Category Archives: AMHCA

APA DIVISIONS 29 & 17 PASS RESOLUTION IN FAVOR OF DIVERSE TRAINING OF MASTERS-LEVEL PRACTITIONERS: Building Support for the Inclusion of Psychologists and Other Professions in the Continued Training of a Diverse Workforce

APA DIVISIONS 29 & 17 PASS RESOLUTION IN FAVOR OF DIVERSE TRAINING OF MASTERS-LEVEL PRACTITIONERS:

Building Support for the Inclusion of Psychologists and Other Professions in the Continued Training of a Diverse Workforce

On Sunday 10/11/15 the American Psychological Association (APA) Division 29 (Society for the Advancement of Psychotherapy) unanimously passed a resolution, joined by Division 17 (Society of Counseling Psychology), in order to:

  • Fully support the role of psychologists, counselors, MFTs, psychiatrists, social workers, and other professionals in the training of master’s level counselors, and
  • To NOT support any efforts that “limit core faculty or supervisors to only those from one designated training/professional background”.

Conversations with persons knowledgeable with the vote indicate that Divisions 17 and 29 may be looking to create greater support within the APA as a whole for master’s level practitioners.  State counseling boards that are looking at adopting  more narrow rigid program accreditation requirements in licensing (like CACREP) may want to reconsider given the increasing support from within APA divisions and elsewhere that are promoting quality accreditation and licensing standards with less rigid requirements.

The clear and public voicing of resolution by these two APA divisions joins the groundswell of support for a more inclusive and just solution to training accreditation, licensing, and insurance/government paneling of practitioners.  ACA division Counselors for Social Justice (CSJ) and some state AMHCA chapters have previously come out in favor of solutions that allow all competently trained counselors equal status in the workplace.  A new national association is expected to be announced in the next few weeks which will concentrate on this matter.

It is anticipated that efforts to develop methods, institutions, associations, or financial means to advocate on behalf of all counselors will receive a boost from the public support of these two APA divisions.  Currently APA, as an organizational whole, maintains its position of not being involved in master’s level training or licensing.  The growing pressure from APA divisions may impact this position in the future.

This resolution is GOOD NEWS for master’s level non-CACREP counselors, and particularly students and staff involved with master’s level counseling psychology training programs, in their efforts to promote high quality and inclusive accreditation requirements.

The announcement in its entirely follows below.  While not involved in this announcement, Dr. Jesse Owen (original submitter of this resolution) when contacted indicated that he is available to answer questions and concerns related to the resolution at Jesse.Owens@du.edu  .

……………………………………………………………

[For More Information: Jesse Owen, PhD. – Jesse.Owen@du.edu]

Society for the Advancement of Psychotherapy

(Division 29)

American Psychological Association

Resolution: #2917

Subject: Inclusive Training of Master-Level Counselors and Related Licensed Professionals by Trained Psychologists and Other Mental Health Professionals (e.g., Social Workers, Counselors, Psychiatrists, Marriage and Family Therapists)

Old Resolution or Amendment typed here if applicable

WHEREAS, Trained Psychologists and Other Mental Health Professionals (e.g., Social Workers, Counselors, Psychiatrists, Marriage and Family Therapists) have an important and vital role in training Master-level counselors and related licensed professionals,

WHEREAS, Trained Psychologists and Other Mental Health Professionals (e.g., Social Workers, Counselors, Psychiatrists, Marriage and Family Therapists) have shaped the nature of training of Master-level counselors and related licensed professionals,

WHEREAS, Trained Psychologists and Other Mental Health Professionals (e.g., Social Workers, Counselors, Psychiatrists, Marriage and Family Therapists) affirm inclusivity in training to those from a variety of professional backgrounds and nationalities,

RESOLVED, That the Society for the Advancement of Psychotherapy (Division 29, APA), fully support the role of Trained Psychologists and Other Licensed Mental Health Professionals (e.g., Social Workers, Counselors, Psychiatrists, Marriage and Family Therapists) in the training and education of Master-level counselors and related licensed professionals,

RESOLVED, That the Society for the Advancement of Psychotherapy (Division 29, APA), cannot support any efforts or programs that limit core faculty or supervisors to only those from one designated training/professional background (e.g., Counselor Educators, Counseling Psychologists, Psychiatrists, Clinical Psychologists, Social Workers).

