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Witness Testimony of Mr. Dennis M. Cullinan, National Legislative Service, Director, Veterans of Foreign Wars of the United States

MR. CHAIRMAN AND MEMBERS OF THIS SUBCOMMITTEE:

Thank you for the opportunity to present the view of the Veterans of Foreign Wars of the U.S. (VFW) on this important subject.  Vet centers are an integral part of the Department of Veterans’ Affairs (VA) capacity to care for veterans.  They provide readjustment counseling to veterans who were exposed to the rigors of combat, and who may need services to help them cope with the traumas of war.  The community-based services provided at Vet Centers are a helping hand, giving these brave men and women assistance in obtaining the benefits and health care they are entitled to through VA.

The program began in 1979, when Congress gave VA – then the Veterans Administration – the authority to provide readjustment counseling services to Vietnam Veterans, many of whom were encountering serious problems that interfered with their work, education and personal and family lives.  The centers were created as outpatient treatment facilities to increase the ease and availability of services.  Over time, the mission has rightly expanded to provide a number of essential services beyond counseling, and has begun providing services to the families of service members, who often are affected just as much by the difficulties of their loved one’s combat service.

This program is so essential because its design helps to break down much of the stigma of treatment.  Vet Centers, by and large, are accessible and welcoming.  The less formal setting helps to encourage those veterans who need its services to utilize them.  Vet Centers aim to eliminate many of the barriers to care, and its employees are adept at breaking down these barriers.

The quality and variety of services provided at Vet Centers is excellent.  We have heard few complaints about the quality of care, and the treatment vets receive in these facilities.

Our concern lies with the access to these services.  The October 2006 report, “Review of Capacity of Department of Veterans Affairs Readjustment Counseling Service Vet Centers,” conducted by the then-minority staff of the Subcommittee on Health provided many details of the access problems veterans face at these centers.

The Subcommittee found that many vet centers have had to scale back services: “40 percent have directed veterans for whom individualized therapy would be appropriate to group therapy.  Roughly 27 percent have limited or plan to limit veterans’ access to marriage or family therapy.  Nearly 17 percent of the workload affected Vet Centers have or plan to establish waiting lists.”

These are worrisome trends.  But they tell just a part of the story.

In conversations representatives of our National Veterans Service have had with Vet Centers throughout the country, their greatest concern is not with the demands for service today, but with the future.  Although the Subcommittee report noted that the number of OEF/OIF veterans accessing care at Vet Centers had doubled, they are still just a portion of the population served.  As more come back, and more start to access the benefits and services provided by VA, we can anticipate an even larger demand for these services.

This is especially true of the mental health services provided at these centers.  We are all aware of the difficulties returning service members are having because of the unique stresses of this conflict, and there correctly has been an increased emphasis on their mental well-being.  VA’s most recent data, through the first quarter of 2007, shows that around 36% of hospitalized OEF/OIF veterans are returning with some degree of mental disorder.  If these numbers hold form, as they have with previous VA reports, it will represent a challenge for these Vet Centers.

Mental impairments affect veterans in different ways.  Some are able to easily adapt.  Others have intense and immediate needs.  Still others require time and patience to come to terms with what they are feeling, and to make the sometimes difficult decision to accept treatment.  That latter group is the one that is going to affect these Vet Centers the most in the future.  We must be prepared to handle their growing needs, and the demands they place on the system.  While the Subcommittee had reported on the problems of today, it is 5 to 8 years from now that must also be of concern.

To that end, we are pleased to see the Secretary’s recent decision to add 23 new Vet Centers throughout the country.  Expanding access is clearly a good thing.  Accordingly, we need to see that each center, new and existing, is fully staffed, and that areas that report exceptionally high demands for service are staffed sufficiently so that these centers can retain one of the characteristics that make them unique and a convenience for veterans, the drop-in aspect.  The informality of not having to make an appointment is one of the things that makes these Vet Centers an attractive option for veterans.  With rationed treatments, veterans may be less likely to utilize these essential services. 

We would urge this Committee to utilize its oversight authority by continuing to monitor the demand for services.  As demands rise, funding priorities must adapt.

There are a few other concerns we have:

First, these centers must be able to handle the increasing number of women veterans sure to seek treatment, and increase treatment options and outreach efforts to them.  While all centers are required to have sexual trauma treatment, we must ensure that services are available to address any issues that arise from them serving in a war zone where there is no true front line.

Second, the original vision of the Vet Center was of veterans helping veterans.  That is still a worthy goal, but we understand the need for qualified and highly trained counselors and staff members -- especially those dealing with the complexities of mental impairments -- who might not always be veterans; what’s important is that they are caring, compassionate, and capable.  A number of senior Vet Center counselors and staff, though, are Vietnam Veterans and are edging closer towards retirement age.  We must be mindful of finding replacements, especially if we can draw on the experiences of the younger veterans, including OEF/OIF veterans and those who served in the Persian Gulf War.   VA must do more to educate and train these men and women, so that they can play an active role in their fellow veterans’ treatment.

Mr. Chairman, I again thank you for the opportunity to present the VFW’s testimony.  I would be happy to answer any questions that you or the members of the Subcommittee may have.