U.S. GOVERNMENT PRINTING OFFICE

WASHINGTON : 

For sale by the Superintendent of Documents, U.S. Government Printing Office

Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800

Fax: (202) 512–2250 Mail: Stop SSOP, Washington, DC 20402–0001

92–258PDF 2004

HOMELESS ASSISTANCE PROGRAMS IN VA

HEARING

BEFORE THE

SUBCOMMITTEE ON HEALTH

OF THE

COMMITTEE ON VETERANS’ AFFAIRS

HOUSE OF REPRESENTATIVES

ONE HUNDRED EIGHT CONGRESS

FIRST SESSION

MAY 6, 2003

Printed for the use of the Committee on Veterans’ Affairs

Serial No. 108–11

(
COMMITTEE ON VETERANS’ AFFAIRS

CHRISTOPHER H. SMITH, New Jersey, Chairman

MICHAEL BILIRAKIS, Florida

TERRY EVERETT, Alabama

STEVE BUYER, Indiana

JACK QUINN, New York

CLIFF STEARNS, Florida

JERRY MORAN, Kansas

RICHARD H. BAKER, Louisiana

ROB SIMMONS, Connecticut

HENRY E. BROWN, JR., South Carolina

JEFF MILLER, Florida

JOHN BOOZMAN, Arkansas

JEB BRADLEY, New Hampshire

BOB BEAUPREZ, Colorado

GINNY BROWN-WAITE, Florida

RICK RENZI, Arizona

TIM MURPHY, Pennsylvania

LANE EVANS, Illinois

BOB FILNER, California

LUIS V. GUTIERREZ, Illinois

CORRINE BROWN, Florida

VIC SNYDER, Arkansas

CIRO D. RODRIGUEZ, Texas

MICHAEL H. MICHAUD, Maine

DARLENE HOOLEY, Oregon

SILVESTRE REYES, Texas

TED STRICKLAND, Ohio

SHELLEY BERKLEY, Nevada

TOM UDALL, New Mexico

SUSAN A. DAVIS, California

TIM RYAN, Ohio

PATRICK E. RYAN, Chief Counsel and Staff Director

SUBCOMMITTEE ON HEALTH

ROB SIMMONS, Connecticut, Chairman

JERRY MORAN, Kansas

RICHARD H. BAKER, Louisiana

JEFF MILLER, Florida

JOHN BOOZMAN, Arkansas

JEB BRADLEY, New Hampshire

BOB BEAUPREZ, Colorado

GINNY BROWN-WAITE, Florida

RICK RENZI, Arizona

CLIFF STEARNS, Florida

TIM MURPHY, Pennsylvania

CIRO D. RODRIGUEZ, Texas

BOB FILNER, California

VIC SNYDER, Arkansas

TED STRICKLAND, Ohio

SHELLEY BERKLEY, Nevada

TIM RYAN, Ohio

LUIS V. GUTIERREZ, Illinois

CORRINE BROWN, Florida

DARLENE HOOLEY, Oregon

(II)
(III)

C O N T E N T S

May 6, 2003

Page

Homeless Assistance Programs in VA ................................................................... 1

OPENING STATEMENTS

Chairman Simmons ................................................................................................. 1

Hon. Ciro D. Rodriguez ........................................................................................... 2

Prepared statement of Congressman Rodriguez ............................................ 62

Hon. Bob Filner ....................................................................................................... 5

Hon. Ted Strickland ................................................................................................ 11

Hon. Cliff Stearns .................................................................................................... 13

Hon. Chris Smith, Chairman, Full Committee on Veterans’ Affairs .................. 64

WITNESSES

Blecker, Michael, Executive Director, Swords to Plowshares, San Francisco,

CA .......................................................................................................................... 32

Prepared statement of Mr. Blecker ................................................................. 129

Boone, Linda, Executive Director, National Coalition for Homeless Veterans .. 26

Prepared statement of Ms. Boone ................................................................... 101

Cooney, Ned, Ph.D., Director, Newington Campus, Mental Health Programs,

VA Connecticut Health Care System ................................................................. 16

Prepared statement of Mr. Cooney ................................................................. 75

Cooper, Ralph, Executive Director, Veterans Benefits Clearing House, Inc.,

Roxbury, MA ......................................................................................................... 30

Prepared statement of Mr. Cooper .................................................................. 119

Downing, John F., Executive Director, United Veterans of America, Inc.,

Western Massachusetts Shelter for Homeless Veterans .................................. 18

Prepared statement of Mr. Downing, with attachments ............................... 78

Mackay, Jr., Leo S., Ph.D., Deputy Secretary, Department of Veterans Affairs,

accompanied by Claude Hutchinson, Director, Office of Asset Enterprise

Management, Department of Veterans Affairs; William McLemore, Deputy

Assistant Secretary, Office of Intergovernmental Affairs; Peter H. Dougherty, Director, Office of Homeless Veterans Programs; And M. Gay Koerber,

Associate Chief Consultant, Health Care For Homeless Veterans .................. 3

Prepared statement of Dr. Mackay ................................................................. 66

Spearman, Kathryn E., President and CEO, Volunteers of America, Florida ... 28

Prepared statement of Ms. Spearman ............................................................ 112

MATERIAL SUBMITTED FOR THE RECORD

Letter of July 6, 2004, from Secretary Principi to Chairman Smith re enclosed

second annual report of the Advisory Committee on Homeless Veterans ....... 176

Public Law 107–95, the Homeless Veterans Assistance Act of 2001 .................. 41

Statements:

Paul Errera, MD, Woodbridge, CT .................................................................. 135

Paralyzed Veterans of America ....................................................................... 137

The American Legion ....................................................................................... 142

Vietnam Veterans of America ......................................................................... 149

Disabled American Veterans ........................................................................... 155

Non Commissioned Officers Association ......................................................... 157
Page

IV

Statements—Continued

Ms. Tara O’ Connor, Director, Fund Development, Massachusetts Veterans Inc. .......................................................................................................... 165

Veterans of Foreign Wars ................................................................................ 167

Written committee questions and their responses:

Chairman Simmons to Department of Veterans Affairs ............................... 169

Chairman Simmons to Dr. Ned Cooney, Director, Newington Campus,

Mental Health Programs, VA Connecticut Health Care System .............. 215

Chairman Simmons to Ms. Linda Boone, Executive Director, National

Coalition for Homeless Veterans ................................................................. 216

Chairman Simmons to Mr. John Downing, Executive Director, United

Veterans of America, Inc. ............................................................................. 219
(1)

HOMELESS ASSISTANCE PROGRAMS IN VA

TUESDAY, MAY 6, 2003

HOUSE OF REPRESENTATIVES, SUBCOMMITTEE ON HEALTH, COMMITTEE ON VETERANS’ AFFAIRS, Washington, DC

The subcommittee met, pursuant to call, at 1:30 p.m., in room

334, Cannon House Office Building, Hon. Rob Simmons (chairman

of the subcommittee) presiding.

Present: Representatives Simmons, Miller, Rodriguez, Filner,

Snyder, Boozman, Beauprez, Brown-Waite of Florida, Stearns,

Strickland and Ryan.

OPENING STATEMENT OF CHAIRMAN SIMMONS

Mr. SIMMONS. The subcommittee will come to order. I want to

thank everyone for coming this afternoon. Welcome, members of

the National Coalition for Homeless Veterans and others in attendance. I hear that a Florida group, the Volunteers of America, has

a mobile clinic outside the Cannon Building parked in Lot 1 adjacent to the Capitol South Metro entrance. If anybody has an interest after this hearing in looking at that mobile facility, I encourage

you to do so. More than 3,000 homeless men and women have received services and care through this vehicle, and it continues to

bring aid and comfort to our veterans who are homeless.

The purpose of this afternoon’s hearing is to ensure that our government does not forget those men and women who risked their

lives to defend our freedoms and who later, on returning home,

have had difficulty adjusting and have fallen victim to self-destructive behaviors and have found themselves in a homeless situation.

The subcommittee wants to explore the relationships that exist between VA and community-based providers because I think we all

know that community-based providers, veterans groups and other

similar groups provide great services in dealing with our homeless

population.

I am told that upwards of a quarter of a million homeless veterans spend the night on the streets of America on any given night,

and this is a terrible tragedy for our veterans, for our military and

for our people. Often these veterans end up finding a place to stay,

and all too often it is prison and jail, and this is simply wrong.

We set a goal a couple of years ago to end chronic homelessness

among veterans within 10 years, and right now we are in the middle of year 2 of that decision. I think that the hearing we are having today is very timely, and I thank the members of the sub-
2

committee and those who will be on our panel for participating in

a look at this important issue.

I will suspend at this point and ask my friend Mr. Rodriguez if

he has an opening statement in addition to what he has already

said.

OPENING STATEMENT OF HON. CIRO D. RODRIGUEZ

Mr. RODRIGUEZ. Thank you very much. I think the topic of the

homeless is one of the areas that concerns us a lot. And once again,

I know how—I saw Mrs. Linda Boone come in, and I want to thank

you for your efforts for the coalition and the hard work that you

have done there.

And I know I have mentioned Mr. Martinez with the GI Forum

in San Antonio. But I wanted to share with you, in San Antonio

there is estimated there are more than 18,000 residents who are

homeless, of which more than 2,500, or 14 percent, are veterans.

While these numbers have been reduced in recent years due to— a large part to the efforts of the American GI Forum there in San

Antonio, unfortunately I don’t think the VA will be able to tell us

where we are on the way of meeting the needs or the goals that

we had set out for the homeless based on the numbers that are out

there.

I am disappointed that the VA has not moved on programs such

as the creation of special needs grants for women, the chronically

mental ill—we really have a real difficulty with those that suffer

from chronic mental illness—as well as the fragile elderly and the

terminally ill. These programs have not yet been designed and

have not even been funded. And the VA falls well short of appropriating that 75 million that Congress authorized for these programs in 2004. There are no HUD vouchers targeted for veterans,

nor has the VA spent a single dollar for multifamily transition

housing grants we approved in 1998.

The VA estimates that they have treated about 10,000 veterans

in rehabilitation settings last year, as I indicated earlier, but we

have over a quarter of a million. And I know the chairman would

agree with me that we are still not there yet. And soon the quarter

of a million deployed troops will return back home. And to add to

that challenge, we need to ensure there are safety nets in the form

of preventive programs and early detection to intervene on their

behalf when they come back. For those who have served this Nation, we have got to make sure that we are there for them, and we

need to make sure we move forward in that direction.

Thank you, Mr. Chairman.

Mr. SIMMONS. I thank you for those comments.

[The prepared statement of Congressman Rodriguez appears on

p. 62.]

Mr. SIMMONS. Before I introduce our panel, I am going to suggest

to our Members that we hear the testimony, and then I will allocate to each member 5 minutes to make statements or ask questions as they see fit.

That being said, I am pleased to welcome our first panel. Representing the Department of Veterans Affairs is the official who is

second in command, the Honorable Leo S. Mackay, who has a

Ph.D., is a graduate of the U.S. Naval Academy, and has a distin-
3

guished military record and record of working with our veterans.

I also understand he did a little bit of business down in Texas, so

he has been around. He is accompanied by Deputy Assistant Secretary Bill McLemore at the Office of Intergovernmental Affairs.

Also, Mr. Peter Dougherty, Director of VA’s Office of Home Inspections Programs; Ms. Gay Koerber, Associate Chief Consultant

for Health Care for Homeless Veterans; and Mr. Claude Hutchinson, Director of VA’s Office of Asset Enterprise Management.

Welcome to the subcommittee. Dr. Mackay, we look forward to

hearing your statement.

STATEMENTS OF LEO S. MACKAY, JR., Ph.D., DEPUTY

SECRETARY, DEPARTMENT OF VETERANS AFFAIRS, ACCOMPANIED BY CLAUDE HUTCHINSON, DIRECTOR, OFFICE OF

ASSET ENTERPRISE MANAGEMENT, DEPARTMENT OF VETERANS AFFAIRS; WILLIAM McLEMORE, DEPUTY ASSISTANT

SECRETARY, OFFICE OF INTERGOVERNMENTAL AFFAIRS;

PETER H. DOUGHERTY, DIRECTOR, OFFICE OF HOMELESS

VETERANS PROGRAMS; AND M. GAY KOERBER, ASSOCIATE

CHIEF CONSULTANT, HEALTH CARE FOR HOMELESS

VETERANS

Dr. MACKAY. Thank you, Mr. Chairman. I would point out for the

Ranking Member’s benefit my hometown is San Antonio.

It is indeed a pleasure to be here, and I am flanked by my contemporaries and colleagues at the Department, and we are prepared to answer and to give you a full account as best we can of

the programs.

I am pleased to be here to discuss the VA’s programs and services for homeless veterans. As you requested, I will focus my remarks on the progress VA has made in implementing programs

and services authorized by the Homeless Veterans Comprehensive

Assistance Act of 2001, Public Law 107–95, and our implementation of the Loan Guaranty for Multifamily Transitional Housing for

Homeless Veterans Program that Mr. Hutchinson has special responsibility for.

We have made good strides with your help in improving homeless veterans’ access to high-quality transitional housing with programs that we can directly control and programs in partnership

with other Federal departments. As you may know, Secretary

Principi, is deeply committed to this effort, and has become Vice

Chair of the U.S. Interagency Council on Homelessness. We expect

that he will chair the Council in the coming year.

