[House Hearing, 112 Congress]
[From the U.S. Government Publishing Office]
BUILDING BRIDGES BETWEEN VA
AND COMMUNITY ORGANIZATIONS
TO SUPPORT VETERANS AND FAMILIES
=======================================================================
HEARING
before the
SUBCOMMITTEE ON HEALTH
of the
COMMITTEE ON VETERANS' AFFAIRS
U.S. HOUSE OF REPRESENTATIVES
ONE HUNDRED TWELFTH CONGRESS
SECOND SESSION
__________
FEBRUARY 27, 2012
__________
Serial No. 112-45
__________
Printed for the use of the Committee on Veterans' Affairs
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COMMITTEE ON VETERANS' AFFAIRS
JEFF MILLER, Florida, Chairman
CLIFF STEARNS, Florida BOB FILNER, California, Ranking
DOUG LAMBORN, Colorado CORRINE BROWN, Florida
GUS M. BILIRAKIS, Florida SILVESTRE REYES, Texas
DAVID P. ROE, Tennessee MICHAEL H. MICHAUD, Maine
MARLIN A. STUTZMAN, Indiana LINDA T. SANCHEZ, California
BILL FLORES, Texas BRUCE L. BRALEY, Iowa
BILL JOHNSON, Ohio JERRY McNERNEY, California
JEFF DENHAM, California JOE DONNELLY, Indiana
JON RUNYAN, New Jersey TIMOTHY J. WALZ, Minnesota
DAN BENISHEK, Michigan JOHN BARROW, Georgia
ANN MARIE BUERKLE, New York RUSS CARNAHAN, Missouri
TIM HUELSKAMP, Kansas
MARK E. AMODEI, Nevada
ROBERT L. TURNER, New York
Helen W. Tolar, Staff Director and Chief Counsel
SUBCOMMITTEE ON HEALTH
ANN MARIE BUERKLE, New York, Chairwoman
CLIFF STEARNS, Florida MICHAEL H. MICHAUD, Maine, Ranking
GUS M. BILIRAKIS, Florida CORRINE BROWN, Florida
DAVID P. ROE, Tennessee SILVESTRE REYES, Texas
DAN BENISHEK, Michigan RUSS CARNAHAN, Missouri
JEFF DENHAM, California JOE DONNELLY, Indiana
JON RUNYAN, New Jersey
Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public
hearing records of the Committee on Veterans' Affairs are also
published in electronic form. The printed hearing record remains the
official version. Because electronic submissions are used to prepare
both printed and electronic versions of the hearing record, the process
of converting between various electronic formats may introduce
unintentional errors or omissions. Such occurrences are inherent in the
current publication process and should diminish as the process is
further refined.
C O N T E N T S
__________
February 27, 2012
Page
Building Bridges between VA and Community Organizations to
Support Veterans and Families.................................. 1
OPENING STATEMENTS
Chairwoman Ann Marie Buerkle..................................... 1
Prepared statement of Chairwoman Buerkle..................... 39
Hon. Michael H. Michaud, Ranking Democratic Member............... 2
Prepared statement of Congressman Michaud.................... 39
Hon. Silvestre Reyes, Democratic Member, prepared statement only. 40
WITNESSES
Andrew Davis, Veteran, Director, Saratoga County Veterans Service
Agency, Saratoga County, New York.............................. 3
Prepared statement of Mr. Davis.............................. 40
Chaplain John J. Morris, Joint Force Headquarters Chaplain,
Minnesota National Guard....................................... 13
Prepared statement of Chaplain Morris........................ 43
Shelley MacDermid Wadsworth, Ph.D., Director, Military Family
Research Institute, Purdue University.......................... 15
Prepared statement of Ms. MacDermid Wadsworth................ 46
M. David Rudd, Ph.D., ABPP, Dean, College of Social and
Behavioral Sciences, Scientific Director, National Center for
Veteran Studies, University of Utah............................ 17
Prepared statement of Mr. Rudd............................... 49
George Ake III, Ph.D., Assistant Professor of Medical Psychology,
Duke University, American Psychological Association............ 19
Prepared statement of Mr. Ake................................ 51
Rev. E. Terri LaVelle, Director, Center for Faith-based and
Neighborhood Partnerships, Office of the Secretary, U.S.
Department of Veterans Affairs................................. 29
Prepared statement of Rev. LaVelle........................... 54
Chaplain Michael McCoy, Sr., Associate Director, National
Chaplain Center, Veterans Health Administration, U.S.
Department of Veterans Affairs................................. 31
Prepared statement of Chaplain McCoy......................... 56
SUBMISSION FOR THE RECORD
Consortium for Citizens with Disabilities, Veterans, and Military
Families Task Force............................................ 58
MATERIAL SUBMITTED FOR THE RECORD
Post-Hearing Questions and Responses for the Record:
Questions from Hon. Michael H. Michaud, Ranking Democratic
Member, Subcommittee on Health, Committee on Veterans'
Affairs to Honorable Eric K. Shinseki, Secretary, U.S.
Department of Veterans Affairs............................... 63
Responses from Hon. Eric K. Shinseki, Secretary, U.S.
Department of Veterans Affairs to Honorable Michael H.
Michaud, Ranking Democratic Member, Subcommittee on Health,
Committee on Veterans' Affairs............................... 64
BUILDING BRIDGES BETWEEN VA
AND COMMUNITY ORGANIZATIONS
TO SUPPORT VETERANS AND FAMILIES
----------
MONDAY, FEBRUARY 27, 2012
U.S. House of Representatives,
Committee on Veterans' Affairs,
Subcommittee on Health,
Washington, DC.
The Subcommittee met, pursuant to notice, at 4:02 p.m., in
Room 334, Cannon House Office Building, Hon. Ann Marie Buerkle
[Chairwoman of the Subcommittee] presiding.
Present: Representatives Buerkle, Roe, Runyan, Michaud,
Reyes, and Donnelly.
Also Present: Representative Walz.
OPENING STATEMENT OF ANN MARIE BUERKLE,
CHAIRWOMAN, SUBCOMMITTEE ON HEALTH
Ms. Buerkle. Good afternoon, and thank you all for being
here this afternoon.
Before we would begin, I would like to ask unanimous
consent--although I don't see him here yet, for our colleague,
Mr. Tim Walz from Minnesota, to sit at the dais and participate
in today's proceeding.
Without objection, so ordered.
Today, we meet to discuss the role of faith-based and
community providers in helping servicemembers, veterans, and
their families transition from active duty to civilian life and
the need to foster better communication, education, and
collaboration between the Department of Veterans Affairs and
these critical community resources.
The responsibility for each one of us to care for those who
have borne the battle has never been so strong with the brutal
toll of a decade of war and a bad economy. We continue to hear
stories of veterans from past conflicts and our recently
returning veterans from Iraq and Afghanistan struggling to find
a home, a job, or a helping hand. The need to meet these
honored heroes where they are and provide them the care, the
hope, and the help they earned has never felt so immediate.
As a Nation, we are uniquely blessed to live in a country
with a rich history of civic pride and responsibility, and it
is to these communities where our veterans return home, where
they have maintained their existing relationships, and, more
often than not, where they first turn for help.
While the primary responsibility for caring for our
veterans does and should lie with the VA, faith-based and
community groups are playing an increasingly key role in
supporting the varied needs of our servicemembers, veterans,
and their families. They act as a bridge to accessing Federal,
State, and local programs and services.
Members of the clergy in particular are often the first
point of contact with the veteran grappling with the wounds of
war. Data from the VA National Chaplain Center indicates that
four out of ten individuals with mental health challenges seek
clergy assistance, more than any other mental health providers
combined.
We already know that faith-based and community groups can
be effective in filling known gaps in VA care and supporting
the day-to-day needs of a veteran population. However, a
district symposium I held in my home district of Syracuse last
December revealed to me a shameful lack of communication,
collaboration, and coordination between the VA and these
critical community resources and, subsequently, an urgent need
to act to establish meaningful partnerships between the VA and
nongovernmental organizations.
With more of our servicemembers returning home each day, we
cannot afford to let any opportunity to better support our
veterans pass us by. Where partnerships exist, they need to be
strengthened. Where they don't, they need to be fostered. For a
veteran or a loved one in need, every door should be an open
door.
Again, I thank all of you for joining us this afternoon. I
look forward to a productive and ongoing conversation.
I now recognize our Ranking Member, Mr. Michaud, for any
remarks he might have.
[The prepared statement of Ann Marie Buerkle appears on p.
39.]
OPENING STATEMENT OF HON. MICHAEL H. MICHAUD,
RANKING DEMOCRATIC MEMBER
Mr. Michaud. Thank you very much, Madam Chair.
I, too, would like to thank everyone for attending today's
hearing.
This hearing is intended to open up the broader thought
process and better understanding on how the VA and community
organizations collaborate to support veterans and their
families.
More than 2 million servicemembers have been deployed since
September of 2001, with hundreds of thousands of them being
deployed more than once. As of February 2012, more than 6,000
troops have been killed and over 47,000 have been wounded in
action in the recent conflicts.
When these servicemembers come home and take off the
uniform, many of them have the expectation that life will just
pick up where they left off before they were deployed. However,
this is not the case. Many of them struggle to reconnect with
their families and communities. They find themselves feeling
isolated and unable to cope. The Department of Veterans Affairs
reports that half of the OEF, OIF, and OND population that has
access to VA health care has sought mental health treatment.
Post-traumatic stress disorder is the number one reported
mental health concern among this population.
With so many OEF, OIF, OND servicemembers and veterans
experiencing psychological wounds, reports suggest that there
is an increase in the rates of suicide, alcohol and drug abuse,
homelessness, and domestic violence. For this reason, it is
essential that our servicemembers, veterans, and their families
receive the help they need and that they have necessary tools
to rejoin their communities. These programs and resources would
not be possible without the thousands of community
organizations across the country that work in partnership with
the VA.
At this hearing, I want to hear more about the
reintegration challenges that servicemembers, veterans, and
veterans' families face as well as the challenges the VA and
community organizations face as well in providing support
services. We need to identify potential solutions to these
barriers and how we can strengthen these partnerships.
Despite historic increases in the VA funding over the past
5 years as the Nation prepares for an influx of returning
veterans, reintegration efforts are simply not possible without
collaboration between the Federal Government, business sector,
and nonprofit organizations; and more needs to be done to
facilitate these partnerships.
I would like to take the time to thank our panelists for
being here today, this afternoon, and I look forward to working
with you as you support the Nation's veterans.
I would especially like to thank Mr. Morris and Mr. McCoy
for their service as chaplains in the Minnesota National Guard
and the VA's National Chaplains Center respectively.
In 2009, I led a congressional delegation to Afghanistan
and came to learn that our servicemembers rely immensely on
their chaplains for emotional support. Every trip since then I
have come to respect the unique insight that our chaplains
possess in terms of mental health, spiritual guidance, and the
overall well-being of our servicemen and women. I look forward
to hearing your testimony today as well.
I want to thank you once again, Madam Chair, for having
this very important hearing this afternoon. Thank you.
[The prepared statement of Michael Michaud appears on p.
39.]
Ms. Buerkle. Thank you, Mr. Michaud.
Now I would like to invite our first panel to the witness
table. With us today is Andrew Davis, a veteran of Operation
Enduring Freedom and Operation Iraq Freedom, the Director of
the Veterans Services for Saratoga County, New York, and the
founder of the Saratoga County Veterans Resource Initiative.
Mr. Davis served in both Afghanistan and Iraq with the U.S.
Army 75th Ranger Regiment where he earned the Bronze Star with
Valor, the Combat Parachutist Badge, and the Combat
Infantryman's Badge and is a true American hero.
Mr. Davis, thank you for your service to this country. It
is an honor to have you here today with us, and I very much
look forward to hearing your testimony. You may begin.
STATEMENT OF ANDREW DAVIS, VETERAN, DIRECTOR, SARATOGA COUNTY
VETERANS SERVICE AGENCY, SARATOGA COUNTY, NEW YORK
Mr. Davis. Good afternoon, Chairwoman Buerkle, Ranking
Member Michaud, and Members of the Committee. Thank you for the
invitation to discuss the role of community providers and
faith-based organizations in helping servicemembers transition
to civilian life and the need for the U.S. Department of
Veterans Affairs to use these resources and collaborate.
My name is Andrew Davis. I am currently the Director of the
Saratoga County Veterans Service Agency and the founder of the
Saratoga VRI. I have been a veterans advocate since separating
from the service in 2004 where I served as a United States Army
Ranger for 5 years, to include two tours of duty in Afghanistan
and one in Iraq.
Upon returning to my home in Minnesota to further my
education, I was faced with my first taste of how little I knew
about being a veteran. In fact, like many of my peers, I was
unsure if I even was a veteran. I was on a campus of 40,000
students, and I didn't know any veterans around me. Because of
this, I founded a nonprofit veterans support organization on
the campus of the U of M to aid returning veterans in
connecting with earned benefits and services.
In later roles as a congressional staffer and a Department
of Defense Transition Assistance Advisor, I saw firsthand the
disconnect between veterans, their families, and the systems
that are intended to support them. For the past 3 years, I have
spent my career as a veterans advocate, either training
accredited benefits counselors or being one myself; and this
has provided me a frontline view of what is lacking in outreach
and networked support to our veterans and their families.
Last, I am currently an enrolled patient with the Veterans
Health Administration in VISN-2 and use both the Albany
Stratton VA Medical Center and Clifton Park Community-Based
Outreach Clinic regularly.
Veterans and the ways they serve have changed significantly
over the last decade, resulting in the need for changes in the
way our country, in turn, serves them. The veterans of today
tend to be more geographically dispersed and more mobile than
previous generations. Families and communities are affected and
changed differently than ever before with multiple deployments
and the unique use of the Guard and Reserve. Many of these
individuals suffer from a lack of a ``Fort New York'' or a
``Fort Minnesota'' or a central support system, making the
local community even more crucial in the reintegration process.
Despite a constant bombardment of media in all forms that
afford the public access to our current wars, issues facing our
neighbors, friends, family members, and other local veterans
are often invisible to us as communities. Add to this a
military culture that can encourage emotional toughness and
self-sufficiency, and we face a large potential public health
problem.
Last, the uniqueness that makes our military and our
veteran population great also means that there is not a one-
size-fits-all support system that can be created nationwide. We
must garner community support and use community services to
serve our veterans and their families completely.
First and foremost, the population of veterans that find
their way into the VA system of care or benefits system merely
by accident is staggering. I can safely say that approximately
five to seven veterans knock on my door weekly for some form of
unrelated government service to find they are eligible for
veterans benefits or care because of their service to this
Nation.
Just last week, a young Marine with two tours of duty in
Afghanistan appeared in my office asking for directions to the
office that handles unemployment benefits. This Marine outlined
he had no idea what services he was eligible for or how to use
his 5 years of free health care. So we sat down with him and
helped him. If this Marine had not knocked on the wrong door,
he would not have met with my staff to turn on his GI Bill
benefits or learn where he could get health care.
By all appearances, the U.S. Department of Veterans Affairs
has recognized the need for community outreach but holds their
hopes in the idea that top-down, one-sided information will
filter down to the grassroots folks at the bottom helping
individuals. For example, in the VISN-2 of Upstate New York, a
few competent and well-trained veterans justice coordinators
have been hired and put in place. However, the operative words
here are ``a few.'' These people are responsible for numerous
counties and for interacting with courts, district attorneys,
and law enforcement, when in fact the police officers on the
beat may be able to help them immediately.
The correct mindset for reaching veterans must transition
to a ``no wrong door'' approach. This can and should be created
through a localized national training by VA, veterans
advocates, and other experts to all members of the local
communities. These newly created veteran-friendly communities
would have the tools to make referrals to the proper resources,
whether a veteran walks into a rectory, a tax assessor's
office, or is pulled over during a traffic stop.
Additionally, outreach and assistance programs cannot be
reactionary in nature. The time to begin helping a veteran in
legal trouble, for example, is upon first interaction, not just
at sentencing. In fact, in my own transition, it was a police
officer who pulled me over for driving in Minneapolis like I
had been in Haditha and Bagram and introduced me to my first
veterans advocate and helped me to realize that difficulty
transitioning was normal. Additionally, I now receive as an
accredited service officer a large number of referrals from
local police officers that I call my friends.
In sum, we as a Nation must stand committed to ensuring
that sustainable and quality supportive services are accessible
to veterans and their families right in their communities. I
believe this can be done by leveraging resources that largely
already exist in a cost-effective manner. The VA has the
geographical disbursement and expertise to lead change, but we
must think outside the box and look to those who are ready and
willing to assist in our own backyards. The requirements to
make this successful are not numerous. In many cases, putting
out outreach staff and community advance is all it will take.
We must begin immediately leveraging relationships and
expertise that has long existed.
Thank you again to the Committee for allowing me to speak
to these important issues.
[The prepared statement of Andrew Davis appears on p. 40.]
Ms. Buerkle. Thank you very much, Mr. Davis; and, again,
thank you for your service to our country.
I am going to begin by yielding myself 5 minutes for
questions.
In your written testimony, you remark that after leaving
the military you, as well as some of your peers, were unsure if
you were even a veteran. If you look at the overall scheme of
things, that is incredible, with the service that you gave to
our Nation. I would like you to, if you could, expand on that
statement and give us some insight into that.
Mr. Davis. Absolutely. I like to point that out, ma'am, at
any chance I can.
In my eyes, a veteran was my grandfather at the American
Legion who was telling World War II stories when I was a young
kid.
Additionally, I think there is a large confusion among our
Guard and Reserve population and even those who support these
wars from the homeland who may not even think of themselves as
a veteran when you consider the folks who are coming home
missing limbs or who have served multiple tours in combat.
So an important distinction I like to point out to
community members who are interested in helping is asking
somebody if they or a family member have ever served in the
United States military, as opposed to are you a veteran,
because that can be sort of a dicey question.
Ms. Buerkle. Thank you.
Can you talk about how we can get to that veteran community
when they are processing out and they are still active duty?
How can we make it known to them that they would qualify for
veteran assistance?
Mr. Davis. Ma'am, I think one important thing to understand
is that, no matter where we separate from, there is a very good
possibility that is not where we are going to stay. I can tell
you from my own experience separating in Fort Benning, Georgia,
and returning to Minnesota, I got every resource available to
me to stay in Fort Benning, Georgia, but I wasn't staying
there.
So the veteran returning to Syracuse from Marine duty in
Camp Pendleton needs to be provided in Syracuse that local
contact, whether that is a veterans service agency director or
whether it is a VA clinic contact. But they need the contacts
at home, not where they are separating from.
Ms. Buerkle. Can you tell me how you think that the VA's
reluctance to integrate with community resources may have
obstructed your transition or other veterans' transitions into
becoming a veteran?
Mr. Davis. Yes, ma'am. I think the important thing that
veterans need to understand when they are separating from duty
is that every benefit needs to be turned on with the process of
an application. For me, going to the University of Minnesota
and having to use GI Bill benefits, I guess I just assumed
somebody on campus was going to be there to help me, another
veteran or somebody who was responsible for this benefit. But
there wasn't one out of 40,000 that was there to assist with
that effort.
So if the VA had seen that this massive college campus was
going to attract veterans, they may have put somebody
proactively there or trained somebody. That is just education.
But that person could also refer me to a health care resource
or something similar.
Ms. Buerkle. So now you are director of a community
program; and I would like you to, if you could, describe for us
your interactions with the VA now and what kind of relationship
you have and how the VA is treating your group?
Mr. Davis. Madam Chair, we come in quarterly to the VA
hospital in Albany, and we do get to hear about departmental
changes. We get a top-down budget overview of what the VA
hospital director is dealing with. It does tend to be a fairly
one-sided conversation. We hear about changes to the
orthopedics ward or something like that, and we occasionally
get to talk about an issue that is facing maybe one of our
veterans. But as far as being able to have a two-way
conversation about how to improve, that does not take place.
In addition, I would point out that we hold events as
county agencies that are for the purpose of outreach. The VA is
invited to all of those, and I would be remiss if I told you
that they were at all of those. They rarely take advantage of
those community activities, at least in my area.
Ms. Buerkle. I don't mean to ask you to speak or try to be
in the mind of the VA, but why do you think there is a
reluctance to collaborate with some of the outside groups
rather than just the VA?
Mr. Davis. Purely speculation, ma'am. I would say they may
feel that they are the experts and the veterans should come to
them and they can't share that load. But, again, that is purely
speculation.
I also would say that maybe it has never happened before,
so maybe there is some reluctance to jump in and try something
new.
Ms. Buerkle. And last, if you could--and I just have a few
seconds left--what barriers do you see for more effective
relationships between the VA and some of the outside service
groups?
Mr. Davis. Ma'am, I think information sharing is obviously
a fear among all agencies, how do we talk about veterans and
get the proper consent for issues that they may be facing,
whether it be mental or physical health care.
But I also think staffing is something they always fall
back on, and I have seen that take place in my area.
Ms. Buerkle. I thank you very much, Mr. Davis.
I now yield 5 minutes to the Ranking Member, Mr. Michaud.
Mr. Michaud. Thank you very much, Madam Chair.
I also want to thank you, Mr. Davis, for your service to
this great Nation of ours. I appreciate it.
Speaking about mental health, do you have any suggestions
for us or the VA on creative approaches to addressing the
mental health needs of returning veterans and their families?
Mr. Davis. Sir, I appreciate the question. I would say that
one thing that comes up often among my veterans is a reluctance
to go physically to a VA mental center or even to a VA vet
center, which is even more comfortable for that mental care,
and a strong leaning toward paying out of pocket for private
providers in their own backyard. So if there was some way to
leverage that outsourcing, for lack of a better term, I would
say that would go a long ways.
But, too, also opening more mental health care to families
and children out there where that family dynamic has changed
through deployment, sometimes multiple deployments, sir.
Mr. Michaud. Thank you.
You mentioned the collaboration between the VA and the
local community resources, some of the things that they should
do. Is there anything in particular that you can tell this
Subcommittee on what can we do to encourage more of that
particular collaboration between the two?
Mr. Davis. Sir, I think the VA needs to get out into the
community a little more. My experience has been that there is
not a shortage of people out in my communities that want to
help, whether that be mental health providers on the private
side or whether it be churches and law enforcement where I get
a lot of my referrals from. They are ready to help, but they
are not really sure where to send people to, because the VA, at
least in my area, hasn't been out in force giving them cards
and saying what they do.
Mr. Michaud. You made an interesting point, and I actually
heard Judge Russell, who is a judge in New York for the
Veterans Court, and he made a good point and you just
reemphasized that point. A lot of times veterans don't feel
that they are veterans, and he rephrases the question now is
how many people served in the military.
When you look at outreach, I know the VA is trying to do
more in outreach, getting veterans into the VA system, what do
you think that we should do for more of an outreach type of
program? Because a lot of veterans out there are not signing up
because they don't realize that they are eligible. How do you
envision us doing a better job in getting people into the VA
system?
Mr. Davis. Sir, I believe the question does need to be
rephrased across the board. I think anytime we are looking to
help veterans we need to ask that, have you or a family member
ever served in the United States military, and that really
breaks the ice. But, too, it allows me as an advocate and all
of my peers as advocates to really start to look at what
benefits might be available.
I hate to put it this way, but the thing that gets a lot of
veterans in my door is you might be missing out on some
significant savings financially or on some serious financial
benefits, whether it be a property tax exemption or disability
compensation or free health care. So money gets people in the
door, unfortunately, but also asking the right questions.
Mr. Michaud. Do you think the Governors of each State and
probably the President ought to do an executive order requiring
every Federal agency or State agency that has an interaction,
whether it is unemployment benefits, Medicare, or Medicaid,
that one of the first questions that they ask is have you ever
served in the military and somehow getting that information to
the VA so they can reach out to those types of individuals?
