[House Hearing, 110 Congress] [From the U.S. Government Publishing Office] MEDIA OUTREACH TO VETERANS ======================================================================= HEARING before the SUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS of the COMMITTEE ON VETERANS' AFFAIRS U.S. HOUSE OF REPRESENTATIVES ONE HUNDRED TENTH CONGRESS SECOND SESSION __________ JULY 15, 2008 __________ Serial No. 110-98 __________ Printed for the use of the Committee on Veterans' Affairs U.S. GOVERNMENT PRINTING OFFICE 44-000 PDF WASHINGTON DC: 2009 --------------------------------------------------------------------- For Sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512-1800; (202) 512�091800 Fax: (202) 512�092104 Mail: Stop IDCC, Washington, DC 20402�090001 COMMITTEE ON VETERANS' AFFAIRS BOB FILNER, California, Chairman CORRINE BROWN, Florida STEVE BUYER, Indiana, Ranking VIC SNYDER, Arkansas CLIFF STEARNS, Florida MICHAEL H. MICHAUD, Maine JERRY MORAN, Kansas STEPHANIE HERSETH SANDLIN, South HENRY E. BROWN, Jr., South Dakota Carolina HARRY E. MITCHELL, Arizona JEFF MILLER, Florida JOHN J. HALL, New York JOHN BOOZMAN, Arkansas PHIL HARE, Illinois GINNY BROWN-WAITE, Florida SHELLEY BERKLEY, Nevada MICHAEL R. TURNER, Ohio JOHN T. SALAZAR, Colorado BRIAN P. BILBRAY, California CIRO D. RODRIGUEZ, Texas DOUG LAMBORN, Colorado JOE DONNELLY, Indiana GUS M. BILIRAKIS, Florida JERRY MCNERNEY, California VERN BUCHANAN, Florida ZACHARY T. SPACE, Ohio STEVE SCALISE, Louisiana TIMOTHY J. WALZ, Minnesota DONALD J. CAZAYOUX, JR., Louisiana Malcom A. Shorter, Staff Director ______ SUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS HARRY E. MITCHELL, Arizona, Chairman ZACHARY T. SPACE, Ohio GINNY BROWN-WAITE, Florida, TIMOTHY J. WALZ, Minnesota Ranking CIRO D. RODRIGUEZ, Texas CLIFF STEARNS, Florida BRIAN P. BILBRAY, California Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public hearing records of the Committee on Veterans' Affairs are also published in electronic form. The printed hearing record remains the official version. Because electronic submissions are used to prepare both printed and electronic versions of the hearing record, the process of converting between various electronic formats may introduce unintentional errors or omissions. Such occurrences are inherent in the current publication process and should diminish as the process is further refined. C O N T E N T S __________ July 15, 2008 Page Media Outreach to Veterans....................................... 1 OPENING STATEMENTS Chairman Harry E. Mitchell....................................... 1 Prepared statement of Chairman Mitchell...................... 29 Hon. Ginny Brown-Waite, Ranking Republican Member................ 3 Prepared statement of Congresswoman Brown-Waite.............. 30 WITNESSES U.S. Department of Veterans Affairs, Hon. Lisette M. Mondello, Assistant Secretary for Public and Intergovernmental Affairs... 18 Prepared statement of Ms. Mondello........................... 49 ______ Goodstein, Ronald C., Ph.D., Associate Professor of Marketing, The Robert Emmett McDonough School of Business, Georgetown University, Washington, DC..................................... 8 Prepared statement of Dr. Goodstein.......................... 34 Iraq and Afghanistan Veterans of America, Vanessa Williamson, Policy Director................................................ 6 Prepared statement of Ms. Williamson......................... 33 O'Herrin, Elizabeth, Washington, DC.............................. 4 Prepared statement of Ms. O'Herrin........................... 30 Sutton, Sharyn M., Ph.D., Washington, DC......................... 10 Prepared statement of Dr. Sutton............................. 44 MATERIAL SUBMITTED FOR THE RECORD Background Material: Hon. James B. Peake, M.D., Secretary, to Under Secretaries, Assistant Secretaries, and Other Key Officials, U.S. Department of Veterans Affairs, Memorandum dated June 16, 2008, Regarding Rescission of VA Advertising Policy and Delegation of Authority for the Purchase of Media Advertising................................................ 50 Post Hearing Followup, Questions and Responses for the Record: Hon. Harry E. Mitchell, Chairman, Subcommittee on Oversight and Investigations, Committee on Veterans' Affairs, to Hon. Lisette M. Mondello, Assistant Secretary, Public and Intergovernmental Affairs, U.S. Department of Veterans Affairs, letter dated July 18, 2008, and response letter dated September 16, 2008................................... 53 Hon. Ginny Brown-Waite, Ranking Member, Subcommittee on Oversight and Investigations, Committee on Veterans' Affairs, to Hon. James B. Peake, Secretary, letter dated July 22, 2008, and responses............................... 56 Hon. Ginny Brown-Waite, Ranking Member, Subcommittee on Oversight and Investigations, Committee on Veterans' Affairs, to Ms. Elizabeth O'Herrin, letter dated July 22, 2008, and responses........................................ 59 Hon. Ginny Brown-Waite, Ranking Member, Subcommittee on Oversight and Investigations, Committee on Veterans' Affairs, to Ms. Vanessa Williamson, Policy Director, Iraq and Afghanistan Veterans of America, letter dated July 22, 2008, and Ms. Williamson's responses....................... 60 Hon. Ginny Brown-Waite, Ranking Member, Subcommittee on Oversight and Investigations, Committee on Veterans' Affairs, to Ronald C. Goodstein, Ph.D., Associate Professor of Marketing, Robert Emmett McDonald School of Business, Georgetown University, letter dated July 22, 2008, and Dr. Goodstein's responses...................................... 62 Hon. Ginny Brown-Waite, Ranking Member, Subcommittee on Oversight and Investigations, Committee on Veterans' Affairs, to Sharyn M. Sutton, Ph.D., Washington, DC., letter dated July 22, 2008, and Dr. Sutton's responses..... 63 MEDIA OUTREACH TO VETERANS ---------- TUESDAY, JULY 15, 2008 U.S. House of Representatives, Committee on Veterans' Affairs, Subcommittee on Oversight and Investigations, Washington, DC. The Subcommittee met, pursuant to notice, at 2:02 p.m., in Room 334, Cannon House Office Building, Hon. Harry E. Mitchell [Chairman of the Subcommittee] presiding. Present: Representatives Mitchell, Space, Walz, and Brown- Waite. OPENING STATEMENT CHAIRMAN MITCHELL Mr. Mitchell. Good afternoon. And welcome to the Subcommittee on Oversight and Investigations hearing on media outreach to veterans. This meeting will come to order. Today we will be hearing from veterans, marketing experts, and the U.S. Department of Veterans Affairs (VA) about the prospects and challenges in using television media to reach veterans not currently enrolled in VA services. In November, CBS News got some shocking and critical information, information to light that veterans aged 20 to 24 were killing themselves when they returned home at rates between two and a half to four times higher than their nonveteran peers. Possibly more troubling, though, was that the Department of Veterans Affairs was not keeping track of veterans' suicides nationwide. In December, we had a hearing to find out why. I do not think anyone at that hearing will forget the moving testimony of Mike and Kim Bowman, whose 23-year-old son, Tim, survived a year of duty in Iraq only to come home and take his own life. Mr. Bowman warned us that the VA needs to do a better job of reaching out to veterans at risk for suicide. Do not just make it so veterans have to go to the VA, he told us, make the VA go to the veteran. The VA reports that out of a veteran population of about 25 million, only 7.8 million are enrolled to receive healthcare services and only five and a half million were actually treated last year. I want to know about the other 17 million veterans. What is being done to bring them to the VA? Following the hearing, I asked the VA for information about what the folks in the field, those helping veterans one on one every day, have been asking for to reach veterans at risk for suicide and their families. After 4 months of stonewalling and a suggestion that I go file a ``Freedom of Information Act'' request, the VA finally began producing documents and cooperating with my inquiry in May. Documents began arriving and VA officials began meeting with my office. As we learn more about the VA's efforts to reach veterans outside the VA system, we learn more about the potential advantages of television advertising as well as the frustration with the VA's ban. Until recently, the VA had a self-imposed ban against television advertising. In other words, if anyone at the VA suggested using public service announcements (PSAs) to raise the public awareness of VA's suicide hotline or other mental health services, they were told that it was against VA policy to do so. In an era when slogans like ``Be All You Can Be'' and ``The Few, The Proud, The Marines'' have become household phrases and commercials touting them are only a few clicks away on YouTube, the VA's ban on television advertising seem to many of us, outdated and out of touch. Of course, those are recruiting ads, but I think they illustrate an important point. We have the means to spread important messages. We just need to have the will. On June 18, 2008, Secretary Peake called to inform me that he had formally lifted the ban on television advertising. I am grateful for his action and I commend him for it. It is a decision that I hope will end up saving lives. Lifting the ban is only the beginning. The VA will now have to partner with advertising professionals to design and implement an effective public awareness campaign and find an effective way to monitor its impact. This Congress has placed a high priority on funding VA healthcare. As a result, the VA has been able to hire thousands of new mental health professionals. Veterans now need to know where to go to get that help. To that end, I am excited to hear from the VA about its plans for a pilot public awareness campaign. First, however, we will hear from Elizabeth O'Herrin, an Iraqi War veteran, about how veterans see the VA today, as well as Vanessa Williamson, about how private organizations are using media to help veterans. Before I recognize others for opening remarks, I want to thank Chairman Filner and Ranking Member Buyer for their bipartisan leadership on this issue as well as Ranking Member Brown-Waite who has been an invaluable partner. I would also like to thank Mr. Boozman for his leadership in recognizing potential legislation and Mr. Hall whose Subcommittee has been actively searching for ways to publicize benefits available to veterans. I would like our witnesses to stay within the 5 minutes of opening statements. Your full statement will be submitted for the record, but this panel is large and we need to make sure we have a great dialog. I would also like to ask Members to stay within the 5 minutes so that we can get to everyone. I will not interrupt an answer, but please do not ask any questions after the time is complete. And, again, this is a large panel. We will have a second round of questions, if possible. At this time, I would like the witnesses from both panels if they would please stand to be sworn in. [Witnesses sworn.] [The prepared statement of Chairman Mitchell appears on p. 29.] Mr. Mitchell. At this time, I would like to recognize Ms. Brown-Waite. OPENING STATEMENT HON. GINNY BROWN-WAITE Ms. Brown-Waite. Thank you very much, Chairman Mitchell. Informing veterans about the benefits that are available to them should be a very high priority for the Department of Veterans Affairs. Printing brochures and handbooks in this day of the Internet and instant messaging is still an option. But the use of the 21st century technology does need to be explored. On May 20, 2008, the House passed H.R. 3681, the ``Veterans Benefit Awareness Act of 2007.'' This provides authorization for the Secretary of Veterans Affairs to promote benefits available to veterans by advertising through the national media. This advertising would promote awareness of veterans' programs provided by the Secretary including, but not limited to, programs for homeless veterans, promotion of veteran-owned small businesses, opportunities for employment in the Department of Veterans Affairs, educational opportunities and training, compensation, pension, vocational rehabilitation, and healthcare benefits, along with mental healthcare including the prevention of veteran suicide. This bill, which was authored by Congressman Boozman, the Ranking Member of the Subcommittee on Economic Opportunity, and Congresswoman Stephanie Herseth Sandlin, the Chair of that Subcommittee, was introduced due to raised concerns by officials at the Department of Veterans Affairs that they did not have, or they thought they did not have, the authority to advertise their services to the public through a national media campaign. That bill is still awaiting Senate action. On June 4th, the Chairman and I sent a letter requesting the Chairman and Ranking Member of the full Committee to use the resources of the Committee to explore the potential efficacy of a broadcast public awareness campaign as a means of conducting outreach to veterans at risk for suicide. On June 16th, Secretary Peake sent a memo to the Under Secretaries, Assistant Secretaries, and other key officials at the Department clarifying the ability of the VA to advertise in the national media. That memorandum provided within 2 months after this delegation of authority, the Assistant Secretary for Public and Intergovernmental Affairs review the purchases of media advertisement under this memorandum, at which time the Assistant Secretary would provide a recommendation to the Secretary to either continue the existing program or pursue a new policy. Mr. Chairman, I ask unanimous consent that a copy of the Secretary's memo be included in the official record. Mr. Mitchell. Thank you. Without objection, so ordered. [The Secretary's Memorandum, dated June 16, 2008, appears on p. 50.] Ms. Brown-Waite. Thank you. Mr. Chairman, I am looking forward to hearing from the witnesses today on the implementation of the Secretary's memorandum. It has been 1 month since the memorandum has been issued and I am interested to learn what steps have been taken to further inform our veterans about these services that are available through the VA. I yield back the balance of my time. [The prepared statement of Congresswoman Brown-Waite appears on p. 30.] Mr. Mitchell. Thank you. On our first panel, we have Elizabeth O'Herrin, Operation Iraqi Freedom (OIF) veteran and former Wisconsin Air National Guard member; Vanessa Williamson, Policy Director for Iraq and Afghanistan Veterans of America (IAVA); Ronald C. Goodstein, Ph.D., Associate Professor of Marketing from Georgetown University; and Dr. Sharyn Sutton from Washington, DC, a communications and social marketing consultant. We will begin with you, Ms. O'Herrin. And thank you. If you would, keep it within 5 minutes. STATEMENTS OF ELIZABETH O'HERRIN, WASHINGTON, DC (OIF VETERAN AND FORMER WISCONSIN AIR NATIONAL GUARD MEMBER); VANESSA WILLIAMSON, POLICY DIRECTOR, IRAQ AND AFGHANISTAN VETERANS OF AMERICA; RONALD C. GOODSTEIN, PH.D., ASSOCIATE PROFESSOR OF MARKETING, THE ROBERT EMMETT MCDONOUGH SCHOOL OF BUSINESS, GEORGETOWN UNIVERSITY, WASHINGTON, DC; AND SHARYN M. SUTTON, PH.D., WASHINGTON, DC (COMMUNICATION AND SOCIAL MARKETING CONSULTANT) STATEMENT OF ELIZABETH O'HERRIN Ms. O'Herrin. Good afternoon, Chairman Mitchell and other distinguished representatives of the Subcommittee. I thank you for the opportunity to be here today and share my perspective as a young Iraq War veteran who believes there is much to be done to reach out to our returning troops. I joined the Air National Guard on September 13th, 2001, and I have deployed three times in support of Operation Iraqi Freedom. I can personally attest to my experiences with the Department of Veterans Affairs as both a member of the National Guard and a veteran, which is a little bit different than being a veteran of active duty. I would like to pull one particular thought from my written testimony and use this opportunity to expound on it a little bit. I went on my third deployment to Iraq this spring and I was stationed there just for a couple months. And so the experience I am about to speak of right now is especially salient to me. The theory is when you are on active duty, the U.S. Department of Defense (DoD) is supposed to take care of you and after you have served your country, they hand you off to the Department of Veterans Affairs. But I believe a rather significant disconnect can be illustrated by the awareness campaigns for post traumatic stress disorder (PTSD) that I witnessed while I was on active duty and the complete lack thereof when I separated from active duty after deploying. It is interesting to me that while I was deployed, public service announcements were literally everywhere you turned because they are constantly on the Armed Forces Network which is broadcast everywhere in the desert. They are in the gym. They are at the chow hall. You see the Armed Forces Network and the PSAs everywhere. But when I came home, these public service announcements completely disappeared. There was no awareness campaign despite the fact that you generally get PTSD after the fact. It's called post traumatic stress disorder for a reason. I was actually in Iraq when the Super Bowl was aired and I distinctly remember sitting down at chow and having a long discussion with a bunch of Army guys about public service announcements on American Forces Network (AFN). They were kind of grumbling because there were not going to be any good commercials on during the Super Bowl. It was going to be about 4 hours of public service announcements. And I have to say that they have a notorious reputation for being a little bit on the cheesy side, but I think it is common practice for military members to joke about public service announcements. But I want to emphasize one thing in particular. We talked about these PSAs and we talked about them on a very regular basis. And while people might joke about the need to be careful during lightning strikes or the importance of shredding important documents or even post traumatic stress disorder symptoms, these PSAs are doing their job which is to create awareness because they stick in people's heads and people talk about them. For example, while I was deployed, if I had been unfortunate enough to have been sexually assaulted, I would have known exactly where to go to talk to somebody. I knew that I would not have to report it officially on the record. I knew what protocol to follow to ensure that everything remained confidential. And this was literally hammered into my head through PSAs. And should something have happened, I would not have had to go searching for the answers after the fact. It was a very proactive outreach method used by the Department of Defense. And I was fortunate enough to never witness anything of this, but if I had, the tools to cope with the incident were routinely given to me. It did not leave any room for confusion or hesitancy, which when confusion and hesitancy happens, it can often lead to individuals not actually seeking out the help that they really need. And I feel at the VA, they have a plethora of services and benefits and information, but I feel that the attitude is a little bit like we are here for you, but you have to come to us. And many veterans wait until there is a legitimate problem before they start to dig for answers. And I believe taking a less passive stance, instead using more active outreach methods could do a great deal to encourage veterans to seek out assistance before it is too late. I commend the Department of Veterans Affairs for their efforts in reaching out to veterans and also veterans service organizations for trying to fill in the gaps. It is not an easy job and there is a lot of work to do, but I believe that a few key changes within the Department of Veterans Affairs could go a long way into giving young veterans the tools that they need to reintegrate into civilian life upon return home. I talked a great deal about new methods such as e-mail in my written testimony, the VA implementing the use of e-mail, and I would be happy to answer any questions about my written testimony. Thank you. [The prepared statement of Ms. O'Herrin appears on p. 30.] Mr. Mitchell. Thank you. Ms. Williamson. STATEMENT OF VANESSA WILLIAMSON Ms. Williamson. Mr. Chairman, Ranking Member, and Members of the Subcommittee, thank you for the opportunity to testify today on the need for VA media outreach. I am the Policy Director of Iraq and Afghanistan Veterans of America, the country's first and largest nonprofit and nonpartisan Iraq and Afghanistan veterans' group. As a civilian who has worked with this population for almost 4 years now, I have seen firsthand the tremendous gap between the VA and the veterans they are seeking to help. There are millions of veterans who qualify for VA benefits and services, but who do not use them simply because they do not know the programs exist, they do not know they qualify, or they do not know how to apply. These veterans could be getting a college education, buying their own home, qualifying for healthcare when they are sick, but they are not because they do not think they can afford it. And the VA has not told them otherwise. The VA's healthcare system is actually a very good system, but accessing it can be very difficult. Right now at least 1.8 million veterans lack health insurance and half of those veterans actually qualify for VA care. That is almost a million veterans without regular access to healthcare who the VA could be serving. Like other uninsured Americans, these veterans are avoiding getting their health problems treated while relying on expensive emergency room care. Among Iraq and Afghanistan veterans in particular, less than half have signed up for VA care. These veterans have only 5 years to get into the door of the VA or they risk getting labeled Priority 8 and losing their access altogether. The VA needs to take steps now to reach these veterans before it is too late. In the meantime, veterans are missing out on some of the best healthcare you can get in this country. Veterans of Foreign Wars (VFW), American Veterans (AMVETS), Disabled American Veterans (DAV), and Paralyzed Veterans of America (PVA) agree that VA healthcare is ``equivalent to or better than care in any private or public healthcare system.'' But until the VA advertises their healthcare services, hundreds of thousands of veterans will lack access. Veterans also qualify for tens of thousands of dollars in education benefits. Under the GI Bill, which became law only weeks ago, Iraq and Afghanistan veterans receive free tuition up to the cost of the most expensive in-State public university. They also get a living stipend and a book stipend, and there is even a new program to encourage expensive private schools to offer veteran scholarships. But we know from history that many veterans do not take advantage of their GI Bill. In fact, under the old Montgomery GI Bill, only 8 percent of veterans used their whole benefit and 30 percent of veterans did not use their GI Bill at all. A VA advertising campaign now would ensure that Iraq and Afghanistan veterans get the chance to build a brighter future for themselves and their families. And I know how hard this Committee worked to make this GI Bill a reality, so we really do need to take the next step. The last area I am going to talk about in terms of the need for VA advertising is home loans. Military towns are ground zero for the subprime mortgage crisis. Foreclosure rates in towns around military bases are increasing at four times the national average. While troops and veterans were being bombarded over the last few years with advertising for subprime mortgages, they heard no advertising at all regarding safe and reliable VA home loans. As a result, the VA Home Loan Program has been under- utilized. The number of new VA loans has declined every year between 2004 and 2007. And in 2006, at the peak of U.S. subprime lending, the number of VA loans had fallen to barely a third of the level of 2 years earlier. This is especially unfortunate because veterans using VA home loans get a much safer mortgage and the support of VA financial counseling if they need it. And VA backed mortgages are not going into foreclosure like subprime loans are. In fact, although 90 percent of current VA backed home loans were given with no down payment at all, their foreclosure rate is near the level of prime borrowers which is borrowers with the highest possible credit rating. But because the VA does not advertise, many troops and veterans who could have gotten a VA home loan are now suffering with a subprime mortgage and are at risk of losing their homes altogether. So in terms of home loans, healthcare, and education, the VA offers excellent programs, but access is difficult. And without a strategy to advertise their services, veterans are going to continue to miss out. Knowing that nonprofit advocacy organizations can often respond faster than the government, IAVA has partnered with the Ad Council to conduct a multi-year public service announcement campaign to reduce the stigma of mental healthcare and to ensure that veterans seeking access to care get the benefits and support that they deserve. The Ad Council is responsible for many of the Nation's most iconic public service announcement campaigns including ``Only You Can Prevent Forest Fires,'' ``A Mind Is A Terrible Thing To Waste,'' and ``Friends Do Not Let Friends Drive Drunk.'' The Ad Council has also shown great success. For example, as a result of Ad Council's Big Brother, Big Sister Campaign, applications for Big Brother's, Big Sister's mentors soared from 90,000 