We join with the Departments of Housing and Urban Development (HUD) and Health and Human Services (HHS) on the joint

Notice of Funding Availability to address the chronically homeless.

This initiative will for the first time require that communities collaborate to aid the chronically homeless with permanent housing

and comprehensive support services to ensure that veterans needs

be fully addressed, or the project will not be funded. More than 100

applications were received, and they are under review. We are very

excited that every community’s application will comprehensively

address the needs of veterans.

Even more importantly, the President’s budget identified $50

million in HUD funding this year for this initiative, which is now
4

known as the Samaritan Project. VA and HHS will provide supportive services to this effort, resulting in chronically homeless veterans accessing a wide variety of community services, including

VA’s excellent health care and benefits program. Taken together VA will commit some $15 million over the next 3 years to these

efforts.

We are also actively working with the Department of Labor

(DOL) on a six-site pilot demonstration project for those veterans

being released from institutional care. We believe that the first

three projects will be announced within the next 3 months, and the

remaining sites will become operational next fiscal year.

We also have a memorandum with the Department of Justice

that we hope will assist eligible veterans who are returning from

incarceration to access health care and benefits assistance. We published new regulations that allow us to offer technical assistance

grants, something that this committee supports. And our Notice of

Funding Availability (NOFA) was published yesterday. This will

allow small organizations that have great passion and service capability, but without resources, to afford grant-writing assistance to

get on a level playing field. We hope to broaden and deepen the

competition in order to increase capacity and outcomes.

Our new regulations will increase the amount we can pay home- less service providers from the maximum of $19 per day to $26.95

to be on a par with our State domiciliary care rate. It will provide

additional grant funding to those populations that you have identified, women, the frail elderly, terminally ill and the chronically

mentally ill, for additional grant funding. It will provide a mechanism to existing grant providers to ensure a safe environment for

veterans by providing funding to meet national fire and safety

codes. And finally, it has the mechanism to recapture funds not

used by grantees so other providers may use those funds.

The newly published regulations give us the discretion to target

funding to locations and populations with little or no specific transitional housing services for homeless veterans. We exercised that

option under the current 8 million NOFA. The NOFA identifies

seven States, Alaska, Idaho, Kansas, Montana, North Dakota, New

Hampshire and Wyoming, with a total population of 7.8 million

that States targeted to receive at least 140 of the anticipated 800

beds expected to be created. In addition, at least 140 beds are expected to be created with Native American tribal entities. If applicants supporting these targeted areas apply and meet our rigorous

application standards, they will be funded. We are confident that

as the number of beds continues to rise, we will be far more effective in seeing that all of our Nation’s veterans get served in all

areas of the country.

We have approximately 5,000 beds available for homeless veterans tonight under our Grant and Per Diem Program, and we will

create and authorize more than 2,500 this year. We are on a path

to see there are nearly twice as many beds available within the

next 3 years as there are available today. And as you can see, the

current per-diem-only NOFA is not the end of our effort this year.

We hope to publish both the bricks and mortar and in coordination

with the per-diem-only NOFA later this summer. While we are still

working on the specifics, we hope these NOFAs will allow us to fur-
5

ther increase the number of transitional housing beds by up to

1,800.

Mr. FILNER. With the indulgence of the Chair, just for 30 seconds, may I interrupt, because I want to introduce someone from

my hometown who just walked in, Al Pavich from San Diego, who

is the president and CEO of the Vietnam Vets in San Diego and

has established what I think is the model treatment center for

homeless vets. And it is not only the beds, it is the counseling, the

medical care, the comprehensive approach that will get these men

and women back into productive lives. He is roughly 95 percent

successful. And Al and Darcy Pavich, I want to thank you not only

for everything you do for San Diego, but for the model for programs

for around the Nation.

Mr. SIMMONS. Please proceed.

Dr. MACKAY. I am also very pleased to point out that they are

grantees of the Department, so we partner with them as well.

While we fully acknowledge that we have had strong concerns

about the Multifamily Housing Loan Guarantee Program, we have

been aggressively working to meet Secretary Principi’s commitment

that was made here last September. By the end of fiscal year 2003,

we hope to have three to five pilot sites identified and with a VA

loan guarantee commitment.

Partnership is our primary emphasis. While VA has many excellent programs and services, we recognize that assisting veterans is

something that we do best when we collaborate and seek advice

from others.

The Secretary announced the Advisory Committee on Homeless

Veterans some 13 months ago. They have met and submitted their

first report. There are 30 areas and more than 60 recommendations

contained in their report. As I look at your committee’s witness list,

I see you have recognized a number of experts from our advisory

committee who will testify here today. We have a good record of

working with a wide variety of service providers. We think this is

both healthy and productive. And while some may be critical, we

continue to try to ensure that our focus is on quality care.

We have always worked with a variety of organizations, State,

local and territorial government, Native American tribal governments, veterans service organizations, and community and faithbased service providers. While we are extremely pleased and proud

of our work with these organizations, our intention and effort will

continue to be to maintain our focus on the needs of the veteran,

not the type of organization that provides service to that veteran.

Regardless of the provider, we will demand quality service and accountability for results from all.

There really is never enough that we can do to support homeless

veterans.

Mr. Chairman, that concludes my oral statement, and I ask that

my entire statement be entered into the report.

Mr. SIMMONS. Without objection.

[The prepared statement of Dr. Mackay appears on p. 66.]

Mr. SIMMONS. I also have a statement from our full committee

chairman Chris Smith that he has asked be made a part of this

record. If there is no objection, his statement will be made part of

this record.
6

[The prepared statement of Chairman Smith appears on p. 64.]

Mr. SIMMONS. Mr. Secretary, I have one question, at which point

I will defer to my colleagues. I am just intrigued by the numbers.

In my opening statement I made mention of the fact that upwards

of a quarter of a million veterans find themselves on the street on

any given night, and, of course, we don’t know exactly what the

numbers are, but that kind of creeps into the conversation, about

a quarter of a million.

In your testimony we are talking about 5,000 beds. In your testimony you are also talking about other providers and how the VA

leverages its own resources with other providers to provide, hopefully, additional beds. The comment was made from the dais about

the fact that it really is not just about beds and bricks and mortar,

but it is about what is going on in the mind of the veteran, what

illness, what chronic condition, what addiction, what nightmares

may be going on in that person’s life that makes a bed and a home

uninhabitable and unsleepable.

How does your organization work with the larger group of service

providers? Is there any way of tabulating or adding those beds and

those resources so we are closer to the quarter-of-a-million-dollar

figure? I wonder if you could respond to that question—the quarter-of-a-million bed figure.

Dr. MACKAY. I would like to make some initial remarks and then

ask Gay or Pete to flesh those out. The 5,000 beds that we talked

about and the other programs, domiciliary program, health care for

homeless veterans, when you look at the number of veterans that

we will serve or touch this year, that figure for fiscal year 2003 is

about 84,000 veterans, and that consists of about 64,000 veterans

that will be helped in some way, shape or form through health care

for homeless veterans through the work of our employees as they

give dental care and medical care to veterans that are found homeless. Those 5,000 beds translate into about 11,000 veterans that

over the course of a year will be served in the Grant and Per Diem

Program, and another 5,000 or the balance in terms of the domiciliary program. So we are able to leverage the resources that we

do bring.

Pete.

Mr. DOUGHERTY. Mr. Chairman, I think your question goes beyond what the Department itself is doing and what we are doing

with others. Secretary Principi has been very active with the U.S.

Interagency Council on the Homeless. HUD is a major player in

homeless assistance, as is the Department of Health and Human

Services. The Department of Housing and Urban Development has

developed a management information system. We have been working with them on that information system. We are trying to ensure

that those community service providers who are serving veterans

are properly accounting them. We think that is helpful for us on

both of us. It identifies that veterans are getting assistance from

other programs, but it also tells us that we would be able to, with

verified information systems that are compatible, to know whether

our health care and benefits assistance programs are also working

in that wider community.

HUD released a report about a year ago that said there were

about 160,000 veterans who received assistance through HUD
7

housing programs as well. The problem is we have to a certain extent, there isn’t a verification, that those are, in fact, veterans or

they are, the same veteran, if it is the same veteran perhaps counted repeatedly.

We are committed to working through the Interagency Council to

make sure we have both a coordinated system of care as well as

a better accounting of the care provided.

Dr. MACKAY. I would like to point out, I know your question

talked about quantities, but one of the things that is important— I think is that the committee understand is some of the qualitative

changes that are happening in the program right now. The fire and

safety grants and the technical assistance grants are part of that

broadening and deepening. The ability to target, to try to give priority to these seven States that don’t have any sort of—that aren’t

touched by our Grant and Per Diem Program, and also Native

American tribal governments, and to look at other and a wider

array of community and faith-based organizations, those are all

part and parcel of what I regard as qualitative improvement and

I think bear on your concern on meeting the needs of homeless

veterans.

Mr. SIMMONS. And those seven States, Mr. Secretary.

Dr. MACKAY. Let me read them again. It starts with Alaska.

Alaska, Idaho, Kansas, Montana, North Dakota, New Hampshire

and Wyoming. Of the 800 beds in the current NOFA, 140 of will

be prioritized for those seven States. So if they meet our threshold

requirements and our evaluation process, then they will get funding under the Grant and Per Diem Program in our next round.

Mr. SIMMONS. Mr. Rodriguez.

Mr. RODRIGUEZ. Dr. Mackay, you haven’t forgotten where you

came from, right? San Antonio. Welcome.

Let me—I was pleased you mentioned the mentally ill, fragile

and the chronically mentally ill. Let me ask you—and I didn’t pick

up on how much—you indicated that you are going to start looking

at those populations. Do you have, number one, a timetable; number two, have you looked in terms of the amount of resources that

you are going to put in these areas?

Dr. MACKAY. What we have done in our last round, the last

round of regulations that we released provided for these special

and targeted populations. It is our intention in the fiscal year 2004

funding cycle to target that $5 million target for the special

categories.

Mr. RODRIGUEZ. Five million?

Dr. MACKAY. That is our objective.

Mr. RODRIGUEZ. Because that is a very small amount in comparison, because you look in terms of actually trying to provide good

quality of care, and it is difficult, because I know this can be a very

costly population because of the resources.

Also, I would—in reference to the homeless, I know they exist

throughout, but a lot of them exist in urban areas such as San Antonio and elsewhere. So that prioritization that was done for those

areas was based on what, the fact that there wasn’t services available in those areas?

Dr. MACKAY. Yes, sir. Those are the seven States that currently

are not touched by the Grant and Per Diem Program. And, of
8

course, we only have two programs that are in all of Indian country, all of the Native American tribal governments. So we looked

to prioritize—on a prioritized basis we are going to consider grant

requests from those places. I would point out the $5 million figure is the authorization level

in Public Law 107–95. So we are targeting at the authorization

level.

Mr. SIMMONS. Mr. Boozman?

Mr. BOOZMAN. No questions.

Mr. SIMMONS. Mr. Beauprez.

Mr. BEAUPREZ. Thank you, Mr. Chairman.

Dr. Mackay, good to see you again.

I am struck by a couple of statistics that I see in your testimony;

one, that approximately 23 percent of the chronically homeless are

veterans. I am going to assume that is a much higher percentage

than—percentage of veterans for the general population. Does anyone know what the percentage of the general population would be

that is veterans about?

Mr. DOUGHERTY. Based on our work with the Department of

Housing and Urban Development and the Samaritan Initiative the

belief is within the entire homeless population, about 10 percent of

that homeless population fits in the definition of the ‘‘chronically

homeless.’’ The VA says 23 percent of homeless veterans treated

are chronically homeless based upon clinical assessment. Using his

information VA estimates veterans are almost two and a half times

more likely to be chronically homeless.

Mr. BEAUPREZ. The entire population, what would be veterans;

not just homeless, entire population?

Mr. DOUGHERTY. On the entire population, there is about 25 million veterans in the country.

Mr. BEAUPREZ. So 9 percent roughly. So this percentage is alarmingly high. And I notice in your testimony reference to veterans

that are released from penal institutions and those challenges.

What I would like to probe or hear you probe, I guess, a little bit,

I am quite certain we don’t want more homelessness. The objective

would be to have zero. At the same time, compassionate and reasonable, decent people want to address this problem so we try to

strike some balance, if you will, of serving the need and making

sure that we are not also having somehow that continued dilemma

or problem.

And where is that balance? How do we—I guess the best, or at

least one way to address that, to eventually get to zero, would be

to go at the source. What is it that we are doing or not doing for

the sake of our veterans once they are discharged to integrate them

back into society? For the sake of those who do find themselves incarcerated and are released that they can’t again integrate into society, what should we be doing better at that level?

I don’t want to minimize this challenge. As the chairman pointed

out, we have a quarter of a million veterans that are homeless, but

how do we avoid getting them there in the first place?

Dr. MACKAY. Well, it is a challenge—there is a very significant

component of this that is based in mental illness and in mental difficulties. So many veterans, whether they face combat, even the

rigors of operational training, can induce post-traumatic stress
9

disorder, and it is an illness that we understand better every year.

I would say we understand incompletely the stresses and the

strains and the ways it manifests over the years. It is not very well

understood, and I think it is a significant component in the elevated numbers of homeless that we see with regard to the veteran

population.

