health Disparities, including Maternal Health and Rural Health Veteran Care Improvement Act of 2023 (H.R. 3520) Making Community Care Work for Veterans Act of 2023 (S.2649) Dept. of Defense Military OneSource Program Provider Directories Transparency in Coverage and Machine-Readable Files Change Healthcare Cyber Incident Telehealth Modernization Act of 2024 Addressing Anti-Competitive Contracting Clauses Act No Suprises Act Implementation Provider and Nursing Licensure

Client expense: $1,220,000 · Firm income: Not reported

ACA Exchanges & Enrollment Prior Authorization Mental Health Parity Facilitating Accountability in Reimbursements Act (FAIR Act) (H.R. 3417) Site-based Invoicing and Transparency Enhancement (SITE) Act (S.1869) Lower Cost, More Transparency Act (H.R. 5378) AI Use in Healthcare Health Disparities, including Maternal Health and Rural Health Veteran Care Improvement Act of 2023 (H.R. 3520) Making Community Care Work for Veterans Act of 2023 (S.2649) Dept. of Defense Military OneSource Program Provider Directories Transparency in Coverage and Machine-Readable Files Change Healthcare Cyber Incident Telehealth Modernization Act of 2024 Addressing Anti-Competitive Contracting Clauses Act No Suprises Act Implementation Provider and Nursing Licensure

Client expense: $1,220,000 · Firm income: Not reported

Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 762, HCBS Access Act; S. 100, Better Care Better Jobs Act; H.R. 547, Better Care Better Jobs Act; Tax credits for long term care expenses; H.R. 1795, Homecare for Seniors Act; S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; Veteran Care Improvement Act of 2023 (H.R. 3520); Veterans' Health Empowerment, Access, Leadership, and Transparency for our Heroes (HEALTH) Act of 2023 (S.1315); Credit for Caring Act of 2024 (S.3702; H.R. 7165)

Client expense: Not reported · Firm income: $30,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; S. 1315, HEALTH Act of 2023; Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 762, HCBS Access Act; S. 100, Better Care Better Jobs Act; H.R. 547, Better Care Better Jobs Act; Tax credits for long term care expenses; H.R. 1795, Homecare for Seniors Act; S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; Veteran Care Improvement Act of 2023 (H.R. 3520); Veterans' Health Empowerment, Access, Leadership, and Transparency for our Heroes (HEALTH) Act of 2023 (S.1315); Credit for Caring Act of 2024 (S.3702; H.R. 7165)

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 762, HCBS Access Act; S. 100, Better Care Better Jobs Act; H.R. 547, Better Care Better Jobs Act; Tax credits for long term care expenses; H.R. 1795, Homecare for Seniors Act; S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; CMS Proposed Rule (CMS-2442-P), Ensuring Access to Medicaid Services; Veteran Care Improvement Act of 2023 (H.R. 3520); Veterans' Health Empowerment, Access, Leadership, and Transparency for our Heroes (HEALTH) Act of 2023 (S.1315); Credit for Caring Act of 2024 (S.3702; H.R. 7165)

Client expense: Not reported · Firm income: $30,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 762, HCBS Access Act; S. 100, Better Care Better Jobs Act; H.R. 547, Better Care Better Jobs Act; Tax credits for long term care expenses; H.R. 1795, Homecare for Seniors Act; S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; CMS Proposed Rule (CMS-2442-P), Ensuring Access to Medicaid Services; Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 762, HCBS Access Act; S. 100, Better Care Better Jobs Act; H.R. 547, Better Care Better Jobs Act; Tax credits for long term care expenses; H.R. 1795, Homecare for Seniors Act; S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; Veteran Care Improvement Act of 2023 (H.R. 3520); Veterans' Health Empowerment, Access, Leadership, and Transparency for our Heroes (HEALTH) Act of 2023 (S.1315); Credit for Caring Act of 2024 (S.3702; H.R. 7165)

