[House Hearing, 118 Congress]
[From the U.S. Government Publishing Office]
MISSION TRANSITION: EVALUATING
MENTAL HEALTH SUPPORT PROGRAMS
FOR SEPARATING SERVICEMEMBERS
=======================================================================
HEARING
before the
SUBCOMMITTEE ON ECONOMIC
OPPORTUNITY
of the
COMMITTEE ON VETERANS' AFFAIRS
U.S. HOUSE OF REPRESENTATIVES
ONE HUNDRED EIGHTEENTH CONGRESS
SECOND SESSION
__________
TUESDAY, SEPTEMBER 10, 2024
__________
Serial No. 118-78
__________
Printed for the use of the Committee on Veterans' Affairs
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
Available via http://govinfo.gov
______
U.S. GOVERNMENT PUBLISHING OFFICE
57-072 WASHINGTON : 2026
COMMITTEE ON VETERANS' AFFAIRS
MIKE BOST, Illinois, Chairman
AUMUA AMATA COLEMAN RADEWAGEN, MARK TAKANO, California, Ranking
American Samoa, Vice-Chairwoman Member
JACK BERGMAN, Michigan JULIA BROWNLEY, California
NANCY MACE, South Carolina MIKE LEVIN, California
MATTHEW M. ROSENDALE, SR., Montana CHRIS PAPPAS, New Hampshire
MARIANNETTE MILLER-MEEKS, Iowa FRANK J. MRVAN, Indiana
GREGORY F. MURPHY, North Carolina SHEILA CHERFILUS-MCCORMICK,
C. SCOTT FRANKLIN, Florida Florida
DERRICK VAN ORDEN, Wisconsin CHRISTOPHER R. DELUZIO,
MORGAN LUTTRELL, Texas Pennsylvania
JUAN CISCOMANI, Arizona MORGAN MCGARVEY, Kentucky
ELIJAH CRANE, Arizona DELIA C. RAMIREZ, Illinois
KEITH SELF, Texas GREG LANDSMAN, Ohio
JENNIFER A. KIGGANS, Virginia NIKKI BUDZINSKI, Illinois
Jon Clark, Staff Director
Matt Reel, Democratic Staff Director
SUBCOMMITTEE ON ECONOMIC OPPORTUNITY
DERRICK VAN ORDEN, Wisconsin, Chairman
NANCY MACE, South Carolina MIKE LEVIN, California Ranking
C. SCOTT FRANKLIN, Florida Member
JUAN CISCOMANI, Arizona FRANK J. MRVAN, Indiana
ELIJAH CRANE, Arizona MORGAN MCGARVEY, Kentucky
DELIA C. RAMIREZ, Illinois
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
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TUESDAY, SEPTEMBER 10, 2024
Page
OPENING STATEMENTS
The Honorable Derrick Van Orden, Chairman........................ 1
The Honorable Mike Levin, Ranking Member......................... 3
WITNESSES
Panel I
Ms. Melissa Cohen, Executive Director, Outreach, Transition, and
Economic Development, Veterans Benefits Administration, U.S.
Department of Veterans Affairs................................. 6
Accompanied by:
Ms. Jill Debord, Executive Director, Care Management and
Social Work, Veterans Health Administration, U.S.
Department of Veterans Affairs
Ms. Susan Orsega, Deputy Assistant Secretary of Defense for
Health Services Policy and Oversight, U.S. Department of
Defense........................................................ 7
Ms. Alyssa Hundrup, Director of Health Care, U.S. Government
Accountability Office.......................................... 9
Mr. James Rodriguez, Assistant Secretary for Veterans' Employment
and Training Service, U.S. Department of Labor................. 10
APPENDIX
Prepared Statements Of Witnesses
Ms. Melissa Cohen Prepared Statement............................. 25
Ms. Susan Orsega Prepared Statement.............................. 36
Ms. Alyssa Hundrup Prepared Statement............................ 39
Mr. James Rodriguez Prepared Statement........................... 62
Statements For The Record
Western Governors' Association Prepared Statement................ 69
MISSION TRANSITION: EVALUATING
MENTAL HEALTH SUPPORT PROGRAMS
FOR SEPARATING SERVICEMEMBERS
----------
TUESDAY, SEPTEMBER 10, 2024
Subcommittee on Economic Opportunity,
Committee on Veterans' Affairs,
U.S. House of Representatives,
Washington, DC.
The subcommittee met, pursuant to notice, at 3:06 p.m., in
room 360, Cannon House Office Building, Hon. Derrick Van Orden
(chairman of the subcommittee) presiding.
Present: Representatives Van Orden, Levin, McGarvey, and
Ramirez.
OPENING STATEMENT OF DERRICK VAN ORDEN, CHAIRMAN
Mr. Van Orden. Please be seated. The subcommittee will come
to order. Before we get into this, I just want to say we did
our second field hearing.
The first field hearing for the entire committee was done
in Ranking Member Levin's district. He represents Camp
Pendleton. I thought that was fantastic and I want to thank you
personally and professionally for coming to Wisconsin.
We did another field hearing on Transition Assistance
Program (TAP), and I think it was very, very successful. You
really showed yourself to be a dedicated legislator and a
consummate professional, sir. Thank you.
I guess that was a--was that a point of personal privilege?
I do not know. There is some language for that, but I really
mean that. It was awesome. You did great.
Ms. Ramirez, I apologize for being tardy.
I want to thank everybody for being here today to discuss
how we can ensure that our transitioning servicemembers are
receiving the mental health support they may need before,
during, and after transition.
As always, I appreciate the nonpartisan nature of this
subcommittee. We got a little squirrely this morning, honest to
goodness, and we do not need that here in politics.
Myself I am guilty of it, also, Ms. Ramirez, so if I said
something to offend you earlier, I apologize publicly and
privately if you would like also,
You are also a professional, ma'am, so we are just not
going to do that here. We are just not.
It is no secret to anyone as a former Seal, fixing the TAP
program for our transitioning servicemembers this is something
I am very passionate about. I have had over 21 of my friends,
actually 21, sorry, commit suicide, Navy Seals that you never
heard about. You know, one is too many. 21 is very troubling.
We have made improvements in the transition assistance
program, one of my top priorities during the Congress and have
advanced numerous bills in that direction.
I know change does not happen overnight but for some of our
veterans if change is not implemented soon it will be too late.
The scourge of suicide takes an average of 17 veterans lives a
day, and I believe that number is not accurate.
I believe it is much higher because of the way the Veterans
Administration actually records suicide. I believe it is much
more than that.
Data shows that in recent years many of our veterans who
died by suicide had transitioned from the military no less than
2 years prior to the death. The year before transitioning
servicemembers are discharged and 2 years after the most
dangerous time for a new veteran, especially those who are
younger and are trying to navigate the civilian world.
The issue is just that in a millisecond you lose your
uniform, your rank, your authority, anywhere from half to your
entire paycheck.
The joke with my wife and several other military spouses is
twice the husband, half the paycheck. That is real. How many
spouses do we have here?
In 2020, the suicide rate for veterans who had transitioned
from the military just 1 year prior was twice as high as the
national average and that statistic keeps me up at night and it
should keep everybody up at night, especially people who sit on
this panel.
These veterans are not just numbers. They are my friends.
They are the people that have ensured that we have the ability
to conduct this hearing in peace.
We just simply have to make sure that we do better and we
can. There has got to be some actual accountability in these
programs for the failures that have been identified and these
agencies cannot simply check a box and call these programs a
success. One life lost, again, is too many.
The Government Accountability Office has identified
numerous ways that we are failing to connect our servicemember
with mental health services. The warm handover process is not
happening as it should.
Who in the Federal Government or personnel on these bases
is accountable and what can we do to change it? This is not
just a big hand, little map issue. When we identify people and
hold them accountable, we got to start doing that.
The inTransition program which is supposed to ensure
servicemembers with identified mental health issues are
connected with a mental health provider after transition is not
connecting with servicemembers about 70 percent of the time.
According to the Government Accountability Office (GAO) ,
inTransition has a successful contact rate of 2 percent. Who in
the Department of Defense (DOD) is accountable for calling
these programs a success and coming back here and getting money
every year? It is 2 percent. It is absurd.
I am very frustrated by DoD's failure to respond to the
GAO's recommendations immediately, and to my knowledge DoD only
did so after I sent a letter to them asking about these
recommendations for their plan to improve this program to reach
actual servicemembers.
I believe I will be reading the response that I got back
because it makes absolutely no sense at all. I do not want to
hear platitudes any longer. I do not want to hear any excuses
today.
I want to hear concrete ideas for how we are going to reach
the goal and that is to get in contact with as many veterans
and vulnerable veterans as possible.
With that, I would like to yield to Ranking Member Levin
for his opening remarks.
OPENING STATEMENT OF MIKE LEVIN, RANKING MEMBER
Mr. Levin. I thank the chairman for your dedication to this
topic and thank you for your hospitality as well. Had a great
time in La Crosse. I learned that, well, La Crosse is, you
know, roughly halfway between Green Bay and Minneapolis. You do
not cheer for the Vikings. You cheer for the Packers and
excellent cheese curds. Again, really appreciate your whole
staff as well. Excellent field hearing and I think it is
archived on the Internet somewhere, hopefully?
Mr. Van Orden. It is. It was on ESPN, The Ocho, which as we
know it as C-SPAN.
Mr. Levin. It was really good. Then hearing from, you know,
some of the veterans themselves I think in particular was
really impactful.
You know, we have done a number of hearings on transition
and we have actually made some great progress thinking back in
the 5-1/2 years I have been doing this.
I remember my friend Jodey Arrington and I got the Bill
Mulder legislation across the finish line. That is named after
a friend of Jodey's from high school that tragically took his
own life after service.
We now have the off-base transition training program, the
pilot. Better late than never and we are getting that off the
ground. You know, certainly look forward to discussing that
with you in future hearings, but a lot to cover today.
As servicemembers prepare to end their active duty military
service, it is critical that they have effective support to
reintegrate into civilian life, especially important for those
who may be at risk for a difficult transition.
We know that connecting veterans with services as early as
possible will help prevent a crisis, and the best time to do
that is before their exit from the military.
Separation is a milestone characterized by a variety of
stressors and adjustment challenges. Recent studies have shown
that the risk of a veteran dying by suicide is particularly
elevated during the first year after the separation from the
military.
That is why I introduced the TIER Act, The Transition to
Improvement by Estimating Risk Act, which would add new
screening criteria to better tailor the transition process to
individuals.
