[Senate Hearing 119-155]
[From the U.S. Government Publishing Office]
S. Hrg. 119-155
BREAKING BARRIERS: IMPROVING VETERANS'
MENTAL HEALTH IN LOUISIANA
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FIELD HEARING
BEFORE THE
COMMITTEE ON VETERANS' AFFAIRS
UNITED STATES SENATE
ONE HUNDRED NINETEENTH CONGRESS
FIRST SESSION
__________
AUGUST 14, 2025
__________
Printed for the use of the Committee on Veterans' Affairs
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
Available via the World Wide Web: http://www.govinfo.gov
__________
U.S. GOVERNMENT PUBLISHING OFFICE
61-532 PDF WASHINGTON : 2025
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SENATE COMMITTEE ON VETERANS' AFFAIRS
Jerry Moran, Kansas, Chairman
John Boozman, Arkansas Richard Blumenthal, Connecticut,
Bill Cassidy, Louisiana Ranking Member
Thom Tillis, North Carolina Patty Murray, Washington
Dan Sullivan, Alaska Bernard Sanders, Vermont
Marsha Blackburn, Tennessee Mazie K. Hirono, Hawaii
Kevin Cramer, North Dakota Margaret Wood Hassan, New
Tommy Tuberville, Alabama Hampshire
Jim Banks, Indiana Angus S. King, Jr., Maine
Tim Sheehy, Montana Tammy Duckworth, Illinois
Ruben Gallego, Arizona
Elissa Slotkin, Michigan
David Shearman, Staff Director
Tony McClain, Democratic Staff Director
C O N T E N T S
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August 14, 2025
Page
SENATOR
The Honorable Bill Cassidy, U.S. Senator from Louisiana.......... 1
WITNESSES
Panel I
Fernando O. Rivera, Director, Southeast Louisiana Healthcare
System and Network Director, VISN 16 (Interim), Veterans Health
Administration, U.S. Department of Veterans Affairs accompanied
by Catina McClain, MD, Chief Mental Health Officer, VISN 16,
Veterans Health Administration; and Laurel Harlin, PhD, Chief,
Psychology Service, Southeast Louisiana Veterans Health Care
System, Veterans Health Administration......................... 3
The Honorable Charlton Meginley, Secretary, Louisiana Department
of Veterans Affairs............................................ 4
Panel II
Dr. Cheryl Magee-Baker, Director, Hope Center, Inc............... 15
Emily Meyers, LPC, Chief Executive Officer, Longbranch Recovery
and Wellness................................................... 16
Jackson Smith, JD, Executive Director, Bastion Community of
Resilience..................................................... 18
Kirk Long, Former Chief Executive Officer, Crescent City Surgical
Centre......................................................... 20
Paul Hermann, Executive Director, Disabled American Veterans,
Department of Louisiana........................................ 21
APPENDIX
Prepared Statements
Fernando O. Rivera, Director, Southeast Louisiana Healthcare
System and Network Director, VISN 16 (Interim), Veterans Health
Administration................................................. 37
The Honorable Charlton Meginley, Secretary, Louisiana Department
of Veterans Affairs............................................ 45
Dr. Cheryl Magee-Baker, Director, Hope Center, Inc............... 61
Emily Meyers, LPC, Chief Executive Officer, Longbranch Recovery
and Wellness................................................... 63
Jackson Smith, JD, Executive Director, Bastion Community of
Resilience..................................................... 66
Kirk Long, Former Chief Executive Officer, Crescent City Surgical
Centre......................................................... 68
Paul Hermann, Executive Director, Disabled American Veterans,
Department of Louisiana........................................ 69
BREAKING BARRIERS: IMPROVING VETERANS'
MENTAL HEALTH IN LOUISIANA
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THURSDAY, AUGUST 14, 2025
U.S. Senate,
Committee on Veterans' Affairs,
Washington, DC.
This field hearing was held, pursuant to notice, on August
14, 2025, at 9:11 a.m., in Lac Ponchartrain Room, 2nd Floor,
Student Life Center, Delgado Community College-City Park
Campus, New Orleans, LA, Hon. Bill Cassidy, presiding.
Present: Senator Bill Cassidy
OPENING STATEMENT OF HON. BILL CASSIDY,
U.S. SENATOR FROM LOUISIANA
Senator Cassidy. Good morning, everybody. Thank you for
being here. First, I have to apologize. I am dressed casually
because I'm going on an alligator hunt----
[Laughter.]
Senator Cassidy [continuing]. With President Trump's
Secretary of Labor. Now, wearing a tie on an alligator hunt is,
shall we say, not the way to do it. So, I apologize for being
so casual because I have multiple responsibilities today.
But none of them is as important as this. This is actually
a Senate Veterans' Affairs Committee hearing. This is something
which will go into our record, and it is a chance for our
veterans to communicate with me and with folks in the Veterans
Administration upon issues important to us all. We're focusing
today on mental health which we know is an issue.
President Lincoln, in his second notable address spoke of--
well, I won't get it quite right, but we shall, we shall bind
up the wounds of those who have served our country on the
battlefield. But it's also the motto for the VA. Now, some of
those words are unseen. And some of those wounds, nonetheless,
even though unseen, affects somebody for their whole life. That
is what we're addressing here today. And by the way, before I
go further, I want to thank Delgado. Madam Chancellor, thank
you very much.
[Applause.]
Senator Cassidy. There's different issues. Our State is a
rural State. We're in New Orleans. If you're in New Orleans, if
you're Jefferson Parish, you can come to this area and you can
get your care. But what if you're in Allen Parish? What if
you're in Jackson Parish? What if you are in Lafourche Parish?
How are we going to get those services there as well? That's
number one.
Number two, we know that according to the Department of
Defense, half of the overdose deaths in the military are
related to fentanyl. So, that is a problem which afflicts all
our society, not just veterans, and not just those in the
Department of Defense. It afflicts us all. And so how do we
address that?
Now, I will say, and I'm very proud of this, President
Trump just signed into law my bill, the HALT Fentanyl Act,
which gives law enforcement one more tool by which to go after
fentanyl. But that is something which continues to afflict our
communities, and we're going to hear from the VA how they may
specifically be addressing that.
I would also like to point out that sometimes you need
somebody from the outside looking in to help stimulate or get
suggestions as to the reforms that are required. One piece of
legislation that I have promoted is called the VetPAC. The
VetPAC would be an independent board of the VA, which looks at
the VA operations and make suggestions to Congress and to the
VA how they can improve service.
I say this because this hearing should be part of an
overall bigger effort to address these concerns. And this is
modeled after something which is done for Medicare, it's called
MedPAC, and for Medicaid called MACPAC, in which independent
agencies are making suggestions to improve Medicare and
Medicaid.
So, I'm hopeful that this hearing, that effort is part of,
in partnership with the VA, improving the services that are
delivered to those who have served our country. So, well,
that's the goal.
Now, today, we get to hear from folks who can answer
questions. And our first panel, Fernando Rivera, who is the
director of the Southeast Louisiana Healthcare System. And now,
you have VISN 16?
Mr. Rivera. Yes, sir. In an interim role.
Senator Cassidy. Interim. Scott McDougall has left. And so,
he's actually over the whole VISN, which includes not just New
Orleans, but also Shreveport, and other areas as well.
Mr. Rivera. Yes, sir.
Senator Cassidy. Second will be--he's accompanied by Catina
McClain. We've decided that we're related through an ancestor
who died in a drunken brawl----
[Laughter.]
Senator Cassidy [continuing]. But that's another story--who
is the chief mental health officer in VISN 16. And Laurel
Harlin, who is the chief of psychology services at the
Southeast Louisiana Veterans Healthcare System.
And also, very much appreciate Hon. Charlton Meginley, who
is the secretary of the Louisiana Department of Veterans Care.
And we'll hear from each of them, and then we'll open it up.
PANEL I
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STATEMENT OF FERNANDO O. RIVERA, DIRECTOR, SOUTHEAST LOUISIANA
HEALTHCARE SYSTEM AND NETWORK DIRECTOR, VISN 16 (INTERIM),
VETERANS HEALTH ADMINISTRATION, U.S. DEPARTMENT OF VETERANS
AFFAIRS ACCOMPANIED BY CATINA MCCLAIN, MD, CHIEF MENTAL HEALTH
OFFICER, VISN 16, VETERANS HEALTH ADMINISTRATION; AND LAUREL
HARLIN, PHD, CHIEF, PSYCHOLOGY SERVICE, SOUTHEAST LOUISIANA
VETERANS HEALTH CARE SYSTEM, VETERANS HEALTH ADMINISTRATION
Mr. Rivera. Good morning, Senator Cassidy, and
distinguished guests. Thank you for the opportunity to discuss
the Department of Veterans Affairs efforts to support mental
health and well-being of veterans in Louisiana, particularly in
rural and underserved communities.
My name is Fernando Rivera, I serve as the interim network
director for Veterans Integrated Service Network 16, VISN 16.
Joining me today are Dr. Catina McClain, mental health lead for
VISN 16, and Dr. Laurel Harlin, chief psychologist of the
Southeast Louisiana Veterans Healthcare System.
Veterans in rural areas face unique challenges; long
distances to care, limited provider availability, and social
isolation. Across VISN 16, which spans large rural populations,
we are committed to bridging these gaps, but we know that
Louisiana Veterans face compounded challenges beyond PTSD,
traumatic brain injury, and chronic illness.
Severe weather events such as hurricanes, often displaced
veterans from their homes, jobs and support systems, and rural
parishes, access to mental health care is limited and suicide
risk remains high. Despite these challenges, we're proud of the
strong integrated care we deliver statewide. VA facilities in
Shreveport, Pineville, and New Orleans have served Louisiana
for over 95 years.
Across our service area, nearly 5,800 VA employees provide
care to over 151,000 veterans annually. Access remains a key
concern, particularly for mental health, residential
rehabilitation and treatment programs, or mental health RRTPs.
