Kathryn E. Spearman
Chairman Michaud, Ranking Member Miller and Members of the Subcommittee:
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 501 (c) (3) non-profit, faith-based social service community provider in Florida for 87 years. We are an affiliate of Volunteers of America, a national organization whose headquarters are located in the Washington, DC area, in existence for 111 years, with affiliates in 44 states.
Volunteers of America of Florida, in partnership with various committed funding sources, provides housing and services to the homeless, low-income elderly, persons with mental illness, and persons with developmental disabilities. With a continuum of services, Volunteers of America offers housing, health care, training, education and employment services to advance self-sufficiency. Housing and support services are offered in 13 Florida cities: Jacksonville, Gainesville, Tampa, Sebring, Bradenton, Clearwater, Orlando, Cocoa, Lakeland, Miami, Ft. Lauderdale, Pompano, and Key West. Currently, there are new projects in development in Pensacola, Punta Gorda, and Lake City, and assistance is being offered to potential providers in Trenton and Sebastian, Florida.
Florida attracts many homeless veterans, and Volunteers of America of Florida has been focused on addressing the needs of these individuals for the past ten years. We partner with the VA Grant and Per Diem Program in serving this population of veterans. This partnership is demonstrated by the fact that Volunteers of America of Florida and VISN 8 have jointly responded to five major hurricanes utilizing the Mobile Service Center which we will mention later in our talk. 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 currently has transitional housing and support services capacity for 216 homeless veterans in seven Florida cities: Jacksonville, Gainesville, Cocoa, Key West, Miami, Ft. Lauderdale, and Lake City. There are 171 beds through the VA Grant and Per Diem Program and 45 through our HUD Supportive Housing Programs. Another 81 beds are in development bringing our service capacity to 297 veterans in nine Florida cities and surrounding communities. Our first and most innovative 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. Veterans also benefit from a Multi-Service Center in some cities.
Volunteers of America of Florida currently has the largest number of Veterans Affairs Grant and Per Diem supportive housing and service programs in Florida, as well as one of the largest number of HUD McKinney-Vento Supported Housing Programs in the State.
Our service to veterans is based on excellent partnerships and common goals to support the needs of homeless veterans. As a provider, I appreciate the dedication of Roger Casey and his staff to make the program what it needs to be; the continual funding to add more beds; the grant segment which provides tremendous leverage and incentive; the opportunity for the VA and the community to partner to address the needs of homeless veterans; the per diem that strengthens the operations and program; the service center potential; and the strategic gateway for veterans to live in and be part of the community.
Volunteers of America of Florida’s success with homeless veterans is founded in strong partnerships, the ability to work statewide, a continuum of housing options and array of support services, and diligence in combining federal and local resources to get the job done. Our ten 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 issues facing Grant and Per Diem providers. From a provider perspective I will spend the rest of my testimony offering information and suggestions.
Partnership – The overall partnership between the VA and the community needs strengthening. Local providers address the needs of veterans everyday and complement the VA services. We accept this as our role and we would like the VA to value that role in partnership – often a tall order I believe for the “big VA”. In service to the homeless veterans, local community providers offer easier accessibility, 24/7 availability of staff in our programs, fewer barriers to receive immediate service, and a more coordinated individualized, and timely approach to the needs of each homeless veteran. Providers are good housing developers; problem solvers; resource developers; and grant writers. We are a linkage for the veteran to the community where we offer an expansion to VA’s clinical and substance abuse treatment as well as training and education in preparation for employment.
Furthermore, the community needs the VA and its tremendous assets and resources in order to meet the goal of ending homelessness among veterans. The homeless veteran needs us both and the homeless veteran needs us to work together. A partnership approach does work and Volunteers of America of Florida is becoming more selective in its funding partners because so much more can be accomplished if we sit at the same table trying to find ways to reach an agreed upon outcome. With a good partnership comes shared risk because we own the problem together.
- Suggestion: A work group to advise on a provider friendly / VA accountability and funding mechanism for Grant and Per Diem payment with representation from all members of the partnership.
VA Medical Center Relationship – Volunteers of America of Florida has worked well with the Healthcare for Homeless Veterans and Compensated Work Therapy staff. In my experience, the staff from the VA hospitals that provide contract management and site inspections often lack the same goals as the VA Grant and Per Diem Program. However, as in many monitoring situations, it becomes confusing when the monitoring staff misconstrues their role as the expert in housing development, safety, service delivery, client intake, and generally – everything that is good for the veterans. I believe being a more integral part of the Grant and Per Diem staff and its strategies to work with the community could be beneficial.