I think that the site program, the six-site demonstration program, that we have with the Department of Justice is part of an

effort to interdict, if you will, a particularly high-risk group. Veterans who have been incarcerated that are coming back and

transitioning out of course have all of the potential illnesses and

injuries of veterans, plus their incarceration experience that they

are dealing with. This effort to especially get incarcerated veterans

that are at risk for homelessness into programs of case management and other kinds of medical care and mental health care is a

way to try to short-stop some readily anticipatable difficulties that

we can see.

Other than that, that is about as good an accounting I can give

you right on the spot.

Mr. BEAUPREZ. And I appreciate that, and I appreciated your testimony. Obviously there is much to be done, maybe much you have

already done. This committee is, I think, understandably frustrated

that things can’t always go faster, quicker, better, but I hope we

always pay some attention to the real source, the front end of the

challenge. Whatever we are—thinking of an analogy, if I can, early

childhood education, if we are not sending our young people out of

the school systems prepared to be productive citizens, to run their

own lives, their own families, take care of themselves, then kind

of shame on us in charge of that system.

I think we have to look critically at our whole military infrastructure and how we are dealing with our veterans or not dealing

with them to prepare them to go back into the private sector, because this problem seems to persist.

Dr. MACKAY. Congressman, I couldn’t agree with you more, and

the transition assistance and other benefits that we have are a critical part of that. Taking young men and women from Active Duty

military service and getting them back into the private sector in

terms of the educational benefits, the loan guarantees, the insurance and other programs, those are robust programs that need to

be continually looked at to see if they are up to the real demands

that we have.

Sadly, one of the things that I see is that when I talk to private

sector peers and colleagues that I have, that there is not the kind

of an appreciation that perhaps there used to be when the private

sector was more leavened with veterans for exactly the kind of

skills, the determination, the talents and other attributes that military veterans bring to employers. That is something that we are

working on at the Department with the national veterans business

development cooperation to educate employers as to the real resource that they have and to give veterans a chance to be some of

their best and most productive employees.

Mr. BEAUPREZ. Thank you, Mr. Chairman.

Mr. SIMMONS. Thank you.

Ms. Brown-Waite.
10

Ms. BROWN-WAITE OF FLORIDA. I don’t have any questions.

Mr. SIMMONS. No questions.

Let me—yes, Mr. Filner.

Mr. FILNER. Thank you, Mr. Chairman. I apologize for stepping

out, and if anything I say has been asked, just say it has been

asked, and I will just move on, okay?

Mr. SIMMONS. It depends on what you ask.

Dr. FILNER. What has struck me about what we have been doing,

we have authorized, I think, a pittance in some of these programs,

and yet the authorized level has not even been reached in the appropriations. So you are not given enough to deal with all these

needs that we know about. The commitment that the folks who are

going to testify to us is just incredible. And they have found answers. When we have the Stand-Downs in various communities,

which started in San Diego, we show we know what to do. We

bring together a comprehensive approach, and those homeless vets

for 3 days have safety, they have counseling, they have haircuts,

they have dental care. They get clothes, they get good food, they

get friendship, they get support, they get some stability, and then

after 3 days it stops. We can do that for 365 days because we know

how to do it, and I know Al Pavich in San Diego has shown us how

to do it.

And so, when we get a program like the Homeless Vets Reintegration Program, which is very cost-effective—the administration request is for $19 million, but we have authorized it for $50

million. The Work Force Investment Program gets less than $17

million or so, even though it is authorized for millions above that.

The Per Diem Program, you were talking about this, sir. The

folks in the field are not sure there is going to be any competitive

grants that you are going to do after the existing Per Diem. Maybe

you can comment on that. And they are afraid that if the money

goes into the same VERA model that we have been using—it loses

its focus, and they want the Per Diem money, I think, segregated

from the VERA kind of model.

So these are some of the issues that we are going to have

brought up to us, Mr. Chairman and Dr. Mackay. I don’t know if

you want to comment on any of that. And again, I appreciate your

indulgence, Mr. Chairman.

Dr. MACKAY. Mr. Congressman, I would like to comment just a

little bit. First of all, we have had some significant gains in the appropriate levels of funding. Whereas we were at $25 million in fiscal year 2002 for the Grant and Per Diem Program, we are going

to be at $50 million here in fiscal year 2003. The submitted budget

was for $69 million in fiscal year 2004. So we are making some real

progress toward what I know is the authorized level of $75 million.

The Grant and Per Diem Program is a competitive program, and

funding is not allowed through VERA. It is a completely different

process where the grant applications are submitted, and we evaluate them based on the ability of the program providers to provide

good services, and several other factors that Gay or Pete could go

into more detail, if that’s desired, and then we make decisions. We

are trying to get more evenly distributed, as I talked about, I think

you may have been out of the room, where we are targeting on a

priority basis places—seven States, Native American tribal govern-
11

ment authorities and others that have not traditionally been participants with us. So we are making some real improvements to the

program.

You also asked to talk about our other granting activity in the

balance of the year. We just released regulations, and we will have

in the June time frame another round that is about, $8 million in

June. We hope to end the fiscal year with one more round that

would fund about an additional 1,000 beds under Per Diem only

awards. That will be a Per Diem money, and it will be funded with

fiscal year 2004 funds. We are really moving out from about 5,000

beds currently. As I covered briefly in my statement, we hope to

have about another 2,500 beds authorized in this fiscal year because we are going to have a good number of notices of funding

availability this year, three to my recollection, as well as other

funding availabilities for fire and safety money, about $3.5 million

for those, for grantees that need that kind of help.

Mr. FILNER. But you are saying you are going to do this funding

outside the VERA model segregated for the homeless veteran.

Dr. MACKAY. Yes, sir, that is where the program has run. So we

have a good deal of activity. We are really changing the program,

and we are at a real shift in gears, if I could describe it that way.

Where there is more funding available, we are changing some of

the methodologies in the way we look at some of our grant providers. We are trying to do a much better job, getting it to a much

broader range of providers, keeping our connections to our quality

providers that we have, different types of funding, like that fire

and safety funding and the technical assistance grants that will

allow smaller providers that don’t have grant writers on their staff

to participate in this, people that are community-based and close

to the homeless veteran and can really serve them and attend to

their needs. So I am very optimistic.

With that said, I share your concern about where we are versus

the numbers that we have out here. We could always use more

money, more funding for these programs. I think the quality of the

programs is significantly being improved here in the last 18

months or so.

Mr. FILNER. I just want you to take as your motto something

like: we can do Stand-Down 365 days a year, meaning we can provide the comprehensive services to these veterans who, in my

mind, are heroes, and yet they are on the streets of our country.

And it can’t be tolerated. We passed a law that said we were going

to end homelessness. I am not sure there has been that much

progress made, but I hope—I think you take it seriously, and I

know you know the commitment of these folks who are going to

testify to us. It is just incredible. They have a passion, they are

serving these folks, and they want to see a similar passion and a

similar commitment from our VA.

Thank you, Mr. Chairman.

Mr. SIMMONS. I thank the gentleman. Mr. Strickland.

OPENING STATEMENT OF HON. TED STRICKLAND

Mr. STRICKLAND. Thank you, Mr. Chairman. And I want to

apologize for having to go in and out, and you understand what it

is like here, and I apologize to the witnesses as well.
12

I just have one comment, sort of a question, I guess. And we

have been concerned that these mandates were provided through

legislation. And there has been concern that there may not have

been the kind of implementation that we had hoped for in part at

least because of lack of funding. But why has the administration

not requested additional funding for this purpose, for these purposes, in the 2004 budget? Would that be helpful if there was a

specific budgetary request in the budget so that we could follow

through with these mandates?

I mean, this is my point, I guess. On the one hand, we are saying

that certain things should be done, and we are asking that you do

them. And we have authorized resources for that purpose. You

don’t have the money you need. Isn’t it—wouldn’t it be helpful if

there was a request for additional funds for this purpose?

Dr. MACKAY. Congressman, you are right. We could always use

more dollars. I will not be the first deputy Cabinet member on

record to say that we have got as much money as we could ever

hope for. But, all and the same, you realize, as we all do, that we

have many things that we must do with the funds that we have

provided in our budget. We are stepping out purposefully to get to

that authorized level of $75 million. As I just pointed out, we doubled the budget from 2002 to 2003, and there is another 38 percent

requested increase from 50 million to 69 million for this Grant and

Per Diem Program. So there are significant new monies being

made available.

At the same time I think that we are making some significant

progress toward qualitatively not only making our own program inside VA, but also partnering through the Samaritan Project is a

real good example with HHS and with HUD to get those kind of

comprehensive services that Representative Filner talked about,

the Stand-Down 365-day-type ethic.

So I am very hopeful that we are making real progress, and even

though we plan to touch 84,000 different veterans in different ways

with all the programs during this year, we think that we are going

to increase that by about 10,000 in fiscal year 2004. There are

about 95,000 veterans that will be touched that are homeless either

with health care, with dental care, with transitional housing services or with these case management services that we will be doing

with the Samaritan Project.

So while we can never rest, while we have not fulfilled that mandate to end chronically—chronic homelessness, I think there are

reasons for hope, and there are new monies that are being put to

this task.

Mr. STRICKLAND. Thank you. You know, I was just sitting here

listening and thinking, I wish every homeless veteran had a military uniform to wear, because I think if we could see these homeless people on the streets in military garb, it would really bring to

us in a way that probably we don’t fully understand. I don’t fully

understand the breadth of this problem. And I will just—— Mr. FILNER. Would you yield to me before you finish?

Mr. STRICKLAND. Sure. I just want to make a comment, and then

I yield to my friend.

This need seems so inconsistent with what I frequently talk

about, and that is what I call the VA’s gag order regarding the
13

marketing of VA services. It really seems so inconsistent to me that

on the one hand we would want to reach out to this vulnerable population, and on the other hand we would place any limits at all on

the marketing and the outreach, which seems to have been limited

by the memo that went out from Laura Miller.

But anyway, I yield whatever remaining time I have to Mr.

Filner.

Mr. FILNER. Thank you, Mr. Strickland.

You know, what strikes me—you’re talking about $75 million.

And if we pass the Filipino veterans bill, it is going to be on the

order of $30 million. We just finished a war on which we spent

about $1 billion every 2 days. A billion! Now, we want to give our

Active Duty everything they need to conduct their war, but when

they come home, what do we have? $75 million is crumbs; $35 million is crumbs relative to what this Nation has as its resource. We

just showed we are the most powerful Nation in the history of the

world, and yet we have this picture. Not only are we laying off

teachers in every State, but we are asking our veterans to do more

with less—I mean, and our VA to do more with less.

We have the money. It is the will and the sense of priorities, and

people in this country have got to see that picture. You are struggling just to get $75 million and yet we just spent $70 billion in

a few months. It is that distinction that ought to be made clear to

all the American people who would then say we can do this for our

veterans. I thank the gentleman.

Mr. SIMMONS. Mr. Stearns.

Mr. STEARNS. I thank you, Mr. Chairman, and I am pleased to

be here and participate, although a little bit late, but it looks like

I got near the end here.

So, Dr. Mackay, I can ask you a question. Is there any conflict

in funding priorities, because the VA homeless programs are funded by health care funds. So the fact that we had health care funds,

and is there a conflict because VA programs coming out of the

health care funds, and what should we as legislators do? Does that

make sense?

Dr. MACKAY. Yes, sir, it does. I wouldn’t describe it as a conflict.

I think it is something that we both get paid to do. We have to set

priorities and to set limits and amounts. It is an issue of priorities

that this money does come out of medical care. But I think that is

the task that is in front of all of us, both in the executive and in

the legislative branch.

Mr. STEARNS. Well, let’s say—let me get more specific. Let’s say

where do the VA homeless programs come in your priorities?

Dr. MACKAY. Well, it is a very high priority.

Mr. STEARNS. What is higher?

Dr. MACKAY. Well, we have stated goals by—priorities by statute

we have to deliver health care and also benefit services.

Mr. STEARNS. Health care in the hospitals.

Dr. MACKAY. But health care, of course, is—we pride ourselves

on a continuum of care, Congressman. And, of course, homeless

care, because it is almost always intimately bound up with health

care, is part of a continuum of health care. It is very hard to separate these programs from other parts of our health care continuum.
14

Mr. STEARNS. Well, I guess we spend $25 billion for health care,

and of that, 25 million, staff has pointed out, is for homeless. So

that is 1/1000. So there has got to be a priority here. So what I

am trying to see if within that 25 billion is homeless—you say it’s

under a continuum of health care, but obviously you have a very

small amount of money. Is that 25 million that you have for homeless adequate?

Dr. MACKAY. Well, it—actually, if you want to be fair, we have

gone from 25 million, that is the figure for fiscal year 2002, and

now in fiscal year 2003 we have doubled that to 50 million. But

your point is taken. Against the quarter million veterans that are

homeless on any night, it is not a figure that is equal to the task

of all that quarter million. But there is some good news, a lot of

good news in that not only are resources increasing, but also, as

I have covered in my answers to other questions, there are significant qualitative improvements in the program that I regard that

are going to allow us to touch this year about 84,000 veterans, and

we hope next year in fiscal year 2004, 94,000.

Mr. STEARNS. Well, you have indicated that the $25 million is

rising, and you are saying now we have 50 million. And I am sure

that you have already covered this, so just for my own edification,

in your opinion is that $50 million enough to solve the problem?

