As VA's budget continues to Increase, greater oversight is required

As VA's budget continues to Increase, greater oversight is required
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This past week, the Trump administration released its annual budget request for the U.S. Department of Veterans Affairs (VA) — specifically requesting a total of $243.3 billion in the fiscal year 2021, a 10.2 percent increase above fiscal 2020 enacted levels.

If the budget request is authorized, it will make VA the second-largest agency as measured by discretionary spending, second only to the Department of Defense (VA is also the second-largest agency in terms of the number of employees, where it is also second to DoD).

It is highly likely that the VA will receive the requested budget increase without much pushback from lawmakers. As summarized by The New York Times:

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"Congress, ever mindful of the politics of veterans care, is almost certain to comply, despite the recent troubles. While the Department is second only to the Defense Department in size and budget, it operates with far less oversight of its spending and activities. And while the mission of the Pentagon is higher in profile, lawmakers are loath to cut services for veterans or lose facilities in their districts, and they rarely suggest cuts to the Department, regardless of its inefficiencies or problems."

Blindly appropriating more and more money for VA without proper oversight of how the money is being spent, and without accompanying demands for accountability of that spending, is not only a wasted opportunity for Congress but also a literal death sentence for some veterans.  

It's time to acknowledge why this keeps happening: because Congress doesn't want to do the real work needed to fix VA's "inefficiencies or problems." Such work requires in-depth oversight, lengthy conversations with stakeholders, and is not only time-consuming but also incredibly difficult. Much of what ails the VA are systemic issues that predate the current administration, and overcoming entrenched problems often requires more than just a simple solution or a partisan rant.

"You have green and inattentive members on the committee, very few who are willing to conduct systematic oversight," Rep. Jim Cooper (D-Tenn.) observed in the wake of the 2014 appointment wait-time scandal, "most couldn't name senior officials below the secretary level. Most don't know how [the VA system] works. The warnings were not heeded."

Put, throwing more money at the VA's problems is easier than actually solving the VA's problems.  

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Although VA indeed operates with far less oversight of its spending and activities than DoD does, as its budget continues to grow, it is time to change that practice. 

Ensuring that the VA has the proper resources to care for the nation's 18 million veterans should be a priority, but ensuring that that money is spent on effective programs that help veterans should be an even higher priority.

Take, for example, the veteran suicide epidemic. Both Congress and the VA have stated that this is their top priority, and the fiscal21 budget reflects that. Specifically, the budget reflects an increased $682 million in mental health and suicide prevention spending, including $76 million for suicide prevention programs such as the Veterans Crisis Line, and $53.4 million to the president's interagency task force on veteran suicide prevention. 

However, it is also worth noting that VA's funding for such programs has more than doubled since 2005, without any significant decrease in the rate of veterans' suicides. Indeed, the number of veterans suicides now dwarfs the number of combat fatalities since 9/11. 

According to a recent report, 78,875 took their own lives between 2005 and 2017; by contrast, approximately 7,000 lives have been lost in combat across two decades.

Instead of continuing to fund ineffective programs, Congress should be asking the administration more tough questions about why specific programs are not working and what can be done to change that, to include investing in new and innovative ideas.

For example, earlier this month, the House passed legislation that would allow VA to start funding service dog programs. As acknowledged by House Veterans' Affairs Committee Ranking Member Phil RoeDavid (Phil) Phillip RoeAs VA's budget continues to Increase, greater oversight is required US to evacuate Americans from cruise ship in Japan Overnight Health Care: Appeals court strikes down Medicaid work requirements | Pelosi's staff huddles with aides on surprise billing | Senate Dems pressure Trump to drop ObamaCare lawsuit MORE (R-Tenn.):

"Mental wellness does not have a one-size-fits-all solution, which is why the VA must provide innovative and out-of-the-box treatments to help veterans combat these invisible illnesses and thrive in their civilian lives. There is no question that the companionship and unconditional love offered by man's best friend can have powerful healing effects on men and women from all walks of life, including our men and women in uniform."

Although the passage of this legislation funding an alternative treatment for veterans with mental health issues is a promising start, it is of note that VA has been studying the issue since 2011 without producing any concrete findings (VA says the results of an internal study will be released this summer) — and Congress hasn't pressed them to move any faster despite the amount of anecdotal evidence from veterans that having a service dog has saved their life.

Importantly, VA's overall budget is now more than five times what it was in 2001 when the funding for the entire Department was just $45 billion

Although VA has experienced a number of problems since then — including, most recently, questions surrounding the handling of a sexual assault investigation and the treatment of women veterans; how to deal with an OIG report confirming that a new office designed to protect whistleblowers was retaliating against them; and significant delays implementing promised IT upgrades — throwing more money at any of these problems alone hasn't solved a single them. 

It is important to realize that increased funding in the wake of challenges is often a reactionary response and, in the wake of both the post 9/11 conflicts, as well as the 2014 wait-time scandal, this was indeed the response we saw from Congress. Instead of continuing to respond with reactionary measures, VA, Congress, and veterans would all be better served through greater planning and oversight, not just of VA's budget, but also of the specific programs receiving that funding to evaluate their effectiveness.

Rory E. Riley-Topping served as a litigation staff attorney for the National Veterans Legal Services Program (NVLSP), where she represented veterans and their survivors before the U.S. Court of Appeals for Veterans Claims. She also served as the staff director and counsel for the House Committee on Veterans' Affairs, Subcommittee on Disability Assistance and Memorial Affairs for former Chairman Jeff Miller (R-Fla.). You can find her on Twitter: @RileyTopping.