These programs provide essential support to veterans with
serious mental health and substance use conditions.
Currently, there are only seven VA mental health RRTP beds
in Louisiana, limiting timely access to this level of care.
Within VISN 16, we've begun implementing centralized screening
for our RRTPs. As a result, we've seen a nearly 6 percent
increase in veterans admitted within 72 hours of a referral.
And this year, and the President's fiscal year 2026 budget
proposes a $1.5 billion investment to expand our RRTP capacity
nationwide.
We're also expanding virtual mental health services, such
as VA Video Connect. Since the start of this fiscal year,
Louisiana VA facilities have delivered nearly 10,000 virtual
mental health visits. Many rural areas still lack broadband
infrastructure, so we're committed to technology collaborations
that enhance access to care regardless of the ZIP Code.
To address transportation challenges, VA's Veterans
Transportation Service helps ensure veterans can reach the care
they need. In VISN 16, we're expanding access to community-
based outpatient clinics, and growing our network of more than
1,800 mental health providers and VA's Community Care Network.
The Veterans Community Care Program, or VCCP, enables
eligible veterans to receive care for more than 1.4 million
non-VA providers nationwide. This program is especially vital
for those in rural Louisiana, providing high quality, timely
care closer to home. We are proud of our community
collaborations from local mental health providers and
nonprofits, to educational institutions, and faith-based
organizations.
These collaborations expand our reach and build capacity.
Initiatives such as the veteran community partnerships
involving churches, shelters, and nonprofits help us to upgrade
at risk veterans before crisis occurs, our collaboration with
the Louisiana Department of Health, Louisiana Department of
Veterans Affairs, and local providers, helps close the service
gaps and align suicide prevention strategies essential to
executing Secretary Collins's vision for a unified veteran care
across the Federal, the State, and community levels.
Senator Cassidy, thank you for the opportunity to speak
today. Sir, we remain steadfast in our commitment to reaching
and serving every veteran in Louisiana. And with your support,
sir, we will continue delivering the care our veterans have
earned.
[The prepared statement of Mr. Rivera appears on page 37 of
the Appendix.]
Senator Cassidy. Thank you. Secretary Meginley.
STATEMENT OF HON. CHARLTON MEGINLEY, SECRETARY, LOUISIANA
DEPARTMENT OF VETERANS AFFAIRS
Mr. Meginley. Senator Cassidy, I want to thank you,
Chairman Moran, the Ranking Member, for holding this hearing
today. On behalf of Governor Landry and Louisiana Department of
Veterans Affairs, I'm very proud to affirm our state's
unwavering commitment to serving our Louisiana veterans. I
think as most people know, we are very passionate about doing
this and veterans first. This is our job.
During my 19 months in this position, I'll tell you there's
two numbers that have weigh very heavily on my mind. The number
17.5 and 150,000. 17.5 represents the estimated number of
veterans who die by suicide each day, and the 150,000, is the
estimated number of veterans who have died by suicide since
2001. And that's an estimate. I think the number actually just
sit a bit higher.
Senator Cassidy, given the billions of taxpayer dollars
that have been spent on veteran mental healthcare for the last
few years, these numbers are not just unacceptable, they're
unfathomable. The mental health of our veterans should not be
simply a top priority, it must be the priority.
Nationwide, about 25 percent of veterans struggle with
mental health issues, but Louisiana, that figure may be as high
as 50 percent. The demands for services is increasing with 40
percent of all VA appointments now addressing mental health. We
must act now to close any gaps in care and ensure that our
veterans receive the support they have earned.
As you'll see from our written testimony, the LDVA operates
within two key environments, which we may encounter veterans
with mental health issues, those veterans who are in our homes,
and of course the veterans within the community. Our veteran
homes face a critical and pervasive challenge with mental
health disorders affecting a staggering 78 percent of our
residents.
With 493 out of 632 individuals diagnosed with at least one
condition, more than half of these residents grapple with
multiple mental health disorders and diagnosis, compounding the
complexity of their care. Furthermore, 435 residents, about 69
percent, rely on antipsychotic or psychotropic medications to
manage their conditions.
Unfortunately, on too many occasions, we've had to deny
admission to veterans with certain mental or behavioral health
issues because we simply don't have the means to adequately
take care of them or manage their needs. Over the last 2 years,
72 percent of our admission denials were due to mental and
behavioral health issues.
These findings highlight wider challenges in the VA system.
Some of the frequent comments that we receive from veterans
around the State regarding VA services include; insufficient
training in hospitals and clinics, community care coordination
failures, long wait times, especially for psychiatric
appointments. And most concerning that we hear that's often is
the over-reliance on mental health-related medications without
sufficient follow-up.
Senator Cassidy, with this said, I firmly believe that if
you want to address the mental health needs of our veterans,
you have to address the root causes. Why are so many veterans
distressed? Underlying factors include exposure to combat
trauma, PTSD and TBI, the stress of separation from family and
support systems, difficulties transitioning to civilian life
such as adjusting to new roles and isolation, legal issues, and
co-occurring issues like substance use disorders, anxiety, and
depression, exasperated by military demands. And of course, the
experiences that some may have had with sexual assault or
training accidents.
These causes are compounded in Louisiana by geographic
isolation, rural poverty, and limited access to services. With
respect to our 263,000-veteran community as a whole, we know
that our Federal VA partners can't prevent suicide and address
the mental health issues that veterans face by themselves.
Fortunately, they don't have to. There are an estimated
45,000 non-profit organizations nationwide that have stepped up
to help veterans. In our written testimony, we've written we've
highlighted just a few of these organizations that have made
life and death differences in the lives of veterans.
There is one partner that I want to specifically
acknowledge, and that is the University of Louisiana at
Lafayette. An R1 institution, ULL is in the process of
preparing a report that will undoubtedly shed some light on the
extent of Louisiana's mental health crisis within its veteran
community.
Preliminary findings from the survey are deeply concerning.
While the national average for PTSD amongst veterans is 11 to
20 percent, our survey preliminarily is showing that that rate
could be around 45 percent for Louisiana's veterans. Similarly,
depression and anxiety rates are more than doubled than the
national average according to, again, the preliminary results
of the survey.
Factors include; geographic isolation, with 42 percent
living more than an hour away from a VA clinic, transportation
gaps, rural poverty, food insecurity, nation and neighborhood
safety concerns. Many are Vietnam-era veterans with complex
medical and mental health needs. Others are younger veterans
dealing with combat trauma, TBI, and challenges transitioning
to civilian life.
We plan to work with our ULL partners to conduct post-
survey-focused discussion groups across the State to better
understand the findings. I have probably a little bit more to
go, but if you need me to stop, I will.
[The prepared statement of Mr. Meginley appears on page 45
of the Appendix.]
Senator Cassidy. I see the time expired over there. And so,
we'll allow you to develop some of that and go through the
discussion.
Mr. Meginley. Fair enough, sir.
Senator Cassidy. Okay. Thank you. Thank y'all for that.
Fernando, if I'm asking some of the folks out there, they're
going to say you got a lot of turnover in your healthcare
staff, and particularly in mental health. When I see the stats,
I'll see in Washington, they'll tell us, oh, we've hired this
many people, which it's a lot of people, but that tells me as
well that you're filling a lot of positions and there's a
little bit of a flow through.
So, I think one of the concerns would be why so much
turnover and what can be done to limit the turnover as a
physician. I know the therapeutic relationship is something
which has to be developed, and if it's changing on a regular
basis, that's difficult. What can you inform people?
Mr. Rivera. Well, thank you for that question, Senator
Cassidy, as usual, extremely insightful, and open for quite a
bit of discussion. We've always balanced, in the VA, the
opportunity of serving and providing healthcare services to
veterans. And then also, preparing and educating the future
providers of those healthcare services.
At the VA here in New Orleans, we have a huge education
mission. We're privileged to be one of only 15 VA hospitals
across the country that's co-located with more than one medical
school, and as a result, we're able to draw specialty care
providers. We're able to associate Louisiana future providers
who are enrolled in this freshman class at your alma mater, and
encourage them to stay to learn about veterans.
70 percent of the doctors that graduate from a United
States medical school rotate through a VA hospital for some of
their training. This year, over 2,300 trainees in associated
health programs and programs related to nursing, dental care,
pharmaceutical care, and the like, psychologists of course. And
in that sense, we we're finding that roughly about 50 percent
of the staff of the students tend to stay in the State. They
tend to go back to the communities that they serve.
Senator Cassidy. I get that. But I think that the issue is
that people feel like the doctor that they're seeing, the
psychologists whom they are seeing, the nurse, et cetera, is
different on a--there's a turnover there. And I accept that
some of them may be resident physicians, and that's true. But
there also seems to be a turnover in terms of the psychiatrist,
for example.
Is there a root cause of that, and is there something that
can be done to change that? Because as we spoke, you have a
therapeutic relationship, and all of a sudden, somebody is
gone.
Mr. Rivera. Yes, sir. There's a shortage. We can't get
around the fact that the predictions are roughly 100,000
physicians nationwide, 200,000 registered nurses nationwide in
our State. We don't have an overabundance of mental health
providers.
Senator Cassidy. Now, let me ask you, because one thing
that's been done for optometrists, for example, is that if
there is a sudden opening, an optometrist scheduled, there is a
program that will take somebody who needs an eye examination
and they will do it by internet. And they may be talking to
someone in Wisconsin, even though they live in Jackson Parish.
And it fills in that gap.
So, knowing that some cities have an overabundance of
psychiatric support and others not so much, and the rural
areas, not at all. Is the VA, or is our VA, embarking on any
sort of virtual scheduling and other visits that will allow
their sudden opening to be filled with somebody who needs acute
care here?
Mr. Rivera. Absolutely. And our telehealth program
continues to grow in the mental health division. It has grown
more than probably in other areas. We experience using
telehealth to stay connected and maintain continuity of care.
