Veterans and Homelessness (11/29/2013): Several issues regarding veterans and homelessness have become prominent, in part because of the Iraq and Afghanistan wars. One issue is ending homelessness among veterans. In November 2009, the VA announced a plan to end homelessness within five years. Both the VA and HUD have taken steps to increase housing and services for homeless veterans. Funding for VA programs has increased in recent years (see Table 5 ) and Congress has appropriated funds to increase available unit s of permanent supportive housing through the HUD-VASH program (see Table 6 ). Congress has appropriated $425 million to support initial funding of HUD-VASH vouchers in each year from FY2008 through FY2013, enough to fund nearly 58,000 vouchers.
The Mental Health Workforce: A Primer (10/18/2013): Congress has held hearings and introduced legislation addressing the interrelated topics of the quality of mental health care, access to mental health care, and the cost of mental health care. The mental health workforce is a key component of each of these topics. The quality of mental health care depends partially on the skills of the people providing the care. Access to mental health care relies on, among other things, the number of appropriately skilled providers available to provide care. The cost of mental health care depends in part on the wages of the people providing care. Thus an understanding of the mental health workforce may be helpful in crafting policy and conducting oversight. This report aims to provide such an understanding as a foundation for further discussion of mental health policy.
Post-Traumatic Stress Disorder and Other Mental Health Problems in the Military: Oversight Issues for Congress (08/08/2013): Military servicemembers suffering from post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), and depression, as well as military suicides, continue to be a major concern of Congress. Numerous legislative provisions have been enacted over the past years to address these issues. Members will likely seek to offer legislation in the 113th Congress to address this complex set of issues. This report is intended to provide assistance in understanding the issues associated with psychological health in the active duty forces, potential congressional responses, and what questions may remain unanswered.
Military Sexual Assault: Chronology of Activity in Congress and Related Resources (7/30/13): This report focuses on activity in Congress regarding recent high profile incidents of sexual assault in the military. Included are separate sections on the official responses related to these incidents by the Department of Defense (DOD), the Administration, and Congress including legislation in the 113th Congress. The last section is a resource guide for sources in this report and related materials on sexual assault and prevention.
Reserve Component Personnel Issues: Questions and Answers (07/12/2013): The strength of our nation’s armed forces, including the reserve components, has historically been an area of keen interest to the Congress. The increasing use of the reserves since the end of the cold war has led to greater congressional interest in various issues that bear on the vitality of the reserve components, such as funding, equipment, and personnel policy. This report is designed to provide an overview of key reserve component personnel issues.
Mental Disorders Among OEF/OIF Veterans Using VA Health Care: Facts and Figures (2/4/13): The mental health of veterans—and particularly veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF)—has been a topic of ongoing concern to Members of Congress and their constituents, as evidenced by hearings and legislation. Knowing the number of veterans affected by various mental disorders and actions the Department of Veterans Affairs (VA) is taking to address mental disorders can help Congress determine where to focus attention and resources. Using data from the VA, this brief report addresses the number of veterans with (1) depression or bipolar disorder, (2) posttraumatic stress disorder (PTSD), and (3) substance use disorders. For each topic, this report also briefly describes what the VA is doing in terms of screening and treatment. From FY2002 through FY2012, 1.6 million OEF/OIF veterans (including members of the Reserve and National Guard) left active duty and became eligible for VA health care; by the end of FY2012, 56% of them had enrolled and obtained VA health care. The VA publishes the cumulative prevalence of selected mental disorders among OEF/OIF veterans using VA health care, based on information in the VA’s electronic health records. Systematic information regarding veterans who do not use VA health care is not available. Data about OEF/OIF veterans using VA health care should not be extrapolated to the rest of the OEF/OIF veteran population, or to the broader veteran population. Limitations of the VA’s data are discussed in Appendix A. Reports that have evaluated VA’s efforts and offered recommendations are listed in Appendix B.
Suicide Prevention Efforts of the Veterans Health Administration (1/10/13): Responsibility for prevention of veteran suicide lies primarily with the Veterans Health Administration (VHA), within the Department of Veterans Affairs (VA). The VHA Strategic Plan for Suicide Prevention is based on a public health framework, which has three major components: (1) surveillance, (2) risk and protective factors, and (3) prevention interventions. ... This report identifies challenges the VHA faces in each component of suicide prevention and discusses potential issues for Congress. A recurring theme is the need for the VHA to work in concert with other federal, state, and local government agencies; private for-profit and not-forprofit health care providers; veterans, their families, and their communities; and other individuals or organizations that might be able to help. Specific challenges in surveillance include timeliness of data, accurate identification of decedents as veterans, and consistent classification of deaths as suicides. Challenges in risk and protective factors research include a need for more collaboration and dialogue among agencies involved in suicide prevention and across other areas of public health (because suicide has some of the same risk and protective factors as other public health problems). Challenges in VHA suicide prevention interventions also include the need for more collaboration and dialogue, as well as an apparent gap between policy and practice, and misperceptions about mental illness and mental health care.
