From Patchwork to Network: Serving the Whole Veteran

Yesterday marked the 100th anniversary of the armistice ending World War I. Over 4.7 million Americans served in the military during that war, with about 2.8 million serving overseas. Today, the U.S. has been at war for 17 years in the wake of 9/11 terrorist attacks, with 3.5 million Americans having served in post-9/11 conflicts.

Over the past century, a patchwork of organizations and services have evolved to support returning veterans and their families. The Veterans Affairs Department is of course largest and most well-known, but other federal agencies also provide services, including the departments of Defense, Labor, Education, Health and Human Services and the Small Business Administration. States and many localities, along with more than 40,000 veteran-serving nonprofits and other charitable institutions also provide a wide range of services and care.

Given this bewildering array, how can a veteran sort out what’s helpful? And how can public and private entities best prioritize their resources to be effective? A new report for the IBM Center by researchers at Syracuse University’s Institute for Veterans and Military Families offers a set of building blocks to transform this patchwork into a network.

An Enterprise Approach   

The VA has crafted a compelling strategic plan for how it will serve veterans. But the report’s authors note: “no mechanism exists to establish priorities, resources, and responsibilities across the federal government and align federal efforts with those of the broader public (state and local), private, and non-profit sectors working to serve the veteran community.” They found that current federal efforts to support veterans focus on one or a small handful of issues facing veterans—suicide prevention, opioid addiction, homelessness, job training—and not the whole person. This doesn’t meet the needs of veterans and it doesn’t adequately engage the many community-level resources available.

The authors examined how other policy domains, such as national security, foreign affairs, homeland security, and energy, address complex issues and found that they applied an enterprise approach—coordinated planning and governance that spanned organizational boundaries.

“What is needed is an enterprise approach that reaches beyond the VA to encompass veterans services and care across the federal government, and promote robust federal connections to community-level action,” the authors concluded. To do this, they identified five building blocks, and the actions required to implement them:

1. An Appropriate Inter-Agency Collaboration Mechanism. This must sustain leadership engagement and participation, effective cross-agency planning and collaboration, and accountability for implementation actions. The White House should establish an interagency group on veterans’ services and care that would align existing federal policy, multi-agency councils, task forces, committees, and programs across the federal government, under the direction of the White House Domestic Policy Council.
2. A Comprehensive Vision for Delivering Effective Services and Care. The challenge of supporting veterans is multi-dimensional and should be defined in terms of holistically meeting a range of needs—such as health, education, employment, family support and housing—rather than addressing each need in isolation. The proposed interagency group would develop a “whole of nation” enterprise approach organized in a veteran-centric fashion.
3. A Coordinated Set of Agency Core Competencies. The interagency group should develop an inventory of existing federal programs and “journey maps” to understand how veterans interact with various federal services in order to rethink the roles, missions, and responsibilities of different agencies and programs. Agency responsibilities would be allocated based on expertise, capabilities, and mission focus.
4. A Robust Engagement Strategy with Community-Level Stakeholders. Agencies involved with the interagency group should increase the use of “business models that promote localized innovation, coordination, and bottom-up engagement in communities,” according to the report.
5. The Effective Use of Technology and Data. An important step would be to coordinate disparate data sharing initiatives and prioritize greater flexibility and interoperability across federal, state, local, and nonprofit entities serving veterans.

The authors conclude that benefits and services for veterans are insufficient to meet the range of needs veterans experience. Many of these needs are social or local in nature, as summed up in a quote by former Undersecretary of Defense for Policy Michèle Flournoy:

“Veterans don’t come home to federal agencies; they come home to communities, and meeting their greatest needs often falls on the shoulders of county and city organizations.”

As such, communities must serve as the center of gravity in delivering care and supportive services. The existing patchwork of programs and services therefore need to be woven into a community-centric network.