[Senate Hearing 109-328]
[From the U.S. Government Publishing Office]
S. Hrg. 109-328
SEATTLE FIELD HEARING: COMING HOME FROM COMBAT--ARE VETERANS GETTING
THE HELP THEY NEED?
=======================================================================
HEARING
BEFORE THE
COMMITTEE ON VETERANS' AFFAIRS
UNITED STATES SENATE
ONE HUNDRED NINTH CONGRESS
FIRST SESSION
__________
August 3, 2005
__________
Printed for the use of the Committee on Veterans' Affairs
Available via the World Wide Web: http://www.access.gpo.gov/congress/
senate
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COMMITTEE ON VETERANS' AFFAIRS
.........................................................
Larry E. Craig, Idaho, Chairman
Arlen Specter, Pennsylvania Daniel K. Akaka, Hawaii, Ranking
Kay Bailey Hutchison, Texas Member
Lindsey O. Graham, South Carolina John D. Rockefeller IV, West
Richard Burr, North Carolina Virginia
John Ensign, Nevada James M. Jeffords, (I), Vermont
John Thune, South Dakota Patty Murray, Washington
Johnny Isakson, Georgia Barack Obama, Illinois
Ken Salazar, Colorado
Lupe Wissel, Majority Staff Director
D. Noelani Kalipi, Minority Staff Director
C O N T E N T S
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August 3, 2005
SENATORS
Page
Murray, Hon. Patty, U.S. Senator from Washington................. 1
WITNESSES
Lowenberg, Major General Timothy, Adjutant General, Washington
State Military Department...................................... 4
Prepared statement........................................... 5
Lewis, Dennis, Assistant Deputy Under Secretary, Health
Operations and Management; Acting Network Director, Veterans
Integrated Service Network 20 (VISN 20)........................ 7
Prepared statement........................................... 8
Arnold, Kristine A., Director, Seattle Veterans Affairs Regional
Office, Veterans Benefits Administration, Department of
Veterans Affairs............................................... 10
Prepared statement........................................... 12
King, John, Director, Washington State Department of Veterans
Affairs........................................................ 15
Prepared statement of John Lee, Deputy Director, Washington
State Department of Veterans Affairs....................... 16
Hall, Specialist Blaine Miles, Washington Army National Guard.... 24
Prepared statement........................................... 25
Romanelli, Staff Sergeant Kevin (Ret.), U.S. Army................ 26
Prepared statement........................................... 26
Hampton, Crystal, Veteran, U.S. Army............................. 28
Prepared statement........................................... 29
Kauder, Sergeant Robert, Washington Army National Guard.......... 30
Prepared statement........................................... 31
Hunt, Stephen, M.D., Director, Deployment Clinic, Puget Sound
Health Care System, Department of Veterans Affairs............. 42
Prepared statement........................................... 43
Boxmeyer, Ron, M.S., Team Leader, Seattle Veterans Center,
Readjustment Counseling Services, Department of Veterans
Affairs........................................................ 45
Prepared statement........................................... 46
Holt, Linda, Tribal Council Member, Suquamish Tribe.............. 47
Prepared statement........................................... 49
Forbes, Colonel Mary, J-1 and Human Resources Director,
Washington Army National Guard................................. 51
Prepared statement........................................... 52
SEATTLE FIELD HEARING: COMING HOME FROM COMBAT--ARE VETERANS GETTING
THE HELP THEY NEED?
----------
WEDNESDAY, AUGUST 3, 2005
U.S. Senate,
Committee on Veterans' Affairs,
Washington, DC.
The Committee met, pursuant to notice, at 10:07 a.m., at
the Army National Guard Armory, 1601 West Armory Way, Seattle,
Washington, Hon. Patty Murray, presiding.
Present: Senator Murray.
OPENING STATEMENT OF HON. PATTY MURRAY,
U.S. SENATOR FROM WASHINGTON
Senator Murray. Good morning. I call this hearing of the
Senate Veterans' Affairs Committee to order. I want to welcome
all of you and thank you very much for coming today. By being
here today, you are sending a very strong message that we care
about everyone who serves our Nation. Every day, in ways large
and small, Washington State military personnel are making all
of us proud. They are facing challenges overseas and their
families are making sacrifices here at home. They are doing
what our country asked. Now, as they come home, we must do what
our country has promised; heal their wounds, meet their needs
and ease their return to family, to work, and to our
communities.
I called this hearing today to explore one question. Are
today's veterans getting the help they need as they come home
from combat? To answer that question, we will hear testimony
today from military leaders, service providers and our veterans
themselves. In the audience today, we have many people who have
answered our call to their country's service in times of war
and peace. We have an obligation to you and I am honored to
serve on the Senate Veterans' Affairs Committee so I can be a
voice for you and the 670,000 veterans throughout our State.
I grew up understanding sacrifice that veterans make.
During World War II, my dad was one of the first GIs to land in
Okinawa. He was injured, sent to Hawaii and then immediately
sent back to Okinawa. Like many in our audience today, he was
awarded the Purple Heart.
When I was in college at Washington State University, I
asked to do my internship at the VA hospital here in Seattle. I
moved from home to Seattle for the semester, rented a room and
I spent my days on the psychiatric ward working with veterans
who had just come home from Vietnam. Today, I am the first
woman to serve on the Senate Veterans' Affairs Committee, and
as you know, I do not hesitate to speak out when our veterans
need help.
I am holding this hearing here in Washington State because
sometimes I cannot get straight answers from Washington, DC. In
Washington, DC, they will tell you everything is fine. For
months the Administration and the VA were telling me they had
all the money they needed. They said, ``Don't worry about it,
Patty.'' But I did worry, because every time I came home and
talked with veterans here, I heard a much different story. I
heard about the VA's hiring freeze. I heard about veterans
waiting for months just to get an appointment, and I heard
about veterans who had to drive for hours to see a doctor
because the clinics they had been promised were not yet built.
So, in March, I proposed increasing veterans spending by 3
percent. It is a small amount, but it would have lifted the
hiring freeze, reduced delays and allowed the VA to open those
clinics here in Washington State and throughout the country.
It is hard to believe, but my proposal was defeated not
just once, but three times. In Washington, DC, people were
telling me everything was fine. Well, 6 weeks ago, we learned
the truth. Things were not fine. The VA in Washington, DC,
admitted that it was at least $1 billion, and that's billion
with a B, short of what it needed to care for veterans this
year. That means many of our veterans face delays or do not get
the care they deserve. That is wrong.
I went back to the Senate floor and I offered my amendment
again. This time, Members finally saw the light and last week
the full Senate approved an additional $1.5 billion for
veterans' health care for this year.
I am pleased that we got the money in the end, but it
should not have taken that long. Every day that was wasted over
politics was a day our veterans were not treated right. That
whole episode showed me that if I ask people in Washington, DC,
they will tell me everything is fine. If I ask people here in
Washington State, I learn the truth. That's the only way we can
make sure we are taking care of the people who are taking care
of us.
Today, I want to hear about the challenges veterans and
their families face as they return home. For 2 years now, I've
been meeting with military personnel at every stage. In January
of 2004, I met with members of the 81st Brigade right before
they shipped out to Iraq. This March, I traveled to Iraq and
Kuwait to meet with members of our armed services from
Washington State. I saw their courage in the face of difficult
and dangerous missions. Since then I have met with Guard
members who have returned home to Everett, Spokane and Port
Orchard. This past Monday, I met with family members at Camp
Murray. Yesterday, I sat down with returning vets in the Tri-
Cities, and tomorrow, Thursday, I'll be meeting with more
veterans in Longview.
I am holding these meetings so I can build a record of what
we need to do so when people in Washington, DC, tell me
everything is fine I can show them what is really going on and
push them to do the right thing.
This hearing today will be an important part of the record
I am assembling. For this hearing to be legitimate, we have to
follow the same procedures that are used at hearings in
Washington, DC. That means that testimony is limited to the
invited witnesses. There are strict time limits, which these
timers I have in front of me will indicate, and we have a court
reporter here to create a formal record of the proceedings.
Unfortunately, that means that we are not allowed to take
questions or comments from the audience. But I want to make
sure that anyone here has the opportunity to share their view.
We do have comment forms available for you to fill out. We also
have a sign up sheet so you can get updates from me as I
continue working back in the Senate.
In addition, I want you to know that I have created a place
in my Web site where veterans throughout our State can share
their stories with me. The address for that is
murray.senate.gov. If you go to that Web site you can see a
section where you or anyone you know can share their story with
me.
Now, let me explain how today's hearing is going to work.
We are going to hear from the panels of witnesses. The first
panel will include officials from the Washington State Guard,
the Federal VA and the State Department of Veterans Affairs.
They will give us a bird's-eye view of what's happening
throughout the State and will set the stage for our discussion.
On the second panel, we are going to hear directly from our
veterans. I especially want to thank each of you for having the
courage to come here today and talk in public about some very
personal challenges. Again, I want everyone to know there are
more chances. We will not have time to raise questions today,
but I want everyone to know that if you have a concern that you
didn't hear mentioned today, I want you to write it down and
give it to my staff.
Our third panel includes people who work directly with
veterans who returned from Iraq and Afghanistan. They have
received a wide range of issues veterans are facing and can
give us a firsthand view from the ground level. When I call the
first panel, each witness will have up to 3 minutes to present
their testimony and then I will ask them questions. Of course,
I want all of our panelists to know that your full written
statements will be included in the official record. When we are
done with each of our witnesses on the first panel, I'll call
the second panel and then I'll go on to the third panel.
Now, before we turn to our first panel, I want you to know
that hearings like this can truly make a difference. Two
summers ago, as many of you know, the VA tried to close down
three of our hospitals here in Washington State. I worked with
veterans throughout our State to make sure that the VA
understood we needed these hospitals to stay open. Within a
day, we were able to persuade the VA secretary to keep our
hospital open. Months later, we persuaded the commission to
save our second hospital. That left one of our hospitals in
jeopardy, the Wainwright Medical Center in Walla Walla. I knew
that the Senate needed to hear from the people in the local
community who would have a harder time getting health care if
their hospital was closed.
So, in April of last year, I held a veterans' hearing in
Walla Walla just like the one we are holding today. We built a
record of the need at that hearing and then I used that record
back in Washington, DC, to help protect that hospital. With the
support of the veterans in Walla Walla and throughout our State
we won. I know that a hearing like this can make a real
difference in giving the people in Washington, DC, a dose of
reality about what our local veterans are facing.
The witnesses here today will help us build an accurate
record, and I, again, want to thank all of them and all of you
who are here today.
Now, I want to add one thing. I know we have many veterans
who are here in the audience today. If you are here and you do
need help from the VA, we have representatives here onsite
today who can help you file a claim if you need us to do that.
You can meet with officials from the VA regional office, from
Tri-Care and from the VA hospital. And if you need help with an
existing claim, members of my staff are here and they may be
able to help you file a claim with the VA.
Now, I just want to remind everybody if you ask for
assistance, because of Federal privacy rules, we do need a
signed letter giving us permission to investigate your case
before we can do anything to help. If you are here and need
assistance with a case be sure to stop and talk with my staff
before you leave.
Senator Murray. With that, I would like to introduce our
first panel who is here with us today, Major General Timothy
Lowenberg, Adjutant General of the Washington State Military
Department; Max Lewis, Veterans Integrated Service Network 20
and VISN 20 within the Veterans Health Administration;
Christine Arnold, regional director of the VA's Benefits
Administration; and John King who is filling in for John Lee
with the Washington State Department of Veterans Affairs. Thank
you very much.
General, we will start with you.
STATEMENT OF MAJOR GENERAL TIMOTHY LOWENBERG,
ADJUTANT GENERAL, WASHINGTON STATE MILITARY
DEPARTMENT
General Lowenberg. Thank you. I would first like to
recognize in the audience today, the State's most distinguished
veterans' advocate. The first Gentleman, Mike Gregoire, and I
would like to thank Governor Gregoire and you, too, Senator
Murray for supporting your National Guard as we have repeatedly
mobilized and deployed our communities' sons and daughters,
mothers and fathers, and in some cases grandfathers and
grandmothers to operations throughout the world, from Iraq to
Afghanistan, to countries throughout Africa, to Cuba, to South
America, to the jungles of the Philippines and to South Korea
where we have personnel serving today.
We have mobilized and deployed more than 4 times the number
of Guardsmen in the last 3 years than were activated for the
Korean war and the Vietnam conflict combined. And this
represents a significant transformation not only for the Guard,
but for all the forces from the strategic reserve to an
operational reserve, and we are generating a recurring cycle of
force presentations never before experienced in modern history.
In answering our country's call, we have adopted many
thoughtful and creative ways of taking care of our soldiers and
the challenges our new operations tempo is putting on our
families. In many respects, I think we have initiated some
national ``best practices'' in the State of Washington. But by
leaning forward aggressively we are both in a better position
to appreciate the scope of unmet needs as well as recognizing
the amount of work and systems changes that still need to be
made to sustain a combat-ready force and combat-ready National
Guard families.
Our major focus, of course, has been on ensuring that our
returning veterans are cycled back into family life. But we
believe strongly that the collective commitment and support we
put together to address that need through a coalition of
national and state veterans organizations, private non-profit
volunteer organizations, public service agencies, and
employment service agencies is really a long-term solution.
Long-term solutions are needed to sustain the needs of veterans
as they go through a lifecycle of change in components and
Reserve to active service, veteran's status, active combat
service, and it is a recurring cycle not experienced in recent
history.
These and other solutions are within our capacity to
conceive and develop and execute, but many of the other
solutions can only be created by refinements to Federal policy
and compensation authorized by decisive Congressional action. I
would just like to briefly mention three of those in my formal
statement.
First, the transition assistance program. The Transition
Assistance Program is really designed for a Cold War era force.
Although it arguably met the needs at that time, we now need a
revised model that focuses on a wide range of training,
readjustment counseling and workshops that are presented both
before the end of active service and then continued for up to 1
year after active service. In light of the remaining time,
Senator, I will submit my formal remarks for the record.
[The prepared statement of General Lowenberg follows:]
Prepared Statement of Major General Timothy Lowenberg, Adjutant
General, Washington State Military Department
Good morning. For the record, I am Major General Tim Lowenberg,
Adjutant General of the State of Washington. I would like to preface my
remarks by thanking Senator Murray for her tireless support of our
Guard members and their families before, during and following their
activation for Federal military service. Thank you, Senator, for
standing with and supporting your National Guard as we have repeatedly
mobilized and deployed our communities' sons and daughters, fathers and
mothers (and in some cases grandfathers and grandmothers) at home and
abroad in support of Operation Noble Eagle, Operation Enduring Freedom
and Operation Iraqi Freedom. From Afghanistan to Iraq to countries
throughout the Horn of Africa; from Cuba to South America, to the
jungles of the Philippines and to South Korea--in the past 3 years, we
have mobilized and deployed more than 4 times the number of Washington
National Guard soldiers and airmen as were activated for the Korean War
and the Vietnam Conflict combined.
The attacks of September 11, 2001 and the ensuing Global War on
Terrorism have triggered a paradigm shift for our military--one that
has transformed our Nation's Guard and Reserve forces from a strategic
reserve to a fully combat ready and combat-tasked operational reserve.
In answering our country's call, the Washington National Guard has
greatly expanded our traditional roles and missions and we have
responded in creative and thoughtful ways to the new soldier-care and
airmen-care issues and to the unprecedented stresses our operations
tempo is putting on our families. In many respects, I believe we have
initiated national best practices in our State. By leaning forward so
aggressively, however, we're both in a position to better appreciate
the scope of unmet needs and to recognize the amount of work and
systems corrections that still need to be made to sustain a combat
ready force and combat-ready National Guard families.
Our major focus has been on ensuring our returning servicemembers--
America's new generation of combat veterans--can quickly and smoothly
integrate back into their family lives, employment and civilian career
tracks and community activities. We have formed an impressive, formal
coalition of Federal and State veterans agencies, social service and
employment agencies, and veterans and other non-profit service
organizations to support these new American heroes. And we believe
strongly that the collective commitment and support of these coalition
members is one of the most important long term solutions for
reintegrating servicemembers and addressing their individual and family
needs--now and throughout the remainder of their service careers.
These and other solutions are within our capacity to conceive,
develop and execute, but many other solutions can only be created by
refinements in Federal policy and, in some cases, by decisive
Congressional action. I would like to call the Committee's attention to
three (3) such problem areas. All three revolve around the fact that
programs, laws, policies and regulations formulated in the Cold War
often no longer support an operational reserve force or the tempo of
deployments we have maintained since 9/11/01.
First, we need to review the overall Transition Assistance Program
(TAP). Second, we need to find more innovative and effective means of
communicating with our veterans community. And, third, we need to make
fundamental adjustments in the legal constructs and administrative
programs that support our servicemembers before, during and after their
deployments for Federal military service.
The Transition Assistance Program (TAP) is a nationally coordinated
effort designed to assist military men and women in transitioning to
civilian life. It focuses on employment and job training. (Public Law
Pub. L. 101-510, sections 1142, 1143, Title X, U.S.C.; DOD Directive
1332.35 and DOD Instruction 1332.36; Sec of Def Policy Memorandum 30
April 2002; DOD/DVA and DOL MOU; AR 600-8-101).
Although it arguably met the needs of a strategic reserve force in
which the bulk of the load was carried by the active duty services, we
now need a revised and updated Transition Assistance (TAP) model that
is specifically tailored for the needs of today's National Guardsmen
and reservists as they transition from extended service in overseas
combat and stabilization missions. The revised model should include
interpersonal and life-skills training, readjustment counseling, and VA
briefings and workshops that are presented before the member's active
duty tour ends, as well as training sessions and workshops that
continue for up to 1 year after the veteran's release from active duty.
A broad cross-section of civilians (e.g., dependents and family
representatives), Veterans Administration officials and military
professionals should be charged with reviewing and updating today's
``dated'' reintegration programs.
Second, we need to find innovative ways of educating our veterans
about the many Federal and State benefits to which they are entitled,
as well as the growing number of services provided by private, non-
profit public service organizations. States, for example, should be
encouraged to form veterans outreach committees that recruit and
capitalize upon the creative talents of the private-sector marketing
and advertising industry. Private sector companies are, by and large,
eager to assist military servicemembers. They simply need encouragement
and some positive direction in channeling their energies and expertise.
Such assistance can obviously be outsourced and contracted, but that
option bleeds money from already under-resourced veterans services.
We're in the early stages of shaping such an initiative in our State. I
look forward to briefing you in the not-too-distant future on our
success.
Finally, many of our Cold War era laws and regulations are simply
no longer sufficient to meet the needs of today's operational Guard and
Reserve forces. Many of these statutes, separate and unequal pay and
benefits regulations, and other bright-line distinctions between career
active duty personnel and career National Guard and Reserve personnel
no longer fit today's high operations tempo, combat ready reserve
forces. Changes in these arcane and outdated systems would go a long
way toward recruiting and retaining the 21st Century Guard and Reserve
force and substantially enhance the reintegration of these veterans and
their families following each recurring period of Federal military
service. I refer, of course, to the separate and unequal systems of
pay, our members' severely restricted access to medical and dental care
and other vestiges of the Cold War era.
With each cycle of domestic base realignments and closures, active
duty forces are also becoming confined to a shrinking number of CONUS
operating sites, while Guardsmen and Reserve soldiers, airmen, sailors,
Marines and Coast Guardsmen remain scattered throughout the depth and
breadth of America, thereby further isolating Guardsmen and reservists
from active duty service centers, Tri-Care providers and other sources
of traditional support for veterans.
As we rush headlong into the 21st Century--as we answer the call of
destiny in responding to the scourge of transnational terrorism--time
is not our ally. We must do everything necessary to support and sustain
a combat ready, operational Guard and reserve force now. We must
therefore make these adjustments now. Our veterans and their families
require and deserve nothing less.
Thank you for your kind attention and for your personal commitment
and dedication to America's veterans. On their behalf, I thank you for
your sacrifice and service and for your bold statement of support in
conducting this field hearing. I would be happy to answer any questions
you may have.
Senator Murray. Thank you very much.
Mr. Lewis.
STATEMENT OF DENNIS LEWIS, ASSISTANT DEPUTY UNDER SECRETARY,
HEALTH OPERATIONS AND MANAGEMENT; ACTING NETWORK DIRECTOR,
VETERANS INTEGRATED SERVICE NETWORK 20 (VISN 20)
Mr. Lewis. Thank you very much. I would like to first start
off by recognizing you for providing this forum, and for all of
your support in Washington, and everything you do for veterans
in Washington State and veterans in the Nation. Thank you. I
also, on behalf of our 8,000 employees, would like to thank all
of the veterans in the audience for your sacrifices and service
to your country. Thank you very much.
The core of VA's mission is a solid commitment to the
service of those men and women who so faithfully serve our
country. VISN 20 is honored to provide veterans, including
those recently returning from active duty, reservists and
National Guard troops with services designed to specifically
address the health care needs of their military deployment.
As you know, Washington State has contributed a large
number of troops to service, not only in Iraq and Afghanistan,
but around the world. Today, of those nearly 3,300 vets who
have returned to Washington State--300 of those not within
Washington State--about 65 percent of that number or about
2,100 have been treated at Washington State facilities.
Ensuring that veterans get the care that they need is an
ongoing endeavor and it is a constantly evolving process that
we go through, each generation is required to go through. There
are new types of care, and there is a different expectation on
what to expect, and there is no difference here in the
Northwest.
The Puget Sound Health Care System, for example, and I am
going to tell you a little bit about some of the things that
were done just recently to address the needs particularly of
the veterans that are returning. At the Puget Sound Health Care
System, the Deployment Health Clinic is the only one of its
kind in the country. It is dedicated to caring for the unique
health concerns related to specific military deployment.
Beginning in September 2003, we located VHV social workers at
the Madigan Medical Center and worked closely with our
counterparts, the Department of Defense and the VA to help
support the successful transition of veterans returning to
civilian life.