Submitted by: Jesse Owen, PhD. Training & Education Domain Representative

Approved by the Training & Education Committee

Action Taken: TBD

 Date: TBD

 Effective Time Period: TBD

The Trouble With the CACREP-Only Counselor Movement

A lot of people are wondering what the fuss is about professional counseling moving to CACREP accreditation standards, especially since organizations like the ACA, AMHCA, ACES, and NBCC are promoting this move.

Therein lies the first problem: COMPLEXITY (and acronyms)

A whole post could be written about just the players and organizations involved. (CACREP = Council for Accreditation of Counseling and Related Educational Programs, ACA = American Counseling Association, AMHCA = mental health counseling division of ACA, ACES = counselor education division of ACA, NBCC = National Board of Certified Counselors which handles national testing and increasingly looks like an ACA rival). Then we could badly use a dictionary of terms… then a history lesson… then a paper on each of the problems outlined below…

Busy counselors don’t want to sort through this complexity.

 

The second problem: BOREDOM (and perceived irrelevance)

The CACREP accreditation issue is usually described as a new standard for graduate schools to adhere to. Yawn. If you graduated 10 years ago and work seeing clients, an academic discussion on standards puts you to sleep. Nowhere in the usual discussions of this issue is there a suggestion that your FUTURE CAREER may be affected.

 

The third problem: ASSURANCES

If you have listened at all to the ACA and other advocates, you have been told that this won’t effect those currently licensed, that ACA will advocate for your equality, and that its all for “great reasons” (see below). Official associations keep on speaking ever so carefully so as to not quite lie, while giving the impression all is well.

 

So, in a nutshell (or as short as we can make it), what are the fastest descriptions possible of the problems with a CACREP-Only approach?

CACREP-ONLY: There are other styles of training and other emerging standards. Few people are rallying against the CACREP accreditation standard itself as an optional accreditation. It’s the implications of only having CACREP that is the problem.

FUTURE EMPLOYMENT: Graduation from a CACREP-accredited program in the past increasingly makes a difference in your ability to get a future job. TRICARE and the VA both prefer or require CACREP degrees. CACREP-Only partisans are working very hard to get CACREP mentioned in any Medicare regulations passed to allow professional counselors to accept Medicare. The fewer panels are willing to accept you, the harder it will be to make a living or get hired by employers. (This is why being able to keep your license is not enough. CACREP graduation or CACREP-influenced certifications may also be required.)

MEDICARE – THE GATEWAY: Private insurance companies often set their policies by what Medicare does. This is why we are so worried about CACREP-Only language getting into Medicare.

REPUTATION: The ACA’s official policy is now to lobby all 50 state Boards for CACREP-Only licensure. ACA goes to pains to say they will support the equality of currently licensed non-CACREP counselors. We hope so. How does one get a message of equality out to government, health plans, and the general public in the middle of persuading state Boards that CACREP is the “gold standard” that must be switched to? A DoD official was interviewed last year to discuss TRICARE’s two-tier policy in which certain (mostly CACREP) counselors are allowed independent practice, whereas non-CACREP counselors (otherwise independently licensed) are judged in need of doctor supervision. This kind of messaging will work its way into the public mind.

LOSS OF DIVERSITY: The problem with too rigid a standard is that you can lose some diversity. There are hundreds or thousands of approaches to counseling. Some arguments have been made that special communities (American Natives, disabled counselors-in-training) may be better served by alternatives.

BASIC FAIRNESS, “COUNSELING PSYCHOLOGISTS” AND VENGENCE VENDETTAS: CACREP-Only partisans are dead-set on excluding future students with master’s degrees in counseling psychology from obtaining professional counselor licenses (after a grandfathering period for current students). These programs have been with counseling since its inception. CACREP won’t even accredit these programs unless they make arbitrary changes requiring absurd expense and turn-over of core staff – its closer to truth to just say that CACREP won’t accredit them (see that part about not quite lying in assurances section above). There is a constant campaign to conflate and confuse in the public mind professional counselors holding master’s degrees in counseling psychology (who identify as professional counselors) with Ph.D. psychologists who have psychologist licenses. The two are not the same. More than a few commentators have opined that at one level the intractability of this dispute is about vengeance. The Ph.D. counselor educators are not allowed to teach in Ph.D. psychology programs. They are trying to push Ph.D. counseling psychologists out of their traditional role in teaching master’s level professional counselors (at “counseling psychology” masters programs). This is in part a war between two feuding groups of professors.

