EMBARGOED UNTIL 6AM ET NOV 11 Our Shared Duty: Serving Those Who Serve The American military represents the best of who we are and what we can be. The women and men of our Armed Forces come from every corner of America and from all backgrounds. But what unites our service members is a shared commitment to support and defend the United States. In this, they have stepped up and set an example for us, and the world, about the potential of the American experiment. Each day we are reminded of the sacrifice and dedication of our service members overseas. Less recognized but no less important are the contributions they continue to make in civilian life. Even after they take off the uniform, veterans are often eager to continue serving. Like the generations of service members before them, today’s veterans are tackling some of America’s largest challenges. Over the last decade, hundreds of veteran-founded businesses and non-profits have been started by the generation that fought in Iraq and Afghanistan. These veterans have made great strides in clean energy, in innovative technology, and in the formation of organizations that bring services to those in need. Veterans who have served since September 11, 2001 now make up nearly half of all veterans in Congress, ushering in a new generation of political leadership. Most inspiring is that they have not just taken care of fellow veterans, but for all of those in need—not only in their local communities but around the world. In this they have demonstrated the power of service and set an example for the rest of America. Our service members and veterans hold a special place in America because of their dedicated commitment and sacrifice. But while not everyone can serve in the military, we can all follow their example of service. Let us honor the sacrifice of those serving, and those who served before, by joining hands with them and finding ways for each of us to give back to our communities and serve our nation. Serving in uniform can be the defining experience of a lifetime—but it can also lead to challenges that last a lifetime. During my time in Afghanistan, I served beside Americans from all walks of life who were willing to risk their lives to promote security and peace. When I returned home, like so many others, I felt disoriented. Too many veterans like those I have served with have suffered from post-traumatic stress and, tragically, some have died by suicide. And the sacrifice isn’t limited to the service members alone; their family and loved ones sacrifice as well. Our service members and their families deserve a Commander-in-Chief who understands and holds the service of our veterans sacred, and honors them in word and deed. When we ask our service members to put their lives on the line for America, we must be ready to provide them, and their families, with the care they need to recover from the wounds of war. ​This is not about doing veterans a favor. This is about the United States keeping a promise. When you put your right hand up and make a promise to give everything to your country, the promise America makes is to remember 1 you, respect your service, and care for you and your family. That promise lasts long after you hang up your uniform. It lasts a lifetime. It is not enough to make sure that just the basic needs of veterans and their families are met, though that is surely necessary. We must ensure that veterans are able to thrive. Veterans and their families are not a “problem to be solved,” but talent to be competed for. Above all, this requires all of us, as Americans, to reach out to our fellow citizens who have served on the battlefield and to the families who support them. We have to invest properly and fully, not just in services, but also in establishing a sense of belonging and community for veterans and their families. I understand the value of our veterans and military families, and saw firsthand how their example of service can help us all to build better communities. I am proud that in South Bend we provided channels for citizens of all walks of life to offer their experience and expertise to help returning veterans and their families reintegrate more quickly and effectively. I will honor the commitment of our service members, veterans, and their families and ensure that every veteran has the opportunity to continue to lead on the home front. We will support service members throughout their military journey, and integrate veterans back into society in ways that honor their service and experience, respect and meet their needs, and position them to continue to contribute to the fabric of America. Together, we Americans can emulate their example of service, and together we build an even better country. My priorities as Commander-in-Chief will be to: ● Heal the wounds of war and other service-related injuries and ensure our veterans, recovering service members, and those who care for them, have the support they need after service. ● Support those currently serving, and their families, ​to ensure a strong and well-supported national defense strategy​. ● Engage Americans to provide opportunities for veterans and military families to thrive. Part One: Heal the Wounds of War and Other Service-Related Injuries Many of our veterans return home with wounds—visible and invisible—only to experience challenges in accessing the benefits that were promised to them for their service. To change this, Pete’s approach for how we provide veteran health services is laser-focused on the needs of veterans and their families. This means a Department of Veterans Affairs (VA) that is transparent, innovative, responsive, and easy to access, and it means focusing on the kinds of comprehensive care that veterans need. 2 Ensure All Veterans Have Access to Affordable, Comprehensive Health Care Less than half of all veterans use or are enrolled in VA health care, and o​ver half a million veterans lack any health insurance.1 Most veterans cannot utilize the VA because they lack a service-connected disability or do not meet the financial threshold. Many veterans rely on other sources of health coverage for some or all of their care, some of which may be unaffordable.2 ​To provide every veteran with the affordable health care they deserve, Pete will: ● Ensure all veterans and their family members have access to affordable health care through Medicare for All Who Want It​. ​Pete’s public plan would provide veterans and family members who are not enrolled in VA care, don’t have private insurance, or are dissatisfied with their insurance with a high-quality, affordable public alternative. ● Ensure the VA has an adequate professional staff to provide care to all. ​The VA has over 1,600 vacant physician positions and a personnel shortage of over 49,000.3 To address these shortages, Pete will ensure the VA is fully funded, increase clinical pay to bring it more in line with market rates, cut in half the time-to-hire period to make it easier to join the VA, and aggressively recruit more providers. Pete will also ensure the VA is fully funded to provide quality, in-house medical care. ● Expand benefits to veterans with “bad-paper” discharges who were denied the due process rights of court martial.4 Since World War II, the military has increasingly relied on non-judicial administrative discharges for service members. Too often, affected troops are removed from service for conduct that is directly related to traumatic experiences.5 Service members who report sexual assault or harassment,6 as well as minority service members,7 are more likely to receive less-than-honorable discharges than their peers. The process of upgrading these discharges and restoring veterans’ benefits can take decades, and is rarely successful.8 Veterans with “bad-paper,” or less than honorable, discharges are more likely to face challenges from untreated illnesses and injuries, have interactions with the criminal justice system, have high rates of 1 Center on Budget and Policy Priorities. “​Taking Away Medicaid For Not Meeting Work Requirements Harms Veterans​.” March 14, 2019. Haley, Jennifer, Genevieve Kenney, and Jason Gates. “​Veterans Saw Broad Coverage Gains Between 2013 and 2015.