to 620,000 in only 9 months. Ready.gov, the Department of Homeland Secretary's outreach site, received more than 18 million unique visitors within the first 10 months of their campaign launch. We are hoping to see the same kind of success with our campaign. IAVA, Ad Council PSAs will appear on the television, in radio, in print, outdoors, and online, and will be rolling out in November of this year. Over the last 2 months, IAVA has met with VA on three occasions to discuss our new campaign and we are hopeful that the VA will be able to prepare for any increase in demand the campaign generates. But our PSA campaign will in no way eliminate the need for the VA to plan its own outreach and advertising campaign. Our veterans have earned these benefits defending their country and should not have to fight for them when they come home. Thank you for your time. [The prepared statement of Ms. Williamson appears on p. 33.] Mr. Mitchell. Thank you. Dr. Goodstein. STATEMENT OF RONALD C. GOODSTEIN, PH.D. Mr. Goodstein. Thank you, Mr. Chairman, Members of the Subcommittee. I am Ron Goodstein from Georgetown University. And I just came today from teaching this morning for Kimberly-Clark and 50 executives from hospitals around the USA. We were talking their communications, their media strategy, their marketing strategy, and I spent 3 hours not talking about communications at all but talking about marketing research. I agree with everyone here that the idea is to advertise to the veterans, to let them know that you are out there, to build the awareness. You do have the means. You do have the motivation, but you need to know what to say and to whom. Of course, being an academic, I have to have slides, so let me go that way. [Slides shown.] I think the idea of the media outreach is strong. I think you are talking to people who not only need our help but deserve our help for what they have done for the country. I want to talk a little bit about the benefits of the media outreach, the idea of how to do the research that is needed, illustrate why SW square C is a formula for success, and provide a couple ideas for moving forward all within 5 minutes. The reality of communications is people do not watch, people do not look, people opt out. Unless the advertising that is done is relevant to the audience it is going to reach, this campaign might have no effect as well even though having an effect is not an option. What does a media outreach campaign do? Build awareness for the services is just a start. People need to comprehend what those services are and, more importantly, why they are relevant to the people you are trying to reach. What is the image of receiving that service from the VA? It does not come without prior attitudes and prior associations, some of which are very positive and some of which are very negative and need to change, as well as what is the attitude toward receiving those services from the VA, how easy are they to do business with, can I guarantee that my psychologist will be there 3 months from now, and will they give me the services I need before I am willing to put my life, my mental health into your hands. So the idea here is to begin not with an ad campaign but to begin with marketing research to understand what the Veterans Administration officers and what their campaign can do. I would not suggest the idea of benchmarking competitors. There are a lot of positive PSAs, public service announcements in the field, but there are a lot that are negative as well. And the difference is doing your homework. I have worked for 16 years with the Head Start organization and their last public service announcement campaign is not very useable by the people who need their help the most. The campaign is well-developed. It is well-created. It is compelling. However, it features kids holding up posters with paper plates, spaghetti hair, macaroni eyes, something we would all find very cute, very attractive. However, Head Start is for the poorest of the poor. They do not allow their kids to use food as artwork. These ads are rendered useless. They cannot post them in the places where Head Start prospects might be. So rather than benchmark PSAs on competitors, my suggestion is to benchmark what it is that veterans actually need, who are their motivators, what is their motivation, what are their issues, what are their problems, what do they read. The idea is not to just communicate to them but before a Request for Proposal goes out from an ad agency, it ought to go out to a research agency. You need to know as much about that veteran and move the VA closer to them. And we call that process customer relationship marketing. And for the things that the VA has that people do not know they need, educate them as to what that is. So the idea here is to begin the process not with advertising but to begin it with research. In order to assure success, the VA only has to answer two really important questions and it is a function of SW square C. In layman's terms, so what, who cares. The answer to who cares is not the VA and not us. It is not political officials. The answer to who cares is the veteran and the answer to so what is what do they care about. In order to be effective, a PSA campaign in any format has to answer who are we trying to target and what are their motivations and key drivers. So we have to view this from the customer's perspective. None of us are contemplating suicide. None of us have lost a limb in the war. None of us are having the same psychological issues they have, so let us talk to them first. Let us make sure that what we are offering them actually is a benefit they need. If the VA is offering the right services, let us inform them that that is the case. If the image is that the VA does not offer the services they need or the quality is not there, then you have to correct the problem and then work to change the image. But the whole point is we have to start with them, not the VA. We do not need to be different from what has gone on in the past. We need to be better. And the answer to better means we are different in a way that matters to the veteran. We need to make sure that what they get, why it is better, and the support for that is worth the cost to them. And this is all a function of research. How do you find out? Primary research, secondary research. Some has already been done. More has to be done in terms of focus groups and interviews. As you said, 17 million vets not going to the VA. Do they all have the same issues or do they differ? And if they do, let us develop a series of campaigns that will make it work best. As I said, there is a lot of research techniques that are out there that are applicable. I would never even attempt to go through this slide, but the issues that I have been discussing with your committee are those that can be addressed by research. My hope is that we do. The veterans deserve our help. They deserve happiness, but we have to start dealing with their issues and not ours. It is not yet time for the PSA. It is time for research. Thank you. [The prepared statement of Dr. Goodstein, and the attached slides, appear on p. 34.] Mr. Mitchell. Thank you. Dr. Sutton. STATEMENT OF SHARYN M. SUTTON, PH.D. Dr. Sutton. Thank you. I thank the Subcommittee today for inviting me to share my experience and thoughts on social marketing, particularly related to outreach to the veterans. While I have not worked directly with the VA, I have had the privilege to design and direct a number of national outreach campaigns in the government. I have also worked for 25 years as a strategic planning consultant for a number of government agencies as well as national foundations, nonprofits, and the private sector. And I would like to agree with my colleague that talking about an outreach campaign sounds easier than it really is. While I do not represent any organization today, my views reflect 25 years of experience in trying to conduct effective outreach within a government setting. In preparation, I reviewed the testimony from May 22nd that was examining the effectiveness of the Veterans Benefits Administration outreach effort. And I hope that what I have to offer will continue that discussion. I would like to highlight three points from my written testimony that I submitted to the Committee. First, it is crucial that a strategic plan serve as a foundation for any outreach effort. The plan must be grounded in an understanding of the VA's mission and priorities. It should include research-based audience profiles and specify outreach strategies for integrated marketing communication. So while there is a role for broadcast and outdoor public service advertising, there is an important role for paid media to get the message out there. However, this must be within the context of integrated marketing communication in order to actually break through and communicate effectively. The strategic plan must also provide measurable objectives for success. It is all too easy to create attractive media campaigns that appear to fulfill outreach mandates without delivering desired outcomes. Second, the role of audience research to plan, develop, and evaluate integrated outreach efforts cannot be overemphasized. The VA should access or collect data on marketing questions such as audience perceptions, lifestyles, and media habits. The VA must also have the ability to conduct ongoing, timely tracking surveys that measure changes in targeted behaviors and not merely audience awareness. Such data are essential to evaluate the success of outreach campaigns based upon outcomes and not just campaign outputs like media time and material distribution. Third, an integrated outreach campaign should leverage the available State and local infrastructure such as the veterans agencies and the county veteran service officers. They are invaluable to delivering the VA's outreach. Development of campaign messages and materials are best created at the national level while funding should be given to State and local partners for campaign dissemination and implementation as well as for interpersonal communication. In the private sector, organizations like Intel, Bank of America, and AARP readily and routinely access technology that allows them to efficiently take national messages and customize them for the needs of local communities. There is no reason why the same technology cannot be put to use for social reasons. In addition, given the effectiveness of local and direct outreach, efforts should be made to use and share available data to reach and communicate with the veterans, one on one. In summary, strategic planning, audience research, and strengthened local implementation are essential elements for success. There is significant evidence that marketing-based approaches can help government agencies achieve their policy objectives for better programs and outreach. Given its demonstrated contribution, the important question becomes how to better integrate the marketing discipline within a government context. Public/private partnerships along with positive Congressional support, such as today's hearing, are very important steps. Thank you, and I am happy to answer any questions. [The prepared statement of Dr. Sutton appears on p. 44.] Mr. Mitchell. Thank you. I would like to start out asking some questions, first with Ms. Williamson. I am very impressed and thankful for the initiative you have taken with the IAVA to address the critical needs to destigmatize mental healthcare and get young veterans into the Vet Centers and the VA Medical Centers. The Ad Council has made some memorable and effective ads like those that you have mentioned in your testimony, but they typically seem to reach a well-defined, traditional audience. What kind of challenges have you had in defining the priorities of your audience? Ms. Williamson. I think we have actually been very lucky with this campaign, that the Ad Council has been so open to really researching what veterans today need not only, you know, by reaching out to our membership--we are, you know, the first and largest Iraq and Afghanistan veterans' group, so we brought a lot to the table on that front--but also doing focus groups and interviews nationwide to really identify not only where are the gaps in services, certainly we talked about that, but also what kind of messaging is going to be effective. You know, you do not necessarily want to hear mental healthcare in an advertisement. That is actually probably kind of intimidating to a lot of people. So on a lot of those fronts, I think Ad Council can do a really good job of making sure to do their research. I think in terms of like ad placement and those elements, I think we are lucky in that public service announcements tend to get run in places where people are aware of those issues. So, for example, around military towns, we can expect a high level of interest in the campaign. And I think we will do more work on that front going toward as we get closer to the launch. Mr. Mitchell. Thank you. Dr. Goodstein, your five steps to building an effective outreach plan seem pretty self-explanatory, but I am concerned about the implementation. The government operates at a different pace with different concerns and priorities than the private sector. We need complex oversight and bureaucracy to get things done and that usually takes some time which is definitely not on our side. In developing this plan, what should be the measures of success and how would you ensure that the VA's efforts are effective? Mr. Goodstein. Thank you. I think the five steps, awareness, comprehension, image, attitude, and behavior, you do not have to do them all at one time. In fact, they rarely happen all at one time, nor will all of them occur through advertising. And I think the idea is to set up and understand for a particular veterans' group with particular problems where are they currently. If they are unaware that the VA has those issues, then we need to make them aware. Advertising is a good way to do that. But we need to change image. Advertising is a good way to do that. But as far as enacting behaviors, attitudes and behaviors, that is more one-to-one. We have to get them in to have the initial conversations and coordinate and integrate a sales strategy in the private sector by the one-on-one meeting strategy with these people and behavior to make that happen. I also think it is the case that when we look at it that way that peer-to-peer communications is going to matter a lot. Using social networks of people who have been successful, telling customer success stories, and integrating what my colleague, Dr. Sutton, as well, the measures have to reflect what the goals are. So if we are looking to change behavior and get people with the need into the VA hospitals for mental health, then measuring awareness of a campaign is an incorrect measure. Measuring exposure is an incorrect measure. You have to measure what the goals are at each step. And even though this is public sector versus private sector, you cannot ignore any of the steps. People are not going to see Gary Sinise, for instance, in a public service announcement and say, great, lay me down on the sofa and let me talk to you about my issues. I think you have to go through those stages more quickly or less quickly, but the idea of integrating communications allows you to go through that whole process. Mr. Mitchell. Thank you. And, Ms. O'Herrin, you spoke about the box of VA brochures in your written statement in your closet at your parents' house and also about the need for VA to use new media to reach younger veterans. E-mail has a greater potential to get the word out quickly, but it also can turn into a box of unread brochures. In the end, it comes down to making sure veterans know that the VA is there to help. How do you reinforce that in younger veterans and in women? Ms. O'Herrin. Well, I think that now that we are in the information age that the VA definitely needs to implement e- mail. I am really, really surprised that there is no implementation of e-mail. There is no line to fill out for veterans when they separate to write down their e-mail address so the VA can conduct them that way. It is strictly a snail mail campaign. And that to me is something that I understand that e-mail in boxes can clog up very easily. I mean, I have hundreds in my spam folder. But with the data collection capacities that the VA has, it is very easy for them. I think it would be easy to implement a strategy to pluck categories from the different data to specifically tailor e-mails to a veteran. A veteran could choose which benefits they want to receive more information on. For example, I graduated college. I am not particularly interested in receiving education benefit information in the State of Wisconsin any longer. But if I could tailor my requests and kind of take myself off a mailing list or add myself to a mailing list, I think that that would make the e- mails much more relevant to me and it would not become a box of pamphlets gathering dust underneath my parents' bed. I think it would be a much better system. And when you have an e-mail system--for example, I understand the VA is implementing a calling campaign to reach out to veterans and I think that that is a very personal touch to let them know somebody cares whether or not they are getting their healthcare. But I also know that the only way of getting a hold of me is through my cell phone. And I do not pick up my cell phone ever if I do not recognize the number. And I think that that is the case with a lot of veterans and I foresee some problems with that. And I think that when it is an e-mail information technique, that it would be reaching a more receptive audience. Mr. Mitchell. Thank you. Ms. Brown-Waite. Ms. Brown-Waite. Thank you very much. Ms. O'Herrin, first of all, thank you very much for your service spending three tours in Iraq. I think every Member of this panel admires and respects your service, so thank you very much for that, first of all. And you answered a question that I asked just last night and that is are the e-mails of those who are ending their tours in OIF or Operation Enduring Freedom (OEF), is either DoD and/ or VA capturing those e-mail addresses. I think it is very important that when you fill out the forms, that be part of it so that people can communicate and get the latest information. I just asked that question last night and thank you very much. The response was they did not think it was there and you just confirmed it. I believe that the VA should concentrate on their customer, the customer being the returning veteran. From your experience, what do you think transitioning men and women who have served think or what are their perceptions of the VA? Ms. O'Herrin. I worked in college at my student veterans organization, so I dealt with veterans from every branch, every kind of background you could ever imagine. So I spent a lot of time in conversation with other veterans thinking about how they view the VA. I have had a lot of these conversations. And I think by and large, everyone knows that the VA provides services. They know where the VA building is located. They know how to get the VA Web site. They know that the information is there. But I do not know that they necessarily feel that it is approachable. I do not think that there is anything especially appealing about the VA's services. They are just there. And I think oftentimes most veterans wait until there is a very significant problem before they seek out like, do I even have healthcare. It takes coming down with, you know, appendicitis or something like that before they actually investigate if they have VA services available to them. And I think that if these things are conveyed in different manner, through ad campaigns, through e-mail campaigns that it would be less of veterans waiting until there is an actual problem before they seek out help. I think if there is a more proactive method that veterans would feel that the VA is significantly more approachable. Ms. Brown-Waite. So is it safe to say it is not a lack of trust of the VA, but rather stale information? Would that be a fair thing to say? Ms. O'Herrin. I guess it depends on the issue. For example, I think with PTSD, I understand that--I have a lot of comrades that would not go to the VA for post traumatic stress disorder because they were still in the National Guard. And so they knew that if they were seen for certain things that it would get put on their record. So I do not know if it is a lack of trust. It is a problem in the system where they were not seeking treatment from the VA even though there was that help available because they did not want it to reflect poorly on them. So I guess it depends on the issue. I do not think that it is necessarily a lack of trust across the board. I think it is that it is just not necessarily that appealing, but I do not think it is a lack of trust in all issues, no. Ms. Brown-Waite. Okay. So it is stale, not really appealing to the current veteran? Ms. O'Herrin. Right. I think most people---- Ms. Brown-Waite. Would that be a fair thing to say? Ms. O'Herrin. Yes, ma'am. I think that most people, they know that the services are there, but they are not seeking them out for whatever reason. And I think it is our job to figure out why that is. Ms. Brown-Waite. About how much time would you say that veterans on average, the new generation of veterans, spend using the Internet? Just give me a ballpark figure. Ms. O'Herrin. I am going to be totally honest here. When I was in college, I think I spent like 6 hours a day on the Internet at least, at least, I mean, if not more. Now, that is a college environment. It is not like I had a full-time job that kept me off the computer. But I would say anywhere between 1 hour to 6 hours a day on the Internet in all honesty. Ms. Brown-Waite. Okay. Ms. Williamson, I have one, and my time is running out here, but I have just one question where you talk about the VA home loan program and the VA backed mortgages are not going into foreclosure at the same rate as subprime loans are. Certainly this is to VA's credit because they did not change their underwriting standards, which is very important. As you know, there is a timing problem here and I have introduced legislation that actually extends the VA's adjustable rate mortgage (ARM) and Hybrid ARM under title 38. Hopefully that bill will pass and get that language out there. When you do the ads through the Ad Council, are they coordinated with the VA? Now that the VA is going to be doing ads, do you plan on coordinating? Ms. Williamson. Thank you. I'll answer the two parts there. First of all, on the home loan part, I think you are absolutely right. There are several legislative fixes that the home loan system needs, not the least of which I think is the ability for the VA to be able to refinance loans that are bad right now. As I understand, that is still a problem. On the coordination with the VA front, IAVA has met with the VA actually specifically about our campaign three times now in the last 2 months. So we have taken that first step. We still have about 6 months before the campaign begins and I want to make sure that the VA is ready for an increase in demand and to make sure that we have coordinated so that the campaign directs you to the best possible resources. In terms of the substance of the campaign, that is something that IAVA is working with Ad Council and the ad company that is producing the ads. They are separate from VA. Ms. Brown-Waite. Okay. Thank you. And I yield back the balance of my time. Mr. Mitchell. Thank you. Mr. Walz. Mr. Walz. Thank you, Mr. Chairman. And thank you to all of you for coming here to help us understand this issue and work through it. I can say that I think you had some of the most lucid testimony we have heard here in a long time and I very much appreciate that. An important issue. It is also one that is part of a bigger, the 30,000 foot vision here, and I think Ms. O'Herrin summed it up right. It is this seamless transition issue. The DoD is one silo and VA is another silo and this is an issue people have been working on. And I will have to say to Secretary Peake, and I know we are going to have Assistant Secretary Mondello up here, these are people who are totally committed to getting this right. And there is a real proactive approach to getting this. So all of you being here today to help us understand this is part of the solution. So I very much appreciate that. Ms. O'Herrin, I especially like your--you are definitely an AFN aficionado, myself too. I still practice Opsec every day on my car from a year of that in 2003, 2004. So you are right. And I am interested in this issue of awareness versus effectiveness, which I think is very important. And I know Dr. Goodstein was getting at that part, we are all in this. We all want to go. We want to put the resources forward. We have a great institution that hopefully, as Ms. Williamson talked about, is prepared for the influx. But let us make sure that it is actually targeted right. And I am interested across the spectrum. Obviously we have different generations of veterans. We are trying to reach all of them. Obviously this newest generation is much more of a challenge. And I was going to ask a question. As we heard, I think it would shock many younger veterans and it should shock many people here that you are receiving no e-mail communications on the VA side. That part, of course, somewhat troubles me. There was an article today in my local newspaper about the Kosovo veterans who are returning and one of the comments they made was, Facebook was their life line. That was the first thing they said when they came back. Not asked about anything else. Oh, it is great to be home, but I am