CONSOLIDATION OF CONTROL AND MONEY: At another level this may also be about money and control. The ACA helped create CACREP a long time ago, and now does not have official control over standards. CACREP partisans are also persuading state licensing boards to give-up control of their standards to this outside entity. CACREP charges a lot of money to programs wishing to obtain and maintain accreditation. NBCC controls at least two key gateways to the professional counseling career: national exams and national certifications. Currently no one is fighting over their control of the NCE and NCMHCE exams (unless they restrict taking them to only CACREP students…). They also control the NCC (National Certified Counselor) and CCMHC (Certified Clinical Mental Health Counselor) certifications. These certifications are currently of questionable value, but NBCC is working hard to get these certifications required for licensure portability between states, as a stepping stone to independent TRICARE provider status, and more (See Portability below). It costs MONEY and lots of it to maintain certifications in addition to your state license.

PORTABILITY: There are currently conflicting proposed plans from NBCC/AMHCA/ACES and from AASCB (American Association of State Counseling Boards) for licensure portability when counselors move between states. The NBCC/AMHCA/ACES plan requires CACREP graduation to move between states unless a stubborn state board goes its own way or unless current non-CACREP counselors obtain and hold the NCC certification before 2022 (at which point CACREP graduation is required for the NCC). This is one example where NBCC can make millions of dollars from non-CACREP counselors by requiring them to grab an NCC certification while they can if they ever wish to work in another state in the future.

“GREAT REASONS” FOR THE “GOLD STANDARD”: Here are the most prominently mentioned reasons for moving to CACREP-Only:

So far here is what we’ve gleaned from CACREP-Only partisans as to reasons for CACREP-Only:

  1. Obligation to our forefathers. One CACREP-Only inclined historian states “We have an obligation to all of our forefathers/mothers and mentors to be good/honest stewards of the history of Professional Counseling. Please see that we pass on our family’s story.” (This sort of invites you to join a shared destiny and unity in which it is glorious to kick dozens of excellent graduate schools out of existence, destroy professional diversity, and cede immense power and money to organizations like CACREP and NBCC that are far less accountable to members than the ACA with its elections system.)
  2. Only immersion in a CACREP program can impart the correct spirit of shared IDENTITY and UNITY. (No training after-the-fact short of redoing graduate school will give this mystic feeling and purpose. We’ve never managed to get a definition of what this IDENTITY is, other than being told to read the 20/20 vision statement again (hint: nope, that does not solve it). UNITY if you are them we suppose.)
  3. Quality (Which, when challenged, results in vague mutterings about testing and program inspection standards… then reference to really flawed studies about NBCC tests being passed at higher percentage by CACREP students.)
  4. Counseling psychology master’s programs have more reliance on testing and the medical model. (If true, is that a problem?)
  5. Control of the standards of our own profession. (Because master’s in counseling psychology are somehow not our own profession…?)
  6. The government demands one standard. (It’s murky as to whether or not perhaps the government was first advised as to what standard it ought to ask for… Also – the “one standard” could so easily have been two (nursing has a few accreditation bodies) or have been a national certification allowing counselors from several backgrounds to attain the certification after demonstrating competence.)
  7. The IOM Study recommendations (Which some of us have described at some length as flawed.)

This letter is envisioned as something of a 101 primer. Problem is, this is such a complex topic that it will surely need revision and expansion almost as soon as its published. Consider this a draft.

 

WHAT CAN YOU DO?

At the immediate moment – BE LOUD. Participate in this Linked-In Group, on the Concerned Counselors listserv (see www.concernedcounselors.org), on ACA Connect Open Forum, and on CESNET. Plans will shortly be announced for a new national association dedicated to fighting the CACREP-Only injustice.

Two Competing Licensure Portability Plans

A curious thing happened late this summer – two competing plans for licensure portability emerged.  This is a long post, but make sure you also get to the 2nd plan below from AASCB.

AMHCA-ACES-NBCC Portability Standards for Counselors
(link to actual plan document)

This first one is bad.  It is a joint plan by AMHCA, ACES, and NBCC which calls for:

EITHER

• A degree from a clinically focused counselor preparation program accredited by CACREP;
OR
• Certification as a National Certified Counselor;
OR
• Fulfillment of standards adopted by a state counseling licensure board;

AND

• Possession of a counselor license for independent practice for at least two years.

