ON BEHALF OF:
Heather Ansley, Co-Chair
VetsFirst, a program of United Spinal Association
Susan Prokop and Len Selfon, Co-Chairs
Paralyzed Veterans of America
Chairwoman Buerkle, Ranking Member Michaud, and other distinguished members of the Subcommittee, thank you for the opportunity to submit testimony for the record on behalf of the Consortium for Citizens with Disabilities (CCD) Veterans and Military Families Task Force regarding efforts to establish meaningful relations between the Department of Veterans Affairs (VA) and community organizations to assist disabled veterans and their families.
CCD is a coalition of over 100 national consumer, service provider, and professional organizations which advocates on behalf of people with disabilities and chronic conditions and their families. The CCD Veterans and Military Families Task Force works to bring the disability and veterans communities together to address issues that affect veterans with disabilities as people with disabilities. Task force members include veterans service organizations and broad based disability organizations, including organizations that represent consumers and service providers.
Since its creation, the CCD Veterans and Military Families Task Force has sought to connect veterans and military service organizations with the disability community to allow for cross collaboration and the application of lessons learned to new populations of people with disabilities. Because of the intersection of the disability and veterans communities that occurs when a veteran acquires a significant disability, the task force is uniquely suited to bring a holistic perspective to issues impacting disabled veterans.
Many CCD member organizations provide vital services to veterans with disabilities that might not otherwise be readily accessible to them. These programs complement the wide array of services and supports available to our nation’s veterans through VA, but should be viewed as supplementary. We believe that disabled veterans must have access to needed health care services through the VA health care system, including accessible physical and appropriate mental health services, as well as long-term services and supports. Specifically, we recognize the concerns expressed by the veterans’ community in documents such as The Independent Budget (IB) about proposals to contract out core missions of the VA health care system.
At the same time, however, the IB acknowledges that veterans will always receive health care services through multiple sources but recommends that VA retain a role in coordinating that care. The CCD Veterans and Military Families Task Force believes that public-private partnerships allow VA to effectively augment services available to veterans, particular those who live in rural and remote areas. Increased development of these partnerships allows VA to go to the veteran.
These partnerships also allow VA to ensure that disabled veterans have access to the support models that are widely available in the community, but with VA’s oversight. For example, community based organizations have developed best practice models to facilitate the long-term support needs of people with disabilities. Through partnerships with community organizations, the VA can integrate new services into the existing VA systems for populations that are requiring new types of services, including veterans with significant disabilities.
The Need for Community and Faith-Based Organizations:
VA estimates that more than 1 million active-duty personnel will join the ranks of America’s 22 million veterans during the next five years. In many cases, these men and women will return home with unique challenges that often go unmet despite the enormous effort and reach of VA. This Subcommittee has focused on some of these challenges, including recent hearings on the suicide rate among veterans and their lack of access to mental health services. The U.S. Government Accountability Office (GAO) reported that “logistical challenges” was one factor that may hinder veterans from accessing mental health care. The report cited “distances to obtain treatment” as one of the barriers, particularly for veterans who live in rural areas. Another increasing concern is the homeless problem among women veterans. The GAO reported in a December 2011 study that the number of homeless women veterans has doubled in four years and found that women veterans lacked awareness of VA programs, services, and benefits. A separate 2011 report echoed those findings and recommended that solutions to address women veterans’ transition challenges should be “informed, holistic, collaborative, and community-based.”
The unmet needs of current veterans combined with the projected rise in the veteran population make leveraging the existing social services community to supplement the VA network more critical than ever. We believe that no veterans or their families should suffer from a lack of access to or understanding of how to navigate reintegration services. Many community service providers have the expertise, experience, and local capacity to more fully partner with VA through its important veterans initiatives.
Since the issuance of an executive order in 2004, VA has made working with the non-governmental organizations (NGO), non-profits, and faith-based communities a priority. The objective of the VA’s Center for Faith Based and Neighborhood Partnerships is to coordinate agency efforts for the elimination of regulatory, contracting, and other programmatic obstacles that often prevent these organizations from providing community-based veterans’ services through VA funding and contracts. In 2009, VA announced a new NGO Gateway Initiative to “tap the power of communities” and help NGOs extend services to veterans. The VA reiterated its commitment to fostering and expanding partnerships with federal, state, and private sector agencies and faith-based and community organizations in its fiscal year 2013 budget request to Congress.
