Responding to the Needs of Veterans

1. Department of Veterans Affairs Responding to the Needs of Veterans Sherri Claudio, LCSW, CAP Veterans Justice Outreach Specialist Department of Veterans Affairs Orlando VAMC

2. The VA – who are we? The Department of Veterans Affairs (VA): Veterans Health Administration (VHA) • Administered by VHA – All Health care services • VA Medical Centers, Ambulatory Care & Community Based Outpatient Clinics Veteran Benefits Association (VBA) • Administered by VA Regional Offices - All VA Benefits • Compensation & Pension, Education, GI Bill, Home Loan Guaranty, etc. National Cemetery Administration (NCA) • National and State Veterans Cemeteries • Headstones, Markers & Presidential Memorial Certificates

3. Orlando VAMC • Orlando VAMC officially became a medical center on October 1, 2006. • 5201 Raymond St., Orlando (Baldwin Park) • Catchment area includes Orange, Seminole, Osceola, Volusia, Brevard and Lake Counties

4. Clinic Locations • Outpatient Clinics • Daytona and Viera • Community Based Outpatient Clinics • Kissimmee, Orange City, Leesburg, and Clermont • Annex Locations • Crossroads (Semoran Blvd.) and Lake Nona • Vet Center

5. Available VA Services • Medical, Surgical, Psychiatric Inpatient and Outpatient Care • Mental Health Residential Rehabilitation Treatment Programs (Homeless Veterans Program, PTSD Program, Coping Skills Program, & Substance Use Disorder Program) • Homeless Programs (HCHV, Grant & Per Diem, HUD-VASH, VJO, HCRV) • Post-Traumatic Stress Disorder Treatment • Military Sexual Trauma Treatment • Home Health Care/Home Medical Equipment (Prosthetics) • Nursing Home Care • Women’s Health Clinic • Dental Care for Eligible Veterans

6. VA Eligibility • Eligibility is based on each individual’s service and is determined by the VA eligibility/enrollment office. • Usually determined by length of service and character of service. • What is a DD214? • VET Center – served in Combat Era • honorable, general and other than honorable

7. How will YOU know if someone is a Veteran? • Ask: Have you ever served in the United States Armed Forces or Military? • Do not ask: Are you a Veteran? Many Veterans mistakenly think this applies only to Veterans who served in combat or retired from the military. • Refer to local VA facility • We encourage all Veterans to apply for VA services.

8. Common Issues • Unemployment • Financial Problems • Risk of losing home • Medical Issues • Mental Health Issues • Substance Abuse Issues • Family Issues • Legal Problems • Homelessness

9. Invisible Wounds • Combat can cause invisible wounds to the brain, mind, and soul • Traumatic Brain Injury (TBI) • Post Traumatic Stress Disorder (PTSD) • Both types of injuries can lead to • Poor judgment • Impulsivity • Difficulty in matching behavior to the context • Behaviors attributable to these injuries • Can look like criminal behavior (Video) • Can be criminal

10. Veterans Justice Programs • VA is making a system-wide effort to ensure access to services for the justice-involved veteran population at risk for homelessness, substance abuse, mental illness, and physical health problems • Healthcare for Reentry Veterans Program (HCRV) • Veterans Justice Outreach Program (VJO)

11. Goal of VJO The goal of the VJO program is to avoid unnecessary criminalization of mental illness and extended incarceration among Veterans by ensuring that eligible justice-involved Veterans have timely access to VA mental health and substance abuse services when clinically indicated as well as other VA services and benefits.

12. Limits on VA Authorization • Can provide: • Outreach, assessment, referral and linkage to services • Treatment for justice-involved Veterans who are not incarcerated • Title 38 CFR 17.38 does not allow VHA to provide: • Hospital and outpatient care for a Veteran who is • Either a patient or inmate in an institution of another government agency • If that agency has a duty to give that care or services

13. DUSHOM Memo to VISN Directors (May 2009) • Designation of a Veteran Justice Outreach (VJO) Specialist at every VAMC to: • Provide outreach to justice-involved Veterans in the communities they serve • To take initiative in building working relationships and reach out to potential Justice System Partners to see that eligible justice-involved Veterans get needed care • Partner with Law Enforcement Crisis Intervention Teams (CIT) to train law enforcement personnel on Veteran specific issues.

14. Veterans Justice Outreach Specialists • Responsible for • Outreach, assessment, case management for justice involved Veterans in local courts and jails • Liaison with local justice system partners • Providing/coordinating training for law enforcement personnel • Specialists will • Assist in eligibility determination and enrollment • Function as members of court treatment teams • Refer and link Veterans to appropriate providers

15. Justice Outreach Program • While incarcerated, Veterans can: • Request his/her DD214 • Enroll at their local VA Medical Center • Apply for the VA transitional and/or supportive housing programs • Learn about VA and non-VA community resources for post-release needs

16. Statistics (Orange County Jail) • Veterans were arrested and booked at the Orange County Jail. • 2009 = 1368 • 2010 = 1361 • 2011 = 1687 • On a daily basis, Veteran arrests average about 6-8 a day. • On one of these days, 14 Veterans were arrested being the most in a single day.