Almost every year with hurricane seasons, our mental health
providers will work from home. We will work with other mental
health providers at other sites. I'm going to ask Dr. McClain
to talk a little bit about our clinical contact centers because
that is one of the real opportunities that we have not only to
support VA hospitals that may be serving rural communities, but
to support them through periods where they may have had staff
turnover where we may have only had one or two psychiatrists
and one has taken ill, another one has relocated because their
spouse now works somewhere else. So, Dr. McClain.
Dr. McClain. Thank you, Mr. Rivera. And thank you, Senator,
for the question. We are very fortunate in VISN 16 that we do
have a clinical contact center where veterans can call and make
same day linkages with mental health providers. May not be
their provider, though.
And so, we also have a clinical resource hub. If a provider
is ill, a provider retires, leaves VA for whatever reason,
we're able to assign one of our virtual psychiatrists to pick
up the care of that veteran and fill that gap until another
permanent psychiatrist can be hired by the local facility.
Other steps that we've taken to try to reduce turnover
include the establishment of a virtual on-call telepsychiatry
program within the VISN. We were hearing anecdotes from some of
our departing psychiatrists that they were taking positions in
where the on-call burden was less than in VA. And so, while
we've not eliminated on-call responsibilities, we have been
able to alleviate some of the burden of that for our psychiatry
staff.
Also, VA has taken steps to adjust the physician pay
scales. For example, VA has done special salary surveys for our
psychologists. So, lots of things underway to try to reduce
that turnover.
Senator Cassidy. So, there could be a systems issue, but
y'all attempting to address it?
Mr. Rivera. Yes, sir. And there is an opportunity to
incentivize future providers to stay in Louisiana and return to
the communities where they serve.
Senator Cassidy. And you also mentioned, and I would be
interested, I'm not sure everybody kind of caught this, but I
think I got it. The mental health residential and
rehabilitation treatment program, did you say there's 7 or 17
beds?
Mr. Rivera. Seven.
Senator Cassidy. Seven. And describe for people like what
that actually means, because when Charlton is saying he's got a
limited ability to take care of people with severe psychosis,
and I'm presuming that veteran might get a referral to you and
this sounds like a wraparound service. Describe what these beds
are please.
Dr. McClain. So, residential rehabilitation beds are
established where we can give evidence-based therapies in a
more concentrated manner that can be achieved on an outpatient
basis. The RRTP beds are in layman's terms, I suppose, sort of
the in between outpatient, full outpatient care and acute
inpatient care.
Services include: substance use treatment, general homeless
domiciliary programs, PTSD, residential care. Veterans in these
programs receive intensive services, evidence-based therapies,
state-of-the-art psychopharmacology, if indicated. And then, it
helps them to transition to that more stable condition where
they're able to manage successfully on an outpatient basis.
Senator Cassidy. So, wraparound services that restore
somebody to wholeness, but it's a more intense environment than
just the outpatient. So, there's only seven beds. What is the
waiting list for entry into these drugs?
Dr. McClain. The number of veterans, I don't have the exact
number of veterans. One of the things that we have done across
the VISN is to try to leverage our RRTP resources to serve
Louisiana veterans. Given the low number of RRTP beds
available, we have established single screening so that if a
veteran is screened in Louisiana, that is good enough for
Mississippi or Arkansas, for example, to accept that veteran
into a residential program there.
We're also leveraging our community partners. We've
outsourced a number of veterans this year, about 313 referrals,
to our community partners for residential care. Our wait time
has improved. We are shifting that curve to the left so that
more of our veterans are getting into our RRTP care within 72
hours of the referral, about a 6 percent improvement over
fiscal year 2024 for that group. Another 6 percent improvement
in the number getting in within four to seven days. So, we've
had about a 12 percent increase in the number of veterans
accessing that level of care within a week of referral.
Senator Cassidy. That's great. So, I'm very happy about
that. By the way, I'm not blaming you if there's a shortage.
It's up to Congress to kind of, I'm learning from you, redirect
resources to expand those number of beds.
Dr. McClain. Yes.
Senator Cassidy. So, Charlton, your testimony didn't go
there, but we know that mental health is oftentimes tied to
transition to the community, is tied to getting a good job that
makes you feel good about yourself. I once heard a testimonial
from a Marine who had been in Fallujah. He came back, and he
tried to commit suicide. And he said over there I was part of a
unit, and I was a Marine. And here, I was, you know, whatever
it was, wasn't fulfilling to him.
And so, there was that transition of all the things that
are implied in that. What can your agency do, and how do you
manage that? And how do you work with the VA Federal?
Mr. Meginley. Well, that's a great question, Senator
Cassidy. I've only been retired from the military for a little
over two and a half years, so I think a lot of folks even still
consider me to be a transitioning vet. And so, the first thing
that comes to my mind when I was thinking about when I hit the
retirement button was, ``What am I going to do with myself?''
You know, ``Where am I going to work?''
Well, in Louisiana, we have two incredible partners that
actually get to the core root of what you're talking about
right now. One of them is a program called The Boot, and one of
them is Next Op. And their entire mission, both of them, is to
put the transitioning service member to work. So, they have
forged relationships with various companies and entities.
They've gone in the house, said, ``We've got a ready-made
employee ready for you. They're trained, they're disciplined,
and they may not have the skills that you're looking for, but
we know that you can train them because they've already been
trained.'' And they help kind of ease that transition to get to
that point where that individual is put to work, getting a good
paying job, and can kind of start moving away from their
military time back to transition into the civilian world.
And so, both The Boot and the NextOp, again, they've been
incredible partners, and this is their sole mission. This has
been a focus of ours since we came in; is what do we do for
that young 22-year-old soldier who wants to say, ``I really
like it here in Louisiana, but there's no jobs.'' We're telling
them, ``No, there actually are plenty of jobs here. We're going
to help you find one.''
Senator Cassidy. And implicit in that, is that if you can
get them plugged into a job, they're more likely to find
community and they're more likely to be mentally whole----
Mr. Meginley. That's correct.
Senator Cassidy [continuing]. Because you don't have the
vacuum left from that camaraderie, from being in the service.
Mr. Meginley. That's right. And those of us who were in for
extended periods of time will tell you, when you're in the
military, there is a certain process. There is a certain code
of discipline, essentially. There is a certain way of acting.
And when you get into civilian world, it's not like that.
Oftentimes, the discipline and the structure that you had
oftentimes does not exist. And so, you expect more of your
civilian counterparts. Oftentimes, that doesn't come. And so,
these programs help kind of ease our service members back into
what real life is.
Senator Cassidy. Now, there's lots of folks here from
veterans service organizations, and thank y'all for being here.
Now, as it turns out, we know a lot of veterans will never
knock on your door, on his door, on my door, but they will show
up and play pool with somebody in a VSO.
Can you tell us how you can work with those organizations?
So, if someone sees a buddy who's having a problem, he can say,
or she can say, listen, ``We know where to direct you.'' How do
you disseminate your information to them? You see where I'm
going with that?
Mr. Meginley. So, I'll tell you the State gave us a car,
and we've put over 30,000 miles on it in the last 11 months.
All we do is travel. We go into the VFWs, we go into the
Legions, we go into DAV, and we're talking to the veterans who
feel like no one's listening to them. You can't live behind a
desk in Baton Rouge. And I think myself and my deputy, you
know, at least once or twice a week, we're out there talking to
the veterans and trying to understand what their issues are.
But I'll tell you something else. There's a really
important component to this, and that is the gentleman sitting
down here at the end, and then Mr. Crockett's in here, Mr.
Dante's in here, the VAMC directors, anytime I call them with a
veteran issue, they respond. And sometimes it's just a matter
of making the phone call to them because the veteran doesn't
know how to get to them.
You know, one of the complaints that I get about the VA is
phones. If someone would just answer the phone, most of the
time the issue gets resolved. Okay? I will leave that up to the
VA to determine and how to figure that out. But once that
veteran calls me, and I get them to the right person, most of
the time the issue is taken care of.
So, the VSOs, it's important for everyone to know this. I
can't do my job without the VSOs. I don't have a State budget
for mental health. But for me to get the VSOs to trust me and
to trust our team, we have to go to them. And that's what we've
been doing. And it's not just the Legion, it's not just the
DAV, it's also the other partners, the 501(c)(3) partners that
we have, the folks who are dealing with homelessness, the other
ones who are dealing with mental health care. And it's forging
those bonds, those partnerships, that allow them to kind of
pick up where the VA may not understand or be able to capture
those issues.
I'll give you one example. There's an organization called
Objective Zero. They have an app that deals strictly with
mental health for veterans, and the veteran has a live person
to talk to. They may not want to go to the VA, but they have a
resource right then and there that they need to talk to someone
and chat with someone. It's there.
Supporting those types of partnerships and those types of
entities who are getting in the mix, really at the grassroots
level, is really important for the VA and Congress to start to
understand and to fund, in my opinion.
Senator Cassidy. So, the audience is here. They are
motivated. They are here because they care about veterans'
issues. So, ask first, you, then Fernando, or your staff. If
somebody is needing services from the VA because of
homelessness, or because of job transition, or because of
mental health issues, fill in the blank. And one of the folks
in this room can finally tell me how that would work. Just lay
it out for--give a do this, do this, do this, for if the person
lives in an urban area, like say Jefferson Parish or a suburban
area like St. Tammany, or if they live in a rural area. So,
chop, chop, chop, tell them what they should do.
Mr. Meginley. From the DVA point of view, we have 74
counselors spread out throughout the entire State. So, if
there's a veteran who's having an issue, they've got a parish
counselor right then and there. Oftentimes that phone call is
made----
Senator Cassidy. How do they reach that? Is it on the
internet? How do they know where to find that person?
Mr. Meginley. So, our website is brand new. We just
completely renovated it. It's updated. All you got to go to the
website. Phone numbers are there for every VAC office.
Senator Cassidy. Give them the website.
