Veteran Policy Insights

Recent government turmoil threatened the smooth functioning of government and demonstrated how precarious the diverse benefits veterans and their families rely on can be. These events highlight the importance of our research and insights. Our researchers continued their work without pause, identifying how to effectively provide care and support to veterans and their families. Two important new reports are highlighted below: one on measuring the quality of behavioral health care and another on rates of veteran enrollment in the largest federal nutrition assistance program.

You’re welcome to forward this newsletter to friends and colleagues or encourage them to subscribe here so they too can stay informed about developments in research, policy, and public discussions on veterans’ issues. Learn more about our published and ongoing work, as well as how to collaborate with us, at veterans.rand.org.

Warmly,

Carrie M. Farmer and Rajeev Ramchand

Codirectors, RAND Epstein Family Veterans Policy Research Institute

It is essential that behavioral health care for veterans, service members, and their families is high-quality, effective, and aligned with clinical recommendations. While large organizations like the U.S. Department of Veterans Affairs (VA) have robust systems to monitor care, community-based organizations may need additional guidance. This new report introduces two approaches to assessing and improving behavioral health care: the organizational process of using quality measures and the clinical process of measurement-based care. The researchers propose a core set of quality measures that are relevant to the treatment of depression, PTSD, and anxiety.

Using Quality Measures and Measurement-Based Care to Improve Behavioral Health Care for Veterans and Service Members

VA routinely screens veterans for food insecurity and refers them to support resources. Nonetheless, RAND researchers found that food-insecure veterans are consistently less likely than their nonveteran peers to be enrolled in the Supplemental Nutrition Assistance Program (SNAP), the largest federal nutrition assistance program. This research adds to the evidence base on food-insecure veterans’ SNAP enrollment by highlighting, in particular, how older veterans and those with disabilities are less likely to be enrolled in SNAP, as well as veterans’ reasons for starting, ending, or losing SNAP benefits and patterns in their use of other safety-net programs. Although it is a federal program, SNAP is administered by states, and the analyses identified links between these state-level policies and food-insecure veterans’ SNAP enrollment.

Food Insecurity Among Veterans: Examining the Discrepancy Between Veteran Food Insecurity and Use of the Supplemental Nutrition Assistance Program (SNAP)

Congress passed and President Biden signed a 45-day continuing resolution just hours before the fiscal year ended on September 30, giving Congress until November 17 to pass appropriation bills for fiscal year 2024 to continue government operations.

The Senate confirmed VA’s deputy secretary, Army combat veteran and former VA chief of staff Tanya Bradsher; she is the first woman and the first woman of color to be confirmed to that role. In addition, VA has announced several new or expanded initiatives:

• The Food is Medicine Initiative, a collaboration with the Rockefeller Foundation, will promote healthy eating habits, expand access to nutritious foods for food-insecure veterans, and provide assistance in tailoring meals for veterans to specific medical needs. To see how veterans are affected by food insecurity, read our new report Food Insecurity Among Veterans.
• As of October 1, veterans can reach a VA maternity care coordinator throughout their pregnancy to 12 months postpartum, an expansion from 8 weeks postpartum. VA will also screen pregnant and postpartum veterans for social determinants of health, relationship health and safety, mental health risks, and more.
• A data-sharing agreement with the National Cancer Institute will support VA’s research on cancers among veterans, shedding light on their causes and helping VA advance treatments. The agreement includes the exchange of cancer diagnoses and treatment data to facilitate comparisons with treatments and research outside of the veteran community.
• VA launched the New Horizons in Health podcast, in which VA officials and researchers discuss progress on new and emerging health care treatments for veterans. The first episode discussed psychedelic-assisted treatments for veterans with certain conditions. Read RAND researchers’ insights on these therapies and their policy implications in Psychedelics and Veterans’ Mental Health.
• On October 6, VA announced an agreement with 13 community health systems to improve veterans’ health care and information-sharing about their treatments, benefits, and routine care. As RAND researchers have noted, better care coordination between VA and community providers is a major step toward improving health care quality for veterans.

• VA appointed RAND researcher Sarah Hunter to the Veterans Community Oversight and Engagement Board, a federal advisory committee that will provide recommendations to improve care, support, and convenience for veterans at the West Los Angeles VA. Hunter has conducted extensive research on veterans and other populations experiencing homelessness in Los Angeles County.
• New RAND research compared the economic, educational, and health outcomes of military retirees, veteran nonretirees, and nonveterans born in the decade before World War II, finding that military retirees fared as well or better than their peers.
• RAND research was mentioned in an article about the use of service dogs in combating veteran suicide.
• The recently released piece Home and Community-Based Services was cited in an article about a bill to allow more veterans to age at home.
• Researcher Kayla Williams was a panelist at the 2023 VA Women’s Health Research Conference.
• RAND’s report on veteran food insecurity generated headlines, including from Military.com and Stars and Stripes, and was entered into the Congressional Record.
• The U.S. Department of Defense announced new actions in response to recommendations by the Suicide Prevention and Response Independent Review Committee, of which VPRI codirector Rajeev Ramchand was a member.
• The National Academies released Identifying and Managing Veteran Suicide Risk, proceedings from a workshop that Rajeev Ramchand and legislative and government affairs analyst Heather Salazar took part in.
• Researcher Shira Fischer published an opinion piece on the ongoing delays in VA’s rollout of its new electronic health record system.

Stay tuned for more information about our next webinar, which will be about veterans in today’s housing market and held on November 16 at 4:00pm EST / 1:00pm PST.