telling you without Facebook, I would have been lost. So it is not jumping on the newest fad. It is not us looking for quick ways because Dr. Goodstein is going to say the research will point us there, but I am concerned that we have not embraced it enough. And I get to thinking and I think you have comments in your written testimony on the VA Web site. How would you describe the VA Web site, Ms. O'Herrin, in your opinion? Ms. O'Herrin. It is very informative. There are links to every possible benefit you could possibly imagine and there is no shortage of information whatsoever. But a lot of times, people are eligible for conflicting benefits. They are not entirely sure which one overrides the other. It is not extremely user friendly. The information is there, but it is not in layman's terms. It is in dense language. Mr. Walz. So for people of your generation, our incoming veterans, its effectiveness again, awareness that it is there and information, but its effectiveness in working, you would say is probably not as good as it could be? Ms. O'Herrin. Sure. And I think this is where veterans service organization, I think, are trying to carry the ball is they are trying to break it down into layman's terms. They are trying to make it understandable for your average returning veteran. And so they are taking the official language and breaking it down. And that can get a little dangerous sometimes because then it is not coming from an official source, but that is what is happening. It is being condensed by other groups who are translating it into normal layman's terms. Mr. Walz. Okay. Very good. Dr. Goodstein, I want to get back to you. And I could not agree with you more. We need to get this right. We need to do the research ahead of time. Dr. Sutton was very clear to talk to us about that. In a campaign like this and what we are trying to do in terms of outreach and make sure that there is that seamlessness there to the VA, what kind of timeline are you talking about that it would take to do this, to plan, prepare, implement, and then measure results? Mr. Goodstein. I am going to answer two questions, one that was not asked and one that was because I am going to followup on Ms. O'Herrin's comment. I agree. I do analyses of a lot of companies' Web sites. I would have to say that the VA's Web site is ineffective as well. And I just want to point out the reason is it is all about the VA and what the VA does and offers. What it is not about is the VA's customers. So instead of talking about who are we and what do we offer you, there should be a place to come in on the initial site and say who are you and what are the issues you are having. So instead of seeing the 5,000 things that the VA does, okay, like a buffet, what you do is you put in who are you and what are your issues and you only see the meal that is appropriate for you. And the best Web sites in the world look at it more like that. Okay? As far as the research timeline, to do the kind of research we are talking about, qualitative to find out what the issues are, who these people are, what their motivations are, and then following up with quantitative surveys to see how many people have those issues, what their media habits are, et cetera, to get all that in. I do not think you are delaying the delivery of a campaign by more than probably 4 to 6 months if you do the research right. It is just a matter of starting it now and it may also be the case that a lot of research already exists, especially on the qualitative side. It sounds like there has been interviews, there has been focus groups. Taking those and then quantifying who are these people and how do you reach them. Mr. Walz. I very much appreciate that because I think the ironic thing of this whole discussion is there is probably no more focused group on what it takes to reach out a message than people who sit here, and the number of times they will see their faces on TV or on Web sites between now and November. And, yet, we are having problems getting this part of it right. They know what it takes. We know what it takes and we know exactly what you are talking about on doing that. Now we need to implement that. So I thank you. Mr. Mitchell. Mr. Space. Mr. Space. Thank you, Mr. Chairman. I have no questions or comments. I would simply like to thank the panel for its preparation and candid testimony. And in so thanking you, I yield back. Mr. Mitchell. We are going to go to votes probably within the next half hour; is that correct? So I want to thank you all for coming and I appreciate very much for all your service, for your advice and information that you are giving us today. One thing I think we all know is that just because you spend a lot of money does not mean that you are going to get the results that you want. Obviously, and as a former teacher myself, I know that research is so important if you are going to ultimately get where you are after and not just to throw time or money into it. It is important. And thank you so much for all of your comments. Thank you. Thank you for being here. Ms. Mondello is the Assistant Secretary of Public and Intergovernmental Affairs for the U.S. Department of Veterans Affairs. And thank you so much for being here. STATEMENT OF HON. LISETTE M. MONDELLO, ASSISTANT SECRETARY, OFFICE OF PUBLIC AND INTERGOVERNMENTAL AFFAIRS, U.S. DEPARTMENT OF VETERANS AFFAIRS Ms. Mondello. Chairman Mitchell, Ranking Member Brown- Waite, Members of the Subcommittee, I am very pleased to be here today to participate in this hearing regarding media outreach to veterans. I want to thank you for giving me the opportunity to talk about an important tool the VA now has at our disposal, a paid advertising option for outreach. With the recent decision to allow VA to use paid advertising resources, we are excited to share with you our ideas on using this tool to modernize and reshape our efforts to more effectively reach and educate veterans and their families about VA's benefits and services. Our mission at the VA is very clear. To do all within our authority and ability to help servicemembers readjust successfully back into civilian society after their military experience ends and to make sure they know that the VA is there to provide healthcare, benefits, and other services they have earned. I am confident that appropriate use of paid advertising will allow us to dramatically modernize our techniques to reach out to veterans and their families in more creative and effective ways. I would certainly be remiss if I did not thank you, Mr. Chairman, and Congressman Boozman for your role in helping invigorate this effort as your interest led to a reexamination of the scope of VA's authorities in this area. As mentioned previously, on June 16th, less than a month ago, Secretary Peake lifted the restriction on paid advertising. And I will tell you, and I think many of you already know this, I am a very enthusiastic supporter of this effort and my office, the Office of Public and Intergovernmental Affairs, very gladly accepts this new responsibility for coordinating the Department's media advertising efforts. The Ranking Member mentioned that Secretary Peake's decision requires the Under Secretaries of Health, Benefits, and Cemeteries to coordinate with the Assistant Secretary for Public and Intergovernmental Affairs about outreach, media plans, education, and awareness campaigns and initiatives, and for me to recommend to him further steps to improve our ability to reach veterans. In the few weeks since the change, there have already been a number of meetings with the Veterans Health, Benefits, and National Cemetery Administrations as well as relevant staff offices working together to move this effort forward. And, Mr. Chairman, we are committed to keeping the Committee informed as we turn these plans into concrete actions. This partnership with Congress and your support is critical to the success of this effort. One of the key parts of the rescission allows the Under Secretaries to purchase advertising in media outlets for the purpose of promoting awareness of benefits and services. The decision allows us to use proven, modern advertising techniques that will appeal to veterans of all ages and their family members. It will give VA, with its variety and diversity of services and benefits, the ability to provide the right message through the right medium to reach veterans. Traditional advertising venues such as broadcast and print are available to us, but we are also looking at social marketing and Internet-based, nontraditional media such as YouTube, Facebook, My Space, as well as podcasting. All will be considered and evaluated in our outreach efforts to veterans. Our goal is to reach veterans who have just returned from Iraq and Afghanistan, but also those who served in World War II, in Korea, during the Cold War, Vietnam, the Persian Gulf War. We want to reach all veterans of all eras of service with the messages of greatest concern to them. And we want to do it through the medium that is most appropriate and most effective. Face Book might work best for veterans returning from Iraq and Afghanistan who, frankly, are on Facebook while they are in combat and in theater, but it may not be the best avenue to reach our Vietnam veterans. On November 14th, 2006, the VA submitted to Congress a 5- year strategic plan that covered 2006 to 2011 and it included an outreach component. At that time, the plan was done with the preclusion from using paid outreach advertising. It is now being revised to include a robust advertising approach. It is our goal to provide the updated outreach strategic plan to you in December of 2008 when we submit our already scheduled report to Congress of outreach activities. We also aim to include this year's, fiscal year 2008 fiscal year's accomplishments of our current business plan objectives which will be linked to the strategic plan goals in the report. Of course, with every new opportunity, there come new challenges. Moving forward, we intend to develop a sound approach, a business-like approach that has been mentioned here with steps that will include such things as an internal group including key legal, budget, communication staff who, by the way, have already begun meeting with me to move forward and begin to take action steps quickly. We are developing a request for proposals and information to contract for outside professional advertising and research expertise to assist the VA. And I just mention as an aside that when I met with Ms. Williamson from IAVA, as well as the Ad Council representative, that was one of the Ad Council representative's key recommendations to us; to get outside expertise before we start any initiative. We are reviewing the budget to determine available funding for the remainder of this fiscal year and fiscal year 2009 and we are already actively engaged with the national Ad Council and the Iraq and Afghanistan Veterans of America to, as the Ranking Member said, to coordinate on their fall national public service campaign on mental health for returning veterans. And both Ms. Williamson and the Ranking Member talked about the importance of coordination. As a Department, we recognize that we must seek outside professional outreach and advertising assistance. While I am very proud of our public affairs professionals, we simply do not have the advertising and research expertise within the Department at this time. Our goal is to make veterans and their families aware of the benefits and the services that VA has to offer. Looking to the future, we intend to use whatever outreach and advertising techniques appear to work. We will keep an open mind. We will aggressively seek to find the best advertising technology available. Before I conclude, I wanted to just share with you a current outreach pilot that the Veterans Health Administration is getting ready to conduct on suicide prevention awareness. Let me just share with you some of the examples that we will be using in this initial effort to reach out to veterans, and the pilot program is in the Washington, DC, area. And the first is the dioramas that will be in the metro stations and this program is going to start out, it launches July 21st, next Monday. The second are the bus tail lights will be on metro buses, on a variety of routes, and these are the bus taillight placards. And third are the metro signs inside the metro rail cars and it has a message and asks people to call if they need help. And it is to increase the awareness of our suicide prevention hotline number where they can access help. And, lastly, I want to show you, it was mentioned a little earlier, there is a public service ad nonpaid, a voluntary public service announcement that Gary Sinise who, as you know, is in the show CSI and has been in Forrest Gump, but he is also a tremendous advocate for veterans and has served as the MC for Veterans Day ceremonies at Arlington National Cemetery for the VA. He did a public service ad and we have the raw footage. We have not done the post production editing yet, but the Office of Health Communication has done this. [Video shown.] The Department is going to assess the effectiveness of this pilot campaign and if it is successful, it will be exported to other parts of the country. As we move forward, sir, we will continue to work closely with you and we welcome your suggestions. We believe the opportunities are vast and we will pursue this new approach with vigor. On this issue, I believe we are in total agreement. We must move quickly with sound expertise based on the strategic needs of this Department using a wide variety of options to reach out and positively connect with veterans and the families with the information they need. [The prepared statement of Ms. Mondello appears on p. 48.] Mr. Mitchell. Thank you. Ms. Mondello. Thank you, sir. Mr. Mitchell. Thank you very much. I just have a couple questions before we turn it over. First, I am sure you heard the testimony before you. Ms. Mondello. Yes, sir. Mr. Mitchell. One of the things that was interesting was that you really need, and maybe not you, but someone in the VA, to redo your Web site, one that is more inviting. And I think we heard that from everybody here on the panel before you, make it more inviting, not just a list of menu items. We all know as politicians how important Web sites are to attract people to them and to have them become involved. So I know there is a lot of expertise out there and I think that is something that needs to be done almost immediately. And the other thing I heard over and over is the importance of research. You just do not go do something and throw money at it. Ms. Mondello. Right. Mr. Mitchell. You have to do sound research. And I am not suggesting, and I think you even mentioned that you do not have the expertise within, and I am not saying you should. Ms. Mondello. Right. Mr. Mitchell. But what you should be able to do is to go out and seek the newest and the best research on how to reach the variety of veterans that we have out there. And, again, like you say, maybe Facebook is good for Iraqi veterans, but it is important that we find a variety of ways to reach these veterans. And I think you mentioned this, and I just want to mention this very quickly before I pass this on. We have heard from a lot of veterans that sometimes they do not think they need suicide counseling. But just talking to veterans, we realize how important it is to have these people and I guess it is destigmatizing, which is what many of the veterans service organizations are trying to do about PTSD. Do you plan on promoting alternatives to a suicide hotline? And the second part of that, do you consider this developing in developing a pilot program about suicide hotline promotional materials? It is important that we understand the materials that you are using to get people to first of all contact the hotline, and then followup on it. And I also want to know about, are you having a way to measure this? Is there a way that you are measuring how effective the hotline is? Ms. Mondello. Yes, sir. Let me take each one of those separately. Let me first start by saying, listening to both the experts on the panel before me, we absolutely agree that we need to have the appropriate research done. When I said we are not experts in advertising, you are absolutely right. The scenario that I envision that I think does not benefit anyone, most of all veterans who need to become aware of our services, is for us to throw an ad campaign up that is not targeted, that has not been researched, and is not effective. I mean, that makes no sense whatsoever. And I think we would be coming back here and talking to you a few months down the road to say we are so sorry. I would like to avoid that. I absolutely agree. We are going out to get that expertise to start with so that when we do it, we do it right. We have an obligation. One of the things, and I digress for a minute, but I think it answers the second part of your question, is the last meeting we had, and I think it was last week, Ms. Williamson came to my office and we had her meet with not just our public affairs and community relations folks, but also with Dr. Al Batres who heads up the Vet Centers for the VA. That is a fabulous program that targets only, as the Committee is well aware, our combat veterans. And that we wanted to make sure that we were speaking with IAVA and the Ad Council early in their process of determining what goes on their Web site and where they are steering veterans to know various places to go for help. I think that you are going to see a lot of dialog with the Vet Centers, which is probably the place that most folks are going to come first. We are going to make sure that we are talking up front and early. I think that is something that addresses the first part of your questions. I am trying to remember the second half of your question now. Mr. Mitchell. That is okay. We are kind of running out of time. Ms. Mondello. Okay. Sorry. Mr. Mitchell. Ms. Brown-Waite. Ms. Brown-Waite. Thank you very much, Mr. Chairman. And thank you very much for being here. Ms. Mondello. Thank you. Ms. Brown-Waite. Right now are there any policies that prohibit the VA from capturing e-mail addresses? Ms. Mondello. I do not know if it is policies, although privacy issues always are looming in the background. I do not know if it is policies or not. Ms. Brown-Waite. You get Social Security number, name, date of birth, and everything else, so I doubt very highly, ma'am, with all due respect that getting one's e-mail is--because you can change e-mail addresses, your Internet service provider, but you are not going to change your date of birth and you are not going to change your Social Security number. So I do not accept that as a response. Ms. Mondello. But I think that I understand from Veterans Benefits Administration that the Benefits Executive Committee between DoD and VA is meeting to look at gathering and asking for e-mail addresses. Ms. Brown-Waite. You are not answering my question. Is there a prohibition now against getting one's e-mail addresses? Ms. Mondello. I do not know. Ms. Brown-Waite. Okay. Ms. Mondello. I can find that out and get that information and get back to you, ma'am. Ms. Brown-Waite. Okay. If you would get that, I would appreciate it. [Followup information regarding veterans' e-mail distribution lists are included in the post-hearing questions and response for the record from Ms. Brown-Waite, which appear on p. 56.] Ms. Mondello. Yes, ma'am. Ms. Brown-Waite. The other question is, does the VA actually have the authority to use, for example, commercial Web sites like Facebook and YouTube? And the reason I am asking this is because the House cannot use these sites or even have a link to them because of the advertisements that are on there. So obviously I think the VA would face the same problem because what you do not want to do is you do not want to have an implied---- Ms. Mondello. Endorsement. Ms. Brown-Waite [continuing]. Endorsement of the latest GM product or Viagra or whatever is being advertised there. Ms. Mondello. There are issues facing the VA, as well as all the Federal Government. I know Federal Government agencies have certain issues that are precluding them from getting on the commercial, social marketing Web sites. Other agencies, as well as the VA, are looking at how to do that; how to allow the Federal Government to work with those sites. I do not know if the House and the Senate have the same rules. The question for us is can the Federal Government rules be adapted or their standard procedures be adapted to allow us to use those social marketing sites? The Secretary has asked the General Counsel to look at that. I know that a lot of the other Federal agencies are looking at the same thing. Ms. Brown-Waite. I think what you would be looking at is a nonbranded site, that you would be looking to those entities to have a nonbranded site where there are not advertisements on there. I have a large number of Vietnam vets coming back and had a tacky situation in my district where the VA was trying to--I do not want to use a pejorative term, but where the VA was trying push them out of the nest. I think that is a very kind statement, of pushing this group of Vietnam vets out of the nest. What are you going to do to help the VA help the Vietnam vets who are out there who also need to have advertisements so that they know, for example, where they can be treated for PTSD, where they can get counseling, and how exactly are you going to remedy this ``I cannot go for counseling because someone will find out''? Ms. Mondello. Well, for the first part of your question, I think that we at the VA are very cognizant that we represent all veterans of all eras. I think in the outreach campaign for mental health, as well as for other benefits and services, we would want to ensure that we are using the right messages and the right medium for each era's veterans that we are trying to reach. I think that the Ranking Member is bringing up a very important point. It is not just current conflict, but all conflicts and all eras of veterans that we are providing services to and we need to make sure that they hear the right message about our services, tailored for them. Ms. Brown-Waite. The impression that was out there was, okay, we took care of you guys for X number of years, now we have new people coming in needing counseling, so we are breaking up this group. I had to intervene. I had to do that because these veterans were finally having a breakthrough. And I can tell you that I got a lot of cooperation from the nearby hospital when the veterans contacted me and said help, but please let us make sure we do not send out the wrong message. Let us not say we want to bring in OEF/OIF and then be slowly pushing others aside. I think that would be a travesty. Please commit to me that that is not going to happen. Ms. Mondello. That is definitely not our policy. I do not know about this particular instance you referenced and I am sorry that you had to intervene. Ms. Brown-Waite. I got involved and I got it resolved thankfully. Ms. Mondello. Thank you. Ms. Brown-Waite. But what I do not want to see this happening in other districts where veterans may be somewhat reluctant to go to their Member of Congress or not even know who their Member of Congress is and then have those services sharply curtailed. Ms. Mondello. Yes, ma'am. Ms. Brown-Waite. Thank you. I yield back. Mr. Mitchell. Thank you. Mr. Walz. Mr. Walz. Thank you, Mr. Chairman. And, Assistant Secretary Mondello, thank you. I appreciate the passion with which you are going after this. I can tell you that this Committee is here and the people of the district that I represent in Minnesota are totally committing to whatever it takes to get our veterans everything that we can possibly get them to make their lives whole again. A couple of things. I know we are only a month into the change in policy on the, you know, purchasing of the media and the things like that. You have given us a timeline of the strategic plan. That strategic plan is bigger and has already been out there before this planning. Am I to understand, are you hiring the experts and doing the research now as we speak with the idea that we will look at it in December? Ms. Mondello. Yes. We have already met with the communications folk. I have already brought in the administrations. We've talked to the lawyers in the General Counsel's Office as well as our Budget and Management Assistant Secretary and the head of acquisition. They will tell you at the VA that I am not shy. We are pushing to get this done now. Mr. Walz. And Dr. Goodstein's suggestion on, you know, I guess I would summarize it as best practices of research for advertising---- Ms. Mondello. Yes. Yes. Mr. Walz [continuing]. That is happening as we speak? Ms. Mondello. Yes, because as I mentioned---- Mr. Walz. How did this campaign come about? Did this go through all those procedures? Ms. Mondello. No. Mr. Walz. Because I would ask, Ms. O'Herrin, would this work for you, this placard on the metro? Ms. O'Herrin. I do not think I would call. Mr. Walz. Okay. So I am wondering, you know. So we put money into this and it did not go through those procedures of best practice to measure effectiveness or anything? Ms. Mondello. That would be correct. Although the Office of Health Communication in VHA does a very good job of working and doing programs like this to reach out to various veterans, I think that bringing in more professional best practices will benefit and make all their work, which is very good, more effective. Mr. Walz. Did the ad with Gary Sinise, did it go through that or was that different too? Ms. Mondello. It did not. It did not go through formal---- Mr. Walz. Did that one