Texas Veterans Commission

Policy Concerns

  • Continued expansion of veteran peer specialist services
  • Tracking the needs of, outreach to, and services available to women veterans in the state
  • Coordination of federal and state services
  • High risk of post-traumatic stress disorder (PTSD) and suicide among veterans
  • High rates of homelessness among veterans
  • Lack of supports for veterans returning to civilian life after deployment

Fast Facts

  • Texas is home to nearly 1.7 million veterans of the armed forces, more than any other state except California.
  • Women are the fastest growing group within the veteran population and are projected to make up 16 percent of all living veterans by 2043. There are over 177,000 women veterans in Texas.
  • Fifty-five out of every 100 women and 38 out of every 100 men report having been sexually harassed (including offensive comments about a person’s body or sexual activity, displays of pornographic material, and unwanted sexual advances), while in the military.
  • A 2016 report by the Department of Veterans Affairs found that the prevalence of veterans with mental health or substance use conditions receiving services through the Veterans Health Administration (VHA) had increased from 27 percent in 2001 to more than 40 percent in 2014.
  • Veterans exhibit significantly higher suicide risk compared with the U.S. general population. The Department of Veterans Affairs 2016 Suicide Data Report concluded that 20 veterans die from suicide each day. Three out of five veterans who died by suicide were diagnosed as having a mental health condition.
  • Reports show that veterans are overrepresented in the U.S. homeless population, constituting 12.3 percent of all adults experiencing homelessness in the country but only 9.7 percent of the total US population.

Organizational Chart

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Data obtained from: Texas Veterans Commission. (2016). Texas Veterans Commission Organizational Chart.

Introduction

Texas is home to nearly 1.7 million veterans of the armed forces, more than any other state except California. Veterans face a myriad of challenges as they transition from active duty to civilian life. Among these challenges is an increased risk for behavioral health conditions. Approximately 11-20 percent of veterans of the Iraq and Afghanistan wars (Operations Iraqi Freedom and Enduring Freedom) are diagnosed with post-traumatic stress disorder (PTSD). In comparison, only 7-8 percent of American adults in the general population will experience PTSD at some point during their lifetime. In addition to combat trauma, sexual assault while in military duty (referred to as military sexual trauma) can also result in symptoms of PTSD.

Among those women who use Veterans Affairs (VA) health care, 23 out of 100 report having been sexually assaulted (unwanted physical sexual touching that involves some form of coercion) while in the military. Additionally, 55 out of 100 women and 38 of 100 men report having been sexually harassed, which includes behavior such as offensive comments about a person’s body or sexual activity, displays of pornographic material, and unwanted sexual advances while in the military. Thus, veterans are at increased risk for developing mental health conditions and substance use problems stemming from their military service.

Veterans with mental health and substance use conditions face a number of increased risk factors including: chronic homelessness, a greater risk of suicide, a wide range of serious medical problems, premature mortality, and incarceration.

Unfortunately, only about half of all veterans with a diagnosed behavioral health condition have accessed appropriate services, and even fewer have received adequate care.

The Texas Veterans Commission (TVC) serves veterans and their dependents in all matters pertaining to veterans’ disability benefits and rights. It is the designated agency of the state of Texas to represent the state and its veterans before the U.S. Department of Veterans Affairs (VA). The agency represents veterans in filing VA disability claims and during VA appeals processes, and it assists dependents with survivor benefits. Additionally, the TVC focuses on the following program areas:

  • Veterans’ employment services
  • Veterans’ education services
  • Claims representation and counseling
  • Funding assistance

Both the claims representation and counseling and funding assistance programs impact veterans’ ability to access behavioral health services.

The U.S. Department of Defense Military Health System is responsible for providing health care to active duty and retired U.S. military personnel and their families.

Changing Environment 

In 2015, the 84th legislature appropriated funding to help to address the mental health needs of veterans in Texas through several pieces of legislation. It is important to note that the following bills are related to veterans’ behavioral health but not coordinated directly through the Texas Veterans Commission (TVC).

