VCAT Journal Article #6:  VCAT Communities: San Diego and San Antonio Making Big Strides

The two primary goals of the VCAT for each community are to develop a sustainable veteran coalition and to develop a veteran services system of care. Together with Altarum Institute’s VCAT project team, the San Diego Veterans Coalition (SDVC) and the San Antonio Alliance for Veterans and Families (AVF) have been formed in their respective communities to improve services for veterans and their families.  The second and more difficult goal of establishing the veteran services system of care is underway through the combined efforts of the coalitions, community partners, and the VCAT team. Both San Diego and San Antonio communities have fully adopted this initiative and are making great progress.

San Diego:

San Diego is rightfully proud of its reputation as a national leader in serving and supporting its veterans.  The SDVC demonstrates that support by building relationships and forming work groups within the coalition to act on issues that are important to veterans and their families. 

• The Seamless Transition working group has developed a Veterans Transition Assistance Program (VTAP), supported by the SDVC and the San Diego VA Medical Center, to ensure a smoother transition for veterans as they enter back into civilian life. This program will cover important topics such as health benefits, veteran benefits, educational benefits, and employment. It is scheduled to begin its first class on August 4, 2010 and will run over four consecutive weeks throughout the month.
• The Iraq and Afghanistan Veterans of San Diego (IAVSD) veteran support group has been formed by two of the SDVC’s work group leaders with 150 current members and growing. The Access and Outreach working group seeks to bring OIF/OEF veteran leaders in the San Diego area together to create unity and opportunity.
• The Veteran Legal working group has submitted a $750,000 grant application to the Department of Justice to support continued efforts to establish a San Diego Veterans Court.
• Together, the VCAT project and the SDVC leadership has conducted strategic planning sessions helping to identify 15 critical issues and they are developing a tactical plan to be implemented within the next 12 months to lead them into the future.   

San Antonio:

San Antonio, known as “Military City USA,” is one of the top performers in delivering services and benefits to veterans.  

• Upon successful completion of the Veterans Leadership Forum held in January 2010 and through a collaborative effort between veteran community leaders and Altarum Institute, the Alliance for Veterans and Families (AVF) was formed.
• The AVF has established a total of seven working groups focusing on the following priority areas:  development of a sustainable network, veteran transition, quality, communications, behavioral health, spiritual health, and finance. These working groups fully support this initiative to work with veterans and community members to develop a system of care that provides easily accessible, high quality services to all veterans, their caretakers, and their family members.
• In order to sustain this initiative, the AVF has submitted a letter of interest for the opportunity to bid on the TVC Veterans Assistance Grant Fund. If invited to submit a proposal for this grant opportunity, it will allow them to sustain the AVF over the next 24 months and will greatly support the development of the provider network allowing them to reach the goal of developing a system of care for veterans and their families.
   

The VCAT project will continue to assist the San Diego and San Antonio communities to collaborate, coordinate, and ultimately integrate processes, information, provider networks, and leaders to fully leverage each community’s capabilities to better serve the needs of their veterans and families.

VCAT Journal Entry #5: VCAT Team conducts successful Veterans Leadership Forum in San Antonio

On January 20, Altarum Institute’s Veterans Community Action Teams Mission Project conducted a Veterans Leadership Forum in San Antonio, Texas. A primary goal of the forum was to obtain feedback on the community assessment that took place in the fall of 2009 and to work with community leaders to identify new opportunities to improve services and integration efforts. 

With the support of Texas State Senator Leticia Van de Putte, State Rep. Frank J. Corte, Jr., and Jim Nier, the Executive Director of Texas Veterans Commission, approximately 95 veteran leaders and service providers attended the forum. Participants included members of the Veterans Administration, the Texas Veterans Commission, Department of Defense, the San Antonio Coalition for Veterans, and numerous local and national organizations. 

The project has now entered the community service integration phase in San Antonio.  Under the leadership of the San Antonio VCAT Advisory Committee, seven working groups have been established to develop strategies and associated action steps around several priority areas, as described below:

• Building a Sustainable Network: Coordinate the efforts of committees and working groups to raise awareness of benefits of collaboration and promote the merits of a community based approach to serving the veteran community.
• Sustainment Finances: Assist in defining an organizational structure that maximizes opportunities to access funding streams.
• Communications: Engage and leverage media support to promote activities, programs, initiatives, and provide general public awareness
• Transition: Promote the development of a smart, veteran-centric transition program.
• Quality: Ensure high quality services through education, assessment, review, reporting and partnerships.
• Behavioral Health: Increase educational awareness of the scope of behavioral health issues affecting veterans, families and caretakers and the resources available throughout the Alamo area to address those needs.
• Spiritual Health: Conduct outreach to faith based communities on behalf of both veterans and their families and service providers. 

