Readjustment Counseling Service... Celebrating 30 Years i

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Readjustment Counseling Service Dr. Alfonso R.
Batres, Chief Officer
Air Force Combat Action Medal
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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.
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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

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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 VAs 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.
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What Works Vet to Vet Services Confidentiality V
eteran focused Veteran Satisfaction Eligibility
to see families Listen to what Veterans and
Families need and adjust services Adaptive/flexibl
e Culturally Competent Services Outreach
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• 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.

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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

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• 2011 All Employee Survey (Organizational Culture)
• The RCS profile was statistically significantly
  higher than the VHA in the following
• Entrepreneurial (lets 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.

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• 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

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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.
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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
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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
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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
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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
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525,168 OEF/OIF Veterans Cumulative through
03/31/11
The Vet Centers have touched over 39 of all
separated OEF/OIF Veterans.
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Doonesbury
Veterans helping Veterans.
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Secretary's RCS T21 Project
RCS is hiring a Licensed Family Counselor at
every Vet Center to extend services to families.
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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.
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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).
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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.

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Response to Ft. Hood Tragedy, November 2009
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Ft. Hood Veterans Day Parade, November 11, 2009
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Homeless Stand Down Events 2009
Ft. Walton Beach, FL
Colorado Springs, CO
Marysville, CA
Boise, ID
Tallahassee, FL
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Red River Flooding Deployment MAR/APR 2009
Fargo, ND
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Rocky Boys Indian Reservation, MT Flood
Deployment June 2010
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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
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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
• Veterans military service.

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Vet Center Combat Veteran Call Center 877-
WAR-VETS (927-8387)

• Staff have received training from OIT, 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.

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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 CBOCs.
• At 47 Vet Centers, VHA medical staff provide
  regularly scheduled services.
• 69 Vet Centers provide readjustment services
  at their supporting VAMC and/ or
• CBOC.

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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.

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• 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.

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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.

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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.


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