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Hearing Transcript on Building Bridges between VA and Community Organizations to Support Veterans and Families

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Committee on Veterans' Affairs, Health Subcommittee, Building Bridges
between VA and Community Organizations to Support Veterans and Families, 2-27-13

 

 

BUILDING BRIDGES BETWEEN VA AND COMMUNITY
ORGANIZATIONS TO SUPPORT VETERANS AND FAMILIES

 



HEARING

BEFORE THE

SUBCOMMITTEE ON HEALTH

OF THE

COMMITTEE ON VETERANS' AFFAIRS

U.S. HOUSE OF REPRESENTATIVES

ONE HUNDRED TWELFTH CONGRESS

SECOND SESSION


FEBRUARY 27, 2012


SERIAL No. 112-45


Printed for the use of the Committee on Veterans'
Affairs

 

 

U.S. GOVERNMENT PRINTING OFFICE

WASHINGTON, DC:  2012


For sale by the Superintendent of
Documents,  U.S. Government Printing Office

Internet: bookstore.gpo.gov  Phone: toll free (866) 512-1800; DC
area (202) 512-1800

Fax: (202) 512-2104  Mail: Stop IDCC, Washington, DC 20402-0001

 



COMMITTEE ON VETERANS' AFFAIRS


JEFF MILLER, Florida, Chairman

  CLIFF STEARNS, Florida

DOUG LAMBORN, Colorado

GUS M. BILIRAKIS, Florida

DAVID P. ROE, Tennessee

MARLIN A. STUTZMAN, Indiana

BILL FLORES, Texas

BILL JOHNSON, Ohio

JEFF DENHAM, California

JON RUNYAN, New Jersey

DAN BENISHEK, Michigan

ANN MARIE BUERKLE, New York

TIM HUELSKAMP, Kansas

MARK E. AMODEI, Nevada

ROBERT L. TURNER, New York
BOB FILNER, California, Ranking

CORRINE BROWN, Florida

SILVESTRE REYES, Texas

MICHAEL H. MICHAUD, Maine

LINDA T. SÁNCHEZ, California

BRUCE L. BRALEY, Iowa

JERRY MCNERNEY, California

JOE DONNELLY, Indiana

TIMOTHY J. WALZ, Minnesota

JOHN BARROW, Georgia

RUSS CARNAHAN, Missouri
 

 

 

Helen W. Tolar,
Staff Director and Chief Counsel


SUBCOMMITTEE ON HEALTH

ANN MARIE BUERKLE, New York,
Chairwoman

CLIFF STEARNS, Florida

GUS M. BILIRAKIS, Florida

DAVID P. ROE, Tennessee

DAN BENISHEK, Michigan

JEFF DENHAM, California

JON RUNYAN, New Jersey
MICHAEL H. MICHAUD, Maine,
Ranking

CORRINE BROWN, Florida

SILVESTRE REYES, Texas

RUSS CARNAHAN, Missouri

JOE DONNELLY, Indiana

Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House,
public hearing records of the Committee on Veterans' Affairs are also
published in electronic form. The printed hearing record remains
the official version.
Because electronic submissions are used
to prepare both printed and electronic versions of the hearing record,
the process of converting between various electronic formats may
introduce unintentional errors or omissions. Such occurrences are
inherent in the current publication process and should diminish as the
process is further refined.

 

       

C O N T E N T S

February 27, 2012


Building Bridges between VA and Community Organizations to Support Veterans
and Families

OPENING STATEMENTS

Chairwoman Ann Marie Buerkle

    Prepared statement of Chairwoman Buerkle

Hon. Michael H. Michaud., Ranking Democratic Member

    Prepared statement of Congressman Michaud

Hon. Silvestre Reyes, Democratic Member, prepared statement only


 

WITNESSES

Andy Davis, Veteran, Director Saratoga County Veterans Service
Agency Saratoga County, New York

    Prepared statement of Mr. Davis

Chaplain John J. Morris, Joint Force Headquarters Chaplain Minnesota National
Guard

    Prepared statement of Chaplain Morris

Shelley MacDermid Wadsworth, Ph.D., Director, Military Family Research Institute
Purdue University

    Prepared statement of Ms. MacDermid Wadsworth

M. David Rudd, Ph.D. ABPP, Dean, College of Social and Behavioral Sciences
Scientific Director, National Center for Veteran Studies University of Utah

    Prepared statement of Mr. Rudd

George Ake, III, Ph.D., Assistant Professor of Medical Psychology, Duke
University American Psychological Association

    Prepared statement of Mr. Ake

Rev. E. Terri LaVelle, Director Center for Faith-based and Neighborhood
Partnerships, Office of the Secretary, U.S. Department of Veterans Affairs

    Prepared statement of Rev. LaVelle

Chaplain Michael McCoy Sr., Associate Director, National Chaplain Center,
Veterans Health Administration, U.S. Department of Veterans Affairs

    Prepared statement of Chaplain McCoy

 


SUBMISSIONS FOR THE RECORD

Consortium for Citizens with Disabilities, Veterans, and
Military Families Task Force


MATERIAL SUBMITTED FOR THE RECORD

Post-Hearing Questions and Responses for the Record:

Questions from Hon. Michael H. Michaud, Ranking Democratic
Member, Subcommittee on Health,
Committee on Veterans' Affairs to Honorable Eric K. Shinseki, Secretary,
U.S. Department of Veterans Affairs

Responses from Honorable Eric K. Shinseki, Secretary, U.S.
Department of Veterans Affairs to Hon. Michael H. Michaud, Ranking
Democratic Member, Subcommittee on Health, Committee on Veterans' Affairs

 


BUILDING BRIDGES BETWEEN VA AND COMMUNITY ORGANIZATIONS TO
SUPPORT VETERANS AND FAMILIES


Monday, February 27, 2012

U. S. House of Representatives,

Subcommittee on Health,

Committee on Veterans' Affairs,

Washington, DC.

The subcommittee met, pursuant to notice, at
4:02 p.m., in Room 334, Cannon House Office Building, Hon. Ann Marie Buerkle
[chairwoman of the subcommittee] presiding.

Present:  Representatives Buerkle, Bilirakis,
Roe, Runyan, Michaud, Reyes, and Donnelly.

Also Present:  Representative Walz.

OPENING STATEMENT OF ANN MARIE BUERKLE, CHAIRWOMAN,
SUBCOMMITTEE ON HEALTH

Mr. BUERKLE.  Good afternoon, and
thank you all for being here this afternoon. 

Before we would begin, I would like to ask
unanimous consent ‑‑ although I don't see him here yet, for our colleague, Mr. Tim Walz from Minnesota, to sit at
the dais and participate in today's proceeding. 

Without objection, so ordered. 

Today, we meet to discuss the role of faith‑based
and community providers in helping servicemembers, veterans, and their families
transition from active duty to civilian life and the need to foster better
communication, education, and collaboration between the Department of Veterans
Affairs and these critical community resources. 

The responsibility for each one of us to care
for those who have borne the battle has never been so strong with the brutal
toll of a decade of war and a bad economy.  We continue to hear stories of
veterans from past conflicts and our recently returning veterans from Iraq and
Afghanistan struggling to find a home, a job, or a helping hand.  The need to
meet these honored heroes where they are and provide them the care, the hope, and
the help they earned has never felt so immediate. 

As a Nation, we are uniquely blessed to live
in a country with a rich history of civic pride and responsibility, and it is
to these communities where our veterans return home, where they have maintained
their existing relationships, and, more often than not, where they first turn
for help. 

While the primary responsibility for caring
for our veterans does and should lie with the VA, faith‑based and
community groups are playing an increasingly key role in supporting the varied
needs of our servicemembers, veterans, and their families.  They act as
a bridge to accessing Federal, State, and local programs and services. 

Members of the clergy in particular are often
the first point of contact with the veteran grappling with the wounds of war. 
Data from the VA National Chaplain Center indicates that four out of ten
individuals with mental health challenges seek clergy assistance, more than any
other mental health providers combined. 

We already know that faith‑based and
community groups can be effective in filling known gaps in VA care and
supporting the day‑to‑day needs of a veteran population.  However,
a district symposium I held in my home district of Syracuse last December
revealed to me a shameful lack of communication, collaboration, and
coordination between the VA and these critical community resources and,
subsequently, an urgent need to act to establish meaningful partnerships
between the VA and nongovernmental organizations.

With more of our servicemembers returning
home each day, we cannot afford to let any opportunity to better support our
veterans pass us by.  Where partnerships exist, they need to be strengthened. 
Where they don't, they need to be fostered.  For a veteran or a loved one in
need, every door should be an open door. 

Again, I thank all of you for joining us this
afternoon.  I look forward to a productive and ongoing conversation. 

I now recognize our ranking member, Mr.
Michaud, for any remarks he might have. 

[The statement of Ann Marie Buerkle appears in the Appendix.]

OPENING STATEMENT OF HON. MICHAEL H. MICHAUD, RANKING
DEMOCRATIC MEMBER

Mr. MICHAUD.  Thank you very much,
Madam Chair. 

I, too, would like to thank everyone for
attending today's hearing. 

This hearing is intended to open up the
broader thought process and better understanding on how the VA and community
organizations collaborate to support veterans and their families. 

More than 2 million servicemembers have been
deployed since September of 2001, with hundreds of thousands of them being
deployed more than once.  As of February, 2012, more than 6,000 troops have
been killed and over 47,000 have been wounded in action in the recent
conflicts. 

When these servicemembers come home and take
off the uniform, many of them have the expectation that life will just pick up
where they left off before they were deployed.  However, this is not the case. 
Many of them struggle to reconnect with their families and communities.  They
find themselves feeling isolated and unable to cope.  The Department of
Veterans Affairs reports that half of the OEF, OIF, and OND population that has
access to VA health care has sought mental health treatment.  Posttraumatic
stress disorder is the number one reported mental health concern among this
population. 

With so many OEF, OIF, OND servicemembers and
veterans experiencing psychological wounds, reports suggest that there is an
increase in the rates of suicide, alcohol and drug abuse, homelessness, and
domestic violence.  For this reason, it is essential that our servicemembers,
veterans, and their families receive the help they need and that they have
necessary tools to rejoin their communities.  These programs and resources
would not be possible without the thousands of community organizations across
the country that work in partnership with the VA. 

At this hearing, I want to hear more about
the reintegration challenges that servicemembers, veterans, and veterans'
families face as well as the challenges the VA and community organizations face
as well in providing support services.  We need to identify potential solutions
to these barriers and how we can strengthen these partnerships. 

Despite historic increases in the VA funding
over the past 5 years as the Nation prepares for an influx of returning
veterans, reintegration efforts are simply not possible without collaboration
between the Federal Government, business sector, and nonprofit organizations;
and more needs to be done to facilitate these partnerships. 

I would like to take the time to thank our
panelists for being here today, this afternoon, and I look forward to working
with you as you support the Nation's veterans. 

I would especially like to thank Mr. Morris
and Mr. McCoy for their service as chaplains in the Minnesota National Guard
and the VA's National Chaplains Center respectively. 

In 2009, I led a congressional delegation to
Afghanistan and came to learn that our servicemembers rely immensely on their
chaplains for emotional support.  Every trip since then I have come to respect
the unique insight that our chaplains possess in terms of mental health,
spiritual guidance, and the overall well‑being of our service men and
women.  I look forward to hearing your testimony today as well. 

I want to thank you once again, Madam Chair,
for having this very important hearing this afternoon.  Thank you.

[The statement of Michael Michaud appears in the Appendix.]



Mr. BUERKLE.  Thank you, Mr. Michaud. 

Now I would like to invite our first panel to
the witness table.  With us today is Andrew Davis, a veteran of Operation
Enduring Freedom and Operation Iraq Freedom, the Director of the Veterans
Services for Saratoga County, New York, and the founder of the Saratoga County
Veterans Resource Initiative. 

Mr. Davis served in both Afghanistan and Iraq
with the U.S. Army 75th Ranger Regiment where he earned the Bronze Star with
Valor, the Combat Parachutist Badge, and the Combat Infantryman's Badge and is
a true American hero. 

Mr. Davis, thank you for your service to this
country.  It is an honor to have you here today with us, and I very much look
forward to hearing your testimony.  You may begin.

STATEMENT OF ANDREW DAVIS, VETERAN, DIRECTOR, SARATOGA COUNTY VETERANS
SERVICE AGENCY, SARATOGA COUNTY, NEW YORK

Mr. DAVIS.  Good afternoon, Chairwoman
Buerkle, Ranking Member Michaud, and members of the committee.  Thank you for
the invitation to discuss the role of community providers and faith‑based
organizations in helping servicemembers transition to civilian life and the
need for the U.S. Department of Veterans Affairs to use these resources and
collaborate.

My name is Andrew Davis.  I am currently the Director of the Saratoga County Veterans Service Agency and the founder of the
Saratoga VRI.  I have been a veterans advocate since separating from the
service in 2004 where I served as a United States Army Ranger for 5 years, to
include two tours of duty in Afghanistan and one in Iraq. 

Upon returning to my home in Minnesota to
further my education, I was faced with my first taste of how little I knew
about being a veteran.  In fact, like many of my peers, I was unsure if I even
was a veteran.  I was on a campus of 40,000 students, and I didn't know any
veterans around me.  Because of this, I founded a nonprofit veterans support
organization on the campus of the U of M to aid returning veterans in
connecting with earned benefits and services. 

In later roles as a congressional staffer and
a Department of Defense Transition Assistance Advisor, I saw firsthand the
disconnect between veterans, their families, and the systems that are intended
to support them.  For the past 3 years, I have spent my career as a veterans
advocate, either training accredited benefits counselors or being one myself;
and this has provided me a frontline view of what is lacking in outreach and
networked support to our veterans and their families. 

Lastly, I am currently an enrolled patient
with the Veterans Health Administration in VISN‑2 and use both the Albany
Stratton VA Medical Center and Clifton Park Community Based Outreach Clinic
regularly. 

Veterans and the ways they serve have changed
significantly over the last decade, resulting in the need for changes in the
way our country, in turn, serves them.  The veterans of today tend to be more
geographically dispersed and more mobile than previous generations.  Families
and communities are affected and changed differently than ever before with
multiple deployments and the unique use of the Guard and Reserve.  Many of these
individuals suffer from a lack of a "Fort New York" or a "Fort
Minnesota" or a central support system, making the local community even
more crucial in the reintegration process. 

Despite a constant bombardment of media in
all forms that afford the public access to our current wars, issues facing our
neighbors, friends, family members, and other local veterans are often
invisible to us as communities.  Add to this a military culture that can
encourage emotional toughness and self‑sufficiency, and we face a large
potential public health problem. 

Lastly, the uniqueness that makes our
military and our veteran population great also means that there is not one‑size‑fits‑all
support system that can be created nationwide.  We must garner community
support and use community services to serve our veterans and their families
completely. 

First and foremost, the population of
veterans that find their way into the VA system of care or benefits system
merely by accident is staggering.  I can safely say that approximately five to
seven veterans knock on my door weekly for some form of unrelated government
service to find they are eligible for veterans benefits or care because of
their service to this Nation. 

Just last week, a young Marine with two tours
of duty in Afghanistan appeared in my office asking for directions to the
office that handles unemployment benefits.  This Marine outlined he had no idea
what services he was eligible for or how to use his 5 years of free health
care.  So we sat down with him and helped him.  If this Marine had not knocked on
the wrong door, he would not have met with my staff to turn on his GI Bill
benefits or learn where he could get health care. 

By all appearances, the U.S. Department of Veterans
Affairs has recognized the need for community outreach but holds their hopes in
the idea that top‑down, one‑sided information will filter down to
the grassroots folks at the bottom helping individuals.  For example, in the
VISN‑2 of Upstate New York, a few competent and well‑trained
veterans justice coordinators have been hired and put in place.  However, the
operative words here are "a few."  These people are responsible for
numerous counties and for interacting with courts, district attorneys, and law
enforcement, when in fact the police officers on the beat may be able to help
them immediately. 

The correct mindset for reaching veterans
must transition to a "no wrong door" approach.  This can and should
be created through a localized national training by VA, veterans advocates, and
other experts to all members of the local communities.  These newly created
veteran‑friendly communities would have the tools to make referrals to
the proper resources, whether a veteran walks into a rectory, a tax assessor's
office, or is pulled over during a traffic stop. 

Additionally, outreach and assistance
programs cannot be reactionary in nature.  The time to begin helping a veteran
in legal trouble, for example, is upon first interaction, not just at
sentencing.  In fact, in my own transition it was a police officer who pulled
me over for driving in Minneapolis like I had been in Haditha and Bagram and
introduced me to my first veterans advocate and helped me to realize that
difficulty transitioning was normal.  Additionally, I now receive as an
accredited service officer a large number of referrals from local police
officers that I call my friends. 

In sum, we as a Nation must stand committed
to ensuring that sustainable and quality supportive services are accessible to
veterans and their families right in their communities.  I believe this can be
done by leveraging resources that largely already exist in a cost‑effective
manner.  The VA has the geographical disbursement and expertise to lead charge,
but we must think outside the box and look to those who are ready and willing
to assist in our own backyards.  The requirements to make this successful are
not numerous.  In many cases, putting out outreach staff and community advance
is all it will take.  We must begin immediately leveraging relationships and
expertise that has long existed. 

Thank you again to the committee for allowing
me to speak to these important issues.

[The statement of Andrew Davis appears in the Appendix.]



Mr. BUERKLE.  Thank you very much, Mr.
Davis; and, again, thank you for your service to our country. 

I am going to begin by yielding myself 5
minutes for questions. 

In your written testimony, you remark that
after leaving the military you, as well as some of your peers, were unsure if you were even a veteran.  If you look at the overall
scheme of things, that is incredible, with the service that you gave to our
Nation.  I would like you to, if you could, expand on that statement and give
us some insight into that. 

Mr. DAVIS.  Absolutely.  I like to
point that out, ma'am, at any chance I can. 

In my eyes, a veteran was my grandfather at
the American Legion who was telling World War II stories when I was a young
kid. 

Additionally, I think there is a large
confusion among our Guard and Reserve population and even those who support
these wars from the homeland who may not even think of themselves as a veteran
when you consider the folks who are coming home missing limbs or who have
served multiple tours in combat. 

So an important distinction I like to point
out to community members who are interested in helping is asking somebody if
they or a family member have ever served in the United States military, as
opposed to are you a veteran, because that can be sort of a dicey question. 

Mr. BUERKLE.  Thank you. 

Can you talk about how
we can get to that veteran community when they are processing out and they are
still active duty?  How can we make it known to them that they would qualify
for veteran assistance? 

Mr. DAVIS.  Ma'am, I think one
important thing to understand is that, no matter where we separate from, there
is a very good possibility that is not where we are going to stay.  I can tell
you from my own experience separating in Fort Benning, Georgia, and returning
to Minnesota, I got every resource available to me to stay in Fort Benning,
Georgia, but I wasn't staying there. 

So the veteran returning to Syracuse from
Marine duty in Camp Pendleton needs to be provided in Syracuse that local
contact, whether that is a veterans service agency director or whether it is a
VA clinic contact.  But they need the contacts at home, not where they are
separating from. 

Mr. BUERKLE.  Can you tell me how you
think that the VA's reluctance to integrate with community resources maybe
obstructed your transition or other veterans' transitions into becoming a
veteran? 

Mr. DAVIS.  Yes, ma'am.  I think the
important thing that veterans need to understand when they are separating from
duty is that every benefit needs to be turned on with the process of an
application.  For me, going to the University of Minnesota and having to use GI
Bill benefits, I guess I just assumed somebody on campus was going to be there
to help me, another veteran or somebody who was responsible for this benefit. 
But there wasn't one out of 40,000 that was there to assist with that effort. 

So if the VA had seen that this massive
college campus was going to attract veterans, they may have put somebody
proactively there or trained somebody.  That is just education.  But that
person could also refer me to a health care resource or something similar. 

Mr. BUERKLE.  So now you are director
of a community program; and I would like you to, if you could, describe for us
your interactions with the VA now and what kind of relationship you have and
how the VA is treating your group? 

Mr. DAVIS.  Madam Chair, we come in
quarterly to the VA hospital in Albany, and we do get to hear about departmental
changes.  We get a top‑down budget overview of what the VA hospital
director is dealing with.  It does tend to be a fairly one‑sided
conversation.  We hear about changes to the orthopedics ward or something like
that, and we occasionally get to talk about an issue that is facing maybe one
of our veterans.  But as far as being able to have a two‑way conversation
about how to improve, that does not take place. 

In addition, I would point out that we hold
events as county agencies that are for the purpose of outreach.  The VA is
invited to all of those, and I would be remiss if I told you that they were at
all of those.  They rarely take advantage of those community activities, at
least in my area. 

Mr. BUERKLE.  I don't mean to ask
you to speak or try to be in the mind of the VA, but why do you think there is
a reluctance to collaborate with some of the outside groups rather than just
the VA? 

Mr. DAVIS.  Purely speculation,
ma'am.  I would say they may feel that they are the experts and the veterans
should come to them and they can't share that load.  But, again, that is purely
speculation. 

I also would say that maybe it has never
happened before, so maybe there is some reluctance to jump in and try something
new. 

Mr. BUERKLE.  And lastly, if you
could ‑‑ and I just have a few seconds left ‑‑
what barriers do you see for more effective relationships between the VA and
some of the outside service groups? 

Mr. DAVIS.  Ma'am, I think information
sharing is obviously a fear among all agencies, how do we talk about veterans
and get the proper consent for issues that they may be facing, whether it be
mental or physical health care. 

But I also think staffing is something they
always fall back on, and I have seen that take place in my area. 

Mr. BUERKLE.  I thank you very much,
Mr. Davis. 

I now yield 5 minutes to the ranking member,
Mr. Michaud. 

Mr. MICHAUD.  Thank you very much,
Madam Chair. 

I also want to thank you, Mr. Davis, for your
service to this great Nation of ours.  I appreciate it. 

Speaking about mental health, do you have any
suggestions for us or the VA on creative approaches to addressing the mental
health needs of returning veterans and their families? 

Mr. DAVIS.  Sir, I appreciate the
question.  I would say that one thing that comes up often among my veterans is
a reluctance to go physically to a VA mental center or even to a VA vet center,
which is even more comfortable for that mental care, and a strong leaning
towards paying out of pocket for private providers in their own backyard.  So
if there was some way to leverage that outsourcing, for lack of a better term,
I would say that would go a long ways. 

But, too, also opening more mental health
care to families and children out there where that family dynamic has changed
through deployment, sometimes multiple deployments, sir. 

Mr. MICHAUD.  Thank you. 

You mentioned the collaboration between the
VA and the local community resources, some of the things that they should do. 
Is there anything in particular that you can tell this subcommittee on what can
we do to encourage more of that particular collaboration between the two? 

Mr. DAVIS.  Sir, I think the VA needs
to get out into the community a little more.  My experience has been that there
is not a shortage of people out in my communities that want to help, whether
that be mental health providers on the private side or whether it be churches
and law enforcement where I get a lot of my referrals from.  They are ready to
help, but they are not really sure where to send people to, because the VA, at
least in my area, hasn't been out in force giving them cards and saying what
they do. 

Mr. MICHAUD.  You made an interesting
point, and I actually heard Judge Russell, who is a judge in New York for the
Veterans Court, and he made a good point and you just reemphasized that point. 
A lot of times veterans don't feel that they are veterans, and he rephrases the
question now is how many people served in the military. 

When you look at outreach, I know the VA is
trying to do more in outreach, getting veterans into the VA system, what do you
think that we should do for more of an outreach type of program?  Because a lot
of veterans out there are not signing up because they don't realize that they
are eligible.  How do you envision us doing a better job in getting people into
the VA system? 

Mr. DAVIS.  Sir, I believe the
question does need to be rephrased across the board.  I think anytime we are
looking to help veterans we need to ask that, have you or a family member ever
served in the United States military, and that really breaks the ice.  But,
too, it allows me as an advocate and all of my peers as advocates to really
start to look at what benefits might be available. 

I hate to put it this way, but the thing that
gets a lot of veterans in my door is you might be missing out on some
significant savings financially or on some serious financial benefits, whether
it be a property tax exemption or disability compensation or free health care. 
So money gets people in the door, unfortunately, but also asking the right
questions. 

Mr. MICHAUD.  Do you think the Governors
of each State and probably the President ought to do an executive order
requiring every Federal agency or State agency that has an interaction, whether
it is unemployment benefits, Medicare, or Medicaid, that one of the first
questions that they ask is have you ever served in the military and somehow
getting that information to the VA so they can reach out to those types of
individuals? 