Mr. Davis. Yes, sir. I think every temporary assistance
office, social services department, Medicaid, Medicare, but
also every college application at a State-run school should
have that question being asked and it should generate some sort
of referral. Again, that no-wrong-door approach is crucial in
helping these folks.
Mr. Michaud. You had mentioned in your testimony that the
VA interaction, that there is more of it dealt with on the VHA
side versus the VBA side. How do you think the interaction
between the two should be between VHA health and benefits side?
Mr. Davis. Sir, I think one thing I am up against
oftentimes with my clients is explaining the siloed barriers
within the VA, that the cemetery administration and the health
care administration and the benefits administration are not one
entity. So you can actually theoretically get care at the VA
hospital for 40 years and never have a disability claim put in,
and vice versa, and I think that is confusing to veterans. And
I think oftentimes when a veteran has a real problem with a
claim within the VBA, they tend to blame the doctor at the
hospital at the VHA, and vice versa, and it is not fair to the
VA employees, but it is also not fair to the veteran to not
understand that disparity.
So I think having a more across-the-board understanding,
but also, when we are talking to VHA, VBA and VCA should be in
the room as well, and vice versa.
Mr. Michaud. Thank you very much.
I yield back, Madam Chair.
Ms. Buerkle. Thank you.
I now recognize the gentleman from Tennessee, Dr. Roe.
Mr. Roe. Thank you.
I just have a couple of questions for Mr. Davis. Again,
thank you for your service to our country. I appreciate that.
I think probably the first time I ever realized I was a
veteran was somebody asking me to stand up at a Lincoln Day
dinner. I never really thought about it very much. And,
obviously, until you need those benefits, you don't.
Last Congress, I went to Afghanistan with Mr. Michaud, and
just got back from Afghanistan again on a CODEL I led about 4
months ago. And we stopped in Landstuhl. I think the DoD is
doing a better job of informing, at least from when I got out.
Really, it was a couple of days and you were gone, not really
knowing what benefits you had, if any. So I think they are
doing a better job today.
Where is the breakdown? Because there is so much access to
information. It is just that our soldiers, when you have made
that determination that you are going home, you go home and you
don't think about it until you have a problem. Then, like you
say, when you are at Benning or where I grew up near Fort
Campbell, Kentucky, you have all kinds of support there. But if
you move down to Hole in the Wall, Tennessee, you may not.
We have a VA hospital in our community. People know where
to go. But that is not necessarily for everyone, there are only
three of them in the State of Tennessee. So how would you best
get that information out to people? How do you do that?
Mr. Davis. Well, sir, as my friend Colonel Morris will
probably say, you are given the world's most important
information as a veteran at the world's worst time by the
world's worst briefers. As you are attempting to move your
family and your livelihood back home or to the new location in
this country, you are not thinking about those benefits, as you
say. So even just having a contact card printed out for you at
your transition would be a lot more helpful than a 130-slide
briefing on the big picture of benefits.
So the first thing I would say is we need to start teaching
people how to be veterans at the beginning of their service and
throughout their service, as opposed to right in the last 2
weeks. But the second piece is getting people in who are
actually advocates to brief, as opposed to the payers of the
benefits, meaning the big-picture VA folks giving us that long
PowerPoint presentation.
Mr. Roe. I know our veterans service officers where we are
do a tremendous job. And people come in, they really don't know
the difference between these acronyms--VBA, VA. I mean, it is
all one to them. They just think it is one. You are absolutely
right.
I see it all the time in my congressional office. If a
disability claim is not moving forward and we get in on it,
they don't know that the VA has nothing to do it. The hospital
where they are going doesn't have anything to do with that.
That is a totally different issue. I don't know that that is
important. All the veteran wants is their benefits taken care
of.
So you would suggest a simple thing to do would be just be
some contact, just a card with contact information. We ought to
be able to make that happen pretty easily, if you think that
would be helpful.
Mr. Davis. I do, sir. I think attached to that DD-214 when
you leave Fort Campbell should be here is the six most
important people in your home county you need to see:
unemployment, veterans advocate at the service office. You
know, you name it. But these are the go-to folks when you get
home.
Mr. Roe. If you need some help, if the issue comes up,
contact one of these people; and, like you said, there is no
wrong door.
Mr. Davis. Yes, sir.
Mr. Roe. Any of them can open the door.
I am not going to disagree with anything you said, except
for one thing. I don't think the needs of veterans have changed
at all. I had an aunt that knew my great-grandfather who
survived the Civil War, and my great grandmother had said that
he was never right after that war, meaning that he had
problems. There just were no benefits then. I think veterans
have experienced the same things.
I think we are doing a better job. The GI Bill is
spectacular. That is all I can say about it. It wasn't kicked
out very well, but the Secretary has smoothed out some of those
bumps. When a person goes and gets their veterans' benefit for
their GI Bill, you are saying that the University of Minnesota,
a huge, great university, didn't have any help. I mean, they
have thousands of people working at that college, and so do
most colleges that are of any size like that. They had no one
there who knew what to do for you, where to send you?
Mr. Davis. No, sir. And I can say that that has improved
greatly across the country. Just 2 years ago, we kicked off a
veteran-friendly campus event around New York; and we saw great
universities like Syracuse University who have full offices for
veterans. But that was not in existence when I separated in
2004.
Mr. Roe. So just in a short time you have been able to see
that?
Mr. Davis. Yes, sir.
Mr. Roe. Once again, thank you for your service.
I yield back.
Ms. Buerkle. Thank you, Dr. Roe.
Now I recognize the gentleman from Indiana, Mr. Donnelly.
Mr. Donnelly. Thank you, Madam Chair; and, Mr. Davis, I too
want to thank you for everything you have done for our country.
There is no way we can ever repay your hard work, your
dedication, and everything you have done for us; and we are
very much in your service and in your appreciation.
I wanted to ask about the Saratoga County Veterans Resource
Initiative. What role does the VA play in the gatherings that
you have when you gather quarterly to check best practices?
Mr. Davis. Sir, to date, we have had six meetings, and the
VA has been present at one, and it was the second meeting, and
that was in the form of the families outreach program that
existed at the Albany VA Medical Center. The VHA and the Vet
Center have been invited to every meeting and have yet to have
much participation.
Mr. Donnelly. Did they tell you why?
Mr. Davis. Every time, sir, it has been that they didn't
have the staff or they hadn't gotten approval to attend.
Mr. Donnelly. Okay. And I apologize if I missed this early
on in your testimony, but, at those gatherings, have they
proved pretty fruitful for you?
Mr. Davis. Yes, sir. At the very beginning, we learned how
this room full of people that all knew each other had no idea
what any of us did on behalf of veterans, so at that very level
it started being helpful.
In addition, I don't go more than 3 days without a call
from a fellow member of the Resource Initiative with a referral
from a veteran who came into their office. So, yes.
Mr. Donnelly. So have you found that there is a lot of
people trying real hard, but it is like a bunch of cars driving
past each other and nobody knows what is going on in the other
cars?
Mr. Davis. Yes, sir. Exactly.
Mr. Donnelly. Okay. Well, I promise you we will work real
hard with you, take the lessons you have given us, and try to
make sure we can spread the things you are doing to the rest of
the country. Thank you again, sir.
Ms. Buerkle. Thank you.
I now yield to the gentleman from Florida, Mr. Bilirakis.
Mr. Bilirakis. Thank you so much for holding this hearing,
Madam Chair. I appreciate it.
Thank you for your service, sir.
We are pretty active in our congressional district. I have
an advisory council. We have a resource fair on an annual
basis. We just finished a jobs fair that was very well
attended. I visit the VFWs, as does my staff, American Legions,
what have you, and also go to the VA.
But what more can we do as a congressional office. I know
that one of the reasons you are here is to testify on behalf of
how we can bring the VA closer to our veterans. What more can
we do? Do you have any suggestions? You know, we can always do
more. What can we do as a congressional office to further that
goal?
Mr. Davis. Sir, it sounds like you are doing a lot of the
things that I would suggest. But one thing I often point out to
congressional staff is that veterans, when they come to a
congressional staff member, have never, many times, filed a
claim or even interacted with the VA for the first time. They
are just under that assumption that they are a veteran who is
eligible for something and in turn is not getting what they
deserve.
So that reverse referral to a local advocate, whether it be
an American Legion service officer or whether it be a county
person or a State person I think is the first step I would
take. Because, oftentimes, your staff is very overwhelmed and
may not know everything about the local benefits or the State
benefits on top of the Federal, or vice versa. So a reverse
referral would be a big suggestion I would make.
Mr. Bilirakis. Thank you very much.
I yield back, Madam Chair.
Ms. Buerkle. I now yield to the gentleman from New Jersey,
Mr. Runyan.
Mr. Runyan. No questions. I yield back.
Ms. Buerkle. Thank you.
We will wait for Mr. Reyes.
Mr. Reyes, I know you just joined us. We have Mr. Davis
here, if you have any questions.
Mr. Reyes. I have no questions.
Ms. Buerkle. I guess that is it for questions, Mr. Davis.
Again, thank you very much for your testimony and for your
comments. You are now excused.
Mr. Davis. Thank you, Madam Chair.
Ms. Buerkle. I invite the second panel to the witness
table.
With us today is Chaplain John Morris, the Joint Force
Headquarters Chaplain from the Minnesota National Guard.
Chaplain Morris is a Colonel in the Minnesota National
Guard and is the co-founder of the Beyond the Yellow Ribbon
Initiative which facilitates collaborations between the
Minnesota National Guard, VA, and local faith-based and
community resources to support the reintegration of Minnesota's
National Guard combat veterans.
I would like to thank you, Chaplain Morris, for your
service to our Nation and for your very important advocacy
efforts.
I will now yield to Mr. Donnelly to introduce our next
witness.
Mr. Donnelly. Thank you, Madam Chair; and it is a great
honor to have Dr. MacDermid Wadsworth.
Madam Chair, fellow Health Subcommittee Members, I would
like to introduce you to Dr. Shelley MacDermid Wadsworth, an
Associate Dean of Purdue University's College of Health and
Human Sciences. As a Notre Dame grad, it pains me to mention
Purdue, but I will do so anyhow.
Dr. MacDermid Wadsworth also serves as director of Purdue's
Military Family Research Institute which works to improve the
lives of servicemembers and their families in Indiana and
across the country by strengthening and supporting the efforts
of military and civilian organizations to provide services,
education, and training to military families. I just want to
mention Purdue has done an extraordinary job with this, and we
are incredibly grateful.
We are grateful to Dr. MacDermid Wadsworth, who knows how
many people in our State serve and how dedicated the families
and everyone is. And I just want to say that your work is
making a difference in the lives of everyone, not only in our
State but in the country. Thank you very much.
Ms. Buerkle. Thank you, Mr. Donnelly, and welcome, Dr.
MacDermid Wadsworth.
Also joining our second panel is Dr. David Rudd and Dr.
George Ake. Earlier in my opening comments I mentioned we had a
symposium in Syracuse, and I was honored to welcome both of you
to Syracuse for that event. I don't believe it was snowing that
day, and we had a very successful symposium.
Dr. Rudd is the Dean of the College of Social and
Behavioral Sciences at the University of Utah, where he also
serves as Scientific Director for the National Center for
Veterans Studies. In addition, he was recently elected
Distinguished Practitioner and Scholar of the National
Academies of Practice in Psychology.
Dr. Rudd is also a Gulf War veteran, and I would like to
thank him for his honorable service to our Nation in uniform
and for his continued dedication to improving the lives of his
fellow veterans through his research. Thank you, Dr. Rudd.
Dr. Ake is an Assistant Professor of Medical Psychology at
the Duke University Medical Center, and he is here today on
behalf of the American Psychological Association.
Dr. Ake is a child psychologist and has worked extensively
with the National Child Traumatic Stress Network, where his
work has focused on assisting children and families who have
experienced stressful and traumatic life events, including a
military deployment and its aftermath. He is a recent winner of
the Durham, North Carolina, Police Department's Community
Service Award, and it is an honor to have him with us today.
I thank you all very much for being here this afternoon. I
am eager to begin our discussion.
So, Chaplain Morris, we will start with you. Thank you very
much.
STATEMENTS OF CHAPLAIN JOHN J. MORRIS, JOINT FORCE HEADQUARTERS
CHAPLAIN, MINNESOTA NATIONAL GUARD; SHELLEY MacDERMID
WADSWORTH, PH.D., DIRECTOR, MILITARY FAMILY RESEARCH INSTITUTE,
PURDUE UNIVERSITY; M. DAVID RUDD, PH.D., ABPP, DEAN, COLLEGE OF
SOCIAL AND BEHAVIORAL SCIENCES, SCIENTIFIC DIRECTOR, NATIONAL
CENTER FOR VETERAN STUDIES, UNIVERSITY OF UTAH; AND GEORGE AKE
III, PH.D., ASSISTANT PROFESSOR OF MEDICAL PSYCHOLOGY, DUKE
UNIVERSITY, AMERICAN PSYCHOLOGICAL ASSOCIATION
STATEMENT OF CHAPLAIN JOHN J. MORRIS
Colonel Morris. Chair Buerkle, Ranking Member Michaud, and
Members of the Subcommittee, thank you for the honor of being
here.
I am Chaplain Morris. I am the State Chaplain of the
Minnesota National Guard, and I am fortunate to be the co-
founder of the Beyond the Yellow Ribbon Program that you made
the national standard for the reintegration of the Reserve and
the Guard. I am a three-tour combat veteran. I am the son of a
combat veteran. I am the father of two combat veterans.
I am here as a fan of the VA. I am a customer. I am also a
close collaborator, and my daughters are customers. The
Minnesota Guard has had a very productive relationship with the
VA, and I think we have something to share with the Nation, but
I will encapsulate it in this story from Saturday.
I was at an event for 2,500 of our families whose soldiers
are now serving in Kuwait. We were feeding them. A mother came
up to me and said, you don't remember me. My son came home with
a local infantry unit from Kosovo, and you were at the
reintegration event, and I asked you to help my son. I want you
to see him. He is doing so much better.
I sat down with the young man. I indeed had pulled him out
of the registration line that morning 30 days after returning
from a 9-month tour in Kosovo. He was high on crack. We
immediately took him to the emergency room of the local
hospital in Rochester, Minnesota. After a 72-hour hold there,
he was taken to St. Cloud VA for inpatient chemical dependency
treatment. And he was proud to tell me a year and a half later
he was straight, he was sober, he was married, and introduced
me to his wife, who was pregnant with twins, and he was facing
a tremendous future. That is the collaboration that we have
with the VA in Minnesota.
We have done the RINGS 1 and 2 study with our First
Brigade, which is on its second combat deployment. The
Minneapolis VA has done a tremendous longitudinal study with
our soldiers and their families that I think is going to set
straight some of the mythology around PTSD and over-reporting
of that problem and an under-reporting of the impact that
healthy community reintegration-based programs can have on
returning veterans.
We have pushed VA teams far forward to enroll our
demobilizing soldiers at demob sites around the country. We
have had the VA actually train our command and staff--I was a
part of this in 2009--preparing to deploy to Iraq. We had the
VA train our commanding general and all of our leading staff in
the polytrauma unit in Minnesota. We got a first-hand look at
what war is really like, the impact of the weaponry of war and
on the human body and what combat trauma can do.
So we have a good relationship, but I think the VA could do
even better, and so I am here today to talk about some of those
problems and some of the solutions.
The VA suffers under the perception of being a very
isolated institution, and it has a stigma. All we hear about it
is bad things. We rarely hear the great things they do. From
loss of laptops and compromise of our security to homeless
veterans who commit suicide, the mantra of bad news about the
VA is steady, and it really affects the community's view of the
VA. And I can say that as a person who deals every day with
community leaders throughout Minnesota.
The institutionalism of the VA which Andy Davis so well
alluded to is a problem and it keeps the VA inside its building
and not always out in the community sharing its knowledge with
us who are on the ground working with the majority of the
veterans.
I think, unfortunately, the steady mantra about PTSD, 25
percent--whatever it is, the CBO report that came out last week
saying 21 percent--I think it is over-reported, and it is not
substantiated, and it has created an impression that the VA is
the only institution that can solve combat trauma, that all
veterans have it, and it is contributing to a double-digit
unemployment rate among our veterans--which is truly the
problem we have. It is getting work. It is not getting mental
health care.
Minnesota is the land of 10,000 mental health and chemical
dependency treatment centers. We like to say it is 10,000
lakes, but it is 10,000 treatment centers. There are plenty of
people who want to help us with mental health. That is not our
biggest problem. And we are caught in some kind of a loop
between the VA and Congress trumpeting a problem, when the
bigger problem is being underfunded and underaddressed. And we
can fix it, and we can do it in Minnesota, and we are going to
do it.
We have gotten the VA to come out into the community and
work with us, get on to our drill floors and talk to our
families. We have had the VA come and meet with our physicians
and share the knowledge that the VA has so that the provider
out in rural America can take care of families and veterans. We
have synchronized services so that when somebody leaves VA care
they can tie into Yellow Ribbon communities to get the care
they need. And we have asked the VA to not only publish what
they know in academic journals but to share with lay people
through veterans organizations and through our political and
elected representatives so that news can get down and counter
the steady stream of bad news.
I think the VA's one important part of the reintegration
process--it is not the only part, and it is not the most
important part--the most important part of the reintegration
process is the community. It is our responsibility to bring our
soldiers all the way home and to take care of their families.
We sent them to war. It is our job to bring them back. The VA
is a partner in that, but it is not a stand-alone partner. It
is not the only partner. It is a partner.
Every State that is empowered through its Governor to
partner with its VA will be an effective State in reaching its
communities and empowering them to bring their veterans all the
way home. At the end of the day, we are going to live in
communities, we are going to serve in communities, and if we
can't learn to be productive in our communities, it won't
matter how good the VA is. We still won't be all the way home.
Madam Chair, thank you for this privilege to be here; and,
Committee Members, thank you for what you are doing. It is an
honor to be here, and it has been a great privilege for me as
part of my career to have this chance to share this with you.
[The prepared statement of John Morris appears on p. 43.]
Ms. Buerkle. Thank you very much Chaplain Morris.
Dr. MacDermid Wadsworth.
STATEMENT OF SHELLEY MacDERMID WADSWORTH, PH.D.
Ms. Wadsworth. Thank you.
Chairwoman Buerkle, Congressman Michaud, and distinguished
Members of the Committee, thank you for convening this hearing;
and thank you to Representative Donnelly for such a kind
introduction.
I am proud to be a faculty member at Purdue University, the
land grant institution for the great State of Indiana, and also
to direct the Military Family Research Institute. I am pleased
to report that we were involved in several innovative
collaborations involving the VA. Our vision is to make a
difference for families who serve.
My institute has created or participates in collaborations
involving VA partners in the areas of homelessness, higher
education, vocational rehabilitation, behavioral health care,
outreach to community partners, and research. Our higher
education initiative, for example, is putting mechanisms in
place that could help every student, servicemember, and veteran
in Indiana and potentially reduce GI Bill costs with the help
of VA certifying officials, the Indiana Commission on Higher
Education, and others.
The vocational rehabilitation effort for which we serve as
the evaluation partner has been a national leader in placing
wounded warriors in employment and keeping them there; and,
again, without VA professionals at the table, this would not
have occurred.
Based on these experiences, I know that successful
collaborations are possible, can benefit military and veterans'
families significantly, and can contribute substantively to the
VA mission.
I identify several keys to success in my written statement
but will focus my remarks here on challenges and opportunities
that might benefit from policy or legislative attention.
Number one: Create clear points of entry for prospective
collaborators in multiple VA tracks. Prospective community
partners, particularly those located at a physical distance
from a medical center, find it very difficult to determine whom
to approach to partner, and the independence of the medical
centers means that there must be a local connection. The VA
Office of Faith-Based and Neighborhood Partnerships is very
important, but there are still many untapped partners who can
multiply the reach of the VA.
Number two: Develop mechanisms to separate the ``wheat''
from the ``chaff'' among prospective partners. VA professionals
are understandably wary of showing favoritism to particular
organizations. Unfortunately, this means that reputable
partners with much to offer may get held at arm's length, the
same as bad actors.
Number three: Reduce structural barriers to collaboration.
It is difficult to get information from the VA sometimes. It is
difficult for outsiders to engage in research with VA
populations. It is difficult for community partners to find and
connect with military and veteran families, particularly in
low-density areas. Sometimes it feels as though there is a
fence around the VA.
Number four: Provide tangible incentives and benefits to
community and VA partners who collaborate effectively.
Collaborations do take resources, but they also can generate
resources by attracting additional contributions of skills,
people, money, or information. Compared to the costs of
services that don't get used and clients who don't get served,
collaborations can be very cost-effective instruments.
It has been our great honor to work to make a difference
for military and veteran families. We are inspired by the
commitment and dedication shown by professionals in many
sectors who share that mission, and we are eager to continue
collaborating to make positive change.
Thank you for all you do to try to make sure that our
Nation's veterans receive the care and support they have been
promised.
This concludes my statement. Thank you for your kind
attention.
[The prepared statement of Shelley MacDermid Wadsworth
appears on p. 46.]
Ms. Buerkle. Thank you very much, Dr. MacDermid Wadsworth.
Dr. Rudd, you may proceed.
STATEMENT OF M. DAVID RUDD, PH.D., ABPP
Mr. Rudd. Chairwoman Buerkle, Ranking Member Michaud, and
Members of the Subcommittee, I very much appreciate the
opportunity to testify on behalf of the National Center for
Veterans Studies and the University of Utah.
Chairwoman Buerkle, I am very pleased and would tell you
enthusiastic about seeing you taking leadership on what I
believe to be a critical issue on the reintegration of veterans
into society after having served so admirably in terms of our
Nation and our needs.
You have my written statement. I am not going to repeat
much of what is in the statement. I do want to highlight a few
critical points.
I want to comment on Colonel Morris' note about the issue
of reintegration and misunderstanding.
I think it is important to recognize that, since the Gulf
War, less than 1 percent of Americans have served in the Armed
Forces. This is a tremendous shift from World War II when
almost 9 percent served; Korea and Vietnam, both greater than 2
percent served. And as we have fewer and fewer Americans
serving in the Armed Forces the possibility for
misunderstanding, the possibility for difficulty in
reintegration is compounded; and I think that probably speaks
to the issue that was raised by Colonel Morris, which I think
is a vital one.
I would like to speak about a couple of areas of research
and highlight a few things that I think sheds some light on the
opportunity for reintegration, in two areas in particular: one,
universities; and, two, organizations, communities of faith and
local churches.
Some recent work by the Pew Research Center revealed that
27 percent of veterans reported that readjustment to civilian
life was either difficult, somewhat difficult, or very
difficult. The survey also revealed significant burdens of
service identified by servicemembers, with 48 percent reporting
strains in family relationships, 47 percent frequently feeling
irritable or angry, 44 percent reporting problems reentering
civilian life, and 37 percent reporting post-trauma symptoms.
This doesn't necessarily mean post-traumatic stress disorder
but trauma-related symptoms. Despite the fact that many
veterans transition from military life with few problems, I
think these data indicate the significance of the problem, and
it has been fairly profound over the course of the last 5
years.
The Pew data offer insight into the source of the problem
as well, particularly in terms of emotional and psychological
adjustment. Among those having experienced combat, 50 percent
or more report post-trauma symptoms, a difficulty with family
relationships. When they were queried about factors reducing
the probability for successful reentry into civilian life,
veterans identified traumatic experiences and physical injury
as the most significant variables.
Of importance for this hearing, veterans identified
attending church at least weekly as the most important variable
associated with an easy and successful reentry into civilian
life. A remarkable 67 percent identified attending church once
a week or more as making reentry easier.
Clearly, the social connections and support offered by
religious communities and institutions around the Nation are
essential for our veterans. I would tell you that they really
possess enormous opportunity to help veterans transition. I
think that Colonel Morris spoke to this issue in terms of
stigma that is associated with mental health problems, with
PTSD in particular. The opportunity for intervention, the
opportunity for assistance in local churches is truly
remarkable.