Client expense: Not reported · Firm income: $30,000

VA budget: Lobbied for Congress to provide funding to plug a $15 billion budget shortfall for FY 2024 and FY 2025. Veterans Benefits Administration: Lobbied for changes to and oversight of Veterans Benefits Administration's (VBA) employee performance standards. Lobbied for increased oversight and changes to performance standards for Legal Administrative Assistants in the VBA National Call Centers. Lobbied for comprehensive changes to internal VBA processes for claims, including changes to the VBA National Work Queue. Lobbied to require the VA to include VA employee input when making changes to the claims process, employee performance standards, and training for claims processors. Lobbied on the processing of complex claims within the Veterans Benefits Administration, including how it relates to Military Sexual Trauma, Traumatic Brain Injury, and catastrophic injury claims. Lobbied on the specialization of claims processing for highly complex cases. Lobbied for reforms to the VBA National Work Queue. Lobbied for oversight and improvements into VBA employee training. Lobbied on VBAs use of Performance Improvement Plans. Board of Veterans Appeals: Lobbied for the introduction and in support of H.R. 9046, the Board of Veterans Appeals Attorney Retention and Backlog Reduction Act including the re-instatement of GS-14 career ladder position and the career path to a journeyman GS-15 position. Lobbied for the re-instatement of experience requirements for Board of Veterans Appeals Members (Veterans Law Judgements). Lobbied in support of and for changes to H.R. 1378, the Veterans Appeals Backlog Improvement Act. Lobbied for additional oversight at the Board of Veterans Appeals. Lobbied for additional training for Board of Veterans Appeals Attorneys. Lobbied in support of ANS to H.R. 1530, the Veterans Benefits Improvement Act of 2023. C&P Exams: Lobbied against contracting out of Compensation and Pension (C&P) Exams and bringing those exams back into the VA. Lobbied to keep all specialty C&P Exams including but not limited to Traumatic Brain Injury (TBI), Post Traumatic Stress Disorder (PTSD), Military Sexual Trauma (MST), veterans who served as Prisoners of War (POWs), veterans who suffered catastrophic injuries, and veterans who are currently eligible to pursue toxic exposure claims. Lobbied for the VA to utilize more internal C&P Providers by hiring more staff and returning staff to C&P positions who had previously been reassigned. Lobbied to keep Integrated Disability Evaluation System (IDES) Exams within the VA. Lobbied for the continued oversight of contract C&P Exams. Lobbied to make C&P Exams available in every VA Medical Center. Lobbied to make sure the VA is in compliance with Section 2002 of the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020. Lobbied in support of S. 2718, the Medical Disability Exam Improvement Act of 2023. Lobbied for technical changes to S. 3979, to make permanent and codify the pilot program for use of contract physicians for disability examinations, and for other purposes. Collective Bargaining Rights: Lobbied in support of H.R. 4906 "Protecting VA Employees Act" to repeal parts of the VA Accountability Act. Lobbied in support of H.R. 6538, the VA Correct Compensation Act of 2023 and for its introduction in the Senate. Lobbied in support of S. 4046/H.R. 9855, the "VA Employee Fairness Act. Lobbied in support of and for changes to S. 2679, the Leadership, Engagement, Accountability, and Development (LEAD) Act of 2023. Lobbied in opposition to H.R. 4278 / S.2158, the "Restore Department of Veterans Affairs Accountability Act." Lobbied in support of and for changes to H.R. 6531, the TRAIN VA Employees Act. HR modernization: Lobbied to address problems created by VA reorganization of its human resources processes including centralization and implementation of new information technology systems, and practices and policies related to filling and posting unfilled positions. Lobbied to have Congress require the VA to return the HR functions back to VA facilities and to appropriate funding for it. VA Compensation: Lobbied in support of H.R. 7127/S. 3688, the "FAIR Act" to raise pay for federal employees at the VA. Lobbied in support of H.R. 866/S. 3194, the "Equal COLA Act" to protect VA employees in FERS. Lobbied in support of H.R. 82/S. 597, the Social Security Fairness Act" to protect VA employees affected by the Windfall Elimination Provision (WEP) and the Government Pension Offset (GPO). Lobbied in support of H.R. 543, the "VA CPE Modernization Act." Lobbied in support of H.R. 1322 the "Law Enforcement Officers Equity Act" and S. 1658, the "Law Enforcement Officers Parity Act" as it pertains to VA Police Officers. VA Infrastructure: Lobbied for restriction on VA's authority to close or reduce services at rural healthcare facilities in the 2024 and 2025 VA Military Construction appropriations bill. VA Quality: Lobbied to amend H.R. 6330, the Veterans Sentinel Act to include data collection and analysis for suicides that happen when veterans are served at non-VA facilities. Privatization: Lobbied against continued increased spending on community care at the expense of VA's own staffing and infrastructure. Lobbied against an amendment to H.R. 8580, the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2025 forcing VA to apply the same access standards for Mental Health Residential Rehabilitation Treatment Program (MH RRTP) as for primary care, specialty care, and non-institutional extended care services. Lobbied against amendments to H.R. 8070, the Servicemember Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025 that would codify Trump-Era access standards responsible for rapid privatization of the VA, prohibit VA from modifying access standards to allow telehealth to satisfy these access standards and require VA to meet strict timeframes evaluating high-risk veterans for referral to residential treatment and rehabilitative programs without providing any additional funding to staff these new obligations. Lobbied against amendments to H.R. 8070, the Servicemember Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025 that would require VA to meet 72-hour evaluation timeframe for evaluating high-risk veterans for residential treatment centers without providing adequate funding or putting equivalent credentialing and quality requirements on private programs. Lobbied against a proposal to create a pilot program under which the Secretary would contract out to fill vacancies at a medical facility with non-department health care providers. Lobbied against a provision in H.R. 9438, the No Wrong Door for Veterans Act, reduces the wait time for VA mental health care from the current 20 day to just 3 days. Lobbied in opposition to H.R. 9146, Ensuring Continuity in Veterans Health Act, which would require the Secretary to include continuity of care as one of the criteria used to determine when private care would be in the best medical interest (BMI) of a veteran undermining VAs ability to decide when returning a veteran to the VA is the in the best interest of the veteran. Lobbied against the Veterans Mental Health Access Act, which would create a parallel private mental health program that supplants VAs direct care system rather than supplement it when veterans cannot reasonably access VA care. Lobbied in opposition to H.R. 3520, the Veteran Care Improvement Act of 2023, H.R. 1315, the Health Act and S. 2649, Making Community Care Work for Veterans Act. Lobbied in opposition to H.R. 3146, the Veterans Health Care Freedom Act, which would codify community care access standards that create a bias toward referral to community care over VA's own healthcare. Lobbied for oversight of new VA private contracting program, the Integrated Critical Staffing Program. Lobbied for oversight of VA staffing reductions. Lobbied against potential closure or privatization of services at VA Medical Centers in Philadelphia and Coatesville, PA. Testimony, Statements for the Record, and Letters. Lobbied for better information on scheduling and appointment times for both in-house VA and private care. Lobbied for more information about the costs of VA care. Lobbied against VA raising the ceiling for payment to third party private, Community Care contractors. Lobbied against prohibiting public health care programs from using QALYs to determine price. Lobbied in opposition to H.R. 485, the Protecting Health Care for All Patients Act, and urge that it be defeated on the House floor. H.R. 485 would increase already high healthcare costs for the Federal Employees Health Benefits Program (FEHBP), which covers the vast majority of AFGE members and their families. In additional to FEHBP, the bill would prohibit Medicaid, Medicare Advantage (MA) plans, Medicare Part D Plans (PDPs), the VA, and the Defense Health Agency from using Quality Adjusted Life Years (QALYs) - a measure that ascertains the value of a drug - to make decisions about a drugs price. Medicare already prohibits the use of QALYs in ways that discriminate against the elderly (such as by valuing the extension of life of an older person as less than extending the life of a younger person). Lobbied against amendments to H.R. 8070, the Servicemember Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025 that would: 1) codify Trump-Era access standards responsible for rapid privatization of the VA, prohibits VA from modifying access standards to allow telehealth to satisfy these access standards and requires VA to meet strict timeframes evaluating high-risk veterans for referral to residential treatment and rehabilitative programs without providing any additional funding to staff these new obligations and 2) require VA to meet 72-hour evaluation timeframe for evaluating high-risk veterans for residential treatment centers without providing adequate funding or putting equivalent credentialing and quality requirements on private programs. Lobbied against Amendment to H.R. 8580, the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2025 forcing VA to apply the same access standards for Mental Health Residential Rehabilitation Treatment Program (MH RRTP) as for primary care, specialty care, and non-institutional extended care services that would not apply to private RRTP facilities, promoting privatization. Lobbied against provisions in H.R. 8371, the Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act that would allow decisions between a veteran and a doctor to remain final without VA authorization and provisions that would require strict timeframes for placement of high-risk veterans in mental health treatment programs for VA programs but not private programs. Statements and Correspondence: Submitted a statement for the record for a September 11, 2024 House Veterans Affairs Committee, Health Subcommittee legislative hearing. Submitted a statement for the record for a September 18, 2024 House Veterans Affairs Subcommittee on Disability Assistance and Memorial Affairs hearing titled Examining VAs Challenges with Ensuring Quality Contracted Disability Compensation Examinations. Testified before the House Veterans Affairs Subcommittee on Disability Assistance and Memorial Affairs at a July 23, 2024 hearing on Is the Veterans Benefits Administration Properly Processing and Deciding Veterans Claims? Testified before the House Veterans Affairs Subcommittee on Disability Assistance and Memorial Affairs at a July 10, 2024, hearing on Pending Legislation. Specific Legislation: Lobbied in support of H.R. 6538, the "VA Correct Compensation Act of 2023." Lobbied in support of S. 4046/H.R. 9855, the VA Employee Fairness Act. Lobbied in support of H.R. 536/S. 124, the "FAIR Act" to raise pay for federal employees at the VA. Lobbied in support of H.R. 866/S. 3194, the "Equal COLA Act" to protect VA employees in FERS. Lobbied in support of H.R. 82/S. 597, the "Social Security Fairness Act" to protect VA employees affected by the Windfall Elimination Provision (WEP) and the Government Pension Offset (GPO). Lobbied in support of H.R. 543, the "VA CPE Modernization Act." Lobbied in support of H.R. 1322 the "Law Enforcement Officers Equity Act" and S. 1658, the Law Enforcement Officers Parity Act" as it pertains to VA Police Officers. Lobbied in support of and for changes to H.R. 1378, the "Veterans' Appeals Backlog Improvement Act." Lobbied for changes to S. 10 the "VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support (CAREERS) Act of 2023." Lobbied for changes to S. 10, the "VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support" (CAREERS) Act related to market pay, performance pay, cost of living adjustments, licensure, and certification reimbursement, covid leave flexibility, and recruitment and retention at VA community living centers. Also lobbied for specific changes to the bill related to the inclusion of VA Police Pensions, Continuing Professional Education Benefits, and Collective Bargaining Rights for Title 38 Employees. Lobbied to renew a defunded corpsmen and medic vocational education and training program Grow Our Own. Lobbied in support of H.R. 4906 "Protecting VA Employees Act" to repeal parts of the VA Accountability Act. Lobbied for oversight of the "Honoring Our PACT Act." Lobbied in opposition to H.R. 4278 / S. 2158, the "Restore Department of Veterans Affairs Accountability Act." Lobbied in support of and for changes to H.R. 6531, the TRAIN VA Employees Act. Lobbied in support and for changes to S. 2679, the VA LEAD Act of 2023. Lobbied in opposition H.R. 3520, the Veteran Care Improvement Act of 2023. Lobbied in opposition to S. 2649, the Making Community Care Work for Veterans Act. Lobbied in opposition to S. 1315, the HEALTH Act. Lobbied in opposition to H.R. 485, the Protecting Health Care for All Patients Act. Lobbied for changes to H.R. 1089, the "VA Medical Center Facility Transparency Act." Lobbied in support of H.R. 1530, the "Veterans Benefits Improvement Act of 2023." Lobbied in support of H.R. 3504, the "VA Medical Center Security Report Act." Lobbied in support of, S. 1951, the "Department of Veterans Affairs Income Eligibility Standardization Act," which would eliminate subcategories of priority for enrollment to make more veterans eligible for enrollment in VA health care. Lobbied in support of the, S. 1954, the "Improving Whole Health for Veterans with Chronic Conditions Act," which would create a pilot to provide dental benefits to veterans with diabetes and ischemic heart disease. Lobbied in opposition to S. 1545, "Veterans Health Care Freedom Act," which would set up a pilot program to allow veterans to choose community providers at their preference without the need for referral by the VA. Lobbied in opposition to H.R. 754, Modernizing Veterans' Health Care Eligibility Act, which establishes the Commission on Eligibility (staffed with bipartisan congressional and presidential appointees) to examine veterans' eligibility for health care from the VA. Lobbied in opposition to H.R. 41, VA Same-Day Scheduling Act of 2023, which requires the VA to ensure that when a veteran enrolled in the VA health care system contacts the VA by telephone to schedule an appointment for care or services at a VA facility, the appointment must be scheduled on that same call. Lobbied in support of S. 1113, the "Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act," which would set minimum nurse‐ patient staffing requirements for public and private health care systems, including YA and Department of Defense medical facilities. Lobbied in support of H.R. 542, the "Elizabeth Dole Home-and Community-Based Services for Veterans and Caregivers Act." Lobbied in support of S. 2718, the Medical Disability Exam Improvement Act of 2023. Lobbied to preserve changes to H.R. 3738, a bill To amend title 38, United States Code, to establish in the Department of Veterans Affairs the Veterans Economic Opportunity and Transition Administration, and for other purposes. Lobbied for technical changes to S. 3979, to make permanent and codify the pilot program for use of contract physicians for disability examinations, and for other purposes. Lobbied in support of and for changes to H.R. 7765, the VA Security Screening Pilot Program Act Lobbied for the introduction and support of the Board of Veterans Appeals Attorney Retention and Backlog Reduction Act. Lobbied for changes to H.R. 7793 the Veterans Appeals Operations Expansion Act of 2024; Lobbied for changes to H.R. 7917, the Veterans Appeals Efficiency Act of 2024; Lobbied for changes to H.R. 7919, the Veterans Claims Quality Improvement Act of 2024. Lobbied or changes to H.R. 7883, the Toxic Exposures Examination Improvement Act Lobbied in opposition to H.R. 7734 the Personnel Integrity in Veterans Affairs Act of 2024 Lobbied in support of H.R. 9046, the Board of Veterans Appeals Attorney Retention and Backlog Reduction Act Lobbied in support of H.R. 2971, the Veterans Claims Education Act of 2023 Lobbied for changes to H.R. 8874, the Modernizing All Veterans and Survivors Claims Processing Act Lobbied in support of and for changes to H.R. 8879, the Improving VA Training for Military Sexual Trauma Claims Act Lobbied for changes to H.R. 8881, the Rural Veterans Improved Access to Benefits Act of 2024. Lobbied for passage of H.R. 9747, the Continuing Appropriations and Extensions Act, 2025 to continue to fund the federal government through December 20, 2024.

ACA Exchanges & Enrollment Prior Authorization Mental Health Parity Facilitating Accountability in Reimbursements Act (FAIR Act) (H.R. 3417) Site-based Invoicing and Transparency Enhancement (SITE) Act (S.1869) Lower Cost, More Transparency Act (H.R. 5378) Primary Care and Workforce Act (S. 2840) AI Use in Healthcare Health Disparities, including Maternal Health and Rural Health H.R. 3520 Veteran Care Improvement Act of 2023. Making Community Care Work for Veterans Act of 2023 (S.2649) Dept. of Defense Military OneSource Program Provider Directories Transparency in Coverage and Machine-Readable Files Affordable Connectivity Program Change Healthcare Cyber Incident Telehealth Modernization Act of 2024 Addressing Anti-Competitive Contracting Clauses Act

Client expense: $1,330,000 · Firm income: Not reported

ACA Exchanges & Enrollment Prior Authorization Mental Health Parity Facilitating Accountability in Reimbursements Act (FAIR Act) (H.R. 3417) Site-based Invoicing and Transparency Enhancement (SITE) Act (S.1869) Lower Cost, More Transparency Act (H.R. 5378) Primary Care and Workforce Act (S. 2840) AI Use in Healthcare Health Disparities, including Maternal Health and Rural Health H.R. 3520 Veteran Care Improvement Act of 2023. Making Community Care Work for Veterans Act of 2023 (S.2649) Dept. of Defense Military OneSource Program Provider Directories Transparency in Coverage and Machine-Readable Files Affordable Connectivity Program Change Healthcare Cyber Incident Telehealth Modernization Act of 2024 Addressing Anti-Competitive Contracting Clauses Act

Client expense: $1,330,000 · Firm income: Not reported

Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 762, HCBS Access Act; S. 100, Better Care Better Jobs Act; H.R. 547, Better Care Better Jobs Act; Tax credits for long term care expenses; H.R. 1795, Homecare for Seniors Act; S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; Veteran Care Improvement Act of 2023 (H.R. 3520); Veterans' Health Empowerment, Access, Leadership, and Transparency for our Heroes (HEALTH) Act of 2023 (S.1315); Credit for Caring Act of 2024 (S.3702; H.R. 7165)

Client expense: Not reported · Firm income: $30,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 762, HCBS Access Act; S. 100, Better Care Better Jobs Act; H.R. 547, Better Care Better Jobs Act; Tax credits for long term care expenses; H.R. 1795, Homecare for Seniors Act; S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; CMS Proposed Rule (CMS-2442-P), Ensuring Access to Medicaid Services; Veteran Care Improvement Act of 2023 (H.R. 3520); Veterans' Health Empowerment, Access, Leadership, and Transparency for our Heroes (HEALTH) Act of 2023 (S.1315); Credit for Caring Act of 2024 (S.3702; H.R. 7165)