work for you? Ms. O'Herrin. That one I liked. Mr. Walz. So did I. And I am wondering. Dr. Goodstein would you say there are certain elements here, I am guessing, that were at play. Dr. Goodstein. Right. But I would also say that part of it is for a particular generation, Forrest Gump is relevant as being whatever his character was, Lieutenant Dan. But for the younger generation that is coming back from Iraq, they probably did not even see Forrest Gump. It is 20 years old. Mr. Walz. He is on CSI. Ms. Mondello. He is on CSI, so that is---- Mr. Walz. That's on AFN. And I want to make it clear that these questions are meant so we get this right. I do not question the commitment of the Secretary, yourself, or anyone else. My biggest concern that I would end with here is, and this is the bigger cultural issue of probably this Congress, maybe even country-wide, is we are 5 to 7 years into these conflicts and here we sit talking about this. This was anticipated. This should have been anticipated and these plans should have been there. So I will ask the next question that our job is to hope for the best, plan for the worst. What are we going to do for the next conflict? What are we going to do for the next group that surpasses the Iraqi and Afghan veterans? What are we going to do now as we implement this with a strategic vision that extends and can seamlessly get us into that? Has that been brought up, been talked about? Ms. Mondello. Yes, sir. I think what we want to do and the way we have talked about it in Public Affairs and certainly among the communication folks that have been meeting is we want to set the appropriate foundation. I think someone on the first panel mentioned VA healthcare is some of the best healthcare you can get in the country period. Mr. Walz. Absolutely. Ms. Mondello. We have a plethora of benefits that are available to returning servicemembers and to our veterans. We want to make sure that for this tool from what my office and what our communicators can do is that we are setting a foundation that we are doing it right so that we are most effectively raising the awareness and using the tools to raise the awareness of those services and benefits so hopefully some of my successor Assistant Secretaries are not up here saying I do not know why that plan did not work. And I think the Chairman or the Ranking Member also asked about Metrix. We are going to do Metrix to determine the effectiveness. I think that Dr. Goodstein said you really should not just throw things up there without knowing if they work. Someone told me, you are talking about business plans. We are. We are talking about best practices and a business foundation that is correct. Mr. Walz. At the VA, and I know this probably is at a little different level, but it is one that better be happening, has a discussion on realistic budgeting been brought up on this because if you are successful, it is going to cost more money? I will guarantee you that. And as the Chairman said, it is not about throwing money at it. But if we are successful in ramping up those numbers, that is going to be an implication down the road. And to wait and not do it and then all of a sudden find ourselves in a budget shortage where we say, okay, Priority 7 veterans are no longer allowed, Priority 6, to take care of these, has that been discussed? I mean, is that at least out there? And this is, I understand, somewhat subjective because you are not the person involved in that. Ms. Mondello. I believe that should be discussed at higher than my station at the Department, but I believe that we are looking at ensuring that we--our job, we feel, is to let as many veterans know about the services and the benefits. Mr. Walz. Very good. Thank you. Mr. Mitchell. Thank you very much. And as we started out in my opening statement, I pointed out that there is a veterans' population of about 25 million and only 7.8 are actually enrolled in healthcare. And of the 7.8, only 5\1/2\ million were actually treated. So there is a large number, and that is what this is about, of veterans who are not enrolled who do not know about the services. Now, what started this, of course, was reaching out for those who have PTSD or traumatic brain injury. It is important for all the other services, but we want to try to save lives. We do not want someone to be able to survive a tour of duty in the theater and come back here and feel all is lost. Ms. Mondello. Right. Mr. Mitchell. This is what is important. Ms. Mondello. Yes, sir. Mr. Mitchell. So the whole purpose of this is to try to reach out, for the VA to go out and to find these veterans and make them feel at home and provide the services that they need and that are actually out there. I think we have already heard there is a whole list of services. It is just that all of these people, in fact the majority of veterans do not know about them. And, in fact, half of them are not even enrolled in the healthcare service. And I think that is a responsibility that we hope that you as the VA go out and try to bring these people in. Ms. Mondello. Yes, sir. Thank you. Mr. Mitchell. Thank you. If there is no other questions--yes? Ms. Brown-Waite. Mr. Chairman, I would just interject that many of the veterans who did not seek the VA healthcare had healthcare benefits through their employers and/or are now retired and on Medicare. So many people, I know many veterans have told me, no, I did not enroll because I had excellent healthcare. So while we have that many veterans out there, we have to also remember that many of them have great healthcare. And comments had been made to me like, well, I just felt it would be selfish of me to apply for some veteran's healthcare when I had healthcare of my own and that it should be reserved for those combat-related injuries, someone who does not have insurance. So while the figure may be 25 million, many of them do have health insurance coverage elsewhere. One other thing that I did want to bring up and that is the ``National Defense Authorization Act,'' Public Law 110-181, that was just signed by the President this January that extends the period of enhanced enrollment opportunities for healthcare for veterans who served in a theater of combat after November 11th, 1998, and it gives them a long period of time. How are you getting this word out there? Ms. Mondello. Currently, even before the advertising authority, I know that the Veterans Health Administration, as well as the Veterans Benefit Administration, as well as the Cemetery Administration, they all do outreach efforts, especially for newer veterans at their demobilization sites, at the transition assistance sites, that they are doing as much and as extensive outreach to bring veterans in and to let them know about, particularly for our newest veterans, the extension of the 5 years, from 2 years to 5 years of eligibility. Ms. Brown-Waite. But you already do that. What are you doing beyond that to reach out to these individuals who thought that their time to apply had already passed? Ms. Mondello. Well, for those who have not come to the VA and enrolled, and I think you may be aware the Secretary has initiated a call-out, literally a call-out to, I think it is approximately 550,000 veterans of the Iraq and Afghanistan Wars, to come, to let them know that the VA service is there, to let them know that the eligibility period has been more than doubled, to let them know what is there, do we need to do anything to help them come and sign up and is there anything that we need to do. So we are doing an actual call-out to all the veterans which is still ongoing. Ms. Brown-Waite. Do you use veterans service agencies in various counties? Many counties do have a veterans service officer, you know, even encourage them to go before county commissions which are very often televised where we can help to get this word out? Ms. Mondello. We have a very good relationship with county veterans service officers, in the Office of Intergovernmental Affairs, which is the other side of my shop, because they meet with veterans at a very local level. And we have a pilot program that the Secretary has initiated to work with the county service officers to help develop claims, so to help make sure that veterans are getting in the system quickly and more efficiently. So we are looking at all sorts of ways also to work with States on how we can help reach out to veterans who are already back in their communities which is particularly important with Reserve and Guard units, but how to reach veterans in their communities who have not signed up. Ms. Brown-Waite. And that is a perfect reason why you need to have e-mail addresses. Absolute perfect reason. Ms. Mondello. I agree. Ms. Brown-Waite. I yield back the balance of my time. Thank you for your indulgence. Mr. Mitchell. Mr. Walz. Mr. Walz. No. Mr. Mitchell. Thank you very much, and I appreciate all the witnesses coming today. This has been very helpful and I believe it will serve everyone and their best interest. So thank you all, and this concludes the hearing. [Whereupon, at 3:25 p.m., the Subcommittee was adjourned.] A P P E N D I X ---------- Prepared Statement of Hon. Harry E. Mitchell, Chairman, Subcommittee on Oversight and Investigations In December, the full Veterans Affairs Committee held a hearing on suicide. We heard from the parents of an Iraq veteran who took his own life following his return from combat. Tim, the soldier in question, never sought help for his demons. It is impossible to know whether things would have been different if Tim had learned of counseling and therapy available at VA through televisions advertisements, or Facebook postings, or other means that featured Iraq veterans experiencing the same problems readjusting to civilian life. But one thing I do know: we have an obligation to try to reach the Tims of this world. The necessity of outreach is not limited to veterans like Tim. Many Iraq and Afghanistan veterans are dealing with combat stress and reintegration issues. Many vets have been exposed to IED blasts that may have caused subtle visual dysfunctions, or hearing loss, that VA can help with. And veterans have earned a number of benefits provided by a grateful nation, including the newly enacted GI bill educational benefit. VA, and DoD as well, provide lots of information to our troops during the discharge process, but numerous hearing of this Subcommittee, as well as its sister Subcommittees and the full Veterans' Affairs Committee, have shown the necessity for VA to proactively seek out veterans after discharge. The need for outreach is not limited to our younger veterans. The VA has transformed itself over the past 10 to 15 years. VA needs to find ways to communicate to older veterans that the VA has health and other services, and many benefit programs of which veterans might not be aware, that veterans of all ages can benefit from. Modern media, such as the Internet and television, are essential tools for outreach, particularly when it comes to the younger servicemembers. For 20 years, the VA has operated under a policy that restricted the use of paid media. On June 16, Secretary Peake rescinded this policy. I want to personally commend him for this action. The VA now needs to take advantage of the communication possibilities of modern media. But it must do so intelligently. VA marketing efforts, if that is the right term, are not about the VA, it is about our veterans. Before doing anything, the VA must learn to see the world from the perspective of the veterans VA wants to reach. VA must come to understand where veterans can be reached and what messages and messengers will get veterans' intention. This is not something VA has done before. We have assembled an impressive and, we believe, very helpful group of people to discuss these issues. We will first hear from Liz O'Herrin, an Iraq veteran, who knows as well as anyone the difficulties involved in outreach, as well as the necessity for doing so. We will hear from the Iraq and Afghanistan Veterans Association, which has partnered with the Ad Council to do outreach. And we will hear from two marketing experts who know very well how essential it is for VA to understand the veterans it is trying to reach, and who are fully aware of the unique difficulties and pitfalls government agencies face when trying to use modern media to reach beneficiaries of government programs. We look forward to hearing as well from the VA about its plans to move forward. We understand that this is new to the VA, but we also know that VA must use all of the tools available to reach out to our veterans. Hopefully this hearing will be a catalyst for the VA and that in short order, consistent with VA doing this the right way, the VA will be moving forward and will be able to provide a detailed plan of action to Congress and the public.Prepared Statement of Hon. Ginny Brown-Waite, Ranking Republican Member, Subcommittee on Oversight and Investigations Thank you Mr. Chairman, Mr. Chairman, getting the word out about veteran benefits to our Nation's heroes should be a high priority for the Department of Veterans Affairs. Printing brochures and handbooks in this day of the Internet and instant messaging is still an option, but 21st Century technology needs to be explored. On May 20, 2008, the House passed H.R. 3681, as amended, the Veterans Benefits Awareness Act of 2007, which would provide authorization to the Secretary of Veterans Affairs to advertise in the national media to promote awareness of benefits under laws administered by the Secretary by allowing the purchase of advertising in national media outlets for the purpose of promoting awareness of benefits under laws administered by the Secretary. This advertising would promote awareness of veterans programs provided by the Secretary, including but not limited to: homeless veterans; promotion of veteran owned small businesses; opportunities for employment in the Department of Veterans Affairs; opportunities for education, training; compensation, pension, vocational rehabilitation, and healthcare benefits; mental healthcare including the prevention of veteran suicide. This bill, authored by Congressman John Boozman, the Ranking Member of the Subcommittee on Economic Opportunity and Congresswoman Stephanie Herseth Sandlin, the Chair of that Subcommittee, was introduced due to concerns raised by officials at the Department of Veterans Affairs that they did not have proper authority to advertise their services to the general public in the national media. The bill is currently waiting to be taken up in the Senate. On June 4, 2008, you and I, following meetings of your personal staff with the VA, sent a letter requesting the Chairman and Ranking Member of the full Committee use the resources of the Committee to explore the potential efficacy of a broadcast public awareness campaign as a means of conducting outreach to veterans at risk for suicide. On June 16, 2008, Secretary Peake sent out a Memorandum to the Under Secretaries, Assistant Secretaries and other Key Officials at the Department, clarifying the ability of the VA to produce advertising in the national media. The memorandum provided that within two months after the delegation of authority, the Assistant Secretary for Public and Intergovernmental Affairs review the purchases of media advertising under this memorandum and provide a recommendation to the Secretary either a continuation of the existing delegation or a new policy. Mr. Chairman, I ask unanimous consent that a copy of the Secretary's Memorandum be included in the official record. Mr. Chairman, I am looking forward to hearing from the witnesses today on the implementation of the Secretary's Memorandum. It has been one month since the Memorandum has been issued, and it will be interesting to learn what steps the VA has taken to further inform our veterans about the services the VA provides. I yield back my time. Prepared Statement of Elizabeth O'Herrin, Washington, DC, (OIF Veteran and Former Wisconsin Air National Guard Member) Good afternoon Chairman Mitchell and other representatives of this distinguished Subcommittee. I thank you for the privilege of sharing my perspective as a young Iraq war veteran who believes much can be done to reach out to our returning troops. When I returned home from my first deployment with the National Guard and attained veteran status, I was eligible for a slew of new benefits. Upon my arrival back in Wisconsin, I was given a crash course in my new Department of Veterans Affairs benefits and went home with a box load of pamphlets and brochures that I didn't have time to wrap my mind around because my head was spinning simply from the shock of going from the blazing heat of the Middle East to Wisconsin in January. After initial inspection, the box was promptly shoved in the back of a truck and hauled to my parents' house, where it has since collected dust under the guest bed. Three days after I arrived home, I was sitting in class at the University of Wisconsin. I barely made it in time, but I did. A short time after that, I wandered into my campus student veterans center, where I knew there would be other student veterans who could help me decipher my newly earned benefits. I knew the VA was not going to be of much help; I had already spent quite awhile on hold on the VA hotline, and experienced a barrage of information in a briefing immediately after returning home. I ended up not leaving the campus veterans center--I was so grateful for the immediate help they gave me in deciphering my benefits, I promptly asked for a job, ready to help fellow veterans weave through the maze of benefits when they arrived back into the civilian world. While there is certainly no shortage of information available to veterans coming home from Middle East, all too often I hear ``no one told me'', and often I feel that way myself. More effective ways of encouraging veterans to use the services available to them must be investigated. The Department of Veterans Affairs' reliance on traditional mailing campaigns to inform veterans of their earned benefits may work well for older, more sedentary veterans. However, for many recently discharged veterans, this form of communication is less than optimal. For example, in the past seven months, I have changed my address from my college apartment, to my parents' house, to my deployment address in Iraq, back to my parents address, to my current residence in Washington, D.C. Trust me when I say that there have been a few key pieces of mail that have slipped through the cracks--and the amount of address changes that I have experienced is not unusual among veterans trying to find a foothold in the civilian world after separating from active duty. While ultimately it is my responsibility to ensure that I officially change my address each time, one thing has remained constant throughout my hectic journey the past several months: my email address. My email was accessible throughout all of my moves, to include my time in Iraq. In the information age, electronic mail has become the preferred mode of communication such that regular mail has been given the connotation ``snail mail''. E-mail is accessible everywhere, throughout the world, instantaneously. I understand that the VA does not request a current email address when individuals separate from active duty. I have never been asked for one. In my opinion, speaking from the perspective of a young veteran, I would have eagerly provided the VA my email address in the hopes that it would establish a direct line of communication between me and the VA. I know that the VA has undertaken a massive calling campaign to Operation Iraqi Freedom and Operation Enduring Freedom veterans, to ensure we are aware of healthcare benefits available to us. While I appreciate the VA's effort on this matter, I can also attest that calling me is actually not the best way to make sure I am informed. Personally, I do not retain information that is rattled off to me in a telemarketer fashion. Should this information be emailed to me, it provides a reference in my inbox that I can continually go back to. A brief phone conversation provides no such touchstone. Moreover, a phone call does not occur at the convenience of the recipient, rather it occurs at the will of the initiator. Email is checked at the convenience of the recipient, providing a more effective method of communication because the recipient is ready and willing to receive communications. While email communications would be a welcome addition to the VA's communication tactics, I do not believe this should replace hard copy mailings or personal calls. Rather, I believe email can be used to expand the VA's reach. There is certainly something to be said about the tangible nature of receiving something in my mailbox. Many companies and services ask individuals if they would appreciate communication via email as an option, and I believe I speak on behalf of the majority of young veterans when I say that I would check this box in hopes that I would remain conveniently informed about my benefits. Many banks and credit card companies now allow their customers to choose between e-statements and hard copy statements in the mail. This is an option the VA could provide veterans: allow us to pick electronic communication in lieu of hard copy mailings if we so desire. This choice could allow the VA to save a great deal of money that is currently being poured into printing and postage costs. As a recent college graduate and new entrant in the ``real world'', I can also attest that there is nothing more annoying than irrelevant emails clogging my inbox. If the VA were to overhaul their communications to implement an email update system, it would be crucial that these emails are tailored specifically to the individual receiving them. However, I believe that would be relatively easy to do, given the VA's massive data collection capacity and ability to identify categories within the broad group they provide services for. Should these tailored emails provide a clean, attractive hook, written in layman's terms, about a new benefit, a benefit change, or simply a benefit reminder with a link to more information, this could do a great deal to make the VA's services appear more approachable and appealing. Ideally, with the creation of a VA electronic mail enrollment form, veterans should be able to self-identify themselves for specific updates regarding disability, health, education benefits, etc. A veteran interested in attending college could enroll in education updates that ensure he or she is aware of the latest VA policies regarding the implementation of the new GI Bill. Then, upon graduation, that same veteran could opt out of education updates, thereby minimizing unwanted communication from the VA. The ability to create a "smart" electronic outreach system would give the VA exponentially more outreach power at a minimal cost. It seems to me that the general belief is that veterans know where to find services and benefits. This is true. Everyone knows the big concrete building is where the VA is, everyone knows the VA website, and everyone knows that if they have a problem, they are supposed to go to the VA. However, as the conflicts in Iraq and Afghanistan have continued, it has become apparent that this knowledge does not translate into veterans actually using the services provided to them. As we young veterans struggle with the stigmas of treatment for Post Traumatic Stress Disorder, as we struggle with the lack of knowledge about Traumatic Brain Injury, as we struggle with rising divorce, unemployment, and suicide rates, we must all ask ourselves what can be done to make help more accessible. It is no longer enough to simply inform, we must encourage. The Department of Defense, on the other hand, has gone to great lengths to ensure that they are quite encouraging to young individuals. The Department of Defense puts millions of dollars into glossy magazine spreads, television advertisements thumping with bass beats, catchy slogans that get revamped every few years in order to capture the ears of those about to graduate high school. Type in www.airforce.com and you are immediately given a swirling view of the Pentagon, accompanied by the majestic roar of fighter jets, as an ``advisor'' offers to chat with you during extended hours, even on Sundays, and you are tantalized by ``amazing videos of airmen in action.'' With an all-volunteer force, the need to make the choice of enlisting in the military attractive is understandable. All of these bells and whistles go a long way in making the military more appealing. However, it is interesting that all of these fancy ways of reaching out to individuals dissipates after one actually signs on the dotted line. Where are all of the bells and whistles calling veterans to the services available to them? When their abilities were desired, there was no shortage of appealing methods of reaching out to them; it seems the appeal in attracting veterans diminishes once they have served their country honorably. Take, for example, the VA homepage. While full of information, the page is less than encouraging. Abounding are links filled with bureaucratic language, which everyone knows is tough to navigate even when you are schooled in the language of the law. The VA currently does not provide ``in a nutshell''; the VA currently does not provide much to stimulate interest in their services; the VA currently does not provide encouragement to seek out benefits. What you see is what you get, but this is no longer enough. An untold number of veterans are coming back from the current conflicts, suffering from conditions we proclaim we must do something about. The Department of Defense has deemed Post Traumatic Stress Disorder an important enough