I would tell you that, of the veterans that I know, the
veterans that I have worked with would much rather go to local
clergy than to go to a clinical psychologist, to go to a
psychiatrist, to go to a mental health specialist. With the
right training, with the right resources, that kind of a
partnership is precisely one that we need to pursue; and I
would like to see the VA take a lead in that area.
Now, I can tell you a little bit about my own work that I
think has helped clarify the severity and the magnitude of the
problems in terms of emotional and psychological issues faced
by veterans, and a very specific subset of veterans that I
would speak to are student veterans.
We recently did a national survey looking at student
veterans transitioning from the service back on to university
campuses, and I would tell you that, arguably, this is the
second-best place to capture veterans, is on university
campuses, that outside of the medical centers, outside of the
Veterans Benefit Administration, this is where you will find
veterans.
If you look at the data that are in my statement, you will
find that the numbers are fairly profound in terms of the rates
and the magnitude of the reported problems. Now, what is
interesting is that those veterans are on campus, those
veterans are functioning on campus, and I would tell you that
they are functioning quite well, but they need assistance.
Making sure that campuses are well prepared is something that
is critical for us to do.
So I would encourage you, in terms of looking for
partnerships and expanding partnerships that the VA has already
pursued, universities are a wonderful place, communities,
organizations, institutions of faith, local churches are a
wonderful place. Those are places where veterans will go, those
are places where veterans don't feel the severity and the
magnitude of stigma, and the opportunity to help is tremendous.
So I would encourage you to think about those two areas
specifically.
I would be happy to talk to you in a little bit more detail
if you have questions afterward. But, Chairwoman Buerkle, thank
you very much for your time.
[The prepared statement of David Rudd appears on p. 49.]
Ms. Buerkle. Thank you, Dr. Rudd.
Dr. Ake.
STATEMENT OF GEORGE AKE III, PH.D.
Mr. Ake. Good afternoon, Chairwoman Buerkle, Ranking Member
Michaud, and Members of the Subcommittee. Thank you for the
opportunity to testify on behalf of the 154,000 members and
affiliates of the American Psychological Association regarding
the collaboration between the Department of Veterans Affairs
and community organizations to support veterans and their
families.
As a child psychologist at Duke University Medical Center
and with the National Child Traumatic Stress Network, my work
focuses on assisting children and families who have experienced
traumatic life events, including military combat and its
aftermath. I am honored to speak with you today about the
collaborative work that I and my colleagues are engaged in to
support our Nation's military and veteran families.
Collaboration among all sectors of society is needed to
support the health and well-being of veterans and their
families. This includes key partnerships with policymakers,
government agencies, universities, the health care community,
and the faith-based community.
Scientific evidence continues to identify psychological and
neurological disorders, including post-traumatic stress
disorder, depression, suicidal ideation, and traumatic brain
injury as some of the signature wounds of recent conflicts.
While psychologists and other health professionals play an
essential role in helping veterans and families to address
these challenges, partnerships and collaborations with other
sectors of society are also critical.
While there are numerous specific programs for veterans and
their families, many families rely upon the support of faith-
based providers as a first point of contact. The members of
this community who are here today will address these issues,
but I want to underscore the extraordinary value of our
collaborative mental health work with faith-based providers
related to military and veteran families, a partnership which
enriches our work in many ways.
I would like to express my deep appreciation to you,
Chairwoman Buerkle, for your leadership in advancing
collaboration between the mental health faith-based communities
and military and veteran families. The unique military and
veterans mental health workshop that you hosted for faith-based
providers in your district in December served as a wonderful
example of the collaboration that is possible across sectors. I
was honored to join the distinguished panel of experts that you
assembled. Such events help to break down barriers and foster
partnerships that benefit veterans and their families.
Replicating this training in other congressional districts
could serve as a valuable resource.
Collaboration between military and faith-based and other
community systems is especially important as we consider 2010
Department of Defense data which estimates that 44 percent of
the 1.4 million active duty and National Guard-Reserve
personnel who deployed to combat missions as a part of OEF,
OIF, and OND are parents. DoD also estimates that nearly 2
million children in the United States have parents who are
active duty or Reserve personnel, many of whom have experienced
multiple combat deployments.
Some military families face severe challenges during
reintegration, such as a parent who returns changed due to the
winds of war or financial hardship, homelessness, marital
discord or violence and other difficulties. Still other
families experience the grief and loss associated with their
loved one's fatal combat injury or even suicide. These findings
highlight the necessity of considering the context and
challenges for children and families of veterans, as well as
the role of the family in facilitating a successful transition
to stateside service or civilian life.
To support veterans, their families need easy access to
collaborative programs and supports through VA and many other
service sectors. As a member of the National Child Traumatic
Stress Network, we are proud to contribute to such efforts.
The NCTSN is an initiative launched by Congress in 2000 to
develop a national collaborative network to improve best
practices and standards of care for children and families
affected by traumatic stress, including military families. Our
130 centers in 40 States collaborate with many organizations,
including the VA, DoD, the National Guard, the American
Psychological Association, faith-based organizations, and many
others.
We offer evidence-based interventions, educational
materials, curriculum for civilian providers, and much more,
all available on the Web site. My written testimony offers many
specific examples of this work, including a Welcome Back
Veterans program at the Duke University for training community
clinicians, a collaboration with the VA's National Center for
PTSD to train providers, including military chaplains, on acute
stress interventions, collaboration with the military
chaplains, and a family resilience program called FOCUS now
being used at more than 20 military installations, a
partnership with the TAPS program to help military families
after the death of a loved one, and the ADAPT parenting program
for Reserve families in Minnesota.
In conclusion, we have seen the collaborative efforts
between the military and veteran communities and partners such
as faith-based providers, mental health professionals, and
others have yielded effective services for our military and
veteran families. The American Psychological Association, Duke
University Medical Center, and the National Child Traumatic
Stress Network all stand ready to continue our collaborative
efforts with the Subcommittee, the VA, the DoD, our community-
based partners, and the military and veteran community to
address these important issues.
Thank you for the opportunity to speak with you today and
for your leadership and commitment to our Nation's veterans and
their families.
[The prepared statement of George Ake appears on p. 51.]
Ms. Buerkle. Thank you all very much.
I will now yield myself 5 minutes for questions. I will
start with Chaplain--Colonel Morris. As an experienced chaplain
and someone who has been in the military and a veteran, first
of all, do you think there is value with the faith-based
community; but, beyond that, how can we integrate that
transition using faith-based services?
Colonel Morris. Madam Chair, there certainly is value in
collaboration between faith-based institutions and the VA and
being a part of the reintegration process. We do this in
Minnesota in a variety of ways. We train clergy in every
community that wants to be a yellow-ribbon community in how to
help military families during deployments, and then how to help
returning combat veterans reintegrate into their community and
into their family.
Another thing that faith-based organizations can do is be a
part of the employment process. The military does not provide
guidance counseling, nor should it, to veterans preparing to
leave in how to reenter this free market globally oriented
economy. It is a tough transition to find a job here when you
have been hauling a rifle around the mountains of Afghanistan.
Faith-based organizations have employed people who have done
it. Life-to-life transfer, those skills, job-seeking support
groups and faith-based organizations are a grass-roots, easy-
to-tap sort of a resource that doesn't cost anybody anything,
and it provides that sense of community that a veteran needs to
hang in there to find that job. This is just a couple of
examples. There are plenty more that can be done to tap that
virtually untapped segment of our community.
Ms. Buerkle. Thank you. Dr. Ake, what is, if any, the VA's
involvement with the National Child Traumatic Stress Network?
Mr. Ake. To my knowledge there are many different
collaborative efforts, including a Webinar tomorrow, a master
speaking series from Zero to Three, and the National Child
Traumatic Stress Network focused on making sure services are
available to veteran families. And so the network often draws
on the expertise of many different entities working with
military and veteran families to speak on their perspective on
how to help them.
Ms. Buerkle. So that is your group, not the VA. Are you
working directly with the VA?
Mr. Ake. I think that is one example as far as drawing on
VA speakers for the master speaker series, but there are others
related to the Adapt program in Minnesota where there is an
after-deployment adapting parenting tools program pulling from
several different groups, but I would need to defer to the
partners that are actually doing those initiatives.
Ms. Buerkle. Thank you. Dr. Wadsworth, in your testimony
you talk about structural barriers more so with the veteran
population. Can you expand on that a little bit?
Ms. Wadsworth. Yes. I think because the Veterans
Administration and those who care about the Veterans
Administration care a lot about making sure that veterans
privacy is protected, making sure that veterans are never
subjected to care that is of substandard quality. There are
many rules and policies and restrictions and checks and
balances in place to try to ensure that all those things
happen, but the result is that it can make it very difficult to
move forward in collaboration.
My primary identity is as a researcher. If I would like to
conduct a study of a VA population, the study must be led by a
Veterans Administration principal investigator, and that is a
structural barrier because it means I have to find somebody who
would agree to let me partner with them to do the study.
We have a partner who we work with to do outreach. They
actually arranged for us to receive the funding instead of
them, because we can work with hotels and do logistics more
easily than they can. So people find creative workarounds. But
these same policies, in many cases that are put in place to
protect, end up serving as barriers.
Ms. Buerkle. Thank you. And last, Dr. Rudd, you mentioned
education being the second-best place to serve as a safety net
to locate veterans. Do you have any suggestions for how we can
integrate that piece into education with our universities and
our colleges and our community colleges?
Mr. Rudd. Well, I think there are a number of things we can
do. The VA has already implemented the Vet Success on Campus
program, which provides actually benefits counselors and
rehabilitation counselors that work on university campuses, so
they are hired and employed by the VA but actually are placed
on the university campus, which is a very good program.
But I would tell you that the kind of barrier that exists
is a really simple one. So if you take that program as an
example of which the University of Utah just started
participating this year, the VA has broadly expanded that
program over the course of the last year. One of the issues for
us, we ultimately were able to work through it, was that we
didn't actually get to be involved in the interview process for
the hiring of that employee. So we had two employees hired. We
didn't get to participate in the interview process because it
is a VA employee, but yet they are going to work full time on
our campus. Real partnering means that you participate fully.
It doesn't mean we get to make the decision, but it means we
get to be intimately involved in that partnership, and I think
expanding that program would be wonderful.
The VA is also experimenting with the placement of
psychologists in counseling centers, and so if you look in the
University of Texas at Austin, this past year they hired a VA
psychologist to work specifically in the counseling center to
provide therapy, given issues of stigma at local VA medical
centers, and these are individuals that are trained very
specifically in the treatment of combat-related trauma. That is
a wonderful program. It would be nice to see that expanded and,
again, to have that be a true partnership so that you don't
necessarily get to dictate who is hired but you are involved in
the process of hiring and making sure that it is the right
person for the campus.
The last thing that I would suggest is that universities as
a whole could do a better job at probably the issue that
Colonel Morris spoke to, which is really giving credit for
military experience. We need to do a better job at giving
soldiers credit for life experiences and technical training
that they have, and providing college credit for that that
facilitates employment.
So I would tell you on the university side, we can do a
better job. And actually our center is going to pursue some
effort nationally about trying to coordinate that in terms of
giving academic credit, facilitating the employment picture for
veterans.
Ms. Buerkle. Thank you all very much.
I now yield 5 minutes to the Ranking Member, Mr. Michaud.
Mr. Michaud. Thank you, Madam Chair. Once again I would
like to thank the four panelists for your testimony this
afternoon.
Colonel Morris, what would you say is the biggest
difference there is between reintegration between Guard and
Reserves as opposed to the Active military?
Colonel Morris. Sir, I have done it both ways. Andy and I
spent a lot of time talking about this. I think that the
Federal soldier, sailor, airman, and marine, the Active Duty or
the reservist, have the most difficult challenge. Generally
they are returning to a place different than they served, and
often if they are a Reservist, their unit has been pulled
together from diverse geographic locations, and they are going
home alone or in ones and twos. I have gone to war as a person
all by myself, the Army of one, and it is not fun to come home
as the Army of one. Guard units generally return as a
community, out of an armory located in a community; they have
built-in camaraderie and community support. I think the Guard
actually has an advantage in terms of reintegration.
I think the toughest organization for reintegration is the
United States Marine Corps, an elite, proud group. And elite
warriors across the services that are serving on Active Duty
have a very tough challenge coming back. They leave a very
community, they have a lot of secrets, and they come back to a
public that absolutely does not understand what they have done,
and they are by themselves. They have the hardest challenge, no
doubt.
Mr. Michaud. Thank you.
Dr. Rudd, you mentioned the Pew Research Center, and part
of the study had talked about--you mentioned 44 percent of the
post-9/11 veterans say their readjustment to civilian life was
difficult by contrast to just 25 percent of veterans who served
in earlier eras. What do you distinguish--or do you know in
this study why the difference? Is it because if you look at
what is happening in Iraq and Afghanistan, a huge influx of
Guard and Reserves, or do you think there is a distinction
between Guard and Reserves in the readjustment versus Active
military?
Mr. Rudd. I think that is a great question. I would tell
you, it is somewhat speculative, it is probably a combination
of those things. I think reintegration is problematic from one
perspective in that fewer and fewer Americans serve in the
Armed Forces, and so fewer and fewer understand the issues that
military face.
I think, too, I think a larger portion of the combat
mission has fallen to Guard and reservists, which makes it a
little bit more difficult in terms of reintegration. The
primary problem, if you look at the West, if you look at Utah
as an example, one of the challenges for our Guard individuals
is the dispersion after they return, that they are dispersed
into relatively low populated areas, limited access to service,
and limited access to one another, so that there is limited
access to one another.
One of the wonderful things about student veterans is that
they have an opportunity to gather on a campus, they have an
opportunity to identify on a campus, and that helps. And I
think that that is a part of what churches do. I think that
they provide an opportunity to gather, provide that critical
emotional support.
So I think it is probably a confluence of factors and that
these have been unique wars. It is a unique time in our
history, and the way that we structured the military is very
much unique relative to Vietnam, relative to Korea, and
relative to World War II, and as a result I think the
reintegration challenges are unique.
Mr. Michaud. Thank you.
Dr. Wadsworth, you discussed in your testimony the
structural barriers to collaboration as it pertains to the VA
system. Do you find the same barriers are there dealing with
the Department of Defense?
Ms. Wadsworth. There certainly are some barriers. I would
say that over the course of this war, DoD has really come to
understand that they cannot rely on simply their own resources
to meet the needs, particularly of the Reserve component, and
with the closing of bases and the increased reliance on the
Reserve component, they must partner with communities. I think
they still are working out their models, but there are many,
many examples of partnerships really permeating throughout the
country. For example, an extensive partnership with the
cooperative extension system, which means that DoD now has a
reach into every county in the country.
Mr. Michaud. My last question is for Colonel Morris. How
many community organizations does Beyond the Yellow Ribbon
Initiative work with? Is it pretty much throughout your State?
Colonel Morris. Sir, we have 73 communities that the
Governor has officially recognized as yellow-ribbon
communities, dozens of corporations and different entities,
faith-based organizations, that have been recognized as well.
The adjutant general's plan is that every community in
Minnesota that has a National Guard, Army Reserve, Navy Reserve
facility will be a yellow-ribbon community. We anticipate being
well over a hundred. Each community has to train every aspect
of their community: faith-based, law enforcement, behavioral
mental health, education and employers. So it is an extensive
effort to get every community online to do what they really
want to do, and that is go Beyond the Yellow Ribbon and take
care of their military families and their veterans.
Mr. Michaud. Great. Thank you. Thank you very much, Madam
Chair.
Ms. Buerkle. Thank you, Mr. Michaud. I now yield to the
gentleman from New Jersey, Mr. Runyan.
Mr. Runyan. Thank you, Madam Chair. I know, Dr. Rudd just
kind of answered my question in just giving the opportunity to
meet and talk, but I can tell you firsthand in my district
there is actually a faith-based hospital system that does a lot
of the mental health for the joint base there in my district.
And it has been a tremendous help because it really comes on--
especially when you talk about the West, but in my district,
too, access to care is a huge part of it. And I think what the
chaplain is really saying, and I want to ask you this, because
that is the ultimate issue is the access, whether it is
religious based or whether it is on a college campus.
In the programs you run, what is that initial hurdle? What
got that ball rolling to make this a community-based--to get
the community involved? Because I know the community on many
levels in the Guard--in dealing with the Guard is involved. But
on this aspect of it, what was the one thing that got the ball
rolling and allowed it to happen?
Colonel Morris. Well, two things, sir. Our previous
adjutant general hired me with this statement: I don't want my
soldiers treated the way I was when I came home from Vietnam.
Go fix that.
Pretty big challenge. But what he was saying is I don't
want my soldiers stigmatized by the people who sent them to
war. So that put it right down at the community level.
It is very obvious in Minnesota where we have a lot of
trained behavioral mental health professionals, chemical
dependency professionals, that anybody needing that kind of
care is much more comfortable using their TRICARE benefits in
their backyard, with people that they know and trust, versus
traveling to a large institution that is unfamiliar to them.
But helping those people understand what our peculiar set of
issues might be, how to get that training, that was a challenge
for us at first, because the people with that training are
inside the VA. So getting them to come out and share the wealth
of experience with the provider at the local level was
initially a tough hurdle to overcome, and we have overcome it;
and now maybe too well, because now we have a constant message
of, ``You are mentally ill, you are a victim. You went to
war.''
Most of us are not mentally ill, most of us were not
traumatized in war. The fact of the matter is, after three
combat tours, I can certify most of us were bored to death. We
never saw anybody to shoot, and we never fired our weapon. We
were never fired at. So we have a whole different set of issues
to deal with. But we have trumpeted that issue so well that I
have a steady stream of mental health providers offering me
help, more than I could probably use. Good collaboration with
the VA; I just don't have enough employers. That is my next
hurdle.
Mr. Runyan. I think we would all agree on that as we
continue to--our unemployment in our men and women coming home
continue to rise. And with that I yield back, Chairman.
Ms. Buerkle. Thank you. Mr. Donnelly.
Mr. Donnelly. Thank you, Madam Chair.
This would be to Dr. Rudd and Dr. Wadsworth. When you talk
about college programs and college models that you have, is
there any effort being put in now to, in effect, almost putting
like a college, here is a model college program together,
something that can be used at IU or at TCU or at Rice or at any
other schools that are out there that they can almost get a
turnkey program?
Mr. Rudd. I think there are. I can tell you that actually
our center is leading an effort on two fronts. One on the
mental health front; but also more broadly, just on student
reintegration, we are actually trying to initiate forming a
national consortium to do that very thing, to say here are best
practices on college campuses both in terms of how you work
with distressed students, but more importantly, how you work
with transitioning students from their education to employment.
And really trying to create community partnerships is a piece
of that, so that we can help individuals find jobs and make the
transition. So I would tell you that there is some effort.
The other thing I would tell you is that the VA actually
has been very proactive in this area. We have the Assistant
Secretary for Policy and Planning is going to come visit our
campus at the end of March for this very issue. We are looking
at exploring how do we partner, how do we get models in place,
and then how do we distribute and, most importantly, how do we
do that quickly?
Mr. Donnelly. Dr. Wadsworth.
Ms. Wadsworth. Yes, I think the data are still not
completely clear about exactly which strategies work the best,
but we do know promising practices. In Indiana we have actually
been working with institutions across the State, so we
approached it right from the beginning at a systemic level, and
we try to think about it from a life-cycle perspective: What do
colleges and universities have to do to be well prepared for
students when they first get there, including transfer credit;
how do they best support them while they are there; and how do
they ease the transition from the campus?
And so we are working with systems of higher education to
try to help them remove some of the structural barriers, and
that is where the transfer credit issue really can come in.
We also work closely with student veteran organizations who
are a key element, I think, in providing a sense of home on
campus where student veterans can find each other and help each
other.
Mr. Donnelly. Thank you very much.
Dr. Morris, or Chaplain Morris, one of the areas that has
continued to break everyone's hearts here is the suicide of
vets, and a lot of these cases you hear afterwards say, Well, I
saw one or two people, but they never really understood me.
I just wonder if you have any ideas on what organizations
or what people or what are the critical elements to best have
someone who can understand that person when they talk to them?
Colonel Morris. Sir, first of all, after Indiana beat
Minnesota twice this year in basketball, I am struggling with
depression.
Mr. Donnelly. Well, sir, we haven't won a national
championship in about 25 years, so we give it a good run
ourselves.
Colonel Morris. Minnesota tragically leads the Nation in
terms of the National Guard in suicide, so this is an issue
that has got the entire focus of our Governor, adjutant
general, and all the staff. I wish I had a magic answer for
you, sir. We have thrown everything against this problem that
we possibly can.
I think General Chiarelli, before he retired, his
exhaustive report to the Army on this issue highlighted several
things. We need to do a better job screening before people come
into the military because we know that we have seen suicides of
people who brought preexisting conditions to us. In the
Minnesota Guard, most who committed suicide never had deployed.
Some committed suicide prior to ever going to basic training.
Something was going on in their lives before they came to us.
Now, how can we all be more alert? We focus most of our
effort on that. Is it the first sergeant, the first line
leader, is it the company commander, is it the chaplain? We
have decided to train them all down to the squad level leader.
We have also decided to train families, and so we are
working aggressively in all our reintegration academies to
train our families in suicide prevention. That is a step we
have never considered before. We are doing that full fledged.
We train local clergy, we train the local behavioral mental
health providers. But, again, we are cognizant that we are
fearful that we are going to create a stigma against the people
we are actually trying to help, that, again, we are all
mentally ill, and we know we are not. We know that society has
a suicide problem, not just the military, but we are owning
this problem, and we are facing it head on because these are
precious soldiers who we have invested so much in and want so
much to retain, but we haven't found the magic bullet of the
person to solve the problem.
Mr. Donnelly. Well, thank you very much for your efforts on
this, and obviously it is a concern to all of us because these
men and women come back having served our country, and they
reach out, and what you hear time after time is, ``I couldn't
find anybody who really understood what I am going through.''
And so we will stay after it, but thank all of you for your
help. Madam Chair, I yield back. Thank you.
Ms. Buerkle. Thank you, Mr. Donnelly. I now yield to the
gentleman from Texas, Mr. Reyes.
Mr. Reyes. Thank you, Madam Chair. I appreciate the
opportunity to be here. I am wondering, if we go back even to
the days of the Romans, if they didn't deal with these same
kinds of issues. And I say that because I came back from
Vietnam after serving with some really bad guys that society
had said, ``You have a choice, go to jail or go to the Army.''
And those were very good soldiers that exemplified, the bad
cards that they were dealt for many different reasons.
Obviously I don't know what happened to them after we came
back from Vietnam. I can only use my example that having come
back under the circumstances that we came back under, where we
weren't received well, we each individually wrestled with the
question, what I did for the past 13 months, was that worth it
for these people that are ungrateful? But what got me through
was my family. My family and a priest that my mom said, You
know, you need to go to Father Velazquez and have him help you
through this. So community and family are an important part of
the healing process.
But I am wondering, for those soldiers that were dealt the
bad hand, that went and excelled under the most difficult
circumstances anybody who has been in combat can tell you it
sucks. It is the most difficult challenge you will ever face.
But they did it, and they excelled. I don't know if it was
because they came from the inner cities or they came from
gangs, or whatever the situation was. I can tell you, they were
very good soldiers that knew how to fight, and fought and
distinguished themselves.
So you fast-forward to today, and the situation is
dramatically different. The country appreciates the all-
volunteer force. I am a little bit troubled, Chaplain, by the
fact that you make a statement that some of these people had
issues when they joined the military. I thought we had a way of
screening, because these are all volunteers in today's
military. They are supported, at least in my community, 110
percent by the people of El Paso, Texas; including Fort Bliss,
White Sands, and Holloman.