We need to also ensure that transitioning servicemembers
have access to the healthcare that they need as soon as
possible after they separate from the military.
Ranking Member Takano has the Ensuring Veterans' Smooth
Transition Act, and that is what that legislation would do. It
would automatically enroll veterans into U.S. Department of
Veterans Affairs (VA) healthcare unless the veteran opts out
upon discharge from active duty.
It appears there are a number of services and different
things happening, some which are working, some which need to be
working better.
The GAO report in particular concern me on how some of
these programs are being implemented and their relative
effectiveness. TAP is jointly administered by seven Federal
agencies. Think of that, seven Federal agencies. This adds just
complexity, layers of complexity.
Ensuring each and every servicemember receives the support
or assistance that he or she needs is complicated by the fact
that you have so many agencies involved.
GAO found that from April 1st, 2021 to March 31st, 2023,
4,300 servicemembers who were considered at risk of having
challenges during transition did not receive a warm handover,
4,300.
The warm handover means person-to-person connection from
TAP to agency partners that provide services and resources.
That could mean the VA. It could mean the Labor folks, you
know, that is tailored to the veteran's needs. That is the key.
I am worried that warm handovers are not happening. That is
not acceptable when we are talking to thousands and thousands
of people. That means veterans are falling into the cracks.
That means they are falling literally into the cracks between
the agencies and that just simply cannot be happening.
I am also concerned that TAP is not a priority for the DoD.
For the Chairman, we have been concerned about this for 6 years
that the DOD does not have that same level of urgency when it
comes to TAP.
According to GAO, 11,000 servicemembers transitioning
between April 1st, 2021 and March 21st, 2022 that were
considered tier 3, meaning they were at risk of having a
difficult transition, did not attend at least a portion of the
required core TAP classes.
That is 22 percent of the servicemembers in the sample. It
tells me DOD is not focusing enough on this.
I know DOD has many other priorities, important priorities.
Their job is to fight and win war, but I also believe that
taking proper care of servicemembers and their families during
the transition out of the military helps enable the DOD to do
their core mission.
Every successfully reintegrated veteran shows the next
generation the opportunities that are provided through service.
Every veteran in crisis gives potential enlistees pause. We
cannot accept the status quo.
Now, Ranking Member Takano and I have met with former
Secretary Chuck Hagel and the Veterans Justice Commission. I
took note of their finding that there is no single primary
entity or person accountable for the effectiveness of
transition.
I also found their recommendation for the creation of an
under secretary of Defense for Transition an interesting idea,
though it falls outside of our jurisdiction of this
subcommittee. I cannot help but wonder if a change like this
would provide the structure necessary to make servicemember
transition a priority within DOD.
I know that in the lead up to November we are going to be
seeing a lot of finger pointing. It is silly season. I do not
see this topic as an attack on any party or any administration
because this problem has existed as long as I have been around
under different administrations.
We are here to call out the culture within DOD and push to
provide frontline commanders, servicemembers, and their
families the time and resources to make informed, thought-
through decisions about their reintegration into civilian life.
This is going to continue to be a priority for us regardless of
what happens with any election.
The last thing I will say, and thank you for giving me this
time, we need to have a serious discussion on which committee
has primary jurisdiction of TAP.
I have been saying this, and I believe you share this
opinion, the implications of a good or bad transition on
preventing veteran death by suicide are too important to be at
the mercy of an annual National Defense Authorization Act
(NDAA) cycle.
Fixes need to come quickly and as standalone legislation,
and so I am a little biased being on House Veterans Affairs
Committee (HVAC), but I think that this is where primary
jurisdiction should be.
I thank the Chairman for the time. Look forward to working
on this for a long time to come, and I yield back.
Mr. Van Orden. Yes, sir, thank you very much, Ranking
Member Levin. For the record, I concur with you that this does
not belong anywhere but here.
We bear the brunt of poor decisions made by the DoD, this
committee does and the families, too. I feel that we have a
moral obligation to fulfill the duty, which is to make sure
that we take care of our veterans in a lifecycle.
I would like to now introduce our witnesses. Our first
witness is Ms. Melissa Cohen, executive director of Outreach,
Transition and Economic Development at the Veterans Benefits
Administration. Ms. Cohen is accompanied by Ms. DeDord--did I
get that right? Excellent--executive director of Care
Management and Social Work at the Veterans Health
Administration (VHA).
Our second witness is Ms. Susan Orsega, deputy assistant
Secretary of Defense for Health Services Policy and Oversight
at the Department of Defense. I want to thank you for coming.
To my knowledge, you are only the second person from the
Department of Defense that has been here. We ask you guys all
the time and we get blown off all the time, so thank you. It is
probably going to get worse from here, ma'am. I will just be
honest with you.
Our third witness is Melissa, sorry, Alyssa Hundrup,
director of Healthcare at the Government Accountability Office.
Our final witness is Mr. James Rodriguez, my friend,
assistant secretary for Veterans' Employment and Training
Service at the Department of Labor.
Please stand and raise your right hand. Do you swear that
the testimony you are about to provide us the truth, the whole
truth, and nothing but the truth? Very well, thank you. Let the
record reflect that the witnesses have answered in the
affirmative.
[Witnesses sworn.]
Mr. Van Orden. Ms. Cohen, you are now recognized for 5
minutes to deliver your testimony on behalf of the Department
of Veterans Affairs.
STATEMENT OF MELISSA COHEN
Ms. Cohen. Thank you. Chairman Van Orden, Ranking Member
Levin, and distinguished members of the subcommittee., I
appreciate the opportunity to appear before you today to
discuss access to mental healthcare programs and services
during the transition from military to civilian life.
Accompanying me today is Jill Debord, licensed clinical
social worker and executive director, Care Management and
Social Work Services.
Within VA our focus is on increasing transparency,
improving collaboration, and keeping veterans at the center of
everything we do. Support for transitioning servicemembers is
an interagency effort.
The VA, Department of Defense, and Department of Labor, for
example, work to ensure transitioning servicemembers and
veterans are equipped with the knowledge, tools, and skills
needed to meet their career readiness standards, as well as
have access to the benefits and services they have earned and
deserve.
While VA has implemented several successful avenues like
Solid Start to connect servicemembers and veterans with needed
resources, we have more work collectively to do.
Excuse me. During VA's portion of the transition assistance
program we outline many critical topics to include community
resources, disability compensation, education, and healthcare
benefits.
We cover support for housing insecurity, homelessness,
military sexual trauma, as well as discuss the warning signs
and risk factors related to suicide.
We also underscore the value of the veteran crisis line
prioritizing mental health. During this course VA introduces
veteran service organizations to facilitate on the ground
community relationships.
We now use signup sheets during TAP course to encourage
same-day scheduling, hoping to surpass the 53,000 one-on-one
appointments conducted last year.
VA's clinical transition process, which is available to
servicemembers prior to leaving the military, is through the VA
liaison program.
Social workers and nurses coordinate the transition of
healthcare to include mental healthcare when clinically
indicated to meet the needs of each servicemember.
Through this process the transitioning servicemember is
registered for VA healthcare and connected to the post-911
military to VA case management program at their home VA medical
facility. Over 80 percent of the time these servicemembers have
initial VA healthcare appointments scheduled prior to discharge
from the military.
In Fiscal Year 2023, more than 14,000 servicemembers
received a coordinated transition of care from DoD to VA
through the VA liaison program.
Since the program's inception in 2003 over 178,000
servicemembers have had their care transitioned through this
clinical process.
Assistance continues post-separation with the VA Solid
Start program. In this program VA calls all eligible veterans,
regardless of their character of discharge, at three key
stages, 90 days, 180 days, and 365 days post-separation during
their first year after separation from active duty.
Using data provided by DoD, Solid Start provides priority
contact to veterans meeting certain risk factors during their
last year of active duty. VA has focused efforts to improve the
Solid Start's successful connection rate, achieving incremental
improvements from approximately 57 percent in 2020 to 77.7
percent in 2023.
Although we are proud of this improvement, we will not be
satisfied until we successfully connect with every recently
separated veteran, helping them connect with the benefits and
services they have earned.
These are just a few examples of how VA is working to
ensure transitioning servicemembers and veterans are supported
during this process. We appreciate the committee's continued
support and collaboration in the shared mission.
Mr. Chairman, this concludes my statement. My colleague and
I are ready to answer any questions you and the committee may
have.
[The Prepared Statement Of Melissa Cohen Appears In The
Appendix]
Mr. Van Orden. Thank you, Ms. Cohen. The written statement
of Ms. Cohen will be entered into the hearing record.
Ms. Orsega, you are now recognized for 5 minutes to deliver
your testimony on behalf of the Department of Defense.
STATEMENT OF SUSAN ORSEGA
Ms. Orsega. Chairman Van Orden, Ranking Member Levin, and
distinguished members of the House Veterans Affairs Committee
Subcommittee on Economic Opportunity, thank you for the
opportunity to testify before you here today.
I am pleased to represent the Office of the Assistant
Secretary for Defense for Health Affairs to discuss the
Department of Defense's commitment to mental health support
programs for separating Servicemembers.
DoD is committed to providing the highest level of mental
health services for our members. We ensure that those who serve
in the Nation receive timely and high-quality care, including
care to address their mental health needs.
You know, this is particularly important during transition
from military to civilian life when Servicemembers are most
vulnerable to suicide and some experiencing challenges, such as
the loss of sense of purpose, post-traumatic stress disorder,
and other mental health symptoms.
In this testimony we will inform the Subcommittee about the
Department's current mental health programs and resources
during the transition from military to civilian life and
including the inTransition program and the Transition
Assistance Program, TAP.
The DoD created the inTransition program in 2010 in
response to a 2007 report by the Department of Defense Task
Force on Mental Health, which revealed that a number of
Servicemembers were disengaging from mental healthcare
treatment as they transition from the Department of Defense to
the veterans' healthcare system.
For the past 14 years, the inTransition has facilitated
continuity of care and connection to mental health resources
for Servicemembers as they move into civilian life. The
inTransition program supports all transitioning Servicemembers
and veterans regardless of the duration of service, time since
discharge, or category of discharge.
All Servicemembers who are leaving the military service and
who have received care for mental health and/or moderate to
severe traumatic brain injury within 1 year of separation are
also automatically enrolled into this program. Servicemembers
can also get connected through services that through either
self or provider referrals.