The Puget Sound Health Care System has nominated Seattle as
the Northwest Network's Tertiary Polytrauma Center, which has
been approved, and there will be additional resources coming to
Seattle to help support that Center in the future. What this
means is, Seattle will now assure throughout the network that
veterans who have suffered loss of limbs or very severe
debilitating injuries due to their service in the military have
access to the same high level of care.
In Eastern Washington, Spokane and Walla Walla have taken
the lead with other Federal and State veterans agencies and
organized Family Days. These are roundtable discussions held
with veterans and their families describing in detail what
services are available from the VA, as well as from the State
agencies, and helping them understand what those benefits are
and what they are entitled to.
At the Portland VA Medical Center and its Vancouver campus,
we are working with veterans in the southwest part of the
State, and particularly working with the Washington State
National Guard, in developing a new Web site that helps
explain, again, all of the different educational benefits that
are available not only to OIF/OEF veterans, but to all of our
veterans.
And finally, local VA staff has taken the initiative in
addressing mental health. In 2004, we sponsored a very large
comprehensive clinical update for VA as well as other folks
outside the VA, behavioral/mental health staff and others, on
issue of responding to trauma particularly as it relates to
military service. The program provides an opportunity for the
more than 330 participants to share best practices. It
highlighted recent research and data to assist others working
with veterans. The program is so successful that we are
planning to hold another one for November, and it will be in
Washington State.
I have given you a very short overview of VISN 20's
commitment to our veterans. There is more information in my
testimony, and I would like to say that on behalf of the
Network, I can assure you that we are prepared not only to meet
the needs of veterans in other parts of the world, but to meet
the needs of all veterans that we serve. Thank you. I will
submit my formal comments.
[The prepared statement of Mr. Lewis follows:]
Prepared Statement of Dennis Lewis, Assistant Deputy Under Secretary,
Health Operations and Management; Acting Network Director, Veterans
Integrated Service Network 20 (VISN 20)
Good Morning Senator Murray and Members of the Committee: Thank you
for the opportunity to appear today to discuss our preparedness to meet
the needs of returning Operation Iraqi Freedom and Operation Enduring
Freedom veterans. I am Dennis Lewis, the Acting Network Director of the
Veterans Integrated Services Network (VISN 20), providing healthcare to
Northwest veterans. I am also the Assistant Deputy Under Secretary for
Health for Operations and Management; a position I have held since July
2002.
I would like to recognize you, Senator Murray, for providing this
forum to focus on our returning OIF/OEF veterans and for your
continuing leadership and support for all veterans in Washington State.
At the core of VA's mission is a solid commitment to the service of
those men and women who so faithfully have served our country. The VA
Northwest Health Network is honored to be able to provide veterans,
including recently returning active duty, reservists and National Guard
troops with services designated to specifically address the health care
needs of their military deployment.
In addition to Washington State, the VA Northwest Health Network is
comprised of the States of Alaska and Oregon, most of Idaho, and one
county each in Montana and California. Our 135 counties cover
approximately 23 percent of the United States land mass. VISN 20
consists of 6 medical centers, including 2 academic referral sites, 1
independent outpatient clinic, 1 rehabilitation center, 19 community-
based outpatient clinics, and one mobile clinic. Other services include
7 nursing home care units, 2 homeless domiciliaries, and 14 Veterans
Outreach Centers (Vet Centers). VISN 20 has one of the VA's most robust
research programs. Program areas of significance to veterans include
limb loss prevention and prosthetics; spinal cord injury and
rehabilitative medicine; mental health; addiction treatment; Post-
Traumatic Stress Disorder (PTSD); and deployment health programs.
VISN 20 supports the use of Telemedicine to enhance care to our
veterans. Telemedicine involves the use of electronic medical
information and communication to provide and support health care when
distance separates the provider from the patient. Because of our
geographic distribution, we use telemedicine throughout the Network to
increase access to our care, and find it especially useful in providing
care for veterans in remote areas, veterans in State Veterans Home and
those who are disabled and elderly. We use telemedicine in radiology,
mental health, cardiology, pathology, dermatology, psychiatry, and in-
home care teleconsultations for spinal cord injury patients and for
patients with other chronic conditions.
In Washington State, veterans receive care at the VA Puget Sound
Health Care System, the VA Medical Center (VAMC) Spokane, VAMC Walla
Walla and the Vancouver campus of the VAMC Portland, in addition to
eight community-based outpatient clinics (CBOCs) and five veterans
readjustment counseling centers (Vet Centers). During fiscal year 2005,
VISN 20's operating budget has amounted to approximately $1.20B, and
the Network employs 7,966 staff. In fiscal year 2004, VISN 20 served
194,949 veterans, a 6.6 percent increase over fiscal year 2003, making
us first in growth within the Veterans Health Administration (VHA),
more than double the national average growth rate. In spite of these
increases, the Network costs grew at just 0.6 percent in fiscal year
2004.
As you well know, Washington State has a significant number of
troops currently serving in Operation Enduring Freedom and Operation
Iraqi Freedom. To date, we have seen nearly 3,300 (3,281) returning
veterans from OIF/OEF within the Network, of whom, nearly 65 percent
(2,131) have been treated at our Washington State facilities.
In addressing today's topic, I would like to profile the Washington
State facilities who provide care to our returning veterans. I am
pleased that Dr. Stephen Hunt will be sharing information with you
about the VA Puget Sound Health Care System (PSHCS) Deployment Health
Clinic that follows the care of veterans (including active duty,
National Guard and reservists) who are experiencing unique health
concerns related to their specific military deployment. This care is
provided even if the veteran is receiving his/her care outside a VA
setting. As a result of Dr. Hunt's leadership, the PSHCS has become
known as a national leader in issues of deployment health.
The VA PSHCS, with campuses in Seattle and at American Lake
(Tacoma) is the largest VA academic referral medical center in the
Northwest. As a primary and tertiary care facility, the VA Puget Sound
Health Care System provides a full range of patient care services, with
state-of-the-art care.
The PSHCS had approximately 612,377 patient visits in fiscal year
2004, providing care to 59,329 veterans, throughout the State and
across the VISN. So far this year, they have provided care to 5.7
percent more veterans than last year at this time including 1,567 OIF/
OEF veterans.
At our Spokane facility, during fiscal year 2004, there were
204,915 patient visits providing care to 21,008 veterans, primarily
from Spokane and Kootenai counties. So far this year, the VAMC Spokane
has provided care to 8.9 percent percent more veterans than last year
at this time including 368 OIF/OEF veterans. Spokane VA operates a
mobile primary care clinic that visits nine remote sites (five in WA,
three in ID and one in MT) providing follow-up care to their patients.
At the Walla Walla VAMC, 93,643 patient visits occurred in fiscal
year 2004. The Medical Center provided care to 12,611 veterans,
primarily from 15 counties. So far this year, the VAMC Walla Walla has
provided care to 196 OIF/OEF veterans. In addition to the parent
facility, the VAMC Walla Walla operates Community-Based Outpatient
Clinics in Yakima and Richland (Washington) and in Lewiston (Idaho).
VISN 20 has demonstrated our commitment to the seamless transition
of returning combat veterans. In anticipation of returning OIF/OEF
veterans, our Medical Center employees, throughout the VISN, have been
thoroughly trained to ensure that they can identify these new combat
veterans, and to take appropriate steps to ensure that they receive the
world class care they have earned.
Since August 2003, VISN 20 has supported the placement of two VHA
social workers located at Madigan Army Medical Center working with
Veterans Benefits Administration (VBA), to ensure a successful
transition for returning service personnel. These employees work
closely with specifically assigned Points of Contact (POCs) at each of
VISN 20's facilities and our VISN office; this active out-processing
program has touched the lives of 2,624 individuals throughout the VISN
since 2003 resulting in over 1,700 referrals. Our intent is to continue
this important partnership as a means of encouraging those who are
returning home from military commitments to pursue post-deployment
support.
VISN 20 is also prepared to provide specialized care for
servicemembers and veterans. The PSHCS Spinal Cord Injury Unit (SCI)
has provided care to four veterans transferred directly from Walter
Reed Army Hospital. In addition, their Rehabilitation Care Service has
provided a combination of inpatient and outpatient care to 12 veterans
also directly transferred directly from Walter Reed.
The PSHCS has been nominated to be the Northwest Network's Tertiary
Polytrauma Center. The facility will coordinate the care and services
required to meet the needs of the amputee population and assure that
patients have access to the same high level of care across the network.
They will be responsible for implementing care that transitions
individuals back into their home community.
VISN 20 is also participating in VHA National initiatives focused
on OIF/OEF. PSHCS has been approved to develop ``VISN-Wide Outreach,
Early Intervention Collaborative Care with DoD and State Partners.''
Spokane VAMC has been funded to establish ``PTSD Rural Outreach
Services.''
VISN 20 has taken a collaborative approach in addressing the Mental
Health care needs for our Nation's newest veterans. In 2004, we
sponsored a comprehensive clinical update for our behavioral/mental
health staff and others (Readjustment Counseling Centers, Private
Sector Health Care Systems and Agencies, other VISNs and Washington
State DVA). The program provided an opportunity among the 330
participants for sharing best practices. In addition, it highlighted
recent research and data to assist clinicians as they provide care to
veterans. An OIF/OEF Conference is currently planned for November 3-5,
2005. The program will be comprised of three 1-day programs focusing on
specific audiences (Primary Care, Mental Health Clinicians and Veteran/
National Guard and Families).
Additionally, VISN 20 is an active participant in a Memorandum of
Understanding, initiated by the Washington State Department of Veterans
Affairs, with the Washington State Department of Defense, the National
Guard and the Reserve to inform returning servicemembers and their
families of their benefits and deliver the services that are needed for
our Nation's newest veterans. Oregon has also recently entered into a
similar agreement and one is pending in the State of Idaho.
Senator Murray, I have provided you an overview of VISN 20 and the
services we provide to our veterans and patients. However, it is our
veterans who tell us how we are doing and provide us ongoing feedback.
VHA measures patient and veteran satisfaction for both outpatient and
inpatient care. I am proud to share with you that VISN 20 has tied
nationally as number one for overall satisfaction for inpatient care
(Spokane is rated number one for all VHA facilities) and we are number
five overall for outpatient care. We also measure how long our veterans
wait to see their providers once they arrive for their clinic
appointment. Our goal is for them to be seen within 20 minutes or less.
We are ranked 3rd in the Nation and continually strive to improve. As
you can see, our veterans continue to acknowledge we are providing
timely quality care.
As we celebrate the VA's 75th anniversary, all of the dedicated
employees in the Northwest Network are proud to serve the VHA mission:
Honor America's Veterans by Providing Exceptional Healthcare that
Improves Their Health and Well-being. I believe we have demonstrated
and can promise that we are prepared to continue meeting the needs of
returning veterans.
Thank you, Senator Murray. This concludes my formal remarks. I
welcome any questions the Committee Members may have.
Senator Murray. Thank you very much. We will move to
Kristine Arnold.
STATEMENT OF KRISTINE A. ARNOLD, DIRECTOR, SEATTLE VETERANS
AFFAIRS REGIONAL OFFICE, VETERANS
BENEFITS ADMINISTRATION, DEPARTMENT OF VETERANS
AFFAIRS
Ms. Arnold. Thank you very much. I appreciate your giving
me the opportunity to testify today on the Veterans' Benefits
Administration's response to the needs of veterans returning
from for Operation Enduring Freedom and Operation Iraqi Freedom
(OEF/OIF).
I would like to address three topics: the programs that VBA
developed to ease the transition of veterans back into civilian
life; the outreach efforts that VBA and Seattle Regional Office
have made to the National Guard and Reserves; and the Seattle
Regional Office's specific plans for recently returned
Washington National Guard and Reserve units.
Veterans returning from Iraq and Afghanistan, like all
other veterans, are eligible for a full array of monetary
benefits offered through VBA programs to assist them in
readjusting to civilian life, and through outreach effort, to
inform them about the many benefits and services.
The Seattle VA Regional Office is actively involved in
educating returning soldiers about VA benefits: helping
servicemembers, soon to be released from active duty, with the
processing of their claims; and ensuring their smooth
transition back to civilian life.
The Benefits Delivery At Discharge program, which there are
140 based throughout the country, has been in place for almost
10 years. In Washington State, we have Benefits Delivery At
Discharge programs at Fort Lewis which also serves McCord, at
Bremerton which serves all the Naval installations in the Puget
Sound area, and Fairchild Air Force Base, as well.
In most cases, disabled servicemembers under the Benefits
Delivery At Discharge program receive their disability benefits
within 60 days of discharge. Returning servicemembers,
including members of the National Guard and Reserves, may elect
to attend Transition Assitance Program (TAP) sessions which
were discussed by General Lowenberg. At TAP workshops,
servicemembers are fully briefed on the VA benefits available
to them and are encouraged to apply.
The Seamless Transition Initiative is aimed at helping
returning veterans make a smooth transition back into civilian
life. Since March 2003, a VBA OEF/OIF Coordinator is assigned
to each military treatment facility. Since March 2003, each
claim from a seriously disabled OEF/OIF veteran has been case
managed for seamless and expeditious processing.
Gene Finney, Seattle's nationally recognized OEF/OIF
Coordinator, works with case managers at Madigan Army Medical
Center to assure seamless transition for all servicemembers,
particularly those identified as being either Very Seriously
Injured (VSI) or Seriously Injured (SI). We have identified 21
soldiers in those 2 categories. But in addition, since October
2003, we have seen 915 injured soldiers at Madigan, 826 of
which were either National Guard or Reserve. We coordinated
with transition counselors from the local VA Medical Center
regarding 547 servicemembers to ensure seamless services; we
processed 243 claims for compensation and 152 claims for
vocational rehabilitation.
Outreach efforts to the National Guard and Reserve members
take on critical importance in light of the composition of our
forces. Return and deactivation of Reserve and Guard units
presents significant challenges to the VA because rotation is
irregular and servicemembers spend short periods of time at a
military installation before being released to their Guard or
Reserve components. For this reason, outreach efforts are
focused at the local armories or Reserve centers within 2
months of the unit's return.
Washington State is unique because Fort Lewis is the major
mobilization/demobilization point for the National Guard and
Reserves for the whole Western United States. So we have unique
challenges for all of those troops even if they are admitted
off to Idaho, California, and places far away. Since March
2003, the Seattle regional office has conducted 345 briefings
to nearly 22,000 demobilizing OIF/OEF servicemembers. In fiscal
year 2005, alone we have conducted 158 briefings to 11,000
demobilizing servicemembers.
The 81st Brigade and its associated National Guard units
returned from deployment in Iraq beginning in March 2005. They
demobilized through the Soldier Readiness Program at Fort Lewis
prior to returning home. The Seattle Regional Office OEF/OIF
Coordinator provided a Transition Assistance Briefing as part
of their demobilization activity at Fort Lewis. And again, they
received a full array of information about all of the benefits
and services offered by the VA.
The OEF/OIF coordinator maintains weekly contact with the
servicemembers who are assigned to the 654th Army Support
Garrison. This unit includes about 400 Guard and Reserve
servicemembers who are recovering from illnesses or injuries
which have resulted in an extension of their mobilization.
In addition, the coordinator maintains weekly contact with
the servicemembers at Madigan and its associated Medical Hold
Unit. The purpose of these contacts is to counsel
servicemembers on the benefits and services available to them.
On November 5, 2004, the Seattle Regional Office signed a
Memorandum of Understanding with the Washington State Military
Department, the Washington State Department of Veterans
Affairs, the Washington State Employment Security Department,
the Veterans Health Administration, the U.S. Department of
Labor, the Association of Washington Businesses, and the
Governor's Veterans Affairs Advisory Committee.
On May 26, 2005, the 70th Army Reserve Support Command
became an MOU partner and on August 8th, coming up, we will
sign the same MOU with the Naval Reserve Command. We have 27
Family Activity Days scheduled through November 6th in support
of the Washington Army National Guard. We intend to revisit
these units within a year.
I thank you, Senator, for the opportunity to speak.
[The prepared statement of Ms. Arnold follows:]
Prepared Statement of Kristine A. Arnold, Director, Seattle Veterans
Affairs Regional Office, Veterans Benefits Administration, Department
of Veterans Affairs
Senator Murray, I appreciate this opportunity to testify today on
the Veterans Benefits Administration's (VBA's) response to the needs of
veterans returning from Operation Enduring Freedom and Operation Iraqi
Freedom (OEF/OIF).
My testimony addresses three related topics: the programs that VBA
developed to ease the transition of OEF/OIF veterans back into civilian
life; the outreach efforts of both VBA and the Seattle VA Regional
Office to the National Guard and Reserves; and the Seattle VA Regional
Office's specific plans for recently returned Washington National Guard
and Reserve units.
Veterans returning from Iraq and Afghanistan are eligible for a
full array of benefits offered through VBA. These include:
Disability Compensation and Related Benefits;
Education and Training Benefits;
Vocational Rehabilitation and Employment;
Home Loan Guaranties;
Life Insurance;
Burial Benefits; and
Dependents' and Survivors' Benefits.
In addition to providing this broad range of benefits, VBA is
reaching out to OEF/OIF veterans with programs to assist them in
readjusting to civilian life, and with information about our many
benefits and services. I will briefly discuss some of these assistance
programs and then talk about our outreach efforts. My focus will be on
outreach to members of the National Guard and Reserves.
programs to assist returning oef/oif veterans
The Seattle VA Regional Office is actively involved in educating
returning servicemembers about VA benefits, in helping servicemembers,
soon to be released from active duty, with the processing of claims,
and in ensuring a smooth transition from military duty back into
civilian life. The Benefits Delivery at Discharge Program, the
Transition Assistance Program, and the Seamless Transition Initiative
all exemplify VBA's active participation in the readjustment process.
The Benefits Delivery at Discharge Program, or BDD, is in place at
140 military installations around the country and overseas. In
Washington State, we have BDD programs at Ft. Lewis, which also serves
McChord Air Force Base, at Bremerton, which serves all naval
installations in the Puget Sound area, and at Fairchild Air Force Base.
Under this program, active duty servicemembers who are within 180 days
of separation are encouraged to file disability compensation claims
with VA staff who are serving at military bases either on a full-time
or itinerant basis. Servicemembers can complete the necessary physical
examinations and have their claims evaluated before or closely
following their military separation dates. In most cases, disabled
servicemembers participating in the BDD program begin receiving VA
disability compensation benefits within 60 days of their separation
from active duty, which serves to ease the transition from active duty
to civilian status.
Returning servicemembers, including members of the National Guard
and Reserves, may elect to attend the formal 3-day workshops provided
through the Transition Assistance Program (TAP), a joint effort of VA,
the Department of Defense, and the Department of Labor. At TAP
workshops, servicemembers are fully briefed on the VA benefits
available to them and encouraged to apply for all benefits to which
they are entitled. In fiscal year 2004, the Seattle VA Regional Office
conducted 37 TAP briefings attended by 1,851 servicemembers.
The Seamless Transition Initiative is aimed at helping returning
veterans make a smooth transition back into civilian life. In 2003, VA
began placing Veterans Service Representatives at key military
treatment facilities (MTFs) where severely wounded servicemembers from
OEF/OIF are frequently sent.
Since March 2003, a VBA OEF/OIF coordinator has been assigned to
each MTF. As of January 2005, over 4,500 hospitalized returning
servicemembers were assisted through this program at Walter Reed Army
Medical Center, Bethesda Naval Hospital, Madigan Army Medical Center,
Eisenhower Army Medical Center, and Brooke Army Medical Center. Since
March 2003, each claim from a seriously injured OEF/OIF veteran has
been case managed for seamless and expeditious processing.
Gene Finney, Seattle's OIF/OEF Coordinator, works with Veterans
Health Administration (VHA) transition case managers at the Madigan
Army Medical Center to ensure seamless transition for all
servicemembers, particularly those identified as being either Very
Seriously Injured (VSI) or Seriously Injured (SI). Either Frank Pierce,
the Assistant Director, or I contact injured servicemembers to thank
them for their service and review benefits and services available to
them. We have identified 21 soldiers as either very seriously injured
or seriously injured. Since October 2003, we have seen 915 injured OIF/
OEF soldiers at Madigan, 826 of whom were either in the National Guard
or Reserve. We coordinated with transition counselors from the local VA
Medical Centers regarding 547 servicemembers to insure seamless
services; we processed 243 claims for compensation and 152 claims for
vocational rehabilitation services.
outreach to national guard and reserves
Outreach to Reserve/Guard members is part of the overall VBA
outreach program. In peacetime, this outreach is generally accomplished
on an ``on call'' or ``as requested'' basis. With the activation and
deployment of large numbers of Reserve/Guard members following the
September 11, 2001, attack on America, and OEF/OIF, VBA outreach to
this group has been greatly expanded.
Outreach efforts to National Guard and Reserve members take on
critical importance in light of the composition of our forces. Return
and deactivation of Reserve/Guard units present significant challenges
to VA because rotation is irregular and the servicemembers spend
extremely short periods of time at military installations prior to
being released to their Guard or Reserve components. For this reason,
outreach efforts are focused at the local armories or reserve centers
within 2 months of a unit's deactivation. Washington State is unique
because Ft. Lewis is a major mobilization/demobilization point for Army
National Guard and Army Reserve Units for the Western United States.
Since March 2003, the Seattle VA Regional Office has conducted 345
briefings to 21,480 demobilizing OIF/OEF servicemembers. In fiscal year
2005 alone, we have conducted 158 briefings to 11,000 demobilizing
servicemembers.
