VA Testimony of Pete Dougherty before Congress on September 27, 2007

United States Department of Veterans Affairs

STATEMENT OF
PETE DOUGHERTY, DIRECTOR, HOMELESS VETERANS PROGRAMS
DEPARTMENT OF VETERANS AFFAIRS
BEFORE THE
UNITED STATES
HOUSE VETERANS' AFFAIRS COMMITTEE
SUBCOMMITTEE ON HEALTH

September 27, 2007

Mr. Michaud, and members of the Subcommittee:
I am pleased to be here today to discuss the Department of Veterans Affairs' ( VA) Grant and Per Diem program. This program is VA's largest and most comprehensive collaboration with more than 300 communities, faith based non-profit organizations, state, local and tribal governments. I am pleased to be accompanied by Mr. Paul Smits, Director of Homeless and Residential Rehabilitation Programs within the Veterans Health Administration.

I would like to thank you for inviting us to join in today's hearing. I am always reminded that the efforts to engage hundreds of community and faith-based service providers began with this Committee when in July 1992, the House passed HR 5400, the Homeless Veterans Comprehensive Service Programs Act of 1992. Later that year, the Senate also passed that legislation and it was signed into law by President George H. W. Bush on November 10, 1992.

The 102nd Congress acted upon a concern that veterans were appearing in a disproportionately high percentage among what was seem as an ever increasing number of Americans who were homeless. Congress also found that veterans were not able to access existing efforts to assist the homeless. Since the provision of that authorization required specific appropriation, which took another year to accomplish, VA did not offer its first Notice of Funding A VAilability until 1994 when we awarded 15 grants in September, 1994. Since that time each year, we have offered one or more notices of funding a VAilability and today we now have more than 450 programs that have authorized 11,000 beds. As of September 2007, we have over 300 programs and 8,000 beds in service today. The remaining 3,000 beds are expected to come into service as soon as needed construction, reno VAtion or repairs have been completed. VA must also complete its inspection of the physical facility to ensure that the program is ready to open with appropriate staffing and operational plans.

As you know, VA will soon announce awards under its latest notice of Funding A VAilability. We expect that we will be able to add 950 beds under this program. We have continued to offer new funding because of our great faith in the ability of many community providers to provide high quality services to veterans. Our goal, based upon this Congress' mandate, is to end chronic homelessness among veterans. We have made good strides in achieving that goal and we simply would not be able to do it without our community-based partners.

It is troubling when veterans or their families become homeless, especially in light of the service these brave men and women have made to our country. Our efforts, since the initial programs, have been to create positive partnerships. VA is committed to working with local communities to find those veterans through outreach programs. VA is committed to provide the care and services they need in order to facilitate their return to productive lives in their communities.

Our efforts are national as well as local. We partner with other Federal agencies, national, state, local, tribal governments, local non-profits and faith based community providers. Each year, we provide health care services to more then 100,000 homeless veterans. We do not sit and wait for homeless veterans to come to us. We reach out to homeless veterans in shelters, soup kitchens, in parks, on the streets, and other places homeless persons frequent, including stand downs for homeless veterans. We have dedicated over 330 of our own staff who work collaboratively in communities across the country to find homeless veterans.

Mr. Chairman, we understand that this Committee is very interested in the effectiveness of our Homeless Grant and Per Diem program to serve veterans. The number of veterans being seen has increased and we have every intention to continue to increase the a VAilability of transitional housing. We have rapidly increased the number of beds since last year. We expect to add nearly 2,700 before the end of the year. Our performance measures to increase access and a VAilability to both primary health care and specialty care within 30 and 60 days are showing great success. We are adding substance abuse counselors on-site of the community programs. In addition, we are increasing the number of veterans in community programs getting dental care, adding VA staff to work with community programs both in the form of reentry specialists working with veterans returning from incarceration, and fulltime health care network coordinators. These efforts are increasingly showing positive results.

In Fiscal Year 2006, VA provided transitional housing services to nearly 15,500 homeless veterans. This year, we anticipate that before the end of this Fiscal Year, we will serve more than 18,000 veterans. We anticipate that the number of veterans will continue to increase as programs already approved begin to provide direct services.