Mr. DAVIS.  Yes, sir.  I think every
temporary assistance office, social services department, Medicaid, Medicare,
but also every college application at a State‑run school should have that
question being asked and it should generate some sort of referral.  Again, that
no‑wrong‑door approach is crucial in helping these folks. 

Mr. MICHAUD.  You had mentioned in
your testimony that the VA interaction, that there is more of it dealt with on
the VHA side versus the VBA side.  How do you think the interaction between the
two should be between VHA health and benefits side? 

Mr. DAVIS.  Sir, I think one thing I
am up against oftentimes with my clients is explaining the siloed barriers
within the VA, that the cemetery administration and the health care
administration and the benefits administration are not one entity.  So you can
actually theoretically get care at the VA hospital for 40 years and never have
a disability claim put in, and vice versa, and I think that is confusing to
veterans.  And I think oftentimes when a veteran has a real problem with a
claim within the VBA, they tend to blame the doctor at the hospital at the VHA,
and vice versa, and it is not fair to the VA employees but it is also not fair
to the veteran to not understand that disparity. 

So I think having a more across‑the‑board
understanding, but also, when we are talking to VHA, VBA and VCA should be in
the room as well, and vice versa. 

Mr. MICHAUD.  Thank you very much. 

I yield back, Madam Chair. 

Mr. BUERKLE.  Thank you. 

I now recognize the gentleman from Tennessee,
Dr. Roe. 

Mr. ROE.  Thank you. 

I just have a couple of questions for Mr.
Davis.  Again, thank you for your service to our country.  I appreciate that. 

I think probably the first time I ever
realized I was a veteran was somebody asking me to stand up at a Lincoln Day
dinner.  I never really thought about it very much.  And, obviously,
until you need those benefits, you don't. 

Last Congress, I went to Afghanistan with
Mr. Michaud, and just got back from Afghanistan again on a CODEL I led about 4 months
ago.  And we stopped in Landstuhl.  I think the DOD is doing a better job
of informing, at least from when I got out.  Really, it was a couple of days
and you were gone, not really knowing what benefits you had, if any.  So I
think they are doing a better job today. 

Where is the breakdown?  Because there is so
much access to information.  It is just that our soldiers, when you have made
that determination that you are going home, you go home and you don't think about
it until you have a problem.  Then, like you say, when you are at Benning or
where I grew up near Fort Campbell, Kentucky, you have all kinds of support
there.  But if you move down to Hole in the Wall, Tennessee, you may not. 

We have a VA hospital in our community. 
People know where to go.  But that is not necessarily for everyone, there
are only three of them in the State of Tennessee.  So how would you best get
that information out to people?  How do you do that? 

Mr. DAVIS.  Well, sir, as my friend
Colonel Morris will probably say, you are given the world's most important
information as a veteran at the world's worst time by the world's worst
briefers.  As you are attempting to move your family and your livelihood back
home or to the new location in this country, you are not thinking about those
benefits, as you say.  So even just having a contact card printed out for you
at your transition would be a lot more helpful than a 130‑slide briefing
on the big picture of benefits. 

So the first thing I would say is we need to
start teaching people how to be veterans at the beginning of their service and
throughout their service, as opposed to right in the last 2 weeks.  But the
second piece is getting people in who are actually advocates to brief, as opposed
to the payers of the benefits, meaning the big‑picture VA folks giving us
that long PowerPoint presentation. 

Mr. ROE.  I know our veterans service officers where we are do a
tremendous job.  And people come in, they really don't know the difference between these acronyms ‑‑
VBA, VA.  I mean, it is all one to them.  They just think it is one.  You are
absolutely right. 

I see it all the time in my congressional
office.  If a disability claim is not moving forward and we get in on it, they
don't know that the VA has nothing to do it.  The hospital where they are going
doesn't have anything to do with that.  That is a totally different issue.  I
don't know that that is important.  All the veteran wants is their benefits
taken care of. 

So you would suggest a simple thing to do would be just be some contact, just
a card with contact information.  We ought to
be able to make that happen pretty easily, if you think that would be helpful. 

Mr. DAVIS.  I do, sir.  I think
attached to that DD‑214 when you leave Fort Campbell should be here is
the six most important people in your home county you need to see: 
unemployment, veterans advocate at the service office.  You know, you name it. 
But these are the go‑to folks when you get home. 

Mr. ROE.  If you need some help, if
the issue comes up, contact one of these people; and, like you said, there is
no wrong door.

Mr. DAVIS.  Yes, sir. 

Mr. ROE.  Any of them can open the
door. 

I am not
going to disagree with anything you said, except for one thing.  I don't think
the needs of veterans have changed at all.  I had an aunt that knew my great‑grandfather
who survived the Civil War, and my great grandmother had said that he was never
right after that war, meaning that he had problems.  There just were no
benefits then.  I think veterans have experienced the same things. 

I think we are doing a better job.  The GI
Bill is spectacular.  That is all I can say about it.  It wasn't kicked out
very well, but the Secretary has smoothed out some of those bumps.  When a person
goes and gets their veterans' benefit for their GI Bill, you are saying that
the University of Minnesota, a huge, great university, didn't have any help.  I
mean, they have thousands of people working at that college, and so do most
colleges that are of any size like that.  They had
no one there who knew what to do for you, where to send you? 

Mr. DAVIS.  No, sir.  And I can say
that that has improved greatly across the country.  Just two years ago, we
kicked off a veteran‑friendly campus event around New York; and we saw
great universities like Syracuse University who have full offices for
veterans.  But that was not in existence when I separated in 2004. 

Mr. ROE.  So just in a short time you
have been able to see that? 

Mr. DAVIS.  Yes, sir. 

Mr. ROE.  Once again, thank you for
your service. 

I yield back. 

Mr. BUERKLE.  Thank you, Dr. Roe. 

Now I recognize the gentleman from Indiana,
Mr. Donnelly. 

Mr. DONNELLY.  Thank you, Madam Chair;
and, Mr. Davis, I too want to thank you for everything you have done for our
country.  There is no way we can ever repay your hard work, your dedication,
and everything you have done for us; and we are very much in your service and
in your appreciation. 

I wanted to ask about the Saratoga County
Veterans Resource Initiative.  What role does the VA play in the gatherings
that you have when you gather quarterly to check best practices? 

Mr. DAVIS.  Sir, to date, we have had
six meetings, and the VA has been present at one, and it was the second
meeting, and that was in the form of the families outreach program that existed
at the Albany VA Medical Center.  The VHA and the Vet Center have been invited
to every meeting and have yet to have much participation. 

Mr. DONNELLY.  Did they tell you why? 

Mr. DAVIS.  Every time, sir, it has
been that they didn't have the staff or they hadn't gotten approval to attend. 

Mr. DONNELLY.  Okay.  And I apologize
if I missed this early on in your testimony, but, at those gatherings, have
they proved pretty fruitful for you? 

Mr. DAVIS.  Yes, sir.  At the very
beginning, we learned how this room full of people that all knew each other had
no idea what any of us did on behalf of veterans, so at that very level it
started being helpful. 

In addition, I don't go more than 3 days
without a call from a fellow member of the Resource Initiative with a referral
from a veteran who came into their office.  So, yes. 

Mr. DONNELLY.  So have you found that
there is a lot of people trying real hard, but it is like a bunch of cars
driving past each other and nobody knows what is going on in the other cars? 

Mr. DAVIS.  Yes, sir.  Exactly. 

Mr. DONNELLY.  Okay.  Well, I promise
you we will work real hard with you, take the lessons you have given us, and
try to make sure we can spread the things you are doing to the rest of the
country.  Thank you again, sir. 

Mr. BUERKLE.  Thank you. 

I now yield to the gentleman from Florida,
Mr. Bilirakis. 

Mr. BILIRAKIS.  Thank you so much for
holding this hearing, Madam Chair.  I appreciate it. 

Thank you for your service, sir. 

We are pretty active in our congressional
district.  I have an advisory council.  We have a resource fair on an annual
basis.  We just finished a jobs fair that was very well attended.  I visit the
VFWs, as does my staff, American legions, what have you, and also go to the VA. 

But what more can we do as a congressional
office.  I know that one of the reasons you are here is
to testify on behalf of how we can bring the VA closer to our veterans.  What
more can we do?  Do you have any suggestions?  You know, we can always do
more.  What can we do as a congressional office to further that goal? 

Mr. DAVIS.  Sir, it sounds like you
are doing a lot of the things that I would suggest.  But one thing I often
point out to congressional staff is that veterans, when they come to a
congressional staff member, have never, many times, filed a claim or even
interacted with the VA for the first time.  They are just under that assumption
that they are a veteran who is eligible for something and in turn is not
getting what they deserve. 

So that reverse referral to a local advocate,
whether it be an American Legion service officer or whether it be a county
person or a State person I think is the first step I would take.  Because,
oftentimes, your staff is very overwhelmed and may not know everything about
the local benefits or the State benefits on top of the Federal, or vice versa. 
So a reverse referral would be a big suggestion I would make. 

Mr. BILIRAKIS.  Thank you very much. 

I yield back, Madam Chair. 

Mr. BUERKLE.  I now yield to the
gentleman from New Jersey, Mr. Runyan. 

Mr. RUNYAN.  No questions.  I yield back. 

Mr. BUERKLE.  Thank you. 

We will wait for Mr. Reyes. 

Mr. Reyes, I know you just joined us.  We
have Mr. Davis here, if you have any questions. 

Mr. REYES.  I have no questions. 

Mr. BUERKLE.  I guess that is it for
questions, Mr. Davis.  Again, thank you very much for your testimony and for
your comments.  You are now excused. 

Mr. DAVIS.  Thank you, Madam Chair. 

Mr. BUERKLE.  I invite the second
panel to the witness table. 

With us today is Chaplain John Morris, the
Joint Force Headquarters Chaplain from the Minnesota National Guard. 

Chaplain Morris is a Colonel in the Minnesota
National Guard and is the co‑founder of the Beyond the Yellow Ribbon
Initiative which facilitates collaborations between the Minnesota National
Guard, VA, and local faith‑based and community resources to support the
reintegration of Minnesota's National Guard combat veterans. 

I would like to thank you, Chaplain Morris,
for your service to our Nation and for your very important advocacy efforts. 

I will now yield to Mr. Donnelly to introduce
our next witness. 

Mr. DONNELLY.  Thank you, Madam Chair;
and it is a great honor to have Dr. MacDermid Wadsworth. 

Madam Chair, fellow Health Subcommittee
members, I would like to introduce you to Dr. Shelley MacDermid Wadsworth, an
Associate Dean of Purdue University's College of Health and Human Sciences.  As
a Notre Dame grad, it pains me to mention Purdue, but I will do so anyhow. 

Dr. MacDermid Wadsworth also serves as
director of Purdue's Military Family Research Institute which works to improve
the lives of servicemembers and their families in Indiana and across the
country by strengthening and supporting the efforts of military and civilian
organizations to provide services, education, and training to military
families.  I just want to mention Purdue has done an extraordinary job with
this, and we are incredibly grateful. 

We are grateful to Dr. MacDermid Wadsworth,
who knows how many people in our State serve and how dedicated the families and
everyone is.  And I just want to say that your work is making a difference in
the lives of everyone, not only in our State but in the country.  Thank you
very much. 

Mr. BUERKLE.  Thank you, Mr. Donnelly,
and welcome, Dr. MacDermid Wadsworth. 

Also joining our second panel is Dr. David
Rudd and Dr. George Ake.  Earlier in my opening comments I mentioned we had a
symposium in Syracuse, and I was honored to welcome both of you to Syracuse for
that event.  I
don't believe it was snowing that day, and we had a very successful symposium. 

Dr. Rudd is the Dean of the College of Social
and Behavioral Sciences at the University of Utah, where he also serves as
Scientific Director for the National Center for Veterans Studies.  In addition,
he was recently elected Distinguished Practitioner and Scholar of the National
Academies of Practice in Psychology. 

Dr. Rudd is also a Gulf War veteran, and I
would like to thank him for his honorable service to our Nation
in uniform and for his continued dedication to improving the lives of his
fellow veterans through his research.  Thank you, Dr. Rudd. 

Dr. Ake is an Assistant Professor of Medical
Psychology at the Duke University Medical Center, and he is here today on
behalf of the American Psychological Association. 

Dr. Ake is a child psychologist and has
worked extensively with the National Child Traumatic Stress Network, where his
work has focused on assisting children and families who have experienced
stressful and traumatic life events, including a military deployment and its
aftermath.  He is a recent winner of the Durham, North Carolina, Police
Department's Community Service Award, and it is an honor to have him with us
today. 

I thank you all very much for being here this
afternoon.  I am eager to begin our discussion. 

So, Chaplain Morris, we will start with you. 
Thank you very much.

 

STATEMENTS OF CHAPLAIN JOHN J. MORRIS, JOINT FORCE HEADQUARTERS CHAPLAIN,
MINNESOTA NATIONAL GUARD; SHELLEY MACDERMID WADSWORTH, PH.D., DIRECTOR,
MILITARY FAMILY RESEARCH INSTITUTE, PURDUE UNIVERSITY; M. DAVID RUDD, PH.D.,
ABPP, DEAN, COLLEGE OF SOCIAL AND BEHAVIORAL SCIENCES, SCIENTIFIC DIRECTOR,
NATIONAL CENTER FOR VETERAN STUDIES, UNIVERSITY OF UTAH; AND GEORGE AKE, III,
PH.D., ASSISTANT PROFESSOR OF MEDICAL PSYCHOLOGY, DUKE UNIVERSITY, AMERICAN
PSYCHOLOGICAL ASSOCIATION

STATEMENT OF CHAPLAIN JOHN J. MORRIS

Colonel MORRIS.  Chair Buerkle,
Ranking Member Michaud, and members of the subcommittee, thank you for the
honor of being here. 

I am Chaplain Morris.  I am the State
Chaplain of the Minnesota National Guard, and I am fortunate to be the co‑founder
of the Beyond the Yellow Ribbon Program that you made the national standard for
the reintegration of the Reserve and the Guard.  I am a three‑tour combat
veteran.  I am the son of a combat veteran.  I am the father of two combat
veterans. 

I am here as a fan of the VA.  I am a
customer.  I am also a close collaborator, and my daughters are customers.  The
Minnesota Guard has had a very productive relationship with the VA, and I think
we have something to share with the Nation, but I will encapsulate it in this
story from Saturday. 

I was at an event for 2,500 of our families
whose soldiers are now serving in Kuwait.  We were feeding them.  A mother came
up to me and said, you don't remember me.  My son came home with a local
infantry unit from Kosovo, and you were at the reintegration event, and I asked
you to help my son.  I want you to see him.  He is doing so much better. 

I sat down with the young man.  I indeed had
pulled him out of the registration line that morning 30 days after returning
from a 9‑month tour in Kosovo.  He was high on crack.  We immediately
took him to the emergency room of the local hospital in Rochester, Minnesota. 
After a 72‑hour hold there, he was taken to St. Cloud VA for inpatient
chemical dependency treatment.  And he was proud to tell me a year and a half
later he was straight, he was sober, he was married, and introduced me to his
wife, who was pregnant with twins, and he was facing a tremendous future.  That
is the collaboration that we have with the VA in Minnesota. 

We have done the RINGS 1 and 2 study with our
First Brigade, which is on its second combat deployment.  The Minneapolis VA
has done a tremendous longitudinal study with our solders and their families
that I think is going to set straight some of the mythology around PTSD and
over‑reporting of that problem and an under‑reporting of the impact
that healthy community reintegration‑based programs can have on returning
veterans. 

We have pushed VA teams far forward to enroll
our demobilizing soldiers at demob sites around the country.  We have had the
VA actually train our command and staff ‑‑ I was a part of
this in 2009 ‑‑ preparing to deploy to Iraq.  We had the VA train
our commanding general and all of our leading staff in the polytrauma unit in
Minnesota.  We got a first‑hand look at what war is really like, the
impact of the weaponry of war and on the human body and what combat trauma can
do. 

So we have got a good relationship, but I
think the VA could do even better, and so I am here today to talk about some of
those problems and some of the solutions. 

The VA suffers under the perception of being
a very isolated institution, and it has a stigma.  All we hear about it is bad
things.  We rarely hear the great things they do.  From loss of laptops and
compromise of our security to homeless veterans who commit suicide, the mantra
of bad news about the VA is steady, and it really affects the community's view
of the VA.  And I can say that as a person who deals every day with community
leaders throughout Minnesota. 

The institutionalism of the VA which Andy
Davis so well alluded to is a problem and it keeps the VA inside its building
and not always out in the community sharing its knowledge with us who are on
the ground working with the majority of the veterans. 

I think, unfortunately, the steady mantra
about PTSD, 25 percent ‑‑ whatever it is, the CBO report that
came out last week saying 21 percent ‑‑ I think it is over‑reported,
and it is not substantiated, and it has created an impression that the VA is
the only institution that can solve combat trauma, that all veterans have it,
and it is contributing to a double‑digit unemployment rate among our
veterans ‑‑ which is truly the that problem we have.  It is
getting work.  It is not getting mental health care. 

Minnesota is the land of 10,000 mental health
and chemical dependency treatment centers.  We like to say it is 10,000 lakes,
but it is 10,000 treatment centers.  There are plenty of people who want to
help us with mental health.  That is not our biggest problem.  And we are
caught in some kind of a loop between the VA and Congress trumpeting a problem,
when the bigger problem is being underfunded and underaddressed.  And we can
fix it, and we can do it in Minnesota, and we are going to do it. 

We have gotten the VA to come out into the
community and work with us, get on to our drill floors and talk to our
families.  We have had the VA come and meet with our physicians and share the
knowledge that the VA has so that the provider out in rural America can take
care of families and veterans.  We have synchronized services so that when
somebody leaves VA care they can tie into Yellow Ribbon communities to get the
care they need.  And we have asked the VA to not only publish what they know in
academic journals but to share with lay people through veterans organizations
and through our political and elected representatives so that news can get down
and counter the steady stream of bad news. 

I think the VA's one important part of the
reintegration process ‑‑ it is not the only part, and it is
not the most important part ‑‑ the most important part of the
reintegration process is the community.  It is our responsibility to bring our
soldiers all the way home and to take care of their families.  We sent them to
war.  It is our job to bring them back.  The VA is a partner in that, but it is
not a stand‑alone partner.  It is not the only partner.  It is a
partner. 

Every State that is empowered through its
Governor to partner with its VA will be an effective State in reaching its
communities and empowering them to bring their veterans all the way home.  At the
end of the day, we are going to live in communities, we are going to serve in
communities, and if we can't learn to be productive in our communities, it
won't matter how good the VA is.  We still won't be all the way home. 

Madam Chair, thank you for this privilege to
be here; and, committee members, thank you for what you are doing.  It is an
honor to be here, and it has been a great privilege for me as part of my career
to have this chance to share this with you.

[The statement of John Morris appears in the Appendix.]



Mr. BUERKLE.  Thank you very much
Chaplain Morris. 

Dr. MacDermid Wadsworth.

STATEMENT OF SHELLEY MACDERMID WADSWORTH, PH.D.

Ms. MacDermid Wadsworth.  Thank you. 

Chairwoman Buerkle, Congressman Michaud, and
distinguished members of the committee, thank you for convening this hearing;
and thank you to Representative Donnelly for such a kind introduction. 

I am proud to be a faculty member at Purdue
University, the land grant institution for the great State of Indiana, and also
to direct the Military Family Research Institute.  I am pleased to report that
we were involved in several innovative collaborations involving the VA.  Our
vision is to make a difference for families who serve. 

My institute has created or participates in
collaborations involving VA partners in the areas of homelessness, higher
education, vocational rehabilitation, behavioral health care, outreach to
community partners, and research.  Our higher education initiative, for
example, is putting mechanisms in place that could help every student, servicemember, and veteran in Indiana and potentially reduce GI Bill costs with
the help of VA certifying officials, the Indiana Commission on Higher
Education, and others.  

The vocational rehabilitation effort for
which we serve as the evaluation partner has been a national leader in placing
wounded warriors in employment and keeping them there; and, again, without VA
professionals at the table, this would not have occurred. 

Based on these experiences, I know that
successful collaborations are possible, can benefit military and veterans'
families significantly, and can contribute substantively to the VA mission. 

I identify several keys to success in my
written statement but will focus my remarks here on challenges and
opportunities that might benefit from policy or legislative attention. 

Number one: Create clear points of entry for prospective collaborators in
multiple VA tracks.  Prospective community partners, particularly those
located at a physical distance from a medical center, find it very difficult to
determine whom to approach to partner, and the independence of the medical
centers means that there must be a local connection.  The VA Office of
Faith‑Based and Neighborhood Partnerships is very important, but there are still many untapped partners who can multiply
the reach of the VA.

Number two:  Develop mechanisms to separate
the "wheat" from the "chaff" among prospective partners.  VA professionals are
understandably wary of showing favoritism to particular organizations. 
Unfortunately, this means that reputable partners with much to offer may get
held at arm's length, the same as bad actors. 

Number three:  Reduce structural barriers to
collaboration.  It is difficult to get information from the VA sometimes.  It
is difficult for outsiders to engage in research with VA populations.  It is
difficult for community partners to find and connect with military and veteran
families, particularly in low‑density areas.  Sometimes it feels as
though there is a fence around the VA. 

Number four:  Provide tangible incentives and
benefits to community and VA partners who collaborate effectively. 
Collaborations do take resources, but they also can generate resources by
attracting additional contributions of skills, people, money, or information. 
Compared to the costs of services that don't get used and clients who don't get
served, collaborations can be very cost‑effective instruments. 

It has been our great honor to work to make a
difference for military and veteran families.  We are inspired by the
commitment and dedication shown by professionals in many sectors who share that
mission, and we are eager to continue collaborating to make positive change. 

Thank you for all you do to try to make sure
that our Nation's veterans receive the care and support they have been
promised. 

This concludes my statement.  Thank you for
your kind attention.

[The statement of Shelley MacDermid Wadsworth appears in the Appendix.]



Mr. BUERKLE.  Thank you very much, Dr.
MacDermid Wadsworth. 

Dr. Rudd, you may proceed.

STATEMENT OF M. DAVID RUDD

Mr. RUDD.  Chairwoman Buerkle, Ranking
Member Michaud, and members of the subcommittee, I very much appreciate the
opportunity to testify on behalf of the National Center for Veterans Studies
and the University of Utah. 

Chairwoman Buerkle, I am very pleased and
would tell you enthusiastic about seeing you taking leadership on what I
believe to be a critical issue on the reintegration of veterans into society
after having served so admirably in terms of our Nation and our needs. 

You have my written statement.  I am not
going to repeat much of what is in the statement.  I do want to highlight a few
critical points. 

I want to comment on Colonel Morris's note
about the issue of reintegration and misunderstanding. 

I think it is important to recognize that,
since the Gulf War, less than 1 percent of Americans have served in the Armed
Forces.  This is a tremendous shift from World War II when almost 9 percent
served; Korea and Vietnam, both greater than 2 percent served.  And as we have
fewer and fewer Americans serving in the Armed Forces the possibility for
misunderstanding, the possibility for difficulty in reintegration is
compounded; and I think that probably speaks to the issue that was raised by
Colonel Morris, which I think is a vital one. 

I would like to speak about a couple of areas
of research and highlight a few things that I think sheds some light on the
opportunity for reintegration, in two areas in particular: one, universities;
and, two, organizations, communities of faith and local churches. 

Some recent work by the Pew Research Center
revealed that 27 percent of veterans reported that readjustment to civilian
life was either difficult, somewhat difficult, or very difficult.  The survey
also revealed significant burdens of service identified by servicemembers, with
48 percent reporting strains in family relationships, 47 percent frequently
feeling irritable or angry, 44 percent reporting problems reentering civilian
life, and 37 percent reporting post‑trauma symptoms.  This doesn't necessarily
mean posttraumatic stress disorder but trauma‑related symptoms.  Despite
the fact that many veterans transition from military life with few problems, I
think these data indicate the significance of the problem, and it has been
fairly profound over the course of the last 5 years. 

The Pew data offer insight into the source of
the problem as well, particularly in terms of emotional and psychological
adjustment.  Among those having experienced combat, 50 percent or more report
post‑trauma symptoms, a difficulty with family relationships.  When they
were queried about factors reducing the probability for successful reentry into
civilian life, veterans identified traumatic experiences and physical injury as
the most significant variables. 