Mr. Meginley. vetaffairs.la.gov
Senator Cassidy. Veterans?
Mr. Meginley. vetaffairs.la.gov
Senator Cassidy. La.Gov?
Mr. Meginley. Yes, sir. And so, you go to the website, it
has the phone number and it has the contact information for
that local veteran affairs office. And so if that individual,
that veteran calls one of our guys and lets us know, we can get
them to the proper local authorities if we need to or get them
to the big VA if that's necessary.
Senator Cassidy. I'm in Cameron Parish. I can go to
vetaffairs.la.gov, I'll find the local person in Cameron Parish
who I can call. Maybe they come visit, and they can intervene,
and they can be a navigator for this person to reach your
services through you or through Federal VA?
Mr. Meginley. That's correct. And then at the campuses, we
have 32 college campus navigators. So, if there's a college
student who's having some sort of distress, a veteran college
student, we have campus directors, campus navigators who are
there to help our college students as well.
Senator Cassidy. So, Fernando, how would you build upon
that?
Mr. Rivera. The average piece, sir is very much about
seeing the fabric, the veteran family, across the Louisiana
Department of Veterans Affairs, the Federal Veterans Affairs,
the veteran service organizations, spiritual leaders in our
communities. So, our outreach programs are designed to connect
at all of those levels, to not only be partners in outreach
activities, but to have our own outreach activities.
Our facilities and clinics so far this year have conducted
nearly 3,000 outreach visits. Whether those outreach visits are
being conducted on a daily basis by a team of homeless veteran
outreach providers, social workers primarily who are going out
every day to shelters, verifying whether there are any veterans
there, making sure those veterans are connected to a program.
Senator Cassidy. So the VA sends people to shelters on a
daily basis looking for veterans who are homeless?
Mr. Rivera. That's correct, and we are in that level of
communication. We work closely with the student veteran
associations at the universities as well. We stay connected.
My personal practice for 20 years now is to give every
veteran that I have the privilege to serve my cell phone
number, my email address. And often, I get phone calls. Every
one of these individuals who know me have my cell phone number.
They know how to find me. We view this concept of expanding our
outreach program and developing it even further as critical.
When we're talking specifically about high-risk mental
health patients being able to make that connection, whether
it's because we have inclement weather coming and we need to
know where our patients who are at risk for suicide are, and
how we can stay connected with them so that there is continuity
of care, whether we're talking about a veteran who is homeless,
who is also having mental health illness. How do we connect
them to those services?
This piece is very much a community piece. We all have skin
in this game. We all have to know and be better at recognizing
veterans in distress, understanding how to help that veteran,
whether that veteran is sitting next to you in church, or he's
in front of you at the Walmart, or he is next to you in a
clinic.
Senator Cassidy. Okay. So, hang on. I was not aware of
this. Do y'all actively go out to pastors, priests, to rabbis,
to Imans, you name it, and say, listen, here's our phone
number, sir.
Mr. Rivera. Yes, sir. We hold mental health stand downs. We
invite spiritual leaders and other key stakeholders.
Senator Cassidy. Now, what is the participation. To what
degree does everybody who attends such an organization--I'm in
the church. Do I need to knock on the door of my pastor and
say, ``Pastor Kevin, are you aware of this? And if so, are you
making a referral?'' So, how much uptake do you have from the
faith-based community to be your liaison?
Mr. Rivera. The short answer, sir, is not enough. When
we're talking specifically about suicide, statistics are
showing that 60 percent of that 17 are not enrolled in the VA.
And they may be very well entitled to receive mental health
care in the VA. So, reaching to that 60 percent that isn't even
connected to the VA healthcare system is critical.
Senator Cassidy. So, one thing everybody in this room can
do, if they're based in any sort of civic organization, whether
it's faith-based, Rotary, is the leadership of that node. If
there is in our community someone who needs help, what number
would they call? I mean, what is the specific point of entry
into the services required?
Mr. Rivera. The 24/7 service is the Veterans Crisis Line,
which I, myself, called on behalf of a veteran two nights ago.
And VA was able to provide care for that veteran. And then
there's the medical center number. There are the community-
based, our clinic numbers that can be reached.
Senator Cassidy. So, the Veterans Crisis Line?
Senator Cassidy. Yes, sir.
Senator Cassidy. What is that phone number?
Senator Cassidy. 988
Senator Cassidy. 988. Okay. And that seems like something
which like--well, let me ask you, Charlton, after speaking of
that, people download, what's the name of that app?
Mr. Meginley. Objective Zero.
Senator Cassidy. Objective Zero.
Mr. Meginley. The objective being no suicides
Senator Cassidy. And I presume it could also link there.
Correct?
Mr. Meginley. They do have contact information for the
Veterans Crisis Line.
Senator Cassidy. By the way, going back to the job
transition programs and the job training programs, do y'all
also connect veterans with those programs?
Mr. Rivera. We do, and we work with NextOp in our outreach.
When we do outreach out of our facilities, it's usually a
multi-professional team. We will have mental health providers
on that team, but we'll also have human resources staff who can
teach veterans about employment, how to seek employment, not
just within the VA or the Federal Government, but other
opportunities.
Senator Cassidy. Now, again, if somebody wants to access
those services, because a good job is good for somebody's
mental health. And if you can look at the so-called deaths from
despair, they're concentrated among men, principally men, but
also women, who feel like the economy has left them behind.
And by the way, I asked one of the previous VA secretaries
if some of the suicide in the VA was just representative of
this broader societal phenomenon. He said he thinks so. And so,
it's an influence back and forth.
So, if somebody wants those job training resources, and
we're all listening, and people who are watching by other means
are listening, so I'm asking to speak to them as well. I'm
trying to transition out, I want a better job. I think their
job training programs out there, and I don't think to call the
State, I want to call the VA, what number would they use? How
do they reach?
Mr. Rivera. They would call the medical center's number,
sir, and each medical center has its own number, and request
assistance.
Senator Cassidy. And so I can call and say, I would like
information on job training. I'm a veteran. I'm eligible for
benefits. Where do I call next?
Mr. Rivera. They would be able to refer to either our human
resources department that would be able to refer to our
veterans' experience officers and all of them would be able to
make that connection.
Mr. Meginley. I think it's important though, for veterans
to know the VA's website as well. The website has tremendous
amounts of information.
Senator Cassidy. Va.Gov?
Mr. Meginley. Yes, sir. And when I was in my process of
getting out, I spent almost a day just going through the VA's
website seeing, ``Okay, what may I qualify? How am I going to
start preparing for my exit out?'' And I learned so many things
the VA was doing I had no clue.
And so just sitting there and going through everything, as
I would've expected, especially with training and education
opportunities once I was done and how to use my GI bill, the
best way possible for my kids.
So, that's my biggest encouragement for any veteran. Go
spend some time on the VA website. You will learn a tremendous
amount about the veteran benefits. There's a benefit not too
long ago that I learned, I didn't even know about. One of my
counselors said, ``oh, did you know about this?'' I'm like,
``no.'' And it was just like, ``yes, here it is.'' I'm like,
``wow, that's amazing.''
Senator Cassidy. Yes. By the way, I was once explained,
again, in fairness to the VA and the DoD, I asked if they
walked through the process of somebody leaving from Fort Polk
and how would they transition out? And they said, we have a
whole day in which we tell them everything. I'm thinking, yes,
but you're 26 years old, you're super excited. You want to
move. And you're sitting there thinking----
Mr. Meginley. You might strike a nerve on this one. For
those of us who have walked out in recent times, I had a TAP,
it was 5 days. The one thing that I was told, if you listen to
nothing else, Friday, 9 o'clock, VA briefing was the most
important thing. And I was lucky enough, I did pay attention,
it helped me out a lot.
But TAP is shotgunned at you and you're just sitting there
saying, ``I don't understand a lot of what you're talking
about.'' And you're getting it within 6 months of walking out
of the service. You're just worried about getting a job. That's
what I want to know. How are you going to put me to work when
I'm walking out, right? If I have medical benefits, how am I
going to access those when I walk out?
And so, to me, the TAP program does need to have some
reformation done to it. Not just the shotgun approach, ``Hey,
here's some tools, good luck,'' because that's what I think a
lot of service members, and now veterans, will tell you that's
what they got out of the program. Was, ``Here's some stuff.
Thanks for serving. Good luck.''
Senator Cassidy. So, I just got a note. I'm supposed to
wrap up this panel and go to the next, thank y'all very much.
Mr. Meginley. Yes, sir.
[Applause.]
Senator Cassidy. Okay. Thank y'all for being here. In the
second panel, we're going to have veterans and leaders of the
community that have been doing outstanding work regarding
mental health on behalf of our veterans such as community care
provider, providing state-of-the-art clinical care for
veterans, faith-based homelessness center.
And I'll just let them introduce themselves. And so again,
I thank you for being here, and thank you for contributing to
this dialogue. Ms. Magee-Baker, please introduce yourself, and
please make your remarks.
PANEL II
----------
STATEMENT OF DR. CHERYL MAGEE-BAKER, DIRECTOR,
HOPE CENTER, INC.
Dr. Magee-Baker. Good morning. I am Dr. Cheryl Magee-Baker,
the director of the Hope Center, Incorporated. So, good
morning, Senator, and Members of the Committee. And since this
is a testimony, I cannot let it pass without being honored to
say I'm thankful to God for the grace He has given us in my
Lord and Savior Jesus Christ.
I'm honored to represent Hope Center, which is a faith-
based organization headquartered in Gretna, Louisiana, of
Jefferson Parish. It is an outreach ministry of the Hope of
Glory Church under the extraordinary leadership of Dr. W. Ron
Walker, President. I'm here today to speak about the lifesaving
work we've done under the Staff Sergeant Gordon Parker Fox
Suicide Prevention Grant Program, and the Supportive Services
for Veteran Families Program. This is about our unwavering
commitment to the veterans and military families who call
Louisiana home.
