January 11, 2018

Trump signs executive order intended to bolster veterans' access to mental health care

Daily Briefing

    President Trump on Tuesday signed an executive order intended to expand veterans' access to mental health care in an effort to lower suicide rates among such individuals.  

    Three innovative ways to better manage behavioral health patients

    Background

    The executive order states that veterans are particularly vulnerable to mental health risks during the first year of their transition back to civilian life. However, such risks often go unaddressed because veterans do not have access to adequate mental health care, according to a White House fact sheet.

    Executive order details

    The executive orders aims to ensure departing servicemembers have access to mental health resources as they transition back to civilian life and for at least one year after leaving the military, the Washington Post "Checkpoint" reports. According to the "Checkpoint," the executive order specifically relates to the 60% of new veterans who do not quality for mental health care services until the federal government has established a connection between a medical issue and their military service. The executive order takes effect March 9.

    The executive order directs the secretaries of the Department of Defense (DOD), the Department of Homeland Security (DHS), and Veterans Affairs (VA) to:

    • Develop and submit a joint action plan within 60 days to provide veterans with "seamless access to mental health treatment and suicide prevention resources" in the year following their military service; and
    • Provide the president with a status report within 180 days that includes an update on the progress made to implement the joint action plan and any additional reforms needed to increase veterans' access to mental health services.

    According to the Wall Street Journal, officials have said implementing the executive order could cost $200 million annually. Officials said existing funds will cover the cost of the initiative. However, House and Senate lawmakers on each chamber's committee on veterans' affairs have said they are unsure how existing funds would pay for the initiative.

    Comments

    VA Secretary David Shulkin during a White House signing ceremony for the executive order said before the executive order, "only 40% of [departing] servicemembers had coverage in the VA to get mental health." But under the executive order, he said "100% will have that coverage."

    VA in a release said it will work with DOD and DHS to "develop a joint action plan to ensure that the 60% of new veterans who currently do not qualify for enrollment in health care—primarily due to lack of verified service connection related to the medical issue at hand—will receive treatment and access to services for mental health care for one year following their separation from service." As part of the plan, VA said the departments will:

    • Eliminate previous time limits for such coverage;
    • Expand peer community outreach and group sessions in the VA Whole Health initiative from 18 facilities to all facilities;
    • Extend DOD's "Be There Peer Support Call and Outreach Center" services to offer peer support for veterans in the year following their departure from the military; and
    • Extend DOD's Military One Source services for active-duty servicemembers to separating servicemembers for one year beyond their departure.

    Shulkin said veterans under the plan will be pre-enrolled in mental health care coverage before leaving the military.

    DHS Secretary Kirstjen Nielsen called the executive order "critically important" because it will offer servicemembers "the support they need as they transition to civilian life.

    VA spokesperson Curt Cashour said, "The executive order has already received strong support from veterans groups and members of Congress.

    But several lawmakers and advocacy groups said the Trump administration did not seek their input on the executive order before Tuesday, the Journal reports.

    Rep. Tim Walz (Minn.), the top Democrat on the House Veterans' Affairs Committee, in a statement said, "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." He continued, "The lack of transparency also raises skepticism of the White House's claim that this executive order will not require additional funding."

    Sen. Jon Tester (Mont.), the top Democrat on the Senate Veterans' Affairs Committee, in a statement expressed concerns over whether the executive order provides "sufficient resources and staff needed to successfully execute this initiative." Tester called on VA to release a detailed plan for the initiative.  

    Garry Augustine, an official with Disabled American Veterans (DAV), applauded the executive order, saying, "Any time (government officials) do some initiative that opens up the opportunity for veterans to get treatment of any kind, [DAV is] supportive of it" (Slack, USA Today, 1/9; Nicholas/Kesling, Wall Street Journal, 1/9; Lamothe, "Checkpoint," Washington Post, 1/9; VA release, 1/9; Tester statement, 1/9).

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