House & Senate Veterans’ Affairs Committee Hearing
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Legislative Presentation of the
Thank you for all you have done for our veterans since 9/11 and for this opportunity to testify.
Background - Unique Citizen Service Member/Veteran
The
Since 9/11, 455,461
While serving in their states, members are scattered geographically with their families as they hold jobs, own businesses, pursue academic programs, and participate actively in their civilian communities. Against this backdrop, members of the
Using the
Military service in the
H.R. 1025-RECOGNITION AS VETERANS OF MEMBERS OF THE NATIONAL GUARD AND RESERVE WHO SERVE 20 YEARS TO EARN MILITARY RETIREMENT PAY
Most members of
Some
Take the example from a message last year from a retired Guard general officer who served 30 years in the Guard during the Cold War. Although never deployed, he served on numerous reforger exercises and on other training missions far from his home and family while occupying a key leadership position in managing the
We believe that
As many may recall, a predecessor bill to H.R. 1025 passed the House unanimously in 2010 only to stall in the
NGAUS is concerned from reports it has received that there exists pushback exists against this bill from lower echelon staff within the VA and congressional staff, feeling that passing this bill would be "allowing the camel's nose under the tent." This metaphor is both puzzling and deeply troubling to
As a cost-neutral standalone bill, H.R. 125 provides an excellent opportunity for a divided
REQUIRE THE VA TO FULLY IMPLEMENT SECTION 304 OF THE CAREGIVERS AND VETERANS OMNIBUS HEALTH SERVICES ACT OF 2009, PUBLIC LAW 111-163, TO PROVIDE MENTAL HEALTH SERVICES TO IMMEDIATE FAMILY MEMBERS OF OIF/OEF VETERANS
Post-deployment, our
Section 304 of the Family Caregiver Act (reproduced in the Appendix) now requires the VA to make full mental health services available to immediate family members of OIF/OEF veteran for three years post-deployment. However, the VA refuses to comply with the law by insisting that it does not have any obligation beyond providing the counseling at Vet Centers, which it has been doing since well before the law was passed. As terrific as Vet Centers are with their peer-to-peer outreach, they do not have the full range of mental health services that are present in the highly praised
Section 304 was enacted on
IMPLEMENT COMMUNITY BASED MENTAL HEALTH CARE FOR VETERANS
Section 304 also authorizes the VA to contract with private entities in communities to bridge the geographical barriers preventing many of our veterans, and now their families, from receiving mental health treatment. The issues of veterans' unemployment and mental health maintenance cannot be separated. Before veterans can maintain gainful employment in a challenging job environment, they must be able to maintain a healthy mental status and establish supportive social networks.
In 2007, the
Rand recommended that a network of local, state, and federal resources centered at the community level be available to deliver evidence-based care to veterans whenever and wherever they are located. Veterans must have the ability to utilize trained and certified services in their communities. In addition to training providers, the VA must educate veterans and their families on how to recognize the signs of behavioral illness and how and where to obtain treatment.
To facilitate the leveraging of mental health care providers in our communities, the VA can actively exercise its authority under section 304 to contract with private entities in local communities, or creatively implement its fee-based option by issuing voucher cards that would allow our veterans to seek fee-based treatment with VA certified providers outside the brick and mortar of the
VA facilities are often located hundreds of miles from a veteran in need, particularly our
Several of our veterans have fallen through the cracks of the VA health care system, and will continue to do so. According to the
CONFIDENTIALITY MUST BE OBSERVED WITH MENTAL HEALTH CARE
Most of our
It is essential that confidentiality be maintained by the VA for the mental health treatment records of these veterans to encourage their treatment with VA providers. It is critical that this be established as soon as possible legislatively, as the VA is believed to be operating under advice from its legal staff that all VA medical records can be transferred to DoD. Lack of confidentiality will chill the treatment process and is likely contributed to the under utilization of VA medical care by our veterans.
THE DEPARTMENT OF DEFENSE MUST COOPERATIVELY WORK WITH THE VA IN SCREENING BEHAVIORAL HEALTH CARE NEEDS OF OUR MEMBERS BEFORE THEY ARE RELEASED FROM ACTIVE DUTY
At all stages of PTSD and depression, treatment is time sensitive. However, this is particularly important after onset, as the illness could persist for a lifetime if not promptly and adequately treated, and could render the member permanently disabled. The effects of this permanent disability on the member's entire family can be devastating. It is absolutely imperative that members returning from deployment be screened with full confidentiality at the home station while still on active duty by trained and qualified mental health care providers from VA staff and/or qualified health care providers from the civilian community. These providers could include primary care physicians, physician assistants, and nurse practitioners who have training in assessing psychological health presentations. Prompt diagnosis and treatment will help to mitigate the lasting effects of mental illness. This examination process must be managed by the VA in coordination with the National Guard Director of
As an
It is absolutely necessary to allow home station screening for all returning members by trained health care professionals who can screen, observe, and ask relevant questions with the skill necessary to elicit medical issues either unknown to the self-reporting member, or unreported for fear of being retained at a far removed demobilization site. In performing their due diligence before the issuance of an insurance policy, insurance companies do not allow individuals to self assess their health. Neither should the military. If geographical separation from families is causing some to underreport, or not report, physical or psychological combat injuries on the PDHA, then continuing this process at the home station for those in need would likely produce a better yield at a critical time when this information needs to be captured in order for prompt and effective treatment to be administered.