The Repeal of “Don’t Ask, Don’t Tell”: Issues for Congress (12/21/12): On December 22, 2010, President Obama signed P.L. 111-321 into law. It called for the repeal of the existing law (Title 10, United States Code, §654) barring open homosexuality in the military by prescribing a series of steps that must take place before repeal occurs. One step was fulfilled on July 22, 2011, when the President signed the certification of the process ending the Don’t Ask, Don’t Tell policy, which was repealed on September 20, 2011. However, in repealing the law and the so-called “Don’t Ask, Don’t Tell” policy, a number of issues have been raised, but were not addressed by P.L. 111-321. This report considers issues that Congress may wish to consider regarding matters arising as a result of the repeal of §654.
Veterans’ Benefits: Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012 (P.L. 112-154) (11/5/12): Congress has in the past enacted legislation providing authority for the Department of Veterans Affairs (VA) to treat certain veterans for specific medical conditions resulting from their exposure to certain toxic substances or environmental hazards while on active military duty. In the 1980s, officials at Camp Lejeune became aware of the presence of volatile organic compounds (VOCs) in drinking water samples. Camp Lejeune was placed on the National Priorities List by the Environmental Protection Agency in 1989, and the Agency for Toxic Substances and Disease Registry continues to monitor samples from the water table. The Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012 (H.R. 1627, P.L. 112-154, enacted on August 6, 2012) provides authority for the VA to provide medical services for 15 specific illnesses to certain veterans as well as their eligible family members, who were stationed at Camp Lejeune, North Carolina, from January 1, 1957, to December 31, 1987. In addition to providing the VA authority to provide medical services associated with these specific illnesses to veterans and their families stationed at Camp Lejeune during this time period, P.L. 112-154 makes a number of changes to other VA programs, including housing and other benefit programs. Some of these changes affect VA administration and expand congressional oversight of the VA through increased reporting to Congress, while other changes made by P.L. 112-154 would impact the larger population of veterans. That is, the changes would impact all veterans utilizing these programs, not just veterans stationed at Camp Lejeune during the above specified period. This report provides information on the various provisions of P.L. 112-154 by program, benefit, or topic, rather than by each legislative provision. However, for each change in a program, benefit, etc., the section number of P.L. 112-154 is provided.
GI Bills Enacted Prior to 2008 and Related Veterans’ Educational Assistance Programs: A Primer (10/22/12): The U.S. Department of Veterans Affairs (VA), previously named the Veterans Administration, has been providing veterans educational assistance (GI Bill) benefits since 1944. The benefits have been intended, at various times, to compensate for compulsory service, encourage voluntary service, avoid unemployment, provide equitable benefits to all who served, and promote military retention. In general, the benefits provide grant aid to eligible individuals enrolled in approved educational and training programs. Since three of the GI Bills have overlapping eligibility requirements and the United States is expected to wind down involvement in active conflicts, Congress may consider phasing out one or more of the overlapping programs. This report describes the GI Bills enacted prior to 2008. Although participation in the programs has ended or is declining, the programs’ evolution and provisions inform current policy. The Post- 9/11 GI Bill (Title 38 U.S.C., Chapter 33), enacted in 2008, is described along with potential program issues in CRS Report R42755, The Post-9/11 Veterans Educational Assistance Act of 2008 (Post-9/11 GI Bill): Primer and Issues, by Cassandria Dortch. This report provides a description of the eligibility requirements, eligible programs of education, benefit availability, and benefits. The report also provides some summary statistics, comparisons between the programs (see Table 2), and brief discussions of related programs.
Military Medical Care: Questions and Answers (10/4/12): The primary objective of the military health system, which includes the Defense Department’s hospitals, clinics, and medical personnel, is to maintain the health of military personnel so they can carry out their military missions and to be prepared to deliver health care during wartime. The military health system also covers dependents of active duty personnel, military retirees and their dependents, including some members of the reserve components. The military health system provides health care services through either Department of Defense (DOD) medical facilities, known as “military treatment facilities” or “MTFs” as space is available, or through private health care providers. The military health system currently includes some 56 hospitals and 365 clinics serving 9.7 million beneficiaries. It operates worldwide and employs some 58,369 civilians and 86,007 military personnel. been provided through a program still known in law as the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), but more commonly known as TRICARE. TRICARE has four main benefit plans: a health maintenance organization option (TRICARE Prime), a preferred provider option (TRICARE Extra), a fee-for-service option (TRICARE Standard), and a Medicare wrap-around option (TRICARE for Life) for Medicare-eligible retirees. Other TRICARE plans include TRICARE Young Adult, TRICARE Reserve Select and TRICARE Retired Reserve. TRICARE also includes a pharmacy program and optional dental plans. Options available to beneficiaries vary by the beneficiary’s duty status and location. This report answers several frequently asked questions about military health care...