The problem here is that NBCC has indicated that the NCC certification will require a CACREP degree for new applicants after 2022.  So while this plan gives a grandfathering period for all of us non-CACREP counselors to go grab and hold an NCC certification for life,  it very much fits with the CACREP-Only stance.  There does appear to be an exception there for state boards which don’t take their obvious suggestion that CACREP should be involved and instead set their own standards.

This plan also represents a financial bonanza for NBCC.  Non-CACREP counselors – if they ever want to be able to move out-of-state – are going to flock to grab the NCC credential right now while they still can.

Think about the money involved…  Some non-CACREP counselors may need to take another exam.  We are not sure what the original application cost is.  A 2014 newsletter said that annual maintenance fees were $80 per year.  Then of course NBCC sponsors and approves many of the CEU courses necessary for maintaining NCC status, but we won’t count that money…

Let’s do a little bit of back-of-the-envelope calculating although certainly the figures will be off.  Let’s assume:

  • This plan succeeds exactly as written (we’ll see)
  • 56,000 ACA members (although not all counselors are ACA members)
  • 70% are non-CACREP
  • 50% of the non-CACREP folks decide to maintain NCC status in case they ever need to move anywhere in their lifetimes.
  • We magically assume that all of these folks will work another 20 years so they all keep their NCCs for 20 years.

56,000 ACA members X .7 non-CACREP X .5 elect NCC status X $80 X 20 years = $31,360,000

This number is bogus of course, but however you calculate this, NBCC will make a fortune.

On a per person basis (assuming fees never rise) that is:

1 person X $80 X 20 years = $1600

This essentially amounts to extra money these folks would not have had to pay at all, except that NBCC participated in the CACREP-only enterprise of making their non-CACREP degrees second-rate, and then charged this membership fee so that at least these non-CACREP counselors could move around the country.

If they can get a job.  And take insurance and government programs.  And work around TRICARE, the VA, maybe Medicare, etc.  Good luck.

But – if they can make a living – perhaps in time they will appreciate their NCC membership as NBCC continues to offer more and more services that make NBCC nearly indistinguishable from ACA, minus some of the democracy and elected positions.

AASCB (American Association of State Counseling Boards)
(link to actual plan document)

The American Association of State Counseling Boards is what it sounds like – the place where all the state boards in charge of professional counselor licensing get together to hash out high-level issues, such as licensure portability.

Many of the state boards are resistant to the CACREP-Only cry.  Many states have lots of counseling psychology masters programs and/or few CACREP programs.  Others are worried about having enough counselors to serve their population, basic fairness in the profession, or other concerns.

On the other hand, CACREP and NBCC and ACA are all over their annual convention with money, presentations, and officers present.  CACREP and NBCC regularly sponsor events and underwrite costs.  This does not imply undue influence, but does illustrate some of the CACREP-Only pressures this organization is under.

The AASCB has tried to come up with a core set of requirements for years for counselors to be able to port their licenses from state-to-state.  They have finally hit upon an elegantly simple plan:

A fully-licensed counselor, who is licensed at the highest level of licensure available in his or her state, and who is in good standing with his or her licensure board, with no disciplinary record, and who has been in active practice for a minimum of five years post-receipt of licensure, and who has taken and passed the NCE or the NCMHCE, shall be eligible for licensure in a state to which he or she is establishing residence. The state to which the licensed counselor is moving may require a jurisprudence examination based on the rules and statutes of said state. An applicant who meets these criteria will be accepted for licensure without further review of education, supervision and experiential hours.

Furthermore “AASCB is open to research supporting a shorter time period if the research indicates no difference in disciplinary issues with those licensees who have less experience.”

This plan has several benefits, not least of which is that the plan does not mention CACREP by name and is much more inclusive.  Also:

1. It leaves more power to the states to determine what their needs are.

2. It does not tie state governments to the dictates of one outside body (CACREP) with whom they may or may not agree in the future.

3. It places more value and respect with counselor experience than with only the accreditation of the degree obtained.

4. It does not require multiple millions of dollars to be funneled into NBCC by non-CACREP counselors holding onto NCC status in order to have license portability.