​” Urban Institute. April 2017; Bagalman, Erin. “​The Number of Veterans That Use VA Health Care Services: A Fact Sheet.​” Congressional Research Service. June 3, 2014. 2 Holder, Kelly Anne, and Jennifer Cheeseman. “​Health Insurance Coverage of Veterans​.” Census Blogs. September 14, 2017. 3 Veterans Health Administration. “​OIG Determination of Veterans Health Administration’s Occupational Staffing Shortages​.” Department of Veterans Affairs Office of Inspector General - Office of Healthcare Inspections. September 30, 2019. Davidson, Joe. “​VA Struggles to Fill Hospital Jobs; It Has 49,000 Openings across the Country​.” Stars and Stripes. November 5, 2019 Davidson, Joe. “​Perspective VA Doctor Shortage Fueled by Management Issues, Poor Pay​.” The Washington Post, March 31, 2019. 4 Rowan, John. “​A Less Than Honorable Policy.​” The New York Times. December 30, 2016. 5 Ader, Melissa, Robert Cuthbert, Kendall Hoechst, Eliza H. Simon, Zachary Strassburger, and Michael Wishnie. “​Casting Troops Aside: The United States Military’s Illegal Personality Disorder Discharge Problem.​” Veterans Legal Services Clinic, Jerome N. Frank Legal Services Organization at Yale Law School. March 2012. 6 “​Booted Lack of Recourse for Wrongfully Discharged US Military Rape Survivors.​” ​Human Rights Documents Online.​ May 2016. 7 “​Racial Disparity in Military Justice.​” Protect Our Defenders, June 7, 2017. 8 Sidibe, Sundiata, Francisco Unger, Veterans Legal Services Clinic, and Jerome N. Frank Legal Services Organization at Yale Law School. “​Unfinished Business - Correcting ‘Bad Paper’ for Veterans with PTSD.​” 3 unemployment and homelessness, and are far more likely to die by suicide.9 Pete will ensure that those who served remain eligible for reintegration services and benefits designed to assist their reintegration back into society by working to upgrade bad-paper discharges and ensuring that service members no longer receive bad-paper discharges for service-related health issues. Streamline Access to Medical Care For too long, the Department of Defense (DoD) and the VA have operated in silos, rather than cooperating to better serve American veterans. Pete will build on efforts already underway to continue to streamline veterans’ access to health care. ● ● Implement better processes informed by veterans’ needs. ​Pete’s administration will improve the system to ensure veterans have familiar and reliable interactions with VA providers.10 The design of the system will be based on veterans’ perspectives and needs. o Establish a White House coordinator​ to work with the VA and DoD to streamline processes and data collection that facilitate connections between veterans and health care, and in particular mental health care.​ ​This includes standardizing eligibility and intake processes and enabling seamless and integrated health record sharing between the VA and DoD. o Implement a veteran-centric portal. ​Pete will accelerate the personalized portal for veterans that has been designed and tested with veterans themselves.11 This tool understands and is responsive to veterans’ needs today, across the VA, and anticipates their needs for the future. In terms of health care practices, it will be on par with best-in-class practices and will set the standard for health access in the country. o Deploy proactive outreach efforts​, improve nights-and-weekends resources, and engage caregivers in the planning of care for veterans. We need to find veterans where they are, and engage them there by investing in outreach tools that bring them information in language meaningful to them. Ensure one medical record from the time of enlistment​. DoD health records must transfer seamlessly to the VA so that no one needs to worry about tracking their records as they transition from active duty to veteran status. 9 Goldsmith, Kristofer. “​Restoring Honor to Veterans with Invisible Injuries​.” Higher Ground Veterans Advocacy. December 30, 2015. VA Center for Innovation. “​Veteran Access to Mental Health Services. Current Experiences and Future Design Opportunities to Better Serve Veterans and Frontline Providers​.” 2016​. 11 Nazi, Kim M, Carolyn L Turvey, Dawn M Klein, and Timothy P Hogan. “​A Decade of Veteran Voices: Examining Patient Portal Enhancements Through the Lens of User-Centered Design​.” Journal of Medical Internet Research 20, no. 7 (October 2018). 10 4 Guarantee Access to Mental Health Care Service often leaves servicemembers and veterans with invisible wounds: one in three veterans of the wars in Iraq and Afghanistan report symptoms of mental illness.12 Veterans are at an increased risk for complex mental health challenges, like post-traumatic stress disorder , traumatic brain injury , depression, and addiction.13 Veterans need convenient, timely, transparent, effective, and respectful mental health support. Mental health support must be available to veterans when they need it, not just during work hours. Pete will work with Congress to usher in a new standard for VA best-in-class mental health care. ● Expand the number of mental health and addiction clinicians treating veterans. ​Pete will ensure the VA is equipped to address veteran mental health and addiction by increasing pay and cutting red tape that has prevented the hiring of new clinicians. ● Invest in training for mental health providers​. Veterans are a specialized population with unique demands related to mental health. As more veterans visit network providers, there is little accountability regarding whether or not civilian providers are adequately trained to treat the pathology stemming from service or even in basic vernacular regarding military culture. Pete will increase funding to train mental health providers in specific modalities to address post-traumatic stress disorder and other veteran issues. ● Address stigma among veterans experiencing mental illness, moral injury, and addiction by changing how we talk about them. ​Pete will require the VA, all federal agencies, and private sector partners to assess and address this pervasive stigma, by using his presidential platform to change the narrative around mental health and addiction, and by launching a grant program that provides local veterans organizations with resources and training to end stigma around mental illness and addiction. ● Invest in veteran treatment court (VTC) program model. ​Left untreated, mental illness can lead to involvement with the criminal justice system.14 Instead of placing veterans behind bars for certain crimes, we must invest in proven models that support their long-term care and rehabilitation. Pete will dramatically expand access to VTCs, and implement national standards to ensure consistent quality and outcomes. 12 American Psychological Association. “​The Mental Health Needs of Veterans, Servicemembers, and their Families​.” Olenick, Maria, Monica Flowers, and Valerie Diaz. “​US Veterans and Their Unique Issues: Enhancing Health Care Professional Awareness​.” Advances in Medical Education and Practice 6 (December 1, 2015): 635-639. 14 Richman, Mike. “​Veterans and the Criminal Justice System​.” US Department of Veterans Affairs Office of Research and Development. September 7, 2018. 