Working groups formed around each priority area will translate these priorities into action plans which will require continued commitment from leaders and volunteers within this community. 
 

VCAT Journal Entry #4: Progress Since the San Diego Veterans Leadership Forum

Upon successful completion of the San Diego Veterans Leadership Forum conducted October 2, 2009 in San Diego, Calif., the Veterans Community Action Teams (VCAT) initiative has entered into the community service integration phase in San Diego.

Following the October forum, the San Diego VCAT Steering Committee, renamed the San Diego Veterans Coalition, has expanded its membership to ensure greater representation of the community that they serve. Together with the VCAT team, the San Diego Veterans Coalition developed a charter and formalized working groups to implement the strategies identified at the Veterans Leadership Forum. These strategies are designed to help improve the delivery of services to veterans and their families.

The VCAT team and the San Diego Veterans Coalition have mutually planned to accomplish five strategic priorities. This work is being accomplished through corresponding workgroups, populated by volunteers identified at the Veterans Leadership Forum. The workgroups have begun work to accomplish their priorities and are reporting their progress to the San Diego Veterans Coalition on an ongoing basis. The five working groups/priorities that have been established and identified are:

• Leadership Development: Establish a framework to find OIF/OEF veterans and place them into leadership positions in the veterans community
• Seamless Transition: Seek to improve coordination by improving "seamless transition" between DoD and VA for active duty members moving to veterans status/civilian life
• Access/Outreach: Develop a 211-like function by obtaining information from stakeholders and making it available to veterans through a variety of electronic mechanisms
• Basic Needs and Services: Assess needs related to housing, healthcare, employment, and transportation
• Veterans Legal Initiatives: Continue the work already begun to improve knowledge of veterans issues and needs when involved with the legal system

The VCAT team continues to work with the San Diego community leaders to ensure sustainability of the strategies identified at the VLF. A continual process of reevaluation and refinement of strategies ensures their viability through the duration of the VCAT project. The VCAT team continues to conduct research for methods to sustain the VCAT mission in the San Diego community past the Mission Project funding period. Check back for future updates on continued progress in the San Diego community.

VCAT Journal Entry #3: Understanding and Enhancing Relationships

One year has passed and the Veterans Community Action Teams (VCAT) initiative has approached the mid-point of the Mission Project cycle at the two demonstration sites, San Diego, Calif. and San Antonio, Texas. We continue to work to develop a sustainable, collaborative community strategy and model that enhances the delivery of services from public, private, nonprofit, and voluntary organizations to veterans and their families.

While work in San Antonio is just beginning, a major milestone has been reached in San Diego with the completion of the first Veterans Leadership Forum on October 2, 2009. Altarum sponsored the forum to help solidify the professional relationships in San Diego among veterans service providers and to identify new opportunities for collaboration, cooperation, and integration. The primary goal of the Leadership Forum was to identify a community vision of integrated services and to develop a strategic action plan to achieve sustainability.

Participants in the forum included

• The County of San Diego, Department of Health and Human Services (HHS): HHS leads the way and serves as one of the champions by supporting service providers in better serving veterans and their families. HHS actively fosters the notion that there are “No Wrong Doors” when veterans and their families seek assistance.
• The U.S. Department of Veterans Affairs: VA promotes and models the concept of “One VA” by coordinating their services within the VA and among the multitude of partners from public, private, and community providers including all of the veteran service organizations.
• The U.S. Department of Defense: The Department of Defense and their health services providers, TriCare and TriWest continue to demonstrate leadership, commitment, and sincere compassion for veterans and their families. They have been active participants throughout the project. The Commander of point Loma Naval Sub Base, a member of the San Diego steering committee, made the Admiral Kidd Center available for our Leadership Forum.
• The California Department of Veterans Affairs (CDVA): CDVA plays a significant role by supporting outreach, claims/case management and providing training to county veterans service officers.
• Trilogy: Trilogy, a private sector organization, has developed a robust information system called “Network of Care” that assists veterans and their families in navigating the complex array of services they need. The system is a “point and click” that guides them to services, provides maps and identifies different means of transportation to obtain services. This system may some day connect service providers to one another within the community and beyond.
• Nonprofit providers: Vietnam Veterans of San Diego providing transition assistance and housing for homeless veterans; and Interfaith Services assisting families in meeting their basic necessities by providing food, shelter, clothing, counseling, daycare, and more.
• The Veterans Family Forum (VET/FAM) is an amazing consortium of public, private, nonprofit, and volunteer service providers who collaborate monthly to broaden their knowledge about each others capacities in meeting the needs of Veterans and their families.
• The crown jewel of this community is the “United Veterans Council,” a collection of the multitude of Voluntary Veteran Service Organizations joined together to serve veterans. This council, possibly the only one of its kind in the nation, allows competing organizations to put aside their differences and work on the common cause of serving veterans and their families.