In our humble opinion, it suggests that AASCB may not be entirely sold on CACREP and only CACREP as in the best interests of the profession and the public at large.

Please look for every opportunity to support the AASCB plan, including writing letters of support to their Board.

Two Important Letters You Need to Write Now to ACA Governing Council & the AASCB Board

Hi All,

There are two letters that I am going to ask you to write.  I’m also asking that, given the nature of these letters, we be especially polite (more so than I often am).  I know we are all angry – and often that anger is what gets officials to pay attention.  But not this time.

When you write a letter, please consider sharing it – either to our listserv or to inquiries@concernedcounselors.org .  Letters sent to Concerned Counselors may be reposted on the concernedcounselors.org website.

For those feeling adventurous, it would be very useful if you also post your letters to ACA Open Forum and CESNET as well.

Both of these letters need to be fairly unique to have impact.  That is, we are not going to provide talking points.  Talking points help tremendously with getting a primary message across, but these need to be unique from you and from the heart.

During the Virginia regulatory comment period over *300*(!) of you wrote to express displeasure with the CACREP-Only proposed regulations.  Which was awesome, but being the busy professionals that we are, a number of the comments were exact cut and paste from the talking points.  This was especially true also for letters to Congress this past summer in support of less restrictive TRICARE regulations (and thank you – hundreds of these also came in).

So what we are asking for are well-crafted, painfully polite, fully fleshed-out, profession letters with your credentials laid out (and bonus points if on letterhead).

***#1***

The first letter is to the individual members of the ACA Governing Council.  Yes, these are the folks who just passed all of those CACREP-Only policies, announced that ACA will be lobbying all 50 state Boards to go CACREP-Only in licensing, and announced that ACA will only support CACREP accreditation even after the MCAC accreditation alternative is approved by CHEA. (See http://www.counseling.org/knowledge-center/faqs-licensure-policies )

The thing is, many of the ACA Governing Council members are surprisingly NOT up on the politics of CACREP-Only.  Others have only been fed the CACREP party line for months.  Still others may have been pressured or surprised by the recent resolution votes.  It was not long ago that the Governing Council passed resolutions in support of ALL counselors.

We are told that many on the Governing Council voted AGAINST the CACREP-Only policies.  Several others may be persuaded to reverse course.

Please write the following Governing Council members and tell them how CACREP-Only policies will hurt currently licensed counselors, why it’s a mistake to jettison counseling psychology master’s programs, how you personally are effected, and any verifiable facts about the situation in your state that they are unlikely to be aware of:

ACA GOVERNING COUNCIL:

Thelma.duffey@utsa.edu, croland@thechicagoschool.edu, Robert.Smith@tamucc.edu, Elias.zambrano@utsa.edu, ttd_1@msn.com, RYep@counseling.org, dtgibmac@aol.com, suzdegges@yahoo.com, dee.ray@unt.edu, shane.haberstroh@utsa.edu, pfrancis@emich.edu, mperepiczka@gmail.com, mkocet@yahoo.com, skbutler@ucf.edu, sgiunta@troy.edu, pdunlap@wayne.edu, alan.burkard@marquette.edu, lisa.jackson-cherry@marymount.edu, nmmerchant@stcloudstate.edu, judydaniels@gmail.com, simone.lambert@gmail.com, bret.hendricks@ttu.edu, ssees1@msn.com, dosborn@fsu.edu, sepressman@aol.com, Christopher.Roseman@utoledo.edu, tmitchell@breweredu.org, mwallace@jsu.edu, dianapals@hotmail.com, ricshawnadkins@hotmail.com

***#2***

The American Association of State Counseling Boards (AASCB) came out recently with a wonderfully inclusive plan for licensure portability that would protect many non-CACREP counselors.  See http://www.aascb.org/aws/AASCB/pt/sd/news_article/110786/_PARENT/layout_details/false

Furthermore, they published this plan directly after the horrible “portability” plan was announced from AMHCA, ACES, and NBCC (http://www.nbcc.org/assets/eblast/AMHCA-ACES-NBCC_Portability_Plan.pdf ).

The president of AASCB, Karen Enegess, is under some pressure from members of their Board to adopt a harder line in favor of CACREP-Only policies.  (In other news, CACREP has spent generously in support of AASCB conference events for many years, and last year even held a large CACREP meeting  in the same hotel concurrently with the AASCB conference.)