Dr. MACKAY. Congressman, obviously it is not enough to cover

the whole needs of those quarter million veterans that are out

there.

Mr. STEARNS. Okay. And what would you say the funding that

would be required to make this a solution that is solvable?

Dr. MACKAY. I don’t——

Mr. STEARNS. No projection?

Dr. MACKAY. I don’t know.

Mr. STEARNS. I mean, is it 100 million or 200 million. Is it 10

percent higher, 55 million. Are we talking about proportionality to

solve a problem? Do we have to double again, or do you think that

there is some kind of increase every year that should be expected?

In other words, I am trying to get a feel for you of how comfortable

you feel with $50 million to solve the homeless problem.

Dr. MACKAY. Well, you know, I feel much more comfortable than

I did with 25 million. But your point is well taken. I don’t know

what the figure would be to totally solve the problem.

Mr. STEARNS. Dr. Mackay, I don’t know if anybody else on your

staff—having served on this committee—this is starting the 15th

year. Every year, you know, we are talking about the homeless, so

I am just trying to get at the bottom line here, what would we have

to spend, and perhaps you could give us an analysis and come back

to the chairman of what you think is the ceiling here, or what

under, if you will, funding could be done, or what should be done.

And I think your staff should look at this and provide an analysis

for the subcommittee on what funding, how much funding is necessary to solve this problem. Is that feasible?

Dr. MACKAY. We would be happy to give you the benefit of an

analysis, yes, sir.

Mr. STEARNS. Okay. And perhaps anybody else would like to

comment.
15

Ms. KOERBER. Yes. I just wanted to mention that when we talk

about 50 million this year and 69- next year, that really is limited

to the Grant and Per Diem Program. And if you look at VA’s estimates for total health care costs associated with services to homeless veterans for fiscal year 2003, it is above $1.3 billion. And for

those specialized programs for homeless veterans, including the

Grant and Per Diem Program, we are closer to about $159 million.

Mr. STEARNS. And I thank you.

My time has expired, Mr. Chair. Thank you.

Mr. SIMMONS. Thank you. Mr. Ryan.

Mr. RYAN. I don’t have any questions at this point. Thank you,

Mr. Chairman.

Mr. SIMMONS. Thank you.

It is my understanding, Dr. Mackay, that you were a top gun in

the Navy, and I congratulate you on that service. I think that perhaps negotiating the halls of this Congress and some of the subcommittee takes the same skills that helped you land on an aircraft

carrier, I think over 200 times.

Dr. MACKAY. Yes, sir. There are some expert dogfighters up on

Capitol Hill.

Mr. Chairman, I have to testify tomorrow in some other business

back at the Department, I am going to, with your permission, excuse myself. But my staff will remain to hear the testimony of the

other panel members.

Mr. SIMMONS. I look forward to it. Just by way of closing, before

the next panel, I represent a district in eastern Connecticut. I have

a common border with the State of Rhode Island and the State of

Massachusetts, and many of my veterans serve or seek services in

both of those States. Interestingly enough, this spring the headlines out of Massachusetts went to the issue of a lack of Federal

funds forcing a veterans shelter to close 60 beds. These articles

went on to say that changes at VA vex advocates for homeless.

My colleague, Representative Neal, invited the Secretary up to

discuss the Leeds shelter issue and so on and so forth. Mr. Dougherty apparently spoke to the press and said the problem was that

2 years ago there were 67 applicants for 53 awards, and this time

around there were over 270 groups seeking grants and awards.

I guess my comment is this: The Leeds facility has been operating for a decade, as I recall, and stability, I think, is an important

value in providing quality care to veterans, whether it be the homeless population or others. And running a competition may disrupt

that stability, may cause problems. I just raise that because there

has just been a huge amount of disruptive press on this particular

issue, and whether or not that facility eventually closes, and I hope

it doesn’t, certainly the process of having competitive grants has

been disruptive.

So I just share that thought with you. I think this may be an

issue that we will hear about again this year, maybe we will hear

from the next panel. But I think especially when we are trying to

provide services to our homeless veterans, we need to focus on the

stability of the program and the fact that certain facilities, certain

people, or certain programs are there year in and year out, and I

just leave you with that thought.
16

I want to thank the whole panel for appearing this afternoon,

and we will now welcome panel number two. Our second panel

today—is made up of two individuals. One hails from my home

State of Connecticut, and the other is a nearby neighbor from Massachusetts. We are heavy on New England on this panel, and I

apologize, but we did have Texas in the last panel.

Dr. Ned Cooney is the Director of the Mental Health Programs

at VA Connecticut Health Care System; and Mr. Jack Downing is

the Executive Director of the United Veterans of America Western

Massachusetts Shelter for Homeless Veterans. And again, I will

ask the gentlemen to make their statements, after which we will

have questions. I believe we have statements for the record, so if

you wish to summarize, feel free. Gentlemen. Thank you.

Dr. Cooney.

STATEMENTS OF NED COONEY, Ph.D., DIRECTOR, NEWINGTON

CAMPUS, MENTAL HEALTH PROGRAMS, VA CONNECTICUT

HEALTH CARE SYSTEM; AND JOHN F. DOWNING, EXECUTIVE

DIRECTOR, UNITED VETERANS OF AMERICA, INC., WESTERN

MASSACHUSETTS SHELTER FOR HOMELESS VETERANS

STATEMENT OF NED COONEY

Mr. COONEY. Okay. Yes, I am the director of the mental health

and substance abuse programs at the Newington campus, which is

the northern facility in Connecticut. And I was asked to testify because I manage treatment programs that provide care for veterans

and many of them being homeless, not all of them certainly. And

I will speak as a VA clinician and a clinical administrator sharing

my experience with the daily challenge of promoting recovery for

homeless veterans with substance use disorders.

The Mental Health Care Line at the Newington Campus provides

standard and intensive out-patient services for veterans with psychiatric and substance use disorders, and we estimate that about

43 percent of the clients who come to us in our intensive program

in substance abuse are homeless, could be classified homeless on

admission.

And treating homeless patients in an out-patient setting is difficult. Homeless patients often are living in shelters or on the

streets where alcohol and drugs are readily available, and most

have concurrent severe and persistent mental illnesses. They have

limited abilities to cope with the drinking and drug use situations

and urges to use, and they are often in danger of relapse when they

try to stop using.

You know, programs that first address clients’ subsistence needs

and then provide long-term treatment in progressive stages are

necessary for treating homeless substance abusers. So one of the

things that we do in Connecticut, we have a brief residential support that is provided to patients that are enrolled in our intensive

treatment programs by having them stay in a unit at the West

Haven Campus, which is in the southern part of the State, called

the Quarterway House. And the patients take a daily 45-minute

shuttle between the West Haven Campus and the Newington Campus to come to our intensive treatment programs.
17

The bed capacity at this Quarterway House is limited, so this is

really just for the very initial stage of treatment, for about a 14-

day length of stay. But it does provide a safe and substance-free

residential support for homeless patients without requiring any period of sobriety prior to admission. So it is kind of a housing first

program, and it is very important to provide initial stability.

So most homeless patients need much more than 2 weeks of inpatient or residential intensive treatment to stabilize. And so we

rely on our partnerships with programs outside of VA Connecticut,

and these include the Western Massachusetts Shelter for Homeless

Veterans at Leeds and also the veterans domiciliary run by the

State of Connecticut at Rocky Hill. These facilities provide stable

and substance-free housing for our patients and the opportunity for

them to receive rehabilitation, including continuing care and employment services.

Now, the Leeds shelter is further away—it is about an hour and

10 minutes—than the Rocky Hill, which is just a few minutes

away, but the Leeds shelter is good in that it has the same eligibility criteria as the VA, while the Rocky Hill, the State-run facility, will only accept wartime veterans. So that excludes a number

of the folks that are coming to us for services.

Combining the services, our intensive programs, with these residential supports has been fairly successful. We have about 80 percent of the veterans who come to our intensive treatment program

successfully completing that phase of treatment. And when we first

started the program, we didn’t have these kinds of supports in

place, and at that time only 5 out of the first 12 homeless veterans

that we saw in the program successfully completed the program, so

that is about a 40 percent rate. So it makes a big difference.

Now, funding cuts have been looming at the Leeds shelter and

at the State facility as well, the Rocky Hill veterans home, and

those would threaten our ability to provide residential support necessary for treating homeless veterans. There are a few smaller facilities that also provide residential supports, but none have the capacity to handle the number of referrals generated by our program.

And the local homeless shelters will provide emergency shelter, but

they don’t provide the structure and substance-free environment

needed to support abstinence in these patients.

We also have some beds that are funded by the Grant and Per

Diem Program. There is a small number in northern Connecticut.

Right now it is 10 beds. We are going to be adding nine more soon.

There are about 50 beds in the southern half of the State, but that

is a small number compared to the need—in the north there is estimated to be over 500 homeless veterans that stayed in shelters last

year.

So to summarize, the VA Connecticut is committed to providing

high-quality, accessible mental health and substance abuse treatment to homeless veterans, and we have really made a strong effort to create a seamless kind of one-stop continuum of care for

homeless veterans in northern Connecticut. And this is accomplished with minimal residential support provided directly by VA

Connecticut, and we rely very heavily on partnerships with the

State and nonprofit agencies. If our community partners lose funding or have inadequate funding, it threatens our ability to provide
18

quality care to homeless veterans, and that ultimately means that

fewer of these veterans break the cycle of homelessness and addiction and mental disorder.

Thank you. That concludes my testimony.

Mr. SIMMONS. Thank you. Just right down to the red light.

Thank you.

[The prepared statement of Mr. Cooney appears on p. 75.]

Mr. SIMMONS. Mr. Downing.

STATEMENT OF JOHN F. DOWNING

Mr. DOWNING. Chairman Simmons and members of the committee, I am honored to be here today on behalf of the 120 homeless

veterans at the United Veterans Shelter in Leeds, MA. The United

Veterans of America—— Mr. SIMMONS. Jack, could you push your microphone?

Thank you.

Mr. DOWNING. The United Veterans of America entered into a

partnership agreement with the Department of Veterans Affairs in

1994. Since that time there has been a series of contracts and

grants through the VA Grant and Per Diem Program that has allowed this partnership to effectively, compassionately and creatively meet the needs of homeless veterans who served our Nation. Shelter, substance abuse treatment, anger management,

criminal justice outreach, reintegration, aftercare services have

evolved from this partnership that now includes the VA Connecticut, and the VA Massachusetts, and the Grant and Per Diem, and

the VA Health Care.

The United Veterans Homeless Shelter is located on the campus

of the Veterans Administration Medical Center in Leeds, in buildings 6 and 26. During fiscal year 2001/2002, we served 509 homeless veterans: 265 from Massachusetts, 204 from Connecticut, 40

from Rhode Island, New Hampshire and Vermont. The average age

of a homeless veteran in our program is 53 1⁄2 years old. Approximately 85 percent of all our clients are alcohol or drug abusers; 5

percent are elderly, and by elderly we mean over 70; 4 percent are

female; 20 percent have been diagnosed with post-traumatic stress

disorder. Twenty-eight percent of the total men and women in our

program are on parole or probation, and 38 percent are nonwhite.

The VA Grant and Per Diem decision to deny funding to grant

number 02–106MA for 40 additional beds was difficult for us to understand because the reality was the UVA was operating every day

with a waiting list of 51 more vets waiting to come in. So when we

got the denial on it, while we realized we were in competition, we

had a documented need of men and women lined up in mental

health facilities, in clinics, in jails and prisons waiting to come to

us.

The VA Grant Per Diem decision to deny at the same time grant

number 02–98MA was devastating. The loss of 60 beds for homeless veterans at the UVA Shelter/Program could cause the weakening of the partnership between VA Grant and Per Diem, VA Connecticut and VA Massachusetts.

The partnership was built on trust, integrity and a commitment

to the dignity of each homeless veteran. The long-term security of

this partnership was underwritten by the VA Grant and Per Diem
19

Program and the VA Connecticut and the VA Massachusetts health

systems. The U.S. Department of Housing and Urban Development, the Department of Labor, the Federal Emergency Management Agency, and the Massachusetts Division of Veterans Services

all provide support to these programs we operate with through

grants.

The elimination of the funding for 60 beds created an environment filled with anxiety and fear for all 120 veterans in our care.

The UVA’s responses—our response to that crisis was to continue

to operate the beds after April 1 until we had depleted all our financial resources. We immediately began to downsize our staff. We

eliminated five full-time positions. Transportation for recreation

was eliminated, and requests for emergency funding have been

sent out to all the veterans service organizations, trying to get

more dollars in the door to fund this hole so that we are trying to

get into the next round, which we believe and hope will have funding available by, let’s say, July 31.

The UVA immediately contacted the Massachusetts congressional delegation and Connecticut congressional delegation. Local

and national media coverage started to take shape, and the public

interest story really became how are we conducting a war with Iraq

and not living up to our commitment to veterans at home. And

that’s the story that really generated us and pushed us forward on

this issue.

As a result of an April 3, 2003, meeting with the New England

delegation and Secretary of the VA Principi, the new—a committee

was made to provide technical assistance to us in the next round

of VA Grant and Per Diem funding.