Of importance for this hearing, veterans
identified attending church at least weekly as the most important variable
associated with an easy and successful reentry into civilian life.  A
remarkable 67 percent identified attending church once a week or more as making
reentry easier. 

Clearly, the social connections and support
offered by religious communities and institutions around the Nation are
essential for our veterans.  I would tell you that they really possess enormous
opportunity to help veterans transition.  I think that Colonel Morris spoke to
this issue in terms of stigma that is an associated with mental health
problems, with PTSD in particular.  The opportunity for intervention, the
opportunity for assistance in local churches is truly remarkable. 

I would tell you that, of the veterans that I
know, the veterans that I have worked with would much rather go to local clergy
than to go to a clinical psychologist, to go a psychiatrist, to go to a mental
health specialist.  With the right training, with the right resources, that
kind of a partnership is precisely one that we need to pursue; and I would like
to see the VA take a lead in that area. 

Now, I can tell you a little bit about my own
work that I think has helped clarify the severity and the magnitude of the
problems in terms of emotional and psychological issues faced by veterans, and
a very specific subset of veterans that I would speak to are student veterans. 

We recently did a national survey looking at
student veterans transitioning from the service back on to university campuses,
and I would tell you that, arguably, this is the second‑best place to
capture veterans, is on university campuses, that outside of the medical
centers, outside of the Veterans Benefit Administration, this is where you will
find veterans. 

If you look at the data that are in my
statement, you will find that the numbers are fairly profound in terms of the
rates and the magnitude of the reported problems.  Now, what is interesting is
that those veterans are on campus, those veterans are functioning on campus,
and I would tell you that they are functioning quite well, but they need
assistance.  Making sure that campuses are well prepared is something that is
critical for us to do. 

So I would encourage you, in terms of looking
for partnerships and expanding partnerships that the VA have already pursued,
universities are a wonderful place, communities, organizations, institutions of
faith, local churches are a wonderful place.  Those are places where veterans
will go, those are places where veterans don't feel the severity and the
magnitude of stigma, and the opportunity to help is tremendous.  So I would
encourage you to think about those two areas specifically. 

I would be happy to talk to you in a little
bit more detail if you have questions afterwards.  But, Chairwoman Buerkle,
thank you very much for your time.

[The statement of David Rudd appears in the Appendix.]



Mr. BUERKLE.  Thank you, Dr. Rudd. 

Dr. Ake.

STATEMENT OF GEORGE AKE, III, PH.D.

Mr. AKE.  Good afternoon, Chairwoman
Buerkle, Ranking Member Michaud, and members of the subcommittee.  Thank you
for the opportunity to testify on behalf of the 154,000 members and affiliates
of the American Psychological Association regarding the collaboration between
the Department of Veterans Affairs and community organizations to support
veterans and their families. 

As a child psychologist at Duke University
Medical Center and with the National Child Traumatic Stress Network, my work
focuses on assisting children and families who have experienced traumatic life
events, including military combat and its aftermath.  I am honored to speak
with you today about the collaborative work that I and my colleagues are
engaged in to support our Nation's military and veteran families. 

Collaboration among all sectors of society is
needed to support the health and well‑being of veterans and their
families.  This includes key partnerships with policymakers, government
agencies, universities, the health care community, and the faith‑based
community. 

Scientific evidence continues to identify
psychological and neurological disorders, including posttraumatic stress
disorder, depression, suicidal ideation, and traumatic brain injury as some of
the signature wounds of recent conflicts.  While psychologists and other health
professionals play an essential role in helping veterans and families to
address these challenges, partnerships and collaborations with other sectors of
society are also critical. 

While there are numerous specific programs
for veterans and their families, many families rely upon the support of faith‑based
providers as a first point of contact.  The members of this community who are
here today will address these issues, but I want to underscore the
extraordinary value of our collaborative mental health work with faith‑based
providers related to military and veteran families, a partnership which
enriches our work in many ways. 

I would like to express my deep appreciation
to you, Chairwoman Buerkle, for your leadership in advancing collaboration
between the mental health faith‑based communities and military and
veteran families.  The unique military and veterans mental health workshop that
you hosted for faith‑based providers in your District in December served
as a wonderful example of the collaboration that is possible across sectors.  I
was honored to join the distinguished panel of experts that you assembled. 
Such events help to break down barriers and foster partnerships that benefit
veterans and their families.  Replicating this training in other congressional
districts could serve as a valuable resource. 

Collaboration between military and faith‑based
and other community systems is especially important as we consider 2010
Department of Defense data which estimates that 44 percent of the 1.4 million
active duty and National Guard‑Reserve personnel who deployed to combat
missions as a part of OEF, OIF, and OND are parents.  DOD also estimates that
nearly 2 million children in the U.S. have parents who are active duty or
Reserve personnel, many of whom have experienced multiple combat deployments. 

Some military families face severe challenges
during reintegration, such as a parent who returns changed due to the winds of
war or financial hardship, homelessness, marital discord or violence and other
difficulties.  Still other families experience the grief and loss associated
with their loved one's fatal combat injury or even suicide.  These findings
highlight the necessity of considering the context and challenges for children
and families of veterans, as well as the role of the family in facilitating a
successful transition to stateside service or civilian life. 

To support veterans, their families need easy
access to collaborative programs and supports through VA and many other service
sectors.  As a member of the National Child Traumatic Stress Network, we are
proud to contribute to such efforts. 

The NCTSN is an initiative launched by
Congress in 2000 to develop a national collaborative network to improve best
practices and standards of care for children and families affected by traumatic
stress, including military families.  Our 130 centers in 40 States collaborate
with many organizations, including the VA, DOD, the National Guard, the
American Psychological Association, faith‑based organizations, and many
others. 

We offer evidence‑based interventions,
educational materials, curriculum for civilian providers, and much more, all
available on the Web site.  My written testimony offers many specific examples
of this work, including a Welcome Back Veterans program at the Duke University
for training community clinicians, a collaboration with the VA's National
Center for PTSD to train providers, including military chaplains, on acute
stress interventions, collaboration with the military chaplains, and a family
resilience program called FOCUS now being used at more than 20 military
installations, a partnership with the TAPS Program to help military families
after the death of a loved one, and the ADAPT parenting program for Reserve
families in Minnesota. 

In conclusion, we have seen the collaborative
efforts between the military and veteran communities and partners such as faith‑based
providers, mental health professionals, and others have yielded effective
services for our military and veteran families.  The American Psychological
Association, Duke University Medical Center, and the National Child Traumatic
Stress Network all stand ready to continue our collaborative efforts with the
subcommittee, the VA, the DOD, our community based partners, and the military
and veteran community to address these important issues. 

Thank you for the opportunity to speak with
you today and for your leadership and commitment to our Nation's veterans and
their families.

[The statement of George Ake appears in the Appendix.]



Mr. BUERKLE.  Thank you all very
much. 

I will now yield myself 5 minutes for
questions.  I will start with Chaplain ‑‑ Colonel Morris.  As an
experienced chaplain and someone who has been in the military and a veteran,
first of all, do you
think there is value with the faith‑based community; but,
beyond that, how can we integrate that transition using faith‑based
services? 

Colonel MORRIS.  Madam Chair, there
certainly is value in collaboration between faith‑based institutions and
the VA and being a part of the reintegration process.  We do this in Minnesota
in a variety of ways.  We train clergy in every community that wants to be a
yellow‑ribbon community in how to help military families during
deployments, and then how to help returning combat veterans reintegrate into
their community and into their family. 

Another thing that faith‑based
organizations can do is be a part of the employment process.  The military does
not provide guidance counseling, nor should it, to veterans preparing to leave
in how to reenter this free market globally oriented economy.  It is a tough
transition to find a job here when you have been hauling a rifle around the
mountains of Afghanistan.  Faith‑based organizations have employed people
who have done it.  Life‑to‑life transfer, those skills, job‑seeking
support groups and faith‑based organizations are a grass‑roots,
easy‑to‑tap sort of a resource that doesn't cost anybody anything,
and it provides that sense of community that a veteran needs to hang in there
to find that job.  This is just a couple of examples.  There are plenty more
that can be done to tap that virtually untapped segment of our community. 

Mr. BUERKLE.  Thank you.  Dr. Ake,
what is, if any, the VA's involvement with the National Child Traumatic Stress
Network? 

Mr. AKE.  To my knowledge there are
many different collaborative efforts, including a Webinar tomorrow, a master
speaking series from Zero to Three, and the National Child Traumatic Stress
Network focused on making sure services are available to veteran families.  And
so the network often draws on the expertise of many different entities working
with military and veteran families to speak on their perspective on how to help
them. 

Mr. BUERKLE.  So that is your group, not the VA.  Are you working directly with the VA? 

Mr. AKE.  I think that is one example
as far as drawing on VA speakers for the master speaker series, but there are
others related to the Adapt program in Minnesota where there is an after‑deployment
adapting parenting tools program pulling from several different groups, but I
would need to defer to the partners that are actually doing those initiatives.

Mr. BUERKLE.  Thank you.  Dr.
Wadsworth, in your testimony you talk about structural barriers more so with
the veteran population.  Can you expand on that a little bit? 

Ms. WADSWORTH.  Yes.  I think because
the Veterans Administration and those who care about the Veterans
Administration care a lot about making sure that veterans privacy is protected,
making sure that veterans are never subjected to care that is of substandard
quality.  There are many rules and policies and restrictions and checks and
balances in place to try to ensure that all those things happen, but the result
is that it can make it very difficult to move forward in collaboration. 

My primary identity is as a researcher.  If I
would like to conduct a study of a VA population, the study must be led by a
Veterans Administration principal investigator, and that is a structural
barrier because it means I have to find somebody who would agree to let me
partner with them to do the study. 

We have a partner who we work with to do
outreach.  They actually arranged for us to receive the funding instead of
them, because we can work with hotels and do logistics more easily than they
can.  So people find creative workarounds.  But these same policies, in many
cases that are put in place to protect, end up serving as barriers. 

Mr. BUERKLE.  Thank you.  And lastly,
Dr. Rudd, you mentioned education being the second‑best place to
serve as a safety net to locate Veterans.  Do you have any
suggestions for how we can integrate that piece into education with our
universities and our colleges and our community colleges? 

Mr. RUDD.  Well, I think there are a
number of things we can do.  The VA has already implemented the Vet Success on
Campus program, which provides actually benefits counselors and rehabilitation
counselors that work on university campuses, so they are hired and employed by
the VA but actually are placed on the university campus, which is a very good
program. 

But I would tell you that the kind of barrier
that exists is a really simple one.  So if you take that program as an example
of which the University of Utah just started participating this year, the VA
has broadly expanded that program over the course of the last year.  One of the
issues for us, we ultimately were able to work through it, was that we didn't
actually get to be involved in the interview process for the hiring of that
employee.  So we had two employees hired.  We didn't get to participate in the
interview process because it is a VA employee, but yet they are going to work
full time on our campus.  Real partnering means that you participate fully.  It
doesn't mean we get to make the decision, but it means we get to be intimately
involved in that partnership, and I think expanding that program would be
wonderful. 

The VA is also experimenting with the
placement of psychologists in counseling centers, and so if you look in the
University of Texas at Austin, this past year they hired a VA psychologist to
work specifically in the counseling center to provide therapy, given issues of
stigma at local VA medical centers, and these are individuals that are trained
very specifically in the treatment of combat‑related trauma.  That is a
wonderful program.  It would be nice to see that expanded and, again, to have
that be a true partnership so that you don't necessarily get to dictate who is
hired but you are involved in the process of hiring and making sure that it is
the right person for the campus. 

The last thing that I would suggest is that
universities as a whole could do a better job at probably the issue that
Colonel Morris spoke to, which is really giving credit for military
experience.  We need to do a better job at giving soldiers credit for life experiences
and technical training that they have, and providing college credit for that
that facilitates employment. 

So I would tell you on the university side,
we can do a better job.  And actually our center is going to pursue some effort
nationally about trying to coordinate that in terms of giving academic credit,
facilitating the employment picture for veterans. 

Mr. BUERKLE.  Thank you all very
much. 

I now yield 5 minutes to the ranking member,
Mr. Michaud. 

Mr. MICHAUD.  Thank you, Madam Chair. 
Once again I would like to thank the four panelists for your testimony this
afternoon. 

Colonel Morris, what would you say is the
biggest difference there is between reintegration between Guard and Reserves as
opposed to the Active military? 

Colonel MORRIS.  Sir, I have done it
both ways.  Andy and I spent a lot of time talking about this.  I think that
the Federal soldier, sailor, airman, and marine, the Active Duty or the
reservist, have the most difficult challenge.  Generally they are returning to
a place different than they served, and often if they are a Reservist, their
unit has been pulled together from diverse geographic locations, and they are
going home alone or in ones and twos.  I have gone to war as a person all by
myself, the Army of one, and it is not fun to come home as the Army of one. 
Guard units generally return as a community, out of an armory located in a
community; they have got built‑in camaraderie and community support.  I
think the Guard actually has an advantage in terms of reintegration. 

I think the toughest organization for
reintegration is the United States Marine Corps, an elite, proud group.  And
elite warriors across the services that are serving on Active Duty have a very
tough challenge coming back.  They leave a very community, they have a lot of
secrets, and they come back to a public that absolutely does not understand
what they have done, and they are by themselves.  They have the hardest
challenge, no doubt. 

Mr. MICHAUD.  Thank you. 

Dr. Rudd, you mentioned the Pew Research
Center, and part of the study had talked about ‑‑ you mentioned 44
percent of the post‑9/11 veterans say their readjustment to civilian life
was difficult by contrast to just 25 percent of veterans who served in earlier
eras.  What do you distinguish ‑‑ or do you know in this study why
the difference?  Is it because if you look at what is happening in Iraq and
Afghanistan, a huge influx of Guard and Reserves, or do you think there is a
distinction between Guard and Reserves in the readjustment versus Active
military? 

Mr. RUDD.  I think that is a great
question.  I would tell you, it is somewhat speculative, it is probably a
combination of those things.  I think reintegration is problematic from one
perspective in that fewer and fewer Americans serve in the Armed Forces, and so
fewer and fewer understand the issues that military face. 

I think, too, I think a larger portion of the
combat mission has fallen to Guard and reservists, which makes it a little bit
more difficult in terms of reintegration.  The primary problem, if you look at
the West, if you look at Utah as an example, one of the challenges for our
Guard individuals is the dispersion after they return, that they are dispersed
into relatively low populated areas, limited access to service, and limited
access to one another, so that there is limited access to one another. 

One of the wonderful things about student
veterans is that they have an opportunity to gather on a campus, they have an
opportunity to identify on a campus, and that helps.  And I think that that is
a part of what churches do.  I think that they provide an opportunity to
gather, provide that critical emotional support. 

So I think it is probably a confluence of
factors and that these have been unique wars.  It is a unique time in our
history, and the way that we structured the military is very much unique
relative to Vietnam, relative to Korea, and relative to World War II, and as a
result I think the reintegration challenges are unique.

Mr. MICHAUD.  Thank you. 

Dr. Wadsworth, you discussed in your
testimony the structural barriers to collaboration as it pertains to the VA
system.  Do you find the same barriers are there dealing with the Department of
Defense? 

Ms. WADSWORTH.  There certainly are
some barriers.  I would say that over the course of this war, DOD has really
come to understand that they cannot rely on simply their own resources to meet
the needs, particularly of the Reserve component, and with the closing of bases
and the increased reliance on the Reserve component, they must partner with
communities.  I think they still are working out their models, but there are
many, many examples of partnerships really permeating throughout the country. 
For example, an extensive partnership with the cooperative extension system,
which means that DOD now has a reach into every county in the country.

Mr. MICHAUD.  My last question is for
Colonel Morris.  How many community organizations does Beyond the Yellow Ribbon
Initiative work with?  Is it pretty much throughout your State? 

Colonel MORRIS.  Sir, we have got 73
communities that the Governor has officially recognized as yellow‑ribbon
communities, dozens of corporations and different entities, faith‑based
organizations, that have been recognized as well. 

The adjutant general's plan is that every
community in Minnesota that has a National Guard, Army Reserve, Navy Reserve
facility will be a yellow‑ribbon community.  We anticipate being well
over a hundred.  Each community has to train every aspect of their community: 
faith‑based, law enforcement, behavioral mental health, education and
employers.  So it is an extensive effort to get every community online to do
what they really want to do, and that is go Beyond the Yellow Ribbon and take care
of their military families and their veterans.

Mr. MICHAUD.  Great.  Thank you. 
Thank you very much, Madam Chair. 

Mr. BUERKLE.  Thank you, Mr. Michaud. 
I now yield to the gentleman from New Jersey, Mr. Runyan. 

Mr. RUNYAN.  Thank you, Madam Chair. 
I know, Dr. Rudd just kind of answered my question in just giving the
opportunity to meet and talk, but I can tell you firsthand in my district there
is actually a faith‑based hospital system that does a lot of the mental
health for the joint base there in my district.  And it has been a tremendous
help because it really comes on ‑‑ especially when you talk about
the West, but in my district, too, access to care is a huge part of it.  And I
think what the chaplain is really saying, and I want to ask you this, because
that is the ultimate issue is the access, whether it is religious based or
whether it is on a college campus. 

In the programs you run, what is that initial
hurdle?  What got that ball rolling to make this a community‑based ‑‑
to get the community involved?  Because I know the community on many levels in
the Guard ‑‑ in dealing with the Guard is involved.  But on this
aspect of it, what was the one thing that got the ball rolling and allowed it
to happen? 

Colonel MORRIS.  Well, two things, sir. 
Our previous adjutant general hired me with this statement:  I don't want my
soldiers treated the way I was when I came home from Vietnam.  Go fix that. 

Pretty big challenge.  But what he was saying
is I don't want my soldiers stigmatized by the people who sent them to war.  So
that put it right down at the community level. 

It is very obvious in Minnesota where we have
a lot of trained behavioral mental health professionals, chemical dependency
professionals, that anybody needing that kind of care is much more comfortable
using their TRICARE benefits in their backyard, with people that they know and
trust, versus traveling to a large institution that is unfamiliar to them.  But
helping those people understand what our peculiar set of issues might be, how
to get that training, that was a challenge for us at first, because the people
with that training are inside the VA.  So getting them to come out and share
the wealth of experience with the provider at the local level was initially a
tough hurdle to overcome, and we have overcome it; and now maybe too well,
because now we have got a constant message of, "You are mentally ill, you
are a victim.  You went to war." 

Most of us are not mentally ill, most of us
were not traumatized in war.  The fact of the matter is, after three combat
tours, I can certify most of us were bored to death.  We never saw anybody to
shoot, and we never fired our weapon.  We were never fired at.  So we have a
whole different set of issues to deal with.  But we have trumpeted that issue
so well that I have got a steady stream of mental health providers offering me
help, more than I could probably use.  Good collaboration with the VA; I just
don't have enough employers.  That is my next hurdle. 

Mr. RUNYAN.  I think we would all
agree on that as we continue to ‑‑ our unemployment in our men and
women coming home continue to rise.  And with that I yield back, Chairman. 

Mr. BUERKLE.  Thank you.  Mr.
Donnelly. 

Mr. DONNELLY.  Thank you, Madam
Chair. 

This would be to Dr. Rudd and Dr. Wadsworth. 
When you talk about college programs and college models that you have, is there
any effort being put in now to, in effect, almost putting like a college, here
is a model college program together, something that can be used at IU or at TCU
or at Rice or at any other schools that are out there that they can almost get a
turnkey program? 

Mr. RUDD.  I think there are.  I can
tell you that actually our center is leading an effort on two fronts.  One on
the mental health front; but also more broadly, just on student reintegration,
we are actually trying to initiate forming a national consortium to do that
very thing, to say here are best practices on college campuses both in terms of
how you work with distressed students, but more importantly, how you work with
transitioning students from their education to employment.  And really trying
to create community partnerships is a piece of that, so that we can help
individuals find jobs and make the transition.  So I would tell you that there
is some effort. 

The other thing I would tell you is that the
VA actually has been very proactive in this area.  We have the Assistant
Secretary for Policy and Planning is going to come visit our campus at the end
of March for this very issue.  We are looking at exploring how do we partner,
how do we get models in place, and then how do we distribute and, most
importantly, how do we do that quickly? 

Mr. DONNELLY.  Dr. Wadsworth. 

Ms. WADSWORTH.  Yes, I think the data
are still not completely clear about exactly which strategies work the best,
but we do know promising practices.  In Indiana we have actually been working
with institutions across the State, so we approached it right from the
beginning at a systemic level, and we try to think about it from a life‑cycle
perspective:  What do colleges and universities have to do to be well prepared
for students when they first get there, including transfer credit; how do they
best support them while they are there; and how do they ease the transition
from the campus? 

And so we are working with systems of higher
education to try to help them remove some of the structural barriers, and that
is where the transfer credit issue really can come in. 

We also work closely with student veteran
organizations who are a key element, I think, in providing a sense of home on
campus where student veterans can find each other and help each other. 

Mr. DONNELLY.  Thank you very much. 

Dr. Morris, or Chaplain Morris, one of the
areas that has continued to break everyone's hearts here is the suicide of
vets, and a lot of these cases you hear afterwards say, Well, I saw one or two
people, but they never really understood me. 

I just wonder if you have any ideas on what
organizations or what people or what are the critical elements to best have someone
who can understand that person when they talk to them? 

Colonel MORRIS.  Sir, first of all,
after Indiana beat Minnesota twice this year in basketball, I am struggling
with depression. 

Mr. DONNELLY.  Well, sir, we haven't
won a national championship in about 25 years, so we give it a good run
ourselves. 

Colonel MORRIS.  Minnesota tragically
leads the Nation in terms of the National Guard in suicide, so this is an issue
that has got the entire focus of our Governor, adjutant general, and all the staff. 
I wish I had a magic answer for you, sir.  We have thrown everything against
this problem that we possibly can. 

I think General Chiarelli, before he retired,
his exhaustive report to the Army on this issue highlighted several things.  We
need to do a better job screening before people come into the military because
we know that we have seen suicides of people who brought preexisting conditions
to us.  In the Minnesota Guard, most who committed suicide never had deployed. 
Some committed suicide prior to ever going to basic training.  Something was
going on in their lives before they came to us. 

Now, how can we all be more alert?  We focus
most of our effort on that.  Is it the first sergeant, the first line leader,
is it the company commander, is it the chaplain?  We have decided to train them
all down to the squad level leader. 

We have also decided to train families, and
so we are working aggressively in all our reintegration academies to train our
families in suicide prevention.  That is a step we have never considered
before.  We are doing that full fledged.  We train local clergy, we train the
local behavioral mental health providers.  But, again, we are cognizant that we
are fearful that we are going to create a stigma against the people we are
actually trying to help, that, again, we are all mentally ill, and we know we
are not.  We know that society has a suicide problem, not just the military,
but we are owning this problem, and we are facing it head on because these are
precious soldiers who we have invested so much in and want so much to retain,
but we haven't found the magic bullet of the person to solve the problem. 

Mr. DONNELLY.  Well, thank you very
much for your efforts on this, and obviously it is a concern to all of us
because these men and women come back having served our country, and they reach
out, and what you hear time after time is, "I couldn't find anybody who
really understood what I am going through." 

And so we will stay after it, but thank all
of you for your help.  Madam Chair, I yield back.  Thank you. 

Mr. BUERKLE.  Thank you, Mr.
Donnelly.  I now yield to the gentleman from Texas, Mr. Reyes. 

Mr. REYES.  Thank you, Madam Chair.  I
appreciate the opportunity to be here.  I am wondering, if we go back
even to the days of the Romans, if they didn't deal with these
same kinds of issues.  And I say that because I came back from Vietnam after
serving with some really bad guys that society had said, "You have a
choice, go to jail or go to the Army."  And those were very good soldiers
that exemplified, the bad cards that they were dealt for many different reasons. 

Obviously I don't know what happened to them
after we came back from Vietnam.  I can only use my example that having
come back under the circumstances that we came back under, where we weren't received  well, we each individually wrestled with
the question, what I did for the past 13 months, was that worth it for these people that are ungrateful?  But what got
me through was my family.  My family and a priest that my mom said, You know,
you need to go to Father Velazquez and have him help you through this.  So
community and family are an important part of the healing process. 

But I am wondering, for those soldiers
that were dealt the bad hand, that went and excelled under the most difficult
circumstances anybody who has been in combat can tell you it sucks.  It is the most difficult
challenge you will ever face.  But they did it, and they excelled.  I don't
know if it was because they came from the inner cities or they came from gangs,
or whatever the situation was.  I can tell you, they were very good soldiers
that knew how to fight, and fought and distinguished themselves. 