So I am wondering, should the VA be doing some kind of
research that includes either case histories or organizations
or a community's role in how you embrace your soldiers? Wel
send them into combat on the drop of a hat and therefore, we
better be there for them when they come back with nightmares
and, all the things that a lot of us experienced but got
through because of our family and because of a priest or a
rabbi or another religion figure. Sometimes a buddy would do
help get you through an experience.
So should the VA be doing some kind of comprehensive
research? You know, here it is centuries after the Roman
legions, and before that the Vikings. I am just thinking, if
you were in combat, no matter whether it is modern or ancient,
that is pretty tough stuff that you have to deal with. So
anybody have any thoughts on that?
Colonel Morris. Sir, Chaplain Morris. First of all, thank
you for your service and welcome home. I want to tell you
something about your generation, sir. Referring back to my
general's challenge to me, don't let this generation be treated
like me. It was pointed out to me very quickly by Vietnam
veterans that despite the stigma of America, you now lead this
Nation in every area of productivity; you run our universities,
our hospitals; you are our political leaders; you have attained
the highest offices in the land despite the stigma heaped on
you. And I keep using that illustration with my young veterans:
If you could attain the position you have today, despite all
you went through, we should be able to go to Mars and back with
all the goodwill that we have today, and all the gains we have
today are because of the pain of the Vietnam veteran. So, sir,
I salute you and your colleagues. Welcome back, you have done a
great job.
Should the VA study this issue? They are, sir. The
Minneapolis VA, the RINGS 1 and RINGS 2 study will be the
definitive study on the challenges of reintegration, and has
within it the seeds for understanding how to successfully bring
soldiers all the way back. This brigade that is in Iraq today
from the Minnesota Guard is under the research of the
Minneapolis VA, and I think when this longitudinal study is put
together, we are going to have the answers to the questions
that you raise. But I do think, sir, we have to do a better job
in the all-volunteer Army screening for prior mental health
issues.
I intervened personally in Iraq in five cases where
soldiers were suicidal. They were on medication prior to
enlisting in the military, knew they couldn't enlist if they
took and owned up to what they were on under the care of a
psychiatrist. They stopped taking the medication, made it
through basic, made it through advanced individual training,
got into combat, and spiraled to become suicidal. They should
have never been on the battlefield.
We do not provide much screening for mental health issues
other than to ask you, Do you have a history and are you taking
any medication? That is a pretty low bar. So undoubtedly, I am
telling you from firsthand, we have taken people in and we are
taking people in who should not be in the military because of
conditions that they are afflicted with. We have to do a better
job on the front end if we want to see that suicide rate go
down.
Mr. Reyes. Thank you. Madam Chair, maybe that is something
that we can pursue via a hearing at a later date, because I
really do think it is important, especially if we have that
sense that there are those that are coming into an all-
volunteer force. Maybe we ought to find out what percentage you
would think that they were. But it is something worth pursuing.
Ms. Buerkle. It certainly is worth pursuing. Thank you all
very much for your testimony and for answering our questions,
and you are all dismissed. Thank you.
I invite the third panel to the witness table. Joining us
on our third panel is Reverend E. Terri LaVelle, director of
the Center for Faith-Based and Neighborhood Partnerships in the
Office of the Secretary for the U.S. Department of Veterans
Affairs; and Chaplain Michael McCoy, Sr., associate director
for the National Chaplain Center for Veterans Health
Administration in the U.S. Department of Veterans Affairs.
Before we begin your testimonies, I would like to thank
Chaplain McCoy for his service to the Navy.
Reverend LaVelle, you may proceed.
STATEMENTS OF REV. E. TERRI LaVELLE, DIRECTOR, CENTER FOR
FAITH-BASED AND NEIGHBORHOOD PARTNERSHIPS, OFFICE OF THE
SECRETARY, U.S. DEPARTMENT OF VETERANS AFFAIRS; AND CHAPLAIN
MICHAEL McCOY, SR., ASSOCIATE DIRECTOR, NATIONAL CHAPLAIN
CENTER, VETERANS HEALTH ADMINISTRATION, U.S. DEPARTMENT OF
VETERANS AFFAIRS
STATEMENT OF REVEREND E. TERRI LaVELLE
Reverend LaVelle. Chairman Buerkle, Ranking Member Michaud,
and Members of the Subcommittee, thank you for the opportunity
to appear before you today to discuss VA's outreach to faith-
based, nonprofit community leaders and organizations to better
equip them to work with our veterans, their family survivors,
and caregivers.
As director of the Center for Faith-Based and Neighborhood
Partnerships since September 2009, every day I draw on my
experience as a registered nurse, ordained minister, and
program director to connect faith-based nonprofit and community
leaders to the people, programs, and services VA offers our
veterans. Our primary goal, focus, and mission is to get our
veterans the help they need and deserve.
The Center for Faith-Based and Neighborhood Partnerships,
along with VA colleagues from across the country, work hard to
develop strong partnerships with faith-based, nonprofit and
community leaders and to provide them with the information on
VA services and invite them to participate in VA programs.
Every day, servicemembers are returning home to stay, some
after multiple deployments. After returning home--returning
home can be challenging. Often I hear stories about how
difficult it is for these veterans to connect with family,
settle into a new routine, and find work. These challenges may
seem commonplace to us, but they represent unique stresses for
our veterans. Many veterans seek help and support from family,
their place of worship, or their community. When they do, we at
the Center for Faith-Based and Neighborhood Partnerships make
sure these individuals are well equipped to provide information
on VA's programs and services.
Just as important, we make sure that every leader knows at
least one VA staff person he or she can call on when working
with a veteran, someone who can act as a resource and help them
help the veteran in need and find useful VA programs and
services. We do this by cohosting outreach events across the
country to introduce faith and community leaders to the
programs and services VA provides. We try to help these leaders
understand how to work with VA and other partners and, in doing
so, expand and enhance the ministries and programs they
currently have in place that can serve veterans.
For example, sometimes the only thing keeping a veteran
from getting the health or mental health or benefit services he
or she needs from the VA is not having a way to get to the
necessary clinic or office, so an organization may want to
provide transportation through their existing transportation
ministry, providing each veteran with a dependable free ride.
The organization can work with VA's voluntary service office,
which is located at every VA medical center, to coordinate a
volunteer transportation program. Volunteer services is ready
with all the information the organization needs to spring into
action.
In addition, many faith-based organizations have counseling
ministries or programs unfamiliar with the unique challenges
veterans face returning home--and their families. VA chaplains
and social workers will provide training to community leaders,
pastors, lay leaders, and support staff to help them understand
the unique needs and challenges veterans may be facing. In all
of our outreach efforts, VA includes both local and regional VA
staff as panelists and roundtable participants and a VA
chaplain who can provide an understanding on the special needs
of veterans returning from deployment.
We grow our relationships with community and faith-based
leaders by hosting quarterly conference calls, maintaining an
informative Web site, and sending information out on a regular
basis to over 1,200 Listserve members, and our Listserve is
growing all the time. We know our veterans come from a variety
of different backgrounds, cultures, and faith traditions and
that they represent the diversity that makes up our great
country, so we continue to expand our outreach by developing
new relationships with diverse communities.
Madam Chairwoman, I believe that, without a vision, that
people perish; but under the leadership of Secretary Shinseki
and the Center for Faith-Based and Neighborhood Partnerships,
our veterans will not perish. We offer a vision and a plan for
preparing faith-based and community leaders with the tools they
need to serve our veterans in their communities.
I would also like to extend my thanks to all of my fellow
panelists and our elected officials who have served in our
military for your service and your sacrifice.
I am now prepared to answer any questions.
[The prepared statement of Reverend LaVelle appears on p.
54.]
Ms. Buerkle. Thank you very much, Reverend LaVelle.
Chaplain McCoy, you may proceed.
STATEMENT OF
LIEUTENANT COMMANDER MICHAEL McCOY, SR.
Lieutenant Commander McCoy. Chairwoman Buerkle and Ranking
Member Michaud, and Members of the Subcommittee, thank you for
the opportunity to speak about the Department of Veterans
Affairs (VA) Chaplain Service's outreach efforts with community
and faith-based organizations.
As a VA chaplain over the last 21 years and a former Navy
chaplain, I have found one of my greatest joys has been working
with veterans and providing meaningful programs to aid them in
their healing. My testimony today will cover three programs
created by VA chaplains to help build bridges between VA, the
faith-based communities, and neighborhood leaders to aid in the
spiritual care of our returning veterans and their families.
The VA National Chaplain Center started the Veterans
Community Outreach Initiative to educate community clergy about
the spiritual and emotional needs of our returning veterans and
their families. Nationwide, VA chaplains have conducted over
200 training events and provided education to approximately
10,000 clergy through this effort. As a result, clergy across
the Nation are learning to help veterans identify and cope with
readjustment challenges the veterans and their families face
following deployment, identify the psychological and spiritual
effects of war trauma on survivors, and serve as a trusted and
knowledgeable resource for veterans to use to connect with VA.
Just a week ago I received a phone call from a local pastor
in Virginia who had attended one of our outreach events. He
said, ``I am very impressed by the passionate commitment and
excellent resources available to veterans, and I need your
help. Today a member of my church, whose son recently returned
from deployment in Iraq, called me, hopeless, his father did,
and in despair. He said the young man had just been arrested
and put in jail in Richmond, Virginia. His father said his son
was clearly experiencing PTSD, but he didn't know how to help
him. Can you help me link the veteran to the VA services he
needs?'' I promptly made the call linking the veteran to VA
providers who could most effectively care for him.
This is just one among many veterans who has benefited from
the Veteran Community Outreach Initiative events that our
chaplains are sponsoring to establish collegial relationships
between VA chaplains and community clergy. I truly believe that
a worthy goal of this program is for local clergy across the
Nation to say, ``I know the local VA MC chaplains. They are
devoted to care for veterans and their families. If I call
them, they will help me connect families who have come to me
for guidance to the VA resources they need.''
Each clergy who attends a VCOI event receives a tool kit,
prepared by the National Chaplain Center, of books, brochures,
information packets and important phone numbers and Web sites
to aid them in providing a helpful support to the veterans and
his or her family.
My time here is short, so I will just briefly mention two
other important VA programs. Our marriage enrichment program
was developed based on concerns over the large number of stress
marriages experienced by our veterans who are returning. We
have discovered that all too often the spouse who has gone to
war and returned may have physical, emotional, and spiritual
wounds that have not yet healed. These stresses often led to
family crisis and divorce, so we began a program called Getting
It Back, reclaiming your relationship after combat deployment.
It is designed to help married couples develop healthy ways of
interacting and relating with one another. Community leaders
and faith-based volunteers collaborating with VA chaplains,
psychiatrists, and social workers have contributed in making
the program a success.
Finally, I will mention our Heal the Healer program for
returning National Guard and Reserve chaplains home from recent
deployment. The program offers an open forum to share the
experience and emotions associated with employment, introduces
them to other chaplains with similar experience, and offers
insight on how we may intervene in the future to provide
appropriate and timely care for our chaplains returning from
combat zones. The stories and tears in these sessions are many.
And we, working and caring for our veterans, they too have
changed our chaplains who have worn our uniforms in caring for
partnerships and creating partnerships with local clergy, our
faith group endorsers and community faith group leaders,
working together to reach out and offer support to returning
chaplains, veterans, and family.
Madam Chair, thank you for the opportunity to share this
opportunity with you to speak on these concerns, and I am now
prepared to answer any questions.
[The prepared statement of Reverend McCoy appears on p.
56.]
Ms. Buerkle. Thank you both very much for your testimony. I
will now yield myself 5 minutes for questions.
Reverend McCoy, the 200 or so training events that were
conducted throughout the country, can you just expand on that a
little bit? How do you choose the sites, how many people
attend, and is followup done after those events?
Lieutenant Commander McCoy. Yes, thank you for the
opportunity to respond to that question. We have offered
actually 233 of these training events throughout the country
really, where our VA medical centers primarily are located.
What we have done in these particular programs is to identify
the readjustment challenges that veterans and their families
face following deployment. The goal is to identify
psychological and spiritual effects of war trauma, of
survivors, consider appropriate pastoral care interventions
with the local clergy so they can have some idea, when we talk
about PTSD and when we talk about brain injury, that they kind
of understand something about these and the signs of these
particular diseases.
We had a community clergy to brainstorm with us how we can
partner together in order that we can provide the best of care
to our returning warriors. We refer veterans to local VA health
care facilities. We always give them a packet of information,
Web sites, phone numbers, and books that they can have, that is
free, and these have been very beneficial in making veterans
connect to the VA, and it created relationships among the
chaplains with local clergy throughout their various
communities.
Ms. Buerkle. Thank you very much.
Does the VA chaplain group have a strategic plan? For
instance, I have a VA facility in my district. We have a
wonderful VA hospital in Syracuse, and we had an event where we
targeted the clergy. We had a distinguished panel come in and
instructed our clergy as to what to look for, what the signs
and symptoms are, family involvement. It was very
comprehensive. Now, we probably invited maybe 600 members of
the clergy, all denominations. No one mentioned your
organization. So maybe this is where the disconnect is.
We are talking about all these parallel initiatives going
on. How do you get your word out? Do you have a strategic plan
to hit all of the communities throughout the country?
Lieutenant Commander McCoy. Yes, we are expanding that,
Madam Chairman. We have a strategic plan, and we have efforts,
and the local clergy at that particular VA, and we have a
template for them to follow. Our numbers for this outreach is
increasing.
I understand you are from the New York area. I think we
have had 22 of these veteran outreach programs with clergy in
the New York area to this date.
Ms. Buerkle. We are in Upstate, so that may be different
than the New York area. We are in the country.
Lieutenant Commander McCoy. One of the things we are, if I
can--we have started a rural program, and our initiative, rural
initiative, is to target some of the rural areas where there is
not perhaps VA hospitals, but perhaps where we can use--where
we can go near CBOCs or various clinics and so forth where we
can offer these services. We always bring in various speakers,
not just chaplains, but the clergy. We also have a
psychiatrist, a social worker, somebody perhaps from the faith-
based community, all to intersect in creating this partnership
with us.
Ms. Buerkle. Thank you very much.
Reverend LaVelle, I understand that much of your outreach
efforts center on educating the community about programs and
services available through the VA. How do you--what kind of
outreach is done with the VA so that they know that you exist
and that they know of your services that are available?
Reverend LaVelle. Well, we have a steering committee, and
all three administrations are represented on our steering
committee. A representative from the three VA administrations
and the VA program and staff offices, and our steering
committee meets quarterly. We also do quarterly conference
calls where we have internal and external partners that are a
part of our Listserve, which includes VA staff. We also work
with veterans benefits administrations, vocational
rehabilitation and employment service, and four times a year we
do outreach events at four different regions throughout the
country in partnership with the regional office in that host
city. So that is how we get the word out and work
collaboratively within VA.
Ms. Buerkle. Thank you both very much. I now yield to the
Ranking Member, Mr. Michaud.
Mr. Michaud. Thank you, Madam Chair. This question is for
both. Colonel, you touched upon it, but what is being done
specifically to address the support needs of our veterans that
reside in rural areas or underserved areas of the country?
Let's start with Reverend LaVelle.
Reverend LaVelle. Well, one thing. Last year I requested
from the Vocational Rehabilitation Employment Services field
office that when they choose the four sites for the fiscal year
2012 roundtables, that one of those sites be a rural area. So
that is the one thing we have done. But I also know that our
Chaplain Service has had a rural initiative where they have
been working with rural clergy.
The other thing I did is that in our quarterly conference
call in September of 2011, there is a VA medical center
chaplain in Arkansas, in Little Rock, who has started an
initiative with rural clergy. We had him as a guest speaker so
that he could describe his program so that others on the call
could learn how to work with rural clergy.
So those are some of the things that our center has done as
relates to outreach to the rural areas.
Lieutenant Commander McCoy. Thank you for that opportunity
to respond. We as chaplains have begun a rural clergy program
with a strategy, and this--as a matter of fact, next week we
are having one, I think it is going to be in the Roanoke area,
and we are moving throughout the country and we will expand
that program, and I think there will be several this year, but
we will expand it in rural areas. We are actually targeting
these areas. We are sending out hundreds of invitations and
letters. We are working with the community clergy to also--
sometimes, I found out, when other clergy sometimes talk to
other clergy, you get better attendance. So we are using word
of mouth and using the presidents of some of the clergy
associations to help us bridge this gap.
Mr. Michaud. Reverend LaVelle, you mentioned the four
areas. Which area is the rural area? You mentioned you did
outreach in four areas. What one is going to be in the rural
area? What is your definition of what area is the rural area?
Reverend LaVelle. Well, I don't have--I don't know the
definition of a rural area. But I just made the request to the
field office for Veterans Benefits Administration to say one of
the areas needed to be a rural area, and the four cities that
they gave us back for this year was Huntington, West Virginia;
Albuquerque, New Mexico; Lincoln, Nebraska; and Boston,
Massachusetts. And if I am not mistaken, it is the Huntington--
--
Mr. Michaud. I think there is a definition problem because
those are not--none of them are rural.
Reverend LaVelle. Okay. Then I will go back and check with
them, but I specifically requested.
The other problem is that--it is not a problem, I shouldn't
say that. They sent me an email maybe a week ago, and I have
been away on travel, that some of those cities are changing. So
they must have--because I reiterated, but those are the initial
cities they sent me for fiscal year 2012. I apologize. I don't
have in my head the definition of ``rural.''
Mr. Michaud. Well, I mean, when you mentioned one of those
four areas should be rural, I mean the fact that you just said
all four are cities, you know, that is not rural. When you look
at what is happening with our Active military as well as the
veterans that actually do live in rural areas, I think they
should not be left behind. So since you are the director of the
VA Center for Faith-Based and Neighborhood Partnerships within
the VA system, have you talked to the Office of Rural Health?
Reverend LaVelle. Yes, I have met with them once. Yes, I
met with them, and I will go back, and really for my own
benefit get the--what they define as rural, so that I make sure
when I get the information again from the field office that
there is a meeting of the minds and that we are both speaking
the same language.
Mr. Michaud. You said you met with them once?
Reverend LaVelle. When I first came on board.
Mr. Michaud. How long have you been on board?
Reverend LaVelle. It has been 2\1/2\ years.
Mr. Michaud. Two-and-a-half years.
Reverend LaVelle. But the field offices are the people that
actually work with them and provide me with the locations. I
don't make that determination. But I will definitely follow up,
and if you want me to, I can get back to your office with the
definitive information.
Mr. Michaud. Thank you. You talk about collaboration with
faith-based organizations. To the best of your knowledge, do
these faith-based organizations, do they charge veterans to
access whatever help that they might need, do you know?
Lieutenant Commander McCoy. May I answer that? No. Most are
volunteers. They actually, out of their compassion and their
love and willingness to help the veterans, they have went into
their pockets often to provide services for our veterans,
either transportation or various types of programs that they
are offering in the communities.
Reverend LaVelle. The organizations that I have worked
with, the churches that have transportation ministries, have
said we are more than willing to say that so many days a week,
so many hours, we will use our current transportation ministry
to get veterans to and from appointments. Churches that have
counseling ministries or support groups have said, ``We are
more than willing to develop a support group if you can provide
us with people to come in and talk to us specifically about the
unique challenges of veterans returning from combat.''
Like my home church here in D.C., our entire counseling
ministry consists of Ph.D.s and licensed clinical social
workers, but their expertise has not been in dealing with
veterans per se, so they are open to having VA chaplains and/or
our social workers come in and do training so that they are
better equipped as our veterans return and become a part--and
return to the church, to work with them and their families
without any charge.
Mr. Michaud. Thank you. I see my time has run out. Thank
you very much.
Ms. Buerkle. I now yield to the gentleman from Texas, Mr.
Reyes.
Mr. Reyes. Thank you, Madam Chair. You mentioned the four
cities in 2012. Did you have four cities in 2011?
Reverend LaVelle. Yes, the Center for Faith-Based and
Neighborhood Partnerships has been collaborating with VBA,
Vocational Rehabilitation and Employment Service since 2005 in
these efforts, yes.
Mr. Reyes. So in 2011 what were those cities; do you have
that information?
Reverend LaVelle. Yes, I do.
Mr. Reyes. The reason I ask is because, traditionally,
Texas and California have the most veterans and the most Active
Duty----
Reverend LaVelle. The center was in Waco, Texas, twice.
Once in Waco, Texas, as a result of VBA and the center's
collaboration, but then the Waco Foundation requested that we
come back and do another roundtable. And so then when I came on
board we went back to Waco, Texas. We were in----
Mr. Reyes. Just out of curiosity, why can't your outreach
programs be part of every VA director's duties? For instance, I
have a VA clinic, what they call a super clinic, in El Paso.
Joan Ricard is our director. Why can't your programs be part of
the menu of services, or have her be responsible to provide
information? As the chairwoman said, in her case she actually
convened people at a meeting and your programs never came up. I
find that a little bit troubling.
So why can't it be part of every Veterans Administration
director? Albuquerque is good, they are 386 miles northwest of
El Paso, but they serve a different clientele than the El Paso
VA clinic. And if not by the VA director, why not the VISN? But
there has got to be a way to send the information out because
veterans desperately need these kinds of support systems.
Lieutenant Commander McCoy. Thank you for that question
because we are collaborating with the Office of Rural Health
and with our programs and chaplains, and we also are
collaborating with mental health and other agencies. All of our
chaplains who worked for various VA medical centers have been
basically mandated to provide this type of program.
Now, in terms of the rural health, we at the National
Center, with chaplains of course, move out into various other
areas.
Mr. Reyes. So is the closest chaplain to El Paso in Waco?
Lieutenant Commander McCoy. Yes.
Mr. Reyes. It is? That is 600 miles. Albuquerque is closer
to me than Waco, and that is what----
Lieutenant Commander McCoy. Now, you do have clinics. And
so we have chaplains that will visit occasionally those
clinics. And we also are going to expand the program where we
will have--actually, hopefully, we will have programs in the
clinics--that is our directions--and to go out to the various
locations.
Now, all of the faith-based activities do not happen, or
these clergy events do not happen in a VA hospital or a VA
facility. They are happening in churches, educational
buildings, and that type of thing.
Mr. Reyes. I understand that, but I have a veterans meeting
every month. It is a citizens advisory panel for veterans.
Lieutenant Commander McCoy. Yes.
Mr. Reyes. And Joan Ricard goes there every month. She is
very good about attending. But the times that I have been, we
have never heard the information about your programs. So is
there a reason why you can't designate the VA directors in our
respective areas to provide information and a process? I think
it makes perfect sense for Joan Ricard to have these programs
and to select maybe a clergy board or some other system where
there is a chaplain or chaplains, because we have a facility
that is going to grow to 45,000 soldiers and they are all
coming back from multiple tours in Iraq and Afghanistan.
I hear it from the priests, the ministers, and the rabbis
of the work that they are doing to support the military, both
soldiers and their families. And I also hear it from judges
that are working in the family courts where there are divorces
going on, and they are asking me why isn't there some kind of
an intervention program that provides counseling for these
families that are being torn apart because of multiple tours
and things like that? I think this would be a great way to at
least try to do that, and I don't understand why the VA
wouldn't want to impart that authority or that responsibility
to our VA directors. I certainly hope you would take that back,
and maybe we can follow that up and make that happen somehow.
Reverend LaVelle. I can--I will definitely send an email to
the chief of staff for VHA, who is someone I have worked with
closely when I am getting VA staff to speak at these regional
events, and bring this issue to her attention.
The other thing, though, is that at every medical center
there is what is called a minority veterans program
coordinator, and as an ancillary duty, it is not part of their
paid job. But every medical center has a coordinator, minority
mentors program coordinator, who part of their responsibility
is to do outreach. So maybe sometimes we are not getting the
information to the right person.