The DoD also implements TAP, which is a result of the
interagency partnership between the Department of Defense, the
VA, the Departments of Labor, Education, Homeland Security,
Small Business Administration, and the Office of Personnel
Management.
TAP addresses the many facets of the Service member's
transition while providing information, resources, and tools to
Servicemembers to help them prepare for their move from
military to civilian life.
The mental health of Servicemembers remains a priority of
the Department of Defense, and we are continuously identifying
opportunities to improve the delivery of mental health support
for those who serve our Nation.
A recent GAO report examined elements of the DoD's
inTransition program and the DoD-VA Joint Executive Committee's
assessment of the effectiveness of their efforts that
facilitated access to mental health services for transitioning
Servicemembers. The DoD reviewed the GAO report and
recommendations and a formal comment from the Department is in
progress.
Thank you for your continued support of the health and
well-being of our Servicemembers and inviting me to be here
with you today to discuss this important issue of continuity of
mental health support services for transitioning
Servicemembers.
We recognize we have more work to do and much more progress
to make in support of our Servicemembers when they transition
into civilian life. We remain committed to enabling
Servicemembers to receive the necessary mental health support
that they need during this life-changing and important
transition.
I look forward to your questions.
[The Prepared Statement Of Susan Orsega Appears In The
Appendix]
Mr. Van Orden. The gentlelady yields back. Thank you, Ms.
Orsega. The written statement of Ms. Orsega will be entered
into the hearing record.
Ms. Hundrup, you are now recognized for 5 minutes to
deliver your testimony on behalf of the Government
Accountability Office.
STATEMENT OF ALYSSA HUNDRUP
Ms. Hundrup. Chairman Van Orden, Ranking Member Levin, and
members of the subcommittee, thank you for the opportunity to
discuss our work on DoD and VA efforts to provide mental health
support for servicemembers and veterans during their transition
from military to civilian life.
The transition period can be fraught with challenges as
servicemembers adjust to social and civilian life outside of
the structured military. Tragically, as has already been
mentioned, studies have found that the suicide rate for
veterans in their first year of separation is about 2-1/2 times
higher than that of the active-duty population.
My testimony today covers findings and recommendations we
have made related to three different VA and DoD programs that
are in place to support servicemembers and veterans during the
transition period.
In July, we reported on DoD's inTransition program, a
program intended to facilitate connections to mental health
services during times of transition. The program identifies
individuals for automatic enrollment if they meet certain
criteria, including the use of mental healthcare in the year
prior to their separation.
However, we found several concerns with this program.
First, inTransition does not identify eligible individuals
until 2 to 3 months after their separation. This falls during
the last 9 months of the 24-month transition period which may
result in a gap in assistance during a particularly vulnerable
time.
Second, inTransition is often unable to successfully reach
eligible individuals, due in part to outreach that relies on
cold telephone calls. We found the program was unable to
successfully contact over 70 percent of enrollees.
This means that individuals were dropped from participating
before they were potentially even aware that assistance could
be provided. We recommended that inTransition identify eligible
servicemembers prior to their separation, as well as expand
methods of outreach, such as through emails or texts to better
reach individuals and ensure their continuity of care.
Last, we found that inTransition lacked performance goals
and we recommended that it establish them to help assess the
program's effectiveness. This would help decision-makers
identify improvements and hold the program accountable.
In March of this year, we reported on DoD's warm handover
process within its transition assistance program. Through
person-to-person connections, warm handovers are intended to
assist servicemembers who may be at risk, such as with gaps in
medical care, unemployment, or homelessness.
However, we identified several issues with DoD's warm
handover process. For example, we found that DoD does not know
why some servicemembers who are at risk for challenging
transitions are not receiving those warm handovers.
Our analysis found that at least 4,300 servicemembers who
separated from the military during a 2-year period should have
received one but did not. We also found that DoD has not
reliably verified who is receiving a warm handover or assessed
their helpfulness, such as confirming whether individuals
received needed services.
We made a number of recommendations to improve the warm
handover process, including that DoD determine why
servicemembers may not be receiving them, better verify when
they are occurring, and assess the helpfulness of the process.
In January 2023, we also reported on aspects of VA's Solid
Start program, a program that supports the well-being of new
veterans by helping them to connect with mental health and
other services. Of note, Solid Start prioritizes earlier
outreach to those who received mental healthcare in the year
prior to separation.
In May 2023, VA implemented our recommendation to work with
veterans organizations to address outreach gaps and assess
strategies for hard-to-reach groups, such as those experiencing
homelessness.
Finally, in light of the many programs DoD and VA have in
place, we have recommended the two departments work together
through the Joint Executive Committee to assess the
effectiveness of their programs overall in facilitating access
to mental health across the transition period and, importantly,
address any identified gaps.
In closing, DoD and VA have taken steps to implement some
of our recommendations. However, continued leadership attention
and critical improvements are needed to ensure transitioning
servicemembers and veterans have the mental health support they
need and deserve.
This concludes my prepared statement. I would be happy to
answer any questions you may have. Thank you.
[The Prepared Statement Of Alyssa Hundrup Appears In The
Appendix]
Mr. Van Orden. Thank you, Ms. Hundrup. The written
statement of Ms. Hundrup will be entered into the hearing
record.
Mr. Rodriguez, you are now recognized for 5 minutes to
deliver your testimony on behalf of the Department of Labor.
STATEMENT OF JAMES RODRIGUEZ
Mr. Rodriguez. Thank you, Mr. Chairman. Chairman Van Orden,
Ranking Member Levin, and distinguished members of the
subcommittee, thank you for inviting me to testify today.
Successful employment is one key to economic success and
can strongly impact physical and mental health, life
expectancy, and the quality of life.
Veterans with service-connected disabilities, including
mental health conditions, often experience relatively low labor
participation rates and high unemployment compared to their
non-disabled counterparts.
Research indicates that unemployment can adversely affect
mental health and is associated with the higher risk of suicide
among veterans. Veterans with mental health conditions,
particularly those at risk of or experiencing homelessness, may
face increased risk of suicide following job loss.
To address these issues it is critical for transitioning
servicemembers and veterans to receive the employment and
training support that they need. U.S. Department of Labor-
Veterans Employment and Training Service (DOL-VETS) administers
the employment component of the transition assistance program.
As detailed in my written testimony, we have made great
strides in developing a number of innovative employment
curriculums and working with public and private partners to
connect participants to the services they need.
For example, participants of the TAP Employment Navigator
and Partnership Program (ENPP) have faster transitions from the
military service to civilian employment and higher wages. While
ENPP aims to get the military to civilian transition right from
the start, we recognize that not all journeys are linear.
The off-base transition training program is designed as a
safety net for veterans who may have fallen outside the
traditional transition path. It offers a flexible no wrong door
approach meeting veterans where they are in their post-service
life to provide support whenever it is needed.
When TAP participants need mental healthcare or other
services we provide person-to-person referrals to DOL's
American Job Centers and other partners when needed.
DOL's American Job Centers are one-stop locations that
offer a broad range of employment and wrap around supportive
services, which includes linkages to physical and mental
healthcare, as well as referrals to the veteran readiness and
employment program at the Department of Veterans Affairs and
other services and programs in their local communities.
It is important to note that veterans receive priority
service for all workforce training programs funded in whole or
in part by the Department of Labor.
VETS administers the jobs for Veterans State Grant program,
which provides funding for dedicated staff who work in the
American Job Centers to provide individualized career and
training-related services to eligible veterans and to assist
employers to fill their workforce needs with job-seeking
veterans.
This includes but is not limited to veterans who self-
identify as having a physical or mental health disability, as
well as veterans experiencing homelessness. VETS has leveraged
our available flexibilities to expand program eligibility and
ensure the delivery of quality service to our veterans.
Veterans experiencing homelessness face specific
challenges, including higher prevalence rates of post-traumatic
stress disorder, as well as physical disabilities and
challenges transitioning to civilian life.
VETS administers the homeless veterans reintegration
program, or HVRP, which is designed to address these barriers
and empower veterans to secure good jobs in stable and high
demand occupations paying livable wages.
HVRP programs partner closely with their local American Job
Centers helping veterans experiencing homelessness reintegrate
into the workforce by providing the employment and wraparound
services, including mental healthcare, suicide prevention
services, and addiction counseling.
All of the services I have discussed are critical to
veterans, especially those struggling with unemployment, which
can negatively impact mental health and create difficult
experiences.
We have made important investments in veteran benefits and
healthcare, and I urge Congress to similarly invest in our
veterans employment programs as well as the personnel who help
facilitate these programs.
I am committed to working with the subcommittee and our
many partners and stakeholders to ensure the best transition
for our servicemembers and their families and to connect them
to mental health and other services that they need.
Chairman Van Orden, Ranking Member Levin, and distinguished
members of the subcommittee, this concludes my statement. Thank
you for the opportunity to be part of this hearing and as
always, I welcome your questions.
[The Prepared Statement Of James Rodriguez Appears In The
Appendix]
Mr. Van Orden. Thank you, Mr. Rodriguez. The written
statement of Mr. Rodriguez will be entered into the hearing
record.
I am now going to proceed to questioning, and I would like
to recognize Ranking Member Levin for 5 minutes to question the
witnesses.
Mr. Levin. Thank you, Mr. Chairman, and I have got a bunch
of questions. We will get through as much as we can in 5
minutes. Hopefully we will have a second round if there is time
for it.
I want to start with DOD. Want to, you know, as the
chairman said, thank you for being here. In all, you know,
honesty it is really reassuring and this is what we need.
I can tell you, you know, we appreciate your record of
service as well. I saw, I believe you were in the Commissioned
Corps for the Public Health Service was your background. I am
very grateful for that service.
You know, I hope you agree with the statement, every
successfully reintegrated veteran shows the next generation the
opportunities provided through service and every veteran in
crisis gives potential enlistees pause. Yes, do you agree with
that? Good.
We have a huge problem here, okay, according to information
that we have seen. You have got tens of thousands of high-risk
servicemembers that are not attending their TAP classes the way
they are supposed to.
What are you doing? What is--this is not your fault, right?
It is not you, but what is the department doing to enforce the
current mandated timelines for attendance for TAP and how are
you holding the services accountable for doing this?
Ms. Orsega. Thank you very much, Chairman (sic), for the
question. First of all, I think we recognize there is so much
work, more work to be done.
While the office that I work under is not responsible for
the TAP, under Health Affairs we are responsible for the
policies and the guidance that influence TAP.
