Author: Schaffer, Bradley
Date published: July 1, 2010
Journal code: AMJA
The Department of Veterans Affairs' (VA) has been addressing the needs of the homeless veteran population since the advent of Public Law 100-6 in 1987. This law authorized appropriations to support clinical teams to conduct outreach to homeless veterans and community providers.
As an outgrowth of these homeless prevention efforts, the VA started prison reentry and jail diversion efforts, not only for homeless prevention, but also to assist with seamless reentry transition. Many other veterans are considered near homeless or at risk because of their mental health, substance abuse, poverty, employability, lack of support from family and friends, dismal living conditions in transitional settings, substandard housing, and lack of finances. Others have to endure the impact of their legal history and the mark of their criminal records. These marks impact their employment and housing opportunities, especially those convicted of sex offenses.
These veterans are men and women who served their country in the United States Armed Services in every branch. They come from different eras, which include World War ?, Korean War, Vietnam War, Post- Vietnam, Grenada, Panama, Lebanon, Kosovo, Somalia, and, more recently, Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF).
A veteran's greatest risk of homelessness is at early post-incarceration. Recent national and local media accounts have highlighted a small but growing trend of OEF/OEF veterans entering homeless shelters, missions, prisons, and jails. A Bureau of Justice Statistics report contains the most recent estimate of the number of veterans in penal institutions (Noonan & Mumola, 2007). This report stated that veterans (23%) were twice as likely as nonveterans (9%) to have been convicted of sexual assault, mcluding rape. However, veterans are less likely than non-veterans to be incarcerated in the first place.
The numbers mirror a trend seen in military prisons, where populations have declined, but sexual assault remains the most common crime. Each year, nearly 650,000 people are released from U.S. prisons, and more than 7 million are released from jails. The general incarceration rate for veterans is 630 per 100,000, compared with 1,390 per 100,000 for nonveterans (Noonan & Mumola, 2007). More than 90 percent of U.S. veterans are male, and 99 percent of the veterans in prison are male. More than 10 percent of those coming in and out of prisons and jails are homeless in the months before their incarceration. Shelter use, both before incarceration and after release, is associated with an increased risk of return to prison. Release planning from correctional facilities can prevent homelessness among former prisoners. Many former prisoners need help accessing affordable housing and services to help them reenter their community.
VAs, like the one in Cincinnati, are continuing to develop (not substitute) re-entry and diversion initiatives with the Ohio Department of Rehabilitation & Corrections (ODRC), community-based correction facilities, and local county jails in southern Ohio. Their goal is to facilitate the transition of veteran prisoners to a productive life in the community and to ensure these veterans receive timely services from the VA for a successful transition back to the community.
During general re-entry outreach in Ohio, this VA outreach encountered 12.9% of veterans who reported being convicted of a sex offense. These veterans present difficult housing, transitional, or discharge placement challenges. This is especially true for those veterans identified in prisons and jails, as well as those homeless and hospitalized for various mental health and medical treatments. Health services are coordinated for veterans, but with the sensitive balance of safety for the victim and society in general.
Since 2003, the Cincinnati VA has provided re-entry and outreach services to nearly 400 veterans through the Incarcerated Veteran Outreach Program (IVOP). IVOP focuses on delivering two kinds of service:
* Outreach and case management in corrections locations.
* Linkage with available medical and psychiatric services.
IVOP staff assess veterans in both corrections settings and at the VA. A structured intake instrument is used to assess socio-demographic and clinical characteristics of all veterans contacted.
To facilitate re-entry services for incarcerated veterans, this exploratory sub-study, from 2004-2008, examined veteran characteristics, VA enrollment, homeless episodes, medical and mental health status, and reentry needs in a group of imprisoned and released military veteran sex offenders. The assessments were completed in face-to-face interviews in correctional locations and at the Veterans Administration Medical Center. TVOP staff developed a collaborative relationship with corrections and Adult Parole Authority staff. Contacts with incarcerated veterans were limited to assessment post-release planning. No formal VA medical or mental health services were delivered to inmates in corrections.
A sample of 42 veteran sex offenders who agreed to receive re-entry outreach contact completed the reentry, self-report assessment. Tables 1, 2, and 3 highlight the multiple psycho-social factors and problems these veteran sex offenders presented. Those veterans enrolled and eligible were treated accordingly and referred to community providers. The self -assessment report showed that:
* The average age of the veterans was 48.4 years old.