17. Statistics (Con’t) • Charges varied from burglary, battery, shoplifting, VOP, sales/delivery, and driving with an invalid driver’s license • Most Veterans encountered thus far by the Justice Outreach Program received an honorable discharge • Common issues in incarcerated Veterans have been substance abuse issues and homelessness • Most returning combat Veterans are entering the legal system with domestic violence and substance related charges.

18. Veterans Treatment CourtsA Growing Movement Currently 75 Veterans Treatment Courts in Operation - dozen being planned Veterans Treatment Courts - hybrid Drug and Mental Health Courts Models to serve veterans struggling with addiction, serious mental illness and/or co-occurring disorders.

19. Why a Separate Veterans Court? • Provision of Veteran Specific Services – VHA, VBA, Volunteer Veteran Mentors • Distinctive Demeanor – Adaption & Humanization • Reduce Community Expenses – “Crisis Systems” • Increase Public Safety

20. Benefits of Veterans Treatment Court • Expedite “access to care” for Veterans • Ease the burden on valuable community resources • Allow Veterans to go through the court process with those who are similarly situated and have past experiences • Provide volunteer Veteran Mentors • Promote Veteran accountability • Promote sobriety, recovery and stability through a coordinated response including treatment in conjunction with judicial monitoring

21. Law Enforcement • The Veterans Justice Outreach Program, OEF/OIF Team, VA Police and Veterans Panel have teamed together to facilitate Veteran specific trainings for law enforcement. • Trainings have been facilitated for Crisis Intervention Teams (CIT), Crisis Negotiation Teams • Police Departments and Sheriff Departments • County and State Probation Officers Video

22. Healthcare for Homeless Veterans (HCHV) • Homeless Outreach Program • Grant & Per Diem Program • HUD/VASH Program • Justice Outreach Program

23. Homeless Outreach • Social Workers visit locations in the community where homeless individuals gather to identify homeless Veterans. • Shelters, soup kitchens, woods, churches • Emergency bed vouchers – Salvation Army • Yearly Stand Down Event • “Walk-in” Homeless Services, Bldg. #509 at VAMC

24. Grant & Per Diem (G&PD) Program • VA's Homeless Providers Grant and Per Diem Program is offered annually (as funding permits) by the Department of Veterans Affairs Health Care for Homeless Veterans (HCHV) Programs to fund community agencies providing services to homeless veterans.

25. G&PD Eligibility • Veteran must be homeless or at risk for homelessness and/or have a mental illness or substance abuse problem. • Veteran must have served at least one day of total active service and have honorable, general or other than honorable discharge. • Veteran can reside in transitional housing program up to 24 months for a total of three episodes in a lifetime.

26. G&PD Programs • Transition House – located in St. Cloud, males & females • Serenity House – Deland, males only • The Center for Drug-Free Living – Orlando, males only (accepts sex offenders) • Salvation Army – Daytona Beach, males & females • The Tree of Life Ministries – Orlando, males only

27. HUD/VASH • HUD-VASH is Long-Term Intensive Case Management Program for homeless veterans. Funding for HUD-VASH comes from a collaboration between HUD and the VA. • This program targets the chronically homeless veteran population.

28. HUD/VASH Eligibility • Veteran must demonstrate and need and willing to participate in case management • Veterans must be willing to sign a contract, agree to medical and behavioral health treatment recommendations, and regular case management contacts. • Veterans must agree to all requirements of the local PHA who administers the voucher. • Must have stable source of income to pay their portion of the rent, utilities, food and transportation (some exceptions)

29. Homeless Hotline • The Department of Veterans Affairs (VA) has founded a National Call Center for Homeless Veterans hotline to ensure that homeless Veterans or Veterans at-risk for homelessness have free, 24/7 access to trained counselors. Homeless Veteran in need of help? Call 1-877-4AID VET (1-877-424-3838)

30. Veterans Crisis Line • The Veterans Crisis Line connects Veterans in crisis and their families and friends with qualified, caring Department of Veterans Affairs responders through a confidential toll-free hotline, online chat, or text. • Veterans and their loved ones can call 1-800-273-8255 and Press 1,chat online, or send a text message to 838255to receive confidential support 24 hours a day, 7 days a week, 365 days a year.

31. Questions?

32. Orlando VAMC • 5201 Raymond Street, Orlando, Florida 32803 • Main Number: 407-629-1599 • Telephone Triage: (800) 645-6895 (schedule appts)