Trump signs order to improve mental health care for new vets
By NIKKI WENTLING | STARS AND STRIPES Published: January 9, 2018
WASHINGTON — President Donald Trump signed an executive order Tuesday afternoon paving the way for servicemembers to be enrolled automatically with the Department of Veterans Affairs for mental health care when they leave the military – an attempt to eliminate barriers for transitioning troops to get treatment during their first year after service.
The order, titled "Supporting Our Veterans During Their Transition from Uniformed Service to Civilian Life," directs the VA, Department of Defense and Department of Homeland Security to develop a plan by March 9 on how to seamlessly provide mental health care to new veterans and implement that plan within 180 days.
Surrounded by VA and Defense Department officials, Trump said the order was "a historic step to make sure veterans are taken care of in the proper manner." He signed the order in a quick ceremony in the Oval Office.
The action highlights the issue of veteran suicide, which VA Secretary David Shulkin has named as his top clinical priority. Every day in 2014, an average of 20 veterans succumbed to suicide, according to the latest available VA data. According to a 2016 study from the Naval Postgraduate School, transitioning veterans are particularly at risk.
“People may not realize the highest risk for veteran suicide is in the 12 months following transition out of service,” Shulkin said. “That’s why we’re taking this unprecedented step.”
Veterans who use VA services are less likely to succumb to suicide than other veterans, VA data shows.
Officials with the Trump administration, who spoke on the condition of anonymity, said Tuesday that many transitioning servicemembers have difficulty enrolling in VA health care because of the complex process in place. Only 40 percent of veterans enroll in VA mental health care in the first year after leaving the service, Shulkin said.
In the next 60 days, the departments will work out specifics of how to allow exiting troops to be enrolled automatically in VA mental health care, with the option to opt out, Trump administration officials said. The order did not go into specifics on how to accomplish that.
Shulkin wants to ensure new veterans will not be required to have served in combat in order to be eligible for one year of mental health care and they won’t have to prove their military service caused mental health problems, he said Tuesday during a teleconference with reporters.
A Trump administration official said approximately 265,000 troops leave the military every year and the changes would come at a cost of hundreds of millions of dollars to the VA and Defense Department each year. The funds will be diverted from within the departments’ regular budgets, but specifics on where exactly the money would come from was not made available Tuesday.
New veterans will be permitted to use the Veterans Choice program, which allows them to seek care in the private sector. Concerned Veterans of America, a conservative advocacy group that criticized VA health care and pushed for more private-sector treatment for veterans, said the government should look to the private sector for help implementing the changes.
Rep. Tim Walz, D-Minn., the ranking Democrat on the House Committee on Veterans' Affairs, said in a statement that he was concerned the order would be used as a tool to push more care to private providers.
The American Psychological Association said they supported the changes, as long as priority is placed on veterans receiving mental health care within the VA system.
The new policy does not apply to veterans with other-than-honorable discharges – a population cut off from some VA services and seen as particularly at-risk for mental health issues.
More than 13,000 servicemembers separated from the military for misconduct in recent years suffered from post-traumatic stress disorder, traumatic brain injury or another disorder and were prevented from receiving treatment from the VA because of their discharge status, according to a recent report from the Government Accountability Office.
Last March, Shulkin, who is a physician, announced the VA would offer those veterans 90 days of mental health care in emergency situations. Since that change was put into effect in July, 3,200 veterans with other-than-honorable discharges have utilized that care.
Administration officials said Tuesday that the VA needs more authority from Congress to provide veterans with other-than-honorable discharges more than the 90 days of emergency mental health care.
“It’s our hope that if Dr. Shulkin feels he’s done all that he can for veterans with bad-paper, that the president will stand with veteran service organizations and instruct Congress to expand the statutory authority of the secretary to ensure that our country leaves no veteran behind,” said Kristofer Goldsmith, a longtime advocate of veterans with other-than-honorable discharges.
Reed Cordish, an assistant to Trump, said the changes announced Tuesday showed the president’s commitment to modernizing the VA. During his campaign, Trump criticized the agency as the “most corrupt” in Washington. Before the signing Tuesday, Trump said he was “at the forefront of the greatest strides ever made at the VA.”
Major veterans organizations were unaware of the executive order before it was announced on Trump's schedule Monday night. Walz said lawmakers who deal with veterans' issues were also not consulted.
"I am seriously concerned by the White House’s failure to provide any specific details to Congress or engage with veterans organizations in the community until the day of the executive order," Walz said in a written statement. "The lack of detail raises significant concerns with regard to targeted funding, outreach, and the education of servicemembers and veterans about the new policies. The lack of transparency also raises skepticism of the White House’s claim that this executive order will not require additional funding."
Republican leaders on the House veterans committee commended the order. Its chairman, Rep. Phil Roe, R-Tenn., said it would explore new avenues to critical care.
The American Legion applauded the changes announced Tuesday as part of an important safety net available to transitioning servicemembers.