Let me begin with a truth we all know too well. Suicide
among veterans is a public health crisis, and for far too long,
too many have slipped through the cracks. But I'm proud to say
that in our corner of the country, we're doing something about
it. The work of suicide prevention and ending homelessness is
our opportunity to reach veterans and their families with help
and hope.
At Hope Center, we touch the lives of 123 veterans and
service members through the SSG Fox Grant Program. And not one,
not a single one, has been lost to death by suicide. This is
the impact of timely outreach, culturally competent care, deep
rooted community trust. And on the homelessness side, in the
past 13 years, Hope Center has served over 5,425 veteran
households.
The work is not easy. We must address mental health
concerns and move from trauma-informed care to healing center
engagement if we want the best outcomes. Over the past year,
Hope Center has conducted outreach across six parishes in
Southeast Louisiana in libraries, churches, barbershops, and
coastal communities where veterans live in isolation.
Through these grassroots efforts, we've engaged over 530
veterans and service members, many of them for the first time.
We've connected 26 individuals to the VA who had never accessed
their benefits, and I can imagine there are more. And then
there was another 42 who are on the rolls at the VA, but not
accessing VA benefits or services or VA healthcare.
These are men and women who served our country with honor,
but carried their battles home in silence. And silence,
Senator, can be deadly. The stigma of admitting suicidal
thoughts keeps many from speaking openly even when they come to
us asking for help. We've seen veterans on suicide watch unable
to check a box on a form. What they really need is someone to
sit down, look them in the eye and say, ``You matter. We are
not going anywhere. We are here with you.'' That's the heart of
what we do.
Our peer support specialists, veterans themselves, offer
more than services. They offer hope. They hold healing circles.
They walk into someone's living room at 6 p.m. on a Friday.
They host the Still Standing Podcast where listeners hear real
stories from real people who walked through darkness and made
it out on the other side.
We build partnerships with the VA Suicide Prevention team
meeting weekly to coordinate care Veteran. And Hope Center is
working to inform and educate the community by training faith-
based organizations to open up veteran welcome centers in their
houses of worship.
Senator Cassidy. Dr. Magee, can you wrap up?
Dr. Magee-Baker. Yes, sir. So, we urge the Committee to
continue to expand the SSG Fox and SSVF Programs, including re-
engaging veterans who are on the rolls but not using VA
services.
[The prepared statement of Dr. Magee-Baker appears on page
61 of the Appendix.]
Senator Cassidy. Thank you. Ms. Meyers.
STATEMENT OF EMILY MEYERS, LPC, CHIEF EXECUTIVE OFFICER,
LONGBRANCH RECOVERY AND WELLNESS
Ms. Meyers. Hi, my name is Emily Myers, and I'm a licensed
professional counselor in the State of Louisiana. I have
dedicated my career developing programs to support individuals
and their families recover from the mental health and substance
use disorders.
Today, I proudly serve as the Chief Executive Officer of
Longbranch Recovery and Wellness. We are a part of the
Community Care Network, and it's both an honor and a profound
responsibility to be here today to speak on behalf of an issue
that's deeply personal to me; showing timely, effective, and
equitable access for behavioral healthcare for veterans.
I want to begin my testimony by expressing my respect and
admiration for the Veterans Health Administration and its
dedicated employees. We work very closely with them. In my
experience, the VA staff care dear equally for the veterans.
They serve and work tirelessly within their constraints of
policy to deliver the best care possible.
At Longbranch, we view ourselves not as critics of the VA,
but as partners standing alongside the VHA and its mission to
ensure every veteran receives the highest quality care. Since
the inception of the MISSION Act, and more recently, the
COMPACT Act, our organization has worked hand in hand with the
VA responding whenever a veteran calls us directly or is
referred to us by the VA staff.
We understand mistakes. Veterans struggling with substance
abuse and mental health issues face an elevated risk of
suicide, medical crises, and premature death. When they reach
out for help, the window to act is short and the urgency is
real.
Longbranch was founded in 2018 and provides evidence-based
holistic treatment for substance use and co-occurring
disorders. Our company is clinician-led, trauma-informed, and
tailored to the unique needs of each individual, recognizing
the distinct experience of veterans. We worked with the
feedback of the local VA staff to develop both a separate male
and female extended care program for veterans. These programs
address the veterans' clinical issues coupled with the
developing life skills and recovery for progressive autonomy.
As Longbranch's CEO and COO positions are filled by
clinicians, it is one of our guiding ethical principles to
invest in the excellence of our clinical team to be trained and
competent working with this population. For example, all of our
clinicians are trained in interventions such as prolonged
exposure therapy and cognitive processing therapy for PTSD, or
post-traumatic stress disorder, that is a very common co-
occurring diagnosis for our veterans.
We also have collaborated with the research within the VA
on improving approaches such as yoga therapy for veterans with
substance use disorders and chronic pain. These results have
shown very promising outcomes for a significant reduction in a
variety of symptoms that we survey across the treatment
process.
Longbranch offers a full spectrum of care from
detoxification, to residential to extended care, intensive
outpatient long-term monitoring medications, assisted
treatment, and aftercare. We are one of the few programs that
offer services to families for our patients through workshops,
counseling services, and aftercare support groups because
family involvement could substantially improve patient
outcomes.
We take pride in exceeding not only VA, but our third-party
administrator Optum standards, and also, the requirements of
the State licensing bodies, and national accreditation
agencies.
Lastly, Longbranch employ many veterans who are in
recovery, which is something that our leadership team is
extremely proud of. While the MISSION Act and the COMPACT Act
were landmark steps toward improving access, implementation for
veterans with substance use disorders has been inconsistent and
those inconsistencies can be deadly for this population.
Different VA Medical Centers or VAMCs interpret the same
policy in vast different ways. In some locations, veterans are
offered a choice of community providers and the opportunity for
those providers to educate the VAMC staff on available services
or resources and others that choice is restricted or absent.
Some VAMCs maintain strong ongoing communication with the
community partners. Others do not.
These variations result in delays, confusion, and sometimes
in cases, the loss of the short willingness window when a
veteran is ready to enter treatment. I'll give you an example
of what might a veteran have to navigate under the current
status quo. This is cited from Veterans report, VA staff, VA
policy, and VA literature.
The veteran must schedule an appointment to see their
provider to discuss their substance use issues and that might
have a wait time. Then, they're provided a referral to a
substance use disorders clinic or staff to assess them for
treatment needs. If their current provider believes they need
treatment at the time of the original appointment, that
doctor's referral must be reviewed by another provider and
approved.
Once the substance use disorder assessment is completed or
referral to treatment is approved, the staff first look for a
VAMC residential treatment bed. If the VA residential treatment
bed is not available, the veteran may be referred to community
care, but only if the wait time is expected to be 20 to 30
days. This process from the first phone call to actual
placement commonly can exceed 30 days as the clock times does
not start until they come in for the original appointment.
There are numerous phone calls and back and forth for
appointments to get care. And as you might be able to tell,
this process can be confusing to navigate for anyone,
especially someone with an active substance use disorder. This
process can also vary from VA Medical Center to VA Medical
Center based on resources and staffing, so veterans giving
veterans the accurate information for the VAMC they're
connected to of how to get help when they reach out to us, can
be unclear.
For veterans with substance use disorders, 20 to 30 days is
not simply a wait, it can be a fatal gap. During that time,
they face heightened risks of medical emergencies, accidents,
incarceration, suicide, or overdose, particularly given the
dangers of today's fentanyl-laced drug supply.
The result is that the VA staff who are doing their best
are forced to follow a process that works against the urgency
of substance use disorders treatment. It's not a matter of the
individual performance, but a policy that does not count for
the acute risks of substance use disorders. And unless the
veteran is actively suicidal, they're lost in the gap between
the MISSION Act standards and the COMPACT Act standards.
[The prepared statement of Ms. Meyers appears on page 63 of
the Appendix.]
Senator Cassidy. Mr. Jackson.
STATEMENT OF JACKSON SMITH, JD, EXECUTIVE DIRECTOR, BASTION
COMMUNITY OF RESILIENCE
Mr. Smith. Thank you, Senator Cassidy, for the privilege of
testifying here today. And I also want to start by saying thank
you to the representatives of the 15,000 strong veteran
population of this city who fill this room. I'm acutely
conscientious that I testify up here, not on my own behalf, but
on behalf of you.
My name is Jackson Smith. I'm the Executive Director of the
Bastion Veterans Community here in New Orleans, and a Marine
combat veteran. My experience with the most pressing issues
facing our veteran population began in 2010 in Helmand
Province, Afghanistan. I spent eight months there in high-
intensity frontline combat with the 78 Marines and Sailors of
Third Platoon, India Company, 3/6.
And over those eight months, I watched virtually every one
of those Marines experience multiple, in some cases, dozens of
brain-injuring events like landmine explosions and firefights.
And in the years since then, I have seen how few resources
there are out there for the hundreds of thousands of veterans
with experiences.
Just like the Marines of Third Platoon, suicide, PTSD,
traumatic brain injury, overdoses, deaths of despair, these
problems are growing worse for our veterans, not better. In the
last two years of available data, we have seen the veteran
suicide rate here in our State of Louisiana increased by nearly
35 percent, while the civilian rate has stayed relatively flat.
The Wounded Warrior Project's 2025 Community Survey, some
of the most detailed data that we have available on post-9/11
disabled veterans, shows that homelessness among this
population has doubled between the last two surveys. We've
heard today about continuing to lose nearly 18 veterans per day
to suicide. But that number grows to 44 when we account for
overdoses and other self-induced deaths. That means during the
course of this hearing alone, we will lose as many as four more
veterans. Four right now as we speak.
But the news is not all bad. Initiatives like the Staff
Sergeant Fox Grant are an important first step toward
delivering the innovation and care that our veterans so
desperately need. But it is only that a first step. I have
heard witnesses before this Committee in previous hearings
testify that the primary purpose of the Fox Grant is outreach,
connecting with those veterans who are otherwise slipping
through the cracks.
