USS Fort Snelling (LSD-30)
Shipmates of 1954 - 1984
Project SHAD
PROJECT SHAD USS FORT SNELLING CREW (CARIB 1-69) MAY 1969
Department of Veterans Affairs VHA DIRECTIVE 1127
Veterans Health Administration Transmittal Sheet
Washington, DC 20420 March 24, 2015
PROVISION OF HEALTH CARE SERVICES TO VETERANS INVOLVED IN PROJECT 112/SHIPBOARD AND LAND-BASED HAZARD AND DEFENSE TESTING (PROJECT 112/SHAD)
1. REASON FOR ISSUE: This Veterans Health Administration (VHA) Directive explains that Veterans who participated in a test conducted by the Department of Defense (DoD) Desert Test Center as part of a program for chemical and biological warfare testing from 1962 through 1973 (including the program designated as “Project Shipboard Hazard and Defense (SHAD)” and related land-based tests) are eligible for hospital care, medical services, and nursing home care under Title 38 United States Code (U.S.C.) 1710(a)(2)(F) for any illness, notwithstanding that there is insufficient medical evidence to conclude that such illness is attributable to such testing. No copayments apply to the receipt of such care.
2. SUMMARY OF CONTENT: Project 112 is the name of the overall program for both shipboard and land-based biological and chemical testing that was conducted by the United States (U.S.) military between 1962 through1973. For the purpose of this Directive, Project 112/SHAD refers to both shipboard and land-based biological and chemical testing. VA’s special treatment authority for this cohort of Veterans is codified at 38 U.S.C. 1710(e)(1)(E). Veterans who participated in Project 112/SHAD are eligible for enrollment in Priority Group 6, unless otherwise eligible for placement in a higher enrollment priority based upon other eligibility factors.
3. RELATED ISSUES: None.
4. RESPONSIBLE OFFICE: The Chief Business Office (10NB6) is responsible for the content of this Directive. Questions about patient care and possible adverse health effects related to Project 112/SHAD maybe addressed to Office of Public Health (10P3) at 202-461-1020. Questions concerning enrollment and eligibility maybe referred to the Chief Business Office at 202-382-2500.
5. RESCISSIONS: VHA Directive 2009-047, dated September 30, 2009, is rescinded.
6. RECERTIFICATION: This VHA Directive is scheduled for recertification on or before the last working day of March 2020.
Carolyn M. Clancy, MD Interim Under Secretary for Health
DISTRIBUTION: Emailed to the VHA Publications Distribution List on 03/26/2015.
March 24, 2015 VHA DIRECTIVE 1127
PROVISION OF HEALTH CARE SERVICES TO VETERANS INVOLVED IN PROJECT 112/SHIPBOARD AND LAND-BASED HAZARD AND DEFENSE
TESTING (PROJECT 112/SHAD)
1. PURPOSE: This Veterans Health Administration (VHA) Directive provides Department of
Veterans Affairs (VA) policy for providing Project 112/Shipboard and Land-based Hazard and Defense (112/SHAD) Veterans enrollment in the VA Health Care System. This Directive describes
the type of care for which these Veterans are eligible from VA at no cost, notwithstanding insufficient medical evidence to conclude their conditions are attributable to such testing.
AUTHORITY: 38 U.S.C. 1705, 1710(a)(2)(F), and 1710(e)(1)(E).
2. BACKGROUND:
a. For the purpose of this Directive, Project 112/SHAD refers to both shipboard and landbased biological and chemical testing. Pursuant to sections 1710(a)(2)(F) and 1710(e)(1)(E) of Title 38, United States Code (U.S.C.), Veterans who participated in Project 112/SHAD, (see
paragraph 2.b.) are eligible to receive needed VA hospital care, medical services, and may be provided nursing home care for any illness notwithstanding insufficient medical evidence to
conclude that such illness is attributable to such testing.