So you fast‑forward to today, and the
situation is dramatically different.  The country appreciates the
all‑volunteer force.  I am a little bit troubled, Chaplain, by the fact
that you make a statement that some of these people had
issues when they joined the military.  I thought we had a way of screening,
because these are all volunteers in today's military.  They are supported,
at least in my community, 110 percent by the people of El Paso, Texas; including Fort Bliss, White
Sands, and Holloman. 

So I am wondering, should the VA be doing
some kind of research that includes either case histories or organizations or a
community's role in how you embrace your soldiers?  Wel send
them into combat on the drop of a hat and therefore, we better be there for
them when they come back with nightmares and, all the things that a
lot of us experienced but got through because of our family and because of a
priest or a rabbi or another religion figure.  Sometimes a buddy would
do help get you through an experience. 

So should the VA be doing some kind of
comprehensive research?  You know, here it is centuries after the Roman
legions, and before that the Vikings. I am just thinking,
if you were in combat, no matter whether it is modern or ancient, that is
pretty tough stuff that you have to deal with.  So anybody have any thoughts on
that? 

Colonel MORRIS.  Sir, Chaplain
Morris.  First of all, thank you for your service and welcome home.  I want to
tell you something about your generation, sir.  Referring back to my general's
challenge to me, don't let this generation be treated like me.  It was pointed
out to me very quickly by Vietnam veterans that despite the stigma of America,
you now lead this Nation in every area of productivity; you run our
universities, our hospitals; you are our political leaders; you have attained
the highest offices in the land despite the stigma heaped on you.  And I keep
using that illustration with my young veterans:  If you could attain the
position you have today, despite all you went through, we should be able to go
to Mars and back with all the goodwill that we have today, and all the gains we
have today are because of the pain of the Vietnam veteran.  So, sir, I salute
you and your colleagues.  Welcome back, you have done a great job. 

Should the VA study this issue?  They are,
sir.  The Minneapolis VA, the RINGS 1 and RINGS 2 study will be the definitive
study on the challenges of reintegration, and has within it the seeds for
understanding how to successfully bring soldiers all the way back.  This
brigade that is in Iraq today from the Minnesota Guard is under the research of
the Minneapolis VA, and I think when this longitudinal study is put together,
we are going to have the answers to the questions that you raise.  But I do
think, sir, we have to do a better job in the all‑volunteer Army
screening for prior mental health issues. 

I intervened personally in Iraq in five cases
where soldiers were suicidal.  They were on medication prior to enlisting in
the military, knew they couldn't enlist if they took and owned up to what they
were on under the care of a psychiatrist.  They stopped taking the medication,
made it through basic, made it through advanced individual training, got into
combat, and spiraled to become suicidal.  They should have never been on the
battlefield. 

We do not provide much screening for mental
health issues other than to ask you, Do you have a history and are you taking
any medication?  That is a pretty low bar.  So undoubtedly, I am telling you
from firsthand, we have taken people in and we are taking people in who should
not be in the military because of conditions that they are afflicted with.  We
have got to do a better job on the front end if we want to see that suicide rate
go down. 

Mr. REYES.  Thank you.  Madam Chair,
maybe that is something that we can pursue via a hearing at a later date,
because I really do think it is important, especially if we have that sense that there are
those that are coming into an all‑volunteer force.  Maybe we ought to
find out what percentage you would think that they were.  But it is something
worth pursuing. 

Mr. BUERKLE.  It certainly is worth
pursuing.  Thank you all very much for your testimony and for answering our
questions, and you are all dismissed.  Thank you. 

I invite the third panel to the witness
table.  Joining us on our third panel is Reverend E. Terri LaVelle, director of
Center for Faith‑Based and Neighborhood Partnerships in the Office of the
Secretary for the United States Department of Veterans Affairs; and Chaplain
Michael McCoy, Sr., associate director for the National Chaplain Center for
Veterans Health Administration in the U.S. Department of Veterans Affairs. 

Before we begin your testimonies, I would
like to thank Chaplain McCoy for his service to the Navy. 

Mr. BUERKLE.  Reverend LaVelle, you
may proceed.



STATEMENTS OF REV. E. TERRI LAVELLE, DIRECTOR, CENTER FOR FAITH‑BASED
AND NEIGHBORHOOD PARTNERSHIPS, OFFICE OF THE SECRETARY, U.S. DEPARTMENT OF
VETERANS AFFAIRS; AND CHAPLAIN MICHAEL MCCOY, SR., ASSOCIATE DIRECTOR, NATIONAL
CHAPLAIN CENTER, VETERANS HEALTH ADMINISTRATION, U.S. DEPARTMENT OF VETERANS
AFFAIRS

STATEMENT OF REVEREND E. TERRI LAVELLE 

Reverend LAVELLE.  Chairman Buerkle,
Ranking Member Michaud, and members of the subcommittee, thank you for the
opportunity to appear before you today to discuss VA's outreach to faith‑based,
nonprofit community leaders and organizations to better equip them to work with
our veterans, their family survivors, and caregivers. 

As director of the Center for Faith‑Based
and Neighborhood Partnerships since September 2009, every day I draw on my
experience as a registered nurse, ordained minister, and program director to
connect faith‑based nonprofit and community leaders to the people,
programs, and services VA offers our veterans.  Our primary goal, focus, and
mission is to get our veterans the help they need and deserve. 

The Center for Faith‑Based and
Neighborhood Partnerships, along with VA colleagues from across the country,
work hard to develop strong partnerships with faith‑based, nonprofit and
community leaders and to provide them with the information on VA services and
invite them to participate in VA programs. 

Every day, servicemembers are returning home
to stay, some after multiple deployments.  After returning home ‑‑
returning home can be challenging.  Often I hear stories about how difficult it
is for these veterans to connect with family, settle into a new routine, and
find work.  These challenges may seem commonplace to us, but they represent
unique stresses for our veterans.  Many veterans seek help and support from
family, their place of worship, or their community.  When they do, we at the
Center for Faith‑Based and Neighborhood Partnerships make sure these
individuals are well equipped to provide information on VA's programs and
services. 

Just as important, we make sure that every
leader knows at least one VA staff person he or she can call on when working with
a veteran, someone who can act as a resource and help them help the veteran in
need and find useful VA programs and services.  We do this by cohosting
outreach events across the country to introduce faith and community leaders to
the programs and services VA provides.  We try to help these leaders understand
how to work with VA and other partners and, in doing so, expand and enhance the
ministries and programs they currently have in place that can serve veterans. 

For example, sometimes the only thing keeping
a veteran from getting the health or mental health or benefit services he or
she needs from the VA is not having a way to get to the necessary clinic or
office, so an organization may want to provide transportation through their
existing transportation ministry, providing each veteran with a dependable free
ride.  The organization can work with VA's voluntary service office, which is
located at every VA Medical Center, to coordinate a volunteer transportation
program.  Volunteer services is ready with all the information the organization
needs to spring into action. 

In addition, many faith‑based
organizations have counseling ministries or programs unfamiliar with the unique
challenges veterans face returning home ‑‑ and their families.  VA
chaplains and social workers will provide training to community leaders,
pastors, lay leaders, and support staff to help them understand the unique
needs and challenges veterans may be facing.  In all of our outreach efforts,
VA includes both local and regional VA staff as panelists and roundtable
participants and a VA chaplain who can provide an understanding on the special
needs of veterans returning from deployment. 

We grow our relationships with community and
faith‑based leaders by hosting quarterly conference calls, maintaining an
informative Web site, and sending information out on a regular basis to over
1,200 Listserve members, and our Listserve is growing all the time.  We know
our veterans come from a variety of different backgrounds, cultures, and faith
traditions and that they represent the diversity that makes up our great
country, so we continue to expand our outreach by developing new relationships
with diverse communities. 

Madam Chairwoman, I believe that, without a
vision, that people perish; but under the leadership of Secretary Shinseki and
the Center for Faith‑Based and Neighborhood Partnerships, our veterans
will not perish.  We offer a vision and a plan for preparing faith‑based
and community leaders with the tools they need to serve our veterans in their
communities. 

I would also like to extend my thanks to all
of my fellow panelists and our elected officials who have served in our
military for your service and your sacrifice. 

I am now prepared to answer any questions. 

[The statement of Reverend LaVelle appears in the Appendix.] 



Mr. BUERKLE.  Thank you very much,
Reverend LaVelle.

Chaplain McCoy, you may proceed.

STATEMENT OF LIEUTENANT COMMANDER MICHAEL MCCOY SR. 

Lieutenant Commander MCCOY. 
Chairwoman Buerkle and Ranking Member Michaud, and members of the subcommittee,
thank you for the opportunity to speak about the Department of Veterans Affairs
(VA) Chaplain Service's outreach efforts with community and faith‑based
organizations. 

As a VA chaplain over the last 21 years and a
former Navy chaplain, I have found one of my greatest joys has been working
with veterans and providing meaningful programs to aid them in their healing. 
My testimony today will cover three programs created by VA chaplains to help
build bridges between VA, the faith‑based communities, and neighborhood
leaders to aid in the spiritual care of our returning veterans and their
families. 

The VA National Chaplain Center started the
Veterans Community Outreach Initiative to educate community clergy about the
spiritual and emotional needs of our returning veterans and their families. 
Nationwide, VA chaplains have conducted over 200 training events and provided
education to approximately 10,000 clergy through this effort.  As a result, clergy
across the Nation are learning to help veterans identify and cope with
readjustment challenges the veterans and their families face following
deployment, identify the psychological and spiritual effects of war trauma on
survivors, and serve as a trusted and knowledgeable resource for veterans to
use to connect with VA. 

Just a week ago I received a phone call from
a local pastor in Virginia who had attended one of our outreach events.  He
said, "I am very impressed by the passionate commitment and excellent
resources available to veterans, and I need your help.  Today a member of my
church, whose son recently returned from deployment in Iraq, called me,
hopeless, his father did, and in despair.  He said the young man had just been
arrested and put in jail in Richmond, Virginia.  His father said his son was
clearly experiencing PTSD, but he didn't know how to help him.  Can you help me
link the veteran to the VA services he needs?"  I promptly made the call
linking the veteran to VA providers who could most effectively care for him. 

This is just one among many veterans who has
benefited from the Veteran Community Outreach Initiative events that our
chaplains are sponsoring to establish collegial relationships between VA
chaplains and community clergy.  I truly believe that a worthy goal of this
program is for local clergy across the Nation to say, "I know the local VA
MC chaplains.  They are devoted to care for veterans and their families.  If I
call them, they will help me connect families who have come to me for guidance
to the VA resources they need." 

Each clergy who attends a VCOI event receives
a tool kit, prepared by the National Chaplain Center, of books, brochures,
information packets and important phone numbers and Web sites to aid them in
providing a helpful support to the veterans and his or her family. 

My time here is short, so I will just briefly
mention two other important VA programs.  Our marriage enrichment program was
developed based on concerns over the large number of stress marriages
experienced by our veterans who are returning.  We have discovered that all too
often the spouse who has gone to war and returned may have physical, emotional,
and spiritual wounds that have not yet healed.  These stresses often led to
family crisis and divorce, so we began a program called Getting It Back,
reclaiming your relationship after combat deployment.  It is designed to help
married couples develop healthy ways of interacting and relating with one
another.  Community leaders and faith‑based volunteers collaborating with
VA chaplains, psychiatrists, and social workers have contributed in making the
program a success. 

Finally, I will mention our Heal the Healer
program for returning National Guard and Reserve chaplains home from recent
deployment.  The program offers an open forum to share the experience and
emotions associated with employment, introduces them to other chaplains with
similar experience, and offers insight on how we may intervene in the future to
provide appropriate and timely care for our chaplains returning from combat
zones.  The stories and tears in these sessions are many.  And we, working and
caring for our veterans, they too have changed our chaplains who have worn our
uniforms in caring for partnerships and creating partnerships with local
clergy, our faith group endorsers and community faith group leaders, working
together to reach out and offer support to returning chaplains, veterans, and
family. 

Madam Chair, thank you for the opportunity to
share this opportunity with you to speak on these concerns, and I am now
prepared to answer any questions.

[The statement of Reverend McCoy appears in the Appendix.]



Mr. BUERKLE.  Thank you both very much
for your testimony.  I will now yield myself 5 minutes for questions. 

Reverend McCoy, the 200 or so training events
that were conducted throughout the country, can you just expand on that a
little bit?  How do you choose the sites, how many people attend, and
is follow‑up done after those events?

Lieutenant Commander MCCOY.  Yes,
thank you for the opportunity to respond to that question.  We have offered
actually 233 of these training events throughout the country really, where our
VA medical centers primarily is located.  What we have done in these
particular programs is to identify the readjustment challenges that veterans
and their families face following deployment.  The goal is to identify
psychological and spiritual effects of war trauma, of survivors, consider
appropriate pastoral care interventions with the local clergy so they can have
some idea, when we talk about PTSD and when we talk about brain injury, that
they kind of understand something about these and the signs of these particular
diseases. 

We had a community clergy to
brainstorm with us how we can partner together in order that we can provide the
best of care to our returning warriors.  We refer veterans to local VA
healthcare facilities.  We always give them a packet of information, Web
sites, phone numbers, and books that they can have, that is free, and these
have been very beneficial in making veterans connect to the VA, and it created
relationships among the chaplains with local clergy
throughout their various communities. 

Mr. BUERKLE.  Thank you very much. 

Does the VA chaplain group have a strategic
plan?  For instance, I have a VA facility in my district.  We have a wonderful
VA hospital in Syracuse, and we had an event where we targeted the clergy.  We
had a distinguished panel come in and instructed our clergy as to what to look
for, what the signs and symptoms are, family involvement.  It was very
comprehensive.  Now, we probably invited maybe 600 members of the clergy, all
denominations.  No one mentioned your organization.  So maybe this is where the
disconnect is. 

We are talking about all these parallel initiatives
going on.  How do you get your word out?  Do you have a strategic plan to hit
all of the communities throughout the country?

Lieutenant Commander MCCOY.  Yes, we
are expanding that, Madam Chairman.  We have a strategic plan, and we have
efforts, and the local clergy at that particular VA, and we have a template for
them to follow.  Our numbers for this outreach is increasing. 

I understand you are from the New York area. 
I think we have had 22 of these veteran outreach programs with clergy in the
New York area to this date. 

Mr. BUERKLE.  We are in Upstate, so
that may be different than the New York area.  We are in the country.

Lieutenant Commander MCCOY.  One of
the things we are, if I can ‑‑ we have started a rural program, and
our initiative, rural initiative, is to target some of the rural areas where
there is not perhaps VA hospitals, but perhaps where we can use ‑‑
where we can go near CBOCs or various clinics and so forth where we can offer
these services.  We always bring in various speakers, not just chaplains, but
the clergy.  We also have a psychiatrist, a social worker, somebody perhaps
from the faith‑based community, all to intersect in creating this
partnership with us. 

Mr. BUERKLE.  Thank you very much. 

Reverend LaVelle, I understand that much of
your outreach efforts center on educating the community about programs and services available through the VA.  How do you ‑‑ what kind of
outreach is done with the VA so that they know that you exist and that they
know of your services that are available? 

Reverend LAVELLE.  Well, we have a
steering committee, and all three administrations are represented on our
steering committee.  A representative from the three VA administrations and the
VA program and staff offices, and our steering committee meets quarterly.  We
also do quarterly conference calls where we have internal and external partners
that are a part of our Listserve, which includes VA staff.  We also work with
veterans benefits administrations, vocational rehabilitation and employment
service, and four times a year we do outreach events at four different regions
throughout the country in partnership with the regional office in that host
city.  So that is how we get the word out and work collaboratively within VA. 

Mr. BUERKLE.  Thank you both very
much.  I now yield to the ranking member, Mr. Michaud. 

Mr. MICHAUD.  Thank you, Madam Chair. 
This question is for both.  Colonel, you touched upon it, but what is being
done specifically to address the support needs of our veterans that reside in
rural areas or underserved areas of the country?  Let's start with Reverend
LaVelle. 

Reverend LAVELLE.  Well, one thing. 
Last year I requested from the Vocational Rehabilitation Employment Services
field office that when they choose the four sites for the fiscal year 2012
roundtables, that one of those sites be a rural area.  So that is the one thing
we have done.  But I also know that our Chaplain Service has had a rural
initiative where they have been working with rural clergy. 

The other thing I did is that in our
quarterly conference call in September of 2011, there is a VA Medical Center
chaplain in Arkansas, in Little Rock, who has started an initiative with rural
clergy.  We had him as a guest speaker so that he could describe his program so
that others on the call could learn how to work with rural clergy. 

So those are some of the things that our
center has done as relates to outreach to the rural areas.

Lieutenant Commander MCCOY.  Thank you
for that opportunity to respond.  We as chaplains have begun a rural clergy
program with a strategy, and this ‑‑ as a matter of fact, next week
we are having one, I think it is going to be in the Roanoke area, and we are
moving throughout the country and we will expand that program, and I think
there will be several this year, but we will expand it in rural areas.  We are
actually targeting these areas.  We are sending out hundreds of invitations and
letters.  We are working with the community clergy to also ‑‑
sometimes, I found out, when other clergy sometimes talk to other clergy, you
get better attendance.  So we are using word of mouth and using the presidents
of some of the clergy associations to help us bridge this gap. 

Mr. MICHAUD.  Reverend LaVelle, you
mentioned the four areas.  Which area is the rural area?  You mentioned you did
outreach in four areas.  What one is going to be in the rural area?  What is
your definition of what area is the rural area? 

Reverend LAVELLE.  Well, I don't have ‑‑
I don't know the definition of a rural area.  But I just made the request to
the field office for Veterans Benefits Administration to say one of the areas
needed to be a rural area, and the four cities that they gave us back for this
year was Huntington, West Virginia; Albuquerque, New Mexico; Lincoln, Nebraska;
and Boston, Massachusetts.  And if I am not mistaken, it is the Huntington ‑‑

Mr. MICHAUD.  I think there is a
definition problem because those are not ‑‑ none of them are
rural. 

Reverend LAVELLE.  Okay.  Then I will
go back and check with them, but I specifically requested. 

The other problem is that ‑‑ it
is not a problem, I shouldn't say that.  They sent me an email maybe a week
ago, and I have been away on travel, that some of those cities are changing. 
So they must have ‑‑ because I reiterated, but those are the
initial cities they sent me for fiscal year 2012.  I apologize.  I don't have
in my head the definition of "rural." 

Mr. MICHAUD.  Well, I mean, when you
mentioned one of those four areas should be rural, I mean the fact that you
just said all four are cities, you know, that is not rural.  When you look at
what is happening with our Active military as well as the veterans that
actually do live in rural areas, I think they should not be left behind.  So
since you are the director of the VA Center for Faith‑Based and
Neighborhood Partnerships within the VA system, have you talked to the Office
of Rural Health? 

Reverend LAVELLE.  Yes, I have met
with them once.  Yes, I met with them, and I will go back, and really for my
own benefit get the ‑‑ what they define as rural, so that I make
sure when I get the information again from the field office that there is a
meeting of the minds and that we are both speaking the same language. 

Mr. MICHAUD.  You said you met with
them once? 

Reverend LAVELLE.  When I first came
on board.

Mr. MICHAUD.  How long have you been
on board? 

Reverend LAVELLE.  It has been 2‑1/2
years. 

Mr. MICHAUD.  Two‑and‑a‑half
years.

Reverend LAVELLE.  But the field
offices are the people that actually work with them and provide me with the
locations.  I don't make that determination.  But I will definitely follow up,
and if you want me to, I can get back to your office with the definitive
information. 

Mr. MICHAUD.  Thank you.  You talk
about collaboration with faith‑based organizations.  To the best of your
knowledge, do these faith‑based organizations, do they charge veterans to
access whatever help that they might need, do you know?

Lieutenant Commander MCCOY.  May I
answer that?  No.  Most are volunteers.  They actually, out of their compassion
and their love and willingness to help the veterans, they have went into their
pockets often to provide services for our veterans, either transportation or
various types of programs that they are offering in the communities. 

Reverend LAVELLE.  The organizations
that I have worked with, the churches that have transportation ministries, have
said we are more than willing to say that so many days a week, so many hours,
we will use our current transportation ministry to get veterans to and from
appointments.  Churches that have counseling ministries or support groups have
said, We are more than willing to develop a support group if you can provide us
with people to come in and talk to us specifically about the unique challenges
of veterans returning from combat. 

Like my home church here in D.C., our entire
counseling ministry consists of Ph.D.s and licensed clinical social workers,
but their expertise has not been in dealing with veterans per se, so they are
open to having VA chaplains and/or our social workers come in and do training
so that they are better equipped as our veterans return and become a part ‑‑
and return to the church, to work with them and their families without any
charge. 

Mr. MICHAUD.  Thank you.  I see my
time has run out.  Thank you very much. 

Mr. BUERKLE.  I now yield to the
gentleman from Texas, Mr. Reyes. 

Mr. REYES.  Thank you, Madam Chair. 
You mentioned the four cities in 2012.  Did you have four cities in 2011? 

Reverend LAVELLE.  Yes, the Center for
Faith‑Based and Neighborhood Partnerships has been collaborating with
VBA, Vocational Rehabilitation and Employment Service since 2005 in these
efforts, yes. 

Mr. REYES.  So in 2011 what were those
cities; do you have that information? 

Reverend LAVELLE.  Yes, I do. 

Mr. REYES.  The reason I ask is
because, traditionally, Texas and California have the most veterans and the
most Active Duty ‑‑

Reverend LAVELLE.  The center was in Waco,
Texas, twice.  Once in Waco, Texas, as a result of VBA and the center's
collaboration, but then the Waco Foundation requested that we come back and do
another roundtable.  And so then when I came on board we went back to Waco,
Texas.  We were in ‑‑

Mr. REYES.  Just out of curiosity, why
can't your outreach programs be part of every VA director's duties? 
For instance, I have a VA clinic, what they call a super clinic, in El Paso.  Joan Ricard is
our director.  Why can't your
programs be part of the menu of services, or have her be responsible to provide
information?  As the chairwoman said, in her case she actually
convened people at a meeting and your programs never came up.  I find that a
little bit troubling. 

So why can't it be part of every Veterans
Administration director?  Albuquerque is good, they are 386 miles
northwest of El Paso, but they serve a different clientele than the
El Paso VA clinic.  And if not by the VA director, why not the VISN?  But there
has got to be a way to send the information out because veterans desperately
need these kinds of support systems.

Lieutenant Commander MCCOY.  Thank you
for that question because we are collaborating with the Office of Rural Health
and with our programs and chaplains, and we also are collaborating with mental
health and other agencies.  All of our chaplains who worked for various VA
medical centers have been basically mandated to provide this type of program. 

Now, in terms of the rural health, we at the
National Center, with chaplains of course, move out into various other areas. 

Mr. REYES.  So is the closest chaplain
to El Paso in Waco?

Lieutenant Commander MCCOY.  Yes. 

Mr. REYES.  It is?  That is 600
miles.  Albuquerque is closer to me than Waco, and that is what ‑‑

Lieutenant Commander MCCOY.  Now, you
do have clinics.  And so we have chaplains that will visit occasionally those
clinics.  And we also are going to expand the program where we will have ‑‑
actually, hopefully, we will have programs in the clinics ‑‑ that
is our directions ‑‑ and to go out to the various locations. 

Now, all of the faith‑based activities
do not happen, or these clergy events do not happen in a VA hospital or a VA
facility.  They are happening in churches, educational buildings, and that type
of thing. 

Mr. REYES.  I understand that, but I
have a veterans meeting every month.  It is a citizens advisory panel for
veterans.

Lieutenant Commander MCCOY.  Yes. 

Mr. REYES.  And Joan Ricard goes there
every month.  She is very good about attending.  But the times that I have
been, we have never heard the
information about your programs.  So is there a reason why you can't designate
the VA directors in our respective areas to provide information and a process? 
I think it makes perfect sense for Joan Ricard to have these programs and to select maybe a clergy board or some other system where
there is a chaplain or chaplains, because we have got a facility that is going
to grow to 45,000 soldiers and they are all coming back from multiple tours in
Iraq and Afghanistan. 

