Stronger support for Americans who risk their lives for ours: Changes for veterans

Happy New Year, Veterans (and all of us who benefit from your selfless service on behalf of our country)! Despite a year of political upheaval and angst in Washington, veterans can be pleased with the new administration’s Veterans Affairs (VA) policy direction that has earned significant bipartisan support.

Key decisions made by VA Secretary David Shulkin can best be described as novel: pragmatic; transition-focused, veteran-centric; and refreshingly direct in addressing formerly intractable systemic problems that have long confounded the VA. While Secretary Shulkin is the first non-veteran to hold this Cabinet position, he is an MD born to, and influenced by, an Army psychiatrist. The following initiatives make me optimistic about continued VA progress in 2018 for service and family members as they transition to veteran status.

  1. Electronic Health Records (EHR) and interoperability

In June 2017, Secretary Shulkin decided that the VA would update its aging Vista Electronic Health Record (EHR) and adopt the same system the Department of Defense recently procured from Cerner. The VA’s decision to sole-source the same off-the-shelf EHR system surprised many, but it saved several years by foregoing a competitive procurement and significant taxpayer procurement dollars. It will locate patient data in one common system and structurally enable seamless care (interoperability) between the two departments. I was further heartened by Secretary Shulkin’s recent decision to delay the final agreement until Cerner includes requirements for similar interoperability with the private-sector providers that are part of the VA’s Choice Program. It reconfirms the Secretary’s understanding of the challenges ahead and his commitment to an evolving transition-focused veterans’ care service.

    2.  Increasing the availability of mental health services for all veterans

For more than a decade, we’ve heard that approximately 20 veterans commit suicide each day. I am impressed by, and optimistic about, Secretary Shulkin’s policy change in 2017 to authorize veterans with less than honorable discharges, an extremely high-risk population, access to emergency mental health services for an initial 90-day period. The Veterans Health Administration and the Veterans Benefits Administration will now work together for a period of three months to determine whether the veteran’s mental health condition (e.g., PTSD, depression) is a result of a service-related injury. If that is the case, the veteran becomes eligible for ongoing coverage for that condition.

Secretary Shulkin’s decision is significant. It authorizes emergency mental health services for 40,000 other-than-honorable (OTH) discharged veterans in 2018. It is important to note that an OTH discharge is different from a bad conduct or dishonorable discharge. An OTH discharge is often based on erratic behavioral issues, such as inappropriate language or actions – actions that can often be the result of something that occurred during the veteran’s service. Secretary Shulkin’s decision recognizes that different commanders may have reacted differently to the same erratic behaviors – some requiring the service member to get mental health treatment while others moved forward with the OTH determination. The VA’s decision to provide emergency mental health services and review all OTHs is long overdue.

   3.  Expediting VA benefits for service members transitioning out of the military

We’ve heard for decades about the overwhelming backlogs in VA disability determinations that result in hardships for new veteran families entitled to financial compensation based on their veteran’s disability rating. As of Oct. 1, 2017, military service members who plan on filing for disability compensation will now be required to submit a claim 90 to 180 days prior to separating from the military. The purpose of this benefit redesign is to ensure all military service members receive a VA health exam at least 45 days from the date they submit their claim. Doing so ensures they receive their disability rating prior to military discharge, hopefully eliminating the backlogs that have frustrated veterans for decades.

Based on these developments and many others, I am hopeful that the VA will continue to innovate and support policies in 2018 to improve the health care experience of all service members transitioning to Veteran services. It is time that veterans get the care they deserve.

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