I am committed to taking back to those service Military
Departments this point about TAP and ways of which we can work
better.
Mr. Levin. I appreciate your answer and, again, it is not
your fault, but the inability to, you know, do something about
it yourself I think is a symptom of the department not having a
single person or entity responsible.
It is deeply frustrating. I think we have to work on a
bipartisan basis here. We have got to do everything we can to
try to address this.
We have heard veterans express concern and frustration.
They did not feel the level of support that they needed. They
felt rushed, I have heard this personally, rushed through the
process.
They are given a lot of information in a very short period
of time and they are perceived, and I have heard this from
multiple transitioning servicemembers in the last number of
years, that they are being treated significantly differently as
soon as they communicate their decision to leave the military.
How is the department addressing all of this and what
changes can you commit to, again in your limited capacity, but
what changes can you personally commit to help shift the
culture and the priorities related to those who are separating
from military service?
Ms. Orsega. Yes. Again, thank you for the question. Since I
have come been appointed, you know, I have identified mental
health as one of my big focuses in my portfolio. My team is
committed to mental health of our Servicemembers, both active
duty and then transitioning members.
There are really three focuses: one, reducing the stigma.
We have got to do better at reducing stigma; two, increasing
awareness; and then three, promoting the capacity, the capacity
of those that have behavioral health professionals who you can
touch, touch and tap into reaching and connecting with those
individuals.
Mr. Levin. I think all that sounds great. I think there is
fundamentally a culture shift that needs to occur as well and
look forward to further discussion in the months and years
ahead.
With the time I have left for now, I want to turn to Solid
Start. Director Hundrup, thank you for the work that you have
provided, very enlightening.
Does VA's Solid Start program have a more effective
outreach strategy than inTransition for connecting with new
veterans in need of mental health services? If so, could you
expand on that?
Ms. Hundrup. Thank you. Yes. We did find some notable
differences between the two programs, particularly that Solid
Start has been more successful in reaching veterans.
To put a point on it, in our work we found that Solid Start
was able to successfully reach over 70 percent of veterans. In
contrast, the inTransition program during the time period we
looked at was not able to successfully contact 72----
Mr. Levin. I get that but why?
Ms. Hundrup [continuing]. percent. Right. I think there are
key differences.
Mr. Levin. You have 18 seconds.
Ms. Hundrup. Okay, key differences in their outreach
strategies. Solid Start is using different methods, many
different phone calls at different points in the year.
inTransition makes just one----
Mr. Levin. Hold that thought because I am going to come
back to you----
Ms. Hundrup. Okay.
Mr. Levin [continuing]. assuming he gives me a chance.
Ms. Hundrup. Okay.
Mr. Levin. Thank you. I yield back.
Mr. Van Orden. The gentleman's time has expired.
The chair now recognizes Ms. Ramirez from the great State
of Illinois for 5 minutes.
Ms. Ramirez. Thank you, Chairman.
As a member of this subcommittee, I have been really proud
to stand beside my colleagues who recognize the importance and
the value of investing in mental health support programs. Thank
you, Chairman, for this committee hearing.
We really are at a critical moment where mental health is
at the forefront of hearings, of discussions, of roundtables
across several congressional committees, obviously, including
this one.
Why? It is because the communities we serve they cannot
wait no longer. We have the ability to treat and provide
support for these struggling with mental health and we have to
use every single tool in our toolbox so we can ensure that
these resources are widely available and that they are known.
I cannot emphasize enough that as a member of this
committee we are advocating for all veterans and that includes
women veterans. That includes veterans of color and certainly
disabled veterans.
Every single veteran deserves quality, accessible mental
health support, especially while they are going through the
process of transitioning to civilian life.
Supporting our veterans means we have to support them
through these transitions. We have to equip them with the
resources, including mental health support, to ensure they can
live a full and happy life.
My question is for Ms. Cohen. Ms. Cohen, my concern is that
the VA has all of these resources available but not everyone is
aware of them. Actually, quite a number of our veterans do not
have access to this information.
What are you doing to do a better job at ensuring awareness
of the resources, the services, and the benefits available to
them?
Ms. Cohen. Thank you for that question. There is a number
of things outside of the TAP course where we provide a
comprehensive outline of all the benefits and services. If you
are not able to attend TAP or maybe it has been now a long
time, we have now started an off-base transition training where
it is a virtual opportunity to hear about our benefits and
services again.
We have also implemented a new outreach strategy where we
worked with all the 56 regional offices and we have asked that
they come forward with a plan that is data-informed that they
better understand their communities.
In Fiscal Year 2025, you will see a focus on counties that
have never received outreach before. We are also asking for
increased stakeholder engagement.
The three top topics will be homelessness, rural
communities, and focuses on women for Fiscal Year 2025. Those
are a few of the examples of how we are stretching and trying
to reach more veterans.
Ms. Ramirez. Thank you, Ms. Cohen.
I guess this question is almost a follow up, but this one
is for Ms. Cohen and Ms. Orsega. Can you both explain how the
DoD and the VA are ensuring that transitioning servicemembers,
especially those with unplanned or unexpected transitions and
those with disabilities are provided the resources to all the
benefits available in the short time they have before exiting
the military?
I guess we can start with you, Ms. Orsega.
Ms. Orsega. Thank you again for the question. I think one
of the things, first of all, is, as we previously mentioned, is
we have mechanisms in place where the Department of Defense and
the inTransition program particularly that I can speak to under
Health Affairs, has connections and really starts to look at
connecting with the folks on the VA side in terms of bridging
those gaps and leaning in.
I think also I would say is each separating Service member
is not a one-stop shop, meaning it is each individual, has
different has different needs and different resources. In the
time that I have come onboard, you know, I have talked to a
variety of different staff across the Department and those
inside of Health Affairs and outside in the Military
Departments and really to try to look at those resources and,
as you pointed out, kind of, bring all those tools together so
that we are capitalizing on not just one-stop tool but multiple
tools and resources to tackle the behavioral issues.
Ms. Ramirez. Ms. Cohen, when you answer, because our time
is running out, can you also answer this last question I have
here? Are there plans for the DOD and the VA to allocate
additional resources to enhance mental health support available
during the military to civilian transition? If you can speak to
that as well?
Ms. Cohen. Thank you so much. Very quickly, we try to reach
every single veteran that transitions to your first question,
so some of the successes of Solid Start are we are going to e-
mail them and talk about the benefits.
We give them a welcome packet. We talk about it in TAP. We
are going to call them 21 times if needed to connect. It is a
priority for our organizations to collaborate and continue
focus on this topic of mental health.
Mr. Van Orden. The gentlelady's time has expired. Ms.
Ramirez, if you would like a second round of question I would
be more than happy to do that.
Mr. Rodriguez. Yes, great.
Mr. Van Orden. Very well.
The chair now recognizes Mr. McGarvey for 5 minutes.
Mr. McGarvey. Thank you, Mr. Chairman.
Thanks everyone for being here today. As you all know, a
robust and well-supported transition is critical to preventing
our veterans from falling through the cracks.
However, I have got to echo the frustrations of my friends
and colleagues on the dais here that there is a disconnect in
how seriously DoD is taking transition and its implementation.
Ms. Orsega, I understand from the GAO report on access to
mental health services that you all plan to release the
enterprise individualized self-assessment in 2025. I think what
concerns me is that we have not yet addressed the attendance
issues that seem to be prevalent within TAP.
According to the GAO's December 2022 analysis of TAP data,
nearly a quarter of servicemembers who were required to attend
TAP did not do so. Seventy percent did not start TAP more than
1 year in advance of their separation as is supposed to happen.
That is incredibly concerning.
We have heard from veterans on an individual level.
Commanders sometimes do not make time for their servicemembers
to attend the needed classes.
We have also heard on a structural level that there is a
pervasive and lingering culture across the DOD that makes TAP a
back burner issue, or worse, they just do not care. That is
unacceptable. This must be a partnership. VA cannot carry the
weight all on its own shoulders.
Ms. Orsega, my question to you is what steps are you all
taking to ensure that every servicemember attends TAP and that
individual commanders and others responsible for
servicemembers' time comply with requirements?
Ms. Orsega. Thank you very much, Congressman. While I am
not responsible for the TAP within my responsibilities, I
understand. I understand the frustration and I am committed to
carrying this information and this message back to the
departments.
Each of the departments are responsible for the TAP. What
Health Affairs does and what is in my responsibility of focus
is looking at those policies and working toward the guidance
that implements and informs the TAP program.
I am committed to taking that message back to the
department.
Mr. McGarvey. Thank you for taking it back. Who is
responsible for TAP?
Ms. Orsega. Each Military Service Department is responsible
for the execution of the TAP within each of their services.
Mr. McGarvey. I do not want this to be an example of where
everyone can point the finger at somebody else and then no one
becomes accountable. Who would be the most accountable to
getting our servicemembers to--actually to the TAP services?
Ms. Orsega. Important question. Each of the servicemembers
that are connected and assigned to each of the Service Military
Departments, that is predominantly where the individual TAP
counselors are assigned to each of those Servicemembers.
Mr. McGarvey. What steps are being taken to ensure that
those servicemembers determined to be at risk for a difficult
transition actually attend all their required core TAP classes?
Ms. Orsega. Yes, thank you for that question. While I am
not responsible for TAP and the execution of it, I will take
that question for the record.
Mr. McGarvey. To whom will you take that question?
Ms. Orsega. I will take that question back to the
Department and will take it for the record.
Mr. McGarvey. Which department or which person?
Ms. Orsega. Each Service Department executes the TAP
program so each of those Military Departments. If you are in
the Navy, the Navy. If you are in the Army, the Army, et
cetera, et cetera.
Mr. McGarvey. Is there a specific person or office in each
one of those departments?
Ms. Orsega. I will take that information back and we will
take that for the record.
Mr. McGarvey. All right. When you say you are taking it to
the Navy, that is just a big entity for us. Who?
Ms. Orsega. Each of the Services. If you look at the
commands and down to the individual Service member's unit, all
of those individuals as they separate, as they retire, they
have counselors, and those counselors then meet with those
individuals.
We will have to get those details for you and get that
information back to you.
Mr. McGarvey. That would be great because, I mean, I feel
like we all want the same thing but I do not have an answer to
the questions yet.
Ms. Orsega. I understand.
Mr. McGarvey. This is really important to all of us, and I
would just love to know specifically who you are going to take
that information to that is capable of implementing it because
that would help us have some accountability.
