By Kaanita Iyer, Brian Todd
3小时前
发布于 2026年3月20日,美国东部时间凌晨5:00
退伍军人 贫困 联邦机构
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美国退伍军人事务部总部大楼前的标识(2014年5月23日,华盛顿,行人从旁走过)。
Larry Downing/路透社
退伍军人权益倡导者对退伍军人事务部与司法部之间的新协议表示担忧,该协议可能剥夺退伍军人在医疗保健决策方面的自主权,并阻止他们寻求医疗服务,尤其是那些面临无家可归的退伍军人。
上周,两部门宣布的这份备忘录将授权退伍军人事务部律师“启动并参与州法院的监护或财产管理程序”,同时他们将作为司法部任命的美国特别助理。
Bazelon心理健康法律中心副主任詹妮弗·马西斯(Jennifer Mathis)告诉美国有线电视新闻网(CNN):“监护权‘不会剥夺你的身体自主权,但它会剥夺你投票、结婚、进行某些金融交易的权利’。这是个大问题,我们不能掉以轻心。”
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退伍军人事务部在声明中表示,该机构服务于“数百名无法自主做出医疗保健决策且没有家人或法定代表的退伍军人”,其中包括无家可归者。
根据备忘录,退伍军人事务部律师将能够在“需要法定决策者进行急性后护理过渡的情况下”启动监护程序。退伍军人事务部新闻秘书彼得·卡斯帕罗维奇(Peter Kasperowicz)告诉CNN,若法院批准,将任命一名“非退伍军人事务部雇员”的第三方担任监护人。
当法院授予监护权时,允许家庭成员或法院指定的人代表他人做出部分或全部决定。美国司法部网页指出,“监护权会导致个人法律权利的丧失,并限制其自主决策的权利。因此,州法律将其视为最后手段。”
马西斯告诉CNN,她担心该备忘录“可能成为将住院退伍军人(尤其是无家可归者)转移到他们可能不愿选择的环境中的一种方式”。
“如果人们滞留退伍军人事务部医院而无法出院,很可能是因为缺乏足够的服务或住房,而非因为他们没有监护权,”马西斯说。
当被问及倡导者对该备忘录尤其影响无家可归退伍军人并将其置于风险中的担忧时,卡斯帕罗维奇回应称:“退伍军人事务部的公告并非针对无家可归的退伍军人。它针对的是全国约700名目前在退伍军人事务部设施中、无法自主做出医疗保健决策且没有家人或法定代表协助的退伍军人。”
“这些退伍军人仍滞留于退伍军人事务部医院,这可能并非最适合他们的环境,且无法过渡到更合适的护理场所,”他补充道,“其中一些人无家可归或有无家可归风险,但关键特征并非无家可归,而是缺乏自主做出医疗决策的能力。”
退伍军人事务部临床服务代理副部长托马斯·奥图尔(Thomas O’Toole)周三在众议院退伍军人事务委员会作证时也传达了类似信息。他告诉议员们:“这并非针对无家可归者的倡议。”
马西斯认为,让退伍军人事务部律师申请监护权是一项不寻常的举措。然而,卡斯帕罗维奇对此表示反驳,称这与“医疗服务提供者和医院”提交监护申请类似,并强调律师必须遵循与其他申请人相同的规则。
全国无家可归退伍军人联盟首席执行官凯瑟琳·莫内特(Kathryn Monet)表示,通过该备忘录,两部门“试图让将退伍军人置于监护或财产管理类处境变得更容易”。
她向CNN表示,她担心“存在大量被滥用的可能性”,并指出特朗普政府在无家可归问题上的行动——她形容该行动“侧重于强制治疗并惩罚身处户外的人”。
例如,去年夏天,唐纳德·特朗普总统签署了一项行政命令,使地方司法管辖区更容易将无家可归者从街头清除。卡斯帕罗维奇告诉CNN,该备忘录“与总统的行政命令无关”,并对滥用担忧予以驳斥。
近3.3万名退伍军人面临无家可归
根据2024年美国住房和城市发展部发布的报告,约有3.3万名退伍军人面临无家可归,其中近1.4万人无家可归。全国无家可归退伍军人联盟指出,约5%的成年无家可归者是退伍军人。
莫内特告诉CNN,无家可归相关的污名化可能使医生更容易将退伍军人的选择和行为误认为是精神疾病的表现,而非贫困环境的反应。
(2021年4月22日,加利福尼亚州洛杉矶,退伍军人管理局校园外圣文森特大道旁的30顶帐篷中居住着无家可归退伍军人。2020年统计显示,洛杉矶街头估计有4000名退伍军人。)
George Rose/盖蒂图片社
莫内特补充道,另一个风险是,一旦被置于监护状态,无家可归的退伍军人可能“没有能力进行法律辩护以摆脱这种处境”。
莫内特也承认,该备忘录可能会阻止退伍军人寻求医疗服务。
“这是我最不愿看到的情况,因为长期以来,退伍军人事务部一直是医疗服务的强大提供者,也是贫困人口的资源地,”莫内特说。
众议院退伍军人事务委员会高级成员、民主党众议员马克·塔卡诺(Mark Takano)也对该备忘录将损害退伍军人自主权表示担忧。他在声明中表示:“退伍军人为我们和他们自己的自由而战。联邦政府不应设计剥夺这些权利的手段。”
退伍军人事务部长道格·柯林斯(Doug Collins)和司法部长帕姆·邦迪(Pam Bondi)强调,允许退伍军人事务部律师申请监护权将提高程序效率,并确保退伍军人获得“及时”医疗。
邦迪在声明中称:“司法部自豪地与退伍军人事务部合作,通过确保退伍军人在医疗决策和获得及时护理方面拥有最佳法律资源,来支持我们国家勇敢的退伍军人。我们欠退伍军人一份永远无法完全偿还的债务——但我们可以给予他们应得的支持。”
(2026年1月28日,华盛顿特区,参议院退伍军人事务委员会听证会上,退伍军人事务部长道格·柯林斯发言。)
Anna Moneymaker/盖蒂图片社
然而,即使是该举措的支持者也认为其实施存在挑战。
保守派智库曼哈顿研究所高级研究员、研究无家可归问题的斯蒂芬·艾德(Stephen Eide)告诉CNN,他坚信“应该更多地使用非自愿干预来应对心理健康危机和无家可归危机”。
“有些个体——无家可归或有此风险——患有精神分裂症等未得到治疗的疾病,他们根本无法自愿寻求治疗,”艾德表示,“对这类人而言,选择要么是不接受治疗,要么是某种非自愿治疗。我倾向于后者。”
不过,他补充道,“从联邦层面解决这一问题非常棘手”。
“这需要警方、社会工作者、州和地方政府之间的大量协调,”艾德说,“执行过程中会面临诸多复杂性。”