Client expense: Not reported · Firm income: $30,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 762, HCBS Access Act; S. 100, Better Care Better Jobs Act; H.R. 547, Better Care Better Jobs Act; Tax credits for long term care expenses; H.R. 1795, Homecare for Seniors Act; S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; CMS Proposed Rule (CMS-2442-P), Ensuring Access to Medicaid Services; Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 762, HCBS Access Act; S. 100, Better Care Better Jobs Act; H.R. 547, Better Care Better Jobs Act; Tax credits for long term care expenses; H.R. 1795, Homecare for Seniors Act; S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; Veteran Care Improvement Act of 2023 (H.R. 3520); Veterans' Health Empowerment, Access, Leadership, and Transparency for our Heroes (HEALTH) Act of 2023 (S.1315); Credit for Caring Act of 2024 (S.3702; H.R. 7165)

Client expense: Not reported · Firm income: $30,000

Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; S. 1315, HEALTH Act of 2023; Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 762, HCBS Access Act; S. 100, Better Care Better Jobs Act; H.R. 547, Better Care Better Jobs Act; Tax credits for long term care expenses; H.R. 1795, Homecare for Seniors Act; S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; Veteran Care Improvement Act of 2023 (H.R. 3520); Veterans' Health Empowerment, Access, Leadership, and Transparency for our Heroes (HEALTH) Act of 2023 (S.1315); Credit for Caring Act of 2024 (S.3702; H.R. 7165)

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

Veterans Benefits Administration: Lobbied for changes to and oversight of Veterans Benefits Administration's (VBA) employee performance standards. Lobbied for increased oversight and changes to performance standards for Legal Administrative Assistants in the VBA National Call Centers. Lobbied for comprehensive changes to internal VBA processes for claims, including changes to the VBA National Work Queue. Lobbied to require the VA to include VA employee input when making changes to the claims process, employee performance standards, and training for claims processors. Lobbied on the processing of complex claims within the Veterans Benefits Administration, including how it relates to Military Sexual Trauma, Traumatic Brain Injury, and catastrophic injury claims. Lobbied for the specialization of claims processing for highly complex cases. Lobbied to preserve language in H.R. 3738, a bill To amend title 38, United States Code, to establish in the Department of Veterans Affairs the Veterans Economic Opportunity and Transition Administration, and for other purposes. Lobbied for reforms to the VBA National Work Queue. Board of Veterans Appeals: Lobbied for reimbursement for Bar Membership dues for attorneys working at the Board of Veterans' Appeals. Lobbied for the re-instatement of GS-14 career ladder position. Lobbied for the creation of a journeyman GS-15 position. Lobbied for the re- instatement of experience requirements for Board of Veterans Appeals Members (Veterans Law Judgements). Lobbied in support of and for changes to H.R. 1378, the Veterans Appeals Backlog Improvement Act. Lobbied for additional oversight at the Board of Veterans Appeals. Lobbied for additional training for Board of Veterans Appeals Attorneys. Lobbied in support of ANS to H.R. 1530, the Veterans Benefits Improvement Act of 2023. C&P Exams: Lobbied against contracting out of Compensation and Pension (C&P) Exams and bringing those exams back into the VA. Lobbied to keep all specialty C&P Exams including but not limited to Traumatic Brain Injury (TBI), Post Traumatic Stress Disorder (PTSD), Military Sexual Trauma (MST), veterans who served as Prisoners of War (POWs), veterans who suffered catastrophic injuries, and veterans who are currently eligible to pursue toxic exposure claims. Lobbied for the VA to utilize more internal C&P Providers by hiring more staff and returning staff to C&P positions who had previously been reassigned. Lobbied to keep Integrated Disability Evaluation System (IDES) Exams within the VA. Lobbied for the continued oversight of contract C&P Exams. Lobbied to make C&P Exams available in every VA Medical Center. Lobbied to make sure the VA is in compliance with Section 2002 of the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020. Lobbied in support of S. 2718, the Medical Disability Exam Improvement Act of 2023. Lobbied for technical changes to S. 3979, to make permanent and codify the pilot program for use of contract physicians for disability examinations, and for other purposes. Collective Bargaining Rights: Lobbied in support of H.R. 4906 "Protecting VA Employees Act" to repeal parts of the VA Accountability Act. Lobbied in support of H.R. 6538, the VA Correct Compensation Act of 2023 and for its introduction in the Senate. Lobbied in support of S. 4046 of "VA Employee Fairness Act, and for its reintroduction in the House of Representatives. Lobbied in support of and for changes to S. 2679, the Leadership, Engagement, Accountability, and Development (LEAD) Act of 2023. Lobbied in opposition to H.R. 4278 / S.2158, the "Restore Department of Veterans Affairs Accountability Act." Lobbied in support of and for changes to H.R. 6531, the TRAIN VA Employees Act. Lobbied in support of and for changes to H.R. 7765, the VA Security Screening Pilot Program Act VA HR Modernization: Lobbied to address problems created by VA reorganization of its human resources processes including centralization and implementation of new information technology systems, and practices and policies related to filling and posting unfilled positions. Lobbied to have Congress require the VA to return the HR functions back to VA facilities and to appropriate funding for it. VA Compensation: Lobbied in support of H.R. 7127/S. 3688, the "FAIR Act" to raise pay for federal employees at the VA. Lobbied in support of H.R. 866/S. 3194, the "Equal COLA Act" to protect VA employees in FERS. Lobbied in support of H.R. 82/S. 597, the Social Security Fairness Act" to protect VA employees affected by the Windfall Elimination Provision (WEP) and the Government Pension Offset (GPO). Lobbied in support of H.R. 543, the "VA CPE Modernization Act." Lobbied in support of H.R. 1322 the "Law Enforcement Officers Equity Act" and S. 1658, the "Law Enforcement Officers Parity Act" as it pertains to VA Police Officers. VA Infrastructure: Lobbied for restriction on VA's authority to close or reduce services at rural healthcare facilities in the 2024 and 2025 VA Military Construction appropriations bill. Privatization: Lobbied against continued increased spending on community care at the expense of VA's own staffing and infrastructure. Lobbied in opposition to H.R. 3520, the Veteran Care Improvement Act of 2023, H.R. 1315, the Health Act and S. 2649, Making Community Care Work for Veterans Act. Lobbied in opposition to H.R. 3146, the Veterans Health Care Freedom Act, which would codify community care access standards that create a bias toward referral to community care over VA's own healthcare. Lobbied for oversight of new VA private contracting program, the Integrated Critical Staffing Program. Lobbied for oversight of VA staffing reductions. Lobbied against potential closure or privatization of services at VA Medical Centers in Philadelphia and Coatesville, PA. Testimony, Statements for the Record, and Letters. Lobbied for better information on scheduling and appointment times for both in-house VA and private care. Lobbied for more information about the costs of VA care. Lobbied against VA raising the ceiling for payment to third party private, Community Care contractors. Lobbied against prohibiting public health care programs from using QALYs to determine price. Lobbied in opposition to H.R. 485, the Protecting Health Care for All Patients Act, and urge that it be defeated on the House floor. H.R. 485 would increase already high healthcare costs for the Federal Employees Health Benefits Program (FEHBP), which covers the vast majority of AFGE members and their families. In additional to FEHBP, the bill would prohibit Medicaid, Medicare Advantage (MA) plans, Medicare Part D Plans (PDPs), the VA, and the Defense Health Agency from using Quality Adjusted Life Years (QALYs) - a measure that ascertains the value of a drug - to make decisions about a drugs price. Medicare already prohibits the use of QALYs in ways that discriminate against the elderly (such as by valuing the extension of life of an older person as less than extending the life of a younger person). Lobbied against amendments to H.R. 8070, the Servicemember Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025 that would: 1) codify Trump-Era access standards responsible for rapid privatization of the VA, prohibits VA from modifying access standards to allow telehealth to satisfy these access standards and requires VA to meet strict timeframes evaluating high-risk veterans for referral to residential treatment and rehabilitative programs without providing any additional funding to staff these new obligations and 2) require VA to meet 72-hour evaluation timeframe for evaluating high-risk veterans for residential treatment centers without providing adequate funding or putting equivalent credentialing and quality requirements on private programs. Lobbied against Amendment to H.R. 8580, the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2025 forcing VA to apply the same access standards for Mental Health Residential Rehabilitation Treatment Program (MH RRTP) as for primary care, specialty care, and non-institutional extended care services that would not apply to private RRTP facilities, promoting privatization. Lobbied against provisions In H.R. 8371, the Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act that would allow decisions between a veteran and a doctor to remain final without VA authorization and provisions that would require strict timeframes for placement of high-risk veterans in mental health treatment programs for VA programs but not private programs. Statements and Correspondence: Sente a letter to the House Veterans Affairs Subcommittee on Disability Assistance and Memorial Affairs for an April 16, 2024 subcommittee markup. Sent a letter to the House Veterans Affairs Committee for a May 1, 2024 full committee markup. Testified before the House Veterans Affairs Subcommittee on Oversight and Investigations on May 16 at a hearing titled Ensuring VA's Security: How Can Congress Best Support VA's Law Enforcement? Testified before the House Veterans Affairs Committee on June 13, 2024 at hearing titled A Call to Action: Meeting the Needs of the Spinal Cord Injury and Disorders (SCI/D) Veteran Community. Testified before the House Veterans Affairs Subcommittee on Disability Assistance and Memorial Affairs at a hearing titled Examining Shortcomings with VAs National Work Queue Veterans Benefits Claims Management System. Specific Legislation: Lobbied in support of H.R. 6538, the "VA Correct Compensation Act of 2023." Lobbied in support of S. 4046, the VA Employee Fairness Act. Lobbied in support of H.R. 536/S. 124, the "FAIR Act" to raise pay for federal employees at the VA. Lobbied in support of H.R. 866/S. 3194, the "Equal COLA Act" to protect VA employees in FERS. Lobbied in support of H.R. 82/S. 597, the "Social Security Fairness Act" to protect VA employees affected by the Windfall Elimination Provision (WEP) and the Government Pension Offset (GPO). Lobbied in support of H.R. 543, the "VA CPE Modernization Act." Lobbied in support of H.R. 1322 the "Law Enforcement Officers Equity Act" and S. 1658, the Law Enforcement Officers Parity Act" as it pertains to VA Police Officers. Lobbied in support of and for changes to H.R. 1378, the "Veterans' Appeals Backlog Improvement Act." Lobbied for changes to S. 10 the "VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support (CAREERS) Act of 2023." Lobbied for changes to S. 10, the "VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support" (CAREERS) Act related to market pay, performance pay, cost of living adjustments, licensure, and certification reimbursement, covid leave flexibility, and recruitment and retention at VA community living centers. Also lobbied for specific changes to the bill related to the inclusion of VA Police Pensions, Continuing Professional Education Benefits, and Collective Bargaining Rights for Title 38 Employees. Lobbied to renew a defunded corpsmen and medic vocational education and training program Grow Our Own. Lobbied in support of H.R. 4906 "Protecting VA Employees Act" to repeal parts of the VA Accountability Act. Lobbied for oversight of the "Honoring Our PACT Act." Lobbied in opposition to H.R. 4278 / S.2158, the "Restore Department of Veterans Affairs Accountability Act." Lobbied in support of and for changes to H.R. 6531, the TRAIN VA Employees Act. Lobbied in support and for changes to S. 2679, the VA LEAD Act of 2023. Lobbied in opposition H.R. 3520, the Veteran Care Improvement Act of 2023. Lobbied in opposition to S. 2649, the Making Community Care Work for Veterans Act. Lobbied in opposition to S. 1315, the HEALTH Act. Lobbied in opposition to H.R. 485, the Protecting Health Care for All Patients Act. Lobbied for changes to H.R. 1089, the "VA Medical Center Facility Transparency Act." Lobbied in support of H.R. 1530, the "Veterans Benefits Improvement Act of 2023." Lobbied in support of H.R. 3504, the "VA Medical Center Security Report Act." Lobbied in support of, S. 1951, the "Department of Veterans Affairs Income Eligibility Standardization Act," which would eliminate subcategories of priority for enrollment to make more veterans eligible for enrollment in VA health care. Lobbied in support of the, S. 1954, the "Improving Whole Health for Veterans with Chronic Conditions Act," which would create a pilot to provide dental benefits to veterans with diabetes and ischemic heart disease. Lobbied in opposition to S. 1545, "Veterans Health Care Freedom Act," which would set up a pilot program to allow veterans to choose community providers at their preference without the need for referral by the VA. Lobbied in opposition to H.R. 754, Modernizing Veterans' Health Care Eligibility Ace, which establishes the Commission on Eligibility (staffed with bipartisan congressional and presidential appointees) to examine veterans' eligibility for health care from the VA. Lobbied in opposition to H.R. 41, VA Same-Day Scheduling Act of 2023, which requires the VA to ensure that when a veteran enrolled in the VA health care system contacts the VA by telephone to schedule an appointment for care or services at a VA facility, the appointment must be scheduled on that same call. Lobbied in support of S. 1113, the "Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act," which would set minimum nurse‐ patient staffing requirements for public and private health care systems, including YA and Department of Defense medical facilities. Lobbied in support of H.R. 542, the "Elizabeth Dole Home-and Community-Based Services for Veterans and Caregivers Act." Lobbied in support of S. 2718, the Medical Disability Exam Improvement Act of 2023. Lobbied to preserve changes to H.R. 3738, a bill To amend title 38, United States Code, to establish in the Department of Veterans Affairs the Veterans Economic Opportunity and Transition Administration, and for other purposes. Lobbied for technical changes to S. 3979, to make permanent and codify the pilot program for use of contract physicians for disability examinations, and for other purposes. Lobbied in support of and for changes to H.R. 7765, the VA Security Screening Pilot Program Act Lobbied for the introduction and support of the Board of Veterans Appeals Attorney Retention and Backlog Reduction Act. Lobbied for changes to H.R. 7793 the Veterans Appeals Operations Expansion Act of 2024; Lobbied for changes to H.R. 7917, the Veterans Appeals Efficiency Act of 2024; Lobbied for changes to H.R. 7919, the Veterans Claims Quality Improvement Act of 2024. Lobbied or changes to H.R. 7883, the Toxic Exposures Examination Improvement Act Lobbied in opposition to H.R. 7734 the Personnel Integrity in Veterans Affairs Act of 2024