13 5 ● Improve how veterans access mental health care, far upstream of a crisis, by developing a VA mental health care concierge service. ​Getting access to mental health care at the VA is often prohibitively difficult.15 Pete’s administration will design and implement a 24/7 health care concierge service to guide veterans into mental health care and refer them to appropriate services. ● Work with the VA to allow medical cannabis for service-connected diagnoses.​ Pete will push for the legalization of marijuana nationwide. In the meantime, recognizing the benefits of marijuana for certain service-connected issues like post-traumatic stress, Pete will support legislation that will empower VA physicians to issue medical cannabis recommendations ​to augment a veterans’ broader treatment plan,16 ​in accordance with the laws of states where it is legal, and to conduct studies on the use of marijuana to treat pain.17 ● Expand the National Intrepid Center of Excellence (NICoE)​. NICoE has been a vital part of transition for the Special Operations community, supporting areas from mental health and wellness to combating stigma.18 Pete will expand this program and offer its benefits earlier in a service member’s career. Prevent Veteran Suicide Between 2008 and 2017, over 60,000 veterans ended their own lives.19 About 20 veterans and active service members take their own lives each day.20 The alarming rate of veteran suicide is part of the crisis of “deaths of despair,” which include lives lost to drugs, alcohol, or suicide.21 Pete will confront the high rate of suicide among veterans by addressing unique needs and risk factors: social isolation, limited health care options, and high rates of opioid addiction.22 Pete will support pioneering new solutions to this challenge and reinforcing programs that are working. ● Increase investments in veteran suicide prevention. ​In addition to investing in and enhancing the VA’s National Strategy for Preventing Veteran Suicide,23 Pete will focus public health and prevention to address this epidemic. Pete will also provide community support to veterans to 15 VA Center for Innovation. “​Veteran Access to Mental Health Services. Current Experiences and Future Design Opportunities to Better Serve Veterans and Frontline Providers​.” 2016​. 16 “​Veterans Medical Marijuana Safe Harbor Act.​” S. 3409. 115th Congress. Introduced September 5, 2018. 17 ​“​First FDA approved study for cannabis for PTSD in veterans underway​.” Helio Psychiatry. May 6, 2018. Ayer, Lynsay, Farris, Coreen, Carrie M., Geyer, Dionne, et al. “​Care Transitions to and from the National Intrepid Center of Excellence (NICoE) for Service Members with Traumatic Brain Injury.​” RAND Corporation, May 7, 2015. 19 US Department of Veterans Affairs Office of Mental Health and Suicide Prevention. “​National Veteran Suicide Prevention Annual Report​.” 2019. 20 US Department of Veterans Affairs Office of Mental Health and Suicide Prevention. “​Suicide Among Veterans and Other Americans 2001–2014​.” August 2017. 21 Case, Anne and Deaton, Angus. “​Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century​.” Proceedings of the National Academy of Sciences of the United States of America. December 8, 2015; for more on combating deaths of despair, 18 see ​Pete’s Healing and Belonging in America Plan​. 22 Yen, Hope. “​Suicide rates among veterans highest in western US, rural areas​.” Military Times. September 16, 2017. 23 US Department of Veterans Affairs Office of Mental Health and Suicide Prevention. “​National Strategy for Preventing Veteran Suicide: 2018 to 2028​.” 2018. 6 improve connection and belonging, while simultaneously increasing access to services when needed. Every suicide sends a shockwave through the community, heightening family and community members’ risk for suicide, mental health issues, and substance use.24 Because a suicide can tragically increase the likelihood of additional suicides, Pete will develop “postvention” strategies that reduce the ripple effect of suicide and encourage community healing. 25 ● Support common sense and responsible gun safety. ​Between 2005 and 2017, over 53,000 military veterans died by suicide as a result of guns.26 This is more than 13 times the number of service members who were killed in action in Iraq and Afghanistan combined.27 Self-inflicted death by firearms is the most common method for veterans.28 Pete supports gun policies and practices that reinforce what our service members know well from their time in the military: training, safety, and accountability.29 The VA’s public health approach to mitigating suicide will include a comprehensive strategy for gun safety. Deploy Investment and Innovation to Secure the Health of Rural Veterans Nearly one in four veterans reside in rural areas, and they face unique health challenges.30 Building on Pete’s​ ​Securing a Healthy Future for Rural America​ plan, Pete will transform rural health care for veterans. ● Dramatically reduce care shortages in rural areas by increasing the number of physicians and other health providers. ​Pete will expand the Public Service Loan Forgiveness Program and the National Health Service Corps and encourage immigrant doctors to work in rural communities by expanding the Conrad 30 waiver program. ● Make it easier for veterans to be treated at or near their home by investing in telehealth services. ​Pete will ​m​assively expand coverage of high-speed broadband and help providers implement telehealth technology so they can virtually treat patients in their homes, including teletherapy and telepsychiatry.31 Pete will increase support for the Connected Care pilot program, which deploys telehealth and mobile health to improve veterans care.32 24 Ruocco, Kim. “​We can do more: suicide prevention cannot be the only strategy​.” Military Times. August 9, 2019. Suicide Prevention Resource Center. “​Provide for Immediate and Long-Term Postvention​.” 2019. 26 “​Fact Sheet: Those Who Serve: Addressing Firearm Suicide Among Veterans​.” Everytown for Gun Safety. 2019. 27 Ibid. 28 Giffords Law Center. “​Veterans and America’s Gun Suicide Crisis.​” October 2018. 25 ​ US Department of Veterans Affairs Office of Mental Health and Suicide Prevention. “​National Strategy for Preventing Veteran Suicide: 2018 to 2028​.” 2018. 30 Hunter, Kelly. “​Veterans in Rural America 2011-2015: American Community Survey Reports​.” U.S. Census Bureau. ​January 2017. 31 Department of Veterans Affairs. “​Fact Sheet: VA Telehealth Services.​” 32 Connected Care Portal. U.S. Department of Veterans Affairs. “​Improving Health care through Technology: Find Out More About the Office of Connected Care Here​.” 