What would be helpful for my center is if we could find out
who the faith liaison is at either here in D.C. for every
congressional office, because then we could at least let them
know what we are doing and, when we have events, get the
information to them to say let the faith leaders of your
community know this is what we are doing, and we can get
information out that way. That would be one step to kind of
bridge this divide between at least your Representatives within
the congressional districts or at least starting here in D.C.
or in your congressional district. Like there are some people
that I know in different offices, so I automatically send them
stuff just because I have known them.
Mr. Reyes. That tells me that there needs to be----
Reverend LaVelle. We need to broaden that. I will contact
the staff of VHA and say this is an idea that came up, how do
we get some kind of relationship going with your medical center
directors so they have our information on hand and can
disseminate it and work more closely with the faith
communities, and then keep us abreast, and we figure out how to
help them develop those relationships.
Mr. Reyes. Especially when, as Congressman Michaud was
talking about, when it is the rural areas, there are huge gaps
out there. You are talking about States like Idaho, Wyoming,
Colorado that have a lot of rural areas. Texas in the panhandle
and all of--most of West Texas that is not El Paso, that is all
rural area.
Lieutenant Commander McCoy. Yes. And, sir, I agree that we
need--we can expand that. But I think that one of the things,
that all chaplains in the VA work for a director of a VA
medical center. So I think with that in mind and with our
policy from the National Chaplain Center, I have went to many--
several of these events, and the director has been the one who
has given the opening welcome at the event for the clergy.
Mr. Michaud. Thank you, Madam Chair.
Ms. Buerkle. Thank you both very much. I must say I am a
bit chagrined, and, maybe worse than that, concerned because
when we did our symposium on faith-based providers and invited
the clergy, we did have the VA there because we wanted them to
be able to tell the clergy members what services are available.
And even the VA didn't mention your offices. They made no
mention of it at all, that either program existed. I think we
have a really big disconnect here in knowing what is available
and what is out there.
If I could, Chaplain McCoy, I would ask that you provide
for us the template that you spoke about earlier and the tool
kit that you spoke about earlier so we can see what it is you
are doing.
Lieutenant Commander McCoy. Yes.
Ms. Buerkle. To make sure we get our veterans the services
they need.
Lieutenant Commander McCoy. I will.
Ms. Buerkle. Thank you both very much for your time and
answering our questions. You are both excused. Thank you.
In closing here today, I think that Chaplain Morris said it
best: we really do need a community effort to make sure that
our veterans have what they need. We expect and look to the VA
to be a leading partner in this. That is their mission.
It is going to be important for all of us to look to our
communities and make sure every section is covered. And Mr.
Runyan has left, but I think his comments, and Chaplain Morris'
comments about employment and making sure our economy gets back
on track so when our veterans come home, there is a good,
viable alternative and that they can seek an engaging good job.
With regard to the universities--those who choose to go back to
the universities and be educated--that there be that safety net
that Dr. Rudd spoke of, and that they are equipped to know and
appreciate and understand what the veterans are up to--and what
they are up against, I should say.
With that, I ask unanimous consent that all Members have 5
legislative days to revise and extend remarks and include
extraneous material. Without objection, so ordered.
Ms. Buerkle. Thank you again to all of our witnesses and to
our veterans who have served our Nation so courageously, and to
each of our audience members for joining today's conversation.
This hearing is now adjourned.
[Whereupon, 6:04 p.m., the Subcommittee was adjourned.]
A P P E N D I X
----------
Prepared Statement of Hon. Ann Marie Buerkle,
Chairwoman, Subcommittee on Health
Good afternoon and thank you all for being here.
Today, we meet to discuss the role of faith-based and community
providers in helping servicemembers, veterans, and their families
transition from active-duty to civilian life and the need to foster
better communication, education, and collaboration between the
Department of Veterans Affairs (VA) and these critical community
resources.
The responsibility of each one of us to `care for those who have
borne the battle' has never felt so poignant with the brutal toll of a
decade of war and a bad economy.
We continue to hear stories of veterans from past conflicts and our
recently returning veterans from Iraq and Afghanistan struggling to
find a home, a job, or a helping hand. The need to meet these honored
heroes where they are and provide them the care, the hope, and the help
they earned has never felt so immediate.
As a Nation, we are uniquely blessed to live in a country with a
rich history of civic pride and responsibility and it is to these
communities where our veterans return home, have maintained existing
relationships, and, more often than not, where they first turn for
help.
While the primary responsibility for caring for our veterans should
and does lie with VA, faith-based and community groups are playing an
increasingly key role in supporting the varied needs of our
servicemembers, veterans, and their families. They act as a bridge to
accessing Federal, State, and local programs and services.
Members of the clergy in particular are often the first point of
contact with a veteran grappling with the wounds of war. Data from the
VA National Chaplain Center indicates that four out of ten individuals
with mental health challenges seek clergy assistance, more than all
other mental health providers combined.
We already know that faith-based and community groups can be
effective in filling known gaps in VA care and supporting the day-to-
day needs of the veteran population.
However, a district symposium I held in my home district of
Syracuse, New York, last December, revealed to me a shameful lack of
communication, collaboration, and coordination between VA and these
critical community resources. And, subsequently, an urgent need to act
to establish meaningful partnerships between VA and nongovernmental
organizations.
With more of our servicemembers returning home each day, we cannot
afford to let any opportunity to better support our veterans pass us
by.
Where partnerships exist, they need to be strengthened. Where they
don't, they need to be fostered. For a veteran or loved one in need,
every door should be an open door.
Again, I thank you all for joining us this afternoon. I look
forward to a productive and ongoing conversation.
Prepared Statement of Hon. Michael H. Michaud,
Ranking Democratic Member, Subcommittee on Health
I would like to thank everyone for attending today's hearing. This
hearing is intended to open up the broader thought process and better
understand how the VA and community organizations collaborate to
support veterans and their families.
More than 2 million servicemembers have been deployed since
September 2001, with hundreds of thousands of them being deployed more
than once. As of February 2012, more than 6,000 troops have been killed
and over 47,000 have been wounded in action in the recent conflicts.
When these servicemembers come home and take off the uniform, many
of them have the expectation that life will just pick up where it left
off before being deployed. However, this is just not the case.
Many of them struggle to reconnect with their families and
communities. They find themselves feeling isolated and unable to cope.
The Department of Veterans Affairs reports that half of the OEF/OIF/OND
population that has accessed VA health care sought mental health
treatment.
Post-traumatic stress disorder is the number one reported mental
health concern among this population. With so many OEF/OIF/OND
servicemembers and veterans experiencing psychological wounds, reports
suggest that there is an increase in the rates of suicide, alcohol and
drug abuse, homelessness, and domestic violence.
For this reason, it is essential that our servicemembers, veterans,
and their families receive the help they need and that they have the
necessary tools to rejoin their communities. These tools, programs, and
resources would not be possible without the thousands of community
organizations across the country that work in partnership with the VA.
At this hearing, I want to hear more about the reintegration
challenges that servicemembers and veterans face, as well as the
challenges the VA and community organizations face in providing support
services. And we need to identify potential solutions to these barriers
and how we can strengthen these partnerships.
Despite historic increases in VA funding over the past 5 years, as
the Nation prepares for the influx of returning veterans, reintegration
efforts are simply not possible without collaboration between the
Federal Government, business sector, and nonprofit organizations. And
more needs to be done to facilitate these partnerships.
I would like to take the time to thank our panelists for being here
with us this afternoon and for the work that you do every day to
support our Nation's veterans. I would especially like to thank Mr.
Morris and Mr. McCoy for their service as Chaplains in the Minnesota
National Guard and at VA's National Chaplain Center, respectively.
In 2009, I lead a Congressional delegation to Afghanistan and came
to learn that our servicemembers rely immensely on their chaplains for
emotional support. And on every visit since, I've come to respect the
unique insights that our chaplains possess in terms of mental health,
spiritual guidance, and the overall well-being of our service men and
women.
I look forward to hearing from all of our distinguished guests
today. Thank you, Madam Chair, and I yield back.
Prepared Statement of Hon. Silvestre Reyes,
Democratic Member, Subcommittee on Health
Thank you Chairwoman Buerkle and Ranking Member Michaud for
convening this hearing.
Over the past decade, our Nation has seen the effects of two wars
in both Iraq and Afghanistan. Over 2 million servicemembers have been
deployed to these regions during that time period and have selflessly
served our Nation. These brave men and women and their families have
endured a lot.
After completion of their honorable service, many of these men and
women will leave our military and return to civilian life. The process
of reintegration into the local community is nothing new, as we have
had countless numbers of veterans leave military service over the years
to seek civilian employment.
Unfortunately, this process of reintegration has not always gone
smoothly. Many Vietnam veterans did not receive the care and respect
they deserved once they left the military. This cannot occur with our
veterans today. Therefore, we must ensure that our servicemembers,
veterans, and their families receive the help they need and that they
have the necessary tools to re-join their communities.
Reintegration is a cooperative effort among the Federal Government,
the business sector, and community organizations, ensuring that our
veterans are welcomed back into the local communities where they can
contribute as proud, hard-working citizens. They must receive the care
and consideration they have earned.
Prepared Statement of Andrew Davis, Veteran
Good afternoon, Chairwoman Buerkle, Ranking Member Michaud and
Members of the Committee. Thank you for the invitation to discuss the
role of community providers and faith-based organizations in helping
servicemembers transition to civilian life and the need to foster
better communication, education, and collaboration between The U.S.
Department of Veterans Affairs (VA) and these resources.
My name is Andrew Davis, and I am currently the Director of the
Saratoga County, NY Veterans Service Agency and the Founder of the
Saratoga County Veterans Resource Initiative. I have been a Veterans
Advocate since separating from service in 2004. I served as a United
States Army Ranger for 5 years to include two tours of duty in
Afghanistan and one in Iraq.
Upon returning to my home in Minnesota to further my education, I
was faced with my first taste of how little I knew about being a
veteran. In fact, like many of my peers, I was unsure if I even was a
veteran. Because of this, I founded a non-profit veteran support
organization on the campus of the University of Minnesota to aid
returning veterans in connecting with earned benefits and services. In
later roles as a congressional staffer and Department of Defense
Transition Assistance Advisor I saw firsthand the disconnect between
veterans, their families, and the systems that are intended to support
them. For the past 3 years I have spent my career as a veterans
advocate either training accredited benefits counselors or being one
myself. This has provided me a frontline view of what is lacking in
outreach and networked support to our veterans and their families.
Last, I am currently an enrolled patient with the Veterans Health
Administration (VHA) in VISN-2 and use both the Albany-Stratton
Veterans Administration Medical Center (VAMC) and the Clifton Park, NY
Community-Based Outreach Clinic (CBOC) regularly.
Opening Remarks:
Veterans and the ways they serve have changed significantly over
the last decade, resulting in the need for changes in the way our
country, in turn, serves them. The veterans of today tend to be more
geographically dispersed and more mobile than previous generations.
Families and communities are affected and changed differently than ever
before with multiple deployments and the unique use of the guard and
reserve. Many of these individuals suffer from the lack of a ``Fort New
York'' or central support system, making the local community even more
crucial in the reintegration process.
Despite a constant bombardment of media in all forms that affords
the public access to our current wars, issues facing our neighbors,
friends, family members and other local veterans are often invisible to
us as communities. Add to this, a military culture that can encourage
emotional toughness and self sufficiency, and we face a large potential
public health problem.
Last, the uniqueness that makes our military and our veterans
population great, also means that there is not a one-size-fits-all
support system that can be created nationwide. We must garner community
support and use community resources to serve our veterans and their
families completely.
Accessing Traditional Veterans Resources:
Issue
First and foremost, the population of veterans that find their way
into the VA system of care or benefits delivery system, merely by
accident, is staggering. I can safely say that approximately 5-7
veterans knock on our door weekly for some form of unrelated government
service(s) to find that they are eligible for veterans benefits because
of their service to this Nation. Just last week a young Marine with two
tours of duty in Afghanistan appeared in my office asking for
directions to the office that handles unemployment benefits. This
Marine outlined, that although his home of record on his discharge
stated Saratoga Springs, NY, he had no idea who his local contacts in
Veterans Services were, or where he could take advantage of his 5 years
of free health care from the VA. Nobody, from his pastor, to his
friends and family in the community knew how to connect him to his
earned benefits and services. If this Marine hadn't knocked on the
``wrong'' door he would not have met with my staff to turn on his GI
Bill benefits or learn where he could enroll in health care.
By all appearances, the U.S. Department of Veterans Affairs has
recognized the need for community outreach but holds their hopes in the
idea that top down, one sided information will filter down to the
grassroots folks at the bottom. For example, in the VISN-2 area of
upstate NY, a few competent and well trained veterans justice
coordinators have been hired and put in place. However, the operative
words here are ``a few veterans justice coordinators.'' These people
are responsible for numerous counties and for interacting with courts,
district attorney's and law enforcement, when in fact the police
officers on the beat and on our streets and highways are where the
first difference can be made.
Solution
The correct mindset for reaching veterans must transition to a ``no
wrong door'' approach. This can and should be created through a
localized, national training by VA, Veterans Advocates and other
experts to all members of local communities. These newly created
``Veteran Friendly Communities'' would have the tools to make referrals
to the proper resources whether a veteran walks into a rectory, a tax
assessor's office or is pulled over during a traffic stop.
Additionally, outreach and assistance programs cannot be
reactionary in nature. The time to begin helping a veteran in legal
trouble for example, is upon first interaction, not just at sentencing.
In fact, in my own transition, it was a police officer who pulled me
over for driving in Minneapolis like I had in Hadithah and Bagram that
introduced me to my first veterans advocate and helped me realize that
difficulty transitioning was normal. Additionally, I now receive as an
accredited service officer, a large number of referrals from local
police officers that I call my friends.
Local Solutions to a National Issue:
While much of our conversation has always revolved around what VA
and DoD does, can do and should do better, the reality is that much of
the care delivered to veterans in NY and across this country is done
through private providers and other not for profit and public sector
providers or other forms of government assistance. By urging VA to
reach out to these providers, a referral and information sharing system
can be implemented to ensure veterans are maximizing their earned
benefits and services.
As a veterans advocate, I can and do certainly play a role in
culling these local resources. For example, we have created the
Saratoga County Veterans Resource Initiative, which gathers local
elected officials, college administrators, veterans advocates, private
mental health providers, non-profits and others on a quarterly basis to
familiarize all with what we do and how referrals can work between
organizations. However this is an uphill climb for us because the
impression that most of the citizenry has, is that taking care of
veterans is solely a VA or Federal Government role. When in reality the
transition back to civilian life is a community process. I believe this
to be caused by the generally one-sided dissemination of information by
the VA to the general public as opposed to community engagement.
Local Engagement Opportunities:
1. The VA has in place a network of county and State veterans benefits
counselors that when given a level of training and funding, can and
should serve as community liaisons. While the U.S. Department of
Veterans Affairs may be our Nations experts on veterans related issues,
our community leaders will be who brings veterans back into the fold of
everyday life. My experience as a veterans advocate has been that the
information sharing is largely one-sided from the VHA to us with little
opportunity to engage with the Veterans Benefits Administration (VBA)
and the VHA on real issues and improvements. Veteran's advocates are on
the ``front lines'' doing a large amount of VA's enrollment and
benefits delivery and are a valuable and many times an undervalued
asset.
2. Our country is filled with competent mental health care
professionals that are constantly volunteering to treat and see
veterans. VA reluctance to use these community-based providers in many
instances turns veterans and their families away from treatment at all.
VA should look for ways to engage these highly trained professionals so
veterans can be treated comfortably in their community.
3. In our county's communities, local law enforcement, clergy and
educators have been more than willing to learn about veterans issues
and provide referrals to care and benefits. This is merely the first
step, but giving those who are willing and able to help an education
can go a long ways in figuring out where the legitimate gaps are in the
Federal systems. Simply put, existing organization many times do not
realize they are already serving veterans. Understanding veterans
perspectives and service needs will improve the overall delivery of
benefits and services at all levels.
4. Associations such as PBA's, Association of Sheriffs, First
Responders and Firefighters typically meet annually and regionally. In
both Minnesota and New York we have had little difficulty getting in
front of these groups to introduce ourselves and what we do as
advocates. The VA should be at these events to not only help veteran
members, but to continue to expand their ``free'' outreach team.
5. The VA has come a long ways in a short amount of time in the use of
technology, social media and non-traditional forms of outreach.
However, VA must continue to leverage these resources at a localized
level to engage a new generation of veterans who is mobile and tech-
savvy.
6. The VA can work together with service organizations with mutual
benefit to VA, veterans and local posts and chapters to modernize an
out-dated model. Veterans of this generation no longer find themselves
gathering in mass at their local Legion, but instead gathering via
Facebook and Skype. However, the power of gathered voice and advocacy
these national organizations provide could be crucial if used properly.
7. The VA's implementation of MyHealtheVet and E-Benefits portals is a
step in the right direction, but the centralized and physical nature of
enrollment have made it difficult for a financially and employment
challenged veterans population to take advantage of these systems.
Providing enrollment in the community or even outsourcing enrollment to
CBOC's and accredited veterans advocates would assist in these matters
greatly.
8. My experience to date has shown me that VA employees in any part of
the VA lack a basic understanding of local and State benefits and
services. These can range from veterans property tax exemptions like we
have in NY to local transportation to medical appointments. Not only
are the numerous people taking advantage of these benefits a good place
to find potential patients and enrollees, but they are simple, quality
of life benefits that can really help a veteran engage the system for
the first time.
Conclusion:
In sum, we as a Nation must stand committed to ensuring that
sustainable and quality supportive services are accessible to veterans
and their families' right in their communities. I believe this can be
done leveraging resources that largely already exist and in a cost
effective manner. The VA has the geographical disbursement and
expertise to lead this charge, but must think outside the box and look
to those who are ready and willing to assist in our own backyards. The
requirements to make this successful are not numerous. In many cases
putting outreach staff at community events is all it will take. We must
begin immediately leveraging relationships and expertise that has long
existed.
Thank you again to the Committee for allowing me to speak to these
important issues.
Prepared Statement of Chaplain John J. Morris
Chairman Buerkle, Ranking Member Michaud, distinguished Members of
the Subcommittee, I am honored to appear before you today.
I am the State Chaplain for the Minnesota National Guard. I am the
co-founder of the Beyond the Yellow Ribbon initiative. I have spent the
last 7 years of my military service facilitating the collaboration of
the Minnesota National Guard, faith-based and community organizations
and the VA resources of the Midwest VA Health Network (VISN 23) to
support the reintegration of over 20,000 Minnesota National Guard
combat veterans.
I am a consumer of VA medical care as an enrolled veteran with the
Minneapolis VA. I am the father of two combat veteran daughters who are
receiving medical care through the VA system.
I am an ardent supporter of the VA and the resources it provides to
our veterans.
The Minnesota National Guard Beyond the Yellow Ribbon Collaboration
With the VA
In 2005 Major General Larry Shellito, then Adjutant General of the
Minnesota National Guard, hired me to create a reintegration program to
help the Minnesota National Guard combat veterans successfully
transition from warriors to productive citizens.
The first institution we turned to for help was the Minneapolis VA
medical center. We wanted our veterans to receive medical care if
needed and benefits if earned. We knew that the demobilization process
used at that time was ineffective in connecting veterans with the VA
process. We were concerned that a majority of our veterans would not
access all that was available to them in terms of VA services.
We found a very willing partner in the Minneapolis VA medical
center. Our partnership grew to include the VA medical centers in St.
Cloud, MN; Fargo, ND; Twin Ports in Superior, WI and Sioux Falls in SD.
We expanded our partnership to include the Vet Centers in Fargo, ND;
St. Paul, MN; Sioux Falls, SD and Duluth, MN. Today we enjoy a close
collaboration with the leadership of VISN 23 and all the VA entities in
Minnesota.
We have successfully collaborated with the VA on the following
initiatives in support of our returning combat veterans:
1. Expedited enrollment of our demobilizing soldiers, at their
demobilization site, by MN VA personnel. This is insures our veterans
are enrolled in the VA in the catchment area they live in and they are
provided initial appointments.
2. RINGS 1 and RINGS 2, (Readiness and Resilience in National Guard
Soldiers), Research studies on the soldiers/families of the 1st
Brigade, 34th Infantry Division. These longitudinal studies have
focused on the role of the community in facilitating successful
reintegration and mitigating the effects of combat stress.
3. Collaborative training of local clergy utilizing VA Chaplains and
Vet Center staff.
4. Collaborative training of Minnesota Army National Guard Chaplains
and Chaplain Candidates in Clinical Pastoral Education utilizing the
Supervisory Chaplain of the St. Cloud, MN VA. We have trained 15
chaplains and chaplain candidates, to date.
5. VA Behavioral Mental Health providers from the OIF/OEF outreach
clinic providing satellite service at Camp Ripley, MN during annual
training periods of the Minnesota Army National Guard.
6. Vet Center Staff and VA OIF/OEF outreach personnel present at
every Minnesota National Guard reintegration event, pre- and post-
deployment.
7. Minneapolis VA Suicide Prevention Specialists regularly provide
training to the Minnesota National Guard and participate in clergy
outreach training with the Minnesota National Guard Chaplain Corps.
8. The Minneapolis VA Polytrauma Center Staff provided training for
the 34th Infantry Division Command and Staff prior to their deployment
to Iraq in 2009.
9. The Recruiting Command of the Minnesota Army National Guard
provides soldiers trained by the Minneapolis VA to visit wounded
warriors in the Minneapolis VA polytrauma unit.
10. The Vet Centers of Minnesota have collaborated with the Minnesota
National Guard to provide training for marriage and family therapists,
as well as licensed social workers, and psychologists at community
outreach events hosted by the Minnesota National Guard Beyond the
Yellow Ribbon program.
11. The Minnesota National Guard and the Minneapolis Regional Pension
and Disability Claims Office work collaboratively to provide the medial
records of soldiers seeking disability compensation.
The Minnesota National Guard Beyond the Yellow Ribbon Program and
Community Partnerships
The underlining operating principle of the Minnesota National Guard
reintegration initiative, (also known as, ``Beyond the Yellow Ribbon'')
is that it takes the entire community to help a warrior return from
war, reunite with his/her family and resume a productive life as a
civilian. Consequently, while partnering with the VA the Minnesota
Guard has also worked to partner with business, social service,
education, and faith-based organizations in every community in
Minnesota that is host to National Guard facility.
The Beyond the Yellow Program, under the purview of Governor
Pawlenty (2005-2010) and Governor Dayton (2011-present), thru the
Minnesota National Guard as program manager, has a formal process for
synchronizing the services of Federal, State and county agencies for
the benefit of returning combat veterans and their families. In
addition the program provides training for community organizations on
how to support military members, veterans and their families. To date
twenty-five Minnesota communities have been certified by the Governor's
office as `Yellow Ribbon' communities. The program synchronizes the
good will and services of the agencies of the government and community
organizations to support military families during the duress of
deployments and the returning combat veteran during reintegration, post
combat.
We have garnered tremendous support for our military families and
returning combat veterans. The Beyond the Yellow Program has
synchronized the agencies of the Federal, State, and local government
with the services of our communities to result in providing the support
needed by our military families. This has resulted in more productive
combat veterans and reduced pathology as demonstrated by the VA's Rings
1 study.
The Challenges and Opportunities the Beyond the Yellow Ribbon Program
Presents for the VA System
The VISN 23 VA organizations and institutions have been significant
partners in our Beyond the Yellow Ribbon initiative. I believe they
could play even more significant roles. They have vital information to
share with civilian medical providers, clinical social workers and
faith-based leaders. They have expertise to share with community-based
organizations. The involvement of the VA and their synchronization into
Beyond the Yellow Ribbon reintegration efforts will enhance the
initiative and result in healthier combat veterans and their families.
