As VA Reaches Out to Veterans, Health Care Access Issues Magnify

Outreach Can Only Be Effective with Improved Accessibility

Washington, D.C. – On Tuesday, May 19, 2009, the House Veterans’ Affairs Health Subcommittee, led by Chairman Michael Michaud (D-ME), held a hearing to assess the responsibility of the Department of Veterans Affairs (VA) to conduct an outreach program to veterans of all eras. The hearing focused on the coordinated efforts between the three separate administrations (Veterans Health Administration, Veterans Benefits Administration and National Cemetery Administration) to reach veterans and alert them of available benefits and services, and the role of nonprofit and community organizations currently providing services to veterans.

“Six decades separate the newest generation from the oldest generation and nine million veterans are over the age of 65, and outreach strategies for older veterans should differ from that of younger veterans,” stated Congressman Harry Teague (D-NM).  “According to the VA’s Center for Minority Veterans, the minority veteran population including women veterans comprises approximately 15 percent of the nation’s 23.4 million veterans. The VA is also faced with the challenge of developing effective outreach strategies which are culturally competent and thus, able to overcome potential cultural barriers.  This demographic data illustrate the sheer number of veterans who stand to
benefit from improved VA outreach efforts.”  

During the Vietnam War, increased awareness of veterans not receiving adequate information about health care benefits resulted in Congress enacting the Veterans Outreach Services Program (VOSP).  Congress charged the VA with the responsibility of actively seeking out eligible veterans and providing them with benefits and services.  Under the current law, the Secretary is responsible for advising each veteran at the time of discharge or release of all benefits for which the veteran may be eligible.  Enacted in 2001, the Veterans’ Survivor Benefits Improvement Act (VSBIA) further expanded outreach to eligible dependents and provided that the Secretary ensure the availability of outreach services and assistance through the Internet, veterans publications, and media. 

On July 18, 2002, a VA Deputy Undersecretary for Health for Operations and Management issued a memorandum to all regional directors of the VHA prohibiting marketing geared toward increasing enrollment.  VHA at the time was facing a growing demand for health care services that exceeded their resources.  Veteran Service Organizations accused the VA of not providing outreach to veterans and dependents in accordance with the law.  Nearly 18 months later a second memorandum was issued by VHA instructing the directors to ensure that their facilities were in compliance with responsibilities outlined in the VOSP. 

Dr. Romberg, founder and president of Give an Hour, offered the following assessment of the balance between outreach efforts and current needs of veterans:

 “Our government is clearly working hard to assist this generation of combat veterans and families.  VA funding for the past four years is at unprecedented levels and continues to grow. We cannot assume, however, that more money, more staff, more outpatient clinics, more Vet Centers, more “clinics on wheels,” more organizational restructuring, and more (and different) leadership will enable the VA to meet the mental and physical health care needs facing this generation of combat veterans. We see from all the statistics, which I will cover shortly, that this is a public health crisis that will take more than extended outreach. Yes, current outreach efforts are clearly insufficient. But even if the current outreach efforts were sufficient, it is evident that the system does not have the capacity to meet the growing and ongoing needs of OIF and OEF veterans who are experiencing a full range of ongoing physical and mental health concerns upon returning home. Finally, even if outreach efforts were sufficient and the VA had the capacity to meet most of the needs of returning service members, this solution would still be inadequate. If returning troops are to truly and successfully reintegrate into our communities, than our communities must be involved in the solution.”

National Association for Uniformed Services Legislative Director Rick Jones discussed the critical need for outreach during the transition from military to civilian life:

 “Studies conducted by The Army surgeon general’s Mental Health Advisory Team clearly show that our troops and their families face incredible stress today.  According to the Department of Defense (DoD), 27 percent of noncommissioned officers on their third or fourth tour exhibited symptoms commonly referred to as post-traumatic stress disorder.  That figure is far higher than the roughly 12 percent who show those symptoms after one tour and the 18.5 percent who demonstrate these disorders after a second tour.  And among the approximately half-million active-duty soldiers who have served in Iraq, more than 197,000 have deployed more than once, and more that 53,000 have deployed three or more times.   A recent Rand Corporation study suggests that
almost half of these returning troops will not seek treatment.  Many of these veterans do not believe they are at risk or they fear that admitting to a mental health problem will mean being stigmatized.  Yet if these brave individuals and their families are made aware of access to VA facilities, to which they are entitled, they are likely to find a treatment therapy that leads to health.   If not addressed, stress symptoms can compound and lead to more serious health consequences in the future.”

“Unfortunately, initial war planning did not include a plan to care for veterans when they returned home,” commented Bob Filner, Chairman of the House Committee on Veterans’ Affairs.  “The Obama Administration understands that added resources and immediate attention are needed to meet the growing demands of veterans of all generations.  Priority Group 8 veterans will soon be able to access VA health care, severely injured veterans are returning home after combat, and veterans of past generations are increasingly in need of specialized care.  We must act boldly and we must act now.”  

Witness List:

Panel 1

*       John Rowan, National President, Vietnam Veterans of America

*       Reynaldo Leal, Jr., OEF/OIF Veteran, Representative, Iraq and
Afghanistan Veterans of America

*       Richard A. Jones, Legislative Director, National Association for
Uniformed Services

Panel 2

*       Bruce Bronzan, President, Trilogy Integrated Resources

*       Barbara Van Dahlen Romberg, Ph.D., Founder and President, Give
an Hour

*       John King, Co-Director, Veterans Community Action Teams Mission
Project, Altarum Institute

*       Randall L. Rutta, Executive Vice President, Public Affairs,
Easter Seals

*       Jeffrey W. Pollard, Ph.D., ABPP, Director, Counseling and
Psychological Services, George Mason University, American Psychological Association

Accompanied by:

o       Michael Johnson, Military and Veterans Liaison, George Mason
University

Panel 3

*       Paul J. Hutter, Chief Officer, Legislative, Regulatory, and
Intergovernmental Affairs, Veterans Health Administration, U.S.
Department of Veterans Affairs

Accompanied by:

o       Ev Chasen, Chief Communications Officer, Veterans Health
Administration, U.S. Department of Veterans Affairs

o       John Brown, Director, Operation Enduring Freedom/Operation Iraqi
Freedom Outreach Officer, Veterans Health Administration, U.S.
Department of Veterans Affairs

o       Emily Smith, Deputy Assistant Secretary for Intergovernmental
Affairs, Officer of Public and Intergovernmental Affairs, U.S.
Department of Veterans Affairs

Prepared testimony and a link to the webcast is available on the internet at this link:
http://veterans.house.gov/hearings/hearing.aspx?newsid=401