Streamline mental health services for Veterans

Every Veteran of the U.S. military, especially those with visible and invisible wounds of war, should have access to high-quality services and supports, including for MH/SUDs. Congress should work to close gaps in services, including for Veterans who live in U.S. Territories (Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa) and U.S.-affiliated Pacific Islands that are freely-associated states (the Marshall Islands, Micronesia, and Palau). Individuals from U.S. territories are U.S. citizens, while individuals from freely-associated states are eligible to come to the U.S. as nonimmigrants to work and live indefinitely.[1] The U.S. is currently investing billions of dollars in military installations on these Pacific Islands as part of the U.S. geostrategic pivot to Asia.[2]

Nearly 3 percent of all U.S. Veterans live in U.S. territories, and Veterans make up nearly 8 percent of Guam’s population and more than 5 percent in American Samoa, the Northern Mariana Islands, and the U.S. Virgin Islands. Puerto Rico has more than 80,000 Veterans.[3] Given the high proportion of Veterans, Congress must do more to ensure the availability of services across U.S. territories. Currently, the nearest Veterans Affairs Medical Center to Guam is 4,000 miles away in Hawaii.[2]

While Veterans in freely-associated states are entitled to care, Congress should pass the Care for Compact of Free Association (COFA) Veterans Act to allow the Department of Veterans Affairs (VA) to provide services in the Marshall Islands, Micronesia, and Palau and to compensate Veterans for the cost of travel to receive needed health care services.[4] In June 2023, the U.S. Secretary of State Anthony J. Blinken and Interior Secretary Deb Haaland requested that Congress make these essential changes to help these U.S. Veterans access services.[5]

More broadly, Congress should work with the VA to streamline the process of applying for VA benefits, which is notoriously complex and frequently requires help to navigate.[6] One issue is that the Veterans Health Administration (VHA) has a wide variety of different, complicated authorities that limit which Veterans are eligible to receive different benefits. Congress should work with the VHA to streamline these authorities and simplify eligibility requirements to help reduce the bureaucracy, thereby improving the efficiency of service delivery and increasing Veterans’ access to MH/SUD services and supports.