It's a paradox found here in Southern California but probably also from Peoria to Miami as well: The worst-off veterans -- often homeless and mentally ill single men -- can get help while veterans struggling to raise families or pay child-support are more or less on their own.

DefenseTracker recently received a copy of the groundbreaking report by the Altarum Institute, a respected nonprofit health systems research and consulting organization, on veteran programs within San Diego County.

In it San Diego County is lauded as a national leader in serving veterans with such programs as Stand Down for homeless veterans and its ability to look for opportunities instead of dwelling on weaknesses.

But it also paints a picture of a community where veteran services are not uniformly distributed and one that needs to do a better job at getting the word out about what programs are available.

Other findings include:

· An explosion of veteran help groups makes it difficult to parse out the legitimate organizations bent on helping veterans from the ones more interested in helping themselves from the ones with good intentions but lacking the necessary skills to help

· There's no comprehensive alignment of independent - and often competing -- organizations into a cohesive network of care for our veterans and their families

· Concern that those seeking services aren't always asked if they are veterans or are the family of veterans and whether they need services related to experiences in the military

· More outreach to the family of veterans is needed to determine problems within the vet population and also to address their own needs

· Veterans receiving less than an honorable discharge are extremely vulnerable for homelessness, substance abuse and suicide

· Housing is a major hurdle for veterans who have completed substance use programs

· Services are not available for veterans struggling to get by, but not currently experiencing active substance abuse or serious mental health problems

· No mechanism or process currently exists for determining whether an organization is legitimate and is effectively serving veterans

· Outreach is not presently tailored to specific problems or targeting veterans groups

· Veterans' services and facilities are not uniformly distributed throughout the county. This issue if currently being addressed, by the VA.

· National Guard and reserve troops need to be given access to the services and support they are eligible for

Max Burke is the co-director of the Veterans Community Action Teams Project for San Diego County and San Antonio, Texas.

He said the goal of the projects was to describe issues that representatives of the veterans' community in San Diego are raising as opportunities or concerns and their ideas for addressing them.

Concerning the vetting of organizations soliciting donations for helping veterans, Burke said:

"We are now beginning to hear about means that may be out there for doing so, however, the process to review and assess the legitimacy and effectiveness of new veterans support organizations is not highly visible or comprehensive. The burgeoning rate of their development and spread as seen today needs integration within the veterans community."

While Altarum provided some analysis and suggestions, the intent was to describe the issues raised by the community members spoken with and then have the community come together to determine what they wanted to move forward on and how they wanted to do it.

Burke said the San Diego Veterans Coalition has used the Altarum report to help set
priorities along with recommended action steps for enhancing coordination and services for veterans and families.

Working groups have been formed to address these priorities. Organizationally, the Coalition is focused on establishing an operational construct and gaining sustainability in order to support veterans over the long term.

Thus far, the Coalition has approved a charter, elected officers and launched working groups.

In addition, the State's Operation Welcome Home has chosen the San Diego Veteran Coalition as it's collaborative partner in the San Diego area and we are planning to track progress in all areas.

The findings from the Veterans Community Action Teams Mission Project can be compared in San Diego and San Antonio in challenges and progress made and the research findings can be used as a role model to help coordinated national solutions.

They can be used by the Defense Department, VA and Department of Labor, service organizations, and state veterans departments all or in part to identify and develop solutions to service delivery challenges.

Burke said the challenges in San Diego and San Antonio are not unique but the opportunity to develop solutions through collaboration and provider service coordination and integration is unique.

Altarum researchers spent a few months in San Diego County last summer analyzing the strengths, weaknesses, opportunities, and threats to the veteran population living here. They interviewed more then 30 communities partners from the Veterans Administration, San Diego County government, non-government organizations and veterans.