issue to launch PTSD public service announcements on the Armed Forces Network, but even these campaigns disappear once you depart from active duty. I do not know any military members who still watch AFN public service announcements after leaving active duty, and I am not aware of any television awareness campaigns in the civilian advertising world for conditions such as these, save for the campaigns currently being undertaken by veterans service organizations, like the public service announcement being launched by Iraq and Afghanistan Veterans of America. I commend the Department of Veterans Affairs for their efforts in reaching out to veterans, and I commend veterans service organizations for trying to fill in the gaps. It is not an easy job, by any means. I believe a few key changes within the Department of Veterans Affairs in their methods of outreach could go a long way in giving young veterans the tools they need to successfully transition back into civilian life after sacrificing so much for their country. Prepared Statement of Vanessa Williamson, Policy Director, Iraq and Afghanistan Veterans of America Mr. Chairman, Ranking Member and members of the committee, thank you for the opportunity to testify today on the need for VA media outreach. I am the Policy Director for and Afghanistan Veterans of America, the country's first and largest nonpartisan and veterans' group. As a civilian who has worked with this population for almost four years now, I've seen firsthand the tremendous gap between the VA and the veterans they are seeking to help. There are millions of veterans who qualify for VA benefits and services but do not use them, simply because they don't know the programs exist, they don't know they qualify, or they don't know how to apply. There are millions of veterans across the country who could be getting a college education, buying their own home, or getting quality healthcare when they are sick--but they are not, because they don't think they can afford it, and the VA hasn't told them otherwise. Because the VA doesn't advertise their services, veterans of all generations are missing out on benefits they have earned. Health Care At least 1.8 million veterans lack health insurance.i About half of those veterans actually qualify for VA care, but have not sought it out. That's almost a million veterans without regular access to healthcare--a million veterans that the VA could be serving. For some of those vets, VA hospitals are too far away, or co-pays are too high to make VA care practical--but some are just not enrolled. These veterans, like the other 45 million uninsured Americans, are avoiding getting their health problems treated, or are relying on expensive emergency room care. --------------------------------------------------------------------------- \i\ Testimony of Stephanie J. Woolhandler, Harvard Medical School, based on data from the Census Bureau and the Department of Health and Human Services. House Veterans' Affairs Committee hearing, June 20, 2007. --------------------------------------------------------------------------- We have a short window of opportunity, in the next few years, to ensure that and veterans do not join these 1.8 million uninsured veterans. Right now, less than half of the veterans who are eligible for VA healthcare have signed up. The rest, about half a million people, have five years to get in the door at the VA, or risk getting labeled ``Priority 8'' and losing access altogether. The VA needs to take steps now to reach these veterans, before it's too late. What makes this a particular shame is that VA healthcare is universally recognized to be some of the best care you can get in this country. The VA regularly outperforms many of America's best private hospitals. The American Legion calls the VA ``the healthcare model others in the healthcare field should emulate.'' ii Veterans of Foreign Wars, AMVETS, Disabled American Veterans, and Paralyzed Veterans of America, agree that VA healthcare is ``equivalent to, or better than, care in any private or public health-care system.'' iii --------------------------------------------------------------------------- \ii\ American Legion, ``A System Worth Saving,'' 2006. \iii\ FY2008 Independent Budget, pg. 35. --------------------------------------------------------------------------- A concerted effort by the VA to advertise their healthcare services could give an estimated 1\1/2\ million veterans access to this high- quality healthcare. Education Veterans also qualify for tens of thousands of dollars in education benefits. In fact, the new GI Bill that became law only a few weeks ago entitles veterans to free tuition up to the cost of the most expensive in-state public university. The new GI Bill also includes a living stipend, a book stipend, and a new program to encourage expensive private schools to offer scholarships to new veterans. This program will give hundreds of thousands of veterans the chance to build a brighter future for themselves and their families. But we know from history that millions of veterans do not take advantage of their GI Bill. In fact, under the old Montgomery GI Bill, ``only 8 percent of veterans use their whole benefit and 30 percent of veterans don't use their GI Bill at all.'' iv --------------------------------------------------------------------------- \iv\ Elizabeth Farrell, ``GI Blues,'' The Chronicle of Higher Education, May 13, 2005. --------------------------------------------------------------------------- A VA advertising campaign would ensure that this generation of veterans takes full advantage of the historic educational opportunities the new GI Bill affords. Housing Military towns are ground zero for the subprime mortgage crisis; foreclosure rates in military towns are increasing at four times the national average.v While troops and veterans were being bombarded with advertising for subprime mortgages with hidden fees, teaser rates, and penalties for prepaying, they heard no advertising at all regarding safe and reliable VA home loans. As the marketing of subprime mortgages skyrocketed, the VA Home Loan Program has been underutilized. The number of new VA loans has declined every year between 2004 and 2007, and ``in 2006, at the peak of U.S. subprime lending, the number of VA loans fell to barely a third of the level two years earlier.'' --------------------------------------------------------------------------- \v\ Kathleen M. Howley, ``Foreclosures in Military Towns Surge at Four Times Rate,'' Bloomberg News, May 27, 2008. --------------------------------------------------------------------------- This is especially unfortunate because veterans using the VA Home Loans program get a much safer mortgage, and the support of VA financial counseling if they need it. And VA-backed mortgages aren't going into foreclosure like subprime loans are. Even though 90 percent of current VA-backed home loans were given without no downpayment,vi the share of VA mortgages in foreclosure was only slightly higher than the share for ``prime borrowers,'' those with the highest credit scores. --------------------------------------------------------------------------- \vi\ VA Press Release, ``VA Reaching Out to Vets with Mortgage Problems,'' June 12, 2008. --------------------------------------------------------------------------- Part of the reason VA loans lost popularity is because soaring housing prices have made VA loans less relevant to many home buyers in expensive areas. But because the VA doesn't advertise, many troops and veterans who could have used a VA home loan are now suffering with a subprime mortgage, and are at risk of losing their homes altogether. As the mortgage crisis continues to unfold, the VA needs to do more to promote their excellent home loan program, and to encourage veterans facing housing problems to contact a VA financial counseling center. IAVA and Ad Council With 1.7 million veterans coming home from and, we have to do a better job of informing veterans about their benefits. For this generation, the time is now for the VA to conduct a coordinated, national and local outreach campaign. Knowing that nonprofit advocacy organizations can often respond faster than the government, IAVA has partnered with the Ad Council to conduct a multiyear Public Service Announcement campaign to reduce the stigma surrounding mental healthcare and to ensure veterans seeking access to care and benefits, and particularly those who need treatment for their psychological injuries, get the support they need. We are proud to be partnering with Ad Council, who are responsible for many of the nation's most iconic PSA campaigns in history, including ``Only You Can Prevent Forest Fires,'' ``A Mind is a Terrible Thing to Waste,'' and ``Friends Don't Let Friends Drive Drunk.'' Thanks to their rigorous research model and focus-group testing process, the Ad Council has shown great success. For example, as a result of the Ad Council's Big Brother/Big Sister campaign, applications for Big Brothers Big Sisters mentors soared from 90,000 to 620,000 in nine months. ``Ready.gov,'' the Department of Homeland Security outreach site, received more than 18 million unique visitors within the first ten months of its campaign launch. We're hoping to see the same kind of success in our campaign. The IAVA-Ad Council PSAs will exist on television, radio, in print, outdoors and online, and will be rolling out in November of this year. Over the last two months, IAVA has met with the VA on three occasions to discuss our upcoming campaign, and we are hopeful that the VA will be able to prepare for any increase in demand our campaign generates. But our PSA campaign will in no way eliminate the need for the VA to plan its own outreach and advertising campaign. Only a concerted effort on the part of the VA will ensure that veterans finally have easy access to the many benefits the VA has to offer. Above all, our veterans earned these benefits defending our country, and should not have to fight for them when they come home. Thank you for your time. Respectfully submitted. Prepared Statement of Ronald C. Goodstein, Ph.D., Associate Professor of Marketing, The Robert Emmett McDonough School of Business, Georgetown University, Washington, DC SW\2\C: Developing a Media Outreach Campaign that Works Good afternoon Mr. Chairman and Members of the Committee. My name is Dr. Ronald C. Goodstein and I am honored to be before you today. I am also humbled to be asked to employ my experience to help our veterans get the psychological help many so desperately need. It is encouraging to meet members of our government who are truly as concerned about our soldiers after their duty is over as they were when our soldiers were on the frontline. This Committee has been able to put aside political differences on the battles abroad in order to concentrate on the safety and mental wellbeing of our daughters and sons upon their return from those battles. Improving the lives of our veterans is an issue that serves no political agenda, but instead focuses upon those that need and deserve our gratitude and assistance. Thank you for making me part of that effort. Background By way of background, I am an Associate Professor of Marketing at Georgetown University's McDonough School of Business here in Washington, DC and an invited professor to several executive programs throughout the world. My executive teaching and consulting are in the areas of ``voice of customer'' research and training, building and managing brand equity, ethnicity in marketing, and integrated marketing communications. My practical approach to these areas extends beyond the ``ivory tower'' and has guided executives at some of the world's leading companies including HSBC, Microsoft, Dow Chemical, IBM, CR Bard, Kimberly Clark, Coca-Cola, and others. For the past 16 years, I have also been active in teaching and training directors of Head Start centers nationwide in the business skills they need to run their organizations in order to improve the lives of so many of our most challenged children and their families. Additionally, I serve as an expert witness in these domains and have done so locally with both Williams & Connolly and Gibson, Dunn, & Crutcher. In 2004, I was honored as Washington, DC's ``Hall of Fame Marketer'' by the Capital Area's American Marketing Association chapter. I hope that the above information attests to my ability to speak on the matters at hand, but this hearing is not about me, nor my background. This meeting is about supporting the letter sent by Rep. Mitchell and Rep. Brown-Waite that asks ``that the full Committee use its resources to explore the potential efficacy of a broadcast public awareness campaign as a means of conducting outreach to veterans at risk for suicide.'' A Call for Research In today's turbulent times, the success of the VA's mental wellness programs has become less assured than in any period in recent history. A number of factors account for this uncertainty including tight budgets, a charged political environment, media reports questioning the quality of VA care, the presence of medical professionals that specialize in the same types of issues that the VA covers, and the pervasiveness of abusive alternatives such as alcohol and drugs to counteract the mental anguish experienced by many of our vets. Though the VA is ``working hard'' to keep ahead of these factors, the idea of using media outreach to assist in these efforts is a prime example of ``working smarter.'' The major contention of my testimony is that instead of focusing closely on its internal resources and services, the VA can guarantee an effective media outreach program only by focusing on the needs and desires of its constituents (e.g., veterans, their families, medical professionals, etc.). That is, while media outreach will prove an important tool for the VA, its usefulness and success depend upon the VA doing adequate due diligence to analyze and develop the right communication tools and messages to affect its target audiences. This issue is not new for public service organizations. It is not at all unusual for vital service organizations to utilize media outreach to improve their effectiveness. There are a host of public service announcements (hereafter, PSAs) that attest to this fact. What the VA needs, however, is not a PSA per se. Instead, the VA needs an integrated communications campaign that actually encourages its target markets to seek the help many so desperately need. This is more than just semantics. While many famous ad agencies have stepped forward to volunteer their services for PSAs, few of these firms do the research necessary to make these PSAs effective. For instance, the latest PSA for the Head Start organization features great creative commercials, great metaphors in print and television, and a billboard and signage campaign that is interesting and compelling. Many of the communications in this campaign feature very cute pictures of children holding up the faces they created with paper plates, pasta, and glue. Yet, at Head Start, children are not allowed to use food for artwork as the families Head Start serves often cannot afford to put food on their plates at all. So, here is an example of a lot of hard work and money wasted because it appears that the advertising firm did little to research the actual audience they wished to affect. I implore the VA to not repeat these shortcomings and to begin this media outreach effort by taking the time and effort to do the research required for success. Customers in Focus The Veteran's Administration cannot simply tell its ``story'' to constituents hoping this will generate support and visits for mental health. Instead, the VA must determine what its constituents need and desire and how to best position the organization to satisfy these needs and desires. This does not mean that current VA offerings are necessarily missing the mark with their targeted audiences. For instance, The Annals of Internal Medicine published a study several years ago that compared veterans health facilities with commercial managed-care systems in their treatment of diabetes patients. In seven out of seven measures of quality, the VA provided better care (Washington Monthly 2005). Yet, the VA's mental health services and performance have not received the same positive reviews and in fact have often been under scrutiny in the past decade (e.g., NAMI Report 2008). Before beginning a multi-million dollar communications campaign, it is imperative that the VA conduct research to determine the key criteria that will drive veterans to seek the services offered by the VA and to feel good in doing so. Customer perceptions drive markets and if it is these perceptions, whether true or false, that are leading vets in need to avoid the VA then until the root of these issues are discovered through research and the underlying causes are resolved, an ad campaign will do more to harm than to help the VA and those in need. The VA must undertake serious marketing research to better reach each of the target audiences, understand how to fulfill the potential customers' needs and desires, and enact strategies that evoke the desired behavior from each--whether a Marine who now feels too macho to come in for help or a family of an amputee unaware that the VA is there for them. To be successful, the VA must influence the behavior of a wide range of target audiences. These audiences go far beyond the veterans in need of care, and includes their families, medical professionals, peers and colleagues, the press, and the government among others. Thus, the VA has three major questions that must be addressed to develop a great media outreach campaign: (1) which constituencies should we target, (2) what behaviors need to be enacted by each targeted group, and (3) what tactics will best evoke/stimulate these behaviors. SW\2\C Be cautioned that the marketing process from identifying target groups to developing the proper communications tactics to enact behavior is seldom accomplished in a single step. Constituents typically move through a continuum of responses before they are ready to perform the desired behavior. That is, it will take more than mere ad exposure to move these veterans from avoiding the VA to attending the therapy sessions that will help improve their lives. In general, marketing professionals address five steps that must be achieved to move constituents to the desired behavior. In the case of the VA, the first step is to build awareness that the VA offers the counseling services needed. While awareness is a necessity in reaching veterans, it is not sufficient to arouse the outcome sought. The second step is to develop comprehension, meaning that each constituency needs to understand what the VA does that is important from the veteran's perspective. Note that this is not a simple listing of what the VA believes are its good points, but instead educating the target in how the VA can help them to realize their own goals. The third step is image management, as the VA wants to develop a reputation of caring and partnering with each veteran in need. The fourth step is achieving a positive attitude. An attitude is simply a predisposition to behave in a certain way, based on how easy it is to do business with the VA. The objective is to build a positive attitude toward the VA so that behavioral change, the final step, occurs. To achieve any of these steps requires the VA to have deep insights into the people they wish to affect--their behaviors, motivations, influencers, attitudes and perceptions, knowledge, reading and viewing habits, etc. I am suggesting that there is much to be done before an advertisement is even developed by the VA. Simply stated, a PSA is not enough. The VA already has a campaign featuring Tom Hanks and while emotionally nice, the campaign does little to resolve the psychological needs of our veterans. It is great that there are advertisements to welcome our veterans home, which is the theme of this campaign. To get these veterans into counseling, often for a lifetime however, will require deeper insights than those used to develop the current PSA. In my teaching and consulting work, I use a simple formula to summarize this approach. VA Success = f (SW2C) SW2C stands for the two questions that veterans will ask in response to the offers and communications delivered by the VA. So what? Who cares? The only answer to ``who cares'' is the veterans whose behavior the VA wishes to change, not the VA itself. And the answer to ``so what'' is what does this particular target audience care about? That is, what will drives their behavior and opinions and how can the VA align itself with these in order to reach its goals? There are many specific research techniques and questions that get at these issues, and my goal today is not to get into the technical details of how to conduct the research. I am happy to offer my assistance to the VA, its selected agency, or to any other government organization that decides to take on such a worthwhile cause. My goal today though is to emphasize the clear, irrefutable necessity of first doing the requisite research before the first advertisement is developed and aired. The idea of advertising and media outreach is great, but without the proper inputs into the campaign, little should be expected of the outputs. There are literally lives at risk if the VA gets this wrong, and lives and families that will be positively changed if the VA gets this right. Concluding Remarks In summary, the concepts and procedures reviewed in this report suggest a commonsense approach to understanding the VA's marketing environment and the research required to develop a successful media outreach campaign. The key premise in all of this is a central and in- depth comprehension of the VA's constituencies, as the customer is the central figure in marketing not the organization that wishes to serve that customer. If the VA truly champions its customer, the veterans in need of psychological services, by understanding who they are, the influence of their family, peers and friends, their perceptions and attitudes toward getting help through the VA, why they so often turn to harmful solutions to resolve their pain, the messages that will affect them, and the media outlets that they use, then a successful media outreach program is possible. Without such research, the answer to ``SW2C'' will be ``not me.'' In that case the VA, veterans they wish to serve, and public in general all lose out on what should be a great opportunity. I ask this Committee to continue its efforts in making sure that a media outreach program for the VA's mental wellness programs becomes a reality. Yet, I plead that this campaign be based on sound marketing research that extends beyond the walls of Congress and the Veterans Administration and into the minds, hearts, and homes of the veterans we wish to serve. Thank you. [GRAPHIC] [TIFF OMITTED] T4000A.001 [GRAPHIC] [TIFF OMITTED] T4000A.002 [GRAPHIC] [TIFF OMITTED] T4000A.003 [GRAPHIC] [TIFF OMITTED] T4000A.004 [GRAPHIC] [TIFF OMITTED] T4000A.005 [GRAPHIC] [TIFF OMITTED] T4000A.006 [GRAPHIC] [TIFF OMITTED] T4000A.007 [GRAPHIC] [TIFF OMITTED] T4000A.008 [GRAPHIC] [TIFF OMITTED] T4000A.009 [GRAPHIC] [TIFF OMITTED] T4000A.010 [GRAPHIC] [TIFF OMITTED] T4000A.011 [GRAPHIC] [TIFF OMITTED] T4000A.012 [GRAPHIC] [TIFF OMITTED] T4000A.013 [GRAPHIC] [TIFF OMITTED] T4000A.014 Prepared Statement of Sharyn M. Sutton, Ph.D., Washington, DC. (Communication and Social Marketing Consultant) I would like to thank the Subcommittee on Oversight and Investigations for inviting me here today to share my social marketing experience and thoughts on outreach to our veterans. I have been working in the field of social marketing and communication for over 25 years. I have designed and directed outreach programs within the Federal government (National Cancer Institute and USDA) and have served as a strategic planning consultant for a number of Federal programs (HHS, NHLBI, FDA, CMS, EPA, CDC, NHTSA), foundations, nonprofit and private sector organizations. I am not representing any organization today and my comments only reflect my views as a social marketing professional. In preparation for today, I reviewed written testimony from the hearing held before this Subcommittee on May 22nd ``Examining the Effectiveness of Veterans Benefits Administration Outreach Efforts.'' I would like to offer a social marketing perspective regarding outreach efforts by the Veterans Administration (VA) and address four areas of particular importance. These are: The critical need for a strategic outreach plan and its essential components; The synergistic role of national and state/local outreach; The importance of audience research to build the plan, strengthen the VA brand, develop a message strategy and evaluate outcomes; and Opportunities and Challenges for outreach within the Federal government. Sadly, it is common for government agencies to offer benefits and services to the public, but then place the burden on citizens to access them. Many agencies fear the consequences of effective outreach in that it is believed the citizen response would overwhelm operations and resources. Without accepted standards and approaches to outreach, that hold agencies accountable for outcomes not just outputs, it is easy to reward poor performance. The testimony previously offered by the AD Council and presented here today provides an insightful explanation of key marketing and outreach principles. It is important to add that these principles must be executed within the context of a research-based strategic plan that includes a commitment of sufficient resources and ongoing evaluation to ensure success. A strategic plan establishes the goals and