Ms. Orsega. Understood.
Mr. McGarvey. Thanks so much. I see I am short on time, but
appreciate it, Mr. Chairman.
Mr. Van Orden. The gentleman yields back.
I now recognize myself for 5 minutes. Ms. Cohen, you said
you contacted 14,000 veterans. Is that right, 14,200? Was that
your testimony?
Ms. Cohen. Thank you for that. Let me just----
Mr. Van Orden. I believe page 2 out of 11 of your written
testimony. The answer is yes.
Ms. Cohen. Yes.
Mr. Van Orden. Okay.
Ms. Cohen. Sorry.
Mr. Van Orden. You have contacted 14,000 out of how many?
Ms. Cohen. Thank you for that question and that is specific
to VHA and I will turn that over to my colleague Ms. Debord.
Mr. Van Orden. All right.
Ms. Debord. Thank you for that question, Director Cohen.
Are speaking, Representative, to the VA liaison for healthcare
program?
Mr. Van Orden. Yes.
Ms. Debord. Yes. In my humble opinion of a best practice
for transitioning veteran servicemembers when they leave the--
--
Mr. Van Orden. 100 percent you are not answering the
question I asked. I said you contacted 14,000 according to Ms.
Cohen's testimony. Out of how many?
Ms. Debord. Out of----
Mr. Van Orden. The answer is 200,000.
Ms. Debord [continuing]. that would be 200,000 that would
have been----
Mr. Van Orden. That is 0.07 percent. Okay. Where I come
from that is a failure. I certainly would not come up here in
front of this committee and count that as a good number. That
is horrible. That is 0.07 percent.
Ms. Orsega, we wrote a letter. I wrote a letter. It was
really detailed, fancy words and stuff, about the GAO report,
whole bunch of things, and I asked this series of questions.
There was nine of them, very detailed.
How does the Department of Defense plan to revise
transition assistance criteria? How did DoD plan to modify
outreach, DoD coordinate, blah, blah, blah, blah, all separate
and they were, like, super detailed, right?
Here is the response, and I will ask unanimous consent that
these are both entered into the record. Without objection, so
ordered.
``The department agrees with the recommendations provided
by the GAO report and is currently assessing the feasibility
and resources needed to implement the actions and procedures
required to adequately address the GAO recommendations.''
Now, the only thing missing from this is some ranch
dressing because that is straight up word salad. This means
nothing. Okay?
I do not know how many 40-pound brains it took to write
that sentence, but it has nothing to deal with these very
detailed and specific questions that were asked that pertained
to one of the most important things we can possibly do, which
is transition someone from a productive member of the uniformed
services to a productive member of the civilian community. This
is wholly unacceptable.
When Mr. McGarvey is asking you a question, you blew him
off, too. The Navy is not a person. It is not. When you say I
am going to take it back, to who?
I was in command career counselor for two different
commands, and I told everybody if you are going to get out of
the service you do not talk to anybody but me. I set them up
for success as a civilian in a very open way. I did everything.
I had a 100 percent retention rate because I truthfully
looked at these servicemen and women and said you want to stay
that is great. You do not, that is great, too. Let us help you
out.
The Department of Defense writ large is failing our
servicemembers and you know it. You absolutely know it.
You said that this is your testimony. You are not
responsible for the TAP program but you are responsible for the
policies that inform the transition assistance. That does not
mean anything. It literally means nothing.
These people, you got seven bosses so doctrinally you
should have, what, six to nine direct reports talking to you?
You should not have seven people telling you what to do and
this is just wholly unacceptable.
The culture of the Department of Defense is such, from my
direct observation. The DoD recruiting is horrible now, worse
since the Vietnam War and they think if they give our
servicemembers a smooth transition to the civilian world it is
going to increase people getting out of the service. That has
been proven wrong by Naval Special Warfare.
We have got to do something and it sure as heck is not
this, ma'am. I am going to print this for you and I would like
you to take this, get the answers back, and then I want the
names, names, of every single person you are going to bring
this to in every one of the uniformed services. I would like
that by the end of the month.
Now, my time has expired and out of respect for my
colleagues, I know that Mr. Levin has got some more questions,
we will do a second round of questioning, so I will yield back.
I recognize Ranking Member Levin for 5 minutes.
Mr. Levin. Thank you, Chairman.
Director Hundrup, I am going to pick up right where we left
off. Solid Start is working better, more effective outreach
strategy than inTransition for connecting with new veterans who
need mental health services.
The question when we last spoke was why? What about,
specifically what about Solid Start makes it work better?
Ms. Hundrup. I think what--thank you for the question. I
think what it boils down to is the level of effort. For
example, as my fellow panelists stated, Solid Start sends an
advance e-mail, a packet of information and will call a veteran
up to seven times at each touch point, which is at three
different points across a 1-year period.
Contrast to that to inTransition. inTransition will make up
to three phone calls, but actually the reality is depending on
demand and resources. They are really only making one or two
phone calls depending on the month. If they do not make
contact, they will then remove the individual from the program
if they are unsuccessful in contacting them.
These folks are removed or unenrolled after only one or two
attempts, which is, I think, behind the very abysmal rate that
we are seeing in terms of the ability for folks to even know
about or participate in the inTransition program.
Very quickly, I would just note that we are seeing some
overlap across the two programs and particularly that is coming
out with the fact that they are identifying the same
individuals when it comes to the priority list for the Solid
Start as well as the inTransition list.
They are calling them via telephone during the same period,
which we have heard can be confusing, especially for those that
may not understand the programs or determine which one is best.
They are getting a lot of phone calls during a very
specific period of time. You know, we note that overlap
sometimes is warranted. Perhaps that allows for better reach or
multiple entry points.
I think that is why I would just emphasize the importance
of our recommendation to the Joint Executive Committee to look
across these programs and really understand the different touch
points when they are happening and be deliberate about that and
look for their effectiveness so that we are avoiding any areas
or concentrating them in areas when it is just adding to the
confusion.
Mr. Levin. Knowing what you know about the, I would say, a
labyrinth of people in charge of TAP and the limitations that
Ms. Orsega has, if you were in her shoes what would you do
right now to implement some of GAO's recommendations?
Ms. Hundrup. I mean, the first thing I would do is look to
Defense Health Agency (DHA) and look to their leadership to
hold the Transition program accountable. There is very little
oversight of the inTransition program right now that is run by
contractors.
They have no performance goals. There are no metrics. We
heard from the officials themselves that the program is working
as intended, which is very troubling.
I think there needs to be leadership within DHA that is
monitoring this program and holding the contractor accountable
for specific goals, conducting outreach, getting to those
individuals earlier in the transition process, and ensuring
they are getting that touch point so that the eligible
individuals have a chance to participate in this important
resource.
Mr. Levin. Ms. Hundrup, that seems like an extremely
reasonable plan.
Ms. Orsega, will you commit to following up in that manner?
If so, how long will it take you and when can we follow up with
you about it?
Ms. Orsega. Thank you very much and I appreciate the GAO's
recommendation. While we may not agree on all of the components
of it, the expertise----
Ms. Levin. It is a pretty simple yes or no. Will you----
Ms. Orsega. Yes. I will commit.
Mr. Levin [continuing]. commit to following up in the
manner just prescribed by Ms. Hundrup?
Ms. Orsega. Yes, I will.
Mr. Levin. How long will it take you and when will you
follow up with us?
Ms. Orsega. We--I will follow up at the beginning of the
next Fiscal Year cycle.
Mr. Levin. Okay. You will commit to that?
Ms. Orsega. Yes, sir.
Mr. Levin. Staff will take that back and we will follow up
with the DOD. We appreciate you continuing to work with us.
Definitely Solid Start is working better. It is still not
perfect. I am running short on time so I will make a couple
points.
VA issued a proposed rule for implementation of the Veteran
and Spouse Transitional Assistance Grant Program. That is
pretty important to us.
Now that VA has funding in hand when do you expect to open
the grant application?
Ms. Cohen. Thank you for the question. The notice of
funding opportunity has concluded on August 23d. We have
selected 13 organizations and we are working on that
announcement for release.
Ms. Orsega. We will provide more details in terms of the
additional resources.
If you are asking if they are needed to address mental
health, certainly I will take that for the record and can
provide a follow up.
Ms. Ramirez. Okay. Thank you.
Chairman, I yield back.
Mr. Van Orden. The gentlelady yields back.
The chair now recognizes Mr. McGarvey for 5 minutes.
Mr. McGarvey. Thank you, Mr. Chairman.
Votes have been called on the floor I am going to be brief
and turn my questions into a little bit more of a statement/
directive.
I appreciate you all being here today, and I really do hope
that DoD will take TAP and ensuring a smooth transition as
seriously as is warranted and will continue to support our
servicememembers through thick and thin, when they are out,
when they are in.
Ms. Debord, thank you. We have not gotten to some of the VA
stuff. I do want to thank you all for your engagement, for your
leadership in addressing the social drivers of health and
helping our veterans as they transition to civilian life.
One thing, I just want to make sure that the VA is not only
assessing and providing initial interventions that match
veteran families to social resources, but also to see these
referrals through to completion.
Even in some way maybe you all are doing it, but making
sure there is a systematic way to capture completion data
related to the internal consults and community referrals and to
provide necessary follow ups for veterans who might have just
engaged a social worker even one time. Something to think
about.
I appreciate you all being here today.
Thank you, Mr. Chairman. I yield back.
Mr. Van Orden. The gentleman yields back.
I now recognize myself for as much time as I may consume.
In the military you issue orders and things like that, and one
of the things that you do is you have someone restate the
mission so that you know that they know what your intent is.
Ms. Orsega, I would like you to restate the mission that
was given to you by my colleague from the great State of
Kentucky.
Ms. Orsega. The mission is to get and provide more details
for each of the Servicemembers specifically to TAP in terms of
how they are connected, who they are connected with, and what
are those specific responsibilities of both the counselor, the
TAP counselor, and the individual.
Mr. Van Orden. Mr. McGarvey, is that accurate?
Mr. McGarvey. Somewhat, yes. I think we want to know who is
responsible and how this is happening and who we can actually
get this information from as well.
Mr. Van Orden. Okay. This is your mission, ma'am, from Mr.
McGarvey. You are going to come back here and you are going to
tell us by department, by name, who is responsible for these
specifically and this series of things that my colleague from
the other side of the aisle has asked you will be reported on.
That will happen by the end of the month or I will personally
hold you accountable because now I have a name.