H.R. 3520: Veteran Care Improvement Act of 2023 and H.R.542 - Elizabeth Dole Home Care Act of 2023 Met with various congressional offices, including members of the House Committee on Veterans Affairs and its health subcommittee, to advocate for the inclusion of language following ASAM (American Society of Addiction Medicine) guidelines for placement, continued stay, transfer, or discharge of patients with addiction and co-occurring conditions. Additionally, advocated for the inclusion of a requirement to asses high suicide risk veterans presenting to VHA hospitals and affiliated facilities within 72 hours, followed by admitting the veteran to the appropriate level of care within 48-hours.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3520: Veteran Care Improvement Act of 2023 and H.R.542 - Elizabeth Dole Home Care Act of 2023 Met with various congressional offices, including members of the House Committee on Veterans Affairs and its health subcommittee, to advocate for the inclusion of language following ASAM (American Society of Addiction Medicine) guidelines for placement, continued stay, transfer, or discharge of patients with addiction and co-occurring conditions. Additionally, advocated for the inclusion of a requirement to asses high suicide risk veterans presenting to VHA hospitals and affiliated facilities within 72 hours, followed by admitting the veteran to the appropriate level of care within 48-hours.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3520: Veteran Care Improvement Act of 2023 and H.R.542 - Elizabeth Dole Home Care Act of 2023 Met with various congressional offices, including members of the House Committee on Veterans Affairs and its health subcommittee, to advocate for the inclusion of language following ASAM (American Society of Addiction Medicine) guidelines for placement, continued stay, transfer, or discharge of patients with addiction and co-occurring conditions. Additionally, advocated for the inclusion of a requirement to asses high suicide risk veterans presenting to VHA hospitals and affiliated facilities within 72 hours, followed by admitting the veteran to the appropriate level of care within 48-hours.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3520: Veteran Care Improvement Act of 2023 and H.R.542 - Elizabeth Dole Home Care Act of 2023 Met with various congressional offices, including members of the House Committee on Veterans Affairs and its health subcommittee, to advocate for the inclusion of language following ASAM (American Society of Addiction Medicine) guidelines for placement, continued stay, transfer, or discharge of patients with addiction and co-occurring conditions. Additionally, advocated for the inclusion of a requirement to asses high suicide risk veterans presenting to VHA hospitals and affiliated facilities within 72 hours, followed by admitting the veteran to the appropriate level of care within 48-hours.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Prior Authorization Mental Health and Substance Use Behavioral Health Crisis Intervention 9-8-8 hotline services Mental Health Parity Facilitating Accountability in Reimbursements Act (FAIR Act) (H.R. 3417) Site-based Invoicing and Transparency Enhancement (SITE) Act (S.1869) Lower Cost, More Transparency Act (H.R. 5378) Primary Care and Workforce Act (S. 2840) AI Use in Healthcare Health Disparities, including Maternal Health and Rural Health H.R. 3520 Veteran Care Improvement Act of 2023. Making Community Care Work for Veterans Act of 2023 (S.2649) Dept. of Defense Military OneSource Program H.R. 2670 FY2024 National Defense Authorization Act of 2024 Provider Directories Transparency in Coverage and Machine-Readable Files Affordable Connectivity Program Change Healthcare Cyber Incident

Client expense: $2,350,000 · Firm income: Not reported

Prior Authorization Mental Health and Substance Use Behavioral Health Crisis Intervention 9-8-8 hotline services Mental Health Parity Facilitating Accountability in Reimbursements Act (FAIR Act) (H.R. 3417) Site-based Invoicing and Transparency Enhancement (SITE) Act (S.1869) Lower Cost, More Transparency Act (H.R. 5378) Primary Care and Workforce Act (S. 2840) AI Use in Healthcare Health Disparities, including Maternal Health and Rural Health H.R. 3520 Veteran Care Improvement Act of 2023. Making Community Care Work for Veterans Act of 2023 (S.2649) Dept. of Defense Military OneSource Program H.R. 2670 FY2024 National Defense Authorization Act of 2024 Provider Directories Transparency in Coverage and Machine-Readable Files Affordable Connectivity Program Change Healthcare Cyber Incident

Client expense: $2,350,000 · Firm income: Not reported

Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 762, HCBS Access Act; S. 100, Better Care Better Jobs Act; H.R. 547, Better Care Better Jobs Act; Tax credits for long term care expenses; H.R. 1795, Homecare for Seniors Act; S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; Veteran Care Improvement Act of 2023 (H.R. 3520); Veterans' Health Empowerment, Access, Leadership, and Transparency for our Heroes (HEALTH) Act of 2023 (S.1315); Credit for Caring Act of 2024 (S.3702; H.R. 7165)

Client expense: Not reported · Firm income: $30,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; S. 1315, HEALTH Act of 2023; Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 762, HCBS Access Act; S. 100, Better Care Better Jobs Act; H.R. 547, Better Care Better Jobs Act; Tax credits for long term care expenses; H.R. 1795, Homecare for Seniors Act; S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; Veteran Care Improvement Act of 2023 (H.R. 3520); Veterans' Health Empowerment, Access, Leadership, and Transparency for our Heroes (HEALTH) Act of 2023 (S.1315); Credit for Caring Act of 2024 (S.3702; H.R. 7165)

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 762, HCBS Access Act; S. 100, Better Care Better Jobs Act; H.R. 547, Better Care Better Jobs Act; Tax credits for long term care expenses; H.R. 1795, Homecare for Seniors Act; S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; CMS Proposed Rule (CMS-2442-P), Ensuring Access to Medicaid Services; Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 762, HCBS Access Act; S. 100, Better Care Better Jobs Act; H.R. 547, Better Care Better Jobs Act; Tax credits for long term care expenses; H.R. 1795, Homecare for Seniors Act; S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; Veteran Care Improvement Act of 2023 (H.R. 3520); Veterans' Health Empowerment, Access, Leadership, and Transparency for our Heroes (HEALTH) Act of 2023 (S.1315); Credit for Caring Act of 2024 (S.3702; H.R. 7165)

Client expense: Not reported · Firm income: $30,000

Develop and execute a government relations strategy relating to legislative and regulatory home care issues. S. 762, HCBS Access Act; S. 100, Better Care Better Jobs Act; H.R. 547, Better Care Better Jobs Act; Tax credits for long term care expenses; H.R. 1795, Homecare for Seniors Act; S. 141, Elizabeth Dole Home Care Act; H.R. 542 Elizabeth Dole Home Care Act; CMS Proposed Rule (CMS-2442-P), Ensuring Access to Medicaid Services; Veteran Care Improvement Act of 2023 (H.R. 3520); Veterans' Health Empowerment, Access, Leadership, and Transparency for our Heroes (HEALTH) Act of 2023 (S.1315); Credit for Caring Act of 2024 (S.3702; H.R. 7165)

