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Testimony of

Kathryn E. Spearman, M.S.W.

President and CEO

Volunteers of America of Florida

Before the United States House of Representatives Committee on Veterans Affairs Subcommittee on Health 

May 6, 2003

Washington DC 

Chairman Simmons and Subcommittee members: 

Thank you for the invitation to testify today and for all you do to assist our nation’s veterans.  Volunteers of America of Florida is a statewide non-profit 501 (c) (3) faith-based social service community provider in Florida for 83 years.  We are an affiliate of the prominent and well-known Volunteers of America national organization whose headquarters are located in the Washington D.C. area, in existence for 107 years, with affiliates in 45 states. 

Volunteers of America of Florida specializes in offering hope and support to veterans, the elderly, the mentally ill and the developmentally disabled through providing mental health, substance abuse, health, and supported employment services and operating drop-in and multi-service centers.  The agency is a statewide Medicaid and Medicare provider, accredited by the Joint Commission on Accreditation of Healthcare Organizations as a behavioral health care provider.  Our emphasis is on housing and supportive services that lead persons with special needs to independent living, however that might look for each individual.   

On any given night in Florida between 17,000 and 23,000 homeless veterans are living in shelters, on the streets, in encampments, on derelict boats or in other places not meant for human habitation.  Volunteers of America of Florida has the largest number of Veterans Affairs Grant and Per Diem supportive housing and service programs in Florida, as well as the largest number of HUD McKinney-Vento Supported Housing Programs in the state.   

Currently Volunteers of America of Florida provides outreach and support services to 6,000 veterans each year at Stand Downs and in encampments, through our multi-service centers and through our housing and support services programs.  Currently we provide housing and support services to 125 veterans through 5 VA Grant and Per Diem  programs totaling $956,662, and to an additional 42 veterans through its HUD McKinney-Vento programs, for a total of 167 veterans served. Outreach is provided throughout the state; housing programs are located in Miami, Key West, Jacksonville, Ft. Lauderdale, Tampa and Cocoa, Florida.  Veterans Multi-Service Centers are offered in Miami and Cocoa. 

Our most innovative program (and first) Grant and Per Diem program is the Florida Veterans Mobile Service Center, a 40-foot state-of-the-art vehicle with a fully-contained medical, dental and health service facility that outreaches to homeless veterans throughout the state.  Of the 20,000 + homeless veterans in Florida, an estimated one-third are very resistant to receiving services and living in the isolated encampments in places like the Florida Everglades, Ocala National Forest, on abandoned boats, and on isolated islands off the Florida Keys.   

This outreach service offers immediate assistance of food and clothing, health screening, dental services, VA eligibility determination, and linkages with local service providers.  The mobile unit is supported by Disabled American Veterans, Vietnam Veterans of America, AMVETS, Veterans of Foreign Wars, Paralyzed Veterans of America, Jewish War Veterans, VietNow, Marine Corps League, American Legion, Korean War Veterans, Non Commissioned Officers Association, and the U. S. Department of Veterans Affairs, as well as by corporate sponsors USAA, Eli Lilly, Harley Davison, Applied Geodentics, and individual contributions.   

Florida was fortunate to have an innovative and creative VISN 8 homeless working group that developed the outreach plan, and Volunteers of America of Florida had the capacity and willingness to move the project forward.  Dr. Roswell, then the VISN 8 Medical Director supported the project and encouraged the support of VA Medical Center directors. 

The Mobile Service Center has some impressive statistics: it is on the road 200 days a year; has traveled more than 30,000 miles in 2 years, and has reached more than 4800 men and women.  The unit uses a team approach including staff from Volunteers of America of Florida, the Veterans Administration Medical Centers, VISN 8 Veterans Benefits Administration, and a variety of community providers.  Currently the unit is under funded and lacks Veteran Administration Medical Center support.  This is a program that can really make a difference, yet requires enormous amounts of agency and staff time to find resources to keep it in operation.  By now we expected to have more support and more vehicles on the road. 

Because of our work in the Mobile Service Center and the first-hand knowledge we have gained and documented, not only of the severity of homeless veterans’ needs, but of their complete lack of awareness that any benefits at all were available to them, we have been able to present their stories compellingly throughout Florida, resulting in Veterans Services Organizations’ increased involvement with the program, greater community awareness of the underlying factors contributing to their needs, and state and corporate support for this initiative.  It was also this first-hand knowledge that led us to apply for and obtain the VA Grant and Per Diem supported housing programs, and it has allowed us to successfully offer more specific services that lead to veterans transitioning to independent living. 

We are especially appreciative of Retired General Norman Schwarzkopf, who narrated a public service video supporting the innovative Mobile Service Center outreach program, emphasizing both the need for such programs and our communal responsibility to provide these programs to the men and women who bravely served our country.  

Volunteers of America of Florida’s success with homeless veterans is due in part to its ability to work statewide, its continuum of housing options and array of support services, and the diligence in combining federal and local resources to get the job done.

Most importantly, we are dedicated to solving the problems of all homeless veterans, in spite of not only resistance from our communities to give up limited resources to serve veterans they feel the Veterans Administration should serve, but also resistance from homeless veterans themselves who do not want to trust a system that has been neglectful at best, and sometimes abusive to them.  