SB 55 – THE TEXAS VETERANS + FAMILY ALLIANCE PROGRAM

Senate Bill 55 (84th, Nelson/S. King) directed HHSC to establish a new grant program to support community mental health programs that provide mental health services and treatment for both veterans and their families. HHSC must work with an outside stakeholder to administer the pilot program. The Meadows Mental Health Policy Institute (MMHPI) is the administrator of the one-year pilot program. The program is currently in the pilot phase and was funded through $1 million in state funds and $1 million raised through private and local funds. The request for proposals (RFP) was released in December 2015.

Twenty million dollars was appropriated by the 84th legislature to continue and expand this grant program for the current biennium, which started in September of 2016. The grant funding period will continue through August 31, 2017.

The pilot program awardees are:

  • Center for BrainHealth
  • Emergence Health Network
  • Texas Panhandle Centers
  • United Way of Denton County
  • Tropical Texas Behavioral Health

Access updates on the Texas Veterans + Family Alliance program.

HB 3404 – STUDY ON VETERANS WITH POST-TRAUMATIC STRESS DISORDER (PTSD)

HB 3404 (84th, Thompson/Lucio) required Health and Human Services Commission to conduct a study on the benefits of providing integrated care to veterans with post-traumatic stress disorder (PTSD). The study will be coordinated with a university and medical school with expertise in behavioral health or PTSD. The study will evaluate the benefits of 1) using a standardized comprehensive trauma and PTSD assessment to identify and target evidence-based treatment services to provide integrated care for veterans; and 2) involving family members in the treatment of veterans diagnosed with PTSD. Finally, HB 3404 requires a report describing the results of this new effort to be released by December 1, 2016.

The 84th legislature did not appropriate funding in the biennial budget for the study required in HB 3404. As of print date, HHSC is exploring options for partnering with institutions of higher education.

SB 1304- MENTAL HEALTH INTERVENTION PROGRAMS FOR FEMALE VETERANS 

SB 1304 (84th, Menéndez/Minjarez) required DSHS to develop a mental health initiative as part of the mental health intervention program for female veterans. Women veterans face unique mental health concerns, from military sexual trauma to consolidating dual roles as soldiers and family caregivers.

SB 1305- MENTAL HEALTH INTERVENTION PROGRAMS FOR VETERANS LIVING IN RURAL AREAS 

SB 1305 (84th, Menéndez/Minjarez) also required DSHS to develop a mental health initiative for veterans living in rural areas of the state. Of the 1.67 million veterans in Texas, 30 percent (approximately 503,000) live in rural areas with limited or no access to mental health services. Veterans in these areas have been historically underserved in this capacity. These disparities are compounded by the continued shortage of mental health professionals in rural areas (see the Texas Environment section for further discussion of the mental health workforce shortage in rural areas).

SB 169- INTEREST AND WAIT LISTS OF HHS PROGRAMS FOR ACTIVE DUTY SERVICE MEMBERS

SB 169 (84th, Uresti/King, S.) required health and human services agencies to ensure active duty members, or their spouses or dependents, do not lose their place on interest lists or other waiting lists for any assistance programs provided by certain agencies. This provision impacts veterans, their spouses, or dependents who are temporarily residing out of state as a result of military service. SB 169 states that this protection ends one year after the military member leaves active duty, is killed in action, or dies while in the service. If a military member is out of state when his or her name reaches the top of the interest list, agencies will maintain the individual’s position on the interest list. Several agencies already allow this protection for veterans, their spouses, and dependents. This legislation provides consistency across program policies and agencies. SB 169 applies to programs at DADS, DARS, DSHS, and HHSC. Implementation varies by agency and program.

Funding

The Texas Veterans Commission (TVC) receives both state and federal funding, as well as other funds. Note: TVC is not part of the Health and Human Services enterprise.