I think it should be telling to everybody here on this
panel and the people behind you that when we all agree there is
no daylight between the Republicans and the Democrats on this
committee, zero.
We have to do better. This we are going to work harder, we
are going to double efforts, no. It is wholly unacceptable.
That is your first mission.
The second one is I want answers in the English language
for these nine questions that I do not need to put a condiment
on. Okay? No more word salad, not doing it, because our
veterans are killing themselves because they have seven bosses.
On that note, today is world suicide prevention day. If
anybody is having any issues I need you to dial 988 and then
press 1.
I am unwilling to have another one of my friends or
colleagues or someone that has protected our Nation kill
themselves because of word salad. It is not happening.
I want to thank everybody for attending today, and I
appreciate the discussion and this is not over. We just have to
do better and we can. The road to hell is paved with good
intentions, and I do not want to go there okay?
With that, I yield to my friend and colleague Ranking
Member Levin for any closing statements you may have?
Mr. Levin. I just appreciate the Chairman's commitment to
working together in a collaborative way, and I know staff took
plenty of notes here on all the things you said you were going
to do and they are going to hold you to it.
Had plenty more questions, but until we meet again. Thank
you for the work that you are doing and look forward to
speaking with you all offline. I yield back.
Mr. Van Orden. The gentleman yields back.
Thank you again everyone for coming here today. Ma'am, Ms.
Orsega, no kidding. I really appreciate you showing up.
By the way, this is the best committee hearing Mr.
Rodriguez has ever had, right? It is, like, I am out of here,
whoo.
I ask unanimous consent that all members may have 5
legislative days to revise and extend their remarks and include
extraneous materials. Without objection, so ordered.
The hearing is adjourned here
[Whereupon, at 4:11 p.m., the subcommittee was adjourned.]
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A P P E N D I X
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Prepared Statements of Witnesses
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Prepared Statement of Melissa Cohen
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Prepared Statement of Susan Orsega
Chairman Van Orden, Ranking Member Levin, and distinguished Members
of the House Veterans' Affairs Committee, Subcommittee on Economic
Opportunity, thank you for the opportunity to testify before you today.
I am pleased to represent the Office of the Assistant Secretary of
Defense for Health Affairs to discuss the Department of Defense's
(DoD's) commitment to mental health support programs for separating
Service members.
The DoD is committed to providing the highest level of mental
health care to Service members. We ensure that those who serve our
Nation receive timely and high-quality health care, including care to
address their mental health needs. This is particularly important
during the transition from military to civilian life, when Service
members are most vulnerable to suicide and some experience challenges
such as the loss of a sense of purpose, post-traumatic stress disorder,
and other mental health symptoms.
In this testimony, we will inform the Subcommittee about the
Department's current mental health programs and resources during the
transition from military to civilian life - including the inTransition
program, the Transition Assistance Program (TAP), and Military
OneSource, as well as the Department's implementation of
recommendations from the U.S. Government Accountability Office (GAO)
report, ``DOD AND VA HEALTH CARE: Actions Needed to Better Facilitate
Access to Mental Health Services During Military to Civilian
Transitions'' (GAO-24-106189).
The DoD created the inTransition program in 2010 in response to a
2007 report by the DoD Task Force on Mental Health, which revealed that
a number of Service members were disengaging from mental health care
treatment as they transitioned from the DoD to the Department of
Veterans Affairs (VA) health care system, contributing to their
worsened mental health. For 14 years, inTransition has facilitated
continuity of care and connection to continued mental health resources
for Service members receiving mental health and/or moderate to severe
traumatic brain injury (TBI) care as they move into civilian life. The
program supports a Service member's efforts to achieve and maintain
wellness and enables continuity of needed services, including mental
health services.
The inTransition program supports all transitioning Service members
and veterans regardless of the duration of their service, time since
discharge, or category of discharge. All Service members who are
leaving the military service and who have received care for mental
health and/or moderate to severe TBI within 1 year of their separation
are automatically enrolled in the inTransition program, and Service
members can also get connected to services through self-or provider-
referrals.
Automatic enrollment is an ``opt out'' process, where neither
written consent from the patient nor a signed authorization is required
to enroll the Service member in the inTransition Program; however,
Service members are provided a choice to remain in or opt out of the
program. If the Service member does not opt out of the program, health
care providers or designated staff can, in collaboration with the
Service member, start enrollment by calling the inTransition number at
(800) 424-7877. During this process, health care providers or
designated staff provide the name, contact information, destination or
discharge status, and diagnosis to the inTransition coach. Service
members may also be made aware of the inTransition program and self-
refer through multiple channels, including the TAP curriculum, provider
referrals, and inTransition program marketing and outreach activities.
If not self-referred or provider-referred, all eligible service members
are automatically enrolled and called by the inTransition program to
discuss the program and provide services.
The inTransition program includes a call center that operates 24/7,
365 days a year, where program staff are available to respond to
Service member questions concerning their mental health, and to inform
Service members of local resources to meet their mental health needs.
The program also provides Service members with specialized one-on-one
motivational coaching, information, support, and education to encourage
Service members to continue to engage with any needed mental health
services. Coaches maintain regular telephonic contact (weekly, or at
the preference of the Service member) until the Service member has been
transitioned to the new provider and/or opts out of the program.\1\
Coaches work with Service members to identify eligible referral
destinations, support connecting them with a new mental health
provider, and facilitate ``warm handoff'' referrals to VA personnel who
guide Service members through the VA healthcare system to a VA mental
health provider.\2\, \3\ Through DoD's inTransition program,
the program staff, coaches, and separating Service members work
together to help continue Service member engagement with mental health
care services in accordance with the individual needs, preferences, and
circumstances of each Service member.
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\1\ Defense Health Agency Administrative Instruction (DHA-AI)
6490.02, ``inTransition Program,'' March 7, 2024.
\2\ DHA-AI 6490.02.
\3\ Health.mil; ``inTransition.''
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Since 2019 the DoD has leveraged an Interactive Customer Evaluation
(ICE) tool, which collects feedback on services provided within the
DoD. All Service members and Veterans who participate in inTransition
coaching services are requested to evaluate the program through the
completion of an ICE survey. Since its inception, ICE data demonstrates
that Service members who have participated in the inTransition program
have indicated their satisfaction with the program and its ability to
help connect them with necessary mental health supports and resources
during their transition. The inTransition program regularly receives
positive feedback from the field, including from military medical
treatment facility staff, the VA, Vet Centers, and the Veterans Crisis
Line--reflecting the program's significant and successful role within
the DoD and VA community.
In addition to inTransition, the DoD implements TAP, which is the
result of an interagency partnership among the DoD, VA, the Departments
of Labor, Education, and Homeland Security, the Small Business
Administration, and the Office of Personnel Management.\4\ TAP
addresses the many facets of a Service member's transition while
providing information, resources, and tools to Service members to help
them prepare for the move from military to civilian life. TAP includes
counseling from DoD, VA, and DOL on various benefits, programs,
services, tools, and other important resource entitlements for which
Service members may be eligible, as well as curriculums that educate
Service members on VA mental health resources that they can engage with
during their transition and when they have reintegrated into civilian
life.\5\ Through TAP, if it is determined that a Service member is not
prepared for transition, there is a warm handover between TAP
counselors and the appropriate partner or agency to connect Service
members with the needed resources to further assist them post-
transition.
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\4\ DoDTAP.mil; ``Partnering Agencies.''
\5\ DoDTAP.mil; ``TAP Curriculum.''
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Service members participate in TAP up to 1 year prior to separation
or 2 years prior to retiring to help prepare for their transition and
to proactively inform them of available resources to maintain their
mental health during their journey back to civilian life.\6\ Service
members who have participated in TAP have indicated that the program is
valuable and that they are satisfied with its ability to educate them
on accessing resources, with 91 percent of respondents confirming that
they know how to access transition-related resources, according to 2023
survey results.
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\6\ DoD Instruction 1332.35, ``Transition Assistance Program (TAP)
for Military Personnel,'' September 26, 2019.
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Military OneSource is a 24/7 resource available to all Service
members and families regardless of whether they are transitioning to
civilian life. One element of Military OneSource offers transitioning
Service members consultations on navigating their transition and
provides information on the resources and programs available to help
Service members have a successful transition.\7\ Through Military
OneSource, Service members have access to confidential non-medical
counseling up to a year after their separation or retirement.\8\ These
resources, along with programs like inTransition and TAP, offer
transitioning Service members with a comprehensive set of tools to
promote continuity of mental health care.
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\7\ Militaryonesource.mil; ``Military OneSource's Transitioning
Veterans Consultation.''
\8\ Militaryonesource.mil; ``Military Transition to Civilian Life
Comes with a Full Year of Support from Military OneSource.''
---------------------------------------------------------------------------
The mental health of Service members remains a priority for the
DoD, and we are continuously identifying opportunities to improve the
delivery of mental health support for those who serve our Nation. The
recently published GAO report, ``DOD AND VA HEALTH CARE: Actions Needed
to Better Facilitate Access to Mental Health Services During Military
to Civilian Transition'' (July 15, 2024), reviewed access to mental
health services for transitioning Service members, which included
examining elements of the DoD's inTransition program and the DoD-VA
Joint Executive Committee's (JEC) assessment of the effectiveness of
efforts to facilitate access to mental health services for
transitioning Service members.
The GAO's review identified challenges for inTransition to conduct
outreach to Service members and to connect with Service members that
are automatically enrolled in the program. Consequently, GAO provided
the following five recommendations, which included a revision of
inTransition's enrollment criteria and outreach policy, establishment
of inTransition performance goals, and an assessment by the DoD-VA JEC
of the departments' efforts to facilitate access to mental health
services:
Recommendation 1: The Defense Health Agency (DHA) should
revise the inTransition program's criteria for auto-enrollment as
outlined in its policy to identify and enroll eligible Service members
prior to their separation from the military.
Recommendation 2: DHA should revise the inTransition
program's policy to expand the outreach methods used by the program to
contact automatically enrolled Service members, such as by adding
requirements for outreach through email, text, or the use of location
services.
Recommendation 3: DHA should establish measurable
performance goals for the inTransition program that have quantitative
targets and timeframes.
Recommendation 4: DHA should implement a process for the
inTransition program to use performance information to assess its
effectiveness and make any needed improvements, as appropriate.
