Department of Veterans Affairs: Structure and Services Sean

Department of Veterans Affairs: Structure and Services Sean Clark, J.D. National Coordinator Veterans Justice Outreach July 28, 2015 Jessica Blue-Howells, LCSW National Coordinator, Health Care for Reentry Veterans VA: Mission and I CARE Values Mission To fulfill President Lincoln's promise To care for him who shall have borne the battle, and for his widow, and his orphan by serving and honoring the men and women who are Americas veterans. I CARE Values Integrity Commitment Advocacy Respect Excellence VETERANS HEALTH ADMINISTRATION

What is Federal VA? United States Department of Veterans Affairs Veterans Health Administration 150 hospitals, 830 outpatient clinics, 370 Vet Centers Veterans Benefits Administration 57 Regional Offices Life Insurance, Home Loan, Disability Compensation, Pension, Education, Vocational Rehabilitation National Cemetery Administration 131 National Cemeteries Veteran Population 2016: estimated 21,368,000 VETERANS HEALTH ADMINISTRATION Unique Veteran Users Report, FY 2014 National Center for Veterans Analysis and Statistics, March 2016

VETERANS HEALTH ADMINISTRATION 4 National Cemetery Administration (NCA) Mission The National Cemetery Administration honors Veterans with final resting places in national shrines and with lasting tributes that commemorate their service to our Nation. Cemeteries 3.1 million gravesites in: 131 National cemeteries 33 soldiers lots/monument sites Burial Benefits (private cemetery) Headstone/marker, burial flag, Presidential Memorial Certificate VETERANS HEALTH ADMINISTRATION 5 5 NCA (cont.) Eligibility for Burial in a National Cemetery

Servicemember who died on active duty Veteran who was discharged under conditions other than dishonorable Reserve/National Guard members entitled to retired pay What to do: Contact the National Cemetery Scheduling Office Fax all discharge documentation to 1-866-900-6417 Follow-up with a phone call to 1-800-535-1117 Resources Locate a National Cemetery: Additional information: VETERANS HEALTH ADMINISTRATION 6

6 Veterans Benefits Administration (VBA) Administers programs that provide financial and other forms of assistance to Veterans, their dependents, and survivors. Benefits include: - Veterans compensation - Veterans pension - Survivors benefits - Vocational rehabilitation and employment assistance - Education assistance - Home loan guaranties - Life insurance VETERANS HEALTH ADMINISTRATION VBA Regional Offices Togus Manchester Seattle White River Jct. Anchorage

Ft. Harrison Fargo Portland St. Paul Boise Milwaukee Sioux Falls Cheyenne Boston Des Moines Lincoln Reno Oakland Salt Lake

City Buffalo Detroit Providence Hartford Pittsburgh New York Cleveland Chicago Newark Philadelphia Wilmington Indianapolis Denver Huntington

St. Louis Baltimore Wichita DC Roanoke Louisville Los Angeles Winston Salem Nashville Albuquerque San Diego Muskogee Phoenix WACO

Little Rock Atlanta Montgomery Columbia Jackson New Orleans Houston Eastern Area Southern Area Central Area Western Area St. Petersburg Honolulu San Juan

VBA: Homeless/Incarcerated Veterans Outreach Coordinators (HVOC) At least one HVOC at every VBA Regional Office Outreach to homeless Veterans at homeless shelters, homeless Stand Downs, through state and local community partners and other areas where homeless Veterans may be located Processing claims for homeless Veterans and those at risk of homelessness to ensure they are expedited Outreach to justice-involved Veterans in Veterans treatment courts, prisons, and jails Outreach includes providing information and assistance on VA benefits and services such as discussing eligibility criteria and filing a compensation and/or pension claim. VETERANS HEALTH ADMINISTRATION 9 VBA: Types of Benefits Note: More detailed information about each of these programs, including their eligibility requirements, is available at:

Disability Compensation Tax-free payment Disability is service-connected Discharged under other than dishonorable conditions Pension Tax-free payment Wartime Veterans with limited or no income who are either: Aged 65 or older, or Permanently and totally disabled (non-service-connected) VETERANS HEALTH ADMINISTRATION VBA: Types of Benefits (cont.) Education and Training Post-9/11 GI Bill (Financial assistance: tuition and fees, books, supplies, housing allowance) Montgomery GI Bill Reserve Educational Assistance Program