And I agree, but outreach requires presence, boots on the
ground in the communities where these veterans live and in
their lives. And at less than two Fox grantees per State today,
and seven states with no grantees at all, we are not cutting
it. The Fox Grant program should be expanded significantly,
including the availability of significantly more grants for
first-time applicants.
In the last cycle, more than 80 out of 93 Fox Grants went
to existing grantees making the pool of available funds for new
initiatives vanishingly small. Thus, for small community
organizations like Bastion, it is difficult to justify the
significant effort required to even assemble a Federal grant
application. And that really matters because it's organizations
like ours on the ground that are often best to deliver that
follow-through, that in-person care, eyeball to eyeball that
can make the difference.
Organizations like Bastion are already working furiously to
innovate and fill gaps in the continuum of care. Bastion's
Headway program, funded since its inception by the Wounded
Warrior Project, is a perfect example. One of the first long-
term no cost community-based rehabilitation programs for
veterans dealing with traumatic brain injuries.
An expanded Fox Grant, particularly one that specifically
incentivizes programming for brain injury affected veterans,
could help to deliver programs like headway at the scale that
is required.
I also urge this Committee to consider renewing or
replacing the Assisted Living-TBI Pilot Program. That program
was terminated in 2017 without replacement for a variety of
reasons, including that it was deemed prohibitively expensive.
But I would submit to this Committee, respectfully speaking,
that given that there is no alternate or replacement program in
place, expensive compared to what? I believe that we owe it to
these veterans to deliver the care that they need regardless of
cost, just as they raised their hand and swore to defend this
Nation and their Constitution, regardless of cost, even that of
their lives.
I would also submit to this Committee that in terminating
that program without replacement, we have merely passed on the
cost to our veterans and their families with stark
consequences. Today, the suicide rate for long-term caregivers
of non-seniors is as high as 20 percent. We can do better, and
we must.
I will leave this Committee with the words said to me just
last week by one of our head of veterans, ``This program saved
my life.'' To hear those words from a fellow veteran is a gift
that I lack the words to properly describe other than to say to
my friend, if he's listening, ``I'm proud of you.''
But when I hear those words, I cannot help but to think of
how many more veterans we have not yet reached. How many of my
brothers and sisters we have already lost because we could not
reach them in time. How many more will we lose if we wait
another year? How many more will we lose today? Too many.
Organizations like Bastion can make the difference in the lives
of these veterans. We prove it every day, but we need your help
and your resources to turn the tide. Thank you.
[Applause.]
[The prepared statement of Mr. Smith appears on page 66 of
the Appendix.]
Senator Cassidy. And next is Kirk Long. Kirk Long is the
one who said to me, ``Hey, when you go out on that boat today,
don't fall off.''
[Laughter.]
Mr. Long. Don't fall out the boat, Doc.
STATEMENT OF KIRK LONG, FORMER CHIEF EXECUTIVE OFFICER,
CRESCENT CITY SURGICAL CENTRE
Mr. Long. Good morning. My name is Kirk Long, and I
appreciate Senator Cassidy's invitation to speak with you
today. I'm also a United States Marine Corps veteran, and the
proud father of an active-duty Marine, currently serving in
Camp Pendleton, California.
I have been a hospital developer and operator for over 30
years. With the last 15 years being spent as a Chief Executive
Officer of Crescent City Surgical, located in Metairie
Louisiana. Crescent City Surgical is a licensed general acute
care hospital focusing on a broad array of specialized care to
include neurosurgery, orthopedics, surgical oncology, pain
management, and mental awareness. Our provider network is large
and is augmented by a partnership with LCMC Health, the largest
hospital system in the New Orleans region.
Initially, I was asked to speak on the barriers to entry
with the Community Care Network. Put simply, unless you know
someone in Congress, you'll not receive a return phone call.
Then, when and if you do, you will be presented with a
boilerplate contract with lower than market payment rates.
There's no room for negotiation. All of this combined with the
immense difficulties of dealing with the VA in general, present
little to no incentive for private network providers to engage.
However, these challenges encouraged our team to propose
the creation of a pilot program that would augment the current
VA system. Specifically, our intent was to address the
egregious wait times many veterans encounter, especially if
they need specialized care. We learned that the NOLA VA Medical
Center was faced with many staffing shortages, especially in
the surgical specialties.
Since our network does have access to these specialists, we
are confident that we will be able to successfully reduce these
wait times and treat the veterans in a timely manner. We have
presented this project to Members of Congress and have been
encouraged by the response, and we look forward to seeing it to
fruition.
Additionally, we are encouraged by the ACCESS Act
legislation currently making its way through Congress. It is
apparent that the Members of Congress, such as you, Senator
Cassidy, as well as other Members of the United States House
and Senate VA committees, have heard about the many challenges
of working with the community care networks and are working
hard to address them. We applaud this.
We are also encouraged by the renewed focus within the new
ACCESS Act legislation to address the dire mental health issues
currently faced by our veteran community. I would like to take
this opportunity to announce the creation of a new mental
health facility in New Orleans, the Crescent City Behavioral
Health Center. The comprehensive care provided at this new
center will include both inpatient, outpatient, and partial
hospitalization mental health services in a safe and
comfortable environment.
The center will also be committed to the treatment of
chronic pain, including the myriad of organic and degenerative
diseases contributing to the mental illness. We will also
recognize the need for additional substance abuse disorder
services and intend to include this in our services.
I'll be happy to discuss any of the further details or
answer any questions at your convenience. Thank you.
[The prepared statement of Mr. Long appears on page 68 of
the Appendix.]
Senator Cassidy. And then, Paul, please.
STATEMENT OF PAUL HERMANN, EXECUTIVE DIRECTOR, DISABLED
AMERICAN VETERANS, DEPARTMENT OF LOUISIANA
Mr. Hermann. Yes, good morning. My name is Paul Hermann.
Senator Cassidy, Members of the Committee, thank you for the
opportunity to appear before you today as we discuss how we can
improve mental health care for veterans in Louisiana across the
country.
On behalf of the Disabled American Veterans, Department of
Louisiana, I'm honored to offer testimony in support of one of
our organization's top legislative priorities for the 119th
Congress; eliminating persistent gaps in veterans' mental
health care and suicide prevention, particularly for service-
disabled veterans in rural, remote, and underserved
communities.
Now, I want to be clear, VA has done a lot over the years
to improve mental health services. They built strong programs
for PTSD, depression, anxiety, substance abuse, and military
sexual trauma. But even with all that, too many veterans are
still falling through the cracks. And that's especially true
for veterans who historically have been overlooked, like women
veterans, rural veterans, and those dealing with MST and
intimate partner violence.
Here's one example. VA has a suicide prevention model that
helps identify veterans at crisis. It's a smart tool and it's
saving lives, but originally it did not include MST or intimate
partner violence despite evidence that both are major
contributors to veteran suicide. We are very pleased that VA
has addressed the issues and recently rolled out REACH VET 2.0,
which includes MST and IPV. Same goes for the community care.
VA trains its own staff in things like suicide prevention,
lethal means safety, trauma-informed care. But once you send a
veteran to a proper provider in the community, those
requirements disappear. That's just not good enough. If we're
going to trust the community providers with veterans' mental
health care, they need to understand where veterans are coming
from and be trained accordingly. We need to make sure that all
providers, VA or not, are prepared to meet the veterans where
they are with understanding with the right training and with
consistency.
The last part, consistency is a huge issue. Veterans often
finally build up the courage to open up to a therapist or a
psychiatrist only to find out that that person has left and
moved on. Then, they've got to start over again with someone
new. Trust doesn't come easy when you've been through trauma.
Losing a trusted provider can set someone back months and
sometimes years.
Another thing we've got to address is how we deliver care
in the rural areas. Look, not every veteran can or wants to do
therapy over video. Some veterans live in areas where there is
no reliable internet. Others just don't feel comfortable
talking about trauma on a screen. They want to see someone face
to face, not feel like they're just another face on the
monitor.
After Hurricane Katrina, the VA sent out mobile clinics to
serve veterans where they are. Why not do the same for mental
health? Let's bring psychiatrists care to rural veterans, even
if it's just a few days a quarter. The mobile units could run
out of the VA medical centers in New Orleans, Alexandria, and
Shreveport, and rotate throughout the rural parishes. That kind
of regular in-person contact could make a real difference,
especially for veterans who are isolated and don't have
transportation.
Now, when we talk about MST, we have to understand it's a
different kind of trauma than combat.
Senator Cassidy. Just for a second, MST is military sexual
trauma.
Mr. Hermann. Yes, sir.
Senator Cassidy. Yes, so everybody knows what you're
talking about.
Mr. Hermann. I'm sorry. MST survivors shouldn't be placed
in group therapy with combat veterans. They need tailored
support, and that goes for any mental health issue. We have to
meet veterans as individuals, not try to treat everyone the
same way.
Finally, I want to emphasize something simple but
important. Veterans need to know they matter. They're not just
a number. They need to be heard, believed, and treated with
dignity. When veterans feel like they're being passed around,
rushed through appointments, or pushed to the side, it can feed
into the hopelessness that we are trying to prevent. One
suicide is too many. We have to do better.
So, here's what we're asking; continue to update the
suicide risk tools to reflect real veterans' experiences, make
suicide prevention and trauma-informed care training mandatory
for all providers who see veterans, and invest in face-to-face
rural outreach, especially for mental health. If we can do
that, we can start closing the gaps, and truly show veterans
that their lives and their well-being are worth fighting for.
On behalf of DAV, Department of Louisiana, and the veterans
we serve, thank you for your leadership and continued
commitment to this mission. I'm happy to answer any questions
you may ask.
[The prepared statement of Mr. Hermann appears on page 69
of the Appendix.]
Senator Cassidy. Thanks, Paul. Again, thank you all and
I'll just kind of go down some lines, some questions I came up
with. Doctor----
Dr. Magee-Baker. Yes.