The National Coalition for Homeless Veterans has been extremely supportive to the United Veterans of America’s efforts to

bring our funding crisis to a successful conclusion. The VA Grant

and Per Diem Program in our local VAMC sees the United Veterans of America as a subservient partner, and it has continuously

brought about needless misunderstandings and tensions in the dayto-day working of the relationships. The implementation and funding of Public Law 107–95 would certainly send the message that

the National Coalition for Homeless Veterans is to be an equal and

trusted advocate for homeless veterans across the board and a

voice to be reckoned with.

I want to acknowledge the strength and wisdom and support that

we have received during this time from the congressional staffs,

from Richard Neal, from John Olver, from Chairman Simmons,

from Senators Kerry and Kennedy and Christopher Dodd in Connecticut. I want to thank Assistant Secretary for Congressional Affairs Gordon Mansfield, who has accepted my phone calls and

worked with me to keep my beds open by starting to move at

health care, not to take the rent and utilities that I pay the VA

now.

Just so you are aware, in the year 2001, 2002, 46 cents of every

dollar I got for homeless funds was returned to my VA hospital for

rent utilities. I got $660,000, and I paid back 246,000 in rent and

utilities. So it is a—so I am now not paying my rent as another

way of holding my beds. Thank you.

Mr. SIMMONS. Thank you.
20

[The prepared statement of Mr. Downing, with attachments, appears on p. 78.]

Mr. SIMMONS. I have a couple of questions. First of all, as you

probably heard, I raised this issue with the Secretary before his departure. It seems to me that consistency, stability, and security are

all values that we would extend to programs dealing with homeless

veterans for all the reasons that we understand. I guess I have a

couple of questions that I will put on the table, and you gentlemen

can answer them as you see fit.

My question for Dr. Cooney is, were you consulted as a part of

the grant decision that Mr. Downing described? If so, what was

your reaction? If not, should you have been? Hold that answer for

one moment.

And then to Mr. Downing, you have described a relationship

which has continued since, I believe, 1994, a 10-year relationship

where presumably in each cycle you requested grants, and in each

cycle services were provided. Speaking from my perspective as a

veteran from Connecticut, we thought it was a good program. It

doesn’t matter whether it is in the State or not. It is close by, and

so it worked. And it worked for us.

Did VA give you any warning that, in the past, any of your applications for grants were deficient or that your program was in jeopardy, or did all of this just come crashing down on you?

The third question is, if, in fact, that hypothesis is correct, what

can this subcommittee or the Congress do to ensure that these

types of things don’t happen elsewhere in the country now and into

the future?

Mr. COONEY. Okay. No, I was not consulted regarding the decision-making about the funding of the Leeds shelter. And I think it

would be helpful to be in the loop in terms of decisions about Grant

and Per Diem beds. I think that the State line might have been

one reason why people didn’t consider VA Connecticut for a Massachusetts shelter, but it would still have been useful.

Mr. SIMMONS. Thank you. I think it is a VISN line, or at least

I assume it is not a State line. So the political border should not

be an issue. But I thank you for that response.

Mr. DOWNING. It was a shock to us. We came into the round assuming we were going to be renewed. I knew the 40 additional

beds were going to be competitive, and I expected them to be competitive, but the 60 beds I was under the impression were going to

be renewed, so that when we found out after the fact that this— there were no automatic renewals, and you were given no points

for 2 years or 4 years of good service, you know, that, you know,

we will just move the beds, and I—you know, and it just threw me.

I mean, you talk about creating instability with the people you

most want to stabilize and creating insecurity with people who

don’t know how to trust and don’t want to trust, and that is the

population we work with. And what—and so that is the piece. So

I—none of us saw it coming that way.

Then I think the second part that frustrates me in this as we

play it out was originally the grants were going to be announced

around Veterans Day, and then it is going to be announced then.

And then finally December 11, or just before the congressional

break, that is when it gets announced. And truly, from my view
21

point, if it hadn’t been for congressional staffers taking our phone

calls and taking our faxes and saying, wait until you read this,

okay, this would have kicked over into January, February, and at

that point we have lost our audience.

So we were very fortunate for the congressional impact on this

process, number one, and number two, the congressional staffers

had the energy and the time to support us all the way through. I

mean, it is the factor that saved us. So I have become a believer.

I am a convert to fencing that budget, fencing the job titles, with

it this concept of, gee, you are half-time homeless and you are halftime outreach. Okay. I say to myself, would I want that? If my son

or my daughter is that veteran in that chair, do I want a part-time

person taking care of them, or do I want full-time attention? Do I

want—so what we do in our program is we say to our staff, if you

won’t do it for your son or your daughter in that chair, don’t do it

for the veteran. Demand the best. They gave their best. Many people may not have thought it was best, but it was their best.

We will give them their best. We must bring intensity and passion to this. I worked 30 years in substance abuse and in the jails

and prisons doing reintegration aftercare. I learned one thing: Unless you love the people you work with, you can’t touch their

wounds. You have to love them. And the men and women that I

work with, the noble people that do this, whether they are doctors,

whether they are case managers, whether they are voc ed, if you

love them, you do it well.

I worked with an old corrections officers years ago in my first

class. He said to me, Jack, if you are going to be a car mechanic,

I tell you you have got to like cars. If you are going to work with

inmates, you had better love them, otherwise you will make them

the enemy.

We want the veterans to know they have great dignity and great

respect, and that is the reason we have kept the 60 beds open with

the help of Assistant Secretary Mansfield and the congressional

people. We have had the courage to keep it open, and we are just

burning up the few bucks we saved getting there. But I want those

vets to know they come before process, they come before dollars,

they come before people’s paychecks, and we are going to put their

heads on a clean bed every night. That is what we are about. That

is the first thing we do. Once we have them stabilized, then these

great clinicians and talented and gifted people can start to work

their magic. But we have got to have them stable first, and we

have got to have them safe. Per Diem is about safety.

Mr. SIMMONS. Thank you very much for your response to my

question. I appreciate it. And I agree you have got to have passion.

Mr. DOWNING. Thank you.

Mr. SIMMONS. Mr. Rodriguez.

Mr. RODRIGUEZ. Thank you, Mr. Downing, and thank you, Mr.

Cooney. I think that there is no doubt that you have got plenty of

passion there, and I want to thank you for providing that and the

insistence.

Let me ask you, how much money were you asking on the program for the program process that you didn’t get?

Mr. DOWNING. The one that didn’t fly, sir, was around, I think,

$600,000.
22

Mr. RODRIGUEZ. Six hundred thousand.

Mr. DOWNING. And when I started to chase this down, I talked

to somebody on the Interagency Council for Homelessness at the

White House, and he said to me, hey, Jack, that is decimal dust,

okay? And I said, you are right, it is. It is decimal dust. But you

know what? It is the future for 60 men and women 365 days of the

next year.

Mr. RODRIGUEZ. And you service how many—how many beds did

that account for?

Mr. DOWNING. Sixty, sir.

Mr. RODRIGUEZ. Sixty?

Do you know how many—and you had been in existence for how

long there?

Mr. DOWNING. Ten years, sir.

Mr. RODRIGUEZ. Ten years?

And you had been getting that, the resources, and you indicated

that you almost didn’t have any notice, and at least you indicated

you felt that you were—you might—you were competing for the

second part, but not—but you didn’t expect to lose the initial one?

Mr. DOWNING. I would say this to you, sir, so that I am fair in

my answer to that, too, and I can clarify the point. I think that the

National VA and Per Diem Office is tremendously—has grown tremendously in the last few years, the programs and all that they do,

and I think there was a communication process here that could

have been better. But it was really not to any bad will or ill will.

I just think people were overworked trying to handle a multitude

of things, and I think issues were slipping by everyone at that

point, and we certainly weren’t any more aware than they were.

Mr. RODRIGUEZ. Yeah. Because I can understand, you know, if

there was only, you know, the number of programs, and then they

had to jump on about, what was it, 200 something request proposals, 270 proposals, because I can also see the importance of funding

existing programs, but also looking at new programs, but not necessarily at the expense of programs that are doing well. And so

somehow we have got to look at that. And I know, Mr. Chairman,

I know that I had an amendment before the House last time because of those 80 billion that went to Iraq. Two billion of that went

for health care for Iraqis at the same time that we are looking at

some of the needs for our own veterans. So thank you for your

testimony.

Mr. DOWNING. Amen.

Thank you Mr. Rodriguez.

Mr. SIMMONS. Ms. Brown-Waite.

Ms. BROWNE-WAITE OF FLORIDA. Thank you. I have a question.

What is the average length of stay of the veteran in your shelter?

Mr. DOWNING. Right now it is averaging about 7 months. They

can stay up to a maximum of 2 years.

Ms. BROWN-WAITE OF FLORIDA. What sort of counseling is

offered?

Mr. DOWNING. Okay. All my case managers on my staff are what

we call CADAC certified, certified alcohol and drugs. So we have

that piece. And then I have a clinical director who has got 25 years

experience in the substance abuse issue. We then interface with

the VIC at the Northampton Hospital, and they get all their case
23

management. They can go to the PTSD unit, the psychiatrist, psychologist, the 21-day intensive substance abuse. They are going

down to Dr. Cooney and to the 21-day program at the Newington

Hospital. So, you know, there is all kinds of counseling that way.

I also—we do job counseling. We have an HVRP contractor that

comes in and does the skill development job counseling, that type

of thing. And we do a lot of work on responses to anger.

Ms. BROWN-WAITE OF FLORIDA. Two other questions. One is how

many veterans have actually stayed for 2 years? Because I have

been involved in homeless shelters, and that seems to be an inordinate amount of time.

Mr. DOWNING. I probably, on the average, if I had—right now I

probably have six to eight veterans that are with me for 2 years,

ma’am. Okay. That would be—you know, what happens normally

is once—for many of them, once we get them stabilized, they are

in treatment and things are going well, they will move into some

type of transitional housing that is closer to their home base, closer

to friends and relatives, that type of thing. And so we work with

a number of veteran-specific programs in both Connecticut and

Massachusetts to reintegrate them that way.

Ms. BROWN-WAITE OF FLORIDA. Okay. And the third question is

there was a newspaper article attached to your testimony that it

appeared as if the funding went to faith-based organizations. Do

you still feel that way?

Mr. DOWNING. I don’t feel it was as intentionally as originally we

thought it was. And I don’t have a problem with faith-based getting

money, okay? I just felt that I certainly should have been given

more consideration for having a history than somebody new on the

block. That is all I was really trying to say in that. And probably

in my frustration and anxiety to get my message out, I wish I could

rephrase it differently, okay?

Ms. BROWNE-WAITE. I think we have all had times like that.

Thank you, sir.

Mr. DOWNING. Thank you, ma’am.

Mr. SIMMONS. I thank you.

Mr. Filner, any questions?

Mr. FILNER. No. I think you said it all, Mr. Downing. But Mr.

Stearns had asked a question earlier—how much money should we

be trying to get? Would it be fair at all, sir, just to extrapolate

what you cost for 60? And that would come out to, I don’t know,

$2 1⁄2 billion, you know, which is a week of the war that we just

bought.

Mr. DOWNING. In 1969, I started in the poverty program, and

after the War on Poverty there were more poor people, okay? I then

got involved with the drug war, and there were more drug addicts

at the end of the drug war than when I started. And now I am into

the veterans homeless, and it is mushrooming.

Mr. FILNER. You have got to get out of this stuff!

Mr. DOWNING. That is right. I think I am the curse.

But honestly, what you have to look at with the men and women

we work with, family has failed, faith community has failed, the

military experience has failed, the support system in the communities have failed. Standard psychosocial agencies don’t work effectively with them. And so what we have to do is constantly get out-
24

side the box and find creative ways to entice them to come in and

get sober so we can start the process of sanity. And so what we are

constantly trying to do is say, what does draw them? And we are

not always sure. We know this: If we keep drawing you in, eventually people change.

And so at this point I can’t really give you great, great statistical

analysis information. I can tell you this: Just like people getting

sober, the more often you go to detox, the more likely you are to

finally hit that one time that you don’t pick up again. That is really

what I think we are trying to do. This is a very difficult population,

and when we hear success rates, we really need to look at real

numbers, because real numbers tell us that about 20 percent of the

people identified as chronically homeless in any 10-year period

seem to move out of the system and become unhomeless and become more stable and live in safer places. We are trying to raise

the bar on that, but it is a very difficult process, and it requires

tremendous dedication and commitment.

And to Ms. Brown-Waite’s question, I would also say at times I

think, boy, if I could keep them here 50 years, maybe I could help

more people. Sometimes time is just a great thing and—time and

a safe place where you become secure. Remember, now, the people

that we work with don’t have significant others, don’t have families

as we would know them. So they are not attached to an anchor

every day, like you or I may be. And so we need to get them attached as well. And so we get them attached at first to their sobriety, and then we try to get them attached to the kindness, the care,

the dedication, the respectful ways we talk to them. Then we try

to draw them into the service and see if that will click. But it is

a repetitive, difficult process, and I don’t have a better answer than

that. I am sorry.

Mr. FILNER. Thank you, sir.

Mr. SIMMONS. Mr. Strickland.

Mr. STRICKLAND. Thank you, Mr. Chairman.

I just want to thank you, Mr. Downing, for your testimony and

for your willingness to use the word ‘‘love’’ when it came to describing the people that you are serving. I think it is an appropriate— I think it is rather unusual in the halls of Congress to hear that

word used, but I do think it is appropriate. We love those who

serve our country, and we should love those who have served our

country. And so I am going to thank you both for your testimony.

Thank you.