Client expense: Not reported · Firm income: $30,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Veterans Benefits Administration: Lobbied for changes to and oversight of Veterans Benefits Administration's (VBA) employee performance standards. Lobbied for increased oversight and changes to performance standards for Legal Administrative Assistants in the VBA National Call Centers. Lobbied for comprehensive changes to internal VBA processes for claims, including changes to the VBA National Work Queue. Lobbied to require the VA to include VA employee input when making changes to the claims process, employee performance standards, and training for claims processors. Lobbied on the processing of complex claims within the Veterans Benefits Administration, including how it relates to Military Sexual Trauma, Traumatic Brain Injury, and catastrophic injury claims. Lobbied for the specialization of claims processing for highly complex cases. Lobbied to preserve language in H.R. 3738, a bill To amend title 38, United States Code, to establish in the Department of Veterans Affairs the Veterans Economic Opportunity and Transition Administration, and for other purposes. Lobbied for reforms to the VBA National Work Queue. Board of Veterans Appeals: Lobbied for reimbursement for Bar Membership dues for attorneys working at the Board of Veterans' Appeals. Lobbied for the re-instatement of GS-14 career ladder position. Lobbied for the creation of a journeyman GS-15 position. Lobbied for the re-instatement of experience requirements for Board of Veterans Appeals Members (Veterans Law Judgements). Lobbied in support of and for changes to H.R.1378, the Veterans Appeals Backlog Improvement Act. Lobbied for additional oversight at the Board of Veterans Appeals. Lobbied for additional training for Board of Veterans Appeals Attorneys. Lobbied in support of ANS to H.R. 1530, the Veterans Benefits Improvement Act of 2023. C&P Exams: Lobbied against contracting out of Compensation and Pension (C&P) Exams and bringing those exams back into the VA. Lobbied to keep all specialty C&P Exams including but not limited to Traumatic Brain Injury (TBI), Post Traumatic Stress Disorder (PTSD), Military Sexual Trauma (MST), veterans who served as Prisoners of War (POWs), veterans who suffered catastrophic injuries, and veterans who are currently eligible to pursue toxic exposure claims. Lobbied for the VA to utilize more internal C&P Providers by hiring more staff and returning staff to C&P positions who had previously been reassigned. Lobbied to keep Integrated Disability Evaluation System (IDES) Exams within the VA. Lobbied for the continued oversight of contract C&P Exams. Lobbied to make C&P Exams available in every VA Medical Center. Lobbied to make sure the VA is in compliance with Section 2002 of the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020. Lobbied in support of S. 2718, the Medical Disability Exam Improvement Act of 2023. Lobbied for technical changes to S. 3979, to make permanent and codify the pilot program for use of contract physicians for disability examinations, and for other purposes. Collective Bargaining Rights: Lobbied in support of H.R. 4906 "Protecting VA Employees Act" to repeal parts of the VA Accountability Act. Lobbied in support of H.R. 6538, the VA Correct Compensation Act of 2023 and for its introduction in the Senate. Lobbied in support S. 4046 of "VA Employee Fairness Act, and for its reintroduction in the House of Representatives. Lobbied in support of and for changes to S. 2679, the Leadership, Engagement, Accountability, and Development (LEAD) Act of 2023. Lobbied in opposition to H.R. 4278 / S.2158, the "Restore Department of Veterans Affairs Accountability Act." Lobbied in support of and for changes to H.R. 6531, the TRAIN VA Employees Act. Lobbied in support of and for changes to H.R. 7765, the VA Security Screening Pilot Program Act VA HR Modernization: Lobbied to address problems created by VA reorganization of its human resources processes including centralization and implementation of new information technology systems, and practices and policies related to filling and posting unfilled positions. Lobbied to have Congress require the VA to return the HR functions back to VA facilities and to appropriate funding for it. VA Compensation: Lobbied in support of H.R. 7127/S. 3688, the "FAIR Act" to raise pay for federal employees at the VA. Lobbied in support of H.R. 866/S. 3194, the "Equal COLA Act" to protect VA employees in FERS. Lobbied in support of H.R. 82/S. 597, the Social Security Fairness Act" to protect VA employees affected by the Windfall Elimination Provision (WEP) and the Government Pension Offset (GPO). Lobbied in support of H.R. 543, the "VA CPE Modernization Act." Lobbied in support of H.R. 1322 the "Law Enforcement Officers Equity Act" and S. 1658, the "Law Enforcement Officers Parity Act" as it pertains to VA Police Officers. VA Infrastructure: Lobbied for restriction on VA's authority to close or reduce services at rural healthcare facilities in the 2024 VA Military Construction appropriations bill. Privatization: Lobbied against continued increased spending on community care at the expense of VA's own staffing and infrastructure. Lobbied in opposition to H.R. 3520, the Veteran Care Improvement Act of 2023, H.R. 1315, the Health Act and S. 2649, Making Community Care Work for Veterans Act. Lobbied in opposition to H.R. 3146, the Veterans Health Care Freedom Act, which would codify community care access standards that create a bias toward referral to community care over VA's own healthcare. Lobbied for oversight of new VA private contracting program, the Integrated Critical Staffing Program. Lobbied against potential closure or privatization of services at VA Medical Centers in Philadelphia and Coatesville, PA. Testimony, Statements for the Record, and Letters. Lobbied for better information on scheduling and appointment times for both in-house VA and private care. Lobbied for more information about the costs of VA care. Lobbied against VA raising the ceiling for payment to third party private, Community Care contractors. Lobbied against prohibiting public health care programs from using QALYs to determine price. Lobbied in opposition to H.R. 485, the Protecting Health Care for All Patients Act, and urge that it be defeated on the House floor. H.R. 485 would increase already high healthcare costs for the Federal Employees Health Benefits Program (FEHBP), which covers the vast majority of AFGE members and their families. In additional to FEHBP, the bill would prohibit Medicaid, Medicare Advantage (MA) plans, Medicare Part D Plans (PDPs), the VA, and the Defense Health Agency from using Quality Adjusted Life Years (QALYs) - a measure that ascertains the value of a drug - to make decisions about a drugs price. Medicare already prohibits the use of QALYs in ways that discriminate against the elderly (such as by valuing the extension of life of an older person as less than extending the life of a younger person). Statements and Correspondence: Testified at a March 21, 2024, House Veterans Affairs Subcommittee on Oversight and Investigations Subcommittee Hearing on Pending Legislation Specific Legislation: Lobbied in support of H.R. 6538, the "VA Correct Compensation Act of 2023." Lobbied in support of S. 4046, the VA Employee Fairness Act. Lobbied in support of H.R. 536/S. 124, the "FAIR Act" to raise pay for federal employees at the VA. Lobbied in support of H.R. 866/S. 3194, the "Equal COLA Act" to protect VA employees in FERS. Lobbied in support of H.R. 82/S. 597, the "Social Security Fairness Act" to protect VA employees affected by the Windfall Elimination Provision (WEP) and the Government Pension Offset (GPO). Lobbied in support of H.R. 543, the "VA CPE Modernization Act." Lobbied in support of H.R. 1322 the "Law Enforcement Officers Equity Act" and S. 1658, the Law Enforcement Officers Parity Act" as it pertains to VA Police Officers. Lobbied in support of and for changes to H.R. 1378, the "Veterans' Appeals Backlog Improvement Act." Lobbied for changes to S. 10 the "VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support (CAREERS) Act of 2023." Lobbied for changes to S. 10, the "VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support" (CAREERS) Act related to market pay, performance pay, cost of living adjustments, licensure, and certification reimbursement, covid leave flexibility, and recruitment and retention at YA community living centers. Also lobbied for specific changes to the bill related to the inclusion of VA Police Pensions, Continuing Professional Education Benefits, and Collective Bargaining Rights for Title 38 Employees. Lobbied to renew a defunded corpsmen and medic vocational education and training program Grow Our Own. Lobbied in support of H.R. 4906 "Protecting VA Employees Act" to repeal parts of the VA Accountability Act. Lobbied for oversight of the "Honoring Our PACT Act." Lobbied in opposition to H.R. 4278 / S.2158, the "Restore Department of Veterans Affairs Accountability Act." Lobbied in support of and for changes to H.R. 6531, the TRAIN VA Employees Act. Lobbied in support and for changes to S. 2679, the VA LEAD Act of 2023. Lobbied in opposition H.R. 3520, the Veteran Care Improvement Act of 2023. Lobbied in opposition to S. 2649, the Making Community Care Work for Veterans Act. Lobbied in opposition to S. 1315, the HEALTH Act. Lobbied in opposition to H.R. 485, the Protecting Health Care for All Patients Act. Lobbied for changes to H.R. 1089, the "VA Medical Center Facility Transparency Act." Lobbied in support of H.R. 1530, the "Veterans Benefits Improvement Act of 2023." Lobbied in support of H.R. 3504, the "VA Medical Center Security Report Act." Lobbied in support of, S. 1951, the "Department of Veterans Affairs Income Eligibility Standardization Act," which would eliminate subcategories of priority for enrollment to make more veterans eligible for enrollment in VA health care. Lobbied in support of the, S. 1954, the "Improving Whole Health for Veterans with Chronic Conditions Act," which would create a pilot to provide dental benefits to veterans with diabetes and ischemic heart disease. Lobbied in opposition to S. 1545, "Veterans Health Care Freedom Act," which would set up a pilot program to allow veterans to choose community providers at their preference without the need for referral by the VA. Lobbied in opposition to H.R. 754, Modernizing Veterans' Health Care Eligibility Ace, which establishes the Commission on Eligibility (staffed with bipartisan congressional and presidential appointees) to examine veterans' eligibility for health care from the VA. Lobbied in opposition to H.R. 41, VA Same-Day Scheduling Act of 2023, which requires the VA to ensure that when a veteran enrolled in the VA health care system contacts the VA by telephone to schedule an appointment for care or services at a VA facility, the appointment must be scheduled on that same call. Lobbied in support of S. 1113, the "Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act," which would set minimum nurse‐ patient staffing requirements for public and private health care systems, including YA and Department of Defense medical facilities. Lobbied in support of H.R. 542, the "Elizabeth Dole Home-and Community-Based Services for Veterans and Caregivers Act." Lobbied in support of S. 2718, the Medical Disability Exam Improvement Act of 2023. Lobbied to preserve changes to H.R. 3738, a bill To amend title 38, United States Code, to establish in the Department of Veterans Affairs the Veterans Economic Opportunity and Transition Administration, and for other purposes. Lobbied for technical changes to S. 3979, to make permanent and codify the pilot program for use of contract physicians for disability examinations, and for other purposes. Lobbied in support of and for changes to H.R. 7765, the VA Security Screening Pilot Program Act

