STATEMENT OF PETER H. DOUGHERTY
DIRECTOR, HOMELESS VETERANS PROGRAMS
DEPARTMENT OF VETERANS AFFAIRS
HOUSE COMMITTEE ON APPROPRIATIONS
SUBCOMMITTEE ON MILITARY CONSTRUCTION, VETERANS' AFFAIRS AND RELATED AGENCIES
March 8, 2007
Mr. Chairman, and members of the subcommittee , I am pleased to be here today to discuss the Department of Veterans Affairs' programs and services that help homeless veterans achieve self sufficiency. I am pleased to be with Mr. Paul Smits, Associate Chief, Health Care for Homeless and Residential Treatment Programs. Thank you for inviting us to testify today.
Homelessness for any person is not acceptable; however, for those who have honorably served our nation in the military, homelessness should be inconceivable. VA's commitment is, and remains, ending chronic homelessness among veterans. To meet that goal, VA has made, and continues to create opportunities to bring together those veterans in need of assistance with the wide range of services and treatment VA provides.
As the largest integrated health care system in the United States and, as such, the largest provider of homeless treatment and assistance services to homeless veterans in the nation, VA provides health care and services to more than 100,000 homeless veterans each year. We do this by aggressively reaching out and engaging veterans in shelters and in soup kitchens, on the streets and under bridges. By not waiting for veterans to contact us and by proactively offering services, VA helps some 40,000 of these veterans each year who would not otherwise know of their eligibility for assistance. We connect homeless veterans to a full complement of VA health care and benefits, including compensation and pension, vocational rehabilitation, loan guaranty and education services.
We continually work to reach and identify homeless veterans and encourage their utilization of VA's health care system. Once they are enrolled, we furnish timely access to quality primary health care, as well as psychiatric evaluations and treatment and engagement in treatment programs for substance abuse disorders. In addition, it is extremely important that these veterans are seen by mental health specialists and a case manager. Thus, our objective is to help these veterans receive coordinated needed care and other VA benefits, which, in turn, furthers their chances of obtaining and maintaining independent housing and gainful employment. At the least, the provision of such VA assistance should enable most to live as independently as possible given their individual circumstances.
We work very closely with our Federal partners at the Departments of Housing and Urban Development ( HUD), Health and Human Services ( HHS) and Labor ( DOL) specifically DOL's Veterans' Employment and Training Service to ensure those homeless veterans who want and need housing, alternative access to health care and supportive services and employment have an opportunity to become productive, tax-paying members of society. Housing and employment are very important because we understand from many formerly homeless veterans that having opportunities for gainful employment is vital to their being able to overcome psychological barriers that contributed to their homelessness.
With the support of Congress, VA continues to make a significant investment in the provision of services for homeless veterans. We expect to spend nearly $1.5 billion for treatment and $266 million for programs for the homeless this year, and our budget estimate for next year is $1.6 billion for homeless specific medical treatment and $287 million for homeless specific programs. These costs cover homeless veteran treatments and programs to assist homeless veterans supported through the Veterans Health Administration (VHA).
Services and treatment for mental health and substance use disorders are essential both to the already homeless veteran and to those at risk for homelessness. VA's overall mental health funding increased by $390 million this year, and we use those funds to enhance access to mental health services and substance use treatment programs. Increasing access to and availability of mental health and substance use treatment services are critical to ensure that those veterans who live far away from VA health care facilities are able to live successfully in their communities.
Equally important is the work of the Veterans Benefits Administration's ( VBA). VBA's Loan Guaranty Service program allows non-profit entities to purchase VA foreclosed properties. More than 200 homes have been sold to non-profit and faith-based organizations that are helping to provide thousands of nights of shelter to homeless veterans and other homeless individuals. I also want to note VBA's Compensation and Pension Service strives to provide timely processing and payment of benefits claims to homeless veterans. As a result of VBA's concerted efforts, thousands of veterans entitled to benefits now receive them.