Examples of Successful VA and Community-Based Organization Partnerships
Members of the CCD Veterans and Military Families Task Force have successfully partnered with VA in certain areas to meet the needs of disabled veterans and their families. Below are three examples that illustrate the positive impact that VA partnerships with community-based organizations can have on addressing the issues facing today’s veterans and their families.
Center for Independent Living Care Coordination
An example of a successful care coordination model between VA and a community-based organization involves the Veteran Directed Home and Community Based Services (VDHCBS) program offered through the Sioux Falls VA medical center (VAMC). Launched in August 2010, the VAMC contracted with the local Minnesota River Area Agency on Aging (MnRAAA) to provide case management, fiscal management services, and assessment services for veterans seeking to obtain long-term services and supports in the community.
Because of previous outreach efforts by the South West Center for Independent Living (SWCIL) to the VAMC, National Guard Family Assistance Center and other veterans’ groups, the MnRAAA program managers were familiar with SWCIL and its services to people with disabilities in rural Minnesota. The Agency on Aging subcontracted with the Center for Independent Living to conduct the actual assessments of veterans and provide certain case management services because of the CIL’s expertise in this arena under its mandate to offer similar assistance through the Rehabilitation Act.
A licensed social worker with SWCIL serves as the liaison with nursing staff at the VAMC when a veteran is referred through MnRAAA for evaluation for VDHCBS. The SWCIL sends the veteran a packet of materials describing the consumer-directed program and schedules a follow up visit with the veteran if he/she is interested in VDHCBS. A VA nurse determines what services the veteran needs that are available through VA and works with the SWCIL social worker to identify additional services that must be engaged to fully implement a home and community-based care plan. For example, SWCIL has used several other community options to obtain services or needed home modifications for veterans. The Center for Independent Living receives a one-time fee for each assessment and bills for case management under its subcontract with MnRAAA. As a result of this project, approximately 18 veterans have been successfully enrolled in VDHCBS.
AbilityOne® Serves Employment Needs of Veterans
The AbilityOne® Program is a federal initiative to help people who are blind or have significant disabilities, including wounded veterans, find employment by working for nonprofit agencies (NPAs) that provide products and/or services to the U.S. government. With a national network of 600 NPAs, which work through NISH and the National Industries for the Blind, and AbilityOne® projects in every state of the nation, the AbilityOne® Program is the largest single source of employment for people who are blind or have other significant disabilities in the United States. The U.S. AbilityOne® Commission is the federal agency authorized to administer the AbilityOne® Program.
The AbilityOne® Program employs over 50,000 people who are blind or have significant disabilities, of which 3,300 are veterans and 1,700 were veterans with disabilities. Through National Industries for the Blind and NISH, the AbilityOne® Program’s NPAs also support and employ thousands of veterans within their community outside their AbilityOne® workforce. The AbilityOne® Program can offer increased community career transition support, exploration, and direct training for veterans in transition to management opportunities.
In 2003, VA’s Compensated Work Therapy Program (CWT) signed an MOU with theAbilityOne®Program as the referral conduit between VA CWT and theAbilityOne®NPAsto collaborate with VA beneficiaries who have a disability. Approximately 2,100 veterans with disabilities have been employed since the partnership’s inception. The partnership agreement promotes local relationships between NPAs and VA CWT offices. This allows VA to pre-screen veterans to match AbilityOne® job requirements and to refer qualified veterans with significant disabilities to participate in AbilityOne® job coaching programs.
Easter Seals Serves Veterans and Their Families
Easter Seals has a longstandingrecord of service to veterans, military service members, and their families. Easter Seals expanded its mission at the end of World War II to include adult services specifically to address the growing number of soldiers returning home with disabilities. Recognizing the new and unmet needs of the hundreds of thousands of men and women returning from the wars in Iraq and Afghanistan, Easter Seals launched its Military and Veterans Initiative in 2005 to address serious gaps in service for veterans and military families by mobilizing its national community-based provider network. Today, Easter Seals touches the lives of America’s heroes and their families through its more than 70 affiliates across 48 states and its network of 24,000 professional staff and 40,000 local volunteers.