Mr. DOWNING. Thank you, Mr. Strickland.

Mr. SIMMONS. Mr. Ryan.

Mr. RYAN. Thank you, Mr. Chairman.

I was listening to your testimony, Mr. Downing, and also reading

through it, the statistic that 85 percent of your clients are alcohol

and drug abusers, I think, clearly identifies the problem that we

need to get to the next step, and how you are a critical first step

to get there, and also just join with other members of the committee to just thank you, because we sit through a lot of committee

meetings and listen to a lot of testimony, but to feel the passion

come from you is a motivating factor for us.

Two questions—actually, one question. Can you just tell us—you

said you downsized the staff by five. Can you give us an example
25

of a day in your facility with and a day without those five staff

workers?

Mr. DOWNING. Yes, sir. The difference is that, first of all, we run

four groups every day in our facility. Each case worker would run

a group with their members. Now, instead of there being 12 to 15

people in a group, there is 25 to 30. That is the first significant

difference.

The second significant difference, all of us administrators are

now running groups. I run a group every Monday night from 5:30

to 7:30 called Foundations for Life for seven veterans who are trying to make a long-term commitment to a sane lifestyle.

The third thing is that we no longer are taking our people all

over the place for recreation. When people have appointments for

Social Security, Housing Authority and that, we used to throw you

in a van and run you wherever you had to go. Now we have to bulk

load up the vans. We only go to Social Security once a week. We

go to DTA once a week. We go to the Housing Authority once a

week. We have had to eliminate all that. I had to eliminate all the

recreation, the cookouts and softball games and that sort of thing,

because I don’t have dollars. Beds are more important than that,

and they understand it. So that is what I have done.

Mr. RYAN. I would imagine that those programs—the softball,

the cookouts—those are instrumental in helping the process along.

Well, thank you very much again for your testimony.

Also, I think it was in your packet that you gave us—you cited

a statistic that 32 cents of every tax dollar paid by western Massachusetts residents this year went directly to the military or to pay

for military-related debt, 32 cents on the dollar; and only three

cents of every dollar went to veterans’ services. Just on a personal

note, I think we really need—we understand we need a strong military and we understand there are certain obligations we have

around the world, but I think until this fact takes the center stage

in our political debate today, I think that is the real disconnect we

have. I think that is why people don’t vote, is because we have

these priorities, but we are not giving them just due, and, ultimately, it results in the kind of cuts that you are talking about.

So thank you for being on the front lines and all of your service,

both to Dr. Cooney and yourself.

Mr. SIMMONS. I want to thank you two gentlemen and thank the

members for their questions. I realize this is a snapshot of a problem, but to the extent that this snapshot replicates similar conditions elsewhere in the country, I think it is a problem and I think

it is important for the members to know. I thank you very much

for your testimony and wish you a safe journey back to God’s green

acre, New England.

We are prepared now for the third panel. To help me introduce

one of the members of the third panel, I understand that Representative Brown-Waite would like to make a comment. I believe

she will introduce Ms. Kathryn Spearman from Tampa, FL—

Tampa being the home of U.S. Central Command where a few

years ago I did my Reserve duty, a wonderful place, Ybor City,

where they roll the best cigars in America.

Ms. Brown-Waite, the floor is yours.
26

Ms. BROWN-WAITE. Thank you very much, Mr. Chairman; and

you are absolutely right about the Tampa, FL, area.

I wanted to introduce Kathy Spearman, who was one of the 15

members appointed by Secretary Principi for a 3-year term to the

Volunteers of America of Florida—to the Volunteers of America.

The Advisory Committee has been meeting since June, 2002, and

has prepared its first report to be presented to the Secretary in the

near future.

Ms. Spearman was appointed in April, 2002; and her term will

end in 2005. I’m sorry. I misread that. She has been appointed by

Secretary Principi to the Advisory Committee. Ms. Spearman has

been the Chief Executive of the Volunteers of America of Florida,

Inc. Organization for 15 years, actually, since its inception. Volunteers of America Florida is a Statewide, faith-based organization

that operates five Veterans’ Affairs Grants and Per Diem funded

transitional housing programs for homeless veterans and two Veterans’ Affairs funded multi-service centers.

Today she has brought up to Washington a full-service mobile

medical and benefits vehicle which is an innovative means of targeting homeless veterans with critical support services. In other

words, she goes out and she finds them.

Volunteers of America of Florida is a direct service provider for

veterans, the elderly, mentally ill and developmentally disabled

populations. The agency has been a Veterans’ Affairs grantee for

5 consecutive years.

Mr. SIMMONS. Thank you, Representative Brown-Waite.

The other members of the panel include:

Executive Director of the National Coalition for Homeless Veterans, a true winter soldier and a friend of this committee, Ms. Linda

Boone—good to have you here—Mr. Ralph Cooper, Veterans Benefits Clearing House from Roxbury, MA; and Mr. Michael Blecker,

the Executive Director of Swords to Plowshares, all the way in

from San Francisco, CA. We have your statements in the book. I

would suggest that the members of the panel summarize their comments for sake of timeliness, and I would ask you to proceed.

STATEMENTS OF LINDA BOONE, EXECUTIVE DIRECTOR, NATIONAL COALITION FOR HOMELESS VETERANS; KATHRYN E.

SPEARMAN, PRESIDENT AND CEO, VOLUNTEERS OF AMERICA, FLORIDA; RALPH COOPER, EXECUTIVE DIRECTOR, VETERANS BENEFITS CLEARING HOUSE, INC., ROXBURY, MA;

AND MICHAEL BLECKER, EXECUTIVE DIRECTOR, SWORDS

TO PLOWSHARES, SAN FRANCISCO, CA

STATEMENT OF LINDA BOONE

Ms. BOONE. Mr. Chairman and committee members, the National

Coalition for Homeless Veterans is a nonprofit corporation established by community-based veterans’ service providers to educate

America’s people about the extraordinarily high percentage of veterans among the homeless and place homeless veterans on the national public policy agenda.

This week, the National Coalition for Homeless Veterans is holding its seventh annual conference; and we have over 300 partici-
27

pants from 38 States, the District of Columbia and Puerto Rico

attending.

Of primary concern to our coalition is the implementation of Public Law 107–95, the Homeless Veterans Assistance Act. The VA has

the primary role for responsibility for provisions in this law for implementing.

While some pieces of the legislation are being implemented, there

are still a number of pieces needing to be addressed. The VA has

expressed concern that Public Law 107–95 is an unfunded mandate, and they do not have the resources to implement its provisions. The House Veterans’ Affairs Committee in their report to the House Committee on Budget for 2004 requested $75 million for implementation of certain provisions in this law and noted that the

VA did not request additional funding to implement provisions in

this law.

In reviewing the history of the VA budget request compared to

congressional appropriations since 1997, each year Congress has

provided the VA more funding than they requested. Again, for

2004, the President’s budget requested $61.5 billion; and the con- gressional conference report is providing $63.8 billion.

So what is the real issue? Perhaps the internal priorities of the

VA need adjustment.

Even if funds were appropriated by Congress specific for homeless veterans’ programs, how would the money be internally allocated? The VA projects that by the end of 2003 there will be almost

7,000 transitional housing beds available through the homeless

providers Grant and Per Diem program. The need for increased

funding for beds through this program has never diminished since

its inception. These beds funded by the program at the current rate

of approximately $27 per day will require about $65 million funding for 2004. To add new beds will require an additional investment. In fiscal year 2002, the VA only offered $45 million in grants

when the authorized level was $60 million. What will be the internal level of allocations for this program for 2003 and 2004 when

the authorization level is $75 million?

Public Law 104–262 enacted in October of 1996 required the VA

to maintain capacity to provide for specialized treatment and rehabilitation needs of disabled veterans, including those with mental

illness. However, the VA has not maintained that capacity to serve

these veterans; and Public Law 107–95 is even more specific. How

will the VA respond?

The reductions in curtailment of services are drastic in mental

health and substance abuse disorder programs. Seventy-six percent

of homeless veterans have mental health and/or substance abuse

issues. It is shocking to hear from the VA Advisory Committee on

Seriously and Mentally Ill Veterans an estimate of over $600 million has been diverted from mental health programs over the last

few years.

What type of veteran should the VA be serving? Public Law 104–

262 specified seven priority categories. At the time of the law’s enactment, Priority 7 veterans made up 3 percent of those who used

the health care system. The VA’s budget for 2003 discloses that

Priority 7 veterans are expected to make up 33 percent of the

enrollees.
28

Earlier this year, a new Priority Group 8 was established, which

appears to be a marketing move to have a method to not enroll veterans that are non-service-connected and higher income, but the

VA still continues to serve those Priority 7 veterans enrolled prior

to this new category being established. These veterans often have

other health care coverage, but the VA is redirecting the resources

to serve these veterans, while VA mental health and substance

abuse, which overwhelmingly serve service connected and low income veterans, have suffered severe cost cutting.

The VA has allowed a redirection of funds to nonmental health

care in a clear violation of the law. It is shocking to realize that

the VA has diminished its support to veterans who are most vulnerable and most in need and in doing so has altered its mission

to serve an ever-growing number of those with the lowest claim to

VA care.

NCHV is extremely pleased that Representative Evans has introduced H.R. 1906, the Service Members Transition Assistance Program and Services Enhancement Act. This bill will take advantage

of the successful transition assistance program by making it a

mandatory process and adds a piece on homelessness risk awareness.

Newly released information from the VA points out the increased

risk for becoming homeless among veterans. Male veterans are 1.3

times more likely to become homeless than their nonveteran counterpart. Female veterans are 3.6 times more likely to become homeless. Prevention of homelessness among veterans should be a top

priority if our Nation is going to really end homelessness among

veterans. Providing mandatory transition assistance coupled with

homelessness information is a step in the right direction.

Thank you, Mr. Chairman and the committee, for this opportunity.

Mr. MILLER (presiding). Thank you very much, Ms. Boone.

[The prepared statement of Ms. Boone appears on p. 101.]

Mr. MILLER. Mr. Blecker? Ms. Spearman?

STATEMENT OF KATHRYN E. SPEARMAN

Ms. SPEARMAN. We need $600 million. If you are going to ask me

how much, we know.

I am here today testifying specifically from my experience with

Volunteers of America of Florida and the work we have done there

through a lot of outreach and provision of housing with supports.

We have had a lot of success, and we have a lot to do. This subcommittee as well as all of us have quite a challenge ahead of us.

I really appreciate the opportunity for the subcommittee to hear

my testimony today. As Representative Brown-Waite was so nice to

introduce and to tell a little bit about our organization, I won’t repeat any of that but appreciate that introduction.

We have been focusing on the outreach to veterans I guess now

for 5 years. That was the time of our first Grant and Per Diem that

we have received, and we have had a marvelous outreach opportunity. We really do invite everybody to come and see the mobile

vehicle. It is a very successful outreach program which takes a lot

of commitment and needs a lot more funding.
29

Let me just tell you a little bit about our emphasis. Our service

is housing and supportive services and the emphasis is on moving

people to independent living, whatever that might be for each individual.

VOA has five VA grant and per diems grants, and three HUD

McKinney-Vento grants that are targeted just for homeless vets.

We reach about 6,000 veterans during the year with our multiservice centers and our outreach program. We house and provide

supportive services to 167 veterans; and we are in the State of

Florida from the Keys up to Jacksonville, not anything in the Panhandle at this time except for our mobile outreach, which often

does end up in the Panhandle because of that very rural area.

As I mentioned, the mobile unit was our first grant and is our

most innovative program. It is a 40-foot, state-of-the-art vehicle

which is a fully contained medical, dental and health facility. It is

targeted for the real resistant, and that is a population of homeless

veterans that I think is very underserved, and they are all around

Florida. We find them in encampments in Ocala National Forest,

the Florida Everglades, and on abandoned boats off the Keys. We

have often taken a boat out to derelict boats to tell vets when the

mobile unit is going to be in an area off the Florida Keys, and they

have been very receptive to that outreach.

The action steps that are important to Volunteers of America of

Florida as we have looked at the gaps and the barriers while doing

this program of outreach and support services for homeless veterans include:

Develop and support more creative funding specifically to address the homeless population, the homeless veterans.

Place VA Medical Center staff working with homeless veterans

on site in community veteran homeless programs or change some

of them—I assure you that some do not have the compassion that

they need to have and cannot address the problem.

Provide prevention and mental health services for returning veterans so they do not have an attached stigma.

Issue directives with incentives for the VA Medical Centers to

reach out and plan for homeless veterans’ reintegration into the

whole care system.

Reduce the bureaucracy to get things done in a timely manner

for all concerned, particularly in the areas of benefits and medical

care.

Educate the community on eligibility of veterans for all entitlements and services. We find this is a very significant barrier. The

community does not know how the combination of resources could

be put to better use.

Continue to look at what works and collect and analyze data.

Increase support services and to get real on what the costs are.

It really is an issue. The mobile unit costs us $1,000 a day to have

it on the road, and it does good stuff. It does stuff that is not being

done that needs to be done. It is done night and day and weekends,

and it is done when a veteran is more likely to come out of the

woods and receive services, and it is done in an outreach method

that is slow and progressive and builds trust. To do just services,

it ranges anywhere from—Grant and Per Diem is paying $26, $27

a day now; and the cost is more in the range of—most of the veter-
30

ans that we outreach to, it is up to like a hundred dollars a day.

