Chairman Michaud and Members of the Subcommittee:
I am pleased to be here today to discuss the VA Grant and Per Diem program serving homeless veterans. I thank you for the invitation to testify before the subcommittee and discuss this worthy program. I have had the honor of serving as the Director of the New York State Division of Veterans’ Affairs for the past ten years and also currently serve as the Chair of the Department of Veterans Affairs Advisory Committee on Homeless Veterans. In both of these roles I have had an opportunity to witness not only the benefits of this program to those veterans who need a hand getting back on their feet but also the challenges it brings to the provider community. Recent estimates by the National Alliance to End Homelessness (NAEH) place the number of homeless individuals in the United States at 750,000. VA estimates the number of homeless veterans to be approximately 180,000, making homeless veterans one quarter of the entire homeless population.
Established by Congress in 1992, the Grant and Per Diem (GPD) program has provided nearly 10,000 transitional beds for homeless veterans through the efforts of over 300 community-based providers. These community and faith-based organizations provide shelter, food, and supportive services to homeless veterans for up to two years for a per diem currently set at a maximum of $31.30 per day.
Originally designed to meet the needs of Vietnam era veterans, I believe it is time to revisit the Grant and Per Diem program in light of the need to also serve the veterans of the current conflict as well as those older veterans. VA estimates they have already seen over 1500 OEF/OIF veterans in various settings with several hundred referred to GPD providers for assistance.
The VA Advisory Committee on Homeless Veterans in its recent report discussed concerns about GPD. Specifically:
- The VA GPD program uses a process to reimburse providers designed like the system VA uses to reimburse state governments for the State Home program. The Advisory Committee is concerned this capped process discourages providers in high-cost areas from even applying. The current $31.30 rate is based in law on the rate paid to state home programs. There is no basis in fact for the $31.30 rate in the state home program and no defined rationale for determining that figure. Additionally, the current process does not allow the use of other federal funds without offset by VA. While the State Home program rules were recently changed to allow this, the restriction still applies to GPD programs.
- The accounting process required for reimbursement is a burden on small community based providers. Asking this group to meet the same level of expertise as state governments with large accounting staff is unreasonable and discourages participation. Additionally, recent audits of some providers have led to allegations of significant overpayments – sometimes years after the fact – based on differing interpretations of allowable expenses.
- Community based GPD providers frequently use other federal programs to augment the services provided to veterans. Current GPD regulations do not allow these funds to be used as a match for VA programs, often discouraging participation. Conversely, other federal programs do allow VA funds to be used as a match, creating a disincentive to participate in VA programs.
The Advisory Committee recommended the Per Diem be revised to allow payments to be related to service costs rather than a capped rate, allowing higher cost areas where homeless veterans are often numerous to participate.
The Advisory Committee also recommended allowing other federal funds to be used as a match to VA funds and also allow other federal funds to be used without offset.
Incorporated in these recommendations is the implied recommendation that the current burdensome accounting process would be scrapped and replaced by a simpler mechanism to provide reimbursement and protect the taxpayer’s interest. Paying a fee for services provided meets the needs of both the veteran client and the providers without placing an undue burden on either the providers or the government.
Beyond adjustments to the existing Grant and Per Diem program, other related concerns need to be addressed. Historically, most homeless and housing services have been provided by the US Department of Housing and Urban Development (HUD) and the US Department of Health and Human Services (HHS). VA housing initiatives have focused almost exclusively on transitional housing, reasoning that traditional VA programs coupled with GPD support services were all that was needed to return homeless veterans to a permanent housing environment. With twenty years experience in homeless veteran programs, we now know this is a simplistic view. Veterans with the co-morbidity of substance abuse and behavioral health disorders are frequently incapable of making the jump from transitional housing and programs to self-sufficiency. Experience has again taught that supportive permanent housing is often the most effective and economical way to have these individuals re-enter the mainstream. The existing HUD-VASH program providing Section 8 vouchers is woefully inadequate due to a lack of specific appropriations for the program by HUD. The Advisory Committee has recommended to VA that HUD-VASH be expanded and further that VA look for opportunities to partner with HUD and other agencies to find innovative ways to bring permanent housing and supportive services to veterans. Consideration should be given to site-based Section 8 vouchers as a way to provide those services on an ongoing basis by community based providers. Success of programs such as New York City’s New York, NY III initiative have demonstrated an integrated approach can provide positive results at an affordable cost.
The still ongoing Capital Asset Realignment for Enhanced Services (CARES) process VA is using to identify capital requirements for the next twenty years has identified a significant amount of surplus VA land and facilities. One of the Advisory Committee recommendations was to have VA make reuse of this land for veteran housing a priority. VA officials contend that the existing Enhanced Use Lease (EUL) program is adequate to meet that need, but experience shows the EUL to be a time consuming, cumbersome process fraught with opportunity for delay and lost opportunities. The Department of Defense Base Realignment and Closure (BRAC) process is much more efficient in terms of making reuse opportunities reality in a reasonable period of time.
There is a growing concern regarding women veterans. With women now making up nearly 20% of today’s military, VA programs are being accessed by an increasing number of women veterans, including programs for homeless veterans.
There are unique challenges in this shift. Most VA programs were designed when the military was nearly exclusively male, necessitating changes by the Veterans Health Care Administration to facilities and procedures that are ongoing even today. Transitional housing programs for women veterans are rare, given the relatively low numbers involved and the economies of scale needed to provide services. Issues of safety and appropriateness of facilities likewise challenge traditional homeless service providers.
Another consideration is the authority of VA to only care for the veteran. Children who have no other parent to care for them also often accompany the increasing number of women veterans. Accessing VA services by these veterans means leaving children with other relatives or non-family caregivers; a difficult choice that often leads to walking away from VA care and looking for help elsewhere. VA should explore ways to cope with the changing demographics of the military and adjust accordingly, either in partnership with other agencies or through programmatic changes of its own.
The VA Grant and Per Diem program has provided a valuable service to homeless veterans over the past fifteen years. Adjusting the program in light of experience is appropriate; creating new policy to meet the needs of returning veterans from the current conflict is a necessity.
Mr. Chairman, this concludes my formal remarks. I appreciate the opportunity to present my views and am prepared to answer any questions you or members of the Subcommittee may have. Thank you.