I hear it from the
priests, the ministers, and the rabbis of the work that they are doing to support
the military, both soldiers and their families.  And I also hear it from judges
that are working in the family courts where there are divorces going on, and
they are asking me why isn't there some kind of an intervention program that
provides counseling for these families that are being torn apart because of
multiple tours and things like that?  I think this would be a great way to
at least try to do that, and I don't understand why the VA wouldn't want to
impart that authority or that responsibility to our VA
directors.  I certainly hope you would take that back, and maybe we can follow
that up and make that happen somehow. 

Reverend LAVELLE.  I can ‑‑
I will definitely send an email to the chief of staff for VHA, who is someone I
have worked with closely when I am getting VA staff to speak at these regional
events, and bring this issue to her attention. 

The other thing, though, is that at every
medical center there is what is called a minority veterans program coordinator,
and as an ancillary duty, it is not part of their paid job.  But every medical
center has a coordinator, minority mentors program coordinator, who part of
their responsibility is to do outreach.  So maybe sometimes we are not getting
the information to the right person. 

What would be helpful for my center is if we
could find out who the faith liaison is at either here in D.C. for every
congressional office, because then we could at least let them know what we are
doing and, when we have events, get the information to them to say let the
faith leaders of your community know this is what we are doing, and we can get
information out that way.  That would be one step to kind of bridge this divide
between at least your Representatives within the congressional districts or at
least starting here in D.C. or in your congressional district.  Like there are
some people that I know in different offices, so I automatically send them
stuff just because I have known them. 

Mr. REYES.  That tells me that there
needs to be ‑‑

Reverend LAVELLE.  We need to broaden
that.  I will contact the staff of VHA and say this is an idea that came up,
how do we get some kind of relationship going with your medical center
directors so they have our information on hand and can disseminate it and work
more closely with the faith communities, and then keep us abreast, and we
figure out how to help them develop those relationships. 

Mr. REYES.  Especially when, as
Congressman Michaud was talking about, when it is the rural areas, there are
huge gaps out there.  You are talking about States like Idaho, Wyoming,
Colorado that have a lot of rural areas.  Texas in the panhandle and all of ‑‑
most of West Texas that is not El Paso, that is all rural area.

Lieutenant Commander MCCOY.  Yes. 
And, sir, I agree that we need ‑‑ we can expand that.  But I think
that one of the things, that all chaplains in the VA work for a director of a
VA Medical Center.  So I think with that in mind and with our policy from the
National Chaplain Center, I have went to many ‑‑ several of these
events, and the director has been the one who has given the opening welcome at
the event for the clergy. 

Mr. MICHAUD.  Thank you, Madam Chair. 

Mr. BUERKLE.  Thank you both very
much.  I must say I am a bit chagrined, and, maybe worse than that, concerned
because when we did our symposium on faith‑based providers and invited the clergy,
we did have the VA there because we wanted them to be able
to tell the clergy members what services are available.  And even the VA didn't
mention your offices.  They made no mention
of it at all, that either program existed.  I think we have a really big
disconnect here in knowing what is available and what is out there. 

If I could, Chaplain McCoy, I would ask that
you provide for us the template that you spoke about earlier and the tool kit
that you spoke about earlier so we can see what it is you are doing.

Lieutenant Commander MCCOY.  Yes. 

Mr. BUERKLE.  To make sure we get our
veterans the services they need.

Lieutenant Commander MCCOY.  I will.

Mr. BUERKLE.  Thank you both very much
for your time and answering our questions.  You are both excused.  Thank you. 

In closing here today, I think that Chaplain
Morris said it best:  we really do need a community effort to make sure
that our veterans have what they need.  We expect and look to the VA to
be a leading partner in this.  That is their mission. 

It is going to be important for all of us to
look to our communities and make sure every section is covered.  And Mr. Runyan
has left, but I think his comments, and Chaplain Morris' comments about employment and
making sure our economy gets back on track so when our veterans come home,
there is a good, viable alternative and that they can seek an engaging good
job.  With regard to the universities ‑‑ those who choose to go
back to the universities and be educated ‑‑ that there be that
safety net that Dr. Rudd spoke of, and that they are equipped to know and
appreciate and understand what the veterans are up to ‑‑ and what
they are up against, I should say. 

With that, I ask unanimous consent that all
members have 5 legislative days to revise and extend remarks and include
extraneous material.  Without objection, so ordered.

Mr. BUERKLE.  Thank you again to all of our witnesses and to our
veterans who have served our Nation so courageously, and to each of our audience members for joining today's
conversation.  This hearing is now adjourned. 

[Whereupon, 6:04 p.m., the subcommittee was
adjourned.]




 


APPENDIX


Prepared Statement of Chairwoman Buerkle

Good
afternoon and thank you all for being here.

Today,
we meet to discuss the role of faith-based and community providers in helping
servicemembers, veterans, and their families transition from active-duty to
civilian life and the need to foster better communication, education, and
collaboration between the Department of Veterans Affairs (VA) and these
critical community resources.  

The
responsibility of each one of us to ‘care for those who have borne the battle’
has never felt so poignant with the brutal toll of a decade of war and a bad
economy. 

We
continue to hear stories of veterans from past conflicts and our recently
returning veterans from Iraq and Afghanistan struggling to find a home, a job,
or a helping hand.  The need to meet these honored heroes where they are and
provide them the care, the hope, and the help they earned has never felt so
immediate.

As a
nation, we are uniquely blessed to live in a country with a rich history of
civic pride and responsibility and it is to these communities where our
veterans return home, have maintained existing relationships, and, more often
than not, where they first turn for help.

While
the primary responsibility for caring for our veterans should and does lie with
VA, faith-based and community groups are playing an increasingly key role in
supporting the varied needs of our servicemembers, veterans, and their
families.   They act as a bridge to accessing federal, state, and local
programs and services.

Members
of the clergy in particular are often the first point of contact with a veteran
grappling with the wounds of war.  Data from the VA National Chaplain Center
indicates that four out of ten individuals with mental health challenges seek
clergy assistance, more than all other mental health providers combined.

We already
know that faith-based and community groups can be effective in filling known
gaps in VA care and supporting the day-to-day needs of the veteran population.

However,
a district symposium I held in my home district of Syracuse, New York, last
December, revealed to me a shameful lack of communication, collaboration, and
coordination between VA and these critical community resources.  And,
subsequently, an urgent need to act to establish meaningful partnerships
between VA and nongovernmental organizations.

With more
of our servicemembers returning home each day, we cannot afford to let any
opportunity to better support our veterans pass us by.

Where
partnerships exist, they need to be strengthened. Where they don’t, they need
to be fostered. For a veteran or loved one in need, every door should be an
open door.

Again,
I thank you all for joining us this afternoon. I look forward to a productive
and ongoing conversation. 

Prepared Statement of Hon. Michael H. Michaud, Ranking
Democratic Member

I
would like to thank everyone for attending today’s hearing.  This hearing is
intended to open up the broader thought process and better understand how the
VA and community organizations collaborate to support veterans and their
families.

More than 2 million service members
have been deployed since September 2001, with hundreds of thousands of them
being deployed more than once.  As of February 2012, more than 6,000 troops have
been killed and over 47,000 have been wounded in action in the recent conflicts. 
 

When these service members
come home and take off the uniform, many of them have the expectation that life
will just pick up where it left off before being deployed.  However, this is
just not the case. 

Many of them struggle to
reconnect with their families and communities.  They find themselves feeling
isolated and unable to cope.  The Department of Veterans Affairs reports that half
of the OEF/OIF/OND population that has accessed VA health care sought mental
health treatment.

Post-traumatic stress disorder
is the number one reported mental health concern among this population.  With
so many OEF/OIF/OND service members and veterans experiencing psychological
wounds, reports suggest that there is an increase in the rates of suicide,
alcohol and drug abuse, homelessness, and domestic violence. 

For this reason, it is essential
that our service members, veterans, and their families receive the help they
need and that they have the necessary tools to rejoin their communities.  These
tools, programs, and resources would not be possible without the thousands of
community organizations across the country that work in partnership with the
VA.

At this hearing, I want to
hear more about the reintegration challenges that service members and veterans
face, as well as the challenges the VA and community organizations face in
providing support services. And we need to identify potential solutions to
these barriers and how we can strengthen these partnerships.

Despite historic
increases in VA funding over the past five years, as the nation prepares for
the influx of returning veterans, reintegration efforts are simply not possible
without collaboration between the federal
government, business sector, and nonprofit organizations. And more needs to be
done to facilitate these partnerships.   

I would like to take the time
to thank our panelists for being here with us this afternoon and for the work
that you do every day to support our Nation’s veterans.  I would especially
like to thank Mr. Morris and Mr. McCoy for their service as Chaplains in the
Minnesota National Guard and at VA’s National Chaplain Center, respectively.

In 2009, I lead a
Congressional delegation to Afghanistan and came to learn that our service
members rely immensely on their chaplains for emotional support.  And on every
visit since, I’ve come to respect the unique insights that our chaplains possess
in terms of mental health, spiritual guidance, and the overall well being of
our service men and women.

I look forward to hearing
from all of our distinguished guests today.  Thank you, Madam Chair, and I
yield back.

Prepared Statement of Hon. Silvestre Reyes, Democratic
Member

Thank
you Chairwoman Buerkle and Ranking Member Michaud for convening this hearing.

Over
the past decade, our nation has seen the effects of two wars in both Iraq and
Afghanistan.  Over 2 million service members have been deployed to these
regions during that time period and have selflessly served our nation.  These
brave men and women and their families have endured a lot. 

After
completion of their honorable service, many of these men and women will leave
our military and return to civilian life.  The process of reintegration into
the local community is nothing new, as we have had countless numbers of
veterans leave military service over the years to seek civilian employment.

Unfortunately,
this process of reintegration has not always gone smoothly.  Many Vietnam Veterans
did not receive the care and respect they deserved once they left the military. 
This cannot occur with our veterans today.  Therefore, we must ensure that our
service members, veterans, and their families receive the help they need and
that they have the necessary tools to re-join their communities.           

Reintegration
is a cooperative effort among the federal government, the business sector, and
community organizations, ensuring that our veterans are welcomed back into the
local communities where they can contribute as proud, hard-working citizens. 
They must receive the care and consideration they have earned.       

Prepared Statement of Andrew
Davis, Veteran

Good
afternoon, Chairwoman Buerkle, Ranking Member Michaud and Members of the
Committee. Thank you for the invitation to discuss the role of community
providers and faith-based organizations in helping service members transition
to civilian life and the need to foster better communication, education, and
collaboration between The US Department of Veterans Affairs (VA) and these
resources.    

My
name is Andrew Davis, and I am currently the Director of the Saratoga County,
NY Veterans Service Agency and the Founder of the Saratoga County Veterans
Resource Initiative. I have been a Veterans Advocate since separating from
service in 2004. I served as a United States Army Ranger for 5 years to include
two tours of duty in Afghanistan and one in Iraq.

Upon
returning to my home in Minnesota to further my education, I was faced with my
first taste of how little I knew about being a Veteran. In fact, like many of
my peers, I was unsure if I even was a Veteran. Because of this, I founded a
non-profit Veteran support organization on the campus of the University of
Minnesota to aid returning Veterans in connecting with earned benefits and
services. In later roles as a congressional staffer and Department of Defense
Transition Assistance Advisor I saw firsthand the disconnect between Veterans,
their families, and the systems that are intended to support them. For the past
three years I have spent my career as a Veterans advocate either training
accredited benefits counselors or being one myself. This has provided me a
frontline view of what is lacking in outreach and networked support to our
Veterans and their families.

Lastly,
I am currently an enrolled patient with the Veterans Health Administration
(VHA) in VISN-2 and use both the Albany-Stratton Veterans Administration
Medical Center (VAMC) and the Clifton Park, NY Community Based Outreach Clinic
(CBOC) regularly.

Opening Remarks:

Veterans and the ways they serve have changed significantly
over the last decade, resulting in the need for changes in the way our country,
in turn, serves them. The Veterans of today tend to be more geographically
dispersed and more mobile than previous generations. Families and communities
are affected and changed differently than ever before with multiple deployments
and the unique use of the guard and reserve. Many of these individuals suffer
from the lack of a “Fort New York” or central support system, making the local
community even more crucial in the reintegration process.

Despite
a constant bombardment of media in all forms that affords the public access to
our current wars, issues facing our neighbors, friends, family members and
other local Veterans are often invisible to us as communities. Add to this, a
military culture that can encourage emotional toughness and self sufficiency,
and we face a large potential public health problem.

Lastly,
the uniqueness that makes our military and our Veterans population great, also
means that there is not a one-size fits all support system that can be created
nationwide. We must garner community support and use community resources to
serve our Veterans and their families completely.

 Accessing Traditional Veterans
Resources:

Issue
-

First and foremost, the population of Veterans that find
their way into the VA system of care or benefits delivery system, merely by
accident, is staggering. I can safely say that approximately 5-7 Veterans knock
on our door weekly for some form of unrelated government service(s) to find
that they are eligible for Veterans benefits because of their service to this
nation. Just last week a young Marine with two tours of duty in Afghanistan
appeared in my office asking for directions to the office that handles
unemployment benefits. This Marine outlined, that although his home of record
on his discharge stated Saratoga Springs, NY, he had no idea who his local
contacts in Veterans Services were, or where he could take advantage of his 5
years of free health care from the VA. Nobody, from his pastor, to his friends
and family in the community knew how to connect him to his earned benefits and
services. If this Marine hadn’t knocked on the “wrong” door he would not have
met with my staff to turn on his GI Bill benefits or learn where he could
enroll in health care.

By all appearances, the US Department of Veterans Affairs
has recognized the need for community outreach but holds their hopes in the
idea that top down, one sided information will filter down to the grassroots
folks at the bottom. For example, in the VISN - 2 area of upstate NY, a few
competent and well trained Veterans justice coordinators have been hired and
put in place. However, the operative words here are “a few Veterans justice
coordinators”. These people are responsible for numerous counties and for
interacting with courts, district attorney’s and law enforcement, when in fact
the police officers on the beat and on our streets and highways are where the
first difference can be made.

Solution
-

The correct mindset for reaching Veterans must transition to
a “no wrong door” approach. This can and should be created through a localized,
national training by VA, Veterans Advocates and other experts to all members of
local communities. These newly created “Veteran Friendly Communities” would
have the tools to make referrals to the proper resources whether a Veteran
walks into a rectory, a tax assessor’s office or is pulled over during a
traffic stop.

Additionally, outreach and assistance programs cannot be
reactionary in nature. The time to begin helping a Veteran in legal trouble for
example, is upon first interaction, not just at sentencing.  In fact, in my own transition, it was a police
officer who pulled me over for driving in Minneapolis like I had in Hadithah
and Bagram that introduced me to my first Veterans advocate and helped me
realize that difficulty transitioning was normal. Additionally, I now receive
as an accredited service officer, a large number of referrals from local police
officers that I call my friends.

Local Solutions to a National
Issue:

 While
much of our conversation has always revolved around what VA and DoD does, can
do and should do better, the reality is that much of the care delivered to Veterans
in NY and across this country is done through private providers and other not
for profit and public sector providers or other forms of government assistance.
By urging VA to reach out to these providers, a referral and information
sharing system can be implemented to ensure Veterans are maximizing their
earned benefits and services.

As
a Veterans advocate, I can and do certainly play a role in culling these local
resources. For example, we have created the Saratoga County Veterans Resource
Initiative, which gathers local elected officials, college administrators,
Veterans advocates, private mental health providers, non-profits and others on
a quarterly basis to familiarize all with what we do and how referrals can work
between organizations. However this is an uphill climb for us because the
impression that most of the citizenry has, is that taking care of Veterans is
solely a VA or federal government role. When in reality the transition back to
civilian life is a community process. I believe this to be caused by the
generally one-sided dissemination of information by the VA to the general
public as opposed to community engagement.

Local Engagement
Opportunities:

  1. The VA has in place a network of county and state
    Veterans benefits counselors that when given a level of training and
    funding, can and should serve as community liaisons. While the US
    Department of Veterans Affairs may be our nations experts on Veterans
    related issues, our community leaders will be who brings Veterans back
    into the fold of everyday life. My experience as a Veterans advocate has
    been that the information sharing is largely one-sided from the VHA to us
    with little opportunity to engage with the Veterans Benefits
    Administration (VBA) and the VHA on real issues and improvements.
    Veteran’s advocates are on the “front lines” doing a large amount of VA’s
    enrollment and benefits delivery and are a valuable and many times an
    undervalued asset.
  1. Our
    country is filled with competent mental health care professionals that are
    constantly volunteering to treat and see Veterans. VA reluctance to use
    these community based providers in many instances turns Veterans and their
    families away from treatment at all. VA should look for ways to engage
    these highly trained professionals so Veterans can be treated comfortably
    in their community.
  1. In our county’s communities, local law
    enforcement, clergy and educators have been more than willing to learn
    about Veterans issues and provide referrals to care and benefits. This is
    merely the first step, but giving those who are willing and able to help
    an education can go a long ways in figuring out where the legitimate gaps
    are in the federal systems. Simply put, existing organization many times
    do not realize they are already serving Veterans. Understanding Veterans
    perspectives and service needs will improve the overall delivery of
    benefits and services at all levels.
  1. Associations such as PBA’s, Association of
    Sheriffs, First Responders and Firefighters typically meet annually and
    regionally. In both Minnesota and New York we have had little difficulty
    getting in front of these groups to introduce ourselves and what we do as
    advocates. The VA should be at these events to not only help Veteran
    members, but to continue to expand their “free” outreach team.
  1. The VA has come a long ways in a short amount of
    time in the use of technology, social media and non-traditional forms of
    outreach. However, VA must continue to leverage these resources at a
    localized level to engage a new generation of Veterans who is mobile and
    tech-savvy.
  1. The VA can work together with service
    organizations with mutual benefit to VA, Veterans and local posts and
    chapters to modernize an out-dated model. Veterans of this generation no
    longer find themselves gathering in mass at their local Legion, but
    instead gathering via Facebook and Skype. However, the power of gathered
    voice and advocacy these national organizations provide could be crucial
    if used properly.
  1. The VA’s implementation of MyHealtheVet and
    E-Benefits portals is a step in the right direction, but the centralized
    and physical nature of enrollment have made it difficult for a financially
    and employment challenged Veterans population to take advantage of these
    systems. Providing enrollment in the community or even outsourcing
    enrollment to CBOC’s and accredited Veterans advocates would assist in
    these matters greatly.
  1. My
    experience to date has shown me that VA employees in any part of the VA
    lack a basic understanding of local and state benefits and services. These
    can range from Veterans property tax exemptions like we have in NY to
    local transportation to medical appointments. Not only are the numerous
    people taking advantage of these benefits a good place to find potential
    patients and enrollees, but they are simple, quality of life benefits that
    can really help a Veteran engage the system for the first time.

Conclusion:

In sum, we as a nation must stand committed to ensuring that
sustainable and quality supportive services are accessible to Veterans and
their families’ right in their communities. I believe this can be done
leveraging resources that largely already exist and in a cost effective manner.
The VA has the geographical disbursement and expertise to lead this charge, but
must think outside the box and look to those who are ready and willing to
assist in our own backyards. The requirements to make this successful are not
numerous. In many cases putting outreach staff at community events is all it
will take. We must begin immediately leveraging relationships and expertise
that has long existed.

Thank
you again to the committee for allowing me to speak to these important issues.

Prepared Statement of
Chaplain John J. Morris

Chairman Buerkle, Ranking Member Michaud, distinguished members of the subcommittee; I
am honored to appear before you today.

 I am the State Chaplain for the Minnesota
National Guard.I am the co-founder of the Beyond
the Yellow Ribbon initiative.  I have
spent the last seven years of my military service facilitating the
collaboration of the Minnesota National Guard, faith-based and community organizations
and the VA resources of the Midwest VA Health Network (VISN 23) to support the
reintegration of over 20,000 Minnesota National Guard combat veterans.

I am a consumer of VA medical care
as an enrolled veteran with the Minneapolis VA. I am the father of two combat
veteran daughters who are receiving medical care through the VA system.

I am an ardent supporter of the VA
and the resources it provides to our veterans.

The Minnesota
National Guard Beyond the Yellow Ribbon collaboration with the VA

            In 2005
Major General Larry Shellito, then Adjutant General of the Minnesota National
Guard, hired me to create a reintegration program to help the Minnesota National
Guard combat veterans successfully transition from warriors to productive
citizens.

            The first
institution we turned to for help was the Minneapolis VA medical center.   
We wanted our
veterans to receive medical care if needed and benefits if earned. We knew that
the demobilization process used at that time was ineffective in connecting
veterans with the VA process. We were concerned that a majority of our veterans
would not access all that was available to them in terms of VA services.

            We found a
very willing partner in the Minneapolis VA medical center. Our partnership grew
to include the VA medical centers in St. Cloud, MN. Fargo, ND., Twin Ports in
Superior, WI and Sioux Falls in SD. We expanded our partnership to include the
Vet Centers in Fargo, ND. St. Paul, MN, Sioux Falls, SD and Duluth, MN. Today
we enjoy a close collaboration with the leadership of VISN 23 and all the VA
entities in Minnesota. 

            We have successfully collaborated
with the VA on the following initiatives in support of our returning combat
veterans:

1) Expedited enrollment of our demobilizing soldiers, at
their demobilization site, by MN VA personnel. This is insures our veterans are
enrolled in the VA in the catchment area they live in and they are provided
initial appointments.

2) RINGS 1 and RINGS 2, (Readiness and Resilience in
National Guard Soldiers), Research studies on the soldiers/families of the 1st
Brigade, 34th Infantry Division. These longitudinal studies have
focused on the role of the community in facilitating successful reintegration
and mitigating the effects of combat stress.

3) Collaborative training of local clergy utilizing VA
Chaplains and Vet Center staff.

4) Collaborative training of Minnesota Army National Guard
Chaplains and Chaplain Candidates in Clinical Pastoral Education utilizing the
Supervisory Chaplain of the St. Cloud, MN VA. We have trained 15 chaplains and
chaplain candidates, to date.

5) VA Behavioral Mental Health providers from the OIF/OEF
outreach clinic providing satellite service at Camp Ripley, MN during annual
training periods of the Minnesota Army National Guard.

6) Vet Center Staff and VA OIF/OEF outreach personnel
present at every Minnesota National Guard reintegration event, pre and post
deployment.

7) Minneapolis VA Suicide Prevention Specialists regularly
provide training to the Minnesota National Guard and participate in clergy
outreach training with the Minnesota National Guard Chaplain Corps.

8) The Minneapolis VA Polytrauma Center Staff provided
training for the 34th Infantry Division Command and Staff prior to
their deployment to Iraq in 2009.

9) The Recruiting Command of the Minnesota Army National
Guard provides soldiers trained by the Minneapolis VA to visit wounded warriors
in the Minneapolis VA Polytrauma unit.

10) The Vet Centers of Minnesota have collaborated with the
Minnesota National Guard to provide training for marriage and family
therapists, as well as licensed social workers, and psychologists at community
outreach events hosted by the Minnesota National Guard Beyond the Yellow Ribbon
program.

11) The Minnesota National Guard and the Minneapolis
Regional Pension and Disability Claims office work collaboratively to provide
the medial records of soldiers seeking disability compensation.

The Minnesota
National Guard Beyond the Yellow Ribbon program and community partnerships

            The
underlining operating principle of the Minnesota National Guard reintegration
initiative, (also known as, “Beyond the Yellow Ribbon”) is that it takes the
entire community to help a warrior return from war, reunite with his/her family
and resume a productive life as a civilian. 
Consequently, while partnering with the VA the Minnesota Guard has also
worked to partner with business, social service, education, and faith-based
organizations in every community in Minnesota that is host to National Guard
facility.

            The Beyond
the Yellow Program, under the purview of Governors Pawlenty (2005-2010) and
Governor Dayton (2011-present), thru the Minnesota National Guard as program
manager, has a formal process for synchronizing the services of Federal, state
and county agencies for the benefit of returning combat veterans and their
families. In addition the program provides training for community organizations
on how to support military members, veterans and their families. To date twenty
five Minnesota communities have been certified by the Governor’s office as
‘Yellow Ribbon’ Communities.  The program
synchronizes the good will and services of the agencies of the government and
community organizations to support military families during the duress of
deployments and the returning combat veteran during reintegration, post combat.

            We have
garnered tremendous support for our military families and returning combat
veterans. The Beyond the Yellow Program has synchronized the agencies of the
federal, state, and local government with the services of our communities to
result in providing the support needed by our military families. This has
resulted in more productive combat veterans and reduced pathology as demonstrated
by the VA’s Rings 1 study.