Dialysis services, HR 4366, S 2127, S 1315, HR 3520

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

H.R. 3520: Veteran Care Improvement Act of 2023 Met with various congressional offices, including members of the House Committee on Veterans Affairs and its health subcommittee, to advocate for the inclusion of language following ASAM (American Society of Addiction Medicine) guidelines for placement, continued stay, transfer, or discharge of patients with addiction and co-occurring conditions. Additionally, advocated for the inclusion of a requirement to asses high suicide risk veterans presenting to VHA hospitals and affiliated facilities within 72 hours, followed by admitting the veteran to the appropriate level of care within 48-hours.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3520: Veteran Care Improvement Act of 2023 Met with various congressional offices, including members of the House Committee on Veterans Affairs and its health subcommittee, to advocate for the inclusion of language following ASAM (American Society of Addiction Medicine) guidelines for placement, continued stay, transfer, or discharge of patients with addiction and co-occurring conditions. Additionally, advocated for the inclusion of a requirement to asses high suicide risk veterans presenting to VHA hospitals and affiliated facilities within 72 hours, followed by admitting the veteran to the appropriate level of care within 48-hours.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Veterans Benefits Administration: Lobbied for changes to and oversight of Veterans Benefits Administration's (VBA) employee performance standards. Lobbied for increased oversight and changes to performance standards for Legal Administrative Assistants in the VBA National Call Centers. Lobbied for comprehensive changes to internal VBA processes for claims, including changes to the VBA National Work Queue. Lobbied to require the VA to include VA employee input when making changes to the claims process, employee performance standards, and training for claims processors. Lobbied on the processing of complex claims within the Veterans Benefits Administration, including how it relates to Military Sexual Trauma, Traumatic Brain Injury, and catastrophic injury claims. Lobbied for the specialization of claims processing for highly complex cases. Lobbied for changes to H.R. 3738, a bill To amend title 38, United States Code, to establish in the Department of Veterans Affairs the Veterans Economic Opportunity and Transition Administration, and for other purposes. Board of Veterans Appeals: Lobbied for reimbursement for Bar Membership dues for attorneys working at the Board of Veterans' Appeals. Lobbied for the re-instatement ofGS-14 career ladder position. Lobbied for the creation of a journeyman GS-15 position. Lobbied for the re-instatement of experience requirements for Board of Veterans Appeals Members (Veterans Law Judgements). Lobbied in support of and for changes to H.R.1378, the "Veterans' Appeals Backlog Improvement Act." Lobbied for additional oversight at the Board of Veterans' Appeals. C&P Exams: Lobbied against contracting out of Compensation and Pension (C&P) Exams and bringing those exams back into the VA. Lobbied to keep all specialty C&P Exams including but not limited to Traumatic Brain Injury (TB!), Post Traumatic Stress Disorder (PTSD), Military Sexual Trauma (MST), veterans who served as Prisoners of War (POWs), veterans who suffered catastrophic injuries, and veterans who are currently eligible to pursue toxic exposure claims. Lobbied for the VA to utilize more internal C&P Providers by hiring more staff and returning staff to C&P positions who had previously been reassigned. Lobbied to keep Integrated Disability Evaluation System (IDES) Exams within the VA. Lobbied for the continued oversight of contract C&P Exams. Lobbied to make C&P Exams available in every VA Medical Center. Lobbied to make sure the VA is in compliance with Section 2002 of the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020. Lobbied in support of S. 2718, the Medical Disability Exam Improvement Act of 2023. Collective Bargaining Rights: Lobbied for the reintroduction of the "Protecting VA Employees Act" to repeal parts of the VA Accountability Act. Lobbied for the reintroduction of the "VA Employee Fairness Act." Lobbied to amend 38 USC 7422. Lobbied in opposition to H.R. 4278 / S.2158, the "Restore Department of Veterans Affairs Accountability Act." VA HR Modernization: Lobbied to address problems created by VA reorganization of its human resources processes including centralization and implementation of new information technology systems, and practices and policies related to filling and posting unfilled positions. Lobbied to have Congress require the VA to return the HR functions back to VA facilities and to appropriate funding for it. VA Compensation: Lobbied in support of H.R. 536/S. 124, the "FAIR Act" to raise pay for federal employees at the VA. Lobbied in support of H.R. 866/S. (pending reintroduction) the "Equal COLA Act" to protect VA employees in FERS. Lobbied in support of H.R. 82/S. 597, the Social Security Fairness Act" to protect VA employees affected by the Windfall Elimination Provision (WEP) and the Government Pension Offset (GPO). Lobbied in support of H.R. 543, the "VA CPE Modernization Act." Lobbied in support of H.R. 1322 the "Law Enforcement Officers Equity Act" and S. 1658, the "Law Enforcement Officers Parity Act" as it pertains to VA Police Officers. VA Infrastructure: Lobbied for restriction on VA's authority to close or reduce services at rural healthcare facilities in the 2024 VA Military Construction appropriations bill. Privatization: Lobbied against continued increased spending on community care at the expense of VA's own staffing and infrastructure. Lobbied in opposition to H.R. 3520, the Veteran Care Improvement Act of 2023, H.R. 1315, the Health Act and S. 2649, Making Community Care Work for Veterans Act. Lobbied in opposition to H.R. 3146, the Veterans Health Care Freedom Act. , which would codify community care access standards that create a bias toward referral to community care over VA's own healthcare. Lobbied against potential closure or privatization of services at VA Medical Centers in Philadelphia and Coatesville, PA. Testimony, Statements for the Record, and Letters: Statements and Correspondence: Sent letter to the House Veterans Affairs Committee Subcommittee on Oversight and Investigations for its July 12, 2023, legislative hearing. Sent letter to the House Veterans Affairs Committee Subcommittee on Health for its July 18, 2023 markup. Sent letter to the House Veterans Affairs Committee Subcommittee on Oversight and Investigations for its July 19, 2023, markup. Sent a joint union letter to the House Veterans Affairs Committee for its July 26, 2023, markup. Submitted a Statement for the Record to the Senate Veterans Affairs Committee July 26, 2023 hearing titled Implementing the PACT Act: One Year Later. Submitted a Statement for the Record to the House Veterans Affairs Committee Subcommittee on Disability Assistance and Memorial Affairs Subcommittee July 26, 2023 hearing titled VA Disability Exams: Are Veterans Receiving Quality Services? Specific Legislation: Lobbied for reintroduction of the "VA Employee Fairness Act." Lobbied in support of H.R. 536/S. 124, the "FAIR Act" to raise pay for federal employees at the VA. Lobbied in support of H.R. 866/S. (pending reintroduction) "Equal COLA Act" to protect VA employees in FERS. Lobbied in support of H.R. 82/S. 597, the "Social Security Fairness Act" to protect VA employees affected by the Windfall Elimination Provision (WEP) and the Government Pension Offset (GPO). Lobbied in support of H.R. 543, the "VA CPE Modernization Act." Lobbied in support of H.R. 1322 the "Law Enforcement Officers Equity Act" and S. 1658, the Law Enforcement Officers Parity Act" as it pertains to VA Police Officers. Lobbied in support of and for changes to H.R. 1378, the "Veterans' Appeals Backlog Improvement Act." Lobbied for changes to S. 10 the "VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support (CAREERS) Act of2023." Lobbied for changes to S. 10, the "VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support" (CAREERS) Act related to market pay, performance pay, cost of living adjustments, licensure and certification reimbursement, covid leave flexibility, and recruitment and retention at YA community living centers. Also lobbied for specific changes to the bill related to the inclusion of YA Police Pensions, Continuing Professional Education Benefits, and Collective Bargaining Rights for Title 38 Employees. Lobbied to renew a defunded corpsmen and medic vocational education and training program Grow Our Own. Lobbied for the reintroduction of the "Protecting VA Employees Act" to amend parts of the "VA Accountability and Whistleblower Protection Act." Lobbied for oversight of the "Honoring Our PACT Act." Lobbied in opposition to H.R. 4278 / S.2158, the "Restore Department of Veterans Affairs Accountability Act." Lobbied for changes to S. 2679, the VA LEAD Act of 2023. Lobbied in opposition H.R. 3520, the Veteran Care Improvement Act of 2023. Lobbied for changes to H.R. 1089, the "VA Medical Center Facility Transparency Act." Lobbied in support of H.R. 1530, the "Veterans Benefits Improvement Act of 2023." Lobbied in support of H.R. 3504, the "VA Medical Center Security Report Act." Lobbied in support of, S. 1951, the "Department of Veterans Affairs Income Eligibility Standardization Act," which would eliminate subcategories of priority for enrollment to make more veterans eligible for enrollment in VA health care. Lobbied in support of the, S. 1954, the "Improving Whole Health for Veterans with Chronic Conditions Act," which would create a pilot to provide dental benefits to veterans with diabetes and ischemic heart disease. Lobbied in opposition to S. 1545, "Veterans Health Care Freedom Act," which would set up a pilot program to allow veterans to choose community providers at their preference without the need for referral by the VA. Lobbied in opposition to H.R. 754, Modernizing Veterans' Health Care Eligibility Ace, which establishes the Commission on Eligibility (staffed with bipartisan congressional and presidential appointees) to examine veterans' eligibility for health care from the VA. Lobbied in opposition to H.R. 41, VA Same-Day Scheduling Act of 2023, which requires the VA to ensure that when a veteran enrolled in the VA health care system contacts the VA by telephone to schedule an appointment for care or services at a VA facility, the appointment must be scheduled on that same call. Lobbied in support of S. 1113, the "Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act," which would set minimum nurse patient staffing requirements for public and private health care systems, including YA and Department of Defense medical facilities. Lobbied in support of H.R. 542, the "Elizabeth Dole Home-and Community-Based Services for Veterans and Caregivers Act." Lobbied in support of S. 2718, the Medical Disability Exam Improvement Act of 2023. Lobbied for changes to H.R. 3738, a bill To amend title 38, United States Code, to establish in the Department of Veterans Affairs the Veterans Economic Opportunity and Transition Administration, and for other purposes. Lobbied for a clean appropriations bill or CR covering these issues that does not cut federal pay or benefits.