29 7 ● Empower the VA’s Office of Rural Health to conduct outreach. ​Pete will build on successful outreach programs to ensure that veterans living in rural areas know what benefits are available to them and how to obtain them. Ensure Care for an Aging Veteran Population Over the next eight years, veterans over the age of 70 in the VA system will grow by 30 percent. Those who are cared for by VA-supported nursing home care will double by 2024.33 Beyond health care, older veterans visit the VA for the social connections, which both improves their clinical outcomes and reduces long-term costs through improved social determinants of health. Pete will work with VA and the broader health care community to find innovative solutions for our older veterans. ● Improve the quality of aging-in-place options for veterans. ​Aging-in-place can improve independence and quality of life and yield cost savings for families, government, and health systems. Pete will expand cost effective, innovative public and private/non-profit solutions for our aging veterans that increase safety, appropriate nutrition, and access to medical care through convenient transportation support. ● Expand respite services for caregivers. ​Pete will work with the VA to expand the qualification criteria for respite support so that veterans can age where they choose to age, and so their family members are supported throughout the process.34 ● Modernize data sharing between the VA health system and nursing homes to improve health outcomes for aging veterans. ​Pete will invest in cost-effective technologies to modernize our outdated, manual process and ensure veterans get timely care while their data is protected. Create a VA Centered on Veterans and Their Families The VA was established by General Omar Bradley to meet the needs of World War II veterans returning home. The VA has a long history of health care innovation. From the first cardiac pacemaker to models to identify individuals most at-risk for suicide, the VA has developed dynamic advances in how we approach, design, and deliver health care. Today’s veterans have different needs: the population is more diverse, and families are a much more integral part of transition to civilian life. Pete will blend the best of private sector innovation with the unique assets of the VA’s broad reach and resources to create a modern VA that best serves today’s veterans and their families. ● 33 34 Restore the impartial and apolitical focus on veteran care.​ Pete will appoint VA leaders known for their excellence in health care, mental health, technology, education, community “​As America’s Veterans Grow Older, The VA Faces A Long-term Care Crisis​.” North Carolina Public Radio WUNC. August 21, 2018. AARP. “​Helping Family Caregivers Take a Break​.”​ ​2014. 8 transition, and benefits. To ensure critical continuity across administrations, certain key positions, such as Undersecretary of Health, will be made five-year term positions. ● Design and implement a human-centered electronic health system that is responsive to the real needs of veterans. ​The $16 billion contract the VA has with Cerner and the strategy to execute its integration must use a human-centered approach so that veterans can seamlessly access benefits.35 ● Strengthen and fund VA teams that successfully engage ​novel ideas, ​measured by increased customer satisfaction, improved health outcomes, and lowered health care costs. This includes teams like VA Innovators Network,36 Digital Service at VA, Diffusion of Excellence, and the National Center for Collaborative Healthcare Innovation. Pete will ensure that innovation is formally recognized in the VA budget every year. ● Expand innovations in genomics and invest in precision medicine to improve the health of veterans. ​Genomics has a direct impact in how we manage and treat depression, post-traumatic stress disorder, traumatic brain injury, neurodegenerative diseases, and even suicide. Pete will work with the VA and the broader medical community to advance innovative research in genomics that can lead to personalized treatments for veterans and other Americans. Part Two: Support Those Currently Serving, and Their Families 37 Less than one percent of Americans keep us safe through their military service. We owe them and their families the support that their sacrifice deserves. Recent events in Syria have exposed again that any administration that dishonors our troops as simple pawns in a game played without strategy undermines our values and empowers our foes. Our global leadership, assured through strong alliances and built upon trust, is crucial to America’s standing and our safety. The “moral injury” and lasting psychological effects for troops on the ground when rashly ordered to abandon allies and surrender their five-year mission will not easily heal.38 The Commander-in-Chief must provide strong, principled leadership that protects our values, our allies, and above all, the lives and well-being of our service members. As President, Pete’s foreign policy and national security decisions will be made commensurate with the commitment and dignity that our troops bring to their service. Pete will prioritize the needs of the women and men who are serving, while they are serving. And it is not only those in uniform who serve. Service members’ families bear the burdens of service alongside them. We owe these military families the support they need to maintain the world’s best fighting force. 35 Allen, Arthur. “​$16B Veterans' Health Project Hits Major Snag.​” POLITICO, August 23, 2019. ​“​Testing Innovative Ideas and Saving Veteran Lives in the Process​.” 2018 Year in Review. US Department of Veterans Affairs. “​Profile of the Military Communit​y.” Department of Defense. 2018. 38 Maguen, Shira., Brett Litz. ​“​Moral Injury in the Context of Wars.​” U.S. Department of Veterans Affairs. 36 37 9 Care for Military Children The priority of every parent is for their children to be healthy, happy, and well-educated. The turbulence of military life makes this difficult—even more so under an administration that is diverting DoD funding intended for military schools and facilities. Military families are often unable to find adequate child care and specialty medical services for children and mothers. For children who frequently change schools, instilling self-confidence and creating a sense of belonging can be especially challenging. Yet our school systems often fall short in meeting the unique needs of military children and providing them with the best possible education and sense of inclusion. ● Fix the acute shortfall of available, high-quality child care in military communities​. Pete will provide additional resources to the DoD’s Office of Military Family Readiness Policy to ensure that every military family has access to high-quality, affordable child care. ● Ensure that educators nationwide are trained to recognize and support the needs of our military children​. Pete will direct the Department of Education to work with school administrators and teachers throughout the country on start-of-school briefings and materials highlighting the unique needs and capacities of children of military parents. Unlock the Potential of Military Spouses The challenges facing military spouses have been exacerbated over the past decades. Unlike during the draft era, today more than 50 percent of the force is married, and military families are often dual-income and have high levels of education.39 As a result, spouses today looking for independent careers and flexibility must adapt to a system designed for single-income families with stay-at-home spouses. Military spouses suffer from high rates of unemployment, and even among those who are employed a majority, 56 percent,consider themselves to be underemployed—and this hardship increases with the number of moves a military family makes.40 This puts military families at an economic disadvantage and directly affects the career choices of service members, leading many to leave the military. Building off the success of programs spearheaded by Michelle Obama and Jill Biden,41 Pete will: ● Reduce the “tax” on military service​ ​by pausing repayment on federal student loans for military spouses​ who experience unemployment as a result of moving on government orders, work with states toward license reciprocity for spouses moving on government orders, and create 39 “​2017 Demographics Profile: Active Duty Members​.” Department of Defense. 2018. Hiring our Heroes: US Chamber of Commerce Foundation. “​Military Spouses in the Workplace​.” June 2017. 40 ​“​Military Family Lifetime Survey​.” Blue Star Families. 2018. 41 “​FACT SHEET: First Lady Michelle Obama and Dr. Jill Biden Announce That All 50 States Have Taken Action On Military Spouse Licensing.