The Challenges and
Opportunities the Beyond the Yellow Ribbon Program presents for the VA system

            The VISN 23 VA organizations and institutions have
been significant partners in our Beyond the Yellow Ribbon initiative. I believe
they could play even more significant roles. 
They have vital information to share with civilian medical providers,
clinical social workers and faith-based leaders. They have expertise to share
with community based organizations. The involvement of the VA and their
synchronization into Beyond the Yellow Ribbon reintegration efforts will
enhance the initiative and result in healthier combat veterans and their
families.

            There are
significant challenges to overcome, however, in order for the VA to truly be a
‘community partner’. I will outline those challenges:

1) Perception and Stigma-My experience with community
leaders has been that they perceive the VA to be a distant and closed
institution.  By virtue of the fact that
relatively few citizens are veterans most Minnesotans have no experience with
the VA, thus the ‘mystery’ surrounding the institution. Combined with anecdotes
shared by the media of controversy with the VA, (e.g., inadequate care, lack of
resources, theft of computers resulting in social security numbers of veterans
being lost, etc..) and perception becomes reality in the minds of community
leaders.

2) Institutionalism-The VA is a federal bureaucracy.
Consequently, its system is foreign to outsiders. This is a significant bar to
inclusion in community outreach and synchronization of services with
community-based organizations. I can illustrate this is several ways:

            a) The
Minneapolis VA has a world-class Polytrauma unit providing the finest medical
care to our most severely injured warriors. It has deservedly received positive
media coverage and accolades.  However,
on numerous occasions, when community organizations have wanted to donate
goods, gifts and goodwill to the families/wounded warriors they have met with
hurdles too high to overcome. At the core of the problem is HIPA. The VA’s
understandable need to protect truly vulnerable wounded warriors’ results in
them being shut off from the support of the community.  I have personally witnessed this on a least a
dozen occasions. From inability to donate professional sports team tickets to
wounded soldiers to the recent inability of Best Buy Corporation to personally
deliver care packages to wounded warriors the community is shut off from
working closely with this world class program.

            b) The VA
is not staffed to conduct effective community outreach. While mandated to
provide training for civilian providers and clergy I have personally attended
ten VA outreach events, none of which was able to garner more than a handful of
community members. The VA does not know how to effectively meet, greet and
share with the community the tremendous work they do and the wonderful services
they offer.

            c) The VA
appears to lack a means to share their vast experience of working with veterans
with their civilian counterparts in the fields of medicine, behavioral mental
health and faith-based institutions.  An
example would be the growing body of knowledge surrounding Traumatic Brain
Injury. Health care providers in the greater community need to know what the VA
knows about this wound, its symptoms, impact and treatment. Symposiums, media
messaging, training outreach events and community forums would be ideal means
for transmitting the VA experience to the greater community. To date, I know of
few of these events. In a similar vein VA Chaplains have much to share with
their colleagues in the civilian community.

            d) The VA
lacks the means to connect returning wounded warriors, that have received in
patient care in their hospitals, with the greater community. I have personally
witnessed four severely injured OIF/OEF veterans struggle
tremendously in readjusting within the community, post VA care. They were
isolated and the VA social worker was unable, due to large case load, to meet
often enough with the veteran to help them connect successfully to community.

PROPOSED SOLUTIONS

            In
Minnesota the simplest way to address the issues I have outlined would be for
the VA, in all of its configurations, to become an official Beyond the Yellow
Ribbon partner under Governor Dayton’s model of partnership.

- Have the VA receive the community training all community
leaders receive and have the VA meet all the program requirements that other
partners in the community meet.

-Have VA leadership join their civilian colleagues at Beyond
the Yellow Ribbon community leaders’ events.

-Have the VA partner with community and faith-based
organizations for more effective synchronization of support for veterans and
military families.

            In the area
of working with faith-based organizations the VA needs to invite faith-based
leaders onto their campuses and into their facilities for orientation tours,
seminars and collaborative sharing of information about the needs of veterans
and pastoral care of veterans.

            Minnesota
is blessed to be the home of four major theological seminaries that train
faith-based leaders. The VA would be well served to introduce itself to the
leadership of the seminaries and to find ways to partner in the sharing of
knowledge.

-Have the VA officially partner with the Guard leadership in
each state. In Minnesota the Adjutant General, Major General Nash, has a
personal relationship with the VA Medical Center directors in Minneapolis, MN.
St Cloud, MN and Fargo, ND. He has been in their facilities and knows their
capabilities. He has personally authorized the Rings 1 and 2 studies of his soldiers.
He monitors the results of the study and insures its findings inform the best
practices of the Minnesota National Guard. He has invited the VA to the drill
floors of his units and relies on the VA for the first class service they can
provide.  This type of senior leader
partnership results in great access to service, smoother facilitation of the
claims process and greater care of veterans. 
This could be replicated nationwide.

            -In times
of fiscal austerity the Fischer Houses of the VA system could easily
synchronize their efforts with the Family Programs Office of the Guard. This
would result in the families of veterans residing at the Fischer Houses
receiving the good will of the communities that flows through the Family
Programs of the Guard. The Guard, as America’s local military force, most
immediately receives the support of the community. The Guard Family Programs
has access to community resources that the Fischer Houses need, but often have
to find on their own, with limited knowledge of the local community
capabilities. Collaboration saves money, helps families and enhances the
effectiveness of the VA and the Guard Family Programs.

Closing Remarks

            In closing
I would like to reiterate my support and admiration for the men and women of
the Veterans Administration. As a veteran I know we are truly blessed by their
service. I believe they have a vital role in the reintegration of our veterans
and welfare of the families of our veterans. I believe the VA’s effectiveness
can be increased by its inclusion in our greater community and enhanced
collaboration with all segments of the community that seek to support our
military families and combat veterans.

            I
appreciate the opportunity to be here today and invite your questions and
comments.

Prepared Statement of
Shelley MacDermid Wadsworth, Ph.D.

Chairwoman
Buerkle, Congressman Michaud, and distinguished members of the Committee, thank
you for convening this hearing today and for inviting me to share my thoughts
about “Building Bridges between VA and Community Organizations to Support
Veterans and Families.”

I am proud to be
a faculty member at Purdue University, the land grant institution for the state
of Indiana. I am also proud to direct the Military Family Research Institute
and the Center for Families at Purdue. 
Each of those organizations works to address all three missions of the
university:  generating new research
knowledge, helping students to learn, and most important for this hearing,
reaching beyond the campus to collaborate with others to solve community
challenges.  I will speak today based on
my own experiences and those of my staff, however; I am not speaking on behalf
of the university. 

The Military
Family Research Institute (MFRI) was created at Purdue in 2000 through funding
awarded competitively by the Department of Defense’s Office of Military
Community and Family Policy.  Today we
continue to have significant funding from DoD and other federal sources, but
are funded primarily by private philanthropy.  
I mention this because it is this funding that has made it possible for
us to invest so heavily in community collaborations.   Our mission is to ‘make a difference for
families who serve.’

We are located
in West Lafayette, Indiana, which is in VISN 11, along with parts of Michigan,
Illinois, Indiana, and Ohio.  I am
pleased to be able to report that MFRI is engaged in many collaborations with
organizations in the civilian, military, and veteran communities.  We carry out an average of more than one
event or activity each week aimed at helping to make our state a better place
for military and veteran families.  Our
recent collaborations involving VA partners include the following: 

a.      
With
regard to homelessness, in November,
2011, as part of our university’s participation in President Obama’s Interfaith
and Community Service Campus Challenge, we organized the first Stand Down for
homeless and nearly homeless veterans in our community, and the first organized
by a university in our state.  More than
100 community organizations participated, including both campus and community
faith-based groups, and more than 100 student volunteers, including students
from Hospitality and Tourism Management who managed food service, and students
from the School of Nursing who provided an on-site health clinic guided by
several of their faculty including a military veteran.  A number of VA entities
joined in this effort, including representatives from the Illiana Suicide
Prevention, Healthcare, and Minority Programs offices.  VA Roudebush Medical Center sent
representatives, as did VA benefits,  and
a VA Mobile Veteran center.  We were very
pleased at this initial effort and are seeking out collaborators to make this a
statewide effort with Stand Downs in several communities leading up to Veterans
Day 2012.  

b.     
As
researchers, we are collaborating
with VA colleagues in Minneapolis and Ann Arbor, working together to obtain
funding and gather data.

c.      
In
the area of higher education, we
work with colleges and universities throughout our state to help them
strengthen their supports for student service members and veterans.  In that capacity, we work closely with VA
certifying officials, the Indiana Commission on Higher Education, institutional
leaders,the Servicemembers Opportunity Colleges, and others. 

d.     
In
the area of vocational rehabilitation,
we work with the Career Learning and Employment Center, a pilot project set up
in our state as a collaboration established initially between community groups,
the Crane Naval Station and the NAVSEA command, VA vocational rehabilitation
officials, and several state offices. 
This project for which we are the evaluation partner, helps service
members who must leave their military careers because of life-altering wounds
or injuries, transition to education and employment in an environment of full
support and assistance for their families and themselves as they relocate,
enter or re-enter educational training, leave their military careers, and begin
new jobs as civilians. 

e.     
In
the area of behavioral health, we
serve as a training partner for the Indiana Veterans Behavioral Health
Network.  Funded by a grant from the
Health Resources and Services Administration, IVBHN is a network of
community-based behavioral health clinics working to extend services to rural
veterans using telehealth technologies. 
We also are working together to create a designation for agencies to
indicate to military and veteran families that providers within the agency have
received significant training in working with that population, to complement a
training system and registry we have already created with the Indiana National
Guard to improve the behavioral health infrastructure in our state.  VA collaborators include the  Department of Mental Health Patient Care
Services, the Psychiatry Ambulatory Care Clinic, the Seamless Transition
Clinic, and the Information Technology Department at Roudebush VA Medical
Center, as well as the VISN 11 Medical and Information Technology staff.

f.       
Finally,
in the area of outreach, we work closely with the Seamless Transition Team at
the Roudebush VA Medical Center to implement an annual statewide meeting
focused on growing awareness, motivation, and skills among helping
professionals in a variety of communities to support veterans and their
families.  In September 2011, this
meeting was attended by over 250 professionals from Indiana, Illinois, and
Kentucky.  The Indiana National Guard
director of family programs reported that his staff described this as the best
training event they had attended in many years. 

Based on these
experiences, what are some lessons we’ve learned about successful
collaborations between community organizations and the VA?

First, there are great opportunities for success, and I know that
there are success stories happening around the country.  I have been pleased by the enthusiasm we have
experienced from many of our VA partners. 

Second, all of the successful partnerships we know involve
partners who have come to know and trust each other. Until partners know each
other well enough, it is difficult to trust. 
Without trust, it is very hard to collaborate.  It can take several years to exchange
sufficient knowledge and build sufficient trust to be willing to embark on a
more extensive collaboration.  Without
that ground work, it is much less likely that the collaboration will be
successful and sustainable.  

Third, we have learned that mutual transparency, responsiveness, and
accountability are important for successful collaborations. Each of these of
course ties back to basic trust – perhaps ‘trust but verify’ is an apt
phrase. 

Fourth, we think successful collaborations do a good job of taking
advantage of each organization’s unique strengths. MFRI contributes something
different to each of the collaborations I described earlier – sometimes our
research expertise, sometimes our skills as educators, sometimes our convening
power, and in each case our VA partners are contributing  expertise that complements ours. 

Fifth, I believe that successful collaborations result when each
partner can enthusiastically pursue their self-interest while they work
together to achieve a shared goal. 
Collaborations that require one or both partners to work against their
self-interest will not last long. 

Sixth, in the spaces in which we operate, cultural translators
are very important.  Partners who can
explain military or veteran experiences and culture to civilians, or who can
explain the environment within which civilian community organizations operate
to members of military or veteran organizations, play key roles in helping
collaborative partners learn to see the world through one another’s eyes. 

A final ingredient for success is leadership,
but we believe that it may be servant leadership that is the most
important.  At MFRI we believe that
leadership is as much about taking and distributing minutes, arranging
meetings, and sending out reminders as it is about crafting vision and facilitating
strategic planning.  We are just as happy
to try to be the glue that holds initiatives together and the lubricant that
keeps them moving forward, and we are fortunate to have found funders who share
our belief. 

Although the
scientific literature about collaborations among community organizations or
with the VA is quite limited, the studies that are available reinforce our
observations.  For example, one study of
collaborations between faith-based and health organizations found that passion
and commitment for their shared goals, mutual trust and respect, and the
convening power of faith-based organizations were seen as key to their success (Kegler,
Hall, & Kiser, 2010). 

Policy-Related Challenges and Barriers

What about the
challenges and barriers that make it difficult for community collaborations
with the VA to become established or successful?  Many of these are no doubt familiar to you.

The landscape
both inside and outside the VA can be very crowded and confusing.  Prospective community partners, particularly
those located at a physical distance from the VA facility with which they would
like to collaborate, can find it very difficult to determine whom in the institution
to approach.  As a test, I conducted a
search for the word ‘collaborate’ on the main VA website, which yielded a
single hit, for the Center of Excellence on Implementing Evidence Based
Practice. From vantage points inside the VA it may be just as difficult, again
particularly in far-flung communities. 
The not-for-profit sector is full of agencies with alphabet-soup names, sometimes
with considerable turnover, and idiosyncratic local variations.  VA professionals are understandably wary of
showing favoritism to particular organizations, getting involved with
organizations that might prove unreliable, or taking time away from other
duties to establish and maintain community partnerships.  These
challenges could be reduced by making sure that there are clear points of entry
and information for prospective collaborators on key websites, and some regular
mechanism for prospective partners and VA leaders to learn about one
another.   

There are
structural barriers to collaboration. 
For researchers, these come in the form of requirements that projects
involving the VA be led by VA researchers. 
For all collaborators, a serious barrier is the inability to share
data.  Sometimes this impediment makes it
very difficult to connect VA patients and their families with community services;
for researchers, it is very difficult to gain access to data for analyses.   In our
work with higher education, we have found it very difficult to get information
about schools in our state, or even our state as a whole, because only data
aggregated across an entire region are available.  We have also found it very challenging to
secure answers to questions from at least one office, even though some of the
information we are seeking is not at all sensitive and could probably be made
publicly available on the web.  Community
collaborators find it very frustrating when they train up to increase their
capacity to serve military and veteran families, but then can never find any of
those families to serve nor be sure those families will learn about their
availability. This is especially frustrating when it is so clear that there is
far more work to do than the VA can handle alone.  I’m
not certain how this problem can be solved, but I believe it is resulting in a
staggering waste of resources, with  more
work to do than the VA can manage by itself, service members and families who
want help, and community partners who want to be of use, all separated by gaps
and barriers that should be avoidable. We are working on a collaboration with
the Indiana National Guard that is aimed at addressing this problem for
military families, but the challenge for veterans is much larger and even more
complex. 

Of course securing
resources is always a challenge.  Community
collaborators may not have excess capacity sitting unused on the shelf that can
easily be diverted to military or veteran families, and need to know that if
they incur expense to serve service members and veterans that they can recoup
those costs.  While DoD and VA have seen their budgets grow significantly in
recent years, many community-based not-for-profits have seen their resources
decline. VA professionals who want to collaborate with community partners may
have to do so ‘out of their back pockets’ and on top of their regular duties. Building the bridges of collaboration
that you seek will require resources, and ideally those resources will be made
readily apparent to community partners so that proposals can be solicited,
evaluated, and selected.  Ideally,
resources will be structured to provide tangible incentives and benefit to
community and VA partners who collaborate effectively.    

It has been our
great honor to work to make a difference for military and veteran
families.  We are inspired by the
commitment and dedication shown by military and veteran professionals in many
sectors who share that mission, and we are eager to continue collaborating to
make positive change.  Thank you for all
you do to try to make sure that our nation’s veterans receive the care and
support they have been promised. 

 References

Abdul-Adil, J., Drozd,
O., Irie, I., Rachel, R., Alexis, S., A. , F. D., et al. (2010).
University-community mental health center collaboration: Encouraging the
dissemination of empirically-based treatment and practice. Communityy Mental
Health Journal, 46
, 417-422.

Garrow, E., Nakashima,
J., & McGuire, J. (2011, March). Providing human services in collaboration
with government: Comparing faith-based and secular organizations that serve
homeless veterans. Review of Religious Research, 52(3), 266-281.

Gray, B. (1989). Collaborating:
Finding common ground for multiparty problems.
San Francisco: Jossey-Bass.

Guo, C., & Acar, M.
(2005). Understanding collaboration among nonprofit organizations: Combining
resource dependency, institutional and network perspectives. 34(3).

Kauffman, L. (2010,
July). Veterans Rural Health Resource Center-Western Region: Fostering
innovations in mental health care for rural veterans. NARHM Notes, 2(1).
National Association for Rural Mental Health.

Kegler, M. C., Hall, S.
M., & Kiser, M. (2010, Aug. 9). Facilitators, challenges and collaborative
activities in faith and health partnerships to address health disparities. Health
Education and Behavior, 37
, 665.

Kudler, H., Batres, A.
R., Flora, C. M., Washam, T. C., Goby, M. J., & Lehmann, L. S.  (2011). 
The continuum of care for new combat veterans and their families:  A public health approach.  In Combat
and Operational Behavioral Health
(Ch. 20). 
Borden Institute.  http://www.bordeninstitute.army.mil/published_volumes/combat_operational/CBM-ch20-finaI.pdf.
 

London, S. (1995). Colllaboration
and Community.
Scott London.

MOAA- Zeiders
Enterprises. (2011). Wounded warrior and family-caregiver support:
DoD-VA-Communiity collaborations.
Roundtable Discussion Summary.

Prepared Statement of M. David
Rudd. Ph.D. ABPP

Good afternoon Chairwoman Buerkle, Ranking Member Michaud,
and Members of the Subcommittee.  I
greatly appreciate the opportunity to testify on behalf of the National Center
for Veterans Studies at the University of Utah and the countless American
Veterans that have served and sacrificed. 
I want to thank Chairwoman Buerkle for providing much needed leadership
on an issue that will become increasingly important given the end of combat
operations in Iraq and the planned reduction of forces in Afghanistan.  The successful reintegration of many of our
troops into civilian life will require thoughtful and coordinated efforts
between the Department of Veterans Affairs (VA) and community organizations,
with communities of faith offering particular promise.  I am grateful for Chairwoman Buerkle’ S
efforts to draw attention to the problem of reintegration, particularly given
that there is an intellectual and emotional disconnect between those that have
served and the rest of society.  Since
the Gulf War, less than 1% of  Americans
have served in the armed forces, a dramatic shift from World War II (almost
9%), Korea, and Viet Nam (both greater than 2%).  The remarkably small number of Americans
choosing to serve in the Armed Forces compounds the potential for misunderstanding,

As a veteran of the Gulf War era and a clinical
psychologist, I am keenly aware of the issues faced by service members both engaged
in combat and returning from war.  Over
the last decade, I have been involved in the treatment of service members experiencing
emotional and psychological problems secondary to combat and serving during
wartime.  In particular, I have directed
treatment research focusing on active duty service members that have made suicide
attempts.  Although my research is only
partially complete, what has become clear is that many service members (and
families) need assistance in order to make a successful transition from
military life.  My work has been focused
on that portion of the Veteran population that has struggled and experienced
emotional and psychological problems. It’s important to point out, though, that
this is only a portion of the population, with many making a seamless
transition to civilian life.

A recent survey of Veterans by the Pew Research Center
(2012) revealed that 27% of Veterans reported that re-adjustment to civilian
life was either “somewhat difficult” or “very difficult”.  The survey also revealed significant “burdens
of service” with 48% reporting “strains in family relations”, 47% frequently
feeling irritable or angry”, 44% reporting “problems re-entering civilian
life”, and 37% reporting “post-trauma symptoms”.  Despite the fact that many Veterans
transition from military life with few problems, these data indicate that many
have difficulty making the shift. 

The Pew data offer insight into the source of the problems
as well, with emotional and psychological adjustment at the forefront.  Among those having experienced combat, 50% or
more report post-trauma symptoms and difficult family relations.  When queried about factors reducing the
probability for successful re-entry into civilian life, Veterans identified
traumatic experiences and injury as the most significant variables. Of
importance for this hearing, Veterans identified “attending church at least
weekly” as the most important variable associated with an easy and successful
re-entry into civilian life. A remarkable 67% identified attending church “once
a week or more” as making re-entry easier. 
Clearly, the social connection and support offered by religious
institutions around the nation are essential for our Veterans. The Pew study
also reported that churches were second only to the military itself as
“institutions” in which Veterans have a “great deal” or “quite a lot” of
confidence.  Clearly, communities of
faith offer a unique and critical opportunity to connect with Veterans
transitioning from military life.  If
aware and appropriately trained, clergy can serve a critical role in assisting
Veterans struggling with emotional and psychological symptoms.  Available data suggest communities of faith
as a critical linchpin in helping Veterans transition to civilian life.

My own work has helped clarify the severity and magnitude of
the emotional and psychological issues faced by a particularly large subset of
the Veteran population, student veterans. Nearly two million Veterans will
return home from overseas deployments as part of Operation Iraqi Freedom,
Operation Enduring Freedom and Operation New Dawn.  A large number of them will make use of the Post-9/11
GI Bill and transition quickly to college and university campuses.  My recent study of student veterans
nationwide revealed that many student veterans struggle with psychological
symptoms, consistent with the data reported in the Pew survey.  More specifically, I found that almost 35% of
participants reported suffering “severe anxiety”, 24% experienced “severe
depression” and 46% reported “significant symptoms of post-traumatic stress
disorder”.  Somewhat alarming, my data
indicate that 46% reported thoughts of suicide, with 20% having a plan.  Further, 10.4% reported thinking about
suicide “often or very often” and almost 8% reported making an attempt, almost
six times the frequency of the general student population. 

From the limited data available to date, it would appear
that problems with psychological and emotional adjustment are perhaps the
single greatest barrier faced by returning Veterans transitioning to civilian
life.  Of particular importance for this
committee, two community resources offer a unique opportunity to engage and
connect with Veterans, communities of faith and college and university
campuses.  Veterans hold religious
institutions in high regard, reporting that regular contact and participation
help “ease” their transition, offering critical support and assistance.
Similarly, college and university campuses are arguably second only to the VA
itself as institutions where the largest numbers of Veterans gather. 

The VA has already expanded efforts to actively collaborate
with college and universities around the country, including an increase in
positions allocated to the Vet Success on Campus program and the new VA campus
grant program funding projects meant to extend services to student veterans and
extend outreach on campus, with five projects funded to date (Veterans
Integration to Academic Leadership Initiative-VITAL). I would also like to mention and applaud VA
efforts to explore additional partnerships with colleges and universities.  I recently participated in a meeting with the
Assistant Secretary of the VA for Policy and Planning, Dr. Henze, along with a
collection of other campus leaders to discuss possible collaborations to meet
identified Veteran needs.  The VA has
been proactive on this front, an effort that should be commended.

Let me emphasize my support for efforts on both fronts; that
is, working directly with communities of faith around the nation, along with
college and university campuses.  There
is empirical evidence indicating a significant need, along with data to suggest
these two domains offer unique opportunities and promise to help ease the
transition to civilian life.  Training is
needed in order for communities of faith to effectively respond to the demand.  Many clergy members are already aware, sensitive
to, and equipped to respond to the psychological and emotional needs of
Veterans. Large numbers, however, are not. 
Given the serious nature of the problems identified (e.g. suicidality)
thoughtful and thorough training is needed. The National Center for Veterans
Studies would welcome the opportunity to assist in any such effort.

As with communities of faith, many colleges and universities
around the country are unprepared to meet the psychological and emotional needs
of student veterans. Although some entities offer training for college
counseling centers, such as the Department of Defense Center for Deployment
Psychology, resources are limited. 
Greater resources are needed to meet the growing demand.  In response to this need, The National Center
for Veterans Studies will be launching an effort to form a national higher
education consortium targeting student veterans. We would welcome the chance to
partner with any similar efforts around the country, including any launched by
this subcommittee.

Thank you again for the opportunity to address the
subcommittee. These issues are critical and the needs of many of our Veterans
transitioning to civilian life are profound. 
The National Center for Veterans Studies is poised to help. I am happy to respond
to any and all questions. 

References:

Pew Research Center, The
Military-Civilian Gap: War and Sacrifice in the Post-9/11 Era,
January 13,
2012

Rudd, M.D., Goulding, J., & Bryan, C.J. (2011).  Student veterans: A national survey exploring
psychological symptoms and suicide risk. Professional
Psychology: Research & Practice,
42 (5), 354-360. 