Who is paying for it? Not VA. Volunteers of America is looking continuously for resources to supplement what the VA is not doing.

Use only those providers who can demonstrate that they are

deeply concerned about homeless. This is a big issue, and I think

you will find over and over again that we need a lot of providers

and a lot of resources, but we need to look at who is more compassionate about and knows how to reach out to this particular population.

And support fully our Public Law 107–95. It is—for the first

time, really addressing some special needs and looking at that the

funding requirements.

The gaps and barriers are many: emergency care; timely benefits

provision; consistent and specific outreach to service the homeless

vets, including veteran women; dental care; veteran shelters that

take in the inebriated; immediate detox services; inpatient services

for PTSD; adequate support for veterans unable to stay in gainful

employment due to health issues; adequate community education;

substance abuse and mental health access.

The funding concerns are in four areas. One that I would like to

mention is, as interagency efforts in Washington shift funding collaborations and responsibilities, attention must be given to the outcome of increased services specifically to the homeless veterans,

that that doesn’t get lost in that whole process, which I feel like

it has this first time around with the collaboration.

Second, our emphasis is resistant veterans especially from the

Vietnam era. This group needs—they take more time, they take

more money, and they need funding services and support services

that offset the many years of isolation, rejection and VA neglect.

You have to have the right staff. It is crucial. It is a slow process,

and it is costly, but these veterans deserve it.

The other is the maximum funding for the special needs category

of Public Law 107–95, the first attempt to start to get near to what

it costs.

And then, fourthly, rental assistance vouchers.

Thank you very much.

Mr. MILLER. Thank you very much, Ms. Spearman.

[The prepared statement of Ms. Spearman appears on p. 112.]

Mr. MILLER. I would like to recognize Mr. Cooper, if I might, for

some comments.

STATEMENT OF RALPH COOPER

Mr. COOPER. Thank you very much, Mr. Chairman. It is an

honor that I am here before you, and I humbly submit my testimony.

As I was looking over it, I realized that I am not really used to

writing testimony for such august bodies as the Congress of the

United States; and I made quite a few errors. One of them is a fellow by the name of Charles Brown, who happens to be dead; and

his sister, when I told her I was coming to testify, told me that she

wanted me to tell his story and use his name, because you know

that we can’t give names of individuals who we service because of

confidentiality.
31

Veterans Benefits Clearing House has been around a long time,

incorporated in 1977. We service about 4,000 homeless veterans—

well, not just homeless veterans but veterans and their families annually. And we have a Stand-Down that we are getting ready to

celebrate, our 11th Stand-Down in which we never had less than

500 homeless veterans at, and—you know, just to point out that I

have heard that the funding for the Stand-Downs through the VA

might be cut out.

But Charles Brown was one of our very early clients. He

overdosed on heroin, and he died homeless in 1987. I remember the

struggle for a job and readjustment after Nam. I remember the

horror stories he told me and nightmares and how he got addicted

trying to self-medicate for a few hours of peaceful sleep. How the

faces and mangled bodies would be entering his dreams, his sleep,

disturbing his sleep; and those faces that are dead, they wouldn’t

go away. I remember his sister who always tried to understand

what happened to little Charles that caused him to come back to

us like this.

I know—I remember when VBC got him his first job with an employer who was sympathetic to returning vets who overlooked his

criminal record.

You know, right now we are going through—around this CORI

thing. No one wants to hire a person who has been incarcerated.

You know, if we had H.R. 1906 for the TAP services so servicemen could get the homelessness risk awareness counseling, maybe

Charles would be alive today. Maybe he wouldn’t be dead.

Then there was also Al, who is still living. Now he was from the

first Gulf War struggle. I know that—he told us about how he was

on a truck and it got hit, it got zapped. Everybody on the truck

turned to charcoal. He went over to help one of the fellow veterans,

and the guy’s arm snapped off in his hand. He came in to us, and

he said I don’t know. I am going nuts. He tried to work, but he

couldn’t hold down a job too well.

We finally got him into some counseling and got him stabilized,

and all of a sudden he had a real problem. He wanted to kill one

of his coworkers for saying something to him that made him angry.

So he went into the hospital and said, I am going to bring myself

in. Help me out. I am having these terrible thoughts. They put him

under lock and key and said, you are a danger to yourself and others; and he called me.

Fortunately, we have one of our Congressman that I could talk

to; and we were able to get the hospital people to realize that all

he needed was a little help and get squared away.

Now this is a good story because he right now works for AMTRAK, and he is doing fabulous, and he just bought a new home

in Rhode Island. So this means that intervention and treatment

works. But if we don’t have intervention and treatment, if we don’t

have housing—reintergration won’t work.

Claude Hutchinson is here from the VA, and he is trying to help

put 5,000 units of affordable housing all across this country for

homeless veterans. That is the kind of thing that we really need.

And we need to make sure that it is not only housing but support

so that the veterans can stay in the housing.
32

I know the President’s initiative to end chronic homelessness,

there was $35 million for the entire country, $35 million for the entire country in which HUD, HHS and VA were there and involved

in; and I happen to be fortunate enough to have helped Massachusetts put forth a proposal to get about 70 of these chronic homeless

folks off of the streets. But you know what the figure was to do

that with? Less than—for the whole State, for the whole State, less

than $3 million.

So, you know, it seems to me that we need to make sure that

we do what George Washington, the Nation’s first Commander in

Chief, said: The willingness with which our young people are likely

to serve, no matter how justified, shall be directly proportional to

how they perceive the veterans of earlier wars were treated and appreciated by this Nation.

You know, a grateful Nation in appreciation of our Armed Forces

for a job well done, the funds for homeless assistance for veterans

should be our first priority because, if we don’t make it our priority, the cost is absolutely too high for us not to do anything.

You know, Charles Brown and Al are fortunate that they had a

place to go to like Veterans Benefits Clearing House. But if we

can’t get the funding to put up the beds, if we can’t get the funding

to supply the counseling and direct treatment to these men and

women, you know—and I am mentioning women because it says

here that the female veterans are almost four times as likely to become homeless as people who are nonveterans.

You know, men and women are coming back to this country after

putting their lives on the line, after some of them paying the ultimate price; and we have to be there for them and their families.

We can’t leave any of them. We can’t leave no veteran out on the

field; and, in this case, this field is the streets of our Nation. We

can’t leave them out there at all. We have to bring them home.

Mr. MILLER. Thank you, Mr. Cooper.

Let me say that you mentioned about addressing this august

body. Let us say, and I think my colleagues agree, that we are honored to have you testify to this committee today. It is we that are

humbled by your service.

Thank you, Mr. Cooper.

[The prepared statement of Mr. Cooper appears on p. 119.]

Mr. MILLER. Mr. Blecker.

STATEMENT OF MICHAEL BLECKER

Mr. BLECKER. I am here representing really the same basic community-based system of care.

I am a local operator in San Francisco. We started in 1974, called

Swords to Plowshares. I have been there since 1976.

At Swords, we have always been, you know, in the field helping

the vets most in need; and we have various services.

We have a supportive service unit that is funded by the Department of Public Health.

We have a legal services unit that is fairly unique because oftentimes Vietnam veterans have never had their day in court, so to

speak. Many veterans have issues that could receive claims from

the Veterans’ Administration on post-traumatic stress or disability
33

compensation claims, but they don’t have adequate representation

with their claims. So we have a legal services unit.

We have an employment and training unit. We provide 300 veterans every year—place them in jobs, and it averages out about $13 an hour.

And we have housing programs.

And, again, we are representative of a lot of members of the National Coalition for Homeless Veterans. In a sense, we are a local

provider.

I think unique about Swords is that we took advantage of some

of the decommissioned bases. We have a housing program on the

Presidio. We have one on Treasure Island, and we have two group

homes near City College. So a lot of this stuff is laid out.

We are talking about a population of veterans in need, and in the

year 2003 we are talking again about an urban underclass in San

Francisco. Racially, their age group is between 45 and 55. Fifty-five

percent are African American. We have over 30 percent served in

combat. Sixty percent suffer from mental health disorders, including PTSD, issues around depression, which is a big-time issue. Seventy percent have substance abuse issue. We know the issues.

We can’t forget the primary health care needs. Many of them are

Vietnam era vets. They are between 50 and 55 years, and they

have lots of problems with hepatitis C. In fact, that is rampant

with Vietnam veterans; and there is lots of good reasons for that.

There are HIV problems, diabetes, high blood pressure, et cetera.

So you are dealing with a population of veterans who served and

gave it their all, and now they need help.

When we talk about the topic for this discussion is the veterans

homeless programs, what I would say is the homeless programs are

great, but they are just outmanned. The need is overwhelming. I

think that has been a message you heard from the very beginning,

and it is a message that you brought to the table here. That quick

and ready recognition. What does that mean on the local level?

In San Francisco, there is probably 3,000 homeless veterans; and

I would 75 percent of them have issues around substance abuse

and mental health. They need treatment and residential care. Now

what is out there? We have 10 social detox beds through the Salvation Army that the VA funds. They have 35 Section 8 housing

vouchers. And then there is Swords for Plowshares program that

is funded for Treasure island for 56 beds.

Recently, we lost funding for our contract residential treatment

beds because the VA has made a decision to collapse the contract

care beds into the Per Diem beds. I assume the committee has

some knowledge of what that means. For us, what it means is that

the contract care beds, which paid $55 a day, is now reduced to the

level of the Per Diem beds, which went from 16 to 19 to 26.95.

What I think it means is that lots of veterans who have serious

mental health issues are going to be left out because it is difficult

to run a program on that level of Per Diem.

What it also means as a provider, what you have to do is you

have to go outside the VA health care system. You have to get

mental health care. You have to go to the county. You have to go

to HUD and bring everything to the table. And that is what the

successful CBO, community-based organization, has to do and does.
34

The VA programs can only be as good as I think residential capacity and meaningful treatment, and one of the problems—and,

again, it has been articulated by Linda and others—is this whole

issue with cuts in VA mental health care. What does that mean on

the local level? It is very difficult, for instance, to get individual

therapy the veterans may need. There is lots of group counseling.

There is counseling around taking medications, but it is very difficult to see a caregiver for individual counseling. So what we have

to do is, as a nonprofit, we had to take our one mental health budget from the county, and we hired a part-time psychiatrist because

this was a need.

I want to talk about employment and training, because, you

know, that has always been one of the key answers, is getting the

guys back on their feet and getting them employed.

The HVRP program is a remarkable program. You know, all of

us have been fighting that program for years since the earliest

days. I remember when it was $1.1 million for the entire country;

and now it is up to 17 or $19 million, even though we asked it to

be as much as $50 million, and it has been authorized for $50 million but not appropriated.

I think it is crucial. It is one of the programs that is funded because employment and training—HVRP takes into consideration

that when you are working with homeless veterans it can’t just be

job placement. It has to include housing, mental health care, a

range of support services. I don’t know any other employment program that allows you to do that. Many of these employment programs are very data driven.

I want to say two quick things. Here is the one thing. There is

the thing called the Federal contractor compliance, and what that

means is those Federal contractors who have contracts over

$25,000 are supposed to do the right thing and hire veterans. Yet

that has been shamefully unenforced forever since I remember.

Here we are today. We have lots of private military contractors.

We have homeland security. We have national defense. I wonder

how many veterans are going to be hired by those contractors.

When I was in the transition commission, we made a recommendation that said, at the procurement stage those contractors

had to demonstrate a commitment to hire veterans in order to be

awarded some of those contracts. It is very important for that to

be enforced.

I want to say the second thing is I think the TAP program is

very important, that idea of early intervention.

The third thing is the soldiers of Iraq have all the ingredients

of having serious post-traumatic stress disorder. There has been

lots of terrible issues that happened in the Iraq war. Those soldiers

were put in impossible situations, and they are going to be hurting

and suffering, and I don’t want to have them wait 10 years like we

had to wait in Vietnam. I don’t want those men and women soldiers to wait in line to be put aside or be backdrops in political

campaigns. They need our utmost attention. I think we need to do

planning now, and that planning has to go beyond the Pentagon

medical establishment and the VA medical establishment and

should take into consideration those of us who have been in the

field for 30 years that know something about healing and caring.
35

Mr. MILLER. I thank you for participating in this panel.

[The prepared statement of Mr. Blecker appears on p. 129.]

Mr. MILLER. I have a couple of questions, and we will allow the

members that are still with us to also ask questions.

My first one is to you, Ms. Boone, since you have been sitting

there patiently listening to the rest of the testimony. What would

you say VA needs to do to get on top of homelessness that it is not

doing today?

Ms. BOONE. It certainly needs to become a higher priority, and

the members have already discussed that today that it is very low

on the priority list. Even though Secretary Principi himself has a

great understanding and sensitivity to the issue, that does not resonate throughout the VA medical system. If you go hospital by hospital, you will find a wide range of commitment to treating homeless veterans.

So, first of all, they need to make it a priority. Put more money

into it. Allocate the money to implement Public Law 107–95. At a

minimum, that is what needs to happen, and the Secretary can do

that, and we feel he should do that. That would send a message

that he is committed and he is committing resources and not just

words to that.

Mr. MILLER. Ms. Spearman, if I could ask you a question, what

other services does your organization supply to the homeless,

whether veterans or not?

Ms. SPEARMAN. We do some substance abuse treatment. We do

mental health services—we have a whole clinical staff that provides home-based care. We have a transportation and basic support

system.

