November 20, 2019

Chairman Takano: “In order to mitigate veteran suicide, we need new solutions.”

WASHINGTON, D.C. – Today, House Committee on Veterans’ Affairs Chairman Mark Takano (CA-41) delivered opening remarks before the full committee legislative hearing assessing two measures to address veteran suicide: HR 3495 and Chairman Takano’s draft bill that would utilize VA grants to create a community hub model. A diagram of the community hub model and Chairman Takano’s opening remarks as prepared can be found below.

Community hubs can help connect veterans to resources already present in their communities.

 

Chairman Takano’s remarks as prepared:

Good morning. This legislative hearing is an opportunity for stakeholders to make their comments and concerns public following last week’s closed-door roundtable.

 

Today’s hearing follows months of meetings and discussions with VSOs, mental health professionals, experts in suicide prevention policy, union leadership and other stakeholders.

 

I am grateful for their responsiveness and willingness to work toward improved language that delivers VA’s finite resources to the communities that need them most.

 

In order to mitigate veteran suicide, we need new solutions. We all acknowledge that VA has the ability to provide top-level mental health services but that only works for veterans connected with VA.

 

Today, we’ll hear about two measures that attempt to address veteran suicide - H.R. 3495 as it stands in its current form and my discussion draft.

 

While I agree with the underlying intent of H.R. 3495, I do have significant concerns.

 

First, this bill would allow VA grants to fund community-based clinical care and would clearly circumvent the MISSION Act that streamlined clinical care under one program. Instead this legislation creates a separate lane for care in the community without critical safeguards and accountability measures in place. I will oppose any language that authorizes use of VA grants to provide clinical care.

 

At the roundtable, the coordinating or “hub” organizations we heard from said they had the ability to make clinical services available to veterans ineligible for care at VA. Veterans with other than honorable discharges can already receive mental health care at VA facilities.

 

Furthermore, grant funding for clinical health care does not solve the problem of under resourced and underserved geographic areas suffering from a general shortage of providers.

 

Clinical care paid for with VA dollars should be subject to accountability and culturally competent clinical providers in the community should become part of the VA’s Community Care Network created under the MISSION Act.

 

The urgency of addressing the crisis of veteran suicide should not be the pretext for allowing VA money to go to providers who are not held to account for measurable outcomes, providing culturally competent care, nor subject to any oversight.

 

Second, H.R. 3495, as introduced would provide direct temporary cash assistance to veterans, their families, and anyone else who may live with them. My understanding is that cash assistance to veterans needs further, careful consideration and should be taken up in separate legislation.

 

Third, H.R. 3495, as introduced would also distribute VA’s limited funds to community partners without any controls in place to ensure those funds are properly utilized. H.R. 3495 as introduced authorizes the VA Secretary to award grants to organizations unbound to any performance criteria and irrespective of whether there is demonstrated local need for the services provided by these organizations.

 

Funding decisions should be driven by local coordinating organizations who have the pulse on their communities and regions. The coordination should be as local as possible. There are many examples of such excellent organizations which are called “hubs” by many who do this work. Funding grants through “hubs” promotes accountability through widely recognized metrics and effectiveness through local funding determination.

 

Without local need and metrics tied to the award of grant funding, this is not consistent with the policy goal of reaching the 60 percent of veterans at risk for suicide who are not connected with VA.

 

I am grateful for General Bergman’s commitment to ensuring we work together to ensure vital accountability measures are in place and my concerns on H.R. 3495 as introduced are addressed.

 

My legislation presented today as a “discussion draft” delivers a public health solution focused on “upstream intervention” - the idea that if we provide wrap-around services to address housing insecurity, unemployment, or social isolation, we can better prepare veterans to deal with life stressors that may lead to suicidal ideation itself.

 

My discussion draft seeks to channel federal grants into local community organizations through local coordinating organizations that mirror the recommendations embedded in the President’s PREVENTS Executive Order. I do not believe the Office of the Secretary with an advisory committee in Washington, D.C. meets the intent or spirit of this Executive Order, especially section 5. Establishing metrics and coordination of local resources are emphasized in this section.

 

Veterans’ daily lives don’t solely revolve around VA. They frequent small businesses, attend classes at community colleges and universities, volunteer in their neighborhoods, and participate in the local workforce-- just like everyone else.

 

My draft legislation aims to leverage these deep ties by using the “hub model” which can help connect veterans with existing community-based partners already working to serve veterans and their families. Hubs are similar to the vet centers, resource centers, and case managers VA provides, but they can also coordinate services, make referrals, and track effectiveness, demand, and capacity, across a network.

 

My discussion draft goes beyond doling out cash to unestablished organizations and ensures key accountability measures are in place that require organizations with a demonstrated track record of providing services to veterans. It creates an opportunity for coordination. It creates an opportunity for communities, as a whole, to surround and support veterans with the services they wish to access most often.

 

The draft legislation would authorize VA to provide grants - $500 thousand in first year, matched 100% by the organization - for up to 10 community-based coordinating organizations each year. Qualifying organizations are those that provide social services that mitigate known life stressors like employment counseling, family counseling, debt forgiveness, higher education assistance, housing services, legal counseling, and recreational therapy.

 

We must create a public health infrastructure. If we fail to provide our communities with the support they need in order to assess, increase, and leverage community-based services to better serve veterans, then veterans will not be able to access these services.

 

By allowing VA to responsibly partner with the community organizations already serving veterans, while at the same time protecting VA’s expertise in providing clinical care, I believe we can reduce the overall number of veteran suicides.

 

Hubs already have their fingers on the pulse of their communities, and have collectively served hundreds of thousands of veterans. They speak to veterans and their families every day. They don’t care about VHA eligibility or disability ratings -- they just care about offering solutions to life’s problems, when and where the veteran needs it.

 

Focusing VA’s limited funds to fill gaps in resources will provide the most sought-after services based on recommendations from local stakeholders in the community -- not politicians in Washington, D.C.

 

We’ve long been debating how to address the crisis of veteran suicide. My discussion draft is a clear solution that will direct resources to those who need them most, increase coordination in our communities, improve the quality of life for veterans and their families, and help reduce veteran suicide as a result.

 

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