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Source: Legislative Budget Board. (2016). Veterans Commission, Legislative Appropriations Request Fiscal Years 2018-2019

*Other funds include: Fund for Veterans Assistance, Appropriated Receipts, Interagency Contracts, License Plate Trust Fund No. 0802, Governor’s Emer/Def Grant

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Source: Legislative Budget Board. (2016). Veterans Commission, Legislative Appropriations Request Fiscal Years 2018-2019

*Other funds include: Fund for Veterans Assistance, Appropriated Receipts, Interagency Contracts, License Plate Trust Fund No. 0802, Governor’s Emer/Def Grant

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Source: Legislative Budget Board. (2016). Veterans Commission, Legislative Appropriations Request Fiscal Years 2018-2019.  

Claims Representation and Counseling Program

TVC’s claims representation and counseling program helps veterans and their family members apply for disability benefits and enroll in VA health care programs. TVC employs over 75 counselors accredited by the VA to provide direct representation in claims and appeals as well as general assistance with the process of securing benefits at many veterans integrated service network (VISN) facilities. Claims counselors act as liaisons between the veteran and VA medical facilities and assist veterans with applications for VA compensation benefits.

The following sections describe VA benefits eligibility and available VA behavioral health services that can be accessed by an individual independently or with the assistance of TVC counselors. TVC counselors work with veterans throughout the state.

Eligibility for VA Benefits

Eligibility for most VA benefits, including health services, occurs upon discharge from active military service, except when under dishonorable conditions. Veterans are assigned to one of eight priority groups upon enrollment. The higher priority groups include veterans with service-connected disability ratings, including former prisoners of war, Purple Heart Medal recipients, Medal of Honor recipients, veterans discharged with a disability incurred or aggravated in the line of duty, and veterans awarded special eligibility due to a disability incurred during treatment or vocational rehabilitation. See a complete listing of all eight priority groups.

There are two types of compensation available: 1) Service-Connected and 2) NonService Connected. Service-Connected compensation is a monetary benefit paid to veterans who suffered an injury or illness incurred or aggravated during military service, regardless of their combat experience. A Non-Service Connected pension is a monetary benefit paid monthly to veterans with low or no income who are aged 65 and older, or have permanent disability. Additional eligibility requirements for a Non-Service Connected pension include: having served 90 days or 24 months (depending on dates of service) of active duty with one day during a period of wartime (combat experience not required) and a family income lower than a specified limit (depending on spouse/dependents).

VA Behavioral Health Services

Nationally, veterans’ health care services are administered on a regional level by a system of 23 veterans integrated service networks (VISN), each containing a hierarchy of medical centers, on-site outpatient clinics, community-based outpatient clinics and vet centers, which provide counseling, outreach, and referral services to help veterans adjust to life post-combat. Texas has one VISN, VISN 17: VA Heart of Texas Health Care Network, which is located in Arlington, along with multiple clinics and vet centers throughout the state. Learn more.

The TVC does not directly operate or provide behavioral health services to veterans; instead it links veterans to these services through the claims representation and counseling programs described above. There is a wide array of VA settings that provide both inpatient and outpatient behavioral health services, including primary care clinics, general and specialty outpatient mental health clinics, residential care facilities, and community living centers. Services and programs include:

  • Specialized PTSD services,
  • Psychosocial rehabilitation and recovery services,
  • Suicide prevention programs,
  • Evidence-based psychotherapy programs, and
  • Substance use services.

The VA also provides behavioral health services for family members and survivors of active duty military personnel and veterans. Additionally, 300 Vet Centers nationwide provide psychological counseling for war-related trauma and other services such as outreach, case management, and social services referrals. Vet Centers served a total of 219,509 veterans, service members, and military families in FY 2015 and provided 1,663,011 no-cost visits for readjustment counseling, military sexual trauma counseling, and bereavement counseling services. There were a total 8.97 million veterans enrolled in the VA Health Care system in FY 2015.

Access a comprehensive description of federal benefits and services available to veterans, family members and survivors.