In addition to these briefings and our other efforts to reach out
in person to returning veterans, all separating and retiring
servicemembers (including Reserve/Guard members) receive a ``Welcome
Home Package'' that includes a letter from the Secretary of Veterans
Affairs, a copy of VA Pamphlet 21-00-1, A Summary of VA Benefits, and
VA Form 21-0501, Veterans Benefits Timetable, through the Veterans
Assistance at Discharge System (VADS). Six months later similar
information is mailed to servicemembers following discharge with a
follow-up letter.
Finally, VA has created a new internet Web page especially for
veterans returning from Afghanistan and Iraq at http://
www.seamlesstransition.va.gov/. Information specific to National Guard
and Reserves is also included on this Web page, along with links to Web
sites with information about other Federal benefits that may be of
interest to returning servicemembers.
seattle va regional office plans for the washington national guard
Beginning in March 2005, the 81st Brigade and its associated
National Guard units returned from deployment to Iraq. They mobilized
and demobilized through the Soldier Readiness Program (SRP) at Ft.
Lewis prior to returning home. The Seattle VA Regional Office OIF/OEF
Coordinator provided a Transition Assistance Briefing as part of their
demobilization activity at Ft. Lewis. During this presentation, the
OIF/OEF Coordinator reviewed VA benefits and services available and
provided each servicemember with a packet of pamphlets and forms to
assist the servicemember in applying for services. The following
activities are already underway:
1. Coordination with VA Medical Centers: The Seattle Regional
Office's (RO's) OIF/OEF Coordinator maintains regular contact with his
counterparts in all of the VA Medical Centers (MCs) that support
Washington's veterans. When OIF/OEF veterans go to one of these MCs for
care, the coordinators refer them to the Seattle RO for benefits.
Conversely, the RO refers all veterans who come there to the MCs.
2. Coordination with Madigan and the 654th Army Support Garrison
(ASG): The OIF/OEF Coordinator maintains weekly contact with
servicemembers assigned to the 654th ASG. This unit includes
approximately 400 Guard and Reserve servicemembers who are recovering
from illnesses or injuries, which have resulted in an extension of
their mobilization. In addition, the coordinator maintains weekly
contact with servicemembers at Madigan and its associated Medical Hold
unit. The purpose of these contacts is to counsel servicemembers on VA
benefits and services and assist them in the application process.
3. Coordination of Services: On November 5, 2004, the Seattle VA
Regional Office signed a memorandum of understanding (MOU) with the
Washington State Military Department, the Washington State Department
of Veterans Affairs, the Washington State Employment Security
Department, the Veterans Health Administration, the U.S. Department of
Labor, the Association of Washington Businesses, and the Governor's
Veterans Affairs Advisory Committee. On May 26, 2005, the 70th Army
Reserve Support command became an MOU partner, and on Monday, August
8th, in a signing ceremony at the Bangor Sub Base, the Naval Reserve
Command will become an MOU partner. The Seattle Regional Office and the
other MOU signatories participate in Family Activity Days at their
facilities that provide servicemembers and their families personalized
assistance in understanding and applying for Federal and State benefits
and services. We currently have 27 Family Activity Days scheduled
through November 6th in support of the Washington Army National Guard.
We intend to revisit these units within 1 year of their return from
Iraq or Afghanistan.
Senator Murray, I hope this testimony has given you and the
Committee a better understanding of the VA benefits, services, and
outreach being provided to veterans of the OEF/OIF conflicts. I also
want to assure you that the Seattle VA Regional Office is ready and
eager to serve the men and women coming home to Washington State. This
concludes my testimony. I will be pleased to answer any questions you
might have.
Senator Murray. Thank you very much.
John King.
STATEMENT OF JOHN KING, DIRECTOR, WASHINGTON STATE DEPARTMENT
OF VETERANS AFFAIRS
Mr. King. Thank you, Senator, for the opportunity to talk
with you today. We regret that John couldn't be here today. It
is truly his leadership that has made Washington State's
collaborative effort to the MOU a national model. Long before
the recent homecomings, we were most concerned about how well
we would receive those returning home. Our country could not
afford to make the same mistakes it did when our Vietnam
veterans returned. There isn't time today to discuss all of the
elements needed to ensure that our veterans are taken care of.
So I will focus on an area that is of particular interest to
you and one that we think needs to be aggressively addressed at
the national level.
Year after year, we have watched the VA budget negotiation
process. Each year the scenario is the same. The Administration
in office proposes a budget. The veterans community responds by
pointing out what is lacking. And the country's veterans end up
with something in the middle. That needs to change. The
historical budget leaves Washington always playing catch up.
As you well know, the national veterans population is
diminishing as the State of Washington continues to grow. You
know, Washington is a militarily strong State. Half of those
that discharge stay here. They like Washington State for a lot
of reasons. What is needed is a method to deal with the VA
budget in a forward thinking way, with a cost estimate, and it
is not hard to do. The science is there, but the bureaucratic
process and the old ways of doing business prevent Washington
from ever catching up. And that makes it near impossible
through VISN 20 and the service providers to continue to
perform in the most excellent manner they do.
I do know in my 8\1/2\ years in this job about the quality
of care. It is world class care. It is about access. It is
about being resourced. Our colleagues and peers at the Federal
level suffer from unbelievable workloads. It needs to be a
level playing field.
Most recently we heard that the VA described the needs of
Operation Enduring Freedom and Operation Iraqi Freedom Veterans
as being an absolute priority. They were assured that VA would
provide health care for 2 years. Unfortunately it isn't
translating on the ground. Our veterans in the general veteran
population are finding their waits are longer, especially for
specialty services. Veterans from Enduring Freedom and Iraqi
Freedom are being treated only for issues directly related to
service in these operations. And I know the service providers
are looking for every way possible to make them eligible, but
they are dealing with a strained budget. This is not how that
policy was promoted.
Another close to home example is the success--you brought
it up--in adding specific budget language asking the VA to open
a community-based outpatient clinic in North Central
Washington. There is a demonstrated need, especially in rural
Washington. With the ongoing budget crisis, the opening of this
CBOC has been pushed back again at a time when our soldiers are
returning to rural areas, and community-based care is
absolutely essential to their getting VA benefits and
entitlements. So what are we going to do about it?
Washington State in particular is going to put a lot more
effort into outreach, making sure that we help eligible
veterans get enrolled in the VA health care. As you well know
in these tough economic times when unemployment rates are high,
more people are choosing VA health care in spite of the long
lines. They know it is quality care, and it is their option of
choice and during hard economic times, in many cases, their
only option.
Lines may grow a little longer. What we would like to see
is the budget process itself changed to be more prospective.
Now, the latest news is that our current VA system is
cutting back on mental health fees for service care. This
affects veterans returning to rural Washington. Cutting PTSD
services simply doesn't make sense. We know that we can make
issues around veterans as they return home, but the young men
and woman returning from extended deployment, 20 percent are
exhibiting symptoms of PTSD, and another 20 percent would
likely benefit from counseling to deal with marital issues,
substance abuse and readjustment issues. So while we are busy
saying we appreciate your service and sacrifice we are
restricting access to the very services that they need the
most.
Throughout MOU partnership we will reach out to these
returning veterans at 18 family activity days in August and
September. These family activity days are opportunities for
service providers to offer information and services not only to
the veterans, but also to the family members who may see the
signs that help is needed before the soldier does or admits.
Information and assistance provided, include counseling, health
care, mental health, employment rights and veterans' benefits.
As an example, we held a family activity day in March. Of
the 76 soldiers who attended that event, over 40 filed claims--
35 requesting counseling for PTSD. Not only does this tell us
that there is a great need, it tells us that we could continue
taking the services to them. Family activity days are the third
direct contact as indicated by Director Arnold, yet for over
half of those in attendance it was the first time that they
asked for help. So it takes a while after you have been home
and you assimilate and realize that life has changed.
Our goal is to ensure that when they ask for help we can
follow through by providing access to the benefits and services
that they are entitled to. And, again, in no way do I want to
impugn the quality of services out of the health care side or
the benefit side. I think we have world class services here in
the State of Washington, and the leadership will utilize all
the resource base that they have to be able to provide all we
need. Thank you, Senator.
[The prepared statement of Mr. Lee follows:]
Prepared Statement of John Lee, Deputy Director, Washington State
Department of Veterans Affairs
Senator Murray, thank you for the opportunity to talk with you
today about the needs of our military personnel returning from extended
deployments.
Long before the recent homecomings, we began evaluating the needs
of returnees from Operation Enduring Freedom and Operation Iraqi
Freedom, We looked at everything from employment to mental health to VA
health care. There was a common theme that ran through our discussions:
Our country could not afford to make the mistakes that were made when
soldiers returned from Vietnam.
We found numerous providers ready and willing to help--all with the
very best intentions to serve these new veterans, but there was a lack
of coordination to ensure soldiers didn't fall through the cracks and
efforts weren't duplicated unnecessarily.
WDVA began serving as a benefits and service coordinator through a
Memorandum of Understanding. This document was signed by a number of
Federal, State, local and private partners; and to date, is resulting
in our newest veterans, and their family members being offered
information and assistance not once, or twice, but time and again to
ensure we're there when they need us.
There isn't time today to discuss all the elements needed to ensure
our newest veterans are taken care of, so I will focus on an area where
I think, you Senator, and other Members of the Senate Committee on
Veterans' Affairs can make a difference--the Federal VA Budget.
Year after year, we watch the VA budget negotiation process. Each
year the scenario is the same. The Administration in office proposes a
budget, the veterans community responds by pointing out where it is
lacking, Congress battles to restore what was omitted, and our
country's veterans end up with something in the middle.
However, regardless of what the amount is, the budget is never
focused on the prospective needs of veterans. The bulk of the budget is
written based on what the VA used in the past, rather than what we know
will happen in the future.
A case in point is Washington State. We remain stuck in a pattern
of being in the highest \1/3\ for veteran population and in the lowest
\1/3\ for percentage of VA utilization.
This historical budgeting leaves Washington always playing catch-
up. What is needed is a method to deal with the VA budget in a forward
thinking way based on need, not on past performance.
We've seen what happens when the VA is faced with an emergent issue
but doesn't have flexibility in its budget to effectively deal with it.
For example, when VA Health Care was opened to all veterans in the
late 1990s, the VA's enrollment numbers skyrocketed, but budgets built
on historical data rose more slowly. The result was longer waiting
lists for primary and specialty health care and finally a moratorium on
providing care for veterans in Priority Groups 7 and 8.
More recently, we heard the VA describe the needs of Operation
Enduring Freedom and Operation Iraqi Freedom veterans as being an
absolute priority. They were assured the VA would provide Health Care
for 2 years. This too is a great initiative. It's an initiative that
kept the fear of repeating the mistakes of Vietnam from creeping into
our thoughts. Unfortunately it isn't translating on the ground. Other
veterans are finding that their waits are longer, specifically for
specialty services, and veterans of Enduring Freedom and Iraqi Freedom
are being treated only for issues directly related to service in these
Operations. This was not how the new policy direction was promoted.
This incredibly good idea is faltering because of a lack of
prospective budgeting. And that is a shame, because we knew from the
initial deployments how many military personnel would be returning a
year in advance, and how many would be eligible for 2 years of VA
Health Care.
Another close to home example is the success you and your
colleagues had in adding specific budget language asking the VA to open
a Community-Based Outpatient Clinic in North Central Washington.
Although there is a demonstrated need and it was authorized by Congress
and the President, the CBOC still isn't open. With the ongoing budget
crisis, it has been pushed back again. At a time when our citizen
soldiers are returning to rural areas of Washington, community-based
care is absolutely essential to getting them connected with VA benefits
and entitlements.
So, how can Washington State, where we have a demonstrated need, an
increasing veteran population, and a lower than average utilization
rate, continue to wait and see what the VA budget will bring each year?
We are going to get aggressive about ensuring veterans are enrolled
in VA health care.
Lines may grow for a little while, but playing the budget wait and
see game hasn't worked.
Look at what is happening with these young men and women returning
from year long deployments--the largest National Guard deployment since
WWII. We know they will have short-term and long-term care needs. These
veterans are returning to homes all over our State and are encountering
a strained VA system.
Now the latest news is that our strained VA system is cutting back
on mental health fee for service care, which will disproportionately
affect veterans returning to rural Washington.
Cutting PTSD services simply doesn't make sense. We know that we
can prevent many issues by wrapping a support system around veterans.
Of the young men and women returning home from extended deployments 20
percent are exhibiting symptoms of PTSD, and another 20 percent could
likely benefit from counseling to deal with marital issues, substance
abuse, and readjustment issues.
So while we're busy telling veterans we appreciate their service
and sacrifice, we're restricting access to the very services we know
they need.
I don't have all the answers; however, I will tell you that the
system being used to appropriate money to meet veterans' health care
needs is simply not working. In Washington we're going to aggressively
enroll veterans in an attempt to boost our baseline and start seeing an
increase in funding to care for those who need it.
Through our MOU partnership, we will reach out to these returnees
at 18 Family Activity Days in August and September alone. These Family
Activity Days are opportunities for service providers to offer
information and services not only to the veteran, but also their family
members who may see signs that help is needed before the soldier does.
(Information and assistance provided includes employment counseling and
assistance, health care, mental health, employment rights and veterans
benefits.)
As an example, we held a Family Activity Day in March. Of the 76
soldiers who attended this event, over 40 filed claims for VA Health
Care and 35 requested counseling for PTSD. Not only does this tell us
the need is great, it tells us that we need to continue taking the
services to them. Family Activity Days are the third direct contact
each of these returnees receive, yet for over half of those in
attendance, it was the first time they asked for help.
Our goal is to ensure that when they ask for help, we can follow
through by providing access to the benefits and services they are
entitled to.
As I said in the beginning, the VA Health Care budget is only one
component of the issues facing our returnees; however, it is imperative
that we fix it.
Senator Murray. Thank you very much. Thank you for all of
your testimony. I really appreciate it. Your testimony will be
a part of the official Senate record as well. General
Lowenberg, let me begin with you.
In your statement today you talked about the transitional
assistance program that needed to be adjusted for the current
military model. You have been with me around the State as we
have heard from soldiers returning from Iraq and Afghanistan,
and I am hearing a lot about medical care that gets lost in
that transition, and soldiers paying for their own health care
because they got lost in the system. And they are frustrated.
Military pay that gets lost someplace. Is that all part of a
transitional program that isn't built around a model of Guard
and Reserve?
General Lowenberg. The problem is widespread. It is not all
related to the TAP program. The TAP program, I think, is
symptomatic of systems that are predicated on Cold War models
where the Navy, Marines and Air Force, Army--whatever--to be on
activated Federal service, perhaps once in their career, are
separated perhaps from that active service one time.
Operationally, there is a continuing cycle of Federal
service, peacetime training over an extended career. Programs
like that aren't focused on preparing them for transition while
they are still on active service deployed overseas. That would
be a beneficial change. And then providing a continuum of
support for up to a year after they have deactivated. The
program is much more narrowly focused than that, but it doesn't
reflect the current operational commitment of the American
forces worldwide.
Senator Murray. So we need to revise the transition program
so it works for the fact that we are using it for Guard and
Reserve soldiers differently than we have in the past?
General Lowenberg. What I would suggest is that the VA
convene a task force that would include attendance of family
members, as well as Veterans' Administration officials and
military professionals to take a look at the new dynamic under
which we are operating and reassess what the veterans' needs
are.
Senator Murray. Thank you very much. I appreciate that.
Director Lewis, in your testimony you stated the VISN 20
Pacific Northwest network's growth rate for veterans seeking
service. Can you tell me what is causing those rates to be so
high particularly here in the Northwest?
Mr. Lewis. I think there are a number of reasons. I think
the first has to do with economics. The State has mentioned
already there are a number of employment factors that weigh
into this. Veterans returning home, they thought that they had
health insurance, and they come back and they find that the
company they worked for has gone bankrupt, or the fact that
they do not have a job. And that is a problem that we are
continually working with the State too, you know, some
commitment that has been made.
I think that there are, at least in the case of Washington
State, more folks moving into the State who are veterans. That
plays a role in that. I think the reputation for the quality of
care that is being provided also plays a role in that. There
have been a number of articles in the last year that have
identified VA care as being the best in the country if not in
the world. That plays a part, too. I think the communications
that have been ongoing from the veterans service organizations,
from the military itself, have played a large part in making
folks aware of what benefits are available and what they are
entitled to.
Senator Murray. I heard John King say they were going to do
more outreach. Are you taking into account the effect of that
in the increased number of soldiers or veterans who are seeking
care?
Mr. Lewis. Yes, because we do participate in that outreach
as well. So that is part of our early warning at this stage.
The work last year doubled by a factor of, you know, twice what
the national growth rate was. It slowed down a little bit this
year. It is not quite twice now. But it is still higher than
any of the other networks in the country.
Senator Murray. Are you able to demonstrate that growth to
Under Secretary Perlin and others at the VA and get increased
funding for VISN 20 as a result of that?
Mr. Lewis. To identify it, we do have a bearer system, and
a bearer system is basically a historical model which
recognizes workload as it occurred 2 years in the past. But the
short answer to your question is Dr. Perlin was just in this
network 2 days ago and is very well aware of the workload
impact in this network. He actually visited Walla Walla, has
been out there and toured the facility as well, and understands
some of the issues that are occurring in Network 20.
Senator Murray. And I agree he has been active in that and
done good, but we are relying on a system that doesn't take
into account----
Mr. Lewis. The system does work, though. Part of that also
plays into how the managers in these facilities operate and how
they operated before the supplemental funding that we just
learned about recently was coming in. The managers were already
working on some new models for providing care.
It is true that we have increased demand in the network,
and that the wait is long, but they have developed some
strategies for getting those wait lists down and we will
continue to work with our counterparts, both VBA and the State,
to provide timely care for those folks. And so it is always a
balancing act.
Senator Murray. I do believe that the system here does an
excellent job of providing care, but they can only deal with
the resources they have been given. I think the fact that we
are $1 billion short this year alone says there is something
wrong with how money in interpreted back in Washington, DC,
based on calculations and what Congress has been told they need
versus in reality what is happening on the ground.
Mr. Lewis. Our headquarters in Washington are aware of
network 20's issues and, in fact, did provide supplemental
dollars to this network even before the Congressional votes of
last month.
Senator Murray. We still have work to do.
Mr. Lewis. Yes.
Senator Murray. So, we will work with you on that.
Let me ask you one more question before I return to
Director Arnold. I heard John King talk about the need for care
in isolated areas, the clinic that we have been working on for
North Central Washington, and the lack of access for our
veterans. Many of these are members who have returned home to
remote communities. What is the VA doing today to increase
medical access and care in remote parts of Washington State?
Mr. Lewis. Well, there are a number of activities that are
ongoing. I have been in the--with your permission, I will
probably call them to give you just a little bit more
information than I can provide. But just briefly, we have
actually allocated additional dollars both to our medical
services primarily for mental health and PTSD in rural areas.
About $400,000 last month went for these programs. An
additional $450,000 was provided in July for our Telehealth
home care coordination program in rural areas in Washington
State and there are a number of other outreach activities that
are going on. We have also submitted the North Central
community-based clinic for approval in Washington.
Senator Murray. When are we going to see that new clinic in
North Central Washington?
Mr. Lewis. When it is approved and when it is built are
probably two separate questions, because it will take a while
to coordinate the space, and award the contract and things like
that. I can tell you that it is in Washington State being----
Senator Murray. We will be following up on that.
Mr. Lewis. If I could just ask Joe----
Senator Murray. Very quickly.
Mr. Lewis. The director in Spokane----
Senator Murray. Actually what I would like to do is get
your testimony for the record on that because I want to make
sure that we have time for a few other questions.
Mr. Lewis, I did have one other thing. Mr. King pointed out
that Washington has one of the highest per capita veterans
populations, but very low VA utilization. One of the concerns I
have is, as health care itself becomes harder to access for
many people, those who are veterans are turning to our VA
system. Are we able to quickly adjust your budget? Should we
see a large number of veterans coming to your system that
weren't accessing it before, but who qualify for it?
Mr. Lewis. I think, again, that is communication, and that
is the VA communicating with our Congressional representatives
and making them aware of the needs that we have to adjust the
budget.
Senator Murray. Thank you very much.
Director Arnold, let me turn to you. As Regional Director
of the Veterans Benefits Administration, can you tell us how
well we are processing the veterans from Iraq and Afghanistan?
Are there any delays?
Ms. Arnold. I am very proud to announce, Senator Murray,
that we are doing an excellent job in the State of Washington.
We are getting very high marks nationally for this last year.
We have veterans waiting about 5 months for a decision on their
claim. That doesn't mean there aren't some veterans who wait
longer, but in those cases sometimes we talk about more
complicated claims that take us out of the process in getting
the evidence. And specifically PTSD claims, as a matter of
fact, take us somewhat longer to get the evidence. But in
general, we have reduced our inventory of claims by some 3,000
over the last 12 months. What that means to veterans is they
are getting answers more quickly.
Senator Murray. I am hearing from a lot of veterans as I
travel around the State, who have returned from Iraq and
Afghanistan and gone back to try and rebuild their businesses.
A lot of them who had small businesses before they left are
going under. Do you think there is a need for a new benefit for
veterans to access small business loans through the VA?
Ms. Arnold. I know there was legislation passed like that
several years ago and the funds were never appropriated for it.
So I think still that would be a great idea.
Senator Murray. Are you aware, as I am, that there are a
number of veterans who need services like that?
Ms. Arnold. Yes. As a matter of fact, we in our Vocational
Rehabilitation program have now put a special on some self-
employment. Generally before, Vocational Rehabilitation has
been geared toward re-education, retraining type efforts to get
a disabled veteran back into a career. But in many cases they
want a self-employment opportunity. So we are making major
efforts toward self-employment for disabled veterans.
Senator Murray. Thank you very much.
Mr. King, your Department often ends up being the broker
between the Department of Defense and the VA in order to get
our veterans processed. Can you tell us how well these agencies
are working together to get veterans the help they need?