Veterans Benefits Administration: Lobbied for changes to and oversight of Veterans Benefits Administration's (VBA) employee performance standards. Lobbied for increased oversight and changes to performance standards for Legal Administrative Assistants in the VBA National Call Centers. Lobbied for comprehensive changes to internal VBA processes for claims, including changes to the VBA National Work Queue. Lobbied to require the VA to include VA employee input when making changes to the claims process, employee performance standards, and training for claims processors. Lobbied on the processing of complex claims within the Veterans Benefits Administration, including how it relates to Military Sexual Trauma, Traumatic Brain Injury, and catastrophic injury claims. Lobbied for the specialization of claims processing for highly complex cases. Lobbied for changes to H.R. 3738, a bill To amend title 38, United States Code, to establish in the Department of Veterans Affairs the Veterans Economic Opportunity and Transition Administration, and for other purposes. Board of Veterans Appeals: Lobbied for reimbursement for Bar Membership dues for attorneys working at the Board of Veterans' Appeals. Lobbied for the re-instatement ofGS-14 career ladder position. Lobbied for the creation of a journeyman GS-15 position. Lobbied for the re-instatement of experience requirements for Board of Veterans Appeals Members (Veterans Law Judgements). Lobbied in support of and for changes to H.R.1378, the "Veterans' Appeals Backlog Improvement Act." Lobbied for additional oversight at the Board of Veterans' Appeals. C&P Exams: Lobbied against contracting out of Compensation and Pension (C&P) Exams and bringing those exams back into the VA. Lobbied to keep all specialty C&P Exams including but not limited to Traumatic Brain Injury (TB!), Post Traumatic Stress Disorder (PTSD), Military Sexual Trauma (MST), veterans who served as Prisoners of War (POWs), veterans who suffered catastrophic injuries, and veterans who are currently eligible to pursue toxic exposure claims. Lobbied for the VA to utilize more internal C&P Providers by hiring more staff and returning staff to C&P positions who had previously been reassigned. Lobbied to keep Integrated Disability Evaluation System (IDES) Exams within the VA. Lobbied for the continued oversight of contract C&P Exams. Lobbied to make C&P Exams available in every VA Medical Center. Lobbied to make sure the VA is in compliance with Section 2002 of the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020. Lobbied in support of S. 2718, the Medical Disability Exam Improvement Act of 2023. Collective Bargaining Rights: Lobbied for the reintroduction of the "Protecting VA Employees Act" to repeal parts of the VA Accountability Act. Lobbied for the reintroduction of the "VA Employee Fairness Act." Lobbied to amend 38 USC 7422. Lobbied in opposition to H.R. 4278 / S.2158, the "Restore Department of Veterans Affairs Accountability Act." VA HR Modernization: Lobbied to address problems created by VA reorganization of its human resources processes including centralization and implementation of new information technology systems, and practices and policies related to filling and posting unfilled positions. Lobbied to have Congress require the VA to return the HR functions back to VA facilities and to appropriate funding for it. VA Compensation: Lobbied in support of H.R. 536/S. 124, the "FAIR Act" to raise pay for federal employees at the VA. Lobbied in support of H.R. 866/S. (pending reintroduction) the "Equal COLA Act" to protect VA employees in FERS. Lobbied in support of H.R. 82/S. 597, the Social Security Fairness Act" to protect VA employees affected by the Windfall Elimination Provision (WEP) and the Government Pension Offset (GPO). Lobbied in support of H.R. 543, the "VA CPE Modernization Act." Lobbied in support of H.R. 1322 the "Law Enforcement Officers Equity Act" and S. 1658, the "Law Enforcement Officers Parity Act" as it pertains to VA Police Officers. VA Infrastructure: Lobbied for restriction on VA's authority to close or reduce services at rural healthcare facilities in the 2024 VA Military Construction appropriations bill. Privatization: Lobbied against continued increased spending on community care at the expense of VA's own staffing and infrastructure. Lobbied in opposition to H.R. 3520, the Veteran Care Improvement Act of 2023, H.R. 1315, the Health Act and S. 2649, Making Community Care Work for Veterans Act. Lobbied in opposition to H.R. 3146, the Veterans Health Care Freedom Act. , which would codify community care access standards that create a bias toward referral to community care over VA's own healthcare. Lobbied against potential closure or privatization of services at VA Medical Centers in Philadelphia and Coatesville, PA. Testimony, Statements for the Record, and Letters: Statements and Correspondence: Sent letter to the House Veterans Affairs Committee Subcommittee on Oversight and Investigations for its July 12, 2023, legislative hearing. Sent letter to the House Veterans Affairs Committee Subcommittee on Health for its July 18, 2023 markup. Sent letter to the House Veterans Affairs Committee Subcommittee on Oversight and Investigations for its July 19, 2023, markup. Sent a joint union letter to the House Veterans Affairs Committee for its July 26, 2023, markup. Submitted a Statement for the Record to the Senate Veterans Affairs Committee July 26, 2023 hearing titled Implementing the PACT Act: One Year Later. Submitted a Statement for the Record to the House Veterans Affairs Committee Subcommittee on Disability Assistance and Memorial Affairs Subcommittee July 26, 2023 hearing titled VA Disability Exams: Are Veterans Receiving Quality Services? Specific Legislation: Lobbied for reintroduction of the "VA Employee Fairness Act." Lobbied in support of H.R. 536/S. 124, the "FAIR Act" to raise pay for federal employees at the VA. Lobbied in support of H.R. 866/S. (pending reintroduction) "Equal COLA Act" to protect VA employees in FERS. Lobbied in support of H.R. 82/S. 597, the "Social Security Fairness Act" to protect VA employees affected by the Windfall Elimination Provision (WEP) and the Government Pension Offset (GPO). Lobbied in support of H.R. 543, the "VA CPE Modernization Act." Lobbied in support of H.R. 1322 the "Law Enforcement Officers Equity Act" and S. 1658, the Law Enforcement Officers Parity Act" as it pertains to VA Police Officers. Lobbied in support of and for changes to H.R. 1378, the "Veterans' Appeals Backlog Improvement Act." Lobbied for changes to S. 10 the "VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support (CAREERS) Act of2023." Lobbied for changes to S. 10, the "VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support" (CAREERS) Act related to market pay, performance pay, cost of living adjustments, licensure and certification reimbursement, covid leave flexibility, and recruitment and retention at YA community living centers. Also lobbied for specific changes to the bill related to the inclusion of YA Police Pensions, Continuing Professional Education Benefits, and Collective Bargaining Rights for Title 38 Employees. Lobbied to renew a defunded corpsmen and medic vocational education and training program Grow Our Own. Lobbied for the reintroduction of the "Protecting VA Employees Act" to amend parts of the "VA Accountability and Whistleblower Protection Act." Lobbied for oversight of the "Honoring Our PACT Act." Lobbied in opposition to H.R. 4278 / S.2158, the "Restore Department of Veterans Affairs Accountability Act." Lobbied for changes to S. 2679, the VA LEAD Act of 2023. Lobbied in opposition H.R. 3520, the Veteran Care Improvement Act of 2023. Lobbied for changes to H.R. 1089, the "VA Medical Center Facility Transparency Act." Lobbied in support of H.R. 1530, the "Veterans Benefits Improvement Act of 2023." Lobbied in support of H.R. 3504, the "VA Medical Center Security Report Act." Lobbied in support of, S. 1951, the "Department of Veterans Affairs Income Eligibility Standardization Act," which would eliminate subcategories of priority for enrollment to make more veterans eligible for enrollment in VA health care. Lobbied in support of the, S. 1954, the "Improving Whole Health for Veterans with Chronic Conditions Act," which would create a pilot to provide dental benefits to veterans with diabetes and ischemic heart disease. Lobbied in opposition to S. 1545, "Veterans Health Care Freedom Act," which would set up a pilot program to allow veterans to choose community providers at their preference without the need for referral by the VA. Lobbied in opposition to H.R. 754, Modernizing Veterans' Health Care Eligibility Ace, which establishes the Commission on Eligibility (staffed with bipartisan congressional and presidential appointees) to examine veterans' eligibility for health care from the VA. Lobbied in opposition to H.R. 41, VA Same-Day Scheduling Act of 2023, which requires the VA to ensure that when a veteran enrolled in the VA health care system contacts the VA by telephone to schedule an appointment for care or services at a VA facility, the appointment must be scheduled on that same call. Lobbied in support of S. 1113, the "Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act," which would set minimum nurse patient staffing requirements for public and private health care systems, including YA and Department of Defense medical facilities. Lobbied in support of H.R. 542, the "Elizabeth Dole Home-and Community-Based Services for Veterans and Caregivers Act." Lobbied in support of S. 2718, the Medical Disability Exam Improvement Act of 2023. Lobbied for changes to H.R. 3738, a bill To amend title 38, United States Code, to establish in the Department of Veterans Affairs the Veterans Economic Opportunity and Transition Administration, and for other purposes. Lobbied for a clean appropriations bill or CR covering these issues that does not cut federal pay or benefits.