Prepared Statement of George Ake,
III, Ph.D.

Good afternoon, Chairwoman Buerkle,
Ranking Member Michaud, and Members of the Sub-committee. I wish to thank you
for the opportunity to testify on behalf of the 154,000 members and affiliates
of the American Psychological Association (APA) regarding collaboration between
the Department of Veterans Affairs (VA) and community organizations to support
Veterans and their families. As a child psychologist at Duke University Medical
Center and with the National Child Traumatic Stress Network, my work focuses on
assisting children and families who have experienced stressful and traumatic
life events, including military deployment and its aftermath. I am honored to
speak with you today about the collaborative work that I and my colleagues are
engaged in with a variety of partners around the country in support of our
nation’s military and Veteran families. 

Collaboration among all sectors of
society is needed to support the health and well-being of Veterans and their
families. This includes key partnerships with policymakers, government
agencies, universities, the health care community, and the faith-based
community. Scientific evidence continues to identify psychological and
neurological disorders, including posttraumatic stress disorder (PTSD),
depression, suicidal ideation, and traumatic brain injury (TBI), as some of the
signature wounds of the conflicts in Iraq and Afghanistan. While psychologists
and other health professionals play an essential role in helping Veterans and
families to address these challenges, partnerships and collaborations with
others sectors of society are also critical. 

Despite a proliferation of programs
for Active Duty, National Guard, Reserve Component, and Veterans and their
families, many families rely upon the support and counsel of faith-based
providers as a first point of contact. In some communities, particularly small
towns and rural areas, faith-based services are more prevalent and accessible
than health care services.In
theatre, on base or post, at the VA, and in local communities, Veterans and their families not only approach faith-based
providers on spiritual, religious, and moral issues, but also issues of
reintegration, spousal relationships, and parenting. Chaplains and other
faith-based providers can play a key role in addressing concerns about stigma
related to mental and behavioral health services and supports as well as providing
linkages and referrals to appropriate community and professional resources.

I would like to express my deep
appreciation to you, Chairwoman Buerkle, for your leadership in advancing
collaboration between the mental health and faith-based communities with regard
to military and Veteran families. The unique military and Veterans mental
health workshop that you hosted for faith-based providers in your district in
December served as a wonderful example of the collaboration and partnership
that is possible across sectors. I was honored to join the distinguished panel
of experts that you assembled, including Dr. David Rudd of the University of Utah’s
National Center for Veterans Studies, Drs. Judy Hayman and Caitlin Thompson
from the VA, Jason Hansman of the Iraq and Afghanistan Veterans of America, and
Retired Air National Guard Chaplain Tim Bejian. Such events help to break down
barriers and foster partnerships that benefit Veterans and their families. Replicating
this training in other congressional districts could serve as a valuable
resource. 

The importance of collaboration
between military and community systems, and among health professionals and
faith-based providers, is especially important as we consider data from the
2010 Department of Defense (DoD) Profile of the Military Community, which
estimates that 44% of the 1.4 million Active Duty and National Guard/Reserve
personnel, who have deployed to combat missions as part of Operation Iraqi
Freedom (OIF), Operation Enduring Freedom (OEF), and/or Operation New Dawn
(OND), are parents. This same report noted that there are almost 2 million
children in the U.S. who have parents in Active Duty or Reserve services. Many
of these children and families have seen their military parents and spouses
serve multiple combat deployments to Iraq and Afghanistan. A number contend
with a parent who returns changed due to the wounds of war. Some of these families
suffer financial hardship, homelessness, marital discord, violence, and other
difficulties during their reintegration into civilian life. Still other
families experience the grief and loss associated with their loved one’s fatal
combat injury, or even suicide. Taken together, these findings highlight the
necessity of considering the context and challenges for children and families
of Veterans returning from combat, as well as the role of the family in
facilitating a successful transition to stateside service or civilian life.

To support the Veteran and
strengthen the family, Veteran families need easy connection to collaborative
programs and supports through VA Medical Centers, Vet Centers, community mental
health and faith-based services, and professionals from a variety of
disciplines, such as psychologists, pediatricians, clergy, educators, and case
managers who are familiar with the military/Veteran culture. 

As a member of the National Child
Traumatic Stress Network (NCTSN), I would like to highlight some of our efforts
to support such collaboration. The NCTSN is an initiative launched by Congress
in 2000 with the goal of developing a national collaborative network to improve
best practices and standards of care for children and families affected by
traumatic stress. Since 2001, the NCTSN, which is administered by the Substance
Abuse and Mental Health Services Administration, has delivered direct services
to children and families who have experienced all forms of traumatic stress,
including our nation’s military families. Between 2002 and 2009, NCTSN members
reported serving over 320,000 children through direct clinical services, with
many more reached through outreach efforts, community educational programs, and
provider training and consultation. Our work is done in partnership with all
child-serving systems, including military service branches, faith-based
organizations, child welfare, and community mental health agencies. 

In 2008, the National Center for Child Traumatic Stress (NCCTS),
the NCTSN coordinating center co-located at Duke University and the University
of California Los Angeles (UCLA), embarked on a partnership with the Center for
the Study of Traumatic Stress of the Uniformed Services University of the
Health Sciences, to expand and enhance the level of support provided to
military children and their families. Other major government partners include
the VA, the DoD, and the National Guard. Civilian partners include the American
Psychological Association, the National Association of Social Workers, and
other community health care providers.

Of the more than 100 NCTSN funded and affiliate member sites in 40
states, more than 60% serve military children and families. The NCTSN Military
Families Program brings together high-level experts from multiple disciplines
(i.e., mental health, military, and public health) to address the challenges
facing military children, their families, and the providers who serve them. The
NCTSN has modified interventions to meet the unique needs of military families,
has conducted outreach to them in a variety of settings, and has produced
educational and informational materials designed especially for their needs.
Using Web-based, interactive media (e.g., podcasts, speakers series, and teleconferencing),
the NCTSN Military Families Program offers more than a dozen educational
presentations developed by key experts on psychological trauma and military
issues. The NCTSN has
developed a useful curriculum for civilian providers, called Essentials for Those Who Care for Military
Children and Families
, which addresses subjects such as military culture,
the impact of combat on families, the needs of children, programs and services
for Veterans and National Guard and Reserve members and their families,
behavioral health services, frameworks for interventions, and family violence.
Further, we created a web-based Master
Speaker Series
cosponsored by the NCTSN and Zero to Three, which provides
an opportunity for leading authorities from the VA, DoD, and university
settings to discuss military culture, mental health issues, resilience, and
wellness. In fact, tomorrow, the topic of our monthly webinar will be Expanding Services to Veteran Families
and includes panelists from the VA and Zero to Three. These resources are
available on the NCTSN website.

In addition to providing
evidence-based, trauma-informed treatment, the 27 sites of the NCTSN Military
Families Program are actively engaged in research, community outreach, and
partnerships with state and local agencies that serve Active Duty military,
Guard, Reserve, and Veterans. My colleagues at Duke University are implementing
a Welcome Back Veterans program, which is an initiative of the McCormick
Foundation, Major League Baseball, and the Entertainment Industry Foundation.
This national program is intended to develop models for training community
clinicians to offer accessible and effective mental health services to military
and Veteran families in local communities.

Other colleagues with the Duke
Evidence Based Implementation Center have been leading quality improvement collaboratives
with VA teams. One of these collaboratives is based at the Durham VA Medical
Center with teams focused on improving coordination between mental health
services and Veteran-centered care to improve access to services. The other
collaborative based out of VISN 6 with Community Based Outpatient Clinic teams
focuses on increasing patient access to services and enhancing workflow
efficiencies.

Our NCTSN partners at UCLA developed
and disseminated a program called Families OverComing Under Stress (FOCUS). The
FOCUS program is designed to enhance the inherent resiliency of military
families. The program has addressed family adjustment to parental deployment at
more than 20 U.S. military installations, including Camp Lejeune, for which I
provided consultation to their resiliency trainers on the implementation of
FOCUS. The NCTSN has also collaborated with the VA’s National Center for PTSD
to train military and civilian providers on acute stress interventions such as
Combat Operational Stress First Aid that address principles of safety,
connectedness, hope, calming, and self-efficacy. Our NCTSN and VA colleagues
have provided trainings specifically to military chaplains as the training has
embedded components relevant to the work of clergy working with service members
and Veterans.

Further, other NCTSN colleagues at
Allegheny General Hospital in Pennsylvania have partnered with the Tragedy
Assistance Program for Survivors (TAPS), the National Military Family
Association, Zero to Three, the Center for the Study of Traumatic Stress, and
the Center for Health and Health Care in Schools to educate professionals about
the most appropriate resources for aiding families coping with the death of a
loved one in the military. Resources from this program have been widely
disseminated and are available on the NCTSN website for faith-based
organizations to use or adapt when working with military and Veteran families
in the aftermath of loss.

The
NCTSN also has a strong program in support of military families through the
Ambit Network at the University of Minnesota, which has developed the ADAPT
(After Deployment, Adaptive Parenting Tools) program. This groundbreaking
initiative specifically meets the needs of Reserve Component service members
and their families. The 14-week, web-enhanced group parenting program addresses
key challenges faced by deployed parents and their partners, including dealing
with the transitions of deployment, responding to emotional challenges of
deployment and reintegration, and enjoying children during stressful times. The
program is now being tested in a National Institutes of Health-funded
randomized controlled trial of 400 families with children ages 4-12.

Finally, Catholic Charities of
Hawaii, an NCTSN Community Treatment Services Center, has reached out to
military partners at Tripler Army Medical Center and Schofield Barracks to
provide training on evidence-based treatments for children experiencing
traumatic stress.

In conclusion, we have seen that
collaborative efforts between partners such as chaplains and faith-based
providers, mental health professionals, physicians, educators, and the military
and Veterans community have resulted in a growing evidence base and
increasingly high quality services for our military and Veteran families. The
American Psychological Association, Duke University Medical Center, and the
National Child Traumatic Stress Network all stand ready to continue our collaborative
efforts with this Subcommittee, the VA and DoD, our community-based partners,
and the military and Veterans community to address these important issues.

Thank you for the opportunity to
speak with you today and for your leadership and commitment to our nation’s
Veterans and their families.

Prepared Statement of
Reverend E. Terri LaVelle

Chairwoman Buerkle, Ranking Member Michaud,
and Members of the Subcommittee:  thank
you for the opportunity to speak about the Department of Veterans Affairs (VA)
Center for Faith-based and Neighborhood Partnerships’ (CFBNP) outreach efforts
to and with faith-based and community organizations.  As Director of VA’s CFBNP since September 14,
2009, I have had the opportunity to engage first-hand with faith-based,
non-profit and community leaders and organizations.

My testimony today will provide background
information on the VA CFBNP, the collaborative outreach work the Center has
engaged in beginning in 2005 with faith-based, non-profit and community leaders
and organizations, internal VA partners, and the White House Office of
Faith-based and Neighborhood Partnerships. 

 Background

VA’s Center for Faith-based and
Community Initiatives was established on June 1, 2004, by Executive Order
13342.  The objective was to coordinate
agency efforts for the elimination of regulatory, contracting, and other
programmatic obstacles to enable faith-based and community organizations to
access resources they need to provide social and community services.

In February 2009, President Obama amended
Executive Order 13199 to establish the White House Office of Faith-based and
Neighborhood Partnerships (OFBNP).  The
name change reflects the emphasis and importance of developing and cultivating
partnerships, through intentional outreach, with those in the community that
already provide services and meet the needs of so many of our citizens.

The VA CFBNP is one of thirteen
Faith-based and Neighborhood Partnerships Centers in the Federal government.

Mission

The mission of VA’s CFBNP is to
develop partnerships with and provide relevant information to faith-based and secular
organizations and expand their participation in VA programs in order to better
serve the needs of Veterans, their families, survivors and caregivers.  VA’s CFBNP cultivates and develops
relationships with faith-based and secular organizations, working with them as
collaborative partners to serve our Veterans, their families, survivors and
caregivers.  CFBNP outreaches to external
partners to expand their understanding of, and participation in, VA programs.

Outreach Collaboration

Since 2005, Nationwide, VA CFBNP has
conducted pro-active outreach events interacting with over 1200 faith-based,
non-profit and community leaders and organizations.  The outreach events consisted of roundtables,
conferences, and workshops.

Since its inception in 2009, VA’s
CFBNP has proactively outreached to faith-based, non-profit and community
leaders and organizations, often collaborating and/or partnering with internal
and external stakeholders.  The internal
partners for outreach events include the Veterans Benefits Administration (VBA)
Vocational Rehabilitation & Employment (VR&E) Service, VA Chaplain
Service, VA Homeless Program Office, National Cemetery Administration (NCA),
Veterans Health Administration (VHA) Operation Enduring Freedom (OEF) and
Operation Iraqi Freedom (OIF) Coordinators, and VA’s Voluntary Service.  The Center’s external partners include Good
Will International; American Red Cross; Habitat for Humanity; Salvation Army,
USA; State Veterans Organizations; and Catholic Charities in Chicago, IL.

Fiscal Year (FY) 2011 and 2012
Internal Outreach Collaborations

VA CFBNP and VBA VR&E Service
have partnered with local VBA Regional Offices to co-host Veterans Roundtables
with the target audience being faith-based, non-profit and community leaders
and organizations.  Local and regional VA
staff serve as panelists and roundtable discussion participants.  These events provide members of the local
community an opportunity to meet and interact with VA staff and to know their
local contacts and resources for assisting Veterans.  The Veterans Roundtables were held in
Jackson, MS; Seattle, WA; Newark, NJ; Waco, TX; Las Vegas, NV; Cleveland, OH
and Louisville, KY.  The attendee total
at the Veterans Roundtables was 450.  These
VA Regional Roundtables have two primary goals:

  • To
    facilitate collaborative working relationships among faith-based and
    secular organizations, VBA, NCA, and VHA so that holistic service can be
    provided to Veterans, their families, and survivors in the community where
    the Roundtable is held.
  • To
    inform attendees of the number of Veterans in their community, what their
    current needs are, and potential funding available to faith-based and
    secular organizations who can demonstrate an ability to meet those needs
    in collaboration with the VA. 

VA CFBNP is coordinating with VBA to
co-host roundtables in FY 2012 at VBA VR&E Service and Regional Offices in
Montgomery, AL; Lincoln, NE; Albuquerque, NM; and Boston, MA.

FY 2011 and 2012 External Outreach
Collaborations

The VA CFBNP helped planned and
conduct workshops at two outreach events with external partners.  One was with the State of California
Department of Veterans Affairs and the California Statewide Collaborative for
Our Military and Families and held in San Jose. 
The other was the “Battlemind to Home II” Symposium conducted with the
local VA Medical Center, the Department of Labor and the Military Family
Research Institute (MFRI) of Purdue University in Indianapolis, IN.  The number of persons who attended these
workshops respectively was 120 and 95.

The VA CFBNP participated in five
“Connecting Communities for the Common Good” Conferences in collaboration with
the White House OFBNP, local officials from the host city, and the Faith Based
and Neighborhood Partnership Centers from other Federal Agencies.  The conferences were held in Philadelphia,
PA; Detroit, MI; New Orleans, LA; Chicago, IL; and Denver, CO.

In order to support local
organizations as they tackle community challenges, the regional events have
three key goals:

  • To
    build and strengthen relationships between community and faith-based
    groups, and with local, regional and Federal government partners;
  • To
    highlight relevant Federal and public/private partnership opportunities,
    and to connect groups to these opportunities; and
  • To
    open the door and tell the story of the Faith-based and Neighborhood
    Partnerships.

At each “Connecting Communities for
the Common Good” Conference, VA CFBNP moderates a workshop and facilitates a
roundtable discussion.  Each workshop and
roundtable consists of local and regional VA staff as panelists and roundtable
participants.  Having local and regional
VA staff present begins building relationships at the local level between VA and
the faith-based, non-profit and community leaders and organizations in
attendance.  The average attendance at
each VA CFBNP workshop and roundtable discussion was 50 people.  The CFBNP reached over 300 faith-based, non-profit
and community leaders and organizations.

As the CFBNP Director, I have attended,
presented, and conducted training on VA programs and services at the following
events.  These outreach events provide
information about the needs of our Veterans, their families, survivors, and
caregivers. Information is also presented on the opportunities available to
faith-based, non-profit, and community leaders and organizations to become
collaborative partners with VA to meet the needs of Veterans, their families,
survivors and caregivers.  Examples of my
activities as CFBNP Director include:

  • Speaker
    at the MFRI’s November 2011 conference “Battlemind to Home II
    Symposium.”  The goal of the
    conference was to reduce community reintegration barriers for returning Servicemembers
    and their families by increasing community knowledge and awareness of
    challenges faced and the supports available from a collaborative
    perspective.
  • Participant
    at the Working Together to Strengthen Guard and Reserve Couples and
    Families Forum sponsored by the Annie E. Casey Foundation and the National
    Healthy Marriage Resource Center. 
    The Forum was held in Charlotte, NC, August 15-16, 2011.
  • Presenter
    at the Church of God in Christ (COGIC) AIM (Auxiliary in Ministries)
    Conference held in Houston, TX, August 6-9, 2011.
  • Speaker
    at the Veterans Roundtable sponsored by the CA Collaborative for Military
    and Families of San Jose, CA, March 23-24, 2011.  This is a collaborative of over 200
    faith-based and community organizations.
  • Keynote
    speaker a Douglas Memorial United Methodist Church’s Pastor's Forum -
    Veteran Women Resource Center.  The
    Pastor’s Forum was held in Washington, DC, March 26, 2011.
  • Panelist
    at Forging the Partnerships:  DOD/USDA Family Resilience Conference
    held in Chicago, IL, April 27-28, 2011. 
    This was a clergy panel with representatives from the National
    Guard, Air Force, Army, Marines and Coast Guard

The VA CFBNP will join the White
House OFBNP “Connecting Communities for the Common Good” Conference in several
cities beginning in March 2012.  Center
staff is serving on the “Battlemind to Home II” Symposium 2012 planning
team.  The CFBNP joins with the local VA
Medical Center, the Department of Labor and the Military Family Research
Institute (MFRI) of Purdue University in Indianapolis, IN, to convene and co-host
the 2012 Symposium.

Conclusion

The VA CFBNP increases Veterans
participation in VA programs through outreach to, and partnerships with,
faith-based, and community organizations.  CFBNP collaborates with
internal and external partners, creates partnerships between government
agencies and faith-based and community organizations.  CFBNP uses outreach
events and internal and external partnerships to provide VA’s program
information to faith-based and community organizations which enables them to
inform and serve Veterans, their families, survivors and caregivers.

The VA CFBNP is consistently
reaching out to, engaging, and educating faith-based, non-profit and community
leaders and organizations on the role and work of the Center.  The Center is open to diverse ways for
developing collaborative partnerships with faith-based, non-profit, and
community leaders and organizations that will best serve our Veterans, their
families, survivors and caregivers.

Madam Chairwoman, this concludes my
prepared statement.  I am prepared to
answer your questions at this time.

Prepared Statement of Chaplain
Michael McCoy, Sr.

Chairwoman
Buerkle, Ranking Member Michaud, and Members of the Subcommittee:  thank you for the opportunity to speak about
the Department of Veterans Affairs (VA) Chaplain Service's outreach efforts
with community- and faith-based organizations. 
As an Associate Director of VA’s National Chaplains Center and a past
President of the Military Chaplains Association of the United States of America,
I have had the opportunity to engage first-hand with community and faith-based
organizations.

My
testimony today will provide an overview of three programs:  the VA National Chaplain Center’s Veteran
Community Outreach Initiative (VCOI); the marriage enrichment retreats; and the
“Heal the Healer” program.  VA chaplains have
created these initiatives to collaborate and build bridges between VA, the faith-based
communities, and neighborhood leaders to aid in the spiritual care of our
returning Veterans and their families.

VA National
Chaplain Center’s Veteran Community Outreach Initiative (VCOI)

In
2007, the VA National Chaplain Center started the VCOI to educate community
clergy about the spiritual and emotional needs of our returning Veterans and
their families.  Nationwide, VA chaplains
have conducted over 200 training events and provided education to approximately
10,000 clergy through this effort.  As a
result, clergy across the Nation are learning to:

1.      Identify readjustment challenges
that Veterans and their families face following deployment;

2.      Identify psychological and spiritual
effects of war trauma on survivors;

3.      Consider appropriate pastoral care
interventions for the spiritual and theological issues that Veterans and
families often encounter;

4.      Brainstorm ideas for a community
clergy partnership between VA chaplains and local clergy; and

5.      Refer Veterans to local VA health
care facilities by being a trusted and knowledgeable resource for Veterans to
use to connect with VA. 

 

In
2011, VA’s National Chaplain Center made available to the Chaplain Services in VA’s
152 medical centers clergy training materials, program brochures, curriculum and
slides, and DVDs on spirituality. These materials were presented to local
clergy for use as resources to support returning Veterans and provide
information on referring Veterans and their family members to local VA medical
centers, community-based outpatient clinics, Vet Centers, and other related
resources. 

Marriage Enrichment
Program

Our
marriage enrichment program began in February of 2009 and was initiated by the
Chaplain Service at the Charlie Norwood VA Medical Center in Augusta, GA.  This program was developed based on concerns
over the large number of stressed marriages experienced by our returning Veterans;
these stresses often led to family crises and divorce.  For example, in June 2005 an article in the
USA Today stated, “The number of active-duty soldiers getting divorced has been
rising sharply with deployments to Afghanistan and Iraq. The trend is severest
among officers.  Last year, 3,325 Army
officers’ marrages ended in divorce—up 78 percent from 2003, the year of the
Iraq invasion, and more than 3 and 1/2 times the number in 2000, before the
Afghan operation, Army figures show.  For
enlisted personnel, the 7,152 divorces last year were 28 percent more than in
2003 and up 53 percent from 2000.  During
that time, the number of soldiers has changed little.”  

Centered
on the theme, “Getting It Back: Reclaiming Your Relationship after Combat Deployment,”
the program is designed so that married couples can develop healthy ways of
interacting and relating with one another. 
We have discovered that all too often, the spouse who has gone to war
and returned may have physical, emotional, or spiritual wounds that have not
yet healed.  On the other hand, the spouse
who was not deployed also needs support, understanding, and relief from the
stress of trying to maintain some kind of normalcy at home.  Family and friends mean well as they try to
offer support, but they often do not understand what the couple is
experiencing.  This program use material
from the Practical Application of Intimate Relationship Skills (PAIRS) Foundation
to help couples address these issues.  The
program focuses on topics such as constructive conflict resolution, emotional literacy,
and communication and intimacy in stressful situations.  Facilitators spend an average of 17 hours working
with the couples over a 2.5 day weekend. 
Two VA chaplains developed this ministry by using community resources
and collaborating with local organizations to sponsor these programs.  The community leaders and faith-based
volunteers, collaborating with VA chaplains, have contributed in making the
programs a success.  More information,
including some best practices for the program, is available online at:  www.va.gov/chaplain.

Heal the Healer

In
August 2008, VA’s National Chaplain Service introduced the “Heal the Healer”
program for our returning National Guard and Reserve chaplains.  Some of these chaplains have served multiple
deployments.  After realizing that
several were experiencing trauma from their experiences overseas, we developed
a program designed to:

1.     
Help
those returning from deployment in Operation Enduring Freedom/Operation Iraqi
Freedom/Operation New Dawn (OEF/OIF/OND) as military reserve chaplains be
assured that the chaplain community at home cares about them and their
families;

2.     
Provide
chaplains returning from deployment as military reserve chaplains in OEF/OIF/OND
with the opportunity to share openly their experiences and emotions associated
with their deployment;

3.     
Meet
other chaplains with similar experiences from the theater of operations;

4.     
Provide
an educational awareness of combat operational stress and how to deal with it;

5.     
Build
a network for military reserve chaplains who were deployed in support of
OEF/OIF/OND and a support system upon which they may call;

6.     
Provide
a realistic review of lessons learned; and

7.     
Gain
insight on how we may intervene in the future to provide appropriate and timely
care for our chaplains returning from combat zones.

The stories
and tears that are shared in these sessions reinforce the importance of our
ongoing role to support the chaplains who have worn our Nation’s uniform.  These men and women have voluntarily placed
themselves in harm’s way to provide the full range of ministry for our
warriors.  In caring for our Veterans,
they too have changed.  Some also bear
the wounds of war.  Chaplains fill a
vital role, and we must be prepared to help those who assist others in the
process of spiritual healing.  VA
chaplains, in partnership with local clergy, our faith group endorsers, and
community faith group leaders, work together to reach out and offer support to
returning chaplains and their families. 