​” National Archives and Records Administration. National Archives and Records Administration, July 1, 2016. 10 military spouse specific transition and reintegration programs similar to the Transition Assistance Program for service members. ● Bring defense personnel policies up to date. ​While moving among duty stations is an inevitable part of an active and effective standing military, the parameters of moving are negotiable.​ ​Pete will require Congress and the DoD to update outdated defense personnel policies that negatively impact military spouses. He will include longer Permanent Change of Station (PCS) cycles, more predictable training schedules, and more individual choice of duty stations without negatively impacting the service member’s advancement.42 ● Provide additional resources to veteran and military caregiver programs​. VA's Mission Act made pre-9/11 veterans eligible for family caregiving programs but the stipulations for support are overly restrictive. Pete will expand these programs so that they cover all who need them. Fix Military Housing We must ensure that all housing provided to military families is safe. Unfortunately, this administration has left our service members and their families in substandard and often dangerous living conditions that profit landlords while injuring service members and their families. ● Hold privatized housing contractors accountable for providing military families with safe housing and increase federal oversight. ​A ​survey of 15,000 families living in 48 states and 158 military bases showed 55 percent of respondents gave a negative opinion of their housing, while only 16 percent gave a positive opinion.43 Hundreds of military children have been lead poisoned by water and construction materials in contaminated homes.44 These families have been forced to turn to the media and Congress to get attention to the plight of unsafe homes.45 ● Ensure that military families retain control of their housing allowance. ​Direct payments of housing allowances to private contractors mean that contractors receive full payment, even from families that are forced to evacuate their homes due to unsafe living conditions. Such arrangements put families in financial hardship and disincentivize housing contractors from quickly completing necessary repairs. Pete will end this practice, so allowances go to the people for whom they are intended. ● Ban the use of non-disclosure agreements (NDAs) in housing contracts. ​Many lessors require military tenants to sign NDAs when they apply for maintenance work orders. Placing NDAs on 42 “​The Backbone of the Military: Perceptions and Experiences of Modern Military Spouse​.” USO. 2018. Pell, MB. “​U.S. Military Families Far Unhappier with Housing than Landlords Claim​.” Reuters, May 22, 2019. 44 Schneyer, Joshua. “​SPECIAL REPORT: Ambushed at Home: Lead Poisoning on US Bases​.” Reuters. Thomson Reuters. August 16, 2018. 45 Grisales, Claudia. “​Families Living with Military Housing Horrors Plead for Reforms.​” Stars and Stripes. 43 11 military families hinders their ability to hold contractors accountable for substandard housing conditions. Eliminate Barriers To Women’s Success in the Armed Forces Women have served our nation’s military for generations, from Deborah Sampson Gannet fighting in disguise in the Revolutionary war,46 to Harriet Tubman serving as a Union Army scout,47 to WACs and WAVEs serving in World War II, to the women who have led the charge to serve in infantry positions and in combat. Today, nearly one seventh of all active duty service members are women.48 Significant barriers to women’s full inclusion in the military persist—including high rates of sexual assault, lack of adequate reproductive healthcare, and military policies that limit fair promotion and leadership opportunities.49 Pete will honor and elevate women service members. ● Support the full integration of women service members into the military, including in training programs. ​Pete will direct military leadership to continue progress towards gender integration, including in Marine Corps recruit training. Pete will also task his Secretary of Defense to promote women’s cultural inclusion in the military, including in symbols and mottos. Pete will direct his Secretary of Veterans Affairs to review and revise the current VA motto: “To care for him who shall have borne the battle and for his widow, and his orphan” to fairly represent the diversity of service members and veterans. ● Shift prosecution of sexual assault in the military from military commanders to independent prosecutors​. Pete will work with the DoD and Congress to strengthen and improve the response to sexual assault in the military to ensure that justice is served. Pete will also work to ensure continuous and full access to mental health services and other resources for military women who are survivors of military sexual trauma. ● Ensure access to contraception and reproductive health needs​ ​(including menstrual products) before, during, and after deployment​, through staff and military clinician education and through the supply chain. Pete will work with Congress and the DoD to make sure that all forms of contraception are available, accessible, and easily dispensed for prolonged periods of time. 46 Michals, Debra. “​Deborah Sampson.​” National Women's History Museum, 2015. Little, Becky. “​Harriet the Spy: How Tubman Helped the Union Army​.” ​National Geographic. A ​ pril 21, 2016. 48 Krulewitch, Cara J. “​Reproductive Health of Active Duty Women in Medically Austere Environments.​” ​Military Medicine​ 181, no. 1S (2016): 63–69. 49 “​DACOWITS 2018 Annual Report.​” Defense Advisory Committee on Women in the Services, December 11, 2018. 47 12 ● Eliminate barriers to women’s retention and promotion. ​Female officers have lower rates of promotion and retention than male officers, which contributes to the lower representation of women in military leadership.50 Pete will work to eliminate barriers to women’s retention and promotion in the military. Ensure Racial Equity The American military has often driven change in our nation’s struggle for racial equality and the diversity of the force is one of its greatest strengths. Native Americans have served in every major conflict over the past 200 years, and they currently serve at a higher per capita rate than any other demographic group.51 Between 1995 and 2016, the number of active-duty Latinx service members doubled and is now roughly on par with their representation in the United States. as a whole.52 Asian Americans and Pacific Islanders have a long history of serving in our armed forces since the Civil War and are also serving at rates proportional to their representation in the United States.53 Black Americans have proudly served our country since the Revolution, and have been an even greater part of the force since President Truman integrated the armed forces in 1948. Unfortunately, racial inequity still permeates our armed forces. Pete will uproot racism and white nationalism from the military.