退伍军人 贫困 联邦机构
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New VA-DOJ agreement on guardianship could put homeless veterans at risk, advocates warn
By Kaanita Iyer, Brian Todd
3 hr ago
PUBLISHED Mar 20, 2026, 5:00 AM ET
Veterans Poverty Federal agencies
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The sign in the front of the headquarters building at the Department of Veteran Affairs is seen as people walk past in Washington, May 23, 2014.
Larry Downing/Reuters
Veterans’ advocates are raising concerns that a new agreement between the departments of Veterans Affairs and Justice could take away veterans’ autonomy over their health care decisions and deter them from seeking care, particularly those facing homelessness.
The memorandum, announced by the departments last week, would authorize VA attorneys to “initiate and participate in state court guardianship or conservatorship proceedings” while serving as special assistant US attorneys appointed by the Justice Department.
Guardianship “doesn’t take away your physical autonomy, but it can take away your right to vote, your right to marry, your right to engage in some financial transactions,” Jennifer Mathis, deputy director at Bazelon Center for Mental Health Law, told CNN. “That’s a big deal. We shouldn’t take that lightly.”
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The VA said in a statement the agency serves “hundreds of Veterans” who cannot make their own health care decisions and don’t have family or legal representation,including those experiencing homelessness.
Under the memorandum, VA attorneys will be able to initiate guardianship proceedings “in cases where a legal decision-maker is required for post-acute transitions of care.” If the court approves, a third-party, “who is not a VA employee” will be appointed as a guardian, VA press secretary Peter Kasperowicz told CNN.
When a court grants guardianship, it allows a family member or someone appointed by the court to make some or all decisions for another individual. A Department of Justice webpage says that “guardianship results in the removal of an individual’s legal rights and restricts their rights to make their own decisions. For that reason, state laws recognize that it should be a last resort.”
Mathis told CNN she is concerned the memorandum “is that this may be a way to discharge veterans (experiencing homelessness) who are sitting in hospitals to settings that they might not choose.”
“If people are sitting in a VA hospital and not being discharged, it’s very likely because there aren’t enough services or housing, not because they don’t have guardianship,” Mathis said.