Home Loans VA-issued loans (no down payment or mortgage insurance premiums) VA-guaranteed loans (private lenders) Home loan refinancing Specially Adapted Housing Grants (severely disabled Veterans) VETERANS HEALTH ADMINISTRATION VBA: Types of Benefits (cont.) Life Insurance Vocational Rehabilitation and Employment Veterans with service-connected disabilities

VA provides career path evaluation, vocational counseling, job-search assistance Dependents/Survivors Dependency and Indemnity Compensation Monthly benefit paid to surviving spouse/children Eligibility: Servicemember died on active duty, from a service-connected disability, or was rated totally disabled at time of death Survivors Pension - a monthly tax-free benefit payable to the un-remarried surviving spouse and/or child(ren) of a deceased Veteran with wartime service who meet the income threshold Surviving spouses and children also eligible for reimbursement of medical costs, financial assistance to pursue education and training VETERANS HEALTH ADMINISTRATION VBA: Applying for Benefits Online By Phone Questions? VBA National Call Center: 1-800-827-1000 1-877-222-VETS (8387) Completed form sent to Veteran for verification and signature In Person Nearest Regional Office Nearest VA medical center or clinic Working with an accredited Veterans Service Organization representative, attorney, or claims agent VSO offices in VA medical centers and Regional Offices VA Office of General Counsels list of accredited reps: VETERANS HEALTH ADMINISTRATION Veterans Health Administration (VHA) Mission Honor Americas Veterans by providing exceptional health care that improves their health and well-being. VETERANS HEALTH ADMINISTRATION 14 Veterans Health Administration: General Healthcare is the largest component of VAs services VAs medical system is comprised of a network of hospitals, outpatient clinics, Vet Centers, nursing homes, and residential treatment facilities

VA offers comprehensive medical and mental health services to Veterans who qualify for medical benefits VETERANS HEALTH ADMINISTRATION 15 VHA Organization Regional: Organized into 18 Veterans Integrated Service Networks (VISNs) Budgetary, Planning, and Accountability Unit of Veterans health care system VISN or Regional Care Services Examples: Polytrauma, Domiciliary, Vision Impairment Local: 150 Medical Centers with multiple campuses, community-based outpatient clinics more than 1400 total sites VA Health Care Systems (multiple Medical Centers) Affiliation with over 100 academic health systems (trained 65% of US physicians) Where is the Nearest Medical Center or other Health Care Facility? Use the Facility Locator to find VA medical facilities

VETERANS HEALTH ADMINISTRATION 16 Reaching Rural Veterans VA estimates approximately 43% of all Veterans live in rural areas. VA continues to expand health access to rural Veterans through: Fee basis care Rural health care partnerships VETERANS HEALTH ADMINISTRATION Home-based telehealth Mobile health clinics 17 Health Care Delivery Model Patient-Centered

Team Care Continuous Improvement Data-Driven, Evidence-Based Value Prevention / Population Health VETERANS HEALTH ADMINISTRATION 18 Veterans Health Administration: Services

Primary Care Specialty and Inpatient Care Preventive Health Care Pharmacy Benefits Emergency Care Diagnosis and Treatment for Mental Health and Substance Abuse Surgical Care and Organ Transplantation Rehabilitation Nursing Home Care Respite and Hospice Care Readjustment Counseling Blind Rehabilitation Services

Dental (with specific eligibility criteria) Maternity Care VETERANS HEALTH ADMINISTRATION 19 Veterans Health Administration: Mental Health Services Assessment, diagnosis and treatment of mental health issues Services offered in inpatient, residential, and outpatient settings Evidence-based treatments offered for specific conditions and problems including: Anxiety Bipolar Disorder Depression Military Sexual Trauma Posttraumatic Stress Disorder Schizophrenia Suicide Prevention Core principles: mental health care is an integral component of overall health care,

mental health services must be recovery-oriented VETERANS HEALTH ADMINISTRATION 20 Veterans Health Administration: Substance Use Disorder Services Case finding, assessment, diagnosis and treatment of Substance Use Disorders, including tobacco use Services provided in specialty clinics, primary care, and integrated into mental health services Includes medically supervised withdrawal management in both ambulatory and inpatient settings Intensive Substance Use Disorder (SUD) services available in outpatient and residential settings Pharmacotherapy: opioid agonist treatment (methadone, buprenorphine) and for alcohol use