We have been closely monitoring and aggressively reaching out to ensure that those men and women who have served in the war in Iraq and Afghanistan are seen and offered appropriate services. During the past three years, we have seen more than 1,500 veterans who served in Iraq and Afghanistan through our outreach efforts and more than 400 have sought our assistance and been placed in a VA or VA supported community based treatment program.

As the Committee knows, VA can provide up to $31.30 for each day of care a veteran receives in a Transitional Housing program approved under VA's Homeless Providers Grant and Per Diem Program. We are aware that there are concerns about how we make payments to providers under the Grant and Per Diem Program, and that as a result of these concerns, HR 2699 was introduced to make a number of amendments to the program. Although the Department transmitted our views on HR 2699 to Congress on August 19, 2007, I would like to take ad VAntage of this opportunity to discuss VA's position on the different provisions of the bill.

Section 1 of that bill would eliminate the statutory offset for other, outside sources of income when calculating the amount of a grantee's per diem payment. While we support this provision and appreciate the need for such a measure, we remain concerned that HR 2699, as written, could result in a grantee-provider receiving more than 100 percent of its costs for furnishing services to homeless veterans. We therefore recommend that Congress amend that provision to ensure safeguards to prevent such an occurrence.

Section 2 would require the Secretary to carry out a demonstration program in at least three locations for the purpose of identifying members of the Armed Forces on active duty who are at risk of becoming homeless after they are discharged or released from active duty. The demonstration program would also have to include the provision (either directly or by contract) of referral, counseling, and supportive services to help those members, upon becoming veterans, from becoming homeless. Section 2 would further require the Secretary to consult with the Secretary of Defense and other appropriate officials in developing and implementing the criteria for identifying those members who are at-risk of becoming homeless. Finally, Section 2 would authorize the demonstration program up to September 30, 2011, and it would also authorize $2 million to be appropriated to carry out the program.

VA supports Section 2. Research and related literature in this area suggest that prevention activities may be of VAlue in identifying high-risk individuals and preventing them from becoming homeless. The challenge, of course, is in our ability to consult with others and, to identify criteria that can be used to successfully identify those service members who are at high-risk of becoming homeless once they leave the service. The demonstration program would help to add evidence to the current body of research and help us to determine whether this type of approach is effective in reducing the incidence of homelessness among recently-discharged veterans.

The cost of Section 2, if enacted, would be insignificant and absorbed within the current budget.

Section 3 would extend, until September 30, 2011, VA's current program of referral and counseling for veterans who are transitioning from certain institutions and who are at risk for homelessness and will eliminate the program's demonstration status. Section 3 would also expand the program to include at least six more locations, thereby requiring a minimum of 12 sites.

VA defers to the views of the Department of Labor ( DOL), which administers this program. DOL's staff advise us that they believe that the Incarcerated Veterans Transition Program pilot stage played an important and successful role in reducing recidivism among transitioning veterans who have been incarcerated. .

Section 4 would authorize grants awarded under the Homeless Providers Grant and Per Diem Program to be used by service centers to meet staffing requirements.

VA supports section 4 in principle. However, we recommend that the bill be modified so that funding is based on increased per diem payments rates for the service center, not provided to the center in the form of a grant.

Section 5 would require the Secretary to take appropriate actions to ensure that the Domiciliary Care programs are adequate, in terms of capacity and safety, for women veterans.

VA supports Section 5. VA has increased, and will continue to increase, the development of women specific residential treatment programs in VA's domiciliary program. This focus will include efforts to develop new programs for women veterans, along with improving therapeutic environments and clinical approaches in existing residential program.

VA, along with our partners, continues to make progress in prevention and treatment of homeless veterans. We firmly believe that one homeless veteran is too many. The brave men and women who have served and continue to serve deserve no less.

Mr. Chairman, this concludes VA's formal statement. We welcome the opportunity to respond to any questions you or members of the Subcommittee may have.