Senator Cassidy. Fernando really emphasized coordinating
with faith-based institutions, and obviously you're one of
them.
Dr. Magee-Baker. Yes.
Senator Cassidy. What can we do to improve the
understanding of, you name it, mosque, church, synagogue, that
this resource is here, you do it within a faith-based setting,
but the VA? You see where I'm going with that? How can we
improve that? Because I'm not sure my--I have to ask my pastor,
but Fernando suggested that it's not as wide a place as it
should be, because he says it's not as much as it should be.
How do we improve that?
Dr. Magee-Baker. Well, we've improved our relationships
with connecting with houses of worship and faith-based
organizations. And let me just tell you, Director Rivera has
been very open-hearted on, but I think inviting those
institutions of faith into the VA and welcome them in, I think
sometimes what happens is because of, you know, the religious
pact and different things like that in the separation of church
and State that sometimes is operated under, that leads houses
of worship to think that they're not wanted in government.
So, one part is inviting them in to see the facility, to
explore the needs. And part of our work is working with those
other faith-based organizations and houses of worship to
recognize because some of them don't even know that they have
those who served in the military veterans or who are the
military families within their local congregations. So, as we
reach out to them, they become more aware.
Senator Cassidy. Sean, are you still here? Sean is one of
my staff here in Baton Rouge, and he interfaces with a lot of
the VSOs. They have a very active program to help veterans.
Sean is available 24/7. He's a bachelor. You can call him day
or night.
[Laughter.]
Senator Cassidy. If you wake him up, who cares?
[Laughter.]
Senator Cassidy. But, Sean, on our website, we need to put
information for veterans. Somehow, we need to begin
communicating to these faith-based organizations that the VA
wants to work with. And so just think about that.
I want my office to pick up the same challenge I've given
to everybody. How do we help Fernando better connect with those
faith-based organizations? Because they're oftentimes the
person who knows the need.
Emily, you used the word navigation. It almost seems like
there needs to be a navigator to take somebody through this
process. Any thoughts on that?
Ms. Meyers. Thank you for question, Dr. Cassidy. I
appreciate it. Yes, I know there are patient experience
officers within the VA. So, we try as a community care partner,
when a veteran reaches out to us in crisis or their family, to
get connected. We try to direct them to the Veterans Experience
Office----
Senator Cassidy. But you were speaking really fast.
Ms. Meyers. Yes.
Senator Cassidy. And even speaking really fast, it takes a
really long time for someone to potentially work through the
process. And I'm a doctor who used to work with patients with
liver disease, and some patients with liver disease have a
history of addiction. On the other hand, everybody in here
knows somebody who's had a history of addiction. And the
willingness window, we know that exists. We know that
willingness, and you can catch them then, and if not, they are
back on.
So, how do we shorten that process to get to see a
community provider if the VA's not there for someone in that
willingness window?
Ms. Meyers. Yes, I know that there is that current
legislation that was referenced earlier, the ACCESS Act.
They're talking about that for substance abuse, because again,
navigating that process for a mental health or substance abuse
crisis can be very challenging for them. And so, what I had
proposed kind of--I didn't get to, even though I talk fast--was
looking at prioritizing a rapid placement for veterans with
substance use disorder, and especially with detox needs, and
finding a way that maybe we could supplement the VA while
they're waiting for an RRTP bed.
And I know there is a VA up in North Dakota that's done
that, where they work with a community partner for rapid
placement, and then they coordinate the long-term step down to
a residential bed within the VA system. So, that could
potentially be a solution long-term to assist those veterans in
crisis that don't meet acute inpatient criteria.
Senator Cassidy. Now, why do we need legislation if North
Dakota's already doing it?
Ms. Meyers. I think it's that kind of gap between the
Federal legislation and sometimes like the specific VA has
ability to negotiate contracts. So, I think there's that
confusion between the community care process now that exists
and then the specific VA negotiating a contract because there's
a gap in services in their area.
I know North Coast is pretty rural, so that could be part
of the reason they're doing that as well. But I think New York
also has a similar program.
Senator Cassidy. Paul, you mentioned specifically the rural
areas. Thank you for emphasizing that, sir. And it does seem
like somebody in a rural area by definition lives far away from
another person.
Mr. Hermann. Yes, sir.
Senator Cassidy. And so what do we do for outreach that
those people know that they can access the VA, or va.gov is a
nice place to be. But as you point out, sometimes there's not
even good broadband there for the services. By the way, in my
legislation I've worked in the bipartisan infrastructure bill,
I'm hoping it's soon implemented, there'll be access to high
speed, affordable internet for everybody in Louisiana, no
matter where they live. So, we're trying to confront that.
But that said, how do we connect those people, anyone who
might have that need, when they're in a rural area for that
initial visit?
Mr. Hermann. I think a lot comes from family or friends
checking on them, other veterans checking on them. The VA has a
program that they're supposed to check on them so many times
when they first get out. But I believe that if we brought the--
like I was talking about the buses, we did it in Katrina, bring
them out to a local area and these people can----
Senator Cassidy. So, let me ask you, because I've been told
that there's a stigma, and that some people in rural areas do
not want to go to a mental health clinic because small towns
talk.
Mr. Hermann. Correct. Some of them don't even want to admit
they have the problem.
Senator Cassidy. Now, but they have more likely to admit
because you stressed you need to have an appropriate setting
for the appropriate issue.
Mr. Hermann. Correct.
Senator Cassidy. So, if you bring the kind of VA mental
health clinic to small town, does that push people away? You
follow? I'm saying mental health clinics.
Mr. Hermann. I follow you, but I don't--I honestly believe
if we started this program, that veterans would come to it
because now they can see somebody face to face and talk to
somebody face to face. And even if even if the bus came and
they had groups working with PTSD clients or MST clients,
because again, they're PTSD, but it's not the same. Combat and
sexual trauma are two different things.
So, it's just the only way to--we've got to figure out a
way to reach them. And I believe that that could possibly be a
way to do that or find someone in the local community for them
to get together, you know, at a barber shop, whatever it is,
and have someone there that's trained in these types of traumas
so that they're talking to somebody.
One of the biggest things veterans don't want to do is talk
to somebody that doesn't have a clue what they're going
through. I mean, that's the bottom line, too. Iraqi veterans
don't want to necessarily talk to Vietnam veterans because they
don't think it was the same type of war, but it's still war.
So, we've got to get people to talk to other people that are in
their age group or they suffered the same type of trauma.
And like I said, to me it's find a local area that we can
send someone to. The VA sends people out locally to help with
claims. So, why not do the same thing with mental health?
[Applause.]
Senator Cassidy. Chronic pain. Chronic pain, brother, that
drags you down. Once I had a neck pain for about three months,
I had a pinched nerve, and I mean, all my emotional energy went
to managing that pain and eventually the nerve died and that--
so, I hear what you're saying. So, is the chief barrier the
ability to contract with the VA in order to provide those
services?
Mr. Long. So, one of the main barriers, Senator Cassidy, is
the community care networks are statutorily limited in how the
VA is allowed to pay the private providers if a veteran is able
to utilize a community care network. And that was one of the
frustrating things that we ran up against was that even though
the community care networks are administered by Optum, Optum is
owned by UnitedHealthcare. We as a provider had a contract with
UnitedHealthcare, but Optum was not allowed to offer us the
basic same rates.
Senator Cassidy. And these are just fair market rates. And
so, I was actually talking to Fernando before we came up here,
and one of the suggestions that we had was add some language in
some of this legislation that would allow the negotiation for
fair market payment rates through the Community Care Network.
So, if you're a veteran and you need to go see a
neurosurgeon, and a local VA does not have a neurosurgeon
available within two or three months, you're able to go outside
the VA system. You go see a neurosurgeon. Well, as we all know,
a lot of times, we've discussed it here today, the veterans are
usually a fairly complicated case.
They don't just go because they've got back pain. They go
because they have back pain. They also have five other
comorbidities. They have COPD, they might have cancer, they
might have addiction issues, they might have some sort of
mental health issue, but they might have intractable pain that
causes them mental anguish.
And so, these cases require a lot more time, and effort,
and resources by the private provider. All we would ask to just
be paid fairly for that. Not anything more or less, just a fair
market negotiation. And I think that would really open up the
success and provide for many more positive outcomes via the
Community Care Network, which is a great idea.
It's just there's some communications issues with it. There
are continuity of care issues with it. And I think the ACCESS
Act addresses several of those from the version I saw. And we
applaud that. And I think that with the addition of some sort
of fair market payment negotiation, that availability would
really go along way.
Emily, in the initial stages of the fentanyl epidemic,
people spoke about how someone would come in with pain and be
given oxycodone, and that would--they would maybe have a
genetic predisposition or whatever--but they would transition
from taking one oxycodone every three days to escalating doses.
Of those who are addicted that you see, how many of them
begin with a chronic pain kind of precursor and it leads to
that? Of course, not all, believe me, I don't want to put a
stigma on anybody with chronic pain. Period. Don't do that.
Just like we don't want a stigma on veterans regarding mental
health, but for those who have that issue, we want to
acknowledge it. So, how many of those.
Ms. Meyers. Well, thank you, Dr. Cassidy, for that
question. So, a lot of people, I don't have the exact number on
top. I can get that for you in the post hearing. But most of
our veterans come in with two diagnoses for addiction, is going
to be substance--or sorry, alcohol use disorder is the primary
or opioid use disorder is the primary. So, those are usually
our two diagnoses.
Now, what I will say is that every single person, we pretty
much drug test any illicit drug they're taking now. Anything
they get off the street which is a common thing for chronic
pain. When they start with prescriptions and then they navigate
to street drugs, everyone is testing positive for fentanyl.
So, it's every single patient pretty much we drug test that
uses illicit drugs. But yes, many of our veterans especially
have chronic pain issues. And we try to address that
holistically with yoga therapy, coupled with medication-
assisted therapies, as well as helping them work through those
issues with other models.