Conclusion

In
conclusion, these three programs develop community partnerships and work with
faith-based and community organizations to bring attention to the needs of our
Veterans and their families.  Today, we
understand better the evils and horrors of war that can afflict them.  We recognize that their service-related
experiences can cause deep wounds to the spirit, conscience, and soul.  Chaplains, community clergy, and communities
of faith can make a great difference in helping to heal our warriors and the
families who love them.

Madam
Chairwoman, this concludes my prepared statement.  I am prepared to answer your questions at
this time.

Statement for the
Record, Consortium for Citizens with Disabilities, Veterans, and Military
Families Task Force

Chairwoman Buerkle, Ranking Member Michaud, and other distinguished members
of the Subcommittee, thank you for the opportunity to submit testimony for the
record on behalf of the Consortium for Citizens with Disabilities (CCD)
Veterans and Military Families Task Force regarding efforts to establish
meaningful relations between the Department of Veterans Affairs (VA) and
community organizations to assist disabled veterans and their families.

CCD is a coalition of over 100 national consumer, service
provider, and professional organizations which advocates on behalf of people
with disabilities and chronic conditions and their families. The CCD Veterans and
Military Families Task Force works to bring the disability and veterans
communities together to address issues that affect veterans with disabilities
as people with disabilities. Task force members include veterans service
organizations and broad based disability organizations, including organizations
that represent consumers and service providers. 

Since its creation, the CCD Veterans and Military Families
Task Force has sought to connect veterans and military service organizations with
the disability community to allow for cross collaboration and the application
of lessons learned to new populations of people with disabilities. Because of
the intersection of the disability and veterans communities that occurs when a
veteran acquires a significant disability, the task force is uniquely suited to
bring a holistic perspective to issues impacting disabled veterans.

Many CCD member organizations provide vital services to
veterans with disabilities that might not otherwise be readily accessible to
them. These programs complement the wide array of services and supports
available to our nation’s veterans through VA, but should be viewed as
supplementary. We believe that disabled veterans must have access to needed
health care services through the VA health care system, including accessible physical
and appropriate mental health services, as well as long-term services and
supports. Specifically, we recognize the concerns expressed by the veterans’
community in documents such as The Independent Budget (IB) about proposals to
contract out core missions of the VA health care system. 

At the same time, however, the IB acknowledges that veterans
will always receive health care services through multiple sources but
recommends that VA retain a role in coordinating that care. The CCD Veterans
and Military Families Task Force believes that public-private partnerships
allow VA to effectively augment services available to veterans, particular
those who live in rural and remote areas. Increased development of these partnerships
allows VA to go to the veteran.

These partnerships also allow VA to ensure that disabled
veterans have access to the support models that are widely available in the
community, but with VA’s oversight. For example, community based organizations
have developed best practice models to facilitate the long-term support needs
of people with disabilities. Through partnerships with community organizations,
the VA can integrate new services into the existing VA systems for populations
that are requiring new types of services, including veterans with significant
disabilities.

The Need for Community and Faith-Based Organizations:

VA estimates that more than 1 million active-duty personnel will
join the ranks of America’s
22 million veterans during the next five years.[1] In
many cases, these men and women will return home with unique challenges that
often go unmet despite the enormous effort and reach of VA. This Subcommittee
has focused on some of these challenges, including recent hearings on the
suicide rate among veterans and their lack of access to mental health services.
The U.S. Government Accountability Office (GAO) reported[2]
that “logistical challenges” was one factor that may hinder veterans from
accessing mental health care. The report cited “distances to obtain treatment”
as one of the barriers, particularly for veterans who live in rural areas.
Another increasing concern is the homeless problem among women veterans. The
GAO reported in a December 2011 study[3]
that the number of homeless women veterans has doubled in four years and found
that women veterans lacked awareness of VA programs, services, and benefits. A
separate 2011 report[4]
echoed those findings and recommended that solutions to address women veterans’
transition challenges should be “informed, holistic, collaborative, and
community-based.”

The unmet needs of current veterans combined with the
projected rise in the veteran population make leveraging the existing social
services community to supplement the VA network more critical than ever. We
believe that no veterans or their families should suffer from a lack of access
to or understanding of how to navigate reintegration services. Many community
service providers have the expertise, experience, and local capacity to more
fully partner with VA through its important veterans initiatives.

Since the issuance of an executive order in 2004,[5] VA
has made working with the non-governmental organizations (NGO), non-profits,
and faith-based communities a priority. The objective of the VA’s Center for
Faith Based and Neighborhood Partnerships is to coordinate agency efforts for
the elimination of regulatory, contracting, and other programmatic obstacles
that often prevent these organizations from providing community-based veterans’
services through VA funding and contracts. 
In 2009, VA announced a new NGO Gateway Initiative[6] to
“tap the power of communities” and help NGOs extend services to veterans. The
VA reiterated its commitment to fostering and expanding partnerships with federal,
state, and private sector agencies and faith-based and community organizations
in its fiscal year 2013 budget request to Congress.[7]

Examples of Successful VA and Community-Based
Organization Partnerships

Members of the CCD Veterans and Military Families Task Force
have successfully partnered with VA in certain areas to meet the needs of
disabled veterans and their families. Below are three examples that illustrate
the positive impact that VA partnerships with community-based organizations can
have on addressing the issues facing today’s veterans and their families.

Center for Independent
Living Care Coordination

An example of a successful care coordination model between
VA and a community-based organization involves the Veteran Directed Home and
Community Based Services (VDHCBS) program offered through the Sioux Falls VA
medical center (VAMC). Launched in August 2010, the VAMC contracted with the
local Minnesota River Area Agency on Aging (MnRAAA) to provide case management,
fiscal management services, and assessment services for veterans seeking to
obtain long-term services and supports in the community.

Because of previous outreach efforts by the South West Center for Independent Living (SWCIL) to the VAMC, National Guard
Family Assistance
Center and other veterans’ groups, the
MnRAAA program managers were familiar with SWCIL and its services to people
with disabilities in rural Minnesota.
The Agency on Aging subcontracted with the Center for Independent Living to
conduct the actual assessments of veterans and provide certain case management
services because of the CIL’s expertise in this arena under its mandate to
offer similar assistance through the Rehabilitation Act. 

A licensed social worker with SWCIL serves as the liaison
with nursing staff at the VAMC when a veteran is referred through MnRAAA for
evaluation for VDHCBS. The SWCIL sends the veteran a packet of materials
describing the consumer-directed program and schedules a follow up visit with
the veteran if he/she is interested in VDHCBS. A VA nurse determines what
services the veteran needs that are available through VA and works with the
SWCIL social worker to identify additional services that must be engaged to
fully implement a home and community-based care plan. For example, SWCIL has
used several other community options to obtain services or needed home
modifications for veterans. The Center for Independent Living receives a
one-time fee for each assessment and bills for case management under its
subcontract with MnRAAA. As a result of this project, approximately 18 veterans
have been successfully enrolled in VDHCBS.

AbilityOne®
Serves Employment Needs of Veterans

The AbilityOne® Program
is a federal initiative to help people who are blind or have significant
disabilities, including wounded veterans, find employment by working for
nonprofit agencies (NPAs) that provide products and/or services to the U.S.
government. With a national network of 600 NPAs, which work through NISH and
the National Industries for the Blind, and AbilityOne® projects in every state of the nation, the AbilityOne® Program is the largest single source of
employment for people who are blind or have other significant disabilities in
the United States.
The
U.S. AbilityOne® Commission is the federal
agency authorized to administer the AbilityOne®
Program.

The AbilityOne® Program
employs over 50,000 people who are blind or have significant disabilities, of
which 3,300 are veterans and 1,700 were veterans with disabilities. Through
National Industries for the Blind and NISH,
the AbilityOne® Program’s NPAs also
support and employ thousands of veterans within their community outside their AbilityOne® workforce. The AbilityOne® Program can offer increased community career
transition support, exploration, and direct training for veterans in transition
to management opportunities.

In
2003, VA’s Compensated Work Therapy Program (CWT) signed an MOU with theAbilityOne®Program as the referral conduit between VA CWT and
theAbilityOne®NPAsto collaborate with
VA beneficiaries who have a disability. Approximately 2,100 veterans with
disabilities have been employed since the partnership’s inception. The
partnership agreement promotes local relationships between NPAs and VA CWT
offices. This allows VA to pre-screen veterans to match AbilityOne® job requirements and to refer qualified veterans
with significant disabilities to participate in AbilityOne® job coaching programs.

Easter Seals Serves
Veterans and Their Families

Easter Seals has a longstandingrecord
of service to veterans, military service members, and their families. Easter
Seals expanded its mission at the end of World War II to include adult services
specifically to address the growing number of soldiers returning home with
disabilities. Recognizing the new and unmet needs of the hundreds of thousands
of men and women returning from the wars in Iraq
and Afghanistan,
Easter Seals launched its Military and Veterans Initiative in 2005 to address
serious gaps in service for veterans and military families by mobilizing its
national community-based provider network. Today, Easter Seals touches the
lives of America’s
heroes and their families through its more than 70 affiliates across 48 states
and its network of 24,000 professional staff and 40,000 local volunteers. 

Since the passage of the Veterans Millennium Healthcare Act
in 1999, Easter Seals has worked closely with VA at the national, regional and
local level to both raise awareness about access to adult day services for
veterans and to contract locally to provide the direct service. In 2010,
Congress approved the Caregivers and Veterans Omnibus Health Services Act that
authorized a range of new services to support caregivers of eligible Post 9/11
veterans, including the establishment of the National Veteran Caregiver
Training Program. In April of 2011, VA contracted with Easter Seals for its
caregiving expertise in working with individuals with serious disabilities to
develop and provide the training. Easter Seals operates the VA caregiver
contract with Atlas Research, a veteran-owned small business, and three of the
country’s leading caregiving organizations: the National Alliance on
Caregiving, the National Family Caregiver Association, and the Family Caregiver
Alliance. Easter Seals and its partners offer in-person, web-based and
self-study caregiver training through the contract to family members of seriously
injured, Post-9/11 veterans who receive their care at home and are eligible
under VA program guidelines. The training includes topics on caregiver
self-care, home safety, caregiver skills, veteran personal care, managing
difficult behaviors and support resources.  

Easter Seals’ experience with VA has been very positive
throughout the implementation of the caregiver contract. Under the contract
management and direction of VA, Easter Seals and its partners have met the
targets and exceeded expectations. Feedback has been overwhelmingly positive,
including from a mother of a seriously injured veteran who wrote: “Thank you
for re-inspiring us and for all you continue to do to be a part of healing
American heroes.” 

Recommendations
for Expanding Partnership Success

The CCD Veterans and Military Families Task Force believes
that these examples of successful partnerships between VA and community-based
organizations clearly support our position for increased collaboration.
Specifically, we believe that there are opportunities to foster additional
collaboration to meet the needs of disabled veterans living in their
communities. Consequently, VA should expand community-based, supportive
services models (similar to the Supportive Services for Veteran Families
program) that leverage the existing social service network to help assist VA in
achieving its goals.

As an
example, veterans with disabilities often need assistance obtaining appropriate
community-based services to allow them to live and work independently in the
community. Navigating the many different services for people with disabilities
and veterans, such as health benefits, transportation, and vocational
rehabilitation services, can be complex. Organizations like the Protection and
Advocacy agencies located in every state and territory have expertise and
experience navigating these programs and often advocate for veterans with
disabilities to receive appropriate services from community-based and
faith-based organizations. 

For instance,
the New York Commission on Quality of Care and Advocacy for People with
Disabilities has been working with the New York State Department of Health to
create an advisory board of veterans to address the need of veterans to receive
community-based health care services, and to help monitor the services that
veterans receive. Disability Rights California holds weekly trainings and
information sessions for veterans in the San
Diego area to provide them information and assistance
obtaining community-based services. Protection and Advocacy agencies are eager
to work with VA to ensure veterans with disabilities receive the services and
supports necessary to live and work in the community. 

The
National Disability Rights Network (NDRN), a CCD member organization, is
available to assist with coordinating collaboration efforts between VA and the
Protection and Advocacy Network. The CCD Veterans and Military Families Task
Force encourages VA to work with the Protection and Advocacy agencies, NDRN,
and other organizations to provide these unique advocacy services to veterans
with disabilities.

We
commend VA’s NGO Gateway Initiative aimed at helping qualified non-profits who
are interested in assisting VA in a variety of service areas and VA’s
establishment of a dedicated liaison in the Office of the Secretary to support
VA/NGO information sharing and collaboration. However, VA should elevate the
profile of this initiative and include readily available guidance on the VA
websiteregarding how interested organizations
would receive assistance through this initiative. We believe that organizations
interested in partnering with VA, must be able to easily relay their interest
and abilities to VA.

The ability to augment VA services by linking VA with
established community and faith-based organizations represents an opportunity
to greatly increase access to a variety of services needed for veterans with
disabilities and their families in transitioning to and remaining active
members of their communities. The need to expand access to services,
particularly for veterans in rural and remote areas, shows the need to increase
collaboration to meet the concerns of today’s veterans with disabilities.
Qualified community and faith-based organizations represent a clear pathway to
augmenting VA services for our nation’s veterans.

Thank you for the opportunity to submit testimony regarding
the views of the CCD Veterans and Military Families Task Force concerning
collaboration between VA and community-based organizations. We encourage the
Subcommittee to continue its exploration of this topic and commend your
leadership on behalf of our nation’s veterans with disabilities. We are ready
to work in partnership to ensure that all veterans are able to reintegrate in
to their communities and remain valued, contributing members of society.

Information Required by Clause 2(g) of Rule XI of the House of
Representatives

Testimony submitted on behalf of the Consortium for Citizens
with Disabilities Veterans and Military Families Task Force. The co-chairs submitting
this testimony for the task force are as follows:

Heather Ansley, Esq., MSW

Vice President of Veterans Policy

VetsFirst, a program of United Spinal Association

1660 L St, NW, Suite 504

Washington, DC 20036

(202) 556-2076 Ext. 7702

hansley@vetsfirst.org

Susan Prokop

Associate Advocacy Director

Paralyzed Veterans of America

801 18th St, NW

Washington, DC 20006

(202) 416-7707

susanp@pva.org

Leonard Selfon, J.D., CAE

Associate General Counsel

Paralyzed Veterans of America

801 18th St, NW

Washington, DC 20006

(202) 416-7629

lens@pva.org

Receipt of federal grants or contracts:

The Consortium for Citizens with Disabilities
Veterans and Military Families Task Force has not received any federal grants
or contracts during the current or two preceding fiscal years.


[1] U.S.
Department of Veterans Affairs Press Release, February 13, 2012 (http://www.va.gov/opa/pressrel/pressrelease.cfm?id=2263).
[2] U.S.
Government Accountability Office, VA Mental Health Report, October, 2011 (http://www.gao.gov/new.items/d1212.pdf).
[3] U.S.
Government Accountability Office, Homeless Women Veterans December 2011 Report,
(http://www.gao.gov/assets/590/587334.pdf)                .
[4] Joining
Forces for Women Veterans Summary Report, Business and Professional Women’s
Foundation, February 2011, (http://www.bpwfoundation.org/documents/uploads/JFWV_Final_Summit_Report.pdf).
[5]
Executive Order 13342 (http://www.gpo.gov/fdsys/pkg/WCPD-2004-06-07/pdf/WCPD-2004-06-07-Pg980.pdf).
[6] U.S.
Department of Veterans Affairs Press Release, January 7, 2009 (http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1639).
[7] U.S.
Department of Veterans Affairs Congressional Budget Justification (http://www.va.gov/budget/docs/summary/Fy2013_Volume_III-Benefits_Burial_Dept_Admin.pdf).

                                                  


MATERIAL SUBMITTED FOR THE RECORD

Post-hearing Questions and Responses for the Record:

Questions from Hon. Michael H. Michaud, Ranking Democratic
Member, Subcommittee on Health,
Committee on Veterans' Affairs to Honorable Eric K. Shinseki, Secretary,


U.S. Department of Veterans Affairs

February 29, 2012

Honorable
Eric K. Shinseki

Secretary

U.S.
Department of Veterans Affairs

810
Vermont Avenue, NW

Washington,
DC 20420

Dear
Secretary Shinseki:

In
reference to our Subcommittee on Health hearing entitled, “Building Bridges
between VA and Community Organizations to Support Veterans and Families,” that
took place on February 27, 2012, I would appreciate it if you could answer the
enclosed hearing questions by the close of business on Wednesday, April 11,
2012.

In
an effort to reduce printing costs, the Committee on Veterans’ Affairs, in
cooperation with the Joint Committee on Printing, is implementing some
formatting changes for materials for all full committee and subcommittee
hearings.  Therefore, it would be appreciated if you could provide your answers
consecutively and single-spaced.  In addition, please restate the question in
its entirety before the answer.

Due
to the delay in receiving mail, please provide your response to Jian Zapata at jian.zapata@mail.house.gov,
and fax your responses to Jian at 202-225-2034.  If you have any questions,
please call 202-225-9756.

                             Sincerely,

                             MICHAEL
H. MICHAUD

                             Ranking
Democratic Member

                             Subcommittee on Health

CW/jz

Subcommittee on Health

Committee on Veterans’ Affairs

U.S. House of Representatives

Post-Hearing Questions for the

U.S. Department of Veterans Affairs

From the Honorable Michael H. Michaud

February 27, 2012

Hearing on

Building Bridges between VA and
Community Organizations to Support Veterans and Families

  

Question
for Rev. E. Terri LaVelle, Director, VA Center for Faith-based and Neighborhood
Partnerships

1.     What
is being done to specifically address the support needs of service members and
veterans that reside in rural or underserved areas?



Questions for Chaplain
Michael McCoy, Associate Director, National Chaplain Center

1.     Within
the 200 training events that the National Chaplain Center has conducted, how
many clinics have been included in this outreach?

2.     How
is the National Chaplain Center measuring success in terms of outreach and
training?

 

Responses from Honorable Eric K. Shinseki, Secretary, U.S.
Department of Veterans Affairs to Hon. Michael H. Michaud, Ranking
Democratic Member, Subcommittee on Health,

Committee on Veterans' Affairs

Subcommittee
on Health

Committee
on Veterans Affairs

U.S.
House of Representatives

Post-Hearing
Questions for the

U.S.
Department of Veterans Affairs

From
the Honorable Michael H. Michaud

February
27, 2012

Hearing
on

Building
Bridges between VA and Community Organizations to Support

Veterans
and Families

 

Question for Rev. E.
Terri LaVelle, Director, VA Center for Faith-based and Neighborhood
Partnerships (CFBNP)

Question 1:  What is
being done to specifically address the support needs of Servicemembers and
Veterans that reside in rural and underserved areas?

Response: 

The VA CFBNP hosts quarterly conference calls for members
of the Center’s listserv. The quarterly conference call provides listserv
members with updates on the work of VA’s CFBNP especially focusing on sharing
the Center’s collaborative efforts with internal and external stakeholders
working with or on behalf of Veterans.  The call also provides updates on VA programs
and services that will assist listserv members in serving the needs of
Veterans, their families, survivors, and caregivers. 

Some members of the listserv represent and or
work with organizations that provide services to Veterans in rural communities.

Realizing the need to provide additional
information to those serving Veterans in rural communities, the Center’s final
call for FY 2011 provided information on a collaborative community program for
Veterans and clergy living and working in rural communities.

For the September 15, 2011 quarterly
conference call, the speaker was Rev. Steve Sullivan, Chaplain Arkansas VA
Medical Center and Director
of the VA/Clergy Partnership for Rural Veterans.  Chaplain Sullivan shared
information about Project South (Serving Our Units at Home). 
Chaplain Sullivan shared how Project South came into existence, how to
effectively engage and work with local clergy and ways to reach the Veterans
and their families.

Project SOUTH is an
inter-denominational cooperative effort between local churches, the National
Guard and US Army Reserve local units, and the Arkansas Veterans Affairs to
provide basic support and care for local soldiers and National Guardsmen who
are preparing to be or are already deployed, and to their families.  Project
SOUTH works with faith leaders in El Dorado, Arkansas and other surrounding
rural communities. 

The VA CFBNP co-hosts four regional Veterans
Roundtables annually with Veterans Benefits Administration (VBA) Vocational
Rehabilitation and Employment (VR&E) Service and the VR&E Regional
Office (RO) of the host city.

In previous Veterans Roundtables, it became
apparent that information and training programs must be taken to where the
needs are; one place is to our rural communities.  Rural communities often lack
adequate transportation and other resources to get meaningful numbers of
participants to such event.

One of the VA Veterans Roundtables for FY
2012 will be held in a rural community.

The VA Veterans Roundtable has two primary
goals; the first is to facilitate collaborative working relationships among
faith-based and secular organizations working in the host city and with
Veterans Benefits Administration, National Cemetery Administration, and
Veterans Health Administrationso that holistic
services can be provided to Veterans, their families, survivors, and
caregivers.

The second goal is to inform attendees of the
number of Veterans in their community, what their current needs are, and
potential funding available to faith-based and secular organizations who can
demonstrate an ability to meet those needs in collaboration with the VA. 

To strengthen and expand the CFBNP support to
rural Veterans, the Director of the CFBNP met with the Director of Veterans
Health Administration’s (VHA) Office of Rural Health on March 22, 2012.  They
discussed VHA rural health needs and how VA’s CFBNP an assist Veterans by
working with faith-based and community leaders in rural communities.  The next
step is for VA’s CFBNP to work in collaboration with VA’s Community Based
Outpatient Clinics (CBOCs).  Together, these “networks” can directly inform
and assist rural Veterans to secure services they may need.

Question for Chaplain McCoy, Director,
Associate Director, National Chaplain Center

Question 1:  Within the 200
training events that the National Chaplain Center has conducted, how many
clinics have been included in this outreach?

Response:  The majority of the 233 Veterans Community
Outreach Initiative (VCOI) programs have been hosted at or near VA medical
centers.  Outpatient clinical program personnel are invited to participate in
the day-long clergy training events.  The Rural Clergy Training Program,
co-sponsored by the VA National Chaplain Center and the VA Office of Rural
Health, is an initiative to create Best Practices in training rural clergy in
very rural settings.  The eight Rural Clergy Training events planned for 2012, (listed
below) will be held near VA CBOCs.  We anticipate that VA clinic personnel, as
well as VA Mobile Vet Center staff personnel will participate.

Elizabeth City, NC – March 6, 2012

Danville, VA – March 8, 2012

Staunton, Virginia;

Beckley, West Virginia;

Carrolton, Kentucky;

Richmond, Kentucky;

Rogersville, Tennessee; and

Cookeville, Tennessee.

The five objectives of these Rural Clergy Training events
are for VA Chaplains to:

1.  Train rural clergy to recognize the holistic needs of
Veterans and their families;

2.  Train rural clergy to be able to respond sensitively
to the needs of returning rural Veterans;

3.  Train rural clergy to be equipped to make referrals
to VA facilities;

4.  Encourage rural clergy to establish ministry programs
specifically for Veterans living in rural communities; and

5.  Encourage rural clergy to use their influence in the
community to help reduce the stigma attached to mental health issues.

Question 2:  How is the National
Chaplain Center measuring success in terms of outreach and training?

Response: 

We are developing practices and measurement
tools for the Rural Health Clergy Training Project that will assist local
clergy and Veterans Service Organizations representatives to identify problems
of returning Veterans.  These tools will aid Veterans in receiving the
appropriate assistance in rural communities.  Outcome evaluation is designed in
a pre/post framework and is based on three measures: 1) before training, 2)
immediately after training and 3) at yet-to-be-determined periods (potentially 3
months, 6 months, and 12 months) after training.  There are seven discrete
measures related to outcomes, all related to expanded services in local
communities. 

We continue to improve the outcome evaluation
tools by developing best practices and measurement devices that can be utilized
at VCOI events.  Some specific questions among the 33-question evaluation form
distributed following each of the training events are:  How many referrals have
you made to a Veterans Affairs facility in the past 12 months?  If you have
made a referral to a Veterans Affairs facility, how would you rate your
satisfaction with the experience?  How many referrals have you made to a
community mental health facility in the past 12 months?  In your ministry, do
you ever interact with:  Veterans Affairs Chaplains?  Do you ever interact with
Veterans Affairs Mental Health Providers?  Have you spoken about
military/Veteran needs from the pulpit?