There are significant challenges to overcome, however, in order for
the VA to truly be a `community partner.' I will outline those
challenges:
1. Perception and Stigma.--My experience with community leaders has
been that they perceive the VA to be a distant and closed institution.
By virtue of the fact that relatively few citizens are veterans most
Minnesotans have no experience with the VA, thus the `mystery'
surrounding the institution. Combined with anecdotes shared by the
media of controversy with the VA, (e.g., inadequate care, lack of
resources, theft of computers resulting in Social Security numbers of
veterans
being lost, etc.) and perception becomes reality in the minds of communi
ty leaders.
2. Institutionalism.--The VA is a Federal bureaucracy. Consequently,
its system is foreign to outsiders. This is a significant bar to
inclusion in community outreach and synchronization of services with
community-based organizations. I can illustrate this in several ways:
a.
The Minneapolis VA has a world-class polytrauma unit providing
the finest medical care to our most severely injured warriors. It has
deservedly received positive media coverage and accolades. However, on
numerous occasions, when community organizations have wanted to donate
goods, gifts and goodwill to the families/wounded warriors they have
met with hurdles too high to overcome. At the core of the problem is
HIPA. The VA's understandable need to protect truly vulnerable wounded
warriors' results in them being shut off from the support of the
community. I have personally witnessed this on at least a dozen
occasions. From inability to donate professional sports team tickets to
wounded soldiers to the recent inability of Best Buy Corporation to
personally deliver care packages to wounded warriors the community is
shut off from working closely with this world class program.
b.
The VA is not staffed to conduct effective community outreach.
While mandated to provide training for civilian providers and clergy I
have personally attended ten VA outreach events, none of which was able
to garner more than a handful of community members. The VA does not
know how to effectively meet, greet and share with the community the
tremendous work they do and the wonderful services they offer.
c.
The VA appears to lack a means to share their vast experience
of working with veterans with their civilian counterparts in the fields
of medicine, behavioral mental health and faith-based institutions. An
example would be the growing body of knowledge surrounding traumatic
brain injury. Health care providers in the greater community need to
know what the VA knows about this wound, its symptoms, impact and
treatment. Symposiums, media messaging, training outreach events and
community forums would be ideal means for transmitting the VA
experience to the greater community. To date, I know of few of these
events. In a similar vein VA chaplains have much to share with their
colleagues in the civilian community.
d.
The VA lacks the means to connect returning wounded warriors,
that have received in patient care in their hospitals, with the greater
community. I have personally witnessed four severely injured OIF/OEF
veterans struggle tremendously in readjusting within the community,
post VA care. They were isolated and the VA social worker was unable,
due to large case load, to meet often enough with the veteran to help
them connect successfully to community.
PROPOSED SOLUTIONS
In Minnesota the simplest way to address the issues I have outlined
would be for the VA, in all of its configurations, to become an
official Beyond the Yellow Ribbon partner under Governor Dayton's model
of partnership.
-- Have the VA receive the community training all community leaders
receive and have the VA meet all the program requirements that other
partners in the community meet.
-- Have VA leadership join their civilian colleagues at Beyond the
Yellow Ribbon community leaders' events.
-- Have the VA partner with community and faith-based organizations for
more effective synchronization of support for veterans and military
families.
In the area of working with faith-based organizations the VA needs
to invite faith-based leaders onto their campuses and into their
facilities for orientation tours, seminars and collaborative sharing of
information about the needs of veterans and pastoral care of veterans.
Minnesota is blessed to be the home of four major theological
seminaries that train faith-based leaders. The VA would be well served
to introduce itself to the leadership of the seminaries and to find
ways to partner in the sharing of knowledge.
-- Have the VA officially partner with the Guard leadership in each
State. In Minnesota the Adjutant General, Major General Nash, has a
personal relationship with the VA Medical Center directors in
Minneapolis, MN; St. Cloud, MN and Fargo, ND. He has been in their
facilities and knows their capabilities. He has personally authorized
the Rings 1 and 2 studies of his soldiers. He monitors the results of
the study and insures its findings inform the best practices of the
Minnesota National Guard. He has invited the VA to the drill floors of
his units and relies on the VA for the first class service they can
provide. This type of senior leader partnership results in great access
to service, smoother facilitation of the claims process and greater
care of veterans. This could be replicated nationwide.
-- In times of fiscal austerity the Fischer Houses of the VA system
could easily synchronize their efforts with the Family Programs Office
of the Guard. This would result in the families of veterans residing at
the Fischer Houses receiving the good will of the communities that
flows through the Family Programs of the Guard. The Guard, as America's
local military force, most immediately receives the support of the
community. The Guard Family Programs has access to community resources
that the Fischer Houses need, but often have to find on their own, with
limited knowledge of the local community capabilities. Collaboration
saves money, helps families and enhances the effectiveness of the VA
and the Guard Family Programs.
Closing Remarks
In closing I would like to reiterate my support and admiration for
the men and women of the Veterans Administration. As a veteran I know
we are truly blessed by their service. I believe they have a vital role
in the reintegration of our veterans and welfare of the families of our
veterans. I believe the VA's effectiveness can be increased by its
inclusion in our greater community and enhanced collaboration with all
segments of the community that seek to support our military families
and combat veterans.
I appreciate the opportunity to be here today and invite your
questions and comments.
Prepared Statement of Shelley MacDermid Wadsworth, Ph.D.
Chairwoman Buerkle, Congressman Michaud, and distinguished Members
of the Committee, thank you for convening this hearing today and for
inviting me to share my thoughts about ``Building Bridges between VA
and Community Organizations to Support Veterans and Families.''
I am proud to be a faculty member at Purdue University, the land
grant institution for the State of Indiana. I am also proud to direct
the Military Family Research Institute and the Center for Families at
Purdue. Each of those organizations works to address all three missions
of the university: generating new research knowledge, helping students
to learn, and most important for this hearing, reaching beyond the
campus to collaborate with others to solve community challenges. I will
speak today based on my own experiences and those of my staff, however;
I am not speaking on behalf of the university.
The Military Family Research Institute (MFRI) was created at Purdue
in 2000 through funding awarded competitively by the Department of
Defense's Office of Military Community and Family Policy. Today we
continue to have significant funding from DoD and other Federal
sources, but are funded primarily by private philanthropy. I mention
this because it is this funding that has made it possible for us to
invest so heavily in community collaborations. Our mission is to `make
a difference for families who serve.'
We are located in West Lafayette, Indiana, which is in VISN 11,
along with parts of Michigan, Illinois, Indiana, and Ohio. I am pleased
to be able to report that MFRI is engaged in many collaborations with
organizations in the civilian, military, and veteran communities. We
carry out an average of more than one event or activity each week aimed
at helping to make our State a better place for military and veteran
families. Our recent collaborations involving VA partners include the
following:
a. With regard to homelessness, in November 2011, as part of our
university's participation in President Obama's Interfaith and
Community Service Campus Challenge, we organized the first Stand Down
for homeless and nearly homeless veterans in our community, and the
first organized by a university in our State. More than 100 community
organizations participated, including both campus and community faith-
based groups, and more than 100 student volunteers, including students
from Hospitality and Tourism Management who managed food service, and
students from the School of Nursing who provided an onsite health
clinic guided by several of their faculty including a military veteran.
A number of VA entities joined in this effort, including
representatives from the Illiana Suicide Prevention, Healthcare, and
Minority Programs offices. VA Roudebush Medical Center sent
representatives, as did VA benefits, and a VA Mobile Veteran Center. We
were very pleased at this initial effort and are seeking out
collaborators to make this a statewide effort with Stand Downs in
several communities leading up to Veterans Day 2012.
b. As researchers, we are collaborating with VA colleagues in
Minneapolis and Ann Arbor, working together to obtain funding and
gather data.
c. In the area of higher education, we work with colleges and
universities throughout our State to help them strengthen their
supports for student servicemembers and veterans. In that capacity, we
work closely with VA certifying officials, the Indiana Commission on
Higher Education, institutional leaders, the Servicemembers Opportunity
Colleges, and others.
d. In the area of vocational rehabilitation, we work with the
Career Learning and Employment Center, a pilot project set up in our
State as a collaboration established initially between community
groups, the Crane Naval Station and the NAVSEA command, VA vocational
rehabilitation officials, and several State offices. This project for
which we are the evaluation partner, helps servicemembers who must
leave their military careers because of life-altering wounds or
injuries, transition to education and employment in an environment of
full support and assistance for their families and themselves as they
relocate, enter or re-enter educational training, leave their military
careers, and begin new jobs as civilians.
e. In the area of behavioral health, we serve as a training partner
for the Indiana Veterans Behavioral Health Network. Funded by a grant
from the Health Resources and Services Administration, IVBHN is a
network of community-based behavioral health clinics working to extend
services to rural veterans using telehealth technologies. We also are
working together to create a designation for agencies to indicate to
military and veteran families that providers within the agency have
received significant training in working with that population, to
complement a training system and registry we have already created with
the Indiana National Guard to improve the behavioral health
infrastructure in our State. VA collaborators include the Department of
Mental Health Patient Care Services, the Psychiatry Ambulatory Care
Clinic, the Seamless Transition Clinic, and the Information Technology
Department at Roudebush VA Medical Center, as well as the VISN 11
Medical and Information Technology staff.
f. Finally, in the area of outreach, we work closely with the
Seamless Transition Team at the Roudebush VA Medical Center to
implement an annual statewide meeting focused on growing awareness,
motivation, and skills among helping professionals in a variety of
communities to support veterans and their families. In September 2011,
this meeting was attended by over 250 professionals from Indiana,
Illinois, and Kentucky. The Indiana National Guard director of family
programs reported that his staff described this as the best training
event they had attended in many years.
Based on these experiences, what are some lessons we've learned
about successful collaborations between community organizations and the
VA?
First, there are great opportunities for success, and I know that
there are success stories happening around the country. I have been
pleased by the enthusiasm we have experienced from many of our VA
partners.
Second, all of the successful partnerships we know involve partners
who have come to know and trust each other. Until partners know each
other well enough, it is difficult to trust. Without trust, it is very
hard to collaborate. It can take several years to exchange sufficient
knowledge and build sufficient trust to be willing to embark on a more
extensive collaboration. Without that ground work, it is much less
likely that the collaboration will be successful and sustainable.
Third, we have learned that mutual transparency, responsiveness,
and accountability are important for successful collaborations. Each of
these of course ties back to basic trust--perhaps `trust but verify' is
an apt phrase.
Fourth, we think successful collaborations do a good job of taking
advantage of each organization's unique strengths. MFRI contributes
something different to each of the collaborations I described earlier--
sometimes our research expertise, sometimes our skills as educators,
sometimes our convening power, and in each case our VA partners are
contributing expertise that complements ours.
Fifth, I believe that successful collaborations result when each
partner can enthusiastically pursue their self-interest while they work
together to achieve a shared goal. Collaborations that require one or
both partners to work against their self-interest will not last long.
Sixth, in the spaces in which we operate, cultural translators are
very important. Partners who can explain military or veteran
experiences and culture to civilians, or who can explain the
environment within which civilian community organizations operate to
members of military or veteran organizations, play key roles in helping
collaborative partners learn to see the world through one another's
eyes.
A final ingredient for success is leadership, but we believe that
it may be servant leadership that is the most important. At MFRI we
believe that leadership is as much about taking and distributing
minutes, arranging meetings, and sending out reminders as it is about
crafting vision and facilitating strategic planning. We are just as
happy to try to be the glue that holds initiatives together and the
lubricant that keeps them moving forward, and we are fortunate to have
found funders who share our belief.
Although the scientific literature about collaborations among
community organizations or with the VA is quite limited, the studies
that are available reinforce our observations. For example, one study
of collaborations between faith-based and health organizations found
that passion and commitment for their shared goals, mutual trust and
respect, and the convening power of faith-based organizations were seen
as key to their success (Kegler, Hall, & Kiser, 2010).
Policy-Related Challenges and Barriers
What about the challenges and barriers that make it difficult for
community collaborations with the VA to become established or
successful? Many of these are no doubt familiar to you.
The landscape both inside and outside the VA can be very crowded
and confusing. Prospective community partners, particularly those
located at a physical distance from the VA facility with which they
would like to collaborate, can find it very difficult to determine whom
in the institution to approach. As a test, I conducted a search for the
word `collaborate' on the main VA Web site, which yielded a single hit,
for the Center of Excellence on Implementing Evidence Based Practice.
From vantage points inside the VA it may be just as difficult, again
particularly in far-flung communities. The not-for-profit sector is
full of agencies with alphabet-soup names, sometimes with considerable
turnover, and idiosyncratic local variations. VA professionals are
understandably wary of showing favoritism to particular organizations,
getting involved with organizations that might prove unreliable, or
taking time away from other duties to establish and maintain community
partnerships. These challenges could be reduced by making sure that
there are clear points of entry and information for prospective
collaborators on key Web sites, and some regular mechanism for
prospective partners and VA leaders to learn about one another.
There are structural barriers to collaboration. For researchers,
these come in the form of requirements that projects involving the VA
be led by VA researchers. For all collaborators, a serious barrier is
the inability to share data. Sometimes this impediment makes it very
difficult to connect VA patients and their families with community
services; for researchers, it is very difficult to gain access to data
for analyses. In our work with higher education, we have found it very
difficult to get information about schools in our State, or even our
State as a whole, because only data aggregated across an entire region
are available. We have also found it very challenging to secure answers
to questions from at least one office, even though some of the
information we are seeking is not at all sensitive and could probably
be made publicly available on the Web. Community collaborators find it
very frustrating when they train up to increase their capacity to serve
military and veteran families, but then can never find any of those
families to serve nor be sure those families will learn about their
availability. This is especially frustrating when it is so clear that
there is far more work to do than the VA can handle alone. I'm not
certain how this problem can be solved, but I believe it is resulting
in a staggering waste of resources, with more work to do than the VA
can manage by itself, servicemembers and families who want help, and
community partners who want to be of use, all separated by gaps and
barriers that should be avoidable. We are working on a collaboration
with the Indiana National Guard that is aimed at addressing this
problem for military families, but the challenge for veterans is much
larger and even more complex.
Of course securing resources is always a challenge. Community
collaborators may not have excess capacity sitting unused on the shelf
that can easily be diverted to military or veteran families, and need
to know that if they incur expense to serve servicemembers and veterans
that they can recoup those costs. While DoD and VA have seen their
budgets grow significantly in recent years, many community-based not-
for-profits have seen their resources decline. VA professionals who
want to collaborate with community partners may have to do so `out of
their back pockets' and on top of their regular duties. Building the
bridges of collaboration that you seek will require resources, and
ideally those resources will be made readily apparent to community
partners so that proposals can be solicited, evaluated, and selected.
Ideally, resources will be structured to provide tangible incentives
and benefit to community and VA partners who collaborate effectively.
It has been our great honor to work to make a difference for
military and veteran families. We are inspired by the commitment and
dedication shown by military and veteran professionals in many sectors
who share that mission, and we are eager to continue collaborating to
make positive change. Thank you for all you do to try to make sure that
our Nation's veterans receive the care and support they have been
promised.
References
Abdul-Adil, J., Drozd, O., Irie, I., Rachel, R., Alexis, S., A,
F.D., et al. (2010). University-community mental health center
collaboration: Encouraging the dissemination of empirically based
treatment and practice. Community Mental Health Journal, 46, 417-422.
Garrow, E., Nakashima, J., & McGuire, J. (2011, March). Providing
human services in collaboration with government: Comparing faith-based
and secular organizations that serve homeless veterans. Review of
Religious Research, 52(3), 266-281.
Gray, B. (1989). Collaborating: Finding common ground for
multiparty problems. San Francisco: Jossey-Bass.
Guo, C., & Acar, M. (2005). Understanding collaboration among
nonprofit organizations: Combining resource dependency, institutional
and network perspectives. 34(3).
Kauffman, L. (2010, July). Veterans Rural Health Resource Center--
Western Region: Fostering innovations in mental health care for rural
veterans. NARHM Notes, 2(1). National Association for Rural Mental
Health.
Kegler, M.C., Hall, S.M., & Kiser, M. (2010, Aug. 9). Facilitators,
challenges and collaborative activities in faith and health
partnerships to address health disparities. Health Education and
Behavior, 37, 665.
Kudler, H., Batres, A.R., Flora, C.M., Washam, T.C., Goby, M.J., &
Lehmann, L.S. (2011). The continuum of care for new combat veterans and
their families: A public health approach. In Combat and Operational
Behavioral Health (Ch. 20). Borden Institute. http://
www.bordeninstitute.army.mil/published_volumes/combat_operational/ CBM-
ch20-final.pdf.
London, S. (1995). Collaboration and Community. Scott London.
MOAA-Zeiders Enterprises. (2011). Wounded warrior and family-
caregiver support: DoD-VA-Community collaborations. Roundtable
Discussion Summary.
Prepared Statement of M. David Rudd, Ph.D., ABPP
Good afternoon, Chairwoman Buerkle, Ranking Member Michaud, and
Members of the Subcommittee. I greatly appreciate the opportunity to
testify on behalf of the National Center for Veterans Studies at the
University of Utah and the countless American veterans that have served
and sacrificed. I want to thank Chairwoman Buerkle for providing much
needed leadership on an issue that will become increasingly important
given the end of combat operations in Iraq and the planned reduction of
forces in Afghanistan. The successful reintegration of many of our
troops into civilian life will require thoughtful and coordinated
efforts between the Department of Veterans Affairs (VA) and community
organizations, with communities of faith offering particular promise. I
am grateful for Chairwoman Buerkle's efforts to draw attention to the
problem of reintegration, particularly given that there is an
intellectual and emotional disconnect between those that have served
and the rest of society. Since the Gulf War, less than 1 percent of
Americans have served in the armed forces, a dramatic shift from World
War II (almost 9 percent), Korea, and Vietnam (both greater than 2
percent). The remarkably small number of Americans choosing to serve in
the Armed Forces compounds the potential for misunderstanding.
As a veteran of the Gulf War era and a clinical psychologist, I am
keenly aware of the issues faced by servicemembers both engaged in
combat and returning from war. Over the last decade, I have been
involved in the treatment of servicemembers experiencing emotional and
psychological problems secondary to combat and serving during wartime.
In particular, I have directed treatment research focusing on active
duty servicemembers that have made suicide attempts. Although my
research is only partially complete, what has become clear is that many
servicemembers (and families) need assistance in order to make a
successful transition from military life. My work has been focused on
that portion of the veteran population that has struggled and
experienced emotional and psychological problems. It's important to
point out, though, that this is only a portion of the population, with
many making a seamless transition to civilian life.
A recent survey of veterans by the Pew Research Center (2012)
revealed that 27 percent of veterans reported that readjustment to
civilian life was either ``somewhat difficult'' or ``very difficult.''
The survey also revealed significant ``burdens of service'' with 48
percent reporting ``strains in family relations,'' 47 percent
``frequently feeling irritable or angry,'' 44 percent reporting
``problems re-entering civilian life,'' and 37 percent reporting
``post-trauma symptoms.'' Despite the fact that many veterans
transition from military life with few problems, these data indicate
that many have difficulty making the shift.
The Pew data offer insight into the source of the problems as well,
with emotional and psychological adjustment at the forefront. Among
those having experienced combat, 50 percent or more report post-trauma
symptoms and difficult family relations. When queried about factors
reducing the probability for successful re-entry into civilian life,
veterans identified traumatic experiences and injury as the most
significant variables. Of importance for this hearing, veterans
identified ``attending church at least weekly'' as the most important
variable associated with an easy and successful re-entry into civilian
life. A remarkable 67 percent identified attending church ``once a week
or more'' as making re-entry easier. Clearly, the social connection and
support offered by religious institutions around the Nation are
essential for our veterans. The Pew study also reported that churches
were second only to the military itself as ``institutions'' in which
veterans have a ``great deal'' or ``quite a lot'' of confidence.
Clearly, communities of faith offer a unique and critical opportunity
to connect with veterans transitioning from military life. If aware and
appropriately trained, clergy can serve a critical role in assisting
veterans struggling with emotional and psychological symptoms.
Available data suggest communities of faith as a critical linchpin in
helping veterans transition to civilian life.
My own work has helped clarify the severity and magnitude of the
emotional and psychological issues faced by a particularly large subset
of the veteran population, student veterans. Nearly two million
veterans will return home from overseas deployments as part of
Operation Iraqi Freedom, Operation Enduring Freedom and Operation New
Dawn. A large number of them will make use of the Post-9/11 GI Bill and
transition quickly to college and university campuses. My recent study
of student veterans nationwide revealed that many student veterans
struggle with psychological symptoms, consistent with the data reported
in the Pew survey. More specifically, I found that almost 35 percent of
participants reported suffering ``severe anxiety,'' 24 percent
experienced ``severe depression'' and 46 percent reported ``significant
symptoms of post-traumatic stress disorder.'' Somewhat alarming, my
data indicate that 46 percent reported thoughts of suicide, with 20
percent having a plan. Further, 10.4 percent reported thinking about
suicide ``often or very often'' and almost 8 percent reported making an
attempt, almost six times the frequency of the general student
population.
From the limited data available to date, it would appear that
problems with psychological and emotional adjustment are perhaps the
single greatest barrier faced by returning veterans transitioning to
civilian life. Of particular importance for this Committee, two
community resources offer a unique opportunity to engage and connect
with veterans, communities of faith and college and university
campuses. Veterans hold religious institutions in high regard,
reporting that regular contact and participation help ``ease'' their
transition, offering critical support and assistance. Similarly,
college and university campuses are arguably second only to the VA
itself as institutions where the largest numbers of veterans gather.
The VA has already expanded efforts to actively collaborate with
college and universities around the country, including an increase in
positions allocated to the Vet Success on Campus program and the new VA
campus grant program funding projects meant to extend services to
student veterans and extend outreach on campus, with five projects
funded to date (Veterans Integration to Academic Leadership
Initiative--VITAL). I would also like to mention and applaud VA efforts
to explore additional partnerships with colleges and universities. I
recently participated in a meeting with the Assistant Secretary of the
VA for Policy and Planning, Dr. Henze, along with a collection of other
campus leaders to discuss possible collaborations to meet identified
veteran needs. The VA has been proactive on this front, an effort that
should be commended.
Let me emphasize my support for efforts on both fronts; that is,
working directly with communities of faith around the Nation, along
with college and university campuses. There is empirical evidence
indicating a significant need, along with data to suggest these two
domains offer unique opportunities and promise to help ease the
transition to civilian life. Training is needed in order for
communities of faith to effectively respond to the demand. Many clergy
members are already aware, sensitive to, and equipped to respond to the
psychological and emotional needs of veterans. Large numbers, however,
are not. Given the serious nature of the problems identified (e.g.
suicidality) thoughtful and thorough training is needed. The National
Center for Veterans Studies would welcome the opportunity to assist in
any such effort.
As with communities of faith, many colleges and universities around
the country are unprepared to meet the psychological and emotional
needs of student veterans. Although some entities offer training for
college counseling centers, such as the Department of Defense Center
for Deployment Psychology, resources are limited. Greater resources are
needed to meet the growing demand. In response to this need, The
National Center for Veterans Studies will be launching an effort to
form a national higher education consortium targeting student veterans.
We would welcome the chance to partner with any similar efforts around
the country, including any launched by this Subcommittee.
Thank you again for the opportunity to address the Subcommittee.
These issues are critical and the needs of many of our veterans
transitioning to civilian life are profound. The National Center for
Veterans Studies is poised to help. I am happy to respond to any and
all questions.
References:
Pew Research Center, The Military-Civilian Gap: War and Sacrifice
in the Post-9/11 Era, January 13, 2012.
Rudd, M.D., Goulding, J., & Bryan, C.J. (2011). Student veterans: A
national survey exploring psychological symptoms and suicide risk.
Professional Psychology: Research & Practice, 42(5), 354-360.
Prepared Statement of George Ake III, Ph.D.