TVC Employment Services

Unemployment among veterans can have negative mental health and economic consequences, which creates additional obstacles for veterans in securing stable housing. Gainful employment is therefore key to ensuring that veterans live independently and self-sufficiently. The TVC offers employment services to assist qualified veterans in finding and obtaining meaningful and long-term employment. Veteran employment representatives provide job coaching, job training, and resume assistance. They can also provide access to education programs, and conduct outreach to businesses and employers to promote the hiring of veterans. Other employment-related services for veterans include intensive services, vocational services, referrals to training, and other supportive services.

Fund for Veterans’ Assistance (FVA)

The Fund for Veterans’ Assistance (FVA) is operated by the TVC and is funded through a combination of state funds and private donations. The FVA awards four categories of grants to eligible organizations that provide direct services to veterans and their families. The four categories include:

  • General Assistance Grants,
  • Housing for Heroes Grants,
  • Veterans Mental Health Grants, and
  • Veterans Treatment Court Grants.

FVA General Assistance grants reimburse charitable organizations, local government agencies, and veterans service organizations (VSO) for providing direct support services to veterans and their families, including housing assistance, counseling for PTSD and traumatic brain injury, transportation to medical appointments, and information and referrals to other services. Housing for Texas Heroes grants support nonprofit or local government organizations that provide temporary and permanent housing assistance for veterans and their families. Veterans Mental Health Grants fund projects that provide direct mental health services to veterans and their families through a range of services such as peer counseling, PTSD treatment, traumatic brain injury (TBI) services, group therapy, equine therapy, and co-occurring disorder counseling, among others. Veterans Treatment Court Grants assist Texas veterans in obtaining services through Veterans Treatment Court programs.

The FVA is funded through four primary sources: the sale of $2 scratch-off lottery tickets, online or check donations, vehicular registration donations, and the State Employee Charitable Contribution Campaign. The FVA funded 11 organizations involved in veterans mental health across the state for a total of over $1 million for 2016.

Access a list or organizations and grant awards beginning January 1, 2016.

Veterans Mental Health Program (VMHP) and Other Supports

Veterans exhibit significantly higher suicide risk compared with the U.S. general population. The Department of Veterans Affairs 2016 Suicide Data Report (the most recent study of its kind) concludes that 20 veterans die from suicide each day. The Veterans Crisis Line is a resource available during mental health crises, including suicide crises, and can be accessed by veterans, their families, and/or friends. Callers can reach the hotline via telephone, text, or online chat where they will be connected with a trained VA responder. Since its launch in 2007, the Veterans Crisis Line has answered over 2 million calls and initiated the dispatch of emergency services to callers in crisis over 56,000 times. The Veterans Crisis Line anonymous online chat service, added in 2009, has engaged in more than 267,000 online chats. In November 2011, the Veterans Crisis Line introduced a text-messaging service to provide another way for veterans to connect through their personal cell phone or smart phone with confidential, round-the-clock support, and since then has responded to more than 48,000 texts.

TexVet, an initiative by the Texas A&M Health Science Center, is a network of health providers, community organizations, and volunteers who are committed to providing veterans, military members, and their families with referrals and information to successfully access services. TexVet has initiated a “No Wrong Door” policy for the veteran community through its network and event-based activities, which ensures that veterans are properly connected to the services that they need by knowledgeable partners across the state.

Military Veteran Peer Network

One of the Veterans Mental Health Program (VMHP) resources available on the TexVet network is the Military Veteran Peer Network. This organization is an affiliation of veterans and family members who actively identify and advocate for community resources for veterans and provide peer counseling services. Peer Group Leaders are trained in peer support and mental health awareness and establish peer group meetings in their communities. Because members of the group set their own rules, no two peer groups are the same. The Military Veteran Peer Network has 37 chapters across the state and is supported by grants from the Department of State Health Services (DSHS).