Mr. King. I am absolutely impressed with how well the
system is working together. That the commitment from every
entity is there. The practice is there. It is about resources,
Senator. You made a very important statement on the front end
of your opening remarks, and that is we have 670,000 veterans
in the State of Washington. I don't think you will find that
number anywhere else but from those of us that work the
problem. That is not the number that the VA budget is on. They
use Census 2000 as a latest update and modeled after national
modeling. That is part of why the State of Washington which
experiences inordinate growth in our community is so out of
balance with the rest of the Nation. On the east coast they are
declining. On the west coast, especially in the Pacific
Northwest, we are growing at a rate that other States don't
experience.
Senator Murray. In your remarks, you mentioned that 20
percent of the returning vets are seeking care for post-
traumatic stress syndrome.
Mr. King. You know, it is the early indicator. I can't say
that it is a specific trend. But the early indicators are that
of the young men and women returning home from extended
deployments, 20 percent presented with PTSD, and another 20
percent could likely benefit from counseling to deal with
marital issues, substance abuse and readjustment issues. And 35
out of 76 applied for help, this is a real strong indicator
that this was very hard and it does have a huge impact.
Senator Murray. The other thing I am hearing is a concern
that returning Iraq and Afghanistan veterans may displace some
of our Vietnam and Korean veterans who are trying to access
care. Can you share with us any knowledge about that?
Mr. King. Because we are familiar with the care initiative
and watching the wait lines problem being aggressively
addressed, then to find ourselves right back to where we
started, and my concern is this. Both OEF/OIF are certainly
issues presently in front of us, but it should not replace the
focus on the rest of the veterans community who have served
well.
It is almost as if it obfuscates the issue that we thought
was being resolved, and now it is back on our heels again. We
are back to the long waiting lines at or beyond what it was
before we started the care initiative. So I am not sure I
answered your question, but the larger veteran population is
now further in----
Senator Murray. General Lowenberg, let me ask you a few
more questions. How many Guard members from Washington State
have now been deployed to Iraq and Afghanistan?
General Lowenberg. I don't know the exact number, but it
would be in excess of 4,000.
Senator Murray. How many were returned injured?
General Lowenberg. In the hundreds. We at one point had
several hundred on medical hold at Madigan and there are
several still, as you know from our meetings with soldiers in
Everett and other locations, that are still part of that
system.
Senator Murray. I am hearing a number of concerns from them
about the ability to access services because they are still
under a medical care situation.
General Lowenberg. That is correct.
Senator Murray. One other issue I heard recently is the
tremendous impact it has on families when Guard members serve
in Iraq or Afghanistan for over a year, up to 14 months some of
them. I have heard from a number of soldiers on both sides of
the issue, but the suggestion is to shorten that length of time
to 120 days. The impact on marriages, the impact on businesses,
the impact on families has been tremendous. Is there a
discussion of changing deployment for the Guard?
General Lowenberg. There is a very active discussion. The
focus is on shortening the ground time for Army Reserves and
Guardsmen to something less than 12 months, and something in
the neighborhood of 9 months is the short-term goal. In
combination with that, the Army's deployment process needs to
be modernized and timelines shortened. Right now, to have boots
on the ground requires an 18-month commitment on the part of
the soldiers, and nearly all of that is on the front end
getting them ready to deploy.
So recognizing we have to transition from a strategic
reserve to an operational reserve national military strategy
means, that we need to invest the resources in health care, and
in training the soldiers and in helping the soldiers so that
they are closer to ready for deployment as they reach that 5th
or 6th year force rotation model. If we do that and reduce the
down time, then we have a more sustainable force, and I think a
more ready and sustainable family force.
Predictability is the key, whether it is a 12-month
rotation cycle, 9-month rotation cycle or shorter. If families
know that a commitment to public service and military service--
what that cycle will be--they can adjust their lives to that
cycle.
Senator Murray. I think it is an important discussion,
because I talked to one soldier in the Tri-Cities who was
literally gone for 18 months, gone from his wife and children
for 18 months, and stayed at home for 2 weeks feeling like a
visitor in his own home. Now he is really struggling with
family relationships. And we have heard from many, many
families, and I think we need to have a serious discussion if
this is going to be in the future about how Guard and Reserve
are deployed because of the tremendous impact on families.
General Lowenberg. I couldn't agree more. We had an entire
Transportation Company from Ephrata that was extended in
theater twice. They stayed substantially longer. So a lot
depends on the military occupational specialty and the mission
involved.
Senator Murray. And this will have an impact on veterans
because a number of the soldiers returning and the services
they require are measurably increasing, is that right?
General Lowenberg. It goes back to that earlier, that if
that transitional assistance was made available while they were
in theater reaching--you know including months of their
activation, and to continue up to a year after they came back,
it provides for a more stable and sustainable transition for
the veteran and their family.
Senator Murray. Thank you very much. I am sorry our time is
up for this panel. But I really appreciate all of your input.
I would like to invite our second panel. As they are coming
forward, I am going to introduce our second panel. Specialist
Blaine Miles Hall of the Washington Army National Guard from
Moses Lake, Washington; Staff Sergeant Kevin Romanelli who
recently retired from the Army and lives in East Wenatchee,
Washington. We have Crystal Hampton. She is an Army veteran
from Vancouver, Washington who served in Afghanistan; and First
Sergeant Robert Kauder from the Washington Army National Guard
who joins us from Spokane.
Thank you all for joining us again. As I said in my opening
remarks, I particularly appreciate all of you for coming
forward, and for having the courage to come forward and speak
about personal matters. I know it is not easy. I really
appreciate all of you being here today.
With that, Specialist Hall, we will begin with you.
STATEMENT OF SPECIALIST BLAINE MILES HALL, WASHINGTON ARMY
NATIONAL GUARD
Specialist Hall. I would like to say that I am proud to be
in the Washington Army National Guard. And I understand the
possibility for deployment can occur at any time with no
notice, and it is our responsibility to be up and ready for
that deployment. We are told that when we come in.
I heard a lot of positives up here on the panel, but the
problems that the soldiers that I have dealt with and myself
have dealt with, is not in what is available. It is how it is
available to us. It is how the programs that you have heard in
the legislature are actually practically applied.
The SBA, Small Business Association, has a disaster relief
program for National Guard Reserve small business owners that
are being deployed. The program itself is a great program, but
the process isn't failsafe. To prevent people from abusing it,
the regulation in place is making it almost impossible for
soldiers to use it.
The first step says that you need a copy of your orders to
start receiving those funds. You don't receive your orders, and
as a business owner you need that money up front to train, hire
and go over the costs for your business. And a lot of people
think that is a benefit. It is a loan. You are also paying that
back. So it is not like you are getting a hand me down even.
You are paying that back and you are paying it back with a
marginal interest rate at that.
But to begin the process you need to have orders and they
won't start without it. Once you have orders, your boots are on
the ground, and you are training with your troops and you can't
focus on your business anymore. You have to make a decision
then whether you are closing your business or keeping it open
hoping that the loan comes through. Soldiers don't have faith
in those Government programs to let their affairs run like
that.
The second thing is you never will know when you are going
to be deployed, but at least in our instance we were told a
couple of times the deployment was happening and you are to
stand down. Deployment is happening. Stand down. If a warning
letter comes from the Department of the Army saying they are
planning to activate, if they could get the funds available
right away it will really help keep some soldiers--their
financial levels and get the program started.
For instance, the Soldiers Relief Act again requires that
you have orders, but once you have those orders you can't be
calling your creditors, your agencies, because you are already
in Fort Lewis. You are training, you are going through what you
need to focus on--the war at that time. Your time to focus on
your family, business and financing is over. The time you have
left to focus on your business is that 1 month when they tell
you are going to be activated. If you don't have those funds
and resources available to you at that point, you are just
sitting there in the water knowing that there are these
programs available, but you can't use them.
The SBA Disaster Relief Program is not a disaster relief
program. It is more of a credit-rating based. It is still a
loan process. It is still the Government telling you whether
your business needs better criteria. I think the only criteria
for a loan or disaster relief should be that you are a soldier
and that you have a business that is going to be impacted after
your deployment.
When I applied for a loan I didn't have tax documentation.
My business has not been open for 2 years, so I couldn't use
the program. I was also told that anyone who opens a business
can determine through ESP whether your profit and loss
statements--whether they are working or not. My profit and loss
statements don't look profitable in their eyes. My business has
only been open for 2 years and, of course, it is not making a
lot of money. My credit has been overextended in that business
and I would lose a lot if I closed.
It just seems to me that these programs are said to worry
more about abuse than to actually help the deploying soldiers.
Can't they remember that we are soldiers? I mean, that you are
going to get your money. It is the Government. You know, the
Soldier Relief Act is a great relief Act, but it doesn't allow
for--there is no enforcement of it. If a company doesn't apply
for the Soldiers Relief Act, what is there to offer them? There
isn't. But the whole time we are sitting in Iraq we are ruining
our credit rating. Thank you.
[The prepared statement of Specialist Hall follows:]
Prepared Statement of Specialist Blaine Miles Hall, Washington Army
National Guard
deployment issues as they pertain to small business
Intro: I would like to start off by saying that I am proud to be in
the Washington Army National Guard and I understand the possibility for
deployment can occur at anytime with little notice, and that it is our
responsibility to keep our households and business' ready for
deployment while we are members of the Washington Army National Guard.
While I don't want to focus on the situation that occurred with me
personally, I would like to focus more on the program problems
themselves, below you will find a brief outline of my situation, the
problems that I have found with the programs and the solutions I see
available to make the legislature already passed a success.
Personal Story: Opened my business in November of 2002. My business
was turning a profit, though minimal till I was forced to close it in
October of 2003. In May of 2003 we received notice from our command
group that we would be deploying to Iraq within 90 days and that orders
would be sent to us within a week or 2. Upon this notice I contacted
the SBA Disaster relief program to start applying for a loan. I found
out that I cannot start the process until I receive orders. Knowing the
extensive training I was going to have to give the person I hire to
replace me, I spent my own funds to find, hire, and train an employee
to handle my business while I was deployed. Word came down from my
commander at the end of June that we were no longer being deployed. I
had to lay off my employee and continued to struggle with all the money
I had spent coming out of my own pocket. In October of 2003 we were
again told that we would be deploying to Iraq in November, with no
money left to hire and train yet another employee and the SBA unwilling
to work with me until I had orders (they did not arrive in my hand
until December 2nd 2003). I was forced to close my business and file
for bankruptcy.
The Problem: The Disaster program is a great program that needs to
be loosened to accommodate the army way of functioning. Soldiers often
do not receive their orders until after a deployment starts and this
does not allow a business to fund the larger costs of deployment that
occur at the very onset. The soldiers and Sailors relief act that
allows for soldiers to opt out of leases and drop interest rates down
to 6 percent has no enforcement structure to enforce that lending and
leasing agencies actually agree to comply. The SBA loan process allows
for you to apply for the loan after you have been activated but will
not offer a loan to you if you closed your business during the
deployment. The SBA is also Credit Rating based, which means your
business may be financial profitable but if the SBA determines that you
are over extended, your business has not been open for 2 years, your
type of business does not offer the collateral necessary to cover the
loan, or have negative credit they will decline you for a loan. It
seems to me that there is more of a worry that the system will be
abused than there is a worry to actually help the deploying soldiers.
Why can we allow these troops to go risk their lives, but cannot in-
trust them to keep their business alive for when they get back? Does it
make sense to set rules that hinder much needed aid to soldiers in the
fear that one or two might abuse the system?
Suggestion for Solution: Allow soldiers access to the loan process
before they are ordered to active duty, there should be a warning
order, or letter of deployment issued by the army that will suffice for
the SBA to allow the release of funds while the troops are still home
side and able to use the money to benefit their business. This program
should not be based on Credit Ratings or any other means other than the
needs of the individual business and soldier. Remember that soldiers
are government employees and that any abuse of this program can be
deducted from their pay or taxes. Create a penalty program for any
company that does not wish to comply with the Soldiers and Sailors
relief act, it is incredibly easy for companies to negatively effect
your credit report (especially while you are fighting a war over seas
and unable to check it) but it is impossible to fix the damage once it
has been caused, and with no Governmental help.
Senator Murray. Thank you very much.
Staff Sergeant Romanelli.
STATEMENT OF STAFF SERGEANT KEVIN ROMANELLI (RET.),
U.S. ARMY
Sergeant Romanelli. Thank you for allowing me to speak.
Again, I apologize if some of it is negative. I retired in
February of 2005 after 26 years in service. I have got a combat
star as a reservist in Bosnia, Kosovo, Afghanistan. I was home
for 3 months and joined up with the unit to go to Iraq. When I
got injured here at Fort Lewis, I encountered a lot of
problems. One of them, the medical hold. I met a lot of
soldiers from Washington and found out that our common problem
is it is taking a little longer to get the care that we need
and it is putting a financial burden on us.
It is to the point where, I have three little girls, I
couldn't do anything for their birthdays. My vehicle was
repossessed. I tried to call these agencies to get answers, and
I couldn't get them. That is what a lot of the soldiers are
having a hard time with, Senator. And I would like my written
statement put on the record, please.
[The prepared statement of Staff Sergeant Romanelli
follows:]
Prepared Statement of Staff Sergeant Kevin Romanelli (Ret.), U.S. Army
Good morning, Senator Murray. Thank you for inviting me to speak to
you today on my behalf, and on behalf of fellow veterans who have faced
challenges since their return from Afghanistan and Iraq. I will share
my experiences with you in the hope that you will use that information
to improve our transitions into civilian life.
My name is Kevin Michael Romanelli Staff Sergeant (E-6), United
States Army, Retired. I served a total of 26 years in the Army and
Washington State National Guard. During that time I served two tours in
Kosovo, and one tour in Afghanistan. I volunteered to go to Iraq;
however, I was found non-deployable because of my medical condition.
On 3 February 2005 I was placed on the Temporary Disability Retired
List (TDRL) after the Medical Evaluation Board (MEB) at Madigan Army
Medical Center determined that I was 30 percent disabled.
The Medical Evaluation Board determined that I would only receive
disabililty ratings for a fraction of my diagnosed medical conditions.
I received a 20 percent rating for my spinal conditions (upper right
extremity pain and weakness impinging at C-7 nerve group; herniated
disc at C-6 and C-7; and C-6 pinching spinal cord at C-5 and C-6), and
10 percent for my neck condition (neck pain and restricted motion with
insidious onset during AD tour image shows large herniating at C-6-7),
for a combined rating of 30 percent.
I also have severe migraine headaches, chest wall lipoma,
hypertension and hyerlipidemia. The Medical Evaluation Board determined
that those conditions met retention standards, they did not award me a
disability rating for them. During the time I was going through the
Army's Medical Evaluation Board process I was told to wait until that
process was complete before I filed my VA claim. If I had been able to
submit the claim during my MEB process I would have received my VA
disability rating when I was transferred to the TRDL list, which would
have eliminated the hardships that my family and I have experienced.
I have a claim pending with the Department of Veterans Affairs. I
am seeking service connection for 13 separate conditions. I was
diagnosed with all these conditions while serving on active duty. They
include: PTSD, bilateral degenerative joint disease in my knees,
hearing loss, tinnitus, and problems with my eyesight--which are
residuals of an episode of Bells Palsy, herniated discs, limited range
of motion of my neck, hyerlipidemia, hypertension, migraine headaches,
acid reflux and a hiatal hernia. My compensation and pension exams were
conducted by QTC. They referred me to three healthcare providers for
tests and examinations.
I am receiving bills from the places that QTC referred me to
telling me that my bills are past due. I inform them that the VA is
responsible for the bill. QTC sent me to doctor in Moses Lake who
conducted a separate examination, he conducted an upper GI it revealed
that I have acid reflux and a hiatal hernia. The doctor did not have my
medical information when he conducted the exam. QTC sent me a letter
informing me not to bring my medical records because the VA would send
the appropriate medical records to the examining physician before the
exam. All they sent him was a questionnaire. I brought my own medical
records, despite their letter. This gave the doctor something to go by
otherwise he would have had nothing. QTC also sent me to Wenatchee
Valley Medical Center for x-rays. Wenatchee Valley had not been
notified that I was coming. If I had not brought my referral slip the
x-rays would not have been taken. I am being billed for $66.75; the
bill is due on August 6, 2005. QTC also sent me to Chelan-Douglas
Behavioral Health Clinic for my PTSD examination. (I have combat tours
going back to 1999, Bosnia, Kosovo and in 2002 Afghanistan at Bagram
Airfield.) I arrived there 20 April 02 to 16 October 02.
I applied for Social Security disability and my claim was denied.
They said that my claim was denied because they were unable to get my
medical record. They requested information from the VA, from the
physician Dr. Quinn where I referred by QTC and Valley Medical, no
reports were received so my claim was denied. The denial that although
SSA realizes that I cannot do the jobs I had done previously, because
of my age, education and past work experience I could do other work. My
previous work experience is as a firefighter, a Police officer and a
heavy equipment operator. With all the pain medication I am taking, how
could I work in this condition?
The most difficult thing for me is the hardship that has been
imposed on my family. We are living on $300 per month. My car, bed,
washer and dryer have been repossessed. When I was on active duty my
basic pay and VHA came to $4000 per month. Now, I receive 50 percent of
my basic pay. My family of five is living on $1300 per month. My rent
is $1000 per month, so my family is actually living on $300 per month.
While waiting for my VA and Social Security disability claims to be
processed I had to seek financial assistance VFW and the American
Legion with rent and bills. I am constantly contacted by bill
collectors who want to know when I will be able to pay them. When I
contact the VA 800 number to find out how long it will take to process
my claim, so that I have something to tell the bill collectors, I am
told that I need to contact them in writing. I need the help now.
There are many veterans living in the same situation that I am in.
I hope that something can be done to help them. Another sergeant I know
was discharged on November 20th. He was wounded in Iraq and is a purple
heart recipient. His claim still is pending. On Friday he was just
notified by QTC that his compensation and pension examination
appointments have been scheduled.
Other soldiers were not able to endure the challenges and
uncertainty they experience when they come home. Three soldiers from my
platoon have committed suicide after they were separated. One of them,
one individual lost his home, his wife left him and his vehicle was
repossessed. He did not have anywhere to turn. He was trying to get
answers and he couldn't get any. I learned about his death through a
former platoon member.
When I came back from Kosovo, I was contacted by a VA rep
immediately. He wants to know how I was doing and offered support from
the VA. Unfortunately, I did not have the same experience after I was
put on TDRL. I had no contact with anyone after the MEB. I attended a
general VA briefing; however, no one followed up with me. When I out
processed they sent me to Ora Robe from AMVETS. She helped me filled
out the 21-526 on 17 March. I was notified about my first compensation
and pension appointment 23 May 2005. I had to wait for payday. Then I
returned and filed the claim through AMVETS.
Things began to look up for me after I received a letter from the
Governor who informed me about the services available to me. I called
for help. Tom Riggs called me back and he has been helping me ever
since. He is working with me on my claim, he has resolved my
prescription medication issues. A lot of my problems have been resolved
in the last couple of weeks than in the entire time that I have been
out there doing it myself.
Thank you again, for giving me the opportunity to testify.
Senator Murray. Thank you, Sergeant. We will put that as
part of your written statement. I will have a chance to ask you
some questions in a few minutes. Thank you very much.
Ms. Hampton.
STATEMENT OF CRYSTAL HAMPTON, VETERAN, U.S. ARMY
Ms. Hampton. Hello, ladies and gentlemen, directors. My
name is Crystal Hampton. I am 26 years old from Vancouver,
Washington. I served 6 years on active duty in the United
States Army as a CH 26 Delta crew chief. My first duty
assignment was at Charlie Company 159th in Fort Bragg, North
Carolina. Then to Bravo second aviation in Korea where I spent
2 years, and 3 months of it in a hospital in Seoul, after I was
hit by an odeshi, by an AHAR [phon]. Then I went to K 159
aviation, where I was deployed for 7 months to Kandahar,
Afghanistan in support of Enduring Freedom.
I had various assignments while I was there. I was section
sergeant in charge of nine soldiers. I was confined to the fuel
cell mostly because I was the smallest person to fit into the
cell. I was also the downed aircraft recovery team leader. So I
was a very busy girl when I was there.
However, I want to tell you all that I loved my job, and
serving in the military was the greatest thing that I have ever
done. I was honorably discharged with a rank of corporal in
September 2004. Now, when you are about to leave the Army you
are sent to ACAP classes. Unfortunately, I don't remember what
that stands for, but that is what you have. ACAP is where the
active duty servicemembers are taught how to be a civilian
again. You are sent to various different classes where you have
to learn to write a resume, and you go to job interviews and
you get a 30-minute block of instruction on the VA.
I did not know anything about the VA. I learned a little
bit about the VA loan. Nothing that really helped me. I did not
know that I could receive benefits. None of that. The only
reason I found that out was because Bob Cruze happened to be at
my parents' shop one day.
Now, thinking about this, I asked my fiance who is on
active duty in Iraq right now, Staff Sergeant Luke, and he
didn't know anything about the VA. And he has been in the
service for 13 years. So he asked his officers and a few other
enlisted, and they didn't know about it. However, they are very
excited that this opportunity will be accorded to them, but
still it doesn't help them.
My point is that servicemembers coming back from war, a lot
of times, are not aware of the benefits they can receive. And
if we can find a way to inform these future veterans of what
they are entitled to, it would be better for them.
Lucky for me, Bob found me and my personal transition to
the VA was a very good one. The people are fantastic. Being in
the military is a physically and emotionally demanding job.
Being a petite female with a displaced kneecap from running--
some of us aren't meant to run unfortunately--tendinitis in my
wrist from turning wrenches and from push-ups, and some hearing
loss due to working on helicopters for many years.
The VA has done a wonderful job trying to accommodate me
and my injuries. However, I feel that with more resources they
would have an easier time processing these things. A few more
reasons--like a veteran Ob-Gyn for females down in Vancouver.