Good afternoon, Chairwoman Buerkle, Ranking Member Michaud, and
Members of the Subcommittee. I wish to thank you for the opportunity to
testify on behalf of the 154,000 members and affiliates of the American
Psychological Association (APA) regarding collaboration between the
Department of Veterans Affairs (VA) and community organizations to
support veterans and their families. As a child psychologist at Duke
University Medical Center and with the National Child Traumatic Stress
Network, my work focuses on assisting children and families who have
experienced stressful and traumatic life events, including military
deployment and its aftermath. I am honored to speak with you today
about the collaborative work that I and my colleagues are engaged in
with a variety of partners around the country in support of our
Nation's military and veteran families.
Collaboration among all sectors of society is needed to support the
health and well-being of veterans and their families. This includes key
partnerships with policymakers, government agencies, universities, the
health care community, and the faith-based community. Scientific
evidence continues to identify psychological and neurological
disorders, including post-traumatic stress disorder (PTSD), depression,
suicidal ideation, and traumatic brain injury (TBI), as some of the
signature wounds of the conflicts in Iraq and Afghanistan. While
psychologists and other health professionals play an essential role in
helping veterans and families to address these challenges, partnerships
and collaborations with others sectors of society are also critical.
Despite a proliferation of programs for Active Duty, National
Guard, Reserve Component, and veterans and their families, many
families rely upon the support and counsel of faith-based providers as
a first point of contact. In some communities, particularly small towns
and rural areas, faith-based services are more prevalent and accessible
than health care services. In theatre, on base or post, at the VA, and
in local communities, veterans and their families not only approach
faith-based providers on spiritual, religious, and moral issues, but
also issues of reintegration, spousal relationships, and parenting.
Chaplains and other faith-based providers can play a key role in
addressing concerns about stigma related to mental and behavioral
health services and supports as well as providing linkages and
referrals to appropriate community and professional resources.
I would like to express my deep appreciation to you, Chairwoman
Buerkle, for your leadership in advancing collaboration between the
mental health and faith-based communities with regard to military and
veteran families. The unique military and veterans mental health
workshop that you hosted for faith-based providers in your district in
December served as a wonderful example of the collaboration and
partnership that is possible across sectors. I was honored to join the
distinguished panel of experts that you assembled, including Dr. David
Rudd of the University of Utah's National Center for Veterans Studies,
Drs. Judy Hayman and Caitlin Thompson from the VA, Jason Hansman of the
Iraq and Afghanistan Veterans of America, and Retired Air National
Guard Chaplain Tim Bejian. Such events help to break down barriers and
foster partnerships that benefit veterans and their families.
Replicating this training in other congressional districts could serve
as a valuable resource.
The importance of collaboration between military and community
systems, and among health professionals and faith-based providers, is
especially important as we consider data from the 2010 Department of
Defense (DoD) Profile of the Military Community, which estimates that
44 percent of the 1.4 million Active Duty and National Guard/Reserve
personnel, who have deployed to combat missions as part of Operation
Iraqi Freedom (OIF), Operation Enduring Freedom (OEF), and/or Operation
New Dawn (OND), are parents. This same report noted that there are
almost 2 million children in the U.S. who have parents in Active Duty
or Reserve services. Many of these children and families have seen
their military parents and spouses serve multiple combat deployments to
Iraq and Afghanistan. A number contend with a parent who returns
changed due to the wounds of war. Some of these families suffer
financial hardship, homelessness, marital discord, violence, and other
difficulties during their reintegration into civilian life. Still other
families experience the grief and loss associated with their loved
one's fatal combat injury, or even suicide. Taken together, these
findings highlight the necessity of considering the context and
challenges for children and families of veterans returning from combat,
as well as the role of the family in facilitating a successful
transition to stateside service or civilian life.
To support the veteran and strengthen the family, veteran families
need easy connection to collaborative programs and supports through VA
medical centers, vet centers, community mental health and faith-based
services, and professionals from a variety of disciplines, such as
psychologists, pediatricians, clergy, educators, and case managers who
are familiar with the military/veteran culture.
As a member of the National Child Traumatic Stress Network (NCTSN),
I would like to highlight some of our efforts to support such
collaboration. The NCTSN is an initiative launched by Congress in 2000
with the goal of developing a national collaborative network to improve
best practices and standards of care for children and families affected
by traumatic stress. Since 2001, the NCTSN, which is administered by
the Substance Abuse and Mental Health Services Administration, has
delivered direct services to children and families who have experienced
all forms of traumatic stress, including our Nation's military
families. Between 2002 and 2009, NCTSN members reported serving over
320,000 children through direct clinical services, with many more
reached through outreach efforts, community educational programs, and
provider training and consultation. Our work is done in partnership
with all child-serving systems, including military service branches,
faith-based organizations, child welfare, and community mental health
agencies.
In 2008, the National Center for Child Traumatic Stress (NCCTS),
the NCTSN coordinating center co-located at Duke University and the
University of California Los Angeles (UCLA), embarked on a partnership
with the Center for the Study of Traumatic Stress of the Uniformed
Services University of the Health Sciences, to expand and enhance the
level of support provided to military children and their families.
Other major government partners include the VA, the DoD, and the
National Guard. Civilian partners include the American Psychological
Association, the National Association of Social Workers, and other
community health care providers.
Of the more than 100 NCTSN funded and affiliate member sites in 40
States, more than 60 percent serve military children and families. The
NCTSN Military Families Program brings together high-level experts from
multiple disciplines (i.e., mental health, military, and public health)
to address the challenges facing military children, their families, and
the providers who serve them. The NCTSN has modified interventions to
meet the unique needs of military families, has conducted outreach to
them in a variety of settings, and has produced educational and
informational materials designed especially for their needs. Using Web-
based, interactive media (e.g., podcasts, speakers series, and
teleconferencing), the NCTSN Military Families Program offers more than
a dozen educational presentations developed by key experts on
psychological trauma and military issues. The NCTSN has developed a
useful curriculum for civilian providers, called Essentials for Those
Who Care for Military Children and Families, which addresses subjects
such as military culture, the impact of combat on families, the needs
of children, programs and services for veterans and National Guard and
Reserve members and their families, behavioral health services,
frameworks for interventions, and family violence. Further, we created
a Web-based Master Speaker Series cosponsored by the NCTSN and Zero to
Three, which provides an opportunity for leading authorities from the
VA, DoD, and university settings to discuss military culture, mental
health issues, resilience, and wellness. In fact, tomorrow, the topic
of our monthly webinar will be Expanding Services to Veteran Families
and includes panelists from the VA and Zero to Three. These resources
are available on the NCTSN Web site.
In addition to providing evidence-based, trauma-informed treatment,
the 27 sites of the NCTSN Military Families Program are actively
engaged in research, community outreach, and partnerships with State
and local agencies that serve Active Duty military, Guard, Reserve, and
veterans. My colleagues at Duke University are implementing a Welcome
Back Veterans program, which is an initiative of the McCormick
Foundation, Major League Baseball, and the Entertainment Industry
Foundation. This national program is intended to develop models for
training community clinicians to offer accessible and effective mental
health services to military and veteran families in local communities.
Other colleagues with the Duke Evidence Based Implementation Center
have been leading quality improvement collaboratives with VA teams. One
of these collaboratives is based at the Durham VA Medical Center with
teams focused on improving coordination between mental health services
and veteran-centered care to improve access to services. The other
collaborative based out of VISN 6 with Community-Based Outpatient
Clinic teams focuses on increasing patient access to services and
enhancing workflow efficiencies.
Our NCTSN partners at UCLA developed and disseminated a program
called Families OverComing Under Stress (FOCUS). The FOCUS program is
designed to enhance the inherent resiliency of military families. The
program has addressed family adjustment to parental deployment at more
than 20 U.S. military installations, including Camp Lejeune, for which
I provided consultation to their resiliency trainers on the
implementation of FOCUS. The NCTSN has also collaborated with the VA's
National Center for PTSD to train military and civilian providers on
acute stress interventions such as Combat Operational Stress First Aid
that address principles of safety, connectedness, hope, calming, and
self-efficacy. Our NCTSN and VA colleagues have provided training
specifically to military chaplains as the training has embedded
components relevant to the work of clergy working with servicemembers
and veterans.
Further, other NCTSN colleagues at Allegheny General Hospital in
Pennsylvania have partnered with the Tragedy Assistance Program for
Survivors (TAPS), the National Military Family Association, Zero to
Three, the Center for the Study of Traumatic Stress, and the Center for
Health and Health Care in Schools to educate professionals about the
most appropriate resources for aiding families coping with the death of
a loved one in the military. Resources from this program have been
widely disseminated and are available on the NCTSN Web site for faith-
based organizations to use or adapt when working with military and
veteran families in the aftermath of loss.
The NCTSN also has a strong program in support of military families
through the Ambit Network at the University of Minnesota, which has
developed the ADAPT (After Deployment, Adaptive Parenting Tools)
program. This groundbreaking initiative specifically meets the needs of
Reserve Component servicemembers and their families. The 14-week, Web-
enhanced group parenting program addresses key challenges faced by
deployed parents and their partners, including dealing with the
transitions of deployment, responding to emotional challenges of
deployment and reintegration, and enjoying children during stressful
times. The program is now being tested in a National Institutes of
Health-funded randomized controlled trial of 400 families with children
ages 4-12.
Finally, Catholic Charities of Hawaii, an NCTSN Community Treatment
Services Center, has reached out to military partners at Tripler Army
Medical Center and Schofield Barracks to provide training on evidence-
based treatments for children experiencing traumatic stress.
In conclusion, we have seen that collaborative efforts between
partners such as chaplains and faith-based providers, mental health
professionals, physicians, educators, and the military and veterans
community have resulted in a growing evidence base and increasingly
high quality services for our military and veteran families. The
American Psychological Association, Duke University Medical Center, and
the National Child Traumatic Stress Network all stand ready to continue
our collaborative efforts with this Subcommittee, the VA and DoD, our
community-based partners, and the military and veterans community to
address these important issues.
Thank you for the opportunity to speak with you today and for your
leadership and commitment to our Nation's veterans and their families.
Prepared Statement of Reverend E. Terri LaVelle
Chairwoman Buerkle, Ranking Member Michaud, and Members of the
Subcommittee, thank you for the opportunity to speak about the
Department of Veterans Affairs (VA) Center for Faith-based and
Neighborhood Partnerships' (CFBNP) outreach efforts to and with faith-
based and community organizations. As Director of VA's CFBNP since
September 14, 2009, I have had the opportunity to engage first-hand
with faith-based, non-profit and community leaders and organizations.
My testimony today will provide background information on the VA
CFBNP, the collaborative outreach work the Center has engaged in
beginning in 2005 with faith-based, non-profit and community leaders
and organizations, internal VA partners, and the White House Office of
Faith-based and Neighborhood Partnerships.
Background
VA's Center for Faith-based and Community Initiatives was
established on June 1, 2004, by Executive Order 13342. The objective
was to coordinate agency efforts for the elimination of regulatory,
contracting, and other programmatic obstacles to enable faith-based and
community organizations to access resources they need to provide social
and community services.
In February 2009, President Obama amended Executive Order 13199 to
establish the White House Office of Faith-based and Neighborhood
Partnerships (OFBNP). The name change reflects the emphasis and
importance of developing and cultivating partnerships, through
intentional outreach, with those in the community that already provide
services and meet the needs of so many of our citizens.
The VA CFBNP is one of thirteen Faith-based and Neighborhood
Partnerships Centers in the Federal Government.
Mission
The mission of VA's CFBNP is to develop partnerships with and
provide relevant information to faith-based and secular organizations
and expand their participation in VA programs in order to better serve
the needs of veterans, their families, survivors and caregivers. VA's
CFBNP cultivates and develops relationships with faith-based and
secular organizations, working with them as collaborative partners to
serve our veterans, their families, survivors and caregivers. CFBNP
outreaches to external partners to expand their understanding of, and
participation in, VA programs.
Outreach Collaboration
Since 2005, nationwide, VA CFBNP has conducted pro-active outreach
events interacting with over 1,200 faith-based, nonprofit and community
leaders and organizations. The outreach events consisted of
roundtables, conferences, and workshops.
Since its inception in 2009, VA's CFBNP has proactively outreached
to faith-based, nonprofit and community leaders and organizations,
often collaborating and/or partnering with internal and external
stakeholders. The internal partners for outreach events include the
Veterans Benefits Administration (VBA) Vocational Rehabilitation and
Employment (VR&E) Service, VA Chaplain Service, VA Homeless Program
Office, National Cemetery Administration (NCA), Veterans Health
Administration (VHA) Operation Enduring Freedom (OEF) and Operation
Iraqi Freedom (OIF) Coordinators, and VA's Voluntary Service. The
Center's external partners include Good Will International; American
Red Cross; Habitat for Humanity; Salvation Army, USA; State Veterans
Organizations; and Catholic Charities in Chicago, IL.
Fiscal Year (FY) 2011 and 2012 Internal Outreach Collaborations
VA CFBNP and VBA VR&E Service have partnered with local VBA
Regional Offices to co-host Veterans Roundtables with the target
audience being faith-based, nonprofit and community leaders and
organizations. Local and regional VA staff serve as panelists and
roundtable discussion participants. These events provide members of the
local community an opportunity to meet and interact with VA staff and
to know their local contacts and resources for assisting veterans. The
Veterans Roundtables were held in Jackson, MS; Seattle, WA; Newark, NJ;
Waco, TX; Las Vegas, NV; Cleveland, OH and Louisville, KY. The attendee
total at the Veterans Roundtables was 450. These VA Regional
Roundtables have two primary goals:
To facilitate collaborative working relationships among
faith-based and secular organizations, VBA, NCA, and VHA so that
holistic service can be provided to veterans, their families, and
survivors in the community where the Roundtable is held.
To inform attendees of the number of veterans in their
community, what their current needs are, and potential funding
available to faith-based and secular organizations who can demonstrate
an ability to meet those needs in collaboration with the VA.
VA CFBNP is coordinating with VBA to co-host roundtables in FY 2012
at VBA VR&E Service and Regional Offices in Montgomery, AL; Lincoln,
NE; Albuquerque, NM; and Boston, MA.
FY 2011 and 2012 External Outreach Collaborations
The VA CFBNP helped plan and conduct workshops at two outreach
events with external partners. One was with the State of California
Department of Veterans Affairs and the California Statewide
Collaborative for Our Military and Families and held in San Jose. The
other was the ``Battlemind to Home II'' Symposium conducted with the
local VA medical center, the Department of Labor and the Military
Family Research Institute (MFRI) of Purdue University in Indianapolis,
IN. The number of persons who attended these workshops respectively was
120 and 95.
The VA CFBNP participated in five ``Connecting Communities for the
Common Good'' Conferences in collaboration with the White House OFBNP,
local officials from the host city, and the Faith-Based and
Neighborhood Partnership Centers from other Federal agencies. The
conferences were held in Philadelphia, PA; Detroit, MI; New Orleans,
LA; Chicago, IL; and Denver, CO.
In order to support local organizations as they tackle community
challenges, the regional events have three key goals:
To build and strengthen relationships between community
and faith-based groups, and with local, regional and Federal Government
partners;
To highlight relevant Federal and public/private
partnership opportunities, and to connect groups to these
opportunities; and
To open the door and tell the story of the Faith-based
and Neighborhood Partnerships.
At each ``Connecting Communities for the Common Good'' Conference,
VA CFBNP moderates a workshop and facilitates a roundtable discussion.
Each workshop and roundtable consists of local and regional VA staff as
panelists and roundtable participants. Having local and regional VA
staff present begins building relationships at the local level between
VA and the faith-based, nonprofit and community leaders and
organizations in attendance. The average attendance at each VA CFBNP
workshop and roundtable discussion was 50 people. The CFBNP reached
over 300 faith-based, nonprofit and community leaders and
organizations.
As the CFBNP Director, I have attended, presented, and conducted
training on VA programs and services at the following events. These
outreach events provide information about the needs of our veterans,
their families, survivors, and caregivers. Information is also
presented on the opportunities available to faith-based, nonprofit, and
community leaders and organizations to become collaborative partners
with VA to meet the needs of veterans, their families, survivors and
caregivers. Examples of my activities as CFBNP Director include:
Speaker at the MFRI's November 2011 conference
``Battlemind to Home II Symposium.'' The goal of the conference was to
reduce community reintegration barriers for returning servicemembers
and their families by increasing community knowledge and awareness of
challenges faced and the supports available from a collaborative
perspective.
Participant at the Working Together to Strengthen Guard
and Reserve Couples and Families Forum sponsored by the Annie E. Casey
Foundation and the National Healthy Marriage Resource Center. The Forum
was held in Charlotte, NC, August 15-16, 2011.
Presenter at the Church of God in Christ (COGIC) AIM
(Auxiliary in Ministries) Conference held in Houston, TX, August 6-9,
2011.
Speaker at the Veterans Roundtable sponsored by the CA
Collaborative for Military and Families of San Jose, CA, March 23-24,
2011. This is a collaborative of over 200 faith-based and community
organizations.
Keynote speaker at a Douglas Memorial United Methodist
Church's Pastor's Forum--Veteran Women Resource Center. The Pastor's
Forum was held in Washington, DC, March 26, 2011.
Panelist at Forging the Partnerships: DoD/USDA Family
Resilience Conference held in Chicago, IL, April 27-28, 2011. This was
a clergy panel with representatives from the National Guard, Air Force,
Army, Marines and Coast Guard.
The VA CFBNP will join the White House OFBNP ``Connecting
Communities for the Common Good'' Conference in several cities
beginning in March 2012. Center staff is serving on the ``Battlemind to
Home II'' Symposium 2012 planning team. The CFBNP joins with the local
VA medical center, the Department of Labor and the Military Family
Research Institute (MFRI) of Purdue University in Indianapolis, IN, to
convene and co-host the 2012 Symposium.
Conclusion
The VA CFBNP increases veterans participation in VA programs
through outreach to, and partnerships with, faith-based, and community
organizations. CFBNP collaborates with internal and external partners,
creates partnerships between government agencies and faith-based and
community organizations. CFBNP uses outreach events and internal and
external partnerships to provide VA's program information to faith-
based and community organizations which enables them to inform and
serve veterans, their families, survivors and caregivers.
The VA CFBNP is consistently reaching out to, engaging, and
educating faith-based, nonprofit and community leaders and
organizations on the role and work of the Center. The Center is open to
diverse ways for developing collaborative partnerships with faith-
based, nonprofit, and community leaders and organizations that will
best serve our veterans, their families, survivors and caregivers.
Madam Chairwoman, this concludes my prepared statement. I am
prepared to answer your questions at this time.
Prepared Statement of Chaplain Michael McCoy, Sr.
Chairwoman Buerkle, Ranking Member Michaud, and Members of the
Subcommittee, thank you for the opportunity to speak about the
Department of Veterans Affairs (VA) Chaplain Service's outreach efforts
with community- and faith-based organizations. As an Associate Director
of VA's National Chaplains Center and a past President of the Military
Chaplains Association of the United States of America, I have had the
opportunity to engage first-hand with community and faith-based
organizations.
My testimony today will provide an overview of three programs: The
VA National Chaplain Center's Veteran Community Outreach Initiative
(VCOI); the marriage enrichment retreats; and the ``Heal the Healer''
program. VA chaplains have created these initiatives to collaborate and
build bridges between VA, the faith-based communities, and neighborhood
leaders to aid in the spiritual care of our returning veterans and
their families.
VA National Chaplain Center's Veteran Community Outreach Initiative
(VCOI)
In 2007, the VA National Chaplain Center started the VCOI to
educate community clergy about the spiritual and emotional needs of our
returning veterans and their families. Nationwide, VA chaplains have
conducted over 200 training events and provided education to
approximately 10,000 clergy through this effort. As a result, clergy
across the Nation are learning to:
1. Identify readjustment challenges that veterans and their
families face following deployment;
2. Identify psychological and spiritual effects of war trauma on
survivors;
3. Consider appropriate pastoral care interventions for the
spiritual and theological issues that veterans and families often
encounter;
4. Brainstorm ideas for a community clergy partnership between VA
chaplains and local clergy; and
5. Refer veterans to local VA health care facilities by being a
trusted and knowledgeable resource for veterans to use to connect with
VA.
In 2011, VA's National Chaplain Center made available to the
Chaplain Services in VA's 152 medical centers clergy training
materials, program brochures, curriculum and slides, and DVDs on
spirituality. These materials were presented to local clergy for use as
resources to support returning veterans and provide information on
referring veterans and their family members to local VA medical
centers, community-based outpatient clinics, Vet Centers, and other
related resources.
Marriage Enrichment Program
Our marriage enrichment program began in February of 2009 and was
initiated by the Chaplain Service at the Charlie Norwood VA Medical
Center in Augusta, GA. This program was developed based on concerns
over the large number of stressed marriages experienced by our
returning veterans; these stresses often led to family crises and
divorce. For example, in June 2005 an article in the USA Today stated,
``The number of active-duty soldiers getting divorced has been rising
sharply with deployments to Afghanistan and Iraq. The trend is severest
among officers. Last year, 3,325 Army officers' marrages ended in
divorce--up 78 percent from 2003, the year of the Iraq invasion, and
more than 3\1/2\ times the number in 2000, before the Afghan operation,
Army figures show. For enlisted personnel, the 7,152 divorces last year
were 28 percent more than in 2003 and up 53 percent from 2000. During
that time, the number of soldiers has changed little.''
Centered on the theme, ``Getting It Back: Reclaiming Your
Relationship After Combat Deployment,'' the program is designed so that
married couples can develop healthy ways of interacting and relating
with one another. We have discovered that all too often, the spouse who
has gone to war and returned may have physical, emotional, or spiritual
wounds that have not yet healed. On the other hand, the spouse who was
not deployed also needs support, understanding, and relief from the
stress of trying to maintain some kind of normalcy at home. Family and
friends mean well as they try to offer support, but they often do not
understand what the couple is experiencing. This program use material
from the Practical Application of Intimate Relationship Skills (PAIRS)
Foundation to help couples address these issues. The program focuses on
topics such as constructive conflict resolution, emotional literacy,
and communication and intimacy in stressful situations. Facilitators
spend an average of 17 hours working with the couples over a 2.5 day
weekend. Two VA chaplains developed this ministry by using community
resources and collaborating with local organizations to sponsor these
programs. The community leaders and faith-based volunteers,
collaborating with VA chaplains, have contributed in making the
programs a success. More information, including some best practices for
the program, is available online at: www.va.gov/chaplain.
Heal the Healer
In August 2008, VA's National Chaplain Service introduced the
``Heal the Healer'' program for our returning National Guard and
Reserve chaplains. Some of these chaplains have served multiple
deployments. After realizing that several were experiencing trauma from
their experiences overseas, we developed a program designed to:
1. Help those returning from deployment in Operation Enduring
Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) as
military reserve chaplains be assured that the chaplain community at
home cares about them and their families;
2. Provide chaplains returning from deployment as military reserve
chaplains in OEF/OIF/OND with the opportunity to share openly their
experiences and emotions associated with their deployment;
3. Meet other chaplains with similar experiences from the theater
of operations;
4. Provide an educational awareness of combat operational stress
and how to deal with it;
5. Build a network for military reserve chaplains who were
deployed in support of OEF/OIF/OND and a support system upon which they
may call;
6. Provide a realistic review of lessons learned; and
7. Gain insight on how we may intervene in the future to provide
appropriate and timely care for our chaplains returning from combat
zones.
The stories and tears that are shared in these sessions reinforce
the importance of our ongoing role to support the chaplains who have
worn our Nation's uniform. These men and women have voluntarily placed
themselves in harm's way to provide the full range of ministry for our
warriors. In caring for our veterans, they too have changed. Some also
bear the wounds of war. Chaplains fill a vital role, and we must be
prepared to help those who assist others in the process of spiritual
healing. VA chaplains, in partnership with local clergy, our faith
group endorsers, and community faith group leaders, work together to
reach out and offer support to returning chaplains and their families.