Please see the copy of a
ENHANCE EMPLOYABILITY FOR OUR NATIONAL GUARD VETERANS BY AMENDING 10
Included among our unemployed Gulf War II veterans are members of the
One potential solution worth considering is to remove statutory prohibitions against employers offering incentives for
According to the
Under current law, 10
The current law prevents our member veterans from leveraging their ability to be covered with low-cost health insurance as an inducement for prospective employers to hire them. It is a challenge for all of our unemployed members to convince employers that they are worth hiring, especially in the face of disruptive, long-term absences due to deployments. Amending 10
STATUTORILY ESTABLISH AND SUSTAIN THE TRANSITION ASSISTANCE ADVISOR PROGRAM
The Yellow Ribbon Program needs to statutorily establish the Transition Assistance Advisor (TAA) Program, which currently operates with 62 TAAs managed by the Joint Staff of the
The National Guard Transition Assistance Advisor (TAA) program differs from the active duty program primarily by the time and manner in which assistance is delivered, as well as the content of assistance programs. Where the active duty program will allow the TAAs to work over a matter of days with a captured active duty audience by providing training on job searching skills, the National Guard TAAs have time to deliver only very short briefings during the limited time our members remain on active duty at installations before returning to their homes. However, the TAAs remain reachable to provide personalized service to all callers, at all stages of deployments. A TAA program similar to the active forces could be considered if our returning members remained on active duty longer at
The TAAs serve as statewide points of contact, primarily to provide a professional person to assist in accessing veterans' benefits and medical care for members and families before, during, and after deployment. However, they can troubleshoot virtually all deployment-related issues, ranging from processing medical compensation claims, accessing veterans' benefits, pursuing medical care options, assisting with job searches, financial assistance, referral for counseling, and obtaining dependent care. The TAAs, 90% of whom are either veterans or spouse ofmilitary members, make themselves available to members of all components and veterans of any service. It is the "go to" feature and personal interaction follow up that distinguishes the TAA program from other reintegration assistance programs.
A description of what a TAA does is best provided by the following message sent in response to a NGAUS inquiry by Marine,
"As the single point of contact for all Veterans of all branches of all eras, TAA's are very busy. We track our troops through both the Military and civilian healthcare sectors, which can be daunting to say the least. Often the more complicated cases require significant follow-up care. Veterans rarely call with just one problem.
A typical case that is brought to the TAA desk can include the following:
Unemployed Guard Member with no service connection has no capability to travel because his vehicle needs service
SM has been unemployed for 8 months with no end in sight Health problems due to Line-of-Duty injuries / illness
Can't afford car payment / rent / vehicle repair
This means that the TAA has to:
- Help fill out need-based financial grant applications for emergency aid Coordinate with financial planning and state resources to prevent foreclosure Help coordinate military health services for possible return to active duty for treatment
-
Arrange for legal consultation if necessary (home foreclosure, child support modification, will/power of attorney, etc)
Multiply this by any number of cases that the TAA may be managing, add in follow-up care, and you can see that this adds up quickly. This is in conjunction with helping Veterans of all eras which present additional hurdles. Though our primary mission is to focus on the OIF/OEF era Veterans, coordinating end-of-life or elder care for WWII and Korean era Veterans is a necessary and much needed skill-set.
This brings us to what I like to call my "weekend job." At least once a month, sometimes more, the TAA facilitates seminar and classroom learning sessions at Yellow Ribbon reintegration events. We meet individually and in groups with returning or deploying Veterans in order to educate Guard/Reserve members on benefits and services. Because of the large number of troops in both the outgoing and incoming stages of deployment, this means that the TAA often works multiple weekends a month, if not all of them.
Most TAArs also are on a number of planning committees to help coordinate services and events in the future as well. Panel discussions, coordination and feedback meetings with VHA and VBA, and consultation with the military chain-of-command are additional duties that help to forge the working relationships that we use on a daily basis. The bottom line is that the TAA is, by definition, a central point of contact, and we are used heavily by every state, federal, military and Veteran organization on a regular basis.
Although necessarily different from the active duty program because of the limited time our members remain on active duty at
VETERANS PREFERENCE STATUS FOR ALL WHO HAVE HONORABLY SERVED IN THE
NGAUS recently received a letter from
Conclusion
Thank you for that you have done for our veterans since 9/11. Please view our efforts as part of a customer feedback process to refine and improve the ongoing vital and enormous undertaking of the VA. Our
Read this original document at: http://veterans.senate.gov/hearings.cfm?action=release.display&release_id=f599ecbe-69b6-4a69-a737-921dd078d83b
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