What we need are letters thanking Karen Enegess and the AASCB Board for their license portability plan and outlining how much it will help all counselors.  This would also be a good time to insert a bit about how much CACREP-Only policies will hurt both licensed counselors and the public served by their state board members.

AASCB BOARD:

kenegess@gmail.com, sushammonds@bellsouth.net, susan@2liferesources.com, erik_oo@yahoo.com, mmgu2@aol.com, lpcboard@eatel.net, info@aascb.org,

 

The AMHCA Threat to TRICARE and Medicare Counselor Participation

Below is some sample language from what the North Carolina AMHCA state chapter is sending to their members.  Presumably some other AMHCA chapters are doing this as well?  Please note that non-CACREP counselors are being referred to here as “non-clinically trained”. Also please note the very strong connection being made to the push for Medicare recognition. It is abundantly clear that some elements of AMHCA intend to cut non-CACREP counselors out of Medicare (most likely with some grandfathering). Historically many private insurance panels tend to follow Medicare guidelines, so that is very bad news indeed if it happens.

Also below is text taken from a letter sent to Congress from one CACREP-only partisan. This is the kind of attitude problem that we face from their most strident supporters. It may be news to many of the non-CACREP counselors reading this message that you are not trained in the “art and science of Professional Counseling”, and that you are not amongst the “best amd [sic] most qualified counselors”. It is also implied that you may not even be “qualified”.

It is CRITICAL that counselors with a broader vision of professional counseling continue to write Congress urging that the final version of the National Defense Authorization Act (NDAA) include the House version of the language in HR 1735 expanding TRICARE provider eligibility.

Senators and members of Congress are most receptive to letters from their own constituents. You can find your representatives here: http://www.contactingthecongress.org/ Please include particulars about your own state (lack of CACREP programs, etc.)

The Congressional NDAA conference committee members reconciling the House and Senate versions of the bill can be emailed by sending your letters to the following distribution list: tricarecounseling@concernedcounselors.org – this is not an ordinary email address, it directly redistributes your email to the committee members.

The ACA has been supportive of the more inclusive House language. AMHCA has broken with ACA on this issue. However, what ACA has not done is send a mass email campaign out to all of its members urging letters of support for the inclusive House version of the NDAA TRICARE language. ACA is perfectly capable of doing this and does so relatively often. We need to urge ACA to take this step quickly. AMHCA (with roughly 7,000 or so members) should not be able to field a stronger membership lobbying campaign than the 55,000 member-strong ACA.

 

AMHCA NC Chapter — Quotes:

[Italics added]

“IMPORTANT NOTICEThere is a bill in the Senate that could put our chances to get Medicare recognition back years, possibly not until 2027, if then.  It was proposed by ACA without consultation with any other professional association.  It would allow non-clinically trained [at LPC level] counselors to become TRICARE counselors. This would all but eliminate any chance of our getting Medicare recognition.  We have not gotten Medicare recognition because there several states who license LPCs with much lower standards than NC, and this would only worsen that. This has serious implications for us in …”  

“The House passed HR1735, which contains Section 712, which reverses the gains we made in the TRICARE ruling in 2014 and moves them to 2027. The Senate version does not contain the wording of Section 712.  The bill will go into conference soon, if not already.  We need to contact Senators… and … and our Representatives to let them know this will seriously damage the quality of mental health services for our military.”  

 

CACREP-Partisan Letter to Congress – Quotes:

[Italics and bolding added]

“There are many who are writing you today and in the past who have been trained in mental health programs that are not professional counseling by training and not CACREP accredited. Many of these programs while well intentioned do not provide through training in the art and science of Professional Counseling.

CACREP affords veterans and their families the opportunity to have qualified trained counseling professionals to provide the many mental health counseling services they need. Individuals trained in other related professions, while licensed as professional counselors, are not trained in the art and science of professional counseling…”

“I am a member of the American Counseling Association and I do not support their position of a 10 year grandfathering period. As a professional counselor educator in a CAQCREP accredited program, I am concerned that the 10 year period indicates that there is no desire to ensure that veterans get the best amd most qualified counselors.

“Professional counseling is a unique profession that has its own accreditation standards in CACREP and it is important that counselors have that training to provide the best possible services to our veterans and their families.”