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

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

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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.  

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