As part of VA's efforts to eradicate homelessness among veterans, we work in a variety of venues with multiple partners at the Federal, state, territorial, tribal and local government levels. We have hundreds of community non-profit and faith-based service providers working in tandem with our health care and benefits staff to improve the lives of tens of thousands of homeless veterans each night. We have about 1,800 beds for homeless veterans specifically available under our domiciliary care and other VA operated residential rehabilitation programs.
We are finalizing a one-year, follow-up study of 1,350 veterans discharged from VA's residential care programs. Results indicate that we are achieving long-term success for the well-being of these veterans, with four out of five veterans who have completed these programs remaining appropriately housed one year afterdischarge. Through such effective, innovative and extensive collaboration, VA is able to maximize opportunities for success.
We firmly believe that the best strategy to prevent homelessness is early intervention. As the subcommittee knows, veterans returning from the present conflicts in Iraq and Afghanistan have two years of eligibility for VA health care at no cost. We believe that this eligibility policy allows our clinical staff to identify additional health problems that may, if left untreated, contribute to future homelessness among those veterans. During the past two years VA has had a total of 300 veterans who have returned from Iraq and Afghanistan who have needed VA residential services either in VA operated programs or in the community transitional housing programs under our Homeless Grant and Per Diem Program. The best option is to reach out and to treat those in need today who are willing to seek services to prevent more acute problems later.
Interagency Council on Homelessness, Intergovernmental and Local Relationships
VA is an active partner with nearly all Federal departments and agencies that provide services to homeless veterans. We participate in a variety of interagency collaborative efforts to assist homeless veterans and continue to actively participate in the United States Interagency Council on Homelessness ( ICH). Secretary Nicholson is a past chair of the ICH, and VA has participated in each of ICH's cabinet-secretary level meetings. During Secretary Nicholson's tenure as chair of the ICH, VA hosted regular meetings of the ICH Senior Policy Group. These efforts have brought the level of veteran involvement in state and local plans to end homelessness to an unprecedented level.
As part of an ongoing initiative, VA has worked closely over the last three years with HUD and HHS to assist the chronically homeless with housing, health care and benefits coordination. Under this initiative, funding was provided to eleven communities that developed quality plans to house and provide wraparound services. As the result of our collaboration, nearly 1,500 persons have been seen, and nearly 600 persons housed. Thirty percent of those receiving services under this initiative are veterans. This effort is based on the premise that housing and treating those who are chronically homeless will decrease total costs for health care, emergency housing, related social services and court system. VA is pleased to be a partner in this effort.
VA has a long tradition of engaging and working with local providers in their communities. VA collaborates annually with communities across the United States in Project CHALENG (Community Homelessness Assessment, Local Education and Networking Groups) for veterans. At regularly scheduled CHALENG meetings, VA works with faith-based and community homeless service providers, representatives of Federal, state, territorial, tribal and local governments and homeless veterans, themselves. Our meetings and our annual reports are designed to identify met and unmet needs for homeless veterans, aid in the community effort to aid homeless veterans, and develop local action plans to address those identified needs. CHALENG is integral in enabling VA medical centers and regional offices to strengthen their partnerships with community service providers. This leads to better coordination of VA services as well as the development of innovative, cost-effective strategies to address the needs of homeless veterans at the local level. It shows us what is being done effectively and what pressing unmet needs remain. This also helps us to establish, as part of local needs, the number of veterans who are homeless on any given night. While there are still far too many veterans among the homeless, we are making progress, and their numbers are coming down. This progress demonstrates to us that this scourge is not unmanageable and that our collective efforts are realizing success. We are confident that our continued efforts will achieve our goal of ending chronic homelessness among veterans.
VA Involvement in Stand-Downs
VA's involvement in stand-downs is another avenue by which VA continues its collaborative outreach at the local level through coordination of our programs with other departments, agencies, and private sector programs. In calendar year 2006, VA, along with hundreds of veteran service organization representatives, community homeless service providers, state and local government offices, faith-based organizations, and health and social service providers, provided assistance to more than 23,000 veterans. The latest information shows that more than 2,600 spouses, overwhelmingly women, and more than 1,000 children attended these events. Nearly 16,000 volunteers and VA employees participated in these events last year.