Year two of the VCAT Mission project will involve San Diego and San Antonio deploying their community action plans and measuring the outcomes of their efforts. The ultimate goal is to ensure sustainability of the integrated service delivery resulting in better health and stability for veterans and their families.
 

VCAT Journal Entry #2: Setting the Stage

Over the past several months, a number of key milestones have been achieved in the VCAT Mission Project. Most importantly, two pilot sites for the VCAT project have been chosen: San Diego, Calif. and San Antonio, Texas. These sites were chosen based on the presence of large and diverse military and veteran populations and organizations; dispersion across geographic areas (southern, western, and central); stakeholder support including local champions and key contacts; and representation of Altarum Institute in the communities. The partnership with Altarum has been endorsed by key stakeholder organizations in each of these communities, such as the Texas Veterans Commission in Austin and the County Health and Human Services Agency in San Diego. In both communities, Altarum will work with these and many other state and local organizations to foster a community-based approach throughout the life of the project.

In June, the VCAT team conducted a community assessment in San Diego, the results of which will form the foundation for discussion with community partners about opportunities for improved integration of services for veterans and their families. As part of this assessment, Altarum conducted interviews with over 30 community stakeholders and organizations as well as focus groups with veterans and their family members, to obtain their perspectives regarding service system gaps and opportunities for improvement. The results of this community assessment will be presented at a Leadership Forum for Veterans Service Integration scheduled for fall 2009. The Forum will provide an opportunity for community stakeholders to identify priority areas for improved community services integration, and to work in collaboration with Altarum to develop an action plan for addressing these areas. Similar to the process being followed in San Diego, a community assessment will be conducted in San Antonio to form the basis for discussions about the appropriate focus of integration improvement efforts in this community.

While we’ve been working in the pilot sites, Altarum has also had the opportunity to provide input to national-level discussions around veterans’ health care.  On May 19, VCAT Co-Director, John King, testified before the U.S. House of Representatives Veterans’ Affairs Health Subcommittee. John’s testimony provided the committee with information regarding the VCAT Mission Project and the model Altarum is developing to better integrate community services for veterans and their family members. Also, on July 23, VCAT consultant Gary Rossio received the 2008 Presidential Rank Award for his service as Director of the Department of Veterans Affairs’ San Diego Healthcare System. Recipients of this prestigious award are strong leaders, professionals, and scientists who achieve results and consistently demonstrate strength, integrity, industry and a relentless commitment to excellence in public service. 
 

Journal Entry #1: Determining the Need

Work continues on the Veterans Community Action Teams (VCAT) mission project to help veterans and their families access the public, private, and nonprofit programs and services that they need to improve their overall quality of life and economic security. Returning and aging veterans have multifaceted needs that are generally met by a number of independently administered services (e.g., health care, housing, job placement). However, due to limited resources, these services are rarely integrated in a way that enables veterans to easily navigate from one service to another. This can be especially difficult for veterans who have physical, mental, or emotional limitations.

To relieve some of the stress that veterans and their families experience in trying to receive the services that they need, the VCAT Mission Project is developing a model that will help communities integrate their programs and services by listening to the needs of the veterans, learning about the services and programs offered in the community, and applying an evidence-based best-practices model to enhance the delivery of services and improve the community-based system of care for veterans and their families.

Altarum Institute has spent the past 10 months assembling the VCAT team, developing the integration model, and reaching out to large communities of veterans to see where the VCAT model could be the most beneficial. We have lately narrowed the choices for a demonstration site and almost reached a decision. Once the demonstration site is chosen, the VCAT team will arrange focus groups and conduct surveys to learn about the needs of veterans and their families. Next we plan to interview staff from key service organizations to identify the barriers that they face in integrating their programs and services. Lastly, we plan to apply the VCAT model in such a way that it will have long-term sustainability in the community once the demonstration project is over. We will invite multiple government agencies, nongovernmental organizations, and community-based organizations to collaborate throughout the project.