EXAMINING THE ROLE OF VET CENTERS

Members of the Subcommittee:

Thank you for the opportunity to provide The American Legion’s views on the Department of Veterans Affairs (VA) Readjustment Counseling Service (RCS).

From 1969 through 1979, Congressional hearings were held which identified the presence of readjustment difficulties in some veterans returning from duty during the Vietnam era. In 1979, Congress passed legislation that required the Department of Veterans Affairs (VA) to provide readjustment counseling to eligible combat veterans.

In response to this legislation, the Department of Veterans Affairs Veterans Health Administration (VHA) established a nation-wide system of community based programs separate from Veterans Affairs Medical Centers (VAMC’s). The separation was based partially on the premise that many Vietnam era veterans were so distrustful and suspicious of government institutions that they would not go to a VAMC for care.

In 1981, VHA initiated a new organizational element, the Readjustment Counseling Service (RCS), to administer the Vet Centers and the provision of readjustment counseling. In April 1991, in response to the Persian Gulf War, Congress extended the eligibility to veterans who served during other periods of armed hostilities after the Vietnam era. On April 1, 2003, the Secretary of Veterans Affairs extended eligibility for Vet Center services to veterans of Operation Enduring Freedom (OEF) and on June 25, 2003, to veterans of Operation Iraqi Freedom (OIF) and subsequent operations within the Global War on Terrorism (GWOT). Family members of all veterans are eligible for Vet Center services including marriage and family counseling.

On August 5, 2003, the Secretary of Veterans Affairs authorized Vet Centers to furnish bereavement counseling services to surviving parents, spouses, children and siblings of service members who had been killed while serving on active duty, including federally activated Reserve and National Guard Personnel.

Vet Centers assist war-zone veterans and their families through various services including:
• Psychological counseling and psychotherapy (individual and groups)
• Screening and treatment for Post Traumatic Stress Disorder (PTSD)
• Substance abuse screening and counseling
• Employment/education counseling
• Bereavement counseling
• Military Sexual Trauma (MST) counseling
• Marital and family counseling
• Referrals (VA benefits, community agencies, and substance abuse)

Over 40,000 veterans were counseled for PTSD at Vet Centers, and approximately 4,000 clients were seen for other clinical issues according to the Office of Health Information (OHI) information request results.

Readjustment counseling services offered at Vet Centers are not part of VA Medical Benefits; meaning you do not have to apply for benefits to receive services at a Vet Center. To be eligible for readjustment services you must have the qualifying periods and combat theaters including:

• World War II – Three eligible categories
- European-African-Middle Eastern Campaign-Medal (Dec. 7, 1941 to Nov. 8, 1945)
- Asiatic – Pacific Campaign Medal (Dec. 7, 1941, to Mar. 2, 1946)
- American Campaign Medal (Dec. 7, 1941, to March 2, 1946)
• American Merchant Marines – In oceangoing service during the period of armed conflict,
• Korean War – June 27, 1950, to July 27, 1954 (eligible for the Korean Service Medal)
• Vietnam War – Feb. 28, 1961, to May 7, 1975
• Lebanon – Aug. 25, 1982, to Feb. 26, 1984
• Grenada – Oct. 23, 1983, to Nov. 21, 1983
• Panama – Dec. 20, 1989 to Jan 31, 1990
• Persian Gulf – Aug. 2, 1990, to a date yet to be determined
• Somalia – Sept. 17, 1992, to a date yet to be determined
• Operation Joint Endeavor, Operation Joint Guard, Operation Joint Forces
• Global War on Terrorism – Veterans who serve or have served in military expeditions to September 11, 2001, and before a date yet to be determined, Campaigns include:
- Operation “Enduring Freedom”
- Operation “Iraqi Freedom”
• Family members may receive bereavement services if a loved one died in the line of duty, though the death need not be combat related. Service may have been in peacetime or wartime. Family members of persons who died while in reserve or National Guard training also qualify.

As part of the January 3, 2011 Department of Defense (DOD)/VA Integrated Mental Health Strategy (IMHS):

• Eligibility will be expanded to include active duty service members who served in OEF/OIF (including members of the National Guard and Reserve who are on active duty) for readjustment counseling and other services through RCS.
• VA’s RCS Mobile Vet Center program expansion to increase access for active duty service members, National Guard and Reserve members, families and veterans in rural areas who are geographically distant from existing programs

Concerns

Initially Vet Centers allowed veterans to receive “peer to peer” counseling from readjustment counselors who offered personal experiences, giving the counselors the ability to relate to the veterans daily struggles; however as time passed many Vet Centers were unable to keep up with the increased amount of clients and were unable to hire strictly veteran counselors. An emphasis should be placed on hiring Operation Enduring Freedom (OEF) Operation Iraqi Freedom (OIF) and Operation New Dawn (OND) veterans.

According to the 2009, American Legion System Worth Saving report on Vet Centers, there is a growing need for increased funds within the Vet Centers to address staffing and facility needs. Many rural areas have Vet Centers serving as many as 23 counties due to the large geographic area served by the center.

Vet Centers currently offer counseling services for MST for male and female veterans; however it is not noted in any VA literature that veterans may receive counseling for MST not incurred in a combat zone.

Recommendations

The American Legion recommends that VA expand Vet Centers to the most rural areas to address access of care concerns of veterans living in the most rural areas. The American Legion also recommends VA allow compensation benefits information to be disseminated at all transition and access points, to include Vet Centers, so that all veterans are aware of all benefits they may be eligible for. Funds should be directed towards more holistic treatments for those veterans who are counseled for PTSD to include yoga and horseback riding. VA should update its literature to include information directing male and female veterans who are victims of MST that counseling services are available even if the incident did not occur in a combat zone.

VA should recognize how precious an asset combat veterans are to the Vet Centers, especially those who successfully manage their PTSD and are willing to share those experiences with other veterans. VA should establish a training program that recognizes this experience as being equivalent and transferrable for those veterans seeking the required education to become a Peer to Peer readjustment counselor at a Vet Center.

The American Legion recommends Readjustment Counseling Service conduct a needs assessment to ensure proper staffing (psychiatrists/psychologists, licensed clinical social workers and ancillary staff) as well as protocols are being adhered to in terms of wait times and the number of counseling appointments are available to treat both veterans, as Vet Centers plan to expand to active duty, guard and reservists.
The American Legion thanks this committee for the opportunity to provide this testimony today and we would be happy to answer any questions the committee might have.