With the government’s fiscal year having recently come to a close, we can shift our focus to the fiscal year 2020 and look at the VA’s budget requests to gain insight on the agency’s upcoming budgetary priorities. The VA’s 2020 fiscal year budget request of $220.2 billion represents a fifth straight year of budget increases and a 9.6 percent increase from the fiscal year 2019. This increased budgetary request reflects the VA’s continued commitment to several key areas of veteran care.
Mental Health
At the top of the VA’s list of priorities is Mental Health. The VA has requested a mental health budget of $9.4 billion, a $426 million increase from 2019. The budget increase is designed to fund mental health services and treatments for veterans covering a wide range of conditions from depression and anxiety to more severe conditions such as Post-Traumatic Stress Disorder (PTSD) and psychosis. Included in the budget is a $222 million request for a suicide prevention program, an increase of $15.6 million from 2019. The increase in budget requests comes as a response to the growing demand for increased Veterans Health Administration VHA mental health care. In FY 2018, close to 1.7 million veterans (28 percent of all VHA users) received mental health services in a VHA specialty mental health setting, which is an increase of approximately 927,000 veterans from FY 2006. The budget increase will also be used to fund the ongoing expansion of available mental health resources and information on-line. The increase and size of the requested mental health budget by the VA is an indicator of just how important adequate mental health treatment is for veterans.
Homeless Program
The VA remains dedicated to the goal of ending veteran homelessness. This is represented in their $1.8 billion budget request for the homeless program, a $179 million increase. The VA will use these funds primarily to focus on prevention and treatment services, with programs that address psychosocial factors surrounding homelessness while increasing the availability of residential, rehabilitative, transitional, and permanent housing options or resources. Over the past eight years, the VA has worked with federal and state agencies (particularly the Department of Housing and Urban Development, VSOs, advocacy groups, and community-providers to reduce the number of homeless veterans by nearly 50 percent.
Telehealth Program
In order to expand its telehealth program, which is already the largest in the country, to better serve veterans, particularly those in rural communities, the VA requested $1.1 billion, an increase of $105 million from 2019. In FY 2018, more than 782,000 veterans received telehealth services through the VA (45 percent of those veterans live in rural areas), which represents a 57 percent increase over the 497,000 veterans who used the telehealth program in 2012. The number of veterans who used the telehealth program in FY2018 accounted for 13 percent of the total number of veterans who received VHA care. The increased budget for this year is part of the VA’s multi-year plan to expand its telehealth program, specifically its VA Video Connect program, to the level of becoming a routine modality of care for all veterans by 2020.
Caregivers
The VA requested $720 million for the Caregiver Support Program, a 42% and $213.5 million increase from 2019. The increased budget will be used to support over 27,000 caregivers throughout the program which provides support for individuals who serve as caregivers for veterans. The increase in budget is driven by an escalation in the eligible Veteran population. To learn more about the Caregiver Support Program, such as who qualifies and what benefits are available, visit https://www.caregiver.va.gov/
Women Veterans
The VA’s budget request for Women Veterans is $547 million, a $42 million increase above 2019. The increase in the budget request for women (gender-specific health care) comes as the VA anticipates an increase in the number of women veterans. In 2018, women made up 15 percent of the active-duty military force and 19 percent of the National Guard and Reserves. These funds will be used by the VA to train their providers and other clinical staff on how to effectively meet the needs of women veterans. The funds will also be allocated towards enhancing current VA facilities to be better equipped to offer improved privacy and proper consideration of gender-specific conditions. The VA’s goal is to redesign gender-specific health care delivery with models that ensure women receive equal treatment and health care from a single provider as a means of reducing fragmentation and improving overall quality. In addition to redesigning their gender-specific health care delivery, the VA plans to use these funds to better inform women veterans about the gender-specific health care treatments and services that the VA offers.
Opioid Treatment and Pain Management Safety
The VA requested $397 million, a $15 million increase, for Opioid Treatment and Pain Management Safety. The increased budget will provide support for the VA’s Opioid Safety Initiative (OSI) which aims to ensure that pain management is addressed thoughtfully, compassionately and safely. The funds will also look to help decrease the number of veterans on long-term opioids, the number of veterans that are taking opioid and benzodiazepine medications together, and the average dose of selected opioids. In addition to these initiatives, the funds have been used in the past to target the education and training related to opioid overdose, including, prevention and recognition, rescue response and the distribution of naloxone kits. As of September 30, 2018, over 204,000 naloxone prescriptions were dispensed to Veterans.
Rural Health
The VA has asked for a budget of $270 million to provide better rural health care to complement the services being provided through the VA’s telehealth program. This request matches the VA’s 2019 rural health care budget. These funds will be used by the VHA Office of Rural Health (ORH) to support the 33 percent of all VA enrollees who live in rural or highly rural areas. Projects funded through the ORH include home-based primary care, training, and education of medical residents in a rural clinical setting, equipment for rural Community Based Outpatient Clinics (CBOCs), transportation of rural Veterans, and home-based therapies.
Conclusion
An analysis of the VA’s budget requests for the fiscal year 2020 provides encouraging evidence that the VA remains focused on addressing the most pressing issues facing veterans. Perhaps the most important takeaway is the VA’s continued strong commitment to funding mental health treatment. Mental Health not only represented the health care area with the biggest budget, but the area with the biggest requested budget increase as well. The focus on support for veterans’ mental health has never been more important as more and more veterans are reported to be suffering from depression, anxiety or a form of PTSD. Another interesting takeaway is the VA’s dual approach to provide more support for veterans in rural areas, by funding both telehealth and rural health programs designed to make healthcare more accessible. This initiative represents an important step forward for rural veterans who have felt marginalized in the past. The VA’s focus on women or gender-specific issues is another very positive takeaway from this analysis. As the number of women veterans continues to grow, it is encouraging to see the VA begin to fund facility enhancements and specialized training aimed to better meet the needs of women veterans. However, as this website has discussed previously, it will require the attention and action of our entire nation to even begin to effectively address the issues facing our veterans as a means of adequately thanking them for their service.
It is important to note that this analysis provides an overview of some of the VA’s areas of focus in regards to health care, however, it does not represent a complete breakdown of all VA priorities. In addition to the priorities listed, the VA has stated its dedication to several initiatives such as staffing, community care, electronic health record modernization, healthcare facilities, and research.
What are your thoughts on the VA’s FY 2020 health care priorities?