President Joe Biden is calling on the Republican-controlled House to work with his administration to give the Department of Veterans Affairs the tools it needs to expand its health care and benefits programs.

President Joe Biden, in his State of the Union address Tuesday evening, said the VA is “doing everything it can, including expanding mental health screenings” for veterans.

Biden also said he’s doubling down on efforts to prosecute fraudsters who stole COVID-19 relief funds.  He called for tripling the anti-fraud strike force that’s going after criminals and extending the statute of limitations for watchdogs to go after pandemic unemployment insurance fraud from five years to 10 years.

Biden said agency watchdogs still need robust funding to go after pandemic fraud.

“The data shows that for every dollar we put into fighting fraud, the taxpayers get back at least 10 times as much,” Biden said.

The White House, in a preview of Biden’s State of the Union address Tuesday evening, is promoting its VA policy goals as part of a four-part “unity agenda.”

The unity agenda, unveiled during Biden’s first State of the Union address in 2022, also includes ending cancer as we know it, tackling a mental health crisis and cracking down on the opioid epidemic.

The White House is promoting its unity agenda as a playbook for what the administration can accomplish with a Republican-controlled House and a Democratic majority in the Senate.

White House Communications Director Kate Bedingfield told reporters on Tuesday that the administration’s unity agenda is “focused on areas where members of both parties can come together and deliver for the American people.”

The administration, in a preview of its budget request for fiscal 2024, is calling on the VA to hire more mental health experts, and is exploring ways to make it easier to expand mental health care through telehealth.

To better address veterans’ mental health needs, VA will expand proven peer support programs where veterans help fellow veterans to access mental health and substance use treatment and other support services.

The White House, in a fact sheet previewing the State of the Union address, said the VA is on track to hire 280 “peer specialists” by the end of 2023.  Peer specialists are veterans with mental health experience and are trained and certified to assist other veterans going through mental health challenges.

The administration is also looking to help veterans transition out of active-duty military life through federal job training programs for veterans and their spouses.

The Department of Labor Veteran Employment and Training Service (DOL-VETS) this year will implement its Employment Navigator Partnership Pilot, which has already provided one-on-one career assistance to 6,500 transitioning service members and military spouses.

The Department of Defense will use its Military Spouse Career Accelerator Pilot program, a 12-week paid fellowship program, to expand employment opportunities for eligible military spouses.

The White House in its fact sheet said that about 200,000 service members transition from the military to civilian life each year. The administration is focused on veterans’ transition to civilian life as one of five cross-agency “life experiences” outlined in Biden’s 2021 executive order on improving customer experience in government.

Under the President’s Management Agenda, the VA is expected to see a 5% growth in telehealth in targeted areas of care by the end of fiscal 2023. The agency will also develop new survey questions to assess veterans’ experience with their access to VA telehealth services and establish baseline data.

The VA, as part of a governmentwide push to expand telehealth services, will launch a new nationwide network of behavioral health clinicians to ensure timely access to mental health services to veterans enrolled in VA health care.

House VA Committee Chairman Mike Bost (R-Ill.) said in a statement that he appreciated Biden’s discussion of veterans during his State of the Union, and plans to hold the administration “accountable for the billions of dollars we have invested in VA” to address persistent problems.

“Veterans should not be fighting a VA bureaucracy for community care referrals, they should not be stuck on the phone on hold trying to get a simple answer, they should have safe and secure housing; they have earned a system that is worthy of their service,” Bost said.

Administration officials see opportunities for bipartisan support in Congress as the VA implements the Promise to Address Comprehensive Toxics (PACT) Act, which expands access to VA health care and benefits for veterans who were exposed to toxic substances during their military service.

The legislation is the biggest expansion of VA health care and benefits in more than 30 years.

The VA processed an all-time record of 1.7 million veteran claims in 2022 and delivered $128 billion in benefits to more than 6 million veterans and their survivors.

Christen Linke Young, the deputy assistant to the president for health and veterans affairs, said the VA under the PACT Act has conducted more than 1.5 million initial toxic exposure screenings of veterans.

Linke Young said the Biden administration’s fiscal 2024 budget request to Congress will include “a robust agenda to protect American veterans,” with a focus on expanding housing assistance for veterans experiencing homelessness.