Veterans Benefits Administration: Lobbied for changes to and oversight of Veterans Benefits Administration's (VBA) employee performance standards. Lobbied for increased oversight and changes to performance standards for Legal Administrative Assistants in the VBA National Call Centers. Lobbied for comprehensive changes to internal VBA processes for claims, including changes to the VBA National Work Queue. Lobbied to require the VA to include VA employee input when making changes to the claims process, employee performance standards, and training for claims processors. Lobbied on the processing of complex claims within the Veterans Benefits Administration, including how it relates to Military Sexual Trauma, Traumatic Brain Injury, and catastrophic injury claims. Lobbied for the specialization of claims processing for highly complex cases. Lobbied for changes to H.R. 3738, a bill To amend title 38, United States Code, to establish in the Department of Veterans Affairs the Veterans Economic Opportunity and Transition Administration, and for other purposes. Board of Veterans Appeals: Lobbied for reimbursement for Bar Membership dues for attorneys working at the Board of Veterans' Appeals. Lobbied for the re-instatement ofGS-14 career ladder position. Lobbied for the creation of a journeyman GS-15 position. Lobbied for the re-instatement of experience requirements for Board of Veterans Appeals Members (Veterans Law Judgements). Lobbied in support of and for changes to H.R.1378, the "Veterans' Appeals Backlog Improvement Act." Lobbied for additional oversight at the Board of Veterans' Appeals. C&P Exams: Lobbied against contracting out of Compensation and Pension (C&P) Exams and bringing those exams back into the VA. Lobbied to keep all specialty C&P Exams including but not limited to Traumatic Brain Injury (TB!), Post Traumatic Stress Disorder (PTSD), Military Sexual Trauma (MST), veterans who served as Prisoners of War (POWs), veterans who suffered catastrophic injuries, and veterans who are currently eligible to pursue toxic exposure claims. Lobbied for the VA to utilize more internal C&P Providers by hiring more staff and returning staff to C&P positions who had previously been reassigned. Lobbied to keep Integrated Disability Evaluation System (IDES) Exams within the VA. Lobbied for the continued oversight of contract C&P Exams. Lobbied to make C&P Exams available in every VA Medical Center. Lobbied to make sure the VA is in compliance with Section 2002 of the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020. Lobbied in support of S. 2718, the Medical Disability Exam Improvement Act of 2023. Collective Bargaining Rights: Lobbied for the reintroduction of the "Protecting VA Employees Act" to repeal parts of the VA Accountability Act. Lobbied for the reintroduction of the "VA Employee Fairness Act." Lobbied to amend 38 USC 7422. Lobbied in opposition to H.R. 4278 / S.2158, the "Restore Department of Veterans Affairs Accountability Act." VA HR Modernization: Lobbied to address problems created by VA reorganization of its human resources processes including centralization and implementation of new information technology systems, and practices and policies related to filling and posting unfilled positions. Lobbied to have Congress require the VA to return the HR functions back to VA facilities and to appropriate funding for it. VA Compensation: Lobbied in support of H.R. 536/S. 124, the "FAIR Act" to raise pay for federal employees at the VA. Lobbied in support of H.R. 866/S. (pending reintroduction) the "Equal COLA Act" to protect VA employees in FERS. Lobbied in support of H.R. 82/S. 597, the Social Security Fairness Act" to protect VA employees affected by the Windfall Elimination Provision (WEP) and the Government Pension Offset (GPO). Lobbied in support of H.R. 543, the "VA CPE Modernization Act." Lobbied in support of H.R. 1322 the "Law Enforcement Officers Equity Act" and S. 1658, the "Law Enforcement Officers Parity Act" as it pertains to VA Police Officers. VA Infrastructure: Lobbied for restriction on VA's authority to close or reduce services at rural healthcare facilities in the 2024 VA Military Construction appropriations bill. Privatization: Lobbied against continued increased spending on community care at the expense of VA's own staffing and infrastructure. Lobbied in opposition to H.R. 3520, the Veteran Care Improvement Act of 2023, H.R. 1315, the Health Act and S. 2649, Making Community Care Work for Veterans Act. Lobbied in opposition to H.R. 3146, the Veterans Health Care Freedom Act. , which would codify community care access standards that create a bias toward referral to community care over VA's own healthcare. Lobbied against potential closure or privatization of services at VA Medical Centers in Philadelphia and Coatesville, PA. Testimony, Statements for the Record, and Letters: Statements and Correspondence: Sent letter to the House Veterans Affairs Committee Subcommittee on Oversight and Investigations for its July 12, 2023, legislative hearing. Sent letter to the House Veterans Affairs Committee Subcommittee on Health for its July 18, 2023 markup. Sent letter to the House Veterans Affairs Committee Subcommittee on Oversight and Investigations for its July 19, 2023, markup. Sent a joint union letter to the House Veterans Affairs Committee for its July 26, 2023, markup. Submitted a Statement for the Record to the Senate Veterans Affairs Committee July 26, 2023 hearing titled Implementing the PACT Act: One Year Later. Submitted a Statement for the Record to the House Veterans Affairs Committee Subcommittee on Disability Assistance and Memorial Affairs Subcommittee July 26, 2023 hearing titled VA Disability Exams: Are Veterans Receiving Quality Services? Specific Legislation: Lobbied for reintroduction of the "VA Employee Fairness Act." Lobbied in support of H.R. 536/S. 124, the "FAIR Act" to raise pay for federal employees at the VA. Lobbied in support of H.R. 866/S. (pending reintroduction) "Equal COLA Act" to protect VA employees in FERS. Lobbied in support of H.R. 82/S. 597, the "Social Security Fairness Act" to protect VA employees affected by the Windfall Elimination Provision (WEP) and the Government Pension Offset (GPO). Lobbied in support of H.R. 543, the "VA CPE Modernization Act." Lobbied in support of H.R. 1322 the "Law Enforcement Officers Equity Act" and S. 1658, the Law Enforcement Officers Parity Act" as it pertains to VA Police Officers. Lobbied in support of and for changes to H.R. 1378, the "Veterans' Appeals Backlog Improvement Act." Lobbied for changes to S. 10 the "VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support (CAREERS) Act of2023." Lobbied for changes to S. 10, the "VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support" (CAREERS) Act related to market pay, performance pay, cost of living adjustments, licensure and certification reimbursement, covid leave flexibility, and recruitment and retention at YA community living centers. Also lobbied for specific changes to the bill related to the inclusion of YA Police Pensions, Continuing Professional Education Benefits, and Collective Bargaining Rights for Title 38 Employees. Lobbied to renew a defunded corpsmen and medic vocational education and training program Grow Our Own. Lobbied for the reintroduction of the "Protecting VA Employees Act" to amend parts of the "VA Accountability and Whistleblower Protection Act." Lobbied for oversight of the "Honoring Our PACT Act." Lobbied in opposition to H.R. 4278 / S.2158, the "Restore Department of Veterans Affairs Accountability Act." Lobbied for changes to S. 2679, the VA LEAD Act of 2023. Lobbied in opposition H.R. 3520, the Veteran Care Improvement Act of 2023. Lobbied for changes to H.R. 1089, the "VA Medical Center Facility Transparency Act." Lobbied in support of H.R. 1530, the "Veterans Benefits Improvement Act of 2023." Lobbied in support of H.R. 3504, the "VA Medical Center Security Report Act." Lobbied in support of, S. 1951, the "Department of Veterans Affairs Income Eligibility Standardization Act," which would eliminate subcategories of priority for enrollment to make more veterans eligible for enrollment in VA health care. Lobbied in support of the, S. 1954, the "Improving Whole Health for Veterans with Chronic Conditions Act," which would create a pilot to provide dental benefits to veterans with diabetes and ischemic heart disease. Lobbied in opposition to S. 1545, "Veterans Health Care Freedom Act," which would set up a pilot program to allow veterans to choose community providers at their preference without the need for referral by the VA. Lobbied in opposition to H.R. 754, Modernizing Veterans' Health Care Eligibility Ace, which establishes the Commission on Eligibility (staffed with bipartisan congressional and presidential appointees) to examine veterans' eligibility for health care from the VA. Lobbied in opposition to H.R. 41, VA Same-Day Scheduling Act of 2023, which requires the VA to ensure that when a veteran enrolled in the VA health care system contacts the VA by telephone to schedule an appointment for care or services at a VA facility, the appointment must be scheduled on that same call. Lobbied in support of S. 1113, the "Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act," which would set minimum nurse patient staffing requirements for public and private health care systems, including YA and Department of Defense medical facilities. Lobbied in support of H.R. 542, the "Elizabeth Dole Home-and Community-Based Services for Veterans and Caregivers Act." Lobbied in support of S. 2718, the Medical Disability Exam Improvement Act of 2023. Lobbied for changes to H.R. 3738, a bill To amend title 38, United States Code, to establish in the Department of Veterans Affairs the Veterans Economic Opportunity and Transition Administration, and for other purposes. Lobbied for a clean appropriations bill or CR covering these issues that does not cut federal pay or benefits.

H.R. 3520: Veteran Care Improvement Act of 2023 Met with various congressional offices, including members of the House Committee on Veterans Affairs and its health subcommittee, to advocate for the inclusion of language following ASAM (American Society of Addiction Medicine) guidelines for placement, continued stay, transfer, or discharge of patients with addiction and co-occurring conditions. Additionally, advocated for the inclusion of a requirement to asses high suicide risk veterans presenting to VHA hospitals and affiliated facilities within 72 hours, followed by admitting the veteran to the appropriate level of care within 48-hours.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES

H.R. 3520: Veteran Care Improvement Act of 2023 Met with various congressional offices, including members of the House Committee on Veterans Affairs and its health subcommittee, to advocate for the inclusion of language following ASAM (American Society of Addiction Medicine) guidelines for placement, continued stay, transfer, or discharge of patients with addiction and co-occurring conditions. Additionally, advocated for the inclusion of a requirement to asses high suicide risk veterans presenting to VHA hospitals and affiliated facilities within 72 hours, followed by admitting the veteran to the appropriate level of care within 48-hours.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES

Community care provider issues, veteran's timely healthcare access, VA intake timeline, HR 3520 and S2649: Advocacy for the inclusion of a requirement to asses critical veterans is 48 hours, and place in appropriate level of care within 72 hours. Advocacy for the recognition of ASAM industry standards & assessment protocol for the categorization and treatment of veterans with mental health and substance abuse disorders.

Client expense: Not reported · Firm income: Not reported

Community care provider issues, veteran's timely healthcare access, VA intake timeline, HR 3520 and S2649: Advocacy for the inclusion of a requirement to asses critical veterans is 48 hours, and place in appropriate level of care within 72 hours. Advocacy for the recognition of ASAM industry standards & assessment protocol for the categorization and treatment of veterans with mental health and substance abuse disorders.

Client expense: Not reported · Firm income: Not reported

Community care provider issues, veteran's timely healthcare access, VA intake timeline, HR 3520 and S2649: Advocacy for the inclusion of a requirement to asses critical veterans is 48 hours, and place in appropriate level of care within 72 hours. Advocacy for the recognition of ASAM industry standards & assessment protocol for the categorization and treatment of veterans with mental health and substance abuse disorders.

Client expense: Not reported · Firm income: Not reported

Community care provider issues, veteran's timely healthcare access, VA intake timeline, HR 3520 and S2649: Advocacy for the inclusion of a requirement to asses critical veterans is 48 hours, and place in appropriate level of care within 72 hours. Advocacy for the recognition of ASAM industry standards & assessment protocol for the categorization and treatment of veterans with mental health and substance abuse disorders.

Client expense: Not reported · Firm income: Not reported

HR 3520, Veterans Healthcare S 2649, Veterans Healthcare Conference Report

Client expense: Not reported · Firm income: $9,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3520, Veterans Healthcare S 2649, Veterans Healthcare Conference Report

Client expense: Not reported · Firm income: $9,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Prior Authorization Mental Health and Substance Use Behavioral Health Crisis Intervention 9-8-8 hotline services Mental Health Parity Facilitating Accountability in Reimbursements Act (FAIR Act) (H.R. 3417) Site-based Invoicing and Transparency Enhancement (SITE) Act (S.1869) Lower Cost, More Transparency Act (H.R. 5378) Primary Care and Workforce Act (S. 2840) AI Use in Healthcare Health Disparities, including Maternal Health and Rural Health H.R. 3520 Veteran Care Improvement Act of 2023. Making Community Care Work for Veterans Act of 2023 (S.2649) Dept. of Defense Military OneSource Program H.R. 2670 FY2024 National Defense Authorization Act of 2024 Better Mental Health Care, Lower-Cost Drugs and Extenders Act Provider Directories Transparency in Coverage and Machine-Readable Files

Client expense: $1,460,000 · Firm income: Not reported

Prior Authorization Mental Health and Substance Use Behavioral Health Crisis Intervention 9-8-8 hotline services Mental Health Parity Facilitating Accountability in Reimbursements Act (FAIR Act) (H.R. 3417) Site-based Invoicing and Transparency Enhancement (SITE) Act (S.1869) Lower Cost, More Transparency Act (H.R. 5378) Primary Care and Workforce Act (S. 2840) AI Use in Healthcare Health Disparities, including Maternal Health and Rural Health H.R. 3520 Veteran Care Improvement Act of 2023. Making Community Care Work for Veterans Act of 2023 (S.2649) Dept. of Defense Military OneSource Program H.R. 2670 FY2024 National Defense Authorization Act of 2024 Better Mental Health Care, Lower-Cost Drugs and Extenders Act Provider Directories Transparency in Coverage and Machine-Readable Files

Client expense: $1,460,000 · Firm income: Not reported