WASHINGTON — Veterans Affairs Secretary David Shulkin promised House budget planners on Wednesday that he'll move ahead with plans to expand mental health services and caregiver support programs, even if he can't get more money for the effort.
"We're going to find a way to help," he said during testimony before the House Appropriations Committee. "We're going to find a way to do that."
The comments came after the VA subcommittee's chairman, Pennsylvania Republican Rep. Charlie Dent, questioned the potential costs of the proposed expansions. President Donald Trump has already proposed a 6 percent boost in VA spending for fiscal 2018, but Dent noted that money likely will not include funds for those ideas.
Earlier this year, in appearance before a separate House committee, Shulkin announced plans to provide emergency mental health services and other assistance to veterans with other-than-honorable discharges.
No price tag has been placed on what that expansion may cost. Veterans who are dishonorably discharged still would not be eligible for services.
Veterans advocates for years have pushed for some care for the estimated 300,000 veterans who have been separated from the military with so-called "bad paper" discharges, arguing that a significant portion of those cases are troops dismissed for erratic behavior or substance abuse related to undiagnosed service-connected issues.
Shulkin said he recently met one Afghanistan War veteran who left duty to search for his estranged wife and was kicked out of the ranks.
"You could see he was suffering (from post-traumatic stress disorder), but when he showed up at VA, they told him he wasn’t eligible for care," he said. "He served our country for six tours. That’s not acceptable."
Shulkin said he is looking to provide those expanded services without additional funds, hoping that funding for increased staffing needs throughout the Veterans Health Administration will cover those needs.
The caregiver expansion will be more complicated. Shulkin said earlier this year that he is looking into providing expanded support services and stipends to caregivers of veterans to all eras. Currently, only post-9/11 veterans are eligible for the monthly stipends.
The idea has received support among veterans organizations but also comes with cost estimates up to $10 billion a decade, a figure that has repeatedly discouraged lawmakers from pursuing.
But Shulkin said Wednesday that limiting the program to only one group of veterans may not be in the department’s best interests, and that shifting resources to cover caregivers providing the most assistance to the department may make better financial sense than the current set-up.
Shulkin noted that the entire caregiver program is under review at the moment, after an NPR report earlier this year identified numerous cases of families suddenly losing their stipends with little explanation.
The VA secretary said he hopes as that review is finalized in the next few months, his staff will be able to offer recommendations for changes to the entire caregiver program, including providing stipends to more families. But he also said he plans to work within the current fiscal restraints of the program, under the assumption that more money won’t be made available.
Appropriations committee members said they are supportive of Shulkin’s ideas but wary of costs, particularly for a department that has seen significant budget boosts in recent years.
In fiscal 2001, the entire VA budget totaled about $45 billion. Trump’s fiscal 2018 request for the department’s discretionary spending is nearly $79 billion, and the total budget more than $180 billion.
Leo Shane III covers Congress, Veterans Affairs and the White House for Military Times. He can be reached at firstname.lastname@example.org.