Homeless Providers Grant and Per Diem Program
VA's largest program involving local communities remains our Homeless Providers Grant and Per Diem Program. As you are aware, this highly successful program allows VA to provide grants to state and local governments as well as faith-based and other non-profit organizations in developing supportive transitional housing programs and supportive service centers for homeless veterans. These organizations may also use VA funds to purchase vans to conduct outreach and provide transportation for homeless veterans to health care and employment services.
Last year, this program achieved one important goal: to authorize funding for at least one transitional housing program in each state. We did this in part by targeting funding to states that had no or limited veteran-specific transitional housing program. We are continuing to reach out to tribal and territorial areas to ensure increased opportunities for these programs to operate in those locations. Since the program was authorized in 1992, VA has obligated more than $300 million to the program. These funds have helped to develop more than 10,000 transitional housing beds of which 8,000 are operational along with 23 independent service centers and to purchase 180 vans to provide transportation for outreach and connections with services.
We are currently accepting applications to create 1,000 new transitional housing beds. Applications will be accepted until April 4, 2007, and will be promptly reviewed. Awards are expected by this summer. In addition we hope of offer an addition round of funding for capitol grants later this fiscal year.
Technical Assistance Grants
With enactment of Public Law 107-95, VA was authorized to provide grants to entities with expertise in preparing grant applications. We previously awarded funding to two entities that are providing technical assistance to non-profit community and faith-based groups that are interested in seeking VA and other grants relating to serving homeless veterans. We have awarded grants to the National Coalition for Homeless Veterans ( NCHV) and Public Resources to aid us in this effort. We published a multiyear notice of funding availability on February 22, 2007, that will continue to expand and improve services to connect veteran specific service providers to other governmental and non-government resources.
Grants for Homeless Veterans with Special Needs
VA also provides grants to VA health care facilities and existing grant and per diem recipients to assist them in serving homeless veterans with special needs (e.g., women, including women who have care of dependent children, chronically mentally ill, frail elderly; and terminally ill). We initiated this program in FY 2004 and provided special needs funding to 29 organizations totaling $15.7 million. We issued two notices of funding availability on February 22, 2007, that call for approximately $6 million to continue to fund existing special needs grants and an additional $6 million to offer new awards.
Residential Rehabilitation and Treatment Programs (RRTPs)
VA's Domiciliary Care for Homeless Veterans ( DCHV) Program, which was recently renamed the "Residential Rehabilitation and Treatment Program," provides a full range of treatment and rehabilitation services to many homeless veterans. Over the past 17 years, VA has established 34 DCHV programs providing 1,873 beds. Since 1987, there have been over 71,000 episodes of treatment in the DCHV program. VA continues to improve access to the services offered through these programs. In FY 2005, DCHV programs treated 5,394 homeless veterans, while VA funded the development of nine new DCHV programs offering a total of 400 new beds. In FY 2006, VA funded the development of two additional DCHV programs totaling 100 beds. In addition to the DCHV program, homeless veterans receive treatment and rehabilitation services in the Psychosocial Residential Rehabilitation Treatment Program (P RRTP). Currently there are 72 P RRTP programs with a total of 2,020 beds.
Staffing at VBA Regional Offices
Homeless Veterans Outreach Coordinators (HVOCs) at all VBA regional offices work in their communities to identify eligible homeless veterans, advise them of VA benefits and services, and assist them with claims. The coordinators also network with other VA entities, veteran service organizations, local governments, social service agencies and other service providers to inform homeless veterans about other benefits and services available to them. In FY 2005, VBA staff assisted homeless veterans in 34,631 instances. They contacted 4,247 shelters, made 4,803 referrals to community agencies, and made 7,416 referrals to VHA and the DOL's, Homeless Veterans Reintegration Programs (HVRP).
