Readjustment Counseling Service - 30 Years of Honoring Our Veterans

1. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise WWII American Theater Campaign Medal WWII Asian Pacific Campaign Medal WWII European, African, Middle Eastern Campaign Medal WWII Victory Medal Korea Service Medal Armed Forces Expeditionary Medal Vietnam Service Medal SW Asia Service Medal Kosovo Service Medal GWOT Expeditionary Medal Afghanistan Campaign Medal Iraq Campaign Medal USN/USMC Combat Action Ribbon USMC Expeditionary Medal Navy Expeditionary Medal Readjustment Counseling Service Dr. Alfonso R. Batres, Chief Officer Air Force Combat Action Medal

2. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Mission Statement We are the people in VA who welcome home war Veterans with honor by providing readjustment counseling in a caring manner. Vet Centers understand and appreciate Veterans’ war experiences while assisting them and their family members toward a successful post-war adjustment in or near their community.

3. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Services: • Readjustment counseling is a wide range of psycho social services offered to eligible Veterans and their families in the effort to make a successful transition from military to civilian life. They include: • Individual and group counseling for Veterans and their families • 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 including PDHRA, community events, etc. • Substance abuse assessment and referral • Employment assessment & referral • Screening & referral for medical issues including TBI, depression, etc. • VBA benefits screening & referral

4. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise The Senate Veterans Affairs Committee broadly defined ‘the purpose of readjustment counseling provision is to make fully available – and to encourage and facilitate the full use of – the resources of the VA’s health-care system to those Vietnam-era Veterans who feel the need for counseling to help them in their readjustment to civilian life.’ United States Senate Committee on Veterans Affairs, Report 96-100 “Veterans’ Health Care Amendments of 1979” The House Veterans Affairs Committee outlined ‘within the context of readjustment counseling, each Vet Center is tasked with three major functions: outreach, direct service delivery, and referral.’ United States House Committee on Veterans Affairs, Report 98-117 “Veterans’ Administration Health Programs Amendments of 1983” Over the course of the last 30 years the eligibility for Vet Center services has expanded to include combat Veterans of all eras, Veterans sexually traumatized while on active duty, and families of service members killed on active duty.

5. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise What Works: Vet to Vet Services Confidentiality Veteran focused Veteran Satisfaction Eligibility to see families Listen to what Veterans and Families need and adjust services Adaptive/flexible Culturally Competent Services Outreach

6. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise • Vet Center Staff • Over 72% of all Vet Center staff are Veterans and 47% are combat • Veterans. • Over 31% of all Vet Center staff served in Iraq, Afghanistan, or both. • Over 60% of Vet Center direct counseling staff are VHA qualified mental • health professionals (Licensed Psychologists, Licensed Social Workers, • and Nurses). • Over 42% of all Vet Center staff are women.

7. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Veteran Satisfaction The Vet Centers are the gold standard of customer satisfaction in VA and the Government as a whole. 97% of Vet Center clients would recommend the Vet Center to a fellow Veteran. 2011 All Employee Survey (Employee Satisfaction) In the Job Satisfaction Index (JSI), Vet Center staff had statistically significant higher satisfaction scores than the larger VA in all 13 measures including: • Type of work • Amount of work • Coworker • Direct supervision • Senior management • Promotion opportunity • Work conditions • Customer satisfaction • Praise • Quality of work • Current overall satisfaction • Satisfaction vs. 2 years ago • Pay Satisfaction In the Organizational Assessment Inventory (OAI), Vet Center staff had statistically significant higher satisfaction scores than the larger VA in 19 of the 20 measures including: • Cooperation • Conflict Resolution • Diversity Acceptance • Coworker Support • Supervisory Support • Customer service • Innovation • Safety climate • Resources • Leadership • Rewards • Employee development • Work/family balance • Planning evaluation • Job control • Retention • Engagement • Psychological safety • Civility

8. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise • 2011 All Employee Survey (Organizational Culture) • The RCS profile was statistically significantly higher than the VHA in the following: • Entrepreneurial (let’s find a way to do it better!) • Rational (We get the job done!) • Group (our people are our most important asset.) subdivisions. • The RCS profile was statistically significantly lower than the than in the bureaucratic (follow standard operating procedures) subdivision.

9. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise • In FY2010 • 191,508 Veterans and families provided 1,273,035 visits • 74,666 (39%) of all Veterans receiving Vet Center services were not seen at any other VHA Facility • Within the total services listed above 16,134 Veteran families were provided 72,717 visits

10. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Iraq Campaign Medal Global War on Terrorism Expeditionary Medal Afghanistan Campaign Medal In February 2004 the Under Secretary for Health authorized the Vet Center program to hire fifty (50) OEF/OIF Veterans to conduct outreach to their fellow Global War on Terrorism Veterans. Due to the success of the initial 50 Outreach Specialists, an additional 50 positions were authorized by the Under Secretary for Health in April 2005. These positions are located in all fifty states, the District of Columbia, Guam and Puerto Rico.

11. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Global War on Terrorism Expeditionary Medal Afghanistan Campaign Medal Iraq Campaign Medal Elizabeth Lopez, El Paso Vet Center OEF/OIF Outreach Specialist First Outreach Specialist Hired (May 16, 2004) Iraq 2003 - Patriot Missile Crew Member - 11th Brigade, 552 Echo Bat. Iraq 2005 - TMT Gunner - NMCB 22 (Sea Bee) Iraq (2nd Tour) 2005 Vet Center Outreach Event 2006

12. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Global War on Terrorism Expeditionary Medal Afghanistan Campaign Medal Iraq Campaign Medal Dave Hosking, Madison Vet Center OEF/OIF Outreach Specialist Vietnam, Operation Desert Storm, Operation Iraqi Freedom Iraq 2003 Blackhawk Crew Chief 1-147th Aviation Vietnam 1966/67 119th Air Assault

13. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Global War on Terrorism Expeditionary Medal Afghanistan Campaign Medal Iraq Campaign Medal Jamie Hamilton, Austin Vet Center OEF/OIF Outreach Specialist OH-58 D Kiowa Warrior/UH-60 Black Hawk Helicopter Mechanic/Crew Chief Afghanistan 2006-2007 Iraq 2003-2004

14. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Global War on Terrorism Expeditionary Medal Afghanistan Campaign Medal Iraq Campaign Medal Rafiq Raza, BSW - Orlando Vet Center OIF/OEF Outreach Specialist Afghanistan 2001-2002 & 2002-2003 Intelligence Analyst – G2 10th Mountain Infantry Division (Light) Picture Performing Outreach 2001 / Afghanistan 2008 / VFW Convention - Orlando

15. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise 525,168 OEF/OIF Veterans Cumulative through 03/31/11 The Vet Centers have touched over 39% of all separated OEF/OIF Veterans.

16. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Doonesbury Veterans helping Veterans….

17. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise

18. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Secretary's RCS T21 Project RCS is hiring a Licensed Family Counselor at every Vet Center to extend services to families.

19. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise On August 5, 2003, VA Secretary authorized Vet Centers to furnish bereavement counseling services to surviving parents, spouses, children and siblings of service members who have fallen while on active duty, to include federally activated Reserve and National Guard personnel.

20. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Initial MVC Demonstration for Congress, October 2008 50 Mobile Vet Centers are being utilized to provide access to VA for returning Veterans via outreach to demobilization active military bases, National Guard, and Reserve locations nationally. The vehicles provide essential homeless Veteran services including participation in Stand Down events. The vehicles also support Vet Center services to rural areas geographically distant from VA services. Each Mobile Vet Center is equipped with a state of the art satellite communications package that includes fully encrypted tele-health equipment, access to all VA systems (Computerized Patient Record System, MyHealthEVet) and connectivity to emergency response systems (Emergency Management Strategic Healthcare Group).

21. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Response to Ft. Hood Tragedy, November 2009 • 4 Mobile Vet Centers arrived at the • Killeen Vet Center on the day of the • shooting to assist the veteran • community and any assistance • requested by Ft. Hood. • The VHA Vet Center and VA Medical • Center worked collaboratively to • assist the community in the area. • Vet Center staff provided services • 8,200 Veterans, active duty service • members, and families.

22. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Response to Ft. Hood Tragedy, November 2009

23. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Ft. Hood Veterans Day Parade, November 11, 2009

24. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Homeless Stand Down Events 2009 Ft. Walton Beach, FL Colorado Springs, CO Marysville, CA Boise, ID Tallahassee, FL

25. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Red River Flooding Deployment MAR/APR 2009 – Fargo, ND

26. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Rocky Boy’s Indian Reservation, MT Flood Deployment June 2010

27. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise RURAL OUTREACH Vet Center outreach being conducted at the 87th Annual Greeley Stampede in Greeley, Colorado. The 2009 Rodeo was dedicated to OEF/OIF Veterans. Vet Center outreach was coordinated by the Cheyenne Vet Center OEF/OIF Outreach Specialist Larry Little, a retired USMC Sergeant Major and Veteran of both Iraq and Afghanistan. 87th Annual Greeley Stampede Greeley, Colorado

28. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Vet Center Combat Veteran Call Center 877- WAR-VETS (927-8387) • An around the clock confidential call center where combat Veterans • and their families can call to talk about their military experience or • any other issue they are facing in their readjustment to civilian life. • Product of VA leveraging technology to condense a national system • of toll free numbers into a single modern center located in Denver, • CO. • The staff is comprised of combat Veterans from several eras as well • as families members of combat Veterans. • Like all Vet Center services this benefit is prepaid through the • Veteran’s military service.

29. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Vet Center Combat Veteran Call Center 877- WAR-VETS (927-8387) • Staff have received training from OI&T, VA National Crisis • Hotline, and the VA 24/7 Primary care triage hotline (Dayton, • Ohio) • Warm handoff capacity has been established with the VA Crisis • Hotline and Dayton Primary care triage hotline • The Call Center has already made referrals to the Suicide Hotline • and both the warm handoff and outcomes of the referrals has • worked out well.

30. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise

31. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Collaboration With VA Medical Centers and CBOCs • Bi-directional referral process • Participation in VA Medical Centers Mental Health Councils • Joint Participation in VA and Community Events • Medical Centers provide to Vet Centers: • External clinical supervision at a majority of Vet Centers • Clinical Liaisons who coordinate the care for complex cases and shared • Veterans and provide quality reviews of Veteran suicide and other critical • events. • Administrative Liaisons to support fiscal, human resource, procurement, • and engineering service functions. • 14 Vet Centers collocated with CBOC’s. • At 47 Vet Centers, VHA medical staff provide regularly scheduled services. • 69 Vet Centers provide readjustment services at their supporting VAMC and/ or • CBOC.

32. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Further Collaboration • RCS staff attend and contribute to the annual VHA Mental Health • Conference.  • Partnered with OMHS and EES to develop an online course to train • Vet Center Counselors to conduct brief motivational interventions • for Veterans with substance abuse issues.   • Collaboration with OMHS, Social Work Service, and DoD to educate • both VA and DoD on the Intransition Program. • VHA Suicide Hotline Staff and RCA Call Center have warm handoff • capabilities with each other. Locally, Medical Center Suicide Prevention • Coordinators include Vet Centers in their catchment areas for training • and outreach. Medical Center and RCS staffs collaborate to maintain • contact with high risk Veterans. • Partnered with VISN and VAMC staff to end homelessness among • Veterans by providing services, outreach, and community education.

33. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise • Vet Center, VA Medical Center, and VBA • Collaboration • 2010 World Series, Game 4 • Veterans, Family Members, and Concerned Citizens where able to: • Learn more about VA services and • benefits • Enroll for VHA Medical Services • Apply for VBA Benefits • Be referred to their closest Vet • Center • Talk with a Readjustment • Counselor in a confidential setting.

34. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Evidence Based Practice • Goal: All Vet Center Clinical Staff trained in relevant evidence based • practices to better serve the needs of Veterans and their families. • Currently 11 RCS Clinical Staff are certified to provide Cognitive • Processing Therapy (CPT) training to other Clinicians. • RCS will continue to conduct trainings and be equipped to provide • in house supervision for those working toward certification. • RCS will continue to research potential affective treatment • modalities for inclusion in the Vet Center treatment process.

35. Readjustment Counseling Service... Celebrating 30 Years in Service to our Nations Veterans …Keeping the Promise Caregivers and Veterans Omnibus Health Services Act of 2010 • Section 401: Eligibility of Members of the Armed Forces who Serve in Operation Enduring Freedom or Operation Iraqi Freedom for Counseling and Services Through Readjustment Counseling Service • Expands the eligibility for readjustment counseling, as authorized by 38 U.S.C. 1712A and provided at VA Vet Centers, to any current or former member of the armed forces, including federally-activated members of the National Guard and Reserve, who serves or served on active duty in OEF/OIF. • Section 402 : Restoration of Authority of Readjustment Counseling Service to Provide Referral and Other Assistance upon Request to Former Members of the Armed Forces Not Authorized Counseling • Permits Vet Centers to help Veterans with problematic discharges through referral to services outside VA or referral for assistance with discharge upgrades when appropriate. .