Mike McManus, USAF (ret)
Good morning, Chairman Benishek, Ranking Member Brownley, and Members of the Committee. Thank you for the opportunity to provide information to the Committee regarding mental health care services to Southern California veterans through the Greater Los Angeles Department of Veterans Affairs (VA) Healthcare System.
My name is Mike McManus and I am the County of Ventura, Veteran Services Officer. My staff and I connect fellow veterans, their dependents, and survivors with federal and state veterans’ benefits and local resources. One of our primary responsibilities is connecting veterans with VA disability compensation for such conditions as Post Traumatic Stress, Traumatic Brain Injury (TBI), and for conditions resulting from Military Sexual Trauma. We also assist veterans enroll in VA health care and refer to local and regional treatment resources.
The Veteran Services Office has five accredited personnel who interview veterans, file the appropriate benefit claim, advocate on behalf of the veteran, and make needed referrals to other service providers. We also have support staff to include interns that enable us to meet client needs. The Veteran Services office has conducted a variety of out reach activities to inform the veteran community about benefits. The office currently operates out of the main office and nine field offices to make it as convenient as possible for veterans to meet us. In Fiscal Year 11/12 the office saw 1,839 people, however, by Fiscal Year 12/13 office staff had seen 3,572 people (source: VetPro). In FY 10/11 the Veteran Services Office connected county veterans with 3.89 million dollars in federal benefit payments, but by FY 12/13, those benefit payments totaled over 8.75 million dollars (source: California Department of Veterans Affairs Annual Report to the Legislature).
I am also a retired Unites States Air Force Senior Master Sergeant. I spent the last seven years of my 20 years in the military as a First Sergeant with one deployment for Operation Iraqi Freedom in 2003. As a First Sergeant I had overall supervision over all enlisted personnel with my units. I advised the unit commanders on all matters affecting their enlisted force to include issues involving mental health and substance abuse, and those conditions impact on service members, their families, their career, and the unit.
Ventura County veterans needing mental health care can receive treatment from the two psychiatrists and one social worker at the Oxnard Community Based Outpatient Clinic (VA clinic). Veterans can also seek counseling from the four clinicians at the Ventura Vet Center.
Ventura County has over 41,000 veterans, thousands more National Guard, Air National Guard, and Navy and Marine Reserve personnel who are eligible for VA mental health care. Navy Base Ventura County’s active duty Navy personnel, who are combat veterans, can also receive mental health care from the Vet Center.
In essence you have tens of thousands of veterans and military personnel in Ventura County and many of these will seek mental health care from the seven people providing mental health treatment for the VA.
Clearly there is a large unmet need. The VA clinicians providing mental health care in Ventura County do an extraordinary job, there are simply too few of them. As outreach to the military/veteran community increases from organizations such as the Ventura County Veteran Services Office and the Ventura County Military Collaborative, the number of veterans seeking services increases.
Veterans routinely tell my staff and I, how they can only see the psychiatrists at Oxnard VA clinic every other month or in some cases every three months. The option to be seen by a clinician at Sepulveda exists, however, in many cases we are referring to combat veterans with Post Traumatic Stress and driving the I-405 only adds to their stress and anxiety. Ventura Vet Center staff has done an amazing job trying to meet the mental health needs of our veterans. However, they are only four clinicians. I whole heartedly encourage the VA to add clinicians to the Oxnard VA clinic and Ventura Vet Center. The additional clinicians could then provide treatment during evening hours and on weekends. This will improve access to care for veterans going to college, recovering from service-connected injuries, who are employed, etc.
In addition to increasing the number of clinicians at the Oxnard VA clinic and Ventura Vet Center, the VA needs to explore partnerships with community programs, resources, and more quickly assess and adopt alternative mental health treatments. I would suggest the VA establish contracts with mental health and substance abuse counselors for inpatient and outpatient treatment in Ventura County. An example of such cooperation is the newly awarded VA contract to Aurora Vista Del Mar to provide treatment for Post Traumatic Stress. Previously, they treated veterans eligible for Tricare. The VA contract will now enable a much larger pool of county veterans to benefit from their services.
In-patient and intensive out-patient resources availability in Ventura County will greatly benefit the county’s veterans. Programs such as what Aurora Vista Del Mar offers would allow veterans to remain in Ventura County nearer their support structures and enable some to continue their employment while receiving out-patient care. This option would not be appropriate for all veterans and some would receive treatment through one of the programs at the VA Medical Center (VAMC) in Los Angeles. In many instances however, treatment provided in-county is the option best suited to the veteran. One example of how the option of in-county treatment could benefit veterans is through the Ventura County Superior Court’s Veteran Court. Vet Court focuses on treatment, not incarceration, of our combat veterans with service caused Post Traumatic Stress, Traumatic Brain Injury and the resulting behavior problems, substance abuse issues and run-ins with law enforcement. Currently, most veterans in Vet Court needing in-patient or intensive out-patient treatment go to the VA Medical Center in Los Angeles. Ventura County veterans deserve the option to receive in-patient and intensive out-patient treatment in their home county. We have high hopes for the Aurora Vista Del Mar program offering these options.
Partnering with other non-VA service providers to expand the availability of treatment would greatly benefit our veterans. We are fortunate in Ventura County to have an equine therapy program (Reins of H.O.P.E in Ojai, CA) that has proven itself invaluable to our combat veterans and others who have experienced military-related trauma. A VA contract or the possibility of a quick Fee Basis referral would greatly help meet the need for mental health treatment.
VA’s willingness to assess and accept alternative treatments is what’s called for to help meet the need for care. A couple of examples in Ventura County are meditation therapy and farming. Healing in America (Oaji, CA) offers its meditation services as a way for veterans to heal. In addition, Veteran Farmers of America (Ventura, CA) is developing a program and has experienced promising early results that have shown the benefits of their farming intern program.
The VA should actively solicit data on the effectiveness of complimentary and alternative therapies so they can provide access (contract, Fee Basis referral, etc) for veterans needing mental health care. Alternative therapies in conjunction with VA provided care need to work in concert with one another to meet veterans’ needs. Our veterans have earned such care.
Thank you again for this opportunity.
Points of contact from organizations reference above:
Aurora Vista Del Mar, Dr. Pilar Sumalpong, Ph.D., 805-653-6434 ext. 205 , Pilar.Sumalpong@aurorabehavioral.com
Reins of H.O.P.E, Julie Sardinia, 805-797-5539, firstname.lastname@example.org
Healing in America, Roger Ford, 805-640-0211, email@example.com
Veteran Farmers, Mary Maranville, 805-746-0606, firstname.lastname@example.org