measurable objectives that will be achieved through outreach. The following briefly describes elements of a strategic plan designed to serve as a foundation for effective outreach. Strategic Plan The strategic goals are based upon an understanding of the VA's mission. An analysis of current operations and their effectiveness will help establish priorities for program activities, audience segments and measurable outreach objectives. The plan should include research-based profiles of key audience segments for the development of outreach strategies. It should address any branding issues related to the VA's image. Outreach strategies would define specific audience actions, rewards for the actions, openings for reaching the audience and desired brand/image characteristics. The plan would also lay out the integrated media outreach tactics--using multiple channels and materials to deliver campaign messages. These should include print and broadcast public service advertising and paid advertising, media relations, electronic and interactive media, outdoor and point-of-purchase promotions, along with direct and interpersonal communication. Potential community interventions and outreach support for state and local activities should also be addressed. Finally, the plan would commit the requisite funding to achieve sufficient ``media'' weight to ensure messages break through to the target audience and specify evaluation metrics for campaign feedback. One cannot overemphasize the importance of a strategic plan using integrated marketing communication with measurable objectives. It is all too easy to create attractive campaigns that appear to fulfill an outreach mandate without delivering the desired outcomes. Marketing- based outreach is not merely education or information dissemination. Social scientists and educators have acknowledged for decades that information dissemination does not lead to the needed behavior change to achieve program objectives. There is a huge gap between understanding a message and changing behavior. ``I know'' does not automatically translate into ``I do.'' Much has also been written about the effectiveness of public service advertising, and one thing is clear, in most cases stand-alone advertising is insufficient for successful outreach. Everett Rogers, renowned for his theory on Diffusions of Innovation, described conditions related to a successful outreach campaign. He noted that it was ``. . . financially well endowed, intensive, and multi-phased over a long time period; it used formative evaluation, utilized the mass media efficiently to initiate interpersonal communication, was very daring and original in its concepts and implementation, and was run by a very prestigious organization; and skilled people from different disciplines were integrated in a team effort. Unfortunately, all these conditions are seldom found in other media campaigns.'' Outreach efforts in partnership with the Ad Council can provide the VA access to high quality creative and recognition among media outlets. As air time and space devoted to public service has continued to dwindle the nature of a public service campaign has dramatically changed. As the previous Ad Council testimony pointed out, there is a need to move away from a primary focus on advertising to an integrated marketing effort with a strong Web presence and community engagement. In today's technological world, a database of one's clients is invaluable and offers many ways for direct and personalized communication. Dollar for dollar, the efficiency and effectiveness of mass media pales in comparison to direct and tailored communication. Previous testimony from the National Association of State Directors of Veterans Affairs calls for a mechanism for sharing information on veterans for outreach purpose. I believe this recommendation should be strongly considered. Role of State and Local Outreach Understanding the roles for outreach at the Federal, State and local levels can increase the effectiveness and efficiency of a national campaign. The fact that most states have the capability and infrastructure to leverage outreach to veterans is a significant advantage and outreach grants to state Veterans' agencies [S. 1314] have been suggested as a means for improving communication with veterans. However, like their private sector counterparts at the State and local level, most government and nonprofit entities do not have the marketing skill set necessary to create compelling outreach campaigns. Even with additional funding it is cost prohibitive and inefficient to make the necessary investment to develop outreach campaigns within each state. It is also difficult to access available marketing talent in the private sector that possesses an understanding of the special needs within the government and nonprofit sectors. On the positive side, there is technology that allows national and international organizations to develop multi-faceted outreach campaigns at the ``corporate level'' that can be tailored and localized to meet specific community needs. Companies like Intel and Bank of America and nonprofits such as AARP bring highly skilled marketing and communication professionals to the task of message and materials development. These new technological resources then allow for development of electronic material templates and the sharing of these ``templates'' in a manner that protects the national ``brand'' and ensures key messages are accurately delivered. Partners at the state and local level then use these templates to tailor campaign materials (e.g., brochures, posters, websites, ads, exhibits, promotional items) with local information, photos, graphics and logos to share their organization's contact information, explain state benefits, describe local resources, and highlight local events, meeting times, and so forth. Focusing State and local resources on the ground through community engagement and interpersonal communication offers an invaluable presence that cannot be accomplished through national level outreach. It is recommended that State outreach grants be directed toward campaign dissemination at the local level and not message and materials development. That is, messages and materials would be developed at a national level and provided to State and local partners in electronic format that can be customized for local use and dissemination. In this way, the dollars necessary to invest in campaign development are available for essential audience research, message creation, creative execution, materials testing and production. Input from state entities can be leveraged across states and the VA can avoid the cost and inefficiencies resulting from the creation of individual state campaigns. This would maximize the incredible contribution that can only be made at the local level through interpersonal contact such as that provided by the state Veterans agencies and County Veteran Service Officers. It is reasonable to assume that a successful outreach campaign should cost a fraction of what the Department of Defense spends on recruitment but only if an ongoing integrated marketing effort implemented at the national, State and local level is pursued. Audience Research Like strategic planning, the role of audience research cannot be over-emphasized. It is critical to understand the perceptions and attitudes of different segments of veterans and their families for planning and developing messages. This requires appropriately designed audience research. Likewise, materials testing must be an integral part of any communication effort. What can appear to be a simple letter from the VA is an integrated part of outreach and brand building and should be tested among audience members to ensure clarity, believability and desired tone. Audience research must be used to clarify how to position outreach on benefits among other VA efforts such as: Veterans Assistance at Discharge (VADS) program (where the VA generates the mailing of a ``Welcome Home Package'' that includes a letter from the Secretary, VA Pamphlet 21-00-1, A Summary of VA Benefits, and VA Form 21-0501, Veterans Benefits Timetable with a follow-up letter mailed six months later) Benefits Delivery at Discharge (BDD) program and Coming Home to Work (an early outreach effort with special emphasis on OEF/OIF service members at military treatment facilities who are pending medical separation from active duty). These initiatives may be seen as very distinct programs from the agency's point-of-view, but to the consumer they may be an amalgamation of the ``VA''. There is a growing awareness of the need to seek greater consumer input into government outreach campaigns. However, it is often difficult to conduct such studies for outreach purposes, particularly quantitative studies. In the private sector, commercial research entities conduct large surveys annually on media habits, lifestyles, and buying behaviors that can be purchased and analyzed by other companies for marketing and communication purposes. Unfortunately these surveys rarely include the questions important to government programs. On the other hand, government sponsored surveys tend not to collect data on essential marketing variables, like media habits, that would be helpful to marketing initiatives. In addition it should be noted that there are also ways to connect VA data to commercial marketing databases (e.g., geo-demographic audience data) that would be useful for planning and implementing targeted outreach to veterans. There is an opportunity to greatly increase the impact of outreach efforts by taking advantage of the available data the government has on its veterans and their potential benefits. Legislative support to connect public and private sector databases to better serve veterans while maintaining privacy would assist VA access to this cost effective process. The requirement that the VA conduct a survey (P.L. 108-454) (including statistically valid samples of: (1) World War II veterans; (2) Korean conflict era veterans; (3) Vietnam era veterans; (4) Persian Gulf era veterans; (5) active-duty service members; (6) National Guard and Reserve members activated under title 10, United States Code; and, (7) family members and survivors) is a significant opportunity to obtain missing audience information on veteran segments to build targeted and compelling outreach. The VA is being directed to use the results of the survey to determine the collective awareness of benefits and services available to those groups under laws administered by the Secretary. However, ``awareness'' is not the most appropriate marker to build or evaluate outreach success. Research has shown that ``increasing audience awareness'' alone rarely leads to desired behavior change. Effective outreach must purposely promote very specific actions and useful survey research should develop measures for assessing these actions. It would be better for legislation to require the agency to specify program objectives and audience behaviors linked to achieving those objectives (e.g., contacting the VA). Research measures that assess and track these variables across audience segments should then be required and used for accountability rather than audience awareness. In the private sector, survey research is critical for targeting audiences, identifying appropriate communication channels and most importantly evaluating the effectiveness of campaigns. Time sensitive tracking research can be done inexpensively and should be a routine part of any outreach campaign. The Institute of Medicine's report on Speaking of Health strongly recommended that the OMB provide to health agencies a blanket approval for audience surveys necessary to design and evaluate public outreach. Hopefully the VA could be granted similar authority. To ensure audience input into outreach campaigns Congress should not only ask agencies for evidence that it was conducted, but should also ask agencies to demonstrate how the agency responded to audience wants and needs and results from materials testing. This would address agencies under time constraints that conduct consumer research after the fact only to ensure Congressional research mandates are met. Finally, while the private and public sectors reflect two different environments, research and experience have long shown that marketing is a discipline that can make significant contributions to both. The basic marketing fundamentals do not change: The audience must be the driving focus as determined by audience research; A ``marketing exchange'' must be achieved where the benefit to the audience exceeds the cost; Identifiable behaviors or outcomes are targeted for change; and A brand must be established with audience appeal and relevance. Opportunities and Challenges for Government Outreach Marketing and audience research can improve the VA's ability to look at the world from the perspective of a veteran and his or her family. By translating that perspective into outreach that is strategic and effective, the VA can support the veteran's ability to act in his or her own best interest. Marketing like other disciplines (e.g., accounting, program management) supports programmatic needs--increasing the likelihood that an agency's goals and outreach objectives are met. But marketing does not specify what an agency's goals should be. That requires a research base along with policy formulation. Once policymakers specify ``what'' should happen, marketing can then determine how to achieve it. Marketing does not offer a ``magic bullet'' for outreach--however its systematic, research-based application will provide strategies more likely to move such efforts toward successfully accomplishing agency goals. It should be recognized that there are cultural differences between private sector marketing organizations and government programs that must be addressed. The requirements of marketing to generate messages that are attention-getting, relevant to the audience and promote specific actions that promise appealing but potentially subjective rewards--can be troubling within any government context. Philosophical differences become apparent exist over the government's role when the marketing process is put into place. Should government try to influence behavior? To what degree should the government target audience segments versus ``serving everyone?'' Does a government agency have a responsibility to ensure that messages reach and are understood by the audience? There is also confusion over the need for outreach messages to reproduce statutory or expert language or be consistent across audience segments regardless of differing audience needs. The clearance process can also be a major hurdle to a consumer- oriented outreach program. In the private sector the requirements for approval focus on objective audience research measures of clarity, appeal, believability and relevance. As public messages move through the government clearance process, approval is more likely to depend upon internal criteria, such as appeal to the experts; a belief regarding what is or isn't allowed; political risk and desire for the agency to receive credit. While it is not expected that the public sector will change its culture in the near term, one way successful endeavors balance the need to appeal to the audience within government realities is through public/private partnerships. Involving outside organizations from different sectors around a social issue allows strengths and weakness of each to come into play. There are a number of examples of how differences in types of resources, skill sets, constituencies and perspectives have complemented each other building stronger and more lasting outreach efforts. Conclusions So it is not a question of whether or not the marketing discipline can improve the effectiveness of government programs and outreach. One needs only to look at its application and effects in political campaigns and military recruitment. Given its demonstrated contribution, the more important question is how to better integrate the marketing discipline within a government context. We must continue to ensure that the needs and wants of the audience are heard even when they appear to be in conflict with today's political considerations. In summary, the development of a strategic plan that specifies outreach objectives within a broader programmatic frame is essential. The plan must be based upon research and analysis of the role outreach should play to achieve policy goals. Primary audience research, particularly survey research, is a prerequisite for effective outreach and must be readily available for campaign managers. Government databases and other resources also should be tapped for planning and implementation of VA's outreach efforts. It is recommended that the outreach campaign be designed at a national level, and the valuable contribution of the State and local infrastructure, including Veterans agencies and County Veteran Service Officers, be leveraged through outreach grants focused on implementation and dissemination, particularly around community engagement and interpersonal communication. This could be greatly enhanced through technology allowing easy local customization and the sharing of information on veterans with local agencies. Government outreach must then be assessed based upon outcomes and not output. This requires permission and support for ongoing quantitative survey research designed to be timely and cost efficient. Finally, public/private partnerships are strongly encouraged to complement the government's outreach efforts. Prepared Statement of Hon. Lisette M. Mondello, Assistant Secretary, Office of Public and Intergovernmental Affairs, U.S. Department of Veterans Affairs Chairman Mitchell, Ranking Member Brown-Waite and Members of the Subcommittee, I am pleased to be here today to participate in this hearing regarding media outreach to veterans. Thank you for giving me the opportunity to talk about an important tool the VA has been given. With the recent decision to allow VA to use advertising resources we are excited to share with you our ideas on using this tool to modernize and reshape our efforts to more effectively reach and educate veterans and their families about VA's benefits and services. Our mission at the Department of Veterans Affairs is clear: to do all within our authority and ability to help service members readjust successfully into civilian society after their military experience ends and to make sure they know the VA is there to provide healthcare, benefits and other services they have earned. I am confident that our use of this tool will allow us to dramatically modernize our techniques to reach out to veterans and their families in more creative and effective ways. It is particularly exciting to me that we are now free to look at additional options to reach and connect with these veterans. I would be remiss if I did not thank you, Chairman Mitchell, and Congressman Boozman for your role invigorating this effort, as your interest led to a reexamination of the scope of VA's authorities in this area. On June 16, less than a month ago, Secretary Peake lifted the restriction on advertising. I am an enthusiastic supporter of this effort on the advertising policy and my office gladly accepts this new responsibility for coordinating the Department's media advertising efforts. Secretary Peake's decision requires the Under Secretaries to coordinate with the Assistant Secretary for Public and Intergovernmental Affairs about outreach, media plans, education, and awareness campaigns and initiatives, and for me to recommend to him further steps to improve our ability to reach veterans and their families. In the few weeks since the change, there have already been a number of meetings with the Veterans Health, Benefits and National Cemetery Administrations and staff offices working together to move this effort forward. Mr. Chairman, we are committed to keeping the Committee informed as we turn these plans into concrete actions. This partnership with Congress and your support is critical to the success of this effort. One of the key parts of the rescission allows the Under Secretaries to purchase advertising in media outlets for the purpose of promoting awareness of benefits and services, after coordinating with the Department's public affairs office. The decision allows us to use proven modern advertising techniques that will appeal to veterans of all ages and their family members. It will give VA, with its variety and diversity of services and benefits, the ability to provide the right message through the right medium to reach veterans. Traditional advertising venues such as broadcast and print are available to us. But we are also looking at social marketing and Internet based non-traditional media such as YouTube, MySpace and Facebook, as well as podcasting. All can be considered and evaluated in our outreach effort to veterans and their families. Our goal is to reach veterans who have just returned from Iraq and Afghanistan as well those who served in World War II, Korea, the Cold war, Vietnam, and the Persian Gulf War--we want to reach all veterans of all eras of service with the messages of greatest concern to them through the medium that is most effective. Facebook might work best for veterans returning from Iraq and Afghanistan, but not be the best to reach our Vietnam era veterans. On November 14, 2006 VA submitted to Congress a 5-year strategic plan (2006-2011) which included an outreach component. At that time we were still precluded from using paid outreach advertising. It is now being revised to include a robust advertising approach. It is our goal to provide the updated outreach strategic plan to you in December 2008 when we submit our scheduled Report of Outreach Activities to the Congress. We also aim to include this fiscal year's accomplishments of our current business plan objectives which will be linked to the strategic plan goals in the report. Of course with every opportunity there are new challenges. Moving forward we intend to develop a sound approach, with steps that will include: An internal committee including key legal, budget, and communications staff who have already begun meeting to move forward and take action quickly. We are developing a request for proposals to contract for outside professional advertising expertise to assist VA. We are reviewing the budget to determine the available funding for the remainder of Fiscal Year `08 and Fiscal Year `09. We are engaged with the National Ad Council and the Iraq and Afghanistan Veterans of America to coordinate on their fall national public service campaign on mental health for returning veterans. One concrete action already moving is a Veterans Health Administration pilot outreach campaign on suicide prevention. I will share with you today some of the examples we will be using in our initial effort to reach out to veterans in the Washington, DC area. The Department will assess its effectiveness, and if successful, it will be exported to other areas in the country. As a Department we recognize that we must seek outside professional outreach and advertising assistance. While I am proud of our public affairs professionals, we simply don't have the advertising expertise within the Department at this time. Our goal is to make veterans and their families aware of the benefits and services VA has to offer. Looking to the future, we intend to use whatever outreach and advertising techniques appear to work. We will keep an open mind and aggressively seek to find the best advertising technology available. As we move forward we will work closely with you, and welcome your suggestions. We believe the opportunities are vast and we will pursue this new approach with vigor. On this issue, I believe we are in total agreement--we must move quickly with sound expertise based upon the strategic needs of this Department using a variety of options to reach out and positively connect with veterans and their families. Mr. Chairman, this concludes my formal statement. We will continue to seek your counsel as we move forward. I am pleased to respond to any questions you or the subcommittee members may have. THE SECRETARY OF VETERANS AFFAIRS WASHINGTON June 16, 2008 MEMORANDUM FOR UNDER SECRETARIES, ASSISTANT SECRETARIES, AND OTHER KEY OFFICIALS Subject: Rescission of VA Advertising Policy and Delegation of Authority for the Purchase of Media Advertising 1. RESCISSION: Effective immediately, paragraph 4e(1) of MP-1, Part 1, chapter 4 (Advertising) is rescinded. 2. DELEGATION: After coordinating with the Assistant Secretary for Public and Intergovernmental Affairs, Under Secretaries may purchase advertising in media outlets for the purpose of promoting awareness of benefits provided under laws administered by their organizations and for personnel recruitment, and for certain loan guarantee activities. 3. RESTRICTIONS: Under Secretaries may not approve the purchase of media advertising that is: a. Aggrandizing or unduly emphasizing the importance of VA, some part of VA, or VA officials; b. Propaganda (e.g., advocating a particular viewpoint); or c. Purely partisan in nature. 4. REVIEW REQUIRED: Not later than two months prior to the rescission of this delegation, the Assistant Secretary for Public and Intergovernmental Affairs shall review the purchases of media advertising under this delegation and recommend to the Secretary either a continuation of the existing delegation or a new policy. 