SBA Veterans Assistance Programs: An Analysis of Contemporary Issues (9/4/12): Congressional interest in the SBA’s veterans assistance programs has increased in recent years primarily due to reports by veterans organizations that veterans were experiencing difficulty accessing the SBA’s programs, especially the SBA’s Patriot Express loan guarantee program. There is also a continuing congressional interest in assisting veterans, especially those returning from overseas in recent years, in their transition from military into civilian life. Although the unemployment rate (as of July 2012) among veterans as a whole (6.9%) was lower than for nonveterans (8.3%), the unemployment rate of veterans who have left the military since September 2001 (8.9%) was higher than the unemployment rate for non-veterans. ... This report opens with an examination of the current economic circumstances of veteran-owned businesses drawn from the Bureau of the Census 2007 Survey of Business Owners, which was administered in 2008 and 2009, and released on the Internet on May 17, 2011. It then provides a brief overview of veteran employment experiences, comparing unemployment and labor force participation rates for veterans, veterans who have left the military since September 2001, and non-veterans. The report then describes the employment assistance programs offered by several federal agencies to assist veterans in their transition from the military to the civilian labor force, and examines, in greater detail, the SBA’s veteran business development programs, the SBA’s Patriot Express loan guarantee program, and veteran contracting programs. The SBA’s Military Reservist Economic Injury Disaster Loan program is also discussed.
Military Service Records and Unit Histories: A Guide to Locating Sources (7/26/2012): This guide provides information on locating military unit histories and individual service records of discharged, retired, and deceased military personnel. It includes contact information for military history centers, websites for additional sources of research, and a bibliography of other publications.
Veterans Affairs: Historical Budget Authority, FY1940-FY2012 (6/13/12): Budget authority—the amount of money a federal department or agency can spend or obligate to spend by law—for veterans’ benefits and services has increased significantly since FY1940. In FY1940, the budget authority for veterans’ benefits and services was $561.1 million, and in FY2012 the budget authority was $125.3 billion, or more than 200 times the FY1940 budget authority. In constant 2011 dollars (i.e., inflation-adjusted), the FY2012 budget authority is 14 times the FY1940 budget authority. The increases over time have reflected the impact of increases in the number of veterans as the result of wars and other conflicts, the aging of the veteran population, and changes in benefits and services provided for veterans. This report provides information on the historical budget authority of the Department of Veterans Affairs (formerly the Veterans Administration) for FY1940 through FY2012. Budget authority is presented in both current dollars and constant 2011 dollars.
Military Base Closures: Socioeconomic Impacts (2/7/12): The most recent Base Realignment and Closure (BRAC) Commission submitted its final report to the Administration on September 8, 2005. Implementation of the BRAC round was officially completed on September 15, 2011. In the report, the commission rejected 13 of the initial Department of Defense recommendations, significantly modified the recommendations for 13 other installations, and approved 22 major closures. The loss of related jobs, and efforts to replace them and to implement a viable base reuse plan, can pose significant challenges for affected communities. However, while base closures and realignments often create socioeconomic distress in communities initially, research has shown that they generally have not had the dire effects that many communities expected. For rural areas, however, the impacts can be greater and the economic recovery slower. Early planning and decisive leadership from officials are important factors in addressing local socioeconomic impacts from base realignment and closing. Drawing from existing studies, this report assesses the potential community impacts and proposals for minimizing those impacts.
Suicide, PTSD, and Substance Use Among OEF/OIF Veterans Using VA Health Care: Facts and Figures (7/18/11): On May 10, 2011, the Ninth Circuit Court of Appeals ruled against the Department of Veterans Affairs (VA) in a case brought by two nonprofit veterans advocacy groups, Veterans for Common Sense and Veterans United for Truth. The ruling criticized the VA’s mental health services, among other things. This has intensified interest in veterans’ mental health, already a topic of ongoing concern to Members of Congress and their constituents. This brief report addresses three relevant topics: suicide, posttraumatic stress disorder (PTSD), and substance use disorders. Using data from the VA, it answers two questions about each topic: (1) How many veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) are affected? and (2) What is the VA doing, in terms of screening, prevention, and treatment?