Since the passage of the Veterans Millennium Healthcare Act in 1999, Easter Seals has worked closely with VA at the national, regional and local level to both raise awareness about access to adult day services for veterans and to contract locally to provide the direct service. In 2010, Congress approved the Caregivers and Veterans Omnibus Health Services Act that authorized a range of new services to support caregivers of eligible Post 9/11 veterans, including the establishment of the National Veteran Caregiver Training Program. In April of 2011, VA contracted with Easter Seals for its caregiving expertise in working with individuals with serious disabilities to develop and provide the training. Easter Seals operates the VA caregiver contract with Atlas Research, a veteran-owned small business, and three of the country’s leading caregiving organizations: the National Alliance on Caregiving, the National Family Caregiver Association, and the Family Caregiver Alliance. Easter Seals and its partners offer in-person, web-based and self-study caregiver training through the contract to family members of seriously injured, Post-9/11 veterans who receive their care at home and are eligible under VA program guidelines. The training includes topics on caregiver self-care, home safety, caregiver skills, veteran personal care, managing difficult behaviors and support resources.
Easter Seals’ experience with VA has been very positive throughout the implementation of the caregiver contract. Under the contract management and direction of VA, Easter Seals and its partners have met the targets and exceeded expectations. Feedback has been overwhelmingly positive, including from a mother of a seriously injured veteran who wrote: “Thank you for re-inspiring us and for all you continue to do to be a part of healing American heroes.”
Recommendations for Expanding Partnership Success
The CCD Veterans and Military Families Task Force believes that these examples of successful partnerships between VA and community-based organizations clearly support our position for increased collaboration. Specifically, we believe that there are opportunities to foster additional collaboration to meet the needs of disabled veterans living in their communities. Consequently, VA should expand community-based, supportive services models (similar to the Supportive Services for Veteran Families program) that leverage the existing social service network to help assist VA in achieving its goals.
As an example, veterans with disabilities often need assistance obtaining appropriate community-based services to allow them to live and work independently in the community. Navigating the many different services for people with disabilities and veterans, such as health benefits, transportation, and vocational rehabilitation services, can be complex. Organizations like the Protection and Advocacy agencies located in every state and territory have expertise and experience navigating these programs and often advocate for veterans with disabilities to receive appropriate services from community-based and faith-based organizations.
For instance, the New York Commission on Quality of Care and Advocacy for People with Disabilities has been working with the New York State Department of Health to create an advisory board of veterans to address the need of veterans to receive community-based health care services, and to help monitor the services that veterans receive. Disability Rights California holds weekly trainings and information sessions for veterans in the San Diego area to provide them information and assistance obtaining community-based services. Protection and Advocacy agencies are eager to work with VA to ensure veterans with disabilities receive the services and supports necessary to live and work in the community.
The National Disability Rights Network (NDRN), a CCD member organization, is available to assist with coordinating collaboration efforts between VA and the Protection and Advocacy Network. The CCD Veterans and Military Families Task Force encourages VA to work with the Protection and Advocacy agencies, NDRN, and other organizations to provide these unique advocacy services to veterans with disabilities.
We commend VA’s NGO Gateway Initiative aimed at helping qualified non-profits who are interested in assisting VA in a variety of service areas and VA’s establishment of a dedicated liaison in the Office of the Secretary to support VA/NGO information sharing and collaboration. However, VA should elevate the profile of this initiative and include readily available guidance on the VA websiteregarding how interested organizations would receive assistance through this initiative. We believe that organizations interested in partnering with VA, must be able to easily relay their interest and abilities to VA.
The ability to augment VA services by linking VA with established community and faith-based organizations represents an opportunity to greatly increase access to a variety of services needed for veterans with disabilities and their families in transitioning to and remaining active members of their communities. The need to expand access to services, particularly for veterans in rural and remote areas, shows the need to increase collaboration to meet the concerns of today’s veterans with disabilities. Qualified community and faith-based organizations represent a clear pathway to augmenting VA services for our nation’s veterans.
Thank you for the opportunity to submit testimony regarding the views of the CCD Veterans and Military Families Task Force concerning collaboration between VA and community-based organizations. We encourage the Subcommittee to continue its exploration of this topic and commend your leadership on behalf of our nation’s veterans with disabilities. We are ready to work in partnership to ensure that all veterans are able to reintegrate in to their communities and remain valued, contributing members of society.
Receipt of federal grants or contracts:
· The Consortium for Citizens with Disabilities Veterans and Military Families Task Force has not received any federal grants or contracts during the current or two preceding fiscal years.