5. REDELEGATION AND EFFECTIVE DATE: Under Secretaries may not delegate this authority. This delegation is effective upon signature by the Secretary and is rescinded two years from the effective date. James B. Peake, M.D. __________ Memorandum Department of Veterans Affairs Date: June 12, 2008 From: General Counsel (02) Subj: Decision Document--Rescission of VA Policy Limiting Use of Paid Advertising Thru: Deputy Secretary (001) To: Secretary (00) 1. Introduction: Current VA policy, contained in paragraph 4.e(1) of MP-1, Part l, chapter 4, prohibits all paid advertising except for personnel recruitment and certain loan guaranty activities. This policy is more restrictive than statutory prohibitions on advertising which appear in each of VA's appropriations acts, and prohibit the use of appropriated funds for publicity or propaganda purposes not authorized by the Congress. House Bill 3681 (the Veterans Benefits Awareness Act) that passed the House on May 20, 2008, would create a new Title 38 provision to allow paid advertising in national media outlets to project awareness of veterans benefits. 2. Issues: Should the Secretary rescind the current VA policy, and replace it with one that allows the Undersecretaries to purchase advertising in media outlets for the purpose of promoting awareness of benefits provided under laws administered by their organizations, for personnel recruitment, and for certain loan guarantee activities? Should VA support the Veterans Benefits Awareness Act, given that the Secretary already has the authorities provided by the proposed statute? 3. Background: Current VA policy, contained in paragraph 4.e(1) of MP-1, Part I, chapter 4, prohibits all paid advertising except for personnel recruitment and certain loan guaranty activities. It provides: The use of paid advertising by the VA will be limited to specific activities for which a specific designation of budget authority exists. In general, and in the absence of additional legislative authority, the Agency engages in the use of paid media advertising for personnel recruitment and for certain loan guaranty activities. Elements of the VA are otherwise prohibited from purchasing advertising time or space to promote VA benefits and services, to present ``institutional'' messages, to publicize Agency events or activities, to participate in buying congratulatory advertising, or from expending funds for other forms of advertising enterprise. This policy was originally issued by the Administrator of the former Veterans Administration. The Secretary may approve its revision or rescission. If the Secretary rescinds this policy, the statutory prohibition on the use of VA appropriations for publicity or propaganda purposes would remain in effect. This is a perpetual prohibition included in VA's annual appropriation acts. The currently operative provision of that prohibition is in VA's appropriation law at section 501 of Public Law 110-161. It provides: No part of any appropriation contained in this Act shall be used for publicity or propaganda purposes not authorized by the Congress. While decisions of the Comptroller General have held that similar language prohibits self promotional advertising by agencies (``self-aggrandizement or puffery''). It does not prohibit the use of paid advertisements nor legitimate informational activities, such as outreach and recruitment. A House bill, H.H.3681, the ``Veterans Benefits Awareness Act of 2008,'' would authorize the Secretary to promote awareness of VA benefits by purchasing media advertising. It would create a new section in title 38, United States Code, which would provide: The Secretary may purchase advertising in national media outlets for the purpose of promoting awareness of benefits under laws administered by the Secretary, including promoting awareness of assistance provided by the Secretary, including assistance for programs to assist homeless veterans, to promote veteran-owned small businesses, and to provide opportunities for employment in the Department of Veterans Affairs and for education, training, compensation, pension, vocational rehabilitation, and healthcare benefits, and mental healthcare (including the prevention of suicide among veterans). This provision would not give the Secretary any authority that he does not already have. Because the bill uses the words ``may purchase,'' the Secretary could either continue the existing VA policy that prohibits paid media advertising to promote VA benefits or he could make an exception to the policy and permit paid media advertising for this purpose. This bill has passed the House and been referred to the Senate. 4. Analysis: VA requires authority to promote its benefits programs and advertise recruiting opportunities through the commercial media. Current policy is more restrictive than statutory provisions concerning advertising, and prevents paid promotion of VA benefits and services. Current statutory prohibitions on advertising appear only in yearly appropriations acts, and prohibit self aggrandizement and puffery concerning the agency. Rescission of the current policy would allow VA pay for all advertising that does not aggrandize the agency or make overblown claims about it. Rescission of the current policy without guidance to take its place may allow unconstrained advertising that is potentially harmful to the agency and/or wasteful of taxpayer money. Simultaneously with the rescission of the current policy, the Secretary should announce new policy guidance for eventual memorialization in VA Directive and Handbook. Current paid advertising policy is reserved to the Secretary, without delegation of authority to the Assistant Secretary for Public and Intergovernmental Affairs or the Undersecretaries. Arguably, as the Undersecretaries are responsible for the provision of VA benefits and outreach concerning those benefits, they should have authority to promote and, explain them, as approved by the Assistant Secretary for Public and Intergovernmental Affairs to ensure consistency of form and message. The Veterans Benefits Awareness Act of 2008 would memorialize the Secretary's authority to purchase paid advertising, and would allow for complete clarity concerning the source and nature of advertising policy. It would memorialize what is now an inherent authority of the Secretary. 5. Recommendations: A. Rescind paragraph 4.e(1) of MP-1, Part I, chapter 4. B. Issue the attached Memorandum to Undersecretaries and Key Officials. C. Task the Assistant Secretary for Public and Intergovernmental Affairs to incorporate the substance of the attached Memorandum into an appropriate VA Directive and Handbook. D. Support the Veterans Benefits Awareness Act, as appropriate. 6. Decision: APPROVE/DISAPPROVE: _________________ James B. Peake, M.D. Secretary Department of Veterans Affairs ________ Date Comments: Committee on Veterans' Affairs Subcommittee on Oversight and Investigations Washington, DC July 18, 2008 Honorable Lisette M. Mondello Assistant Secretary Public and Intergovernmental Affairs U.S. Department of Veterans Affairs 810 Vermont Avenue, NW Washington, DC 20420 Dear Assistant Secretary Mondello: Thank you for testifying before the House Veterans' Affairs Committee's Subcommittee on Oversight and Investigations on the subject of ``Media Outreach to Veterans.'' I have been interested to hear about how the VA plans to implement the new television media outreach authority since Secretary Peake called to tell me about it on June 18, 2008. I am pleased the VA has acted so quickly to begin the pilot public awareness campaign to publicize the VA's suicide prevention hotline. I believe this is a significant step in the right direction and I am grateful for all the hard work that has gone into it. Due to time constraints at the hearing, I was not able to ask all the questions I have about the campaign. Please provide answers to following questions by August 27, 2008, to Todd Chambers, Executive Assistant to the Subcommittee on Oversight and Investigations. 1. In your testimony you indicated that the VA had not tested the effectiveness of new print ads and public service announcement via polling, focus groups or other standard advertising research techniques. You also indicated that the VA had not hired an advertising agency to create the ads, and that the VA has no advertising experts on staff. How soon can we expect the VA to conduct the necessary market research to ensure that the message the VA uses will have the maximum effectiveness? 2. In the absence of the kind of market research referenced in question 1 above, can you please describe the process by which the VA selected the message that contained in the pilot public awareness campaign? 3. Please provide all the costs associated with this pilot public awareness campaign, and identify where, within VA's budget, such funding is being accessed. 4. How much television time is the VA purchasing for the new public service announcement featuring Gary Sinise? On what broadcast and/or cable channels will the public service announcement air? 5. Please describe the criteria that will be used and the process by which the VA will assess the effectiveness of this pilot public awareness campaign, and make any changes before expanding the campaign to additional markets. 6. Does the VA need any additional resources or legal authority to complete work on this pilot campaign or any expansion of the campaign to additional markets? If so, please describe. Additionally, I am confused about the ``Veterans Press 1'' component of VA's suicide prevention hotline. I am concerned that an automated answering system may not be the safest way to deal with callers in potentially life-threatening situations. In addition, if this is a hotline set up to serve veterans, why would veterans need to press a button to establish that they are veterans? If they are being separated out from other callers, I am confused as to who those other callers would be. If you could please explain this to me I would be grateful. Again, I want to thank you and your colleagues for all your hard work on this. If there is anything I can do to help, please do not hesitate to contact me or my staff. I am eager to help the VA make the final public awareness campaign as effective as possible. We request you provide responses to the Subcommittee no later than close of business on June 11, 2008. If you have any questions concerning these questions, please contact Subcommittee on Oversight and Investigations Staff Director, Geoffrey Bestor, Esq., at (202) 225- 3569 or the Subcommittee Republican Staff Director, Arthur Wu, at (202) 225-3527. Sincerely, Harry E. Mitchell Chairman U.S. Department of Veterans Affairs Washington, DC September 16, 2008 Honorable Harry E. Mitchell Chairman Subcommittee on Oversight and Investigations U.S. House of Representatives 335 Cannon House Office Building Washington, DC 20515 Dear Mr. Chairman, First let me say that I was only recently made aware of your letter of July 18, 2008, and I am at a loss to explain why it appears nowhere in our tracking systems prior to August 28, 2008. Please accept my sincerest apologies for the tardiness of these replies to your original letter. As I said during my testimony before your Subcommittee, VA's new authority to implement a paid advertising component to our on-going outreach and awareness efforts has no greater champion within the Department than I. Your leadership in assisting us to make the most of this opportunity is greatly appreciated. Upon review of your questions contained in the July 18th letter, most would be appropriately answered by the Veterans Health Administration (VHA) Office of Communications since they are the office that actually created and executed this pilot and have the on-going authority over it. I have asked them to provide the answers to your specific questions regarding the suicide prevention awareness pilot. Again, we at the Department of Veterans Affairs (VA) are excited about the opportunity to work with Congress to make our awareness campaigns aimed at veterans as effective as possible. VA is grateful for your continued commitment to this partnership. Below, please find responses to your questions. I would also acknowledge the subject matter experts in VHA who provided the information on the suicide prevention outreach campaign: Question 1: In your testimony you indicated that the VA had not tested the effectiveness of new print ads and public service announcement via polling, focus groups or other standard advertising research techniques. You also indicated that the VA had not hired an advertising agency to create the ads, and that the VA has no advertising experts on staff. How soon can we expect the VA to conduct the necessary market research to ensure that the message the VA uses will have the maximum effectiveness? Response: The suicide prevention awareness campaign was created internally in the VHA Office of Communications. This process highlighted in my mind the possibility that future public service and awareness campaigns-especially with a paid advertising component-would benefit greatly from the expertise of marketing and advertising professionals. During my testimony to the Subcommittee in July, I testified that among the several challenges that we had to meet was to develop a request for proposals (RFP) to contract for professional advertising expertise. We found that going through an RFP would be a very lengthy process. VA's contracting office has actually identified a more efficient way to conduct the market research needed to appropriately identify the marketing, focus group research, social networking and creative advertising expertise we will need at the VA. I am currently in the process of interviewing many companies and I will keep you up- to-date as we approach the decisions. At the hearing, many Members and witnesses stressed the importance of focus groups to identify the best ways to reach our veterans with information about VA's benefits and services. VHA noted that, at the local level, some of our medical facilities already use focus groups to improve outreach to OEF/OIF veterans and to identify opportunities to enhance overall customer service. Question 2: In the absence of the kind of market research referenced in question 1 above, can you please describe the process by which the VA selected the message that contained in the pilot public awareness campaign? Response: I have asked VHA communications project team who did the message development to describe the process they used: At the time we began the process to select the message for our initial Suicide Prevention Pilot awareness campaign in the District of Columbia metropolitan area, the Department was still subject to the paid advertising restriction. Thus, not having available professional marketing expertise within the Department, we decided a reasonable alternative approach would be to have the project team attend a Message Development Workshop. The Workshop was conducted by a communications company contracted by the Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA) in Rockville, Maryland. That workshop helped to prepare the team with the basic skills training necessary to develop a message focused on veterans age, gender, and life experience considerations. Subsequently, the team arranged for, conducted and analyzed the results of several feedback sessions from randomly selected veterans, suicide prevention coordinators, and VA employees who were veterans. During the feedback session we asked those groups to comment on the poster draft image and copy. We received candid feedback including positive, negative responses and recommendation for revisions. We further considered the recommendations and guidance we received from the Committee during Congressman Mitchell's hearing of July 2008, and, as a result we arrived at the final message. Incidentally, we continue to seek and plan to make use of currently received feedback. Question 3: Please provide all the costs associated with this pilot public awareness campaign, and identify where, within VA's budget, such funding is being accessed. Response: The approximate cost for production and distribution including artwork, printing and the leased space for advertisement was $115,000. This funding is from the VHA mental health budget. Questions 4: How much television time is the VA purchasing for the new public service announcement featuring Gary Sinise? On what broadcast and/or cable channels will the public service announcement air? Response: VA is not purchasing advertising time for airing the Gary Sinise video. It is distributed as a public service announcement. Based on our successful experience last year with another public service announcement campaign entitled HealthierUS Veterans, we expect to realize 2,000 or more airings of the Sinise PSA. HealthierUS Veterans featured football legend John Elway. That PSA was aired over 2,000 times on TV commercial stations across the USA to an estimated, audience of nearly 8 million viewers. The only cost involved in airing that PSA the distribution company fee. We estimate that the distribution company fee for 12 months distribution of the Sinise PSA will be $36,000. As in the HealthierUSVet PSA, the Sinise suicide awareness spot will be SIGMAcoded. This will allow electronic monitoring of each single broadcast by station, date and air time. The Sinise PSA airings and viewers are expected to be even greater based on beta research which revealed a positive, enthusiastic feedback received from those who previewed the spot. Currently, the Sinise spot is posted on several VA websites. These include the main VA home page www.va.gov, the VA suicide prevention website www.mentalhealth.va.gov and other sites. Some veterans service organizations have posted the public service announcement on their website--the Vietnam Veterans of America at www.vva.org and the Disabled American Veterans at www.dav.org. Finally, we are considering paid advertising to show the Sinise PSA in movie theaters across the Nation. Question 5: Please describe the criteria that will be used and the process by which the VA will assess the effectiveness of this pilot public awareness campaign, and make any changes before expanding the campaign to additional markets. Response: The criteria used to assess the effectiveness of the Washington Metro pilot public awareness campaign are the rate of increase in daily calls to the suicide prevention hotline and the rate of increase of veterans seeking consultation by the suicide prevention coordinators at the Washington, DC VA Medical Center. In addition, an intangible and admittedly soft yet significant variable is the level of community awareness of the suicide prevention hotline number. While the numbers of calls into the hotline number did increase from area codes in the DC metropolitan area, we cannot necessarily attribute the increase to the advertising campaign per se since the media coverage of the campaign may have had a significant impact on the results. The criteria used to determine in which additional markets VA would consider expanding the Washington, DC Metro campaign include: rates of completed suicide, rates of attempted suicide, ratios of suicide to the size of the veteran population, the numbers of calls to the hotline, the availability of metro and bus systems as an advertising medium. Additional Question: Additionally. I am confused about the ``Veterans Press 1'' component of VA's suicide prevention hotline. I am concerned that an automated answering system may not be the safest way to deal with callers in potentially life-threatening situations. In addition, if this is a hotline set up to serve veterans, why would veterans need to press a button to establish that they are veterans? If they are being separated out from other callers, I am confused as to who those other callers would be. If you could please explain this to me I would be grateful. Response: The suicide prevention hotline is a national hotline provided by the U.S. government to all citizens. The veterans' suicide hotline was integrated with the existing national system in order to be joined to a system with a proven track record and to avoid confusion from the use of different phone numbers for different populations (e.g., veterans vs. non-veterans). Since implementation, it has become renowned as an efficient and effective system. It is an easy to remember number and even with the `Veterans Press l' component it has received much praise as an exceptional system for veterans as well as their friends and family. Again, Mr. Chairman, both my office and the VHA Office of Communications, are available to discuss the suicide prevention awareness campaign with you or your staff. In addition, I will keep you and your staff apprised of the progress we are making in establishing a framework for execution of the new advertising authority as we conduct future VA outreach and awareness campaigns. Ensuring that our veterans receive information about the benefits and services available to them in the most effective manner possible is a key priority for me and I appreciate the support and attention you and your staff have given this matter. Please again; accept my apologies with regard to the lateness of this reply. We are continuing to determine how it could have happened and are working to ensure that it does not happen again. Most sincerely, Lisette M. Mondello Assistant Secretary for Public and Intergovernmental Affairs Committee on Veterans' Affairs Subcommittee on Oversight and Investigations Washington, DC July 22, 2008 The Honorable James B. Peake Secretary U.S. Department of Veterans Affairs 810 Vermont Avenue, NW Washington, DC 20420 Dear Secretary Peake: On Wednesday, July 15, 2008, the Honorable Lisette M. Mondello, Assistant Secretary for Public and Intergovernmental Affairs testified before the House Committee on Veterans' Affairs Subcommittee on Oversight and Investigations on Media Outreach to Veterans. As a followup to the hearing, I request the enclosed questions be answered in written form for the record by close of business, 5 p.m. on Friday, August 22, 2008. If you have any questions, please contact Art Wu, Republican Staff Director for the Subcommittee on Oversight and Investigations, at 202- 225-3527. Sincerely, Ginny Brown-Waite Ranking Republican Member ______ Questions for the Record The Honorable Ginny Brown-Waite Ranking Republican Member Subcommittee on Oversight & Investigations House Committee on Veterans' Affairs July 15, 2008 Media Outreach to Veterans Question 1: What kind of IT security would be needed at VA in order to put in place in order to create an e-mail distribution list for the new generation of veterans raised in the information age? Response: Depending upon the functionality, the current Department of Veterans Affairs (VA) electronic mail (e-mail) system has both the security and the capability to create e-mail distribution lists to reach veterans through that medium. If the information is being sent to a wide audience of users, there may be better methods of getting that information out to the veterans than using e-mail distribution lists, such as list servers or specialized Web pages. The type of information and security requirements will dictate what methods or modes of communication would be best to use. The e-mail addresses of veterans could be secured in the same ways that other sensitive data are. There are a number of ways already available with VA's e-mail system to ensure that a message to a veteran shows only that recipient's e-mail address, as well as any other personal information, and not those of any other veteran to whom VA might send the same message. Some of the common methods are blind copies, forms that can be created for users to use, list servers and third-party tools available in the marketplace. The size of the lists, attachments and type of information will dictate what tools are used. Access to the distribution lists and list servers can also be restricted so only those that need the information have access. Access can also be restricted to a select group of staff that use the distribution list to send information so veterans are not receiving spam messages. The methods used and level of security would be based on the requirements of the information. Regarding the security of the content of the messages, VA's e-mail system currently employs both encryption and rights management. Encryption protects content during transmission by translating the data into a form that is unintelligible without a deciphering mechanism. Rights management controls the subsequent actions that the recipient or any other future user can take (e.g. whether they can forward it, print it or only view it). This same or similar functionality could be extended to e-mail communication with the veteran population; however, it would be highly recommended that sensitive data not be sent in e- mail. That is not only a best practice in VA but a standard industry practice. For example, financial institutions and online retailers do not send sensitive data regarding transactions in e-mail. Instead, the e-mail contains some acknowledgement of a transaction using non- sensitive information and provides a link to a secure location where the customer can log in and obtain any desired details. Question 2: How will the VA protect veterans' e-mail addresses and other personal information? Response: The e-mail addresses and any related personal information of veterans could be maintained and secured in VA in the same ways that other sensitive data is. There are a number of ways already available with VA's e-mail system to ensure a message to a veteran shows only that recipient's e-mail address and not those of other veterans to whom VA might send the same message. Some of the methods are native to the e-mail system and some depend on third party tools. It is highly recommended that sensitive information not be sent in e-mail. Instead, there are ways to craft e-mail notifications to veterans using non-sensitive information and refer them to a secure location where they