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Witness Testimony of Alfonso R. Batres, Ph.D., M.S.S.W., Veterans Health Administration, Chief Readjustment Counseling Officer, U.S. Department of Veterans Affairs

Mr. Chairman and Members of the Subcommittee, I appreciate the opportunity to appear before you today to discuss the Vet Center program of the Department of Veterans Affairs (VA) and the role it plays in providing care and services to veterans.

VA’s authority to provide readjustment counseling to eligible veterans was established by law in 1979 to alleviate the specific psychological symptoms and social readjustment problems that arose from veterans’ traumatic combat experiences in Vietnam.  Today, in the anniversary of the program’s 28th year, the Vet Center program’s eligibility includes veterans that served in combat during any period of war or armed hostility.  In 1993, following the legislative authority for VA to provide military-related sexual trauma counseling, Vet Centers were designated as one of the main VHA sites for providing these services to veterans of any era who were sexually assaulted during military service.

SERVICES

The Vet Center program is a unique Veterans Health Administration (VHA) program designed to provide readjustment counseling services to help veterans  exposed to the stressful conditions of combat military service make a successful transition to civilian life.  In terms of service mission, readjustment counseling consists of a more-than-medical, holistic system of care that provides professional readjustment counseling to help veterans cope with and transcend the psychological traumas and other readjustment problems related to their military experiences in war.  Vet Center services also include a number of other community-based services to help veterans improve the whole range of their post-military social, economic and family functioning.  

One of the distinguishing features of the Vet Center program is the authority to provide services to veterans’ immediate family members as part of the treatment and readjustment of the veteran.  Veterans’ immediate family members are eligible for care at Vet Centers and are included in the counseling process to the extent necessary to treat the readjustment issues stemming from the veterans’ military experience and/or post-deployment homecoming.  Vet Centers promote preventive educational services to help veterans and immediate family members stabilize post-deployment family readjustment problems and assist the veteran to a successful post-war readjustment.     

VA’s Vet Center program currently consists of 209 community-based Vet Centers located in all 50 states, the District of Columbia, Guam, Puerto Rico and the U.S. Virgin Islands and operates in the community outside of the larger medical facilities.  Designed to remove all unnecessary barriers to care for veterans, the Vet Centers are located in convenient settings within the community, and services are tailored in every community to meet the specific needs of the local veteran population.  To further promote ease of access, veterans are always welcome to stop by their local Vet Center at any time.  Vet Center staff members are available to welcome veterans and family members, and to provide useful information about available services.  Vet Centers have no waiting lists and veterans may be seen by a counselor the same day they stop by for an assessment.  Vet Centers also maintain nontraditional after-hours appointments to accommodate veterans’ work schedules.

The Vet Center program is the primary outreach arm of VHA.  All Vet Centers engage in extensive community outreach activities to directly contact and inform area veterans of available VA services and maintain active community partnerships with local leaders and service providers to facilitate referrals for veterans.    Vet Center community-based outreach and referral services also provide many veterans with a point of contact for access into the larger VA health care system and benefits programs.  The Vet Centers make over 200,000 veteran referrals annually to VA medical centers and regional offices combined.  

With the onset of the hostilities in Afghanistan and Iraq, the Vet Centers commenced to actively outreach and extend services to the new cohort of war veterans returning from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF).  From early in fiscal year (FY) 2003 through the end of the third quarter in FY 2007, the Vet Centers provided readjustment services to over 242,000 veteran returnees from OEF and OIF.   Of this total, more than 183,500 veterans were provided outreach services often through group settings, and approximately 58,500 were provided substantive clinical readjustment services in Vet Centers. 

The Vet Center philosophy is early intervention through outreach and preventive educational services.  Research indicates that this may result in the best outcomes for successful post-war readjustment.  To promote early intervention, VA initiated an aggressive outreach campaign to locate, inform, and professionally engage veterans as they return from theaters of combat operation in Afghanistan and Iraq.  Over the two-year period from FY 2004 through FY 2005, the Vet Center program hired 100 OEF and OIF veteran returnees to provide outreach services to their fellow combatants.   Since 2004 when the initial OEF and OIF veteran outreach specialists were recruited, the focus of the Vet Center program has been on aggressive outreach at military demobilization and at National Guard and Reserve sites as well as at other community events that feature high concentrations of veterans.   These fellow veteran outreach specialists are effective in successfully gaining the immediate trust of returning veterans and help them mitigate the fear and stigma associated with seeking professional counseling services. 

