During his 12 years in Congress, Rep. Phil Roe, R-Tenn., has seen the Department of Veterans Affairs' budget balloon from $94 billion in 2008 to $240 billion this year. But as he prepares to retire, he has lingering doubts about how well the money was spent.
"Throwing more money at something doesn't mean you get a better outcome," Roe, who will go home to Johnson City, Tennessee, when the new Congress is sworn in next month, cautioned the incoming Biden administration.
In an interview last month with Military.com, he noted major accomplishments in serving veterans since the VA's 2014 wait-times scandals, but admitted to a level of frustration at the politics and red tape that prevented more from getting done.
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Roe’s legacy was enshrined Thursday by his Senate and House Veterans Affairs Committee colleagues, who named the omnibus VA legislation they had just passed for him and former Sen. Johnny Isakson, R-Ga., who retired last year for health reasons.
"The Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020 [has] something to offer virtually every one of our nation's heroes," Roe said in a statement.
He said he was humbled that the committees "saw fit to name this bill after me and former Chairman Isakson, and I thank them each for their friendship and enduring commitment to bettering the lives of all those who have served."
However, Roe said one of his major concerns in leaving Congress is the lack of progress in suicide prevention at the VA.
Roe cited the loss of an average of 20 veterans to suicide daily, despite the $9.4 billion in the VA's current budget mental health services. For years, VA officials have said that suicide prevention is the department's "highest clinical priority."
"The results haven't changed at all; we haven't affected the rate one notch," Roe said, adding that there won't be progress if Congress and the VA continue to address the issue from "the 30,000-foot level in Washington, D.C."
"We haven't done a very good job. It's almost $10 billion being spent" on mental health at the VA with little to show for the effort thus far, he said.
"It's got to be solved at the ground level where the veteran lives -- someone knows someone who's in trouble, knows a guy or a gal who's in trouble. Get them somewhere where they can get help," Roe said.
The interagency President's Roadmap to Empower Veterans and End a National Tragedy of Suicide, or PREVENTS, task force, set up in June by executive order by President Donald Trump, was a good first step in offering a path for outreach to at-risk veterans who normally shun VA services, Roe said, although the task force's work thus far has been limited by the COVID-19 pandemic.
The task force, which combines the efforts of the VA, the Departments of Defense and Health and Human Services, and other agencies, calls for more coordination with local groups in contacting veterans and helping them navigate existing systems.
Another issue for Roe is the regulations that could get in the way of outreach.
In an interview with Military.com last month, Paul Lawrence, head of the Veterans Benefits Administration, said that his agency possibly could assist on mental health issues by taking note of when a veteran falls behind on payments, which could be an indicator of stress and the need for VA outreach.
Roe said that might be an approach for the next Congress to consider.
"Finances and relationships -- those are the predictors [for a veteran who might be at risk]," he said, adding that agencies would have to deal with the Health Insurance Portability and Accountability Act, which protects against disclosure of sensitive patient information.
"Just ask their permission," he said of veterans under financial distress. "There might be a way to do it."
From suicide prevention to burn pits and perennial attempts to set up a nationwide electronic health care records system at the VA, the key to crafting solutions on veterans issues is to somehow get past the partisan divides that have made politics on Capitol Hill a zero-sum game, Roe said.
"The No. 1 issue is don't get caught up in partisan politics," he said in a bit of parting advice for his colleagues on the House Veterans Affairs Committee, where he served as chairman from 2017 to 2019 and now is the ranking member.
"The focus of the job is the health, welfare and benefits of American veterans. If you do that, it's fun. That's what we did with the Mission Act; that's why the Mission Act has been successful."
He was referring to the Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act signed into law by Trump in 2018. It expanded veterans' access to community care and overcame veterans service organizations' initial fears that it would lead to privatization of VA health care.
A similar bipartisan effort in the next Congress could yield results on whether presumptive illnesses for exposure to burn pits for veterans of Iraq and Afghanistan should be listed by the VA, similar to the presumptive illnesses for Vietnam veterans exposed to Agent Orange, Roe said.
During the campaign, President-elect Joe Biden said the burn pits issue will be on the agenda for the new administration at the VA.
Roe said he has studied the available data and could not come to a conclusion on presumptive illnesses for burn pit exposure, saying a new study comparing groups of veterans who served in Iraq and Afghanistan -- and those who didn't, is needed.
"Then crunch the numbers," he said, "[to find out], 'Yeah, there's an association here or there's no association.'"
In statements in January announcing that he would not run for reelection, Roe said he had committed to serving "five or six terms because I never intended this job to be a second career. After prayerful consideration, I have decided to retire at the end of the 116th Congress."
In a statement at the time, the Veterans of Foreign Wars said, "Without him, the Mission Act, Forever GI Bill and other significant legislation may not have been achieved for our nation's heroes."
Roe's support was pivotal in passage of the landmark Harry W. Colmery Veterans Education Assistance Act, known as the "Forever GI Bill," which combined 18 separate bills and terminated the 15-year limit for veterans to use education benefits.
The bill also created more incentives for veterans to pursue a degree in science, technology, engineering and math.
Roe was also instrumental in rallying Republican support last year for passage of the Blue Water Navy Vietnam Veterans Act of 2019 (PL 116-23), which extended the presumption of exposure to Agent Orange to veterans who served in the offshore waters of Vietnam between Jan. 9, 1962, and May 7, 1975.
"When I looked at Blue Water Navy, I read all the data I could find," Roe said. "There wasn't enough evidence there." But he said he ultimately decided, "Let's err on the side of the sailor."
At age 75, Roe said it is time to get back to Johnson City, Tenn., and to his wife, Clarinda; three children; and five grandchildren.
"It won't be a total retirement. There'll be some other things. I'll just be slowing up a bit," he said.
Roe will serve on the board of the Elizabeth Dole Foundation, an organization that focuses on the needs of military families and caregivers.
"That's something where I can give back," he said.
-- Richard Sisk can be reached at Richard.Sisk@Military.com.
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