Recommendation 5: The DoD-VA JEC should assess the
effectiveness of DoD and VA programs and processes overall in
facilitating access to mental health services across the transition
continuum, and recommend any needed changes to DoD and VA, including
changes to address any identified gaps or unnecessary duplication or
overlap.
The DoD reviewed the GAO report and recommendations and a formal
comment from the Department is in progress. We are committed to
continuing to enhance the inTransition program and to assessing the
effectiveness of transition-related programs in order to improve
continuity of care for transitioning Service members.
Thank you for your continued support of the health and well-being
of our Service members and for inviting me to be here with you today to
discuss the important issue of continuity of mental health support
services for Service members transitioning to civilian life. We
recognize that we have more work to do, and much more progress to make,
in support of our Service members when they are most vulnerable as they
transition into civilian life. We remain committed to enabling Service
members to receive the necessary mental health support they need during
this life-changing and important transition. I look forward to your
questions.
Prepared Statement of Alyssa Hundrup
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Prepared Statement of James Rodriguez
Introduction
Chairman Van Orden, Ranking Member Levin, and distinguished Members
of the subcommittee, thank you for inviting me to testify today. I
appreciate the opportunity to discuss veteran mental health, and the
``warm handover'' processes that occur between agencies and programs,
that help ensure that veterans receive timely and effective mental
health support as they reintegrate into civilian life.
DOL is the lead Federal department for employment and training
programs. Successful employment is one key to economic success, and can
strongly impact physical and mental health, life expectancy, and the
quality of life.\1\ Veterans with service-connected disabilities,
including mental health conditions, often experience relatively low
labor participation rates and high unemployment compared to their non-
disabled counterparts.\2\ Furthermore, veterans with mental health
challenges, such as depression, posttraumatic stress disorder (PTSD),
substance use, and anxiety, may find it difficult to maintain regular
work attendance.\3\ Research indicates that unemployment can adversely
affect mental health and is associated with a higher risk of suicide
among veterans.\4\ Additionally, veterans with mental health
conditions, particularly those at risk of or experiencing homelessness,
may face increased risk of suicide following job loss.\5\
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\1\ See for examples: https://health.gov/healthypeople/priority-
areas/social-determinants-health/literature-summaries/employment
\2\ https://www.bls.gov/news.release/vet.nr0.htm
\3\ https://www.dol.gov/sites/dolgov/files/OASP/evaluation/pdf/
HVRPEval-VeteranPerspectives.pdf
\4\ https://www.mentalhealth.va.gov/suicide_prevention/docs/FSTP-
Employment-Status-and-Suicide-Risk.pdf
\5\ https://www.dol.gov/agencies/oasp/evaluation/completedstudies/
Homeless-Veterans-Reintegration-Program-Impact-Evaluation
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VETS' mission is to prepare America's veterans, Service members,
and military spouses for meaningful careers, provide them with
employment resources and expertise, protect their employment rights,
and promote their employment opportunities. VETS administers programs
designed to address the employment, training, and job security needs of
over 196,000 military Service members who transition to civilian life
each year, 8.6 million military veterans in the U.S. civilian labor
force,\6\ over 760,901 National Guard and Reserve members,\7\ and
923,668 military spouses (578,952 active duty and 344,716 Guard and
Reserve spouses).\8\
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\6\ https://www.bls.gov/cps/cpsaat48.htm
\7\ https://dwp.dmdc.osd.mil/dwp/app/dod-data-reports/workforce-
reports
\8\ https://demographics.militaryonesource.mil/
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VETS administers the employment component of the Transition
Assistance Program (TAP), which includes warm handovers (person-to-
person connections) of transitioning Service members to American Job
Centers and other partners when needed. DOL's American Job Centers are
one-stop locations that offer a broad range of career and supportive
services to the public. Veterans receive priority of service for all
DOL-funded training programs in American Job Centers. Along with our
partners, we are committed to ensuring the best transition for our
Service members and their families and connecting them to the mental
health and other services that they need.
TAP Employment Services and Warm Handovers
TAP provides training, resources, and assistance to separating and
retiring Service members on active duty, Guard, Reserve, and their
spouses, as authorized under 10 U.S.C. Sec. 1144. TAP is a cooperative
effort between VETS, the Department of Defense (DoD), Department of
Veterans Affairs (VA), Department of Education, Department of Homeland
Security (U.S. Coast Guard), Small Business Administration, and Office
of Personnel Management.
There are three core VETS TAP employment workshops. First, VETS is
responsible for the delivery of the Employment Fundamentals of Career
Transition (EFCT) Workshop, which is a mandatory, 1-day course for
employment preparation. In addition, based on Service members'
individual needs, VETS offers two elective tracks to acquire additional
skills through a 2-day workshop: (1) the DOL Employment Workshop, and
(2) the Career and Credential Exploration Workshop. Transitioning
Service members must elect one 2-day track during their individual
counseling. However, they are encouraged to attend any additional
track(s) and attend the courses more than once (as their unit missions
allow) to prepare them for their transition.
As defined in the DoD Instruction\9\ 1332.35, a warm handover is a
Capstone process between the respective military department and
appropriate interagency parties, resulting in the person-to-person
connection of transitioning Service members to services and follow-up
resources, as needed. The warm handover provides a confirmed
introduction and assurance that the appropriate interagency party
acknowledges that an eligible Service member needs post-military
assistance, and the interagency partner follows through on providing
assistance to meet the needs of transitioning Service members, mitigate
risks, and assist them in attaining their post-transition goals and a
successful transition.
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\9\ https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/
133235p.pdf
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Capstone is a two-stage process consisting of a review and
verification of a transitioning Service member meeting Career Readiness
Standards that takes place no later than 90 days prior to separation.
Stage one is an in-depth review of the transitioning Service member's
Individual Transition Plan (ITP) and Career Readiness Standards, which
is conducted by the military Service's TAP staff. Stage two consists of
the commander or commander's designee verifying that the transitioning
Service member has a viable ITP. If the commander or their designee
determines that the transitioning Service member does not have a viable
ITP, he or she must confirm that a warm handover takes place with the
appropriate interagency partners, as needed. For DOL, the Career
Readiness Standards for those completing the employment track are
either a completed resume or confirmation of employment, while a
completed comparison of technical training institutions is required for
those pursuing the vocational track. If a Service member fails to meet
the Career Readiness Standards at Capstone, they are provided a warm
handover to DOL.
DOL currently has two different warm handover procedures: (1)
Employment Navigator and Partnership Program\10\ (ENPP) site warm
handover procedures, and (2) non-ENPP site warm handover procedures.
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\10\ https://www.dol.gov/agencies/vets/programs/tap/employment-
navigator-partnership
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ENPP began as a pilot under the TAP program at 13 military
installations worldwide on April 1, 2021. The pilot was designed in
response to feedback from veterans who stated that, while their TAP
classroom experience was educational, they desired a more personalized
approach. Leveraging the Secretary's authority (10 U.S.C. Sec. 1144),
ENPP provides one-on-one, tailored services for transitioning Service
members and their spouses, helping them identify and connect with
meaningful employment and training opportunities. In Fiscal Year 2023,
5,747 transitioning Service members and 383 military spouses received
services through ENPP with more than 18,100 being served by this
program to date.
Currently at 36 locations, our Employment Navigator staff and our
partner organizations work with ENPP clients to assist them with their
resumes, provide career direction, and provide additional employment-
related personalized support. At ENPP sites, the lead Employment
Navigator serves as the initial point-of-contact for those
transitioning Service members who are receiving a warm handover for
either an employment or vocation track. During a warm handover at ENPP
sites, Employment Navigators connect transitioning Service members to a
designated American Job Center point-of-contact who verifies with DOL
that they have received the contact information and reached out to the
client to offer assistance. In addition to being connected with the
American Job Center in the community where they plan to reside after
transition, many Service members receiving a warm handover continue to
receive services from our Employment Navigators and partner
organizations.
ENPP partners are required to select a primary service from nine
possible categories of services, which include: digital employment
opportunity matching, training services, employment mentorship, hiring
events, employment networking, Registered Apprenticeship opportunities,
referrals to employment opportunities, placement services, and wrap-
around services. Many of our ENPP partners who provide wrap-around
services assist Service members in getting connected to critical
healthcare-related services. ENPP partner organization services are
provided at no cost to transitioning Service members or their spouses
through no-cost agreements between DOL and partner organizations. A
list of our current partners can be found on the VETS ENPP Partner
Page,\11\ and organizations that are interested in partnering with us
can submit an application.\12\ In coordination with our partners, VETS
will continue to extend ENPP to serve as many transitioning Service
members and their spouses as funding allows.
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\11\ https://www.dol.gov/agencies/vets/programs/tap/employment-
navigator-partnership/enpp-partnerships
\12\ https://www.dol.gov/sites/dolgov/files/VETS/files/tap/
DOLVETSENPPPotentialPartnerApplicationForm.pdf
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Notably, preliminary descriptive findings\13\ show that
transitioning Service members who received ENPP services have had
better employment outcomes than those who did not receive ENPP
services. For example, median quarterly wages were 11 percent higher
($11,370) for enlisted transitioning Service members who participated
in ENPP compared to their counterparts ($10,248) who did not
participate. And transitioning Service members who received ENPP
services were employed about 2 months faster than those who did not.
VETS will continue to gather and analyze data and will be able to
provide more nuanced information as this program continues.
---------------------------------------------------------------------------
\13\ https://www.dol.gov/sites/dolgov/files/VETS/files/ENPP-
Factsheet-2024-08-05.pdf
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At non-ENPP sites, the military Service's TAP staff will connect
transitioning Service members receiving a warm handover for employment
or vocation with a staff member at an American Job Center near where
the transitioning Service member will move to after separating. As of
March 31, 2024, 3,493 transitioning Service members in Fiscal Year 2024
have engaged with an American Job Center through Jobs for Veterans
State Grants (JVSG) or Employment Service (Wagner-Peyser) staff,
approximately 564 of whom (16.1 percent) indicated that they were
engaging with the American Job Center as part of a warm handover.
Separate from ENPP, VETS TAP offers the Wounded Warrior and
Caregiver Employment Workshop (WWCEW) to accommodate the individual
needs of transitioning Service members, including individuals with
mental health conditions. Each year\14\ there are approximately 20,000
transitioning Service members who are considered wounded, ill, and/or
injured, transitioning either through their Service branch's warrior
care or military recovery units or through the Integrated Disability
Evaluation System (IDES). In April 2022, VETS launched the WWCEW for
those being evaluated for a disability rating through IDES as an
alternative to the required 1-day EFCT. Disabled Service members face
barriers to completing the traditional EFCT, such as coordinating class
schedules with medical appointments, long class duration, working with
medical and health restrictions, and requiring caregiver attendance.