The Vet Centers also provide bereavement counseling to surviving family members of Armed Forces personnel who died while on active duty in service to their country.  Vet Centers are providing bereavement services to military family members whose loved ones were killed in Afghanistan and Iraq.   Since 2003 through the end of the third quarter FY 2007, 1,045 cases of active duty, military-related deaths have been referred to the Vet Centers for bereavement counseling, resulting in services provided to more than 1,570 family members. 

STAFFING

Vet Centers staffed by small multidisciplinary teams are highly responsive to the needs of the local veterans.   The team comprises a mix of mental health professionals, other professional readjustment counselors, outreach specialists and administrative personnel.  In FY 2006, the Vet Center program had 1066 assigned staff positions of which 876 were authorized counseling staff and 159 were outreach specialist positions.  Of the total counseling staff, 507, or 58 percent, were VHA qualified licensed mental health professionals, i.e., licensed clinical social workers, doctoral level clinical psychologists with an American Psychological Association approved internship, and psychiatric clinical nurse specialists.  Every Vet Center has at least one VHA qualified mental health professional on staff. 

A majority of Vet Center service providers are themselves veterans, most of whom served in a combat theater of operations.  Having a large cadre of veterans on staff is a distinguishing characteristic of the Vet Centers, and enables the program to maintain a veteran-focused treatment environment that communicates a welcome home attitude and respect for veterans’ military service.  The high percentage of combat veteran Vet Center service providers facilitates immediate rapport and promotes a sense of camaraderie within the local veteran community.   Vet Centers also tailor services delivered to meet the specific cultural and psychological needs of the veteran populations they are serving by promoting representative diversity among the staff. 

FUTURE PLANS

Today the Vet Center program is undergoing the largest expansion in its history since the early days of the program’s founding.  The planned expansion   complements the efforts of the Vet Center outreach initiative by ensuring sufficient staff resources are available to provide the professional readjustment services needed by the new veterans as they return home.  In FY 2006, VA announced plans for establishing two new Vet Centers in Atlanta, GA and Phoenix, AZ, and augmenting staff at 11 existing Vet Centers, bringing the current number of Vet Centers to 209.  In February 2007, VA announced plans to increase the number of Vet Centers to 232.  Over the remainder of this and the next fiscal year, VA will establish new Vet Centers in 23 communities and augment the staff at 61 existing Vet Centers.  The following communities will be receiving new Vet Centers: Montgomery, Alabama; Fayetteville, Arkansas; Modesto, California; Grand Junction, Colorado; Orlando, Fort Meyers, and Gainesville, Florida; Macon, Georgia; Manhattan, Kansas; Baton Rouge, Louisiana; Cape Cod, Massachusetts; Saginaw and Iron Mountain, Michigan; Berlin, New Hampshire; Las Cruces, New Mexico; Binghamton, Middletown, Nassau County and Watertown, New York; Toledo, Ohio; Du Bois, Pennsylvania; Killeen, Texas; and Everett, Washington.

In May 2007, VA announced that it planned to add 100 new staff positions to the Vet Center program in FY 2008.  Together with the 100 OEF and OIF outreach specialists hired in FY 2004 and 2005, these program expansions represent an increase in Vet Center staffing by 369 positions over pre-2004 staffing levels, a 39 percent increase. 

The Vet Center program reports the highest level of veteran satisfaction recorded for any VA program.  For the last several years, over 99 percent of veterans using the Vet Centers consistently reported being satisfied with services received and responded that they would recommend the Vet Center to other veterans.

In summary, through their local Vet Centers, eligible veterans have access to professional readjustment counseling for war-related social and psychological readjustment problems, family military related readjustment services, substance-abuse screening and referral, military sexual trauma counseling, bereavement services, employment services, and multiple community-based support services such as preventive education, outreach, case-management and referral services.

To locate their local Vet Center, veterans can consult the yellow pages, as well as the federal government listings.  In both places the listing is under “Vet Center.”  Vet Centers are also listed on the following web site: www.va.gov/rcs.

Mr. Chairman, this concludes my statement.  I am happy to answer any questions that you or other members of the Committee may have.