Conclusion
In conclusion, these three programs develop community partnerships
and work with faith-based and community organizations to bring
attention to the needs of our veterans and their families. Today, we
understand better the evils and horrors of war that can afflict them.
We recognize that their service-related experiences can cause deep
wounds to the spirit, conscience, and soul. Chaplains, community
clergy, and communities of faith can make a great difference in helping
to heal our warriors and the families who love them.
Madam Chairwoman, this concludes my prepared statement. I am
prepared to answer your questions at this time.
Statement for the Record, Consortium for Citizens With Disabilities,
Veterans, and Military Families Task Force
Chairwoman Buerkle, Ranking Member Michaud, and other distinguished
Members of the Subcommittee, thank you for the opportunity to submit
testimony for the record on behalf of the Consortium for Citizens with
Disabilities (CCD) Veterans and Military Families Task Force regarding
efforts to establish meaningful relations between the Department of
Veterans Affairs (VA) and community organizations to assist disabled
veterans and their families.
CCD is a coalition of over 100 national consumer, service provider,
and professional organizations which advocates on behalf of people with
disabilities and chronic conditions and their families. The CCD
Veterans and Military Families Task Force works to bring the disability
and veterans communities together to address issues that affect
veterans with disabilities as people with disabilities. Task force
members include veterans service organizations and broad based
disability organizations, including organizations that represent
consumers and service providers.
Since its creation, the CCD Veterans and Military Families Task
Force has sought to connect veterans and military service organizations
with the disability community to allow for cross collaboration and the
application of lessons learned to new populations of people with
disabilities. Because of the intersection of the disability and
veterans communities that occurs when a veteran acquires a significant
disability, the task force is uniquely suited to bring a holistic
perspective to issues impacting disabled veterans.
Many CCD member organizations provide vital services to veterans
with disabilities that might not otherwise be readily accessible to
them. These programs complement the wide array of services and supports
available to our Nation's veterans through VA, but should be viewed as
supplementary. We believe that disabled veterans must have access to
needed health care services through the VA health care system,
including accessible physical and appropriate mental health services,
as well as long-term services and supports. Specifically, we recognize
the concerns expressed by the veterans' community in documents such as
The Independent Budget (IB) about proposals to contract out core
missions of the VA health care system.
At the same time, however, the IB acknowledges that veterans will
always receive health care services through multiple sources but
recommends that VA retain a role in coordinating that care. The CCD
Veterans and Military Families Task Force believes that public-private
partnerships allow VA to effectively augment services available to
veterans, particular those who live in rural and remote areas.
Increased development of these partnerships allows VA to go to the
veteran.
These partnerships also allow VA to ensure that disabled veterans
have access to the support models that are widely available in the
community, but with VA's oversight. For example, community-based
organizations have developed best practice models to facilitate the
long-term support needs of people with disabilities. Through
partnerships with community organizations, the VA can integrate new
services into the existing VA systems for populations that are
requiring new types of services, including veterans with significant
disabilities.
The Need for Community and Faith-Based Organizations
VA estimates that more than 1 million active-duty personnel will
join the ranks of America's 22 million veterans during the next 5
years.\1\ In many cases, these men and women will return home with
unique challenges that often go unmet despite the enormous effort and
reach of VA. This Subcommittee has focused on some of these challenges,
including recent hearings on the suicide rate among veterans and their
lack of access to mental health services. The U.S. Government
Accountability Office (GAO) reported \2\ that ``logistical challenges''
was one factor that may hinder veterans from accessing mental health
care. The report cited ``distances to obtain treatment'' as one of the
barriers, particularly for veterans who live in rural areas. Another
increasing concern is the homeless problem among women veterans. The
GAO reported in a December 2011 study \3\ that the number of homeless
women veterans has doubled in 4 years and found that women veterans
lacked awareness of VA programs, services, and benefits. A separate
2011 report \4\ echoed those findings and recommended that solutions to
address women veterans' transition challenges should be ``informed,
holistic, collaborative, and community-based.''
---------------------------------------------------------------------------
\1\ U.S. Department of Veterans Affairs Press Release, February 13,
2012 (http://www.va.gov/opa/pressrel/pressrelease.cfm?id=2263).
\2\ U.S. Government Accountability Office, VA Mental Health Report,
October, 2011 (http://www.gao.gov/new.items/d1212.pdf).
\3\ U.S. Government Accountability Office, Homeless Women Veterans
December 2011 Report, (http://www.gao.gov/assets/590/587334.pdf).
\4\ Joining Forces for Women Veterans Summary Report, Business and
Professional Women's Foundation, February 2011, (http://
www.bpwfoundation.org/documents/uploads/JFWV_Final_ Summit_Report.pdf).
---------------------------------------------------------------------------
The unmet needs of current veterans combined with the projected
rise in the veteran population make leveraging the existing social
services community to supplement the VA network more critical than
ever. We believe that no veterans or their families should suffer from
a lack of access to or understanding of how to navigate reintegration
services. Many community service providers have the expertise,
experience, and local capacity to more fully partner with VA through
its important veterans initiatives.
Since the issuance of an executive order in 2004,\5\ VA has made
working with the nongovernmental organizations (NGO), nonprofits, and
faith-based communities a priority. The objective of the VA's Center
for Faith Based and Neighborhood Partnerships is to coordinate agency
efforts for the elimination of regulatory, contracting, and other
programmatic obstacles that often prevent these organizations from
providing community-based veterans' services through VA funding and
contracts. In 2009, VA announced a new NGO Gateway Initiative \6\ to
``tap the power of communities'' and help NGOs extend services to
veterans. The VA reiterated its commitment to fostering and expanding
partnerships with Federal, State, and private sector agencies and
faith-based and community organizations in its fiscal year 2013 budget
request to Congress.\7\
---------------------------------------------------------------------------
\5\ Executive Order 13342 (http://www.gpo.gov/fdsys/pkg/WCPD-2004-
06-07/pdf/WCPD-2004-06-07-Pg980.pdf).
\6\ U.S. Department of Veterans Affairs Press Release, January 7,
2009 (http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1639).
\7\ U.S. Department of Veterans Affairs Congressional Budget
Justification (http://www.va.gov/budget/docs/summary/Fy2013_Volume_III-
Benefits_Burial_Dept_Admin.pdf).
---------------------------------------------------------------------------
Examples of Successful VA and Community-Based Organization Partnerships
Members of the CCD Veterans and Military Families Task Force have
successfully partnered with VA in certain areas to meet the needs of
disabled veterans and their families. Below are three examples that
illustrate the positive impact that VA partnerships with community-
based organizations can have on addressing the issues facing today's
veterans and their families.
Center for Independent Living Care Coordination
An example of a successful care coordination model between VA and a
community-based organization involves the Veteran Directed Home and
Community-Based Services (VDHCBS) program offered through the Sioux
Falls VA Medical Center (VAMC). Launched in August 2010, the VAMC
contracted with the local Minnesota River Area Agency on Aging (MnRAAA)
to provide case management, fiscal management services, and assessment
services for veterans seeking to obtain long-term services and supports
in the community.
Because of previous outreach efforts by the South WestCenter for
Independent Living (SWCIL) to the VAMC, National Guard Family
Assistance Center and other veterans' groups, the MnRAAA program
managers were familiar with SWCIL and its services to people with
disabilities in rural Minnesota. The Agency on Aging subcontracted with
the Center for Independent Living to conduct the actual assessments of
veterans and provide certain case management services because of the
CIL's expertise in this arena under its mandate to offer similar
assistance through the Rehabilitation Act.
A licensed social worker with SWCIL serves as the liaison with
nursing staff at the VAMC when a veteran is referred through MnRAAA for
evaluation for VDHCBS. The SWCIL sends the veteran a packet of
materials describing the consumer-directed program and schedules a
follow up visit with the veteran if he/she is interested in VDHCBS. A
VA nurse determines what services the veteran needs that are available
through VA and works with the SWCIL social worker to identify
additional services that must be engaged to fully implement a home and
community-based care plan. For example, SWCIL has used several other
community options to obtain services or needed home modifications for
veterans. The Center for Independent Living receives a one-time fee for
each assessment and bills for case management under its subcontract
with MnRAAA. As a result of this project, approximately 18 veterans
have been successfully enrolled in VDHCBS.
AbilityOne Serves Employment Needs of Veterans
The AbilityOne program is a Federal initiative to help people who
are blind or have significant disabilities, including wounded veterans,
find employment by working for nonprofit agencies (NPAs) that provide
products and/or services to the U.S. Government. With a national
network of 600 NPAs, which work through NISH and the National
Industries for the Blind, and AbilityOne projects in every State of
the Nation, the AbilityOne program is the largest single source of
employment for people who are blind or have other significant
disabilities in the United States. The U.S. AbilityOne Commission is
the Federal agency authorized to administer the AbilityOne program.
The AbilityOne program employs over 50,000 people who are blind or
have significant disabilities, of which 3,300 are veterans and 1,700
were veterans with disabilities. Through National Industries for the
Blind and NISH, the AbilityOne program's NPAs also support and employ
thousands of veterans within their community outside their AbilityOne
workforce. The AbilityOne program can offer increased community career
transition support, exploration, and direct training for veterans in
transition to management opportunities.
In 2003, VA's Compensated Work Therapy program (CWT) signed an MOU
with the AbilityOne program as the referral conduit between VA CWT and
the AbilityOne NPAs to collaborate with VA beneficiaries who have a
disability. Approximately 2,100 veterans with disabilities have been
employed since the partnership's inception. The partnership agreement
promotes local relationships between NPAs and VA CWT offices. This
allows VA to pre-screen veterans to match AbilityOne job requirements
and to refer qualified veterans with significant disabilities to
participate in AbilityOne job coaching programs.
Easter Seals Serves Veterans and Their Families
Easter Seals has a long-standing record of service to veterans,
military servicemembers, and their families. Easter Seals expanded its
mission at the end of World War II to include adult services
specifically to address the growing number of soldiers returning home
with disabilities. Recognizing the new and unmet needs of the hundreds
of thousands of men and women returning from the wars in Iraq and
Afghanistan, Easter Seals launched its Military and Veterans Initiative
in 2005 to address serious gaps in service for veterans and military
families by mobilizing its national community-based provider network.
Today, Easter Seals touches the lives of America's heroes and their
families through its more than 70 affiliates across 48 States and its
network of 24,000 professional staff and 40,000 local volunteers.
Since the passage of the Veterans Millennium Healthcare Act in
1999, Easter Seals has worked closely with VA at the national, regional
and local level to both raise awareness about access to adult day
services for veterans and to contract locally to provide the direct
service. In 2010, Congress approved the Caregivers and Veterans Omnibus
Health Services Act that authorized a range of new services to support
caregivers of eligible post-9/11 veterans, including the establishment
of the National Veteran Caregiver Training program. In April of 2011,
VA contracted with Easter Seals for its caregiving expertise in working
with individuals with serious disabilities to develop and provide the
training. Easter Seals operates the VA caregiver contract with Atlas
Research, a veteran-owned small business, and three of the country's
leading caregiving organizations: the National Alliance on Caregiving,
the National Family Caregiver Association, and the Family Caregiver
Alliance. Easter Seals and its partners offer in-person, Web-based and
self-study caregiver training through the contract to family members of
seriously injured, post-9/11 veterans who receive their care at home
and are eligible under VA program guidelines. The training includes
topics on caregiver self-care, home safety, caregiver skills, veteran
personal care, managing difficult behaviors and support resources.
Easter Seals' experience with VA has been very positive throughout
the implementation of the caregiver contract. Under the contract
management and direction of VA, Easter Seals and its partners have met
the targets and exceeded expectations. Feedback has been overwhelmingly
positive, including from a mother of a seriously injured veteran who
wrote: ``Thank you for re-inspiring us and for all you continue to do
to be a part of healing American heroes.''
Recommendations for Expanding Partnership Success
The CCD Veterans and Military Families Task Force believes that
these examples of successful partnerships between VA and community-
based organizations clearly support our position for increased
collaboration. Specifically, we believe that there are opportunities to
foster additional collaboration to meet the needs of disabled veterans
living in their communities. Consequently, VA should expand community-
based, supportive services models (similar to the Supportive Services
for Veteran Families program) that leverage the existing social service
network to help assist VA in achieving its goals.
As an example, veterans with disabilities often need assistance
obtaining appropriate community-based services to allow them to live
and work independently in the community. Navigating the many different
services for people with disabilities and veterans, such as health
benefits, transportation, and vocational rehabilitation services, can
be complex. Organizations like the Protection and Advocacy agencies
located in every State and territory have expertise and experience
navigating these programs and often advocate for veterans with
disabilities to receive appropriate services from community-based and
faith-based organizations.
For instance, the New York Commission on Quality of Care and
Advocacy for People with Disabilities has been working with the New
York State Department of Health to create an advisory board of veterans
to address the need of veterans to receive community-based health care
services, and to help monitor the services that veterans receive.
Disability Rights California holds weekly training and information
sessions for veterans in the San Diego area to provide them information
and assistance obtaining community-based services. Protection and
Advocacy agencies are eager to work with VA to ensure veterans with
disabilities receive the services and supports necessary to live and
work in the community.
The National Disability Rights Network (NDRN), a CCD member
organization, is available to assist with coordinating collaboration
efforts between VA and the Protection and Advocacy Network. The CCD
Veterans and Military Families Task Force encourages VA to work with
the Protection and Advocacy agencies, NDRN, and other organizations to
provide these unique advocacy services to veterans with disabilities.
We commend VA's NGO Gateway Initiative aimed at helping qualified
nonprofits who are interested in assisting VA in a variety of service
areas and VA's establishment of a dedicated liaison in the Office of
the Secretary to support VA/NGO information sharing and collaboration.
However, VA should elevate the profile of this initiative and include
readily available guidance on the VA Web site regarding how interested
organizations would receive assistance through this initiative. We
believe that organizations interested in partnering with VA, must be
able to easily relay their interest and abilities to VA.
The ability to augment VA services by linking VA with established
community and faith-based organizations represents an opportunity to
greatly increase access to a variety of services needed for veterans
with disabilities and their families in transitioning to and remaining
active members of their communities. The need to expand access to
services, particularly for veterans in rural and remote areas, shows
the need to increase collaboration to meet the concerns of today's
veterans with disabilities. Qualified community and faith-based
organizations represent a clear pathway to augmenting VA services for
our Nation's veterans.
Thank you for the opportunity to submit testimony regarding the
views of the CCD Veterans and Military Families Task Force concerning
collaboration between VA and community-based organizations. We
encourage the Subcommittee to continue its exploration of this topic
and commend your leadership on behalf of our Nation's veterans with
disabilities. We are ready to work in partnership to ensure that all
veterans are able to reintegrate in to their communities and remain
valued, contributing members of society.
Information Required by Clause 2(g) of Rule XI of the House of
Representatives
Heather Ansley, Esq., MSW
Vice President of Veterans Policy
VetsFirst, a program of United Spinal Association
1660 L St., NW, Suite 504
Washington, DC 20036
(202) 556-2076 Ext. 7702
[email protected]
Susan Prokop
Associate Advocacy Director
Paralyzed Veterans of America
801 18th St., NW
Washington, DC 20006
(202) 416-7707
[email protected]
Leonard Selfon, J.D., CAE
Associate General Counsel
Paralyzed Veterans of America
801 18th St., NW
Washington, DC 20006
(202) 416-7629
[email protected]
Receipt of Federal grants or contracts:
The Consortium for Citizens with Disabilities Veterans and Military
Families Task Force has not received any Federal grants or contracts
during the current or two preceding fiscal years.
MATERIAL SUBMITTED FOR THE RECORD
Post-Hearing Questions and Responses for the Record:
Questions from Hon. Michael H. Michaud, Ranking Democratic Member,
Subcommittee on Health, Committee on Veterans' Affairs
to Honorable Eric K. Shinseki, Secretary,
U.S. Department of Veterans Affairs
February 29, 2012
Honorable Eric K. Shinseki
Secretary
U.S. Department of Veterans Affairs
810 Vermont Avenue, NW
Washington, DC 20420
Dear Secretary Shinseki:
In reference to our Subcommittee on Health hearing entitled,
``Building Bridges Between VA and Community Organizations to Support
Veterans and Families,'' that took place on February 27, 2012, I would
appreciate it if you could answer the enclosed hearing questions by the
close of business on Wednesday, April 11, 2012.
In an effort to reduce printing costs, the Committee on Veterans'
Affairs, in cooperation with the Joint Committee on Printing, is
implementing some formatting changes for materials for all full
Committee and Subcommittee hearings. Therefore, it would be appreciated
if you could provide your answers consecutively and single-spaced. In
addition, please restate the question in its entirety before the
answer.
Due to the delay in receiving mail, please provide your response to
Jian Zapata at [email protected], and fax your responses to
Jian at 202-225-2034. If you have any questions, please call 202-225-
9756.
Sincerely,
Michael H. Michaud
Ranking Democratic Member
Subcommittee on Health
CW/jz
______
Questions for the Record from the
House Committee on Veterans' Affairs Subcommittee on Health
February 27, 2012
Hearing on Building Bridges Between VA and Community Organizations to
Support Veterans and Families
Question for Rev. E. Terri LaVelle, Director, VA Center for Faith-based
and Neighborhood Partnerships
1. What is being done to specifically address the support needs of
servicemembers and veterans that reside in rural or underserved areas?
Questions for Chaplain Michael McCoy, Associate Director, National
Chaplain Center
1. Within the 200 training events that the National Chaplain Center
has conducted, how many clinics have been included in this outreach?
2. How is the National Chaplain Center measuring success in terms of
outreach and training?
Responses from Hon. Eric K. Shinseki, Secretary,
U.S. Department of Veterans Affairs
to Honorable Michael H. Michaud, Ranking Democratic Member,
Subcommittee on Health, Committee on Veterans' Affairs
February 27, 2012
Hearing on Building Bridges Between VA and Community Organizations to
Support Veterans and Families
Question for Rev. E. Terri LaVelle, Director, VA Center for Faith-based
and Neighborhood Partnerships (CFBNP)
Question 1: What is being done to specifically address the support
needs of servicemembers and veterans that reside in rural or
underserved areas?
Response:
The VA CFBNP hosts quarterly conference calls for members of the
Center's listserv. The quarterly conference call provides listserv
members with updates on the work of VA's CFBNP especially focusing on
sharing the Center's collaborative efforts with internal and external
stakeholders working with or on behalf of veterans. The call also
provides updates on VA programs and services that will assist listserv
members in serving the needs of veterans, their families, survivors,
and caregivers.
Some members of the listserv represent and or work with
organizations that provide services to veterans in rural communities.
Realizing the need to provide additional information to those
serving veterans in rural communities, the Center's final call for FY
2011 provided information on a collaborative community program for
veterans and clergy living and working in rural communities.
For the September 15, 2011 quarterly conference call, the speaker
was Rev. Steve Sullivan, Chaplain Arkansas VA Medical Center and
Director of the VA/Clergy Partnership for Rural Veterans. Chaplain
Sullivan shared information about Project South (Serving Our Units at
Home). Chaplain Sullivan shared how Project South came into existence,
how to effectively engage and work with local clergy and ways to reach
the veterans and their families.
Project SOUTH is an inter-denominational cooperative effort between
local churches, the National Guard and U.S. Army Reserve local units,
and the Arkansas Veterans Affairs to provide basic support and care for
local soldiers and National Guardsmen who are preparing to be or are
already deployed, and to their families. Project SOUTH works with faith
leaders in El Dorado, Arkansas and other surrounding rural communities.
The VA CFBNP co-hosts four regional Veterans Roundtables annually
with Veterans Benefits Administration (VBA) Vocational Rehabilitation
and Employment (VR&E) Service and the VR&E Regional Office (RO) of the
host city.
In previous Veterans Roundtables, it became apparent that
information and training programs must be taken to where the needs are;
one place is to our rural communities. Rural communities often lack
adequate transportation and other resources to get meaningful numbers
of participants to such event.
One of the VA Veterans Roundtables for FY 2012 will be held in a
rural community.
The VA Veterans Roundtable has two primary goals; the first is to
facilitate collaborative working relationships among faith-based and
secular organizations working in the host city and with Veterans
Benefits Administration, National Cemetery Administration, and Veterans
Health Administration so that holistic services can be provided to
veterans, their families, survivors, and caregivers.
The second goal is to inform attendees of the number of veterans in
their community, what their current needs are, and potential funding
available to faith-based and secular organizations who can demonstrate
an ability to meet those needs in collaboration with the VA.
To strengthen and expand the CFBNP support to rural veterans, the
Director of the CFBNP met with the Director of Veterans Health
Administration's (VHA) Office of Rural Health on March 22, 2012. They
discussed VHA rural health needs and how VA's CFBNP an assist veterans
by working with faith-based and community leaders in rural communities.
The next step is for VA's CFBNP to work in collaboration with VA's
Community-Based Outpatient Clinics (CBOCs). Together, these
``networks'' can directly inform and assist rural veterans to secure
services they may need.
Questions for Chaplain Michael McCoy, Associate Director, National
Chaplain Center
Question 1: Within the 200 training events that the National Chaplain
Center has conducted, how many clinics have been included in this
outreach?
Response:
The majority of the 233 Veterans Community Outreach Initiative
(VCOI) programs have been hosted at or near VA medical centers.
Outpatient clinical program personnel are invited to participate in the
day-long clergy training events. The Rural Clergy Training program,
cosponsored by the VA National Chaplain Center and the VA Office of
Rural Health, is an initiative to create Best Practices in training
rural clergy in very rural settings. The eight Rural Clergy Training
events planned for 2012 (listed below), will be held near VA CBOCs. We
anticipate that VA clinic personnel, as well as VA Mobile Vet Center
staff personnel will participate.
Elizabeth City, NC--March 6, 2012
Danville, VA--March 8, 2012
Staunton, Virginia;
Beckley, West Virginia;
Carrolton, Kentucky;
Richmond, Kentucky;
Rogersville, Tennessee; and
Cookeville, Tennessee.
The five objectives of these Rural Clergy Training events are for
VA Chaplains to:
1. Train rural clergy to recognize the holistic needs of veterans
and their families;
2. Train rural clergy to be able to respond sensitively to the
needs of returning rural veterans;
3. Train rural clergy to be equipped to make referrals to VA
facilities;
4. Encourage rural clergy to establish ministry programs
specifically for veterans living in rural communities; and
5. Encourage rural clergy to use their influence in the community
to help reduce the stigma attached to mental health issues.
Question 2: How is the National Chaplain Center measuring success in
terms of outreach and training?
Response:
We are developing practices and measurement tools for the Rural
Health Clergy Training Project that will assist local clergy and
Veterans Service Organizations representatives to identify problems of
returning veterans. These tools will aid veterans in receiving the
appropriate assistance in rural communities. Outcome evaluation is
designed in a pre/post framework and is based on three measures: (1)
before training, (2) immediately after training, and (3) at yet-to-be-
determined periods (potentially 3 months, 6 months, and 12 months)
after training. There are seven discrete measures related to outcomes,
all related to expanded services in local communities.
We continue to improve the outcome evaluation tools by developing
best practices and measurement devices that can be utilized at VCOI
events. Some specific questions among the 33-question evaluation forms
distributed following each of the training events are: How many
referrals have you made to a Veterans Affairs facility in the past 12
months? If you have made a referral to a Veterans Affairs facility, how
would you rate your satisfaction with the experience? How many
referrals have you made to a community mental health facility in the
past 12 months? In your ministry, do you ever interact with: Veterans
Affairs Chaplains? Do you ever interact with Veterans Affairs Mental
Health Providers? Have you spoken about military/veteran needs from the
pulpit?