Senator Cassidy. Jackson, my staff confirmed the original
bill, the original legislation that you're describing for the
TBI was my legislation. The Veterans Traumatic Brain Injury
Care Improvement Act passed when I was announced
representative. And as you're speaking of it and the
effectiveness of it. Of course, I like that if you sponsor
something, do we have longitudinal data?
As a doctor and then as a Senator, if I'm going to make the
case that this needs to be reinstituted, you want to have the
outcomes that shows, wow, it did improve lives and by improving
lives, you may think it was expensive up front, but it saved a
lot of money on the back end. Do we have that data for this
program?
Mr. Smith. Sir, I don't believe that we have that data to
show effectiveness at the outset. What we have instead is a
quickly growing body of evidence as to the negative outcomes
that we're heading toward absent intervention. And as I've
stated in my testimony, my overriding concern is that there is
no replacement in place for that permit.
Senator Cassidy. I'm with you on that. But let me ask, it's
a lot easier to make the case, and you're kind of making it,
it's the absence of it. Now we're seeing the untoward effects.
Mr. Smith. Yes, sir.
Senator Cassidy. But it would be good to catalog what those
might be. For example, this VetPAC that I'm proposing, Senator
Hirono from Hawaii is proposing as well, an outside evaluator.
They could look at this program which has been terminated, and
then see the results, and then they give advice back to the
Congress and to the VA that this program should be reinstated.
You with me?
Mr. Smith. Yes, sir.
Senator Cassidy. So, if you're telling me that the folks
who formally were in the program who are now not in the program
are having this and all of that bad, then that's also helpful.
So, I'm going to ask you, if you can, working with others,
however you can do it, and we'll provide resources if you can
document that, because it's easier for me to make a case.
You notice I explored with Emily the relationship with
someone beginning on opioids because of chronic pain, but it's
easier for me to make a case for her position if we establish
that some of what she's catching is related to the absence of
effective therapy. Are you with me?
Mr. Smith. Yes, sir.
Senator Cassidy. That's not a big stretch.
Mr. Smith. No, no, not at all. What I can say right now
that we already know, we've talked a lot about veteran suicide
today. For individuals with moderate to severe TBIs, they are
experiencing suicide and excess mortality across all causes at
11 times the rate of their non-injured counterparts. Numbers
that are that stark combined with the caregiver statistics that
I mentioned. That, to me, is a flashing red fire alarm. And it
tells me that we have to put intervention and resources into
this now.
And given how early we are in this process, we've done this
pilot, that's true. Our understanding of the nature of brain
injury and brain health has advanced considerably even since
2017 when that program was terminated, especially in terms of
understanding how many more veterans there are out there with
these kinds of conditions.
Things like blast exposure and training. I was talking with
my fellow Marine over here about shooting mortars. Every one of
those has a brain injury in the back. Marines fire hundreds
over the course of training alone. So, frankly, we are way
behind the power curve here.
My overriding concern is that we start to pour resources to
see what works. Because right now we're really not even at that
stage yet. Programs like Headway at Bastion have demonstrated
efficacy. We have almost five years of data now on individual
participants in that program, and ``knock on wood,'' we have
yet to lose one of those veterans to suicide.
But across the population, nationally, we are drastically
behind. And when we look at the things that are coming out of
conflicts like Ukraine and Gaza right now, the next war is
going to be horrific in its effect on the brain health of our
service members.
Senator Cassidy. I'm going to ask each of you, Fernando was
so gracious, he is there and I'm here. So, both Congress and
the VA. If you had to each give like one piece of advice that
you would want us to hear on behalf of the veterans, I'm going
to just go to start with you, Paul, and it may be reason
something you've already said, but just emphasize that one
thing, then let us hear it and let us take it back.
Mr. Hermann. The one thing I would say is competent
psychiatrist and psychologist to deal with the issues that
veterans are dealing with. Don't stick somebody that has
depression with a combat veteran, or an MST patient, or an IPV
patient. It is totally different. You need to train those
doctors and psychologists in those fields.
Senator Cassidy. So, MST versus combat and have competent
physicians, psychologists trained for those.
Mr. Hermann. Trained for combat MST and IPV, the
interpersonal violence to be able to help the veterans deal
with that. And it's not just women veterans. Remember, military
sexual trauma does include men veterans.
Senator Cassidy. That's one thing I've heard that believe
me, there's more of a stigma associated with that and the men
are less likely to come forward.
Mr. Hermann. Yes, sir.
Senator Cassidy. But when you do it, you find it.
Mr. Hermann. Yes, sir.
Senator Cassidy. If I had to say one thing, I would say
let's make it easier for the VA to utilize the private sector
and the private providers that are currently out there that
currently have the capacity, the bandwidth, and the runway to
take care of these veterans. It wouldn't be difficult. It will
be a small jump. I'm going to ask you to be offline later.
Communicate that directly because Emily spoke about how there's
this kind of folding over of combat admission and somehow
sometimes things free fall between. And so, later you have my
contact. Send me something specific in regards this is what you
would do. There's been a great deal of discussion and testimony
today around outreach. Outreach requires presence. It requires
presence in person and on the ground.
Mr. Smith. There are no remote jobs in the military. There
are no one person jobs in the military. We have talked about
that veteran living rurally or struggling at home alone with
mental health issues. All of the new things that we're rolling
out; telehealth apps, those are important steps toward access.
But I have been that lonely veteran, and I have gotten on the
app, and I was as lonely when I got off as when I got on. I
might have gotten some good advice. I might have gotten some
counseling to help me with some of the other things that I'm
dealing with. But if I am alone and isolated to be at the
beginning of that call, I'm isolated at the end.
Community organizations, like the ones filling this room,
are already doing the work. We talk about faith groups. When
Bastion's new facility opens, the first thing that we are doing
is going to every one of our local churches because we know,
they know where the veterans are and where the struggling
veterans are.
You give $1,000 to the DAV, you'll get $1,000 worth of
outreach and serving veterans. I guarantee, same thing for the
VFW. Same thing for all of our community organizations who are
face to face with these problems every day. And right now,
resources are not getting down to those ground level
organizations from the pots of truly life changing, game
changing resources like the Federal Government, the VA.
Organizations like ours are not built to compete for a Fox
grant as it is currently configured at 11 grants available per
year nationwide in the last cycle. I just can't justify. I have
no shot competing against organizations that can hire an entire
outside company just to assemble that grant. Organizations like
our VSOs, our DAVs, our American Legions, it's the same thing.
We don't have time to do that because we are face to face with
that veteran.
So, we need avenues of funding that are more accessible.
And that can mean in smaller amounts, a $750,000 Fox rate is a
big deal, especially if you're counting on it renewing next
year. It doesn't have to be that it could be a $50,000 grant,
it could be a $25,000 grant. But with an application process
that is navigable for these community-based organizations, we
need the resourcing to further the work that we are already
showing we are capable of doing.
Ms. Meyers. So, what I would say is the biggest issue and
what I would ask for help with is basically when a veteran
reaches out for help that phone call is really challenging for
most people with substance abuse issues and veterans especially
asking for help is really challenging. And so, we want to help
them urgently navigate the process. So, developing consistent
guidelines of implementation for getting them into.
Senator Cassidy. Did you mention that VA's have different
processes, so what you're saying there needs to be one which is
common for all VAs?
Ms. Meyers. And kind of what they mentioned with VISN 16,
developing an outreach center. You know, I didn't know they had
fully had that yet, and online. So, that's great for me to know
so I can direct them to the right place. Because sometimes them
making a second phone call or a third phone call, they get lost
through the cracks and that's what we, none of us in this room
want. So, finding a way to maybe let us help them urgently and
in crisis and then help them get back to you as a healthier, a
little bit more stable so that we can, we can continue long-
term wraparound care. Veterans with substance abuse issues and
co-occurring mental health disorders are very complex cases.
They usually have a lot of medical comorbidities. They have a
lot of mental health comorbidities.
There is, as we talked about, MST, PTSD sorts of very
challenging mental health diagnoses and they deserve care and
really quality communication between us and them. And I know
most of the community partners that I know in the substance
abuse world and addiction world are willing to coordinate and
talk and work together to get them back to you guys. Get them
back to utilize services more effectively. Help set up
aftercare appointments with, with the VA and also give records
and coordinate. So, developing that consistent implementation
across VAs would be really helpful.
And second on that same note, is how do we engage with the
VA can vary from place to place. So, is it a weekly staffing
meeting? Is it an email? Is it a fax? Is it a you know, just
how do we engage? Can we discuss resources that are available
for the community care office? So, what they get a veteran that
doesn't know where they want to go or what they want to do. You
guys know where to send them. Not every veteran's right for us,
right? There's other places that are better or might be a
better fit for that patient.
So, we want to make sure they get to the right place, they
get the right care at the right time and the right level of
care.
Senator Cassidy. Doctor?
Dr. Magee-Baker. And just to piggyback, many of the things
that we hear from our veterans is about navigation. Where to
begin in the VA you know, telling them a call and waiting on
hold. Not being able to really explain or know what they need
or what department they need to get to is important. So, what
we would recommend is stronger navigation and VSOs and
community-based organizations can be that resource when funding
to help veterans walk them step by step in navigating how to
access VA resources, how to access veteran benefits as well.
Senator Cassidy. Thank you. You all join me in thanking our
panelists.
[Applause.)
Senator Cassidy. This has been very helpful to me. I'm sure
it's been helpful to you, Fernando. I thank you all for being
here. And truly me, Sean will make himself available. If
there's something that you think that you've got a personal
story that's going to help us serve others better, we would ask
that you would reach out to my office. And we're also on the
internet, of course. And with that, I conclude the hearing.
Thank you.
[Whereupon, at 10:56 a.m., the hearing was adjourned.]
A P P E N D I X
Prepared Statements
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