Asked about advocates’ concerns that the memorandum particularly impacts veterans facing homelessness and puts them at risk, Kasperowicz said, “VA’s announcement is not aimed at homeless Veterans. It is aimed at roughly 700 Veterans across the country who are currently in VA facilities and are unable to make their own health care decisions and have no family or legal representation to help them.”
“These Veterans remain in VA hospitals, which may not be the most appropriate setting for them, with no way of transitioning to more appropriate care,” he added. “Some are homeless or at risk of homelessness, but the key characteristic is not homelessness, it is the lack of capacity to make their own medical decisions.”
Thomas O’Toole, VA’s acting assistant undersecretary for health for clinical services, relayed a similar message to the House Committee on Veterans’ Affairs on Wednesday. He told lawmakers, “It is not intended as a homeless initiative.”
Mathis told CNN it is an unusual move to have VA’s lawyers petition for guardianship. However, Kasperowicz pushed back on the claim and said it’s similar to “health care providers and hospitals” filing guardianship petitions, stressing that the lawyers would have to follow the same rules as other petitioners.
Kathryn Monet, the CEO of National Coalition for Homeless Veterans, said with the memorandum, the departments are “trying to make it easier to place veterans in the conservator- or guardian-type situation.”
She told CNN she worries that “there’s a lot of opportunity for misuse,” pointing to the Trump administration’s actions on homelessness, which she described as being “focused on forced treatment and penalizing people for being outside.”
Last summer, for example, President Donald Trump signed an executive order making it easier for local jurisdictions to remove homeless people from the streets. Kasperowicz told CNN the memorandum “has nothing to do with” the president’s executive order and pushed back against concerns of misuse.
Nearly 33,000 veterans facing homelessness
According to a Department of Housing and Urban Development report published in 2024, there are nearly 33,000 veterans facing homelessness and nearly 14,000 of them are unsheltered. According to National Coalition for Homeless Veterans, around 5% of adults experiencing homeless are veterans.
Monet told CNN that stigmas around homelessness may make it easier for doctors to mistake veterans’ choices and behaviors as a sign of mental illness rather than in response to the conditions of poverty.
Homeless veterans are housed in 30 tents on a sidewalk along a busy San Vicente Boulevard outside the Veteran’s Administration campus in West Los Angeles as viewed on April 22, 2021 in Los Angeles, California. During a 2020 count it was reported that there are an estimated 4,000 veterans living on the streets of Los Angeles.
George Rose/Getty Images
Another risk, she added, is once placed in conservatorship, a veteran experiencing homelessness may not have “the means to a legal defense to get out of this situation.”
Monet also acknowledged the possibility that the memorandum could deter veterans from seeking care.
“That’s the last thing that I want to see happen for a veteran facing housing instability, because VA, for a long time, has been a really strong provider of health care, and the place that is, you know, a resource for folks in poverty,” Monet said.
Democratic Rep. Mark Takano, the ranking member of the House Veterans’ Affairs Committee, also raised concerns that the memorandum will put veterans’ autonomy at risk. He said in a statement, “Veterans fought for our freedom and theirs. The federal government should not be engineering ways of taking it away.”
VA Secretary Doug Collins and Attorney General Pam Bondi have touted that allowing VA lawyers to petition for guardianship would make proceedings more efficient and ensure that veterans receive “timely” care.
“The Department of Justice is proud to partner with the Department of Veterans Affairs to support our nation’s brave Veterans by ensuring that they have the best legal resources available when it comes to making medical decisions and receiving timely care,” Bondi said in the statement. “We owe our Veterans a debt we can never fully repay — but we can give them the support they deserve.”
Veterans Affairs Secretary Doug Collins (C) speaks during a hearing with the Senate Committee on Veterans’ Affairs on Capitol Hill on January 28, 2026, in Washington, DC.
Anna Moneymaker/Getty Images
But even one supporter of the move said it would be tricky to implement.
Stephen Eide, who studies homelessness as a senior fellow at the conservative-leaning Manhattan Institute, told CNN he strongly believes “there should be more use of involuntary interventions to deal with the mental health crisis and the homeless crisis.”
“There is a certain kind of individual — who is homeless or at risk of it — who has a condition like schizophrenia and is not being treated, who simply cannot be relied on to seek treatment voluntarily,” Eide said. “For this type of person, the choices are either no treatment or some kind of involuntary treatment. And I’ll go with involuntary treatment.”
However, he added that addressing the issue “from the federal level is very awkward.”
“It will require a lot of coordination between police, social workers, state and local governments,” Eide said. “There will be complexity in the execution of this.”
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