In addition, the IVMF is fortunate to be housed within the nearly completed National Veterans Resource Center at Syracuse University—a university with a longstanding history and connection to the military community dating back to the First World War, and a university with an enduring vision and commitment to be the best place for veterans in the country.
All this is to say, the IVMF and Syracuse University are deeply invested in advancing the lives of New York State’s veterans and contributing to solutions that achieve the same.
So when the New York State Health Foundation initially discussed their interest in pursuing a study to better understand the national landscape of state veterans’ agencies as a means to inform service delivery in New York State, we were naturally enthusiastic.
Over the past two years, we embarked on a comprehensive study that resulted in two reports: a national assessment of state veterans’ agencies, and a strategic roadmap for New York State to enhance its impact based on those findings. From a survey of all 50 state directors, a review of over 82 leading practices serving veterans at the state level, and 10 case studies, we learned a great deal about what states are doing to evolve with the changing needs of their veterans.
While our report outlines seven focus areas for New York State based on our findings, today, I am going to briefly address three key areas that we identified as important to service delivery at the state level. These factors are organizational structure, financial stability and diversity, and coordination of services.
First, how state agencies are organized and where they sit within the broader state bureaucracy and political leadership hold significant implications for their overall operational effectiveness and impact. For example, some state veterans’ agencies are subordinate units that fall under their Department of Military Affairs. Others are stand-alone departments. Political buy-in from the governor’s office can vary as well, not only state by state, but also from one administration to the next.
It is perhaps obvious that state agencies with a high degree of independence and political buy-in from the governor’s office—especially those with cabinet level leadership—enjoy access to greater resources and a platform to work with the governor on new initiatives. This also allows directors ability to work more collaboratively with other department leaders to address veterans’ health and well-being needs that span responsibilities and capacities.
This is relevant because state veterans’ agency portfolios are historically centered on benefits and claims assistance, veterans’ cemeteries, and veterans’ homes for long-term care. Yet, the reality is that state veterans’ agencies must remain engaged in addressing the wider array of veterans’ needs, if not directly, then by collaborating with other public or private sector providers to ensure veterans have access to a continuum of supportive services.
Consider, for example, that only 28% of state veterans’ agencies in our survey offer mental health services, yet 71% of state directors still see it as a top need. So in this case, states have to figure out how to work with other agencies and local community providers best positioned to meet this need.
The good news is there are ways for a state government to institutionalize veterans as a priority, particularly in how state veterans’ agency directors are positioned within the broader state government. The New York State Department of Veterans’ Services (DVS) is already itself an independent agency.
An excellent case to look to on this topic is the state of Ohio. After a 2006 study ranked Ohio 50th out of 50 in helping veterans obtain earned benefits claims, the governor and the legislature worked together to reorganize the state veterans’ agency, giving it the leadership position in state government and an expanded mandate to run state veterans programs more effectively.
Second, in general, well-resourced and financially stable state veterans’ agencies also tend to pursue greater service delivery innovations. By our calculation, the New York State’s DVS spends about $26 per veteran. Now granted, this only accounts for the DVS budget alone, and does not include state benefits that fall to other departments such as education awards or recreation licenses, for example. This is low compared to other state veterans’ agencies. By comparison, the average spending among independent state agencies is nearly seven-fold, at $189 per veteran.
Yet, perhaps more important than budget size is the stability and diversity of annual funding streams, relative to the changing demographics and needs of the state’s veteran population. It is important to note that over one-third of states draw upon supplemental state funding streams for veterans services such as dedicated trust funds or lotteries—in addition to their general fund.
The New York State DVS budget draws primarily from the general fund alongside some additional federal revenues. Of note, the Texas Veterans Commission, which we highlight in our report, spends roughly the same per veteran as the New York State DVS, but it also draws upon multiple funding streams including a dedicated veterans’ special fund.
The bottom line is that stable and diverse funding streams are critical because they provide government greater ability to plan over longer time horizons. Relying primarily on state general funds poses long-term uncertainty, and limits the ability to plan for the needs of the veteran population five years or even a decade from now. And given the changing demographics of the veteran population overall, the future needs of veterans are almost certain to look different from today.
Finally, our study reveals an emerging trend among leading states focused on easing veterans’ access and navigation challenges through care coordination initiatives. From both our research and practical experience, navigating the sea of benefits, resources, and care remains a top challenge for veterans across the country. State governments are well positioned to make a positive impact on this challenge. They typically have a sound understanding of the ecosystem of public and community-based organizations across their state, as well as the potential to influence greater coordination and harness resources to best serve veterans’ needs best.
In recent years, Michigan, Alabama, Texas, Virginia, Washington, Rhode Island, and others have adopted various models to further support service navigation and care coordination. To be sure, not every state operates as a primary service navigator, as in the case of Michigan for example, but they may still play a supporting or participating role in locally owned care coordination activities.
While supporting service navigation is a rising trend across the state landscape, I’ll put this in context for why New York State might consider taking additional steps in this direction. Take, for example, how New York State is rightfully engaged in meaningful work to prevent veteran suicide.
According to the most recent VA data, 17 veterans take their lives every day. Yet, 11 of those 17—nearly two-thirds—are not enrolled in VA Health Care. In addition, research shows that a veteran experiencing suicidal ideation is not likely experiencing one problem in isolation, but rather multiple challenges concurrently. Such challenges often represent a mix of clinical and non-clinical needs such as financial stress or strained personal relationships, for example.
Therefore, preventing veteran suicide is not just a VA problem alone. Rather, it is a challenge that requires an integrated approach to harnesses the full capacity of public and private sector resources supporting veterans in their local communities. Supporting service navigation and care coordination are ideal approaches to holistically address the underlying contributors of veteran suicide, and should play a large role in any suicide prevention strategy.
In addition to the imperative to end veteran suicide, there are other reasons for adopting care coordination models that would benefit New York State in the near term. One commonly cited value of a DVS is how their role in providing earned benefits claims assistance demonstrates a return on investment for the state. Care coordination can be a natural vehicle driving veterans and military families toward securing these benefits.
I’ll close with a recent anecdote from our AmericaServes initiative that highlights the simple power of service navigation assistance.
Earlier this year in our San Antonio network, a local community provider was working with a recently widowed spouse of a veteran. Since the provider was also a member of the coordinated network that serves veterans in San Antonio, she knew to ask the simple question, “did you know you may be eligible for certain benefits?”
The spouse had no idea. So, upon further investigation, the provider came to discover that the spouse’s late husband had been awarded 100% disability, 20 years prior, and the benefit had gone unclaimed. Today, that provider is helping the spouse navigate the process of claiming the full value of those earned benefits so many years later.
Stories like this demonstrate the potential for enhanced impact that our Department of Veterans Services can have here in New York State. From both our research and field experience, we believe a Department that is well-connected to its Governor, with stable and diversified resources, and empowered to work with other state agencies and local providers—will be well equipped to improve the lives of our veterans and military families here in New York State.
On behalf of the veterans and military-connected families the IVMF serves in partnership with New York State every day, thank you for the opportunity to provide testimony today.