The curriculum includes six self-paced online modules that participants
can complete at their own pace, and the course interface enables users
to register for a virtual meeting with a VETS facilitator to ask
questions and to discuss activities and course content. As of July 31,
over 9,600 participants have attended WWCEW in Fiscal Year 2024.
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\14\ As of 2022: https://www.militaryonesource.mil/data-research-
and-statistics/military-community-demographics/2022-demographics-
profile/
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It is also important to provide multiple pathways to assistance, so
that there is no wrong door for veterans to knock on when they're
seeking help. On January 11, 2022, VETS announced the launch of a 5-
year Off-Base Transition Training (OBTT) pilot program, in accordance
with section 4303 of the Johnny Isakson and David P. Roe, M.D. Veterans
Health Care and Benefits Improvement Act of 2020 (P.L. 116-315). The
intent of this law was to improve health outcomes, and the OBTT pilot
helps support mental health by improving economic stability for
veterans and their families. Not all employment journeys are linear,
and as noted above, unemployment can adversely affect mental health and
is associated with a higher risk of suicide among veterans. Which is
why OBTT meets veterans where they are in their post-service life to
provide support whenever it's needed. OBTT provides TAP to veterans and
the spouses of veterans at locations other than active military
installations, in order to improve employment-related outcomes in areas
with high veteran unemployment. OBTT features ten 2-hour and three 1-
hour, instructor-led employment skills and workforce development
workshops, provided in classrooms and virtually. OBTT also offers
another important opportunity for veterans and their spouses to be
connected to other services they may need, including mental health
services in their local community. In Fiscal Year 2023, 6,293 veterans
or spouses of veterans were provided employment-related training
through OBTT.
American Job Center Resources
DOL's Employment and Training Administration (ETA) administers the
public workforce system, which includes nearly 2,250 American Job
Centers across the country. These one-stop locations offer a broad
range of career and wrap-around supportive services to the public, such
as job training programs, employment services, adult basic education
and literacy, vocational rehabilitation for individuals with
disabilities, childcare, transportation assistance, housing assistance,
legal aid services, unemployment compensation (including the
Unemployment Compensation for ex-Service members (UCX) program), as
well as referrals and linkages to physical and mental health care,
suicide prevention services, addiction counseling, and other services
and programs in their local communities. In most states, American Job
Centers coordinate with or co-locate eligibility determination services
for programs like the Supplemental Nutrition Assistance Program (SNAP),
Temporary Assistance for Needy Families (TANF), and other partner
programs, ensuring streamlined access for veterans and eligible persons
seeking support. Veterans receive priority of service for all workforce
training programs funded in whole or in part by DOL, as established by
the Jobs for Veterans Act of 2002 (38 U.S.C. Sec. 4215).
VETS administers the Jobs for Veterans State Grant (JVSG) program,
which provides funding for dedicated staff who work in the American Job
Centers to provide individualized career and training-related services
to eligible veterans and eligible persons with significant barriers to
employment, and other eligible populations\15\, and to assist employers
to fill their workforce needs with job-seeking veterans. This includes
veterans who self-identify as having a physical and/or mental health
disability, as well as veterans experiencing homelessness, or
economically disadvantaged. JVSG supports Disabled Veterans' Outreach
Program (DVOP) specialists, Local Veterans' Employment Representatives
(LVER), and dual-role Consolidated DVOP/LVER staff, located in 50
states, the District of Columbia, Guam, Puerto Rico, and the U.S.
Virgin Islands. DVOP specialists provide individualized career services
and facilitate employment placements to meet the employment needs of
veterans and eligible populations, ensuring that they receive the
customized services that they need. Individualized career services may
include comprehensive and specialized job readiness assessments, resume
development, interview preparation, development of individual
employment plans, career guidance, employment assistance, referrals to
other programs, and other related services. LVER staff conduct outreach
and advocacy efforts with local businesses to increase employment
opportunities for veterans. LVER staff facilitate and support veterans
in gaining and retaining employment and maintain cooperative working
relationships with community organizations that provide complementary
services and reciprocal referrals. Consolidated positions perform both
DVOP and LVER staff functions. These services are critical to veterans,
especially those struggling with unemployment, which can negatively
impact mental health and create difficult experiences.
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\15\ As defined in 38 U.S.C. Sec. 4101. In addition, beginning
with the Consolidated Appropriations Act of 2014, annual appropriations
for JVSG have made three additional groups eligible for JVSG services:
Transition members of the Armed Forces who have been identified as in
need of intensive service; members of the Armed Forces who are wounded
ill, or injured and receiving treatment in military treatment
facilities or warrior transition units; and the spouses or other family
caregivers of such a wounded, ill, or injured member.
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Homeless Veterans' Reintegration Program (HVRP)
Veterans experiencing homelessness and those at risk of
experiencing homelessness face specific challenges, including higher
prevalence rates of PTSD, a condition that can emerge from experiencing
traumatic events, as well as physical disabilities and challenges in
transitioning to civilian life.\16\ VETS administers the HVRP program,
which is designed to address these barriers and empower veterans to
secure good jobs in stable and high-demand occupations paying livable
wages. HVRP is the only Federal grant to focus exclusively on
competitive employment for veterans experiencing or at risk of
homelessness. HVRP programs partner closely with their local American
Job Centers, helping veterans experiencing homelessness and those at
risk of experiencing homelessness reintegrate into the workforce by
providing employment and wrap-around services, including mental health
care, suicide prevention services, and addiction counseling. In Fiscal
Year 2023, HVRP awarded more than $58 million to 159 grantees and
served over 17,300 veterans. Over half (55 percent) of participants
were employed upon completion, with an average hourly wage of $18.34 at
placement.
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\16\ https://www.dol.gov/agencies/oasp/evaluation/completedstudies/
Homeless-Veterans-Reintegration-Program-Impact-Evaluation
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HVRP grantees work one-on-one with veterans and their families to
help them obtain sustainable employment and stable housing, which in
turn improves their mental, physical, and emotional well-being. One
such story comes to us from a 55-year-old Navy veteran in Maryland who
found herself homeless after losing her job with a sub-contractor
shortly after transitioning out of the military. Her recent job loss,
lack of savings and support network, and inability to pay her rent
caused her to experience severe bouts of anxiety and depression. After
enrolling in the HVRP program, her case manager helped her enroll into
mental health counseling and helped her address her immediate mental
health needs, while providing her with the emotional support necessary
to continue her job search with renewed energy. After participating in
numerous interviews and refining her resume and job scope with the HVRP
case manager, she was offered a position as a Program Analyst with an
IT firm. This opportunity marked a significant turning point in her
mental health journey, as the new job provided her with the stability
and security she had been seeking. Her story is a testament to the
power of the comprehensive support systems our agency offers to
veterans facing a myriad of difficult challenges.
National Veterans' Training Institute (NVTI)
VETS established NVTI\17\ in 1986 to provide specialized training
and professional skills enhancement of American Job Center and other
veteran service providers' staff. NVTI provides high-quality and
relevant training, ensuring that veterans receive the best possible
assistance in their transition to civilian careers. NVTI trains nearly
4,000 participants annually, including JVSG-funded State staff and
other Federal agency staff. NVTI fosters a community of practice among
veteran service providers, enabling them to share best practices,
resources, and innovations. This includes supporting the development
and hosting of interagency resources and reports on mental health,
suicide prevention, and burnout prevention.\18\
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\17\ https://www.nvti.org/
\18\ https://www.nvti.org/Resources/Useful-Resources/Suicide-
Prevention-Mental-Health-and-Burnout/
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For example, NVTI offers the course, Preventing and Healing Burnout
in Veteran Service Providers\19\, a 1-day virtual course for veteran
service organizations and providers to define and provide strategies
for addressing burnout in veteran service providers. Course
participants engage in several self-reflective activities and
discussions to enable them to identify signs of burnout, understand
their stress level, and understand where they are on the burnout
spectrum. Participants also discuss resources and strategies for
preventing and overcoming burnout.
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\19\ https://www.nvti.org/training/class-descriptions/#:8:text=9612
%3A %20Preventing %20and %20Healing %20Burnout %20in %20Veteran
%20Service %20Providers
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Interagency Collaboration
President Obama's Executive Order 13625, ``Improving Access to
Mental Health Services for Veterans, Service Members, and Military
Families,'' established the Interagency Task Force (ITF) on Military
and Veterans Mental Health. The ITF has a primary goal of coordinating
and supporting interagency programs and activities related to mental
health, suicide prevention, substance use, and expanding access to
mental health care. DOL is an active participant, and I serve as co-
chair of the ITF's Evidence-Based Treatment Access and Engagement
workgroup, which is tasked with evaluating access and engagement
barriers to evidence-based mental health care for Service members,
veterans, and their families. As a result of this work, NVTI has
expanded its resources related to suicide and burnout prevention.
The National Defense Authorization Act (NDAA) for Fiscal Year 2024
(P.L. 118-31, Sec. 1805) codified DOL as a member with DoD and VA on
the TAP Joint Executive Committee. This enhanced DOL's preexisting
collaboration with DoD and VA, with VETS co-chairing the Transition
Executive Committee, Senior Transition Steering Group, Transition
Working Group, and six functional working groups. Interagency members
and the military Services meet and coordinate on a regular basis to
ensure that the partners are supporting and advancing TAP, as well as
to reduce redundancy, better serve unique populations, and improve
coordination of services across program areas.
Conclusion
The mental health of our veterans, Service members, and military
spouses is a critical concern, especially during their transition to
civilian life and a post-military career. Understandably, financial
struggles, employment barriers, and the stress of reintegration can
take a toll on a person's mental health and make finding meaningful
employment that much more difficult. As the lead agency on veteran
employment, VETS recognizes the importance of addressing these
challenges and works to address them in close coordination with our
interagency partners. We look forward to working with this Subcommittee
and our many partners and stakeholders to create opportunities to
ensure that all veterans, Service members, and their spouses can have a
good job and opportunity for advancement. Chairman Van Orden, Ranking
Member Levin, and distinguished Members of the Subcommittee, this
concludes my statement. Thank you for the opportunity to be a part of
this hearing, and I welcome your questions.
Statements for the Record
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Prepared Statement of Western Governors' Association
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