* They were more likely to be white males.
* 43% were enrolled in the VA system.
* 71.4% were honorably discharged.
* 54.2% were Vietnam era veterans.
* 62.8% were divorced.
[TABLE 2 OMITTED]
* More than 50% had one or more episodes of homelessness.
* 78% had medical problems.
* 81% were unemployed.
* 32% had alcohol problems and 65% drug problems.
* 32% had post traumatic stress disorder (PTSD).
* 18% had domestic abuse perpetration.
* 54% had psychiatric problems.
* 19% used the VA in the past 6 months.
* 18% had demonstrated violent behavior.
* 16% had suicidal ideations.
* 3% were disabled.
* 14.2% were Persian Gulf War (PGW) Veterans.
Of particular concern was the fact that more than 50 percent had homeless histories. In fact, the status of homeless episodes and sex offender conviction did present discharge dilemmas and challenges. Cases in point were two homeless veteran sex offenders who were identified in the inpatient psychiatry unit at the Cincinnati VA Medical Center. When mese veterans were medically stable for discharge, the dilemma was placement because a veteran cannot be discharged homeless. As in a lot of communities, there were no placement options for these veterans. This impacted the length of stay, bed availability, discharge guidelines, and financial costs. Eventually, one veteran was discharged to reside with a relative, and the other was re-incarcerated as he had an outstanding warrant for an Ohio parole violation.
In response to this dilemma, two strategies emerged. One strategy was to develop and negotiate a contract with the local Ohio River Valley Volunteers of America (VOA) to coordinate per them housing services for 90 days, and as clinically indicated, provide sex offender treatment services. A veteran is clinically assessed using the Static 99 risk tool by VOA staff and placed with the concurrence of the VA into one of three options:
[TABLE 3 OMITTED]
* Treatment program for sex offenders.
* Transitional housing with or without treatment.
* Permanent housing with supportive services (two or more individuals).
The VA staff was also afforded Static 99 risk assessment training sponsored by VOA and ODRC. The contractual arrangement came to fruition in the fall of 2008 and placements thereafter.
Moreover, the placement option is dependent upon treatment needs and the level of risk indicated through assessment. The risk assessment is provided by VOA. Individuals placed in the program will be those requiring a full range of treatment services and having a higher degree of risk. Individuals placed in the other two options may only require treatment services in a few areas such as relapse prevention or no treatment services. A collaborative treatment team composed of VA and VOA staff coordinates services through discharge from the VOA for transitional and /or sex offender treatment services. The VA provides medical, mental health, homeless, substance abuse, and domestic violence treatment services, but not an onsite sex offender treatment or housing options.
The second strategy to consider is the VA Homeless Providers Grant and Per Diem programs that specifically target homeless veterans. These programs provide transitional housing (available up to 24 months) and clinical services to veterans who need the help. Operated by local nonprofit and public agencies, who compete for grants, they can be capital cost grants, which can pay for a percentage of housing acquisition, and per them grants, which provide a fixed reimbursement rate to cover the cost of beds. There are only a handful of these nonprofit programs nationwide that accept and /or treat veteran sex offenders.
Veteran sex offenders are a generally acknowledged reentry and housing challenge nationwide for both the VA and the criminal justice system. These study findings and collaboration encourage the development of a reentry outreach model, increased research, and clinical services for veteran sex offenders. This article offers an identified sample and two possible strategies for communities to consider and adopt. There needs to be, however more dialogue, education, and training for VA, criminal justice system, and community providers. Other than the referenced Bureau of Justice Statistics report and these exploratory findings, no known studies exist. These findings and strategies encourage more dialogue, research, and clinical services for these veterans as these problems will not evaporate or yield to apathy.
Noonan, M., and C. Mumola. (2007). Veterans in State or Federal Prison. Bureau of justice Statistics, Special Report.
Schaffer, B. (2009). The jailed veteran and a challenging economy. American Jails, 23 (4): 41-48.
Bradley Schaffer is currently the coordinator of the Veterans Justice Outreach at the Butler VA Medical Center in Butler, Pennsylvania. He is a licensed master social worker (LMSW), Board Certified Diplomat (BCD) in Clinical Social Work, and a United States Marine Corps veteran with over 24 years of Federal service. He is also an adjunct instructor, Thief College, Department of Sociology and Criminal Justice. Mr. Schaffer may be reached at 724-285-2240 or Brad. firstname.lastname@example.org.