by Melanie Brunson
“State of the VA”
On May 31, VA Secretary David Shulkin delivered a State of the Department of Veterans Affairs (VA) address here in Washington. The address outlined the progress that has been made to reform the agency since he took the helm in February, as well as his vision for the future of VA. A wide range of issues were covered, including access to care; community care and choice; accountability; and the quality of care provided to veterans.
Secretary Shulkin identified multiple priorities, such as reducing backlogs and getting more veterans access to mental health care and suicide prevention programs.
In assessing the state of the Department, Dr. Shulkin said: “As a physician, I tend to look at things in terms of the way I was trained — assess, diagnose, and then aggressively treat the patient. Though we are taking immediate and decisive steps, we are still in critical condition and require intensive care. The goal is to turn VA into the organization veterans and their families deserve, and one that America can take pride in.”
Melanie Brunson, right, with VA Acting Undersecretary for Health Poonam L. Alaigh following special Veterans Service Organization Roundtable with Secretary David Shulkin held June 29 at VA Central Office. Also shown in background, VFW Director of Public Affairs Joe Davis and, in foreground, guide dog Sparta.
Greater VA Accountability
Both houses of Congress have also approved legislation aimed at giving the VA Secretary increased authority to demote, discipline, and fire employees who perform poorly or engage in criminal activity or other forms of misconduct on the job. The bill also provides protection against retaliation for VA employees who become whistleblowers by reporting instances of mismanagement or misconduct within VA.
The legislation also gives the VA Secretary authority to streamline the process used to hire directors for VA Medical Centers. A number of medical centers have longstanding openings for directors, which the Secretary contends remain unfilled because the applications of prospective candidates are enmeshed in red tape.
Known as the VA Accountability and Whistleblower Protection Act, the law was approved by both houses of Congress with broad bipartisan support. It was signed into law by President Trump on June 23.
Fiscal Year 2018 Budget
A few weeks before the landmark accountability legislation, the White House released its proposed budget for Fiscal Year 2018, which begins October 1 of this year. The funding priorities proposed by the administration for VA have been the subject of statements expressing both praise and alarm from Veterans Service Organizations.
Although the administration is proposing cuts in funding for many other federal programs, an increase of 3.6 percent is proposed for VA. Most of that increase is dedicated to funding a permanent second phase of the Veterans Choice program, for which Secretary Shulkin says he will outline plans in the next few weeks. The administration proposes to pay for expansion of the Choice program with savings resulting largely from cuts in two veterans benefit programs.
The first involves a cost of living adjustment round down for Disability Compensation beneficiaries. The administration proposes reestablishing the practice, which ended in 2013, of rounding down to the nearest dollar the annual Cost Of Living Adjustments (COLAs) for service-connected disability compensation, Dependency and Indemnity Compensation, and certain education programs. White House officials say that the impact of this round down will be minimal for individual veterans, less than $12 per year, while the cumulative impact will add substantially to the funds available to pay for expansion of the Choice program.
Individual Unemployability And Other Benefits Issues
The administration is also proposing new limits to Individual Unemployability (IU) benefit payments. Veterans receive disability compensation based on disabling conditions incurred during military service. In addition to the benefits provided for these disabling conditions, some veterans are deemed unable to engage in any substantial work as a result of their service and receive supplemental "Individual Unemployability" Benefit Payments, which currently continue past Social Security retirement eligibility.
This proposal, the second of the two aforementioned cuts, would immediately halt those supplemental payments for both current and future beneficiaries once they reach retirement age and first become eligible for Social Security benefits. IU benefits would not be terminated for veterans who are ineligible for Social Security retirement benefits. They would be allowed to continue to receive IU past minimum retirement age.
During the past couple of years, Members of Congress have repeatedly said that they will not balance the federal budget “on the backs of veterans.” In addition, before these changes can be incorporated into any budget, both of the proposals will require Congress to pass legislation that authorizes changes in the amount of benefits paid to veterans under these programs.
In the weeks since the release of the White House’s budget proposal, administration officials and Members of Congress have both said they have no desire to impose hardships on veterans and are, therefore, open to looking for alternative means of funding the next phase of the Choice program and other initiatives anticipated by the proposed VA budget.
We will continue to monitor the negotiations between Congress and the White House on these issues and keep you apprised on their progress. However, it should be noted at this point that in recent years, regardless of which party has controlled the White House, very few of the proposals contained in the budgets submitted by our Presidents have made it into the legislation ultimately approved by Congress. Members of Congress are much more interested in hearing from individual constituents than they are in the views of the White House.
Congressional leaders continue their negotiations across party lines and with the White House. We expect them to get serious about debating the FY 2018 budget sometime after their return from the July 4 recess.
Appeals Process Modernization
Congress is likely to act in the next few weeks to approve legislation that would modernize the process by which veterans can appeal decisions on claims for benefits. The legislation includes measures to quite literally overhaul the appeals process.
The Senate voted to approve this overhaul just before its members left for their Independence Day recess. We expect the House to act on the measures fairly quickly once members return to Washington in mid-July since they have widespread support in both parties in that chamber as well, including unanimous support from Members of the House Committee on Veterans Affairs.
Measures to overhaul the appeals process are under consideration in both the House and Senate and have bipartisan support. We expect both the House and Senate to act on these measures this summer.
Emergency Services for Mental Health Needs
VA has announced that effective July 5, all of its medical centers will be prepared to offer stabilization care for former service members who come to the facility with an emergency mental health need, including those who have other-than-honorable administrative discharges. These individuals may receive care for their mental health emergency for an initial period up to 90 days, which can include inpatient, residential, or outpatient care.
During this time, the Veterans Health Administration and the Veterans Benefits Administration will work together to determine if the mental health condition is a result of a service-related injury, making the service member eligible for ongoing treatment by VA.
This is the first time a VA Secretary has implemented an initiative specifically focused on this group of former service members who are in mental distress.