​ A recent survey found that 22 percent of all service members acknowledged racism and white nationalism to be a problem in the armed forces, and over half of Black and Latinx service members said white nationalism is a problem.54 White nationalist veterans have committed heinous acts of domestic terror.55 Combatting this must start at the top. Pete will ensure that addressing racism in the armed forces and the threat to national security is a priority of all military commanders. He will demand a regular reports on what units are doing to combat racism and extremism, and promote diverse leadership to foster diversity, inclusion, and belonging. Honor the Commitments of Immigrants Who Serve America Since the American Revolution, immigrants have played a vital role in our national security, demonstrating an unwavering commitment to our nation. They have also proven invaluable in bringing critical technical, linguistic, and cultural skills to our forces. This administration has shamefully shut the door on immigrant recruits. It views foreign-born members of the military with suspicion,56 limits 50 Asch, Beth J., Trey Miller, and Alessandro Malchiodi, ​A New Look at Gender and Minority Differences in Officer Career Progression in the Military​. Santa Monica, CA: RAND Corporation, 2012. 51 Gover, Kevin. “​American Indians Serve in the U.S. Military in Greater Numbers Than Any Ethnic Group and Have Since the Revolution​.” HuffPost, December 7, 2017. 52 Bernal, Rafael. “​Latinos Aren't Reaching Top Military Positions​.” Study Shows.” TheHill, July 23, 2018. 53 Fuchs, Chris. “​Since the Civil War, Asian Americans have served in the military with distinction​.” NBC News. May 24, 2019. 54 III, Leo Shane. “​White Nationalism Remains a Problem for the Military, Poll Suggests​.” Military Times. February 28, 2019. 55 Philipps, Dave. “​White Supremacism in the U.S. Military, Explained​.” The New York Times. February 27, 2019. 56 Gonzales, Richard. “​Judge Orders Pentagon To Stop Discriminating Against Naturalized Citizen Soldiers​.” NPR. February 2, 2019. 13 advancement by revoking clearances on the basis of where they were born, and not only makes it harder for them to apply for citizenship, but denies them at higher rates than the general public. This dishonors their service, contradicts our heritage, and makes our country vulnerable to adversaries. Pete will honor everyone who chooses to serve the United States. ● Direct the Pentagon to revamp and reinstate the Military Accessions Vital to National Interest (MAVNI) program​. From 2009 to 2016, the DoD recruited more than 10,000 non-citizens with needed skills to serve in the U.S. military, and allowed these individuals to apply for citizenship even if they were not yet green card holders. Since 2016, the Pentagon has effectively eliminated MAVNI and began discharging participants.57 Reinstating a functioning MAVNI program to provide a pathway for immigrants with critical skills will enhance our military readiness while ensuring security. ● Protect immigrant service members from deportation. ​Despite policies aimed to protect immigrants who serve from deportation, between 2013 and 2018, some immigrant veterans were deported without proper consideration of their service.58 Pete supports legislation that will investigate these deportations and take steps to prevent this from happening again.59 Pete will establish stronger protocols for the government to verify veteran status and potential accommodation with the DoD and report about the number and reasoning behind all veteran deportations. Pete will also promote better DoD outreach to make recruits aware of eligibility for citizenship and facilitate processing. Pete will also equip the VA to take action to mirror DoD protection for active duty legal immigrants’ access to Green Cards. ● Fast-track naturalization for non-citizen service members​. If eligible recruits deploy and fight for our country, it is their country too. Pete will reinstate naturalization services at basic training to ensure that eligible recruits have the opportunity to deploy as American citizens and remove overly restrictive DoD rules and sign-off requirements that have resulted in a 65 percent drop in military naturalizations since 2017.60 ● Ensure the protection of military families so that all service members can focus on the mission without being worried that their family could be deported​.61 This includes supporting the Protecting Immigrant Gold Star and Military Families Act.62 Honor LGBTQ+ Service Members 57 Horton, Alex. “​The Military Is Kicking out Foreign Recruits It Needs - for Having Foreign Ties.​” WP Company, July 30, 2019. ​Horton, Alex. ​“ICE Deported Veterans While 'Unaware' It Was Required to Carefully Screen Them, Report Says​.” The Washington Post. June 9, 2019. 59 “​Veteran Deportation Prevention and Reform Act​.” H.R. 4980. 116th Congress. Introduced October 28, 2019. 60 Stock, Margaret. “​The Impact of Current Immigration Policies on Service Members and Veterans, and their Families​.” October 29, 2019. 61 Ordoñez, Franco. “​Trump Wants To Withdraw Deportation Protections For Families Of Active Troops.​” NPR., June 27, 2019. 62 Gallego, Ruben. “​Protecting Gold Star and Military Families Act.​” House of Representatives. July 17, 2019. 58 14 LGBTQ+ personnel have fought in the American armed forces since the Revolution and continue to serve their country around the world. For too long they had to hide their identities, but the repeal of “Don’t Ask, Don’t Tell” meant service members no longer had to choose between serving their country and being true to themselves. But this victory was not the end of the story. This administration has taken a major step backward by banning open transgender service members. As President, Pete will: ● Immediately rescind the transgender military ban. ​The harms of the ban on military service for transgender Americans can never be fully undone. ​Pete will repeal the ban and ​restore the policies that once enabled​ our transgender troops to serve openly and authentically.​ Pete’s administration will conduct extensive outreach to find all persons discharged because of their gender identity to ensure that they have the opportunity to re-enlist, re-commission, and access resources. ● Rescind the coverage exclusion of surgical treatment of gender dysphoria currently in place at the Veterans Health Administration.​ This policy, which is in place regardless of a provider’s determination on medical necessity, blocks critical health care for transgender veterans. Pete will rescind this policy so everyone who served has the health care they deserve. ● Rescind restrictions on military service for people living with HIV. ​Military policies preventing the deployment of service members living with HIV are not reflective of the advances in medical treatment made over recent decades. These outdated policies reinforce stigma and shame, harm our service members and civilians alike who are living with HIV, and reduce our national readiness. Pete will require the DoD to conduct a study of all disqualifying medical conditions to ensure that they are based on science, not stigma. ● Review and restore honorable discharges and appropriate benefits to veterans discharged solely based on their real or perceived sexual orientation or gender identity. ​Despite the “Don’t Ask, Don’t Tell” repeal, the government has yet to proactively seek out and correct the records of individuals who were impacted by these discriminatory policies. Instead, the burden is on veterans themselves to apply through this lengthy, cumbersome process. Pete will right this wrong by ordering the Pentagon to review and correct the records of all veterans who were removed from service due to their sexual orientation or gender identity. Part Three: Engage All Americans to Provide Opportunities for Veterans and Military Families to Thrive One of our most sacred commitments as a nation is to take care of those who have risked their lives in our defense. When our service members come home, we must provide the care and support they need to recover from the wounds of war, whether visible or not. We must also commit to standing with them well after they take off the uniform to ensure that they never feel like they don’t belong in the country they 15 risked their lives to serve. This