That would be great. Also they would be able to process
paperwork, and processing soldiers like myself would be
quicker.
Finally, I feel that college grants for vets returning home
or for the spouses of stable vets would be a considerable help.
It occurred to me now that I am out, that I do not know how to
do anything but work on helicopters. I remember all of it like
it was yesterday.
Granted that it is a good paying job in the civilian world,
I still don't want it and I can't physically do that for the
rest of my life. If I have no skills, I am sure that there are
other soldiers who are in the same boat as I am. And the
spouses of the disabled veterans who have become the primary
breadwinners of their family, if they had training or more
college education to get a better paying job or find a job that
would be available to them, the stress that would be lifted off
their shoulders would be amazing.
In closing, I feel the Veterans' Administration has done a
world of good for those who know about it. With a few more
resources, what they could do would be unbelievable. Thank you
all for your time.
[The prepared statement of Ms. Hampton follows:]
Prepared Statement of Crystal Hampton, Veteran, U.S. Army
Hello Ladies and Gentlemen.
My Name is Crystal Hamtpon. I am 26 years old and from Vancouver,
WA. I served 6 years in the U.S. Army as a CH47D or`` Chinook''
Helicopter Crew Chief. My First Duty assignment was at C159th Avn at
Ft. Bragg, NC. Then to Bco 2/52 Avn in Camp Humphrey, Korea, where I
spent 2 Years and 3 days in a military hospital after being ran over by
and odeshi. Then to K159th Avn at Hunter Army Airfield in Savannah, GA
where I was then deployed to Kandahar, Afghanistan in support of
Operation Enduring Freedom 3. Home of foot long camel spiders. While in
the desert I had various duty assignments including Section Sergeant in
charge of 9 soldiers. Phase Team Leader (a phase is a period of 200 hrs
at the end of which the helicopter is give a maintenance overhaul. This
usually takes 20 days and costs approximately $5 million). I was also
the Confined Space and Fuel Cell Repair team leader and Downed Aircraft
Recovery Team Leader. I was a busy girl. However, I want to tell you I
did love my job and serving in the Army was the best thing I have ever
done. I reached the rank of Corporal and was honorably discharged in
September of 2004.
When you are about to leave the Army you are sent to ACAP classes,
(sorry I don't remember what that stands for). Acap is where they teach
you to be a civilian again. They teach you things like how to write a
resume and job interview skills, and finally about your VA benefits. I
received a 30 min block of instruction about the VA which mostly
covered the VA Loan. I did NOT learn anything. I did not know I was
entitled to anything. I would not have known of the benefits if it had
not been for Bob Cruze coming through my parent's oil change shop. So
basically it's by random chance I have benefits.
Now thinking about this. I asked my fiance SSG David Luke, Who is
in Iraq at this time. David didn't know anything about VA and he's been
in for 13 years. So he asked some of his officers and a few enlisted,
and they didn't know. They were excited and relieved to hear that they
were entitled to some benefits. My point is that the men and women
coming back from war and serving our country are not aware of the VA,
and what it does. We need to find a way to inform these future
veterans, of what they are entitled to. Lucky for me Bob found me and
made my personal transition to the VA Medical system as easy as
possible.
Being in the military is a physically and emotionally demanding
job. Being a petite female in a predominately man's job definitely took
its toll on me. I have a displaced kneecap from the running. Some of us
were not meant to run. I have tendonitis in my wrists from turning
wrenches and from push-ups and some hearing loss from working on the
helicopters for 6 years. The VA has done a wonderful job trying to
accommodate me and care for my afflictions considering the number of
veterans they serve and the amount of resources they have. I feel with
more resources (like better O/GYN and women's services for example)
they could do their job better and more efficiently. They also would be
able to process paperwork with more ease. So the claims for former
soldiers like myself would go a little quicker.
Finally I think that career training or college grants for the Vets
returning home and for spouses of disabled veterans would be of
considerable help. It occurs to me now that I'm out, I don't know how
to do anything but work on helicopters.
Granted that it is a good job in the civilian world, but I don't
want it, and physically, I can't do that for the rest of my life. And
if I have no skills, I'm sure there are many other Veterans like me.
Also the spouses of disabled vets who have now become the primary
breadwinners, if they were given the opportunity to go to school or get
a better job with a little training so they could make more money to
support their family, they would be less stressed. In closing the
Veterans Administration does a world of good for those who know about
it. With more resources the things they could do would be unbelievable.
Thank you all for your time.
Senator Murray. Thank you very much.
First Sergeant Robert Kauder.
STATEMENT OF SERGEANT ROBERT KAUDER,
WASHINGTON ARMY NATIONAL GUARD
Sergeant Kauder. Good morning, Senator Murray,
distinguished members of the audience. First of all, since this
is for the record I do need to point out I appreciate the
promotion, but actually I am just a sergeant.
Senator Murray. I can't do that for you?
Sergeant Kauder. Having returned recently from a tour in
Iraq, one thing that has struck me is on every squad patrol I
would meet with my squad and squad leader before we go outside
the wire. We would get together in a circle and we would talk,
and I would let them know two things. That no matter what
happens once we roll outside the gate that everyone would come
home dead or alive, and no one would get left behind.
The reason why I am here today, as I was in May when we met
for the first time in Spokane, is I am concerned now that I am
no longer in a position to provide for their care and training
that my soldiers are getting left behind. Soldiers have been
coming home with a variety of feelings, but two of the primary
feelings that they have are guilt and shame. When I say,
``guilt,'' what I am referring to is survivor's guilt.
My platoon sustained several casualties. One of the men in
my squad was killed in action in a firefight on July 9, 2004.
It goes without saying that several battle casualties and non-
battle casualties are forcing some soldiers to rotate home, and
be put on med hold and be put through surgeries. For the
soldiers who didn't get wounded but stayed behind, there is the
traditional guilt that any soldier can attest to. Why was it
that person and not myself?
The other thing they are experiencing is shame. Shame over
having this emotional trauma, post-traumatic stress disorder.
Where a soldier who has been shot or has experienced some sort
of physical trauma can be treated with surgery, someone who
witnesses that or is experiencing survivor's guilt, there's no
Band-Aid. There is no surgery. There is no miracle pill that
can cause them to stop feeling this way.
In my experience, there are two types of soldiers. They are
either going to face their fears, face the problems that they
are having, the sleepless nights, the anger, the frustration
that they are experiencing or they are not. And they are going
to turn inward. This is the dilemma that we are going to face
when dealing with the VA, the soldiers that seek treatment are
going to get it. The soldiers that are not seeking treatment
are going to turn to alcohol, turn to illicit drugs, and their
relationships are going to fail. This is similar to what we saw
in Vietnam.
What we need to do is have them think out of the box. Get
away from what I call the bottom mentality. We need to get away
from the facilities and out into the field. We need to have
more outreach programs to address issues, particularly in North
Central Washington. Reach out to those people, get to the
armories and address these situations, and address these
concerns the soldiers have before it gets too big and we get
into a situation like we were faced with Vietnam veterans who
became disenfranchised. We have the resources. We need to use
those resources to the best of our abilities to reach out to
veterans. Thank you.
[The prepared statement of Sergeant Kauder follows:]
Prepared Statement of Sergeant Robert Kauder, Washington Army
National Guard
My name is Rob Kauder and I present this testimony today not as a
National Guardsman but as a veteran with nearly two decades of service
to his country. My comments and concerns presented here reflect my
experiences in the process of demobilization and reintegration,
attempting to leave the Guard as a soldier on stop-loss and the
challenges soldiers face with processing claims through the Department
of Veterans Affairs. The opinions expressed in this testimony are mine
alone and should not be construed as an official position made by a
National Guardsman.
I am currently a news producer for a television station in Spokane,
Washington, but for the better part of the last 18 years I have also
served in the Armed Forces in varying capacities. Following graduation
from high school in 1987 I enlisted in the United States Marine Corps,
where I served on active duty for 6 years. During my enlistment I
participated in Operations Desert Shield, Desert Storm, the United
Nations Mission to Somalia (UNOSOM) and two counter-narcotics missions
along the US-Mexican border with Joint Task Force-Six.
After my honorable discharge from the Marines I went to college in
Ellensburg and joined the Marine Reserves and served 3 years. In 1998 I
joined the Army National Guard and have served in Charlie Company, 1st
Battalion, 161st Infantry for the better part of the last 7 years.
During the last year-and-a-half I have served on active duty with my
Guard unit as part of the general mobilization of the Washington Army
National Guard's 81st Brigade in November of 2003.
During the last year I served as an infantry squad leader and
participated in full-spectrum stability and support operations in and
around the Green Zone in Baghdad, Iraq with my unit, which was attached
to the 1st Cavalry Division out of Fort Hood, TX. I returned from the
theater of operations on March 1st, 2005 to begin my reintegration back
to civilian life.
I wish I could come to you today and tell you the reintegration of
myself and fellow members of my unit has gone smoothly; the reality is
that a number of men in my platoon are struggling to come to grips with
their adjustment from the combat zone to the homefront. Several men
have left long-term relationships or are going through divorces; others
have not adjusted emotionally to a world where they don't have to be on
a near-constant state of alert, ready for attack from any quarter at
any moment. At least one soldier, offered a lucrative tax-free
contract, has gone back to Iraq with a private security firm; several
others, struggling to cope with life back home are considering
volunteering to go back to Iraq as well.
On the surface, the demobilization process went fairly quickly and
smoothly upon our return from Southwest Asia to Fort Lewis. After our
aircraft touched down at McChord Air Force Base, we were given a flurry
of briefings before being allowed to leave with our loved ones for 3
days of rest and recuperation before beginning the demobilization.
For the majority of the men the demobilization process took
approximately 5 days. During outprocessing soldiers are given a variety
of briefings including discussions about a myriad of support networks
and programs available through the Department of Veteran's Affairs, but
to be honest the briefings were nothing but a hazy blur. I paid
attention to nothing more than checking each box on the outprocessing
sheet and checking my watch to see how much time was left before we
would be done and out of the Army.
It wasn't that the information wasn't important to myself or any of
the other men; it was just that the overriding concern among those in
attendance was to be done with the whole process, be done with the
seemingly never-ending red tape, be done with the active duty military
and be back home in the civilian world.
I would sum up the demobilization phase with a comment made by one
of our instructors at Fort Irwin prior to our deployment to Iraq. He
said once that war is controlled chaos and Americans thrive at war
because we practice controlled chaos on a daily basis. Following his
reasoning then soldiers must also thrive on outprocessing as well.
After outprocessing, the soldiers of Charlie Company were told to
return back to their respective platoon armories in Wenatchee, Spokane
and Moses Lake. For some reason, there was an assumption that each
soldier had their personal vehicles to drive to their home armories
from Fort Lewis so no Government transport had been arranged. As a
result soldiers had to arrange for their own transportation for
themselves and their equipment from the demobilizationsite to their
respective armories.
Upon our platoon's return to the National Guard Armory in Moses
Lake we were told that 5th Army had mandated that we were to stay at
the armory for 2 days; there was however, no plan from what I could
ascertain as to what exactly we were supposed to do during this period
other than have friends, family and community members come to the
armory for an open house. From the perspective of the enlisted man, we
had finished our demobilization and had been told we were to spend two
more days at our home armories with no tangible agenda other than to
spend 2 days at our armories.
At every other phase of our deployment while under Federal orders
we had been provided food and lodging; for some reason when we returned
to Moses Lake there was no contingency for providing either for the
soldiers, which proved inconvenient for those men who did not live in
the immediate vicinity particularly when we were told that since we
were under Federal orders we were not allowed to stay in the armory.
As I am writing this I realize that this week marks the 1-year
anniversary of my original end-of-active-service (EAS) date; like
numerous other soldiers, I was placed on stop-loss prior to our
deployment. As I look at today's date I also realize that it has been
almost 5 months since I returned from the combat zone and yet to this
day, technically, I am still in the Washington Army National Guard,
even though I had been under the assumption that all stop-loss
personnel would be released from their National Guard service 90 days
after their release from Federal service. I was released from active
duty in the first week of March and finished terminal leave the first
week in April, which would mean that the 90-day period would have
expired the first week in July.
Here's where the situation gets confusing.
I talked to a soldier at the armory in Moses Lake and was told that
I was mistaken; all soldiers including those that were on stop-loss
were required to attend the next regularly scheduled drill weekend near
the end of August which, for reference, would be almost 6 months
following our release from active duty (REFRAD). It was made clear to
me that any soldier that did not show up for this important drill
weekend--which would include an award ceremony and a picnic--would be
designated AWOL.
I took the matter up with the battalion S1 (Administration) office
at Geiger Field near Spokane and it was explained to me by the non-
commissioned officer on duty that the 90-day period for stop-loss
personnel was incorrect; all soldiers had been extended--according to
their orders for Federal duty--through 2031, and stop-lossed soldiers
awaiting release from Guard service would be released when the
paperwork was completed. No date was given as to when that would take
place.
So then I talked with my former platoon sergeant and he explained
in detail that any soldier that was on stop-loss had to be released at
the end of the 90-day period as long as they turned in all of their
military equipment and the paperwork was finished. After talking with
him I spoke with another soldier who I served with overseas who
confirmed that according to my records my end of active service (EAS)
date had been July 10th.
My concerns about this situation are several. Over the last 5
months, the National Guard Bureau has seen fit to send multiple
mailings to my home filled with messages highlighting different
programs to help with reintegration for soldiers and their families,
messages of congratulations from various officials, and yet in the 4
months since I finished terminal leave there has not been one letter
explaining the final procedure for stop-loss personnel outprocessing
out of the National Guard.
I have taken the initiative and inquired about the procedure I have
been given several contradictory stories as to what the procedure is
for stop-loss personnel leaving the Guard and when I would be released
from stop-loss. It was only through contacting someone outside my
chain-of-command that I was able to ascertain my EAS date; nobody
within my chain-of-command was able to give me a straight answer as to
when I would be released from service. In summary, I would say that I
have fulfilled my active duty obligation and received an honorable
discharge for that service and now I am curious as to when exactly I
will no longer be contractually obligated to the National Guard.
After returning home and beginning my readjustment back to civilian
life I found myself experiencing varying degrees of anger, frustration
and stress. I've had difficulty sleeping and have experienced bouts of
insomnia, night sweats, tossing and turning in my sleep, shouting while
sleeping and on occasion woken up to the sound of incoming mortars that
weren't there. I've had a hard time relaxing and have found myself
going on-alert in an instant, my internal fight-or-flight mechanism
triggered by the sound of a passing helicopter, a back-firing car or
even the smell of diesel fuel.
I realize that no man is an island, and took action to contact the
VA and begin receiving treatment for what has been diagnosed as post-
traumatic stress disorder. While I took that step to get help, many of
my brothers-in-arms have not. Living in backwater communities across
eastern Washington, access to VA medical care isn't as easy for some
soldiers as it is for those of us that live within close proximity of
the handful of VA clinics across the State.
The other thing to keep in mind when it comes to the VA is the
feelings of the individual soldier, which can be summarized in two
words: shame and guilt. Many soldiers I have served with are suffering
in silence, unwilling to admit they are having a hard time coping with
life back in the States. To admit they cannot cope on their own would
be an admission of weakness to some of them. They would rather turn to
alcohol or turn inwards and away from friends and family, reaching out
only to their fellow soldiers who have ``been there and done that'' as
they would be the only ones who could fully grasp the nature of their
hidden pain.
Some soldiers I have observed also live with a lingering sense of
survivor's guilt; our infantry company suffered several casualties,
including two soldiers killed and a half dozen or so wounded and
injured. While the numbers of killed and wounded among our ranks are a
pittance compared to, say, an infantry company on D-Day in Normandy,
the relatively light numbers of wounded and dead doesn't lessen the
emotional trauma these men feel.
Unfortunately, I cannot offer any realistic solution as to what the
VA can do to help these soldiers. They have to want to reach out for
help, to take that first step like I did, in order to get back on the
path to sound mental and emotional health.
The VA right now does not have, in my opinion, an adequate outreach
program to meet the needs of all of the veterans in eastern Washington
returning home from Iraq and Afghanistan. The major facilities that are
available--one in Walla Walla and the other in Spokane--are hundreds of
miles away from where some soldiers live, making it difficult for them
to schedule regular appointments to receive treatment. For example,
while there are outreach clinics in Richland and Yakima, there is no VA
support to population centers such as Moses Lake or Wenatchee. This
means soldiers living in those areas have to travel to Seattle, Yakima,
Richland or Spokane to receive treatment.
The problem with this is the VA, like the military, requires
extensive inprocessing in order to get enrolled. It took me three
visits over a period of a month to get enrolled in the VA and another
two visits before I met with a clinician that could prescribe
medications to help curb the effects of PTSD. Five hospital visits over
a 6-week period before I could receive medication isn't really
problematic for me since I live 10 miles from the VA Medical Center in
Spokane.
For a soldier in Wenatchee, however, that becomes a 2\1/2\-hour
drive one-way for a 30-minute appointment. When you take into account
that round trip time, multiplied over time with the number of
appointments a veteran needs in order to enroll and begin receiving
treatment you'll find that it can be extremely prohibitive for soldiers
living in north central Washington to receive adequate medical
treatment.
In the years since PTSD was first confirmed as an ailment suffered
by veterans--and traced back to battle fatigue (World War II) and shell
shock (World War I)--there have been numerous advances in treatment and
medications to support veterans returning from combat. While the VA
provides a wealth of resources, there are many other opportunities that
veterans can take advantage of to help them reintegrate back into
mainstream society they may not be aware of.
For example, soldiers of Native American descent could have
opportunities to participate in spiritual cleansing in tribal sweat
lodges; two soldiers in my platoon were Native Americans and did this
upon their return home from Iraq. Through my work as a TV news producer
I've also become familiar with the owners of Hidden Creek Ranch, a
North Idaho camp run by John Muir (a direct descendent of the famous
naturalist) and his wife Iris. They have been running special week-long
programs through their non-profit foundation to support relatives of
victims of 9-11 since 2001; recent attempts to reach out to the
military to help support family members of Iraq casualties in a similar
fashion have been rebuffed by the military.
I use these two examples to highlight the fact that there are other
opportunities that exist outside the VA to support veterans and their
families, and would say that looking into programs like these and
others that exist outside the DoD and the VA and informing soldiers of
their existence can only help them in their search for resources to
help them reintegrate back into society.
Many soldiers that I served with have come home frustrated and
disillusioned; while a handful, lured by the opportunity of tax-free
bonuses, have re-enlisted in the National Guard, many that I served
with have taken off their packs, so to speak, and are done. Several
soldiers, myself included, have decided to end their careers with the
Guard while others who have time left in their service contracts plan
to get out at the soonest opportunity.
The average enlisted man feels shortchanged and harbors resentment
toward the military for what has been done and what has been left
undone. Many I have spoken with look at the camaraderie between the
enlisted men as their only source of pride when it comes to our tour in
Iraq; there is little if any esprit de corps for the National Guard or
the Army in general. They've received the various blanket-awarded
trinkets, hardy handshakes and thanks from a number of various,
anonymous staff officers within the Guard and yet still feel cheated.
In general the average enlisted man probably isn't as well-educated
as the average officer, but that doesn't mean that these soldiers don't
understand the world they operated in. They lament about how at times
the Army in general seems more concerned with force-protection or
polishing its image than accomplishing the mission or troop welfare.
These soldiers survived a season in hell fighting unseen enemies
and coping with life encamped in a foreign capital as part of an
occupying army. Despite the hardships of life in the combat zone, these
men were adequately equipped due in no small part to the billions of
dollars spent to keep our armed forces battle-ready in Iraq. But now
they've come home and don't have the same level of support they did
when they were in-country.
Unfortunately for these soldiers, the war hasn't ended yet, and the
Federal Government has an obligation to each of these men and women to
give them the same amount of care through the VA as they did through
the Army.
Therefore it is our obligation as a Nation, in order to prevent
another generation of returning war veterans from growing disillusioned
with our country, to reach out not with parades, trinkets and
handshakes but with quality medical care and adequate funding for the
VA to respond to the requests for treatment from the thousands of war
veterans returning from Iraq and Afghanistan.
Respectfully Submitted, Rob Kauder.
Senator Murray. Thank you very much. I appreciate all of
your testimony and I have questions that I would like to engage
you on. I want to start with Specialist Hall.
In your written testimony you talked about your business
that you had that you lost subsequently because of the lack of
services, and it is very compelling and I appreciate that.
Another issue that I have heard a lot about are pay issues from
Guard and Reserve members, especially about the Department of
Defense's inability to pay some soldiers while they are
deployed.
Is this something you have experienced or anybody that you
know has experienced?
Specialist Hall. When we first started deployment, we had
two soldiers in my squad who did not receive pay for 3 months.
Senator Murray. Who did not?
Specialist Hall. For 3 months. I don't know exactly what
the program is called, but you go to this office. You present
the paperwork. They will give you funds to get through until
your pay is directed. We found out that we were unable to use
that program because we are National Guard. Allotment programs
and other things like that we are not allowed to use because we
are National Guard. What we found out is that, yes, the Army
does pay you, but that late payment for your house or that
foreclosure notice, all those things that affect you for 7
years, still affect you.
I think as a National Guard, we have the benefit of being
State employees as well as being, you know, soldiers. I would
like to see a program where there was a relief fund for active
soldiers so we could do it like active duty do. And say that
private so and so hadn't been paid. Give him the amount of
money. Because the Government doesn't have to worry about
whether that car gets repossessed, or whether that house gets
foreclosed or whether the kids have food to eat. Like I said,
soldiers always get paid, but there is never a timing factor
that the Government cares about.
Senator Murray. So you saw a number of soldiers who were
really stressed about families left behind who were trying to
make house payments and get food for kids?
