Employee Spotlight
February 11, 2022
Deborah Lee, LCSW, LCAS
Regional Coordinator for the Southeastern United States
Housing and Urban Development-VA Supported Housing (HUD- VASH)
VHA Homeless Programs Office
Q: How long have you worked for VA?
A: This April will be 28 years that I have been working for VA.
Q: How would you describe your role as a HUD-VASH Regional Coordinator?
A: First and foremost, my role as a HUD-VASH Regional Coordinator is about providing support to staff in the field who, in my opinion, have the most difficult job in VA – providing support to vulnerable Veterans in community-based settings.
HUD-VASH is a collaborative program between the Department of Housing and Urban Development (HUD) and VA that combines HUD housing choice vouchers with VA supportive services to help Veterans who are homeless, and their families, find and sustain permanent housing. Being someone who has worked in the field, I can bring a unique perspective to how that support needs to be provided.
My hope is that HUD-VASH field staff across the country will never feel alone in this work. Across my region, which is mostly comprised of VA Medical Centers (VAMCs) throughout the southeastern United States, I try to make sure that this message of support is part of every communication I have with the field about the work they do.
Advocacy is another important component in my role as HUD-VASH Regional Coordinator. I support field staff by advocating for them to have access to all the resources they need to do this very challenging and difficult work.
Q: What led you to working with Veterans experiencing homelessness?
A: To tell you the truth, I think I came upon it by accident. When I first started working in mental health settings, I had an interest in working with people who experienced trauma and struggled with post-traumatic stress disorder. When I started working with VA, I was hired by the local homeless program. And for me, everything changed.
What I found with VA’s homeless program was a community of Veterans who had been ignored. This month, February, is Black History Month, and there will be a lot of talk about diversity and inclusion, as there has been over the past few years. But from my perspective, we weren’t doing what we should have been doing for this community of Veterans and still have a long way to go to ensure equitable access to care.
Working with Veterans who were homeless taught me a lot. The most important thing they taught me was that they are a community of Veterans who care for, and about, each other. And that this community of Veterans wanted VA providers who would stay engaged and meaningfully build relationships with them, not just count them, and disappear.
I heard that desire from the Veterans I worked with over and over again. I knew early on that I wanted to be the type of provider who was truly responsive to their wants and needs.
Even though homeless services weren’t strictly mental health services, I was still able to work with people who had long histories of trauma, either because of issues related to poverty or their military history.
Q: You are helping to lead a collaboration between HUD-VASH and VA’s Geriatrics and Extended Care (GEC) Services. What is this partnership about?
A: The HUD-VASH/GEC partnership aims to address the needs of aging and disabled Veterans by finding innovative ways to use our existing resources, or by forging new partnerships. It focuses on 4 key strategies:
- Increasing access to GEC. This is critical because, historically, Veterans with histories of homelessness often had difficulty getting involved with their local VA’s GEC services.
- Developing housing options to assist with using HUD-VASH vouchers in specialized programs.
- Expanding the use of HUD-VASH project-based vouchers with intensive services that could be provided onsite.
- Proactively developing partnerships with community agencies.
What our internal data show us is that the Veterans who use our services the most are getting older. In fiscal year (FY) 2015, the Veterans who utilized our services the most were around 54-55 years old. But in FY 2020, the Veterans who utilized our services the most were about 62 years old.
The Veterans are literally aging with us. And yet, our programs were really designed for a younger cohort of Veterans. It is absolutely critical that we find ways to adapt and modify the resources and we must ensure the resources are responsive to the Veterans who still depend on us.
Q: How did you come to lead this effort?
A: I volunteered! I always had an interest in working with older adults as they transition from middle adulthood to older age. My concentration in for my Master of Social Work degree school was aging.
In my years of working with older Veterans experiencing homelessness, I encountered numerous unfortunate trends: Veterans who were trying to be successful as supportive grandparents while homeless, untreated chronic mental health conditions, long histories of homelessness, and struggles with substances. Sadly, these Veterans didn’t typically participate in the full range of services that VA offered.
That goes back to stigma.
The biggest difference between aging Veterans and aging Veterans who are homeless is the stigma of homelessness. Stigma passes through a lifetime when there is a history of poverty and homelessness, and it can make it so difficult for Veterans to access the services they want and need.
Q: What accomplishment with the HUD-VASH/GEC partnership are you most proud of?
A: We just started collecting good data on the sites that are working with this initiative. The current data is very preliminary, and we hope to be able to share this soon.
But what I can say is that this partnership – this initiative – began with an idea from a small group of people and is spreading across the country in a big way. More and more local VAMCs are starting to develop meaningful partnerships to address this need. 19 VAMCs included aging partnerships in their HUD-VASH action plans last fiscal year! Even more interesting is that we’re discovering many VAMCs were doing this already on their own, and we had no idea.
What feels most rewarding is that while this is ultimately not new, it’s being nationally recognized as an important need. And we’re doing much better with showcasing both the need and the innovation to meet the need.
That’s not something I did. That’s something we did.
In a way, it’s a movement.
What this movement will help us with is giving us both the will and skill to do it better. We were recently able to dedicate some American Rescue Plan funding to help with the development of project-based voucher units for aging Veterans as well as new staff positions at the regional level to help coordinate.
I didn’t create it, but a movement was definitely created.
Q: VA recently announced that it is expanding its Home-Based Primary Care, Medical Foster Home and Veteran-Directed Care programs to make them available at all VA medical centers by the end of FY 2026. How will this benefit the Veterans you’re working with?
A: The GEC expansion will result in increased opportunities for Veterans experiencing homelessness to participate in these programs. Home-Based Primary Care and Medical Foster Home are 2 of our major focus areas.
Q: What would you say to someone who is hoping to begin a career in homelessness prevention?
A: I think working with homelessness opens you up to experiencing all humanity has to offer.
What you will find is grace, sadness, fear, and humility, in ways that you won’t find anywhere else.
You have to get comfortable with death and dying, seeing people hurt, and with what can be ugly in our society. But you will also experience great joy when you see someone walk into their own home after being homeless for many years. I have found the greatest joy in sharing a peanut butter and jelly sandwich prepared by a Veteran in their home space and seeing the pride in their face of hosting that first lunch.