Our five years of experience in working with homeless veterans, first in outreach and then in providing housing and support services including multi service centers, has led us to an increasing awareness of the gaps and barriers that severely impede the integration of homeless veterans into the community and the need to develop strategies to solve the problems.  We recommend strongly the following action to smooth homeless veterans’ return to active, productive lives. 

Action supported by Volunteers of America of Florida

§         Develop and support creative funding specifically to address needs of homeless veterans

§         Place VA Medical Center staff working with homeless veterans on site in community veterans homeless programs, as well as in hospitals

§         Provide prevention mental health services for returning veterans without the stigma of labeling them as psychiatrically unstable

§         Issue directives with incentives for VA Medical Centers to reach out and plan for homeless veterans’ reintegration into care in order to improve their chances for success

§         Reduce bureaucracy to get things done in a timely manner for all concerned, including processing and releasing benefit entitlements for veterans, providing needed medical care, mental health care, and substance abuse treatment to veterans when they need them, rather than in months or years; improve the capacity of VA staff addressing homeless veterans’ needs to travel throughout the state to work directly with homeless veterans and providers of services to homeless veterans; decrease the delays in releasing grant award dollars and providing the on-site visits required by VA before services can begin to be delivered to homeless veterans

§         Educate the community on eligibility of veterans for all entitlements and services

§         Continue to look at NEPEC’s results and increase its capacity to collect and analyze data

§         Increase support services

§         Use only those providers who can demonstrate that they are deeply concerned about homeless veterans and their problems, and who can offer the services that are unique to the needs of homeless veterans, especially service-resistant veterans

§         Support and fully fund PL 107-95 Homeless Veterans Assistance Act, with its focus on increased provision of individual, special needs services. 

This above plan of action is formulated to respond to three identified needs: to address the gaps and barriers that impede homeless veterans’ opportunities to succeed, to enhance existing services that are helpful but inadequate, and to improve funding streams to better address those needs that are specific to the homeless veteran population.

Gaps and Barriers to Services

• Emergency care

• Timely benefits provision

• Communities willing to set aside service or housing funds for veterans

• Consistent and specific outreach and service to homeless women veterans and their families

• Dental care

• Veterans shelters and emergency shelters that will include those inebriated

• Immediate detoxification services

• Inpatient services for PTSD

• Adequate mobile medical and general outreach to rural encampments

• Adequate support sources for veterans unable to stay in gainful employment due to health issues

• Substance abuse and mental health access and treatment

• Adequate community education with regard to veterans’ entitlements

Services needing enhancement

• Supportive housing

• Service Centers

• Employment options for special needs homeless veterans, including supported employment, part time employment, mentoring and meaningful volunteer opportunities

• General access to health care, nutrition and medication which prepare homeless veterans for employment and create a greater feeling of well being

• Outreach to resistant veterans

• Rental assistance vouchers

Funding concerns and needs

• As interagency efforts in Washington such as the Collaborative Homeless Initiative Program shift funding collaborations and responsibilities, attention must be given to the outcome of increased services specifically for homeless veterans.  The recent collaboration effort left many excellent veteran-specific service providers nothing to gain and the Department of Veterans Affair’s role the same as always – limited resources and additional commitments to the community that are unlikely to have much impact on services.  As competition for HUD McKinney-Vento Supportive Housing Program funds increases, veterans’ service providers are less likely to gain top ranking because they are working with subsets of populations.  For example, in Florida most Continuums of Care generally identify gaps in services first by housing needs such as emergency shelters, transitional housing programs and permanent housing programs.  Next in ranking come the populations in need such as mentally ill, substance abusers and persons with HIV/AIDS.  Limiting persons served to a specific subset – Veterans – may result in those applications’ receiving lower scores than one serving a population mix.  While serving a mix of veterans and non-veterans may be a good long-term plan, in the short term it puts veterans at risk of not being given the special attention they need now.
   

• Service resistant veterans, especially from the Viet Nam era, need VA specific funding for services to offset their many years of isolation, rejection and VA neglect.  This group takes more time and money than any other group of veterans, and, in fact, very often only their severe medical needs may push them to be willing to chance accepting services.  The right staff are crucial.  They must be patient, understanding and sometimes brave.  In reality, outreach to this group often requires these 10 steps only to begin to work with them:

1.      locate them through local sources and build trust with the contacts;

2.      contact in advance through local residents;

3.      go in slowly - as directed by contacts;

4.      build trust;

5.      provide food, clothing and medical care to a few;

6.      build trust, wait, and come back;

7.      provide food, clothing and medical care to a few more;

8.      build trust, don’t ask too many questions, come back;

9.      build rapport and begin to talk;

10.  establish trust to begin a future working relationship. 

·        Maximum funding is essential under the new special needs category for Grant and Per Diem as outlined in PL 107-95 (2061).  This is the first attempt to cover the cost of care for special needs veterans and offer competitive payment for care in the community.   

·        Equally important is the provision of rental assistance vouchers, PL 107-95 (Section 12) which are and will remain greatly needed. 

Thank you for your consideration and support in these important matters.  Together we can make this work.  Volunteers of America of Florida is proud to be associated with a group that is taking seriously the President’s ten year plan designed to solve the problem of homelessness by ending it, especially among veterans in Florida.

Kathryn E. Spearman

President/CEO

Volunteers of America of Florida

605 South Boulevard

Tampa, FL  33606

Telephone:  813 282-1525

FAX:  812 287-8831

Email:  kspearman@voa-fla.org