Specialist Hall. It also affects the mission itself. We had
arguments in our barracks when we were getting ready to deploy
when people didn't stress about the situation and other
soldiers that are trying to get them to work are all stressed
about it. The only thing you should focus on is your job. When
you think about your family, it should be positive and not
worrying about them.
Senator Murray. You have a business?
Specialist Hall. Yes, ma'am.
Senator Murray. You described in your testimony how you
lost that business. Can you just relay it to me again?
Specialist Hall. I opened up a small used book store in Gig
Harbor. It wasn't anything drastic. I had a 5-year plan and it
was going well toward that. But you mentioned earlier that the
VA had signed a program for Small Business Administration that
never was put into effect. On my level, I see that that bill
has been signed and that program is there. As a Guardsman, I
would not have--I am a Guardsman first--but knowing that
disaster relief program is there or the Soldiers and Sailors'
Relief Act is there--you go into business so that you can do
this, this, this. I had time, the first time that I was being
activated, to hire someone, train them, get them ready, and
then when we were told to stand down I had to send that person
to the unemployment line because I can't afford to keep them.
The second time, when they say you are being activated I didn't
have the money in my pocket anymore. The programs aren't
useful.
Senator Murray. So you subsequently lost your business, is
that correct?
Specialist Hall. Yes, ma'am.
Senator Murray. So I am hearing you say that you would very
much support a program similar to the AD loans, the small
business loans, that are directed to National Guard members?
Specialist Hall. But those programs have to be set up
without all the crud that goes along with it.
Senator Murray. Crud is not an official word just so you
know.
Specialist Hall. Without all the--you have to meet these
criteria. If you are a soldier you are a soldier. And if you
are a business owner you are a business owner. Nobody should
tell you if your business is well enough to keep it alive. And
SBA is there to help you.
Senator Murray. Thank you very much. I appreciate that.
Staff Sergeant Romanelli, in your testimony you were quite
eloquent about the number of medical conditions that you faced
and the gap faced in medical care from having to provide for
your own care now that you served your country for, I believe
you said--how many years?
Sergeant Romanelli. Twenty-six years.
Senator Murray. There was a Government Accountability
Office report that outlined many of the problems that you
talked about in your written testimony. It focuses directly on
Guard members who need medical expenses in order to keep
accessing military hospitals, and they just aren't processed in
time. That report cites an inability by the Department of
Defense to process Guardsmen and women that leave. Many that
fall through the cracks just like you have.
Can you describe for us what happened to you after 26 years
of service, the medical conditions that you experienced and
what your battle with medical care has been?
Sergeant Romanelli. Basically, the injuries that I
sustained is a pinched nerve in my neck and also in my spinal
cord. So, at times, my body gets real numb. I am on a lot of
pain medication. That is about the only way I can survive. I
wound up spending almost 2 years at Fort Lewis in a medical
hold going through this process. A lot of the problems that we
were having there is you go to the facilities, and the first
thing they hit you with is, are you Army or are you National
Guard? The issue is brought up through the chain of command to
the General.
And General, I personally want to thank you for helping us
with that problem. I live in East Wenatchee, because like the
other distinguished guests, I like Washington. I am from
Nevada. I love this place up here. This is nice. But my biggest
concern is trying to get the care that I need. Through going
through the med board and then trying to transition in with the
VA, if there is a way we can make them both go at the same time
a lot of the problems would not be happening.
Some of my fellow soldiers call me, and I have been
saddened to find out that one of my fellow soldiers got out
November 20th and he is now just starting his appointments
through QTC, which is a company that the VA uses to verify all
our claims. It has taken me a while to get through that system
and I finally did it.
Senator Murray. You are there now?
Sergeant Romanelli. I am there.
Senator Murray. It has taken you a long time. And I am
hearing this from a lot of Guardsmen and women who come back.
That medical extension prevented them from getting the medical
care they need. And there are people who tell me this problem
has been solved, but clearly in your testimony----
Sergeant Romanelli. It still has a little ways to go,
Senator, before it would be solved.
Senator Murray. When did you first feel like things were
going in the wrong direction?
Sergeant Romanelli. Beginning of April.
Senator Murray. Of this year?
Sergeant Romanelli. Yes, ma'am, this year.
Senator Murray. What options do you have right now to
resolve the situation?
Sergeant Romanelli. I, basically through a letter that I
received, was put in touch with a gentleman by the name of Tom
Riggs. Tom has been working with me constantly on the phone
talking to me and he has gotten things moving a lot quicker. We
have got some other issues to address that have come up,
perhaps we can meet with you, and hopefully we can get them
resolved with the help of our distinguished guests that are
here today.
Senator Murray. When were you first separated?
Sergeant Romanelli. February 25, 2005.
Senator Murray. And it has taken you this long to get
anywhere getting medical services?
Sergeant Romanelli. Yes, ma'am.
Senator Murray. What do you think should have happened?
What can we do better so that people don't fall through the
cracks?
Sergeant Romanelli. Basically, what they did in any case,
Senator, when I got my medical they said go through med board
process first, then you will deal with the VA. If there is a
way you can go through med board and VA process at the same
time, that way you transition out of one right into the other,
that would work great.
Senator Murray. And that does not happen today?
Sergeant Romanelli. No.
Senator Murray. I have another question for you. If you
feel comfortable answering I would appreciate it. In your
written testimony you mentioned three veterans from your
platoon have committed suicide. That is really disturbing. If
you feel comfortable, I would appreciate it if you could
elaborate on those stories so I can have a clear understanding
of how we can prevent that from happening to others.
Sergeant Romanelli. I will try, Senator. It is hard,
because we spent almost a year-and-a-half together. They were
going through the med board process. They got med boarded out,
and with our percent from you get a little bit to live on. Like
in my case I went from $4,000 a month to $1,300 a month. My
rent is $1,000. I am running a family of 5 on $300.
My friend wound up in the same situation. That caused a lot
of stress at home. His wife wound up leaving him. They
repossessed his vehicle. They foreclosed on his house. And we
didn't keep the tight knit that we had before and he wound up
killing himself. And it is sad.
I have got two other soldiers that wound up doing the same
thing because they are not getting the financial help that they
need when they need it, and getting the answers that we need,
we weren't getting. And that is what happened to them, Senator.
Senator Murray. Thank you very much. I really appreciate
your sharing that with us.
Sergeant Romanelli. I thank you, ma'am.
Senator Murray. Crystal Hampton, in your testimony you
mentioned that while you were on active duty you had no idea
that VA benefits were available. And I hear that from many,
many soldiers. I hear they come home, they are separated and
they want to come home, and all that is basically put in the
back seat of your car until you remember that it is there.
What can we do better so that Guard and Reserve members
when they come home know what services are available?
Ms. Hampton. Well, ma'am, I had to make the decision I
would--as far as the active duty goes, I am not sure about the
National Guard Reserve, but we have quarterly classes that we
have to take. They are mandatory. You sign the block, put your
name there and it goes in your company's files, and it goes up
higher until it is observed that your entire company is 100
percent. Things like EO, equal opportunity, or SDOSH [phon]. I
think it is a political organization. Things like that. If the
VA had a quarterly block that all soldiers had to go to, had to
attend, then I think the word would be out there. You can only
ignore a class so many times before you finally start either--
randomly gets in there or it is going to be learned, you know.
And we had started training on my unit every Thursday. You
had sergeants training two times a month. It was learning
things that your squad leader felt you needed to know about. If
your squad leader felt you had to know about VA that squad was
going to know about VA. Do you know what I am saying?
Senator Murray. Yes.
Ms. Hampton. So those are two areas that the word could be
gotten out a little bit. I think during my ACAP briefs I was
given a little bit more than 30 minutes and actually explained
how important this was to me instead of you get a VA loan and
if you have certain disabilities you might get benefits, OK.
Well, at the time I didn't really hear because I was
getting out of the Army and I was going home. Great. If the
person who described that to me actually sat down for longer
than 30 minutes and said, you know, all of you guys, look, if
you pay attention to this and pay attention to me you are going
to get benefits and you will not have the stress of trying to
pay for health care that you can't afford or any of that.
Because none of us realize that once I get out I can't just go
to the doctor anymore. I can't just go to the dentist. It never
occurs to you until you are there. So those are some of the
suggestions that I have.
Senator Murray. Thank you very much.
Sergeant Kauder, I have listened carefully to your fellow
panelists here talk about that financial gap that hits soldiers
when they are brought home and sent back to their communities.
You talked a lot about rural communities and lack of access,
and whether you lose your business, or your finances are just
in terrible shape, or whether it is over medical care or just
trying to get a job. Crystal talked about lack of employment
services, and what is she going to do now and those kinds of
things. That is even more critical in rural communities and for
those who live close to them.
Can you talk a little bit more about the pressure it puts
on soldiers when they come home, go back to their communities
and they have this big gap in services where they just don't
have the finances that allow them to get back on their feet, is
what you were saying?
Sergeant Kauder. I think the primary problem that soldiers,
at least from my unit, are facing is like you were saying, the
gap in coverage. I can't really speak about the financial
problems soldiers are having as much as the problems getting
connected with the VA services. I was with the 81st Battalion,
161st infantry which is headquartered out of Spokane--had some
geographically diverse armies. We are located in Spokane,
Wenatchee and Moses Lake. Just looking at the two armies, for
example, I was based out of Moses Lake and our second platoon
is in Wenatchee. Those two locations have no service available.
There is no VA or medical center or outreach center that we are
aware of. And I say that because we did attend the briefings
and check the appropriate boxes during the demobilization
process.
I will say I have received numerous flyers in the mail both
from the National Guard as well as from the VA talking about
the benefits that are available. But the problem is that for
soldiers who are living in remote locations like Omak,
Okanogan, Wenatchee. They are faced with a 2- to 2\1/2\-hour
drive to the nearest clinic in order to receive support.
My experience in processing into the VA system is when I
had to go to a physical. I had to go through a battery of
tests. Altogether, to make a long story short, it was six
appointments. Now, I live 10 miles away from the VA Medical
Center in Spokane. That happened over a 2-month period in order
to get processed in. Now, imagine a soldier in Wenatchee of
which there are approximately 40 that I am aware of from my
unit. Someone that needs to process a claim or get enrolled in
the VA and get treated for whatever ails them, that is a day.
That is 1 day for one appointment for \1/2\-hour or 45-minute
appointment. And that has proven problematic to those soldiers
who live in those remote locations because it is difficult
getting back on your feet as these other panelists have
discussed. You have got reintegration, reunion with family
members, trying to get back on your feet, and then add to that
several times out of the month you are completely out of the
loop trying to get services in a city several hundred miles
away.
Senator Murray. Thank you. I wanted to ask you because in
your written testimony you talked about the impact of stop-loss
orders. I just wanted to clarify from your statement no one has
ever explained to you how and when the stop-loss will be
lifted?
Sergeant Kauder. No. We returned from the theater of
operations on March 1st. So 5 months ago, Monday. Since I came
back we went through the demobilization process which takes 5
days at Fort Lewis. We were then placed on terminal leave, all
the leave that we accrued during our tour. So that was
approximately 30 days. Stop-loss, at least according to my
platoon sergeant and several others that are well versed in
these matters, ends 90 days after your active duty ends or what
they call RFAD, release from active duty. That would have been
April 9. Now, that would--extending out 90 days would be July
10.
Since April 9, I have received numerous mails, discussing
information about VA benefits and about family support days
that the VA organize. I have received messages from Brigadier
General Tony expressing his personal thanks for my service and
all of the things that the Army is doing in transitioning into
the 21st century, mostly about re-enlisting.
To make a long story short, again, I have received a lot of
mails. Not one message talks about stop-loss. I have had to
take the initiative to find out what was going on through my
chain of command and then finally outside of my chain of
command to get a straight answer.
Senator Murray. Do you know the answer to your question
now?
Sergeant Kauder. At this time I have got four or five
different answers.
Senator Murray. Essentially because you don't know when
that stop-loss is going to be lifted?
Sergeant Kauder. The problem is there are two situations
here. Stop-loss for me, the end of my service date was
technically July 10. But in addition to being stop-loss,
because my original service date was last July, I have also
been involuntarily extended. That has not ended yet. As a
matter of fact, anybody that was placed on stop-loss and was
involuntarily extended, the orders--and this was just kind of
my understanding based on briefing that I received during the
mobilization phase, was that we were being involuntarily
extended until 2031. But that was just explained to us in our
official documentation that is just to cover our bases.
Technically, I am still on active duty even though I have
served and received an honorable discharge for my active
service. But I am still obligated to serve in the National
Guard until such a time as they officially cut my orders and
release me from National Guard service.
Senator Murray. What kind of impact do you think that has
on servicemembers to know that the National Guard intends to
keep them as long as 2031?
Sergeant Kauder. I can only speak for myself. I can't
speculate as to what other soldiers feel. But as I heard some
chuckling in the audience, when I heard that I was going to be
involuntarily extended through 2031 I had to laugh myself. For
me I have got almost two decades of service, but I have decided
not to finish and close, and force retirement and put in 2
years of service for my own personal reasons. My understanding
was that I would do my time. I would serve and I did. And I
served honorably and received a discharge from the active duty
Army for my service.
It has now been close to 6 months since I finished, and as
of July 10th I should have been--at least my understanding--
released from service. That has not happened yet. And like I
said, I received at least five different indications as to why
I am being kept on involuntary extension. I would like to know
why. I would like an official policy statement. I would have
liked some proactivism on the part of the National Guard
telling me here are the boxes you need to check as far as
turning in gear and supplies, getting counsel as far as your
decision not to stay in the National Guard. But none of those
things happened.
I think the National Guard, in my personal opinion as a
veteran, needs to be a little bit more proactive in supporting
soldiers not only who are staying in, but also soldiers who are
opting to get out.
Senator Murray. Let me ask you one other question. I know
time is running out here. You have had quite a lot of contact
with the soldiers in your platoon since you returned. Can you
tell me anecdotally how prevalent you think post-traumatic
stress syndrome is among our soldiers returning from Iraq and
Afghanistan?
Sergeant Kauder. I think it is fairly prevalent. I had
numerous opportunities to be at a dedication for the new VFW
hall down in Tri-Cities which was dedicated to Jeremiah Slunk,
a soldier who was killed. We also got together on July 9, the 1
year anniversary of his death in a firefight south of Baghdad.
On both occasions we had 20 or 25 fellow Guardsmen that we
served overseas with.
I have seen signs of soldiers going through relationship
problems, at least one divorce, several broke-up relationships
with long-term girl friends. One soldier is--I hate to say it,
but he is on assault charges and possibly faces some jail time.
It is prevalent, but like I said in my written testimony, many
soldiers aren't facing it. They are not dealing with it.
Senator Murray. OK. Thank you very much. I really
appreciate all of your written testimony and verbal testimony
today. And thank you very much, again.
We now have our third panel who is going to join us, and I
would like to welcome them up to the table. I will introduce
them as they are coming forward. We have Dr. Steven Hunt who is
the director of the VA's deployment clinic within the Puget
Sound Health Care System; Dr. Ronald Boxmeyer who is the team
leader at the Seattle vet center; Linda Holt who is a tribal
council member in the Suquamish Tribe; and Colonel Mary Forbes
who is human resources director at the Washington Army National
Guard. Thank you all for coming today and participating in this
Senate hearing.
Dr. Hunt, we are going to be hearing from you first.
STATEMENT OF STEPHEN HUNT, M.D., DIRECTOR, DEPLOYMENT CLINIC,
PUGET SOUND HEALTH CARE SYSTEM,
DEPARTMENT OF VETERANS AFFAIRS
Dr. Hunt. Good morning, Senator Murray. I am a physician
and director of the Deployment Health Clinic at the Puget Sound
Health Care Center. VA Puget Sound is the largest VA medical
center in Washington State. It serves as the main referral
center for tertiary care. In my clinic I have evaluated and
continue to follow medically over 200 combat veterans who
returned from service in Iraq and Afghanistan and I see
returning veterans every day.
I would like to thank the Senate Veterans' Affairs
Committee for providing this opportunity to share information
on work that is being done to meet the needs of combat veterans
returning from Afghanistan and Iraq. I would like to thank all
the veterans present and particularly the four of you who just
testified. For me it really brought this room back to what this
is all about today, the struggles and needs of returning
veterans like the ones who are here today.
We have learned about the impacts of war on military
personnel. We know that combat may cause physical injuries and
wounds. We have learned that war causes psychological traumas.
It can cause emotional wounds. We have learned that war may
involve toxic environmental exposure. This can cause health
effects. We have learned the complex and challenging
environment of the war may result in a multitude of unexplained
symptoms and other health changes.
We know now that if you are involved in combat it may
affect your body, mind, and spirit. We understand it affects
not only the veterans, but also the veteran's spouse, the
veteran's children, the veteran's extended family, and the
veteran's community.
We have learned a great deal about how to treat wounds. We
are better able to treat wounds on the battle field. Better
able to evacuate the wounded. We are better able to
rehabilitate people with head injuries, spinal injuries and
amputations. We are better able to treat PTSD, depression,
panic attacks and anxiety disorders that may result from
combat. We have better rehabilitation programs and social
services.
We know what we need to know about the impacts of war on
individuals. Now we must do what needs to be done to meet the
needs of these veterans returning from Iraq and Afghanistan.
There are three necessary components for the care of returning
combat veterans. The care must be accessible. They must know
about it. The care must be integrated care: mental health and
physical health care. The care must be comprehensive and the
care must be ongoing.
To meet the needs of returning combat veterans VA Puget
Sound and VISN 20 deployed the Deployment Health Clinic, a
multi-disciplinary clinic dedicated to the care of veterans
with health concerns related to a specific deployment. In this
case, veterans returning from combat. Essentially the
deployment health clinic provides post combat evaluations and
follow-up treatment.
In the Deployment Health Clinic, veterans receive a
comprehensive evaluation including post combat assessment,
which takes into account all of their combat theater
experiences, a physical examination, a mental health
evaluation, benefits counseling, and assistance with
compensation and pension claims. They can then continue to
receive their primary medical care and mental health follow-up
through the clinic where we will help them to coordinate care.
Individual treatment, group treatment, marital counseling, and
subspecialty referral are all available. Female providers and
liaison with the Women's Clinic are available for female combat
veterans. The purpose of the clinic is to address and support
veterans in all aspects of life that have been affected by
their combat experience.
It is not just a matter of do you or do you not have
physical wounds? Do you or do you not have PTSD? There is a
very complex impact that this experience can have on
individuals. It is essential to provide comprehensive support
in an accessible and integrated way. We want to provide that
support in an ongoing way. Not just an initial examination, and
a pat on the back and thanks, but ongoing care for the first 2
years after returning at a minimum. We want to provide that
support to the veterans and their families so that they can
readjust, recover and be optimally functioning in all areas of
individual and family life as soon as possible and for the long
term.
To date, 250 new returning military veterans have been seen
in the Deployment Health Clinic. They have received both a
physical and mental health assessment as part of their post
combat evaluation. Many of them are receiving ongoing care.
They have also received support on benefits issues.
Approximately 400 individuals have contacted the clinic to
receive other types of assistance and referrals.
We have heard testimony on other services available at VA.
I would highlight the PTSD services which we are offering to
returning veterans. We have a multitude of PTSD services, and
joining me today is Dr. Miles McFall who is the head of our
PTSD program.
I want to conclude by thanking the veterans and their
families present today for their service, and thanking Senator
Murray, the Senate staff and those of you in attendance today
for your interest and support of our returning combat veterans.
It is our national responsibility to collectively embrace and
to ultimately succeed in this mission. That concludes my
testimony and I will submit that.
[The prepared statement of Dr. Hunt follows:]
Prepared Statement of Stephen Hunt, M.D., Director, Deployment Clinic,
Puget Sound Health Care System, Department of Veterans Affairs
Good Morning, Senator Murray, my name is Dr. Stephen Hunt. I am a
physician and director of the Deployment Health Clinic at the VA Puget
Sound Health Care System. VA Puget Sound is the largest of the VA
medical centers in Washington State and serves as the main referral
center for tertiary care. This integrated delivery system is the result
of thorough financial planning, clinical program integration, expanded
access and coordination of care among the five VA facilities located in
the States of Alaska, Idaho and Washington.
VA Puget Sound Health Care System had approximately 612,377 patient
visits in fiscal year 2004, providing care to 59,329 veterans,
throughout the State and across the VISN. So far this year, we have
provided care to 5.7 percent more veterans than last year at this time
including 1,567 OIF/OEF veterans.
In my clinic I have evaluated and continue to follow medically over
200 combat veterans who have returned from service in Iraq and
Afghanistan. I see new returning veterans daily in my clinic.
I would like to thank the Senate Veterans' Affairs Committee for
providing this opportunity to share with you this information on work
that is being done to meet the needs of combat veterans returning from
Iraq and Afghanistan, and would like to thank you all for attending. I
would particularly like to thank any veterans present for their service
and their continued input into this most important issue--providing
care for those who have served.
Through the experiences and struggles of returning combat veterans
over the years, we have learned about the impacts of war on military
service personnel. We have learned that war often involves combat that
may cause physical wounds and injuries. We have learned that war may
frequently involve psychological traumas that may cause emotional
disturbances. We have learned that war may involve toxic environmental
exposures that may cause acute and chronic health effects. We have
learned that the complex and challenging environment of war may result
in medically unexplained symptoms.
We now know that being involved in combat may affect a person's
body, mind and spirit. We understand that these effects impact not only
the veteran, but also the veteran's spouse, the veteran's children, the
veteran's extended family and the veteran's community.
We have learned a great deal about how to treat the wounds of war.
We are better able to treat wounds on the battlefield, better able to
evacuate the wounded, better able to treat and rehabilitate individuals
with spinal cord injuries, head injuries, and amputations; we are
better able to treat post-traumatic stress disorder (PTSD), depression,
panic attacks and anxiety disorders. We have better rehabilitation
programs and social services.