Every single person in our program, we are moving them to independence—most all have special needs, as we have indicated,

whether they are elderly, mentally ill; and very many of those are

veterans as well. So all of the support services in the home in the

community are helping with life’s basic daily living skill development as well as getting vets back into the community with case

management for a period of years. We do a continuum of care and

housing which goes all the way to permanent housing.

So that is one advantage we do have with being able to work so

well with the VA system. We then can follow with the permanent

housing which we continue to develop along with the support services. Support services are any intervention that can take a person—which can include medical care and so forth, depending on

the population, to independence.

Mr. MILLER. Do you know when the last time the mobile van was

in the Panhandle of Florida?

Ms. SPEARMAN. Probably a month ago.

Mr. MILLER. I am glad. I missed it.

Ms. SPEARMAN. It is very rural; and we go in some very interesting, scary places. It takes a real dedicated staff.

Mr. MILLER. Be careful. I represent the Panhandle. I represent

the first district. It is not scary at all.

Mr. Filner.

Mr. FILNER. Again, I want to thank all of you for your commitment and work and love as we have heard the word used.
36

Mr. Stearns asked earlier how much is this going to cost to solve

it. If you extrapolate Mr. Downing’s figures, you get $2.5 billion. If

you take Ms. Spearman’s $600 million for Florida, imagine what

that would mean for the whole country. These are not beyond our

ability to pay. I mean, we have the resources. It is a question of

commitment.

You don’t have to be a great pundit to understand that what you

are asking for isn’t going to happen in this Congress. This Congress

will vote on the same day, and in concurrent resolutions we will

support our troops in one resolution and then cut $25 billion in the

next resolution. This Congress will pass $70 billion for the war and

then cut a million other programs. We have laid off in California,

I think, 25,000 teachers; and we could talk for hours about the

needs of this Nation. I think you all have to elevate your commitment to a more public—maybe more dramatic level.

Forgive me. I am a child of the 1960s, and I started my career

in jail, so I figure everybody else did, also. I mean, I would bring

the homeless to Washington and surround the Capitol and not

move until we funded these veterans. I mean, these are veterans

of the United States of America. Take Mr. Strickland’s idea and

issue a uniform and dare the Capitol Police or anybody to move

them out—and we congressman should stay there with them.

I am sort of brainstorming here. We can talk about your needs

and assistance grants and all that, but the fact of the matter is the

political system, as constituted right now, isn’t going to match your

passion and your commitment and your needs. That is the reality.

But we have the resources to do it, so how do you deal with it?

I have become far more public, I have become far more obnoxious, and I have become far more confrontational in that this system ought to respond, and it isn’t responding. So I would participate with you, but you all have to use your programs and your clients. I would bring them all to Washington and make us very uncomfortable and challenge us to meet your commitment and your

passion.

I know your being here, I am sure I speak for all of us—has reinforced our own commitment. And I promise you that we will bring

to the floor amendments that would actually do what you need to

do; and they will be ruled out of order, they will be voted down,

they will be dismissed. We are going to do it, as we have done this

in the past.

Every person who gave a great speech on Memorial Day or Veterans Day saying that they support veterans then voted to make

my veterans support amendments out of order. Of course, no press

ever reports because it is a procedural item; and nobody ever

knows about it.

But I think you have to make this country uncomfortable in what

it is doing. People don’t look homeless people in the eye. They try

to avoid it. They call the police when they are messing up their

property. If we can’t do for our homeless, especially our veterans

homeless, when we have got the resources, we don’t deserve to be

considered a moral nation.

So I just throw out these ideas. Are you thinking about things

like this or are you struggling with your own programs to survive
37

and meet the needs of your clients. Any thoughts? I don’t want you

to lose your funding because you became a revolutionary.

Ms. BOONE. Well, we don’t have any funding. The National Coalition for Homeless Veterans is here, and our 300 attendees at our

conference are all very concerned, and they are concerned about

the veterans that don’t often vote and have no power, so we are

here to try to speak for them.

But I think, Mr. Filner, what you bring up is a really good point,

to be more in the face of the public. Because the public doesn’t

know about homeless veterans as much as they should, and so we

agree with you. It is tough to organize a bunch of homeless veterans, but we might think about that.

Mr. COOPER. Mr. Filner, I just wanted to share something with

you that Congresswoman Maxine Waters said to a group of us.

Said you are the most quiet bunch of warriors I have ever seen.

You are fighters who don’t make noise.

What I shared with her was is that is what veterans have

learned and are programmed to do. We are programmed to sustain

all kinds of injury, problems. We are programmed to survive and

to do—to sustain all kinds of fire and not complain. Complaining

oftentimes is not rewarded if you are a person in the military.

So we learned—you ask a veteran who is in a little lean-to, he

is homeless and say, how you doing, man? He said, I am doing

okay. I got my lean-to here. I had a little something to eat. I am

doing great. That will lead someone to say he is happy being homeless, but does that deobligate us to let this person know that you

are having an American dream of owning your own home?

Mr. FILNER. I would argue, though, to have a political purpose

would become a part of the treatment. I watched people who didn’t

complain who had no hope, and given things to do in the first

Stand-Down, they became warriors again because they had a purpose. They brought blankets. They organized this and provided

that. They got people back into the mainstream because they had

a purpose, and they were successful. And maybe that political aim

will do more than the counseling.

I am sorry, Mr. Chairman.

Mr. MILLER. Mr. Strickland.

Mr. STRICKLAND. Thank you, Mr. Chairman.

I also want to thank the panelists.

I am going to pick a fight with Ms. Boone, and I really hate to

do that because she is one of the people I most admire. But as I

listened to your testimony and you described Priority 7 and then

Priority Group 8 and I think the implication was that our priorities

may be a little off. And I concur with you that we should help those

that are the most in need first, but I think we should help Priority

Group 7 veterans.

I am really troubled by Priority Group 8 which my understanding is you can make as little as $24,000 and be deprived of the

availability to enroll in the VA health care system, and the reason

that troubles me is because it is unnecessary. It is just unnecessary.

The issue is, do we care enough about our veterans to care for

all of them who are in need? And the truth is we don’t. We don’t.
38

And all the words we utter are empty words until we are willing

to use our resources where they are most needed.

Now Bob wants us to go to jail. I don’t want to do that. I worked

in a maximum security prison, and I have been there, Bob’s been

there, and I can tell you something that may be more effective— and I hope you agree with me, Mr. Filner—than marching or getting arrested.

If we could just convince every veteran in this country to refuse

to pose in a picture with any politician who did not support their

needs—because we all love—I will tell you, I love to get my picture

made with you guys. Your uniform is on, the flag is flying behind

us, it is good politics, but you are too easy on us. You are too easy

on us. And you should not listen to our words, but you should look

at our votes. That is what you should do.

I think if the veterans and the advocates of veterans in this

country did that, then things would change. And until they do—you

know, until you are not willing to settle for a congressman or a

congresswoman who will put their arm around your shoulder and

thank you with words for what you have done and then will not

vote to make sure that your legitimate needs are met and the

promises that we have made are kept, things will not change.

That doesn’t mean that you shouldn’t continue to do what you do

because you are making a difference in individual lives and in certain localities. But in terms of the overall national needs that are

confronting our veterans, I don’t think things are going to change

until there is a will to change; and I don’t think that will happen

until there is a demand from the grassroots veterans around this

country.

I worked in a maximum security prison for almost 10 years, and

I can tell you there were lots of veterans in there. I never served

in the military, but we had veterans in the maximum security prison. Most of them that I had contact with, because I am a psychologist and I work with the mentally ill, were individuals with very

serious mental illnesses—PTSD, schizophrenia, major depressions.

You know, I guess maybe being homeless on the streets is a little

better than being in a maximum security prison, but they are not

appropriate settings for those who served this country honorably,

especially when their legal problems, many of them I am convinced

come directly from untreated mental illness and substance abuse.

So there is a lot of work that confronts us.

This is a great committee, and I think most of what you are advocating for people on this committee are going to, you know,

Stand-Downs behind very substantially and support it, but we have

got to get the message out to the larger body in the House of Representatives and in the Senate and, ultimately, across the country.

So I didn’t ask a question; and, Ms. Boone, you are an asset.

Thank you all very much; and thank you, Mr. Chairman, for this

opportunity.

Mr. MILLER. Thank you, Mr. Strickland. Mr. Ryan.

Mr. RYAN. Thank you, Mr. Chairman.

Mr. Cooper, just a comment about what you said. I do agree with

my colleague regarding the mobilization effort not only with veterans but I think with all interest groups right now that I think have

been disconnected from the political process. But you are absolutely
39

right when you say that veterans—the ones who have been in combat inevitably will never say ‘‘I was in combat.’’ I mean, you have

to hear it through a friend or a family member, because they don’t

really talk about it.

I had an uncle that was in Vietnam, and he was on the front

lines and, you know, it wasn’t until I was 25 years old until I found

out some of the real stories, you know, because he would never

ever talk about them. And he lost numerous friends when he was

there. So it is not flippant to say we need you to mobilize, and I

think we need you to understand or try to understand what you

have been through.

If we want to solve the problem, there is only one way in a democracy that works. You either have a lot of money and you get

what you want, or you have a lot of votes and you get what you

want; and until we get the message out and have the real-life stories, I think we are going to continue to confront these problems.

One question I do have for Mr. Blecker. You stated something

about the Gulf War veterans, and I assume you were talking about

the 1991 war.

Mr. BLECKER. Well, I was thinking about the Iraqi—the soldiers

who just fought in Iraq.

Mr. RYAN. What percent—given the amount of troops, what percent would you say would come back with post-traumatic stress?

Mr. BLECKER. Well, you know, they are all subjected to issues,

whether they were directly in combat or in supplies. Look at some

of those who were taken prisoners and some of the convoys that

were shot up. But there were situations where it was incredibly

stressful, separating those who were friendly from those who were

not. There are issues around family members of the civilians who

were killed, and they were right there, and they were sort of participating while there were funeral rites going on. There were

shootings in buildings.

The fear of their own safety, the fear of the safety of their friends

and the quickness, the way all of this transpired, it reminds me of

Vietnam. A lot of Vietnam vets have talked about that. It reminds

so much of that, being in villages, who was friendly, who was not,

the quickness and explosiveness of the danger and the suffering

that occurred.

I just see it written all over the place. You have lance corporals

that perhaps are 19, 20, 21 who have gone through this now and

they are back and they are disfigured and going to the hospital for

rehabilitation. How are they going to get on with their lives? They

never thought about—because when you are that young you figure

you are invincible. So all those issues we suffered with, we see that

happening with this new generation of war soldiers.

Mr. RYAN. Do you have an idea of a percentage—just a ballpark

figure that you say that that would affect?

Mr. BLECKER. It is hard for me to say that. That is why I called

the beginning of a plan or a pilot project that brings people together who know the situation. I mean, you had firefighters in 9/

11 that were traumatized. We are learning more about crises,

about trauma and about the stress that it imposes to how it affects

our health and with that knowledge we can help the soldiers. That

is why I thought about having a project or planning process that
40

goes beyond—again, beyond just the VA or Department of Defense

medical establishment and brings in the expertise of those who

have been working with veterans and others who are suffering. I

don’t know if it would take a lot of money or anything, but we need

to start the planning now.

Mr. RYAN. I thank the gentleman, and I yield to the gentleman

from Ohio.

Mr. STRICKLAND. I also think we have learned that timely intervention is important and that we need to be thinking now about

these problems so that we can deal with them now rather than

wait until they fester for months or years and dysfunctional behaviors and habits have developed. I think what you have shared with

us is very important, but now is the time we ought to be thinking

about how to provide the kind of intervention that is needed in

order to keep later problems from developing.

Mr. BLECKER. You have National Guard and Reserves. They are

coming back very quickly. You are right. Timely intervention is

crucial.

Mr. STRICKLAND. This is upon us, and this is happening as we

speak.

Mr. COOPER. May I respond to Mr. Ryan?

I didn’t want to imply I am against any kind of mass action. How

the VA got started is that World War II veterans came in and

marched on Washington for housing. How we got to be able to have

a National Coalition for Homeless Veterans is because a bunch of

us Vietnam veterans sat right out there overnight in fatigues and

in bases.

I am not saying that we shouldn’t, but the reality is that we persevere under extreme circumstances. So, oftentimes, we are not

prone to move until it is really, really, too late. And with the climate that is in this Nation now, homeland security and such, a

bunch of veterans moving in on the Capitol or on this building

could create a real, rather difficult situation. So we need to talk

about—this is a time that is not like when World War II or even

when Vietnam was over. This is a different kind of time. We are

never going to go back to those days again—you know, it is a different kind of situation now after 9/11.

Mr. MILLER. Thank you very much.

Having all time expired I want to say thank you to the panelists.

Certainly, your experience, your words, your wisdom that you have

imparted to this committee is important; and I think if there is one

thing we have proven today, it probably happens at the VA committees. There is a lot of work that we need to solve.

Mr. MILLER. With that, this hearing is adjourned.

[Whereupon, at 4 p.m., the subcommittee was adjourned.]
(41)

A P P E N D I X
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169

WRITTEN COMMITTEE QUESTIONS AND THEIR RESPONSES

CHAIRMAN SIMMONS TO DEPARTMENT OF VETERANS AFFAIRS
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219

Æ