Hearing of the Military Construction, Veterans Affairs and Related Agencies Subcommittee of the Senate Appropriations Committee - Opening Statement of Sen. Murphy, Hearing on Preventing Veteran Suicide

Hearing

MURPHY: "I wanted to drill down a little bit more into this issue of care provided to veterans with bad paper discharges -- those who have less than honorable discharges. You know, the numbers are pretty startling. If you have an Other-Than-Honorable discharge, you are twice as likely to commit suicide, and if you're outside of the VA system, you are somewhere around 30 percent more likely to commit suicide. And I think the VA has recognized that.

"I had a back-and-forth about a year ago with Dr. Shulkin about the statutory authorization that I believe clearly allows the VA to provide care to those that have bad paper discharges. Again, these are individuals who have not been given a dishonorable discharge, but because of some conduct that they engaged in that was likely connected to their injury that was caused through their service, they have been given a less than honorable discharge.

"You've made a decision now -- and you note this through your testimony -- to provide a small amount of care, 90 days of care, to individuals who are in emergency circumstances.

"There was for a while an uncertainty about whether VA had the statutory authorization to provide this care to individuals who have bad paper discharges. With your decision to provide care in this limited manner, are we now clear that the VA had the statutory authorization to provide care for this population?"

CLANCY: "Yes, and I think the sense of urgency that came out of the summit that Dr. Shulkin had just over a year ago…. that if we're serious, we need to focus on veterans with bad paper because of the increased risk. And as you point out, some subset of that group -- which we believe to be just over 500,000 altogether -- may actually be able to confirm a service connection for that diagnosis. That will take time to evaluate, but in the meantime they will have at least that initial 90-day period.

"For those for whom we can't document that connection and therefore get them a path to enrolling in VA care permanently, then we will have time to actually enroll them and get them connected with other sources of mental health care."

MURPHY: "As you know, a very well publicized recent report identified within the Army that subset being 24,000 -- 24,000 veterans who had a less than honorable discharge who had a service-connected disability but were denied these services in some way, shape, or form because of that less than honorable discharge.

"So if it is clear that you have the statutory authorization, why limit care to 90 days? That's not a number that's based in medicine. Many of these veterans have no other outlet for care bedsides the VA. Why the 90-day limitation if there's not a dispute any longer over the statutory authorization?"

CLANCY: "We can provide care on a humanitarian basis to anyone who shows up at one of our facilities on an emergency basis. That is a given -- veteran or otherwise. Ninety-days was what we thought was a reasonable timeframe to establish whether they could be permanently in VHA (Veterans Health Administration)…"

MURPHY: "So there is an opportunity then at the end of that 90-day period to stay in VA care."

CLANCY: "Yes. Yes, if we can establish service connection or other eligibility, yes."

MURPHY: "I think this is really important progress that you've made here. I would argue that there's no reason to limit the care to those who are in emergency situations nor to limit it to 90 days. You're talking about the most vulnerable population. You're often talking about young men who just went AWOL for a short period of time because of a very serious service-connected disability -- because of a TBI or PTSD, and because of that, they got a bad paper discharge, and then that disqualifies them for services.

"And again, you're talking about a number that we know is in the tens of thousands at the very least. So I would hope that you continue your progress on opening up the pathway and not having these -- what I would argue -- are arbitrary limitations. And I don't think you need the statutory authorization, but to the extent you do…"

CLANCY: "We will be back. I promise you that."

MURPHY: "I don't see any reason why we wouldn't try to work together to give it to you."

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