No copayments apply to the receipt of this care. Consistent with 38 U.S.C. 1705(a)(6), Veterans who participated in Project 112/SHAD are to be enrolled in Priority Group 6, unless otherwise eligible for placement in a higher enrollment priority based upon other eligibility factors. Note, however, that pursuant to 38 U.S.C. 1710(e)(2)(B), hospital care, medical services, and nursing home care may not be provided with respect to a disability that is found, in accordance with guidelines issued by the Under Secretary for Health, to have resulted from a cause other than the participation in testing as described in section 1710(e)(1)(E). In those situations, copayments may apply. VA does not perform first and third-party billing for services related to Project 112/SHAD exposure.
b. Project 112 is the name of the overall program for both shipboard and land-based biological and chemical testing that was conducted by the United States (U.S.) military between 1962 through 1973. Project 112SHAD was the shipboard portion of these tests, which were conducted to
determine:
(1) The effectiveness of shipboard detection of chemical and biological warfare agents;
(2) The effectiveness of protective measures against these agents; and
(3) The potential risk to American forces posed by these weapons.
c. The Department of Defense (DoD) estimates that about 6,000 Veterans may have been involved in Project 112/SHAD. DoD has provided VA with the names of approximately 5,000 Veterans who participated in the tests. Currently, it is known that these tests involved low levels of
a variety of biological and chemical warfare agents, simulants (thought to be less hazardous substitutes), and decontamination chemical substances.
d. DoD has collected, reviewed, and declassified relevant documentation regarding the testing. As the tests were declassified, DoD provided VA with:
VHA DIRECTIVE 1127 March 24, 2015
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(1) Test name, date, location, and, if a SHAD test, the names of ships involved in these tests;
(2) Names and service numbers of individual Veterans involved; and
(3) The materials to which the participants may have been exposed.
NOTE: Information about the specific ships involved and the known health effects from exposures to agents that were used in Project 112/SHAD tests is available along with other relevant background information at: http://vaww.va.gov/hec/Access/. This is an internal VA Web site and is not available to the public. Another source of information regarding Project 112/SHAD tests is DoD's Web site at: http://mcm.fhpr.osd.mil/cb_exposures/cb_exposures_home.aspx.
e. All Veterans identified by DoD as having participated in Project 112/SHAD were notified by letter from the Veterans Benefits Administration (VBA) in May 2002.
3. POLICY: It is VHA policy that Project 112/SHAD Veterans are offered enrollment in the VA Health Care System, with no cost for treatment for conditions that are clinically determined to be related to exposures related to Project 112/SHAD.
4. RESPONSIBILITIES: VA medical facility Directors are responsible for:
a. Ensuring Project 112/SHAD Veterans are enrolled in Priority Group 6, if they are not eligible for a higher-enrollment priority based on other eligibility factors; however, upon initial enrollment for VA health care, Project 112/SHAD Veterans are not exempt from the requirement to complete a Financial Assessment (Means Test), and VA may charge a copayment for care for conditions found to have resulted from causes other than their participation in Project 112/SHAD tests.
NOTE: Veterans who are currently enrolled and are required to complete a Means Test do not need to complete annual Means Test updates. VA will securely receive income information from the Internal Revenue Service and Social Security Administration to confirm their continued enrollment eligibility.
b. Ensuring VA physicians consider the following types of conditions, which are not ordinarily considered to be due to occupational or military activities, when making the determination if the illness or disability is possibly related to a Veteran’s participation in Project 112/SHAD:
(1) Congenital or developmental conditions, e.g., scoliosis;
(2) Conditions which are known to have existed before military service; and
(3) Conditions having a specific and well-established etiology and that began after military service ceased, e.g., bone fractures occurring after separation from military service, a common cold, etc.
NOTE: Although the preceding types of conditions are not ordinarily considered to be due to military service, if the staff physician finds that a Veteran requires care under this provision for one or more of those conditions, the physician is to seek guidance from the VA medical facility Chief of Staff (COS) regarding the authorization for such treatment. The decision and its basis must be clearly documented in the Veterans electronic health record and chart by the Registry Physician.
c. Ensuring that VA medical facility intake, eligibility, and clinic scheduling staff are knowledgeable of the Project 112/SHAD indicator in Veterans Health Information Systems and Technology Architecture (VistA) on registration screen 7. NOTE: The Project 112/SHAD information entered in this indicator field is also available in other VistA applications to enable other users (e.g., clinicians) to view it.
d. Ensuring that medical facility intake, eligibility, and clinic scheduling staff members contact Health Eligibility Center (HEC) staff members to make any needed changes to SHAD status. NOTE: Staff may contact the VHA HEC at: https://vhahecwe
e. Ensuring the name of the specific Project 112/SHAD test or tests in which the Veteran participated while in military service and possible exposures are recorded in the patient's electronic health record by environmental health providers. This data must be obtained from the patient or from the notification letter the Veteran received from Veterans Benefits Association (see paragraph 2.e.).
5. REFERENCE: 38 U.S.C. 1705, 1710(a)(2)(F), and 1710(e)(1)(E).
March 24, 2015 VHA DIRECTIVE 1127