“No one is better prepared to speak with a Veteran about her experiences than another Veteran, a peer.” – Military Peer Veteran Network

Other VMHP Services

The Veterans Mental Health Program also provides additional services including: Military Cultural Competency training for licensed mental health professionals, Veterans Mental Health Awareness training for community-based organizations and faith-based organizations, and Coordination of Justice Involved programming through engagement, training, and cooperation with justice system agencies.

Specialty Courts

Left untreated, mental health and substance use conditions may lead to involvement in the criminal justice system. Under the typical criminal justice process, a veteran facing charges is assigned to a judge who may be unfamiliar with the unique challenges faced by returning veterans, such as PTSD, TBI, depression, and substance use issues. Alternatively, a judge sitting in a specialty veterans court may have a better understanding of the mental health conditions and veteran-specific struggles that can increase risks for criminal behavior. The judge may also be more familiar with the range of community-based services and benefits available to veterans and often include case managers and court clerks with military experience or familiarity working with veterans. Thus, veterans courts may be more capable of diverting veterans from the criminal justice system and instead linking them and their families to benefits, services, and supports.

The first veterans court in Texas, located in Harris County, began accepting cases in 2009. Results from seven veterans courts (Bexar, Dallas, El Paso, Harris, Hidalgo, Tarrant, and Travis counties) in FY 2013 included: 651 total veterans were assessed for eligibility to participate in the program, 451 veterans enrolled in the program, 226 of the 451 veterans were new enrollees, and 124 veterans successfully completed the program.

As of May 2016, there are twenty-three veterans courts operating throughout the state in the following counties:

  • Bell
  • Bexar
  • Cameron
  • Collin
  • Comal
  • Dallas
  • Denton
  • El Paso
  • Fort Bend
  • Galveston
  • Guadalupe
  • Harris
  • Hays
  • Hidalgo
  • Midland
  • Montgomery
  • Nueces
  • Tarrant
  • Travis
  • Rockwall
  • Smith
  • Webb
  • Williamson

Texas Veterans Portal (TVP)

The Texas Veterans Portal (TVP), managed by the TVC, is a collaborative effort of several state agencies and commissions to provide assistance, services, and benefits for Texas veterans, their families, and service providers. The site provides online access to a comprehensive range of information about veteran’s benefits, education, employment, and health services. Additionally, TVP is a single access point to download pertinent forms, locate community resources, and review frequently asked questions. Currently the TVP collaborates with:

  • TVC
  • Texas Workforce Commission
  • Texas Veterans Land Board (Texas General Land Office)
  • 2-1-1 (Texas Health & Human Services Commission)
  • TexVet (Texas A&M Health Science Center)
  • Office of the Governor
  • Texas Department of Information Resources
  • Staff from Texas State Representative Chris Turner and U.S. Representative John Carter’s offices
  • Texas Army National Guard (Camp Mabry).

Women Veterans

Women are the fastest growing group within the veteran population and are projected to make up 16 percent of all living veterans by 2043. Recognizing the growing number of female veterans, the VA has embarked on efforts to understand how to better serve woman veterans. In the general population, women are more likely to develop PTSD than men. It is unclear whether the incidence of PTSD is higher among military women than military men. However, woman veterans are more likely to have lower incomes, lack private insurance, and have poorer health. Female veterans earn almost $10,000 less per year than male veterans and are up to four times more likely to be homeless than nonveteran women. Because of their heightened risk for having experienced military sexual trauma, PTSD, homelessness and financial stress, it is important that health care, including mental health and substance use services, support services, and transitional resources are responsive to the needs of woman veterans.

The TVC created the Texas Women’s Initiative in an effort to better serve women veterans, by helping them obtain their benefits, increasing services for women veterans throughout the state, and coordinating services and supports with local community organizations. The 84th legislature passed SB 1304 (84th, Menéndez/ Minjarez), requiring DSHS to create an initiative focused on the mental health needs of women veterans.

Access more information on other initiatives to serve women veterans.

 

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