requires us to ensure that veterans have opportunities to seek education, housing, employment, and innovation, and that they can use the skills they learned while serving. We can do more than just say “thanks for your service.” We must enlist entire communities to help them restore the normalcy and sense of community they are seeking by individually and collectively making sure they know they belong. Support Transition From Active-Duty Service ● Support veteran small business owners. ​There​ ​are approximately 2.4 million veteran-owned small businesses in the United States, or nearly 10 percent of all businesses. These employ nearly 5.8 million people.63 Pete will support legislation aimed at bolstering small business and other employment opportunities for veterans.64 Pete will also expand on opportunities to support veterans engaging in the clean energy sector.65 ● Pete will transform the Small Business Administration’s (SBA) Boots to Business entrepreneurship education program from two days to two weeks​. This program will provide many of the technical skills needed to start a business, including support for business plan development, an introduction to relevant SBA programs, and a mentor who will help new entrepreneurs build a professional network. Veterans who successfully complete this program and have an accepted business plan will receive a $10,000 grant to start their business. With tailored government investments and community support, our veterans have the potential to be at the leading edge of the revitalization of rural America. ● Invest in the Transition Assistance Program (TAP) for service members and military spouses exiting the military. ​Pete will direct a periodic review and assessment of TAP to ensure it better meets the needs of veterans who are transitioning into the workforce. Pete will challenge the private sector to collaborate and share best practices and technology tools for assisting veterans and military spouses in finding meaningful, fulfilling employment. ● Support community organizations that help veterans reintegrate back into society​. Many people want to go beyond thanking veterans for their service; we can harness this energy and support these communities. South Bend helped to pilot Veterans Community Connections66 as a resource for veterans who return home and benefit from assistance navigating normal civilian tasks, like where to find a good dentist or where to sign their kids up for soccer. Similar organizations are being developed around the nation. These organizations provide an important way for veterans to connect back to the communities they are a part of and help them feel less 63 “​Facts on Veterans and Entrepreneurship​.” Small Business Administration. Cohen, Steve. “​Putting Our Veterans Back to Work Act.​” House of Representatives. October 23, 2019. 65 Deaton, Jeremy. “​Veterans Find New Mission in Solar Power.​” Nexus Media. February 16, 2017. 66 “​Connecting Veterans and Military with their Community​.” Vets’ Community Connections. 2019. 64 16 isolated. Pete’s administration will provide grants to expand programs like these to more communities. ● Promote veteran service organizations (VSOs).​ Prior generations of veterans turned to VSOs when they needed a safe space to hang out among their peers. But many VSOs are struggling to reach post-9/11 veterans, so their dues-driven memberships are declining. VSOs can play a vital role in helping veterans reintegrate, by providing a sense of belonging and advocating for veterans’ issues. Pete will promote membership as part of the reintegration for veterans leaving active duty. Take Care of Veterans of All Eras Every era’s veterans have special needs and each conflict leaves different wounds. From the extreme cold and hearing injuries common for our Korean War veterans, to the oil well fires and chemical exposures of the Gulf War era, to the burn pit and depleted uranium injuries of our Afghanistan and Iraq veterans, each era has its own characteristics and challenges. The VA must invest in research on these injuries and appropriately expand care and benefits to those harmed. ● Continue to invest in presumptive condition research and benefit expansions for all eras of veterans​. It is not enough to wait for our veterans to get sick decades after their return from the battlefield and then reverse engineer the causation, leaving generations to fight the struggle for benefits and care on their own. The VA must work more closely with the DoD in proactive research and health data analytics to predict injury and illness, and invest in future treatments and health assessments that can identify these conditions today. ● Expedite disbursement of benefits and expand presumptions for Vietnam War era veterans. One in three of today’s veterans served in the Vietnam era.67 Tens of thousands are still waiting for Agent Orange benefits approved in 2017 that are being blocked by the current administration. 68 This generation fought valiantly for a country that fell short in honoring their sacrifice. We cannot change that past, but we can correct our mistakes and improve the care they have earned. ● Conduct a full accounting of those listed as missing or killed in action.​ Thousands of military families are still waiting for the bodies of their loved ones to be recovered from wars ended long ago.69 Pete will support the efforts of the Defense POW/MIA Accounting Agency to bring these families the closure they deserve. 67 Bialik, Kristen. “​The changing face of America’s veteran population​.” Pew Research Center. November 10. 2017. Kime, Patricia. “​White House Responsible for Delayed Decision on New Agent Orange Diseases, Documents Show​.” Military Times. October 23, 2019. 69 Shane, Leo. “​Progress On Recovering Missing Troops, but still a Daunting Task Ahead.​” Military Times. September 19, 2019. 68 17 ● Study the effects of Agent Orange on the descendants of exposed veterans, and ensure that children of Vietnam veterans with Spina Bifida get the care that they are entitled to.70 ● Create a Toxic Wounds Exposure Registry.​ Veterans exposed to toxic substances as a result of their military service should not have to suffer the same fate as Vietnam veterans, who had to wait for decades to have the effects of Agent Orange recognized and addressed. Meet the Needs of Women Veterans Designed originally around the needs of male veterans, the VA has struggled to adapt to the needs of the women who have stepped forward to serve. Women comprised 9.4 percent of the veteran population in 2015 and are projected to make up 16.3 percent of all living veterans in 2043.71 As more women serve their country in uniform, the VA must reorient its services and culture to one where women veterans feel welcome, comfortable, and proud to identify as part of the veteran community. ● ● Change the culture at the VA​. Over the past decade, the number of women veterans enrolled in VA health care increased 83.9 percent, from 397,024 to 729,989.72 Yet one in four women veterans using VA health care have reported inappropriate comments by male veterans at the VA. 73 Women who experience harassment may be less likely to return to the VA for any service—meaning a delay in or missing important care and benefits. This needs to change. Pete will build off work the VA has started to create an environment that attends to women veterans’ dignity, safety, and privacy. ● Ensure that women veterans receive VA benefits and services free from harassment and disrespect. ● Create gender-sensitive environments welcoming to women veterans in VA hospitals and clinics, including by ensuring proper training for staff and caregivers. ● Expand the Office of Mental Health Services’ Military Sexual Trauma Support Program so that all veterans have access to free, confidential treatment for mental and physical health conditions related to sexual trauma. Combat ​homelessness​. The number of women veterans identified as homeless, or who accessed VA programs to end homelessness, tripled to 36,443 in a five-year period ending in 2015.74 That figure is rising. Many homeless women veterans have experienced sexual trauma, do not 70 “​Benefits for Veterans' Children with Birth Defects​.” U.S. Department of Veterans Affairs. “​Women Veterans Forum.