We know what we need to know about the impacts of war on military
personnel. Now we must do what needs to be done to meet the needs of
the individuals returning from Iraq and Afghanistan. There are three
necessary components to meeting the needs of returning combat veterans:
the care must be integrated, the care must be comprehensive and high
quality, and the care must be ongoing.
integrated care
The Department of Veterans Affairs (VA) and the Department of
Defense (DoD) have developed an increasingly effective partnership to
meet the needs of our newest veterans by assisting them with a smooth
transition from active duty to civilian life.
It is our joint goal to ensure that every serviceman and woman
returning from combat receives prompt consideration and world-class
service. Together, the VA and DoD are finding ways to move records more
efficiently between the two agencies; ways to share critical medical
information electronically; ways to protect the health of troops
stationed in areas where environmental hazards pose a threat; ways to
process benefits claims quickly and efficiently; and, in all ways
possible, to hold open the doors to an uncomplicated passage from
soldier to citizen.
benefits and services
Veterans, including Reserve and National Guard members, who served
in a theater of combat operations are eligible for hospital care,
medical services, and nursing home care for injuries or illnesses that
may be related to combat service for a period up to 2 years beginning
on the date of discharge or release from service.
This 2-year eligibility for medical care is available even if there
is insufficient medical evidence to conclude that the veteran's illness
is the result of combat service. At the end of the 2-year period, these
veterans can continue to receive free health care for injuries and
illnesses officially connected to military service.
In addition to health care, VA offers a spectrum of programs for
veterans, including disability compensation, vocational rehabilitation,
prosthetic services, life insurance, pension, education benefits,
specially adapted housing and automobile grants, and survivor and
burial benefits. VA programs for veterans with a service-connected
injury or illness apply equally to those who served in the regular
active duty forces and to National Guard members or reservists
returning from Federal activation.
VA Puget Sound Health Care System and VISN 20 were leaders in
establishing a seamless transition program based at Madigan Army
Medical Center (MAMC), where two VA social workers are working full
time/side-by-side with MAMC personnel as discharge planners, to ensure
a smooth transition to VA services at locations nearest to the
veteran's residence after discharge. Through this coordination, the
veterans are known at the local VA facilities that process their
benefits claims, and continuity of their medical care, including
medications and therapy, is ensured.
va puget sound health care system deployment health clinic
Unique to VA Puget Sound and VISN 20 is the Deployment Health
Clinic. The Deployment Health Clinic is dedicated to the care of
veterans who are experiencing health concerns related to a specific
deployment.
When veterans come to the Deployment Health Clinic, they receive a
comprehensive evaluation including post-combat assessment, physical
examination, mental health evaluation, benefits counseling, and
assistance with compensation and pension claims issues. They will then
continue to receive their primary medical care as well as their mental
health follow-up from the Deployment Health Clinic staff. Individual
treatment, group treatment, marital counseling and sub-specialty
referral are all available. Female providers and liaison with the
Women's Clinic are available to meet the unique needs of returning
female combat veterans.
The purpose of the DH Clinic is to:
1. Address and support veterans in all aspects of life which have
been affected by their combat experience.
2. Provide support in an accessible and integrated way.
3. Provide support in an ongoing way for as long as it is needed.
4. Provide the support necessary for the veteran and his/her family
to readjust, recover, and be optimally functioning in all realms as
soon as possible after return from combat and for the long term.
To date, 250 newly returning soldiers have been seen in the
Deployment Health Clinic and have received both a physical and mental
health assessment as part of their post-deployment health evaluation.
Approximately 400 individuals have contacted the clinic to date and
have received referrals or assistance in other ways.
integrated care, quality care, ongoing care
The integration of services between the DoD, the VBA, the VHA,
Readjustment Counseling Centers (Vet Centers), Veterans' Service
organizations and community resources is occurring in ways far beyond
what has been seen following prior combat deployments. The quality of
care within the VA and satisfaction ratings of veterans relative to
their VA care are high. We have programs, personnel and systems in
place to provide the care which is needed and deserved by combat
veterans returning from Iraq and Afghanistan. We will continue our
efforts to provide that care; when our efforts are less than optimal,
we depend upon the feedback of veterans and their families to help us
to improve our work.
I conclude by thanking those veterans and their families who are
present today for their service, and by thanking Senator Murray and the
Senate staff and those of you in attendance today for your interest and
support in the needs of our returning combat veterans. It is our
national responsibility to collectively embrace and to ultimately
succeed in this mission.
Senator Murray. Thank you.
Dr. Ron Boxmeyer.
STATEMENT OF RON BOXMEYER, M.S., TEAM LEADER,
SEATTLE VETERANS CENTER, READJUSTMENT COUNSELING SERVICES,
DEPARTMENT OF VETERANS AFFAIRS
Mr. Boxmeyer. Thank you, Senator Murray. I want to say I am
not a doctor.
Senator Murray. I am promoting today.
Mr. Boxmeyer. Vet centers have been the VA's first line of
treatment for combat vets returning from combat for every war
since Vietnam. For 26 years, vet centers have provided services
to address the psychological and social readjustment needs of
combat veterans and have worked toward preventing the possible
development of more chronic and delayed forms of war-related
trauma.
The Seattle Vet Center staff consists of two psychologists,
two social workers, one team leader and an office manager.
Since the war on terrorism, we have seen 309 Iraq veterans. The
Seattle vet center's current case load consists of 328 active
cases, of which 120 are global war of terrorism veterans or 36
percent of our active case load. A total of 109 new Iraq
veterans have been seen at the vet center this fiscal year.
The Department of Veterans Affairs, as you are aware, has
approved an additional 100 positions nationwide to provide
services to OEF/OIF veterans. We filled one of these positions
with Michael Colson who is a retired Navy commander and
psychologist. He has served multiple tours in Iraq and
Afghanistan in the Marines, Saudi Arabia, Turkey and the
Persian Gulf. He has provided briefings to over 5,000 returning
veterans. After these briefings, Dr. Colson meets with the
veterans when they indicate they want to be met with and talks
to them about readjustment issues. These individuals are
followed up by him for readjustment counseling needs or
referred to other vet center counselors or community-based
providers in the area.
He has been able to establish onsite office space at Fort
Lewis, Naval Station Everett and Naval Station Whidbey Island.
By having office space available at these facilities, he is
able to assist with readjustment issues in a local setting. He
is also actively involved in providing services for returning
servicemembers at Madigan Army Hospital.
The Seattle Vet Center, along with Puget Sound Health Care
System, the VA regional office and the Washington State
Department of Veterans Affairs have collaborated together to
provide a DVD that we are providing to OIF/OEF veterans in
regard to readjustment needs and dealing with services
provided. Hopefully, when they get this they will better
understand what needs they have and what services are
available.
Treatment modalities at the Vet Center include group
counseling, psychometric evaluation, sexual trauma counseling,
grief counseling, EMDR and benefits assistance. When specific
Vet Center assistance is not indicated, referrals will be made
to appropriate community agencies. As the Seattle Vet Center is
the entry point for many veterans into the VA system, each
veteran is in turn referred to the Seattle VA Medical Center
Deployment Clinic for physical and psychological assessment.
The Seattle Vet Center also operates a fee contract
program, with contract counselors available on the Kitsap
Peninsula, Sequim, and north of Seattle in Everett. The
contract program allows the Vet Center to provide services in
communities where veterans live. We currently have
approximately 80 clients in the contract program, of which 20
are OEF/OIF veterans.
That concludes my formal statement.
[The prepared statement of Mr. Boxmeyer follows:]
Prepared Statement of Ron Boxmeyer, M.S., Team Leader, Seattle Veterans
Center, Readjustment Counseling Services, Department of Veterans
Affairs
Vet Centers have been the VA's first line of contact for troops
returning from combat for every war since Viet Nam. For 26 years, Vet
Center counselors have provided services for the psychological and
social readjustment needs of combat veterans and have worked toward
preventing the possible development of more chronic and delayed forms
of war-related trauma.
The Seattle Vet Center staff consists of two psychologists, two
social workers, one team leader/counselor and an office manager. Our
current caseload is 315 veterans of which 81 are Operation Iraqi
Freedom/Operation Enduring Freedom (OIF/OEF) veterans. The Under
Secretary for Health has approved the hiring of an additional 100
positions nationwide to provide outreach services to returning OIF/OEF
veterans. The Seattle Vet Center filled one of these positions last
January when we were fortunate enough to hire Dr. Michael Colson, a
retired Navy Commander and psychologist.
Dr. Colson has served multiple tours with marines and sailors,
including operational tours in Afghanistan, Iraq, Bahrain, Oman, Saudi
Arabia, Turkey, and other areas in the Persian Gulf. He has provided
on-base briefings to over 5,000 returnees from Iraq/Afghanistan.
Following his educational briefings, Dr. Colson provides individual
sessions with veterans who indicate they may be experiencing
readjustment problems. These individuals are, in turn, referred for
follow-up visits with other Vet Center Counselors or community-based
providers in their area. He has also been able to establish onsite
office space at Ft. Lewis, the Everett Naval Station and the NAS
Whidbey Island Naval Air Station. By having office space available at
these facilities, he is able to assist returnees and deal with
readjustment issues in a community setting. He is also actively
involved in providing services to returning servicemembers on medical
hold at Madigan Army Hospital. Today Dr. Colson is at the Ft. Lewis
Army Base providing briefings to approximately 500 veterans.
The Seattle Vet Center, along with the Puget Sound Health Care
System, VA Regional Office, and the Washington State Department of
Veterans Affairs have collaborated in the development of a DVD that we
are providing to returning OIF/OEF veterans regarding readjustment
counseling services available in Washington State. The DVD discusses
readjustment issues and has assisted many returning OIF/OEF veterans
better understand their military-related readjustment needs.
Treatment modalities at the Seattle Vet Center include individual
and group readjustment counseling, psychometric evaluation, grief
counseling, sexual trauma counseling, and benefits assistance. When
specific Vet Center services are not indicated, referrals are made to
appropriate community agencies.
As the Seattle Vet Center is the entry point for many veterans into
the VA system, each veteran is, in turn, referred to the Seattle VA
Medical Center's Deployment Clinic for a comprehensive physical and
needs assessment.
The Seattle Vet Center also operates a Fee Contract Program, with
contract counselors available on the Kitsap Peninsula in Sequim and
north of Seattle in Everett. The contract program allows the Vet Center
to provide services in communities in which the veteran lives. We
currently have 74 individuals on the contract program of which 18 are
OIF/OEF veterans.
Senator Murray. Thank you very much.
Ms. Holt?
STATEMENT OF LINDA HOLT, TRIBAL COUNCIL MEMBER, SUQUAMISH TRIBE
Ms. Holt. Good morning, Senator Murray and Members of the
Committee on Veterans' Affairs. I would like to acknowledge the
veterans in the room and offer them my personal thanks for
their service.
I am Linda Holt. I am an enrolled Suquamish Tribal member
of the Suquamish Tribe just on the other side of the water
here. I also serve as a council tribal member for the tribe. I
work currently for the tribe as their health director and,
therefore, oversee all of the social service programs that the
tribe has and work closely with a great deal of veterans.
I bring you greetings from the Suquamish Tribe, and I want
to thank Senator Murray and the Committee on Veterans' Affairs
for holding this field hearing, and recognizing the mutual
trust responsibility that exists between the Federal and tribal
governments to recognize and protect our veterans rights to
quality health care on their return home from serving their
country.
First, I would like to acknowledge my inspiration for my
involvement and continued commitment to veterans issues. My
brother, Frank Cordero, a Marine Corps veteran of the Vietnam
War, served two terms. I have seen firsthand the difficulty he
had and still has in accessing care and benefits. Frank was
supposed to be here today to provide testimony on behalf of all
the Native American veterans that he serves, but his daughter,
my niece, is undergoing emergency heart surgery and it is
important for him to be with her today. So those of you who
know Frank,I would ask for your prayers here.
Vietnam vets have waited 30-plus years to apply for post-
traumatic stress disorder benefits because they didn't know it
existed when they left Vietnam. It took the VA that amount of
time to recognize PTSD as a disability. As the previous
veterans who testified indicated, it was something that they
felt shame for. I know my brother Frank waited 30 years to
apply for it, because he didn't feel he was entitled to it
because he was a survivor and had left too many friends back in
the country.
In regard to Vietnam, Agent Orange also is just now
currently arising, and recognizing the Vietnam veterans that
are developing diabetes in record numbers as a result of Agent
Orange. Native Americans have served in the Armed Forces even
before they were citizens of this country. In return, Native
Americans have the least access to veterans services and
benefits.
The first woman casualty in the Iraq war was Opi Warrior
who left two children for her parents to raise. It is a proven
fact that the majority of veterans returning from war are faced
with varying degrees of post-traumatic stress disorder.
When Native American veterans return to their rural
reservation communities, there are few or no services available
to meet their needs. The Veterans' Administration and the
branches of the armed services have not done enough to identify
PTSD and to educate not only the veterans, but the entire
veteran family. When faced with the repercussions of PTSD and
their inability to understand what is happening to them, they
often self-medicate with alcohol, drugs or a combination of
both. This often leads to the possibility of suicide, domestic
violence, divorce and sometimes homicide. When children are
involved, the effect of PTSD on the family is often
devastating.
There needs to be a holistic approach for the whole family
so that everyone has access to the same knowledge on issues
they need to address that arise from the absence and return of
their loved ones. Before a veteran is discharged, the whole
family should go through counseling on how to recognize and
address the issues of PTSD. The VA needs to recognize that the
families are veterans.
Outreach programs never seem to reach the tribal level. A
trip to the VA hospital is an all day endurance for our
veterans. This is very difficult for World War II veterans and
is equally difficult for veterans who live in any rural
setting. The lack of health facilities available to veterans
where they live is a huge issue, limiting the available
facilities access to the care they need. The problems are
compounding when existing facilities are on a priority service
system due to inadequate funding. A Vet living in self-imposed
isolation only to find himself denied access to services
because of priority levels will eventually cost the system even
more money.
I would like to address an MOU that was signed by the VA
and the Indian Health services to provide care in Indian Health
Service facilities for American Indian veterans. This has not
been implemented and it is, again, the outreach problem that
Indian country doesn't know about it. They don't know how to
requisition VA. It is the same issue that our fellow veterans
were saying, is they don't know how. When these veterans come
home, they don't know how to implement and Indian country
doesn't know how to implement.
In closing, I would like to stress that this country
promised quality health care to veterans and promised to meet
their needs. It is time for Congress to fulfill that
obligation. We need to always remember that if it weren't for
our veterans' continued willingness to serve when called upon
and to willingly lay down their lives, we would not enjoy our
ability to share our views in this manner with our Government.
Again, I would like to thank Senator Murray for her
continued efforts to help veterans from all walks of life and
ethnicities. Native Americans in Washington State are estimated
at 10,000 and this doesn't include their families. We continue
to offer our support to you, Senator, and we will continue to
keep you where you are and fight the battle that you are
fighting. We look to you as a warrior for our cause and thank
you. My hands are up to you for your support for our veterans.
[The prepared statement of Ms. Holt follows:]
Prepared Statement of Linda Holt, Tribal Council Member, Suquamish
Tribe
Good morning, Senator Murray and Members of the Committee on
Veterans' Affairs.
My name is Linda Holt; I am an enrolled Suquamish Tribal member and
currently a Tribal Council Member. I am also currently employed by the
Suquamish Tribe as their Human Services Director; as such I oversee all
of the tribes, social service programs. Suquamish is in the process of
establishing a Veteran program to help meet the ongoing needs of our
Native American veterans.
I bring you greetings from the Suquamish Tribe and want to thank
Senator Murray and the Committee on Veterans' Affairs for holding this
field hearing, and recognizing the mutual trust responsibility that
exists between the Federal and Tribal governments to recognize and
protect our veteran's rights to quality health care on their return
home from service to their country.
First, I would like to acknowledge my inspiration for my
involvement and continued commitment to veterans' issues. My brother
Frank Cordero is a Marine Corp veteran of the Vietnam War. Frank was
supposed to be here with you today to provide testimony on behalf of
the all the Native American veterans' he serves, but his daughter is
undergoing heart surgery today, and it is important for him to be with
her at this time. I would ask for all of your prayers on her behalf for
a speedy recovery. I have followed Frank's integration back into his
family and tribal culture since his return from Vietnam, and I have
seen firsthand the difficulty he had and still has in accessing care
and benefits.
It is a well established fact that Native Americans have served in
the Armed Forces of the United States, more per capita than any other
ethnic group, in every conflict the U.S. has ever engaged in from the
Revolutionary War to present. Despite the fact that our ancestors did
so even though they were not even citizens of this country. What is not
well established is the fact that Native Americans are the one minority
group that has the least access to use of veterans' services they are
entitled to.
Native American Iraq and Afghan Veterans of this State returning
from overseas face the same inherent well documented problems faced by
their Great grandfathers of World War II, grandfathers of Korea and
fathers of Vietnam. Many return to the rural reservation community
where there are little or no services available to meet their needs,
neither from the county, State, nor Federal governments. It is a proven
fact that the majority of veterans returning from war are faced with
varying degrees of Post-Traumatic Stress Disorder (PTSD). This has been
true since the first wars fought by our United States veterans. The
Veterans Administration and the branches of our Armed Services have
done very little for our warriors returning home to identify PTSD and
educate not only the veteran, but the entire family that he is
returning to.
Usually the wife and children have learned how to survive and
function as a family without Dads' presence. When the veteran returns
home he or she is faced with how to integrate themselves back into the
family dynamics. When faced with the repercussions of PTSD and their
inability to understand what is happening to them, they often tend to
self-medicate themselves with alcohol, drugs, or a combination of both.
This often leads to the possibility of suicide, domestic violence,
sometimes to the murder of their spouse.
The children of the family have not only had to deal with the
parent being gone for long periods of time, but also become faced with
the person their returning parent has become. This can be emotionally
devastating for these children as they struggle to accept the absence
of and fear for the safe return of their parent, and then are faced
with the very real problems brought about by the PTSD the veteran
returns with.
There needs to be a better way to integrate these veterans back
into their families and mainstream society. There should be a holistic
approach for the whole family so that everyone is receiving the
knowledge they need to address the issues that arise from the absence
and return of their loved one. Before a veteran is discharged the whole
family should go through counseling on how to address the issues of
PTSD and the impact it could have on their family. This should be
followed up by the Veterans' Administration in the treatment of the
PTSD, not only of the veteran, but of the entire family.
The question arises as to what is not working within the VA system
to help our returning veterans with their reintegration back into their
family settings as well as mainstream society. The lack of
congressionally funded outreach programs, county, State and Federal,
designed to assist veterans' in their reintegration. These programs
never reach down to the rural reservation communities, nor consider the
unique circumstances of minorities or the rural nature and isolation of
reservation communities. This is not only true of Native American
veterans but also for all veterans who return to rural settings. Often
a trip to the VA hospital is an all day endurance for our veterans.
This is very difficult for our elderly World War II vets, and most
times they just refuse to go because they cannot endure the trip. The
lack of health facilities for our veterans to utilize in the area they
live is a very large problem. Now we have just faced the closure of the
VA hospital in Walla Walla, this was a key facility to Native American
Veterans in Oregon, Eastern Washington and Alaska. With the growing
number of veterans returning from Iraq and Afghanistan we need to
increase the numbers of medical facilities available to veterans for
treatment, not reduce them. As I stated it is increasingly difficult
for veterans to access the care they need with the limited number of
facilities available, but they also are faced with being turned away
for treatment because many of the existing facilities are on a priority
service only system due to lack of funding.
Also as previously stated there is a general lack of knowledge
among veterans and community organizations on what benefits the veteran
is entitled to. VA needs to develop an outreach program, once again not
only for the veteran, but for the veterans' family and community
organizations that are trying to help them.
This leads me to what is working in Indian Country to assist our
Native American Veterans. A grassroots network of veterans, including
my brother Frank Cordero recognized the need to help our veterans
obtain the services they needed. This core group of Tribal Veterans
Representatives came together to develop a system to help. For the last
15 years the one bright light for Native Veterans within the State of
Washington and several other States across the Nation has been the
Tribal Veterans Representative (TVR) program. First started here, this
program utilizes a Native American of the community of each of the 24
different Tribal communities to assist, provide support and aid to any
and all veterans residing within their tribal community. Where very
little services were provided before, the TVR's have been instrumental
in assisting not only recent returning veterans, but veterans and
eligible dependent family members from other eras as well. Native
American Veterans through the TVR program have been able to access
claims for compensation, pension benefits, housing, employment,
education, insurance and most importantly the outreach to them within
their communities.
In closing I would like to stress that this country made a promise
to these veterans that are returning from a war this country committed
them to, in return they were promised that this country would take care
of them on their return and provide them with quality health care and
to meet their needs. It is time for Congress to recognize their
responsibility to these veterans that have offered their lives for the
many freedoms we enjoy, and sometimes take for granted, in this
country. We need to always remember that if it wasn't for our veterans
continued willingness to serve when called upon, and to lay down their
lives, we would not enjoy the freedom to share our views in this manner
with our Government.
Again I would like to offer my heartfelt gratitude to Senator
Murray for her continued effort to help our veterans from all walks of
life and nationality. Native Americans in Washington State estimated at
10,000 and their families continue to offer our support to keep you
there. I also would like to give my personal thanks and the thanks of
the Suquamish Tribe to the Senate Committee on Veterans' Affairs for
their continued support of veteran's issues.
Senator Murray. Thank you.
Ms. Forbes.
STATEMENT OF COLONEL MARY FORBES, J-1 AND HUMAN
RESOURCES DIRECTOR, WASHINGTON ARMY NATIONAL GUARD
Colonel Forbes. Senator Murray, distinguished guests, I am
truly humbled to be here today and to have this honor, too. My
name is Colonel Forbes and I have been on active duty for 22
years. My main objective for the last year has been to work
with the Army and the Air National Guard on reintegration
programs to reintegrate the families and to help them prepare
to get back into civilian life.