Since the beginning of FY 2003, regional offices have maintained an active record of all compensation and pension claims received from homeless veterans. Procedures for the special handling and processing of these claims are in place. From FY 2003 through FY 2005, VBA received 13,833 claims for compensation and pension from homeless veterans. Of those claims, 56 percent were for compensation and 44 percent were for pension. Of the compensation claims processed, 37 percent were granted, with an average disability rating of 44.20 percent and 9.9 percent of claimants were rated at 100 percent disabled. Of the total claims denied, 48 percent were due to the veteran's disability not being service connected. The average processing time for all compensation claims of homeless veterans was 151 days. Of the pension claims processed, 73 percent were granted. Twenty-one percent of the claims denied were due to the veteran's disability not being permanent and total. The average processing time for all pension claims of homeless veterans was 102 days.
Multifamily Transitional Housing Loan Guaranty Program
Public Law 105-368 authorized VA to establish a pilot program to guarantee up to 15 loans or $100 million, whichever first occurs, for multifamily transitional housing. Since September 2002, Claude Hutchison, Jr., Director of VA's Office of Asset Enterprise Management, has been the lead for the Department in implementing the program. Many complex issues, often varying from jurisdiction to jurisdiction, surround implementation, and VA has worked closely with veteran service organizations, veteran-specific housing providers, faith-based organizations, clinical support service programs, VA medical care staff, state, city and county agencies, homeless service providers, and finance and housing experts. We are also using consultants to assist us with our evaluation of potential sites and providers of housing services.
VA has issued final commitments for guaranteed loans for a transitional housing project that will provide 144 new beds for homeless veterans through the commitment to Catholic Charities of Chicago; Chicago, Illinois. The Catholic Charities' project opened in January 2007 and was full within a week. Vietnam Veterans of San Diego is expected to close on its guaranteed loan by the end of the year, which leaves funding available for up to thirteen remaining program loans or until the remaining $92.1 million in program funds have been guaranteed.
Coordination of Outreach Services for Veterans At-Risk of Homelessness
VA, together with DOL and with additional assistance from the Department of Justice ( DOJ), has helped develop demonstration projects providing referral and counseling services for veterans who are at risk of homelessness and are currently incarcerated. Currently, VA and DOL have seven sites providing referral and counseling services to eligible veterans at risk of homelessness upon their release from correctional institutions. Local staffs from both the VHA and VBA are aiding veterans at each demonstration site to receive information about available VA benefits and services.
DOL also provided funding under its Homeless Veterans Reintegration Programs ( HVRP) for the Incarcerated Veterans' Transition Program ( IVTP). VA and DOL are reviewing this program carefully and will provide a report on its effectiveness.
HUD-Veterans Affairs Supported Housing (HUD-VASH)
VA recognizes HUD's long-standing support of the HUD- VASH program. This very successful partnership links the provision of VA clinical care with permanent housing in order to assist the recovery of chronically homeless, and mentally ill veterans. HUD and VA hope to continue this valuable program, subject to the availability of resources.
Recently Discharged Veterans ( OIF/ OEF Veterans)
There are 300 veterans who have served in Iraq and Afghanistan who have been treated in one of VA's homeless specific residential treatment programs. Currently, there are approximately 50 OIF/ OEF veterans in homeless specific residential treatment programs. It is clear to us that there is a strong need for VA to be extremely diligent in insuring that these veterans get immediate attention. VA, with a host of external partners, seeks out these veterans.
I would like to note that these veterans, like all veterans who enter VA's homeless specific services, get access to primary care, but also as needed to appropriate mental health and substance abuse services. Our efforts to reach out, find, and appropriately serve these veterans will do nothing but increase in the months and years ahead.
VA continues to make progress on addressing both prevention of, and treatment for, the homeless. Each year we provide our annual report to the Congress that outlines our activities for homeless veterans. VA is collaborating closely with other Federal agencies, state and local governments and community and faith-based organizations to ensure that homeless veterans have access to a full range of health care, benefits and support services. We still have much to do to end chronic homelessness among veterans in America, and we are eager to work with you to meet that challenge. Developing appropriate links to health care, housing, benefits assistance, employment and transportation are all components that help bring these veterans out of despair and homelessness. We appreciate all of the assistance the Congress gives us to aid this noble effort.
Mr. Chairman that concludes my statement, I am please to respond to any questions you or the subcommittee members may have.