​” U.S. Department of Veterans Affairs. 2019. 72 “​Women Veterans Report, The Past, Present, and Future Veterans.​” Department of Veterans Affairs, National Center for Veterans Analysis and Statistics. February, 2017. 73 “​How Stranger Harassment of Women Veterans Affects Healthcare​.” U.S. Department of Veterans Affairs. April, 2019 74 “​Women Veterans and Homelessness, Homeless Evidence & Research Roundtable Series​.” VA National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs. July​, 2016. 71 18 self-identify as being a veteran, and are often hesitant to seek help from VA due to their military experiences. Pete’s administration will launch a task force to combat homelessness among women veterans to ensure that these women veterans and their children are no longer invisible. ● Provide jobs​. Women veterans are more likely to complete degree programs than either men who are veterans or women who are traditional students.75 Nevertheless, many women are still struggling to find meaningful employment. Many have heard the infamous line, “you don’t look like a veteran.” Pete will work to engage women veterans as they reintegrate into civilian life and work one-on-one with leaders in the business sector to ensure women veterans​—​and their skill sets​—​are valued and sought-after. End Veteran Homelessness No American veteran should ever be homeless. Building upon the progress made by the Obama administration to end veteran homelessness, Pete will: ● Invest in permanent supportive housing and state and local partnerships.​ Pete will make the federal investments necessary to finally end veteran homelessnes, both by funding permanent supportive housing and by partnering with cities, states, and community groups to provide targeted services. He will promote housing-first approaches to ending homelessness, continue the U.S. Interagency Council On Homelessness’ Mayor's Challenge to End Veteran Homelessness,76 and uplift successful local strategies, like California’s Residential Enriched Neighborhood program and the Veterans Community Project, to create meaningful change for America’s veterans.77 ● Increase availability of disaster relief funding for veterans. ​The VA provides grants for veterans displaced by natural disasters, but many veterans are ineligible or find the process difficult to navigate. Pete will create a Disaster Commission within the first 100 days of his Presidency to streamline access to all disaster recovery needs, including housing, so veterans can quickly get the resources they need. Maximize Educational Opportunities for Today’s Veterans Following their service in World War II, those who later became known as the Greatest Generation went to school, started families, and built homes and businesses. They paired a commitment to continue serving with government assistance in the form of the GI Bill which, for the white veterans best able to access its benefits, proved to be one of the greatest generators of wealth in American history. 75 “​2015 Veteran Economic Opportunity Report​.” U.S. Department of Veteran Affairs. 2015. “​Homeless Veterans​.” U.S. Department of Veteran Affairs. February 19, 2019. 77 California Department of Veterans Affairs. “​CalVet REN Enriched Neighborhood Services​.” 2013. 76 19 The Post-9/11 GI Bill promises to help launch the next Greatest Generation by both educating veterans and their families and helping rebuild a prosperous middle class—without the racial exclusion of the post-World War II period. Pete will extend the life of the GI benefit to ensure that veterans do not miss out. ● Close a loophole that leads for-profit colleges to target service members and veterans, requiring that all taxpayer financial aid—including DoD Tuition Assistance and GI Bill dollars to veterans—count toward federal protections for students and taxpayers. Pete will establish strong benchmarks for educational institutions that want to accept GI Bill funding to include graduation rates, time to completion, job placement rates, income averages for graduates, and expected student debt at the time of graduation. Pete will also ensure students whose colleges lied to them are able to access student loan debt relief, and that borrowers receive automatic loan cancellation if their colleges close. ● Expand options for the utilization of the GI Bill to enable more veterans to succeed in today’s job market. ​As the employment market evolves, so too do the educational and training needs of our veterans. We must look at making the GI Bill benefit more flexible for use in obtaining post-traditional options, including specialized technical and vocational training. Pete will expand the Vet Tec program so that more veterans can access training to enter high-tech industries.78 ● Expand programs to increase veteran awareness of the GI Bill​, extend the ways it can be used, and provide veterans the information about college outcomes needed to maximize their educational benefits to pursue meaningful and rewarding careers. Pete will also encourage the VA to work with non-profit organizations to study outcomes of the GI Bill so we can see where the program has been successful and where it needs work, including by requiring ​data on graduation rates and post-college earnings and ensuring that veterans have access to this information. Use Veterans to Spark Civic-Minded Service Nationwide America’s service members have always answered the call to serve, even after taking off the uniform. After the Revolutionary War, the members of the Continental Army heeded George Washington’s charge to “prove themselves not less virtuous and useful as Citizens, than they have been persevering and victorious as Soldiers.” General Jonathan Wainwright continued that tradition in his post-World War II letter to those being discharged from the Army by telling those young service members that “Back in civilian life you will find that your generation will be called upon to guide our country’s destiny. Opportunity for leadership is yours. The responsibility is yours...Start being a leader as soon as you put on your civilian clothes.” 78 Absher, Jim. “​VA Now Accepting Applications for New VET TEC GI Bill Program.​” Military.com. April 30, 2019. 20 Those young men and women heeded that call and created a vibrant economy, robust school systems, and institutions that were the envy of the world. Our charge today is to continue to build on that foundation. While not everyone can serve in the military, we can all follow their example of service. This is why Pete has proposed ​“​A New Call to Service​” to open a pathway for young people to meaningfully engage in their communities and in communities around the world, and focus on key challenges of our time, from climate disruption and mental health and addiction to long-term caregiving and intergenerational mentorship. We must honor the sacrifice of those serving, and those who served before, by joining hands with them and finding ways for each of us to give back to our communities and serve our nation. It’s not just about policy; it’s about creating a culture. When Pete is President, we will forge this culture together. 21