We have worked really hard to develop a model to transition
soldiers from combat to civilian life. The model had to be
reasonable to unit commanders and be able to fit into the
commander's time constrained drill time on weekends. Once a
Guardsman returns to a traditional role, he or she is only
available on a weekend or 2 days a month.
From the beginning of this process we had John Lee, the
deputy director of WDVA, the Washington Department of Veterans
Affairs, and he advocated the idea of after active duty
customer service. Readjustment counselors and VA doctors also
agreed to this idea of after active duty follow-up, because of
the fact that often it takes months for the soldier or
servicemember to realize that there is a need.
The MOU team or memorandum of understanding team created
this initiative we call family activity day. But we purposely
decided it wouldn't be another briefing, but an opportunity for
veterans organizations to provide one-on-one customer service.
The 4-hour Family Activity Day starts with a 20-minute
introduction which is meant to inspire our soldiers and
servicemembers and their family members to use the entitlements
and benefits they earned. Then it is followed by 3\1/2\ hours
of customer service where they can get one-on-one private time
to really address their needs. That really, truly is private.
General Lowenberg helped this process by making Family
Activity Day an order. This month we will have 11 and we have
followed through with having 22 in the next 5 months.
I see two significant challenges in the next several years.
First, it was talked about several times already today--it's
the challenge of continuously communicating with our veterans.
Second, is ensuring that servicemembers have the right
resources at the right time given that many of their issues may
not surface or materialize for many years to come.
Getting the word out that there is a vast array of agencies
that want to help veterans will continue to be difficult.
Servicemembers may be unaware of the many services that are
available to them because information may be fragmented,
uncoordinated, and changing, or it just may be that they are
given the information, as we have heard, at a time when they
are coming off active duty and their mind is somewhere else.
I strongly believe we need a positive education focused
media plan to encourage our servicemembers and veterans on the
many benefits and services available. I believe we need a media
plan that educates the public using multiple formats, using
radio, TV, print, Internet and hands-on workshops. Our Family
Activity Days is one proven successful model to communicate and
inform our soldiers.
Our Family Assistance Center program could provide a
healthy means to communicate over long term to, inform, educate
and reinforce the benefits we have.
I recommend a partnership that could be formed at the
national level. We could leverage State, Federal and private
organizations to develop such a media campaign for radio and
TV. The goal would be to synchronize the efforts, avoid
duplication, plug gaps in coverage and be sure we reach every
veteran regardless of their location. We need to mutually
support a Federal, State and private communication campaign
over the next 50 years. And I say, ``50 years,'' because these
vets will be with us for that long and even longer. The public
campaign would also reassure our veterans, the public and the
elected officials, the long-term commitment from our Government
and our private business leaders.
The second thing I mentioned, is ensuring that our
servicemembers have access to the right resource at the right
time given that many of the issues arise over a period of
years.
To accomplish this, I think we need a coordinated system
that provides services to our members over an extended period
of time. A working example of that is our family assistance
centers of which we have eight across the State and we talked
about that yesterday. We need dedicated resources and funding
to ensure our decentralized family assistance centers continue
to operate for 2 to 6 years.
Another system I could mention is the assistant or TAP,
which is ongoing and is a long-term process. It is not a
briefing, but it is a customer service piece that must be added
to TAP. We can be very proud of our procedures here in
Washington State to assist our servicemembers in their
transition from combat to civilian life. I encourage everyone
here to continue our collaborative efforts and future
improvements for business practice of taking care of our great
servicemembers and their families who have given us so much.
Thank you.
[The prepared statement of Colonel Forbes follows:]
Prepared Statement of Colonel Mary Forbes, J-1 and Human Resources
Director, Washington Army National Guard
My name is Col. Mary J. Forbes. I am a member of the Washington
National Guard and I have served over 22 years of active duty.
Currently, I am assigned as the Joint Personnel Officer, J-1, for the
Washington National Guard. I am responsible for the oversight of the
Human Resource Office, Family Support Programs, Equal Employment and
Equal Opportunity Programs, Employer Support to Guard and Reserve
(ESGR) and Labor Relations.
Since being assigned in June of 2004, my number one focus has been
the reintegration of Washington Guard soldiers and airmen from active
duty back to their traditional reserve role and the very important job
of reconnecting loved ones and families.
We have worked very hard to develop a model to transition soldiers
from combat to civilian life. The package or model also had to be
reasonable to unit commanders and fit into the commander's time-
constrained weekend training assembly period. Once a guardsman returns
to the traditional reserve role, he or she is only available 1 weekend
per month.
Initially we partnered with the Washington Department of Veterans
Affairs (WDVA). With the assistance and encouragement of WDVA, I
participated in a series of veteran affairs meetings in which members
of our team incrementally brainstormed and then built a model, which we
codified in a groundbreaking memorandum of understanding (MOU).
From the beginning of this process, John Lee, Deputy Director of
the WDVA, advocated the idea of ``after'' active duty customer-service.
Readjustment counselors and VA Doctors on the committee emphasized that
servicemembers often experience a need for interdiction services at the
3-6 month mark after active duty. The MOU team created an initiative we
call ``Family Activity Day.'' Members purposely decided this would not
be another ``briefing'' but an opportunity for veteran organizations to
provide one-on-one customer service. The 4-hour Family Activity Day
starts with a 20-minute introduction which is meant to inspire
servicemembers to use their earned VA entitlements and benefits. The
following 3\1/2\ hours allows the servicemember to personally meet with
counselors, specialist, and professionals from a variety of veteran
organizations.
Washington State's Adjutant General, Major General Tim Lowenberg,
issued the following order: I want each Commander to conduct a Family
Activity Day within 3 to 6 months after returning from Operation
Enduring Freedom, Operation Iraqi Freedom, and Noble Eagle as part of
their normal training assembly schedule. The Family Activity Day
provides servicemembers and their families personalized customer
service in understanding, requesting or filing for Veteran's benefits
and entitlements.
General Lowenberg's order ensured that each commander would conduct
these events in a similar manner for all units across the State. To
date, we have conducted 4 Family Activity Days and have 22 more
scheduled over the next 5 months, by which time we will have provided
customer service to more than 3,000 servicemembers. We have already
received very positive feedback from servicemembers and their family
members. Many have expressed great appreciation for the opportunity to
participate.
We have been successful thus far in leveraging local, State, and
Federal agencies as well as private businesses to assist our
servicemembers at the 6- to 9-month post-active duty time period. In
collaboration with the Washington DVA, the Guard is currently planning
the program and training that we will focus on the next 18-24 months.
I see two significant challenges in the next several years. First,
is the challenge of continuous communication with veterans. The second
is ensuring that servicemembers have access to the right resource at
the right time given that many of their issues may not surface or
materialize for many years to come.
Getting the word out that there is a vast array of agencies that
want to help the servicemember will continue to be difficult.
Servicemembers may be unaware of many of the services that are
available because information is fragmented, uncoordinated and
changing. At the national and State level, I strongly believe we need a
positive educationally focused media plan to inspire, reinforce, and
encourage servicemembers of the many benefits and services available. I
believe we need a media plan that educates the public, using multiple
formats such as radio, TV, print, internet and hands-on workshops. Our
Family Activity Days have proven successful, but are only one method
for communicating to and informing our members.
I recommend a partnership be formed at the national level which
leverages State, Federal, and private organizations to develop and
execute a media campaign for TV, radio and other media forms. The goal
would be to synchronize efforts, avoid duplication, plug gaps in
coverage, and be sure we reach every servicemember regardless of
location. We need a mutually supporting Federal, State, and private
communication campaign over the next 50 years to continue to
communicate with our veterans. I say 50 years because those heroic
servicemembers who are severely disabled will need to hear reinforcing
VA messages for their entire life. The public campaign would reassure
the servicemember, the public and elected officials of the long-term
commitment from our Government and private business leaders.
Second is ensuring our servicemembers have the access to the right
resource at the right time given that many of their issues may arise
over a period of years.
To accomplish this, I believe we need a coordinated system that
provides services to our servicemembers and their families over an
extended time period. An example of a working system is our Family
Assistance Centers. The Washington National Guard needs the resources
and dedicated funding for our decentralized Family Assistance Centers
throughout the State to ensure this continuous support for the next 2
to 6 years and beyond.
We can be very proud of our collaborative efforts to assist our
servicemembers in their transition to civilian life. I encourage
everyone here to continue to collaborate and partner on future
improvements to our business practices of taking care of the great
servicemembers and their families who have given so much to our
country.
Senator Murray. Thank you very much.
Dr. Hunt, I want to start with you. We heard a lot from the
last panel about the prevalence of post-traumatic stress
syndrome in our soldiers returning from Afghanistan and Iraq.
Can you outline for us why we are seeing such a high
prevalence of veterans with PTSD?
Dr. Hunt. Actually the numbers that have been reported
vary. A recent study rates the prevalence as low as 5 percent,
but the study in the New England Journal found rates around 17
percent. Other reports have found rates up to 30 percent. Some
of the most reliable information we have from Vietnam veterans
suggested that 30 percent will have lifetime occurrence of
diagnosable PTSD. And at any given time, 15 percent will have a
diagnosable PTSD. And it is probably the most reliable figure
that is available at this point. I think one of the reasons
that we see different figures is that these symptoms can
present themselves at different times along the way. People may
not have symptoms early on. They may have symptoms a year down
the road or 2 years down the road.
We have a program for ex-POWs at our center and sometimes
these veterans will have PTSD symptoms arise years down the
road. One reason we are seeing high rates is because the combat
traumas involved in the current conflicts are widespread and
almost everybody is exposed to risks on nearly a daily basis in
many areas of Iraq and Afghanistan.
Senator Murray. I would ask if you could provide verbal
testimony for the record? I am hearing that it is a 24/7 war.
There are soldiers in Iraq who don't have any relief, and that
is one of the reasons servicemembers have----
Dr. Hunt. We see many veterans from the 81st Brigade that
have had significant combat. So I think it would be reasonable
to say that for many deployed troops there is a widespread risk
often on a daily basis, certainly for particular parts of Iraq.
Senator Murray. We have heard some pretty disturbing
testimony from some of our previous panelists about what
veterans have been through. You are seeing a lot of those as
they come through your Deployment Health Clinic, and I want to
know if you have any insights on how the situations like
Sergeant Romanelli described are happening?
Dr. Hunt. In terms of gaps in care, for example?
Senator Murray. Correct.
Dr. Hunt. There is no doubt that there is a problem of gaps
in care particularly for those people that are Reservists that
are being demobilized. We do have pre-separation programs for
people who are leaving the military to try to get them into
care before they separate from the military. For Guard and
Reservists who are being deactivated, they are eligible for VA
care for 2 years for any conditions they have. But they may
live in an area where they can't come to the VA.
We do have services available through the Washington State
Department of Veterans Affairs, and at the Vet Centers. So we
can get mental health treatment for people wherever they might
be living in the State, even in the more remote areas, through
contract providers.
Senator Murray. Is part of the problem that we are seeing
the high numbers of Guard and Reserve that don't necessarily
live around the base, and come home and reintegrate in a
community many miles away from the base, or into a community
that is not aware of military needs that we are seeing these
gaps?
Dr. Hunt. That is a problem. We are trying to reach people
while they are still in, when we are having Family Days and
outreach events, trying to reach the National Guard units and
Reserve units, but we really need to get the word out. Also
getting people plugged into benefits early on and getting the
claims process started for these conditions. Once they are
service connected for these conditions, then they are eligible
for contract care even in the remote areas. So we are trying to
assist veterans in getting the claims process started early on.
Even with this, there may be a 3- to 5-month gap in accessible
care.
Senator Murray. Which is a lot.
Dr. Hunt. This is a problem some veterans are experiencing.
Senator Murray. Thank you. Thank you.
Mr. Boxmeyer, we have heard from a number of our panelists
about the problems with employment coming home, and the skills
they used in Iraq such as fixing helicopters does not translate
into jobs here. This poses problems for small business owners.
Can you talk a little bit about employment, what you have seen
and what gaps there are for soldiers?
Mr. Boxmeyer. There is a gap when there are no jobs
available. I don't specialize in employment. We refer people to
jobs through work sourcing. But commenting on the question you
asked before about the number of PTSD clients, we are seeing a
very high percentage of people coming back with full diagnosed
PTSD. For example, in dealing with one member of a unit myself,
obviously they see a lot of trauma in Iraq, because out of a
12-person unit, 8 have been diagnosed with PTSD. That is out of
a 12-person unit.
I think it is also important to realize that in many cases
Vietnam veterans didn't realize they had issues until years
after the war. Veterans coming home now--like Dr. Hunt said--it
might be 17 percent with PTSD, it might be 20 percent with
PTSD, but in 10 years I predict it is going to get a lot
higher.
And the thing we have to remember is that you don't really
cure PTSD. You teach people how to live with it, adjust to it,
and how to function. But every time our country engages in a
war, our country has to accept responsibility to bear the
casually rate. Thank God people like you are speaking up. I
just wish there were more of you.
Senator Murray. Thank you.
Ms. Holt, you testified about post-traumatic stress
disorder in people who live in rural communities. That is a big
category. One of the things that you mentioned was treating the
whole family. I have heard a lot from people whom I have talked
to say that it is not the soldier themselves that recognizes
the problem. It is their spouse. So having them understand what
the symptoms are is absolutely critical.
What have you seen out there that worked or doesn't work
and how can we----
Ms. Holt. Again, Senator, referring to our Native American
veterans, I think it is doubly hard for them, because I know
when my brother Frank applied for veterans benefits, he was
initially denied because they said he didn't seek psychiatric
care when he came home. He was able to appeal that decision and
brought one of our native healers to testify at that hearing
stating that Native American warriors don't seek traditional
western medicine. They seek their traditional tribal cultural
medicine. The tribal veterans organization and the tribal
veterans have done that amongst themselves.
Kent Chaparrel in Yakima has been very beneficial depending
a lot on funding. But I think that access to care--Suquamish
doesn't have a health clinic like a lot of tribes do. So we
are, like I said, transporting our veterans to Seattle to
receive care. There aren't really any psychiatrists--I believe
there is one in Kitsap County that offers treatment for post-
traumatic stress disorder.
I saw this with my brother Frank when he came home from
Vietnam, and watched him go through the process. The
hypervigilance my sister-in-law mentioned, the nightmares that
he had, and that she could not touch him if he was asleep. She
had to stand at the end of the bed and yell at him to wake him
up, because she got knocked down a couple of times before she
learned that. And so the hypervigilance that they have, you
know, the sounds of a helicopter going over, if he were here
right now and heard that, you would see that he would be so
tensed. The indicators that the family would see are
alcoholism, drug abuse, anger, domestic violence and verbal
abuse that spouses take from their spouses.
I think that it is detrimental that the family themselves
aren't being treated as a holistic group when their men come
home, because they are the ones that are facing this and they
are the ones that deal with it silently.
Senator Murray. Dr. Hunt, I want to go back to you because
in the previous panel we heard about the shame word associated
with post-traumatic stress syndrome and the concern that, I
think, especially for men admitting that post-traumatic stress
syndrome is there or employment issues. How do we deal with
that as policymakers, as a society to make sure that we can get
that?
Dr. Hunt. Because it is so important that people get
treatment, what we have done on the treatment side is to try to
make treatment seem less threatening. To try to destigmatize
these post combat symptoms and to really emphasize that these
are symptoms that many people have, rather than saying, well,
``you have got PTSD.'' Many of these symptoms are common and
normal for people who come back from combat. So trying to
destigmatize the symptoms and the treatment is a very important
part of getting people into treatment.
There are real reasons sometimes that people are reluctant
to be labeled as having PTSD, either because it may impact a
security clearance, or working in law enforcement or may result
in a military career being curtailed. That is a real problem.
We have to sort of balance the need for a treatment for these
conditions with the very real and potentially problematic
social stigmas and personal consequence of being ``labeled.''
What we try to do is deemphasize the labeling of people as
having PTSD or not having PTSD and emphasize the issues as post
combat symptoms, many of which we can treat very specifically.
We have a new medication, prazosin, that looks like it works
for treating nightmares, for example, and we have medications
that might help for difficult sleep problems. Counseling
individuals and treating the individual in a more holistic way,
as Linda was advocating is an important approach. There
continue to be stigmas associated with being treated for
depression or PTSD. That may be a problem, unfortunately, until
the public is educated about these conditions.
Senator Murray. Colonel Forbes, I am going to jump to you.
We are in over time, but I wanted to ask you a question about
an issue I have not heard much about here today. I have heard
it everywhere I go in this State and that is that word Tri-
Care. Is that a problem you are hearing from the soldiers you
are dealing with in terms of their access to Tri-Care, not
getting to go see doctors, ending up paying health care out of
their own pockets because the system is so difficult to access?
Can you share a little bit----
Colonel Forbes. Yes, ma'am. Yes, there are a lot of
questions and some of the questions are information based on
educational. It is just because National Guard Reservists don't
have Tri-Care until they are on active duty some of it is a
learning curve, and getting used to learning the system and
learning what not to do or learning to do things ahead of time
and preparing themselves.
And you know, just anecdotally, there are a lot of
customers right now. There appears to be a lot of customers,
and every agency whether they are getting service at a medical
treatment facility or a Tri-Care person off base, everyone is
trying to handle the workload. It appears to me that it has
just been hard to handle the workload at this time with all of
the cases that are there.
Senator Murray. So people have gone through----
Colonel Forbes. Because there was not enough staff. There
was not enough funding available for the number of staff and
doctors needed. All those things taken into consideration to
take care of a large group of folks and their families. I don't
really have documentation to back that up, ma'am, but it
appears to me that a lot of the issues, first of all, go around
understanding the system and then, you know, how to access it
from remote locations that they can get their funding concerns,
but they have to do it in a certain order.
And then an educational piece also is knowing that you have
to get the referral. We heard that yesterday. You have to call
and get a control number to get authorization to see a
physician, and that is an educational piece.
Senator Murray. Are we doing a better job on deployment of
educating soldiers about how Tri-Care works in their families?
Colonel Forbes. Yes, ma'am. What we are doing is we are
continually changing and improving our workshops, our seminars.
We are doing predeployment, more robust predeployment,
reintegration training, and covering and recovering the areas
that we know have been traditionally difficult to get across to
folks. But you know, as I mentioned earlier, it is a constant
struggle to educate and get folks out, because you can't just
give a person a briefing once and think they are going to
understand a complicated, cumbersome bureaucratic Government's
laws or rules. And so we are trying a new model now.
Senator Murray. It was previously referred to as crud.
Colonel Forbes. I will try to be more eloquent. But what we
find now is we need to think about those workshops and coming
back to the topic. I think that the transition program,
starting it well before they come home and proceeding maybe up
to a year after they get home so that it can be that
reaffirming, reinforcing--here are the benefits that you have.
And if I can just mention this situation. It is not so much
for folks that are on active duty. It is while they are on
medical hold. They must be educated and trained, not just once
in a briefing, but multiple times and then that customer
service piece brought in. And I have had the pleasure in the
last week of talking to the commander at Fort Lewis who handles
that, and they are very eager to adopt our model and idea.
The Department of Labor has just hired a person who will be
seated--an Employment Security Department person that will be
seated right there with that medical hold company. And we
talked yesterday because we were excited at Washington
Department of VA, and all of us together trying to figure out
how we can bring what we are doing here to them before they get
off, and know what they are going to have, you know, when their
active duty pay stops and they have to go into the VA system.
So I know that people have already recognized these gaps and
folks are doing things, Department of Labor, active duty, to
try to fill this gap.
Senator Murray. Thank you very much. I want to thank
everyone here for helping the Senate Veterans' Affairs
Committee get a better handle on the needs of our veterans as
they come back from Iraq and Afghanistan. All the statements
and testimony will help our Committee enact policies for our
veterans. But these statements and testimony today really make
clear that we have a lot more that we need to learn and a lot
more work that needs to be done. I think the testimony on needs
for our rural veterans, education, employment, medical
concerns, many other issues that were raised will help me to do
a better job to bring the needs of Washington State veterans
back to the other Washington. I look forward to working with
all of our witnesses who came today, as well as many others in
Washington State and across the country to continue to shed
light on the needs that exist out there.
I certainly want all of you to know that I will continue to
check in with you or others in the future to make sure we are
doing the right thing. I want to encourage everyone here to
sign up for our veterans update. You go to my Web site, again,
www.murray.senate.gov. We continue a dialogue on the issues
affecting veterans and want to encourage people to be able to
use that. And as I mentioned earlier, I just successfully
fought to get the VA funding that it needs for the next several
months and the VA what it needs for now. We are in the process
of making sure today that we are now meeting needs for the
negligent fiscal year and this testimony will be very helpful
for me as we try to make sure we do that right.
But I will let you know that any funding isn't going to
reach the VA for quite some time. So I will keep my eye on
these issues and want to hear from all of you as we continue in
the coming months. I want you to make sure that I, along with
the entire VA Committee continue to look into these issues to
make sure that our veterans have the services they need when
they return home from combat. I want to again thank everyone
for participating in today's hearing, as well as all of you who
attended. There are far too many people to thank who helped me
today.
I especially want to thank Major Phillip Osterley of the
Washington State National Guard----
I am sure he is around here somewhere. There he is--who has
been really helpful to me, and any Guard members who have
helped with all aspects of today's hearing.
Major, you and your staff really went out of your way to
help put this together, and I want you to know how much I
appreciate the work you did, as well as my own staff members
who are here who put in a tremendous amount of time.
Finally, I wanted to remind everyone who is here that we
have a number of service folks who are here from the VA, Tri-
Care and other services that are here to help. You are welcome
to stay and talk with any of them if you need additional
information. Again, thank you to all of you who participated.
This hearing is adjourned. Thank you very, very much.
[Whereupon, at 11:10 a.m., the Committee was adjourned.]