- Suggestion: Staff those positions under Grant and Per Diem. Training, scheduling and a positive attitude could build a better rapport with community providers serving veterans. We could actually problem solve as a team. At a minimum the hospital representatives, as well as everyone representing the VA Grant and Per Diem Program, need to focus on the positive partnership.
Helping the Homeless Veterans – In order to move a homeless veteran to a healthful and productive life in the Grant and Per Diem Program, most of the following services will be required:
- ·Outreach to identify, locate, establish trust and rapport, and link veterans to services
- Immediate access to shelter, food, clothing, and health care
- Assessment of need
- Housing placement
- Medical and dental care
- Support Services – transportation, linkage to assistance and benefits, legal aid, and building a personal support system
- Mental Health and/or Substance Abuse Treatment
- Training and education, and employment assistance
- Employment assistance
- Community integration, support networks
- Relocation to permanent housing
Outreach and services will be successful when they are conducted to build trust and respect. Recognition should be given to the importance of all sources that help the homeless veteran succeed. I must say that I doubt most people realize how disengaged and disabled many of the homeless veterans are when they enter our programs. Drug and alcohol addiction is very serious and disruptive to rebuilding a life acceptable to our society.
Costs in Relation to the VA Grant and Per Diem Payment – The complex barriers experienced by our nation’s homeless veterans reinforce the need to be flexible as a service provider. Costs for housing and services must be constantly evaluated to offer the highest quality of service. The following are some industry costs for your information on this topic. While costs will vary by factors such as quality and volume, the information below shows activities and associated costs.
Therefore, the $32/day per diem note will always fall short of paying in total for what is needed. Identification and combining of resources is essential and should be encouraged strongly. In my opinion, the VA Grant and Per Diem service center payment does not relate to operating a center.
Construction, rehab and acquisition require a 35% cash match from the provider. This usually comes from additional funding sources that are easier to access with the VA portion committed as a grant and a per diem to strengthen the ability to operate. Flexibility needs to be exercised to create projects that offer beds to homeless veterans. There are many creative ways to combine development funding or put together assets of providers, VA grant, and financing. It is crucial also that VA Grant and Per Diem be understood as providers attempt to mesh funding and funders’ requirements. It is not a perfect process and each is different and often challenging.
- Suggested Options of Service Payment:
- Provider prepares an expense budget reflecting housing and services expenses they want the VA to pay for. The provider is then monitored according to that proposed budget and the services those expenses covered. VA is flexible and helpful as circumstances require adjustments. Cost is impacted by the level and type of service.
- Determine a housing base per diem and then two or three levels of service per diem as an overlay (basic to more intensive).
- Determine outcomes desired and steps to arrive at those outcomes. Then determine cost and pay the provider monthly (1/12) of budget if 80% of outcomes are being met or if veterans are moving toward independence that month (documented). Volunteers of America of Florida has two pilots of this nature with the State Department of Children and Families, Office of Substance Abuse and Mental Health. It has a remarkable impact on how services are delivered!
Note: The VA must pay their portion of administrative overhead based on a reasonable percent. It costs a viable organization between twelve and twenty-five percent (12-25%) of administrative costs – the higher percent for the smaller organization.
The flexibility we build now, in this program, should also be with an eye to the future when we will be focused on a new era of veterans with a whole new set of circumstances and needs. Our work over the last decade has been primarily with homeless veterans who served during the Vietnam era. Veterans now returning from Operation Iraqi Freedom or Operation Enduring Freedom should benefit from the lessons we have learned in developing support and interventions. Our returning troops have post traumatic stress disorder, traumatic brain injury, and other serious mental health/substance abuse disorders which will require services on a longer term basis. Please consider the need for permanent supported housing for these veterans. As we work together to address program improvements, we will be better prepared to continue to meet the needs of current homeless veterans and wisely anticipate the needs of our returning troops.
In closing, I hope the pressure on the Grant and Per Diem Program will lift so the staff can more effectively advance the Program goals. We all need to be more secure in what we are doing and why we are doing it! When we embrace common goals to serve and support homeless veterans, and reach out with a sincere helping hand, powerfully positive outcomes will result.
Thank you for the opportunity to share my views on this important and worthwhile program. I hope my comments are representative of other providers or that their opinions are represented in the comments of my other colleagues testifying with me today.