The White House said the president’s FY 2024 budget will triple the number of extremely low-income veterans who can access assistance programs to rent housing in the years ahead.

The VA recently reported that veteran homelessness fell by 11% between 2020 and 2022. The agency also reported that it helped permanently housed more than 40,000 veterans last year.

DoD and VA both reported a decline in veteran suicides last year and released a comprehensive strategy for reducing military and veteran suicide. However, Linke Young said that “much more remains to be done.”

The administration, she added, will make additional resources available to states and territories for community-based programs tackling veteran suicide.

Since 2010, more than 71,000 veterans have died by suicide — more than the total number of deaths from combat during the Vietnam War and operations in Iraq and Afghanistan combined.

VA issues for Congress to address in 2023

Congress in the year ahead will oversee the VA’s resumed rollout of its Oracle-Cerner Electronic Health Record, which is scheduled to pick back up in June.

Top Republicans on the House VA Committee recently introduced two bills to address the troubled EHR rollout.

One would require the vendor Cerner and its parent company, Oracle, to demonstrate “significant improvements” in the EHR system before installing it at additional VA medical centers.  The other would completely pull the plug on the multibillion-dollar EHR rollout.

Committee Ranking Member Mark Takano (D-Calif.) said in a statement this week that he doesn’t support completely canceling the EHR program “without a viable solution to replace it.”

“Cancelling a contract is not going to fix the larger issue of VA’s lack of progress with IT modernization and poor program management stemming from the sole-source award by the Trump administration in 2018. I want to get this right, America’s veterans and VA staff deserve a modern EHR that works,” Takano said.

Takano, as the committee’s chairman in the last session of Congress, supported language in the FY 2023 omnibus that places guardrails on the Oracle-Cerner EHR rollout later this year. He added that patient safety concerns must be adequately addressed before any further EHR go-lives at VA medical centers.

“I am not opposed to changes to the program, and I am committed to working in a bipartisan and bicameral manner to make such changes,” Takano said.

House Republicans, however, see little-to-no room for compromise on the VA’s policy to provide abortions to some veterans under limited emergency circumstances.

Bost and Health Subcommittee Chairwoman Mariannette Miller-Meeks (R-Iowa), are asking the VA to provide the total number of abortions it has provided since last fall. That’s when the VA issued an interim final rule permitting abortions in life-threatening situations or in cases of rape and incest.

The lawmakers say that rule exceeds the VA’s legal authority.

“VA is in clear violation of settled law by currently offering abortion services nationwide. With each week that passes, the number of abortions performed at VA facilities grows and Congress is left in the dark,” Bost said.

Next steps on opioid crackdown, ARPA-H

The Biden administration also plans to outline the next steps for standing up the Advanced Research Projects Agency for Health (ARPA-H), a new agency to drive breakthroughs in the fight against cancer and other diseases. Congress has provided ARPA-H with $2.5 billion in funding.

Biden is also expected to announce new steps for the federal government to crack down on opioids, including fentanyl.

Dr. Rahul Gupta, director of the Office of National Drug Control Policy, said Biden “will lay out a forceful approach for going after fentanyl trafficking and expanding public health efforts to reduce overdose deaths.” The U.S. saw more than 100,000 opioid overdose deaths in 2022.

“We are going to build on the historic progress we’re making, by using advanced technology to stop more fentanyl at the border and working with commercial package delivery companies to catch more packages containing fentanyl,” Gupta said.

The Biden administration’s latest push on opioids will jump-start efforts that began under the Synthetics Trafficking and Overdose Prevention (STOP) Act — which directed the Postal Service, Customs and Border Protection and the State Department to crack down on illegal shipments of opioids in the mail.

The White House said CBP is working with companies to expand a voluntary data-sharing partnership that will help federal law enforcement officials identify, inspect and intercept packages of opioids coming into the U.S.

The administration is also calling for a “sustained diplomatic push” to crack down on the production of fentanyl and its supply chain abroad.

The administration will work with international partners to disrupt the global fentanyl production and supply chain and call on others to join our efforts,” the White House said. “We will focus on seizing chemical ingredients and fentanyl before it can reach our communities and hold accountable the producers, traffickers, and facilitators of these deadly drugs.”

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