can log in (such as the My HealtheVet portal) should they want to view related information of a sensitive nature. In addition, VA already has efforts underway and some capability to use identifiers other than the veteran's Social Security number. VA also has the capability to monitor outgoing e-mail for anything containing data that looks to be of a sensitive nature and either alert administrators of the transmission or block it altogether. If it is necessary to send sensitive information in e-mail then the encryption and rights management technologies could be extended to ensure protection of content in e-mails to the veterans. The capability to force encryption on messages of certain types before they leave the secure VA enclave could be employed. VA has a comprehensive approach for securing veterans' personal information as covered by VA Directive and Handbook 6500--Information Security Program. Question 3: Are you working with Assistant Secretary Howard to put these measures in place and set up an e-mail, distribution system that would allow VA to better communicate with younger veterans? Response: Much of the functionality and security being alluded to already exists within VA and could be extended to the veteran population. I am not aware of any specific efforts to create distribution lists to communicate with particular segments of the veteran population. This would be a business function that the Assistant Secretary for Information Technology, Mr. Howard, can and would facilitate. Question 4: How frequently would information be communicated on to the veteran using this form of communications? Response: Until our plan has been fully developed with the assistance of outside experts it is impossible to provide you a complete answer. My intent would be to purchase the most effective system of communication to make veterans aware of benefits and services available to them. We will strive to provide useful information employing the most effective technology available. Question 5: Has VA investigated the use of Facebook, MySpace and YouTube to disseminate information about the VA product lines? Are there legal implications or prohibitions? Response: VA is working as part of an interagency approach working to enable Federal representation of citizen information on social media Web sites. In mid-June 2008, VA hosted a meeting of 18 Federal agencies to discuss how to break through legal and technical ramifications to allow us to provide public content on private Web sites. We are actively working to resolve remaining policy issues in conjunction with the interagency Federal Web Managers Council and General Counsel. VA's representative has been appointed cochair of the Social Media Subcommittee. VA is planning an initial social media presence on four of the most popular networking Web sites: Facebook, MySpace, YouTube, and Second Life. While legal issues are being worked out, VA and other agencies are working together to secure Federal Government agreements with these social media Web sites. Preliminary discussions are taking place with Google (YouTube), Facebook, Second Life (Linden Labs) and MySpace. Their responses have been encouraging as they appear willing to address the liability issues. During this process, VA has created mockups of our future presence on the major social media Web sites. Our plan is to be ready for an immediate launch when the policy issues are finalized. Question 6: What do you think is the most effective way to communicate with each generation of veterans separated out by era of service? Response: I recognize that VA has a critical mission to communicate with all veterans of all eras of service. It appears that the method of delivering information to such a diverse group requires VA to use different means to the different groups to communicate effectively. All options are under consideration and I am hopeful that in a few months our outreach plan, based upon the strategic needs of veterans, will provide more clarity to the best approaches to reach all veterans. Question 7: Do you believe it may be beneficial for the Secretary to institute an online blog where a discussion, in layman's terms, on what benefits are available and how to go about obtaining them? Response: An on-going interactive ``blog'' from the Secretary would not be practical to monitor and maintain. The best source of information on benefits is at the level closest to the veteran where real contact can be made and benefits and care will likely be administered. The Web offers many ways to get information to veterans and we will work to fully use the Web. VA has been a Federal leader in using plain language in all aspects of its work, particularly in outreach to veterans. Question 8: When should the Committee expect to receive the Department's strategic outreach plan? Response: The Department's Strategic Plan for Outreach is to be submitted to Congress December 2008. That plan is being revised now that the paid advertising outreach ban has been lifted. The December 2008 report will be linked to the strategic goals of VA. Committee on Veterans' Affairs Subcommittee on Oversight and Investigations Washington, DC July 22, 2008 Ms. Elizabeth O'Herrin 300 Massachusetts Avenue, NW Apartment #220 Washington, DC 20001 Dear Ms. O'Herrin: On Wednesday, July 15, 2008, you testified before the House Committee on Veterans' Affairs Subcommittee on Oversight and Investigations on Media Outreach to Veterans. As a followup to the hearing, I request the enclosed questions be answered in written form for the record by close of business, 5 p.m. on Friday, August 22, 2008. If you have any questions, please contact Art Wu, Republican Staff Director for the Subcommittee on Oversight and Investigations, at 202- 225-3527. Sincerely, Ginny Brown-Waite Ranking Republican Member ______ Questions for the Record The Honorable Ginny Brown-Waite Ranking Republican Member Subcommittee on Oversight & Investigations House Committee on Veterans' Affairs July 15, 2008 Media Outreach to Veterans Question 1: Would online products such as YouTube be considered a useful vehicle to get the message out about VA? Response: While I think it is crucial that the VA implement new strategies to get the word out about their services and benefits, I also believe that it is easier for grassroots, innovative organizations to harness up and coming online sites. For example: many grassroots organizations have found that Facebook is a great way to connect with college students--they all use Facebook. However, it is not widely accepted for established, powerful bureaucracies to create Facebook groups and use Facebook messages to get the word out. It almost cheapens them, or makes the organization look like it is trying too hard. Some elected officials have moved to Facebook as a way of stimulating support, and have done so relatively successfully. While I believe it would be more beneficial for the VA to use strategies that I outline in the following paragraphs, I also believe that implementing methods such as blogs and video clips online would be attractive. Veterans relate to other veterans--perhaps the VA could capitalize on personal stories of success (place them in a portal or on a video blog) to motivate other veterans to seek out services available to them. Question 2: Please list your 1-2-3 ways VA could immediately engage today's returning service members and veterans to inform and encourage them to seek benefits from the Department of Veterans Affairs: Response: Revamp the VA website. When a veteran goes to the VA website, he or she has to weave through piles of information before coming across relevant pieces. The search function is not especially efficient, and there the veteran must sift through massive quantities of information. This could be improved by allowing the veteran to enter who he or she is, and utilizing a ``smart'' website that tailors the information to the veteran. The DoD has embraced the concept of portals, which compile information tailored specifically to the veteran in addition to highlighting subject matter the DoD deems important enough, condensed into one convenient location with the help of hyperlinks. I understand the concept has been employed by the VA concerning health benefits: My HealtheVet is seemingly a step into the information age. This scope could be broadened to include education benefits and other information. As part of a three-year study entitled ``Combat Stress Intervention Program'', the DoD has implemented a pilot program in rural Pennsylvania called VOICE. This program has kiosks established where veterans can seek out information without having to wait on hold for hours on end to get the answers to questions about benefits or services. This program can also be fleshed out as a web based, so that veterans would not have to go to the kiosks to discover information about their benefits, but could access them anywhere they have Internet. Despite the fact that the younger generation of Global War on Terror (GWOT) veterans are technologically savvy, the kiosks are available for rural National Guard members who may not have easy access to Internet at home. This pilot project and partnership between Rite- Solutions and the Department of Defense was born out of the recognition that returning National Guard members and reservists were not able to easily access information about services available to them. Collect veterans' email addresses. Many veterans, upon discharge, receive days and days worth of briefings pertaining to their new life as a civilian. Quite simply, it's information overload. We must ensure these veterans can opt in to receiving information at a later point in time, when they are settled into their new lives as civilians and are considering their options for the future. As I stated in my testimony, veterans often migrate after exiting the service, but nearly all of us keep our email addresses current. Concise, pertinent emails from the VA about benefits and reminders for deadlines are a much needed addition to VA outreach services. I believe providing the servicemember or veteran with the opportunity to provide their email address for future communication would prove very valuable--but it is also necessary to ensure these messages are relevant to the recipient. Tailoring the email to the veteran, or to what the veteran wishes to receive, is crucial. Public Announcements. The fact that PTSD is a stigma charged diagnosis is preventing many military members and veterans from seeking help. There is also an element of distrust of the VA, especially among National Guard and reservists who do not want their permanent records tainted by seeking counsel. I believe there should be massive Public Service Announcement campaigns launched about combat stress, and incorporate the confidential services that Vet Centers provide for these ``silent sufferers''. The Vet Centers are a crucial service, and many veterans are not aware of the Vet Centers history or the confidential services they provide. With more and more Vet Centers being established by the VA, awareness campaigns should be implemented to ensure full advantage of their services are being taken. Elizabeth O'Herrin Executive Director Student Veterans of America Committee on Veterans' Affairs Subcommittee on Oversight and Investigations Washington, DC July 22, 2008 Ms. Vanessa Williamson Policy Director Iraq and Afghanistan Veterans of America 308 Massachusetts Avenue, NE Washington, DC 20002 Dear Ms. Williamson, On Wednesday, July 15, 2008, you testified before the House Committee on Veterans' Affairs Subcommittee on Oversight and Investigations on Media Outreach to Veterans. As a followup to the hearing, I request the enclosed questions be answered in written form for the record by close of business, 5 p.m. on Friday, August 22, 2008. If you have any questions, please contact Art Wu, Republican Staff Director for the Subcommittee on Oversight and Investigations, at 202- 225-3527. Sincerely, Ginny Brown-Waite Ranking Republican Member GBW:dc Enc. ______ Honorable Ginny Brown-Waite Questions for the Record Subcommittee on Oversight and Investigations Oversight Hearing on Media Outreach to Veterans July 15, 2008 Vanessa Williamson, Policy Director, Iraq and Afghanistan Veterans of America Question 1: Is the IAVA and Ad Council integration of campaigns intended to target only veterans with mental health issues, or will it incorporate other benefit and healthcare programs such as the GI Bill, housing programs, and reinforcing the need for veterans (to visit] their local Vet Center? Response: The IAVA/Ad Council campaign is aimed at two audiences: returning veterans and their families. The primary purpose of the campaign is to de-stigmatize the psychological challenges many veterans face when they return home, and to encourage these veterans to seek assistance. Many veterans seek only mental healthcare with a family member or friend's encouragement. So in addition to advertisements targeting veterans, unique advertisements targeting military families will urge veterans' loved ones to speak to them about any issues they might be having, and to encourage the veteran to seek treatment if necessary. The ads will direct veterans and their families to specially tailored websites that will link them with the best resources nationwide. While the focus of the resource list will be on mental health, resources for other key veterans' benefits (such as home loans or GI Bill benefits) will also be included. Question 2: Is IAVA working in conjunction with the VA in developing the Ad Council campaigns so that the information provided is accurate and compatible? Response: It is crucial that veterans seeking benefits or care from the VA can get the right access via the IAVA/Ad Council campaign website, IAVA has met with the VA on three occasions to alert them to the development of our campaign, and to talk about potential VA resources to be included on the IAVA/Ad Council campaign website. These potential resources include quick links to care and benefits applications and connections to the Vet Centers. However, all creative development, messaging components and funding of the campaign have been produced independent of the VA. Question 3: How will the Ad Council and IAVA track veterans who respond to the campaign? Response: The campaign websites will have a detailed sign-up procedure, to allow veterans and the families to receive followup information and to allow Ad Council and IAVA to track the veterans participating in the campaign. In addition, Ad Council tracks a number of metrics for all of their campaigns, including number of website visits and changes in consumer attitude. Question 4: Will the Ad Council campaign also refer veterans to VA's existing website, or will the Ad Council create a new website that will link to the VA? Response: The IAVA/Ad Council campaign will refer veterans to an innovative new website, with appropriate links to DoD and VA resources in our resources section. Committee on Veterans' Affairs Subcommittee on Oversight and Investigations Washington, DC July 22, 2008 Ronald C. Goodstein, Ph.D. Associate Professor of Marketing Robert Emmett McDonald School of Business Georgetown University 310 Old North Washington, DC 20057 Dear Dr. Goodstein, On Wednesday, July 15, 2008, you testified before the House Committee on Veterans' Affairs Subcommittee on Oversight and Investigations on Media Outreach to Veterans. As a followup to the hearing, I request the enclosed questions be answered in written form for the record by close of business, 5 p.m. on Friday, August 22, 2008. If you have any questions, please contact Art Wu, Republican Staff Director for the Subcommittee on Oversight and Investigations, at 202- 225-3527. Sincerely, Ginny Brown-Waite Ranking Republican Member GBW:dc Enc. __________ Honorable Ginny Brown-Waite Questions for the Record Subcommittee on Oversight & Investigations Oversight Hearing on Media Outreach to Veterans July 15, 2008 Ronald C. Goodstein, Ph.D., Associate Professor of Marketing, The Robert Emmett McDonough School of Business Georgetown University Question: In the case of PTSD, VA has been the leader in treatment since the Vietnam War. With the current spate of negative press VA has been receiving recently, what remedy do you suggest to improve veterans' perception of VA's ability to effectively and compassionately treat the veteran? Response: The issue of dealing with the spate of negative press is a serious one for VA. I wish that there were a clear answer to dealing with this issue. My response to this important question, however, is again (similar to my original testimony) that until the VA does its research, there is no clear cut method for affecting the perceptions of the VA. The last thing the VA wants to do is to develop a campaign they believe will improve their image if, in fact, the image is due to real shortcomings as opposed simply to perceptions. If this happens to be the case, then the campaign will create what is known in the advertising field as a ``boomerang effect.'' This means that a campaign that was developed to positively affect the perceptions of a company or its products ends up having the exact opposite effect and leads to worse attitudes and images of the brand. Such an effect happens most often when companies attempt to fool customers by making claims that are simply not believable. I am not suggesting that this is the case for the VA, but only that clarifying the facts is vital before actions are taken. The following excerpt from my earlier testimony is appropriate here. ``Customer perceptions drive markets and if it is these perceptions, whether true or false, that are leading vets in need to avoid the VA then until the root of these issues are discovered through research and the underlying causes are resolved, an ad campaign will do more to harm than to help the VA and those in need. The VA must undertake serious marketing research to better reach each of the target audiences, understand how to fulfill the potential customers' needs and desires, and enact strategies that evoke the desired behavior from each . . .'' If you recall from our panel earlier this year, the VA developed an ad campaign in the DC area to affect veterans' desires to seek help through the VA. The campaign was based only on the VA's and its ad agency's hunches and ideas, as opposed to real data collected from the targeted group. That campaign was judged to be completely ineffective by the veteran on our panel and I have yet to hear news of it having a positive outcome subsequently. The VA has the right idea to engage in outreach programs, but those efforts cannot be successful until they conduct primary research on the audience(s) they wish to affect. So, research is the correct action at this point to deal with the negative image. To again quote from my earlier testimony, ``The major contention of my testimony is that instead of focusing closely on its internal resources and services, the VA can guarantee an effective media outreach program only by focusing on the needs and desires of its constituents (e.g., veterans, their families, medical professionals, etc.). That is, while media outreach will prove an important tool for the VA, its usefulness and success depend upon the VA doing adequate due diligence to analyze and develop the right communication tools and messages to affect its target audiences.'' The followup question posed above is another example of a scenario where primary research is required before beginning outreach. As I said during my testimony and again afterward, I would be happy to work with the VA to develop and conduct the proper research to address these important issues. I would not, however, feel comfortable being asked to review any advertising or other outreach to assess its effectiveness without such research. To do so would be irresponsible of me and the VA--the only responsible solution to these issues (both the question posed here and the general outreach program discussed earlier) is to get the research started as soon as possible and to allocate some of the outreach funds toward finding out what is really needed instead of the continual guessing. Committee on Veterans' Affairs Subcommittee on Oversight and Investigations Washington, DC July 22, 2008 Sharyn M. Sutton, Ph.D. 4216 Mathewson Drive, NW Washington, DC 20011 Dear Dr. Sutton, On Wednesday, July 15, 2008, you testified before the House Committee on Veterans' Affairs Subcommittee on Oversight and Investigations on Media Outreach to Veterans. As a followup to the hearing, I request the enclosed questions be answered in written form for the record by close of business, 5 p.m. on Friday, August 22, 2008. If you have any questions, please contact Art Wu, Republican Staff Director for the Subcommittee on Oversight and Investigations, at 202- 225-3527. Sincerely, Ginny Brown-Waite Ranking Republican Member GBW:dc Enc. ______ Honorable Ginny Brown-Waite Questions for the Record Subcommittee on Oversight & Investigations Oversight Hearing on Media Outreach to Veterans July 15, 2008 Sharyn M. Sutton, Ph.D., Washington, DC Communication and Social Marketing Expert This letter is in response to questions I received related to my testimony before the House Committee on Veteran's Affairs Subcommittee on Oversight and Investigations on Media Outreach to Veterans. I offer my apologies to the Subcommittee for the delay in my responses. I was on travel when the original request was sent and have since started a new position that has required my full attention. I hope that my comments may still be useful to your efforts. Question 1: Please elaborate on methods to connect VA data to commercial marketing databases, such as geographic audience data. Response: There are a number of companies that license or provide subscriptions to access consumer data (e.g., Claritas). In this case, the address of a veteran would link that veteran to a profile that has been shown to be characteristic of the veteran. The profile contains previously collected data on attitudes, media habits, purchase patterns, lifestyle, and so on. These data can then provide a more detailed understanding of the veteran and how to reach them. Companies can often link the marketing data using addresses without violating confidentiality of the person. If the VA has addresses or e-mail addresses, use of direct marketing could be done without this step however. The important research that was not conducted for the campaigns shown during the hearing related to audience research (concept and message development as well as message testing). Geo- demographic data is more useful when one does not have access to the targeted population as does the VA. Audience research is pre-requisite for effective outreach. Question 2: What are the missing veteran population segments under current outreach efforts by VA? Response: Since the VA knows the make-up of the veteran population, any segment that is under-represented compared to the existing population is being missed--either through outreach or services that do not meet their needs. A critical point made at the hearing was the need to do research on the population of existing veterans, and not limit studies (as was proposed) to those already in contact and engaging with the VA program. Question 3: What best practices are utilized in the corporate sector that the VA should evaluate when preparing their marketing strategy and implementing their plan on media outreach to veterans? Response: There are best practices for marketing strategy and implementation that are standard and accepted in both the corporate and government/non-profit sectors. These include strategic planning, segmentation, targeting, audience research, message development and tracking. There are also many ways to conduct a communication campaign other than public service announcements that have been shown to have little effect since their airing over broadcast is no longer mandated by the FCC. Question 4: Should VA include in its evaluation a feasibility study of outreach to younger veterans that would include the use of an email database, as well as other new information technologies? Response: No. It is not necessary to spend the time or money on feasibility studies especially when working with email databases and other new technologies since these systems tend to have feedback mechanisms built into them. It is better to test actual outreach activities in the field and track their effect, than it is to waste resources conducting feasibility studies. These process measures will allow one to determine if the approach is feasible. Altering and then comparing different messaging (developed through audience research) will also help to refine and improve any campaign effort--but integrate the research into the actual intervention. Question 5: Should VA hire an outside media consultant to assist in the research and implementation of the plan? Response: It appeared that the VA could benefit from outside expertise since staff reported not having the desired skill set in the agency. However, it is important to ensure that the appropriate consultant is retained, and it may be necessary to have more than one if help is needed with strategic planning, audience research, message development and dissemination. While the technical skill sets are transferable across the corporate and government settings, often there are cultural differences. Having a consultant who has experience working with the government sector would also be advisable. Please feel free to contact me if you have further questions or would like to discuss the above. I am happy to be of service to such an important cause as ensuring our veterans receive the benefits and care they deserve. Sincerely, Sharyn M. Sutton, Ph.D.