Evidence based interventions: motivational enhancement therapy, cognitive behavioral therapy for relapse prevention, 12-step facilitation counseling, contingency management, SUD-focused behavioral couples counseling or family therapy. VETERANS HEALTH ADMINISTRATION 21 Readjustment Counseling Service Vet Centers Eligibility: Veteran or family member served in a combat zone and received a military campaign ribbon Services: Readjustment counseling for Veterans and their families Individual and group counseling Family counseling for military-related issues Bereavement counseling for families who experience an active duty death Military sexual trauma counseling and referral Outreach and education at community events Substance abuse assessment and referral

Employment assessment and referral VBA benefits explanation and referral Screening and referral for medical issues Organized as part of VHA, but separate from VHA health care system VETERANS HEALTH ADMINISTRATION 22 Ending Veteran Homelessness One of VAs top priorities is ending Veteran homelessness The goal is a systematic end to homelessness with no Veterans sleeping on the street and every Veteran with access to permanent housing VA is the largest single provider of homeless services in the Nation

VA offers a wide array of interventions designed to find homeless Veterans, engage them in services, find pathways to permanent housing, and prevent homelessness from occurring VETERANS HEALTH ADMINISTRATION 23 VHA Homeless Programs Health Care for Homeless Veterans (HCHV)* Community Resource and Referral Center (CRRC) Grant and Per Diem Program (GPD)** Supportive Services for Veteran Families (SSVF)** Domiciliary Care for Homeless Veterans (DCHV)

Housing and Urban Development-VA Supported Housing (HUD-VASH) Homeless-Patient Aligned Care Teams (H-PACT) Veterans Justice Outreach (VJO) Health Care for Reentry Veterans (HCRV) Community Homelessness Assessment, Local Education and Networking Groups (CHALENG) *At some sites HCHV includes contract residential treatment services with contracts funding community providers **VA provides grants to eligible community providers; community providers offer services VETERANS HEALTH ADMINISTRATION 24 Employment Employment Preparation and Placement Vocational Rehabilitation

Therapeutic and Supported Employment Services (TSES)/Compensated Work Therapy (CWT) Homeless Veterans Community Employment Services (HVCES) U.S. Department of Labor Partnership Programs VETERANS HEALTH ADMINISTRATION Mission and Vision Veterans Justice Programs MISSION To partner with the criminal justice system to identify Veterans who would benefit from treatment as an alternative to incarceration. VJO will ensure access to exceptional care, tailored to individual needs, for justice-involved Veterans by linking each Veteran to a VA and community services that will prevent homelessness, improve social and clinical outcomes, facilitate recovery and end Veterans cyclical contact with the criminal justice system. VISION Every justice-involved Veteran will have access to the health care and other benefits necessary

to pursue and realize a full, meaningful life as a self-reliant, positively contributing member of the community. VETERANS HEALTH ADMINISTRATION Serving Justice-Involved Veterans Healthcare for Reentry Veterans (Veterans incarcerated in prison facilities) Outreach and pre-release eligibility determination and assessment for treatment Referral and linkages to medical, psychiatric, and social services, including employment services upon release Short term case management assistance upon release Veterans Justice Outreach (Veterans interfacing with front end of justice system) Jail outreach and associated eligibility determination, assessment, & treatment linkage Education of and liaison with VA and community law enforcement Liaison with court system and staffing of collaborative treatment courts Short term case management as indicated Linkage to ancillary support (e.g. child support services, legal assistance)

VETERANS HEALTH ADMINISTRATION Limits on VA Authorization Release of Information Not Authorized to Provide Custodial Care No Locked Residential Facilities Not Authorized to Provide Care While Veteran is Incarcerated VETERANS HEALTH ADMINISTRATION For Additional Information Veterans Justice Outreach Specialists Jessica Blue-Howells, LCSW National Coordinator, HCRV 310-478-3711, ext. 41450 [email protected] VETERANS HEALTH ADMINISTRATION Sean Clark, J.D. National Coordinator, VJO

859-233-4511 ext. 3188 [email protected]

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